Family Medicine Moments (formerly Thursday Morning Memo) is a weekly distribution list that shares stories from the Family Medicine and Community Health community at UMass Chan Medical School that includes Fitchburg, Barre, Worcester, Lawrence and also community docs, students, residents, scribes, and graduates of our program and school. Curated by Hugh Silk, MD and Linda Cragin, MS, it is a forum to share clinical success stories, dilemmas and interesting encounters. This site, established in October 2022, is a collection of Family Medicine Moments submissions. Submissions from 2014-2020 are currently available in a separate archive.

Authors of works posted in this archive agree to the terms of the eScholarship@UMassChan Non-Exclusive Deposit License. Original works are licensed under a Creative Commons Attribution-NonCommercial 4.0 (CC BY-NC) license, which permits re-use, distribution, and reproduction in any medium, provided the original work is properly cited and the material is not used for commercial purposes.


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Recently Published

  • Balance in the In-Between

    Adelstein, Pamela (2023-04-13)
    Introduction: This week we hear from our most avid writer - Pam Adelstein, former resident of Family Health Center of Worcester, and now Medical Director at Fenway Health. She writes regularly for Pulse. Today's piece was previously published there. It takes on the notion of transitions since she has recently experienced a big one. How does one embrace transitions - whether it is from one job to another, or simply from one exam room to another or just getting from work to home. When I graduated from University, the minister at our graduation week ceremony pleaded with us to focus on transitions - that is where the good stuff will happen. Let's see what Pam has to add.
  • Unmasked

    Chang, Chris (2023-04-06)
    Introduction: This week I share with you a post-pandemic reflection from Chris Chang, former Barre Family Health Center resident, who is now at the Austin Regional Clinic in Austin, Texas. He has written several times before for FMM. The reflection below explores how we return to "normal" after a tumultuous three years. Definitely, not easy. Chris wrote this to me: “After nearly exactly three years, our clinic today moved to optional masking for staff. It was a strange day filled with mixed emotions for me. I'm still working on wrapping my brain around it, and this is part of that process. It is a bookend to the poem "Heroics" that I wrote and sent in near the beginning of the pandemic. Many thanks for keeping the fire burning.”
  • I wish I could do more

    Daniel, Paul E (2023-03-30)
    Introduction: This week we hear from Paul Daniel, a hospitalist in our department, and someone who leads teams to provide care in Haiti. Through his reflection he shares with us a feeling that no doubt many readers will identify with. That feeling of questioning if you are doing enough. It becomes particularly true when you interact with patients that you may never see again. See what Dr. Daniel has to say about this.
  • The flutter of an aching heart

    Silk, Hugh (2023-02-23)
    Introduction: I do not have an original offering for this week. In honour of February being American Heart Month, I offer up a story I wrote 12 years ago about an incident in my early years fresh out of residency in private practice. Heart disease is complicated. We do so many "rule outs" proving that a person did not have a heart attack and then we send them on their way. While true heart disease is incredibly prevalent and serious, so too are the many other things that break our hearts. This story is about this latter kind of heart disease.
  • Section 12

    Adelstein, Pamela (2023-02-16)
    Introduction: In the work we do, we often rub up against the limits of Do No Harm. Pam Adelstein, who is a graduate of Family Health Center of Worcester and recently moved her practice work to Fenway Health, writes about an important topic we face - Section 12ing someone. In the work I do in homeless health, this topic comes up often, for many clinicians, it may be rarer and yet when it does occur, it leaves its mark on us. Thanks to Pam for sharing her intimate brush with saving a patient while wrestling with the accompanying emotions.
  • Even More Haiku

    Baldor, Robert A. (2023-02-09)
    Introduction: One more week of Haiku thanks to Bob Baldor, former Vice Chair in our department and now Founding Chair of the Department of Family Medicine/UMass Chan Medical School-Baystate. He clearly had fun with these, covering everything from aging to sage advice from local family medicine legends. Bob said in his email that he's not much of a writer; I beg to differ. Thanks Bob. Enjoy.
  • More Haiku

