Tissues, the box an arm’s length away
from the woman who talks about
her daughter, my client,
her many relapses, how she did well
for a time. I nod. Somewhere, a blast
of car horns. Outside my door,
After I retired, my wife and I moved, giving me a reason to go through my old files. I found the notes from this story scribbled on some scrap paper that used to be everywhere in our offices. “Keep good notes,” someone once advised me. These are good notes and a good story.
Thirty-five years ago I was on the faculty at the University of North Carolina in Chapel Hill and spent a lot of time traveling around the state.
A small wooden figure watches over my office. Four inches tall, hand-carved, neatly painted wood—an angel figurine with golden hair, majestic wings and a simple pure-white gown. Throughout my day seeing patients as an internal medicine and pediatrics resident, this angel watches over me—a constant reminder.
Two years ago, as a fourth-year medical student, I was on my internal medicine “acting internship” on the general internal medicine floor. This service was known for great teaching and complex cases—and notorious for emotionally heavy experiences.
It’s winter of 1993. A cold, snowy day. Windy. A blizzard. The phone rings.
I’m not on call for my patients today–except for one. Daisy has been in my care since the early 1970s, and given the risk that she may suffer a serious downturn, I’ve instructed her nursing home to call me whenever necessary.
Zach Reichert ~
In my third year of medical school, I started a rotation at the nearby VA hospital. Walking toward the polished glass doors that morning, I saw my reflection–clean white coat, assured expression to cover up how lost I felt. It was my second clinical rotation ever, and my first time at the VA.
I found my team and soon met a patient I’d be seeing for the next month. His name was Jim. He’d already been hospitalized for a week–and he wasn’t leaving any time soon.
At seventy, Jim had no muscle or fat on his body. His gray skin hung like a sheet over the ridges of his skeleton, and his bony arms were
Meghan G. Liroff ~
“Why so short?” says the four-year-old girl who’s here with an upper-respiratory infection.
Standing safely between her dad’s knees, she wears a bright pink jumpsuit. Her cheeks are dimpled; her hair is piled in a frizzy bun. She looks me up and down, as if trying to make sense of me.
I can’t help laughing.
It’s true, I think. At five feet even, I’m not blessed with height–but I make up for it in chutzpah. I squat down to bring my eyes level with hers.
“I’m not laughing at you,” I reassure her. “I’m just laughing because you picked up on a major thread in my life.”
Marianna Crane ~
As I sit in the exam room waiting for my first patient of the afternoon, the phone rings. It rings four more times before I realize that Amanda Ringwald, our eighty-year-old receptionist, hasn’t come back from taking a rare lunch break.
I pick up the phone and say, “VA Hospital. Marianna Crane.” Oops, I’m not back at the VA anymore. “Senior Clinic,” I quickly add.
“Hello, my friend.”
The familiar voice makes my throat tighten and my eyes water. How in God’s name did he track me down at work?
“Mr. Foley. How are you?”
Joy Liu
The room is stuffy, but the woman is shivering.
Her husband stands by her bedside. An interpreter that they’ve hired to stay with her day and night stands at the foot of the bed. And then there’s me, the doctor (I’m an intern), waiting to deliver one of many sad speeches I must give today.
Smiling wanly, she struggles into a sitting position and shakes my hand.
Even with a diagnosis of metastatic stomach cancer, she has movie-star looks. She’s only twenty-six–the same age as me. I can imagine her stepping out of a red-carpet premiere in Shanghai. Instead, having hired personal interpreters and taken a flight halfway across the world, here she is in this hospital bed, waiting
Alexandra Godfrey
My dad was once a physician for the coal mines in Yorkshire, England, where I grew up. It’s been decades since I accompanied him on his rounds, and fifteen years since I moved to the States and began to practice as a physician assistant in the Appalachian Mountains of North Carolina. But I still vividly recall my childhood days and the Yorkshire dialect we spoke.
Somehow, the seventy-three-year-old woman sitting in my exam room takes me back to that time.
She’s coughing violently–hacking thick yellow mucous into her tissue, spraying the floor with spittle–just as my father’s patients did.
Carly Bergey
It’s called a missed miscarriage: You arrive, as I did, at the doctor for your first-ever pregnancy appointment, suffering from morning sickness and filled with joyful anticipation–only to learn that your body has not yet registered the death of your small embryo. Despite all of my doctor’s tinkering and double-checking, the ultrasound screen showed no movement. There was just the outline of a baby in me, quiet and still.
Hoping for a natural miscarriage, I told my coworkers what had happened, but asked that we not discuss it at work.
Day after day, I went to the Denver office where I worked as a speech pathologist, carrying my baby deep inside me, like a single stitch woven within fold after fold of
Robert Burns
“She’s been hearing voices,” says Adala’s nephew Diri. “She hears them every night.”
The three of us sit in an examination room of my private geriatrics practice. I’ve been in a community-based practice in Memphis, Tennessee, for nearly twenty years.
Adala is a tall, slender woman. Dressed in a gray-blue guntiino, a long piece of cloth tied over the shoulder and draped around the waist, she has her head covered with a shawl. Her gaze shifts from her nephew to me; her eyes search my face and then stare silently at the floor. Despite the differences in culture and language, she is like many of my patients brought by a family member. She’s not here by choice; she came in
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