Wednesday, October 18, 2017

Cancer in Pregnancy; A Young Mother Fights for Her Life

by Larry Puls @larrypulsauthor

Pregnancy and Cancer
Even now, I still remember the unspeakable sadness and the tragic outcome. It was twenty years ago, and counting. The events still flash back into my mind every time I walk onto the floor where the saga culminated... And ended... The beginning of the two-year journey started something like this--as my mind remembers it anyway: A colleague called and asked me to see a patient she believed had cancer... And was thirty-six weeks pregnant. 

Within an hour, a young woman walked into our facility. She was graced with beautiful long blonde hair, a subtle trace of a German accent, and a very gravid abdomen. Her pleasant smile and handshake could not hide the trepidation I sensed was trickling through her veins. I'm just sure that that morning when she woke, her life had felt so full of promise. And now in the blink of an eye, it was marked with a growing sense of uncertainty.

Wednesday, October 11, 2017

A Gun in the Hospital; A Shooting

by Larry Puls @larrypulsauthor

Medical School, Fear
Kaboom... Kaboom... Kaboom...

A tsunami of terrified people running in every direction, some left, some straight, some right. We suddenly see them bounding into our hallway packed with gurneys, equipment, and injured human lives. Twenty or so people, fleeing towards us into a "safe" zone. Who could possibly know how safe it would prove to be? The wave of frantic runners was stirring up increasing chaos. Panic that stimulated more panic. All the frightened individuals were now engaged in a game of musical rooms, trying to secure safe places for themselves. Someone bad must be stalking the ER and we were all in harm's way. Fears forced the treatment room doors open. People dove in, and then barricaded themselves inside respective fortresses. My first patient was no exception, flying off his table as well, with his stitch and needle swinging from his arm. Desperation was plastered on his face, on every face.

Wednesday, October 4, 2017

Run for Your Life; Who Said Medical Education Was Worth Dying For?

By Larry Puls @larrypulsauthor


Medical Education, A Brush with Death
Three AM. The witching hour. I was twenty-four, na├»ve, roaming the hallowed halls of Parkland Hospital, trying to piece together what I’d learned from my first two years of medical school. Living on short naps. Living on a hope that one day, all of this would make sense. Our team’s mantra was, "sleep is for the weak". I think that’s how it went. Such a different world back then.

We finished rounding. Yes, three AM. Did I say that already? Do patients really want to be seen then? Mine was not to reason why, mine was but to do and (?)... Concluding the floor work, I was hopeful I might slip off and sneak a little sleep before prepping for “morning” rounds. But that thought disappeared with a phone call, a pleading request. Help was needed down in the Emergency Department. A backlog of cases had been created by the nebulous Dallas Knife and Gun Club—or so it seemed. My next three hours had just been defined. Not going to be pretty.

Wednesday, September 27, 2017

Remission; A Cause for Celebration

By Larry Puls @larrypulsauthor

Remission from Cancer, Celebration
Remission. A coveted word. The sought-after goal. A destination that encapsulates both hope and light in the midst of a precarious future.

Over my career, I have witnessed numerous reactions to that word, to that idea. And in all those observations, one thing I have undoubtedly learned was that achieving remission could incite unpredictable responses.

Walking into the room, I had finished studying the chart and her CT scans. I was hopeful that her chemotherapy was now relegated to the past. Remission, which is what I was hoping for, had at one time seemed almost untenable. But now I had a hunch it might happen. Call it the oncologist's sixth sense. We had likely achieved what initially seemed impossible. The patient sitting before me was probably wondering where our conversation would go. In some ways, I wondered too.

Wednesday, September 20, 2017

Supporting Women with Ovarian Cancer; A South Carolina Foundation

by Larry Puls  @larrypulsauthor

Ovarian Cancer, Patient Support
Today I am going to do something a little different. Normally, this blog is dedicated to telling medical stories (usually about cancer) from both the physician’s vantage point and from the patients’. Hopefully, the tales will be heart felt, often informative, and at times may deal with some complicated subjects (that is life's journey). My sagas will always be sprinkled with a dash of emotion and may even require some kleenex. I will commonly bring to light the personal side of cancer, from the individual stories I have been allowed to watch. But today, I will take a slight detour and pause from my normal conversation in order to relate to you a story about a most inspiring collection of individuals. These people have done a beautiful work, bringing increasing awareness to an often-ignored malignant process, ovarian cancer. This story is being told by me today to bring more “voice to the silence”. 

Wednesday, September 13, 2017

A Step of Faith; Allowing the Chemotherapy to Flow

By Larry Puls @larrypulsauthor

Fear of Chemotherapy; Ovarian Cancer
I sit across from a widow. A new patient. A terrified face. Tears filling her eyes. Somehow, I think she knows where this conversation will land. I utter the first word concerning her treatment—chemotherapy. Before I even make it to the last syllable, her head drops and she shivers. A weighted tear hits her lap. Her daughter reaches over and offers a hug. The start of a journey.

I explain the dreaded C-word. But her preconceived fears about that topic cannot be erased. She tunes me out. I now witness a mind heading to default. I try to soften the blow, but my efforts fail. Paralysis owns her.

Wednesday, September 6, 2017

Fear of Elevators; A Funny Story of Cervical Cancer

By Larry Puls  @larrypulsauthor

Cervical Cancer; Embarrassing Moment
A long day on my feet. Numerous surgeries, but all of it a blessing. What else is there to do before I leave this place? I wondered, scratching my head. Two dictations, a set of charts to sign on my desk, a final talk with a family, those tasks remain. Living the dream. My desires turn toward home.

I dictate the final surgery while it remains fresh on my mind. The charts, they could wait until morning. Home just got that much closer. I make it up to the waiting room to chat with the last family of the day. So many questions, but not enough answers until I have pathology reports back. Done. Just change clothes, find the car, and I am off to that other half of my life, the family part. Leaving the final meeting, I find myself next to the public elevator, the one the hospital employees are not supposed to take. A good day. Maybe I made a difference. I hope so anyway. Realizing that no one else is around, the forbidden elevators entice me like like forbidden fruit, and they’re just five feet away. Who is going to know? I give in. I hit the down button.