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Letting Go

She Left before the Snowmageddon


Her spirit left the week before, and her body lay inside her casket shrunken. She died on January 29, 2019 and her family would need to let her go. She had lived eight years with Alzheimer's and, despite a valiant effort and family support, Sue Insuk Kwak could no longer be trapped inside her body.

A week and a half before, I went to Seattle to see my mother for the last time. I tried to coax her to eat and to move, but at sixty-five pounds she was declaring herself no longer part of the living world. She was, quite deliberately, choosing to die. 

Closure 100 Days After

 
I was walking around the neighborhood with my mom as we discussed our plan to visit Grandma in Vietnam. My grandma was suffering from Alzheimer's, uncontrolled diabetes, and necrotizing skin lesions on her back. We decided to plan our visit in three months' time--knowing it would be a long, restless wait.

At the Flick of a Switch

"I want to do something now. What can I do?"

My mother's body and mind were restless, moving in their own patterns just like the gray, low-hanging clouds that morning in August. "Why don’t you tell me what you want me to do?"

She didn't wait for my response but shouted, "Don't you dare tell me what to do, I'm not a child!" while pounding her cane on the floor with such might that I could feel the vibrations in my stomach. Then she sank into her chair and fell silent, her eyes glazing over.

How to Fire Your Doctor

 
Look your doctor straight in the eye. It's okay to smile. Or not--it's your choice.
 
Don't mince words. When your doctor says, "I'd like you to try this prescription..." (or physical therapy or whatever) "...and come back in three months," that's your cue. By all means take the prescription, or the referral sheet, and then say, "I won't be coming back. I'm going to look for a new doctor..."
 

Adieu


One week into a three week "staycation," I enjoyed drinking coffee on the loveseat with my husband, holding his hand and pondering life. We sat in comfortable silence, but an inner turbulence unsettled me. He tapped his foot to some inaudible percussion. 

"I've got two weeks of vacation left, and I already dread going back to work," I blurted without thinking, without self-editing. 

His foot stilled. "Then don't," he said.

Let Him Go? Hell, No!


Several decades ago, my elderly patient, Mr. Waverly, coded in the ICU. Dr. Schiller, myself, and three other nurses tried feverishly to resuscitate him. Unfortunately, without success.
 
Fond memories flashed by of the patient I nicknamed, "My easiest patient with the sickest heart." He struggled with uncomfortable abnormal heart rhythms and fainting spells, yet he never complained. While he confided in me about his fear of dying, he also made me laugh with funny cow stories from his dairy farm.
 
Minutes ago, Mr. Waverly and I had been chatting about his newest grandchild. Now, he was gone, and I was holding his hand. Looking down at his lifeless body and feeling the coolness of his skin, I mentally let go of my favorite patient.
 
Choking back tears, Dr. Schiller pronounced the time of death.  We bowed our heads around the bedside, observing a rare moment of silence in the ICU. The pungent odor of death filled the air as his sphincter relaxed. Clinical death.
 
Before I could turn off the monitor screens, another cardiologist, Dr. Revell, rushed in, "I just got the page, what's going . . . ?

The Hardest Decision

I prepared to let go and wished for more time. There was nothing left but to let my youngest son be at peace. Tomorrow we would unplug the machines.

His transplanted liver was failing, and he was too sick to get another. He coded three days earlier. Now, beneath the sedatives, paralytics and seizure medications, he was convulsing continuously.

There was no hope for meaningful recovery. As a physician, I knew it was the right choice. As a mother, I was heartbroken. How could I reconcile the rightness of the decision with something that felt so wrong?

Single Steps

Sometimes, the answer is so small and simple it goes unnoticed at the time.

I had barely entered my twenties when my parents died, within two years of one another. Well-wishers inundated me with questions about whether I would keep the family homestead, continue my education or change jobs. Should I donate my parents’ clothing and furniture and start a new life in a smaller place? After all, the old status quo was gone, never to return.

What If ...

... You were thirty years old, and your mother was also my patient? What if she said you wouldn’t speak to her? What if she said you told her your grandfather sexually abused you? What if she said, “My father was a lot of things, but he was not a sexual predator”? What if she called you “a liar”? What if she didn’t believe you because your sister denied it happened to her? What if you knew that she knew? What if I couldn’t convince her to validate you? What if you cut off all family ties and turned to drugs? What if you killed yourself?

Surrender


The jolt of pain shot up my back. Oh shit! I immediately stopped rowing. But then I recommenced my “high intensity” work out, with some modifications, not saying a peep to the instructor. Within a day, I had searing pain down my right thigh, like someone was tearing apart my quad with hot tongs. Every time I tried to stand, I turned ashen white and collapsed down. Me, the marathon runner; me, the active ob/gyn; me, the one who doesn’t know how to say no. Me, brought to my knees by overwhelming pain.

Immediately, I’m texting my partner. Prescribe me some steroids please. I’m thinking it has to be a herniated disc. My daughter drives me to the pharmacy, and I can’t make the walk to the back of CVS. I stop part way then, when I’m close, collapse into a chair. My daughter looks scared. “Just ask them for my prescription,” I tell her, trying to sound calm. I don’t know how I’m going to get back to the car.

Death and Forgiveness

"We need to leave. Joan's father just died."

My husband, Richard, our newborn baby, Andy, and I were in Binghamton, New York, where Richard was interviewing for a postdoctoral fellowship.

I had been in our host's guest room nursing Andy when someone called Richard to the phone. As I overheard Richard's words, my consciousness split in half. One part registered the information with dismay. The other continued cooing to Andy, enchanted that he had just awarded me his first smile.  

Mrs. B.

 
At our last office visit, I told Mrs. B., my 88 year-old patient of 18 years, that she was doing very well. Her blood pressure was controlled, her vaccines were up to date, and her mild COPD was well adjusted. She was still an active volunteer for the local VFW, tirelessly preparing food and hellping with events. I encouraged her to keep up the good work and said that I looked forward to seeing her in a few months. She died the following week.
 

Keeva


My dog was lean and strong from swimming, running and walking long distances. Her fur--thick, soft and golden--glistened in the sun. She slept half on and half off her bed near mine. At 6:30 each morning, her wet nose nuzzled me awake. Keeva loved snow and cold weather. She pounced on disappearing snowballs. She chased after balls on the icy beach or plunged after them into the frigid sea. The ocean, a lake or swimming pool all beckoned to her.
 
Keeva died at age eleven from a hemangioma-sarcoma. My husband had died five years before, and now my dog. Keeva's cancer appeared on her left hind paw. She had surgery twice, followed by antibiotics, a bandage and a bootie. For a while the tumors seemed quiet, but tthey returned with increasing frequency. When no medical inervention seemed to work, I let Keeva care for her paw herself. She licked it continuouslty. To my amazement, and to that of her veterinarians, the lesion in her paw dried and scabbed. But eventually the tumor returned.
 

Blessed Theresa of Monroe

 
My sister Theresa came into the world smiling. My parents told the story of how when she was born, instead of crying like most babies do, she just smiled. She was a gift from God and devoted her life to God when she became a Catholic nun. She joined the order of the Sisters, Servants of the Immaculate Heart of Mary, based in Monroe, Michigan.
 

Consumed by Anger

For almost forty-five years, I have been angry. While this anger never leaves me, it becomes more profound on December 11, my son’s birthday. It was on that day in 1973 that the seeds of anger were planted.