Our parents are often our first examples of superheroes. They make gourmet meals from minimum wage, give hugs that vanquish our demons, and provide limitless love. They are impervious to damage or decay and are always ready to save our days. So, seeing the human in them, the mortality in their breath is unsettling. When they come to need us, we feel so grossly unprepared.
Read moreCaring for Our Caregivers: A short reflection by poet and hematology-oncology nurse Nina Solis
Caregivers deserve patience, gratitude and comfort just as much as those they support. As healthcare providers, we all could use a reminder to advocate for these irreplaceable members of a patient’s team.
Read moreLady Psychiatrist Queen: Compassion in Caregiving, a reflection by Eileen Vorbach Collins
Lisa Jacobs, in her nonfiction piece, March Manic (Intima Spring 2019) describes a long shift on a psychiatric unit. She is “beyond exhausted” to the point of having questioned her own grasp on reality.
As a case manager in a Baltimore City hospital, I once spent hours attempting to find placement for a homeless 19-year-old addicted to heroin who needed long term IV antibiotics. When I asked if I might call her mother she replied “I don’t give a fuck” but retracted her permission as I was leaving the room. I pretended not to hear. The next day I was told she had signed out AMA (Against Medical Advice). a colleague said, “Get over it. She was a waste of time and resources.”
Read moreGiving: What Real Generosity Looks Like in Healthcare by pediatrician Lane Robson
Giving defines us as individuals. Patients and healthcare professionals are obliged to share time together. Gifts of shared humanity transcend personal and professional obligations. These gifts might be hoped for but are neither expected nor routine.
Warmth, 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 moreFinding Hope Outside of the Hospital by internal medicine resident Vanessa Vandoren. “Something More Beautiful than the Lives We Were Living.”
Even before the pandemic, the grueling hours of residency left little time for a life outside of it. Once residency starts, your work responsibilities expand astronomically, leaving little room for other aspects of a normal human life: relationships, interests, time alone, time to take care of basic needs.
Read moreHow to Hold Cold Hands by Laura-Anne White
I have spent my career as a nurse working with adult cancer patients. I, too, have experience with the self-protective tool of ‘numbing.’ Last spring, the COVID-19 pandemic hit New York City at full force, and I was temporarily transferred to an inpatient, COVID-19-positive cancer unit. I saw no one aside from co-workers, patients, and other essential workers.
Read moreWho Draws First? A reflection about racial stereotyping by Dr. Ibrahim Sablaban
So, who draws first? Figuratively speaking. In America, someone’s going to draw. Someone’s going to attack and define you by some arbitrary standard. And that someone could be anyone.
Read moreCaught between Floating and Drowning, a reflection about poetry, memory and adapting to chaos by Mikayla Brockmeyer
A state of flux. The COVID-19 pandemic has induced a state of “How will I react to _____?” Listlessness and emotional exhaustion bring about feelings of isolation and longing to be somewhere we are not. Yet, in learning to modify behaviors, collaborations have emerged.
In the opening couplet to Sheila Kelly’s poem entitled “Breathe” (Fall 2017 Intima). she sets the stage and introduces a poignant metaphor, depicting calmness, yet incertitude.
You are floating in the swimming pool again.
Your childhood best friend rises like prayer.
“Breathe” was penned well before the current pandemic, yet the feelings of serenity and safety one day, and panic the next, expressed are relevant today. Using a second-person narrative, she paints a vivid picture of a disjointed home life, sifting through old, painful memories. In the poem, the main character is catapulting between chaos and “floating in the swimming pool.” At the end, I interpret a sense of adaptation from the character that leaves a residue of hope.
In my essay “Turbulent Undertow” (Fall 2020 Intima), parallel feelings are grappled with, as I describe a surfing attempt, and later, my experience as a hospitalist scribe. Woven together, I write about two near-drowning experiences: on surfing and on caring for patients with COVID-19. The best friend in Sheila Kelly’s poem encourages the main character to put on her old swimsuit when distressed. After a long series of days working with the hospitalist, I, too, wanted to offer solace. But instead, all I could offer was “Glad you’re okay,” a phrase that has reverberated through my brain ever since I first heard it myself.
Riding metaphorical surfboards together and finding ways to float in metaphorical swimming pools may not be the best solution to curb the emotional toll of the pandemic. However, validation and shared human connection serve as two ways to avoid possible drowning amidst the pandemic waves.
Mikayla Brockmeyer
Mikayla Brockmeyer is a first year osteopathic medical student at Des Moines University in Des Moines, Iowa. She began working as a hospitalist scribe in 2018, while she was enrolled in the Master of Science in Biomedical Sciences program at Des Moines University. She successfully defended her thesis in 2019 and spent her gap year scribing full time. This is her first time showcasing her storytelling abilities in a public arena. Her non-fiction essay “Turbulent Undertow” appears in the Fall 2020 Intima.
Finding Our Way Home: A Reflection on New Year's Day 2021 by Priscilla Mainardi
In these troubled times of sickness and loss, of protest and division, it’s uplifting to read about positive actions, such as those I took for a dying friend, which I describe in my piece “To Melinda” (Fall 2020 Intima). Two other works in the Fall 2020 Intima also describe small positive acts that make a difference in people’s lives. Reading them eases our sense of helplessness by offering us hope.
Read moreAlways Tell The Truth, Except When It’s Maladaptive by Douglas Krohn
In the most neurotic days of the pandemic, I return home from my contaminated workplace, and sincerely offer my wife solace . . . in the form of a big fat lie. On another day, I confide in her the loss of a colleague . . . and wound her with the facts.
