Page 228 – Pulse

What to Say When You’re Terminal

Leave a Comment / Stories / Ellen Diamond

Ellen Diamond

For the past fifteen years, I have had an incurable form of leukemia.

Such diseases used to be called terminal illnesses, but we don’t hear that term as much anymore. With all the new drugs and treatments available, doctors have become more reluctant to refer to diseases they can’t cure yet as “terminal.”

In the years just after my diagnosis, when friends and family would ask what could be done for it, I used to say that nothing could be done, adding: “It’s terminal.”

I was trying to be honest, to say, “Come now, we must face this.” People’s reactions of shock and sadness, though, made me wish I’d put it some other way. But what other way?

My father, who’d died of the same form of leukemia at age forty-three, had never known what he had. It was a secret my mother kept from him and from my sister and me–and as with many such family secrets, each of us paid a high price. So I wanted to be all about honesty.

I continued to use those words, yet they never felt quite right. I began to sense that there was a » Continue Reading.

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Now We Are Five

Spring, Summer, Fall and Winter

Behind Closed Doors

Leave a Comment / Stories / Sophia Lee Ryan

Sophia Lee Ryan

I’d prepared as much as I could: I had a huge coffee, a water and every kind of snack imaginable stuffed into my bag. In my head I carried as much information about dilation and curettage as I’d been able to absorb during a study session at Starbucks the night before.

I was a third-year medical student doing my obstetrics and gynecology clerkship, and I was about to spend a day at the local family-planning clinic. The clinic offers support to women on all aspects of contraception, from education and counseling to providing various methods of birth control or carrying out terminations. I knew that this was their OR day, so I’d researched some of the cases that I would see: early pregnancy failure, repeated fetal deaths, second-trimester abortions for congenital anomalies.

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Unsuspected Symphony

Leave a Comment / Stories / Jeremiah Horrigan

Jeremiah Horrigan

No one goes to a hospital to heal. They go because they must–as I did three years ago, when a one-hour colonoscopy turned into a four-day surgical sleepover.

My grandfather had warned me long ago against hospitals. “You don’t want to go there,” he said. “That’s where the sick people are.” Pop died at the age of ninety-four, at home.

His warning came strongly to mind as I walked into the place that I’ve come to call HospitalWorld. Silently, I replied: Hospitals are where the sick people are, all right. They’re also where the doctor people are. I have no choice.

I was fifty-nine years old, and, after years of foot-dragging, this would be my first colonoscopy.

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My Friend the Scholar Comes at Last to Attend His Father

1 Comment / Poems / Norbert Hirschhorn

Norbert Hirschhorn

He considered the wasted moult of a once
large, ferocious creature: mouth agape,
muscles twitching with every rattled breath.

Agapé–my friend the scholar marveled
at the homograph, and the thing that feasted
on his father. He laid a futon at the foot

of the high white bed, some books, a laptop,
a thermos. Nearby, an emesis basin,
dentures, bedpan, glass half-full of beaded water.

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The Story of Pulse

Leave a Comment / Uncategorised / Paul Gross

One Monday morning, a number of years ago, the administrators at the family health center where I used to work instituted a new and time-consuming procedure for registering patients. They did this in an attempt to satisfy the rules and requirements imposed by the many different insurance plans our center accepted.

There was just one problem: the administrators forgot to tell anyone what they’d done–not even the center’s medical director, who happened to be on vacation at the time.

As the clerical staff stumbled over a brand-new, complex set of protocols that day, a line of patients, mostly poor, snaked around the lobby, out the front door onto the sidewalk. Tempers grew short. A fight nearly broke out. We providers sat in the back twiddling our thumbs, waiting for patients to trickle into the exam rooms.

Finally, after an hour-and-a-half, enough patients had been registered so that the line could finally fit inside the lobby. The exam rooms were all filled, and the doctors and nurses were desperately trying to make up for lost time.

At that moment, the health center fire alarm went off–signaling one of our periodic fire drills.

Needless to say, it couldn’t have happened at a

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Cross-Examination

Leave a Comment / Stories / Paul Rousseau

Paul Rousseau

“I want everything done. Please, Dr. Rousseau, do everything. We have two children–they can’t be without their father. Do you understand? Do what it takes to keep him alive!”

Angie, a petite woman with long blonde hair, fixes me with piercing blue eyes. Her husband, Joe, fifty-two, has scleroderma, an autoimmune disease. In its most devastating form, it hardens the skin and destroys the kidneys, heart and lungs.

Joe is dying of sepsis and multi-organ failure in my hospital’s intensive-care unit.

