Page 236 – Pulse

Conundrum

Leave a Comment / Stories / Matthew Hirschtritt

Matthew Hirschtritt

Walking from an exam room to the nurse’s station in the small outpatient clinic where I worked as a second-year medical student, I paused by a window to gaze out at the winter sunset. After a moment, I looked down to scan the notebook where I kept my schedule and notes for my last patient of the day.

4:15, Ms. Smith, 26, lump on groin–the bare bones of a story waiting to be filled in.

Feeling tired and looking forward to dinner, I sighed dramatically, dropped into a chair in front of a computer console and called up Ms. Smith’s electronic health record.

Like most medical records, it was divided into tabs that reflected the parts of a medical history–“Past Surgical History,” “Medications,” “Allergies,” etc.

I clicked on the tab labeled “Problem List.” Up popped a staggering collection of diagnoses, from diabetes, hypertension and high cholesterol to kidney failure and dialysis.

Yikes! I thought. This isn’t going to be easy.

In the eighteen months since I’d started medical school, I’d seen quite a few patients with multiple chronic conditions. For the most part when » Continue Reading.

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Mementos and Memories

Leave a Comment / Stories / Paul Rousseau

Paul Rousseau

Delores sits tilted to the right in a worn wheelchair, a curtain separating her from a sleeping roommate.

She is wearing a blue blouse stained with something orange, perhaps Jell-O, and white pants and white socks. A worn gold wedding band adorns the fourth finger of her left hand. Her hair is a shiny gray, perfectly coiffed, and her face is etched with deep wrinkles, a testament to eighty-nine years of life.

A tiny bedside shelf displays two faded black-and-white photos from the 1930s or ’40s: one is of Delores in her twenties, a demure smile on her face; the other shows Delores with a young man in a bow tie–her husband.

A greeting card sits nearby, almost falling off the shelf; its front shows a tree with beautiful, gold-glittered leaves, an old-fashioned style rarely seen today.

Since the card is propped open, I read the scribbled note: “Love you Mom. Miss you so much. See you next week. Anna.”

I walk over to Delores.

“Hi Delores, it’s Dr. Rousseau.”

She looks at me blankly, as if I’m of no more consequence

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The Irony of Being a Student

1 Comment / Poems / Cole Sterling

Cole Sterling

True difficulty lies not
           In school, or staying involved,
           Or scoring well on tests.
Time and dedication are mandatory.
Everyone can distinguish black from white,
And everyone can sculpt something from clay.
           But being able to paint the empty spaces with color,
           Fill the cracks with laughter and passion and spirit–
           Such an art is easily forgotten,
           Or easily ignored.
Rhodopsin alone could suffice for reading resumes,
So why waste the time developing a genuine heart?

True difficulty lies
           In learning when to slow down–
           When to surrender yourself to life’s passions and wonders,
           When to paint or skydive or even just breathe.
           When to enjoy whatever you have at this very moment.
True difficulty lies
           In knowing how to balance the scales–
           How to reach the success found in monochromatic TVs
           Without chewed-up cuticles and tightened shoulders,
           And a cast-iron soul.
Indeed, true difficulty lies
           In trusting yourself.
           Trusting that becoming the person you’ve always dreamed of being
           Is far more important than reaching the position you’ve always dreamed of having.
           Trusting that the path toward finding yourself
           Will always

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On the Bottom Rung

Leave a Comment / Stories / Jordanna Platt

I was in my third year of medical school, and the initial week of my first-ever hospital clerkship had passed without incident. I showed up on time, did what I was told, stepped on no toes and followed my patients as well as I could.

At the close of that week, however, my intern pulled me aside to ask, “Remember learning how to put an IV in a mannequin during the workshop earlier today? Well, there’s a patient in radiology, waiting for a CT scan. The tech can’t flush the IV, and I need you to do it. If you can’t, put in a new one.”

Tech? Flush? I meditated on my intern’s words and realized that this would be my first unsupervised procedure.

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A Passage in India

Leave a Comment / Stories / Justin Sanders

Justin Sanders

“It’s cooler this morning,” I said to Seema, as we left the hospital grounds en route to our home visits.

It was a bright and bustling morning in Trivandrum, the capital of India’s southwesternmost state, Kerala. A third-year resident in family medicine, I had come here to work with the staff of an Indian nonprofit devoted to advancing palliative care services across India. Seema was a young, newly qualified junior doctor who had only recently joined the organization. We were traveling with five others–our driver, two nurses and two nursing trainees–into the mountains east of Trivandrum for the day.

“We don’t really speak about the weather like you do,” Seema gently chided. “In the West you spend lots of time talking about the weather.” As I silently ceded her point, she consoled me: “I think you have more variety to your weather. Here it is only hot, very hot, or cold and rainy. Most people carry an umbrella because it’s useful in any of those cases.”

I counted the passing umbrellas as our van carried us into the foothills on our way to Palode, a village where we would hold a small outpatient clinic before making home visits.

