More Stories from “Pulse—voices from the heart of medicine”

Every Friday, thousands of readers smile when they see an e-mail from Pulse: voices from the heart of medicine in their in-box. Pulse is a free, online magazine  that publishes riveting, often moving, sometimes controversial, and occasionally hilarious first-person stories and poems about medicine.  (Click on “hilarious” for a story that will astound you, and, if you share my sense of humor, make you laugh. )

All of these tales are true, and the authenticity of the writers’ voices helps explain their power.  Written by patients and doctors, nurses, caregivers, and students, these unblinkingly honest stories and poems bear witness to the suffering that patients endure, and to the compassion of caregivers — as well as their doubts.  

                                        Some of My Favorites

Long-time readers may remember poems and stories from Pulse that I have cross-posted in the past. 

 —  “Useless (But Needed), A Doctor’s Constant Companion”  — one of my favorites

 — “First Do No Harm,”  a story about how we train doctors that drew thoughtful and provocative comments from both doctors and nurses; 

— “Broken”– a controversial story about what happens when a trauma surgeon overrules an obstetrical resident. The question:  should they have tried to save the baby or the mother? Could either be saved?                                       

                A Stairwell Conversation, And a Unique Magazine is Born

Pulse founder Paul Gross, practices family medicine at Montefiore hospital in the Bronx, New York.  He recalls how Pulse was conceived:

 “What would it be like, I wondered, if there were a magazine that told about health care the way it really is? What if patients and health professionals alike got to tell their stories? 

“Around the same time, I had a stairwell conversation with a hospital director of nursing. It stopped me short. ‘For the first time in my long career,’ she said, ‘I’m ashamed to be in this business.’

“To me, this sounded like a cry for help; it sounded like a system in crisis,” Gross adds. “And yet, for the most part, popular magazines and medical journals seemed oblivious.

“It occurred to me that if we found a way to share our stories—the difficult moments along with the glorious ones—perhaps we could jump-start a national conversation about health care. Maybe this exchange could lead us toward a better health system.”
                         Pulse Today–A Second Anthology                        

Since then Gross (who continues to practice at Montefiore) and co-editor Diane Guernsey (a professional writer, editor and psychoanalyst), have wedded their knowledge and skills.

Together, they and other Pulse editors have done a brilliant job of selecting and editing stories and poems from the many submissions that they receive.  I am impressed by the high polish of the finished product.

In 2010, Pulse put together an anthology of the pieces it had published online. Dr. Perri Klass reviewed the anthology for JAMA, and summed up what is special about Pulse: “All of the stories in this book . . . are told with a kind of urgency; these encounters change lives and mark memories. This collection is in some sense about writing for one’s life.”

Now, Pulse has published a second collection, Pulse: More Voices,” and this time former CMS director Donald Berwick, M.D. wrote the copy for the cover:  “I don’t just read Pulse, I adore it. The supply of compelling, often poetic accounts is the best around.”

You can buy the anthology ($21.99) here.. If you’re not ready to buy the book, you still should subscribe for free weekly e-mails  You will receive a story or a poem every Friday, be able to comment, and become part of the Pulse community.  

                                   A Story from the Second Anthology

The  story below that raises a pressing– and as yet unanswered –question about how the Affordable Care Act is going to provide, not just access to health insurance, but access to health care, for the many poor Americans who will suddenly become eligible for Medicaid.

 One More Child Left Behind

By Brian T. Maurer

Making the diagnosis might be straightforward, but sometimes getting adequate medical care poses a more formidable challenge.

It was the end of an exhausting afternoon in our busy pediatric practice in Enfield, Connecticut. I had just finished seeing what I thought was the last patient of the day, only to find yet another chart resting in the wall rack, a silent signal that one more patient waited behind an adjacent closed door.

His name was Aaron. Six years old, he sat on the exam table cradling his left arm in his lap. The most striking thing about the arm was the large bluish bulge on the side of his elbow. His mother stood by his side; his grandmother sat in the corner chair.

“What happened?” I asked.

“Another kid pushed him off a table at school. He won’t move his arm.”

I took a step closer. “Let’s have a look.”

Gently, I palpated the borders of the blue bulge. Aaron winced in pain. I felt his wrist to check the circulation to his hand. “Squeeze my fingers,” I said. He tried and winced again.

“It’s likely broken,” I explained. “At this hour all the x-ray facilities in town are closed. Your best bet is to take him to the emergency room,” I said, wrapping Aaron’s arm in a sling.

“When you get to the hospital, they’ll take a special picture of your arm,” I told him. “Give them a big grin so it comes out well, okay?”

Aaron’s grandmother flashed a faint smile as they walked out.

The next morning Aaron’s mother phoned the office to tell me that, although the x-ray showed a fracture of the elbow, no “bone doctor” had come to the hospital to treat the break. [Note: under federal law, ERs do not have to treat the patient. They must evaluate him, and “stabilize” him. That is all. mm]

Instead, she was given the names of some local orthopedic surgeons, with instructions to arrange an appointment with one of them that morning. But none of the surgeons would give her an appointment, so she wanted advice about what to do.

When I flipped through Aaron’s chart, I saw why none of the local orthopedists would see him. It was all too clear: Aaron’s health insurance coverage was through an underfunded state-sponsored Medicaid plan.

