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Stories

The Last Beat

It was midmorning at the hospital where I was a clinical medical-surgical instructor. I was standing at the medications cart with Sally, one of my third-year nursing students. One of the floor nurses approached.

“You have Anna in Room 44, don’t you?” she asked Sally.

Sally nodded.

“You better go in there,” continued the nurse. “She doesn’t look too good.”

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Time Splintered

Time fractured when my first husband died.

There was a before, which no longer existed, and an after, which was unimaginable.

In between, the thinnest–unfathomably thin–line, was the today. The today meant putting one foot in front of the other. One today led to the next today. And finally the year was over.

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Love Is the Key

Collecting dust on the rustic wooden shelves above a sturdy workbench in my basement are models of history-making ships, spaceships and military fighter planes. There’s an enormous replica of the Space Shuttle Atlantis, complete with iconic NASA logo and a massive orange fuel tank nestled next to its launch tower. Not far off is a black-and-brown plastic replica of the forty-four-gun frigate USS Constitution, its hull held together by two gigantic bolts.

Their maker has been gone for four years, but I can’t throw them away. They hold the precious memory of my husband Don, who spent hours gluing, painting and sometimes not so patiently putting pieces together.

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Letter to Myself as a Third-Year Medical Student

At most medical schools, the first two years are spent in lectures, labs and classroom learning. The third year is when students begin rotating on various clinical teams in the hospital and clinics, finally seeing patients as part of a large educational medical team. As I moved through pediatrics, ob/gyn, surgery and other core rotations during my third year, I took notes at the times when I felt out of place or discouraged. These memories became the basis of this letter to myself–a letter I wish that I could have read that year.

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Daring to Dream

For the past three years, I worked as a rural primary-care doctor. Two months ago, I resigned to pursue further training in hospice and palliative care. My patients were the inspiration that illuminated every step of my way towards this new path.

Marly came to me for a workup of her persistently elevated liver enzymes. Together, we navigated her new diagnosis—liver cancer—and a series of failed treatments. Eventually, Marly’s thoughts turned to facing her mortality.

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Northern Lights

“Let me die,” you say.

You’ve listed the reasons, presented the arguments: You’re a burden, a mere speck in a world of billions, one that will not be missed. A life that never asked to be born. Why prolong this pain?

“Please, let me die,” you say again, this time with a sob that allows no more words.

I hear you, I do.

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Gift of Gratitude

We all remember our patients who die, though the first patient death really stands out from the rest. This was certainly true for me.

I was just starting the second year of my internal-medicine residency. This wasn’t the first time I’d seen someone die, but it was the first time I’d seen someone who’d been alive and well, and talking to me that morning, be dead by the afternoon–a shocking dichotomy that haunts me to this day.

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Joe

You’re in the hospital again, propped in bed with pillows keeping you from listing to one side or the other, and I’m sitting on a pink pleather chair I’ve pulled up next to the bed.

We watch Dr. Phil until 4:00. I always find this show melodramatic, but you seem riveted. You want to know about these people, their lives, their lies, what they’ll do with the information unveiled to them.

When Dr. Phil signs off, I switch on the Classic Country music station, and we talk.

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An Exception to the Rule

“I usually talk through the procedure as I go,” I say, pulling on a pair of blue nitrile gloves. “So you aren’t surprised by anything, so you know when to expect a sensation.”

The patient is lying on the table, eyes fixed upwards. One of the ceiling panels is illuminated with the green leafy branches of a tree—an image meant to calm and soothe, though I doubt it’s doing much for this woman.

“Or I don’t have to talk,” I tell her, arranging the instruments on my sterile tray as silently as possible. “We can be quiet or chat about other things.”

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