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The Case of the Lima Bean

Matthew Webb November 21, 2014 7 Comments

Matthew Webb

“Matthew, go see this lady about her breast mass,” says my attending physician at the clinic where, as a third-year medical student, I’m doing a family-medicine rotation.

Okay, I think. I’ve done my ob/gyn rotation; breast masses are no big deal.

I don my short white coat, freshly baked from sitting in the back of my car as I drove to work on this oppressively hot morning. As I sling the stethoscope around my neck, I feel my inner voice (my constant companion amid the stresses of medical school) gearing up, ready to offer insights, questions, distractions….

Busting Grandma Out

S.E. Street September 19, 2014 3 Comments

S.E. Street

I had been in London on business all of seven hours when my son, Tom, called me at two in the morning from our hometown, Sydney, Australia.

“Grandma’s had a fall. She’s been taken to the hospital, but she’s all right.”

My mother’s having a fall was nothing unusual; she had always been an unpredictable fainter. My husband and children and I called it her party trick, making light of it to soothe her embarrassment.

She had no recollection of these episodes; one minute she’d be seated at the table, and the next, she’d be lying on her back on the floor, her feet propped up on a chair, with the family smiling down at her as if she were Sleeping Beauty awakening

A Doctor’s Dilemma

Jessica Zitter September 12, 2014 12 Comments

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.

Last Rites

Candice Carnes July 11, 2014 11 Comments

Candice Carnes

In 2002, I was living in Albuquerque and working as a nursing assistant. My staffing agency had assigned me to a medical surgical floor at a hospital in Santa Fe, a fifty-minute drive away.

One day, as I was enjoying the high-desert beauty en route to the hospital, a code was called.

The patient’s name was Sam, as I recall. It could have been anything, but Sam is the name that echoes in my memories of that day.

His heart stopped.

I hadn’t arrived at the hospital yet, but I had been involved in enough codes to know what had been done.

Despite his advanced age, Sam had full-code status with no restrictions, meaning that he or his family had wanted everything

The Pros and Cons of Living with a Terminal Illness

Ellen Diamond May 9, 2014 8 Comments

Ellen Diamond

Before I retired in 2000, I worked in a state agency as a peer counselor, or more formally, an employee assistance program (EAP) coordinator. The “coordinator” part was there because my job description wasn’t actually to do counseling; it was to assess the problem and refer the client for help.

But of course both of those processes involved counseling. We just couldn’t call it that.

In 1986, shortly after I’d begun the job, I was separately visited by two employees with HIV/AIDS. Treatments such as the antiviral drugs used so successfully today were nearly a decade away, and a diagnosis of HIV meant almost certain death. These clients were understandably upset and frightened, but they each made it clear to me that they

Consult

Daniel Becker May 2, 2014 7 Comments

Daniel Becker

Once the tube is out it takes her a minute to turn blue and relax. Another minute to lose her pulse. I learned as a student to feel the difference between the pulse in my fingers and the pulse at the patient’s wrist. Or thought I learned. When you listen for a heart to stop you start to hear heart sounds that might not be there. Like waking up at night thinking you heard something then listening to the dark to be sure, not quite convinced either way. Weak sounds, S1 and S2, valves closing. Slow and slower, regular then irregular, then almost nothing…then who knows? The monitor is off in her room but on at the nursing station. One screen shows every heart

Saving Grampa

Alia Moore April 25, 2014 9 Comments

Alia Moore

You were supposed to die of cardiac arrest as you circled toward home plate. Or of a brain aneurysm in the summer during one of your countless hikes through the mountains.

You weren’t supposed to die here. Not in a hospital bed, inhabiting this fragile new body, with an oxygen tube in your nose and tumors in your lungs.

Two days before you left us, I traveled home to visit you. I’d last seen you six months before, shortly after your eighty-eighth birthday. You were a lifelong athlete and adventurer, but you seemed just a little less spry than I remembered.

The Couple Next Door

Kelly McCutcheon Adams January 31, 2014 12 Comments

Kelly McCutcheon Adams

In 2005, my husband and I bought a small farmhouse in northern New England next door to Tom and Sally.

They were in their early seventies, married nearly fifty years, with a large family. Tom’s grandfather had built a farmhouse in 1900 on the family’s small pig farm. In the 1970s, Tom and Sally had parceled off the land and built a modern house for themselves, a stone’s throw from the old farmhouse that eventually became ours.

Eleventh Hour

K.D. Hayes January 3, 2014 16 Comments

K.D. Hayes

Uncle Walt died this morning. Finally.

I say “finally” because I believed this day would come four months ago, when he had emergency bypass surgery.

At the time, I didn’t believe Walt would live; he was an ailing, seventy-seven-year-old man with severe pulmonary disease. When his heart started to hurt one Friday, his doctors told him, “With bypass surgery, you might live. Without it, you’ll be dead before the weekend is over.”

Walt’s oldest daughter and my parents, who were with him, told me about the doctors’ recommendations.

As a retired paramedic, I’d seen this scenario before–often enough to have a strong opinion, and my own advance directives.

A Different Kind of Miracle

Anita Fry October 11, 2013 6 Comments

Anita Fry

Once upon a time, I was a newspaper journalist: I chased down sources and sweated over deadlines. Then, in mid-career, I switched to doing marketing and communications for a regional healthcare system. This consisted of a large hospital and many outpatient clinics, including a community cancer center.

Because I handled communications work for the cancer center, I also had a seat on the Cancer Committee–an oversight group of oncologists, pathologists, nurses and other specialists, who met quarterly.

I found these gatherings a bit intimidating. My fellow members were welcoming, but they spoke almost entirely in acronyms and medical jargon–“OCNs,” “PET/CTs,” “staging,” “linear accelerators.”

One Last Sale

Judith Reichtein September 27, 2013 1 Comment

Judith Reichtein

“Did you sell the business yet?”

I marvel at my patient Jack: despite his breathlessness, he’s somehow managed to greet his wife Sara with a complete sentence. Given his condition, it’s truly amazing.

Most of his lung function has been devastated by his forty-year, pack-a-day smoking habit; the rest has been demolished by cancer. The easy, automatic breathing he once took for granted is just a memory. He can’t even lie down without feeling like he’s suffocating. Propped up on pillows in his hospital bed, he struggles for every breath–pulling it in, forcing it out–his brow creased in a perpetual frown of concentration.

Sara and Jack have been married for thirty-five years, since before he took over his father’s small shoe

Return of the Hero

Peg Ackerman May 24, 2013 1 Comment

Peg Ackerman

Blanched by anemia, Mary rested quietly in the hospital bed. Her pallor made her barely visible amid the bleached bed linens–she seemed a mere shock of white hair against the pillowcase.

Age ninety-three, she’d visited the hospital a half-dozen times in as many months, shuttling between nursing home and hospital as many elders unwittingly do in their last year of life. She may have preferred to stay put, but no one knew for sure: as a person with dementia, she was presumably unable to speak for herself.

I was a palliative-care nurse practitioner in the hospital. Until about two decades ago, whenever someone neared the end of life the details of care were discussed with his or her doctor; nowadays, that intimate discussion often

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

Tag: end of life

The Case of the Lima Bean

Busting Grandma Out

A Doctor’s Dilemma

Last Rites

The Pros and Cons of Living with a Terminal Illness

Consult

Saving Grampa

The Couple Next Door

Eleventh Hour

A Different Kind of Miracle

One Last Sale

Return of the Hero

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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

Tag: end of life

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