Henry Schneiderman

The Little Voice Is Wrong

The little voice tells me that I am fraudulent. All the other doctors know more. They understand renal tubular acidosis. Even the residents (trainees) knew about ADAMTS13 antibody in TTP (Thrombotic thrombocytopenic purpura, a blood disorder). Now, an article later, that fragment is addressed, but an ocean of ignorance beckons. How dare I do consultations in the ICU when I have never intubated anybody?

Jipper

In the summer of 1972, I worked for an oncologist at Yale-New Haven Hospital, assisting with research and animal care, and drawing blood on cancer patients. My boss was working on what was then called granulopoietin, a substance that helps white blood cells recover after chemotherapy-induced marrow suppression. He took bone marrow from dogs under general anesthesia and then sampled their blood daily to identify and extract this substance. One such dog was “9557,” a border collie who had lived at the lab’s animal facility for two years; they kept careful records and knew he had been a two-year-old stray when this stint began.

I fell in love with 9557. 

Losing Touch

I worry that in the future, doctors won’t touch patients. When I put my hand on the foot of a dying patient–and feel that it is still warm and offer measured encouragement–I am doing the work of this profession.

Telemedicine, on the other hand, is part of another world; I don’t wish it to go away, but that it coexist with the tactile, earthy, demanding, inconvenient reality of patients’ bodies.  

Race in the Advance Directives Conversation

 
Much of my work as a Palliative Care physician involves conversations with patients and their families for whom the medical outlook is bleak: to help them receive the treatment they want, not more and not less. Such discussions are best held in tandem with the primary medical team and with the nurse. Many times, both attending doctors and housestaff have said, “But it’s so much harder to get a DNR (Do Not Resuscitate Order) with African-American families.”
My experience differs.  
beginning of healing hschneiderman

The Beginning of Healing

Henry Schneiderman

About the artist: 

Henry Schneiderman is a palliative-care physician at St. Francis Hospital in Hartford, CT, and a professor of both medicine and nursing. He has been drawing since age five and studied for a time at the Art Student’s League in New York. His beloved wife Ro died this winter, after thirty-eight years of a good marriage. “Counseling and a spousal-bereavement support group have been helpful; so have the spoken words of friends and family, and the written words of others. This sketch is an expression of quiet, howling grief.”

About the artwork:

“On our garden deck one cold spring day I was looking at the sprouting of seeds I had planted a couple of weeks before. They were seeds I had bought with my wife, Ro, in the autumn, when she was fatally ill. As with so many other material remnants of our time–love letters, food in the freezer, clothes she bought for …

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Engage Brain before Putting Mouth in Gear

After the above-knee amputation of her second leg, the still-too-young diabetic woman did not wish to fight her terrible illness anymore. In due course, she qualified for inpatient hospice.
Today I came to the bedside as the end was approaching, her pain well-controlled with a morphine infusion and her agitation now departed along with most of her speech and perception. Recognizing that my physical examination should be short and tailored to her needs, I planned simply to observe her eyes, her skin, her breathing and her responsiveness. To make sure she was dying comfortably, free of suffering.
I had met her supportive, anguished husband many times during our palliative consultation and follow-up. I greeted Mr. X and said, “If it’s okay, I’d like to do a short examination of your wife now. You are welcome to stay. I won’t do anything embarrassing. I just want to speak to your wife, look at her eyes, observe her breathing and look at her feet.”
“But she has no feet.”

Gloves on Hands

 
When my internal medicine residents put on gloves to examine a patient’s normal abdominal skin, I see red. Don’t they know that the easiest way to make our patients feel dirty and repellent, leprous and untouchable, is to deny them the skin of our hands?
 
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