Tag Archives: Medical Science

Adventures in Medicaid 1 & 2


Google Maps leads her to a haunted house that’s recently been through a tornado. This can’t possibly be the doctor’s office. The patient calls the number. “No, you’re in the right place,” says the receptionist. “We’re in the basement.” The patient opens the iron gate and the hinges fall off in fragments. A small piece of paper is taped to the exterior of the Brooklyn brownstone. “OB-GYN THIS WAY.”

The waiting room is reassuring. It feels vaguely medical, perhaps due to all the fashion magazines. But it is not somewhere that the patient wants to remain for two hours. Two hours later the doctor summons her into a cramped, dusty office. The walls are mostly comprised of narrow closets. The patient wonders what’s in those closets. The patient suspects it might be human skeletons. The doctor tells the patient that she can’t trust her own boyfriend not to give her AIDS. The doctor tells the patient that if she wants to have viable offspring she should probably get pregnant by mid-afternoon. Then the doctor leads her into a dimly lit exam room. It’s a challenge to navigate the exam room without knocking into the rusty metal tables that hold the doctor’s instruments. The patient drops her bra on the tile floor. When she retrieves her undergarment, she must disentangle it from a sizable hairball of diverse DNA.

“Now what have we here?” says the doctor during her vaginal safari. “Is this your uterus?” She pokes around with animated perplexity. “No, I think this is your uterus. Unless your uterus is anteverted.”

“It’s not,” says the patient.

“Then what on earth could this be? Oh! Maybe it’s my finger. You’re skinny so I could be feeling my finger.” The patient wonders if her vagina is so cavernous that fingers can be misplaced in it. “I’m going to send you to diagnostics for an ultrasound.”

“Do I have cancer?” asks the patient.

“It’s probably just my finger,” says the doctor. “But you can never be too sure.”


The patient takes the F train to Brighton Beach. The air smells like Atlantic Ocean and dryer exhaust. After a fifteen-minute walk, the patient locates the psychiatrist’s office. It has a steep, sharply pointed roof and the patient wonders if a witch lives there. The sign on the window says, “ATTN PATIENTS THIS OFFICE NOT CONTAIN NARCOTIC DRUGS.” The Russian receptionists are friendly as can be. The patient fills out her paperwork and takes a seat. The patient deduces from a chorus of grumbles that the other three people in the waiting room have been there for over an hour. More patients arrive every few minutes. Each time someone enters or exits the office, the two exterior doors slam shut violently. When the patient hears this sound, all of her muscles seize up and she feels that something bad is about to happen. The psychiatric traffic continues to increase.

One man has clearly lost command over his grey beard and his overall personal hygiene. His mind seems to be in mutiny as well. He paces back and forth in the waiting room, demanding to see the doctor. “I’ve been here for fifteen hours!” he shouts. He has been there for five minutes. He’d taken the patient’s chair while she was in the restroom. A heavily tattooed woman enters the office wearing a swimsuit and cover-up. She looks as if she’s been tanning all day, every day, buttressed by a bank of mirrors, since April.

“I’m a walk-in,” she says over the counter. “How long is the wait?”

“An hour,” says the receptionist. “There are four patients ahead of you.”

“Do you think they’d let me go ahead of them?” says the woman. “I’ve got my baby with me.”

“You can ask them,” says the receptionist. The woman turns to face the crowded room like an actress under the glow of a spotlight that can only adore her.

“Would it be all right with everyone if I go first?” she says. “I’ve got my baby with me.” A couple maternal-looking Russian ladies shrug their shoulders. “Thank you so much!” gushes the woman. “I’ll only be with the doctor for like two minutes. In and out.” She leaves the office. The doors explode in her wake. Through the window, the patient sees the woman and her partner smoking cigarettes over a baby stroller. Her partner has a teardrop tattoo under one eye, indicating that he probably killed someone in jail. The patient is annoyed.

A lady in a floral housedress sits down next to her. A lap dog pants erratically in the folds of her skirt. The lady soon starts up a conversation with the receptionist at the opposite end of the room. “Are you going to watch the Republican debates tonight?” she asks.

“I don’t know,” says the receptionist shyly in her heavy Russian accent.

“Donald Trump might be a little obnoxious,” says the lady in the housedress, stroking her unstable dog, “but look at all he’s accomplished. He must be doing something right to have made all that money. You have to be pretty smart and resilient to come back from so many bankruptcies.” The patient texts her boyfriend furiously.

The tattooed beach bunny and her partner return to the waiting room with the child they made together. After ramming the stroller into a table from several different angles, causing In Style magazines to rain down upon the rug, the family settles in the corner. The woman turns to the patient and asks her point-blank if she can go ahead of her. The patient seems to be the final barrier between the woman and her shameless line jumping. The patient huffily consents. Shortly thereafter a receptionist summons the woman into the doctor’s office, where the woman remains for 20 minutes.

