The void, the empty feeling of loss; this is perhaps what connects Ceren Ege’s Dictum Wisdom (Intima, Fall 2021) and Pomegranate Protocol (Intima, Fall 2021) above and beyond their chronological relationship.
Read moreWays of Knowing (and Not Knowing) When the Prognosis is Terminal by writer PK Kennedy
"Right in here, remove your clothes. Underwear and bra can stay on but put the robe on so it's open in the back, not the front, okay?"
The words are coming at me in a torrent; I can’t understand any of them, but I know the drill.
I throw my stuff in a bag, take a deep breath, and open the door to the inpatient surgical waiting room. It smells like alcohol and ice and has no memories I can sense. Am I the first person that’s ever come here?
“You’re here for the lumbar?”
I cut her off before she could say puncture. "Yes."
Read moreBedside Mannerisms: Finding the time to care by pediatrics resident Vidya Viswanathan
In medical training, there is an increasing didactic focus on empathy and professionalism. In many of these sessions, I have learned certain skills: Sit down at the patient’s level. Ask them open-ended questions. Don’t interrupt. Use an in-person, video or phone interpreter. These skills are helpful. But often, they run up against the great limiting factor in many of our clinical encounters: time.
Read moreOn Vulnerability and Transformation, a reflection on open hearts and medical training by hematologist-oncologist Jennifer Lycette
“Retrospection Series” (Fall 2019 Intima), Joseph Burns writes on undergoing open-heart surgery at age twenty-three, only two months before In he started medical school. At first, he is reluctant to share his story with his peers. “It was a secret that was contained within the walls of the physical exam simulation rooms.” But as his training moves forward, he is motivated by his experiences “to become the best physician possible…to be the one who provides care, love, compassion, and primarily hope in situations where all may seem lost.”
Read morePlaying Favorites: When Caregivers Recognize a Wider Capacity to Love by Flo Gelo
“The Favorite” (Spring 2021 Intima) by clinician Amy Tubay is a story about having one. It’s a story about the defiant heart—how certain patients enter our affections in ways that are largely mysterious. That love—a love that overrides rules and regulations—isn't something we pay enough attention to in the health professions.
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 moreSirens and Hummingbirds: How Poetry Can Make Sense out of the Mundane by MS4 Anna Dovre
As a medical student, I've gotten into the habit of saving folded-up scrap paper from the hospital and stealing moments during rounds or lectures to jot down scattered words and phrases. They're things I can't get out of my head, like "white cheddar Cheez-its® and stale cigarettes" or "I'm not a bad Mom." Snippets that don't make sense on their own, but together they have a strange sort of alchemy. The distilled essence of a day's humanity. A tragicomic piece of found poetry. After my first year of clinical rotations, I decided to sit down and see what I could cobble together to find out whether meaning would come if I made space for it. What arrived was, if not meaningful, at least interesting, and it eventually became "Self Portrait of the Artist as Medical Student."
Read moreBeyond Acronyms: Contemplating what 'OLD CARTS' really stands for by Tulsi Patel
“OLD CARTS” is an acronym we’re taught in medical school to guide us on questions to ask to elicit a history of the patient’s illness: Onset, Location, Duration, Characteristics, Aggravating or Alleviating factors, Radiation (of pain), Treatment, and Significance. Although OLD CARTS is a helpful checklist initially, over time it begins to feel perfunctory, done to check off a requirement on the rubric. We ask many questions, and I am keenly aware I’m asking because I want something from the patient—I want telltale signs, any clues on the diagnosis, any information that the care team can act upon and use— I feel greedy.
Read moreOut of Time? A reflection about illness and its toll on our past, present and future by Sophia Wilson
In her observant poem “Brain as Timepiece (Administering the Clock-Drawing Test to My Patient With Dementia)” (Intima, Fall 2018), Jennifer Wolkin describes the disordered clockface drawn by a patient with dementia: each number stands outside its perimeter like lost digits. The patient’s subsequent drawing of an ‘X’ over the wayward numbers suggests an erasure, not only of cognitive function, but of time itself. Time’s toll equates to a ‘crossing out’ of past, present and future as the ‘disease devours …organ tissue’.
Read moreRooms and Wombs and Writing: A Reflection on Stories Highlighting Life’s Impermanence by Patrick Connolly
I’ve come back to Hemingway’s “Hills Like White Elephants” so many times. He uses third person objective point of view to create a chill in a scene that could otherwise be exuberant and exotic. A train station, central Spain, a hot afternoon, people talking about their lives together, an unspoken baby on the way – and that is a problem.
Read moreConnecting with the World of Our Patients: A Reflection by Savita Rani
In her poem “Internet Dating for Centenarians” (Intima, Fall 2021), Sarah Smith paints an animated picture of her cheeky and cheerful elderly patient. Smith, a board-certified family physician and author of The Doctor Will Be Late, describes her dilemma about which topic to discuss with her patient—lipids or love.
Read moreInside Voices: Learning When to Listen, When to Control by writer Marleen Pasch
In my short story “Rocks and River,” ( Fall 2021 Intima) a young woman named Tran Huong Giang stands on the MacMillan University Bridge and looks into the ravine below. She knows—as does writer Meredith O’Brien in her essay “Another Game Day”(Fall 2021 Intima)—what it’s like to hear two voices.
