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Beating the Numbers Racket
Thuy D. Bui
“What’s my number?” shouted Betsy as I entered the examination room one day last fall.
“Oh, you mean your A1C? It’s nine-point-four!” I answered. A sentence sped through my mind: “The hemoglobin A1C number tells how well a patient’s diabetes is controlled–seven or less is good.” In my seven years as Betsy’s primary-care doctor, I’ve repeated this information at visits and included it in appointment reminders as well.
Betsy is a pale, stocky woman in her sixties, with short, neatly cropped hair. Her rather tentative smile, to me, always seemed a bit forced, as if covering up for underlying pain. And she’s had plenty of pain in her life.
Last Rites
Candice Carnes
In 2002, I was living in Albuquerque and working as a nursing assistant. My staffing agency had assigned me to a medical surgical floor at a hospital in Santa Fe, a fifty-minute drive away.
One day, as I was enjoying the high-desert beauty en route to the hospital, a code was called.
The patient’s name was Sam, as I recall. It could have been anything, but Sam is the name that echoes in my memories of that day.
His heart stopped.
I hadn’t arrived at the hospital yet, but I had been involved in enough codes to know what had been done.
Despite his advanced age, Sam had full-code status with no restrictions, meaning that he or his family had wanted everything
Continuing Education
H. Lee Kagan
The nasogastric tube was killing me. It had been in place for twelve hours now, threading its way up my nose and down my throat, past my esophagus, into my stomach. Try as I might, I couldn’t swallow away the nasty lump stuck to the back of my throat. And every time I tried, it hurt.
Decades before, as a physician-in-training in upstate New York, I’d put in more nasogastric (NG) tubes than I could remember. At the time, I hadn’t regarded NGs as a big deal. But now I was having my first personal experience with this vile little snake, and it sucked–in every sense of the word.
Two days before, I had come down with a viral gastroenteritis, or stomach
Q & A
Kyle Bernard
The interview had lasted fifteen minutes so far, and we’d made minimal progress. I was a medical student doing a rotation at a physical medicine and rehabilitation clinic back in my home state, Wisconsin. It was the end of the day; to save time, the senior resident, Paul, had joined me in the exam room so that we could hear Leora’s medical history together.
A year earlier, Leora, in her mid-fifties, had suffered a stroke. After a few weeks in the acute-rehabilitation hospital, she’d been discharged, and she and her husband, Ellis, had been lost to follow-up. Now they were back, hoping to resume Leora’s care.
The Arm
David G. Thoele
I was on the cusp of my first year in medical school, and time was running out. Classes started in two weeks. I needed a place to live–ideally someplace cheap, not too far from school.
There was an opening at Phi Chi medical fraternity, a large brick house of faded elegance located less than a block from my classes at the University of Minnesota. At $75 a month for a tiny room in the co-ed fraternity, it fit my budget. When I learned about the “beer machine,” an old Coke machine that dispensed beer at 15 cents a bottle (a bargain in 1979), it felt like my kind of place. I signed the lease.
But throughout the entire discussion with my prospective
No Place Like Home(less)
Josephine Ensign
Recently I had dinner with a friend of mine who, decades ago, had sat on my doctoral dissertation committee. At one point we touched on my dissertation, which covered the health issues of Baltimore’s homeless teens.
“You always had an uncanny connection with homeless kids,” my friend said. “You really understood them.”
I gazed out the window, seeing the homeless people with their shopping carts in the park across the street.
Then I said, “That’s probably because I was homeless myself.”
Collateral Damage
Brenda Scearcy
Dr. Robert’s office felt right to me, with a musical birdsong soundtrack, soft lighting and fresh green tea, and I had my best friend in tow: piece of cake. In this serene atmosphere, I was sure that I’d find out what to do next to finish treating my endometrial cancer.
It’s probably gone now, since my hysterectomy two weeks back, I thought. But let’s play it safe; he’s the gynecological-cancer guru.
Like a general gearing up for combat, Dr. Robert said, “We can beat this. We’ll do a second surgery to remove lymph nodes and omentum–robotically, of course, so your recovery time will be quick. Down the road we’ll definitely do radiation and chemo, and your odds of recurrence will go way down.”
The Pros and Cons of Living with a Terminal Illness
Ellen Diamond
Before I retired in 2000, I worked in a state agency as a peer counselor, or more formally, an employee assistance program (EAP) coordinator. The “coordinator” part was there because my job description wasn’t actually to do counseling; it was to assess the problem and refer the client for help.
But of course both of those processes involved counseling. We just couldn’t call it that.
In 1986, shortly after I’d begun the job, I was separately visited by two employees with HIV/AIDS. Treatments such as the antiviral drugs used so successfully today were nearly a decade away, and a diagnosis of HIV meant almost certain death. These clients were understandably upset and frightened, but they each made it clear to me that they
Saving Grampa
Alia Moore
You were supposed to die of cardiac arrest as you circled toward home plate. Or of a brain aneurysm in the summer during one of your countless hikes through the mountains.
You weren’t supposed to die here. Not in a hospital bed, inhabiting this fragile new body, with an oxygen tube in your nose and tumors in your lungs.
Two days before you left us, I traveled home to visit you. I’d last seen you six months before, shortly after your eighty-eighth birthday. You were a lifelong athlete and adventurer, but you seemed just a little less spry than I remembered.