Author Archives: Simi K. Rao

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Surviving Cancer/Sustaining Self 1: Mindfulness

During my lengthy and ultimately successful treatment for acute myeloid leukemia, there were several practices I deliberately engaged in to sustain myself throughout the ordeal.  These will be the subject of my next few posts.

The first thing that sustained me was mindfulness.  It helped me bring a rich, non-judgmental awareness to each moment as it occurred and realize that everything else – ruminating about the past or worrying about the future – is just noise that detracts from the present moment.

Throughout multiple hospitalizations, prolonged treatments, and gradual recovery, mindfulness reminded me that although I could not control what I was experiencing, I could control how I experienced and responded to it.

My hospital days thus followed a routine of mindful morning stretching and exercises, deep breathing and meditation during the day, evening yoga poses, and a bedtime body scan that led to a peaceful sleep interrupted only by the inevitable intrusions that punctuate every hospital night. The cumulative effect of these practices was a calm acceptance of my situation alongside a serene hope that all would work out for the best.

As I noted in a previous post, I will never know if there was a causal connection between my practice of mindfulness and my recovery and survival. But I do know that this awareness kept me grounded, preserved my identity, and sustained myself through some harrowing times. That in itself felt like a major accomplishment.


Steve Buechler is a recently retired sociology professor and cancer survivor.  In 2016, he was diagnosed with acute myeloid leukemia and successfully treated with chemotherapy, radiation, and a stem cell transplant. He has since become a big advocate of writing stories as a survival strategy in the face of life-threatening illness.  His own story is available in “How Steve Became Ralph: A Cancer/Stem Cell Odyssey (with Jokes),” his memoir from Written Dream Publishing. To learn more visit Steve’s website.

Who Survives Cancer…. and Why?

When people are diagnosed with cancer, the question “why me?” looms large.  For those fortunate enough to survive, the question arises again. While definitive answers to who gets sick and who gets better remain elusive, the questions remain.

In 2016, I was diagnosed with acute myeloid leukemia. I didn’t spend much time asking “why me” because it didn’t seem like a healthy road to go down. After being successfully treated and recovering, I have the luxury of pondering the second question.  Why did I survive while others did not?

In transplant support groups, I often hear people say that everything happens for a reason. I think that is true in a narrow, probabilistic sense. Personal medical history, comorbidities, environmental factors, and genetic abnormalities can dramatically alter the chances of getting and surviving cancer.

But when people say everything happens for a reason, they usually mean that there is a larger, metaphysical reason for the differential survival of patients. As a sociologist, I understand the quest for meaning in the face of life-threatening illness and I respect belief systems that provide comfort and reassurance.

But I just don’t buy it. I don’t think there is an overarching rhyme, reason, or plan that explains life’s most fateful outcomes, whether “miraculously” good or horrifically bad.  Despite our impulse to find larger meanings in such events and after acknowledging how medical interventions can improve our odds, I think there is an irreducible randomness when it comes to surviving a lethal illness.

These thoughts were triggered when people gave me “credit” for surviving my disease. I have always felt uncomfortable accepting such credit.  Part of my discomfort stems from the coupling of credit and blame and the unintended consequences of such thinking.  For example, does crediting survivors for their “positive thinking” imply that non-survivors just weren’t positive enough?

As a patient, there were several coping mechanisms I relied upon throughout my treatment. But I will never know if there was any causal connection between those practices and my positive outcome. What I do know is that they maintained my sanity and preserved my identity during the most challenging experience of my life.

While acknowledging that outcomes may be unpredictable and somewhat random, sustaining ourselves along the way is a worthy goal in itself.  And if it does enhance our odds of survival, so much the better. My own story of what I did to sustain my self will be the subject of posts to follow.


Steve Buechler is a recently retired sociology professor and cancer survivor.  In 2016, he was diagnosed with acute myeloid leukemia and successfully treated with chemotherapy, radiation, and a stem cell transplant. He has since become a big advocate of writing stories as a survival strategy in the face of life-threatening illness.  His own story is available in “How Steve Became Ralph: A Cancer/Stem Cell Odyssey (with Jokes),” his memoir from Written Dream Publishing.

