Life sentences

"Her lymphoma's refractory, transformed, and aggressive."

Damn, how can my friend’s name appear in a death sentence like that?

But wait, we’ve still got LEN or lenolidomide (Say what? Never heard of it!).

Here’s her name in a kinder, gentler sentence:

“LEN has promising clinical activity and achieves durable responses in [insert her name here].”

Overwalked for the cure

She shivered and retched in the medical tent, in terrible pain with a hip flexor pull.

“How far DID you walk today?”

“Nineteen miles…for my sister.”

“How much did you train?

“Well, I’m not generally a walker.”

I didn’t know whether to praise or to scold, but I was smiling too much to do both.

She's come undone, Part II

The coroner called today; Kim found down at home, dead for days, maybe more.

I saw her last two weeks ago. She was holding court in our waiting room, surrounded by a laughing group of ex-strangers, all sharing the pleasure of her story.

But then no one noticed she was gone for days, maybe more.

New skill for my resume

Gayle was engulfed in post-chemo blues. Worst of all, her back end screamed with the runny aftermath of the toxin’s effects on her guts.

I texted her my secret recipe for relief from bad butt day battles. The following day, her upbeat return text had her sitting in style, hailed me as ‘the butt whisperer.’

Home is where no heart is

Marion’s brother offered to move her back ‘home’. Confused and angry, she declined. Months later post-stroke, she said no words at all.

Her neighbor called Robert asking what to do next. Could he arrange care for her now?

“She said no in summer, so we won’t come again.”

And Marion’s niece hung up the phone.

An Abilfy blonde

Pam struggles with mood, so down now she'd forgotten her hair—it hangs lank and uncombed, framing a face slack with despair.

So maybe yes counseling but no energy to arrange, could something be added to her roster of drugs?

Next visit she arrives with a smile, hair washed and shining, a bright Abilify blonde!

Secret secretions

My patient sat down, quickly grabbed for a Kleenex.

"Hold on!" she gasped, turned, and then coughed wetly into the tissue.

"Oh gad," I thought unhappily, "She's going to show it to me."

"Don't worry," she said, dabbing delicately at her lips. "I'm not going to show it to you."

We both burst out laughing.

Any problems getting up in the morning?

Eighty-something and mega-spry, Roland brought his lady friend along to his appointment. BP was great, no problems found.

“I’ve been meaning to ask about Roland’s thyroid,” Ms. LF ventured at visit’s end. “He’s so full of energy; is that normal?”

I so knew what she meant by “energy”, and could not suppress a hearty laugh.

What sermon where?

After church, she went down for a nap and woke up with no memory of the service. She recalled all events within minutes, but her children dragged her in for a visit.

“Everyone’s foggy post-nap,” I declared. “Call if it happens again.”

She sighed with relief and walked out with a smile...her purse still under the chair.

Cramping, Her Style

"Is there a doctor on board the plane?”

Huzzah, I've waited decades for that line.

The teenager behind me fainted, alarming her seatmate. Across an armrest and forty years, we chat as she recovers. She laughs as I call her period a ‘newspaper’ in Spanish, but, despite two languages, we both agree that cramps are a drag.

Wow, hadn't expected that!

My patient pumped Purel in her palm, leaned over the counter as she rubbed it into her hands.

“You should be glad I’m using this,” she opined to my front office clerk who looked up with an inquisitive arching of brows.

“Yep, you see I don’t wash my hands,” my patient shot back with a serious nod.

Out but not down

She went from diarrhea to deadly abscess in less than two weeks. What do you say to a ski instructor whose season nearly ended forever in the surgical suite?

She answered with an upbeat "Hello?"

"How you doing?" I asked. She'd been home for a week.

"I just went for a walk, and so glad to be out."

Life cycles

Mortally injured, Dave lingered a month and then died. Businessmen sat through his funeral next to the grizzled, pony-tailed riders of his beloved Harley club.

I stood afterwards, eyes filling, as one hundred-plus bikers headed down the boulevard, Dave in tow, bearing him away even as he smiled next to me from his daughter’s eyes.

Blow and Tell

She stood by the counter, a brown grocery sack in hand. Without a word, she upended the brimming bag, used Kleenexes tumbling over the surface, some falling onto the ground.

