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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Finding Freedom in Difference

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

It was 3:00 am on my third night shift out of five, in a busy inner-city hospital in Sydney.

Having just reviewed six suicidal patients back to back, I felt tired and frustrated.

If I have to see another suicidal patient tonight…Why don’t they go and be suicidal somewhere else? I wondered wearily, then felt ashamed at the adversarial division I’d created: patient vs. doctor, them against me.

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The Judgment of Solomon

As a cancer doctor, I’m no stranger to asking patients with a life-threatening malignancy about their wishes. My question generally goes something like this: “Going forward, do you want to pursue intensive treatment, or forgo it in favor of enjoying the time that remains to you, with relief for your symptoms as needed?”

Asking this question is an intrinsic part of my job. But when I found myself having to ask it of a family member, I felt shaken. This was different.

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Borderlines

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

When I started as an intern at a regional Australian hospital in the late Nineties, there was a patient—let’s call her Laura—who was notorious among the emergency-department staff.

Laura had sliced up much of her available skin over the years and had moved on to swallowing cutlery and razor blades. She’d had numerous operations to remove the silverware in her stomach, and countless sutures to stitch up the lacerations atop the old scars on her limbs and trunk. Over and over she would be discharged, only to turn up again with yet another macabre self-mutilation.

Each time, the surgical and emergency teams rolled their eyes and gritted their teeth.

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Kids Always Know

This is a story about failures. First, it’s about my inability as a pediatric hospice physician to do the one most important job in this tender space. Second, it’s about well-meaning, loving parents’ inability to do their part in that job.

Jacob was a smart, funny, elementary-age kid, great with Legos.

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My Mother’s Keeper

It is a mitzvah to take care of your parents: “Honor thy father and thy mother.” And caring for people comes naturally to me. I’m a physician; this is what I do.

But when my father looked to me to cure my eighty-five-year-old mother’s dementia, saying, “You’re the doctor! Help her!” I knew he was asking too much.

And yet. How could I stand idly by while my mother’s mental acuity slowly drained away?

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Due Date

It’s the bright orange color that catches my eye. Nestled in a box under my home office desk, alongside unused breast pads and pumping supplies left over from the birth of my first daughter.

My first, because there should have been a second. A girl.

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High Stakes

As a practicing child and adolescent psychiatrist, I’ve been trained to treat depression and evaluate suicidal risk. Yet when it comes to working with an adolescent who expresses a wish not to exist, trying to clarify what’s actually meant feels daunting.

I’m reminded of this one Monday morning as thirteen-year-old Paula sits across from me in the interview room.

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Time Splintered

Time fractured when my first husband died.

There was a before, which no longer existed, and an after, which was unimaginable.

In between, the thinnest–unfathomably thin–line, was the today. The today meant putting one foot in front of the other. One today led to the next today. And finally the year was over.

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Daring to Dream

For the past three years, I worked as a rural primary-care doctor. Two months ago, I resigned to pursue further training in hospice and palliative care. My patients were the inspiration that illuminated every step of my way towards this new path.

Marly came to me for a workup of her persistently elevated liver enzymes. Together, we navigated her new diagnosis—liver cancer—and a series of failed treatments. Eventually, Marly’s thoughts turned to facing her mortality.

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Northern Lights

“Let me die,” you say.

You’ve listed the reasons, presented the arguments: You’re a burden, a mere speck in a world of billions, one that will not be missed. A life that never asked to be born. Why prolong this pain?

“Please, let me die,” you say again, this time with a sob that allows no more words.

I hear you, I do.

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The World’s Second-Best Baklava

In 2013, as a hospitalist, I attended the annual conference of the Society of Hospital Medicine. This meant traveling from my home base in Ohio to Washington, DC, the site of that year’s conference.

The second day was winding down. Colleagues, new friends and countless strangers were scurrying to their rooms to freshen up and get ready for a night out on the town, where they’d continue to mingle, share research and professional achievements and scout out career opportunities.

I had other plans, however.

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Broadway Bound

Ever since his adolescent years, my son and I have had an ongoing conversation (you might call it an argument) about my habit of speaking too frankly when sharing my opinions, which I do frequently.

Or, as he puts it, I have a big mouth.

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