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 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 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 moreSelf-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 moreOur Body is an Ecosystem: A reflection by Jeanne Yu
I came across two Intima pieces in conversation with my recently published poem, “Mercury, A Public Service Announcement” When I was younger, I took my body for granted. I thought medical science or pharmaceuticals would patch all my future ills. Wanting to live life to the fullest made it difficult in my busy life to do more than what was needed at that moment and then move on ... but as I age, I find my body has kept score and is less resilient.
Read morePoetry and Palliative Care, a reflection by writer Dan Yashinsky
I’m writing in response to Danielle Snyderman’s Field Notes essay “Not Yet, The Epilogue” (Spring 2021 Intima). I wrote the poem “The Trail to Ahous Bay” to read aloud to my friend Joan Bodger. She was in the palliative care unit of Tofino Hospital on Vancouver Island. I had come from Toronto to visit with her, and to say goodbye. I was staying on Vargas Island, a short boat ride from Tofino, and had taken the cross-island hike that became the poem.
Read moreMoving into Compassion, One Small Moment at a Time by anesthesiologist Molly McCormick
I 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 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 moreBefore and After: In Response to “The Face as an Organ of Identity” by California community doctor Katie Taylor
I work at a community clinic with patients who are homeless–there is the stigma of homelessness, and then there is the stigma of looking homeless.
Some patients of mine do not–or do not yet– appear unhoused. It is usually those who still have family that support them, who live in a car, who hold a job—running food for Doordash, picking for Amazon, sitting security—or who have not been homeless for so very long. But many of my patients do appear frankly homeless: a shuffling gait, a blanket draped around their shoulders, belongings pushed in a stroller, blackened teeth, leg wounds.
The 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 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 moreListening to Beethoven: A Reflection on Professional Responsibility and Personal Recognition by poet Susan Carlson
“I like Beethoven the best!” is a declaration made by a patient of Mitali Chaudhary, as she readies to leave his hospital room. A busy senior medical resident at the University of Toronto, Chaudhary juggles many demanding responsibilities with her desire to get to know this elderly patient. In her Field Notes essay titled “Beethoven’s Symphony No. 5,” published in Intima’s Fall 2023 issue, she recalls how she’d tried to get her patient to respond to questions about symptomatology, all the while aware that twenty-three other patients – along with a group of junior residents and medical students – were awaiting her time and attention. In that moment, she finds herself turning away from an opportunity for a personal interaction with him in order to ensure she manages her tasks appropriately.
Read more"Reading" Patients When Illiteracy is What Afflicts Them: A reflection by medical oncologist Jose Bufill
While 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 moreWhat Great Literature Taught Me by internal medicine resident Teva Brender
Great 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 moreThe Thing About ‘Good News’ at the Doctor’s Office by neuropsychology postdoc fellow Sarajane Rodgers
In theory, whenever we go to the doctor, most of us want to hear “good news.” The test is negative. You don’t have ___. Your results are inconsistent with ___. There are times where we take that in and walk away with an emotional weight removed. Other times, we are left with a void. The diagnosis we thought we could hang a hat on is taken away. Now where do we put our hat?
Read moreOn Subtraction: Understanding What's Lost and Gained in Clinical Encounters by Abby Wheeler
I recognized right away a kinship with Bessie Liu’s “Variations on the Negative Space Before Healing” (Fall 2023) and its use of subtraction to create new meaning; The poem by Liu, a third-year medical student at Johns Hopkins School of Medicine. very much feels like a sister to my poem, At the Doctor’s Office, I Check, Yes, I Have Experienced the Following: Sudden Weight Loss (Fall 2023).
Read moreWhat Clown Doctors See and Don't See: A Look at Healthy Humor by Phyllis Capello
Phyllis Capello, who is a writer and musician, is a NYFA fellow in fiction I and a winner of an Allen Ginsberg Poetry Award. Her collection “Packs Small Plays Big” is from Bordighera Press, 2018. Cantastoria work (sing/storyteller) has taken her from Ireland-to-Istanbul. She has presented at the International Oral History Conference in Rome, Italy and has been a musician/clown since 1990 with Healthy Humor Red Nose Docs, as well as a member of the poetry/activist trio, The Ferlinghetti Girls. ferlinghettigirls.com In 2023 she was honored with People’s Hall of Fame Award for teaching artistry for her work in New York City schools. Her poem “The Ballad of a Harlem Boy” appears in the Fall 2023 Intima: A Journal of Narrative Medicine.
For thirty years, my hospital work (I’m a clown ‘doctor’/musician for Healthy Humor) has included meeting and entertaining families in clinic waiting rooms, Pediatric ICUs, triaged Emergency Departments and in out-patient, in-patient rooms. Clown-doctor encounters can, if invited, also extend to physical therapy and treatment rooms, hallways, nurses’ stations and elevators. In ED and in out-patient and in-patient rooms permission comes from the medical and childlife staff first (and pertains to situational or isolation status). After that, the child’s permission (being our ultimate “boss”) to enter is strictly respected. In a hospital environment, we are one thing a child can prevent from entering their room.
Knowing when to present ourselves and when to exit means we are not often present for the trauma of Emergency Medical procedures unless specifically requested by staff. I do not see the immediate medical aftermath of a bullet wound. The hands of professionals as they seek to save a life as in Kirilee West’s drawing of hands entitled: “6:21 P.M.” That is why the piece really speaks to me of the drama and humanity inherent in the moments before a medical clown can be of any use to a patient.
Her drawing resonates with me as my poem, “The Ballad of a Harlem Boy,” was written after a nurse shared her distress about a child’s death. Telling us (we work in pairs) of her direct experience, I could only think of her hands and their expert ministrations during that terrible time and of the depth of her humanity for the mortally-wounded fourteen-year-old and his mother.
We all want our hands to be of use: I, in my small way, making music or writing poems; medical staff whose hands take on the most difficult and tender of roles; the artist’s hands who can capture with a charcoal stick the enormity of what we might see if, after the fact, we can allow our creativity to take a step back and tell a story.
Phyllis Capello, who is a writer and musician, is a NYFA fellow in fiction I and a winner of an Allen Ginsberg Poetry Award. Her collection “Packs Small Plays Big” is from Bordighera Press, 2018. Cantastoria work (sing/storyteller) has taken her from Ireland-to-Istanbul. She has presented at the International Oral History Conference in Rome, Italy and has been a musician/clown since 1990 with Healthy Humor Red Nose Docs, as well as a member of the poetry/activist trio, The Ferlinghetti Girls. In 2023 she was honored with People’s Hall of Fame Award for teaching artistry for her work in New York City schools. Her poem “The Ballad of a Harlem Boy” appeared in the Fall 2023 Intima: A Journal of Narrative Medicine.
When Cure and Language are Inadequate, What Remains? Reflecting on bearing witness by Rachel Cicoria
Recalling 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.
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