Medical moments in 55 words

Life sentences

2010-07-05T16:40:00.000-06:00

"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

2010-06-27T11:33:00.000-06:00

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

2010-06-10T23:59:00.001-06:00

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

2010-05-16T14:21:00.000-06:00

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

2010-05-10T21:49:00.001-06:00

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

2010-05-04T15:29:00.000-06:00

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

2010-05-04T00:05:00.001-06:00

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?

2010-04-18T14:30:00.000-06:00

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?

2010-04-05T21:35:00.000-06:00

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

2010-03-30T12:38:00.000-06:00

"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!

2010-03-24T16:41:00.003-06:00

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

2010-03-19T18:15:00.001-06:00

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

2010-03-16T13:14:00.000-06:00

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

2010-03-12T10:34:00.002-07:00

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!

2010-03-10T20:44:00.000-07:00

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

2010-03-07T15:08:00.001-07:00

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

2010-03-05T15:05:00.001-07:00

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

2010-03-02T20:42:00.001-07:00

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

2010-02-28T09:02:00.001-07:00

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

2010-02-20T14:56:00.003-07:00

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

2010-02-16T20:05:00.000-07:00

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

2010-02-13T17:16:00.001-07:00

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

2010-02-11T21:09:00.001-07:00

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"?

2010-02-09T20:04:00.001-07:00

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

2010-02-04T07:33:00.000-07:00

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

2010-02-01T07:58:00.000-07:00

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

2010-01-30T12:16:00.000-07:00

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

2010-01-28T20:02:00.001-07:00

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

2010-01-26T11:20:00.000-07:00

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

2010-01-24T14:21:00.001-07:00

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

2010-01-21T20:22:00.000-07:00

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?

2010-01-18T23:45:00.001-07:00

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

2010-01-17T14:16:00.001-07:00

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

2010-01-14T09:59:00.001-07:00

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

2010-01-12T08:51:00.000-07:00

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

2010-01-11T07:52:00.000-07:00

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

2010-01-09T13:45:00.000-07:00

“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

2010-01-06T19:52:00.000-07:00

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.

2010-01-04T19:58:00.000-07:00

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

2010-01-02T11:28:00.000-07:00

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.”

Whose headache is this?

2009-12-31T11:27:00.000-07:00

Oy, Barbara B. is requesting more narcs. An on-line check confirms my fears--four different docs doling benzos and Percs.

In office, she’s misery embodied, waifish voice barely heard, partner stroking her arm. Part drama, part pain, no knowing what’s what.

Five phone calls, the last one to Barb. I’m no longer the problem, but what’s the solution?

A curry-ous case

2009-12-29T22:29:00.000-07:00

Green curry, rice, and a doughnut for lunch. (Eat as I say, not as I chew!)

I’m good to go for my first p.m. visit, then a carb-laden cloud rolls over my brain. Chin heads to chest, I struggle with eyelids. My patient drones on about issues, but suddenly stops, eyeing me with alarm.

“Are you okay?

A window to her soul

2009-12-28T20:26:00.000-07:00

Overweight, and diabetic, she shut me down with mono-syllables.

“Watching your diet?”

“No.”

“Exercising”

“No.” This punctuated with a lift of the lip.

“Anything special for Christmas?”

“Why yes.” She shifted, eyes widened. “I decorate my apartment, especially the window.”

She e-mailed a pic of the window dressing. Shimmering, bejeweled, it sparkled like her eyes at the end of our visit.

Time to pass it on!

2009-12-26T13:36:00.000-07:00

Lillian works full-time in food prep, fingers and toes in arthritic twists. Her face pale and drawn, feet afire with gout.

“You need a cane,” I urge. And so much more...

She gives an ‘as-if’ sort of shrug.

“Hold on a sec,” I advise. Return post-haste with my mom’s walnut cane. Here, I conclude, is one worthy heir.

Reflux redux

2009-12-22T20:13:00.000-07:00

Carol complained of acid reflux. On the exam table that day, her abdomen rose like a nine month pregnancy...but she wasn’t.

“Am I in trouble doc?” she asked when she saw my face fall.

The gynecologist delivered a twenty pound ovarian tumor. As promised to Carol, I scrubbed in and watched.

The path report was, thank heavens, benign!

Thanks...I guess

2009-12-13T13:43:00.001-07:00

My old patient had on a good-looking jaunty wig and a leopard-print top. She smiled at me and said I was cute.

Nice perhaps, looking good for my age, but cute?

I thanked her but questioned the adjective.

“No honey,” she enthused. “You are cute. You and your pony tail and your little purple nose.”

Say what?

Can I be saved?

2009-12-10T20:04:00.000-07:00

A first year teacher, lots of exposure, frequent colds. This one was bad--severe sore throat, painful cough, no voice at all.

I knew the answer, but looked him over for the hands-on touch.

“Son (I didn’t really call him that), you’ve got a helluva virus.”

He grabbed a pen and pad, looked up anxiously, “Could you spell that?”

The kid and I in 30-some years?

2009-12-09T20:18:00.001-07:00

Bea still drives; she’s 91. Son Gabe’s a sprout of 72. He seemed down, so she brought him by for a morning visit.

“Doctor,” she began after both sat down, “He doesn’t do anything, he just mopes in the house! He should get out and be with his friends.”

“Mo’om” he wailed, stretching two syllables from one.

An unstructured life

2009-12-07T20:25:00.000-07:00

I’d asked Linda in to discuss her bone density. The usual stuff--enough bone to get through her life but no more must be lost. Calcium, D, exercise, drugs...

