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Heroic Measures

Gil Beall

“Doctor! Doctor! He’s stopped breathing!” the stout woman shouted, clutching at my white coat. 

It was 1953, and I was a first-year resident responsible that night for the patients on the medical ward–including those in the four-bed room the woman pushed me into. 

There I saw a melee taking place around a seventy-year-old man with chronic lung disease. 

The man had been examined and admitted that evening by my colleague, who’d given me what little information he had before leaving for the night. 

The man had been too absorbed in his breathing to talk much. We’d hooked him up to an oxygen tank and started an intravenous infusion of the bronchodilator aminophylline, which brought about modest improvement. We couldn’t think of anything else to do and agreed that his prognosis was poor. 

Now I found him unresponsive and surrounded by frantic family members. Someone had knocked a vase off the nightstand, and the floor was littered with broken glass and roses. 

Listening with my stethoscope, I thought I could hear heart sounds, but his chest wasn’t moving. And my informant was correct: He wasn’t breathing. 

But, I thought, he is not dead. I had to try to revive him.

Nowadays, » Continue Reading.

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Cardiography

Norma Smith

How the electrical impulse
begins in the small part
of the heart and provokes
the pumping
of the necessary

fluid, which will carry everything
we need
to live, everything
we can’t do without
those impulses
carried forward,

Carried down, 
around this body’s desire
to liveand move/about
a spark
in a small place.


About the poet:

Norma Smith has lived and worked in Oakland, California, for the better part of forty years. She has worked in hospitals her entire adult life, including a few years as an EKG monitor technician in an intensive care unit.

About the poem:

“This poem was written during the period leading up to my mother’s death from heart failure. I love how the body and its physiology lend themselves to metaphor, and how a line of poetry can illuminate that and help us see the whole person, the whole life, even as we’re focused on the body’s functioning in the moment.”

Poetry editors:

Judy Schaefer and Johanna Shapiro

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Stepping Back From the Edge

Bill Ventres

I can walk.

It’s not pretty. It’s not easy. It’s not without assistance. But I can walk.

Six weeks ago, I wasn’t able to walk. A few days before that, I’d begun a visit to the city of Antigua, in Guatemala, and was enjoying its colonial ambiance with friends.

Then, after a brief bout of sore throat, I contracted Guillain-Barre Syndrome, an autoimmune disorder that afflicts the peripheral nervous system. My body’s defense system, its antibodies triggered by the offending virus, had decided to attack the nerves in my arms, legs and trunk.

Upon awaking at 7:30 am on November 2, 2011, I could barely get out of bed. On rubbery legs, I made my way to the bedroom door to call for help. Six hours later, I was 99.9 percent paralyzed from the neck down. 

In twenty-five years of practice as a family physician, I had never seen a case of Guillain-Barre. And in all honesty, I couldn’t remember any statistics associated with the illness, such as the fact that it affects about two in 100,000 people. I only remembered that it came on quickly and could have devastating effects, which I was experiencing already.

The consulting

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Natural Selection

Jeremy Shatan

By the time my wife and I reached Hospital B’s exam room, early in the afternoon, we’d already put in a very long day. 

Across the room, which was no bigger than a galley kitchen, stood three doctors. One–I’ll call him the Chief–was the bearded, bushy-maned head of the pediatric oncology program. His explosion of salt-and-pepper hair made a startling contrast to his posh British accent. With him were Dr. Transplant, a small, kind-faced woman who specialized in bone-marrow and stem-cell transplants, and Dr. Nice, a genial young pediatrician with a Midwestern accent.

We were there with our fourteen-month-old son, Jacob. A week earlier, he’d had brain surgery at one of the city’s internationally recognized medical institutions. It had revealed a malignant brain tumor.

As my wife and I talked with the doctors, we struggled to wrap our heads around all the new terminology and medical professionals we’d encountered upon entering the world of childhood cancer. Meanwhile, as his grandmother watched, Jacob explored the books and toys in the hospital’s well-stocked, sunlit playroom. He was happy to be out and about after

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Witnessing Consent for an Autopsy

Patty Bertheaud Summerhays

“They just cut the abdomen like an operation, look in and sew him up. No one will know.”

