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First Time, Last Time

Kristin Nguyen August 30, 2019 8 Comments

“Deeper compressions! Deeper! Make sure you get that recoil!”

I push harder and lift off higher. I’m starting to sweat. My stethoscope is banging around my neck. I should have taken it off, I think. My hair is flying around my face. I should have tied it up. I’m on tiptoe; my legs are cramping. I should have stood on a step stool.

“All right, she’s getting tired. Next!”

Embarrassing…I only lasted through one round of compressions. Other people (taller, more muscular people) are lasting longer. I really need to lift weights. Doing chest compressions is much more physically demanding than I’d thought.

The Pronouncement

Carl V. Tyler June 14, 2013 No Comments

Carl V. Tyler

I knew from last night’s house call that my patient Bessie’s time was near. All day long I’d felt the familiar churning inside, the sickly sweet combination of anticipated dread and anticipated relief. So when the phone rang while I was exercising at home, I wasn’t surprised. I quickly dropped the barbell weights to answer the call before it went to voice mail.

It was Bessie’s daughter, Susan.

Deja-vu

Justin Sanders October 1, 2010 No Comments

It looked like the skin of an orange–peau d’orange, in medspeak. My fellow interns and I had heard about it in medical school; some had even seen it before. As our attending physician undraped Mrs. Durante’s breast one sunny morning during our first month as interns, we knew that what we were seeing was bad.

Mrs. Durante wore a hospital gown and a brightly colored head scarf. She looked like a child lying in the bed: small, delicate, demure. Her face was pretty, her voice soft and deep. By contrast, the mass rounding out the side of her right breast bulged aggressively. It was firm to the touch, reddish against her olive skin. When asked, she said it hurt.

Broken

Jordan Grumet September 3, 2010 No Comments

Jordan Grumet

I was a third-year medical student in the first week of my obstetrics rotation. The obstetrics program was known to be high-pressure, its residents among the best. Mostly women, they were a hard-core group–smart, efficient, motivated–and they scared the heck out of us medical students.

I remember the day clearly: Not only was I on call, but I was assigned to the chief resident’s team. I felt petrified.

We’d started morning rounds as usual, running down the list of patients in labor. Five minutes in, my chief got a “911” page from the ER, located in the next building. This seldom happened, so instead of calling back, we ran downstairs and over to the trauma bay.

We walked into pure chaos. The patient

The Cruelest Month

Ray Bingham July 23, 2010 No Comments

Ray Bingham

One day in April, I took the assignment none of the other nurses wanted: Baby Michael. A hopeless case.

Born almost four months premature, weighing barely a pound, he was now all of six days old. His entire body wasn’t much longer than my open hand. As he lay motionless on a warming bed with the ventilator breathing for him, the night nurse gave me report: serious intestinal infection, bowel surgery, septic shock, multiple antibiotics, infusions to support his failing heart, transfusions to replace the serous drainage seeping from the surgical incision on his darkened, swollen belly.

“Take good care of him,” she finished. “He’s been through so much already.”

As experienced nurses, we both knew that a premature infant rarely survives so

Trauma in the ER

Michael Gutierrez July 9, 2010 No Comments

Michael Gutierrez

It was 5 pm on a cold November day. I was a third-year medical student heading into my first night on surgery call.

Changing into my scrubs, I wondered what it would be like. I knew that we had to carry a “trauma pager” and, when paged, get to the ER as fast as possible. There my job would be to listen as the ER physician called out his exam findings and enter them on a history-and-physical form.

I felt a mix of things. I was excited about the learning possibilities, but I also knew that whoever gets wheeled through the ER doors is someone’s daughter, son, mother or father. I decided not to think too hard–I’d just take what came my way

The Winner

Majid Khan July 2, 2010 No Comments

Majid Khan

I pull up on the side of the road on this rainy British summer’s day. The rain doesn’t make it easy to get my doctor’s bag out of the trunk, which I do in a hurry so I can make my way to the house where I’ve been asked to visit a 37-year-old man named Kenneth.

This really isn’t ideal. Now my bag is wet, my papers are wet, my trousers are wet and my mood is wet. I didn’t want to do this visit anyway, but I’m still in my last year of training before becoming a full-fledged GP, and I’ve been given the task by one of the senior GPs in the practice.

“Cough/temperature” says the note the receptionist has scribbled.

Postmortem

Sandy Brown February 5, 2010 No Comments

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

An Intern’s Guilt

Anna Kaltsas December 11, 2009 No Comments

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.

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

My Patient, My Friend

Larry Zaroff November 7, 2008 1 Comment

Larry Zaroff

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.

Sometimes, in a long-term patient-doctor relationship, the two types of death merge: Death becomes the harsh, abrupt end to a journey taken by two travelers.

M was a special patient–thirty-something, warm, charming, brave. At our first meeting, an office visit in the early Sixties, she

Losing Tyrek

John Harrington August 22, 2008 No Comments

John Harrington

Tyrek’s mother and I must have spoken for two hours in the Pediatric Intensive Care Unit, covering every topic but the one that was glaring at us: death. A fourteen-month-old child is not supposed to die–and even though I knew the situation was dire, I couldn’t bring myself to face it. So I excused myself, sat down with her son’s chart and stared blankly at it.

I first met Tyrek and his parents when he was just three months old. Tyrek had Down syndrome, clubbed feet and a large sternal scar on his chest from surgery to repair a complicated heart defect. Despite his bad luck, Tyrek’s most impressive characteristic was his cheery disposition. His mother was a tall African-American woman with straightened

The Pencil Man of Western Boulevard

Paula Lyons June 6, 2008 No Comments

Paula Lyons

His history was Dickensian. As a little boy, born with an IQ of about 80 and a wandersome nature, he’d toppled onto the train tracks and gotten run over. How he didn’t die is a mystery–this was more than fifty years ago, and he lost both legs up to his hips–but live he did.

I met him in the hospital, where he’d had surgery on the pressure sores that came from long hours perched in a wheelchair. When I asked him to roll over so I could see, he hoisted his whole body (200 pounds without legs!) out of the bed via the orthopedic trapeze. His arms were massively strong, his disposition was sweet, and he spoke and behaved like a well-mannered six-year-old.

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

Tag: coping with patient death

First Time, Last Time

The Pronouncement

Deja-vu

Broken

The Cruelest Month

Trauma in the ER

The Winner

Postmortem

An Intern’s Guilt

My Patient, My Friend

Losing Tyrek

The Pencil Man of Western Boulevard

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

Tag: coping with patient death

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