I do have a new poem for my disciples. I've been working on it for a couple of days now. It needs a little 'splaining (as Desi Arnez used to say to Lucy). As you know, one of my jobs is working in a medical office. (Remember, I'm an adjunct English professor, which means I have at least two other jobs to support my family.) As part of my job in the medical office, I file a lot of dictated reports. One kind of report I see a lot of is a History and Physical (H & P, for short). This document basically provides a patient's medical and social background. Over the years, I've noticed that, if you read between the lines, these documents tell stories. That's the inspiration for today's poem.
I know I promised a picture of myself with my new messenger bag. I will deliver on that promise tomorrow. Also, I just got word that my uncle, who has terminal cancer, is not doing very well. Please send some good thoughts/prayers his way tonight.
Saint Marty is ready for some good, quiet reading time.
History & Physical
Chief Complaint: pelvic pain.
History of Present Illness: pelvic pain for eight days, started at granddaughter's high school graduation when patient saw granddaughter in cap and gown, realized she looked exactly like patient's daughter who died three years ago of ovarian cancer on a December night, holding patient's hand, whispering about warm bread and raspberry jam.
Past Medical History: pelvic pain, sense of emptiness, the way a dining room table seems empty when a child goes to school, finds a boyfriend/girlfriend, gets married, has children.
Past Surgical History: tonsillectomy at age eight, Cesarean at 22, patient sometimes rubs C-section scar in middle of night until it burns under her touch, like an infant with an ear infection.
Social History: lives in Michigan, winters in Florida, can't stand cold weather or snow any more, reminds her of things she's lost: her father's buffalo nickel, sound of her mother's voice, smell of her daughter's just-washed hair.
Allergies: aspirin, Tylenol, shellfish, grief.
Medications: Coumadin to thin blood, avoid coagulation, clots, pulmonary embolisms that sit in your chest like forgotten love letters, waiting to be opened.
Physical Examination:
HEENT: Within normal limits (WNL).
HEART: Enlarged, empty, the Grand Canyon at midnight.
LUNGS: WNL
ABDOMEN: WNL
EXTREMITIES: WNL
NEURO: WNL
OTHER: WNL
Impression: pelvic pain, phantom, incurable.
Plan: discharge to home after observation, avoid winter ice, smell of baking rye bread, sound of school bells.
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