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 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 moreRemembering Fathers: Raspberry Picking, the Silence of Roses, and Taking a Breath: A reflection on two poems by Mark Hammerschick
Memory serves as an anchor in our lives, those brief, isolated moments of awe create a sense of warmth, safety, comfort.
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 moreWithin the Outside yet Outside the Within: The Way Art Creates a Liminal Space by Brent Carr
© Man versus Nature versus Man by Ohirenua Giwa-amu. Spring 2020 Intima
Where are these phenomenological crossroads of physician and patient, practitioner of health and the healthy, destroyer of illness and the elusively undefinable concept of disease itself? How can we find such a way of communicating with one another when the path is so clouded by our own perception of self within the world? When we are so seemingly Within the Outside of it, yet Outside of the Within? If the existentialists sure fretted over the taut chords of isolation and apartness in the world, the pandemic has plucked those same chords causing them to vibrate even faster.
Read moreOn “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 moreOn Bodies and Minds: A Reflection on Raina Greifer’s Artwork 'Bodies' by Diane Forman
Raina Greifer’s artwork “Bodies” (Spring 2018 Intima) compels viewers to confront their own preconceptions and biases about body form. Her three headless, faceless bodies, of various sizes and depths, present a seemingly endless network of intertwined organs and bones, of breastplates and intestines and veins. Greifer urges the viewer to consider vulnerability, in the context of these drawings.
©Bodies by Raina Greifer. Spring 2018 Intima
Of course the body is much more than a composite of bones and organs, but a human cannot survive without the exquisite interplay of these parts. Greifer’s drawing asks me to consider not only the body’s intricate internal structure, but the external form shown to the world. Although the drawings are deliberately missing heads, the artist highlights the theme of vulnerability, which can only be contemplated through the integral component of the mind. Our minds magnify our vulnerability; our thoughts determine how we visualize ourselves, how we feel in our own skin.
After a lifetime of my own struggle with body dysmorphia, I was forced to confront both the mind and body’s strength and fragility when dealing with my daughter’s restrictive eating disorder, explored in my piece “Holding my Breath” (Spring 2020 Intima). Helplessly, I witnessed the ways in which the body fails without sufficient nutrition; how the body is reduced to conserving energy for the heart, brain, muscles, digestion. The body truly becomes a vessel of organs and bones all vying to survive.
But the starved mind is trying to survive too. Recovery is dependent on replenishing not only the organs with required energy, but the mind with recognition of the body's miracle and potential, whatever its size. I value Raina Greifer’s artwork, which encourages me to consider the vulnerability of the mind, and its intimate connection with the complexity of the body.
Diane Forman is a writer and educator. After a long career as writing tutor and educational consultant, Forman is currently working on a series of essays and a memoir. Additionally, she leads adult writing groups and retreats on the north shore of Boston. She holds a BS in English and Education from Northwestern University, and an Ed.M. from the Harvard Graduate School of Education and is an AWA affiliate, trained and certified to lead workshops in the AWA (Amherst Artists and Writers) method. Her non-fiction essay “Holding My Breath” appeared in the Spring 2020 Intima: A Journal of Narrative Medicine.
Poetry and Music: How Each Word in a Poem Reflects an Emotion by Anna Delamerced
Life is full of joy and sorrow. The melodies of life involve not only high moments, but low ones, too. My grandmother has lived through more than ninety decades. In those years she has endured war, found love, mourned the loss of relatives, suffered illness, survived a train crash, and discovered new happiness in grandchildren.
Each day carries a crossroads of pain and hope, suffering and healing. In my poem Evening Music, I sought to portray these crossroads. Words like “pillow”and “wooden bench” were written in the same line to juxtapose the softness and harshness of life. “Paper fan” and “electric fan” are used to show the fragility and strength in my grandmother. I wrote the final line, “She plays the piano even in the dark” to show that even if my grandmother has suffered much, she still sees light in the dark and makes something beautiful.
Ellen Sazzman’s poem Assisted Living Lullaby (Fall 2016 Intima) resonated with me and echoed similar sentiments. The words “lullaby” and “assisted living” brought together images of youth and old age in my mind. Life seems cyclical, as we sing lullabies to both infants and seniors. Music compels us to meditate on life, stirring memories of a wide breadth of emotions, from sad memories to happy ones.
Working in the medical world has reiterated the juxtaposition of the sorrows and joys of life. Each day in the hospital sees both life and death. How do we navigate all this? Do the sorrows make the joys all the sweeter? I do not have all the answers, but perhaps it is in poetry where I can wrestle with these thoughts and experiences. Writing allows us to wade in the gray, to make music in the dark.
Anna Delamerced is a medical student at the Warren Alpert Medical School of Brown University. She received funding through the Bray Medical Humanities Fellowship to pursue a year-long project, focusing on poetry for kids in the hospital. Her works have been published in KevinMD, Medscape, Abaton, Plexus, Murmur, Cornerstone and in-Training. She is passionate about listening to people tell their stories. Her poem “Evening Music” appears in the Spring 2020 Intima.
Thoughts on “Doctors and Disobedience” by Nina Gaby, APRN-PMH, CNS
Lisa Jacobs’ story, Doctoring and Disobedience, was gratifyingly evocative, reminding me of promises I had made to myself as a nursing student and then a psychiatric nurse practitioner. Trying to satisfy both one’s own ethics while following the wishes of the family or the legal rights of a guardian makes for often difficult treatment decisions.
Read moreFear in the face of Uncertainty: A Reflection about Patients and Medical Emergencies by Katrina Kostro
Whatever the diagnosis or prognosis, being a patient often includes elements of fear.
Read moreHidden Trauma: A Reflection on Artist Inés Ixierda’s “Fasciotomy” by Karen Germain
In my non-fiction story “Weight,” I explore the complicated relationship that I had with my aunt, as I was her caretaker in the final years of her life. My aunt suffered from a shocking injury when her left femur bone snapped as she was getting her morning newspaper.
Read moreOur Mission to Give Voice: A Physician-Poet’s Reflection on Speech and Human Connection by Katrina Kostro
Speech is a crucial element in human connection. Even more so these days, during the COVID-19 pandemic, when physical touch has become largely forbidden. One can imagine, then, the tremendous loss associated with aphasia – the loss of ability to understand or express speech.
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
Holding Vigil: The privilege of putting death off for another day by Elizabeth Lanphier
Stella’s speaker is running from patient to patient, hoping to catch some sleep in the call room; for my speaker it is only the mind that is running, keeping her awake.
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