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

Maman

Paul Gross

At a recent religious service I attended with Maman, my 87-year-old mother, I watched her fumbling attempts to find hymn number 123, “Spirit of Life,” in the hymnal. I held my book up, opened to the appropriate page, so that we both could sing from it.

She glanced up momentarily, tightened her lips, hunched forward and resumed turning pages, finally arriving at the song when the congregation was singing the second verse, which she needed help finding–what with her poor vision and the swirl of notes and words on the page.

As this ritual repeated itself, hymn after hymn, it occurred to me how much cozier it would be if my mother and I could share from the same hymnal.

It also struck to me how unlike Maman that would be. Her need to do things independently–and the improbability of Maman reciting from someone else’s page–capture in a nutshell the difficulties we’ve experienced with her aging process.

Maman was born in Belgium in 1922. She lived through the Nazi occupation before coming to the U.S. Of her five siblings, only one sister remains.

My father died seven years ago after a lengthy battle » Continue Reading.

Maman Read More »

Help Me

Jennifer Reckrey

Editor’s Note: Jennifer Reckrey kept a weekly journal of her experiences during her intern year.


Week 13

I had a few free minutes at the end of my clinic session this past Thursday morning, so I took over a walk-in patient from an overbooked colleague.

The patient was a large, muscular Salvadoran man in his early forties who had long-standing hypertension. He said that for the past three months, he’d been feeling tired and didn’t have the energy to take his daily medications. Just a few months back, he’d finished a five-year prison sentence for armed robbery. Now he was living temporarily with his twenty-year-old daughter and her boyfriend, but he told me that he couldn’t seem to get his feet back on the ground. Though he made a little money here and there as a freelance mechanic, he couldn’t get steady work: no one wanted to employ a felon, and the job-placement program couldn’t help him because of his mental illness.

“What mental illness?” I asked.

Looking more at the wall than at me, he described voices that he’d heard ever since he was a boy. Though

Help Me Read More »

My Evidence

When I saw dust settling,

the road black and gritty,

and noticed the air
shimmering as it lowered closer to the earth

like a soft blanket suffocating
the damp September

mornings that had morphed seamlessly
into November’s

crowded table
of berries, sweets, and yellow corn,

just before the hospital
phoned to say that Mother had called my name,

familiar syllables
caught in her throat,

I’d already detected her leaving
in my own body

and so while she paused
at the end of her journey,

which was also the beginning,
I rushed to her,

hurrying
as I’d never hurried before.


About the poet:

I work as a nurse practitioner at Sacred Heart University’s health center. I’ve been writing since my childhood, encouraged by my mother who loved poetry, and my father, a writer himself, who would type up the first few sentences of a story and ask me to finish it. I’ve never stopped writing since. My latest book is The Heart’s Truth: Essays on the

My Evidence Read More »

The Resilient Heart

Paula Lyons

He was applying for a job on a refuse truck working for the City. This is a very good job for someone whose hiring prospects are otherwise limited. Excellent benefits, all state and federal holidays off, health insurance for oneself and one’s family, physical exercise in the fresh air. (All right, this was Camden, New Jersey, so exercise in some kind of air.) And one more plus: If the team is efficient and hardworking and get through their rounds by 11:30 am or noon, they can take the rest of the day off, yet get paid as if they’d worked the whole 5 am-to-1 pm shift.

I was the doctor doing his pre-placement physical exam–designed to determine if the potential employee has medical conditions or takes medicines (or recreational drugs) that might interfere with the employee “performing essential job functions in a safe, regular, and reliable fashion.”

He was twenty-five, slender but muscular, and very excited about the prospect of this job. He was polite and engaging. He surely was capable of lifting cans into the “load-packer” and running beside, or hanging onto the side of, the trash truck as it went on its rounds cleaning

The Resilient Heart Read More »

One More Child Left Behind

Brian T. Maurer

Making the diagnosis might be straightforward, but sometimes getting adequate medical care poses a more formidable challenge.

