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.

Galen Schram’s description in the Honor Walk (Fall 2023 Intima) of Ms. Delatierra’s physical therapist, Cybbi helping her patient ambulate, made me vividly recall my mother’s physical therapist, Alfred. He was a broad, sturdy rock of a man with a smile that could make butterflies dance and a dreary room brighten. He was observant, noticing details that others would not, encouraging yet firm, and extremely capable, effortlessly bringing the wheelchair behind while lightly holding onto my mother’s gait belt as she did laps in the hallway. But the reason my mom “put up with him,” as she would say with a twinkle in her eye, was because he listened to her, making for many lively conversations.

In Schram’s short story, Cybbi finds a way to reach Ms. Delatierra through a photograph of her granddaughter, Ava. Cybbi takes the time to look at the picture and comments that Ava looks “just like her grandma,” which lights up Ms. Delatierra’s face and brings joy to her day. Schram, who is a writer, student of Narrative Medicine and physical therapist in New York City, has surely witnessed a fair share of these moments.

Both Schram’s fictional account of Cybbi and Ms. Delatierra, and my non-fiction piece about my mother (Contents Have Shifted, Spring 2024 Intima) reminds us that searching for and finding that elusive nugget of connection – even when our patients or loved ones can’t remember things or they get the details wrong – is the crux of caring. Cybbi saw Ms. Delatierra. And my mom’s nurses, therapists, and caregivers saw her. For that, I am forever grateful.


Kristin Graziano, DO, MPH, FAAFP is a family physician who spent most of her career living and working on the Navajo and Jicarilla Apache Nations where she gained an intense appreciation for the strength and stories of her patients and the beauty of their landscapes. Recently retired from clinical practice, she is exploring the right side of her brain by dabbling in writing. She spends the rest of her time hiking, cycling, and advocating for wilderness and mitigating climate change. She lives in Northern New Mexico with her lovely wife Joan and their impossibly brilliant Blue Heeler, Macy. Her non-fiction essay, Contents Have Shifted, appeared in the Spring 2024 Intima