Ways of Knowing (and Not Knowing) When the Prognosis is Terminal by writer PK Kennedy

"Right in here, remove your clothes. Underwear and bra can stay on but put the robe on so it's open in the back, not the front, okay?"

The words are coming at me in a torrent; I can’t understand any of them, but I know the drill.

I throw my stuff in a bag, take a deep breath, and open the door to the inpatient surgical waiting room. It smells like alcohol and ice and has no memories I can sense. Am I the first person that’s ever come here?

“You’re here for the lumbar?”

I cut her off before she could say puncture. "Yes."

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Written in the Stars: A Reflection on Youth Cancer by Will Moody

For every young adult diagnosed with cancer, a time comes when we ask ourselves a question.

Why?

Why did this happen to me? Why now? They are not questions we want an answer to, but as humans, we crave finding meaning in our lives. We do it because the alternative is accepting that cosmic randomness determines our very breath.

Why did this happen to me? Why now? They are not questions we want an answer to, but as humans, we crave finding meaning in our lives. We do it because the alternative is accepting that cosmic randomness determines our very breath.

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Bedside Mannerisms: Finding the time to care by pediatrics resident Vidya Viswanathan

In medical training, there is an increasing didactic focus on empathy and professionalism. In many of these sessions, I have learned certain skills: Sit down at the patient’s level. Ask them open-ended questions. Don’t interrupt. Use an in-person, video or phone interpreter. These skills are helpful. But often, they run up against the great limiting factor in many of our clinical encounters: time.

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On Vulnerability and Transformation, a reflection on open hearts and medical training by hematologist-oncologist Jennifer Lycette

“Retrospection Series” (Fall 2019 Intima), Joseph Burns writes on undergoing open-heart surgery at age twenty-three, only two months before In he started medical school. At first, he is reluctant to share his story with his peers. “It was a secret that was contained within the walls of the physical exam simulation rooms.” But as his training moves forward, he is motivated by his experiences “to become the best physician possible…to be the one who provides care, love, compassion, and primarily hope in situations where all may seem lost.”

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Playing Favorites: When Caregivers Recognize a Wider Capacity to Love by Flo Gelo

“The Favorite” (Spring 2021 Intima) by clinician Amy Tubay is a story about having one. It’s a story about the defiant heart—how certain patients enter our affections in ways that are largely mysterious. That love—a love that overrides rules and regulations—isn't something we pay enough attention to in the health professions.

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Costumes: What a Plague Doctor Wears to Deliver Care by family physician Carla Barkman →

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.

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Sirens 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."

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Beyond 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.

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Getting 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.

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Out 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’.

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Rooms 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.

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Connecting 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.

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Inside 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.

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Facelessness 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.

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Lauds: 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.

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When 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.

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Still 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.

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A 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.

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When 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.

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