As I read Sarah Gundle’s essay “I Can’t Remember His Name” (Intima, Spring 2023), I recognized a young and eager clinician who felt both moved by someone’s story and inept at affecting change, a dissonance that can reverberate throughout decades of practice. I, too, remembered my earliest encounters, when my own therapeutic skin was most supple and soft, vulnerable to the bruising weights of trauma, addiction and injustice. I recognized the writer’s spontaneous tears – and the impulse to minimize and dismiss them in accordance with the guidelines of rational detachment and therapeutic rapport.
Read moreDeepening Insights on Metaphors for Pain and Medical Care by Vilmarie Sanchez-Rothkegel
In my non-fiction essay "House of Pain" essay (Fall 2024 Intima), I discuss the problematic MS Hug metaphor, used for unpredictable and distressing chest spasms that can make breathing feel impossible. Hugs are a form of affection, except this one is not. I remember being caught off guard by the intensity of the pain. Words in Logan Shannon’s non-fiction essay “The Gold Standard” (Fall 2019 Intima) resonate profoundly: “It’s the pain that comes from nowhere, the surprise, that throws me.”
Read moreRituals of Care: How We All Possess More Agency in the World Than We Think: A reflection by doctor Gaetan Sgro
There is a tendency in times of upheaval to overestimate the agency of certain individuals. Anxieties engender a cast of heroes and villains making games of global events. But the kernels of truth in these conceptions obscure the relatively small influence such figures exert on our daily lives. Still, there is comfort in the notion that somebody, somewhere, is in charge; perhaps because it suggests that we, ourselves, possess more agency than we perceive and are not, as so often seems, simply adrift on the currents of fate.
Read moreWe Are Not Amazons: A Reflection by Medical Illustrator Mesa Schumacher
In my professional role as a medical illustrator, I'm often drawn to a good metaphor. As a patient, the allure of metaphor can be dangerous.
Read moreGiving Up Metaphors: A reflection about how we talk about illness by poet physician Ronald Lands
In both the literary world and in the clinical world, metaphors take hold of our relationship to illness and health.
“Giving Up the Fight,” by Rebeca Stanfel (Spring 2023 Intima) is a first-person account of her struggle with sarcoidosis and the metaphors that complicated her ability to deal with it. Well-meaning friends and family assailed her with encouragement that depicted chronic illness as a battle to be won or lost.
Read moreNormalizing—and Honoring—the Process of Dying," a reflection by veterinarian Jackie Greenwood
Jen Baker-Porazinski's story “Dying at Home” (Spring 2024 Intima) drew a vivid picture of a patient and her family, and the rhythm of her last few weeks. The love and dedication of her husband was especially moving.
I was also struck by the narration of Baker-Porazinski’s journey, as a doctor. Reflexively, at each visit, she listened to her patient's heart and took her blood pressure. Baker-Porazinski felt this showed that she hadn’t given up on her patient .
Read moreBig Moments are Surrounded by Little Moments: An End-of-Year Reflection by doctor Rory O’Sullivan
Big moments are surrounded by little moments. That’s what I was trying to pull out in my story “There’s a Special On Car Washes,” published in the latest issue of Intima. That bewildering sensation, common in life and especially in healthcare, that extraordinary things happen but that time marches on without sentimentality. You win the big game but when you get home you still have to take out the garbage. You receive a life-changing diagnosis and then you have to figure out the machine to get out of the hospital parking lot.
Read moreWitnessing Grief by pediatric hospitalist Sophia Gauthier
Grief walks in many forms, and its footsteps are padded and quiet, imperceptible even, except to those who lay awake at night, counting its tip taps on the upper floor.
Read moreFinding the Human in Humanity. A reflection by Zoran Naumovski
I have been practicing medicine since completing my residency in June 2000. It baffles me that to this day I still hear comments from patients, families and loved ones that we physicians often cannot relate to their concerns, their health struggles and their ailments because we are doctors, because we harbor medical knowledge, because “we are not human.”
Read moreAt the End of a Call Shift, Who Gets to Go Home? A reflection by Angela Tang-Tan
Every now and then, at the end of a call shift, I leave the hospital with aching feet and heavy eyelids. And then I remember: I am the lucky one. I am the one who gets to go home. My patients – the grandfather whose kidneys are failing, the ten-year-old with meningitis – are not so lucky. They will not go home tonight. They may never go home again.
Read moreSearching for the Nugget of Connection by Kristin Graziano, DO, MPH, FAAFP
During the 10 years my mother spent in her nursing home two states away, I struggled with feelings of guilt and remorse. She suffered from dementia, requiring 24/7 care, and I couldn’t provide it to her. Yet there was always the plaguing thought that I should. I knew it wasn’t realistic. Still, I felt inadequate and like I abandoned her, even though I visited every few months.
