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Writing Late reminded me how impactful are the firsts of medical education; the first time one works with a cadaver, is coached through the delivery of a baby, or finds oneself running the code. Late draws from my internship on the GYN oncology service, entrusted to manage patients at the end of their lives.
At the other end of those decades, I now find myself thinking about the impact I have as an attending.
Read moreWe see death so often as healthcare providers. I think often about the cognitive dissonance it brings to our lives: coming in such intimate proximity with it, discussing it in depth with people about themselves or their loved ones, and then returning and retreating to our own spaces and people and homes as if we can be safely tucked away from its harsh reality.
Read moreI wanted my note to sound grateful, but the words couldn’t mask my sorrow over my alienation from any familiar or valuable path. I had lived through transplantation of a stranger’s stem cells into me. The mandatory one year of donor anonymity had passed. Surely I must send thanks to the donor whose cells were keeping me alive. But three years swept me back and forth from the hospital, trying to survive infections and graft-vs-host attacks. I saw my husband’s head shake “no” to each next draft I attempted.
Read moreFor many physicians, a clinical day is a river of tasks to be navigated….These moments come to us randomly, often without any advance warning.
Read moreMedical students Tessa Palisoc and Andrew Murdock comment on how the arts—in this instance painting and dance—allow the artist and the observer to “process death and find a nuanced perspective of loss.”
Read moreI hesitated to write “Top Surgery,” and I hesitated even more to submit it. In it, I wrote that “I stand with my back to the wall, drawing silence around me like armor.”
Read moreMaja Milkowska-Shibata, creator of “Beyond Broken: The Science of Bone Lengthening
and My Ilizarov Story” in the Fall 2024 issue of Intima expresses her appreciation for fellow graphic artist, Gianna Paniagua, whose comic, “Human Experience,” appeared in the Fall 2022 issue.
I leave the hospital, but the hospital doesn’t always leave me. I carry my stress in a thin band across my upper back. On the good days, I think about a patient I sent to a recovery center. I think I did a good job. On the bad days, I find myself scrolling for far too long, when another shift is coming in entirely too few hours, because, as I wrote in my poem “Omens,” “while I am awake, he is still alive.”
Read moreIn 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.”
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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 moreIn 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 moreJen 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. 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 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.
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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 moreEven 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 moreI 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.
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© 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 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.
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