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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 moreI 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 moreEvery 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 moreDuring 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 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 moreMy 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 moreBeing 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 moreKristin 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 moreDuring my many years with chronic illnesses, I’ve spent far more time waiting for healthcare than actually receiving it. It’s always nerve-wracking. I never know how long I’ll be hanging around; it could be anywhere from minutes to hours. I fret over whether to go to the bathroom before or after an appointment, afraid I’ll miss my turn if I’m not there when they call me in. And of course, I worry about what I’ll hear when I finally get attended to; I’ve received lots of bad news over the years.
Read moreI think about time a lot now. My days are ruled by schedules and cases and meetings, and I spend much of my day reacting to the pressures of the unrelenting sweep of the second hand as it moves around turning into minutes and hours, never slow enough for me to accomplish everything I need to do.
Read more“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 moreAn 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 moreWhen I read “All Tuned Up” by Albert Howard Carter III (Spring 2021 Intima), I remembered a pediatric intensive care unit patient from my own 1980’s residency experience. In Carter’s poem, a medical resident presents a case during mortality and morbidity rounds. The resident is moved to tears as he tells the gathered audience about the death of a patient he knew well. A senior doctor “gently” offers context and says, “Maybe he was just tired.”
Mercifully, I’ve muffled memories from some of the deaths during my residency training in the pediatric intensive care unit. But I remember a slight girl of about sixteen with silky, wavy hair, lying in a metal-frame bed parallel to the wall against the window, in silhouette.
Read moreIn 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 moreWhile returning to the U.S. on an international flight not long ago, I sat next to a young African woman. As we approached our destination, she sheepishly passed me her passport and a customs form. Since I was in the aisle seat, I assumed she wanted me to pass it along to the flight attendant, until I realized the form was blank. She was asking me to fill it out.
Read moreGreat books can guide us in every day life, and I found it fitting that Dean Schillinger, MD and I both invoke works of literature to describe the experience of realigning our values with those of our patients. In his essay, “The Quixotic Pursuit of Quality,” (Spring 2015 Intima) Dr. Schillinger compares himself and his patient, Mr. Q, to Quixote and Sancho Panzo from Miguel de Cervantes Saavedra’s Don Quixote. With only misplaced medication lists, no-show appointments, and a stubbornly elevated hemoglobin A1c to show for his repeated efforts to help Mr. Q better manage his many comorbidities, Dr. Schillinger’s frustration melts away when Mr. Q unexpectedly gives him a massage. From then on, “the duel was over.” There would be no more tilting at windmills.
Read moreRecalling the loss of her husband, Mike, Dianne Avey’s essay“Morning Light” (Spring 2023 Intima) reaches back a decade to a quiet September morning on Anderson Island in Washington. Avey, a writer and nurse practitioner, draws us, however, not to the moment of her husband’s death but to a “place of quiet morning light.” This liminal stasis exceeds cure and speech and, in my view, renders the “human” (as defined by technical and linguistic competencies) indeterminate. Yet, beyond our abilities to fix and to say, there remains “the only thing we can ever do”: being present and bearing witness.
Read moreA pediatric intensive care physician advocates for crossing the imaginary line and using the power of touch to comfort those in need.
Read moreA nurse examines a clinical encounter through her poetry and appreciates the individual nature of care.
Read moreA writer and poet honors the memory of her mother by finding the parallels between her own work and the story of another mother and daughter.
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