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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who’d often bring along a family member, and quickly escort them both into my small office, seating them in the stiff, outdated plastic chairs facing my desk.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,

The First Cut

Ralph B. Freidin February 8, 2013 No Comments

Ralph B. Freidin

“Just cut through,” said Dr. Trotter, my anatomy professor.

I had read the instructions in her 1947 dissecting manual. My copy, purchased used, was preserved by stale formaldehyde and smudged with the tissues of past cadavers who’d guided earlier first-year medical students from anatomical landmark to anatomical landmark within the human body.

The time: forty-six years ago. The day: my first day of medical school.

The dissecting room was on the second floor of a building that had been new in 1927. The windows, opened to capacity, vainly invited in any breeze from the still St. Louis fall afternoon. The cinnamon aroma of dry sycamore leaves floated from the sidewalk to the windowsill before being repelled by the pungent embalming chemicals permeating

The One She Calls Milk

Amy Haddad November 23, 2012 No Comments

Amy Haddad

Is for pain but has a longer name
she can’t pronounce. It’s for when he shakes.
She is not sure if the shakes
mean pain since these days
he often cannot say.

Earlier when he could say,
he would mimic the circle faces
on the pain chart the nurses held up to him.
He would try on expressions
until he found one that fit his pain.
He would set his lips into a thin straight line
or deeply furrow his brow. “That one.
That’s how it feels,” he’d say
with just a small note of pride for
getting it right.

Now getting it right is her job.

Nothing to Hide

Kevin Dorsey November 16, 2012 No Comments

About thirty years ago, after I’d completed my internal medicine residency and a rheumatology fellowship, my wife and I moved with our three-year-old son to my wife’s hometown.

There I joined a multispecialty group practice as the second rheumatologist. Over time, the plan was for me to build a rheumatology practice, but while that was happening I took on all kinds of patients, both primary-care and intensive-care. I felt very comfortable doing general internal medicine, and I also liked the intensity of ICU work.

No Red Lights

Loreen Herwaldt October 26, 2012 No Comments

Loreen Herwaldt

As far back as I can remember, I’ve deliberately spent my life on the high road. I was the seventh-grader who was told by adults that she was very serious. I was the college student who majored in chemistry because it was the strongest premed major. I became a doctor.

Before becoming a doctor, I imagined that I would be the epitome of compassion. I envisioned pausing for a moment before I saw each patient to pray for that person and to ask for wisdom. During my last two years of medical school, I enjoyed hanging out with my patients, just listening to their stories. I

Emergency Landing

Shumon Dhar October 5, 2012 No Comments

Shumon Dhar

In the summer of my first year of college, I did an internship as a nursing attendant in a rehab hospital’s stroke unit.

As a premed student, I had little idea of what it meant to be a physician. But that didn’t stop me from feeling slightly superior to others who weren’t on the same path. Although I didn’t know how to take someone’s blood pressure, I often treated friends to detailed descriptions of the biochemistry of complex metabolic diseases.

My summer job took me totally out of this academic comfort zone.

I found myself washing, dressing and caring for the most debilitated people imaginable–unable to walk

Father and Sons

Kathleen Crowley September 28, 2012 No Comments

Kathleen Crowley

It was early November–the sky a sharp, deep blue that only comes at that time of year–and my primary-care clinic in the heart of the city was booked full with bronchitis and early flu. The TV in the corner was tuned to CNN. Children bounced around in boredom, chatting away in an assortment of languages–Haitian and Portuguese creole, Spanish, English.

My last patient of the morning was Jack, a man I’d been seeing for the past few years. He was a middle-aged guy–almost the same age as I was, in fact. I found him sitting quietly in the examining room, reading glasses on and newspaper in hand, wearing a jacket with his employer’s logo on the front.

Unlike most of the people in

Mother And Son

Adnan Hussain May 11, 2012 No Comments

Adnan Hussain

I judge. Even though I’m not supposed to, even though I try my best to stop myself, I still judge. Fundamentally, I guess, I’m a creature of habit, caught up in an endless current of seemingly instinctive behaviors. As a first-year medical resident, I sometimes feel acutely aware of this in my dealings with patients.

I stand at the bedside of Sharon Weathers, an unassuming woman in her mid-thirties for whom I’ve been caring over the past few days. She was admitted with excruciating abdominal pain that has proven resistant to our attempts at pain management. Each morning, I visit her to ask, “How did you sleep? On a scale of one to ten, how would you rate your pain?” And each morning,

Stepping Into Power, Shedding Your White Coat: Donald Berwick’s Graduation Address

Donald Berwick May 4, 2012 2 Comments

Donald Berwick

Editor’s Note: Donald Berwick, recent Administrator of the Centers for Medicare and Medicaid Services in the Obama Administration, and a founder of the Institute for Healthcare Improvement, gave this speech at his daughter’s graduation from Yale Medical School on May 24, 2010.

Dean Alpern, Faculty, Families, Friends and Honored Graduates…

I don’t have words enough to express my gratitude for the chance to speak with you on your special day. It would be a pleasure and honor at any graduation ceremony. But, I have to tell you, to be up here in this role in the presence of my own daughter on the day that she becomes a doctor is a joy I wouldn’t dare have dreamed up. I hope that each of

Common Thread

Peter de Schweinitz March 9, 2012 No Comments

Peter de Schweinitz

One sunny afternoon during my fourth year of medical school, I spent a day assisting a New Yorker turned rural Southern podiatrist. As we whittled dead skin, checked pulses and scheduled minor procedures, an arrogant question formed in my mind: Why did you choose the feet instead of something more impressive, like the heart?

Maybe he read my mind. Later, seeing me off to my car, he said, “I know that you medical doctors could do my job. I’m here so that you can do more important things.”

At the time, I didn’t know whether to pity his lack of aspiration or admire his humility. But a

fostering the humanistic practice of medicine publishing personal accounts of illness and healing encouraging health care advocacy

Tag: doctor-patient communication

Now We Are Five

Cross-Examination

Stardust

The First Cut

The One She Calls Milk

Nothing to Hide

No Red Lights

Emergency Landing

Father and Sons

Mother And Son

Stepping Into Power, Shedding Your White Coat: Donald Berwick’s Graduation Address

Common Thread

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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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