It was the end of an exhausting afternoon in our busy pediatric practice in Enfield, Connecticut. I had just finished seeing what I thought was the last patient of the day, only to find yet another chart resting in the wall rack, a silent signal that one more patient waited behind an adjacent closed door.

His name was Aaron. Six years old, he sat on the exam table cradling his left arm in his lap. The most striking thing about the arm was the large bluish bulge on the side of his elbow. His mother stood by his side; his grandmother sat in the corner chair.

“What happened?” I asked.

“Another kid pushed him off a table at school. He won’t move his arm.”

I took a step closer. “Let’s have a look.”

Gently, I palpated the borders of the blue bulge. Aaron winced in pain. I felt his wrist to check the circulation to his hand. “Squeeze my fingers,” I said. He tried and winced again.

“It’s likely broken,” I explained. “At

One More Child Left Behind Read More »

Reading Entrails

Sugar poisons

ruin your blood,
runs your legs
while you sleep,
revs your irregular
heart beat.

Maple sap, tree ripened
orange, dark chocolate,
honey dripping
from the comb
are not viable substitutes;
only abstinence
and the eleven day
skin crawl withdrawal.

Or an asymmetrical death:
one part at a time,
organ by organ,
memory fog,
the surgeons gnawing
like rats
at the leper’s limbs.

About the poet:

Kenneth P. Gurney lives in Albuquerque, NM, where he hosts a poetry salon at his home twice a month. His poetry mostly appears on the Web. His has two self-published poetry books, Writers’ Block and Greeting Card. Other pleasures he enjoys: baseball, bicycling, hiking the desert and foothills trails, Scrabble and good conversation. Gurney’s Web site is www.kpgurney.me.

About the poem:

“A few people I know are/were in denial about their adult-onset diabetes. So I wrote and performed this piece a couple of times in public in the hope of jarring them into taking care of themselves. One of these people did go through

Reading Entrails Read More »

Second-Guessed

Andrea Gordon

It was a good night, but it’s been a brutal morning.

As a family doctor who does obstetrics, I generally enjoy my time with laboring patients. When I arrived on the maternity floor last night to start my call, things looked pleasantly uneventful. Several patients were in labor. Only one wasn’t progressing well: Ana, age twenty-two. 

I was told that Ana had come to the floor two days earlier, leaking puddles of clear fluid but not contracting. She still wasn’t contracting, even after two days on pitocin, the drug that causes or strengthens uterine contractions.

To add to this difficulty, there was Ana’s shift nurse, Barbara.

Barbara and I had a history. Another night, caring for a very annoying patient, I’d thought that Barbara had acted unprofessionally, and she’d accused me of shirking my responsibilities. We hadn’t parted on the best of terms.

As the night wore on, Ana’s uterus finally began to contract, but she didn’t tolerate the discomfort well. She was also fearful of taking any pain medication–a perfect catch-22.

Avoiding a replay of our last collaboration, Barbara and I managed to soothe Ana and her husband, and they changed

Second-Guessed Read More »

Steep Sledding

Jonathan Han

“Don’t worry,” my doctor said.

I barely heard what he was saying; lying there in the hospital bed, I was caught up in contemplating the diagnostic procedure I was scheduled to have the next morning.

“With these anesthetics,” he continued, “you won’t feel or remember a thing after it’s over.”

“Okay,” I answered weakly, signing the consent form with unaccustomed legibility. But could I really forget the emotional trauma of these past twelve hours?

I’m a physician, and blessedly accustomed to standing on the other side of the health-and-illness divide. But after four days of crampy abdominal pain, my self-diagnosed “gastroenteritis” had horribly morphed into a “rule out carcinoma” directive. Now I faced another twelve hours of waiting–reviewing the possibilities, expecting the worst–until my procedure could be performed. Could I stop silently reviewing my CAT scan findings (that suspicious abdominal mass) and numb my feelings of anguish and anticipatory grief?

“Do you want a sleeping pill for tonight?” asked my doctor.

