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    Quiet Lives: Stories from Beyond the Stethoscope
    Quiet Lives: Stories from Beyond the Stethoscope
    Quiet Lives: Stories from Beyond the Stethoscope
    Ebook261 pages1 hour

    Quiet Lives: Stories from Beyond the Stethoscope

    By Bill Toms MD

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    About this ebook

    Over the years, what does a Family Doctor hear? He may hear the fresh and strong heartbeats of a newborn baby just entering a complex and challenging world. She may hear the fading, weakening heartbeats of a tired Hospice patient. These Family Doctors will do so using the time-honored medical device known as a stethoscope. Even without using the stethoscope they will hear stories from their patients, some stories clinical and worried, others quiet and hidden. The stories may be about their patients' pains and losses, or about their joys and triumphs. They may be about their fears and weaknesses, or about their courage and strengths. They are usually quiet stories, lives beyond the headlines, the town gossip, even beyond Facebook. The stories are heard if the Family Doctor listens closely. These are the stories beyond the stethoscope, relayed here, as free-verse, as homage to those quiet and fascinating lives.
    LanguageEnglish
    PublisherBookBaby
    Release dateDec 3, 2020
    ISBN9781098314590
    Quiet Lives: Stories from Beyond the Stethoscope

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      Book preview

      Quiet Lives - Bill Toms MD

      cover.jpg

      Copyright 2020 by Bill Toms, MD

      First Edition

      All rights reserved. No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, including photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the author, except in the case of brief quotations embodied in critical reviews and certain other noncommercial uses permitted by copyright law. For permission requests or other information, please contact the author at btoms0691@gmail.com.

      ISBN: 978-1-09831-458-3

      E-BOOK ISBN: 978-1-09831-459-0

      Printed in the United States of America

      Net proceeds from this book will be donated to

      Rangeley Health and Wellness

      25 Dallas Hill Rd.

      Rangeley, ME 04970

      Acknowledgements:

      I wish to thank our daughter, Kara Toms, for her art work on the cover design. I also want to gratefully thank my partner and best friend, Mary Angela Toms, who has not only been universally supportive and immensely helpful throughout the years of my writing these Stories, but also was the steadfast editor of this book.

      The following Stories have been published previously in the Journals noted.

      Pulse: The Heart of Medicine:

      Presentation, Riding The Rails, Sounds, Back pain

      Yale Journal of Humanities in Medicine:

      relearning, Home Visit

      Hospital Drive:

      malaise with a cough

      Journal of Cancer Education:

      desktop info, space, special things

      Dartmouth Medicine:

      talking, taking the time, relearning, A New Hampshire Couple, Greta, risk factors, declarations, predictions, life and …., knowing, smiling, siren, Yup, 41

      Contents

      Chapter One:
      Lives, quiet

      102

      A good guy

      Back pain

      Gardening

      Cartoons

      Dancing

      Deference

      Call

      Failure

      Diabetes check

      Forty-one

      Indigestion

      Infections

      Dream

      Leaving

      Wedding

      That’s why

      Organs

      Remembering

      Save

      What will I say?

      The medical student

      An old friend

      Confusion

      Scared

      Seen too much

      Greta

      A New Hampshire couple

      By any measure

      Declarations

      Favorites

      Hearing

      Joke

      Leave ‘em laughing

      Newspapers

      Predictions

      Yes

      Rings

      Sharp

      Shopping

      Smiling

      Siren

      Stories

      Choosing

      Talking

      The birds

      Worth it

      "Yup"

      Together

      Chapter Two:
      Lives, blended

      Biopsy

      Heads

      Kleenex

      Getting old

      Sick, scared

      Belief

      Teammates

      Touch

      Chapter Three:
      Conversations

      Fault

      Nursing home memory

      Pills

      Advance Directives

      Relativity

      System

      Understanding

      Patch

      Seven seconds

      Listening

      Chapter Four:
      Disease

      Fear

      The room

      The necklace

      Two words

      The alien

      Surgical Suite, Cancer

      Checkout

      The tube

      The name

      The monkey

      Not feeling better

      Lonely

      Sweetness

      Anger

      Turning

      Say the name

      Chapter Five:
      The Longest Loss

      Losses

      Slipping

      Empty

      Words

      Emote

      Hiding

      Losing it

      Still

      The bridge

      Chapter Six:
      Medicine

      Space

      Never liked them

      Malaise with a cough

      Relearning

      The scent

      Sounds

      Taking the time

      Fair

      The Award

      Tomorrow

      An exceptional man

      Chapter Seven:
      Getting Too Close

      Worrying

      Bradycardia

      Friendly chat

      Migraine

      Worry

      Waiting

      TGA

      What would they say?