“This,” she declared angrily, “is one day’s worth of tissues. I need help now!”

Eyes wide, mouth clamped shut, my front desk receptionist grabbed for the Lysol.

Oh gad, get me outta' here!

My patient looks sick--eyes glassy, cheeks flushed, and his voice an octave too low.

“Any cough?” I ask. Lord I don’t want what he’s got.

“Yes, just started...it hurts...from deep in my chest,” he rasps then demonstrates wetly, his hand about a yard from his mouth.

Oh yuck, that which he harbors now floats in my air...

A distressing typo' problem

Patients like to weigh in by e-mail, and I, in turn, can read them at will. This strategy, however, may be harmful to health:

"I am still having an upset stomach and episodes of diarrhea. They are happening after each email now instead of just in the evening."

Back away from the computer, ma’am. Phone me instead.

I, Phone Woman

I checked for drug interactions with a flip of a finger, a middle-aged techno-babe plying my apps.

As I put down my iPhone, the room exploded with an arcade-style riff.

“Nice ringtone!” I said to my patient.

“Uh...I think that was your phone.”

Oh dang, I opened my games while closing down drugs. Not so tech savvy after all.

She lives on in my heart

Della died from liver disease one month after her first grandkid was born.

At her funeral, I got a heart-shaped pin with her picture attached. Lipstick red as her shirt, chin lifted, she smiles at me still. I keep it at hand as a reminder that life should never be viewed through a jaundiced eye.

Show and smell

M was annoyed and didn’t look well. She rummaged in her purse, then tossed a Ziploc bag on the desk.

Uh-oh, close encounters of the turd kind. Could’ve figured this out sans sample!

She rose at visit’s end, went to leave without Exhibit A.

“Would you mind throwing out...that?”

So she did, right into the basket underneath my desk.

Lady Madonna

She was nursing her son as I entered the room. Long brown hair cascaded over her shoulders; she smiled and mentioned two special needs toddlers home now with Dad.

Sated and overcome with curiosity, her baby turned, flashing a total body grin at me. This tiny dynamo was long on enthusiasm, energy, and chromosome 23.

And now it's too late

Jeanette was always tired and always in pain. A consultation of experts and I couldn’t figure out why.

One afternoon, she napped in her rocking chair and never woke up. Still, she sang at her funeral; her recorded voice like an angel’s, husky and haunting. I didn’t know she sang. I never asked, she never said.

Hair today, here tomorrow

Two friends shared cancer and chemo, enduring, in tandem, the ebb and grow of hair. R’s grew back in darling ringlets; K sent new growth up in fright wig style.

Waiting for haircuts, a tweenager stared at K and nudged his mom: “That’s how I want my hair to look.”

K roared with laughter, survivor style.

Nothing simple about being old

Eighty-something, on seven drugs, six supplements, and under the care of nine different doctors including four different orthopedists for as many body parts. She wanted to discuss simplifying her care.

As she left the office, she caught her leg on the car door, peeling the fragile skin back like tissue paper. So much for simplification.

So who's the "Glamor Don't"?

I ushered my patient into a room thinking “I wish I could carry off high-heeled boots with such ease.”

She, in turn, regarded me with curiosity as she eased into her seat. Adjusting her tiny skirt, she remarked “Well you’re not exactly styling today.”.

I waited for the ‘just kidding’ to follow, but, alas, it never did.

The lady and the stats

She’d walk each day to the store, a cane in one hand, cigarette in the other. She quit at age 90, walking... not smoking.

Shortly after her 93rd, I sat beside her on the tiled bathroom floor waiting for the paramedics to arrive.

One-third of old ladies die within a year of a hip fracture.

Damn statistics.

One foot away from a normal life

The room was quiet save for the hiss and whir of metered pumps and vacuum drains. Her foot had slipped from the covers, the toes perfectly appointed with rosy polish.

She moaned softly in her drugged sleep. I thought of how just last week she surely groaned with pleasure as her feet slipped into the suds.

Well...sort of okay 2

A hands on sort of doc, I’ve been known to personally tote samples for analysis from restroom to lab. One day, I teetered while toting, splashing the specimen on the front of my shirt.

“Oh well,” I shrugged. “Waste is a terrible thing to mind.”

My mantra that day? I’m okay with urine, I’m okay with urine.

