“If we are in an end-of-life situation, can I be with him?” I asked Lisa, the veterinary technician. She’d brought Alex, my springer spaniel, to my car after his oncology re-check.

COVID protocols had upended vet appointments. I’d park in a numbered space and text the receptionist. A tech wearing PPE fetched Alex. I’d wait in my car for the oncologist’s call, praying for continued remission.

“He looks good; I don’t find anything of concern,” I’d hear, and breathe relief. But as the months since chemo went by, the possibility of recurrence grew. The prospect of not being present to say goodbye, for Alex to feel safe and loved to the end, haunted me.

“Yes, we do allow clients to come inside then,” Lisa answered.

Prior to COVID, the waiting room overflowed with somber pet parents cradling grey-muzzled dogs; dogs with shaved abdomens, amputated limbs, or coats moth-eaten from chemo. So much innocence and vulnerability, love and fear. I’d feel guilty witnessing these sad tableaus, when Alex’s report read, “No evidence of disease.”

During his year-long treatment, I’d come to know the oncology staff. I wondered how they coped, day after day, treating pets with life-limiting illnesses, knowing that each case » Continue Reading.

One of the most interesting aspects of being an ophthalmologist is the daily need to interpret what patients say they see.

Is it a flash or a floater? A gray spot or a fuzzy, broken line? Perhaps a shining area in the upper corner of your vision? Or maybe two images side by side? And what does “blurred vision” mean to any given person? 

Walking to the clinic, I pass a school where children gather in their crisp school uniforms. I admire their superhero lunchboxes, beaded purses, and colorful barrettes; I notice how tightly the younger children hold their older siblings’ hands. Next I pass an abandoned church, with stained-glass windows that shine on a sunny day, with wildflowers and weeds covering its front yard, with its earth-colored stone walls.

Arriving at the clinic, I admire my patients’ homes, standing out boldly among the drug houses. They are painted bright colors, and many have yards full of flowers and vegetables. One of my patients, in her bathrobe and slippers, is sweeping her front steps as her obese cat sits on the stoop, observing the scene and obviously not impressed. Even though she lives across the street from this clinic, she prefers to see me at the downtown office, so she can stop by McDonald’s on her way. Where else can she get such a large meal for so little money? I suppress my worries: Is her blood sugar in the 400s? Is her blood pressure still elevated? Did she see her cardiologist? Instead, I chat with her about her cat and her ailing back

“Estoy cansada,” my client says as she drops onto my couch, settling herself inside the dip that holds her body every week.

I close the door to my therapy office and sit across from her. “I’m sorry you are tired, Anita. Tell me about your week,” I say. Then I sit quietly until she is able to focus.

She tells me that she sleeps all day, that her body hurts everywhere, and that her adult son never visits her despite the sacrifices she made to keep him fed and clothed growing up.

“You are a good mother,” I say. I know this because she also tells me stories about him—how happy, polite, and generous he is with others and how much they laugh together when he calls her on the phone on Sunday afternoons. I sit in silence, waiting until she looks up at me, her lip quivering.

With a crisp gesture, sharp as the crack of a whip, the nurse sends the curtain rings skittering along the track, separating the bed on one side of the room from the other. The doctor does it more sedately, pulling the curtain along as if walking an aging dog, chatting to calm an anxious patient as she does. Either way, the object seems to be patient privacy.

Even when the curtains are drawn tightly enough to prevent a sliver of a glimpse of the person within, the task inevitably fails. There can be no real privacy when a few squares of linoleum and a few yards of fabric separate one bed from its neighbor. Without distance or density to muffle sounds, a discrete murmur directed to one patient easily reaches another.

As someone who has spent a few nights in a hospital bed, am I dismayed or outraged that patient privacy is a polite illusion? In theory, perhaps. In reality: Hell no.

The tedium of confinement sharpens the appetite for distraction, and hospital stories can be particularly tasty. I’ve heard police question a woman about how she landed one bed over from me. Turns out, a would-be boyfriend, spurned and angry,

I treat a lot of patients with multiple disabilities, like cerebral palsy and epilepsy, so things get complicated when they are admitted to the hospital. The parents have to deal with multiple rounding teams who come into the room at unpredictable times.

One such parent told me how she had solved the problem of dealing with surgeons who would not answer her questions. Her child’s surgeons often rounded at an ungodly hour in the early morning when no one was awake, spent a few minutes in the room and then moved on. By the time the mother was awake, the surgeons had left.

So, she figured out a strategy. Once the surgeons came into the room, she closed the door and stood in front of it. The surgeons could not leave until she let them out, and she would not let them out until they had answered all of her questions.

I have often recommended that strategy to other parents. By the way, it also works with rounding teams from other specialties.

David L. Coulter
Natick, Massachusetts