    Saver, Barry G. (2023-02-02)
    Introduction: I continue to receive Haiku and encourage you to keep sending - how talented you all are! This week I am sharing with you the enthusiastic work of one provider who sent me SIX! Barry Saver is a former physician researcher in our department who provided care at Family Health Center of Worcester before moving out west to Swedish Family Medicine in Washington. He is on the verge of retirement (which you will note in his last haiku). His pieces range from tongue-on-cheek reflections on our health care system to sincere care and important good-byes. All in 19 syllables! Enjoy.
  • The Haiku are here

    Chang, Chris; Sullivan, Deborah A; Guggina, Thomas (2023-01-26)
    Introduction: What fun. I asked and you began to send in the Haiku. There is another week to send them in, but I could not resist starting to publish them. Three providers (past and present with UMass affiliations) express their professional and personal reflections through 17 syllables. See what you think.
  • Looking for Haiku

    Silk, Hugh (2023-01-12)
    Introduction: This week rather than send out a piece, I am asking for your reflections in a more formal manner. Others have done this, so it is our turn. We want your Haiku! Please take a few minutes to jot down your reflections on your patient care in the form of 3 lines - 5 syllables, 7 syllables, 5 syllables. Deadline January 24th. Send to Linda and/or I. Have fun with it! A chance for self-gratitude, a pause, a laugh, other....
  • Stories

    Adelstein, Pamela (2023-01-05)
    Introduction: Happy New Year to all. Hoping 2023 will bring fulfillment, wellness, and patience/resiliency as any adversity arises. The new year can be a time for resolution, transition, and new opportunity. To that end, I share with you this week a reflection from Pam Edelstein, a graduate of the Family Health Center of Worcester and as you will see below is transitioning from Codman Family Health Center in Boston to be the Medical Director at Fenway Health (Congrats!). Almost all of us have transitioned at some point from one job to another, and many of us have done this on a clinical level. It brings with it a lot of emotions and reflection. It is a chance to think of all the stories associated with one's patients. See how Pam frames this.
  • The Longest Night

    Silk, Hugh (2022-12-22)
    Introduction: This week, before we take a recess for the holidays, we pause to honour those in our midst who are lacking housing or who are housing insecure. Please take a minute to read and think about this important issue. Happy holidays to all and all the best for the New Year.
  • Post Call At The YMCA

    Kostecki, Anita (2022-12-15)
    Introduction: Hope everyone is doing okay as we approach the holiday season. It has been a challenging time for most due to the tridemic, staff shortages, and so many other personal reasons. In the spirit of offering thoughts about pursuing wellness, I share with you a piece from Anita Kostecki, a graduate of the Family Health Center for Worcester who now works at Boston Medical Center (BMC). She read this reflection at this fall's MedMoth and introduced it by noting the following: Ever since I was a medical student in the late 1980s, I have used swimming as a stress reliever. I almost religiously always go to swim post call, now in the mornings, but I used to do it even in the evenings, when we worked all day post call (would sometimes need to take a power nap in my car to make that work lol). In fact, until clinical clerkships as a 3rd year medical student, I used to use running as a primary form of exercise but once I started on the wards, my feet would ache so much if I ran after standing/walking all day, I decided to switch over to swimming. I took an adult stroke class from a older nun who taught at the YWCA near the Worcester Public Library and then never looked back. The most trouble I ever got in as an FM resident was when a pediatric attending reported me to our residency director (Jim Pease) because he accused me of leaving too early post call "to go swimming" but to this day I think he was just jealous and that I left at the correct time....at any rate, swimming has been a blessing in my life and always helps me to re-orient back to the outside world after a call night when things go on that I imagine most regular folks would never even consider possible! As an avid open water swimmer who also took a course as an adult from a mindful swim master, I concur. See what you think after reading her poem.
  • I Will Be Delivered

    Gleich, Gerry (2022-12-08)
    Introduction: I have always lamented that we have not had music as part of our FMM story telling. That changes today. I am so pleased to share with you the musical reflection of Gerry Gleich, retired family physician who had so many roles in our department including Residency Director and Medical Director of Hahnemann Family Health Center. He has always been an avid guitar player and wrote many songs for the residency and even one for my 40th birthday ("If not for Hugh"!). He has turned his attentions now to more serious music writing and has just released his first album! He wrote to me and said: this song was inspired by a long-time patient of mine at Hahnemann Family Health Center. He was a retired carpenter in his eighties who always wanted me to call him by his first name and dispense with unnecessary titles like “Mr.” I really enjoyed seeing him over the years. It was difficult for me to see his cognitive function begin to decline, as he was fiercely trying to hang on to his independence. The song is called “I Will Be Delivered.” You can read the lyrics below - but I advise you to click on one of the links and get the full musical experience. (Then buy the album!)
  • Listening Days