How Autism Shaped Me as a Writer

      In eighth grade, I discovered a new word I didn’t know existed: ‘autism’.

            Beforehand, I never knew what it meant, until I asked my parents about the definition one day. When I found out, my perspective on my childhood and the world around me shifted, rather than changed completely. Learning that word gave me a sense of clarity. It explained my prescription pills, the challenges I faced compared to other students, and why I couldn’t pay attention to my teacher in class.

For those unaware, autism is a neurological disorder currently found in 1 of 100 children. It is often categorized by an impairment of communication skills and difficulty in social interaction. While the severity of it is variable between patients, symptoms of autism include (but aren’t limited to) a delay in speech during early stages of childhood, anxiety in public spaces, repetitive behaviors/actions/movements, a poor ability of maintaining eye contact, heightened sensitivity and a lack of empathy. All of these symptoms are found on the autism spectrum, which catalogues a person’s autism spectrum disorder (ASD) on a high-functioning/low-functioning scale.

You might have heard of autism in Hollywood films such as Rain Man, Mozart & the Whale, Extremely Loud & Incredibly Close, or even TV shows such as The Good Doctor, where the autistic character is sometimes portrayed comedically as a socially-awkward yet talented savant. While there is some truth to savant syndrome and autism spectrum disorder being often linked, it is not the same for every person on the spectrum. Not every autistic person can be Dustin Hoffman and win every game of blackjack at a casino, or even find the bravery to break away from a planned schedule in their head. It is different for everyone, just as it was for me.

After my revelation, I became depressed. My entire world had been shattered, and I was convinced everyone considered me a freak, and I held this firm belief for a long time. Then I watched a wonderful film called Temple Grandin, a biographical movie about the life and career of Mary Temple Grandin (played by Claire Danes), a woman with autism who revolutionized the humane practices of livestock in slaughterhouses and ranches. Observing how Temple’s mother resisted having her autistic daughter institutionalized, encouraging her daughter to go to college and witnessing Temple become a spokesperson for autism inspired me. It made me believe I was more than a disorder, making me feel more hopeful for the future.

To this day, I’ve unfortunately haven’t had the opportunity to meet Temple Grandin herself, but my younger brother has. He’s attended one of her visiting talks and even requested that she sign a copy of her book Thinking in Pictures for me (Thanks again, Jacob!).

Believe it or not, I originally wanted to become a magician. I wanted to entertain people by pulling them into the wonder of an illusion, which is now the same goal I yearn to accomplish in each story I create. However, it wouldn’t be until tenth grade that I decided to try writing a short story for the very first time. It didn’t seem hard to me, considering I’d often spend my lunch hours in the high school library to escape. I had already devoured almost every book on the shelves, but I craved for more stories to read. There were more stories I wanted to experience, which is when I decided to write my own.

My early writing days are currently a blur, but what I remember the most revolved how to make a story believable. I experienced every symptom of an amateur writer trying to find their style; awkward grammar, complicated stories and writing too much exposition. Each story was harder to write, but each story grew bolder and better. At the same time, I opened myself further than I ever dreamed about. Over time, I slowly realized a writer cannot tell a story about life without experiencing it. If I wanted to make a conversation more believable, or an interaction in a crowd sound more real, in order for the reader to become more engrossed into the narrative, I needed to experience the same thing my characters would.

Creative writing requires patience and the will to let an idea flow to you naturally, which compelled me to practice my craft. At the same time, it compelled me to become more patient in anxious situations. Storytelling also requires making the fictional characters seem as real as you and me. The more I interacted socially, the more I could utilize the diction and mannerisms of a conversation into my dialogue, which in turn benefited my ability to recognize facial expressions and what they mean. Every leap into a conversation improved my writing style, and every interaction in a social setting allowed me to form lasting friendships over the years.

In some way, autism helped me become a better writer and a better friend. Granted, it doesn’t change the fact I still have autism. I become uncomfortable in loud places and sometimes need someone to tell me what they mean versus what they say, which can sometimes irritate my loved ones. Nevertheless, my family, friends and colleagues are very supportive of me as a writer and as someone with high-functioning autism. They gave me the determination to achieve.

