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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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“One of Them”

Suzanne Smith was an elderly white woman who experienced a violent assault some odd years ago. Since then, she’d never been quite the same. Plagued by fears and sleepless nights, the concepts of medicine and psychotherapy were alien to her, and from my understanding in speaking to her children prior to her coming in, she wasn’t keen on speaking to medical professionals.

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Regret

A full head of white hair.

Each in its place.

Not just neatly.

Meticulously.

Perfectly.

A full head of white hair. That’s what I see in my minds’ eye, when I close my actual eyes and conjure up my grandfather.

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Walking in Beauty

The 11,306-foot summit of Mount Taylor in northwestern New Mexico was my destination one sunny autumn morning. But what I sought that day was something else: understanding and forgiveness.

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The Fight of His Life

During the early months of the COVID pandemic, the Utah medical school where I teach asked me to facilitate a small group of first-year students in Layers of Medicine—a course that covers what you might call the “messy” side of medicine, including end-of-life discussions.

Just after the course started, my dad was diagnosed with pancreatic cancer. All at once, I felt my personal and professional responsibilities intersect, unexpectedly and powerfully.

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The Wizard and I

He’s wearing a Yankees T-shirt, an EpiPen holstered to his belt like a lightsaber. We’re old friends. Trevor has been my patient for four years—more than half his life.

This will be our last visit: After forty years, I’m retiring.

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