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Past Medical History

Donald Stewart

My career in medicine began when I was three years old.
Holding tightly to my father’s hand at the end of a dark hospital corridor, I couldn’t keep up with the heavy, sibilant stream of conversation flowing between Daddy and Dr. Mashburn, the man who had delivered me, who had sewn up my chin after I’d slipped in the bathtub a month before and who was now explaining the details of Mommy’s condition. Something, I knew, was making her bad. Sometimes her arms and her back hurt so much she couldn’t even pick me up.
My attention slipped away from the confusing drone of grown-up words and fixed on a bright black-and-white picture shining down from a lighted box on the wall. The “x-array” film clearly showed a gleaming white shaft of bone (my mother’s clavicle, a word unknown to me at the time) with a perfectly round, dark spot in the middle. One day I would understand this spot to be a hole in my mother’s skeleton. Such x-ray findings were evidence of eosinophilic granuloma, a disease that causes white blood cells to multiply and clump together at various points in the body. This illness was the » Continue Reading.

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A Medical School Professor Calls It A Day

Neal Whitman

First Grade, long ago:
The bell was rung.
School’s out.
The Last Day of School!

A lie, of course.
The end of summer proved it so.
But today truly is
My Last Day of School. 
Today I retired:
took my last breath
as a professor.
But what had I professed?
First, that a preceptor without example is a vain thing. 
True teachers dare to be exemplars.
Second, that inspiration is an active process.
A principle of respiratory physiology,
but also a precept of pedagogy.
Finally, a variation of the Shaker saying–
Every breath a prayer.
Every breath a lesson.

About the poet:

Neal Whitman is a University of Utah School of Medicine Professor Emeritus now living in Pacific Grove, California, where he tootles around the Monterey Peninsula in a white hatchback with the auto plate “PG POET” set in a frame inscribed “Poetic License.” Since retiring from academic medicine in 2008, he has published over 300 Western-form and haiku poems. Neal and his wife, Elaine, collaborate on another Japanese art form, haiga, which combines imagery with haiku; Elaine’s photography and Neal’s haiku have been published in several journals and are featured in Pacific Grove’s weekly newspaper Cedar Street Times to

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Tryst With The Microscope

Reeta Mani

“So what kind of doctor are you?” asks my new neighbor, peering curiously at the MD degree on my visiting card.

“I’m a microbiologist,” I tell her. “I work in the lab and help clinicians to diagnose infectious diseases.”

Her questioning look fades. “So you don’t see patients?”

“No,” I answer. “I don’t have to interact closely with patients, except in a few cases.”

She reflects for a moment, then says, “It’s good in a way. You can help them, but you don’t have to witness their pain and suffering up close.”

I agree. In fact, that was one of the biggest reasons why I decided to specialize in microbiology. (In India, after graduating from medical school you can go straight into a three-year residency in microbiology; in the US, you can do a microbiology fellowship after completing a residency in pathology.)

I gained admission to the microbiology residency by describing my “fascination with microbes” and talking about how “infectious diseases are our country’s leading killer.” Later, though, I sheepishly confided to my sister the most important reason why I’d chosen a laboratory-based specialty: I was faint-hearted. 

I’d worked with numerous patients during my internship, and my colleagues

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The Calling

Lawrence Dyche

I am a non-physician who teaches physicians. A clinical social worker by training, I help doctors learn to be more compassionate and skilled in their human interactions. I sit in with residents as they see their patients. I help them to become better listeners, I remind them that as they touch the body they also touch the soul, I emphasize the enormity of witnessing. And after two decades of doing this work with innumerable students, I still regard the medical profession with awe–not simply the doctors but the calling, and the extraordinary way I’ve seen some people answer it.

Back in the Eighties, when I was beginning this work, I shadowed a resident for an entire day on the wards of a city hospital. Despite the years that have passed, my memory of that day remains vivid. 

Ann was in her second year of training in internal medicine. She was tall, with boyish hair, Gaelic freckles and a quick, self-effacing smile. Older than most of her peers, she had two school-aged children and was making the leap into medicine from a prior career in molecular biology. 

