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

A Different Kind of Miracle

Anita Fry

Once upon a time, I was a newspaper journalist: I chased down sources and sweated over deadlines. Then, in mid-career, I switched to doing marketing and communications for a regional healthcare system. This consisted of a large hospital and many outpatient clinics, including a community cancer center.

Because I handled communications work for the cancer center, I also had a seat on the Cancer Committee–an oversight group of oncologists, pathologists, nurses and other specialists, who met quarterly.

I found these gatherings a bit intimidating. My fellow members were welcoming, but they spoke almost entirely in acronyms and medical jargon–“OCNs,” “PET/CTs,” “staging,” “linear accelerators.”

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TheDyingWomansmaller

Dying Woman

Gary Hoff

About the artist:
 

I am Associate Professor of Medicine at the Des Moines University College of Osteopathic Medicine where I have taught cardiology for many years. My career as an artist runs in parallel with my career in medicine. My work is primarily in oils and consists of commissioned portraits as well as landscapes and still life.

 

About the artwork:

Dying Woman is a portrait of my mother during the last month of her life, as she was dying of metastatic lung cancer. The drawing is in an old medium called silverpoint, which was the method used by old master painters long before graphite. It allows a precise but unerasable line to be laid down, so that the artist’s unfiltered first impressions always remain. Over time, silverpoint drawings mellow from dark and harsh to golden, in the same way that memories can.”

 

Visuals editor:

Justin Sanders

 

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One Last Sale

Judith Reichtein

“Did you sell the business yet?”

I marvel at my patient Jack: despite his breathlessness, he’s somehow managed to greet his wife Sara with a complete sentence. Given his condition, it’s truly amazing. 

Most of his lung function has been devastated by his forty-year, pack-a-day smoking habit; the rest has been demolished by cancer. The easy, automatic breathing he once took for granted is just a memory. He can’t even lie down without feeling like he’s suffocating. Propped up on pillows in his hospital bed, he struggles for every breath–pulling it in, forcing it out–his brow creased in a perpetual frown of concentration. 

Sara and Jack have been married for thirty-five years, since before he took over his father’s small shoe concession and turned it into a thriving business. 

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Shattered

Kristina X. Duan

It was a Monday morning in Chengdu, the capital city of China’s Sichuan province. I was a premedical student who had traveled here from the U.S. to do a six-week summer term abroad at People’s Hospital, one of Chengdu’s largest cancer centers.

As the child of Chinese-born parents, I’d always felt a special fascination for my parents’ strange, captivating homeland. In college, I seized the first opportunity to pursue medical studies in China alongside native students. I’d found myself immersed in a healthcare system that was fragmented, corrupt and riddled with problems stemming from overpopulation and limited resources. 

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Saving My Appendix

Andrew T. Gray

The doctor was adamant. “This is America, not Sweden,” he told me. “We operate.” 

How did this happen to me? I wondered, looking at him across the ER exam room. How could I, a healthcare provider, not have insurance? 

I had woken up that morning with a mildly upset stomach. Nonetheless, I’d gone to my job (begun only six weeks earlier) as a physician assistant at a Beverly Hills HIV clinic. I’d seen patients until lunchtime, then attended a research meeting. The subject was a study of irritable bowel syndrome. 

“I need to be in this study,” I joked to a coworker. “My IBS is acting up.” 

I don’t have IBS, but I was indeed having crampy stomach pain. I continued to see patients until 3 pm, when the pain became steady: on a ten-point scale, I gave it a six. I left work early.

As I exited the building, my first thought was Freedom! I can get home early, relax, maybe take a nap…

Crawling into bed, however, I realized that my pain had coalesced in the right lower quadrant of my abdomen. Could it be appendicitis? 

Panic flooded me. After six weeks at my new job, I now qualified

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A Second Chance

Mitch Kaminski

My patient Maria sits before me, looking vaguely distressed.