The last dance

Grandma’s cancer showed up first as a clot in her leg. Two months to diagnosis and a year to her death.

Mary showed me tender red cords on the back of her leg; she was scheduled to dance in ballet class later that day. One week to diagnosis--thanks to Grandma-- and a year to her death.

Taking great pains with patients

She limped in and plopped on a chair. Smiling brightly, she asked how I was.

“Worried,” I replied. “You’re getting Vicodin from three different docs.”

Eyes wide in a ‘Moi?’ sort of way, she phoned her husband--had he picked up these meds?

Our eyes met as tears formed and rolled down her cheeks. She closed up her phone.

A trip down denial

Advil is her friend and her foe.  A health professional with serious pain, she struggles as well with her fear and her bank balance.

Her latest labs come in; D now stands for dialysis and not just denial.  I call with the news.  A teenager sets down the phone as she yells for her mom.  

False pride

Good hair day today so I had to head to the head to take it in once more.  Just a glance, can’t keep my first patient waiting.  Turned slowly in front of the mirror, big smile (teeth looking good too!).  But then...

Two stethoscopes hanging around my neck.  Music grinds to a halt.  Exit laughing.

What am I missing here?

He’s three months short of college graduation.  His mom did most of the talking.  Two years, three symptoms, zero diagnoses.

His exam and his nodes were normal.  No need for tests; it’s dry air and bad posture.  He claimed he felt calmed. 

All this training, all this acumen, and I still don’t know what they needed.

Not so bad after all

It’s lung carcinoma.”

I was crying in the rain, drenched in bad news,  phone pressed to ear. Not surprised by the diagnosis yet completely speechless.

The surgeon was puzzled by my tears: “We did expect this”.

She smiled later as we talked, “Either I’ll die or I won’t.”

And she didn’t. Not for 17 years.

A hint of hope

The young engineer sat bolt upright in his chair, eyes fixed on the floor.

"Anything different on Prozac?"

"Well, perhaps a little less agony."

Ouch.

"Are you keeping up at work?"

"I'm compliant."

Compliant?!?

"Dude," I declared, we've got more work to do!"

With a hint of a smile, he lifted his gaze to mine.

Well...sort of okay

No warm fuzzy doc this radiation MD.  He reassured us not with his discussion of “gray units,”  “fields,” and “we’ll shield your eye.” (Oh now I feel better! A lesson in physics but the subject’s his face!)

“Are you okay with this?” I asked.

“Sure, no problem,” he declared, backing his beloved Jeep Cherokee into a pole.

One count against him

Phone message at two a.m.:  Quest Labs calling with “critical results”.  Oh no, Mr. G. has a white blood cell count over 100,000.

Damn.

No point ruining his sleep.  Morning will come too soon enough.  Meanwhile, I’ll lie wide awake for both of us, thinking of this family man whose shortened life has changed forever.

Dogs, Dung, and D-ficiency

“What fills your heart with joy?”

“My two Italian greyhounds!” 

Their 60-something owner, her skin Minnesota white and muscles undefined, complained that scooping poop was nearly impossible.

“Hurts the back?”

“That and weak, so weak,” she replied and used both arms to struggle from her chair.

This is more than out of shape, I thought, and ordered tests.

Eulogy for a gardener

Why did Dani die?

She overcame alcoholism, sepsis, and pancreatitis to become a gardener.  I  saw her in September; her boyfriend had ‘stolen’ her methadone.  Her next appearance was in the October obits.

I drove crosstown through sleet to the funeral, arrived, alas, ten minutes late.  The service was already over.  What sort of send-off was that?

No brains. Period.

First we chatted a bit, two like-minded women just shooting the breeze.  Joan told me about last year’s hysterectomy; she finally dares again to wear white!

Squinting at my watch (where ARE my darn glasses??), I shifted position and grabbed for my pen.  Time to get down to the annual exam.

“So,” I began, “Periods still heavy?”

Caught in my civvies

Ms. C looked, as always, like a million bucks.  Fresh from church, she wore matching hat, bag, and heels, her suit a resplendent royal blue.  She hailed me in the produce department.

“Ms. C, you look fabulous,” I enthused after a hug.

“And you, Doc,” she began, her eyes sweeping down over sweatshirt and pants. “You look...comfortable.”