Can what we know about PTSD in frontline workers who treated the victims of the Boston Marathon bombings help us understand how to care for our COVID-19 frontline workers? What will be done to understand and treat race-based traumatic stress, a term I hadn’t heard until this summer?
Read moreThe Practice of Prolonging Death, a reflection by palliative care physician Chris Schifeling
“Would we rather die too soon or too late?”
The taboo of talking about death combined with a faith in the insomnia of medical technology leads many to err far on the side of dying too late.
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 moreGlobal Citizenship: The Complex Emotions of ‘Going Home’ to a Place You’ve Never Been by Violet Kieu
Going to Vietnam was a formative time of my life–and also a reminder I am not entirely of that place. I am distance, and culture and language apart. Doing a medical elective in Saigon was a paradox: both familiar and foreign.
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 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.
‘Differential Diagnosis’ Can Be A Lifesaver, a Reflection by Colleen Corcoran
© Differential Diagnosis by Yan Emily Yuan Spring 2020 Intima A Journal of Narrative Medicine
Accurate differential diagnosis can save a life. By being able to determine clearly how one outlying factor or the combination of a group of signs and symptoms tips the scale to the correct pattern confirmation and treatment, our lives can be shaped, saved and lost in this qualifying lens of time. It’s integral to the practice of medicine, but also in many ways to how we make decisions in life. A positive or negative result, a clustering of symptoms, the ticked boxes and specimen samples that can reveal so much as to how we define our experiences of life and are able to move forward.
Read moreIn This Time of Corona: Many Stories, Many Lives, a reflection by surgeon Daly Walker
Sapana Adhkari’s “Covid’s Agony,” an evocative and gruesome depiction of the sagittal section of a human head screaming in agony, represents, in a single image, the anguish seen in the corona-captured characters of my short story, “Resuscitation.”
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 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 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.
Losing Touch: How COVID-19 Has Interfered With the Way We Bond by Adam Lalley, MD
The intimacy of touch is deeply rooted in vulnerability, and COVID-19 is reminding us that this vulnerability is biological as well as emotional. For Dr. Vlasic, touch was an act of trust, but nowadays trust seems best measured by how far apart we stand and how carefully we obscure the lower half of our faces.
Read moreCounterweight: 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 moreSeeing is Believing: Reflecting on Miracles by Andrew Taylor-Troutman
A reflection on “My Grandpa” by Meghan Wang (Poetry / Spring, 2013)
I see his body, but I do not see him
So begins Meghan Wang’s poem and her words cut to the core of the grief I have known in watching an aged loved one. I have lost people before their actual deaths. I know that sight is a metaphor for understanding. That is the double-meaning of the poem’s line:
It’s hard to see him like this
A 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.
Read moreThe Caregiver’s Invisibility Cloak: A Reflection on Albert Howard Carter’s story “The Cookie Intervention” by Rossana Di Renzo
Rossana Di Renzo, author of the academic paper, "Embraced By Words" (Fall 2019 Intima) with Marilena Vimercati, lives and works in Bologna, Italy. Her interest has always been narrative and applied narrative medicine which she uses in different fields: in training courses for health professionals, in the degree course in Nursing at the University of Bologna and in research.
“Oh, there’s the PT’s car pulling up. Is it 11:00 already? Must be; Laura’s always on time. Actually I would love to go upstairs and have an hour of peace, but I do like her. She’s always so upbeat and just full of energy. Besides, she always sees progress in my husband Tom, seeing him just once a week. I see him 15 hours every day, and his recovery from the stroke is so slow that sometimes I see no progress at all. None. I’m so worn down, I just feel numb.”
This narrative from the story “The Cookie Intervention” by Albert Howard Carter brings to our minds the many women we interviewed for our paper “Embraced by Words” (Fall 2019 Intima). They told us how they looked after and cared for their husbands, sisters, brothers, children, and parents.
When dealing with the theme of disability, as in Carter’s story, people need to reassemble stories of care that mainly take place within the family, because it is often that both the place of private life and the place of care overlap.
Usually there is one person who devotes oneself to a sick person and that person is the caregiver.
Our research shows that in 50 percent of cases care work is carried out by women, who continue to define themselves not as caregivers but as wives, mothers, and partners. They consider their duty of care natural; their lives are designed only in function of the sick person.
The women we met told of their loneliness and fragility and the thousands of obstacles they have to face in everyday life without knowing how long that routine will last.
A wife said “I’m feeling so alone. I have too much to think about. I do everything. I have a huge weight on my shoulders, everything falls on me.”
When the wishes of the caregivers cannot be fulfilled, as we read in Carter’s story (“I want my husband back”), what will help them to accept disability and their work of care and to ask for help?
Positive and powerful energies are needed in addition to personal resources. It is important to be listened to and give voice to the pain in body and in soul. The support throughout the care process, the family and social networks, the community, the closeness and authentic solidarity of others, ensure that there is a process of rewriting, of evolutionary readjustment that allows them to tolerate, manage suffering and allow themselves to be open to hope.
Rossana Di Renzo, author of the academic paper, "Embraced By Words" (Fall 2019 Intima) with Marilena Vimercati, lives and works in Bologna, Italy. Her interest has always been narrative and applied narrative medicine which she uses in different fields: in training courses for health professionals, in the degree course in Nursing at the University of Bologna and in research.