I know the inside story–the body parts,
the heart, brain, liver, lungs,
kidney, spleen, bowel, and bladder
sliced on a cutting board
like loaves of bread.
The coroner donning a butcher’s apron
splattered with blood from the last
scrape of blade over bone,
slipping off the scalp like a mask.
The eyes stopping him 
like the end of sentences until
he doesn’t feel the frown of brow–
anger as he drills to its roots.

Emotions leaving both men
with a grasp of brain.

A slice of brain placed in formaldehyde
jiggles like a thought trying to collect its thoughts.

Every organ shredded and a piece
saved until the jar is filled with
a body of its own.
The leftovers gathered 
into a plastic bag and placed
back into the body
like a well-kept secret.

A secret longing for a slip
of the tongue.

About the poet:

Patty Bertheaud Summerhays received her MFA in poetry from George Mason University in 1991. She worked as an intensive-care nurse in hospitals in the northeastern U.S. and as a nurse and ESL teacher

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Cracking the Code

Zohar Lederman

I am a medical student in Pavia, Italy, doing my fifth year out of six. It is summertime, and, as I’ve done every summer for years, I’ve returned to my small hometown in the south of Israel. There, among other things, I volunteer as an emergency medical technician (EMT) with Magen David Adom, the Israeli Red Cross. 

It’s 7:30 on a Friday morning. I’m at the Red Cross office, talking with the paramedic and a doctor, when a young volunteer runs in. 

“There’s a car pulling up outside–they’re bringing an unconscious patient!” he says.

The paramedic goes to get the advanced life support equipment, and the doctor and I quickly go out to the car. 

The patient, a pale, eighty-year-old women, sits in the front seat. Her family says that she complained of chest pain, so they drove her here. She lost consciousness on the way. 

We whisk her out of the car and begin chest compressions right there on the pavement. The equipment arrives almost instantly, and we have plenty of staff and volunteers around to help perform CPR. Even though

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Pained

Remya Tharackal Ravindran

The light from my pen torch strikes the steel-blue eyes of the patient lying before me. Her pupils stand wide open and still.

My pager’s shrilling pierces the quiet. Fumbling with the buttons, I read the message: “Call 7546 STAT.”

It’s my first rotation on the floor as a new internal medicine resident. I dial the number, various possible disasters bubbling through my head.

“The patient in 723, Mr. Martini, is complaining of severe abdominal pain,” says a nurse’s voice. “The day-shift resident ordered one milligram of morphine, but he refused it. I want you to come and evaluate him right away.”

“Can you give me two minutes?” I ask. “I’m in the middle of doing a death pronouncement. Is he otherwise stable?”

“His vitals are fine. But don’t take long. He’s driving me crazy.”

Moments later, hurrying to Mr. Martini’s room, I grab his chart from the rack. Mr. Martini, fifty-six, was admitted earlier today for abdominal pain. Presumed diagnosis, inflammation of the pancreas. He’s suffered from alcohol-induced pancreatic inflammation before. He’s also had surgeries on his back and knees.

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Escape to HuHot

Jennifer Frank

Hunched, shriveled, pinched
Enclosed in the metal prison of the wheelchair
You long to be free, unencumbered
By the oxygen tube connecting you to life

Each visit with me brings worse news
Creatinine up, red cells down
Carbon dioxide rising, oxygen falling
You have a medication deficiency

Once you were adventurous
Living life on the edge
For your generation,
You defied expectation

Now you are ending like
Everyone Else.
Hospital-home-hospital-rehab
Home-hospital-nursing home
Death is next

Your passions now are distilled into
Shopping at Walmart 
Lunch at HuHot Mongolian Grill
I have never been

While I recite the monotony 
End-of-life care
Advise hospice
Encourage compliance
Lecture about smoking
Offering nothing you want or desire

I imagine
Casting off the tubes
Tossing the meds
Lifting you from the prison-chair
Offering you my arm
As we escape to HuHot

About the poet:

Jennifer Frank recently transitioned from academic practice to full-time clinical practice with ThedaCare Physicians in Neenah, Wisconsin. “I write, in part, to help process the often difficult emotions that accompany being a family physician. It is a way to honor my patients and

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Crafting My Own Safety Net

Nicola Holmes

As I guide my car through the evening traffic, I feel tears on my cheeks.