During this interlude the baby wakes up and the father removes him from the stroller. He sings and coos to his son with an exemplary amount of tenderness. And the baby is hands-down the cutest baby the patient has ever seen. The new parents are probably feeling overwhelmed, but they’re doing the best they can, and it’s understandable that they’d need to get their meds an hour before everyone else. The patient regrets being such a raging bitch about the line jumping.

When it’s finally the patient’s turn with the doctor, she’s already established a tentatively low opinion of him based on the fluctuating sea of poor mental health that constitutes his waiting room. She sits down in a stained leather armchair and tries not to read the names on the medical charts stacked messily across his desk. The office is relatively quiet, and the doctor seems sane enough. He begins her evaluation. First some easy questions: age, marital status, history of drug abuse. Then he begins alternating the easy questions with bizarre questions, as if trying to throw her off.

“What do you think of homosexuality?” he says. “Is the money in your wallet sequentially arranged?” Meanwhile the patient can hear a new male voice through the office door. The voice seems to be berating the receptionists about something. They ask him to please settle down. He becomes louder and more belligerent. The doctor seems utterly disinterested in all the waiting room drama. The patient wishes that he would hurry up and fill out her prescriptions so the angry man and his pathological brethren in the waiting room can have their turn and stop freaking the fuck out. The exterior doors begin slamming again. The patient’s nerves are popping like blown fuses. She imagines guns, cops, homicidal rampages. “If you found a stamped envelope on the street,” asks the doctor, “what would you do with it?”

At the end of his interrogation, the doctor peers closely at the patient. “I don’t think you have […],” he says. “I think you have generalized anxiety disorder.”

In the interest of concluding this interview with maximum grace and celerity, the patient does not respond, “Who the fuck wouldn’t develop generalized anxiety disorder after spending an hour in your medical establishment?” She takes the prescriptions, shakes the doctor’s placid hand, and departs through the waiting room, trying not to think about all the eyes burning through her back, especially the dog’s.

“Generalized anxiety disorder my ass,” the patient thinks, while wondering if any psychiatric patients are following her to the Neptune Avenue F station. She sprints up the stairs to the Manhattan-bound platform. After a few stops her crowded train car empties out. “What the hell does he know?” the patient thinks as she slowly inches away from a woman on her plastic bench because she thinks that the woman doesn’t want her to sit so close to her now that there’s more space, but the patient also doesn’t want to hurt the woman’s feelings by making her think that she doesn’t want to sit so close to her. Even though it’s been driving the patient up the goddamn wall that the two of them are still sitting so close together.

“That appointment was horseshit,” the patient thinks as she walks down 7th Avenue behind a cluster of people that includes a teenage boy wearing headphones. The boy disregards a red pedestrian light and steps out in front of a car. “Watch out!” she screams. The driver of the car lays on his horn. The boy does not get hit. “I should have done more,” the patient thinks. “I should have leapt forward and pulled the boy out of harm’s way. I should have thrown myself into traffic and used my body as an organic barrier. The boy could have been killed and it would have been my fault.” The patient stops at the next intersection and a man taps her on the shoulder.

“You just saved that kid’s life,” he says. “He should’ve at least said thank you.”

“Oh no,” the patient sputters. “I didn’t do anything. I think he just heard the car horn.” The patient walks the rest of the way home worrying that she’d mishandled the exchange with the man. He’d just been trying to make a point about the boy’s ingratitude, not her heroics. So it had been narcissistic of her to steer his observation back toward herself.

“What a charlatan,” she thinks, mouth dry and hands twitching. “That psychiatrist needs to go back to medical school.”

A review of Want Not by Jonathan Miles

My older brother and his wife are both doctors. (I know, I know. Less about them, more about me.) This means that they receive a lot of text messages from me and M containing photos of our body parts. At 2 in the morning M will be craning around in the bathroom mirror, trying to get a good angle on his back. “Would you please send your brother a picture of this mole? I think it might be cancerous.” If one of us sprains an ankle or might need stitches, we immediately get out our iPhones and start shooting. If we didn’t do this, we might jump to conclusions that reflect our art school, not our medical school, degrees. For instance last night before bed I was concerned about a little scab on my clavicle. “Do you think I was bitten by a bat?” “Don’t be silly,” said M. “That is the mark of a king cobra.” This morning the wound looks even smaller so I guess my superior immune system fought the venom and I won’t have to text my brother.

