No Apparent Distress
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and pain medication, 229
and segregation in Galveston, 39
Alaska, 153–59
alcoholism, 95, 96
Alpine, Texas, 136–52
Alyssa (friend), 91, 92
Alzheimer’s disease, 177
amputations, 127–35
Amy (friend in Portland), 27
anatomy lab, 65–70, 73–74
Anderson Cancer Center. See MD Anderson Cancer Center (Houston, Texas)
anxiety treatment, 195–97
Arlan’s (grocery store), 215
Army Corps of Engineers, 38
Arnold (great-uncle), 3
Aung, Htin, 211
Austin, Ida Parker, 38
Austin, Texas
abortion clinic, 11–20
RP’s clerkship in wealthy neighborhood, 180–83
RP’s hospital training, 116–26
Baker, Sarah. See Sarah (student director at St. Vincent’s)
Barnes, Mr. (patient), 118–20
Beach, Dr. Robert
after Hurricane Ike, 45
giving phone number to patients, 238
and Jimmy’s lung cancer treatment, 199, 201
and monthly St. Vincent’s meetings, 211
and racial mix at St. Vincent’s, 61
bias, racial, 130–33
Billings, Dr., 137, 145–47
biopsy
endometrial, 235–37
skin, 205–7, 209–10
Black, Dr., 233–35
Black Panther Party, 219–20
Blair, Vicki (patient), 225–27, 233–38
blood draws, 208–9
blood pressure, 74–75
blood transfusions, as potential cause of hepatitis C, 95, 184, 185, 188
bomb threats, 13
brain cancer, 164–67, 169–74
brain surgery, 169–70, 172
Breast and Cervical Cancer Prevention and Treatment Act, 240
breast cancer
grandmother Olive, 175, 177–79
lumpectomy, 124–26
and Texas abortion clinic laws, 13
breast exam, 111–12
cadavers, 44, 65–70
Callender, David, 56n
cancer
delivery of news about, 226–27
Gloria and, 240–43
grandmother Lena Mae and, 108–9
grandmother Olive and, 175, 177–79
Lex Klein and, 228–32
Mr. Rose and, 1–2, 96–102
“cancer belt,” 104–5
Candelaria, Texas, free clinic, 147–51
cardioversion, 86–88
Casebook (UTMB charity care program), 201–2, 231, 249
Catholicism, 16, 17
cervical cancer, 240–43
cervical exam, 113
cesarean section, 145–47
Chandler (medical student), 96, 99–100
charity patients, 52. See also indigent care
Charles (grandfather), 176
Charles V (Holy Roman Emperor), 67
Charlie (RP’s dog), 90, 108
Chicago, Illinois, 91–92
childhood diabetes, 130
Cicero, 245–46
cigarette smoking, 91
cirrhosis, 95, 97, 98
Civil War, 67–68
clinical encounters, 78–81
Columbia University MFA program, 11, 20–21
“complicated cases,” 77–78
Conroe, Texas, 188
Corey (housemate in Portland), 22–23
Correctional Managed Care, 82–83
counseling, at abortion clinic, 14–15
Craig, Alaska, 154, 161–62
craniotomy, 172
criminal records
Malachi’s, 223–24
and medical care for African Americans, 217
criminals
and medical care, 63–64
prison hospital, 81–88
as source of cadavers, 66
C-section (cesarean section), 145–47
CT scan, low-dose, 199, 204
Cuney, Norris Wright, 37
Damien (patient), 127–35
Dave (student director at St. Vincent’s), 214, 244
Dawson State Jail, 82–83
Dean (friend in Portland), 27–28
Delaney (friend), 91–92
delivery, 140–45
dermatology night, 205–8, 228
diabetes patients
Damien, 127–35
Mr. Tran, 71–73
dissection, 66–67; see also anatomy lab
DNR (do not resuscitate), 122
Dovidio, John, 132–33
E. coli, 144
Egypt, ancient, 66
Elias (patient), 164–67, 169–74
Emily (student director at St. Vincent’s), 35
