No One Ever Asked

Today I greet Mr. Williams verbally, which is very different for us; usually we say hello with a hug.

“Mr. Williams,” I say, “I’m not going to hug you today, with this pandemic.”

“I get that, Doc,” he answers, adjusting his mask; I can’t tell if he’s smiling or not.

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I Would Like to Call It Beauty

Gearing up for my night shift in the COVID-19 intensive-care unit, I don my personal protective equipment (PPE)–a white plastic air-purifying respirator (PAPR) hood. The hood connects via a tube to a large battery pack that I strap onto my waist over my scrubs. I turn on the battery and shiver when the rush of cool air blows past my ears. I walk into a bright white antechamber where a safety officer inspects me.

“You’re good to go,” she says. “Stay safe.”

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Life With Father

Life With Father

After forty-three years as a nephrologist-internist and teacher, I recently retired from medicine. This final stage of life is a time of reflection. Was I a good physician? On a more fundamental level, was I a good friend, husband and father?
Despite its many challenges, I have never regretted following my cherished vocation. There were far more rewards than regrets. By contrast, my record as a father feels a bit less exemplary.
During my first three decades as a physician, the prevailing professional ethos could best be described as “macho medicine.” When I trained as a resident-fellow, and later, when I practiced full-time as a nephrologist-internist, my colleagues and I were routinely expected to work sixty or more hours per week.
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Extracurriculars

Extracurriculars

If harsh words fall, but no patient is around to hear them, do they make a sound?
This particular night on my trauma-surgery rotation as a fourth-year medical student, the question weighs heavily as a page alerts the team that a patient with multiple gunshot wounds will arrive in ten minutes.
Everyone’s kind of excited. Anxious, too. Jittery.
1:00 am. Down in the ED, the main actors stand masked, gowned and ready to go. ED Cowboy stands at the head of the bed, Surgery Senior stands to the side. Alongside them, the throngs of people without obvious purpose who always seem to show up just in time for the evening’s episode of “drama in the trauma bay.” Everyone’s done this a

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Saying the D-Word

It was late in the evening, and I was ready to start my night shift as an intern in the intensive-care unit. I sought out my fellow intern, who was finishing his shift, so that we could perform signout–the ritual of passing the patients’ information from one clinician to the next.
“Mrs. Klein in Bed 15 might go,” he whispered.
“Go? Go where?” I asked. “It’s 10 o’clock at night.”
“I mean she might go away.” He wasn’t making eye contact with me.

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Some of the Hardest Weeks

Some of the Hardest Weeks

Editor’s Note: Since the end of March, Pulse has been carrying special edition pieces on the impact of the COVID-19 virus on patients, families and healthcare workers. In response to recent events, we bring you this special edition on Racism, which is also the theme of this month’s More Voices. In weeks to come, we hope to continue addressing both Racism and COVID in our special-edition series.

Today’s piece is by Ladi Oki, a physician colleague. This is not a typical Pulse narrative. It is true to Pulse’s mission, however, in that it explores the impact of events on an individual’s heart and mind.

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In the Biodome

In the Biodome

As a pulmonary and critical-care medicine fellow, I care for patients with a broad variety of respiratory ailments. But little did I know, as I examined my patient Mr. Smith in the outpatient pulmonary clinic this past winter, that I’d see him again only months later as my first patient with COVID-19.

Mr. Smith was tough as nails. A stoic retired steelworker and former smoker, he suffered from significant emphysema, but was inclined–by nature and by necessity–to fight through his symptoms with limited medical help.

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This Is Why

February 2016
Tierra Nueva, Dominican Republic
I’m in the last of five days caring for patients at rural clinics in western DR, along the Haitian frontier.
Tierra Nueva, miles from anywhere, is a collection of clapboard shanties and shacks scattered along a dusty, unpaved road that dead-ends at the border. People survive here by coaxing vegetables out of the earth via scratch farming. The lucky ones have a goat and maybe some hens.

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Burned Out

Burned Out

It’s been five months since I left my position as a psychiatrist and medical director, and like everyone, I’m wrestling with questions about how COVID-19 has changed our lives, maybe forever. As I read the news and hear from my former colleagues, who’ve had to quickly ramp up to deliver telepsychiatry, I feel a mixture of emotions: fear and concern for my former patients; guilt that I’ve left my colleagues behind to fight on without me; and uncertainty over how I can best help out in this crisis.

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