It’s a common conversation: A female patient presents to her male doctor with unexplained weight gain. “I’m not overeating,” she says. “I try to exercise, but it’s getting harder and harder to do that.”
The physician is dubious. “You just need to be more active,” he responds. “You need to stop eating so much,” he adds. “Here’s a diet plan. You just need to stick to it.”
In the early 1980s, I considered everyone at Thomas Jefferson Hospital in Philadelphia to be my friend. As a volunteer and a vestry member at the nearby Episcopal church, I would often arrive at the ER with a homeless person who had come to the church for help after being badly injured. I was so impressed with how the doctors and nurses treated these patients that I developed a real affinity for the hospital.
I wasn’t looking for a new dog. I had recently lost my best friend of over sixteen years, a beloved terrier mix. My sister had dragged me into the shelter so that she could get a new cat. So, while she looked at cats, I decided to pet all the dogs, lingering a little longer with the ones that looked the most sad.
The shelter staff began to follow me like I was a shoplifter. “Can we help you find a dog?” “What kind of dog would you like?” “Would you like to meet that dog?” Desperation tinged their inquiries.
Most people aren’t aware of a cancer that is ruthless above the rest. This cancer lasts a lifetime and never fully remits.
I first became aware that I was susceptible as a child. I was on an examining table and our pediatrician asked my mother to step outside the room. I then heard him berating her: “This child is sunburned! How could you! You know you have genetic skin cancer!”
It was the first day of a course in medical ethics at the University of Vermont medical school. As a graduate student in public administration, I had been invited to sit in on the class because of my research interest in health care distributional ethics. That made me the only student in the room who wasn’t training to be a physician.
I entered the classroom and took a seat. I barely had time to say hello to a couple of other students before the professor walked in.
The year was 1997, or thereabouts. She called on an otherwise slow day in the AIDS service agency I had started and was running on fumes and prayers. Her name was Mary.
Mary’s voice was trembling. She had been raped, and beaten, and feared she had AIDS. I knew she needed medical attention, so I got into my car to find her house, a tiny home next to the railroad tracks.
His wife left him that morning. That’s what he told the police officer who arrived on the scene after his large truck plowed into the back of my little red car. “I wasn’t paying attention. I was speeding up as I hit her.”
Ahead of us, an elderly woman had disobeyed her doctor’s orders not to drive while on pain medication. She decided to make a left turn by cutting off multiple lanes of traffic. My brakes held as all my weight went into them. I had less than a second to be thankful for missing her.
As I was loaded onto the ambulance, my neck and lower back were already in pain. And my knee–my beautifully ACL-reconstructed right knee, scrupulously brought back to strength over months of rehabilitation–had slammed into the dashboard of my car. It was throbbing.
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