Great books can guide us in every day life, and I found it fitting that Dean Schillinger, MD and I both invoke works of literature to describe the experience of realigning our values with those of our patients. In his essay, “The Quixotic Pursuit of Quality,” (Spring 2015 Intima) Dr. Schillinger compares himself and his patient, Mr. Q, to Quixote and Sancho Panzo from Miguel de Cervantes Saavedra’s Don Quixote. With only misplaced medication lists, no-show appointments, and a stubbornly elevated hemoglobin A1c to show for his repeated efforts to help Mr. Q better manage his many comorbidities, Dr. Schillinger’s frustration melts away when Mr. Q unexpectedly gives him a massage. From then on, “the duel was over.” There would be no more tilting at windmills.
Read moreThe Thing About ‘Good News’ at the Doctor’s Office by neuropsychology postdoc fellow Sarajane Rodgers
In theory, whenever we go to the doctor, most of us want to hear “good news.” The test is negative. You don’t have ___. Your results are inconsistent with ___. There are times where we take that in and walk away with an emotional weight removed. Other times, we are left with a void. The diagnosis we thought we could hang a hat on is taken away. Now where do we put our hat?
Read moreOn Subtraction: Understanding What's Lost and Gained in Clinical Encounters by Abby Wheeler
I recognized right away a kinship with Bessie Liu’s “Variations on the Negative Space Before Healing” (Fall 2023) and its use of subtraction to create new meaning; The poem by Liu, a third-year medical student at Johns Hopkins School of Medicine. very much feels like a sister to my poem, At the Doctor’s Office, I Check, Yes, I Have Experienced the Following: Sudden Weight Loss (Fall 2023).
Read moreWhat Clown Doctors See and Don't See: A Look at Healthy Humor by Phyllis Capello
Phyllis Capello, who is a writer and musician, is a NYFA fellow in fiction I and a winner of an Allen Ginsberg Poetry Award. Her collection “Packs Small Plays Big” is from Bordighera Press, 2018. Cantastoria work (sing/storyteller) has taken her from Ireland-to-Istanbul. She has presented at the International Oral History Conference in Rome, Italy and has been a musician/clown since 1990 with Healthy Humor Red Nose Docs, as well as a member of the poetry/activist trio, The Ferlinghetti Girls. ferlinghettigirls.com In 2023 she was honored with People’s Hall of Fame Award for teaching artistry for her work in New York City schools. Her poem “The Ballad of a Harlem Boy” appears in the Fall 2023 Intima: A Journal of Narrative Medicine.
For thirty years, my hospital work (I’m a clown ‘doctor’/musician for Healthy Humor) has included meeting and entertaining families in clinic waiting rooms, Pediatric ICUs, triaged Emergency Departments and in out-patient, in-patient rooms. Clown-doctor encounters can, if invited, also extend to physical therapy and treatment rooms, hallways, nurses’ stations and elevators. In ED and in out-patient and in-patient rooms permission comes from the medical and childlife staff first (and pertains to situational or isolation status). After that, the child’s permission (being our ultimate “boss”) to enter is strictly respected. In a hospital environment, we are one thing a child can prevent from entering their room.
Knowing when to present ourselves and when to exit means we are not often present for the trauma of Emergency Medical procedures unless specifically requested by staff. I do not see the immediate medical aftermath of a bullet wound. The hands of professionals as they seek to save a life as in Kirilee West’s drawing of hands entitled: “6:21 P.M.” That is why the piece really speaks to me of the drama and humanity inherent in the moments before a medical clown can be of any use to a patient.
Her drawing resonates with me as my poem, “The Ballad of a Harlem Boy,” was written after a nurse shared her distress about a child’s death. Telling us (we work in pairs) of her direct experience, I could only think of her hands and their expert ministrations during that terrible time and of the depth of her humanity for the mortally-wounded fourteen-year-old and his mother.
We all want our hands to be of use: I, in my small way, making music or writing poems; medical staff whose hands take on the most difficult and tender of roles; the artist’s hands who can capture with a charcoal stick the enormity of what we might see if, after the fact, we can allow our creativity to take a step back and tell a story.
