It was Mother’s Day and my neighbors had invited me out to brunch. The two of them had met in a diner in New York where Mary was the server and he was a conductor on the railroad. I met them when they decided to retire to Florida and bought the condo next door.
Bradycardia (heart rate 41) one day, tachycardia (heart rate 168) the next, just sitting in bed, before … during … after a seizure. My epilepsy is refractory—resistant to treatment—and this incident scares me. But I hesitate to make an appointment, scared as well about the bill.
When I was a freshman in high school, two of my classmates lost their mothers to suicide. Going to their funerals, my first ones, was traumatic. I remember struggling not to giggle—a blatantly inappropriate response—but for whatever reason, that is how my emotions chose to express themselves. I spent many sleepless nights after these tragedies, haunted by images of my parents hurting themselves.
Dear Pulse readers,
My cousin Pedro had pale, northern European skin and straight brown hair–looks that contrasted with the olive complexion and black waves of his adoptive parents, my Cuban uncle and aunt, and their two biologic daughters.
My brother and I met Pedro when we went to visit my uncle’s family in Colombia. He was about sixteen at the time, an outgoing teen who dressed well, liked to party and had Playboy photos stuck to the walls of his bedroom.
A few years later, he took his own life.
Our ambulance had been summoned to help a woman tripping on mushrooms—activated by a midnight 911 call about a possible assault and death. The police arrived at the location ahead of us to ensure safety. We walked inside to find a woman sobbing and holding a blood-soaked towel against her mangled hand. She had huge, dilated pupils from mushrooms she’d ingested with her boyfriend. Her story unraveled as we listened in horror.
As an intern in 1984, one of my first patients was a woman I’ll call Emily. Soft-spoken, with a wide smile and light brown hair, she was in her mid forties, from rural North Carolina. She’d had intractable headaches for decades. Despite extensive medical workups, no cause had been found.
“I will never let my children have sleepovers,” a mother told me firmly. I was talking to her child as my patient, and he wanted me to convince his mother otherwise.
What do you do when you hear about a sex assault that happened years ago, and you currently interact with the perpetrator in your daily life? What if that perpetrator is seemingly a nice person, and you are friends with his female partner and his family?
What if the perpetrator is a patient of yours, and you are also the primary care provider for his family?
What if the perpetrator is a coworker or a supervisor at your workplace, and you spend time together in meetings and engaged in work tasks?
I overheard the comments from across the busy clinic. The two students working with their assigned patient were gamely trying to dodge his questions and redirect the conversation. But despite their efforts, he persisted with his intrusive line of commentary: “You girls are pretty. You’re both too pretty to be single. Do you have boyfriends? Are you getting married? Why aren’t you getting married? You need to get husbands before your looks start to go. You should wear your t-shirts a little tighter.”
The barrage continued without pause. The students began to look a little desperate.
It was the start of my third year of medical school. My first clinical rotation was on the inpatient psychiatry ward. I put on my white coat, filled my pockets with clinical guides, and donned my stethoscope. I recall feeling both excited and daunted.
At that time, it was the job of the student on the team to interview and examine new admissions before the resident and attending physician saw them. We students would then report our findings and write up a formal H&P, or history and physical exam.
He could have been named Mr Congeniality. He was warm and friendly to people around him, always ready to do a favor. I met him when he worked a summer where I was working. His masters degree wasn’t enough to get the jobs he wanted, so he decided to apply to PhD programs. He and I became friends over the summer, and I helped him with feedback about grad schools, housing, and so on. His wife and child had stayed that summer where she had a full-time job so she could continue working.
When I was twenty, I scheduled my first gynecological exam. I went to a doctor recommended by girlfriends. The appointment was late in the day – five p.m. Maybe this should have alarmed me, but I thought the doctor was busy and had a heart for patients.
© 2022 Pulse - Voices from the Heart of Medicine, Inc. All rights reserved.