NEJM – Dr. Ranjana Srivastava

Dr Ranjana Srivastava

Ranjana Srivastava

Dr Ranjana Srivastava

Writings

A Bridge to Nowhere

It is a typical day in my Melbourne clinic, with missing files, scans gone astray, and patients overwhelmed by their diagnoses. Though a mountain of

Abandonment

“Hospice. It’s where people go to die,” she says, surprising me with her sudden lucidity. “And also for symptom management,” I add gently.

Complicated Lives

Traditionally, as I recently taught medical students on their first hospital rounds, the medical history consisted of the history of the present illness

Cousin Pam

“Cousin Pam! Here, Cousin “Good morning. I’m your doctor. How do you feel today?” “Cousin Pam, you’re my doctor?” He looks puzzled.

Dealing with Uncertainty in a Time of Plenty

It’s the newest trend in medicine: “patient-centered care.”Cynically, I think, “Isn’t that what

Denial

The medical student is watching closely. In an overfilled clinic, time is scarce and the teaching staccato. I point out a malignant lymph node here

When the EMR Stole My Pen

“Lost something, Doctor?” “I think my nice pen slipped under your sheets,” I explain. Groaning at the thought of moving his diabetic legs, the patient says

What I Wish I Had Done for a Grieving Father

“Doctor, I mean no disrespect, but why am I even here?” No patient wants to “belong” to a geriatric oncology clinic, but

Home Help

“Your mother doesn’t haveservices because she hung up on us.” “Really?” I ask, startled. “I have it documented right here.” In medicine, documentation rules,

No Refuge for the Ailing

The still, oppressive heat of the afternoon seems to magnify the queue of waiting patients. A young woman separates herself from the crowd.

Nourishment

“Good morning. How are you feeling today?” “Soufflé — have you any idea how to make soufflé?” “I’m afraid not,” I smile, tensing inwardly.

On the Death of a Colleague

One morning, out of the blue, my close friend, colleague, and mentor has chest pain and collapses on his way to the hospital to begin rounds.

Privacy and All That

A s I flick through the scans, I exhale. The patient’s disease is stable. I know that has little to do with me and much to do with his biology and indefatigable

Speaking Up — When Doctors Navigate Medical Hierarchy

He’s the first patient of the day: admitted overnight, he’s scheduled for surgery this morning. “Do you want to catch him

The Art of Letting Go

“Is there any money we need to pay? Is that why you won’t treat him?” Her face wears a hunted expression; her slender frame is weighed down by fatigue and untold

The Interpreter

I groan internally at the sight of the laminated yellow reminder that the next patient needs an interpreter, who is waiting patiently outside my office.

The Loneliness of Visiting

“The problem is the poor chap is lonely. If they sat with him a little more, they wouldn’t need to call us as much!” My harassed intern is venting her

The Power Proxy

The patient looks better than I expected. Investigations for aseptic episode revealed a liver replaced by tumor, the primary obscure. He cuts a handsome

The Service

This morning, I came uponan intern engrossed at thecomputer. “I am looking up the diseases Mr. Crosby died of,” she explained.

The Sharing of Loss

Just as the Friday evening efflux of staff begins, a patient with cancer whom I saw only days ago is reported to be not quite right.

Through the Undulations of a Long Career — A Mentor’s Legacy

As my son and I walk up to the house, he regards us from the top of his driveway with a bemused expression, but it’s replaced

What’s the Alternative?

Out of curiosity, an impressionable woman in her 30s attends an integrative medicine exhibition; having recently had a child, she’s been sleep-deprived and wants