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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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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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The World’s Second-Best Baklava

In 2013, as a hospitalist, I attended the annual conference of the Society of Hospital Medicine. This meant traveling from my home base in Ohio to Washington, DC, the site of that year’s conference.

The second day was winding down. Colleagues, new friends and countless strangers were scurrying to their rooms to freshen up and get ready for a night out on the town, where they’d continue to mingle, share research and professional achievements and scout out career opportunities.

I had other plans,

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Broadway Bound

Ever since his adolescent years, my son and I have had an ongoing conversation (you might call it an argument) about my habit of speaking too frankly when sharing my opinions, which I do frequently.

Or, as he puts it, I have a big mouth.

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The Eye of the Beholder

One winter morning in 2020, I was called to the reception desk to meet my patient Esther and her husband Hertzel. Some time earlier, I’d asked Esther–somewhat awkwardly–if she’d be willing to talk to me about her experience of being diagnosed with and treated for advanced breast cancer, and she’d willingly agreed. Today was the day.

Eighteen months earlier, Esther, in her sixties, had come to my hospital’s ER at her rabbi’s urging.

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Doing the Math

“I can’t do it—I’ll die!”

Veronica is in tears.

I’m a family physician, working in a pain-management clinic in the Bronx. As Veronica’s doctor, I’ve asked her to see me to discuss coming off her opioid medications. It’s part of a clinic-wide initiative to reassess using these medications long-term with patients who have chronic pain.

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What Do You Want Your Life to Look Like?

In the first months of medical school, we’re taught that patient autonomy should be one of a physician’s guiding tenets. The doctor provides diagnoses, prognoses and treatment plans, but ultimately it’s up to patients to make decisions about their own care.

As a family doctor, I often tell patients: “Only you can know what the right decision is for you. I’m here to provide information and recommendations and then to support your decision.”

But over the past year, as my father’s memory deteriorated and

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Caught in the Crossfire

I’ll call him Rocky. In a drive-by incident, his father was killed, and Rocky, age one, was shot multiple times.

His initial resuscitation was heroic—he received medicines to support his blood pressure, underwent emergency surgeries and was still attached to machines to support his breathing—but by the time I met him, the drama of his shooting had receded: He and his medical team had settled into a stable routine.

Though I suspect that the team had

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Going in Peace

All too often in my forty years of practicing medicine, I’ve seen patients die hard, lonely deaths—lying on a stretcher under the emergency department’s glaring lights, or all alone in an ICU bed.

In extreme situations, the patient is covered in medical equipment: a breathing tube in the mouth, defibrillator pads on the chest, monitor leads on the torso, IV lines dangling from the neck and arms. When family members finally enter the room, it’s

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The Last Gandy Dancer

After I retired, my wife and I moved, giving me a reason to go through my old files. I found the notes from this story scribbled on some scrap paper that used to be everywhere in our offices. “Keep good notes,” someone once advised me. These are good notes and a good story.

Thirty-five years ago I was on the faculty at the University of North Carolina in Chapel Hill and spent a lot of

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Staying Over Our Skates

One winter weekend, I was walking in a local park that has an ice-skating rink. I stopped to watch the skaters for a few minutes. I’m not a skater myself, but I appreciated the skaters’ wide range of ages and abilities.

Off to one side of the rink, I saw a young boy struggling to skate. He was hanging onto one of the walker frames that were provided, his face a mixture of determination, frustration

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