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“Doctor Sahib, Mamnoon!”

Growing up in Pakistan, I aspired to be a doctor. I was fascinated by movies and TV shows centered on the medical profession and the day-to-day work and lives of physicians. To me, they were superheroes, wearing white coats instead of capes.

A familiar figure in the panoply was the stereotypically brilliant and successful physician/surgeon. (Remember Dr. Melendez in The Good Doctor?) Insanely smart and talented, he was also hard-edged, competitive and almost robotic in his laser-sharp focus on reaching diagnoses and treating symptoms.

Observing similar traits among my mentors while in medical school and during my internship, I concluded that while perfect politeness is the norm, feeling or displaying emotion must be atypical.

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“Are You a Girl or a Boy?”

Ever since my primary-care pediatric group practice adopted electronic records, we’ve used them to give our patients pre-visit online questionnaires that screen for various things: tuberculosis, lead exposure, developmental issues, autism, drug and alcohol use, postpartum depression, food insecurity and so on.

I started off thinking that the questionnaires were intended to save precious visit time by asking patients about these subjects before the appointment. Then I realized that our practice bills the health-insurance companies for administering these questionnaires (and some pay quite well). More recently, I’ve realized that these surveys offered another benefit as well—perhaps the most valuable of all.

For my young patient Remi’s three-year checkup, his parents completed all the recommended pre-visit online screenings.

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Not Knowing

A few days after I’d rotated off the adolescent ward at the university hospital where I was a second-year pediatric resident, I stopped in at Billy’s room to see how he was doing. He was pale, with a few fresh bruises below the sleeves of his hospital gown, but his big brown eyes brightened when he saw me.

“Where’ve you been?” he asked.

“She had to go to work on another ward,” his mom said, rubbing his forearm gently. “I told you that, remember?”

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Her Call Was Tougher Than Mine

“Is he in pain?” Joshua’s mother asked, after I told her who I was. She had finally answered the phone after fifteen days of letting my calls go to voicemail.

“I don’t think so,” I answered. The truth was, at that point in my early career as a pediatric resident, I didn’t know whether he was in pain. “We’re giving him medicines to keep him comfortable.”

“Okay,” she said. I could hear young children laughing in the background. I knew from her obstetric records that she had five besides this newborn.

“Any questions?” I asked.

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Lessons From My Teachers

In July 2003, a few days after I had started service as inpatient attending pediatric cardiologist at Lutheran General Children’s Hospital, the neonatologists, nurses and I met with Jenni and Tony to discuss their daughter Grace’s health status.

Grace, now two and a half weeks old, had seemed normal at birth. After a few hours, her skin color had turned blue: Her oxygen level was dangerously low. She’d been whisked off to the neonatal intensive-care unit (NICU), where tests showed that her heart function was poor due to high blood pressure in her lungs. Her heart and lungs began to fail, so we’d placed her on a heart-lung machine (ECMO) for sixteen days. Now taken off the machine, she was breathing with the help of

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Don, 1979

It’s 3:00 am. Deep in the bowels of the hospital, bright fluorescent lights softly buzz overhead in the windowless snack bar, where a row of vending machines give off a low hum.

Don, my sixteen-year-old patient, and I sit huddled in orange plastic chairs at a tiny Formica table. He is ranting, and I am listening. Neither of us can sleep. Don is awake because he is mad at the world, and I’m awake because I’m the pediatric resident on call.

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My Doctor Joe

Winter 1961

I recall Dr. Ulrich making a house call that night to our residential shoebox on Longview Avenue in Akron, Ohio. My parents were renting the pint-size place. My mother loathed visiting cemeteries and talking about death, so I suspect she felt edgy living across the street from the roomy Sherbondy Hill Cemetery.

That freezing night in 1961, I lay in my parents’ bed, a big bed that swallowed up my little-boy body. I wanted to fall asleep, but I was too restless.

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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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The Birthday Party

Forty years ago, I experienced a miracle—the first of many in my nursing career. I was about six months into my first nursing job, in the neonatal ICU at Children’s Memorial Hospital in Chicago. It was there that I met baby Jonathon, and it was his mother who made me a true believer.

Jonathon had come to us with severe kidney disease. He looked sickly: His skin was very pale—translucent even. He acted like a healthy infant, though, and as he got older, he actually smiled at us. But despite the doctors’ best efforts, his kidneys were barely functioning.

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What Remains From the Pediatric Ward

I wake up in a hospital isolation room, where everything smells weird. It’s 1967 in Galway City, Ireland, and I’m four years old.

The worst smell is the antiseptic—a word I don’t know yet. The second smell is the crayons and newssheet coloring books on the nightstand. Christmas is gone, so how can these be for me?

The family lore would say that I spent nearly seven weeks in that hospital. That’s forty-nine days or 1,176 hours’ worth of temperature checks, dosages, white-coated doctors.

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Caught in the Crossfire

I’ll call him Rocky. In a drive-by incident, his father was killed, and Rocky, age one, was shot multiple times.

His initial resuscitation was heroic—he received medicines to support his blood pressure, underwent emergency surgeries and was still attached to machines to support his breathing—but by the time I met him, the drama of his shooting had receded: He and his medical team had settled into a stable routine.

Though I suspect that the team had expressed their grief earlier on, I found this sense of calm jarring and unnatural.

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The Wizard and I

He’s wearing a Yankees T-shirt, an EpiPen holstered to his belt like a lightsaber. We’re old friends. Trevor has been my patient for four years—more than half his life.

This will be our last visit: After forty years, I’m retiring.

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