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 moreGetting it Right, Even When it Feels Wrong: A Reflection by poet Ceren Ege
In his video “Inside Anxiety and Depression,” William Doan’s words “writing is drawing” were a reminder of my existence as a poet and artist, and how the latter is an identity I felt uncomfortable with for a long time. I squirmed at the creation of “art” out of another’s suffering, even though my father’s illness felt like the only thing worth writing about. Now I sit with a different question: whether anyone’s suffering is entirely separate. I think owning suffering defeats the very aim of why we move it to articulation—to release it, to divide the burden of it, and to comprehend it with others.
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 moreFacelessness and the Glass Between Us: Finding Connection In the Era of Covid by Hannah Dischinger, MD
COVID has gotten in the way of so much, literally. It floods lungs with heavy fluid, making it impossible to do meaningful gas exchange. It has become unfathomably, sickly politicized, another ideological wedge between two sides of an already divided country. The currencies of medicine—vulnerability, respect, trust, among others—have become that much harder to exchange. As I read Dr. Uhrig’s beautiful “Facelessness,” I felt some of these barriers lessen in knowing I’m in good company as I think about these new dynamics.
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 moreWhen the “Clock of the Living” Runs Down: A Reflection by clinical social worker and chaplain Betty Morningstar
The fractured stories at the end of life often reflect an ineffable but powerful experience of creativity, insight or even revelation. These opportunities arise because the dying person doesn’t see time according to the clock of the living. Imagine how much one could conceive of were time not of the essence.
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 moreWhat I Learned about the ICU: A Reflection by Benjamin Rattray
In her essay “The Shape of the Shore” (Spring 2020 Intima), Rana Awdish takes us into the intensive care unit during the ravages of a pandemic. She shows us “…the desperate thrashing patients on the other side of the glass” and “…the sticky blood on the floor.” As I read the words, my breath becomes shallow as fear and grief pummel into me. Somewhere deep, beneath the shrouds of consciousness, the words resonate, and I feel as though I am slipping beneath an indigo sea.
Read moreEmpty Highways by Cole W. Williams
Last spring, I drove down empty highways, once frantic with traffic creating a decibel assault, turned strangely serene. Red-tailed hawks perched on light posts felt eerie without the usual commotion. I couldn’t help myself from imagining me gone too, all of us, and the hawk perched despite everything on this empty highway. “Little Isolated Bird” by Brent Carr, recalls the lonely feeling of my drive. The shadow image of a lone bird speaks to a palpable theme; isolation turned loneliness of our innermost desperation during the pandemic.
We have found ourselves in pockets of silence, instances of loneliness with no resolution and often sleep disturbances too. “Overnight Aubade” is a poem of isolated sleeplessness—as depicted in “Insomnia Dreams in the Moonlight” by K. Johnson Bowles—to me the heart is bandaged in the collage and razor blades float all around us in our dreams. However, the poem is also about the craving for connection; how we survive for it.
Most professions don’t require interfacing with daily tragedies and loss. My husband does not work in one of those fields. As an ICU physician, he often works while I sleep and as I lie awake wondering about the state of the pandemic, he is interfacing directly with it. The following mornings I will (maybe) hear stories of the struggle for life and the innate human tendency to resist loneliness.
In “We Almost Lost You” by Varsha Kukafka we read how a mother at ninety-seven still recounts the near-loss of a then infant child to whooping cough and in “Paper Armor” by Cara Haberman, a simple sentiment “—Yes, I promise I will be with you” are the words spoken to a frightened patient. We find ourselves passenger to a drive home in “Homing Signals” by Sophia Wilson. The narrator “can’t sleep at night” and leaves the “city’s pandemically fractured centre” to enter a feeling of pervasive darkness; then light emerges. This light isn’t a natural or supernatural light, but a human-engineered light guiding her home.
Currently, I volunteer in a covid-19 vaccination clinic where without fail an elder’s eyes will warm when I wave them over, they will say something like “I haven’t been waved to in a year” or “Me? It’s not often people talk to me.” In all the darkness and sleepless nights, we are still humans capable of inventing light, capable of preventing empty highways.
Cole W. Williams is the author of Hear the River Dammed: Poems from the Edge of the Mississippi (Beaver’s Pond Press, 2017) as well as several books for children. Her poems have appeared in Martin Lake Journal, Indolent Books online, Waxing & Waning, Harpy Hybrid Review, WINK and other journals and anthologies. Williams is a student in the MFA program at Augsburg University in Minneapolis. Find out more about her work at colewwilliams.com
Mothers 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.
Does the Patient Know the Prognosis is Terminal? A reflection by Julie Freedman
‘Does he know?’
The prognosis is terminal. No treatment will change that fact. His doctors know, but the patient, he seemingly does not.
In Phillip Berry’s essay, “Black Tango,” the narrator wonders if his patient knows his cancer will soon kill him (Please go read it, it’s beautiful, before I spoil it). He worries the patient is living “on fumes” of hope and resents the doctors who previously, falsely, pronounced him cured. He dreads telling him the truth. Finally, he sits down to talk with the patient and his wife. They already knew. In a sudden reversal, it is the patient who was protecting the doctor: “He saw me dancing with words, he read my evasions, and he waited. Waited until I was ready.”