Page 178 – Pulse

A Fine Man

I’ve been afraid twice as a result of my multiple sclerosis. The first time, I was twenty. As I sat down on the edge of the bathtub one day, the backs of my legs felt oddly cold–even numb. I ran to the library and looked up MS, and my heart began to race. Yes, odd sensations of hot and cold were among MS’s symptoms. Suddenly, I could see my future life as my grandmother’s–as that of someone who sat in a chair all day, used a walker and watched TV, not as that of the geologist I was studying to be.

My actual diagnosis came twenty-two years later, after I’d had three children and was embarking on a second career. By the time I received the news, I’d experienced enough incidents like the bathtub moment that I expected it. I wasn’t afraid then.

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My First Code

3 Comments / Stories / Jessica Greenberg

Jessica Greenberg ~

“Code Blue, Interventional Radiology suite,” blare the overhead speakers.

I am a new third-year medical student, doing my first rotation in internal medicine at Yale New Haven Hospital. This morning, I’ve been rounding on patients with my medical team.

The alarm sends us lumbering down the halls, struggling to keep our clogs from falling off our feet, clutching our white jackets to our chests to keep the pockets full of stethoscopes and pens and patient lists from bouncing.

Arriving in the IR suite, I stop about twenty feet from the middle-aged woman lying in the patient bed. More than a dozen physicians and nurses crowd around her, obscuring my view.

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battery of tests

3 Comments / Haiku / Amy Losak

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Hold Me

1 Comment / Afraid / Nguyet Nguyen

Wendy’s hoarse howling startled me. She was usually among the best-behaved, highest functioning residents in our group home for adults with mental challenges. But today I turned to see my colleague, Sandra, struggling to bring Wendy back to her room, while fending off her kicks and bites the whole way. I fought my own fear of getting hurt and ran to help.

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What If

2 Comments / Afraid / Catherine Pipas

I undo the front of the cloth gown and step closer to the menacing machine. The female technician gently lifts one of my breasts—usually she begins with the left—onto a cold, flat surface. I shiver as my warm skin reacts to the chilly metal. Then, the top of the machine slowly descends, pushing into the top of my breast, flattening it, and squeezing it until tears form in my eyes.

“Hold your breath,” the technician states.

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Working Without a Net in Kenya

1 Comment / Afraid / Bruce Campbell

The thirteen-year-old boy sits in a battered ENT exam chair. Henry, my Kenyan colleague, hands me a blurry CT scan. “His neck mass has grown for two years,” Henry says. “We think it is a glomus vagale tumor. Do you agree?”

I hold the scan up to a window. The vascular mass fills the side of the boy’s neck, displacing his carotid artery. “That’s probably right,” I respond. “At home, we would get more studies. We would prepare for bleeding. This kind of surgery can be very dangerous, even fatal.”

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The Care Piece

Leave a Comment / Health Care on the Line / Sarah Buttrey

He was in his younger middle years, generally well. Before he had a wife and kids, he had been a competitive cyclist, an Olympic hopeful. He stayed active, ate thoughtfully, took no medications. But in the mornings, first his hands and within months other joints would swell and ache terribly, refusing to move. His primary doc sent him to a rheumatologist because, based on his symptoms, it appeared that an inflammatory process was to blame. The rheumatologist ran tests and then more tests; all were negative, but she agreed–this was rheumatoid arthritis.

He was started on a medication that made him feel better. Not fully better, but generally able to get up and move in the mornings without significant pain, which he certainly preferred, and his life went on.

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Late-Night Calls

Leave a Comment / Afraid / Ronna L. Edelstein

Many things frighten me–from creepy-crawlers to turbulence on airplanes, from intravenous needles to walking across bridges over menacing rivers. However, late-night phone calls, especially from my family, send shivers up and down my spine. That is why I froze with fear when I received a call from my parents at 11 p.m. on February 28, 1986.

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Simple Acts

14 Comments / Stories / Dianne Avey

Dianne Avey ~

One night on my nursing shift in the cardiac intensive-care unit, I received a new patient from the operating room: an eighty-eight-year-old woman who had suffered a major heart attack and had just undergone emergency coronary-artery bypass surgery.

Her bed was wheeled into the room along with the usual accoutrements: six different IV drips, a ventilator, an aortic balloon pump and various other lines and monitoring devices. Her name, I saw on the chart, was Mrs. Green.

The young surgeon took me aside.

“I don’t care what it takes, just keep her alive for twenty-four hours,” he told me, clearly more worried about his surgical-outcome stats than he was about Mrs. Green’s welfare. The hospital and insurers kept data on these procedures; it didn’t look well for a surgeon to have too many patients die during or right after surgery.

“No problem,” I replied confidently and went right to work, adjusting drips to maintain her blood pressure, cardiac output and heart rhythm.

Despite my efforts, Mrs. Green’s health status remained very unstable. Her heart was extremely weak, and she showed signs of brain damage.

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Mosquitoes Don’t Know

7 Comments / Poems / Sandra Miller

Sandra Miller

Every evening at dusk
As the sun finally shutters its eye,
The mosquitos rise and sing
Their tiny tuneless song
Because mosquitos cannot know
They have only a few weeks to live and find us
They cannot grasp how we recoil
From their delicate voice and touch
Our skin surprisingly vulnerable
Our blood remarkably easy to invade

Maybe they enjoy the breeze and purple sky
As much as the rest of us
Unable to fathom just how slyly
They disperse the miniscule vectors of disease
Inside us

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summer migraine

Learning Respect

5 Comments / Stories / David Edelbaum

David Edelbaum ~

When I finished my medical training, almost sixty years ago, I was like many new graduates: I thought I knew it all.

I opened a private office in Los Angeles and paid courtesy calls on the local physicians to let them know my qualifications and my availability for consultation, as both an internist and a nephrologist. (The treatment of kidney disease was then in its infancy, and I was the area’s first such specialist.)

With a wife, two children under age four, a home mortgage and an office to support, I needed to make a living. I took call at the local emergency rooms, worked nights at the VA Hospital and told my answering service to mention my availability to other physicians who might need assistance.

One of the very first doctors I visited was Dr. Lud, a large, friendly, highly competent and respected family physician. His patients adored him, and if he asked you to consult on one of his cases, that was the Good Housekeeping Seal of Approval: It assured your standing within the medical community–and, of course, a steady income.

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