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Intern’s Journal–Surprises
Jennifer Reckrey
Editor’s note: Jennifer Reckrey is 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 doctor. Today’s stories are from weeks number nine and twenty-five.
Week Nine
I dreaded my rotation in the Intensive Care Unit. Though all the tools to keep a body alive are right there, their continuous bells and beeps jangle my nerves. I’m always afraid that in this place I will be called on to act decisively and invasively. And my mind will go blank. I will hesitate, and that hesitation will make an already awful situation worse. But even more than that, I dreaded this rotation because I think of the ICU
Chemo? No, Thanks
Elaine Whitman
“If I were you,” said the radiologist, as I sat on the gurney discreetly wiping goo from my right breast, “I’d make an appointment with a breast surgeon as soon as possible.” His somber tone of voice, the white blotch radiating ugly spider tendrils on his ultrasound screen…neither of these made me nervous. If anything, I felt mild interest: “How very odd. He must think I have breast cancer. Or something.”
Ten days later, after a lumpectomy and sentinel lymph node biopsy, my husband and I sat in the breast surgeon’s office. “I’m so sorry,” he said. “You have Stage IIb breast cancer. There’s a 1.1 cm tumor in your right breast, and the cancer has spread to three of your lymph nodes.”
First Night Call
Abby Caplin
During my first night on call as an intern, I felt scared. Not just scared–terrified. I was serving on the medical center’s pediatric oncology floor, and medical school hadn’t prepared me for children with cancer. What did I know about cutting-edge chemotherapy regimens? What if a child suddenly developed an overwhelming infection or a seizure triggered by a tumor? Someone would expect me to know what to do.
“It’s okay,” said Brad, the second-year resident. “The nurses do everything. You just treat the kids’ hypertension.”
“How?” I asked.
“Hydralazine,” he answered, glancing at his watch. He looked tired and ready to split. “Ten to twenty milligrams IV every four hours.” When I looked up from my hasty scribbling, he was gone. I was
Snowscape
Jeffrey R. Steinbauer
The snowstorm had started on Friday, before I’d gone on call for my group. At first I’d thought the weekend would remain quiet, that the small town where I practiced might just slumber under a fresh blanket of snow. But by early Saturday morning, things had gotten busy at the hospital. Several emergency-room visits, phone calls and admissions from the nursing home changed the stillness I’d felt amid the snowfall. In no time, there was the familiar stress of trying to bring order to a day that was rapidly becoming chaotic.
Sometime that afternoon, I looked up from a chart to see the town sheriff standing at the nursing station. Although we were acquainted through weekly Rotary Club meetings, he now was
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.