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

Chris

Lisa deMauro

My big sister Chris, 55, had recently returned to her first career, nursing, when she wrenched her back one day while helping to lift a patient. After weeks of physical therapy proved unhelpful, her internist ordered some tests, which indicated that her back injury might signal something more sinister. She’d had a lumpectomy for a “stage 0” breast cancer five years earlier, and her doctor advised her to make an appointment with the newly appointed head of a brand-new cancer center nearby.

Chris and I were nine years apart–a difference that precluded any sisterly rivalry–and we’d always been very close. She’d occupied a central role in my life: first, as a playful second mother to me, then as my ideal of teenage glamour, and finally as a friend with whom I shared confidences about the joys and sorrows of grown-up life. When it became clear that she might be getting bad news, I needed to be with her, just as my parents did.

The three of us converged on the Pennsylvania town where Chris was living. We met her in the hospital lobby, hugged each other for long moments, then headed off together to meet with the » Continue Reading.

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Looking for Respect

Ashrei Bayewitz

This may sound strange, but I secretly looked forward to my colonoscopy.

I was excited to see the people in the colonoscopy suite–the receptionists, the nurses and my doctor. I knew that they would like me, because I would be brave and respectful. That’s what’s always happened since I was diagnosed with Crohn’s Disease ten years ago. During my multiple colonoscopies and countless doctor visits and other outpatient procedures, I invariably build up a rapport with someone, be it a doctor, nurse or staff member. I’ve always been a good patient, and now that I’m a second-year medical student as well, I can understand their work a little better. I expect them to sense my goodwill and to treat me in turn with respect and caring.

This appointment got off to a good start: The woman who registered me seemed nice and appreciated my interest in the pictures decorating her cubicle wall. And I wasn’t just being polite–I really did like those black-and-white photos of old TV and film stars. She even had The Honeymooners up there! I also got along well with the first nurse–we shared a laugh about the trouble I’d had finding a quarter

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Johnny Doe

Policemen pose like plastic toy soldiers,

point rifle barrels in every direction,
ghetto bird’s spotlight glints off helmets.
Ambulance allowed across yellow tape,
diesel engine grinds up the sharp grade.
In no moon you glow fish white belly up,
streetlamp casts mottled shadows,
your blood a preschool finger painting
smeared on sidewalk.
I am ordered to shear off your slick, soaked
jeans, to smash your chest, beat your heart
for you. Your arms extend savior-like,
needles are pounded into veins,
translucent bags held skyward
like offerings to a life-giving deity,
clear liquid bleeds in, your blood pours out,
three bullet holes versus six-minute
trip to emergency room. How old are you?
I think about my son asleep at home.
I wonder if your mother’s at work.
I breathe deep, drive fast,
make the siren a prayer
too loud for your God to ignore.

About the poet:

An emergency medical technician for twelve years, Yvonne Estrada currently works as an ambulance driver for the Los Angeles County Emergency Medical Services Authority. “I have always written poems, and my

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Tug-of-War

Jo Marie Reilly

As I teach first- and second-year medical students to take patient histories and to perform physical examinations, I always feel humbled and privileged–energized by their compassion, enthusiasm and facile, curious minds.

Occasionally, I feel particularly challenged–especially when I’m teaching a student who, though bright, is struggling to acquire some of medicine’s basic skills. As we journey up the learning curve together, my responsibilities can conflict: as a teacher, I want to nurture an aspiring student physician, yet as a physician, I must ensure that patients receive appropriate care.

Now, sitting quietly in the corner of the room and watching a young medical student interview a county hospital psychiatric patient, I begin to feel this tension.

“What brought you into the hospital?” the student queries nervously.

Small and reserved, she’s quite a contrast to her patient–a burly, imposing middle-aged man, his body splattered with tattoos of birds of prey and firearms. He folds his arms tightly across his chest, and a large cross sparkles on his neck chain.

“It’s when I tried to commit suicide on the bridge,” he responds agitatedly.

