fostering the humanistic practice of medicine publishing personal accounts of illness and healing encouraging health care advocacy

fostering the humanistic practice of medicine publishing personal accounts of illness and healing encouraging health care advocacy

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The Battle of Britain

It was winter, and I’d been seeing Raymond in his home for occupational therapy for more than a month. The home health agency physician’s orders had been to evaluate and treat him for home safety, and I was working closely with the nurse and social worker from the same agency.

Unfortunately, the social worker and the nurse were at odds over the need for Raymond to move into a nursing home.

The facts were stacked against him.

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Withering Away on the Outside


You are an angel, undeserving of such tortuous demise.

I bit my tongue to hold back these words I was thinking but couldn’t say to our young, male patient with amyotrophic lateral sclerosis (ALS). The attending physician had just exclaimed, “Foot drop is often one of the first signs of ALS. Do you notice here the distal muscle atrophy, including the intrinsic muscles of the hand, namely the dorsal interosseus muscles and thenar eminence?”

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Last Stand

E. Wesley Ely

The first time I saw Jessa, she lay crumpled in the ICU bed, paralyzed, expressionless and unable to speak. A military veteran, she had fought in Desert Storm, but she now was facing a deadlier and more inexorable foe: amyotrophic lateral sclerosis (ALS), aka Lou Gehrig’s disease.

This disease causes progressive loss of muscle control, and Jessa was unable to speak, eat or breathe on her own. Her only means of communicating was through small facial movements–opening and closing her eyes or mouth, raising her eyebrows.

A dozen people made up her ICU team: three interns, three residents, a pharmacist, a nurse, a respiratory therapist, a social worker, a hospital chaplain and myself–the lead physician, or intensivist.

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