I know what I wantI want the patients to feelSome semblance of neutral“Healthy” being the motionless nodesAlong that sinusoidal waveWith its own peaks and troughsOf pain, of anxiety, of uncertaintyAndOf relief, of hope, of healingLet us give them that equilibriumSo that they can begin again
“Hail Mary full of grace,” the opening to a prayer that Ihad said many times throughout my life.I seldom pray in the hospital, but I also seldom satholding my mother’s hand while she was in a coma in theICU. I finished my prayer, said, “Amen,” and startedagain from the beginning.
“Today is a good morning.”How did I not feel it?Phone rings, stomach knots, answer it.“Are you sitting down?”I don’t sit. I sink, then float, looking down at the scrub-cladgirl shivering on thehospital floor.Footsteps approach, tentative hands on shoulders.“I don’t want to be the girl whose mom died.”
Jaundiced, she presented with acute hepatitis C.Pre-contemplative but concerned, she asked for clean needles.Unable but determined, we offered the 18-year-old mother offour a Nexplanon instead.Implant in place, she proclaimed “now I am invincible!”Later, withdrawing, she quietly left with an IV still in place.Embarrassed, we chuckled and claimed “harm reduction.”
In extremis, her husband deposited her in the ED while bloodpoured from her mouth.Mortified, I wrapped myself in plastic and said “Do you need ahand?”Tremulous, my hands cramped as the Yonker struggled to keepup.Dissociated, I looked at the ceiling and dreamt of red Blakemoreballoons floating to the sky.
Hungover, she presented with her pancreas inflamed.Lucid, fluids and morphine went into her veins.Obtunded, she went to the ICU with an overlooked Tylenollevel.Humbled, my attending said, “This is the part that sucks.”Suppressed, her son caught my eye through a glass-door as Ished a tear and went back to work.
People crowdingPatient is crashingI stand in lineHeart pounding My turn is upI feel crackingRibs fracturingI hear the resident sayLet’s consider stoppingBut next roundROSC was obtained PatientNow intubatedPosturingBruisedTime of deathCame much later Makes me wonderIf we did more harmThan good
Patient on swallow precautionsBecause of a recent trip to the MICUFor aspiration pneumonia I go to examine herLifting her sheets gingerly,to not disturb her sleep And there, right by her mouthIs a Lindt chocolate bunnyWith the head bit right off When you’re 85,Some things are worth aspirating for
Dear Reader, Dear Reader,The stories contained in the upcoming pages reflect a collection of experiences and reflections from the current fourth-year class of medical students. These stories reflect a spectrum of experiences and emotions, from uplifting to sorrowful and even devastating. We experience the spectrum of emotion and connection in our learning from and care …
Continue reading “2024 | Voices from the Wards, Introduction”
HPI: 16-year-old male with a PMHX of teeth problems and a big attitude presents for routine follow up. PE: Heart Rate 140 bpm; Respiratory rate 25 bpm. Short stature, non-verbal but pleasant. Assessment: Amigo, a good boy. Plan: More treats, pets, a walk, and love. Discharge plan: To the bathtub, he definitely needs a bath.
“Gal who brings my pills said she had you,” says my eighty-one-year-old father.Worlds collide.I ask her name.Foggy memory: Back row. Sorority hoodie. Often late.Panic: Did I give her any reason to be less than kind to this old man?“Said you were hard but good.”Relief: “Tell her I said hi.”
“This is not your usual quality of work. Please resubmit when you can.”I totally forgot writing that, and in retrospect it looks harsh.But more than a decade later, that student reminded me and said being seen and treated as aperson changed their life.You don’t necessarily know when you transform someone’s world.
Resident Clinic TherapyHow was the weekend?We talk sports, partners, kids, pets… life.90’s movies & song references.Pop culture quotes from our youth.Residents enter. . . We pause. . . staff the visit. . . teach. . . un-pause.We laugh. . . we bond. . . we connect.Background noise from dragon and keyboardsclacking.Re-charges me for the rest …
Patients cough, die.Then a Black man says“I can’t breathe,”His neck under a knee. Two threats now:violence and virus At my clinic, shattered glass.A rock on the exam-room paper.A Black patient apologizes:for crying mascara on my white coat.I listen to her heart, her breath,and try to breathe.
Her bruised body records her trauma.Her hands clench and unclench.She whispers, “They will say I should have known.”He’ll declare, “Look what you made me do.”I reach out tentatively to touch her hands.A single tear lines her cheek.After the examination and photographs, she sits quietly.Her hands clench and unclench.
Kneeling by her bed, they started to pray.I watched respectfully, and turned to leave,knowing Haldane’s work on the efficacy of prayer:an exercise in futility (but comforting at night).Next morning I met her properly, sat up on pillows,enjoying breakfastfrom a box her children had brought from outside.She smiled, symmetrically.
Slowly, I insert the needle, withdrawing the straw-colored fluid from John’s lung cavity. Only 35 years old, his extreme shortness of breath brought him in. His x-ray shows a right-sided whiteout, with his thoracentesis the first step to his eventual cancer diagnosis. I see his future of chemo, resection, and radiation. And then I cry.
The yellow balloon continued inflating.It enveloped the bedside nurse, then myself.Soon the whole room was awash with dingy mustard light.There was so much pressure, with nothing to relieve it.Inside the balloon, I saw him, scared and strong.Shaking my hand firmly, he thanked me,ready to die with his dignity intact.
My exam room is evidently too plain for my favorite adult patient, whose cognition may be lower than most, but whose wisdom is much higher.He wears his interests on his sleeve. And belt buckle. And hat.“What you need in here is a picture of Godzilla, a Rodin, and a megalodon.”I don’t disagree.
Dear Reader, This year we invited faculty from across Health Sciences to contribute to our publication. Patient care is an interprofessional endeavor and we wanted to showcase how learning to provide medical care takes place across the professions. Jo Rolls illustrates this well in “Still, Teaching,” in which a patient continues to teach, even while …
Continue reading “2024 | Voices from the Faculty, Introduction”
He is admitted for end-stage Parkinson’s diseasewith acute delirium.I ask,Why won’t Neurology see him?Why is he still restrained in bed?Why won’t a skilled nursing facility accept him?Why can’t hospice help?Why does it take so long?He asks,How will it end?How will I die?I don’t know.
Caring for patients is harder some days. “I killed my cat. He was biting and clawing me. I knew he was scared, but I just shook him hard to make him stop. I feel terrible and don’t want to be that person.” I’m glad it wasn’t his baby. Sad about his cat. Sad for him.
Outside, dark and quiet with softly falling snow.It’s Christmas Eve.I see blasts on your bone marrow slide.I am waiting for the flow cytometer. You are waiting too, sweet child.Finally, data–B-lymphoblastic leukemia.Cancer and I will now ruin your holiday.I pick up the phone and tell your hematologist the news.