In conclusion, I do not consider myself an autistic author, but an author with autism. Ever since my awkward days of high school, it was my dream to be published. Now that I’ve accomplished this goal, I hope to become a spokesman for the autism community. I want to prove to children with autism, Asperger’s or ADHD that the disorder never should define them. They can achieve important things, meet amazing minds and treasure friendships while finding a day of solitude as equally rewarding. Writing helped me overcome many of the obstacles of my condition, which can be the same for another person on the spectrum with their passionate hobby. If you’re a parent with an autistic child, my best advice for you is to encourage their interests and let them evolve into something beautiful.

To quote my hero, Dr. Temple Grandin, “If I could snap my fingers and be non-autistic, I would not. Autism is part of what I am.”


Nathan HoppNathan Hopp was born and raised in Green Bay, WI, and discovered his love for literature at a young age. He’s written countless short stories and flash fictions across several years, from vignettes submitted to magazines to short stories he posts online. His debut novel, “The Adventures of Peter Gray” was published in April 2018.

Doctors as Detectives

During my prolonged treatment and recovery from acute myeloid leukemia, I spent many weeks in the hospital with a severely suppressed immune system as a side effect of chemotherapy. This condition is an open invitation to any infectious agents who happen to be in the neighborhood, and I had my share of them.  They included colitis, E-coli, the cytomegalovirus, and several others that were never definitively identified.

I was also on numerous medications, including prophylactic antibiotic, anti-viral, anti-fungal, and anti-rejection drugs as well as other drugs to blunt the side effects of these initial medications.  These drugs nonetheless produced some nasty side effects on their own or in interaction with each other.

The upshot was that on any given day, I would experience symptoms that included fevers, headaches, intestinal indignities, rashes, blurred vision, light-headedness, muscle aches, bone pain, and even persistent hiccups. It was on these occasions that I became acquainted with one of my now-favorite medical specialties known as infectious disease doctors.

I’d only known them as heroic figures in melodramatic movies about plagues threatening all humanity.  But on a more mundane and realistic level, they were also everyday heroes who often provided me relief from a myriad of infections and side-effects.

Their visits would be prompted by my report of unpleasant symptoms or obvious signs like spiking fevers. They would then begin looking for clues like detectives on the trail of a suspect.  They would consider all the medications I was taking as well as their doses and scheduling.  They would listen carefully to my recitation of symptoms. They would prioritize which medications were necessary and which could be eliminated or replaced with others. And they would order blood work, stool samples and other tests to nail down the culprits.

It would often take several days to grow and identify infectious critters in the lab, and sometimes a definitive diagnosis remained elusive.  Even so, their experience, their listening skills, and their hunches often led to solutions that relieved not only my symptoms but their underlying causes.

While it was unpleasant to weather so many infections and side-effects, I came to welcome visits from these doctor/detectives who so often cracked the case, identified the villain, and brought me relief so I could focus on healing and recovery.

Steve Buechler is a recently retired sociology professor and cancer survivor.  In 2016, he was diagnosed with acute myeloid leukemia and successfully treated with chemotherapy, radiation, and a stem cell transplant. He has since become a big advocate of writing stories as a survival strategy in the face of life-threatening illness.  His own story is available in “How Steve Became Ralph: A Cancer/Stem Cell Odyssey (with Jokes),” his memoir from Written Dream Publishing.

My Second Family

I’m not a doctor. I’m not a patient. I’m not a nurse, even. I’m one of those numerous people who flock hospitals alongside the sick one, playing the role of all three simultaneously to the patient as and when he demands and requires. I am the attendant and the family of the patient.