Read moreA House, Not a Home: Reflecting how imagery can reveal the human psyche byJennie Vegt
One of the images from the Mitwelt Melt Series by Jennie Vegt. Spring 2024 Intima
“Finding meaning in suffering is sometimes the only coping strategy remaining,” says the artist. This series of six paintings explores grief in a visually complex manner.
Carl Jung believed house imagery in dreams represent the human psyche. In both artworks, the houses are familiar structures of shelter that simultaneously represent ominous confinement and isolation. We may be capable of observing and moving past some psychological structures that have become an obstruction, while others feel intertwined with our very being, like a house that fits more like a skull.
Read moreArt as a Body’s Blessing: A Reflection by physician-poet Sarah Piper
Even with the astonishing knowledge of medicine, the anatomy of an illness cannot fully be known from the outside. It takes an act of tender and careful acquaintance. And the only one who can truly map the illness of a living being is the occupant of an ill body. The geography of sickness is mysterious: its borders begin vague, its peaks conceal its valleys, its oceans rove and deepen and rearrange patterns of flood and firm ground.
Read moreThe Unexpected Labor of Caregiving by Ann E. Green
The poem titled, “To the Woman at My Mother’s Funeral Who Thought It Was So Lovely that My Mother Died at Home” by Kathryn Paul (Spring 2022 Intima, Poetry), circles around my mind days after reading it. Paul’s poem eloquently speaks back to the assumption that it is always good to die at home, that home deaths are always peaceful. The literal hands-on work of caregiving—the cleaning of blood, mucus, urine and feces — is unspoken and generally done by women, whether paid or unpaid, and the writer, who in her bio calls herself “a survivor of many things” captures this in her poem.
Read moreLearning to be Present for an Act of Dying by UCSF Medical Center professor Krishna Chaganti
It is the great privilege of medicine that we are asked to show up, constantly, albeit in a different role than a family member would be. To not look away is in the fabric of what we do. It is partly why the practice of medicine can be exhausting, electronic charting and reimbursement quibbles aside. We are asked as caregivers not to dispense always but to receive, to hear questions that we don’t want to reflect upon. It is our privilege to be present.
Read moreHow We Doctors Learn How to Act and React by USC Keck School of Medicine medical student Angela Tang-Tan
I am at the point in medical school that I can forget how strange a place the hospital is. Most days, I pre-round around 5am and I leave as the pink and gold of sunset reflects in the windows of the inpatient tower. I no longer smell the antiseptic that pervades the air. I write my notes oblivious to the announcements of “code blue” or “stroke team activation” playing over the intercom. When I walk through the hallways, there is purpose in my strides. The core clinical rotations that every medical student undergoes (family medicine, surgery, pediatrics, etc.) are a time for exploration and the forging of identity. We learn: This is how doctors act and react.
Read moreThresholds and Doorways: Exploring Mental Health Narratives Through Art by Emory MD/PhD candidate Aubrey Reed
© Beyond the Threshold Aubrey Reed Spring 2024 Intima
My first-ever clerkship rotation as a medical student immersed me in the realm of inpatient psychiatry. This profound and eye-opening experience blurred the boundaries between sickness and health. It challenged my preconceived notions and deepened my understanding of mental illness.
Read moreMissing Someone: A Reflection on Loss and Yearning by Shruti Koti
My short story “The Waiting Room” (Spring 2024 Intima) was inspired by recent legislation that threatens women’s rights and health. In the story, a young couple is troubled by a decision they made to terminate a pregnancy – they are scared of persecution and legal action, but they are also emotionally and spiritually haunted by their choice.
The story ends as they drive away from the reproductive clinic, but it is evident they will think about that afternoon for months, and years, to come.
Can one miss something that was barely there?
Read moreA Sestina in Honor of Tia Forsman’s “Remnant” by Lynn Lawrence
© Remnant 2 by Tia Forsman Spring 2022 Intima
“Radiographs serve as distilled moments of a human narrative,
An illness experience in greyscale” (From “Remnant” by Tia Forsman in the Spring 2022 Intima)
Sea glass/cutglass/eyeglass/stonefish/boomerang, Forsman’s remnants
Arrayed/x-rayed on the nightblack ocean floor of shapes and shadows.
From the French : to “rest”; to “remain”, “left over”; an underwater x-ray.
Overlapping, edges blurred, tenderly floating in an uncertain narrative.
This isn’t an x-ray. It just looks like one. Like medicine, a “grey area”
Forman is bilingual.. She paints in watercolor. She speaks in radiology.
Self-Examinations and the Burdens of Being Sick by Amanda Ford
Being sick takes work. There is the pain and exhaustion, the adaptation, the cognitive load required to keep moving forward when my body holds me back. There’s also the business of being a patient: sitting in waiting rooms, standing in line at the pharmacy, being on hold with the insurance company.
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