Hektoen International

A Journal of Medical Humanities

Heart failure

Charles Halsted 
Davis California, United States

By the time I completed my third medical school year, I had learned the basics of physiology and biochemistry, but had never been face-to-face with a person who depended upon my skills to survive. I had never heard a racing heart nor the sounds of gurgling lungs.

I was assigned to a general medical ward for my first patient contact, lowest on the totem pole behind a resident and intern. My patient was a middle-aged man whose heart was failing, his lungs in a death struggle with unpumped blood.

With my patient sitting and my resident overseeing, I tapped out my patient’s back, finding dull sounds at both lower lung bases. Then I placed my stethoscope on his left chest and heard his racing heart. Instructed to listen more closely, I heard a rumbling beat that extended halfway down his chest, together with a drum-rolling murmur. My resident made the diagnosis: mitral valve stenosis. He showed me how to perform a phlebotomy, the removal of blood from a vein in the arm to lower its strain on the heart.

After sliding in a needle, I withdrew at least a pint of my patient’s blood into a series of syringes. Finally, his breathing slowed, his heart rate normalized. I left my patient’s bedside and returned home to sleep, proud to have played a vital part in my patient’s survival.

Arriving next morning, I found his bed empty. One of the nurses said that my patient had died in the night.

X-ray of pulmonary congestion in heart failure
Pulmonary congestion in cardiac failure. Case courtesy of Dr. Roberto Schubert, Radiopaedia.org. From the case rID: 18991

CHARLES HALSTED is a retired academic physician whose poems have appeared in more than thirty-five poetry journals, and who has authored three poetry books. His poetry education consists of six retreats held in California, Oregon, and New Mexico, in addition to twelve on-line courses presented by Stanford Continuing Studies. His medical education consisted of Stanford University, BA, University of Rochester School of Medicine, MD, and specialty training at Johns Hopkins Hospital. He ascended the academic ranks at Baltimore City Hospital and the University of California School of Medicine. He retired from medicine in 2015, when he began his new career as a poet.

Winter 2021



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