emotional restraint, 245–46
EMTALA (Emergency Medical Treatment and Labor Act), 97
environmental contamination, 197–98
errors. See mistakes
Estelle v. Gamble, 82
experimental treatments, 185–86
Facebook, 212
family medicine, rural, 136–52
financial assistance applications
for Vicki Blair, 235, 237
for Gloria, 242–43
for Mr. Klein, 231, 232
for Vanessa, 200–203
fishing, 153–63
form letter, on cancellation of unfunded care, 49–52
Fort Davis, Texas, 138
Frank (premed student), 23–29, 93
free clinics, ethical arguments about, 151–52
gallbladder surgery, 78–81
Galveston, Texas
Great Storm of 1900, 37–39
Hurricane Ike, 40–46
Hurricane Rita, 39–40
see also St. Vincent’s Student-Run Free Clinic
Galveston County Free Care Monitoring Project, 50–51
Gamble, J. W., 82
general surgery, 117
germ cells, 165
Gersztenkorn, David. See Dave (student director at St. Vincent’s)
Gloria (patient), 17–18, 239–43
Gonzales, Texas, 176
Graduate School of Biological Sciences (University of Texas), 36
grandfather (Charles), 176
Great Storm of 1900, 37–39
Greece, ancient, 66
Green, Shebaa, 82–83
Gulf Coast “cancer belt,” 104–5
gynecology
and MUTA-GTA, 111–13
speculum exams, 113–15
Hall, Delaney, 91–92
Harris, Grandison, 68
Hausen, Mr. (patient), 138–39
head-and-neck cancer patients, 47, 48, 52–58
healing, medical interventions and, 219
Heather (housemate in Portland), 23
hemoglobin A1c test, 130–31
hepatitis C, 83, 184–85, 187–89, 192, 199, 205, 217
hepatitis treatment, 183–94
hernia, 138–39
homelessness, as situation, 227–28
homeless patients
Mr. Barnes, 118–20
Damien, 127–35
Mr. Rose, 93–102
Mr. Tran, 71–73
hope, 231–32
hospice, 108–9, 173, 249
Hospital Galveston, 81–88
hospital tower, 44, 215
Houston, Dr., 180–83, 192
Houston, Texas, 242–43
Houston Methodist Hospital, 243
Hurricane Ike
effect on demographics of Galveston Island, 61
and Galveston Island, 40–46
long-term effects, 71
and Susan McCammon, 47–58
Hurricane Katrina, 39, 46
Ijimo, Dr., 171–72
Implicit Association Test (IAT), 131–32
indigent care
applications for, see Casebook; financial assistance applications
UTMB’s cancellation after Hurricane Ike, 49–58
Institute for the Medical Humanities, 36, 47, 77
Institute of Medicine (IOM) racial bias study, 130
interferon, 186
Intermediate Care (IMC), 100
Jackson, Michael Thomas
after Hurricane Ike, 44–45
as director of St. Vincent’s, 218–22
on Hurricane Ike, 43
on racial mix at St. Vincent’s, 61
Jacob (volunteer at St. Vincent’s), 225–36, 246–47
Jacqueline (junior director at St. Vincent’s), 235–43, 249
Jennifer (childhood friend), 7
Jimmy (husband of Vanessa), 196–98
and Hurricane Ike, 41–42
lung cancer, 199–203
John Sealy Hospital
Hospital Galveston and, 82, 84
Hurricane Ike and, 48
Hurricane Rita and, 39
Johnson, John, 29
Julian (student director at St. Vincent’s), 244–46
Juneteenth, 37
Justice, William Wayne, 82
Katie (student director at St. Vincent’s), 35, 69, 72–73
kidney cancer, 100–101
kidney transplant, 160–61
Klein, Lex (patient), 228–32
Kristy (student director at St. Vincent’s), 42, 45
Latinas, cervical cancer rates for, 240
Lenihan, Merle, 51
Leucke, Dr., 137–45, 147–50, 152
liver, 98
low-dose CT scan, 199, 204
lumpectomy, 124–26
lung cancer, 199–203
