I 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.
Read moreObjectivity versus Art: A Reflection on Technology in Medicine
A physician-novelist ponders the troubling implications of the increasing technologization of health care and its encroachment on the art of medicine.
Read moreThe Beautiful Surprise
What is the beautiful surprise that can be found in the clinical encounter between patient and physician? A writer and nurse explains.
Read moreOn Brian Ascalon Roley’s "Caregiving"
A pediatric emergency physician reflects on the burning intensity found at the heart of caregiving.
Read moreThe Hospital Gift Shop: An Unlikely Refuge by Maureen Hirthler
An emergency physician fondly looks back on an unlikely refuge within the hospital: the gift shop.
Read moreCostumes: What a Plague Doctor Wears to Deliver Care by family physician Carla Barkman →
This past Halloween, I rewatched The Rocky Horror Picture Show and thought about costumes. Who here is truly in disguise? Is it Frank-N-Furter with his heavy eye makeup, corset and garter, or Janet and Brad with their buttoned-up blouses, white doll shoes and matching purse, who come alive only after they are stripped to their underclothes and made up, for the final performance, in drag? Sometimes we dress up as monsters, but perhaps more often we hide our quirky selves beneath bland cloaks of conformity, afraid of the attention an unusual performance might attract.
Read moreThe Cost of Efficiency and the Price of Empathy, a Reflection by Jordana Kritzer MD
After the long hours and intense learning curve of my Emergency Medicine residency, I had become one of those efficient robots who could solve medical puzzles and save lives, but I felt empty, disconnected—the classic symptoms of burn-out. I was once a wide-eyed, empathetic intern constantly criticized for trying to solve their patient’s chronic issues. I remember one attending saying, “Figure out the least amount of things you need to do to rule out an emergency.” I see now that he was trying to teach me efficiency.
Read moreWarmth, Body and Longing by Sonya Huber
While writing my essay collection on chronic pain, Pain Woman Takes Your Keys and Other Essays from a Nervous System, I began to explore a relationship with my body that was not constrained to the pain of rheumatoid arthritis. I began to lean into examples provided by such beautiful works as Anatole Broyard’s book Intoxicated By My Illness.
Read more“A Line Blurring Joy and Grief”: Empathizing from a Distance, by Daniel Ginsburg
How do clinicians carry on their vital work without bearing the grief of patients and their families, yet still comfort them?
Read moreAttunement: Reflecting on the Art of Making a Difference by Catherine Klatzker
Empathy and compassion arise from sensitizing events, often many. Sometimes it’s easier than others to track those events to their origins. Patient Jane provided student-doctor Brian Sou with one such activating event. (Field Notes “A Student’s Moment in NYC’s Most Famous Hospital”) In their first encounter, Sou writes “I did not manage to comfort Jane in her moment of vulnerability, when she needed someone to do so the most. I was so interested in the medical aspect of curing that I completely neglected the compassionate side of healing.”
Read moreA Physician's Response in an Emergency: Humility Complements Competence by Rachel Fleishman
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.
Read moreLife and Death in the ER: What's Real and What's Fiction? by Carol EH Scott-Conner MD PhD
Carol Scott-Conner is Professor Emeritus of Surgery at the University of Iowa Carver College of Medicine. Her story "After Midnight" pays homage to the night shift, when everything extraneous seems to fade away and only life and death remain.
Readers of my piece "After Midnight" often ask me, “What happened to the cop?”
I answer, “It’s fiction. There never was any cop.” But the truth is more complex than that.
There were patients very similar to this during my medical school and residency years. From those memories I can say with confidence that although the piece ends with the cop about to arrive, alive, in the Recovery room, he almost certainly would not have survived to leave the hospital. As subsequent decades passed, we became more facile in resuscitation, better attuned to the factors that predict a successful outcome. In that time, at that place, we simply did everything we could to fight for life.
As you may have guessed, the piece is firmly rooted in my own experience as a wide-eyed medical student. Originally destined for a career in the cerebral specialty of cardiology, I became a convert to surgery after a night when the team (at least temporarily) cheated death and everything seemed possible. When the swoosh of the dark wings of death could be heard, and we seemed to be able to beat that old carrion-bird back into the darkness. And the night ended with a trip across the roof to start rounds.
A far more realistic and nuanced view is presented by Anna Belc in “Getting to Know Dying.” She writes of the early recognition of imminent death in those who are in the zone of criticality. She speaks of anticipating death so as to better be able to prevent it – for example, for a patient at risk of bleeding out, start two large-bore IV’s.
She also speaks of the difficulty preparing the survivors, the family. And, implicit in all of this, is the personal toll on the healthcare team. Those who deliberately choose to work in the zone where life and death intersect are, indeed, very special people.
Carol Scott-Conner is Professor Emeritus of Surgery at the University of Iowa Carver College of Medicine. She writes memoir in the form of fiction, exploring the world of women in surgery. Her stories have been published in multiple literary journals ranging from “The Healing Muse” through “North Dakota Quarterly,” and nominated for a Pushcart Prize. A collection of her short stories was published as “A Few Small Moments.” She is past editor-in-chief of “The Examined Life Journal: A Literary Journal of the Carver College of Medicine” and currently serves as its fiction editor. "After Midnight" is homage to the night shift, when everything extraneous seems to fade away and only life and death remain.