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Cherish the Gift

It was a perfect autumn day in St. Petersburg, Florida. The year was 1999, but I still remember that day’s sparkly blue sky. I was driving down a busy street, peering at the signs to locate my destination. Finally I spotted the nursing home, a two-story concrete structure, grey and uninviting. I took a deep breath, parked and walked to the entrance.

Entering the small lobby, I was overwhelmed by the nauseating smell of stale urine. To reach the front desk, I had to weave through a jumble of wheelchairs, some holding slouched bodies, others supporting patients who called out and reached to touch me as I walked by.

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The Case of the Lima Bean

Matthew Webb

“Matthew, go see this lady about her breast mass,” says my attending physician at the clinic where, as a third-year medical student, I’m doing a family-medicine rotation.

Okay, I think. I’ve done my ob/gyn rotation; breast masses are no big deal.

I don my short white coat, freshly baked from sitting in the back of my car as I drove to work on this oppressively hot morning. As I sling the stethoscope around my neck, I feel my inner voice (my constant companion amid the stresses of medical school) gearing up, ready to offer insights, questions, distractions….

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Ms. Taylor

Remya Tharackal Ravindran

Ms. Taylor was one of three newly hospitalized patients I saw that morning. She was a previously healthy woman in her forties, single and childless, who worked in the fashion industry. As I scanned her admission notes, three things stood out: shortness of breath, elevated calcium level and kidney failure. I read on, thinking of possible causes, then something caught my eye. Her breast exam had revealed multiple breast masses, and her chest x-ray showed fluid-filled lungs.

Everything fell into place: cancer, first in the breast and then spreading to the lungs. I was spared a diagnostic challenge, but I now had to face something more difficult–talking with Ms. Taylor about her diagnosis. Did she even know what it was? It didn’t

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