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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Behind Closed Doors

Sophia Lee Ryan

I’d prepared as much as I could: I had a huge coffee, a water and every kind of snack imaginable stuffed into my bag. In my head I carried as much information about dilation and curettage as I’d been able to absorb during a study session at Starbucks the night before.

I was a third-year medical student doing my obstetrics and gynecology clerkship, and I was about to spend a day at the local family-planning clinic. The clinic offers support to women on all aspects of contraception, from education and counseling to providing various methods of birth control or carrying out terminations. I knew that this was their OR day, so I’d researched some of the cases that I

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The Story of Pulse

One Monday morning, a number of years ago, the administrators at the family health center where I used to work instituted a new and time-consuming procedure for registering patients. They did this in an attempt to satisfy the rules and requirements imposed by the many different insurance plans our center accepted.

There was just one problem: the administrators forgot to tell anyone what they’d done–not even the center’s medical director, who happened to be on vacation at the time.

As the clerical staff stumbled over a brand-new, complex set of protocols that day, a line of patients, mostly poor, snaked around the lobby, out the front door onto the sidewalk. Tempers grew short. A fight nearly broke out. We providers sat in the back twiddling

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A Greater Truth

Nancy Elder

Should someone have to lie to get care? For millions of uninsured Americans, finding a way to receive health care is a challenge. In my practice, I’ve been seeing more and more of the following:

“Where have you been living lately?” I ask my third patient of the morning, a heavy-set, forty-nine-year-old man with dark, weathered skin and rough hands.

“I’ve been staying with my friend,” comes the casual reply

“How long have you been staying there?” I continue.

“You know, for a while.” His tone is a bit guarded.

“How long is ‘a while’?” I am wary now.

“You know, a bit of time.” I can

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Adverse Effects

Kenny Lin

Flashback to summer of 2008. I’m looking forward to August 5–the day that I’ll no longer be a faceless bureaucrat. The day that the US Preventive Services Task Force (USPSTF) will issue its new recommendations on screening for prostate cancer–recommendations I’ve labored on as a federal employee for the past year and a half.

For much of 2007 I combed the medical literature for every study I could find on the benefits and harms of prostate cancer screening. In November of that year I presented my findings to the USPSTF, a widely respected, independent panel of primary care experts They discussed and debated what the evidence showed and then voted unanimously to draft new recommendations. I didn’t get to vote, but it has

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Making Headlines

Reeta Mani

“Did he die of swine flu?” demanded a scrawny man wearing a blue shirt and green surgical mask. He was one of a throng of news reporters packing the lobby of a private hospital in the heart of Bangalore, my city.

It was early August 2009, and India had just recorded its first casualty from the novel H1N1 influenza virus. This latest variant of influenza–a chimera of swine, avian and human flu genes–was raising grave concerns among the medical community worldwide. To try to contain a pandemic, countries were ordering stockpiles of antiviral drugs and initiating vaccine production on a wartime footing. 

In Bangalore, as elsewhere, you

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One More Child Left Behind

Brian T. Maurer

Making the diagnosis might be straightforward, but sometimes getting adequate medical care poses a more formidable challenge.

It was the end of an exhausting afternoon in our busy pediatric practice in Enfield, Connecticut. I had just finished seeing what I thought was the last patient of the day, only to find yet another chart resting in the wall rack, a silent signal that one more patient waited behind an adjacent closed door.

His name was Aaron. Six years old, he sat on the exam table cradling his left arm in his lap. The most striking thing about the arm was the large bluish bulge on the side of his elbow. His mother stood by his side; his grandmother sat in

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Late Again

Paul Gross

One thing I love deeply about being a family doctor is that I get to take care of people–body and soul. A patient comes into my exam room with a litany of physical symptoms (“My shoulder…my knee…my stomach…so tired…this nausea…”) and then, in response to a questioning look, suddenly bursts into tears.

It’s all mine to deal with. The shoulder. The stomach. The tears. I get to gather the pieces and see if we can’t put this broken person back together again.

What a privilege.

And yet the joy of primary care is also its curse. With each patient, I have to keep track of everything–the trivial and life-threatening, the physical and mental, the acute, the chronic and the preventive. And

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Halloween Horrors

Paul Gross

One October evening last year, I went to our local pharmacy to pick up a prescription for my daughter. I made sure to bring Cara’s insurance card because my employer had switched us to a new health plan.

I wasn’t sorry about the change. Our prior plan had been operated by incompetents–although they might only have been crooks, I couldn’t be sure–who also managed our flexible spending accounts. These accounts, you may recall, collect pre-tax income from your pay and then return it to you to pay for out-of-pocket medical expenses.

With that plan, nothing ever worked as advertised. I would submit a dental bill for reimbursement and the company would review it for three months before sending me a denial notice, stating

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Rx

 Veneta Masson

Politicians…were quick to rise to the defense 

of a particularly vulnerable population. As a group, 
dual-eligibles [Medicare-Medicaid] have incomes below 
the poverty rate…and take an average of 15 medications a day.

 

Washington Post
January 14, 2006

 

This is how it works: 
as wealth trickles down 
to the poor and old 
it turns into pills.

 

So M and S, their slender portfolios 
long since depleted, can still
compete for bragging rights.
I take twenty a day, says M.
Ha! counters S, I take so many
they had to put in a port.

 

G presides over the corporate enterprise,
his specialty, mergers and acquisitions.
With combined assets (his own and his wife’s)
filling two cupboards, he allocates resources, 
tracks inventory, restocks 
from Canada and

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A Brush With the Beast

It all begins one Sunday morning when Mrs. Morris, a 75-year-old retiree with a heart condition, trips on her way out of church. She falls flat on the sidewalk, can’t get up, and ends up in our Bronx emergency room. A CT scan shows a pelvic fracture, and she’s admitted to our inpatient team.

When I join the family medicine residents to see Mrs. Morris the following day, she can’t get out of bed. She’s got short, unruly white hair and a gee-whiz expression that charms us. “What a pain!” she says. Given how close she lives to the brink–terrible circulation has cost her one heart attack and several toe amputations–I’m impressed with her good cheer.

Things looks promising. Follow-up studies confirm that the

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