After the

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First Visit

Leave a Comment / Poems / Allan Peterkin

Allan Peterkin

He told me
in passing
somewhere in the list
of bad luck and
bad choices
all the things
that had somehow
brought him here

This telling
was so soft
as to be dream-like
that
she had
fallen
off a ride
at the county fair
on a day he
was trying to be her dad
Didn’t make it
was all he said
then moved on
to the next wreck
(the first divorce)

I didn’t ask
what I wanted to
how old
was it a rollercoaster
how?

This
one thing
carried
all the weight

This
is where
I put my pen down

Where I looked in his face
and found something
other than pity.

About the poet:

Allan Peterkin is a Toronto doctor and writer. He heads the Health, Arts and Humanities Program at the University of Toronto and is a founding editor of ARS MEDICA: A Journal of Medicine, the Arts and Humanities.

About the poem:

“The inspiration for the poem came from a newspaper clipping about an accident at a fair where a young girl fell off a ride. I started thinking

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Hospital Librarian

Leave a Comment / Stories / Pam Kress-Dunn

Pam Kress-Dunn

Some people seem surprised to find a library in a hospital. But it’s here, and so am I. Having been a librarian in lots of different libraries–public, academic, archival–I jumped at this job when it opened up. Little did I know what I was getting into.

Like many medical librarians, I work solo. I do have a volunteer who, despite being decades older than me, works tirelessly during the two days a week she’s here. But I’m the one who does the lit searches, tracks down the articles in medical journals and finds the piece of information the doctor requires before the surgery that’s scheduled for noon.

My predecessor told me about his most harrowing moment: A surgeon needed information–stat!–and it was available only from a journal our library didn’t carry. So he placed an interlibrary loan request, marking it “Urgent: Patient Care.” When the article came through on the fax machine, he read it aloud over the phone to the surgeon, who was standing in the OR as a nurse pressed the receiver to his ear.

I’ve had my own anxious

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Little Lady

Leave a Comment / Stories / Samyukta Mullangi

Samyukta Mullangi

Growing up, I was the one thought to be the most squeamish about medicine–the needles, the knives, the musty smell of alcohol swabs and the rusty stench of blood. Whenever my mother, an ob/gyn, talked on the phone with her patients about menstruation, cramps and bloating, I’d plug my ears and wish for death by embarrassment. Once, standing in line for a routine TB test, I had a friend pull up a chair for me “in case you faint.”

So my entire family thought it hilarious when I decided to go to medical school.

“You know that residents practice stitches on each other, don’t you?” my cousin teased.

“Consider real estate instead,” my grandmother advised.

In deference to her, I actually did go and obtain a real estate license. But I also persevered in the pursuit of medicine. So much about the profession appealed to me: the intellectual challenges; the lifelong learning; the intimacy found only in a doctor’s office. Born into a family of physicians, I’d had a glimpse into their working lives that most people don’t get, and I deeply valued what I saw.

My first hurdle in medical school, of course, was anatomy lab.

Four

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ICU

Genuine Touch

Leave a Comment / Stories / Jonathan Gotfried

Jonathan Gotfried

I was a medical student doing my fourth-year rotation on the oncology floor. The floor offered many new sights, and from the first, I was struck by the two mammoth massage chairs sitting in a corner at the end of the longest corridor.

Their exaggerated curves were plastered with jet-black faux leather adorned with stitching details. Long, smooth armrests of oak jutted out on either side. The remote control was a virtual supercomputer offering thousands of programs designed to enhance one’s massaging pleasure–kneading, fast, pressure, heat, full-body massage. On either side of the plush headrest, strategically placed speakers would play soft classical music, drowning out the low hum of the motor that powered the massage. Proudly, the label on the back declared these to be “Genuine Touch” massage chairs.

“These chairs were purchased to make the patients’ experience as comfortable and pain-free as possible,” explained my supervising physician on my first day there.

Other attempts to help ease stress and pain were everywhere. An acupuncturist sometimes joined the teams of doctors, nurses, therapists, psychologists and pastors. There was a daily prayer group, and teams

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Unresponsive

Leave a Comment / Poems / Addeane Caelleigh

Addeane Caelleigh

Do the trees, like us, dream
of falling, falling into the earth’s flat embrace
or share the lilies’ dread of being ripped
from the dark earth,
ungrounded?

Maybe they are more like my friend Annie,
who dreams of being on stage naked
but unembarrassed,
continuing her favorite lecture
to the unseen watchers beyond the lights.

I hope my mother, who has been sleeping so long,
is like my friend,
unafraid and doing what she loves,
with no fear of being ripped from life
or falling into the void.
I hope that somewhere beyond the tubes
and beeps and the clasp of my hand
her true self stands, with the trees,
looking ahead.

About the poet:

Addeane Caelleigh works on issues of accreditation and curriculum at the University of Virginia School of Medicine. She is also senior editor of Hospital Drive, the school’s online journal of literature and art.