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My Black Bag

Retirement means downsizing. “If a thing doesn’t give you joy, throw it away,” says the current mantra, as if it were that simple.
In my study closet, behind my obsolete Kodachrome lecture slides (about as necessary these days as a harpsichord), sits my little black bag. Does it give me joy? It’s much more complicated than that.
The bag holds all the medical instruments I carried through my training as a doctor–internship, residency and fellowship:

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X Factor

I was a brand-new intern on the intensive-care unit, and Cassandra was the very first patient I saw there. A petite, slender woman, she was rolled in on a stretcher, accompanied by her tall, athletic husband, Jack.
Cassandra was in her twenties, like me–but mortally ill. That grabbed my attention from the start. But the biggest lesson she taught me came about because we got her prognosis all wrong.
She had lupus, an autoimmune disease

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Keeping the Flame Alive

This month, at medical schools across the country, first-year students will officially don the physician’s traditional white coat for the first time.

The white-coat ceremony is a powerful symbolic moment. It signifies that the students are moving beyond their identity as ordinary citizens and into their new identity as healers. The ceremony celebrates their idealism and their commitment to a life of caring for others. And, although they may not realize this, it

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Penal Code


Lisa S. Gussak ~

When I see Rosa’s name on my patient list, I smile. I have known her nearly eight years. Under my care, she’s given birth to her last two children, and although she takes the kids to a pediatrician rather than me, we have an uncanny habit of bumping into each other outside the office. I’ve seen her and the kids in the market, at a park and in the

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All I Could Do

Leigh B. Grossman ~

The clinic in rural Haiti is a small stucco building with no electricity or running water. The temperature inside the clinic is 103 degrees, and there is no breeze. The examining-room walls are only seven feet high and afford no privacy.

This is my fourteenth trip to Haiti as a volunteer pediatrician. My twenty-fifth patient of the morning is a three-month-old infant named Joceylyn Marquee, who is completely swaddled

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The Patient I Didn’t Want


Krithika Kavanoor ~

When I first met Ms. Ruiz, I was barely three months into my first year as a family-medicine resident. I was working harder than I’d ever worked before, and continually facing new challenges. I knew that I was learning, and so I persevered, but opportunities for self-doubt were abundant.

Maybe that was why Ms. Ruiz made such a big impression on me.

A middle-aged woman with a small

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The Man Who Handed Me His Poop


Allie Gips ~

In broken English, against the backdrop of the emergency department’s chaos and clatter, Mr. Simon relayed his story: unintentional weight loss, gradually yellowing skin, weeks of constipation. He punctuated his list of devastating symptoms with laughter–exaggerated but genuine guffaws.

Over the next few days, as the medical student responsible for his care, I was also responsible for handing him piece after piece of bad news. An obstructing gallstone in

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About Last Night


H. Lee Kagan ~

It was a night like many others. I was taking call from home for my medical partner and myself. My wife and I had settled in, planning to stream the new season of Goliath on Netflix. But the internet was down, so we were watching a talent competition on regular TV instead.

At 8:30, my phone rang.

“Hello, this is Dr. Kagan.”

A long pause, then

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Me Too


Frozan Walyzada ~

It’s late on a Friday afternoon in the outpatient clinic where I’m a third-year psychiatry resident. I’m wrapping up my appointment with Jane, a thirty-five-year-old woman with a mild intellectual disability who comes every month to refill her antidepressant prescription.

“Have you been watching the court case on TV?” she whispers.

I stop what I’m doing and look at her.

“The case with the judge and

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Wounded Healer

Jamie Sweigart ~

It was a sunny Sunday afternoon on my urban college campus. I’d been sitting on the grass outside a lecture hall where my premed classmates and I would study together on weekends. This particular weekend, I was alone. Campus was empty, except for a man with a backpack who occasionally passed by.

Finished with studying, I started walking down a deserted sidewalk back to my apartment, a few blocks away.

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My Immigrant Patients

Joanna Sharpless ~

In the living room of the house where I grew up hangs a framed copy of a seventeenth-century map of Pennsylvania. The land is divided into tiny plots, each painstakingly labeled with a family name.

When I was little, I’d stand in front of the map and search for the little squares labeled “Sharples”–the original version of my last name. I’d imagine my distant ancestors, John and Jane Sharples and

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Just What the Doctor Ordered

David Edelbaum ~

I began practicing as an internist/nephrologist in the early 1960s. Having rented an office in Los Angeles, I introduced myself to the local medical community and set out to build a practice.

With a growing family, a mortgage and an office to support, I was hungry for patients. Hospital emergency rooms were good referral sources, so I took ER call at three different hospitals.

Late one Friday night, I got

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