Journal of General Internal Medicine, April 2020
We sit at grouped desks, eyes on blinking green pagers then back to bright screens. It’s now the last year of my residency, and I’m admitting and cross-covering patients on night shift. Just as I finish putting in orders from a consultant, my pager buzzes with an admission. I call the Emergency Medicine resident.
“Room 631,” he says. “She’s a 67-year-old female with previous MI, diabetes, and tobacco use. Presented after a low-impact motor vehicle accident. It was a hit and run, those bastards. Anyway, Trauma cleared her, but she still has some chest pain. Needs a cardiac work-up. Her CT chest and abdomen are pending.” More
Intima Journal of Narrative Medicine, October 2021
A white rose was taped to the door, and I pushed the metal handle to enter. The glow of moonlight beamed through the blinds and onto a woman laboring, clutching the hand of the man beside her. In between contractions, she trembled, her cheeks streaming a flow of pain. His eyes were dry, hollow as if his pain was contained somewhere deeper.
Unlike the other rooms we’d entered that night, no displays stood by the bed. No monitor hung around her waist. No fluctuating lines traced onto red graphs. The ultrasound had confirmed the woman’s worst fear: the child’s heart stopped beating at just 23 weeks. His existence, but a brief bloom, here and gone.
I saw my reflection in the window, the short white coat over baggy blue scrubs, aimed at hiding my ever-expanding abdomen. I felt my daughter flutter kick, as she tumbled in my womb. My hand went instinctively to her, then I pulled it away. More
In the Valley
Journal of General Internal Medicine, January 2021
“Mommy, will you sing the valley song?” my three-year-old daughter asks. We came across this folk song a few months ago, and it has become one of her favorite lullabies. She is curled up next to me on her bed.
“Down in the valley, valley so low,” I begin singing.
“Hold me,” she says, and I wrap my arm around her. The soft light illuminates her nose, her round cheeks. It reminds me of the nights I crept into her room after a long shift, peering through the crib slats to watch her sleep. Now in the final months of my residency, I see the immense growth in us both. More
Intima Journal of Narrative Medicine, October 2021
I watch the sun descend from the hallway of the ICU, again covering the unit for the night. Ventilators whoosh while filling injured lungs, monitors chime in varied rhythms. Papers shuffle, doors open, printers buzz. Among all the noise, there is one striking absence: patient conversation. It’s a service of endotracheal tubes, of central lines, of soft restraints. Faces without voices.
“Open your eyes,” I say to them. “Wiggle your toes. Squeeze my fingers.” Give me something. Anything.
My peers have left one by one, handing me a growing list of patients. I collect their portable phones and pagers, and clip them to my waist. They weigh my scrubs down like a pine bearing snow. I tie the drawstrings tighter.
The swell of admissions comes in rapid succession, overwhelming my ability to link a patient’s disease with their name. Each new patient quickly runs with all the others, like raindrops welling up on a windshield, bubbling together, then streaming down the window, off the pane, and out of my consciousness. More
Blood and Thunder: Musing on the Art of Medicine, December 2021
I walk past your room, the room where I met you. The room where your nurses painstakingly cared for you. The room where I told your family you were dying. The room where I listened to your pulseless chest.
I walk past the doorframe where I waited to enter. Where I perched on the handrail and stared at my shoes. It was midnight when your mother placed oil on your feet, when I heard her voice trembling as it lifted desperate prayers.
I walk past the place where dialysis whirred, where the ventilator chimed... More
What She Carried
Gold Humanism website, as part of the first cohort of the Gold Writing Workshop, February 2021
Julie carried the news of two diagnoses, coming just weeks after burying her son: Multiple myeloma and amyloidosis were the unfamiliar words that finally explained her decline. She first welcomed the diagnosis, then despaired.
In her black shoulder bag, she carried the bills of two other hospital visits, as well as Zofran, Compazine, and Phenergan. The medications were not enough to quell her nausea. It was only the tube connecting nose to stomach that provided solace—an outlet backward when nothing in her small bowel advanced forward. More
Cripe LD, Vater LB, Lilly JA, Larimer A, Hoffmann ML, Frankel RM. Goals of care communication and higher-value care for patients with advanced-stage cancer: A systematic review of the evidence. Patient Educ Couns. 2021 Aug 27:S0738-3991(21)00560-7. doi: 10.1016/j.pec.2021.08.016. More
Nguyen R, Vater LB, Timsina L, Durm G, Rupp K, Wright K, Spitznagle M, Paul B, Jalal S, Carter-Harris L, Hudmon KS, Hanna N, Loehrer P, Ceppa D. Impact of smoke-free ordinance strength on smoking prevalence and lung cancer incidence. PLOS ONE. 2021; 16(4): e0250285. More
Lipitz-Snyderman A, Vater LB, Curry M, Li D, Rubin D, Radzyner M, Duck E, Bach P, Schenker Y. Cancer hospital advertising and outcomes: Trust the messenger? Lancet Oncology. 2019; 20(6):760-762. More
Vater LB, Donohue JM, Arnold R, White DB, Chu E, Schenker Y. What are cancer centers advertising to the public? A content analysis. Annals of Internal Medicine. 2014;160(12): 813-20. More
Vater LB, Donohue JM, Park SY, Schenker Y. Trends in cancer center spending on advertising in the United States, 2005 to 2014. JAMA Internal Medicine. 2016;176(8): 1214-16. More
Vater LB, Rebesco G, Schenker Y, Torke A, Gramelspacher G. Palliative care content on cancer center websites. Supportive Care in Cancer. 2018;26(3):1005-11. More
Zgibor JC, Schlenk EA, Vater LB, Kola S, Vander Bilt J, Woody S, Jacob M, Lo-Ciganic WH, Brenckle A, Bradenstein J, Kwoh K, Boudreau R, Albert S, Conroy M, Newman AB. Partnership building of an integrated healthy-aging program. Progress in Community Health Partnerships. 2016; 10(1): 123-32. More
Maciasz RM, Arnold RM, Chu E, Park SY, White DB, Vater LB, Schenker Y. Does it matter what you call it? A randomized trial of language used to describe palliative care services. Supportive Care in Cancer. 2013;21(12): 3411-19. More
Kutkut I, Vater LB, Goldman M, Czader M, Swenberg J, Fulkerson Z, Mehta R. Thrombocytopenia and disseminated histoplasmosis in immunocompetent adults. Clinical Case Reports. 2017;5(12): 1954-60. More
Shin J, Epperson K, Yanjanin NM, Albus J, Borgenheimer L, Bott N, et al. Defining natural history: assessment of the ability of college students to aid in characterizing clinical progression of Niemann-Pick disease, type C. PLoS One. 2011;6(10): e23666. More