Back in 2006, it was at a dinner with some family friends, when my father suddenly didn’t feel right and wouldn’t even touch his favourite dishes. He went to lie down on the bed and a call went to our family doctor. Some tests were scheduled for the next morning. Tests, that revealed he had chronic renal failure with 95% of both kidneys failing to function. I was there in the room with my parents when I sensed the change in the doctor’s expression, the moment he took the reports from my mother. With all that followed, the treatment is just one mechanical part of it. There is a protocol to it. But there is no manual for the collateral damage. We were a young family then, my sister starting her first job and me, still in middle school. The way lives transform when something like this happens, is a sudden and a slow process at the same time. Because all at once, you have so much on your plate that require immediate attention and without realizing you start prioritizing everything in your life keeping this one event in consideration. All other issues seem very trivial. It’s very hard growing up trying to maintain your age and at the same time, trying to think and act with maturity in all situations.
When you enter the hospital building, under those yellow lights, everyone seems to be part of one big family. There is a rich lady, a poor father, a distraught son, a happy mother. There is no discrimination on any basis. You are as sad about a fellow patient whom you’ve seen alongside your bed having his dialysis scheduled at the same time for the past 3 years, as are you happy about the new mother whom you saw getting wheeled in a few hours before into the operating unit.

When my father was again admitted to the ICU after a couple of years, I had my university exams. And my only job was to sit and study outside the unit, on a couch while my mother handled everything else. The doctor used to sneak me in outside of visiting hours so that I could get a glimpse of my father among the tubes and machines before I went to take my exam. When I came back, she was the person who would rush me in just as the doctor would come so that I could talk to him and feel like I was also taking care of my father in some way.

We have had such a long association with our nurses and doctors, and other patients and their families, that we have celebrated festivals together, someone’s marriage anniversary, we have helped decorate the dialysis unit with Christmas bulbs and Diwali candles.

All of it? The good, the bad? The acceptance comes after a long, long struggle with the questions ‘Why us?’ I wish I could have met all these people under better circumstances, but it is what it is, my second family.

VattyVatsalya Gunjan is a 24-year-old young woman trying to find her footing both professionally and personally. She lives in New Delhi trying to find new book haunts while listening to everything from Pink Floyd to new Bollywood. Her part time profession is being a claims adjuster for a govt organization and full-time profession is being a dutiful daughter. Better at one of the two.

Women Who Inspire: Anandibai Joshi

The path for women physicians hasn’t been easy. For the longest time we were considered inferior to our male counterparts. But we have come a long way. According to a recent study it was found that patients cared for by women doctors  have a lower mortality rate. They tend to live longer and fare better.

Today on Women’s Day I’d like to narrate the story of a brave woman who led the way– Dr. Anandibai Joshi.

Dr. Anandibai Joshi (1865-1887)

Indian women pioneered many things not just in India but also in the west becoming a source of inspiration for women and women’s movement across the world. Early in my residency and sometimes even now, I’m made to perceive that I’m not good enough to be a doctor just because I’m a woman. Once an elderly lady told me to my face that she’d prefer a male doctor to do her gynecological exam. I was stunned to comprehend the degree of prejudice women have to face particularly those in the fields of science. So when I read about Anandibai Joshi and women like her, I’m dumbfounded by their bravery and the degree of resistance they had to overcome.

Anandibai Joshi was among the first Indian women qualified to practice western medicine.

Dr. Joshi belonged to an orthodox Brahmin family of rich landlords in Kalyan. At the tender age of nine she was pressured to marry a widower, a man twenty years her senior Gopalrao Joshi. The beginning of a typical Indian story? No. Anandibai was just thirteen when she had her first child.Unfortunately the child died when he was just ten days old. She was heartbroken and angered to realize that her son would have survived if he had received proper medical care. This sparked in her the desire to study medicine and her liberal husband stood fully behind her.

Why would an Indian woman go so far away for medical school?

Because it was the best way to serve her country was the gist of Anandibai’s answer. The reason Anandibai had to look to the west is because in India, Hindu women, particularly those belonging to higher castes were not welcome in the profession.They were pushed to become midwives instead. If they insisted they could enroll in Chennai, to be taught by reluctant male instructors, and receive an incomplete training. It was easier if they converted to Christianity as they could wear a dress and that wouldn’t cause a scandal. Since Anandibai and her husband had no desire to convert, she decided to turn to the America. She applied with the assistance of Presbyterian missionaries. She enrolled and subsequently received her degree in 1886, from the Women’s Medical College in Pennsylvania. Her achievement was lauded, to the extent the dean of her school wrote about it to Queen Victoria, Empress of India. Anandibai was invited to become the physician-in-charge of the women’s department at the Albert Edward Hospital in the princely state of Kolhapur, where she also had the opportunity to instruct women medical students. Unfortunately, before she could embark triumphantly in her career, it was destroyed by the diagnosis of tuberculosis and she breathed her last in the arms of her mother, a month before her 22nd birthday.