    Singer, Robert E (2022-12-01)
    Introduction: I am pleased to again have Dr Bob Singer offer up a reflection. Bob was at the UMass Family Practice Residency Program from 1978 to 1981 at what was then called the Family Health and Social Service Center. (He notes Lucy Candib was his mentor!) He then practiced in Everett for years before moving to Maryland to do geriatric work before retiring. His story reminds me of the advice of Ron Epstein in his book Attending. We are so prone to interrupt, thinking it will speed up our encounter when taking a pensive mindful approach actually has better results. Read Bob's piece and then think about trying his advice for just one session.
  • Together

    Valdini, Anthony (2022-11-17)
    Introduction: This week we are continuing the Veterans theme (Veterans Day just does not seem long enough to honour those who serve and have served in our military). Tony Valdini is Research Director at the Greater Lawrence Family Health Center Residency Program. He shares with us his experiences from the distant past as a student working in a Veterans hospital and how the lessons learned still serve him well. See how it resonates with your experiences with patient educators.
  • In Honor of Veterans Day - Asking the question

    Cragin, Linda J. (2022-11-10)
    Introduction: In honor of Veterans' Day, seven medical and nurse practitioner students participated in this year’s Veterans’ Population and Community Health Clerkship led by Linda Cragin and Janet Hale. Here are some of the take-home messages from their reflections – reinforcing the importance of asking all patients about military service.
  • Population and Community Health Clerkship Reflections: Oral Health

    Young, Soomin; Li, Chrissy (2022-11-03)
    Over the next few weeks, I hope to share with you reflections from some of our UMass Chan 2nd year students who are doing their Population and Community Health Clerkship (PCHC). This week two of the students in my group, Soomin Young and Chrissy Li, responded to the questions: In what ways is this PCHC experience challenging your stereotypes and assumptions? and, How do social determinants of health impact the environment and experience of the community or population on which you are focused? They answered this after working with an adult dentist and a pediatric dentist in Worcester County, visiting a water treatment plant in Shrewsbury, talking with Health Care for All, the state DPH dental director, and Senator Chandler - a long time oral health advocate in Massachusetts. See if their views have an effect on yours.
  • These hands

    Silk, Hugh (2022-10-27)
    Hello FMM community. As I wait for more writing from you all, I will share with you a poem I have been playing with. Not quite there but on its way. I was looking at my patients' hands recently and thinking, "if only those hands could talk." It got me looking at my own hands with new scrapes from weekend gardening, faded calluses from long past rowing glory, scars from accidents, and the untold/unnoticed stories deep in the interstitium and marrow of experience and joy and sorrow. So here goes - my medical life and the life of a patient and her family told through an ode to my hands.
  • My Year with a Good Ol' Boy

    Kostecki, Anita (2022-10-20)
    This week Anita Kostecki, a graduate of the Family Health Center for Worcester who now works at Boston Medical Center (BMC), shares with us a story from her training days. I too did an elective at the hospital she writes about in Texas many years ago. Her recollection resonates with my own experience of being amongst good ol' boys that brought out both positive and negative feelings in me. However, I think Anita captures an important nuance of the complexities of individuals in our midst who outwardly appear one way and inwardly can produce actions that are very different. I applaud her sentiments.
  • A Haiku

    Tolosky, Patrick (2022-10-13)
    I asked and you responded. Thanks to Patrick Tolosky, a PGY2 at Hahnemann Family Health Center, who wrote this brief yet telling haiku about his experience as a resident being transformed into a full-fledged primary care doctor. Two nights ago, at the Cottle lecture for the Worcester District Medical Society, I invoked Atul Gawande and challenged the audience to write something. I then mentioned that writing a 6-word story, 55-word story or a haiku is a pithy way to do this and achieve a sense of satisfaction from your musings at the end of a long clinical day. Patrick gave it a go. See what you think.

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