OB/GYN Introductions
I heard about the blood / that you described as a flood, / and the terrible stomach pain
I heard about the blood / that you described as a flood, / and the terrible stomach pain
With a growing interest in geriatrics, I began to wonder what resilience looks like for elderly patients, who unlike children, present their life trajectories to physicians much later. This is perhaps challenging and even uncomfortable to discuss for those who perceive resilience as a long-term goal — overcoming significant barriers in order to improve over time. Resilience may not seem as relevant for elderly patients who may be nearing the end of their lives.
Freud supposedly understood himself as a surgeon of the mind, dissecting his patients’ mental anatomy through the process of psychoanalysis. I found this comparison appealing, so when I started the psychiatry clerkship in my third year of medical school, I approached the interview in psychiatry as analogous to a surgical procedure — efficient, scripted, precise.
Yours is the name I carry on / You were the first I mourned when gone
“I’m sorry that you have to see me this way,” said Ms. A as we exited the examining room. Twenty minutes earlier, Ms. A had been laughing and cracking jokes while my attending physician and I obtained her medical history and life updates.
An anxious, 36-year-old Hispanic female lays on the exam table, her feet in stirrups. A sleeved arm juts out between her tented legs as she stares resolutely at the ceiling. I wonder if she is afraid of what the amorphous black and white structures shifting on the ultrasound monitor may reveal.
As the door swings open, it hits the chair that was shifted more than usual. / Next to the computer sits a 94-year-old woman in a wheelchair / who is here for one last visit.
The first thing I notice are his boots. He’s still in his street clothes, having just been admitted. He looks thin, emaciated — his clothes hang off him, shirt collar drooping down from his neck like peeling paint. His boots, however, seem to fit him properly. They look warm, well-worn but sturdy, like they have weathered a hundred bitter winters and could withstand a hundred more. For some reason, this comforts me.
I took a quick trip to Target a month ago and browsed for new jeans. I approached the clothing section and was suddenly struck by the overwhelming challenge I had undertaken. From rack to rack, I had to choose from a multitude of different brands (Levis, Wrangler, True Religion and more), different styles (skinny, bootcut, tapered and more) and different colors (blue, black, tan and more). I had to figure out my current exact size and, even then, there are many different ways to size jeans (small-medium-large, waist-by-length and others).
Upon arriving at the room, we learn that the nurse continued trying to speak to this patient in English despite the patient’s evident inability to speak the language. Following her half-hearted attempt at “patient education,” she proceeded to lift the patient’s gown and attempts to strap on the monitors. As a result, the woman is frightened by her nurse because she is unaware of what this foreign nurse is doing to her and her unborn child. One week out from detention. She is scared. Imagine.
In this episode, Peter and I put together the culmination of our first season of podcasting. We took lessons from leaders in medicine, business and the military to bring you five rules for leadership.
“We are taking him to rehab,” she said. I could hear a faint sigh of relief and happiness permeating her voice, which had been distinctly absent for the last few months. I could also hear wind whooshing in the background and a distant trail of her voice, which meant they were already on the road.