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Seeing Patients: The Sketchiest Details
Alan Blum
Editor’s Note: This week Pulse is once again pleased to present sketches by Alan Blum, a family physician who’s been capturing his patients on paper, with grace and affection, for decades. These quick portraits are taken from a collection entitled Seeing Patients: The Sketchiest Details.
You say you think you got a medicine
to stop my seizures?
I don’t know why,
it’s the only exercise I get.
You better just go
Joe the Handyman
Angela Yang
“Forty-two-year old male, chronic pain syndrome,” the chart reads.Â
I’m a third-year medical student doing an elective at a physical medicine and rehabilitation clinic, and this is my first time seeing Joe.Â
Sitting expectantly in the exam-room chair, he’s a gaunt man with a long face and dark tattoos down his arms. Wire-rimmed glasses, stringy ponytail, faded jeans and leather jacket complete the look.Â
“Nice to meet you,” I say. “I’m Angela, a medical student. I’m doing a couple of weeks here with Dr. Ross, the chief physician.”
“Thank you, doc. I’m Joe.” He smiles, dark eyes twinkling, and I glimpse yellow-stained teeth.Â
Probably from smoking, I think.Â
Joe starts talking, jiggling his leg nervously.
The Pronouncement
Carl V. Tyler
I knew from last night’s house call that my patient Bessie’s time was near. All day long I’d felt the familiar churning inside, the sickly sweet combination of anticipated dread and anticipated relief. So when the phone rang while I was exercising at home, I wasn’t surprised. I quickly dropped the barbell weights to answer the call before it went to voice mail.Â
It was Bessie’s daughter, Susan.
Illness 101
Madeline R. Sterling
My time as a medical student is quickly coming to an end. Later this month, along with hundreds of my fellow seniors across the country, I will receive a medical degree.
This past winter, with nearly four years of arduous study, countless examinations and numerous clinical rotations under my belt, I couldn’t help but think, Yes, I’m ready to be a doctor.
And then I became a patient.
Return of the Hero
Peg Ackerman
Blanched by anemia, Mary rested quietly in the hospital bed. Her pallor made her barely visible amid the bleached bed linens–she seemed a mere shock of white hair against the pillowcase.Â
Age ninety-three, she’d visited the hospital a half-dozen times in as many months, shuttling between nursing home and hospital as many elders unwittingly do in their last year of life. She may have preferred to stay put, but no one knew for sure: as a person with dementia, she was presumably unable to speak for herself.Â
I was a palliative-care nurse practitioner in the hospital. Until about two decades ago, whenever someone neared the end of life the details of care were discussed with his or her doctor; nowadays, that intimate discussion often
On the Road
Josephine Ensign
As a community health nurse, I work with homeless and street-involved teenagers. In almost thirty years of doing this work on both coasts, and in Thailand and Venezuela, I’ve gotten to know thousands of young people living on the margins of society.
I love working with them; they challenge me to see the world–and myself–in a broader way, one that opens up vistas of hope for positive change and a better future.
And I always find myself touched by their hopefulness and vulnerability. Their level of optimism varies depending on many factors: their socioeconomic background and level of education, their intelligence and social skills, their involvement with foster care, and factors such as the general level of chaos they experienced growing up, and
What to Say When You’re Terminal
Ellen Diamond
For the past fifteen years, I have had an incurable form of leukemia.
Such diseases used to be called terminal illnesses, but we don’t hear that term as much anymore. With all the new drugs and treatments available, doctors have become more reluctant to refer to diseases they can’t cure yet as “terminal.”
In the years just after my diagnosis, when friends and family would ask what could be done for it, I used to say that nothing could be done, adding: “It’s terminal.”
I was trying to be honest, to say, “Come now, we must face this.” People’s reactions of shock and sadness, though, made me wish I’d put it some other way. But what other way?
My father,
Now We Are Five
Paul Gross
“I’m glad that you’re the one calling me with this.”
John’s comment takes me aback. It’s an unexpected, almost tender, confession from a twenty-year-old young man whom I’ve called with some good news and some not-so-good news.
“The good news is that your HIV test is negative,” I tell him. “You do not have AIDS. But the not-so-good news is that you tested positive for chlamydia, another sexually transmitted infection.”
I want to give him a moment to let this sink in, but he jumps in anxiously: “Can you treat it?”
“Yes, we can treat it. It’s easy to treat. It’s curable.”
“And I’ll be okay?”
“Yes, you’ll be fine. Once we treat it, the infection will be gone.”
I hear the sigh
Behind Closed Doors
Sophia Lee Ryan
I’d prepared as much as I could: I had a huge coffee, a water and every kind of snack imaginable stuffed into my bag. In my head I carried as much information about dilation and curettage as I’d been able to absorb during a study session at Starbucks the night before.
I was a third-year medical student doing my obstetrics and gynecology clerkship, and I was about to spend a day at the local family-planning clinic. The clinic offers support to women on all aspects of contraception, from education and counseling to providing various methods of birth control or carrying out terminations. I knew that this was their OR day, so I’d researched some of the cases that I