Finding your Dx

Recently, I wrote this email:

Hi Dr. W,

I was a patient of yours in 2006 when I started at Scripps college.

I’ve thought about you many times as the years have passed, how lucky I was to receive such wonderful care. I am proud to say I have never relapsed since, and am strong, healthy and happy. In fact, I am now a medical student at Tulane, hoping to pay it forward. 

Thank you for your work,

Alana 

I’ve heard a lot about the self-pathologizing that happens in medical school. How everyone will start to think they have the various diseases we learn about. With my own family history of hyperchondriasis, I too, have been waiting to find my rare diagnosis. Waiting to learn about the condition that pieces together all the symptoms I didn’t even know I had. Luckily, by now we’ve gone those most of the bodies systems, and my bones, blood, and organs have come out “unremarkable”.

Then we started on the brain.

Continue reading “Finding your Dx”

Fortaleza: Part 2

Monday morning she was back in the waiting room. With the nervous look of a girl embarking on her first sleepover, she had her pink backpack on her lap, ready for however many days the hospital would be her new home.

She would have to initiate and terminate her pregnancy under the careful watch of the hospital. First, they would administer a dose of misoprostol vaginally to stimulate uterine contractions. After six hours, an anesthesiologist and Ob/Gyn would perform a D&C (Dilation and Curettage); in reality, a procedure that is longer and more invasive than most protocols recommended for her pregnancy of only 7 weeks.

The reason for this? Like most questions of “why?” here, the answer is unclear. Maybe this is for her safety.  Maybe the hospital doesn’t have access to the Mifepristone or vacuum aspirators typically recommended. Or maybe the additional procedures offer financial incentives that outweigh the health of the patient.

Time certainly wasn’t the issue. They had no problem keeping her in a room waiting for a doctor to see her with the misoprostol to begin the abortive process. The problem was that when he rounded on patients he skipped her room, repeatedly. What she thought was first a mistaken overlook, it became clear the doctor was actively avoiding her. Dr. B doctor warned her to be prepared for these so-called conscientious objecters. So she waited, hoping the next doctor on-duty would be more empathetic. But day 1 passed and still no one came to see her. She closed her eyes and prayed tomorrow would bring better luck.

Dr. B told her to be strong, but as day 2 came and went her patience turned to desparation; she had a daughter to take care of, a job to work, and a life she wanted to get back to normalcy. When she could wait no longer, she called Dr. B, alerting her team to what was happening. Phone calls were made, words were exchanged and on day 3 the patient was finally attended to and discharged from the hospital.

Maybe the invasiveness and time consuming nature of the procedure will serve as a reminder to be more careful next time.

Maybe next time she shouldn’t talk to strangers, shouldn’t drink, shouldn’t go out at night, shouldn’t leave her daughter with her parents.

Maybe she should be a better mother, a better daughter, a better woman.

Yes, maybe this time she would learn her lesson.

the girl with the semicolon tattoo

That day I was supposed to be the patient.

The nurse putting the blood pressure cuff on me was the same one who always takes my vitals. She likes to chew gum; you can see her tuck it between her teeth and cheek as she walks into the exam room. A slight bulge pumping against her straight hair. Today it is dyed a reddish-brown.

As her hands wrapped around my arm, my eyes landed on small blacks on her left wrist.

“Is that a semicolon?” I asked.

“It is,” she replied as she shimmied her stethoscope up around her ears.

“Can I ask if there’s a story behind it?”, a tactless way of indirectly asking the question anyways.

“It is for suicide awareness,” she replied. Continue reading “the girl with the semicolon tattoo”