I telephoned the client services department of Aaron’s health plan. A cordial representative proceeded to give me the names of several participating orthopedic doctors in the area.

“Hold on,” I interrupted her when I heard the first name. “The mother already called that practice and was told they were no longer participating.”

“’Sometimes that happens,’ the representative told me. ‘The doctor opts out, but doesn’t inform us directly, so we still have the name on our list.’ She gave me three other names and telephone numbers. ‘Call me if you’re still having a problem,’ she said cheerfully. ‘Have a nice day.’”

Feeling frustrated and irritable, I delegated the task of locating a participating provider to Laura, one of our medical assistants. ‘When you find someone, schedule the appointment and call the mother to let her know,’ I told her then turned my attention to my morning patients.

I returned from lunch to find Laura still on the phone. “None of the practices you gave me would accept this kid’s insurance,” she said. “I called client services again and got six more names. Each office was happy to schedule an appointment until I told them the insurance carrier. I can’t believe that no one will see a six-year-old boy with a broken arm!”

To find out what happened to Aaron, you can read the rest of hte story here. http://www.pulsemagazine.org/Archive_Index.cfm?content_id=89   Come  back to  HealthBeat to comment.

                         Postscript: Ads on HealthBeat

Often, I am asked whether I sell ad-space on HealthBeat. Normally, I say “No,” because I can’t vouch for the product or service advertised.

But recently, I decided to post ads for organizations that I know well.  Scroll down on the right hand side of this page, and under “RECOMMENDED” you will find links to healthinsurance.org, (for information about family health insurance); the Empowered Patient Coalition (Information and resources for patients, caregivers, and advocates) and Pulse: voices from the heart of Medicine.

In the future, I will be posting more ads for books and publications that I admire and non-profit groups that I know and trust. They are inexpensive–I see these as “public service” ads.  (If interested in advertising please, click on “Contact Maggie” at the top of this page.)  

 

2 thoughts on “More Stories from “Pulse—voices from the heart of medicine”

  1. Maybe not your typical story; but then, I am not your typical patient. My daughter and sons laughed when the ER report described me as a pleasant 63 year old gentleman. They thought it was the wrong write-up.

    September 2012 I ended up in the hospital for an endoscopy and a later gall bladder removal. 3 months to the date (December 2012), I was readmitted for heart problems with elevated heart enzymes and a fluttering heart. I had minor pains in my chest which I though was the onset of pneumonia. Amongst a crowd of doctors and nurses and within 15 minutes, I had a heart pump installed through my groin. My wife drove for three hours to get to me out of state.

    The open heart surgery was scheduled for a Friday and then to a Monday and rescheduled for an earlier Thursday. This was Tuesday and I was set to have my chest cracked on Thursday. I was not happy with this as I was allowing myself to be out of control of my destiny. Surrendering control to another person is not on my list.

    It happened during what I thought was a brief nap and in reality was 4 hours. My family waited in a room with speakers so they could listen. I never though what I helped develop and manufacture would be used on me. The membrane oxygenator worked fine.

    The first time I remembered anything was hearing Sherri the nurse yelling at me to blow through a spirometer and then she would take the tubes out of my throat. The tubes did get removed; but, moving the float in the spirometer was hard to do. Afterwards every hour on the hour I would awake to Sherri sitting at the computer and then taking my vitals. I thanked her for taking care of me that night in the morning.

    The next day Tish took over. She and Connie helped me sit in a recliner chair. I was truly sore and thank god for my runner-legs so I could get up without the help of my arms which clutched a pillow. Rolling over while keeping my legs straight was done in 9 movements while squeezing the pillow.

    The next day Keeley got me up and we slowly moved around the hallway . . . no laps that day or timed ones. Connie was there again to keep me from over exerting myself in lifting things. I sneezed that day after just getting the pillow to my chest. You do not want to do that . . .

    Each day the same three nurses and the assistant were there to get me out of the bed and walk me when my family could not.

    My last night there, I felt a strange buzzing in my chest similar to holding a sparkler. Keeley was there staring at the monitor. I guess I was going through afib. She never said a word and I asked if she could feel the buzzing in my chest . . . no. I think she was scared.

    It wasn’t the Surgeon, the Cardiologist or the PA who yanked the tubes out from my chest that I remember the most, it was the nurses who spent the time caring for me when I could not do much for myself. It is amazing what a half a dozen gift certificates to Target does for a bunch of nurses who took the time.

  2. Run–

    ” A pleasant 63-year-old gentleman” ?

    LOL. You’re rather more alive than that.

    But turning to what actually happened to you, I am very ,very sorry that you had to go through that surgery.
    I realize that the aftermath is extremely painful.

    But if you had to go through it, I as so glad that you had those nurses.

    In recent years, whenever I talk to anyone about being in a hospital, they tend to say “the nurses were terrific.'”

    In some cases, hospitals are under-staffed and the nurses have to do too much as they “multi-task.” But the majority continue to truly care for patients, especially paients at risk and patients in pain.

    More patiens should give their nurses gifts when they leave a hospital!! *Whatever they can afford–it’s just the recognition of what they did for you that counts.)

    At many hospitals, administrators don’t appreciate nurses.
    And some doctors don’t recognize how important they are.