Kendra Peterson
July first Fellow,
a pager blares announcing
my initiating consult, a 29-year-old
(just my age)
malignant melanoma
and a first-time seizure
while receiving an infusion
of experimental treatment.
When I arrive
she’s already gotten
two milligrams of ativan
dilantin load is hanging
and I examine
a somnolent young woman
now coming ’round,
could be my friend, my sister, me,
Deborah Pierce
I first met Marie five years ago. A petite, soft-spoken woman in her thirties, she was the patient of one of the residents whom I supervise at our community hospital. Marie worked in housekeeping for a large corporation; she and her husband, a bus driver, had a six-year-old son. Now she was twenty-six weeks (six months) pregnant with their second child.
Marie’s blood pressure was markedly elevated (168/120), she had fairly high amounts of protein in her urine, and her baby measured small on the ultrasound. These pointed to severe preeclampsia–a serious complication that can quickly worsen, leading to kidney damage, seizures or even death for mother and child, and that can only be cured by delivering the baby.
The
Carl V. Tyler
In my clinic and in the nursing home
Every week I see it
That depthless hollow look behind the eyes
But this time it was your eyes
Sitting across the table
At a TGI Friday’s outside of DC.
And that all-too-familiar look to your face
Of knowing and not knowing
Of barely contained panic
Of quizzically furrowed brow
Of fear.
Lost was your rich and subtle language
The rapid-fire musical cadence
The effortless literary allusions
Of English teacher and poet.
Suzanne Minor
Yesterday my friend Sophie asked me to accompany her to a Miami hospital intensive-care unit to see her older brother, Guillermo. He’d been admitted the previous night with seizures and cardiac arrhythmia.
Joined by my husband, we made our way to the ICU. When she saw Guillermo lying immobile, swollen and unresponsive, with a breathing tube in his mouth and other tubes snaking into his chest from IV poles, Sophie broke down sobbing.
Seeing her reaction, I felt a little ashamed at my own calm, although I knew it was hard-earned. During my years as a family doctor working in Miami-Dade County’s community clinics, I’d witnessed countless scenes like this one. Where Sophie saw a beloved brother utterly vulnerable and
E. Wesley Ely
The first time I saw Jessa, she lay crumpled in the ICU bed, paralyzed, expressionless and unable to speak. A military veteran, she had fought in Desert Storm, but she now was facing a deadlier and more inexorable foe: amyotrophic lateral sclerosis (ALS), aka Lou Gehrig’s disease.
This disease causes progressive loss of muscle control, and Jessa was unable to speak, eat or breathe on her own. Her only means of communicating was through small facial movements–opening and closing her eyes or mouth, raising her eyebrows.
A dozen people made up her ICU team: three interns, three residents, a pharmacist, a nurse, a respiratory therapist, a social worker, a hospital chaplain and myself–the lead physician, or intensivist.
Jenni Levy
I need a new stethoscope. I have to wrap my fingers around the fissures in the tubing to make this one work.
For me, these days, listening to the patient’s chest is more a ritual than a means of diagnosis. After twenty years as a primary-care internist, I now work full-time in hospice and palliative care. I spend more time listening to stories than to hearts and lungs. Even so, there’s something about leaning over and finding the right spot on the chest that makes me feel like a real doctor and helps my patients know that they’re being cared for.
Every morning I put this stethoscope around my neck and walk down the hall of our inpatient hospice unit,
Hilton Koppe
Jeez mate, you are really dead. “Really fucking dead,” as you would say. I don’t need to be a doctor to know that. The cop who rang me was right. You must have been sitting in your lounge chair, dead, for at least twelve hours, maybe more. Looks like you were enjoying a quiet drink when you checked out.
I’ve got to tell you mate, it’s pretty weird sitting here at your dining table, with you there, slumped over all mottled and cold, while I’m trying to fill out your death certificate. With your advance-care directive staring at me from on top of all your papers on the table. Was it left there as a gift for me? I did feel
Raymond Abbott
I never thought it would go on for so long–seeing Donald Wyatt, I mean. I certainly didn’t plan it this way.
More than six years ago, I retired at age sixty-six from my social-work job at a mental-health agency. Donald had been my client there for about eight years.
As I was cleaning out my office, his mother called. She explained how Donald’s father had left when Donald was not much more than an infant, which had made him sensitive to abandonment, especially by male figures. Could I, she wondered, meet Donald once in awhile for coffee or lunch?
“Yes,” I said, “I can do that.”
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.
Deborah Pierce
On the Friday before Christmas, I received an unusual gift.
Like any job, being a primary-care physician has both challenges and rewards. The challenges are many, and the rewards are often fleeting–a smile or a “thank you” from a patient or coworker, for instance. And I’ve found that being a teacher of medical students and residents brings an additional layer of rewards and challenges.
One Friday before Christmas, these arrived in an especially potent mix.
Evan Heald
A Different View
Most days, Mrs. Finch’s perspective was outrageously optimistic and embarrassingly complimentary. Although she had the typical assortment of nonagenarian maladies, she would not let that define her; whenever she visited my office, it was hard to get to a chief complaint because of her relentless focus on how nicely the parking lot had been graveled, or “what a sweet, sweet nurse you have,” or my partner’s haircut or the “clever, clever little hooks” holding the geraniums at the entry.
Never mind the treasure trove of doubled superlatives she saved for me, her physician.
Edward Beal
During most of my career as a psychiatrist, I haven’t often dealt directly with death. For the past five years, though, I have had the privilege of spending two days a week treating service men and women returning from deployments in Afghanistan and Iraq. Listening to their stories and talking with them about their war experiences, I’ve spent much more time thinking about death and dying.
Despite this, I was shocked when my wife recently told me she was planning to donate her body to science–specifically, to the Georgetown University Medical Center’s anatomical donors program.
My first thought was that she obviously has never been a first-year medical student in a Gross Anatomy lab. My next impulse was to warn her
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