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Physician, Heal Thyself
Randy Rockney
After a long day’s work as a pediatrician at an academic medical center in Providence, RI, nothing says “relief” like a visit to my therapist. I don’t see him often, but he has helped me through many life transitions. I think we both agree with the Buddhist precept that the only constant in life is change.
One evening after work, a couple of years ago, I arrived early in the neighborhood of my therapist’s office. I was hungry, but there wasn’t time for a meal, so I stopped at a pharmacy to peruse the snack aisle. The smallest and cheapest option available, a bag of roasted pumpkin seeds, seemed perfect.
Common Thread
Peter de Schweinitz
One sunny afternoon during my fourth year of medical school, I spent a day assisting a New Yorker turned rural Southern podiatrist. As we whittled dead skin, checked pulses and scheduled minor procedures, an arrogant question formed in my mind:Â Why did you choose the feet instead of something more impressive, like the heart?Â
Maybe he read my mind. Later, seeing me off to my car, he said, “I know that you medical doctors could do my job. I’m here so that you can do more important things.”
At the time, I didn’t know whether to pity his lack of aspiration or admire his humility. But a
The Silent Treatment
Frances Smalkowski
Last year, while enjoying a two-week tour of the cultural capitals of China, I was amazed by how at home I felt. Searching my memory for the reasons behind this unexpected state of mind, I suddenly remembered Mr. Loy.
We met more than forty years ago. I was in my third year as a nursing student, doing a semester-long rotation in a large psychiatric hospital. Each student was assigned a patient for the semester, and Mr. Loy was mine.Â
We were expected to forge a therapeutic relationship with our patients. This was a tall order; most of our patients were diagnosed with some form of persistent schizophrenia, and few spoke in any coherent fashion, if they spoke at all.Â
Mr. Loy was no
Fifty Minutes
Elizabeth Tyson-Smith
“I know it will kill me,” my patient Jan says calmly.Â
We sit in my office looking out on the river below, which glints in the fall sunshine. It is a warm day for November. Jan has just learned that her breast cancer has spread to more internal organs.Â
Her doctors have told her that she will not recover.
I–who have had breast cancer twice–cringe inside. Jan’s blue eyes fix on mine, but she expresses no emotion at all.Â
In 1990 a routine mammogram showed a bright white constellation in my breast. The biopsy was positive. I heard four words: “You have breast cancer.” I was forty-eight;
Closing up the Cabin
Robin Schoenthaler
I met Burt the Monday before Labor Day. As I walked into the room, he stood up–a sturdy, fifty-three-year-old guy with a direct, sky-blue gaze. Although he was a little etched around the eyes, he mostly looked the picture of health.
Two years before, he’d had a cancer. It was treated and thought to be gone. But for several weeks now, he’d been having excruciating low-back pain; he rated it a ten out of ten. The day before, a new CT scan had revealed that his original tumor had spread to his liver and bones. A spiderweb of tumor damage in his spine was the cause of
Soon
“Wake up, Eli,” I whisper, tapping his collarbone. “I need to re-check your blood pressure.”
“Aw, come on, doll,” he snickers. “A man can’t snore if he’s dead. Ain’t that good enough?”
“No, sir,” I reply. “I need numbers.”
It’s two a.m. I’m seven hours into a sixteen-hour shift in the emergency department of a busy city hospital, running five rooms in the “sick but stable” section with Dr. Watts.
Sick and Tired
Paul Rousseau
“You told me you’re tired–tired of all the transfusions, and tired of being sick. Do you want to stop all the transfusions, Nancy?” I asked the woman lying in the hospital bed.
She was silent. Her husband of nineteen years, sitting nearby, was silent as well.
“What are you thinking, Nancy, can you tell me?” I asked.
Nancy, forty-eight, was suffering from chronic muscle inflammation, severe lung disease, pneumonia and–most severely–from terminal myelodysplastic syndrome (MDS), a blood and bone-marrow disease for which she had to receive transfusions of platelets and red blood cells every other day.Â
Fed up with the transfusions, she’d asked to speak with the
Healing Words
Gretchen Winter
As a physician-in-training, I find joy in helping to ease pain and occasionally cure illness. But I often find my greatest sense of purpose in helping patients to heal emotionally, whether by allaying a patient’s fears, addressing a lingering concern or lending a listening ear.
Having majored in communications in college, I’d assumed that the patient-physician relationship would be the easy part of medicine. I’ve learned, though, that getting it right isn’t always easy.
An encounter with a patient named Mary Collins brought this lesson home to me.Â
As a third-year medical student, just finishing the third week of my family medicine clerkship at a community health center, I was starting to feel competent at performing the basic history and exam.Â
It was
Heroic Measures
Gil Beall
“Doctor! Doctor! He’s stopped breathing!” the stout woman shouted, clutching at my white coat.Â
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.Â
There I saw a melee taking place around a seventy-year-old man with chronic lung disease.Â
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.Â
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