Pamela Adelstein

Tug of War

A tug of war lives within me, and my physical body and soul are struggling mightily. Gratitude pulls one end of the rope, and burnout yanks the other. I feel immensely grateful that I can meaningfully contribute to people’s care during the pandemic. I’ve triaged, tested, talked with and tended to countless patients since COVID-19 began. I am blessed with wonderful family, friends and community plus a job with deep purpose and meaning. Each workday I feel enriched by those around me.

Asking Permission

When our children were young, my husband and I taught them about the need to ask permission before performing actions that could have consequences. As part of our strategy, we highlighted whenever a poorly thought out choice triggered a positive or negative outcome.

To my bemusement, even into their early adolescence, our kids would ask if they could have a snack or dessert or watch an extra show. I would bring great ceremony to my reply, in the hopes of perpetuating their impression that asking for permission was still necessary.

Health Care and “Anti-Health Care”

My work as a physician is a core part of my identity. I work to heal others: not just their bodies, but their spirits and souls. I strive to provide quality health care to the underserved, for I believe health care is a right, not a privilege. I try to leverage health care to empower the disenfranchised through education about their bodies and wellness.

Smoking Is Glamorous

In the mid-1970s, as a preschooler, I used to stare at a poster in the waiting room of my pediatrician’s office. This poster depicted a disorderly person, dark hair unshorn, snarling and puffing on a cigarette. The poster’s caption: Smoking Is Very Glamorous.

Dear Worried Mother

I can’t stop thinking about you.

Last night, at about midnight, the phone aroused me from my happy slumber. It was Vance, the on-call resident, needing advice from me, as the supervising physician, on how to help a worried mother—you—who’d called our family health center’s after-hours service about your daughter’s worsening asthma.

The “Good” Kind of Cancer?

Years ago, on my first rotation as a third-year medical student, I received a dreaded phone call. My father had arrived home late one night after work. As he entered the house, he tumbled down the stairs. His physician, worried that my dad had suffered a mini-stroke, ordered an ultrasound of the carotid arteries in the neck.

Birthing

Saturday night in my living room, I was surrounded by the parents of the children in my daughter’s kindergarten class. I had boldly offered to host a parent social. We were playing Two Truths and a Lie, one of my favorite icebreakers. My turn had come, and I shared three statements. One of my truths was that my daughters were intentionally born at home. Immediately everyone declared this as the lie, joking that I asked for an epidural as soon as I arrived at the hospital. I understood that no one knew me, yet I was thrown by this gross misunderstanding of who I am and the deliberate choices that I make.

When I was pregnant for the first time, I could not conceive of walking out of my house as two people and then returning home as three. As a family physician who practiced obstetrics, I was well-acquainted with the ups and downs of hospital births. I had seen intervention beget further intervention. I resented the television mindlessly blaring while a woman was laboring. I cringed at hospital staff who would chitchat as if the birthing woman was invisible. Once I learned about the improved outcomes for low-risk home …

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Last Patient of the Day

Last patient of the day, and of the work week! I was finishing what felt like my Thursday Night Endurance Test, after which I could go home to my family, and eventually to bed.

As on so many Thursdays, I was running behind. My final appointment was with a new patient, Ann Miller. Before entering the exam room, I did some fact-finding.

In-Between

Something doesn’t feel quite right these days. I’m in-between, hanging in the wind, waiting for the next set of closed doors to open, for what lies behind those doors to emerge. The earth moved from winter through solstice into spring, yet temperatures still dip. Which jacket and shoes to wear? How many blankets are needed at night? We just sprang the clock ahead, but I haven’t yet adjusted and my sleep is off. A big birthday lies ahead and I want to get into celebratory mode, but I still dwell in this decade, which was capped off by a trying and tumultuous year. Least exciting of all, I’m in that liminal phase dubbed perimenopause by Western medicine.

À Cause de la Guerre

It was the winter of 1991. We were a group of 25 or so Dartmouth College students on a language study abroad (LSA) program in Lyon, France. A few days after our arrival, the United States led a multinational coalition in an intensive bombing campaign against Iraq. This made Americans quite unpopular in Lyon.

When we’d enrolled in the LSA, we’d envisioned train-hopping through Europe during our free time, notre temps libre. We’d imagined bonding together over cheap French wine, chocolate croissants, and buttery baguettes. Instead, we had the war. La guerre.

Blessings

During a routine Thursday evening clinic, I knock on the exam room door, enter, and greet my patient. She is an elderly Puerto Rican woman with worsening Type 2 diabetes, a new bleeding sore on her face, and chronic back pain.

As I log onto the computer, my patient and her niece discuss how guapa I am, and I blush silently. The patient smiles, at ease, as her niece laughs wildly, such music to my ears.

As this visit concludes, we plan a telemedicine follow-up in three months. My sweet patient forgoes her pre-pandemic kisses and hugs, and instead says to me, in rapid Spanish: “May God keep you safe, bless your children, and protect your husband. Take care of yourself, my kind doctor. You have helped me so much. I pray for you and your family.” This song fills the room – and then heals my heart.

Immediately my mind flashes to my family’s weekly Friday evening dinner, when husband and I place our hands on our daughters’ heads. When they were younger, they would squirm, smile and laugh in response. Now, as teenagers, they grudgingly grant us this privilege – to bless them in the Jewish tradition. After we recite the Hebrew prayer, …

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