Read moreLauds: A solitary prayer at the scrub sink by pediatric surgeon Kristen A. Zeller
In the hospital, routines carry us through our days and lend a semblance of structure to the chaos of lives disrupted by illness. Some routines happen on a large scale—weekly gatherings of departments for Grand Rounds, hospital leadership meetings for safety huddles, the hustle of getting a cadre of operating rooms started nearly simultaneously in the predawn. Other routines are more intimate—the sequenced process of doing a sterile central line dressing change, the donning and doffing of PPE outside a patient’s room, the one-one-one nursing handoff at shift change.
Read moreWhen Medical Professionals Care for Their Own: A Response to “Of Prematurity and Parental Leave,” by Mason Vierra
“Of Prematurity and Parental Leave” (Intima, Fall 2021) describes the harrowing experience of giving birth to a premature baby during residency. It’s written by doctors married to each other —Dr. Campagnaro and Dr. Woodside—who co-construct a narrative by telling it from their own perspective.
Read moreStill We Dream: How We Face the Unpredictable World by Mary Anne Moisan
Humans can create a world through perception, imagine a potential life, whether it be the life of a relationship or the life of a baby. We fill in the unknown details to make a whole that is pleasing and good. It’s as if we willfully ignore that so much of life is unpredictable.
Read moreA Simple Ritual: Reflecting on the Moments Before Surgery by poet and orthopedic surgeon Photine Liakos
Surgeons are well-known for precision and protocols. There is often a ritual nature to our actions when preparing for surgical interventions, an orderliness and discipline: checklists, time-outs, pauses, consensus.
Read moreThe Shit Poems: A Reflection by Drea Burbank
I am interested in the juxtaposition between my use of poetry to shed traumatic experiences and memories from medicine, and the description of William Carlos Williams by Britta Gustavson (“Re-embodying Medicine: William Carlos Williams and the Ethics of Attention,” Spring 2020 Intima).
Read moreThe Limits of Love: A Reflection by Carmela McIntire about Anorexia, Overeating and Fulfillment
Disordered eating occupies a spectrum—anorexia nervosa at one end, morbid obesity at the other. Attempting rigid control of the body and its appetites, anorexics are unable to see themselves and their bodies accurately. Compulsive overeaters—often obese—similarly might not see themselves accurately. In both disorders, controlling food is the aim, a genuine addiction, a strategy through which addicts deal with the world and their own circumstances—a necessary coping skill, even though it is risky to health in both cases.
Read moreMothers and Daughters: A Reflection on Cancer, Caring and Seeing the Whole Picture by poet Kathryn Paul
—After ‘Macroscopic” by Adela Wu (Spring 2021 Intima)
My mother and I were not close. I knew she wanted us to be, but I couldn’t do it her way. For most of my adult life, I kept my distance, emotionally and physically. We lived on opposite sides of the continent. In her 80’s, the creeping dementia my mother never discussed was overtaken by a cruel and much more terrifying diagnosis: Stage IV ovarian cancer.
Aided by her cancer-free twin sister, Mom endured multiple surgeries and two lengthy and debilitating rounds of chemo. Each time, her cancer came roaring back within weeks. Her surgeon suggested an experimental Round Three. Mercifully, her oncologist suggested hospice at home instead.
During the first year of Mom’s illness, I was trapped by my own cancer treatment, unable to participate in her care. I called daily, spoke with her, spoke with my aunt, asked about her pain, her “tummy trouble,” her ascites, and her white count. I took notes and dictated the questions to ask at her next appointment.
As soon as my doctors cleared me to visit her, I did. I was always on the verge of moving in with her, but never quite needed to do so. I flew back and forth. The more debilitated she became—by her cancer and her dementia—the more often I visited.
Adela Wu’s Studio Art piece “Macroscopic” simply and eloquently captures the changes in how I experienced my mother during those last months and weeks. The simplest things gave her joy: A small dish of ice cream. A pain-free nap on the down-stuffed cushions of her couch. Cuddles with her cats. A bird visiting the feeder outside her window.
Even as her disease spread through her body, even as she faded, my mom seemed to crystallize. She became, ultimately, the Essence of herself. And—just at the end—I finally saw her.
Kathryn Paul
Photo by Andrew Givhan
Kathryn Paul (Kathy) is a survivor of many things, including cancer and downsizing. Her poems have appeared in Rogue Agent, Hospital Drive, The Ekphrastic Review, Lunch Ticket, Stirring: A Literary Collection, Pictures of Poets and Poets Unite! The LiTFUSE @10 Anthology. Her poem “Dementia Waltz” appears in the Spring 2021 Intima.
Shakespeare, Stanzas and How We Think About Death by Albert Howard Carter, III, PhD
When my sonnet “All Tuned Up” appeared (Spring 2021 Intima), I was asked to write about another piece published in the journal. I chose “I Picture You Here, But You’re There” (Spring 2020 Intima) by Delilah Leibowitz. Her poem and mine both explore how we think and feel about death.
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