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Postmortem
Sandy Brown
Coming out of my exam room on a Monday morning, I saw two overweight police officers standing in my waiting room. From past experience, I knew that they were there to tell me that one of my patients had died and to collect information for the coroner’s report. Even as I geared up to hear the impending bad news, the doctor in me couldn’t help wondering how they’d passed their department physicals.
“Do I need to call a lawyer?” I joked, trying to guess which of my patients it could be.
“Michael Freund died on Saturday,” said Dalia, my office manager.
It was a shot to my gut. Mike was seventy-three years old, but one of my healthiest patients
Confessions of a 75-Year-Old Drug Addict
Arlene Silverman
The physician, a slim, young man with a shaved head and intense, dark eyes, reaches out to shake hands. I fumble to extend one hand while the other clutches a questionnaire that I haven’t finished filling out.Â
“That’s okay,” Dr. Gordon says. “You can finish later.”
He can tell that I’m nervous, but seems to understand. He knows that I’ve had to sign in at a window surrounded by other patients, many younger than my own children. Some of them look dazed; others have dozed off. Still others, alert, look as if they’d just come from their job at the bank.
Me? I walk with a cane. My clothes have been carefully chosen to look presentable. I’ve come
May I Have Your Attention, Please?
Adam Phillip Stern
Some sentences should never be interrupted.Â
“We have the results of your HIV test,” the attending physician had begun. But fate interrupted with a seemingly endless loudspeaker announcement:
“May I have your attention, please? Would the following patients please report to the nurse’s station for morning medications….”
Nothing about Benjamin’s story was ordinary. He had been voluntarily admitted to an inpatient psychiatry unit after reporting many symptoms of depression–extreme somnolence, fatigue, thirty-pound weight loss with poor appetite, diffuse pain, decreased energy and joylessness for about three months.
Benjamin was charming, smart and eager to follow medical advice. As a relatively inexperienced medical student, I found interviewing him a refreshing change of pace from my difficult interactions
Pulse Readers’ Hopes and Wishes for the New Year
Pulse Readers
Editor’s Note: Ten days ago, we invited Pulse readers to share with us their hopes and wishes for the new year. Here are some of their responses.
For my young patients who are living with HIV, I hope for relief from the stigma that shadows their lives, their health and their futures, and for acceptance and respect from family, friends, schools and society. For youth growing up surrounded by violence and poverty and by systems of education, health and human services that often fail them, I wish for empowering systems, safe spaces and nurturing adults who will help them to dream and to realize their potential.
Cathy Samples
(Director, Boston HAPPENS Program
at Children’s Hospital Boston)
Pulse Takes the Day Off–and Reflects Upon a Historic Christmas
Paul Gross
Dear Pulse Readers,
We’d planned to take the day off, it being Christmas and all–and then a historic Christmas Eve Senate vote gave us second thoughts.
When the Obama administration arrived in Washington this past January it occurred to me that Pulse might have arrived on the scene too late. Once health reform came into being, “the heart of medicine” wouldn’t ache quite so much. Maybe Pulse would become superfluous–like an offer of two aspirin after the headache’s gone away.
I needn’t have worried.
The healthcare reform bill that passed the Senate on Christmas Eve may be, as some say, a first step of historic proportions–a holiday gift for our nation, including some 31 million uninsured it promises to
An Intern’s Guilt
Anna Kaltsas
“She’s been here for two months already. She’s very complicated; you’re going to be spending a lot of time with her and her family,” my fellow intern said as she began signing out her patients to me.Â
It was my first rotation in the medical intensive care unit, and I was terrified. I was in my first few months as a “real” practicing physician–a title that I still felt uncomfortable with. If a nurse called out “Doctor!” I wouldn’t respond, thinking that she couldn’t possibly be referring to me.
My fear mushroomed as my co-intern rattled off the patient’s problem list–bone-marrow transplant, shock liver, congestive heart failure, anemia, coagulopathy, sepsis, acute renal failure, ICU neuropathy, encephalopathy, ventilator-dependent…I knew what these meant, I
Mom
Diane Guernsey
By this time next week, my mother may be dead.
In a sense, she’s been dying for a long time. This leg of her journey is the last in a decades-long trek with Parkinson’s disease.
She lies there, her head small and delicate on the pillow. Her hair is a wispy white thatch; her throat muscles are rigid, as if she’s just lifted a huge barbell. But her breaths come slowly, with long pauses in between, as if she’s nearly too tired to go on. Her brown eyes stare up sightlessly, lids half-open.
This nursing facility is part of a stepped-care retirement center where my parents moved more than ten years ago, anticipating the day when my mom would need
Maman
Paul Gross
At a recent religious service I attended with Maman, my 87-year-old mother, I watched her fumbling attempts to find hymn number 123, “Spirit of Life,” in the hymnal. I held my book up, opened to the appropriate page, so that we both could sing from it.
She glanced up momentarily, tightened her lips, hunched forward and resumed turning pages, finally arriving at the song when the congregation was singing the second verse, which she needed help finding–what with her poor vision and the swirl of notes and words on the page.
As this ritual repeated itself, hymn after hymn, it occurred to me how much cozier it would be if my mother and I could share from the same hymnal.
Help Me
Jennifer Reckrey
Editor’s Note: Jennifer Reckrey kept a weekly journal of her experiences during her intern year.
Week 13
I had a few free minutes at the end of my clinic session this past Thursday morning, so I took over a walk-in patient from an overbooked colleague.
The patient was a large, muscular Salvadoran man in his early forties who had long-standing hypertension. He said that for the past three months, he’d been feeling tired and didn’t have the energy to take his daily medications. Just a few months back, he’d finished a five-year prison sentence for armed robbery. Now he was living temporarily with his twenty-year-old daughter and her boyfriend, but he told me that he couldn’t