fostering the humanistic practice of medicine publishing personal accounts of illness and healing encouraging health care advocacy

An Attachment to Gratitude

After my lumpectomy, I walked around with a sore arm but also with gratitude for my good report. I knew the pain would diminish as I inched my arm up the bedroom wall each morning, gaining strength and mobility. The sky would be the limit. Even though I was one of those one in eight women who receives a breast cancer diagnosis, gratitude was going to be my mantra.
 
That fresh start boomeranged as my arm became more and more swollen and I discovered I had lymphedema, a chronic condition that became an albatross I carried for over a year.

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Turning to the New

A former clinical psychologist and sailor, I’ve had myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) since 1990 and have been almost completely housebound, with both neurological and immune system symptoms, all of that time. ME/CFS is a serious, long-term illness that affects many body systems. While each year has come with more than its share of difficulties, this past year was loaded with extensive dental work, back problems, and extended voice loss (I also have muscle tension dysphonia).

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The Promise of Possibility

I excel at making excuses, especially when those excuses have to do with exercise. “I’m too tired” leads the list of why I am not outside walking or at the gym on the treadmill; “I’ll do it later” comes in a close second. Ironically, I consciously deprive myself of exercise, even when I know that I feel more energized when I do engage in some kind of physical fitness.  

From mid-April, when I ended the spring semester as a university teacher, until late August, when I began teaching again, I walked every morning for an hour. I either listened to the Broadway music emanating from my iPod or conversed with my colleague from work when she chose to join me. I came home feeling good—alive and eager to start the day.

Then, I returned to work—and to excuse making. As September gave way to October, Mother Nature provided me with wonderful excuses to stay home—rain, cold temperatures, strong winds and even snow and the possibility of icy sidewalks. I quickly returned to my couch potato life. 

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Doctor-Centered Care

“I realized with alarm that I hadn’t learned how to save anyone at all, not Dr. Sanders or Lazarus or Jimmy or Saul or Anna O., and that what I was thrilled about was learning how to save myself.” (House of God)

Two years ago my life drastically changed for the worse, and I faced an intersection in destiny. I chose the clinician’s path, knowing it is going to be demanding, hoping it will be satisfying. Life now is harder than I imagined, and every single day is a struggle. I live in a house that is no longer my home, and in a country that is no longer my own. Time has become my most precious resource, and yet the end-goal is vaguer than ever, even for a disciple of existential philosophy. Fighting to stay afloat, there is a light source, almost seen from my house: the hospital. There, constantly bustling with life, and occasionally death, stands the emergency department, young and proud.

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An Editor’s Invitation: A Fresh Start

The New Year offers all of us a chance for a fresh start–to look at things differently, to act differently, to try new things or to take on old issues in a new way.

Illness can be an invitation to a fresh start. As we slog through the muck of sickness, it’s tempting to strike a deal with the powers that be: When I recover from this, I’m going to start taking better care of myself.

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The Best Storyteller Award


Daniel Becker ~

At the clinic retreat everyone gets a prize,
and the Best Storyteller reminds us of those times
a man goes on a journey. Not just any man: Dr. William Osler,

the doctors’ doctor, the professors’ professor, the textbook author,
and this Canadian in Philadelphia crosses the Delaware to Camden
where Walt Whitman, the great American poet, the poet’s poet,

endures fame and poor health.
Every case is supposed to be interesting, but Whitman,
according to Osler, suffered only from what his age could explain

plus or minus the usual slings and arrows,
the wear and tear of gravity,
the side effects and worries,

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BLUM mombabe

The Mother and Babe

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. Many of his sketches have appeared in Pulse. He is a frequent guest speaker at medical schools in courses in the humanities.

About the artwork:

“From my first year of medical school until the last day of my family-medicine residency, I kept a visual diary, filling numerous notebooks with clinical vignettes, stories patients shared with me, scraps of overheard dialogue and pasted-in sketches of my patients in ballpoint pen on index cards or prescription pads with pharmaceutical advertisements. This is one of the sketches from more than seventy binders I have filled throughout my career.”

Visuals editor:

Sara Kohrt

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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 a tentative “Hello….”

I muted the TV. “Can I help you?”

More silence, then I heard a woman’s voice uttering inarticulate sounds.

“Who is this?” I asked. “Are you looking for the doctor?”

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At the Flick of a Switch

“I want to do something now. What can I do?”

My mother’s body and mind were restless, moving in their own patterns just like the gray, low-hanging clouds that morning in August. “Why don’t you tell me what you want me to do?”

She didn’t wait for my response but shouted, “Don’t you dare tell me what to do, I’m not a child!” while pounding her cane on the floor with such might that I could feel the vibrations in my stomach. Then she sank into her chair and fell silent, her eyes glazing over.

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How to Fire Your Doctor

Look your doctor straight in the eye. It’s okay to smile. Or not–it’s your choice.
Don’t mince words. When your doctor says, “I’d like you to try this prescription…” (or physical therapy or whatever) “…and come back in three months,” that’s your cue. By all means take the prescription, or the referral sheet, and then say, “I won’t be coming back. I’m going to look for a new doctor…”

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