Hospital Near Dublin

I tiptoed into the slippery hallway of the hospital near Dublin where I’d stayed for three weeks as a baby, trying to find some answers as to why I had been there. I still expected to be reprimanded by sisters—what nurses are still called in Ireland—with raw faces and pursed lips.

The walls were awash in institutional sea-foam green. My boyfriend at the time took a picture of my frightened face, the flash bleaching me out to only dark eyes.

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Beginnings

I want to remember this.

In six weeks, I graduate from nursing school. I learned the fundamentals. I learned the requisite skills. I learned the “why” and the “should.”

I also learned about self-care. Actually, I learned a lot about it. Insomuch that my classmates and I were sick of hearing of it. We heard it so many times. 

My classmates have been an inspiration for me. Our passion and collective drive are astounding. We are invigorated. We are excited. We want to help.

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Ward Wanderer

As usual, I found myself rushing through the labyrinth of hallways at Inkosi Albert Luthuli Hospital, in search of our next tutorial. Every day, as fourth-year medical students, we are expected to present cases to awaiting consultants, in the many wards. This time I was lost. A kind nurse directed me to the place where I was meant to be…the pediatric oncology unit.
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“I’m An Ass. Sue Me.”

Although my training, in both internal medicine and nephrology, was excellent, I was lamentably green for some time when it came to the practical aspects of medicine. I did, however, learn one lesson early on.

One day, I rose from my office chair to greet a new patient who walked in slowly, supported by a cane and holding the arm of a much younger man, who helped her into her seat before taking his. To me, she appeared to be “old,” because in those long-ago days I thought of anyone over sixty-five in such terms. 

 

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Dead, Slightly Dead and More Dead

When the walls of his failed heart collapse, he suffers a damaging heart attack. He lacks any blood flow, so the EMTs declare him dead. Shocked, he fluctuates between slightly dead and more dead. The ambulance volunteers bring him to Northern Westchester’s cath lab.

Unafraid, he sees The Light. He meets Moses carrying tablets down Mt. Sinai, greeting newcomers going up. Relatives weigh his mitzvahs: pro bono work with clients, sick friends, nursing home visits. The judge calls his wife to the witness stand. She says, “He should live.” They await the verdict.

 

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The Third Wheel

I am trying to move the language from forever to this moment, in the aiport departure lounge. To loosen up on declaring “You’re always” and “You’re never” and instead say “Right now you are …”

I might think I know what’s coming, but I have no idea exactly what it will look like and when it might happen. For now, the “what ifs” are not dormant, but also not dominant. Regardless, an illness becomes an uninvited third person in a two-person marriage. 

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Breaking a Frame of Reference

 
When you see one on the subway, get off. When one is coming your way on the sidewalk, cross the street. Despite being a progressive-minded student studying drug policy, this was my frame of mind about drug users outside the research lab. This frame changed after my time at Street Health.

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Daily Constitutional

Rounds at the cancer institute where I’m a nurse practitioner start at 8:00 am: bellies are pressed, labs frowned at, lungs auscultated, pain discussed. Teams of physicians, nurse practitioners, residents, interns and students roam the halls–teaching, conversing, lecturing, scratching their heads.

But one of my favorite parts of the day starts at 10:00 am. That’s when the physical therapists start arriving and the patients start their daily exercise–walking the halls. Some measure their effort in steps, some in laps, some in miles.

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Not That Old a Dog …

I don’t know how to share this without sounding like I am bragging. Maybe I am bragging — but not about my ability. I am proud that I learned a skill not usually taught to MDs. A while ago, a long-held interest in massage led me to learn more bodywork; then I worked with a DO, a doctor of osteopathy. I would feel someone’s back and say to my DO colleague, “Mike, I think she’s out here.” Mike would feel and grudgingly reply, “Pretty good hands for an MD.” He would then do osteopathic manipulation therapy (OMT), and the person

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Dr. Sarno Saved Me!

Back in the 1980s, I was not a family physician but an engineering manager who had been experiencing occasional back pain for several years. Then one summer I overdid it windsurfing, and for the next two and a half months I was bent over in sheer, excruciating pain that I now recognize was a muscle spasm that would not remit.
 
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Just a Little Twist

The ache was in a familiar spot: in my mid thorax, starting over my spine and spreading a little to each side. It showed up a few times a year, always in the same place. It wasn’t terrible. I went to work, shopped for groceries, walked the dog, kept living my life. Maybe I woke up more often at night. Okay, maybe I woke up every hour and maybe sometimes I had trouble getting back to sleep. And maybe I had to cut back on the ibuprofen because it added epigastric pain to my back pain. But it wasn’t bad.

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Her Father’s Back

I first saw “Mary” as I entered the exam room. She was lying on the table in tears, complaining of a three-year history of excruciating back pain. She had seen two neurosurgeons and an orthopedist (my specialty), had had an MRI and, despite great hesitancy on the part of the neurosurgeon, had had a (failed) back surgery: her pain had been relieved for three days before it recurred exactly as it had been before.  Following a second MRI, she had been referred to me because the neurosurgeon thought I was a “pain specialist,” whereas really I was interested in mind-body

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