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Lean on Me

Joseph Fennelly ~

One morning in my office, a tall, slim package arrives along with a note, a portion of which follows:


Dr. Fennelly,

I can’t apologize enough for not getting your walking stick back sooner. Since my dad’s passing we have had to move my mother (who has a memory problem) several times, and with each move the walking stick moved too.



In some ways it reminded me of my dad and the relationship you and he had. It was comforting for him and us to know he had you in his corner to lean on and support him.



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Popping the Question

Mitch Kaminski

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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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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Crafting My Own Safety Net

Nicola Holmes

As I guide my car through the evening traffic, I feel tears on my cheeks.

I am a doctor who plans ahead: I write out plans for my patients. This has led to my nickname, “Plan Doctor.”

Each of my consultations is carefully crafted in separate steps. The conclusion is laid out in my own neat copperplate handwriting on a plain white page. (My father taught me to write copperplate. For hours every evening I would copy stencils of words he’d written out. At the time I felt persecuted; now each day, as my writing flows, I marvel at his wisdom.) 

Each plan leaves the room with

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Piece of Work

Jennifer Frank

“You’re a real piece of work!” he spat at me. He was a patient named Martin; I was the supervising physician, trying to role-model for a second-year resident how to conduct a difficult conversation with patients like this. 

So far, not so good.

At first glance, Martin seemed an ordinary-looking older man, with close-cut gray hair and plain-framed eyeglasses. But I was struck by his scowl–he was expecting an argument, perhaps because during his interview with the resident he’d already encountered some pushback. 

He’d brought a long list of laboratory tests that his biofeedback “doctor” had instructed him to get, saying that his fatigue and other symptoms were caused by “adrenal dysfunction.”

I scanned the list–thyroid, blood count, chemistries, vitamins, adrenal function. “Testing

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