A Christmas Story; Medical Training

by Larry Puls @larrypulsauthor

Christmas, Medical Education, Cancer

Our plane began its descent on the way to our destination. It was the week before Christmas and I was amazingly, or maybe stupidly, flying to my eighth interview in a short three months--yet another chance at landing a training fellowship. My wife, patient as she was, realized we had very little money left from all my traveling. Therefore, this trip was my Christmas present, the price required for me to have a shot at my dream.

Aa a Texan flying to New York, one can only imagine the thoughts swirling about in my mind, heading to such a faraway place in search of an elusive job. And yet there I was, flying to this interview, actually considering transplanting my wife and two young children to this cold climate—all in the name of my education.

Medicine in Third World Countries; Pregnancy; Unsuccessful Labor

By Larry Puls @Larrypulsauthor

Medicine in Third World Country; Pregnancy

The Jammu and Kashmir state in India are home to part of the Himalayan mountain range. Five doctors lived there and handled two hundred patient visits a day in this very remote and isolated area. When the story occurred, four of them left for their annual national meeting, leaving one physician behind to tend the flocks. At the same time, an American medical student arrived, enticed by an opportunity to gain an experience. And an experience is what he received. These events occurred before the birth of words like Internet, Google, or cell towers.

Choriocarcinoma, Treatment of Molar Pregnancy, Cure of Cancer

By Larry Puls  @larrypulsauthor

Choriocarcinoma; Cancer from Pregnancy

Standing outside the door, I collect my thoughts. Walking into her hospital room, I see the young lady who is struggling to breathe. Oxygen is flowing to her. At her rate of decline, she will be on the ventilator soon. And this will not change unless therapy is started quickly. Time becomes a key element. Her breathing is increasingly labored. Her diet is pure oxygen. It is the relative calm before the storm.

Treatment is defined by the word aggressive. A five-drug regimen going by the acronym EMACO. Etoposide. Methotrexate. Actinomycin-D. Cytoxan. Oncovin. Each of those successive letters standing for the listed drugs. But each represents different side effects. All with the potential to eradicate those rapidly growing cells--the little parasites taking over her body. And although they will all be administered through an IV, one is also given directly into her spine. A needle into the back. A drug that will bathe the nervous system with cancer poison. We have to hit the tumor where it lives and breathes--in her brain.