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Entry from an Intern’s Journal
Jennifer Reckrey
Editor’s note: Over the next months we’ll be carrying occasional pieces by Jennifer Reckrey, a family medicine resident in New York City. Each week while she was an intern, Dr. Reckrey recorded some of her experiences as a brand-new resident. Today’s story is from week number six.Â
How do you convince someone to do something they don’t really care about?
This week I took care of a 58-year-old woman who came to the hospital with one week of fevers, diarrhea, burning with urination, and abdominal pain. Though she probably had an infection, the CT scan she got in the ER didn’t reveal its source. It did, however, show that something was wrong with her uterus and ovaries. If the odd-looking mass was an
Carmen’s Story
Carmen Diaz
I used to be a shy woman who didn’t like the spotlight and never did any public speaking. Ovarian cancer has changed all that. Now I look for opportunities to tell my story.Â
I am a 62-year-old, Puerto Rican-born, New York-raised mother of two. I was diagnosed with ovarian cancer in 2004. But for more than a year before that, my symptoms weren’t recognized.Â
In January 2003, I started to suffer from abdominal discomfort, back pain, indigestion and heartburn. My primary-care physician told me to change my diet and prescribed medication for my indigestion. After weeks with no improvement, I went to a gastroenterologist, who diagnosed gallstones. In March, I had gallbladder surgery.Â
Most people go back to work within ten days, but
In the Nick of Time
Barry Thompson
When the ringing woke me at 3:00 a.m., I hoped that it was my alarm clock. For a neurologist on call, middle-of-the-night phone calls mean trouble; as a rule, you don’t get awakened at that hour unless it’s something really serious.
At 6:00 p.m. the prior evening, a young man had shown up in the ER of one of our satellite hospitals with a severe headache. He’d been diagnosed with a tension headache and discharged with a prescription for acetaminophen with codeine. No imaging studies had been done.
Nine hours later, the patient presented to the ER at our main hospital. He was no longer fully alert, the ER doc told me. I told him to get an immediate CT scan of the
Jeannie
Andrea Gordon
“The person with the contractions gets to pick the channel,” I reassure Jeannie, as she tries to talk me into watching The X-Files. It’s not my favorite, but I’m just the moral support–oh, and the doctor.
When she first came to see me, eight months back, Jeannie already had a four-year-old boy and didn’t think that there was much my little white nulliparous self could teach her about pregnancy. I’d offer her my book-learned advice about pregnancy or suggested sources of support, and she would listen patiently, then do what she wanted. She did show up for all her appointments, and she humored me at times: although she refused to stop smoking pot for her nausea, she cut down a little “to make you feel
Losing Tyrek
John Harrington
Tyrek’s mother and I must have spoken for two hours in the Pediatric Intensive Care Unit, covering every topic but the one that was glaring at us: death. A fourteen-month-old child is not supposed to die–and even though I knew the situation was dire, I couldn’t bring myself to face it. So I excused myself, sat down with her son’s chart and stared blankly at it.Â
I first met Tyrek and his parents when he was just three months old. Tyrek had Down syndrome, clubbed feet and a large sternal scar on his chest from surgery to repair a complicated heart defect. Despite his bad luck, Tyrek’s most impressive characteristic was his cheery disposition. His mother was a tall African-American woman with straightened
Once
David Goldblatt
Movement disorders can be horrifying. Afflicted persons are solidified or contorted. They may flail so violently that a fork endangers their lives. As a beginning neurologist, I assumed that all such patients curse their fate. Once I got to know Brian, though, I realized that I could be wrong.Â
Brian and one of his brothers had inherited Wilson’s disease, a rare, genetic movement disorder that had spared their eight siblings.
People who have Wilson’s disease can’t handle dietary copper properly. It accumulates in–and poisons–the kidneys, liver and brain. Avoiding foods rich in copper does not halt the progression of the disease, but it helps. If patients are also treated early and consistently with a drug such as penicillamine, which binds copper and aids
First Patient
It was a quiet knock on my door that morning. So quiet, in fact, that I wondered if I was dreaming. Maybe if I went back to sleep it would go away.
Nope. There it was again: soft but persistent. This time I knew that it really was a knock, and it really was on the front door of my one-room cabin. What I didn’t know was that I’d be hearing that knock for the rest of my life.
I got up, tired and rumpled, and pulled open the door. A young woman I’d never seen before stood there, barefoot and wearing the simple white linen dress of the campesina (as a woman who works the land is called in rural Paraguay). She was probably no
Our Town (Chinese Spoken)
By the time Mrs. Zhang came to see me, her headache, left-sided weakness and facial numbness were two weeks old. Like many Chinese immigrants in this country, she’d hesitated to seek medical care because of language and cultural barriers and her apprehensiveness about Western medicine. In fact, she hadn’t seen a physician in the ten years since she and her husband had come to America. Only after a friend told her about me, the sole Chinese primary-care physician in a small Pennsylvania town, did she and her husband come to see me.
Mr. and Mrs. Zhang struck me as a typical older Chinese couple. With smiles on their faces, they bowed repeatedly to everyone in my office.
Finding Innisfree
Roger looked up at me over the oxygen mask, his eyes drawn wide by the sores stretching his face. He lifted a hand for me to take.
“I’m glad you’re here,” Jen had said before I’d entered his room. “They’ve taken him off a lot of the medication. He’s very lucid, but he’s depressed and scared.”
The previous fall, Roger and Jen had begun couples therapy with me. They were both thirty-two and had been together for ten years. Three years before they came to me, Roger had been diagnosed with leukemia. A bone-marrow transplant had left him cancer-free, but his prognosis was guarded. He and Jen argued frequently, his desire for independence clashing with her insistence on managing his care.
When they first visited