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How Will I Know You’re Not Dead?

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.”

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Popping the Question

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.

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Friday Before Christmas

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.

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Mrs. Finch and Ms. Virginia

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.

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One Last Gift

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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A Doctor’s Dilemma

Jessica Zitter

It was my first day at my new job, practicing a new specialty. Having spent fourteen years as an ICU physician–including a four-year pulmonary/critical-care fellowship in this very hospital–I had just completed a palliative-care fellowship. Now I was the hospital’s palliative-care consult attending.

When I set eyes on the patient in room 1407, my first thought was: THIS LADY NEEDS TO BE INTUBATED–STAT!

The only trouble was that my job was to ease this patient’s passing, not to prolong her life.

The team had told me that Mrs. Zelnick, an eighty-two-year-old widow, was dying from pneumonia and didn’t want to be put on life support.

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Seeing the Light


Sarah Houssayni

Many healers, teachers and parents have them.  

At one point, I did, too. I had delusions. I thought I was a hero, a rescuer clad in a shiny white coat and wielding the sword of clinical wisdom. 

 

I look back on those days with nostalgia and regret. I wish they’d lasted a little longer–my belief in my own medical grandeur and invincibility. 

 

My most memorable patient changed that for me.

I remember how her mother, Gigi, first brought Serenity to see me when she was a newborn. Gigi was fifteen; I was

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Beating the Numbers Racket

Thuy D. Bui

“What’s my number?” shouted Betsy as I entered the examination room one day last fall.

“Oh, you mean your A1C? It’s nine-point-four!” I answered. A sentence sped through my mind: “The hemoglobin A1C number tells how well a patient’s diabetes is controlled–seven or less is good.” In my seven years as Betsy’s primary-care doctor, I’ve repeated this information at visits and included it in appointment reminders as well.

Betsy is a pale, stocky woman in her sixties, with short, neatly cropped hair. Her rather tentative smile, to me, always seemed a bit forced, as if covering up for underlying pain. And she’s had plenty of pain in her life.

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Sharing Secrets

Maria Gervits

“I feel bad…” Amy whispered, then paused.

I’m a family-medicine resident, and I was doing my gynecology rotation, which involved spending a few days at a Planned Parenthood facility. This was my first day. I’d been assigned a patient to shadow: a young woman named Amy, who was here to have a first-trimester abortion.

I’m a fan of Planned Parenthood’s work providing high-quality, affordable contraceptive and gynecological care. In college, when I lost my health insurance, I’d gone to Planned Parenthood for birth control. Now, as a doctor in training, I was curious to see how the clinic worked from the inside.

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Be Lucky

Kenneth Zeitler

In 1996, visiting a mall during an out-of-town trip, I suddenly felt dizzy while descending on the escalator. The sensation rapidly resolved, but to be on the safe side, I went to a local emergency room. My evaluation included a CT scan of my head; the results, I was told, were “normal.”

Shortly after returning home I received another call. The CT results were not normal, and I should see a neurologist to have an MRI scan.

I panicked, as anyone would, but I had more reason than most: I’m a medical oncologist. I knew the implications of this news, and they were mostly quite dire.

The MRI revealed a brain tumor, likely “low grade.” I found this a bit reassuring–but still, it

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Escape from Chemo

Ellen Diamond

And while the stuff drips in, I’m rolling over
in my mind the two words: Kemo Sabe.

It’s the name that Tonto called his friend
the Lone Ranger, back in radio days.

I could use a trusty sidekick now,
crouched behind the white screen near the door,

ready in an instant to unsheathe
his blade, then back us slowly to the window.

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