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Fifty Minutes
Elizabeth Tyson-Smith
“I know it will kill me,” my patient Jan says calmly.
We sit in my office looking out on the river below, which glints in the fall sunshine. It is a warm day for November. Jan has just learned that her breast cancer has spread to more internal organs.
Her doctors have told her that she will not recover.
I–who have had breast cancer twice–cringe inside. Jan’s blue eyes fix on mine, but she expresses no emotion at all.
In 1990 a routine mammogram showed a bright white constellation in my breast. The biopsy was positive. I heard four words: “You have breast cancer.” I was forty-eight;
Closing up the Cabin
Robin Schoenthaler
I met Burt the Monday before Labor Day. As I walked into the room, he stood up–a sturdy, fifty-three-year-old guy with a direct, sky-blue gaze. Although he was a little etched around the eyes, he mostly looked the picture of health.
Two years before, he’d had a cancer. It was treated and thought to be gone. But for several weeks now, he’d been having excruciating low-back pain; he rated it a ten out of ten. The day before, a new CT scan had revealed that his original tumor had spread to his liver and bones. A spiderweb of tumor damage in his spine was the cause of
Soon
“Wake up, Eli,” I whisper, tapping his collarbone. “I need to re-check your blood pressure.”
“Aw, come on, doll,” he snickers. “A man can’t snore if he’s dead. Ain’t that good enough?”
“No, sir,” I reply. “I need numbers.”
It’s two a.m. I’m seven hours into a sixteen-hour shift in the emergency department of a busy city hospital, running five rooms in the “sick but stable” section with Dr. Watts.
Sick and Tired
Paul Rousseau
“You told me you’re tired–tired of all the transfusions, and tired of being sick. Do you want to stop all the transfusions, Nancy?” I asked the woman lying in the hospital bed.
She was silent. Her husband of nineteen years, sitting nearby, was silent as well.
“What are you thinking, Nancy, can you tell me?” I asked.
Nancy, forty-eight, was suffering from chronic muscle inflammation, severe lung disease, pneumonia and–most severely–from terminal myelodysplastic syndrome (MDS), a blood and bone-marrow disease for which she had to receive transfusions of platelets and red blood cells every other day.
Fed up with the transfusions, she’d asked to speak with the
Healing Words
Gretchen Winter
As a physician-in-training, I find joy in helping to ease pain and occasionally cure illness. But I often find my greatest sense of purpose in helping patients to heal emotionally, whether by allaying a patient’s fears, addressing a lingering concern or lending a listening ear.
Having majored in communications in college, I’d assumed that the patient-physician relationship would be the easy part of medicine. I’ve learned, though, that getting it right isn’t always easy.
An encounter with a patient named Mary Collins brought this lesson home to me.
As a third-year medical student, just finishing the third week of my family medicine clerkship at a community health center, I was starting to feel competent at performing the basic history and exam.
It was
Heroic Measures
Gil Beall
“Doctor! Doctor! He’s stopped breathing!” the stout woman shouted, clutching at my white coat.
It was 1953, and I was a first-year resident responsible that night for the patients on the medical ward–including those in the four-bed room the woman pushed me into.
There I saw a melee taking place around a seventy-year-old man with chronic lung disease.
The man had been examined and admitted that evening by my colleague, who’d given me what little information he had before leaving for the night.
The man had been too absorbed in his breathing to talk much. We’d hooked him up to an oxygen tank and started an intravenous infusion of the bronchodilator aminophylline, which brought about modest improvement. We couldn’t think of anything else
Stepping Back From the Edge
Bill Ventres
I can walk.
It’s not pretty. It’s not easy. It’s not without assistance. But I can walk.
Six weeks ago, I wasn’t able to walk. A few days before that, I’d begun a visit to the city of Antigua, in Guatemala, and was enjoying its colonial ambiance with friends.
Then, after a brief bout of sore throat, I contracted Guillain-Barre Syndrome, an autoimmune disorder that afflicts the peripheral nervous system. My body’s defense system, its antibodies triggered by the offending virus, had decided to attack the nerves in my arms, legs and trunk.
Upon awaking at 7:30 am on November 2, 2011, I could barely get out of bed. On rubbery legs, I made my way to the bedroom door to call for
Natural Selection
Jeremy Shatan
By the time my wife and I reached Hospital B’s exam room, early in the afternoon, we’d already put in a very long day.
Across the room, which was no bigger than a galley kitchen, stood three doctors. One–I’ll call him the Chief–was the bearded, bushy-maned head of the pediatric oncology program. His explosion of salt-and-pepper hair made a startling contrast to his posh British accent. With him were Dr. Transplant, a small, kind-faced woman who specialized in bone-marrow and stem-cell transplants, and Dr. Nice, a genial young pediatrician with a Midwestern accent.
We were there with our fourteen-month-old son, Jacob. A week earlier, he’d had brain
Cracking the Code
Zohar Lederman
I am a medical student in Pavia, Italy, doing my fifth year out of six. It is summertime, and, as I’ve done every summer for years, I’ve returned to my small hometown in the south of Israel. There, among other things, I volunteer as an emergency medical technician (EMT) with Magen David Adom, the Israeli Red Cross.
It’s 7:30 on a Friday morning. I’m at the Red Cross office, talking with the paramedic and a doctor, when a young volunteer runs in.
“There’s a car pulling up outside–they’re bringing an unconscious patient!” he says.
The paramedic goes to get the advanced life support equipment, and the doctor