      Interesting

      Smart

      Life and …..

      The convincer

      What I don’t know

      Senses

      Risk factors

      Teaching

      Journals

      Desktop info

      Special things

      Quiet Lives

      Stories Beyond the Stethoscope

      The short stories that follow introduce readers to the lives and voices of patients that I have known over the years. The voices are quiet, heard only if we are willing to listen just a little harder. These voices have come through a metaphorical stethoscope, the listening device of a family doctor.

      Almost fifty years ago, as a medical student, I began writing stories about experiences in medicine, particularly about the people, the people we refer to as patients. Over the years many of these patients have become my friends and have had unique, interesting and timeless stories that illustrate much of what it means to be human. The overwhelming truth and power in their everyday lives as they coped with their healthcare issues propelled me to write stories about them and medicine.

      These stories are about regular people, people like our families and our friends. I found them to be both typical and representative, while still being profoundly unique. An attempt has been made to change names, easy identifiers and personal information. If you think you find yourself in here and it’s complimentary to you, please go ahead and assume the story is about you.

      Most of the stories are written in verse rather than prose, as verse seems to more accurately reflect the depth and context of our mutual shared experiences. The stories are all fairly short and carry all the hazards and insufficiencies of brevity. Most of the stories have a brief comment at the end with a personal perspective.

      Some of the stories were written many years ago and reflect the medical understanding and technologies of the time. They have been left in their original form in an attempt to maintain an honest perspective of the person’s story.

      The Chapter distinctions are somewhat arbitrary and not exclusive but seem to sort themselves as follows:

      Lives, quiet: true stories about individual patients

      Lives, blended: stories that are a very slightly fictional composite of multiple real patient experiences

      Conversations: stories told as dialogue, at

      times verbatim

      Disease: stories about diseases that afflict

      real patients

      The Longest Loss: stories about patients dealing with dementia

      Outside the Lives: stories that more generally reference the science, art or business of Medicine

      Sometimes Getting Too Close: stories about when medicine has become personal

      Why write stories about patients or medicine? Every writer might have his or her own reason to do so. For me writing is a tool toward the goal of being able to improve the way we listen to what our patients are trying to tell us, at times with great difficulty. Modern medicine and health care have evolved very far from their humble historical beginnings and even from where they were twenty or even ten years ago. There is now tremendous potential for diagnosis, treatment and care of even the most dread or exotic diseases. Yet the basics of listening to what patients are saying, what they are trying to tell us, the truth in their lives, is a task that is becoming more elusive and difficult. My hope is that we can honor our patients’ trust in us by remembering and maybe re-telling their stories, even if anonymously. It is also my deepest hope that as you read these stories you will sense the respect, appreciation and affection that I have had for my patients over the last forty-five years.

      Bill Toms, M.D.

      Dedication

      This book is dedicated to my patients who embody the quiet stories, both those recorded here and the so many other stories still waiting to be heard and, perhaps, to be retold. It is also dedicated to our children, Angela, Kara and Matthew Toms, who easily forgave me for all the late dinners and missed games that happened while I was practicing medicine during their youth. They, along with their spouses, Chris, Dan and Kathy, and their collective nine children, our grandchildren, comprise a truly wonderful family and continually remind this family doctor what being a family is really all about. And, most of all, this book is dedicated to my wife and my huckleberry friend of 54 years, Mary Angela Toms, who not only tolerated my professional life with understanding and support but encouraged me to pull the Quiet Lives together into this book which she so kindly and skillfully edited. I owe everything to her, the heart of our family.

      Riding the rails

      Our train starts to move slowly down well-travelled tracks. It’s sunny out, clouds in the distance. We pick up speed.

      We offer obligatory greetings,

      my courtesy How are you feeling?

      We both know why she’s here

      but we both defer that talk

      as if deferring for a few minutes will make it better.

      The trackside turns to trash, human detritus, rusting hulks without utility.

      I edge closer, negotiating perfunctory reviews,

      her history, her physical, her labs, her imaging,

      all clearly owned by her alone.

      Then it’s time to enter

      the forbidden room of abnormals:

      machine-made shadows, the blood’s too highs.

      Her cloak of woven fear lays quietly on her shoulders.

      It stays immobile when I say the halfway word tumor.

      It doesn’t wrinkle or slip upon finally hearing

      that we have arrived at our destination,

      the train stop with the Cancer sign swinging,

      greeting us as we brake to disembark.

      We enter the cavernous shell of an ancient building, great columns suggesting the strength of history, pigeons circling columns as if this was normal. At the center of the main floor the newly electronic train schedule flashes its options. It suggests we are free to

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