luxury care, 180–83
Malachai (patient), 216–18, 220–24
Margaret (student director at St. Vincent’s), 35
in Alpine, 136–37
fishing trip, 158
Maria Dolores (patient), 146–47
Marine Science Institute, University of Texas, 5, 7
Marta (housekeeper), 136
Mayo Clinic, 192–93
McAllison, Dr., 120
McCammon, Susan
and aftermath of Hurricane Ike, 47–58, 248–49
and cancer diagnoses, 236
giving phone numbers to patients, 238
and indigent care cancellation after Hurricane Ike, 50–58
on Jacob’s work ethic, 227
and Lex Klein, 229–32
medical humanities seminar, 101
MD Anderson Cancer Center (Houston, Texas), 48, 175, 242
Medicaid, 54, 116, 210, 229, 247
medical abortion, 13
Medical Assistance Program (MAP), 116, 134
Medical College of Georgia, 68
medical interventions, healing and, 219
mental illness, 216–18, 220–24
methadone, 230–31
Michael (friend in Portland), 31
Miller, Autumn, 83
Miller, Gracie, 83
mistakes, 251
effects of, 73
importance of stories about, 159–61
poor patients as victims of, 210
and Mr. Rose’s case, 2, 96–97, 101–2
Mitchell, Kristy. See Kristy (student director at St. Vincent’s)
Montgomery, Texas, 190, 192
MUTA-GTA (male urogenital teaching assistants/gynecological teaching assistants), 110–13
Naeyeli (patient), 15–17
Nan (patient), 166
Natasha (housemate), 215
National Guard, 43
National Institutes of Health (NIH), 130
neurosurgery, 164–74
New York City, 20–21
non-A, non-B hepatitis, 183–85
nonabandonment, 50, 55, 236
NYU medical school, 34–35
obstetrics
cesarean section, 145–47
delivery, 140–45
Ojinaga, Texas, 148, 150–51
“On Grief of Mind” (Cicero), 245
On the Fabric of the Human Body (Vesalius), 67
opiates, 229
orientation sessions, 208–9
osteomyelitis, 127–28
pacemaker, 190, 191
palliative care, 173, 249
pap smear, 238
pap smears, 113–15, 149, 238, 240
Parks, Ashleigh, 83
pathology lab, 14
Pearson, Charles L., Jr. (father)
cottage renovation project, 8–10
death of mother, 178
index finger injury, 3
and mother’s hepatitis treatment, 186
on RP’s reaction to Frank’s death, 30–31
at University of Texas Marine Science Institute, 5, 7
Pearson, Matthew Joseph (brother), 4, 7
after death of grandmother Olive, 179
cottage renovation project, 8–10
as fisherman, 153–63
Pearson, Olive (grandmother), 175–79
Pearson, Rachel
abortion clinic work, 11–20
in Alaska, 153–60
anatomy lab, 65–70
assisting delivery of baby, 140–45
clerkship in wealthy Austin neighborhood, 180–83
in Columbia University MFA program, 20–21
construction work, 7–8
decision to attend medical school, 21
depression, 89–93
dermatology night at St. Vincent’s, 205–8
early years in Port Aransas, 4–7
first days at medical school, 62–64
and grandmother Lena Mae’s final illness, 105–9
at Hospital Galveston, 81–88
interview and acceptance at UTMB, 45–46
as junior director at St. Vincent’s, 211–15
medical career’s effect on, 248
medical school interviews, 34–35
and mother’s hepatitis treatment, 186–94
move to Galveston, 59–60
and MUTA-GTA, 110–15
on neurosurgery team, 164–74
as new medical student, 62–64
POM course experiences, 76–81
in postbacc premed program, 22–33
at public hospital in Austin, 116–26
rural family medicine rotation, 136–52
and University of Texas at Austin, 7
