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The Pros and Cons of Living with a Terminal Illness

Ellen Diamond

Before I retired in 2000, I worked in a state agency as a peer counselor, or more formally, an employee assistance program (EAP) coordinator. The “coordinator” part was there because my job description wasn’t actually to do counseling; it was to assess the problem and refer the client for help.

But of course both of those processes involved counseling. We just couldn’t call it that.

In 1986, shortly after I’d begun the job, I was separately visited by two employees with HIV/AIDS. Treatments such as the antiviral drugs used so successfully today were nearly a decade away, and a diagnosis of HIV meant almost certain death. These clients were understandably upset and frightened, but they each made it clear to me that they were still feeling pretty good, though with ups and downs.

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Consult

Daniel Becker

Once the tube is out it takes her a minute to turn blue and relax. Another minute to lose her pulse. I learned as a student to feel the difference between the pulse in my fingers and the pulse at the patient’s wrist. Or thought I learned. When you listen for a heart to stop you start to hear heart sounds that might not be there. Like waking up at night thinking you heard something then listening to the dark to be sure, not quite convinced either way. Weak sounds, S1 and S2, valves closing. Slow and slower, regular then irregular, then almost nothing…then who knows? The monitor is off in her room but on at the nursing station. One screen shows every heart in the unit. I don’t want to sign the consult note until the line stays flat. Erratic electrical activity went on for a few minutes is an understatement. She’d be gone for most of the screen then come back for a complex or two then go away again.

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Famino - Baudino

Famine

 

Frank Baudino

About the artist: 

Frank Baudino has worked for more than three decades in family medicine, both as a primary-care clinician and as a teacher. “I am an avid believer in volunteerism, and the volunteer experience which affected me most profoundly was my six-month mission in Sudan with Doctors Without Borders. Photography is another of my passions, and I strive to make images that describe the human condition with compassion.” You can see more of his images at frankbaudino.visualserver.com.

About the artwork:

“Following twenty years of civil war, many of the Sudanese in the south were starving. The children were hardest hit. I was in charge of a therapeutic feeding center for children, where I encountered this mother and child as they waited patiently to be screened. Famine bears witness to the conditions of deprivation under which many of the world’s people live; it illustrates the suffering of a mother and her child in an environment that most of us could not imagine, and of which many are unaware.”

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Saving Grampa

Alia Moore

You were supposed to die of cardiac arrest as you circled toward home plate. Or of a brain aneurysm in the summer during one of your countless hikes through the mountains.

You weren’t supposed to die here. Not in a hospital bed, inhabiting this fragile new body, with an oxygen tube in your nose and tumors in your lungs.

Two days before you left us, I traveled home to visit you. I’d last seen you six months before, shortly after your eighty-eighth birthday. You were a lifelong athlete and adventurer, but you seemed just a little less spry than I remembered.

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Cover-up

Carol Scott-Conner

“The plastic surgeons tell me that women who like to swim do much better with reconstruction than with prostheses,” says a young breast surgeon at our weekly Breast Cancer Tumor Board, the working conference where we discuss every new breast cancer patient before starting treatment.

There’s a slight note of surprise in her voice; to her, it’s simply another consideration when advising women before mastectomy.

For decades, the only option after a mastectomy was a prosthesis, or breast form–something shaped and weighted to fill the empty cup of the brassiere and lie, more or less comfortably, against the chest wall. I sometimes tell my patients that using a prosthesis is a bit like going back to the days when we were little girls, stuffing our bras with tissues or old socks to fill them out.

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Young Warrior - Kern

Young Warrior

Tyler Kern

About the artist: 

Tyler Kern is a third-year medical student at UCLA School of Medicine. “In my free time, I enjoy nature and wildlife photography.”

About the artwork:

“I took this photograph in Tanzania, East Africa, while volunteering at a medical clinic in a rural Maasai village. I would pass this young Maasai boy on my way to work each day. While his outward appearance was calm, cool and collected, I felt his eyes told a different story. I saw in them a battle between innocence, confidence, insecurity and curiosity–which is exactly how I felt as I began my third year of medical school, stepping onto the hospital wards.”

Visuals editor:

Justin Sanders

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Lying in Wait

Rachel Hadas

Lying in bed and waiting for the purple
bruises to fade from my arms,
I remember the grinding pebbles underfoot
when I gave in to the muscular embrace of the ocean.
Now I rest in the wash of what has been accomplished.
A shallow golden river is pouring itself over stones,
over this empty husk, scooped shell of waiting
for transformation. Also transportation:
I need a fresh itinerary now
a dismantled world is being reassembled;
new map of stars I gaze at from the cool
tank of silence where I lie back, bathe,
and wait for the purple to fade.

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Getting a Grip

Raymond Abbott

“Ray, can you bring me some Poligrip?” says the message on my voice mail. “My teeth are falling out.”

I know Barbara means just her uppers, because she has no bottom teeth.

“I don’t get my check until Tuesday,” she adds. It’s now Friday afternoon.

I smile, thinking, Where does she think I might get Poligrip? Does she think I have a supply in my desk drawer?

The support staff, who have a lot of items, won’t have Poligrip. If I asked them for it, however, they too would smile.

Smile is the word you want to remember in this account, because Barbara makes me smile–and I especially value those who can do so these days.

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embrace - liu

Embrace

 

Jessica Liu

About the artist: 

Jessica Liu is currently a third-year medical student at the University of California Davis, where she serves as a codirector of the Willow Student-Run Free Clinic. “One of my favorite quotes is from Albert Einstein, who wrote, ‘The most beautiful thing we can experience is the mysterious. It is the source of all true art and science. He to whom this emotion is a stranger, who can no longer pause to wonder and stand rapt in awe, is as good as dead: his eyes are closed.’ Having a creative outlet while in medical school allows me to continue to stand in awe before the mysterious.”

About the artwork:

“The Willow Student-Run Free Clinic holds a weekly Wellness Night at the local Salvation Army, where residents of the shelter gather to draw, paint and meditate and, in so doing, release some of the stresses of homelessness. As I’ve sat down and painted alongside these residents, I’ve become witness to the powerful healing potential of the

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