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The interview had lasted fifteen minutes so far, and we’d made minimal progress. I was a medical student doing a rotation at a physical medicine and rehabilitation clinic back in my home state, Wisconsin. It was the end of the day; to save time, the senior resident, Paul, had joined me in the exam room so that we could hear Leora’s medical history together.
A year earlier, Leora, in her mid-fifties, had suffered
David G. Thoele
I was on the cusp of my first year in medical school, and time was running out. Classes started in two weeks. I needed a place to live–ideally someplace cheap, not too far from school.
There was an opening at Phi Chi medical fraternity, a large brick house of faded elegance located less than a block from my classes at the University of Minnesota. At $75 a month for a tiny room
I stood right beside them as they slowly slid your head into a plastic bag, looped the coarse twine about your neck and tied it tightly. Like the amateurs they were, they double-knotted it to make sure nothing came loose or dripped out. Then they casually walked away, chatting about what would come next.
Within minutes the bag fogged up, and a clear red liquid pooled at the bottom.
That was just the
Tears should be surprising.
He is, after all, well over six feet tall,
must top 250 pounds,
always quick and confident
with a joke upon his lips.
Most of his patients weigh a pound or two.
Eyes fused shut, translucent skin,
with lives of needles, tubes,
machines and probing hands.
On this week there are too many
who will never have a chance.
Chocolate, silence, and he hauls
himself up from
Forty years passed. His body replaced
its cells, with the exception of his heart’s
persistent pump and the mushroom-like paste
of his brain. Only scattered synaptic charts
of his internship remain, etched in myelin,
a few of them deeply. Nonetheless, a dried
umbilical cord connects that powerful womb
to the aging man, across a gulf as wide
as imagination. He doubts there’s a thread
to follow, a blockaded door to open,
When I was an intern, we carried everything.
We carried manuals and little personal notebooks, frayed and torn,
crammed with tiny bits of wisdom passed on by a senior or attending.
Yet when a midnight patient rolled in with a myocardial infarction
we didn’t look anything up because there were only four drugs we could use:
morphine for the crushing pain,
nitroglycerin to flush open the vessels,
Ralph B. Freidin
“Just cut through,” said Dr. Trotter, my anatomy professor.
I had read the instructions in her 1947 dissecting manual. My copy, purchased used, was preserved by stale formaldehyde and smudged with the tissues of past cadavers who’d guided earlier first-year medical students from anatomical landmark to anatomical landmark within the human body.
The time: forty-six years ago. The day: my first day of medical school.
The dissecting room was on the second
As far back as I can remember, I’ve deliberately spent my life on the high road. I was the seventh-grader who was told by adults that she was very serious. I was the college student who majored in chemistry because it was the strongest premed major. I became a doctor.
Before becoming a doctor, I imagined
I became a doctor of internal medicine in my home country, the Philippines, in 2005. The following year, I immigrated to the United States. In order to practice medicine here, I must complete one more journey–a three-year medical residency in the U.S.
My first week at the hospital has been a hectic blur–one task right after another. I’ve been existing on minimal amounts of sleep, food and social contact and maximum amounts of
Editor’s Note: Donald Berwick, recent Administrator of the Centers for Medicare and Medicaid Services in the Obama Administration, and a founder of the Institute for Healthcare Improvement, gave this speech at his daughter’s graduation from Yale Medical School on May 24, 2010.
Dean Alpern, Faculty, Families, Friends and Honored Graduates…
I don’t have words enough to express my gratitude for the chance to speak with you on your special day. It would be