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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
Physician, Heal Thyself
Randy Rockney
After a long day’s work as a pediatrician at an academic medical center in Providence, RI, nothing says “relief” like a visit to my therapist. I don’t see him often, but he has helped me through many life transitions. I think we both agree with the Buddhist precept that the only constant in life is change.
One evening after work, a couple of years ago, I arrived early in the neighborhood of my therapist’s office. I was hungry, but there wasn’t time for a meal, so I stopped at a pharmacy to peruse the snack aisle. The smallest and cheapest option available, a bag of roasted pumpkin seeds, seemed perfect.
Common Thread
Peter de Schweinitz
One sunny afternoon during my fourth year of medical school, I spent a day assisting a New Yorker turned rural Southern podiatrist. As we whittled dead skin, checked pulses and scheduled minor procedures, an arrogant question formed in my mind: Why did you choose the feet instead of something more impressive, like the heart?
Maybe he read my mind. Later, seeing me off to my car, he said, “I know that you medical doctors could do my job. I’m here so that you can do more important things.”
At the time, I didn’t know whether to pity his lack of aspiration or admire his humility. But a
The Silent Treatment
Frances Smalkowski
Last year, while enjoying a two-week tour of the cultural capitals of China, I was amazed by how at home I felt. Searching my memory for the reasons behind this unexpected state of mind, I suddenly remembered Mr. Loy.
We met more than forty years ago. I was in my third year as a nursing student, doing a semester-long rotation in a large psychiatric hospital. Each student was assigned a patient for the semester, and Mr. Loy was mine.
We were expected to forge a therapeutic relationship with our patients. This was a tall order; most of our patients were diagnosed with some form of persistent schizophrenia, and few spoke in any coherent fashion, if they spoke at all.
Mr. Loy was no