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Tag: doctor-patient communication

Cushioning the Fall

Meghan G. Liroff April 27, 2018 14 Comments

Meghan G. Liroff ~

Angela Harris has been here in the hospital for six hours, awaiting the results of her CAT scan. I won’t take responsibility for all of that wait time: complicated CAT scans and labs do take a significant amount of time to perform. But she didn’t need to wait the last hour.

She was waiting on me–her emergency physician–because I needed to confirm her cancer diagnosis with radiology, arrange some oncology follow-up…and find the most appropriate phraseology for “You have stage IV cancer, but you don’t meet admission criteria.”

A Tingling Sensation

Mitch Kaminski March 23, 2018 10 Comments

Mitch Kaminski ~

It had been a hectic day in the urgent-care clinic of my large family practice, and I was starting to worry about the time: My last two patients had put me thirty minutes behind.

I felt relieved when I saw the note for the next patient: “Seventy-four-year-old female with UTI.”

A urinary-tract infection! This should be quick and uncomplicated….

I walked into the room to find a well-dressed older woman seated on the exam table. I had just enough time to wonder fleetingly, Why do some patients decide to wait on the exam table while others stay seated in the chair nearby? Then I turned my full attention to the woman before me.

A Series of Unfortunate Events

Holland M. Kaplan February 23, 2018 11 Comments

Holland M. Kaplan ~

I’m sitting in the ICU team room, staring at the computer, trying to look like I’m writing a note. But my head is pounding.

As an internal-medicine resident doing my first month of residency, I’ve found the ICU of the bustling county hospital a jarring place to start my training. Although I’d anticipated the clinical challenge of caring for very ill ICU patients, I was unprepared for the emotional burden of having to deliver devastating, life-altering news to them and to their family members.

Faint yells emerge from Room 7. They have an almost rhythmic quality: “Ahhh!”…(three seconds)…”Ahhh!”…(three seconds)…”Ahhh!”

It’s Ms. Burton. I’ve just gotten back from checking on her, but I plod back again.

Too Close for Comfort

Andrea Eisenberg September 29, 2017 6 Comments

Andrea Eisenberg ~

Many years ago, on a busy day in my obstetrics-and-gynecology office, one of my partner’s patients came in for “bleeding, early pregnancy.” Since my partner wasn’t in that day, I saw the woman, whose name was Sarah. After we’d talked a bit, I examined her and did an ultrasound. As I’d expected, she was having a miscarriage. Feeling sorry that Sarah had to hear it from me, rather than from her own doctor, I broke the sad news.

We discussed the options: Did she want to have a D&C, or let nature take its course?

“I’m not sure,” she said. “I need some time to decide.” I agreed that this was understandable and left the room so that she

Cat and Mouse

Kristen Lee September 15, 2017 7 Comments

Kristen Lee ~

On TV shows, therapists decorate their rooms with leather lounge chairs, throw pillows and organza curtains that let in the light.

But Dr. Hassan’s office is in the clinic basement. The fluorescent lighting is sterile. She has a gray metal desk–I think every doctor I’ve shadowed as a medical student has had that same desk.

But I’m not here as a student.

I’ve been anticipating this appointment for a month. In March, I started to take an online physiology exam for school, but instead spent twenty minutes staring motionless at the computer screen. I eventually input the answers and passed the test, but I’d stopped caring.

A week later, I had a panic attack while riding the

Saving Private Ryan

Gregory Rutecki June 2, 2017 21 Comments

Gregory Rutecki

The late Eighties was the worst of times in medical education–the era when doctors in training worked a virtually unlimited number of hours each week. This unceasing and inhumane workload led residents, understandably, to view patients purely as collections of physical ailments.

Back then, I was an attending physician at a community teaching hospital. One day, as usual, I was preparing to make morning rounds and, simultaneously, to do my best to teach my team of internal-medicine residents.

Fourteen patients awaited us, every one of them quite sick. As my team and I proceeded from one bedside to the next, struggling to cram the patient interviews into ever-dwindling snippets of time, I felt a familiar sense of growing pressure; it

Kleenex

Bill Toms April 2, 2017 No Comments

Twenty minutes behind as I knocked on the exam room door and entered. No need for introductions. We knew each other well. We skipped the “asking the patient her goals for the visit.” I already knew them. Twenty years of caring for and being trusted by a patient and a friend allows that. Her goals were the same as mine. We were there to tell the truth.

Brave New World

Rosalind Kaplan March 24, 2017 28 Comments

Rosalind Kaplan

I think a lot about quitting medicine lately. A lot.

Then I have a morning like yesterday morning:

I see a patient I’ve known for more than twenty years, caring for him through an adrenal tumor, a major gastrointestinal surgery and now renal failure, for which he needs a kidney transplant. As we review his last set of labs (stable, thank goodness), he is sanguine, hopeful. He may have found a donor, and he might make it to transplant without dialysis. He has to live–he has a wife and a child.

Next, I mess up my schedule entirely by spending more than half an hour with a patient who only came in to talk–not about herself, really, but about her

Abuela

Anne Walsh March 7, 2017 No Comments

The abuela was a standard admission of my internal medicine rotation. “CVA” said the medical record, which meant this Guatemalan grandmother, or abuela, had suffered a stroke. She was visiting the U.S. to help care for her first grandchild, who was due any day. She had felt fine until, suddenly, her diabetes, high blood pressure, and high cholesterol had imploded. In quick succession, she’d experienced a stroke, a 911 call, and the ER. Uninsured and undocumented, she’d been stabilized and transferred, serendipitously, to our nationally renowned rehab hospital–a stroke (no pun intended) of luck for this far-from-home 54-year-old.

Learning to Trust

Cynthia Stock March 4, 2017 No Comments

I admitted Hiral Jacobs, a twenty-something college student who’d collapsed in her dorm, directly to the ICU from surgery.

The OR report said she’d received two units of blood and was still intubated. Given my forty years of ICU nursing, it sounded routine.

“By the way, the patient is Muslim.”

An American Story

Sara H. Rahman February 17, 2017 31 Comments

“Mr. Douglas?” I call out into the waiting room. A short, grey-haired man in his sixties staggers towards me, bracing his back with his hands. Despite his pain, he gives me a warm smile, which I return.

As I help him onto the exam-room table, he winces, squeezing my hand.

“I’m a medical student,” I begin. “If you wouldn’t mind, I’d like to examine you before Dr. Smith sees you.”

He nods. “Go ahead, you can learn on me–just don’t break my leg!”

Complainer

Christina Phillips February 10, 2017 7 Comments

Christina Phillips

The patient, age forty-nine, complained of abdominal pain. She was taking both slow- and fast-acting oxycodone to manage the pain, and she also took antidepressants and a sleeping aid. She’d come to the hospital several times in the past year, always with the same complaint. This time, not feeling well enough to drive, she’d come by taxi. The veins in her arms were small, threadlike and collapsed, like those of a ninety-year-old or a recreational drug user.

Her medical file was huge, with reports from her primary-care physician, from local hospitals and from the gastroenterology department of a highly regarded teaching hospital across the state.

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: doctor-patient communication

Cushioning the Fall

A Tingling Sensation

A Series of Unfortunate Events

Too Close for Comfort

Cat and Mouse

Saving Private Ryan

Kleenex

Brave New World

Abuela

Learning to Trust

An American Story

Complainer

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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: doctor-patient communication

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