Regrettably, filial telemedicine has its limits. Two months ago when I came down with acute pyelonephritis, I couldn’t exactly call it in. I had to go to a Brooklyn emergency room and receive intravenous fluids, painkillers, antibiotics, anti-nausea meds, a CT scan, a roommate who wouldn’t stop farting, etc. Then I had to lie there shaking uncontrollably for five hours, getting my blood pressure checked every 30 minutes, bemoaning the fact that we couldn’t just take care of this over the phone. But because I was an ER virgin, everything felt new and exciting, and though I was sick to the point where I felt sure I was going to die and be buried in Potter’s Field on Hart Island because my family physician lives so far away, I kept counting my blessings because depression is worse. (The physical and mental illness combo is the cruelest, however. With this double whammy the patient feels deathly ill while also convincing herself that all her caretakers would secretly prefer she be dead, and might in fact be trying to kill her, and that would probably be for the best.)

I originally started this post because I wanted to write about introducing scorpions before surgery, but then I went somewhere else with it, so I’m sorry. I think I really just needed to open up about my traumatic experience in the hospital.

One day I would like to reciprocate my brother and sister-in-law’s cell phone ministrations, but I’m not sure what form that would take. If they ever go on safari in Africa they could text me pictures of animals and I could help identify them. “That is a giraffe,” I could say. Or, “That is probably an elephant.” If they are ever reading The New England Journal of Medicine and don’t know what part of speech a word is, I could probably say with some certainty, “That is a noun” or “No, that seems more like a verb.” My assistance might be less dramatic than responding to a selfie with, “Yup, that’s cancer. You have two months to live.” But it’s something. I work with what I have. And right now I have a headache that mimics a hangover but is caused not by a bottle of Albarino, but by the bite of a stealthy nocturnal tarantula.

You should read Want Not by Jonathan Miles. It was good and I liked it.*

*I’ll stop doing this soon because it’s so misleading, but man do I love driving a joke into the ground.

My dental surgery – a postgame

The Novacaine wore off about halfway through the grafting procedure, so suddenly I could feel as well as see the dentist’s dainty fishhook as it threaded sutures through my gums. I’d be lying if I said I didn’t enjoy the pain. My dentist just hurts me so good, like Steve Martin in Little Shop of Horrors. I still have fond memories of having my wisdom teeth removed a couple years ago, and last week’s receding gum operation was like a second honeymoon. Today at my post-op appointment the dentist said that my gums would continue to look “angry” for another week. “They’re not angry,” I should’ve said. “They’re glowing.”

Medicine and the arts and the Joyce-diagnosed STD

On Monday I had the good fortune to meet the editor in chief of Hospital Drive, a literary and arts journal published through the University of Virginia School of Medicine. As a frustrated writer and an infinitely lazy doctor, I was excited to hear about this two-year-old publication. Finally all my thoughts about blood and guts have a place to go.

I love to read authors like the surgeon Atul Gawande and the neurologist Oliver Sacks who inexplicably moonlight in the medical world. But you don’t have to be an MD to explore issues of pain, illness, and the large intestine. Lorrie Moore’s knock-out short story “People Like That Are the Only People Here: Canonical Babbling in Peed Onk” (PDF) stands out as one such medical drama written by a non-doctor. How does a mother emotionally orient herself in the last place a mother wants to be – the Pediatric Oncology ward (or “Peed Onk”)?

We need these stories (and novels and poems and essays) that marry literature with the unruly universe of the human body. Otherwise there are only a bunch of doctors poking the uninsured and no one trusts anyone on the other side of the scalpel and the only thing to read in the waiting room is Golf Digest.

Hospital Drive links to more established publications that share its same goals:

Ars Medica is a “biannual literary journal that explores the interface between the arts and healing, and examines what makes medicine an art.”

Bellevue Literary Review welcomes “submissions of previously unpublished works of fiction, nonfiction, and poetry that touch upon relationships to the human body, illness, health and healing.”

I encourage you to check out some of these publications. You might discover something you didn’t know about human nature. You might also find out if that infected armpit boil has to be lanced. Forget the doctor’s office – short stories will finally diagnose that burning sensation when you pee.

Science post: I am not a racist doctor I am not a racist doctor omg get that white girl some lemonade she seems thirsty

Yesterday Salon published an article called “Race and the White Coat” by Dr. Rahul K. Parikh. The article discusses the proven disparities in medical care that occur in our country along racial lines. In general, white people receive better medical care than black people. That’s not to say that white doctors are kicking black cancer patients out of hospital beds to make room for white girls recovering from getting their ears pierced, but implicit biases can inform how much pain medication someone is prescribed, or who is going to be recommended for a renal transplant.

Parikh’s article mentions Harvard’s Implicit Association Test, which I took for the first time yesterday after staring at the Proceed and Cancel buttons for 15 minutes. I’m not positive, but I think the results of my test show that next time my local hospital staff pays more attention to the black gunshot victim in the ER than to the fact that the cafeteria salad bar is out of raisins and I require raisins on my salad, I will be lying if I say I’m not resentful. And that’s science, people. Get on board.

