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 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 moreShakespeare, 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.
Read moreHow a Doctor Learns to Act: A Reflection by Claire Unis, MD
“Am I becoming / something unfamiliar?” asks Lauren Fields in her poem “My First Mask Was a White Coat” and in that simple question she brings back for me the struggle of becoming. With our first medical school clerkships we don white coats and mimic our preceptors: some false confidence here, a prayer for invisibility there. Silent reassurances never spoken aloud: It’s okay to pretend at doctoring. That’s how you learn.
Read moreAuscultating Meaning: Reflections on the Heart of Medicine by Marc Perlman
© Gordian Knot by Elisabeth Preston-Hsu Spring 2020 Intima A Journal of Narrative Medicine
From diaphragm to earpiece, a stethoscope dutifully chaperones a patient’s internal orchestra to a clinician’s ears. This facile acoustic communication not only allows a provider to screen for a wide host of cardiovascular, pulmonary and gastrointestinal anomalies, but it also may be a conduit for moral reflection.
Read moreDoctoring and Disobedience: Speaking an Important Truth, a reflection by Kelly Elterman
Sometimes, the truth can be uncomfortable. It can be difficult to hear and often, even more difficult to say. In her Field Notes piece entitled “Doctoring and Disobedience” (Spring 2020 Intima) Dr. Lisa Jacobs recalls her struggle with being told to hide the truth of a prognosis from an elderly patient with metastatic disease. Despite the instruction of her attending physician, and the decision of the patient’s family and ethics team to not speak of death to the patient, Dr. Jacobs feels compelled to let her cognitively-intact patient learn the truth. So strong is her conviction that she takes on considerable risk to her own career for the sake of bringing the truth to her patient.
Read moreAnatomy Lesson: See the Face of Those Before You by Rodolfo Villarreal-Calderon, MD
For those with the privilege of having participated in a longitudinal cadaver dissection, the connection you build with the donor’s body is known to be a truly unique experience. That bond is part of what I attempted to capture in my poem “Through Damp Muslin.” Especially reflecting on how to express gratitude to the person who once was—and now who is, or at least whose body is—lying before you.
What Does ‘Paying Attention’ Mean in a Healthcare Setting? A Reflection by Ewan Bowlby
Ewan Bowlby is a doctoral student at the Institute for Theology, Imagination and the Arts (ITIA) in St Andrews. He is researching ways of using mass-media artworks to design new arts-based interventions providing emotional, psychological and spiritual care for cancer patients. Bowlby’s paper “Talk to me like I was a person you loved”: Including Patients’ Perspectives in Cinemeducation” appears in the Spring 2021 Intima: A Journal of Narrative Medicine.
Narrative Medicine is about creating connections: finding words, ideas or stories that bridge the gap between patients and health professionals. This search for common ground is beautifully rendered in Carol Scott-Conner’s short story “Christmas Rose” (Spring 2017 Intima). Her fictional narrative reveals how mutual understanding can emerge in unexpected places. An encounter between the resolute, inscrutable Mrs. Helversen and her oncologist shows that the relationship between a physician and patient can flourish when the physician pays attention to the intimate, personal details of a patient’s story.
Initially, the clinical encounter in “Christmas Rose” seems unpromising, hampered by reticence and disagreement. Mrs. Helversen, who has a neglected tumor on her breast, has been “strong-armed” into a cancer clinic by her concerned daughter, and she is not receptive to the prospect of treatment. Scott-Conner, a Professor Emeritus of Surgery at the University of Iowa Carver College of Medicine, switches the first-person narrative from Mrs. Helversen to her oncologist, allowing the reader to inhabit two alternative perspectives on the same meeting and reminding us that the same interaction can be interpreted very differently.
When I wrote an academic article that appears in the Spring 2021 Intima proposing that patients’ perspectives should be included in “cinemeducation,” these differences in interpretation were central to my argument. Showing clips from films to encourage medical students to relate to a fictional patient is an excellent idea. Yet listening to how patients respond to these clips can enrich this pedagogical method. As I demonstrate through the qualitative research presented in my article, patients “see things differently.” The same fictional scene featuring a patient-doctor interaction can draw responses from patients that surprise and challenge healthcare professionals. So, why not use such scenes as a space in which different perspectives can be expressed and discussed, bringing patients and providers together through the audio-visual medium?
In “Christmas Rose,” it is a rock that facilitates this meeting of minds. While the oncologist is surprised when Mrs. Helversen describes her tumor as a “rose,” betraying a complex emotional attachment to the growth, she finds a way to react empathetically and imaginatively to Mrs. Helversen’s unusual behavior. Offering the elderly patient a desert rose rock in exchange for her tumorous “rose,” the oncologist persuades Mrs. Helversen to accept treatment. This fictional oncologist shows an adaptability and ingenuity that the health professionals involved in my research also exhibited. In my article, I describe how health professionals engaged constructively with patient’s unique or unexpected responses to imagined patient-doctor interactions in films. Listening to both sides and hearing alternative perspectives on the same encounter can yield important, enlightening insights, whether one is participating in a focus group, watching film clips or doing a close reading of a short story such as “Christmas Rose.”
