One Event, Two Stories

Photo: Kal111

I recently had a patient of mine undergo surgery to remove his gallbladder due to acute cholecystitis.  He’d been out to dinner with some friends and had started to feel nauseated, then developed some right upper quadrant abdominal pain that necessitated ending the evening early.  After a sleepless night, a morning episode of vomiting, and developing a fever, he came in to see me.  I made the diagnosis, called a surgical colleague, and his gallbladder was taken out later that afternoon.

Afterwards, I talked with the surgeon, who reported the operation had gone well, with almost no blood loss.  The gallbladder had looked “as if it was about to burst,” suggesting they’d gone in just in time, he said.  Continue reading…

How To Know Yourself

Photo: kretyen

In the past, I’ve been humbled to discover things about myself I didn’t want to know:  as I wrote in The Good Guy Contract, that I believed I needed other people to like me to be happy, and as I wrote in Keeping Romance Alive, that I was warm when in fact I wasn’t.  As surprising as learning these things was, perhaps even more surprising was that learning them surprised me.  Why wouldn’t I always have known these things?  Why do the things we discover about ourselves so often run counter to our expectations?  How is it our view of ourselves so often turns out to be entirely wrong? Continue reading…

End-Of-Life Discussions

Photo: 28misguidedsouls

When I was a resident working in the intensive care unit (the ICU) at the University of Iowa, one of my responsibilities was to communicate with the family members of my patients.  However, an intensive care unit, as its name suggests, is an intensely busy place, and I often observed among my colleagues a tendency to think about communicating with families as the last thing on their list of things to do.  And though I too often found myself making it the last task of my day, I tried to make it a consistent one, knowing, as I did, that not knowing is perhaps even more anxiety producing than knowing that something is bad. Continue reading…

The Double-Edged Sword Of Hope

Photo: Albion Europe ApS

I’ve taken care of many patients with cancer throughout my career, but one in particular stands out in my mind, a forty-year-old journalist who came to me with a diagnosis of a grade IV glioblastoma—a malignant brain tumor with an almost uniformly fatal prognosis.  The reason I remember him so vividly isn’t just because he was nearly my age, or because, like me, he had a wife, a three-year-old toddler, and loved to write, but because of something he told me at our second visit.  “Hope,” he said, “is the one thing standing between me and peace.” Continue reading…