H. Lee Kagan

This Is Why

February 2016
Tierra Nueva, Dominican Republic
I’m in the last of five days caring for patients at rural clinics in western DR, along the Haitian frontier.
Tierra Nueva, miles from anywhere, is a collection of clapboard shanties and shacks scattered along a dusty, unpaved road that dead-ends at the border. People survive here by coaxing vegetables out of the earth via scratch farming. The lucky ones have a goat and maybe some hens.

About Last Night


H. Lee Kagan ~

It was a night like many others. I was taking call from home for my medical partner and myself. My wife and I had settled in, planning to stream the new season of Goliath on Netflix. But the internet was down, so we were watching a talent competition on regular TV instead.

At 8:30, my phone rang.

“Hello, this is Dr. Kagan.”

A long pause, then a tentative “Hello….”

I muted the TV. “Can I help you?”

More silence, then I heard a woman’s voice uttering inarticulate sounds.

“Who is this?” I asked. “Are you looking for the doctor?”

What’s Love Got To Do With It?

H. Lee Kagan

My longtime patient Brenda let the top of her exam gown drop to her waist, stepped down off the exam table and turned to look at herself in the mirror. As I watched, she cupped her seventy-eight-year-old breasts in her palms and unceremoniously hoisted them up to where they’d probably resided when she was in her twenties.

“I’m thinking about having my boobs done,” she said. “My girlfriend had hers done, and she’s very happy with how they turned out. What do you think, doctor?”

As she spoke, her eyes remained on her reflection. Breasts held high, she made quarter turns to the right and left, then leaned back.

“I don’t like how they look now,” she said, appraising her reflection.

Continuing Education

H. Lee Kagan

The nasogastric tube was killing me. It had been in place for twelve hours now, threading its way up my nose and down my throat, past my esophagus, into my stomach. Try as I might, I couldn’t swallow away the nasty lump stuck to the back of my throat. And every time I tried, it hurt.

Decades before, as a physician-in-training in upstate New York, I’d put in more nasogastric (NG) tubes than I could remember. At the time, I hadn’t regarded NGs as a big deal. But now I was having my first personal experience with this vile little snake, and it sucked–in every sense of the word.

Two days before, I had come down with a viral gastroenteritis, or stomach flu as it’s often called. Twenty-four hours into my illness, the miserable feeling that some dead critter lay rotting inside me still hadn’t eased.

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