Wait! We’ve got tears, lots of them. What’s going on? This can’t be just bone!

Lost job, lost love, no bones about it. What’s the drug for lost hope?

Pet therapy

2009-12-06T15:09:00.001-07:00

Carol warned me last minute; she’d scheduled this appointment to ‘fess up to hubby a large credit card debt.

Yikes! Have I lost my mind? He’s Hell’s Angel scary, she’s frightened and thin.

By sheer luck, my dog was the fourth in the exam room that day. Five scrawny pounds, a lap technician working her charms.

A couple of problems

2009-12-05T10:11:00.000-07:00

Mr. C. came for his physical, his wife in tow. As I took his history, she sat quietly, lips pressed firmly in a downward line.

"So how do you spend your days?" I asked.

He pondered the question, smiling slightly as he considered his answer.

"He doesn't do a goddamn thing," came a thin, angry voice from behind.

Who you calling old?

2009-12-03T23:52:00.000-07:00

Carolyn was a psychiatrist at a time when women weren’t and state hospitals were full. At 90, to my surprise, she opted for a new heart valve.

A year later, she flew to Paris; after two, she fell in love with a man at the home. She died today at 94, two daughters at her side.

Last words

2009-11-28T20:55:00.001-07:00

Helen’s voice was soft on the phone, the words disjointed, unclear. When she quit talking altogether, I yelled to the front desk, Call 911 to her home! Dogs barked frantically as help broke through her door.

Later that day, I spoke with her husband, reassuring him that she had faded out quietly, without fear, without pain.

She's come undone

2009-11-25T07:08:00.000-07:00

Kim was a math teacher until arthritis and toxic drugs got her number. She arrived one day by cab, dirty, vomit-splattered, too weak and dehydrated to come inside.

I saw her at the curbside and sent her straight to the ER.

“She’s a math teacher,” I told the ER doc twice. “This could be you or me.”

Not really done for yet

2009-11-24T07:55:00.001-07:00

“Done with defibrillators!” he declared in spring.

No shock when his heart quivered in November and dropped him to the floor.

A younger Ed clowned and smiled through his memorial slide show. In the final slide, yesterday’s Ed held his tiny grandson like a treasure in his lap, a comma not a period to his life’s story.

A lump in my throat as well

2009-11-23T07:41:00.000-07:00

I struggled to keep my expression neutral as I stared at her breast in disbelief. Peau d’orange the picturesque name, the red skin tense, dimpled by cancer.

“Let’s get a surgical consult,” I said, my voice light. “Today.”

Ten years later, she brought me a bottle of fine red wine to toast the joy of her survival.

Where's her village?

2009-11-22T13:38:00.000-07:00

Marion, an ex-bank officer, still wears matching outfits--velour sweats instead of suits. Eighty-plus, childless and prone to confusion, she cries over lost independence.

Her visiting nurse calls often with updates: “Forgets food and medications", "oxygen off", "legs swollen”.

A Midwestern brother visits. He doesn’t phone, he leaves no plan. Marion muddles on, missing meds and meals.

Lest we forget

2009-11-21T09:16:00.000-07:00

“Where did you go to college?” I asked my new patient as I glanced through the records she’d brought.

“Kent State.”

Looking up, my heart rate accelerated as I put down my pen. She was just my age. “Were you there when...?”

“My roommate died in my arms that day.”

New tears for innocence and a life long lost.

For the birds...

2009-11-20T19:30:00.000-07:00

She lumbered large to the exam room each visit, clutching penciled notes scrawled on tiny pages. I sighed to see her on the schedule, wondering anew if fibromyalgia really exists.

“So,” I said interrupting her litany, “Anything new in your life?”

“Why yes,” she said, “My cockatiel’s eggs have hatched, four babies!”

Our heads touched over pictures.

And I don't much like you either!

2009-11-20T19:14:00.001-07:00

The surgeon exclaimed “I’m like you, let me die in the saddle!. But I can fix this with a wide excision and bone grafts from your skull!”

Could he not see my husband’s face, pale and grimaced beneath the skin cancer on the bridge of his nose, body language screaming “I’m not like you at all.”

I've heard worse...

2009-11-20T19:11:00.000-07:00

“I am so sorry to have to meet you under these circumstances.” The oncologist’s intro had been kind, the words that followed blunt: “undifferentiated carcinoma” “six months without treatment.”

Later, the waiter’s face was crestfallen. “I’m afraid I have very bad news, we’re out of pate foie gras today.” We laughed so hard that we cried.

Why you haven't changed a bit!

2009-11-20T16:47:00.001-07:00

My friend got up slowly from the waiting room chair, much transformed from six months ago. Just my age, too skinny, her left knee puffed above her matchstick leg. As she settled in the exam room, I saw her hands were permanently flexed with arthritis.

"How are you?" I asked.

"Just fine," she answered, "And you?"

Seeing I to eye

2009-11-20T16:38:00.000-07:00

My heart sank. An old patient on the schedule, Ms. Big Hair with Big Demands.

“Long time, no see,” I said, “How are things?”

Lost job, big move, schizophrenic son, now menopause, insult on injury. We talked, we laughed. She’d found a sense of humor, and I my compassion. Two moms with hot flashes and sons.

A touching story

2009-11-20T16:26:00.001-07:00

He was doing a little dance on his feet like the college quarterback he probably once was. Then the doctor tackled a stool and sat with his hand on my husband’s knee, explaining the course of radiation therapy.

My husband’s folded arms and hunched shoulders screamed “Don’t touch me!”, unheard gestures in a cold, white room.