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fostering the humanistic practice of medicine publishing personal accounts of illness and healing encouraging health care advocacy

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Tag: end of life

Fear of Flesh

Sometimes I wish that skin and bones didn’t exist. Of course, that would be impossible—the skeleton is the scaffold for our bodies, while the skin is the insulation for vital organs such as the heart, kidneys and bowels. Without our skin and bones, we’d be mere piles of goo on the floor.

Bones are too complicated, for the simple reason that there are too many. As a first-year medical student studying anatomy, I agonized over learning the grooves and prominences where the muscles originate and insert into the bones. I always struggled to find these so-called bony landmarks on our simulated patients.

And flesh…the skin is even more

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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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Aftershocks

It’s Monday. I wake up at 7:15 am, go down to my apartment building’s lobby and meet with friends to work out before the rest of the day begins. We do arms, chest and back for an hour, then my friend PJ and I hit the steam room and head back to our apartments.

I call my mom for five minutes, then shower, dress and, before breakfast, knock out some flashcards on my laptop, like

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The Man Who Holds Hearts

One spring day last year, I sat in the office of the man who was to be my husband’s heart surgeon, waiting to have one of the most important conversations of my life. My husband, Craig, sat next to me with his guide dog, Chase, at his feet.

The doctor—tall, dressed in surgical scrubs—came in, introduced himself and sat down. His eyes looked kind; his demeanor was serious.

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Living and Letting Go in the ICU

Driving from the Atlanta airport, I arrived at the hospital ICU where my mother had been admitted the day before for trouble breathing. This was the hospital where my siblings and I were born and where our father died. This was the hospital featured in The New York Times following the coronavirus outbreak in March 2020. The hospital still sees record numbers of COVID admissions, and I expected the staff to show signs of exhaustion

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The Last Beat

It was midmorning at the hospital where I was a clinical medical-surgical instructor. I was standing at the medications cart with Sally, one of my third-year nursing students. One of the floor nurses approached.

“You have Anna in Room 44, don’t you?” she asked Sally.

Sally nodded.

“You better go in there,” continued the nurse. “She doesn’t look too good.”

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Gift of Gratitude

We all remember our patients who die, though the first patient death really stands out from the rest. This was certainly true for me.

I was just starting the second year of my internal-medicine residency. This wasn’t the first time I’d seen someone die, but it was the first time I’d seen someone who’d been alive and well, and talking to me that morning, be dead by the afternoon–a shocking dichotomy that haunts me to

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Almost Normal

His steps are wobbly. Our children hold their father’s hands to steady him as they move through the sand toward the ocean. I remain far back on the shore, shading my eyes to make out the three of them as they stand in the shallow water.

I am thinking that he looks like a ten-year-old child from this distance. My sight turns blurry, a combination of sun, sand and sorrow.

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Going in Peace

All too often in my forty years of practicing medicine, I’ve seen patients die hard, lonely deaths—lying on a stretcher under the emergency department’s glaring lights, or all alone in an ICU bed.

In extreme situations, the patient is covered in medical equipment: a breathing tube in the mouth, defibrillator pads on the chest, monitor leads on the torso, IV lines dangling from the neck and arms. When family members finally enter the room, it’s

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Why Isn’t He Listening?

I was in my third year of medical school, partway through my psychiatry rotation.

“You’re ready for your first mental-capacity consult,” my attending said. I felt excited at being deemed ready to administer this evaluation, which is used to determine whether a patient has the ability to make decisions about their own care.

“The medicine team is confused about this one,” my attending continued. “He’s clinically improving from his COVID infection, but he wants to

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Dying Is Ugly

Bang my shins, my temple on the gritty wall
Of Charlie’s deathbed
Where we do not wrest the truth
But beg him Let us change the (piss-stenched) sheets.
He will not go for tests, insists, denial overarching

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Deep Diver

I knock on the partly open door and peek around the curtain. A grainy yellow light above the hospital bed falls on a frail, trembling woman as she struggles to comb her wet grey hair.

“Margaret?” I say quietly.

She does not hear me over the hiss of the supplemental oxygen. I watch her for a moment longer.

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