Phyllis Capello, who is a writer and musician, is a NYFA fellow in fiction I and a winner of an Allen Ginsberg Poetry Award. Her collection “Packs Small Plays Big” is from Bordighera Press, 2018. Cantastoria work (sing/storyteller) has taken her from Ireland-to-Istanbul. She has presented at the International Oral History Conference in Rome, Italy and has been a musician/clown since 1990 with Healthy Humor Red Nose Docs, as well as a member of the poetry/activist trio, The Ferlinghetti Girls. In 2023 she was honored with People’s Hall of Fame Award for teaching artistry for her work in New York City schools. Her poem “The Ballad of a Harlem Boy” appeared in the Fall 2023 Intima: A Journal of Narrative Medicine.
When Cure and Language are Inadequate, What Remains? Reflecting on bearing witness by Rachel Cicoria
Recalling the loss of her husband, Mike, Dianne Avey’s essay“Morning Light” (Spring 2023 Intima) reaches back a decade to a quiet September morning on Anderson Island in Washington. Avey, a writer and nurse practitioner, draws us, however, not to the moment of her husband’s death but to a “place of quiet morning light.” This liminal stasis exceeds cure and speech and, in my view, renders the “human” (as defined by technical and linguistic competencies) indeterminate. Yet, beyond our abilities to fix and to say, there remains “the only thing we can ever do”: being present and bearing witness.
Read moreOn "Feeling Blue" and Self Care: A reflection by neonatologist-poet Elizabeth Osmond
© Feeling Blue Amanda Hage Spring 2022 Intima
It is a challenging time to practice medicine. We are emerging from a global pandemic that is casting a long shadow. This has mingled with austerity for public service funding and a cost-of-living crisis. Members of many healthcare professions have been on strike.
Read moreCrossing the Line: The Power of Touch by Catherine Humikowski
A pediatric intensive care physician advocates for crossing the imaginary line and using the power of touch to comfort those in need.
Read moreThe Individual Nature of Care by Joanne Clarkson
A nurse examines a clinical encounter through her poetry and appreciates the individual nature of care.
Read moreScripting Death: When Words Fail – In Conversation with Liana Meffert’s “Death is Usually an Easy Diagnosis” by Paula Holmes-Rodman
“A medically assisted death, such as I recount in my essay “Mercies, Or, the Mostly True Tale of a Narratively Assisted Death” (Intima Spring 2023), is the antithesis of a traumatic ending in an ER. It is highly anticipated, fully orchestrated and well rehearsed – on everyone’s part but my own.”
Read moreThe Third Ear: Listening for Intergenerational Trauma
A psychiatrist uses her skills of close listening within the clinical encounter to uncover the enduring effects of intergenerational trauma.
Read moreOn Being Confined
A retired hematologist explores the importance of clinical communication and health literacy by close reading two pieces published in this journal.
Read moreThe Importance of Providing Compassionate Palliative and End-of-Life Care
A writer reflects on her own mother’s experience with death and dying and argues for the greater recognition of palliative care in the clinical encounter.
Read moreLeave Work at Work
Which story is heard, and by whom? Which story do people want to hear, and why? A COVID nurse provides explanations as well as recommendations about storytelling.
Read moreThe Embodied Connection in Patient-Provider Interaction
A former PICU nurse examines the power of both embodiment and gaze in the clinical encounter.
Read moreScripting Death: When Words Fail – In Conversation with Liana Meffert’s “Death is Usually an Easy Diagnosis” by Paula Holmes-Rodman
In reading Liana Meffert’s “Death is Usually an Easy Diagnosis,” I was intrigued by her reflections on the learning and limitation of choreographed roles and scripted dialogue in pronouncing death and informing bereaved families.
Read moreReligious Moments in Medical Practice by internist John Pierce
A retired physician reflects on his glimpses into religion and spirituality while confronting his patients’ illness and suffering—as well as his own.
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 moreAbsences in Cortney Davis' "It Was the Second Patient of the Day"
A writer and father ponders the power of absence in the clinical encounter, as well as the power of presence.
Read moreLet Me Speak My Free Mind into You: Seeking Genuine Connection in Medical Practice
A medical student examines two poems published in this journal in order to advocate for genuine connection in medical practice between patients and physicians.
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 more