Genetic Testing
“If you want CVS, you’ll have to decide within the next three days,” the genetic counselor told us. My husband and I were sitting in the upscale office of the maternal fetal medicine (MFM) practice in downtown San Francisco. Our obstetrician had referred us here for genetic testing of our twins in addition to the … Continue reading
Post Hoc, Ergo Propter Hoc
We understand very little about the human body. Sometimes I think that the more we learn, the more we learn how much we don’t know. Occasionally, our patients show us. Take Jim*, for example. He came to me complaining of wheezing and shortness of breath. He had been newly diagnosed and treated for asthma over … Continue reading
Continuity of Care
“I would want you as my doctor. I just wouldn’t want your life,” I said to the thoracic surgeon. It was after midnight and we were standing in the intensive care unit. I, having urgently intubated a critically ill patient; he, having finished a surgery on a patient we shared. This particular patient had had a lung … Continue reading
Anxiety
Anxiety ranks among my least favorite diagnoses. In medicine, we have a long history of blaming a variety of diseases on anxiety. Even in the recent past we attributed gastric ulcers to stress until it was proven that a bacteria that lives in the gut is responsible. Indeed, who would have thought: a bacteria living … Continue reading
Doctors Can Only Give So Much
editorial in SLC Tribune I called it “The Depressed Doctor” in homage to David Foster Wallace and his short story, “The Depressed Person.” The SLC Tribune titled it: “Doctors Can Only Give So Much.” Here’s a link to the Schwartz foundation and more about Schwartz Rounds.
53 Year-Old Black Male
“53 year-old black male,” the medical student begins his presentation of the patient’s case. “53 year-old man,” I correct him. It’s not his fault, we are taught to do this in medical school. We are taught to refer to people as “male ” or “female,” but every time I hear someone say that I think … Continue reading
Brain Transplant
When I was in Boston, I had a patient with a brain tumor and two adult sons. She had a malignant, progressive brain tumor and had been unresponsive for months. Her prognosis was poor. One son, I’ll call him Peter, thought she would have wanted to be DNR/DNI: if her heart stops, if her breathing … Continue reading
Dying
It is another night on call in the intensive care unit. The night shift starts with what we call a sign-out where the physicians who have been taking care of these critically ill patients during the day tell me a bit about each of them as well as any issues that would be useful to … Continue reading
Thinking in Cliches
[From Bellevue Literary Review Vol. 1 Issue 1. Fall 2001.] The Diagnosis You, a 67 year-old cardiologist with a PhD in music theory and an avid interest in ancient Greek history, find yourself re-examining old lessons. The one thing our patients ask, you cannot answer, your first medical professor had warned you. What will happen … Continue reading
Diary of a Disaster: a nonfiction account of 9-11 and its aftermath
Hi everyone, As the 10th anniversary of 9/11 nears this Sunday, it seems everyone’s been looking back on what went on so long ago and reflecting on where we are today. I was a medical student at NYU when the towers fell, and am attaching my account of the events surrounding those days, if you’re … Continue reading
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