Rachel Fleishman is a neonatologist practicing in Philadelphia who studied creative writing as an undergraduate student. She writes about her experiences caring for infants, often exploring the intersection of her own provider grief and the grief of… — Rachel Fleishman is a neonatologist practicing in Philadelphia who studied creative writing as an undergraduate student. She writes about her experiences caring for infants, often exploring the intersection of her own provider grief and the grief of parents whose infants require extraordinary care. Her essay “Bubbles” appears in the Spring 2020 *Intima*.

Physicians are trained to act decisively when crises unfold. We spend years conquering technical proficiency, mastering algorithms, and cultivating closed-loop communication so that when an infant’s heart stops beating or a woman has uncontrolled bleeding after childbirth, we can step in quickly and deftly to save a life. The role of savior is etched indelibly into our professional identities.

Watching a medical emergency as a physician who is not functioning as a leader or caretaker unearths discomfort, a mingling of denied identity with humility. And it is from this vantage that we can harness the power of narrative medicine to create space for reflection, to make sense of medicine and how it unfolds.

In his story "The Birth Plan," Matthew Bucknor describes such feelings with precision when he writes, “I am frozen, impotent. Wishful that, if I hold perfectly still, this moment could reverse itself.” His protagonist is an oncologist whose wife is having a post-partum hemorrhage. As a physician, the character is keenly aware of the severity of what is happening to his wife. Without missing a beat, Dr. Bucknor brings us as readers into the visceral fear of knowing the consequences of a life-threatening complication and at the same time having no role in abating it.

The experience he describes of being a physician without a role in a medical emergency is a theme I also highlight in my own essay, "Bubbles." In this essay, I watch an extremely premature infant code and ultimately die. As a resident early in training, I had a new understanding of both the physiology unfolding and the ethics of decision-making surrounding end-of-life, but I was not capable to advocate for a compassionate death for this infant or her mother.

While each essay draws on prominent societal themes, both Bucknor and myself are hopefully bringing attention to clinical humility and the nuances of high-stakes communication by drawing readers into our emotional response. As Rita Charon instructs us, “it may be that the physician's most potent therapeutic instrument is the self, which is attuned to the patient through engagement, on the side of the patient through compassion, and available to the patient through reflection1.”

1. Charon R. The patient-physician relationship. Narrative medicine: a model for empathy, reflection, profession, and trust. JAMA. 2001;286(15):1897-1902.

Rachel Fleishman is a neonatologist practicing in Philadelphia who studied creative writing as an undergraduate student. She writes about her experiences caring for infants, often exploring the intersection of her own provider grief and the grief of parents whose infants require extraordinary care. She is honored to have her essays appear in publications such as The Philadelphia Inquirer, The Journal of the American Medical Association, Literary Mama, and Hektoen International’s Journal of Medical Humanities. She is a wife and the mother of two boys who haven’t decided yet what they think about her descriptions of their antics.