“Please, do whatever it takes to keep him alive,” Angie pleads.

Suddenly, I am thrust into the depths of grief. Not hers, mine. It happens just like that–no warning, no nothing, just a painful inner quivering and the trickle of tears.

“I want everything done,” Angie repeats. Then she stops and stares at me. Her eyes look down at the table, then up at me again.

“Are you okay?” she asks.

“Yes, I’m fine.”

“I didn’t mean to make you cry,” she says softly.

“You didn’t. It’s okay. But let’s talk about your husband.”

“What’s the matter?” she asks.

Suddenly it’s I

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Desperately Seeking Herb Weinman

1 Comment / Stories / Steven Lewis

Steven Lewis

Minor chest pains that woke me early one morning–and which did not go away three, four, five, six hours later–landed me flat on my back at a local emergency room, a perversely comforting beep beep beep issuing from the monitor hanging precariously over my head.

Frankly, I didn’t really think that I was having a heart attack–as a former EMT, a devoted watcher of medical television, and a cultural cousin of Woody Allen, I’m ridiculously well versed in the symptoms of a myocardial infarction. However, after I’d endured a morning of chest pains at an age where all warranties have lapsed, it was prudent to go to the hospital. And since my wife was out of town–and my grown kids off with their kids–I drove myself over to the ER.

Once the wraparound curtain was pulled to protect my flimsy privacy and the EKG was recording electrical impulses in my thumping heart, I already felt a little better. And yet I had never felt more alone in my life. So alone that every time a nurse or med-tech appeared I tried squeezing megabytes of information into those swishing curtains of opportunity. I let each of them

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Palliative Care

Leave a Comment / Poems / Stacy Nigliazzo

Stacy Nigliazzo

When I cut the stem
I knew it was just a matter of time.

I cleared the sill
and filled a crystal vase.

The petals unfurled.
The smell of summer pierced my skin

for three days.
When the first leaf fell

I added lemon pulp and crushed
an aspirin;

cut away all that waned–
the shoots were spry

one last day.
I scattered them over green earth.

Flecks of pollen
stained my lips and cheekbones.

About the poet:

Stacy Nigliazzo is an ER nurse. Her poems have appeared in Pulse, JAMA, Bellevue Literary Review and the Cancer Poetry Project (second edition), and an upcoming book of her poetry will be published this fall by Press 53 (North Carolina). She is a graduate of Texas A&M University and a recipient of the Elsevier Award for Nursing Excellence.

About the poem:

“I was arranging a vase of Stargazer lilies when it occurred to me that they began the process of dying as soon as they were

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Stardust

Leave a Comment / Stories / Audrey Cortez

Audrey Cortez

Years ago I worked as a registered nurse in a busy surgical pre-admission clinic, preparing patients who’d been scheduled for surgery for the upcoming operation and hospital experience.

My workdays were packed with back-to-back, hour-long appointments. Whatever surgery the patient was facing–oral, orthopedic or anything else–every interview followed the same format. I would greet the patient, who’d often bring along a family member, and quickly escort them both into my small office, seating them in the stiff, outdated plastic chairs facing my desk. On the way, trying to save time, I would explain that as part of the pre-admission process I’d need to do a health interview and a physical assessment, get an accurate list of the patient’s medications, labs, X-rays, EKG results, etc., and also tell the patient various details related to the pending surgery and hospital stay. In that same hour, I also had to chart all that I’d done and make a chart for the day of surgery.

I tried hard to keep the interviews running on time while also keeping the atmosphere warm and friendly. Overall, I felt successful at striking this balance, except when I encountered my biggest challenge:

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A Reason to Stay

Leave a Comment / Stories / Ashish Massey

Ashish Massey

“Aren’t those decorations looking nice?” asks a soft voice beside me.

Startled, I turn to find a young woman wearing a red-and-white sari. Her head and face are swathed in the folds of the sari, leaving only the large red bindi on her forehead clearly visible.

We’re sitting on a grassy tuft amid a large campus green. All about us stand buildings with signs in both Hindi and English. Atop the central building waves an Indian flag, around which workers are hanging colorful garlands, tassels and lights.

“It looks very nice. What is it for?” I reply in Hindi, feeling that my accent must betray my American upbringing.

I am a fourth-year medical student. Two days ago I arrived here in New Delhi, after a sixteen-hour flight from New York City. Today I will begin a six-month fellowship working in pediatric oncology centers. It’s a chance to gain clinical experience working in places where resources are scarce–and it’s also a way to learn more about my ancestry and, in the process, about myself. My parents emigrated from India thirty-seven years ago, and my last visit was at age eight, nearly twenty-five years

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