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 moreFire, Cake and Stone: A Wayfarer’s Guide to Remembering by Deborah Burghardt
Though different cultures and different pastries, the narrator and I both bake in our memories. We share the human desire to displace grief and make our sweetest moments last.
On “When Suicide Speaks Arabic”: A Deeply-felt Call for Cultural Representation in Medicine by Sunidhi Ramesh
A suicide attempt. A Syrian teenager. A team of American psychiatrists whose training suggests he is out of the woods. But, to Dr. Ibrahim Sablaban, something does not sit right. The son of Arab refugees, Dr. Sablaban sees hidden red flags in the teenager’s story.
“When Suicide Speaks Arabic” (Fall 2020 Intima: A Journal of Narrative Medicine) is a story of quiet compassion. It is a story of intuition born from upbringing—of a physician who sees a slice of himself in a patient who is in need of understanding.
It is also, at its core, a story about cultural representation. Dr. Sablaban instantly connects with his young patient by speaking in Arabic (citing that he had “already heard [the] story in English, and from [his] experience, it could be a distant language”). He is able to parse out the boy’s feelings of shame and sinfulness by referring to his own understanding of the Islamic faith. This was not at all the patient he had heard of earlier during rounds; this “was a tragedy waiting to happen.”
Dr. Sablaban’s story of connecting with and ultimately facilitating better treatment for this young Syrian boy can be viewed as a stroke of luck—a happy encounter and a happy ending. But he ends his piece with a striking sentence: “I can’t help but feel like it was more a story about failure than success.”
And it could be made out to be that way. Many knowledgeable and experienced physicians spoke to the patient before Dr. Sablaban did. Yet, it was his cultural knowledge, not his medical knowledge, that ultimately helped this boy.
Some sobering statistics: 0.4% of US medical doctors are Hispanic, while Hispanic individuals make up 17% of the American population.1 4% of US medical doctors are African American, while African American individuals make up 13% of the American population.1 Similar statistics hold for the majority of minority groups throughout the country. This lack of racial representation in medicine is widely cited, and efforts (albeit small ones) are underway to address it.2
Dr. Sablaban’s story, however, is about more than racial representation. Race is not equivalent to a language. Or a culture. Or religion. Race is not at all encompassing, and racial representation would not have been enough to fully address this teenager’s needs. Perhaps, then, there must be an adjustment to the discussion about diversity in medicine—about the need for physicians who “look” (i.e., race and gender) more like the population they are serving.
Perhaps the need is for physicians who simply are more like the populations they serve—who speak the languages, practice the religions, and have had the experiences that their patients face every day.
References
1. Sullivan, Louis W. Missing persons: minorities in the health professions, a report of the Sullivan Commission on Diversity in the Healthcare Workforce. 2004.
2. Cohen, Jordan J., Barbara A. Gabriel, and Charles Terrell. "The case for diversity in the health care workforce." Health affairs 21.5 (2002): 90-102.
Sunidhi Ramesh is an MD Candidate at Sidney Kimmel Medical College at Thomas Jefferson University. She graduated Phi Beta Kappa from Emory University in 2018 with degrees in sociology and neuroscience and is the managing editor of "The Neuroethics Blog." She has also served as the education co-director for the Philadelphia Human Rights Clinic. Ramesh’s writing has been featured in Stroke and Vascular Neurology, Retina Today, and the American Journal of Neuroradiology. She authored the Winning Essay in the 2019 International Neuroethics Society Essay Competition and has written chapters on neuroethics and neurotechnology in various textbooks. Ramesh works on research spanning neurology and neurosurgery, particularly focused on perceptions of invasive brain surgery, intra-arterial chemotherapy, and the implementation of tele-stroke protocols in hospital emergency rooms. Her non-fiction essay “3:43 AM” appears in the Fall 2020 Intima. @sunidhiramesh
Counterweight: On Veteran’s Day 2020, a reflection about carrying the weight of the past by Michael Lund
A response to Karen Lea Germain’s essay titled “Weight” in the Spring 2020 Intima. I begin with the weight of my parents’ cremains (analogues to those of Germain’s aunt and uncle), physical realities blending with the heaviness of regret. I will end, hopefully, with the lightness of relief (in which the pun of light includes illumination). At the center of my response to her fine essay is the weight of a military veteran’s sorrow.
Read moreThe Body Politic: Fashioning our own earthly justice in a challenging time by Adam Lalley
In the short story “Good As New” by Andrew Taylor-Troutman in the Spring 2020 Intima, the site of a teenager’s accidental death becomes a healing destination. At the little white cross beneath an oak tree, cancer is cured and the wounded throw off their wheelchairs. But when a line of pilgrims stretches into the next county, the miracle dries up.
Some, but not all, are restored. The inequity mirrors the disparities of our very own bodies— our health, even the lengths of our lives, are doled out unequally. There’s no earthly justice in our bodies.
Read moreBeing a Patient: Coping with the Loss of Control and Privacy in a Hospital by Rebecca Grossman-Kahn
Patients often feel unexpectedly confined in the hospital.
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 moreOn the Sacrosanctity of the Body Chambers by Michal Coret
A medical student balances the duties of respect and learning in the anatomy lab.
Read moreDiscerning Different Shades of Grief by Jeffrey Millstein, MD
In my essay, “Remembrance,” I discovered my own grief for a recently deceased long-time patient while continuing to care for her widowed husband. John Jacobson’s piece “Now and Then” (Fall 2018 Intima) brought me deep into the chasm of a different type of grief, from loss of someone who was, and to a more attuned place from where to offer empathy.
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