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The Medicine We Don’t Prescribe
I step into the back of a van on a chilly fall day. I’m a family physician; with me are my medical assistant, Lori, and the front-office representative, Maria, from our federally qualified health center in Reno.
This van is our center’s mobile clinic—one exam room, a point-of-care lab and a front desk squeezed into a space no bigger than a typical bathroom.
Today we’re visiting a family shelter, as we do every week.
Student, Interrupted: A Story in Three Parts
Part I: Student, Interrupted
During my psychiatry rotation as a third-year medical student, I observed patients pacing the halls in socks, their shoelaces sealed in plastic bags (to prevent possible self-harm) along with the rest of their belongings. No phones. No laptops. Just the steady rhythm of footsteps looping around the nurses’ station.
A few months later, I found myself walking that same loop—not as a student but as a patient. My shoelaces were stored away, and I was the one being rounded on.
Pushing and Pulling
Medical training consists of years of daily pushing and pulling. As a medical student, or during residency, you are constantly pulling in senior residents for consultations to provide desperately needed guidance ensuring that you don’t hurt anyone; or else you’re pushing away those same senior residents when you finally feel, It’s okay, I got this.
If you ask for help too early, you’ll meet with stern and frustrated rebukes: “I’m busy! Why are you calling me? You should be able to manage this by now!”
But if you call too late, it’s: “Why didn’t you call me? What the hell were you thinking? You coulda killed him!”
Moment of Truth
Twenty-five-year-old male, Type 1 diabetes with recent left-leg amputation, poor glucose control.
Routine case, I figured. I was the senior endocrinologist at a community health center, teaching resident physicians and caring for medically underserved patients.
I had prepared a chair to my immediate right for the medical resident, Anna, so that by turning my head slightly away from my desktop computer I would be able to see her face clearly. Although she didn’t know it, I was deaf–and with one of my cochlear implants failing, I needed to lip-read to understand speech.
A Blink Between Love and Loss
Beep. Beep. Beep….
I stood in the operating room during Cory’s organ-donation surgery, watching the monitor as his blood pressure dropped and his pulse faded. I was a second-year medical student, just beginning my trauma-surgery rotation in an urban hospital. I remember that day as a series of blinks, each one a snapshot of moments that still linger.
Here’s how it began:
Empty
In early February 2020, my husband and I checked into a quaint condo in New Orleans’ French Quarter. We needed a break from our usual lives: My husband worked as a psychiatrist, listening to his patients’ stories of trauma and pain; he was exhausted. I too am a physician; I felt burned out by my administrative job, where I was regularly yelled at and insulted by other physicians.
We hadn’t been coping well. Every evening we sat in front of the television to numb ourselves and quiet the stress enough to go to bed and fall asleep.
The Screening
In 2006, my dad was determined to attend the funeral when his last living brother died. The problem was, Daddy, eighty-two at the time, suffered from cognitive impairment bad enough that for months I’d been trying to get him to move to my home in Tennessee. This trip he was intent on taking would have required a cross-country flight from North Carolina to California—maneuvering through airports, finding a hotel and driving unfamiliar roads in a rental car.
“Daddy, you can’t go out there alone,” I said, wedging the phone between my jaw and shoulder to free my hands for folding laundry.
“Well, why not?”
Surviving with Sisyphus
The patient in room 214 asks me and my attending if we can sit him up in a chair and bring him a Bible. He has a non-survival injury; wires and tubes tether him immovably to the bed. Even so, we tell him yes and leave the room. A medical student on a mission, I go in search of a chair.
Two doors down, the patient with no hands—they were amputated several days ago—yells out to the hallway:
“Hey! Hey! Is that Black man still out there?”
“Out, Out, Brief Candle!”
I grew up in a multigenerational two-family home in Queens, New York City, during the 1960s and Seventies. Every weekend, my grandparents prepared a feast for the whole family. Among them were my mother’s younger brother, Marvin, and his wife, Inge, an artist who’d immigrated from Germany.
They were childless, but Marvin delighted in his four nieces, including my sister and me. A professor of Shakespearean literature, he read Macbeth and King Lear to us when we were young, along with the more child-friendly works of Lewis Carroll.