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Microcalcifications

A cluster, I say,
so small – see? I can cover it
with the tip of my finger. Tiny little
calcifications. I show
you the mammogram.

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A Doctor’s Visit

My new doctor enters the examining room where I have been waiting for him, seated on a rumpled paper sheet at the edge of a brown leather lounge chair. Behind the doctor’s blue mask, he is wearing a furrowed brow of worry.

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Something Stronger

you said he likes it dark in the morning. every morning
he made black coffee by the light through the window over the sink
well anyway he used to. well anyway that’s why it’s so dark in here beg your pardon
the monitor beeped and i ate my yawn and said no problem almost my lunchtime anyway
you laughed and i laughed but he did not see the joke
i’d

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Final Appeal

“He basically killed me,” Sam said flatly, sitting my office. “I don’t want to talk to him.”

I nodded sadly with understanding as his on-demand oxygen hissed away each moment, like the ticking of a clock. Why would a patient want to speak to a doctor who’d missed his diagnosis? Why should he?

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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

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Back Pain

Back Pain

A 77-year-old woman presents with back pain.
No trauma. No radiation. No red flags.
ROS* otherwise surprisingly negative.
Her exam is unremarkable, actually pretty darn good.
FROM, negative SLR, full distal strength, sensation and DTRs.*
After the usual cautions I reassure her,
prescribe activity, no meds and the tincture of time.
She is fine with that, appreciative and pleasant.
Then she says, “Should I

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Greetings and Salutations

Greetings and Salutations

I have seen tribesmen in the West African country of Mali meet each other on a narrow dirt path and stop to spend several minutes chanting highly scripted greetings. When they part, shortly afterwards, there is an equally elaborate farewell.

As a psychiatrist and medical educator, I’ve seen my colleagues carrying out a parallel ritual: Two doctors hurriedly passing each other in a hospital hallway and cheerily but tersely saying, “How are you?”–neither

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Last Day

Last Day

It’s my job to empty a plastic bag
filled with meds both past and present
and read out loud the labels of those we stopped,
and explain why, and while we’re on why
why he needs oxygen at night, and the rescue inhaler.
Between pills it’s my job to ask in a generic way
about life outside the clinic? He takes out his phone
because his story needs a prop.
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Shock Treatment

I sat in the cold, sterile examination room, anxiously awaiting my new orthopedic doctor–the fourth in two months. I was losing hope of ever finding a doctor who would listen to me. The first three had suggested that my pain was all in my head
I want someone to take me seriously, I brooded. I don’t want to be brushed off as the stereotypical hysterical female. My pain is real, and I’m not crazy. I

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Pharmacy Visit

You are a big man, a little heavy, but nothing
that can’t be fixed by daily, brisk walks
or swept away by a
dose of cancer and a blast of treatment.
You have been called from your glass enclosure
to help me.

A productive, bronchial cough
is still with me–too long.
Chinese practitioners call this a lurking pathogen
tossing antibiotics into my weary kidneys

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Unexpected

Christine Loftis ~

“You’re twenty-seven-and-a-half weeks pregnant.”

As I lay on the exam table, time froze.

How can this be? I wondered dazedly. I’m a second-year medical student. I’ve just completed a course in female reproduction and endocrinology. How could I have missed the signs?

I attribute my obliviousness to the surgery I’d gone through only months before: the removal of a twenty-seven-pound, mucus-filled ovarian cyst. My lack of menstrual periods

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Exit Interview


Tamra Travers ~

“I’m graduating and leaving our clinic in June.”

Over and over again, in the months leading up to this transition, I break this news to my primary-care patients. I have developed many meaningful relationships with patients over my past three years of training as a family-medicine resident in a large, urban health center in Manhattan. But now it is time to leave and move on.

The fluorescent lights

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