“Your hands are cold.”
I heard these words throughout my third year of medical school, the year during which we first touched patients on a routine basis.
My hands were cold. I was nervous; how could I not be? What a strange experience for me–asking strangers to disrobe, then touching their bare skin.
E. Wesley Ely
The first time I saw Jessa, she lay crumpled in the ICU bed, paralyzed, expressionless and unable to speak. A military veteran, she had fought in Desert Storm, but she now was facing a deadlier and more inexorable foe: amyotrophic lateral sclerosis (ALS), aka Lou Gehrig’s disease.
This disease causes progressive loss of muscle control, and Jessa was unable to speak, eat or breathe on her own. Her only means of communicating was through small facial movements–opening and closing her eyes or mouth, raising her eyebrows.
A dozen people made up her ICU team: three interns, three residents, a pharmacist, a nurse, a respiratory therapist, a social worker, a hospital chaplain and myself–the lead physician, or intensivist.
Mitch Kaminski
Mr. Dwyer isn’t my patient, but today I’m covering for my partner in our family-practice office, so he’s been slipped into my schedule.
Reading his chart, I have an ominous feeling that this visit won’t be simple.
A tall, lanky man with an air of quiet dignity, Mr. Dwyer is eighty-eight. His legs are swollen, and merely talking makes him short of breath.
He suffers from both congestive heart failure and renal failure. It’s a medical catch-22: when one condition is treated and gets better, the other condition gets worse. His past year has been an endless cycle of medication adjustments carried out by dueling specialists and punctuated by emergency-room visits and hospitalizations.
Michael Carbine
Dr. Peterson, the radiation oncologist, gets right to the point.
“The medical center’s tumor board has concluded that your cancer is inoperable, incurable and untreatable,” he says flatly. “Any chemotherapy or radiation treatments would be palliative in nature.”
He begins explaining the reasons behind the board’s verdict, but everything he’s saying washes out. My mind stopped working as soon as I heard the words “incurable” and “palliative.” I am sliding into shock.
Dr. Peterson pauses.
Anne Whetzel
Pamela sits on the examining-room stool, looking at me expectantly.
I am in my first year of medical school. I do as I’ve been told to do in Medical Skills class: I observe my patient–without judgment or assumptions–and try to figure out what questions to ask, based on the information I am given.
Pamela has curly, strawberry-blonde hair and looks to be thirty, just a few years older than me. Her infant son lies in a carrier beside her.
Dr. Clark, whom I’m shadowing, has just given Pamela osteopathic manipulative therapy for her chronic headaches. Now the doctor is treating Pamela’s older son, age seven, for back pain; he fell off the school jungle gym a few days ago.
All
Adam B. Weiner
Useless….
The word came unbidden into my head.
Oh, no. Here I was, only a few questions into Mr. Marlow’s medical history, and the feeling had begun already.
I’d often experienced this when I was a pre-med student, spending so much time on labs and textbooks instead of with patients. When I’d begun my first year as a medical student, I’d hoped to leave all that behind. Medical school felt energizing: I was ready to see real patients and start helping them!
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.
Andrew T. Gray
The doctor was adamant. “This is America, not Sweden,” he told me. “We operate.”
How did this happen to me? I wondered, looking at him across the ER exam room. How could I, a healthcare provider, not have insurance?
I had woken up that morning with a mildly upset stomach. Nonetheless, I’d gone to my job (begun only six weeks earlier) as a physician assistant at a Beverly Hills HIV clinic. I’d seen patients until lunchtime, then attended a research meeting. The subject was a study of irritable bowel syndrome.
“I need to be in this study,” I joked to a coworker. “My IBS is acting up.”
I don’t have IBS, but I was indeed having crampy stomach pain. I continued to see patients
Mitch Kaminski
My patient Maria sits before me, looking vaguely distressed.
She’s returned for a follow-up visit, six weeks after our first. The morning is half over, and I’m clipping along, staying on time, using the new electronic medical record system (EMR) without a glitch and with a sense of satisfaction. Three months back, when I joined this small-town practice as part of my new position as a health-system medical director, I found the EMR challenging, so I’m pleased that I’ve finally mastered it.
Maria’s face looks familiar–pretty, but with a worried look that matches her hastily applied makeup.
Josephine Ensign
As a community health nurse, I work with homeless and street-involved teenagers. In almost thirty years of doing this work on both coasts, and in Thailand and Venezuela, I’ve gotten to know thousands of young people living on the margins of society.
I love working with them; they challenge me to see the world–and myself–in a broader way, one that opens up vistas of hope for positive change and a better future.
And I always find myself touched by their hopefulness and vulnerability. Their level of optimism varies depending on many factors: their socioeconomic background and level of education, their intelligence and social skills, their involvement with foster care, and factors such as the general level of chaos they experienced growing up, and
Ellen Diamond
For the past fifteen years, I have had an incurable form of leukemia.
Such diseases used to be called terminal illnesses, but we don’t hear that term as much anymore. With all the new drugs and treatments available, doctors have become more reluctant to refer to diseases they can’t cure yet as “terminal.”
In the years just after my diagnosis, when friends and family would ask what could be done for it, I used to say that nothing could be done, adding: “It’s terminal.”
I was trying to be honest, to say, “Come now, we must face this.” People’s reactions of shock and sadness, though, made me wish I’d put it some other way. But what other way?
My father,
Paul Gross
“I’m glad that you’re the one calling me with this.”
John’s comment takes me aback. It’s an unexpected, almost tender, confession from a twenty-year-old young man whom I’ve called with some good news and some not-so-good news.
“The good news is that your HIV test is negative,” I tell him. “You do not have AIDS. But the not-so-good news is that you tested positive for chlamydia, another sexually transmitted infection.”
I want to give him a moment to let this sink in, but he jumps in anxiously: “Can you treat it?”
“Yes, we can treat it. It’s easy to treat. It’s curable.”
“And I’ll be okay?”
“Yes, you’ll be fine. Once we treat it, the infection will be gone.”
I hear the sigh
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