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
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.
“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!”
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.
Andrea Gordon
She burst into tears when I asked if she wanted to get pregnant.
Eman, a beautiful young woman from Jordan, sat in my family-practice office with her husband, Ali, and two adorable children about one and two years old. With her scarf and dark clothing covering all but her pale face and enormous sable-brown eyes, Eman looked closer to fourteen than twenty-four, and scarcely old enough to have any children.
“How can I help you?” I started.
“We wish to remove her IUD, so we can have another baby,” Ali answered.
I don’t think he expected me to address Eman directly.
“You will get better,” the physician told my brother. My brother was younger than I am now when he was diagnosed with multiple myeloma. I don’t think even he believed the doctor, or he wouldn’t have asked me to take care of everything.
I quickly skimmed through the rest of his chart. Mr. Lopes was an elderly Haitian man, a recent immigrant, who had visited the local emergency room for a bad headache, only to discover that his blood pressure was astronomical. Apparently, Mr. Lopes and his family considered him too sturdy a man to be retained at the hospital overnight, labeled as sick. So he fled.
And here he was, weeks later, to meet his new doctor. “BP: 190/100” read the nurse’s note in red.
William Toms
Our train starts to move slowly down well-traveled tracks. Sunny out,
clouds in the distance. We pick up speed.
We offer obligatory greetings,
courtesy How you feelings?
We both know why she’s here
we defer that talk
as if deferring for a few minutes will make it easier.
The trackside turns to trash, human detritus, rusting hulks without utility.
I edge closer, negotiating perfunctory reviews–
her history, her physical, her labs, her imaging–
she owns them, they’re hers alone.
Then it’s time to enter the forbidden room of abnormals:
machine-made “shadows,” the blood’s “too highs.”
Her cloak of woven fear lies quietly on her shoulders.
Hugh Silk
“Why do you want to go into family medicine?” my internal-medicine preceptor asked.
It was an innocent enough question. I’d known from day one of medical school what I wanted to do, so I answered with confidence, and perhaps a bit of a chip on my shoulder.
“I love being with people and getting to know them,” I said. “I’ve always been this way, so it makes sense that’s what I would do for my career. I’m looking forward to having the long-term relationships and seeing where they go.”
A raised eyebrow, followed by his knowing Irish brogue: “I applaud that. My own father was a GP in Ireland. But I’m afraid you won’t find much of that in
Alice Y. Kim
When Teresa showed up forty-five minutes late for her appointment, I sighed. I knew this would disrupt our clinic’s afternoon schedule.
That was nothing unusual, though. The clinic treats large numbers of patients who are undocumented, homeless and uninsured, and many must walk or take public transportation to get here. After seven weeks on rotation here as a third-year medical student, I knew that appointment times were flexible.
As I read Teresa’s notes and recent lab results, the nurse came in.
“Teresa’s blood pressure is 210/122,” she told Dr. Fuentes, the attending physician.
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