Though easily among the brightest in her class, she tended to be

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The Ancients Had It Right

Stanley H. Schuman

In Aramaic scripture*, and Aboriginal Dreamtime.
How else could animal life begin
Except by Divine Breath, oxygen-enriched?
How ingenious! Only two atoms: O2,
Ideal for hemoglobin, mitochondria, 
Neurotransmitters, ideal for fight or flight, for vocalizing, 
For clever humans to shape tools, split atoms, 
Compose opera, sow seeds, harvest grain.

Consider my distress, in my just-opened pediatric office. 
Stumped by Angela, a three-year-old
So panicked by my white coat, no way to examine her.

Screaming, clutching Mother, she knew and I knew 
This wasn’t university-hospital, with back-up nurses.
Instead, it was one-on-one, 
Advantage Angela.

Desperate, I felt for a stray balloon in my 
Pants pocket (from my own child’s birthday).
Putting it to my lips, I strained to inflate the stubborn thing.
Instantly, Angela’s tear-reddened eyes opened wide.
The more I flushed and puffed, clown-like, 
The more she giggled, finally bursting into laughter, 
Sans fear, forgetting pain.
My breath, a yellow balloon, a child’s laughter…
Three gifts from the gods!

*Douglas-Klotz, N.: Prayers of the Cosmos, 1990 Harper, San Francisco, CA.

About the poem: 

“This poem captures two memories for me: my anxious first day in solo pediatric practice in suburban St. Louis, 1954, and my enchantment with the

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Things That Matter

Paul Gross

For me, the best part of being a doctor, and the biggest privilege, is getting to talk with people about things that matter.

“You look sad today,” I say to a patient I’m seeing for the first time–a thirty-eight-year-old woman with a headache. In response, her lower lip starts to tremble, and she wipes an eye.

As I reach for the box of tissues and hand it to her, I know that whatever has caused her tears will be more important than her presenting symptom.

A forty-five-year-old man comes in wanting help sustaining erections. When I ask for a few details, it turns out he’s having sex every single day of the week, and he’s finding it a challenge to maintain an erection for twenty to thirty minutes. When he misses a day, he has sex twice the next day “to catch up.” He has relations with his wife and also with a girlfriend who lives out of town, where he often travels on business.

Should I laugh? Let my eyes pop out of my head? Wag a finger?

Because I cherish the talking and like to think that I’m skilled at it, it’s all the more comical

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Food

Joanne Wilkinson

I have a stress test nearly every year. I do this because my mother dropped dead of a heart attack when she was thirty-six, and now I am thirty-five.

They stick EKG leads on me, and for weeks I have blotchy red circles on my skin where it’s reacted to the adhesive. I run on the treadmill. Sometimes the cardiologist scans my heart and arteries with ultrasound; other times, he injects me with a radioactive marker. Sometimes he looks at me as though I’m wasting his time. Sometimes he frowns and looks concerned when he hears about my family history.

I always pass the test.

Why did my mother have a heart attack? I don’t have satisfying answers for this. Was her cholesterol high? I don’t know. They didn’t check young women’s cholesterol in the 1970s; they just gave them Valium for the tightness in their chests and told them not to worry. Was it because she had uncontrolled hypertension? Because she didn’t exercise? Because she was doomed?

Am I doomed?

Last night I had dinner at an extravagant restaurant in New Orleans.

I’d never been to New Orleans before, and part of me was delighted by

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Morphine, Pearl Harbor

Ann Neuser Lederer

They do not scream. They keep their hands steady as they shoot the shots.
They run from one to the next, on their rounds without walls.
The troops of well trained girls patrol the troops, their wards.

And they make them to inhale their brew
of Friar’s Balsam, tincture of tree resin:
Pines and cooling mountain breezes in the steaming, smoke filled chaos.
Pliable amber beads, shrines for prehistoric bees,
crumbs for tuneful fiddles lull like opium beds
on the dark, explosive rocks

And though they run around, the nurses are careful.

They inscribe the letter M on the foreheads of those they have dosed,
They make their gentle mark on foreheads doomed or wounded,
under dust and thunder.

About the poet:

Ann Neuser Lederer was born in Ohio and has also lived and worked in Pennsylvania, Michigan and Kentucky. Her poems and creative nonfiction can be found in journals such as BrevityDiagram and Hospital Drive, in anthologies such as A Call to Nursing (2009) and The Country Doctor Revisited (2010) and in her chapbooks Approaching FreezeThe Undifferentiated and Weaning the Babies. She has earned degrees in anthropology and in nursing, is employed as an RN and is certified in oncology nursing

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Lost in the Numbers

Donald Stewart

A nurse entered the operating room; her eyes–the only part of her face visible above her surgical mask–held a look of mild distress. She stood quietly until the surgeon noticed her.

