Cervical Cancer, Recurrence of Cancer, A Young Mother's Story

by Larry Puls @larrypulsauthor

Recurrence of Cancer for Young Mom

Two weeks after the cesarean and her lymph node dissection, she comes back to see me. Before we discuss the tough stuff, she proudly shows me her child. Looking down at the sleeping baby, I wonder how will I explain eight positive lymph nodes, the small cell carcinoma, and give hope all in the same breath. The little girl looks so peaceful, dreaming childhood dreams. Deep slumber. An amazing gift. Her understanding of her mom’s situation will not come for years. And I question if she will ever really know her mom--or remember what she looked like. Time will answer that. Yet I know intuitively her pressing journey is about to begin, and it will be every bit as taxing as childrearing. She will need God-given strength for the marathon of therapy facing her... “Where do we go from here?” she asks. Where do we start? I ponder my first words.

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.

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.

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, naïve, 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.

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.

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”. 

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.