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

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Turning the Tables

My iPhone screams me awake, as it does every morning. Recently this incessant screeching has become less irritating, as I’ve grown more accustomed to the demands that clinical education makes on a third-year medical student. I begin my routine: shower, scrubs, microwaved breakfast sandwich, then out into the dark morning, actually looking forward to my day.

I’ve been on a roll in my new family-medicine rotation, enjoying my time with my supervising doctor and learning quickly under her tutelage. It feels as if it’s coming together—the pages upon pages of textbooks and notes replaced by real patients and newfound responsibilities.

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What If…?

During my first two years of medical school, the service-learning program I most enjoyed was Sickle Cell Superheroes. This program matches medical students with teenagers (or “kiddos,” as I like to call them) who are transitioning from pediatric to adult hematology for management of their sickle-cell disease.

My kiddo was Harry, and I absolutely adored him.

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“I Know You Don’t Want to Be Here…”

It’s been an interesting year. Eight months after having a large kidney stone removed, I was diagnosed with very early stage cancer—small, low grade, etc. The treatment (surgery) would very likely cure the cancer. The specter of cancer meant that I found this surgery physically easier, but emotionally much harder.

The aftermath of the surgery was interesting in unexpected ways, too.

Six months after surgery, at one of my periodic follow-up visits, I was sitting awkwardly at the end of the exam table, dressed in the standard patient gown and sheet, and waiting to see Becky, the nurse practitioner I’d been assigned to that day.

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Bea and Me

Editor’s Note: This piece was a finalist in the Pulse writing contest, “On Being Different.”

On the night Bea’s chest pain began—when the heaviness like a fist took her breath away, the beads of sweat gathering on her forehead—it frightened her, as it did not stop. She was alone, and as she reached for the phone, she paused. Who should she call?

The pain increased. She reluctantly dialed 911. She mumbled the answers to the operator and remembered to open her door before collapsing on the couch.

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From One Little Lady to Another

Donna dropped her blood-thinner tablets on the floor prior to surgery.

“It’s a sign I shouldn’t be taking them,” she said.

Now, sometime later, it makes me smile to think of it; she’s recovered well from the surgery and has resumed her medications. I’d told her to stop taking them just prior to the surgery—a complex hernia repair—and to resume them the day after, but she’s the type of person who does what she wants, what she thinks is best.

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My Blankie

One evening, at the age of four, I ran frantically into my bedroom, tears burning in my eyes, and started overturning the furniture, peering under my bed and scrabbling through piles of clothes. I bounded back downstairs into the kitchen to check the chair I’d sat in for dinner. Over and over, I asked my four siblings and my parents:

“Have you seen my blankie?”

Finally, I retraced my steps to the piano bench. There sat my blankie, a soft, bright yellow mound. I let out a sigh of relief, safe at last, and headed off to bed.

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“Doctor Sahib, Mamnoon!”

Growing up in Pakistan, I aspired to be a doctor. I was fascinated by movies and TV shows centered on the medical profession and the day-to-day work and lives of physicians. To me, they were superheroes, wearing white coats instead of capes.

A familiar figure in the panoply was the stereotypically brilliant and successful physician/surgeon. (Remember Dr. Melendez in The Good Doctor?) Insanely smart and talented, he was also hard-edged, competitive and almost robotic in his laser-sharp focus on reaching diagnoses and treating symptoms.

Observing similar traits among my mentors while in medical school and during my internship, I concluded that while perfect politeness is the norm, feeling or displaying emotion must be atypical.

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The Difference

My patients do not speak. Or rather, my patients do not speak using words. Instead, they have taught me the art of body language—of noises, expressions and postures.

I read the movement of ears, the way pupils dilate or constrict. Watch for the tremors, for the hunch of a spine, for the described bows or stretches that could indicate abdominal spasm. Search for the hint of a leg being favored, for the inaudible signs of pain. Wait for tongues darting over lips. Offer food that may be sniffed at or turned away from. I’ve learned to respond to fear with gentleness, to preempt the sharpness of tooth or claw with slow movements.

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The VIP

It was late at night, and as the neurosurgery resident on call, I was alone in the hospital, wishing that I could lie down, or even just slow down, in the midst of a busy shift.

I sat for a moment, awaiting the inevitable next phone call or text. Predictably, my phone rang within minutes. It was the trauma-team resident.

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Disposable

As a third-year medical student, I was two weeks into my trauma-surgery rotation when my resident casually called me “disposable.” I wasn’t offended—in fact, the word perfectly described how I’d been feeling. I also understood that it was no reflection on my performance; rather, it was a commentary on medical students in general.

Surgery was the first rotation of my third year—and, now that the COVID pandemic was winding down, it was also my first in-person clinical rotation.

I’d never been on the floors of the hospital. I felt clueless, underprepared and incompetent.

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Neuro Consult No. 2

we enter
there is
one emaciated body, encased in ivory blankets
and
one clear-walled plastic bag
hanging from the edge of the bed, ominously filled with red liquid
i feel my stomach churn

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Letter to Myself as a Third-Year Medical Student

At most medical schools, the first two years are spent in lectures, labs and classroom learning. The third year is when students begin rotating on various clinical teams in the hospital and clinics, finally seeing patients as part of a large educational medical team. As I moved through pediatrics, ob/gyn, surgery and other core rotations during my third year, I took notes at the times when I felt out of place or discouraged.

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