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Hope Lost

In 2004, Barack Obama delivered the keynote address at the Democratic Convention. He entitled it “The Audacity of Hope.” At the time, as a wide-eyed, innocent medical student who had just finished her third-year clerkships, I wondered if the medical profession had not only lost this audacity but, furthermore, if we discouraged our patients from “the audacity of hope.”

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Heart and Soul

Fredy El Sakr

“Help!” I yelled out of our open apartment door.

I was seven years old, and my family had recently emigrated from Egypt to the US. We’d been feeling elated that week because, after months of interviews, my father had matched into a pediatric residency.

That morning he’d awakened feeling nauseated. My mother and sister went to buy some soothing food. I noticed that he’d vomited in the bathroom; now he

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Abuela

 
The abuela was a standard admission of my internal medicine rotation. “CVA” said the medical record, which meant this Guatemalan grandmother, or abuela, had suffered a stroke. She was visiting the U.S. to help care for her first grandchild, who was due any day. She had felt fine until, suddenly, her diabetes, high blood pressure, and high cholesterol had imploded. In quick succession, she’d experienced a stroke, a 911 call, and the ER. Uninsured and undocumented, she’d

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Learning to Trust

 
I admitted Hiral Jacobs, a twenty-something college student who’d collapsed in her dorm, directly to the ICU from surgery.

The OR report said she’d received two units of blood and was still intubated. Given my forty years of ICU nursing, it sounded routine.

“By the way, the patient is Muslim.”
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Before Ultrasound

Mary looks not too bad for having a two-week-old baby only now getting good at nursing. He looks content. His weight is not quite where I would like to see it, but not worrisome.

Lifted in my hands, his tone is great, his gaze intensely locks on mine. Put back down, his arms and legs flail enthusiastically. Cheeks are chubby, soft skin is pink. He passes the gestalt test – no worrisome sense that something

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At Day’s End

Marc Tumerman

This is a story of two deaths. That these patients’ stories intersected on the same morning, in the same building, in two adjacent rooms, has left me thinking about them now that the day is almost done.

I was surprised to see Mrs. Stevens’ name on my schedule today. She came to the office last week, and I felt sure that she’d be too weak for another visit. But I was glad

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Speeding Ticket

I’m an ob-gyn, so the middle of the night is like a normal workday for me. I view the drive in at 2:00 or 3:00 a.m. as my transition time from interrupted sleep to an important moment for my patient and spend it reminding myself to make the shift from fulfilling my needs to theirs.
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A Stroke of Faith

 
“SIGNED OUT AGAINST MEDICAL ADVICE,” declared the last line of the ER physician’s note, bold and foreboding.

I quickly skimmed through the rest of his chart. Mr. Lopes was an elderly Haitian man, a recent immigrant, who had visited the local emergency room for a bad headache, only to discover that his blood pressure was astronomical. Apparently, Mr. Lopes and his family considered him too sturdy a man to be retained at

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The People a Doctor Worries About

 
The middle of the night is when I worry about a patient like Olevia, whose oldest son was shot and killed at the age of 23. He left behind his baby mama and his two baby girls. Olevia didn’t have enough money for his funeral expenses, so she had to promise to pay in installments over the course of the next two years. So she gets a reminder of his death every month in

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Praying to Pray

 
I was 25 years old, a fourth-year medical student, and suffering from a severe depression. I was getting cognitive behavioral therapy (which was then fairly new) from a psychiatry resident at my medical school. I was a good patient and kept a journal describing my therapy. About a week after thinking seriously about suicide, I wrote this prayer in my journal:
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How to Change a Diaper

Two daughters bring their severely demented mother into the clinic. The mother is no longer able to speak, but over the last few days she has groaned more during diaper changes. Her nursing home is worried she might have a bladder or vaginal infection. To check her urine, we undress her and catheterize her. To check her vagina, we take a swab using a speculum. We spin the urine and look for sediment under the

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