Letter to a Caretaker: An Acknowledgement by Jutta Braun, RN

Dear Caretaker:

As I read, I felt with you the fear, the pain, the madness. 

The would-be caretakers – police, EMT’s, nurses, doctors – all too human and apathetic. Aren’t we all? I, too, am angry with them – for taking your dignity, and giving nothing in return. 

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Dinner, Revelations and Narrative Medicine: Tales told by Intima Spring 2017 by poet Wendy French

This is a blog about Intima and narrative medicine in general and all that we can read and absorb from this excellent online journal. Every issue grabs my attention for the poetry, articles and the blogs that respond to other people’s work.  

Wendy French is a poet, whose latest collection of poems is "Thinks Itself A Hawk" (Hippocrates, 2016). Her collaboration with Jane Kirwan resulted in the book "Born in the NHS" (Hippocrates, 2013). She won the Hippocrates Poetry and Medicine prize for the NHS section in 2010 and was awarded second prize in 2011. She has worked for the past twenty years in healthcare settings. Her poem "Exchange" appears in the Spring 2017 Intima.

Wendy French is a poet, whose latest collection of poems is "Thinks Itself A Hawk" (Hippocrates, 2016). Her collaboration with Jane Kirwan resulted in the book "Born in the NHS" (Hippocrates, 2013). She won the Hippocrates Poetry and Medicine prize for the NHS section in 2010 and was awarded second prize in 2011. She has worked for the past twenty years in healthcare settings. Her poem "Exchange" appears in the Spring 2017 Intima.

My poem "Exchange" was written after my son came home from working in the Far East. He brought with him a girlfriend who had also been working with him for the British Council. Poom was Thai. We had never met before and they arrived in the evening. She was exhausted from the long flight. I had prepared a meal and over supper, a nurturing and nourishing time and good time to talk with new and old friends. She told me that her father had died and she was still very sad.  We had candles on the table but we lit another one for her father and placed it in an important position near the flowers that seem to symbolize new growth, new seasons. 

Then Poom started to tell us that she had had Stevens-Johnson Syndrome, a syndrome I had never heard of. But as she told us her story another narrative emerged, the emotional need to now pass on the story. This for me is what narrative medicine is all about. It’s telling our stories to a health professional who can understand what is going on for us emotionally, intellectually and physically. Poom felt, at this supper in a country she didn’t know, not long after her father’s death and this dreadful illness, that she needed to talk about it and try and rid the experience from her mind in a strange country. This was her narrative being told right now.  

I was very struck by the wisdom in Vivian Lam’s Crossroad's essay "This Game We Play Called Dying."  Even dying has a narrative for each individual although by the time we are in the clutches of death we may be too ill, too sick, to tell our story to anyone. So it is the people who care for us who have to interpret our story at this stage of our lives. Hence the need, as Vivian Lam says, to be able to know whether or not the dying person wants someone with him/her now or whether she/he’d rather take the final steps alone. Therefore it is the responsibility (and I mean responsibility) of the nearest person to the dying to have found out this part of the narrative while it is possible to do so. This may be the health professional who cares and treats the dying with compassion. Dying is the final and may be the most important part of the narrative.   


Wendy French is a poet, whose latest collection of poems is Thinks Itself A Hawk (Hippocrates, 2016). Her collaboration with Jane Kirwan resulted in the book Born in the NHS (Hippocrates, 2013). She won the Hippocrates Poetry and Medicine prize for the NHS section in 2010 and was awarded second prize in 2011. She has worked for the past twenty years in healthcare settings. She was Poet in Residence at the UCH Macmillan Centre from April 2015-2016 and this year will be working with patients/caregivers on writing memoirs. She is one of six poets invited to Bucharest to work with MA students on translations of their novels into English. She currently is writing poems to celebrate Waterloo Bridge. 

 

Rooms with a viewpoint: The metaphorical power of hospitals and medical complexes in illness narratives By Priscilla Mainardi, RN

Rooms can confine us or give us a special place to inhabit.  Hallways and corridors can lead us where we want to go or lead us astray.  Two works in the Fall 2016 Intima, one fiction and one nonfiction, use these physical spaces to represent the emotional struggles that come with severe or mysterious illness. 

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The Heart in Harmony by poet and medical student Schneider K. Rancy

The mechanical properties of the heart are well understood. Tricuspid valve calcification may lead to stenosis, resulting in myocardial hypertrophy and decreased cardiac output. On the other end of the spectrum, mitral valve prolapse may lead to eventual mitral regurgitation. Eventually, chronic tendinous injury to the chordae tendineae attaching the valve to the papillary muscles may occur, producing a flail leaflet. It is simple: the heart strings produce the music of harmony. 

But what of discord? What of when the harmony fails us?

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History Lessons: What Doctors Learn When Doing Patient Histories by Natasha Massoudi

We learn in medical school to take full social, family and physical histories with a new patient. We use checkboxes to run down the list of points in each history. We are taught to be thorough and document each answer. Often though, between the checkboxes and lists, the patient’s story is forgotten.

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The Importance of Transitions: A Reflection by Ob/Gyn Andrea Eisenberg

Transitions are equally important in the hospital as day shifts to night and night to day and we hand off patients we may have been taking care of the past 12 to 24 hours. Just as children need time to adjust to a transition, so do our patients as they transition to a new day, new staff, and possibly a new baby. 

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Being Useful: The Emotional Transformation of A Caregiver. A Commentary on Family and Coming Together by Bekka DePew

We are often powerless in the face of death or illness to do much besides watch; we are forced to recognize “the uselessness of love to give her breath.” This feeling of helplessness we experience, both as physicians and as caretakers, forces us to reevaluate the way we understand ourselves and the purpose behind the role we play as a family member or a healthcare provider.

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This Game We Play Called “Dying." A Meditation About Being on the Sidelines by Vivian Lam

The game of death is quite addictive. 

Of course, the stakes are high—it’s the end of all things, the last chance, last glance, last words. All-or-nothing; last-ditch effort. A lifetime of apologies, love, and tenderness condensed into a prognosis of months, days, a few gasping breaths.  

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The Person Behind the Pattern: A Reflection about Doctors and Diagnoses by Blake Gregory

There’s something you should know about your doctor’s clinical judgement: It relies on a flawed premise. As doctors, our medical education conditions us to look for patterns. Pattern recognition allows us to triage and identify emergencies. It helps us distinguish pulled muscles from heart attacks. It’s a powerful, if imperfect, tool.

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