“Deeper compressions! Deeper! Make sure you get that recoil!”
I push harder and lift off higher. I’m starting to sweat. My stethoscope is banging around my neck. I should have taken it off, I think. My hair is flying around my face. I should have tied it up. I’m on tiptoe; my legs are cramping. I should have stood on a step stool.
“All right, she’s getting tired. Next!”
Carl V. Tyler
I knew from last night’s house call that my patient Bessie’s time was near. All day long I’d felt the familiar churning inside, the sickly sweet combination of anticipated dread and anticipated relief. So when the phone rang while I was exercising at home, I wasn’t surprised. I quickly dropped the barbell weights to answer the call before it went to voice mail.
It was Bessie’s daughter, Susan.
It looked like the skin of an orange–peau d’orange, in medspeak. My fellow interns and I had heard about it in medical school; some had even seen it before. As our attending physician undraped Mrs. Durante’s breast one sunny morning during our first month as interns, we knew that what we were seeing was bad.
Mrs. Durante wore a hospital gown and a brightly colored head scarf. She looked like a child lying
I was a third-year medical student in the first week of my obstetrics rotation. The obstetrics program was known to be high-pressure, its residents among the best. Mostly women, they were a hard-core group–smart, efficient, motivated–and they scared the heck out of us medical students.
I remember the day clearly: Not only was I on call, but I was assigned to the chief resident’s team. I felt petrified.
We’d started morning rounds as
One day in April, I took the assignment none of the other nurses wanted: Baby Michael. A hopeless case.
Born almost four months premature, weighing barely a pound, he was now all of six days old. His entire body wasn’t much longer than my open hand. As he lay motionless on a warming bed with the ventilator breathing for him, the night nurse gave me report: serious intestinal infection, bowel surgery, septic shock,
It was 5 pm on a cold November day. I was a third-year medical student heading into my first night on surgery call.
Changing into my scrubs, I wondered what it would be like. I knew that we had to carry a “trauma pager” and, when paged, get to the ER as fast as possible. There my job would be to listen as the ER physician called out his exam findings and enter
I pull up on the side of the road on this rainy British summer’s day. The rain doesn’t make it easy to get my doctor’s bag out of the trunk, which I do in a hurry so I can make my way to the house where I’ve been asked to visit a 37-year-old man named Kenneth.
This really isn’t ideal. Now my bag is wet, my papers are wet, my trousers are wet
Coming out of my exam room on a Monday morning, I saw two overweight police officers standing in my waiting room. From past experience, I knew that they were there to tell me that one of my patients had died and to collect information for the coroner’s report. Even as I geared up to hear the impending bad news, the doctor in me couldn’t help wondering how they’d passed their department physicals.
“She’s been here for two months already. She’s very complicated; you’re going to be spending a lot of time with her and her family,” my fellow intern said as she began signing out her patients to me.
It was my first rotation in the medical intensive care unit, and I was terrified. I was in my first few months as a “real” practicing physician–a title that I still felt uncomfortable with. If a
Death is not always the same. Quantity, fixed: one per patient. Quality, variable.
Doctors see many deaths, of different kinds. This is true of any doctor, whether or not he or she is a surgeon, as I am.
It’s easier for the doctor when death is expected, following a long illness, a chronic disease. Harder when it’s unforeseen–the heart attack, the accident, the gun shot, the sudden death in a young man or
Tyrek’s mother and I must have spoken for two hours in the Pediatric Intensive Care Unit, covering every topic but the one that was glaring at us: death. A fourteen-month-old child is not supposed to die–and even though I knew the situation was dire, I couldn’t bring myself to face it. So I excused myself, sat down with her son’s chart and stared blankly at it.
I first met Tyrek and his parents
His history was Dickensian. As a little boy, born with an IQ of about 80 and a wandersome nature, he’d toppled onto the train tracks and gotten run over. How he didn’t die is a mystery–this was more than fifty years ago, and he lost both legs up to his hips–but live he did.
I met him in the hospital, where he’d had surgery on the pressure sores that came from long hours