How Doctors Respond to 'Difficult' Patients: A Reflection by Kendra Peterson, MD

In Sarah Shirley’s poem ‘Wernicke-Korsakoff’ (Intima, Spring, 2017), she elucidates the dilemma of caring for a patient who is angry, non-compliant, inarticulate, hostile, confused, or otherwise “difficult”. How do we reach across the barriers that such patients present, to find an opening through which we can glean from them the information we need to take care of them, and to establish mutual trust? 

Read More

Calling to Question: A Reflection on Healthcare Providers’ Perceptions of Life and Death by Tharshika Thangarasa

Life and death, as blatantly simple as they may seem from a purely physiological standpoint, are rather complex phenomena. Healthcare practitioners witness life and death a countless number of times. They are taught the intricacies of the human body: how to optimize its function and how to declare it deceased. Yet, nothing can prepare even the masters of this trade to face their own demise.

Read More

It’s a Pisser: Considering two sides of kidney disease by Larry Oakner

I first discovered I had Minimal Change Disease, the mildest form of nephrotic syndrome, when a routine insurance urine examination came back with higher than normal protein.  Up until then, I assumed that foamy urine was a by-product of what I’d eaten or had to drink. In Sarah Safford’s poem, “A Cute Kidney Failure” from The Intima Fall 2016 issue, she asks the same question, “Kidneys, shmidneys, who thinks about them.”  After my initial diagnosis, I did. A lot.

Read More

Messengers of Grief by Katherine Seluja, ARNP

Katherine DiBella Seluja, who won the Southwest Writers Poetry award,  is a poet and a nurse practitioner.  Her poem "Not Every Homemade Thing" appears in the Spring  2017 issue of The Intima.

Katherine DiBella Seluja, who won the Southwest Writers Poetry award,  is a poet and a nurse practitioner.  Her poem "Not Every Homemade Thing" appears in the Spring  2017 issue of The Intima.

A life well lived is often considered to be one that has had its share of joy and sorrow. The extent of the joy we are able to experience is measured only by the depth of pain we have endured. The same could be said of a professional life well practiced. Life full of its measures of joy and grief is the subject of Ashley Chapman’s essay, “With Dignity” (Field Notes, Spring 2016).

Chapman describes how moved she was when observing her physician preceptor’s deep and genuine and human response to the news of a long-time patient’s imminent death. A response that included the seasoned preceptor’s tears.  

 “There is a sacredness in tears. They are not the mark of weakness, but of power. They speak more eloquently than ten thousand tongues. They are the messengers of overwhelming grief, of deep contrition, and of unspeakable love”, wrote Washington Irving.  It is this very loving and true response that the Chapman admires in her preceptor.

A different response to the challenges of life is found in “Not Every Homemade Thing” (Spring 2017). This exploration of fear and grief was inspired by my mother’s valiant life with Parkinson’s disease and the consideration of inherited illness.  It is a type of “ghost” story and was my response to a request to write about something that “haunts” me.  During the process, I found resonance with a quote by C.S.Lewis, “No one ever told me that grief felt so like fear.”

I’m sorry to admit that during my own healthcare training, I was taught to carefully guard my feelings, to remain composed and “professional”.  The thought of hugging a patient was considered too personal, too involved. Now, decades into my career, I have most definitely put that advice aside.

Because it is in those moments of true and human response, that we learn so much about ourselves and those we care for and love. The tears of Ashley Chapman’s preceptor served as a signpost that said: great wisdom and experience walks here. This was not the cool hands-off approach that, sadly, many of us were taught at one time. But a full hearted and deeply involved response of a caring physician. 

Certainly the same can be said of examining our responses to our family illnesses. We must honor these messengers of grief and fear as indicators of a life well lived or a professional life well practiced.


Katherine DiBella Seluja, who won the Southwest Writers Poetry award,  is a poet and a nurse practitioner.  Her work has appeared in American Journal of Nursing, bosque, Connotation Press, Crab Creek Review, Iron Horse Literary Review and Santa Ana River Review, among others. Her first collection of poetry, Gather the Night, is dedicated to her brother and focuses on the impact of mental illness. It is forthcoming from UNM Press in 2018. Katherine works as a pediatric nurse practitioner in Española, NM and as adjunct clinical faculty at the College of Nursing at UNM. She holds degrees in Nursing from Columbia and Yale University. Katherine is currently working on a collaborative poetry project in response to the 2016 presidential election.


© 2017 Intima: A Journal of Narrative Medicine