Home
/
doctor-patient communication
/
Page 6

Tag: doctor-patient communication

Popping the Question

Mitch Kaminski January 16, 2015 34 Comments

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.

Chemo or Lourdes? Welcome to Cancerland

Michael Carbine December 5, 2014 14 Comments

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.

Exam-Room Follies

Anne Whetzel October 31, 2014 14 Comments

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

Rewriting the Script

Adam Weiner August 22, 2014 15 Comments

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!

Imagine

Linda Koebner November 8, 2013 18 Comments

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.

Saving My Appendix

Andrew Gray September 6, 2013 No Comments

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

A Second Chance

Mitch Kaminski August 30, 2013 No Comments

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.

On the Road

Josephine Ensign May 17, 2013 No Comments

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

What to Say When You’re Terminal

Ellen Diamond May 3, 2013 No Comments

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,

Now We Are Five

Paul Gross April 26, 2013 No Comments

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

Cross-Examination

Paul Rousseau March 22, 2013 No Comments

Paul Rousseau

“I want everything done. Please, Dr. Rousseau, do everything. We have two children–they can’t be without their father. Do you understand? Do what it takes to keep him alive!”

Angie, a petite woman with long blonde hair, fixes me with piercing blue eyes. Her husband, Joe, fifty-two, has scleroderma, an autoimmune disease. In its most devastating form, it hardens the skin and destroys the kidneys, heart and lungs.

Joe is dying of sepsis and multi-organ failure in my hospital’s intensive-care unit.

“Please, do whatever it takes to keep him alive,” Angie pleads.

Suddenly, I am thrust into the depths of grief. Not hers, mine. It happens just like that–no warning, no nothing, just a painful inner quivering and

Stardust

Audrey Cortez March 1, 2013 No Comments

Audrey Cortez

Years ago I worked as a registered nurse in a busy surgical pre-admission clinic, preparing patients who’d been scheduled for surgery for the upcoming operation and hospital experience.

My workdays were packed with back-to-back, hour-long appointments. Whatever surgery the patient was facing–oral, orthopedic or anything else–every interview followed the same format. I would greet the patient, who’d often bring along a family member, and quickly escort them both into my small office, seating them in the stiff, outdated plastic chairs facing my desk. On the way, trying to save time, I would explain that as part of the pre-admission process I’d need to do a health interview and a physical assessment, get an accurate list of the patient’s medications, labs, X-rays,

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

Popping the Question

Chemo or Lourdes? Welcome to Cancerland

Exam-Room Follies

Rewriting the Script

Imagine

Saving My Appendix

A Second Chance

On the Road

What to Say When You’re Terminal

Now We Are Five

Cross-Examination

Stardust

Subscribe to Pulse.

It's free.

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

Start typing and press enter to search

Subscribe to Pulse.

It's free.