“I don’t know,” I stammered.

“It may help you sleep,” he pressed.

“Okay,” I said, grasping at the chance to escape this nightmare. Inwardly, though, I craved

Steep Sledding Read More »

First Cadaver

He presses the Sawzall to

her chest, slices skin to bone.
This unzipping of skin does
not stop our breaths–we’re used to

invasion of the body,
the way his fingers pinch
into her pockets as though
for a cloth or a quarter.

Grasping bone ends, he spreads
her pinkish ribs, not breaking
a sweat, to find what he’s come
for: such a small thing, really,

he plucks it easily.
Fingers bloodied, he holds out
the heart to us: take it, see,
it is no bigger than your fist.

About the poet:

Shanna Germain is a poet by nature, a short-story writer by the skin of her teeth and a novelist-in-training. Her poems and short stories have appeared in publications such as the Absinthe Literary Review, American Journal of Nursing, Best American Erotica, McSweeney’s and Salon. You can see more of her work on her website, yearofthebooks.wordpress.com.

About the poem:

First Cadaver is actually one of two poems that bookend my years of working on the ambulance. In this poem,

First Cadaver Read More »

Late Again

Paul Gross

One thing I love deeply about being a family doctor is that I get to take care of people–body and soul. A patient comes into my exam room with a litany of physical symptoms (“My shoulder…my knee…my stomach…so tired…this nausea…”) and then, in response to a questioning look, suddenly bursts into tears.

It’s all mine to deal with. The shoulder. The stomach. The tears. I get to gather the pieces and see if we can’t put this broken person back together again.

What a privilege.

And yet the joy of primary care is also its curse. With each patient, I have to keep track of everything–the trivial and life-threatening, the physical and mental, the acute, the chronic and the preventive. And try as I might, I simply don’t have enough time.

On paper, my office schedule looks simple: I see one patient every fifteen minutes beginning at 8:30 a.m. If I stick to my timetable, I can wrap up my twelfth patient by 11:30, finish up any leftover paperwork and enjoy an hour’s lunch before starting again at 1:00.

Ha.

The reality is that I’m never done by 11:30. In fact, my colleagues

Late Again Read More »

The Emaciated Infant

Paula Lyons

The police had been called to the house by a neighbor who said she heard children crying and hadn’t seen the mother in two days. It was the middle of a night in July, and the children’s wails would have traveled through the project windows left open to catch cooling breezes.

Paramedics provided transport to the hospital, but the normally cynical and well-defended police were so outraged that they also came to the ER, where I was the resident on call.

The police came to find and punish those who had neglected this waif, but I also sensed that, despite their tough exteriors, they came also to vent their impotent rage and to seek reassurance that this tiny, dirty, appealing thing would live. Our hospital had no pediatric ER staff, and although I was only a second-year Family Medicine resident, I was the senior “pediatrician” in-house. And so I needed information. How was the baby found? What diseases had she been exposed to? Why was she so starved? I chose the greenest member of the team, knowing that he would be the most talkative. And, as a rookie myself, I sensed a kindred spirit.

The Emaciated Infant Read More »

Chemo Patient

She tried

To imagine herself dead
As she lay on her bed
Staring at the ceiling
With chemotherapy
Seeping into her veins
But she couldn’t
She could only think
Of her husband
And her children
And how they had laughed
When her hair had fallen out.

In order to die
Everything had to stop
Her heart
Her brain
The blood surging
Through her arteries
But she could not imagine it.
Everything
Seemed to be running so well.

She was not frightened of dying
But she had always
Looked forward to the future
And now it seemed
There may not be one.
It was not like her
To look backwards
So she carried on
Staring at the ceiling
And tried holding her breath.

About the poet:

Geoffrey Bowe has been writing poetry since he was sixteen and has written nursing poetry since he trained as a nurse, nearly thirty years ago. His work has appeared in two anthologies of writing by nurses (Between the Heartbeats

Chemo Patient Read More »

Scroll to Top

Subscribe to Pulse.

It's free.