Pearson, Reta Mae Wolfe (mother), 3–5
in college, 4
hepatitis treatment, 183–94
Olive and, 177
peritoneal tap, 98–99
phone numbers, giving to patients, 238
physician assistant (PA), 205–8
“pimping,” 117
POM (Practice of Medicine) course, 76–81
“poor historian,” 1–2
Port Aransas, Texas, 4–7, 104
Portland, Oregon, 22–33
poverty
and cadavers, 68–69
and cervical cancer, 241
head-and-neck cancer patients, 47–48
and Hurricane Ike, 46
Presidio, Texas, 148–51
prison, as cause of medical conditions, 217
prison clinic, speculum exams in, 113
prisoners, as blood donors, 188–89
prison hospital (Hospital Galveston), 36, 81–88
psychiatry night, 217, 222–24
Q-4 call, 120
racial bias, 130–33
Raimer, Ben, 49
RANDO (resident ain’t never done one) cases, 202
reduction in force (RIF), 49, 52
review of systems, 62, 64, 65
ribavirin, 186
Rimma (Kristy’s roommate), 43–44
Roman Empire, 245–46
Ron (housemate in Portland), 26
Rose, Mr. (patient), 1–2, 93–102, 251
rural family medicine, 136–52
Rutgers University, 219
Ryan (friend), 91
St. Vincent’s House, 36, 42
St. Vincent�
�s Student-Run Free Clinic, 35–36
after Hurricane Ike, 44–45
dermatology night, 205–8
and Hurricane Ike, 41, 43
Michael Thomas Jackson and, 218–22
RP as junior director at, 195, 211–15
RP’s early patients, 70–73
RP’s first speculum exams at, 114–15
RP’s introduction to, 59–62, 64–65
standard of care, 199
Mr. Tran, 70–73
Sara (housemate in Portland), 23
Sarah (student director at St. Vincent’s), 214, 216–18, 223, 224, 244, 245
Sara (medical assistant), 180
schizophrenia, 216–18, 220–24
Schnadig, Dr., 229
scoliosis, 105, 106
shave biopsy, 210
Sklar, Dr., 129
slavery, cadavers and, 67, 68
small-cell lung cancer, 199
Spanish (language)
and abortion clinic patients, 12, 15
and patients at Candelaria free clinic, 149
in prison hospital, 85
and St. Vincent’s patients, 64
speculum exams, 113–15
standardized patients (SPs), 76–77
stigma, 188
stories, about mistakes, 159–61
suicide
Frank (premed student), 27–29
medical students and, 92
surgery
at Austin public hospital, 117–26
RP’s clinical encounters, 78–81
surgical abortion, 13
Tay (St. Vincent’s front-office manager), 213
TDCJ (Texas Department of Criminal Justice), 82–84
tendons, injured, 163
testicular choriocarcinoma, 165
Texas laws and policies
abortion clinic laws, 12–15
Medicaid expansion refusal, 247
medical care for prisoners, 82–83
Theroux, Mrs. (patient), 247
throat cancer, 228–32
TIA (transient ischemic attack), 105, 108
tracheostomies, 52, 53, 57
Tran, Mr. (patient), 71–73
transfusions. See blood transfusions
trauma pager, 121
trauma team, 120–24
undocumented patients
and cervical cancer treatment, 240, 241
exclusion from ACA, 247
and MAP, 116
and medical mistakes, 210
unfunded care. See indigent care
uninsured patients, 60
University of Texas at Austin, 7
University of Texas Marine Science Institute, 5, 7
urine dip, 96–97
UTMB (University of Texas Medical Branch), Galveston Island, 35–46
evacuation of John Sealy Hospital during Hurricane Rita, 39–40
and Hospital Galveston, 82, 83
and Hurricane Ike, 44, 48–49
reduction of indigent care funding, 50–51
RP’s interview at, 45–46
vaginal exams, 112–13
Vandeem, Mrs., 181
Vanessa (patient)