The ER doc said the trains here
Go too slow
For anybody to kill themselves
By stepping out
In front of one
As if they were sleepy little engines
Without much power
That drifted ghost-like through town
Quietly at night
It was July, and the weather outside my window was sunny—but inside, it was a different story.
At the beginning of the summer I’d been diagnosed with bipolar disorder. I myself thought that I suffered from major depressive disorder.
I felt as though I were sinking into a black hole. My medications didn’t seem to be working, and my psychiatrist was out of the country for the summer.
It is a chilly January night, a week after New Year’s and a few days after my twenty-fourth birthday. I’m halfway through my third year of medical school and have just started my clerkship on the hospital’s trauma unit.
I’ve been dreading this experience; I’m on twenty-four-hour call, and my heart sinks every time the pager goes off.
Having told me you’ve had low energy
and decreased interest
in the things you used to enjoy
(reading, Canasta, sex),
I ask you,
because I believe we have enough rapport—
though how can one ever be certain—
Have you had thoughts of killing yourself?
I was twenty-eight when I first walked into Matthew’s room in the neurosurgery ward at the university medical center. A newly graduated physical therapist, I was working at my first job in the field. I was there to evaluate Matthew for physical therapy, and I had all the right gear–a white lab coat, running shoes, a stethoscope, a clipboard and a goniometer (an instrument that measures joint angles)–and an enthusiastic desire to help this young
Seventeen years ago, I was a senior psychiatry resident, moonlighting on weekends in the psych unit at a small rural hospital. Usually the unit was quiet. In this remote corner of northern Canada, we were taught to value resources and avoid “unnecessary” psychiatry admissions.
Arriving one rainy Friday, I headed to the ER to let them know I was there. Among the mostly frail, elderly patients, one person stood out: a healthy-looking woman in her
Doug Hester
Exhalations materialize in the dark as I walk
from the empty parking deck. I brew coffee,
then print a list–our census is up to thirty.
I grab my coat and start seeing patients:
the gastric bypasses, the nine ex-laps,
the psychotic panniculectomy patient,
and the bowel obstruction we are watching.
I page just before six to ask about his diet,
but you don’t answer me,
Kyle Bernard
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
Alan Blum
About the artist:
Alan Blum is a Professor and Gerald Leon Wallace MD Endowed Chair in Family Medicine at the University of Alabama School of Medicine in Tuscaloosa. A self-taught artist, he has published three books of his sketches and stories of patients, and his artworks have appeared in more than a dozen medical journals and textbooks. He is a frequent guest speaker at medical schools in courses in the humanities.
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Sudeep Dhoj Thapa
It was a summer night during my first year of medical school. Small bugs danced about the school buildings’ lights and filled the air with their penetrating hum.
In the television room, located across a small grassy lawn from the dormitories, I sat watching old movies with my classmate and friend Rajesh.
Rajesh was tall and chunky. He wore his thick, jet-black hair combed
Jeffrey R. Steinbauer
The snowstorm had started on Friday, before I’d gone on call for my group. At first I’d thought the weekend would remain quiet, that the small town where I practiced might just slumber under a fresh blanket of snow. But by early Saturday morning, things had gotten busy at the hospital. Several emergency-room visits, phone calls and admissions from the nursing home changed the stillness I’d felt amid the snowfall. In no
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