There was nothing the professor despised more then the syrup that oozed out of his partner's lips when dealing with patients. He often cringed as he walked by the examining room and imagined the hand holding that was taking place behind closed doors.Privately, they argued about the different approaches. One saw the world in terms of black and white, while the other was steeped in a foggy haze of gray. ...
Jordan Grumet, MD
The challenge of creating a palliative care program
The orders came indirectly from the government.Reduce hospital re-admissions. Cut costs.So, the hospital contacted the local hospice-palliative care center and asked for help. Of course, overwhelmed with work and understaffed, the project was handed off to me.My task sounded simple. Create a palliative care program at the nursing home. But as I gathered for the first meeting with the administrator, social worker, and clinical staff, I knew there would be ...
The magic of learning medicine
There is a time for sitting in classrooms. When such heady topics as congestive heart failure are abstract and intangible. Discussion veers from myocytes to cardiac output and stroke volume.The world, through the student's eyes, is inflamed with passion and opportunity. The reality of doctoring is a distant dream. Hope peals back layers of fear and loss of confidence. Reward is imagined as a handshake, a return to health, and ...
The covenant between doctor and patient is sacred
You know Mr. Miller?I adjusted the phone on my ear as I slipped out of bed and snuck into the bathroom. I tiptoed across the floor and winced as the old hardwood started to creek beneath my feet. I craned my head and listened for signs of stirring children.Remembering the resident holding on the line, I whispered into the cell.Yeah. What about him? He had a choleycystectomy this morning.I waited ...
I told a man that he was dying
Two weeks ago I told a man that he was dying. We sat together in the mid afternoon haze. Puffs of snow meandered by the hospital window and wended their way down to the ground. The sun was lost behind winter's never ending clouds.The tempo of my voice was steady, lacking variation in tenor and pitch. I clung to my lab coat as if I was floating outside the window ...
Health quality requires looking at our caregivers
Sonia struggled to express herself through broken English. Her lively facial expressions and exuberance betrayed by her inability to string the words together fluently. One hand gesticulated widely while the other rested gently on the elderly woman's hair.She somehow managed to coo quietly in her companions ear, calming her, as she continued the conversation with me. Sonia's eyes opened and closed in an exaggerated blinking manner as she questioned me ...
Why this doctor moved to private practice
Chief of Medicine Evanston Hospital October 23, 2005To whom it may concern,I would like to take a moment to express my deep displeasure with one of the interactions I had with a physician in the Church Street location. I use the term "interaction" loosely since the doctor in question, Dr. Jordan, never actually saw me. Apparently he was too busy.Last Thursday I was shopping in downtown Evanston when I felt the sudden ...
Can physicians survive the new world being foist upon us?
As I walked up the stairs I thought about the history of the building I was about to enter. Although the foundation was the same, almost everything else had changed. The hallways were updated. The patient rooms decked out with comfortable furniture and fancy televisions. I even marveled at the bathroom as I answered nature's calling. I could have been in a fancy hotel.Yes. Things were different than when I ...
When sentimentality is lost
I don't know when I lost my sentimentality.Whaaap.With a thud the fish stops flopping up and down. It lays still on the floor of the boat. My camp counselor, a tanned college student, carefully places the paddle on the seat and cuts the fishing line. The hook remains dangling from the lifeless mouth.He grabs the fish with his bare hand and throws it back into the water. He talks slightly ...
I will pray that I am a humble physician
As I sit down to drink coffee tomorrow morning and type away at the computer, I will do something quite uncomfortable for a non-religious person.I will pray.I will pray that my children make it safely to schoolThat the weather is good and the sidewalks are not slick.That their feet will be steady and their minds alert to the dangers that lurk in any suburban neighborhood.That my wife will have an excellent day.That ...
A covenant between doctor and patient
I mean it is kind of lonely being your doctor. I picture it as sort of a covenant. Between you and I.On one side you. And your family. And friends. Your house and your dogs. Your communities and lives.On the other side me. Alone. Of course there is always the hospital, but were really not friends. My partners and specialists. They all make an appearance. But when the going gets ...
I concentrated to distill all that I had learned about death
The recycling container was already full. But I had two more bags to stow before lugging the bin through the gate and into the front yard for pick up. My button down shirt untidy and bulging out from the waist. My long khaki pants felt like a fur coat in the ninety plus Chicago humidity. It was 4pm and I had just arrived home from work, dropped my computer in ...
Father and son, doctor and grieving family member
The edges of Cameron's lips rise undeniably toward the clear blue sky. His legs move methodically. One motionless on the scooter and the other periodically kicking to propel himself forward. He weaves in and out dodging my shadow as I jog beside him.I struggle to keep pace. My breathing unsteady and labored. My joints aching. And my brain foggy from lack of sleep and replaying the events of the day.***The ...
My good intentions had helped start a reaction
If death was the end zone, George had been on the one yard line twice in the last five years. And I, as part of his team of doctors, watched as he stubbornly maintained his goal line stand. Miracles rarely happen in medicine. They certainly don't happen to the same person more then once.Yesterday as George glided into my office you would have never known that eternity's grip had been ...
Being a doctor takes a toll
It takes its toll on me, being a doctor.I think as I wait in the Indian restaurant buffet. My son is curled on my lap. Uncharacteristically tired. Later he will develop a fever and I will realize why he is so warn out.It takes it toll on me. I wouldn't say I am a stressed out person but I certainly live with stress. Most of it is self inflicted.It's ...
An apology to a terminal patient with colon cancer
I'm sorry, Mrs. Lewis, for not making it to the hospital to see you yesterday.Yesterday was one of those days when I felt like I could never catch up. My wife was going downtown for work, and we had to get up early. While she prepared, I helped my two-year-old son get dressed. We walked my wife to the train, then waited for the nanny. She was running late: I ...
How real life medicine is less glamorous than residency
"Code Blue ICU ... Code Blue ICU"I was greeted by the PA system as I walked into the hospital this morning. A shiver ran down my spine as I quickened my pace . The days of running to codes are long gone. But since I have a patient In the ICU I was curious and just a little bit worried.As I walked through the sliding doors I passed the room ...
Entering the golden age of hospice care
Friday in my office is like happy hour for the oldest of the old.They come. 90, 95, 100. Always on Fridays. Some come in wheel chairs. Others walking. Some alone. Others with family. 5,6, 7 sometimes even more in just one short morning. And we talk about life, about their children, about growing old. I apologize that at that age I really have little to offer. After all, they know ...
Government and health insurance intrusion penalizes efficient doctors
I wish I knew how to express myself. I wish I knew how to put this into words. How the direction of things has just become depressing. How each day makes me wonder how we got to where we are today. And I think back. Back to the beginning.I think back to my childhood. And how I looked up to my father ... the physician. How he died when I ...
Why patients are leaving our practices
She was like ... Superwoman. A strapping medical visionary probably in her forties. Gray long coat falling below the knees. She strode confidently down the hallway towards the elevator, a father hurrying beside her with his young lanky daughter cradled in his arms. The girl's head nuzzled into her father's shoulder. She was old enough to walk by herself...but clearly she was sick. Unable.Undoubtedly they were headed from the medical ...
