The Patient I Didn’t Want
Krithika Kavanoor ~
When I first met Ms. Ruiz, I was barely three months into my first year as a family-medicine resident. I was working harder than I’d ever worked before, and continually facing new challenges. I knew that I was learning, and so I persevered, but opportunities for self-doubt were abundant.
Maybe that was why Ms. Ruiz made such a big impression on me.
A middle-aged woman with a small frame and short black hair, she’d been admitted to the hospital overnight for severe abdominal pain and jaundice. Resting quietly in her bed, she listened intently to my colleague’s presentation of her case, her sharp eyes fixed on his face. I too listened carefully, and gathered that she would be
The Man Who Handed Me His Poop
In broken English, against the backdrop of the emergency department’s chaos and clatter, Mr. Simon relayed his story: unintentional weight loss, gradually yellowing skin, weeks of constipation. He punctuated his list of devastating symptoms with laughter–exaggerated but genuine guffaws.
Over the next few days, as the medical student responsible for his care, I was also responsible for handing him piece after piece of bad news. An obstructing gallstone in his bile duct. Actually, an obstructing mass. Likely a malignancy. Chemo. Radiation.
With each update, he would grin. And then he would laugh.
About Last Night
H. Lee Kagan ~
It was a night like many others. I was taking call from home for my medical partner and myself. My wife and I had settled in, planning to stream the new season of Goliath on Netflix. But the internet was down, so we were watching a talent competition on regular TV instead.
At 8:30, my phone rang.
“Hello, this is Dr. Kagan.”
A long pause, then a tentative “Hello….”
I muted the TV. “Can I help you?”
More silence, then I heard a woman’s voice uttering inarticulate sounds.
“Who is this?” I asked. “Are you looking for the doctor?”
Me Too
It’s late on a Friday afternoon in the outpatient clinic where I’m a third-year psychiatry resident. I’m wrapping up my appointment with Jane, a thirty-five-year-old woman with a mild intellectual disability who comes every month to refill her antidepressant prescription.
“Have you been watching the court case on TV?” she whispers.
I stop what I’m doing and look at her.
“The case with the judge and the doctor,” she says.
I sit back in my chair and give her my full attention.
“I’ve been reading about it,” I say. “Why do you ask?”
She looks down at her hands. “It’s just so hard to watch.”
Wounded Healer
Jamie Sweigart ~
It was a sunny Sunday afternoon on my urban college campus. I’d been sitting on the grass outside a lecture hall where my premed classmates and I would study together on weekends. This particular weekend, I was alone. Campus was empty, except for a man with a backpack who occasionally passed by.
Finished with studying, I started walking down a deserted sidewalk back to my apartment, a few blocks away. On the way, I dialed my best friend from home, Laura, and we began chatting.
“Hang up the phone,” said a man’s voice behind me. I felt the cold blade of a knife against the side of my neck.
My Immigrant Patients
Joanna Sharpless ~
In the living room of the house where I grew up hangs a framed copy of a seventeenth-century map of Pennsylvania. The land is divided into tiny plots, each painstakingly labeled with a family name.
When I was little, I’d stand in front of the map and search for the little squares labeled “Sharples”–the original version of my last name. I’d imagine my distant ancestors, John and Jane Sharples and their seven children, dressed in bonnets and breeches as they sailed across the Atlantic in 1682. As Quakers, they’d purchased land from William Penn and had fled religious persecution in their home country, England.
To a young girl, their immigration story sounded romantic; but as I grew older, I
Just What the Doctor Ordered
I began practicing as an internist/nephrologist in the early 1960s. Having rented an office in Los Angeles, I introduced myself to the local medical community and set out to build a practice.
With a growing family, a mortgage and an office to support, I was hungry for patients. Hospital emergency rooms were good referral sources, so I took ER call at three different hospitals.
Late one Friday night, I got a call from one of these hospitals: A middle-aged engineer was in the ER complaining of chest pain. His electrocardiogram showed minor abnormalities, and he needed to be admitted for observation to rule out a heart attack. Back then, this meant several days of blood tests and repeated electrocardiograms. Uncomplicated
A Tingling Sensation
Mitch Kaminski ~
It had been a hectic day in the urgent-care clinic of my large family practice, and I was starting to worry about the time: My last two patients had put me thirty minutes behind.
I felt relieved when I saw the note for the next patient: “Seventy-four-year-old female with UTI.”
A urinary-tract infection! This should be quick and uncomplicated….
I walked into the room to find a well-dressed older woman seated on the exam table. I had just enough time to wonder fleetingly, Why do some patients decide to wait on the exam table while others stay seated in the chair nearby? Then I turned my full attention to the woman before me.
A Stranger Comes to Town
Syed M. Ahmed ~
Twenty-five years ago, having completed my family-medicine residency, I left Houston to start a two-year stint practicing in a remote village of fewer than 2,000 souls in the Appalachian Mountains of Ohio.
The day I arrived at my new workplace (a two-person practice in the only clinic for fifty miles), my new colleague Dr. Jones told me that she was leaving the next day on a two-week vacation.
Hearing this, I felt anxious, to say the least. I’d expected her to take time off, but so soon? Also, not only were this Appalachian town and its folks completely unknown to me, and vice-versa, but I was the first Asian physician to come to those parts.
Playing a Hunch
Amy Crawford-Faucher ~
There’s one thing about being a family doctor: After a while, almost every patient you see is a familiar face. This can be a blessing or a curse, but mostly it’s a blessing.
This morning I’m in my office, reviewing today’s patients with Julia, the medical student rotating in our office.
I’m especially looking forward to my 10:30 appointment. It’s the first checkup for a newborn girl named Ella. I’ve known her parents, Emily and Dave, since before they had their first daughter, Katie, now three. I think of them as one of “my” families.
Emily and Dave, in their late twenties, have been together since college. Emily works full-time in a management position. Everything about her is
Too Close for Comfort
Andrea Eisenberg ~
Many years ago, on a busy day in my obstetrics-and-gynecology office, one of my partner’s patients came in for “bleeding, early pregnancy.” Since my partner wasn’t in that day, I saw the woman, whose name was Sarah. After we’d talked a bit, I examined her and did an ultrasound. As I’d expected, she was having a miscarriage. Feeling sorry that Sarah had to hear it from me, rather than from her own doctor, I broke the sad news.
We discussed the options: Did she want to have a D&C, or let nature take its course?
“I’m not sure,” she said. “I need some time to decide.” I agreed that this was understandable and left the room so that she
Coming Up Short
Meghan G. Liroff ~
“Why so short?” says the four-year-old girl who’s here with an upper-respiratory infection.
Standing safely between her dad’s knees, she wears a bright pink jumpsuit. Her cheeks are dimpled; her hair is piled in a frizzy bun. She looks me up and down, as if trying to make sense of me.
I can’t help laughing.
It’s true, I think. At five feet even, I’m not blessed with height–but I make up for it in chutzpah. I squat down to bring my eyes level with hers.
“I’m not laughing at you,” I reassure her. “I’m just laughing because you picked up on a major thread in my life.”