Ewan Bowlby is a doctoral student at the Institute for Theology, Imagination and the Arts (ITIA) in St Andrews. He is researching ways of using mass-media artworks to design new arts-based interventions providing emotional, psychological and spiritual care for cancer patients. This involves using fictional narratives, characters, and imagery to reflect and reframe patients' experiences of living with cancer, helping them to understand and articulate the effect of cancer on their lives. He is developing the impact of his research through an ongoing collaboration with Maggie Jencks Cancer Care Trust (Maggie's) and Northumberland Cancer Support Group (NCSG). Other interests include theological engagement with popular culture, the relationship between theology and humor and the use of narrative form for theological expression. Bowlby’s paper “Talk to me like I was a person you loved”: Including Patients’ Perspectives in Cinemeducation” appears in the Spring 2021 Intima: A Journal of Narrative Medicine.
Finding 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 moreSpeaking Truth: The Visual Arts Help Clinical Diagnosis by Virali Shah
As a society, we are driven by visuals. Advertisements. Social media. Logos. Paintings. Pictures. It is a 21st century skill to be “visually literate.” Only recently, however, the role of visual literacy has expanded into modern medical training.
Read moreFinding What's Essential in Just Laundry: Painting and Poetry in Dialogue By Alexis Rehrmann
In both the painting and the poem, these particulars are gone but the objects remain and hold an impression of that past life. There’s honor in caring for these objects, in both our daily work and our creative lives.
Read moreMy COVID Hero: How Art Helped Me Reflect on a Global Pandemic by Dr. Brandon Mogrovejo
One late evening, just two months into my intern year in Pediatrics and seven months into a forever changed New York City, I sat down and drew. I drew from a place of anxiety, working the equivalent of two full-time jobs in a hospital during a time when the people I care for, my loved ones and my patients, were under great strain.
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 more"Chronic Black Excellence," a reflection on the power of poetry to reflect structural racism by Elizabeth Walmsley
The poem compelled us to face the magnitude of ways in which our systems have been designed by white people for white people. It especially highlights the workings of a system that rewards Black people for separating themselves from their own communities; the classic effect of forced assimilation. The poem illustrated to us that structural racism demands so much of Black people—not only to work ten times harder than their white counterparts in order to be seen, but also to separate themselves to gain a moderate level of success and recognition. And yet, as our group considered, was the hard won success all it purported to be?
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 moreEmbracing the Emotional and the Empathic in Healthcare by Logan Shannon
Logan M. Shannon has a BFA in Studio Art with a minor in English from the University of Iowa and an MFA in Jewelry + Metalsmithing from Rhode Island School of Design. Her essay, “The Gold Standard,” appears in the Fall 2019 Intima: A Journal of Narrative Medicine.
I’ve often wondered if having a medical degree would have better prepared me for my husband’s illness and eventual liver transplant. Would I have felt more qualified to care for him and advocate for him if I had studied hepatology instead of metalsmithing? Would my preparation for my own living donor surgery have been different if I had more than a rudimentary knowledge of what the liver does and how patients who undergo major abdominal surgery respond to traditional pain medications?
Orly Farber writes about her experience as a medical student and the daughter of a patient in “Watch and Wait” from the Spring 2019 issue of Intima. In it she describes a bifurcation, as her body travels to medical school, and her mind focuses on a different hospital, the tests her father will receive there, and the treatments he will undergo. The study of his disease becomes an extracurricular for her, long nights of studying coursework are bracketed by studying her father’s illness, but her fear and sadness about his illness and suffering don’t abate. I see in her experience similarities to my own experience, and my essay (“The Gold Standard,” Fall 2019 Intima) despite having never studied medicine: a desire to understand what a loved one is going through, to be able to answer their questions, to be able to take away at least some of the fear and pain.
I longed for a practical and high level understanding of medical terminology, tests, and what the results of those tests may indicate before and after my husband’s transplant and my own liver resection surgery. I think it would have helped me feel not quite as lost and confused as I waited to see what would happen. But there is also a universal helplessness that comes with watching someone you love be subjected to those tests and be on the receiving end of a litany of jargony language that more often manages to obfuscate rather than enlighten or soothe. Even if you are fluent in medical terminology, even if you’ve ordered the same test for a patient before, watching someone you love be at its mercy will always be a challenge.
The complexity of the health care machine and the diseases we humans endure can feel debilitating, and while specific knowledge can do much to ease the burden, we are all still doing good work when we embrace our emotional and empathic selves while caring for others.
Logan M. Shannon has a BFA in Studio Art with a minor in English from the University of Iowa and an MFA in Jewelry + Metalsmithing from Rhode Island School of Design. She is currently writing a memoir about her experience as a living liver donor and is generally trying to convince everyone she meets that the liver is, by far, the best organ. Logan lives in New Hampshire with her husband, and their prolific sourdough starter, Seymour. Her essay, “The Gold Standard,” appears in the Fall 2019 Intima.
A Reflection on Philip Berry’s “Semantics in the Elevator” and the Word “Sorry” by V Karri
Karri explores the multiple meaning of the word “sorry” in her daily practice.
Read moreThe Balance of Blame, When Something Goes Wrong, a reflection on "Physician as Enabler" by Philip Berry
In my article ‘Semantics in the Elevator’ a doctor reflects on his culpability after a colonoscopic perforation (not based on a real incident). The patient’s anatomy is fleetingly blamed; then he considers the fact that he just happened to be in the wrong place at the right time – the perforation could well have happened if a colleague had been doing the procedure.
Read moreShould You Limit Your Emotional Connections with Your Patients? Two differing views, by Andrea Eisenberg
Eisenberg looks at the role of emotion in patient care.
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