I am a doctor who plans ahead: I write out plans for my patients. This has led to my nickname, “Plan Doctor.”

Each of my consultations is carefully crafted in separate steps. The conclusion is laid out in my own neat copperplate handwriting on a plain white page. (My father taught me to write copperplate. For hours every evening I would copy stencils of words he’d written out. At the time I felt persecuted; now each day, as my writing flows, I marvel at his wisdom.) 

Each plan leaves the room with the patient, melded with his or her hopes. It is real–you can hold it in your hand. Some patients tell me they put their plans on the fridge; once an elderly lady brought in a crumpled one dating from nine years earlier. 

I always share plans A and B with my patients and hold plans C and D in reserve. The plans are clear, unambiguous. I put in time scales: “review in 5 days if still has

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First, Do No Harm

Alison Block

It’s one of my earliest memories: I’m wrestling with my brother, and I’m losing, because I’m five and he’s seven, and he’s bigger and stronger than I am. So I bite him, hard.

Instantly I know I’ve crossed some sort of line, and I employ my most primitive defense mechanism, shouting out, “He bit me! Jon bit me!” I feel shame, because I am old enough to know it is wrong to hurt people–and to lie.

Some years later, I am accepted to medical school. I go to the first ceremony of my medical career–the one where I get my short white coat–and I take a modernized version of the Hippocratic Oath. I will try to do the best I can for my patients, and I will recognize the awesome responsibility that it is to care for other human beings. I notice one thing is lacking, though–the often-quoted phrase “First, do no harm.” The sentiment is there, but the words are not. I don’t make too much of it.

I spend two years sitting in class learning about various -ologies, and then I take an eight-hour test, the national board exam, to prove that I’ve learned something. I

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Finding a Way Home

Erin Imler

Preparing to assemble my new bed, I open the wordless instruction manual. The first page shows a picture of a single stick-figure standing there, hands on hips, and sadly regarding a bungled, not-put-together bed; the next image is two happy-looking stick-figures standing with their arms around each others’ shoulders, looking at a successfully constructed bed.
Despite the warning, I’m determined to do this by myself. For almost four years, I’ve slept on my couch, preferring it to my twenty-year-old mattress. Now that I’m starting a new job in a new city, it’s finally time for a new bed.
As I put it together, I can’t help but think back on my first real job as a family doctor–a post in rural northern California, working at a mobile clinic serving a predominantly homeless population.
I’d come there at age thirty, eager to experience real-life medicine outside of academia.
One of my

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Please For Tonight

Andrea Wendling

Please for tonight
Just be my wife
She is my life, my center,
She is what makes me whole
And I am finding I cannot exist
Without her

Smell like her
Like hayfields after a day of hard work
lavender and milk baths
Warm breezes blowing through still forests
All of this mixed with the soap
That we shared
That now too slowly disappears

Touch me like she would
Like I belonged to her
Slow, steady, without surprises
Know instinctively when I need to be calmed
And understand when I need 
Your lips, your touch
So desperately that I cannot
Live in this skin
Without you

Feel like she does
Strong and slight
Your skin rough in places
Melting into my touch in others
Pull away from my lips
Yet fill my mouth
Your cross brushing my chest
As you rise above me

Melt into me
Sighing softly
Never talking
And for that moment
Completely believe
That I will simply 
Always be the one

Please for tonight
Become my wife
And help me to feel again
That my life is complete.

About the poet:

Andrea Wendling is a rural family physician in northern Michigan. When not writing poetry,

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