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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Abuela

 
The abuela was a standard admission of my internal medicine rotation. “CVA” said the medical record, which meant this Guatemalan grandmother, or abuela, had suffered a stroke. She was visiting the U.S. to help care for her first grandchild, who was due any day. She had felt fine until, suddenly, her diabetes, high blood pressure, and high cholesterol had imploded. In quick succession, she’d experienced a stroke, a 911 call, and the ER. Uninsured and undocumented, she’d been stabilized and transferred, serendipitously, to our nationally renowned rehab hospital–a stroke (no pun intended) of luck for this far-from-home 54-year-old.
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Learning to Trust

 
I admitted Hiral Jacobs, a twenty-something college student who’d collapsed in her dorm, directly to the ICU from surgery.

The OR report said she’d received two units of blood and was still intubated. Given my forty years of ICU nursing, it sounded routine.

“By the way, the patient is Muslim.”
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Before Ultrasound

Mary looks not too bad for having a two-week-old baby only now getting good at nursing. He looks content. His weight is not quite where I would like to see it, but not worrisome.

Lifted in my hands, his tone is great, his gaze intensely locks on mine. Put back down, his arms and legs flail enthusiastically. Cheeks are chubby, soft skin is pink. He passes the gestalt test – no worrisome sense that something is not quite right.

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At Day’s End

Marc Tumerman

This is a story of two deaths. That these patients’ stories intersected on the same morning, in the same building, in two adjacent rooms, has left me thinking about them now that the day is almost done.

I was surprised to see Mrs. Stevens’ name on my schedule today. She came to the office last week, and I felt sure that she’d be too weak for another visit. But I was glad she’d made it, as I’ve become quite fond of her.

She’s seventy, and dying of metastatic lung cancer. She’s a lifelong smoker, but at this point I’m not worried about cause and effect, accountability and responsibility. None of that changes what I must do now as her physician.

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Speeding Ticket

I’m an ob-gyn, so the middle of the night is like a normal workday for me. I view the drive in at 2:00 or 3:00 a.m. as my transition time from interrupted sleep to an important moment for my patient and spend it reminding myself to make the shift from fulfilling my needs to theirs.
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A Stroke of Faith

 
“SIGNED OUT AGAINST MEDICAL ADVICE,” declared the last line of the ER physician’s note, bold and foreboding.

I quickly skimmed through the rest of his chart. Mr. Lopes was an elderly Haitian man, a recent immigrant, who had visited the local emergency room for a bad headache, only to discover that his blood pressure was astronomical. Apparently, Mr. Lopes and his family considered him too sturdy a man to be retained at the hospital overnight, labeled as sick. So he fled.

And here he was, weeks later, to meet his new doctor. “BP: 190/100” read the nurse’s note in red.

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The People a Doctor Worries About

 
The middle of the night is when I worry about a patient like Olevia, whose oldest son was shot and killed at the age of 23. He left behind his baby mama and his two baby girls. Olevia didn’t have enough money for his funeral expenses, so she had to promise to pay in installments over the course of the next two years. So she gets a reminder of his death every month in the form of a bill.
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Praying to Pray

 
I was 25 years old, a fourth-year medical student, and suffering from a severe depression. I was getting cognitive behavioral therapy (which was then fairly new) from a psychiatry resident at my medical school. I was a good patient and kept a journal describing my therapy. About a week after thinking seriously about suicide, I wrote this prayer in my journal:
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How to Change a Diaper

Two daughters bring their severely demented mother into the clinic. The mother is no longer able to speak, but over the last few days she has groaned more during diaper changes. Her nursing home is worried she might have a bladder or vaginal infection. To check her urine, we undress her and catheterize her. To check her vagina, we take a swab using a speculum. We spin the urine and look for sediment under the microscope. Nothing.  We look at the vaginal smear under the microscope, using both a saline prep and potassium hydroxide. Nothing. We treat her for bacterial vaginosis, because it’s a condition that’s easy to miss.

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The Color of Tears

“Hey Doctor Curly!”

“Hey Hungry Hippo!”

“You still haven’t gotten a haircut? Have you had one since your Bar Mitzvah?! What nice Jewish girl’s gonna go on a date with you with your hair that long?!”

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A Mother’s Son

Hugh Silk

“Why do you want to go into family medicine?” my internal-medicine preceptor asked.

It was an innocent enough question. I’d known from day one of medical school what I wanted to do, so I answered with confidence, and perhaps a bit of a chip on my shoulder.

“I love being with people and getting to know them,” I said. “I’ve always been this way, so it makes sense that’s what I would do for my career. I’m looking forward to having the long-term relationships and seeing where they go.”

A raised eyebrow, followed by his knowing Irish brogue: “I applaud that. My own father was a GP in Ireland. But I’m afraid you won’t find much of that in

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