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The Big Chill

The Big Chill

Tonight was yet another night on call in our emergency department–a chilly winter night on which I did a cruel deed: I discharged a homeless man back out into the cold.
This is a routine event in the life of psychiatry residents like myself. Normally, no one would bat an eye. It shouldn’t have mattered to me, either–except that the previous night I’d had to walk home from the hospital parking garage in decidedly adverse weather.
The streets were covered with slush and ice, which, along with the heavy rain and bitter winds, made my usually effortless fifteen-minute walk a nightmare. As wind gusts kept upturning my umbrella, I struggled to manage it while also trying to keep my feet from slipping on the ice.
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Casseroles and Conversations

2017 was a heartbreaking year for our family.
To start things off, my wife’s parents–both of them!–were diagnosed with terminal illnesses. We spent the next few months immersed in the painful, complex process of transitioning them to home hospice care and beginning to face and grieve the prospect of their deaths.
In the midst of this, Hurricane Harvey began heading towards Houston, our hometown. My wife, Marsha, drove to her parents’ ranch, south of the city, intending to bring them back to our home, on higher ground. But the heavy rains arrived a day earlier than expected, trapping Marsha and her parents for three terrifying days and nights in their flooded house.
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My Black Bag

Retirement means downsizing. “If a thing doesn’t give you joy, throw it away,” says the current mantra, as if it were that simple.
In my study closet, behind my obsolete Kodachrome lecture slides (about as necessary these days as a harpsichord), sits my little black bag. Does it give me joy? It’s much more complicated than that.
The bag holds all the medical instruments I carried through my training as a doctor–internship, residency and fellowship: sphygmomanometer (no longer functional), stethoscope, ophthalmoscope, otoscope, reflex hammer. There’s also a moldy leatherette case containing the dissecting kit that I used in classes from college biology through gross anatomy. The instruments are still shiny and sharp, which is more than I can say for myself.
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Finding the Words

“So how was your trip?” ask well-meaning friends and coworkers when I return from a medical mission to Engeye Health Clinic, in rural Uganda. Even years after my first trip there, trying to find the perfect words to describe it is a challenge.
I have been involved with Engeye since its founding, more than a decade ago. As the administrative coordinator with Albany Medical College’s department of family and community medicine, I helped a second-year medical student, Stephanie Van Dyke, and a faculty member, Dr. Bob Paeglow, put together a medical-mission trip to the small Ugandan village of Ddegeya. The clinic was to be managed by a visionary accountant named John Kalule (born in Ddegeya) and staffed by visiting US physicians. My role was to

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X Factor

I was a brand-new intern on the intensive-care unit, and Cassandra was the very first patient I saw there. A petite, slender woman, she was rolled in on a stretcher, accompanied by her tall, athletic husband, Jack.
Cassandra was in her twenties, like me–but mortally ill. That grabbed my attention from the start. But the biggest lesson she taught me came about because we got her prognosis all wrong.
She had lupus, an autoimmune disease that unleashes the raw power of the immune system against the patient’s organs and joints. Fortunately, my attending rheumatologist, Dr. Schmidt, was an expert in lupus and its intricacies. Although small in stature, he cast a large shadow in the field; physicians from near and far referred their most challenging

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Prayers of Passage

The day began in Mom’s room with a 10:00 am conference at Upper Valley Medical Center, west of Columbus, Ohio. In attendance were my ninety-three-year-old mother Joanne (now in her third week of hospitalization), her palliative-care nurse Richard, her Episcopal priest Mother Nancy and myself.

Mom was on high-flow oxygen therapy delivered through a nasal cannula. Despite this, her blood-oxygen levels were well below normal. Clearly, her lung function was declining. Her heart wasn’t pumping well, and her blood pressure was barely seventy over fifty.
Things can change quickly with our elders. Thirty days earlier, Mom was going to dinner with friends and taking excursions in her assisted-living facility’s van to pick up things she needed, including small bottles of wine to share

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Keeping the Flame Alive

This month, at medical schools across the country, first-year students will officially don the physician’s traditional white coat for the first time.

The white-coat ceremony is a powerful symbolic moment. It signifies that the students are moving beyond their identity as ordinary citizens and into their new identity as healers. The ceremony celebrates their idealism and their commitment to a life of caring for others. And, although they may not realize this, it constitutes a pledge to assume responsibility for their patients’ health and well-being–and the stresses that go with that commitment. As the students accept this responsibility, their lives will be forever changed.
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Shock Treatment

I sat in the cold, sterile examination room, anxiously awaiting my new orthopedic doctor–the fourth in two months. I was losing hope of ever finding a doctor who would listen to me. The first three had suggested that my pain was all in my head
I want someone to take me seriously, I brooded. I don’t want to be brushed off as the stereotypical hysterical female. My pain is real, and I’m not crazy. I need someone to believe me.
Finally, there was a soft knock on the door.
“Good afternoon, I’m Dr. Lee.”
In front of me stood a man with an impeccably groomed goatee. He glanced at my elbows, which I have a habit of bending too far backwards while relaxing. Brow furrowed,

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Shock of Recognition

Lying in a hospital bed while awaiting heart surgery, I looked at my teen daughter and my parents, then smugly pointed out the irregular slashes on the cardiac monitor.

“See these?” I said. “They’re called PVCs. My doctor is going to fix them. Make them all go away.”

The asymmetrical rhythm, a frequent and annoying pattern of multiple skipped heartbeats, had plagued me for the last three years, despite my swearing off caffeine and alcohol and trying different cardiac and thyroid medicines under my doctor’s supervision.

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