Dr. Anandibai Joshi lived a very short life but she achieved a lot. She broke barriers not just for women but also for the Hindu community. Even now we can look to her life and gain strength and inspiration. 

Happy Women’s Day!


simi blog imageDr. Simi K. Rao, creator and founder of The MedBag is a board certified internist and hospitalist currently practising in the Denver area. She has special interest in preventive medicine. She is also a published author of four novels. Her newest book of poems and short stories ‘Under the Shade of The Banyan Tree’ will be published in December ’18. You can learn more about her work at


When is a Little Knowledge a Good Thing?

In the summer of 2016 in seemingly good health, I was diagnosed with acute myeloid leukemia through a routine blood test and subsequent bone marrow biopsy.  In 48 hours, I went from a carefree existence to a week-long, 24/7 chemotherapy drip and a 5 ½ week hospital stay.

Although my doctors described my treatment plan, in retrospect it’s remarkable how little I learned about my disease.  This cancer is not “staged,” because it is so unpredictable, and there were no discussions of long-term prognosis, survival rates, or other such matters.  For my part, I made a conscious decision not to surf the internet collecting all sorts of dubious, unverifiable information about my disease.

Instead, I simply trusted my doctors as we moved through my initial treatment one step at a time: induction chemotherapy, temporary remission, infection management, count recovery, and emerging molecular and cytogenic data on my cancer.  Throughout this period, my doctors’ calm, professional demeanor provided reassurance that my disease was a problem they could solve.

It wasn’t until I was contemplating a stem cell transplant that I heard the first hard numbers and survival rates for consolidation chemotherapy versus a transplant. Even the best-case scenarios looked pretty grim, and it dawned on me that I was fortunate to have survived up to that point.

I proceeded to transplant, recovery and survival.  As I got better, I gradually learned even more about the lethality of my disease. I now believe that it was for the best that I did not initially know all the dire things I eventually came to learn about AML. As it was, I could maintain a more hopeful outlook over my many months of treatment.

I don’t claim that this path is appropriate for every patient or disease.  But I was struck to learn of some research on AML patients that is consistent with my story. In the webcast “Coping with the Emotional Side Effects of AML” (available at, Dr. Thomas LeBlanc reports on interview data from AML patients. Among the more striking findings is that the more accurately patients understood the likely outcomes of their disease, the more emotional distress and sadness they experienced.

I would never advocate that ignorance is bliss. But my experience — backed up by this exploratory research — suggests that just a little knowledge can be a good thing when it comes to surviving AML.


steve bSteve Buechler is a recently retired sociology professor and cancer survivor.  In 2016, he was diagnosed with acute myeloid leukemia and successfully treated with chemotherapy, radiation, and a stem cell transplant. He has since become a big advocate of writing stories as a survival strategy in the face of life-threatening illness.  His own story is available in “How Steve Became Ralph: A Cancer/Stem Cell Odyssey (with Jokes),” his memoir from Written Dream Publishing.



On Patients and Emotional Labor

Given my recent posts on the emotional labor of doctors and nurses, it only seems fair to turn the lens on myself and ponder how I experienced and expressed a variety of emotions throughout my treatment for acute myeloid leukemia.

In the early stages of my care, I sought to be a “good patient” and cultivate positive relationships with my doctors and nurses.  I was seeking to transform routine, clinical encounters into more human and humane interactions. But it was also a strategic move on my part to insure I would receive the best possible care.  While patients’ demeanor should not affect their quality of care, nurses and doctors are also people with their own emotional states.  Getting on their good side seemed like a wise course.

In the later stages of my treatment, it became evident that I was on the road to recovery.  As it gradually dawned on me that my doctors had saved my life with their medical knowledge, treatment plan, and attentive care, I experienced a flood of powerful emotions: unbounded good will, heartfelt gratitude, and a deep appreciation for them and how they practiced their craft.