There is a long, awkward pause. “So…what medication did you

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Invisible Thread

Donald O. Kollisch

From: Michael

To: Donald O. Kollisch
Subject: Serious medical update

Don,

I can’t say for sure why I’m writing to you, but you were such an important part of my life during the onset of my illness that I feel a strong desire to communicate with you.

The mysterious autoimmune disorder that was lurking in my body has finally had the decency to declare itself. Unfortunately, it is systemic sclerosis, also called systemic scleroderma, which means I’m facing a gradual but ultimately fatal process of skin, joint and organ degeneration.

It has hit my lungs, seriously affecting my breathing capacity, and has hit my digestive system also. Recently I was in the hospital for ten days because of serious digestive problems and an inability to eat. I’m now on intravenous nutrition, with a line in my arm. I can eat a small amount of food for pleasure, but there’s a real question as to whether I can ever take in enough nutrition by mouth to get off the intravenous line.

My rheumatologist at DHMC is wonderful–a good, honest and very compassionate young doctor. She has been completely

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Wanting to Be Lovely

Breast budding, spring leaves,

twelve, too young for babies,
she grasps her pillow to her belly,
the smell of the first crocuses,
the last cardinal’s song
echoes from the hawthorn.
The lemons whisper in her ear
before she squeezes, rubs
the rinds on her damp skin,
her hand touches nylon,
lace, a mirror image river,
a windowless desire:
the first stirring of her fingers
between her thighs, the robins’
annual return becomes monthly.

About the poet:

Kenneth P. Gurney lives in Albuquerque, NM. His poetry mostly appears on the Web, and his two self-published poetry books, Writers’ Block and Greeting Card, are available online. Gurney has participated in the University of New Mexico’s Arts-in-Medicine program and hosts a poetry salon at his home twice a month. Other pleasures he enjoys: baseball, bicycling, hiking the desert and foothills trails, Scrabble and good conversation. Gurney’s Website is www.kpgurney.me.

About the poem:

The image of a girl wanting to be adult came to me nearly fully formed out of the artistic ether, and I painted what I saw with words.

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Millie

Edgar Figueroa

Looking at Millie in her living-room-turned-hospital-quarters, I can’t help reflecting on the four years we’ve shared as patient and doctor. 

We’ve come a long way since our first visit. I was an inexperienced resident; she was a wiry woman who looked to be in her late sixties but was actually fifty-three. 

She’d sat back and stared at me, sizing me up.

“You know I have kids that are older than you?” were her first words. 

I wasn’t sure if she was complimenting me on my youthful looks or expressing uneasiness at having me as her doctor. I smiled, blushed, quickly refilled her prescription and asked her to follow up.

Over time, I grew quite fond of Millie; seeing her name on the schedule always sparked feelings of pleasant anticipation. She, for her part, somehow grew to trust me, and the health-center staff learned not to argue when she insisted on seeing only “my doctor.” At each visit she would share more of her story: how hard she’d struggled for much of her life, raising three children as a single mother with little support and less money; how much she liked her cigarettes and the occasional drink.

Now Millie

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The Save

Dan J. Schmidt

I started medical school thinking I wanted to be a family doctor–someone who could work in a small town and deal with whatever walked through the door. But in our third year, when we received our first taste of clinical medicine, I found my surgery and ER rotations exciting. I was at our state’s major trauma center, and I loved it. Fixing things gives me a thrill–and the power to save a life is even more alluring.

Each “save” felt like a miraculous triumph. Take the nineteen-year-old visiting Australian, stabbed in a random street altercation, his blood pressure dropping as fluid accumulated around his heart. Right there in the ER, he had his chest split open and his right ventricle patched by the very cool chief surgery resident. 

But after several weeks of 5 a.m. surgery rounds and every-third-night call, I started to feel a nagging sense of unmet need, both my own and the patients’. To me, it seemed that the specialized care we were giving was excellent but fractured: No one was responsible for the whole person. 

It was 8 a.m. during my third week of the rotation. The third-year resident had led us medical

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The Limits of Medicine

I can not change the color of the sky.

