Pamela Adelstein

Popping the Question

Last week it happened again. It starts with a hesitant smile, a subtle pause, eyes looking me up and down, and a gaze that tentatively rests at my stomach. I sense what is about to occur, and I wait like the proverbial deer in the headlights. Then comes the timid question: “Are you expecting?”

I pause awkwardly and briefly contemplate my response. Because my patient is inquiring out of love and genuine curiosity, I tamp down my sarcasm and mumble, “It’s my pants style.” The patient lowers their eyes and murmurs something apologetic.

Panic in the Outside Messages Folder

As I scan the numerous folders of my electronic medical record in-box, typically I open the “Outside Messages” folder with some trepidation. This folder contains messages from other hospitals detailing emergency room and specialist visits, hospitalizations, and test results concerning my patients.

Searching for Activism

My senior year in college, I took a course called Women and Radicalism. It was an exciting class. We studied radical movements on the left and right, with a focus on women’s participation. The course featured a weekend retreat with women activists. For two days, women took the stage to describe their causes and advocacy roles. I attended many sessions, in awe of these phenomenal women who were making a difference in the world. I noted that most of them had been thrust into their cause by a personal adverse event, such as gun violence or an environmental catastrophe.

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.

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