While I expressed this appreciation, I also felt a certain reticence about whether or how to convey the depth of these feelings.  After all, a famous sociologist once argued that professional role relationships like doctor—patient should be “affectively neutral” and that strong emotional sentiments should be reserved for family, lovers and friends.

I’m guessing that this famous sociologist was never successfully treated for a life-threatening disease. But my experience left me seeking some further outlet for the profound gratitude and deep affection that I felt toward my doctors upon my recovery and survival.  The best I could do was pay it forward through my volunteer work and peer counseling with blood cancer patients. In some small way, those activities help me feel like the benefits I received from my doctors and nurses live on in what I try to bring to current patients as they navigate their own medical destinies.

And just in case my doctors stumble across this entry, please know I cannot thank you enough.

Read the other posts in this series:-

On Doctors and Emotional Labor

On Nurses and Emotional Labor


steve bSteve Buechler is a recently retired sociology professor and cancer survivor.  In 2016, he was diagnosed with acute myeloid leukemia and successfully treated with chemotherapy, radiation, and a stem cell transplant. He has since become a big advocate of writing stories as a survival strategy in the face of life-threatening illness.  His own story is available in “How Steve Became Ralph: A Cancer/Stem Cell Odyssey (with Jokes),” his memoir from Written Dream Publishing.


On Nurses and Emotional Labor

My last post described how doctors appear to rely on a specific feeling norm in managing and displaying emotional states in relation to their patients. The pattern I saw in my own care was initial emotional distance from doctors that gave way to greater emotional availability only when my prognosis significantly improved. In this post, I offer some speculations about the differences between doctors and nurses when it comes to emotional labor.

Whereas doctors may be permitted an initial clinical detachment from their patients, nurses are socialized to be more explicitly caring in their interactions with patients.  This distinction between the emotional distance of doctors and emotional availability of nurses is furthered reinforced by the gender division of labor that leads to male predominance among doctors and female predominance among nurses.

For all these reasons, nurses face even bigger challenges than doctors in managing emotional involvement with patients. This difference in role expectations is reinforced by the daily reality that nurses typically spend much more time with patients across a broader range of interactions than doctors typically do.

The upshot is that whereas my doctors only became emotionally accessible late in the game, most of my nurses were friendly, nurturing and emotionally supportive from the beginning of my treatment and without regard for my prospects of survival. While this is beneficial for patients, it can be challenging for nurses when patients they have come to care about do not respond to life-saving treatments.

In extreme cases, this may lead to the suicidal behavior reported in an earlier post on this site.  But even absent such tragic outcomes, the challenge of managing emotional states looms large for nurses in general and some in particular.

As a final case in point, I recall a conversation about one of my nurses I’ll call Kelly.  Even compared to other nurses, Kelly was unusually warm, nurturing and supportive throughout my extended care. She became my “favorite” precisely because of the emotionally rich bond we formed right from the beginning.

It was only when I mentioned this to anther nurse that I learned of the downside of Kelly’s demeanor.  I was told that when Kelly’s patients did not survive, she was emotionally devastated and took a long time to psychologically recover.  Because my treatment went well, I did not witness this challenge.  But it stands to reason that while such emotional availability can be rewarding for both nurse and patient, it is also extremely stressful for nurses when their patients do not recover from their illness.

It may be that the most profound challenges of nursing lie not in technical mastery of clinical procedures, but in crafting a “feeling norm” that balances caring for others while also caring for self.


steve bSteve Buechler is a recently retired sociology professor and cancer survivor.  In 2016, he was diagnosed with acute myeloid leukemia and successfully treated with chemotherapy, radiation, and a stem cell transplant. He has since become a big advocate of writing stories as a survival strategy in the face of life-threatening illness.  His own story is available in “How Steve Became Ralph: A Cancer/Stem Cell Odyssey (with Jokes),” his memoir from Written Dream Publishing.

