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A Time to Die?

I’ve always liked this hospital. It’s small, just two stories, with natural light flooding through the rain-cleansed windows.

My patient Ruby is on the ground-level medical ward. The ward’s Maori name, Muiriwai, means “confluent point of two streams.” Each ward has a Maori name and four beds. There are no private rooms in this public hospital.

Ruby is lucky to have a bed near the window.

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Fear of Flesh

Sometimes I wish that skin and bones didn’t exist. Of course, that would be impossible—the skeleton is the scaffold for our bodies, while the skin is the insulation for vital organs such as the heart, kidneys and bowels. Without our skin and bones, we’d be mere piles of goo on the floor.

Bones are too complicated, for the simple reason that there are too many. As a first-year medical student studying anatomy, I agonized over learning the grooves and prominences where the muscles originate and insert into the bones. I always struggled to find these so-called bony landmarks on our simulated patients.

And flesh…the skin is even more

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My Superpower

When I was six years old, my parents and I learned that I have type 1 diabetes.

As I grew up, revealing my diagnosis felt awkward and burdensome. Whenever I was in a public place and checked my blood sugar by pricking my finger, I often had to explain my illness to others, which led to unwelcome questions. To avoid this, I developed a habit of mentioning my disease swiftly, as if pulling off a

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“How Does It Look?”

I was born in the mid-1950s into a family where juvenile (type 1) diabetes played a prominent role. A year before my birth, my brother, age four, was diagnosed; when I was three, my sister, age thirteen, received the same pronouncement. As the “healthy” child, I watched my stressed parents try to manage the disease using the existing therapies.

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Breadwinner

Breadwinner

The first thing I notice are the dark circles under Mr. Jones’s eyes.

It’s 4:30 pm on a Wednesday during my third year of medical school. I’m in the fifth week of my family-medicine rotation, and we’re deep into our daily routine: triage, history, physical examination, differential diagnosis, present the case to the attending physician, repeat.

Mr. Jones is a new patient. His face and belly are round, his arms and legs lanky.

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What I Did for Love


Amy McVay Abbott ~

My husband, who’s had type 2 diabetes for twenty years, had been struggling for a long while to lower his hemoglobin A1C–a number that measures how well he’s managing his blood sugar over time. When he and I finally investigated the issue, it turned out that someone close to him was thwarting his efforts.

This person is an addict. Her drug of choice is sugar–often candy no self-respecting

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Beating the Numbers Racket

Thuy D. Bui

“What’s my number?” shouted Betsy as I entered the examination room one day last fall.

“Oh, you mean your A1C? It’s nine-point-four!” I answered. A sentence sped through my mind: “The hemoglobin A1C number tells how well a patient’s diabetes is controlled–seven or less is good.” In my seven years as Betsy’s primary-care doctor, I’ve repeated this information at visits and included it in appointment reminders as well.

Betsy is a pale,

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Florence

Ben White

When I first met Florence in the ER, she’d already been dying for some time.

I was a third-year medical student doing my internal-medicine clerkship. Florence was a soft-spoken, tired woman in her sixties. To her, I was yet another face asking all the same questions, but she didn’t mind telling her story again–although she did stop

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Washing Feet

Robert Fawcett

Being thorough, I remove a holey sock 
to view a diabetic man’s filthy feet.
I use the time to complete our talk
of what drove him to live on the street
as I wonder how any of this can help.

While he tells me more of his medical past, 
I run warm water into a stainless bowl.

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Reading Entrails

Sugar poisons

ruin your blood,
runs your legs
while you sleep,
revs your irregular
heart beat.

Maple sap, tree ripened
orange, dark chocolate,
honey dripping
from the comb
are not viable substitutes;
only abstinence
and the eleven day
skin crawl withdrawal.

Or an asymmetrical death:
one part at a time,
organ by organ,
memory fog,

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