“What is it?” he said.

“It’s your patient in 208, Doctor. His pressure is 82.”

“Systolic?”

“Yes, Doctor.”

The nurse was referring to Mr. Johnson. The previous week, we’d removed a small tumor from his lung without difficulty–and, until now, without complications. He’d been transferred out of Intensive Care to the main surgical floor, and that very morning we had removed the last drainage tubes from his chest. He was scheduled to go home the next day.

Now his blood pressure was plummeting.

“Doctor Stewart, break scrub and go see what’s going on. Nurse, grab that retractor.”

Grateful for the break in a mind-numbing routine (as a surgical intern, my job in the OR was to stand for hours, holding the incision open as the surgeons worked), I stepped away from the table and out of the room, removing my sterile gown and gloves along the way. Running up the stairs to the second floor (surgical residents, like the military, take the steps two at a time),

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Tea and Daisies

Amy Cooper Rodriguez

It’s been almost ten years since Esther died, and I still think of her almost every day. I was her physical therapist at a rehabilitation hospital. My patients had many different diagnoses–head injury, stroke, multiple sclerosis, hip or knee replacements. I was in my early twenties. I thought that if I tried hard enough, I could help everyone. And often, I could.

* * * * *

“What are you going to do to me?” Esther asked, looking up from her hospital chair.

I laughed and pulled up a chair. “I’m Amy, your physical therapist. I’m not going to do anything to you. I’m here to help you get back to doing things you miss.” 

Esther smoothed her long skirt over her plump legs, then pushed her glasses up on her nose. “I just want to go home and be able to do things for myself.”

“All right. We’ll work together to get you stronger and back home,” I said confidently. 

Nobody could tell why Esther felt weak. Doctors said maybe it was old age (she was eighty), arthritis or a vitamin deficiency. She had to use her hands to lift her legs in and out

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Semi-Private Room

Jan Jahner

Sometimes nectar appears
when stories intersect:

I walk into the room 
rearrange the bed-table
and push the pole with its bulging bladder sideways 
for a closer look. 

Her thinness triples the size of the bed
but her father, with his anxious chatter
feels strangely like my own
and her resolve, that tense control
has a familiar edge.

It feels like all the calories she’s ever counted 
and all the sweet things resisted for the last eleven years 
have aligned as a taut shield
protecting that juicy place that hasn’t ripened,
urged too early to carry her family through chaos: 
after all, her mother was dying of cancer
after all, mine couldn’t manage mental illness
after all, aren’t fathers helpless in these things?

The electrolyte imbalance that nearly took her life 
and the nurturance imbalance that emptied
her adolescent pockets of all the in-free tickets,
lie tangled with the feeding tube she never wanted 
while she talks and I listen, my beeper ignored.

Our connection becomes a spoon
with its delicate curve
Starting the good-byes, I hand her my card
she reads through the menu
departing, I feel the full moon
rising in my chest.

About the poet:

Navigating

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Girl Talk

Warren Holleman

“I got pregnant. Quit sports, quit school. Quit all my dreams.”

Brenda looks fit and handsome, despite the scar running down the middle of her face. At six feet tall, she commands respect, even though her sweet, high-pitched voice belies her imposing physique.

We are sitting in a circle: Brenda, six other women and me. Most are in their thirties and forties, and in their fourth or fifth month of sobriety. They look professional in the suits they’ve assembled from the donations closet of our inner-city recovery center.

No one is surprised when Brenda says that, twenty years ago, she trained for the U.S. Olympic volleyball team.

“Did you ever compete again?” someone asks.

“Nope.”

“Why not?”

Brenda shakes her head. The group gives her a moment to think about it, to grieve the loss.

“Later, I took up tennis. I was pretty good! Won lots of tournaments. You know, local stuff.”

Brenda pauses, then continues. “The people I played with, they were doctors, lawyers, people like that. Which was kinda cool. But this was the Eighties, and everybody was using powder cocaine. You know what I mean?”

The older ladies do know what she means. They nod

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