We Invite You to Read Our Stories
FALL 2018 INTIMA: A JOURNAL OF NARRATIVE MEDICINE
In the recent 2018 Jefferson Lecture entitled “To See the Suffering: The Humanities Have What Medicine Needs,” Dr. Rita Charon spoke of the importance of narrative in the clinical encounter. “Narrative skills of attention and representation equip us to accompany the patient, to ally with the patient, to be on the patient's side,” said Dr. Charon. “Instead of solving one problem and then moving on, it lets us be invested in the whole of the patient's predicament, even after the death. We refuse to abandon the patient. Remember John Donne's words in Devotions upon Emergent Occasions: “As Sicknesse is the greatest misery, so the greatest misery of sicknesse is solitude.”
The narratives in our Fall 2018 issue, be it a poem, a photograph, a short story, an academic paper, field notes or creative non-fiction, all make that connection, uniting us in the healthcare and illness experience, so that we, as patients and as clinicians and healers, are not alone. The work of this issue’s contributors is stellar in the ways each narrative connects us with the stories of illness and of healers, of those who are care-taking and those receiving the care, of those living and those dying. We derive meaning and hold experience from these stories. When reading through the hundreds of submissions sent in, our editors found this sense of connection in each of the contributions we selected—and invite you read—in this issue.
Poems in particular deliver that heightened sense of place and point of view that quickens the blood and allows us to focus in on what is important in any given story. In the poem “Captain’s Song,” for example, nephrologist Marta Cristov channels the thoughts of an 81-year-old woman with a weakening heart as she envisions a moment in time when “Out in the harbor’s the best place to be/right where the land is far enough/and seagulls glide along scooping,/unsuspecting fish. I’d rather be there/than in this emergency room.” But later in the poem the woman recognizes that she is not alone, and she sees an ally in her experience:
My stroke of luck: young lady doctor
to keep me company
‘til the crash, when the sea
comes to swallow me whole
Being in the moment is a recurring theme and preoccupation for those involved in care. A stirring example of it comes in “Entering the Sick Room” by nurse practitioner Cortney Davis, whose book Taking Care of Time was just published by Michigan State University Press. At the beginning of the poem, she offers advice for being present in the compromised setting of a hospital suite:
Smiles but do not feign happiness.
Enter with a measured step,
remembering that you carry news
of another world.
The quiet focus of this poem and its compassionate voice fortify the spirit.
Fiction, too, brings us into other worlds—the world of families, of sickness and health, of happiness and tragedy. “Untidy Lipstick,” a short story by Irena Tan, a third-year medical resident at Duke University Hospital, unfolds in the past and present of two sisters, one who develops a rare movement disorder, in which the brain fails to stop the arms or the legs from moving. In a few short pages, we experience the weariness and wonder of the experience, the incessantly flapping arms and seemingly uncontrollable feelings in dealing with this chaotic disease, as seen through the eyes of both of the siblings. We are reminded that any human experience is not black or white, sad or happy, filled with hope or hopelessness—a life experience, especially when it involves the mysteries surrounding illness or healing, is complex and multifaceted.
Our Field Notes essays often reflect the ways in which doctors and nurses see the special world they work and live in. “Scrap of a Story” is by Collin Mulcahy, who is completing his training in otolaryngology at George Washington University. In it, Mulcahy speaks about confronting his own sense of invincibility while treating a young hit-and-run victim in the trauma bay:
He was not the first person I had seen die, or at least seen pronounced dead. He came in in such terrible shape that although we did the best we could to save him, it was just too late. We had nothing to offer this man except routine post-mortem physical exam and a table to lie on instead of the asphalt. Sure, I felt sad, I felt a little angry at the driver (who never stopped we were later told), but I wasn’t connected. I was simply there, doing my job, checking the boxes, lackadaisically lamenting another lost soul.
But that all changed. The charting nurse had pulled his wallet from his trauma-sheared pants in order to try and identify him. He had recently turned 30. He worked as a bartender at a local restaurant not far from the hospital and had probably just finished closing up the place. He was an organ donor. He lived nearby. In his other pocket, the tech found his cell phone. She too was trying to glean more information about him, presumably to find someone to contact. She repeatedly tried to use his thumbprint to open up his iPhone, but it wasn’t working. There was too much dried blood on his hands. Then, she and I both took a closer look at the screen. On it was an unopened text message from a friend that was sent not 15 minutes before. It read “Okay great, I will see you soon!”
This remembered moment has a lasting effect on the young doctor, as the essay continues. We hope you’ll take the time to read it to understand the lasting impact it will have on you.
Equally powerful is “PICU” by Jessica Cheng, a pediatric resident at the University of California Davis in Sacramento, California, who writes movingly about treating the young:
These are the patients that I grapple with, the ones where I see the past, present, and future all jumbled up together. The ones where I wonder “what if...?” but also “HOW?” The ones where I realize that it is the deltas — the yawning gaps and incremental millimeters between baseline and the new normal that define joy and sorrow. The ones where you hope for a miracle because medicine cannot give you an answer.
As editors, we don’t pretend to hold the answers to solve the mysteries of the body or today’s problematic and polemical debates on healthcare. We’re simply happy to put forth these excellent stories that ask questions and often answer them in eloquent, meaningful and powerful ways.
Please let us know which ones move you by sharing them with your friends, family and work associates. And thank you for continuing to support our journal with your enthusiasm and brilliance.—Donna Bulseco for the Editors of Intima: A Journal of Narrative Medicine