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First Language

Carl V. Tyler

In my clinic and in the nursing home
Every week I see it
That depthless hollow look behind the eyes
But this time it was your eyes
Sitting across the table
At a TGI Friday’s outside of DC.

And that all-too-familiar look to your face
Of knowing and not knowing
Of barely contained panic
Of quizzically furrowed brow
Of fear.

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Day of Reckoning

Suzanne Minor

Yesterday my friend Sophie asked me to accompany her to a Miami hospital intensive-care unit to see her older brother, Guillermo. He’d been admitted the previous night with seizures and cardiac arrhythmia.

Joined by my husband, we made our way to the ICU. When she saw Guillermo lying immobile, swollen and unresponsive, with a breathing tube in his mouth and other tubes snaking into his chest from IV poles, Sophie broke

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Last Stand

E. Wesley Ely

The first time I saw Jessa, she lay crumpled in the ICU bed, paralyzed, expressionless and unable to speak. A military veteran, she had fought in Desert Storm, but she now was facing a deadlier and more inexorable foe: amyotrophic lateral sclerosis (ALS), aka Lou Gehrig’s disease.

This disease causes progressive loss of muscle control, and Jessa was unable to speak, eat or breathe on her own. Her only means

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I Need a New Stethoscope

Jenni Levy

I need a new stethoscope. I have to wrap my fingers around the fissures in the tubing to make this one work.

For me, these days, listening to the patient’s chest is more a ritual than a means of diagnosis. After twenty years as a primary-care internist, I now work full-time in hospice and palliative care. I spend more time listening to stories than to hearts and lungs. Even so, there’s

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Last Writes

Hilton Koppe

Jeez mate, you are really dead. “Really fucking dead,” as you would say. I don’t need to be a doctor to know that. The cop who rang me was right. You must have been sitting in your lounge chair, dead, for at least twelve hours, maybe more. Looks like you were enjoying a quiet drink when you checked out.

I’ve got to tell you mate, it’s pretty weird sitting here at

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How Will I Know You’re Not Dead?

Raymond Abbott

I never thought it would go on for so long–seeing Donald Wyatt, I mean. I certainly didn’t plan it this way.

More than six years ago, I retired at age sixty-six from my social-work job at a mental-health agency. Donald had been my client there for about eight years.

As I was cleaning out my office, his mother called. She explained how Donald’s father had left when Donald was not

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Popping the Question

Mitch Kaminski

Mr. Dwyer isn’t my patient, but today I’m covering for my partner in our family-practice office, so he’s been slipped into my schedule.

Reading his chart, I have an ominous feeling that this visit won’t be simple.

A tall, lanky man with an air of quiet dignity, Mr. Dwyer is eighty-eight. His legs are swollen, and merely talking makes him short of breath.

He suffers from both congestive heart failure

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Friday Before Christmas

Deborah Pierce

On the Friday before Christmas, I received an unusual gift.

Like any job, being a primary-care physician has both challenges and rewards. The challenges are many, and the rewards are often fleeting–a smile or a “thank you” from a patient or coworker, for instance. And I’ve found that being a teacher of medical students and residents brings an additional layer of rewards and challenges.

One Friday before Christmas, these arrived in an especially

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Mrs. Finch and Ms. Virginia

Evan Heald

A Different View

Most days, Mrs. Finch’s perspective was outrageously optimistic and embarrassingly complimentary. Although she had the typical assortment of nonagenarian maladies, she would not let that define her; whenever she visited my office, it was hard to get to a chief complaint because of her relentless focus on how nicely the parking lot had been graveled, or “what a sweet, sweet nurse you have,” or my partner’s haircut or the

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One Last Gift

Edward Beal

During most of my career as a psychiatrist, I haven’t often dealt directly with death. For the past five years, though, I have had the privilege of spending two days a week treating service men and women returning from deployments in Afghanistan and Iraq. Listening to their stories and talking with them about their war experiences, I’ve spent much more time thinking about death and dying.

Despite this, I was shocked when

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A Doctor’s Dilemma

Jessica Zitter

It was my first day at my new job, practicing a new specialty. Having spent fourteen years as an ICU physician–including a four-year pulmonary/critical-care fellowship in this very hospital–I had just completed a palliative-care fellowship. Now I was the hospital’s palliative-care consult attending.

When I set eyes on the patient in room 1407, my first thought was: THIS LADY NEEDS TO BE INTUBATED–STAT!

The only trouble was that my job was to ease

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Seeing the Light


Sarah Houssayni

Many healers, teachers and parents have them.  

At one point, I did, too. I had delusions. I thought I was a hero, a rescuer clad in a shiny white coat and wielding the sword of clinical wisdom. 

 

I look back on those days with nostalgia and regret. I wish they’d lasted a little longer–my belief

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