Finding Sick: Dispatches from the Emergency Department

Steve Server// At about 3:30 am during my first week in the Emergency Department, I realized that the space was different from anywhere else in the hospital.  Though it was my second night shift in a row, I wasn’t tired.  Or if I was tired, there were too many signals, too many sights and sounds and feelings…

Medicine’s martial metaphors: “Fighting the good fight”

Steve Server // In 1977’s Illness as Metaphor, Susan Sontag offered a prescription for the “most truthful way of regarding illness—and the healthiest way of being ill” (3).  As Sontag noted, some of the ways in which humans make meaning on “the night-side of life” may hamper our ability to suffer in a “healthy” way (3).  “As long…

Our Olympian Fables: On difficult personalities

Steve Server// The Perfectionist.  The Eccentric.  The Paranoiac.  The Loner.  The Mercurial Partner.  The Serial Dater.  The Sociopath.  The Narcissist.  The Coquette.  The Milquetoast. Archetypes of difficult personalities populate our books, our movies, and our TV shows. Where do they come from?  How do we understand their social function? It is worth considering the extent to which these archetypes are borne or at least informed…

Pain is complex. We should treat it that way.

Steve Server// “What sort of pain is it?” Often, when health care providers inquire after patients’ pain, we get a sort of flummoxed look.  In response, we sometimes get a confused chuckle. As first year medical students, we are trained to differentiate sorts of pain: crampy vs. electrical/burning; dull vs. sharp; localized vs. radiating.  As our medical…

Brave New World: Cyberpunk 2077’s novel depiction of mental illness

Steve Server // By now, many have heard of Cyberpunk 2077, even those not normally within the gamer-orbit.  The early rollout of the game has been plagued by game-breaking glitches and unexpectedly poor graphics and performance.  Beyond the controversial rollout—and underneath the typical blood and guts associated with violent role-playing games—Cyberpunk 2077 has something unique to say about mental…

Amphetamine and its discontents

Steve Server // Nicolas Rasmussen. On Speed: The Many Lives of Amphetamine (New York: New York University Press, 2008). It is a principle of pharmacology that one can never have on-target, desired effects without some off-target side effects.  Amphetamine is no exception to that rule.  The drug leads to higher levels of dopamine and norepinephrine…

There’s more to cancer treatment than survival.

Steve Server // Cancer is conceptually as well-circumscribed as a tumor feels when you palpate it under the skin during a routine exam.  Its hardness imprints itself upon your sensorium, and then upon your psyche, as you feel the burden of the unpleasant truth that must soon make itself known.  Dense, solid, almost like a…

“Without a patient for a text”: Medical Education in the Age of COVID

Steve Server // “The Hospital is the only proper College in which to rear a true disciple of Aesculapius”     Dr. John Abernethy It had been a strange few days.  I had been pulled from my original team in general neurology to join the stroke service for the sake of “social distancing.”  The neurology work room—which…

On Penumbrae: Uncertainty in Neurology

PENUMBRA, noun. 1. (Astronomy) the partial or imperfect shadow outside the complete shadow of an opaque body, as a planet, where the light from the source of illumination is only partly cut off; the grayish marginal portion of a sunspot.2. A shadowy, indefinite, or marginal area. Steve Server // You are sitting at your computer…

On the power of play

Steve Server // A critical part of pediatrics is mastering the physical exam. Kids are squirmy. They aren’t used to tolerating noxious stimuli—like instruments in ears or cold metal on skin—like adults are. Consequently, seasoned pediatricians have a box full of tricks to make for effective physical examinations for kids. Don’t rush immediately to place…