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Ripped From the Headlights
Maureen Picard Robins
“Get a notebook,” he said.
Dr. Altman and I stood face to face on the pediatric surgical floor of Columbia-Presbyterian Babies & Children’s Hospital. It was the first week in December. A metal crib–it seemed more like a cage or prison–separated us. In this center space lay my yellow heart: my eight-week-old daughter, wounded by surgery, dulled by morphine, our whispers flying over her.
It had been nearly twenty-four hours since Dr. Altman opened the baby’s abdomen and held her tiny intestines in his hands, untwisting them like a fisherman untangling his line; nearly one day since he’d performed a Kasai procedure, fashioning a conduit so that bile could tremble down to her small intestine; one thousand four hundred and forty minutes
A View From Nepal
Caroline Jones
The farmer wanted to know why his three-year-old son couldn’t walk or talk.
I sat opposite him in a dark, cold classroom converted into an examination room for a four-day medical clinic last spring in the village of Lapa, high in the Himalayas.
Wind whistled through the stone walls; rain pounded on the tin roof. The room’s single ceiling bulb kept flickering and dying; I had to use a camping headlamp to see my notes. And communications were hampered, to say the least: We conversed via two translators–from English to Nepali, from Nepali to the local Tamang language, then back again. It sounded a bit like the telephone game, and had similarly uncertain results.
Still, one look was all I needed to make
Thanksgiving Reflections
Pulse Writers and Editors
Editor’s Note: This Thanksgiving tugs hard at the emotions. While an economic gale roils the world, our freshly chosen captain stands on deck, pointing out a new direction for our battered ship of state. At the same time, each of us has personal joys and sorrows to contemplate. We asked Pulse’s writers and editors to take a moment to share their reflections.
This year, I am thankful for my four quirky little grandsons, my three loving children and my beloved husband of almost forty years. I am especially thankful that the country we share has a chance to find its way again and to call all of us, young and old, toward a future that can still be bright and full of
Hospice
Joanne Wilkinson
My patient’s beagle is very quiet. He lies next to the brown leather living-room chair she used to sit in when I would come to see her at home. His nose is down on his paws, and his round eyes look up at me, up at the nurses, the home health aides, the family members who go back and forth between here and the back bedroom. He is very alert, but silent. He stays perfectly still.
My patient’s sons want to know things. How much longer will it be, will she be in pain, what will the end be like, will she be conscious? Should they take the rest of the week off from work, should they call the son in California and
My Patient, My Friend
Death is not always the same. Quantity, fixed: one per patient. Quality, variable.
Doctors see many deaths, of different kinds. This is true of any doctor, whether or not he or she is a surgeon, as I am.
It’s easier for the doctor when death is expected, following a long illness, a chronic disease. Harder when it’s unforeseen–the heart attack, the accident, the gun shot, the sudden death in a young man or woman who seemed a conqueror.
Halloween Horrors
Paul Gross
One October evening last year, I went to our local pharmacy to pick up a prescription for my daughter. I made sure to bring Cara’s insurance card because my employer had switched us to a new health plan.
I wasn’t sorry about the change. Our prior plan had been operated by incompetents–although they might only have been crooks, I couldn’t be sure–who also managed our flexible spending accounts. These accounts, you may recall, collect pre-tax income from your pay and then return it to you to pay for out-of-pocket medical expenses.
With that plan, nothing ever worked as advertised. I would submit a dental bill for reimbursement and the company would review it for three months before sending me a denial notice, stating
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.
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.
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.
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.
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