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Latest Voices
Good Story!
My patient complains of chest pain a few days ago while mowing the lawn. He has no chest pain today, but his story is so good I decide to order an EKG, bloodwork, and some other tests. I start running the differential diagnosis algorithm in my mind; sometimes, a patient history is all I need to make a diagnosis.
Inner Duality
If you have ever been in therapy, you likely discovered that while you share personal details about your life, the therapist reveals little information about theirs. From my understanding, when and what to disclose is part of a therapist’s training. In contrast, in medicine, relatively little about self-disclosure is taught. Instead, it is up to the individual to figure it out on their own.
Christmas at My Place
I turned back to look at him only once, that insane parody of Jesus on the rood, his face turned away in death, arms stretched wide, a small white towel draped over his manhood. I stood there in the E.R. covered in the blood he’d spray-painted me with as he lay dying from a gunshot wound to the chest. Blood spray in my hair, my eyelashes, on my lips and in my mouth. My new white shoes with the stylish aerating holes, also bore the shocking red of a life too soon ended.
Not Such a Tough Call
Earlier this year, my beloved family practice doctor retired. Over many years, I had had ample opportunity to appreciate his diagnostic skill, his professionalism and his kindness. Moreover, I felt I could always trust that he would respect my wishes. I had a real partner in my health care.
Rising to the Occasion
Ma lived a blessed life: more than six decades of marriage, two professionally successful children (a physician and a teacher), and three wonderful grandchildren. Yet, these gifts mattered less to her than her forty years working in a baby/children’s store. When health issues forced her to retire at age eighty-two, she lost her heart and her spirit. Ma spent the days in her old recliner, wearing only a tattered white T-shirt and equally torn white underwear. She only got up to use the bathroom and wander the halls of her apartment building at night.
October More Voices: Tough Calls
Dear Pulse readers:
When I was about twenty years old and living in New York, I wandered into a men’s clothing store on Canal Street. There, an army jacket caught my eye. I liked it right away. It was stylish–in a counterculture-rebel sort of way–and I decided to try it on.
It fit perfectly.
The only problem was, it cost more than I wanted to spend.
A Good Psychiatrist
“Do you want to be a good psychiatrist?”
When Dr. G posed this question to me, I was a senior medical student on the last day of a month-long elective on the inpatient pediatric psychiatry unit. I knew by then from Dr. G’s teaching, and from his demeanor, that his questions were often not questions. They were, instead, buckets, drawing from the dark wells of patient stories to make the unknown known, the unseen seen.
Skin Rash
Being a child of medical parents brings special challenges. For example, such children grow up with a unique idea of appropriate dinner conversation. When I exclaim, “Guess what I saw at work today!” my children interrupt to inquire if my story has blood or something “gross” in it. And they regularly yell, “HIPAA!”—a reference to the federal patient privacy regulations—even though I always deidentify patients.
Bedside Manner
Boundaries, respect, culture and personality are all parts of bedside manner. Boundaries and respect are, ideally, reciprocal between physician and patient. I want to project warmth, humanity and concern but I don’t want to burden my patients with my fears, frustration and anger.
During a delivery of a young woman of her first child, she said to me “You look really scared. Are you okay?” I had just found a concerning fetal heart tracing, and my bedside manner was not helpful to her. I quickly tried to rearrange my face.