The texture of the rain, the distance of a star
must needs be fixed by ancient ritual
unaccepted by our modernity.

I can not change the length of your night.
The number of hours, the days of your life
are set by stern fate, impassive to sighs,
unsympathetic, and cold to your plight.

I can not count the breaths that are left.
Day into day, year into frightened morn,
only you, in your heart can know
the obscurity of the sand that now sifts.

I can not make a single tear move;
Its salt will wend its way to the earth
that calls with an irresistible force,
one that will not soon leave off.

I have been roundly trounced
by movements and thunderings greater
by far than my hand’s grasp;
and for their final victory, I apologize. 

About the poet: 

Frances Wu is assistant director of the Somerset Family Medicine Residency Program in Somerville, NJ, and teaches at New Jersey Medical School/UMDNJ and Drexel University College of Medicine. “My passions include caring for my patients as if they were members of my family; teaching family medicine, bioethics and patient safety to

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Giving Care

Ronna L. Edelstein

When I was six, my family and I spent a week in Atlantic City. I loved the Boardwalk with its saltwater-taffy aroma and colorful sights, but I feared the pier that jutted far out into the Atlantic. One moonless night, my big brother bet me a bag of taffy that I couldn’t walk to the pier’s end by myself. Never one to back down, I accepted his bet. But the farther out I walked, the more frightened I got. It felt like one more step would send me off the pier’s edge and into the bottomless black water. My parents rescued me by dashing to the end of the pier and carrying me back to safety. 

I spent the next half-century living under two illusions: one, that nothing in my life would ever be as scary as that dark pier; and two, that my parents would always be there to save me. In school, when my Lilliputian classmates mocked my five-foot-eight-inch stature, Ma and Dad talked to me about inner beauty and strength. After the rice strewn along my wedding aisle disintegrated into sharp slivers of divorce, Ma and Dad gave me the financial and emotional support

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Touched

Karen Myers

“I can feel the life force leaving me,” Mike says as he massages my legs with his rough, careful hands. He doesn’t use oil or lotion like the other massage therapists. Just his sticky, Marlboro-scented fingers. I lie in my underwear beneath a green sheet. My bony shoulder blades and crooked spine press into the table, having long since lost their cushion of muscle. 

“We’re getting older,” Mike says, even though we’ve barely reached forty. “Maybe that’s why we’re so afraid. We don’t have the energy to fight like we used to.”

Mike’s eyes bulge like a bullfrog’s. When I first knew him, I found them a bit frightening. His voice is raspy and deep. He has a fading tattoo on his left biceps and a ponytail that curls down his back. I met him at the massage school, where he was training to be a therapist and I was getting treatment for muscular dystrophy. I always thought he was quirky, and he talks too much, but his massages are cheap.

Since my diagnosis at age fourteen, when we first noticed a slight limp and a protruding shoulder blade, I’d spent most of my years ignoring my body.

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Now a lightness

4:57 am, Sunday

This week went
from caring with hope 
for a lucid patient to facing 
reality in advocating sanity 
to an insane extended 
family to haggling with specialists
to giving up time
and again telling Mary 
she was dying and then watching
her cling to her lost life like
everyone else to 
finally withdrawing all care
except for comfort 
and comforting the now lucid family 
while the breaths became 
distant
and the pauses

prolonged
and everyone 
cried, including myself, 
when 
the last one 
left. 

It was raining
when they called me. The family 
said it just started, right before 
the end. Like the sky had opened up

to let her in.

About the poet:

Fasih Hameed, a family physician in Santa Rosa, California, is currently completing a fellowship in integrative medicine for the underserved. After graduation he will continue to bring integrative medicine to community health centers in northern California. He has dabbled in the creative arts all his life and is currently focusing on music (guitar/vocals/percussion/composition), poetry and building wooden surfboards. In medical school he worked with the art group Students Against Right Brain Atrophy, and he still organizes and attends peaceful anti-atrophy rallies whenever possible. 

About the

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