Your suspicions about my absence were correct

I’m sick. Sick, sick, sick. And I didn’t want to blog about it, but now I have no choice. Three days of sick.

Day 1 – Hey, I think I’m sick. What a novelty for a girl with a superior immune system. Am I sure I’m not faking it? Yes, I think so. I claim this couch for lounging.

Day 2 – I feel worse. I’m not going to blog about it. Sick-blogging is ranked down there with cat-blogging. I claim this bed for coughing on.

Day 3 – The sickness seizes my throat and the space behind my eyeballs. I drink orange seltzer water. I play with my sister’s new puppy. I finally cave and take medication. Nothing seems to help. I suddenly feel compelled to reach out to everyone on the internet and tell them how sick I am. I claim this blog for your sympathetic reactions.

But no sick-blog can beat Waldo’s epic sick-blog from 2006:

My throat is clogged. It’s as if I’ve swallowed a drain plug. Every gulp is conscious, difficult, near-desperate, the flailing of a decked fish. . .

When I cough, the plug reveals itself to be an oversize rusty bolt, tearing at a shredded windpipe. I fear I might blow it out. I half expect that when next I clutch at my burning throat I’ll come away with a handful of neck-flesh.

I realize now that sickness separates the true bloggers from the internet so-and-so’s, the wheat from the chaff. If you have not yet blogged about your runny nose and your aching internals, you are obviously a dilettante – you probably don’t even own your own domain name. It took me eight months and almost 300 posts to get here, but now you finally get to see me blow snot rockets.

Giving birth in hot tubs (this post is for my lady readers)

Giving birth in hot tubs = not cool. I Stumbled upon a birthing stories website yesterday and was horrified to find pictures of a lady in a bathing suit delivering a child in her patio hot tub. Her husband and daughters looked on while she pulled her one-piece aside and pushed out a baby. Later she wrapped herself in a bathrobe and went to take a shower.

Hot tubs are for drinking beer out of cans and making out, NOT for soaking in afterbirth. I’d link you to the website but I don’t want to offend the mother. Plus she’d know immediately that I am less of a woman than she is. Babies are cute and they make me laugh and cause my uterus to flutter, but the second I start thinking about birthing one of them they all start looking like slippery little ogres.

I also saw a scary video yesterday of a puppy who thrashes to death metal music. That video and the hot tub birthing pictures combined to ruin my night. I was looking forward to relaxing under the spa jets with my puppy in one arm and my newborn baby in the other, and suddenly all I could see was blood and teeth.

Glutton for sugar, then punishment

“Ms. Murray,” says the dentist, “are you sure you don’t want to split these four fillings into two appointments?”

“Hell no,” I say. “Recline my chair. Shoot me up with Novacaine. I’ve cleared my morning. Let’s do this.”

Fifteen minutes and five long needles to the mandible later, I’m listening to the dentist’s iPod playlist through headphones and settling in for three hours of drilling and filling.

“You guys are doing awesome,” I say to the doctor and his Russian assistant. I close my eyes and feel the cool water of the technician’s hose mist my cheeks. The fresh water has mingled with my saliva and I am lightly showered with all the fluids in my mouth. I breath in the tooth decay being vaporized by the drill. I feel the corners of my mouth crack with the pressure of the suction hose. I tap my feet to the bad country music coming through the headphones.

“This is even better than getting my wisdom teeth taken out,” I think, “and that was pretty great.”

Anyone know an unfaithful doctor?

Alternative name for this post–“Unfaithful doctor, I advise you to stop having an affair. Your wife is onto you.” Saw this ad on Charlottesville Craigslist this morning with the subject:

“Need info on female drug reps cavorting with local surgeons”

“I am a private investigator in Richmond and have been hired to identify the female drug representative who is having/had an affair with a married physician in the Charlottesville area between 2005 to present. This person may cover the Charlottesville, Lynchburg, Staunton, Harrisonburg and Waynesboro areas. The only information I have is that she has been a drug representative for many years with one of the larger drug companies.

Information I need: which companies work this area and which are the largest. Phone numbers of regional offices and names of managers. Names of physicians who have had improper relationships with pharmaceutical sales persons The names of any of the female reps who may provide me with information.”

Good luck, P.I. Since when do the good people of Charlottesville rat out their doctors? And since when does the Craigslist “Community” section conduct your investigations for you?

Alice Proujansky

In 2006 New York photographer Alice Proujansky went to the Dominican Republic to document the lives born and the lives lost in a dismally-funded maternity ward. Here are some of the affecting images she captured on film.