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July Intern–Taking Off My New White Coat
Heustein Sy
I became a doctor of internal medicine in my home country, the Philippines, in 2005. The following year, I immigrated to the United States. In order to practice medicine here, I must complete one more journey–a three-year medical residency in the U.S.
My first week at the hospital has been a hectic blur–one task right after another. I’ve been existing on minimal amounts of sleep, food and social contact and maximum amounts of coffee.
Inside my head, though, this week has also been all about me. How lucky I was to have been picked for this coveted residency in this highly regarded hospital! How can I regain my rusty diagnostic skills? How do I look in my new white lab coat?
Rushing here and
What About Bob?
Joseph Fennelly
The time: early one morning, thirty years ago.
The place: my local hospital.
At this point, I have been an internist for twenty years. I’ve just entered the cardiac care unit, where my patient Bob, a ninety-five-year-old man with advanced senility, has been brought because he’s having chest pain.Â
As I step through the door, Bob codes. The young residents and staff swing into action, rushing the crash cart over to his bed.
Quickly, I jump between them and Bob.Â
“Don’t resuscitate him!” I shout.
Looking stunned, they eye me as I stand there with folded arms, making myself into a human shield.
Bob lies motionless, not
Cold Comfort
Mary T. Shannon
Leaning against the hospital bed’s cold metal rails, I gazed down at my husband lying flat on his back. Under the harsh fluorescent ceiling lights, his olive skin looked almost as pale as mine.Â
We’d been in the outpatient unit since 6:00 am for what was supposedly a simple procedure–a right-heart catheterization to assess the blood pressure in John’s pulmonary arteries. Now it was 3:00 in the afternoon.Â
Before we’d arrived that morning, John had seen the procedure as a chance to take a day off from the clinic where he practices internal medicine.
“I think I’ll go out this afternoon and hit a bucket of
Gentle Men
Alan Blum
Editor’s Note: This week, Pulse once again presents sketches by Alan Blum, a family physician who for years has been jotting down visual impressions and snippets of conversation as he cares for patients. These sketches go back as far as 35 years, representing patients who have died or with whom he lost touch because of geographic relocation. These drawings are from the recently published book Gentle Men (Firebrand Press).
About the author:
Alan Blum is a professor of family medicine and holds the Gerald Leon Wallace endowed chair in family medicine at the University of Alabama, Tuscaloosa, where he also directs the Center for the Study of Tobacco and Society. In 1977 he co-founded
A Greater Truth
Nancy Elder
Should someone have to lie to get care? For millions of uninsured Americans, finding a way to receive health care is a challenge. In my practice, I’ve been seeing more and more of the following:
“Where have you been living lately?” I ask my third patient of the morning, a heavy-set, forty-nine-year-old man with dark, weathered skin and rough hands.
“I’ve been staying with my friend,” comes the casual reply
“How long have you been staying there?” I continue.
“You know, for a while.” His tone is a bit guarded.
“How long is ‘a while’?” I am wary now.
“You know, a bit of time.” I can
Mother And Son
Adnan Hussain
I judge. Even though I’m not supposed to, even though I try my best to stop myself, I still judge. Fundamentally, I guess, I’m a creature of habit, caught up in an endless current of seemingly instinctive behaviors. As a first-year medical resident, I sometimes feel acutely aware of this in my dealings with patients.
I stand at the bedside of Sharon Weathers, an unassuming woman in her mid-thirties for whom I’ve been caring over the past few days. She was admitted with excruciating abdominal pain that has proven resistant to our attempts at pain management. Each morning, I visit her to ask, “How did you sleep? On a scale of one to ten, how would you rate your pain?” And each morning,
Stepping Into Power, Shedding Your White Coat: Donald Berwick’s Graduation Address
Donald Berwick
Editor’s Note: Donald Berwick, recent Administrator of the Centers for Medicare and Medicaid Services in the Obama Administration, and a founder of the Institute for Healthcare Improvement, gave this speech at his daughter’s graduation from Yale Medical School on May 24, 2010.
Dean Alpern, Faculty, Families, Friends and Honored Graduates…
I don’t have words enough to express my gratitude for the chance to speak with you on your special day. It would be a pleasure and honor at any graduation ceremony. But, I have to tell you, to be up here in this role in the presence of my own daughter on the day that she becomes a doctor is a joy I wouldn’t dare have dreamed up. I hope that each of
Epiphany
George Saj
It happened one wintry night in 1965. I was in my third year of medical school during a rotation on the pulmonary service.
My supervising intern had been busy all evening admitting a dozen people in various stages of respiratory distress; they were suffering from ailments ranging from flu to double pneumonia.
It was my job to collect each patient’s sputum and culture it on a Petri dish, which would take several days to grow out. I also prepared stained slides of each sample. We did this in hopes of being able to visually identify the offending bacteria, so that we could speedily administer the appropriate antibiotic.
This was painstaking work: the intern and I had to repeatedly re-check
Out of This World
Katelyn Mohrbacher
When I met Jasper, I was a third-year medical student doing a nine-month rural clerkship, and he was an eighty-year-old man in a coma.
Family members surrounded Jasper–a tall, broad-shouldered man–as he lay in the hospital bed. His wife, Esther, a petite, lively woman also in her eighties, stood by his head, grasping the bed rail. At the foot of the bed stood their son, a middle-aged man with a baseball cap on his head, his hands fisted in his pockets. Flanking the bed were his sisters (both nurses), one with curly hair and a baggy sweatshirt, the other slim and well-groomed. A warm summer breeze wafted through the room, bringing the scent of fresh-cut grass.
Jasper had been admitted two days