Giving 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.

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Big 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.

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Searching 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.

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Art 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.

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The 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.

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Learning 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.

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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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Our 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.

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We Wait….a reflection by writer Nancy Lewis

During 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.

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Poetry 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. 

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Caring 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.

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Before 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.

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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.

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How 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.

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"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.

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The 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?

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On 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).

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