My Time in Prison.. as a Physician Assistant

Several years ago I took the position of physician assistant at the maximum security unit of the Santa Fe (New Mexico) State Penitentiary. I remember all too well my first entry into the prison. When the guard (or correctional officer, shortened to CO) accompanying me clanged the steel door shut behind me, closing me in, I realized what the inmates there must have felt when they first arrived. The sound had a finality to it. Unless the inmate had to be taken to the Santa Fe hospital, in all likelihood he was there for the rest of his days. I, on the other hand, could leave at the end of my shift and enjoy all my freedoms.

Providing medical treatment to dangerous prison inmates is only slightly different than treating you or your family. The difference is, they have nothing to lose. If they are in there for murder, one more murder means nothing. So when an inmate is brought in to sick bay to be seen by the physician assistant, the COs bring them in chained and shackled. Ankles and wrists are bound by shackles, and both are tied together with a belly chain. All that, plus the accompanying CO, prevents the inmate from acting out.

You can well imagine the challenge of examining someone who is trussed up in chains. Deciding to have the CO release some or all of the locks holding the inmate turned out to be a learning experience. Often the CO helped with the decision. If I asked him to take off the chains and he said it wasn’t a good idea, I’d respect his statement and do my best to work around the obstacles.

I learned another valuable pointer from one of the COs. After I’d asked him to take the shackles and chain off the inmate so I could examine him, he turned to the inmate and told him that if he screwed around with the doc (that was me) he’d never be brought to sick bay again. That turned out to be the biggest gun in my arsenal. No inmate, not even the ‘lifers’ wanted to face the reality of never being seen by a medical person again, which meant for the rest of his life. I have to say, I never had a problem with a single inmate. Of course, that could have changed on any bad day.

The first thing the inmates did when they heard there was a new ‘doc’ in sick bay was to make an appointment to be seen because of some terrible, unrelenting pain. I had an overflowing line-up of inmates for the first two or three weeks. They would count off their symptoms to me, clearly pleading their case to be given pain pills to ease their symptoms.

When I listened to their symptoms and did my exam, the decision to treat them with anti-inflammatory medication like ibuprofen (Motrin, Advil) or the stronger naproxen sodium (Naprosyn, Aleve) rather than pain pills became a no-brainer. They would offer up a list of places around their bodies where they hurt. Most of the time the multiple locations never fit a diagnosis. What was left was muscle pain, so they got anti-inflammatories for their trouble. Truth to tell, I never prescribed pain pills to any inmate. After a while they caught on and stopped trying to con me into giving them some.

I did have one inmate who thought if he saved up a bunch of ibuprofen and took them all at once, he’d get high. It made him violently ill and threatened to shut down his kidneys. He didn’t try it again. Some of them learn from experience. Not all, though.

Of all the injuries I had to treat, the worst was when an inmate got carried into sick bay with multiple stab wounds. The stab wounds were delivered by way of a shank, a homemade knife made from a screw driver, a piece of flat metal stolen from somewhere in the prison, or sneaked in by a friend or relative on visitors’ day. They were usually strong but thin, so they created puncture wounds rather than cutting tissue like a knife would do.

The first time I saw such a victim, with thirty or more puncture wounds in his chest and abdomen, I couldn’t imagine that he’d survive. But survive he did, after a healing visit to the hospital. He never came back to sick bay because of another shank attack while I was working there. Maybe he learned a lesson and avoided another confrontation with the shankers.

I learned more medicine working in that prison than all the other places I’ve worked. I remember early on thinking if I had a problem I wanted to discuss I could call the doctor who signed off on me. So when an inmate was brought in with his forearm laid open to the bone, blood everywhere, I called the doctor. His response? “Why are you calling me? Stitch him up!” Then he hung up.

I stitched him up.


charles-DCharles M. DuPuy has traveled the world, seen Africa as a Peace Corp volunteer, been a saleman and a farmer, and a magazine writer and editor, and an EMT. later he studied for and became a physician assistant which took him from pediatrics to geriatrics, and from Maine to the Santa Fe, New Mexico penitentiary where he worked in the maximum security unit. Retired now, he draws on his lifetime experiences while writing suspense novels. His first published novel, EASY KILL, is the first in the series, featuring his kick ass heroine, E.Z.Kelly. The second in the series is due for release in the Spring.

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