She’s returned for a follow-up visit, six weeks after our first. The morning is half over, and I’m clipping along, staying on time, using the new electronic medical record system (EMR) without a glitch and with a sense of satisfaction. Three months back, when I joined this small-town practice as part of my new position as a health-system medical director, I found the EMR challenging, so I’m pleased that I’ve finally mastered it.

Maria’s face looks familiar–pretty, but with a worried look that matches her hastily applied makeup. 

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Soul Searching

Brian T. Maurer

Ply the scalpel, crack the vault;
Peel back the layers, parcel the salt:
Galeal, subgaleal, arachnoid place,
Dura mater, subdural space,
Lobus frontalis, sulcus centralis,
Corpus callosum, fornix, and rostrum,
Hippocampus, choroid plexus,
(Anatomy most sure to vex us)
Ventricles: first, second, third,
Cerebellum, stem and cord.

When we’ve exhausted the entire onion,
Tell me, what’s become of someone?

 

About the poet:

Brian T. Maurer has practiced pediatric medicine as a physician assistant for the past three decades. As a clinician, he has always gravitated toward the humane aspect of patient care, and for two decades he has explored the illness narrative as a tool to cultivate an appreciation for humane medical care. He has published numerous vignettes, editorials and essays in national and international journals, as well as two books, Patients Are a Virtue and Village Voices. He blogs online at briantmaurer.wordpress.com.

About the poem:

“Freud wrote that wherever he ventured in his scientific investigations of the mind, he found that a poet had been there first. Modern neuroscience continues to struggle to define the human mind by studying anatomical brain function. It occurred to me

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In Sickness and in Health

Larry Zaroff

Four months after having a knee replacement, I stumbled into the bathroom at three AM, not fully awake, hoping to urinate.

Losing my balance, I fell. The result was a compound fracture of my left leg–the one with the prosthetic knee. 

Gazing at my shiny white kneecap, I lost all logic, all control. I simply cried. 

At eighty, I was unprepared for this unexpected anatomy lesson: my twenty-nine years as a surgeon had simply not prepared me for viewing the inside of my own knee. 

It felt like my life was over. 

Fortunately my wife, Carolyn, a painter, four years younger than I, and without any orthopedic experience, took one look, said little, but acted.

She wrapped my naked bones in a clean towel and drove me to the emergency room. I had urgent surgery, with removal of the prosthesis, followed by a post-op period with no internal knee, organic or inorganic. Thus began my one-legged life, and what I now think of as Carolyn’s pre-widowhood.

After my discharge, because of the contaminated wound, I began four weeks of at-home intravenous antibiotics, then two weeks’ waiting to be certain there was no residual infection before I could be

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Bitter Medicine

Karen Libertoff Harrington

As a medical educator in a hospital setting, I often tell first-year medical students about disparities in health care and about the vastly different quality of care that hospitals deliver, depending on their resources. 

I tell my students how important it is to advocate for patients, to learn to navigate the healthcare system and to work respectfully with health professionals in order to get optimal care for your patients.

When my own son was hospitalized, I had an opportunity to put my teachings into practice, and found them wanting.

It was a Thursday evening in early spring, the first hint of green emerging on the lawn of my suburban Connecticut home. 

My son David called from Manhattan to say that he had a job interview the next day; he was going for a run before settling down to prepare. 

I sat on the deck, taking in the twilight and feeling hopeful about the future.

Five hours later, my husband Leo and I were hurrying to a Manhattan emergency room. The police had found David beaten and bleeding in Riverside Park. The park had seen more gang activity lately, and

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Escape from Chemo

Ellen Diamond

And while the stuff drips in, I’m rolling over
in my mind the two words: Kemo Sabe.

It’s the name that Tonto called his friend
the Lone Ranger, back in radio days.

I could use a trusty sidekick now,
crouched behind the white screen near the door,

ready in an instant to unsheathe
his blade, then back us slowly to the window.

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