Alan Blum ~
Nadine Semer ~
"She doesn't like vanilla," Mr. Wyatt says, staring at the nutritional drinks sitting on his wife's bedside hospital table.
I'm here as the palliative-medicine consultant. As my resident Susan and I stand still, taken aback, Susan's expression says it all: She's dying, and her husband is worried about which flavors she likes?
Mrs. Wyatt, fifty-six, came to our urban hospital's emergency room with abdominal pain. She was admitted and given intravenous fluids and broad-spectrum antibiotics. Her workup revealed widespread, untreatable cancer. Her medical team has consulted us because they're frustrated at her family's unwillingness to acknowledge that she's failing.
"Explained her poor prognosis; she needs to be DNR," read the consult request. "But still, the family wants everything done."
Evelyn Lai ~
I walk into your room in the pediatric intensive-care unit as two nurses are repositioning you. Your parents stand nearby--your dad in his frayed baseball cap and khaki cargo shorts; your mom, her baggy jeans wrinkled with the same worry as the lines near her eyes. Your little sister sits near the window with a blue hospital mask over her mouth, hugging her knees; Grandma sits snug beside her, back straight and hair done, expression cordial.
You are a fifteen-year-old boy with leukemia who came into our emergency department last week with fevers, but spiraled quickly into septic shock with multiorgan failure.
Daniel Becker ~
At work there are three kinds of drills: fire, earthquake, shooter.
During a fire drill the building empties into the parking lot
where crowds kill time and blame the fire marshal.
The smokers want to smoke but don't.
A doctor talks to the 2:40 patient and tries to stay on schedule.
If communication is the heart of medicine,
diligence is its best habit. Then he looks for the 3:00 patient.
In a 5th floor office the photograph of a storm-tossed schooner
is 10 degrees off plumb because that wasn't a drill.