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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A Conversation About Race, Fear and Connection

Paul Gross

In the wake of recent events, many speak about the need for conversations about race. In our country, the implications of race are a moral issue, a humanitarian issue, a justice issue and, yes, a medical issue. (One need only examine how racial categorization affects rates of death.) But what would this conversation about race look like?

Today, Pulse’s editor provides one offering. In August, we’ll invite all Pulse readers to join in with their stories, when Race will be the theme of More Voices.

I grew up in Stuyvesant Town, a middle-class housing development just north of Fourteenth Street on the east side of Manhattan. Built after World War II, Stuyvesant Town was a leafy and desirable place to live.

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What’s Love Got To Do With It?

H. Lee Kagan

My longtime patient Brenda let the top of her exam gown drop to her waist, stepped down off the exam table and turned to look at herself in the mirror. As I watched, she cupped her seventy-eight-year-old breasts in her palms and unceremoniously hoisted them up to where they’d probably resided when she was in her twenties.

“I’m thinking about having my boobs done,” she said. “My girlfriend had hers done, and she’s very happy with how they turned out. What do you think, doctor?”

As she spoke, her eyes remained on her reflection. Breasts held high, she made quarter turns to the right and left, then leaned back.

“I don’t like how they look now,” she said,

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Taboo

Ralph B. Freidin

Every fall, medical schools welcome nearly 20,000 college graduates. They arrive anticipating endless hours of lectures, too much coffee, and infinite facts to memorize. There is one thing they do not expect, however. I know. Forty-nine years ago, I was one of them.

The first day I walked onto the wards was in spring of 1967. I was in St. Louis, doing my second year of medical school. Previously my presence in the hospital had been restricted to the cafeteria. I was twenty-three, had only examined the eyes and ears of my classmates–never a patient–and was about to perform an unsupervised cardiac exam.

Anxiously, I waited with an instructor and three classmates outside the room of our assigned patient.

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Imagine

Linda Koebner 

“Her vitals are fine,” the nurse told Besarta’s mother during a rare visit to the family’s basement apartment in the Bronx.

Besarta’s mind is also fine–sharp and clear. She asked me to use her real name in this story.

Her twenty-five-year-old face is beautiful and flawless, despite the howls of frustration, rage and pain she directs at her family, at fate and especially at Friedreich’s ataxia, the disease that controls her.

When I come for our weekly visit, Besarta’s blue-green eyes smile at me from where she sits in her wheelchair. Then her head suddenly wobbles sideways. Her face smashes against the chair’s headrest–first the right side, then the left.

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The Silent Treatment

Frances Smalkowski

Last year, while enjoying a two-week tour of the cultural capitals of China, I was amazed by how at home I felt. Searching my memory for the reasons behind this unexpected state of mind, I suddenly remembered Mr. Loy.

We met more than forty years ago. I was in my third year as a nursing student, doing a semester-long rotation in a large psychiatric hospital. Each student was assigned a patient for the semester, and Mr. Loy was mine. 

We were expected to forge a therapeutic relationship with our patients. This was a tall order; most of our patients were diagnosed with some form of persistent schizophrenia, and few spoke in any coherent fashion, if they spoke at all. 

Mr. Loy was no

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Stigmata

I started my third year of medical school as a surgery clerk.

With this eight-week clerkship came a flood of conflicting advice from older, wiser peers: “Ask a lot of questions, but speak only when spoken to.” “Offer to help, but stay out of the way.” “Be friendly and likeable, but not too friendly–or too likeable.” For the medical student, such is the mystique of the OR.

Three weeks into my general surgery rotation, I was helping my senior resident to see patients in the clinic and evaluate them for surgery. She grabbed the first chart off the day’s pile, knocked on the exam-room door and turned the handle, glancing at the chart before saying, “Hello, Mister–”

“Tran,” the patient finished.

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A Passage in India

Justin Sanders

“It’s cooler this morning,” I said to Seema, as we left the hospital grounds en route to our home visits.

It was a bright and bustling morning in Trivandrum, the capital of India’s southwesternmost state, Kerala. A third-year resident in family medicine, I had come here to work with the staff of an Indian nonprofit devoted to advancing palliative care services across India. Seema was a young, newly qualified junior doctor who had only recently joined the organization. We were traveling with five others–our driver, two nurses and two nursing trainees–into the mountains east of Trivandrum for the day.

“We don’t really speak about the weather like you do,” Seema gently chided. “In the West you spend lots of time talking about the

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Shujinwa Byoki Des

Lucy Moore

I don’t speak Japanese, but I can say “Shujinwa byoki des” (my husband is sick). 

After spending a month in Bali studying art, sweating profusely and slapping mosquitoes, we were heading home to New Mexico, with a stop in Hiroshima on the way. Our first morning there, my husband, Roberto, woke with a fever of 103 and a full body rash. 

The hotel had a thermometer, but no doctor. As Roberto’s fever neared 104, we hailed a cab for Hiroshima City Hospital. (That was when I pieced together shujinwa byoki des from my pocket dictionary.)

In the large, orderly waiting room, we were the only Caucasians. Roberto was a sight–lobster-red and wild-eyed. Staff and patients politely averted their eyes. 

A nurse led us to the

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Our Town (Chinese Spoken)

By the time Mrs. Zhang came to see me, her headache, left-sided weakness and facial numbness were two weeks old. Like many Chinese immigrants in this country, she’d hesitated to seek medical care because of language and cultural barriers and her apprehensiveness about Western medicine. In fact, she hadn’t seen a physician in the ten years since she and her husband had come to America. Only after a friend told her about me, the sole Chinese primary-care physician in a small Pennsylvania town, did she and her husband come to see me.

Mr. and Mrs. Zhang struck me as a typical older Chinese couple. With smiles on their faces, they bowed repeatedly to everyone in my office.

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A Certain Anesthesia

Arthur Ginsberg

Exhaustion sets in by day’s end
when the old Pakistani woman
hobbles into my office.
Raccoon eyes underscore the pain
she feels in her left leg. More cavalier
than a Hippocratic disciple should be,
I pull up her djellaba* to expose
the dark, tumescent flesh of her calf
monogrammed by serpiginous veins.
I am too aggressive with the needles
that search for the source
of the white-hot poker lancinating
from ankle to groin, muscular infidelity.

She is stoic,
so well schooled in cruelty
that even I pretend not to see
the slight jiggle of her jaw, enough
to tell me I have crossed

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