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 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 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 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 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 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.
Read moreDoes one honor or diminish an elderly parent by insisting on the truth? A reflection by Davida Pines
Kristin Graziano’s “Contents Have Shifted” considers how best to respond to a parent’s dementia-inflected reality. “For years,” Graziano observes about her mother, “I felt compelled to refute her falsehoods. I felt that by correcting her, I could yank her back to The Truth, to the real world. When I did this, sharp words with resentful tones followed, leaving us both frustrated and silent.”
Read moreIt’s Happening to Me, Too: Reflections on Interconnectedness, Interdependence, and Independence in Caregiving Relationships by Leena Ambady
“Every thought begins with I. This is happening to him, I try to say,
not happening to me. But it is, too. This is my place to tell it.”
The above is an excerpt from Kristin Camitta Zimet’s “A Dialysis Diary,” (Intima, Fall 2023). In this beautiful essay, Camitta Zimet writes about her husband’s end-stage kidney disease, the initiation of dialysis, and the impact that his chronic condition and the treatment it required had both on her and her relationship.
Read moreCaring and the Challenges of Social Convention, by Jeffrey Millstein, MD
An internist reflects on his short story as well as a fellow physician’s personal essay and explores the complex issue of crossing implicit social boundaries in the clinician-patient relationship.
Read moreWe’re Invisible, Too: Showing Respect for Healthcare Workers by Cheryl Bailey
A retired gynecologic oncologist reflects on her own career and realizes how watercolor artwork can allow for even healthcare providers to be seen.
Read moreThe Healing Power of Empathy: Does it Exist? Can it be Acquired?
In this reflection, a retired surgeon examines the research findings of evidence-based medicine to uncover whether empathy, in addition to the principles and practice of narrative medicine, can facilitate deeper healing.
Read moreFear and Compassion: At the Heart of Panic Attacks by Lisa H.D. Napolitan
© How a Heart Grows. Susan Baller-Shepard. Fall 2018 Intima
Fiction and visual art are a natural pairing, one digging deep through words, the other a profound visual exploration. Both genres allow ways to explore the issue of mental health.
Read moreHow to Write About Cancer: How Poetry Can Break the Rules by writer Lynne Byler
Recently, I read Adam Conner’s short story “How to Write about Your Cancer” (Fall 2022 Intima) with amusement and recognition. And if I transform the rules in it to a scorecard, my poem, “Minds Go Where Bodies Can't” ends in the red.
Read moreDementia and Alzheimer’s Disease: When the Outside Looks Different From What’s Happening Inside by Kimberly Mitchell
© The War Outside. From “The Impact of War on Mental Health” series. Claire Lawrence Spring 2022 Intima
One of my most enduring memories of volunteering is of helping with a beauty club for patients with advanced Alzheimer’s Disease. Each week I would be regaled with stories of young women visiting their mothers and planning fun outings with their girlfriends. While I applied makeup and painted fingernails, the smiles and facial expressions were those of young women anticipating a good time.
On the outside these ladies were quite different.