Leaning Close: "No more interventions. No more transfusions." A reflection on mortality and morbidity rounds by pediatrician-writer Laura Johnsrude

When I read “All Tuned Up” by Albert Howard Carter III (Spring 2021 Intima), I remembered a pediatric intensive care unit patient from my own 1980’s residency experience. In Carter’s poem, a medical resident presents a case during mortality and morbidity rounds. The resident is moved to tears as he tells the gathered audience about the death of a patient he knew well. A senior doctor “gently” offers context and says, “Maybe he was just tired.”

Mercifully, I’ve muffled memories from some of the deaths during my residency training in the pediatric intensive care unit. But I remember a slight girl of about sixteen with silky, wavy hair, lying in a metal-frame bed parallel to the wall against the window, in silhouette.

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The Healing Power of Empathy: Does it Exist? Can it be Acquired?

In this reflection, a retired surgeon examines the research findings of evidence-based medicine to uncover whether empathy, in addition to the principles and practice of narrative medicine, can facilitate deeper healing.

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"Reading" Patients When Illiteracy is What Afflicts Them: A reflection by medical oncologist Jose Bufill

While returning to the U.S. on an international flight not long ago, I sat next to a young African woman. As we approached our destination, she sheepishly passed me her passport and a customs form. Since I was in the aisle seat, I assumed she wanted me to pass it along to the flight attendant, until I realized the form was blank.  She was asking me to fill it out.

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What Great Literature Taught Me by internal medicine resident Teva Brender

Great books can guide us in every day life, and I found it fitting that Dean Schillinger, MD and I both invoke works of literature to describe the experience of realigning our values with those of our patients. In his essay, “The Quixotic Pursuit of Quality,” (Spring 2015 Intima) Dr. Schillinger compares himself and his patient, Mr. Q, to Quixote and Sancho Panzo from Miguel de Cervantes Saavedra’s Don Quixote. With only misplaced medication lists, no-show appointments, and a stubbornly elevated hemoglobin A1c to show for his repeated efforts to help Mr. Q better manage his many comorbidities, Dr. Schillinger’s frustration melts away when Mr. Q unexpectedly gives him a massage. From then on, “the duel was over.” There would be no more tilting at windmills.

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When Cure and Language are Inadequate, What Remains? Reflecting on bearing witness by Rachel Cicoria

Recalling the loss of her husband, Mike, Dianne Avey’s essay“Morning Light” (Spring 2023 Intima) reaches back a decade to a quiet September morning on Anderson Island in Washington. Avey, a writer and nurse practitioner, draws us, however, not to the moment of her husband’s death but to a “place of quiet morning light.” This liminal stasis exceeds cure and speech and, in my view, renders the “human” (as defined by technical and linguistic competencies) indeterminate. Yet, beyond our abilities to fix and to say, there remains “the only thing we can ever do”: being present and bearing witness.

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On Work-Worn Hands and Gestures of Love, a short essay by poet and educator, Joan Baranow

A writer and poet honors the memory of her mother by finding the parallels between her own work and the story of another mother and daughter.

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Scripting Death: When Words Fail – In Conversation with Liana Meffert’s “Death is Usually an Easy Diagnosis” by Paula Holmes-Rodman

“A medically assisted death, such as I recount in my essay “Mercies, Or, the Mostly True Tale of a Narratively Assisted Death” (Intima Spring 2023), is the antithesis of a traumatic ending in an ER. It is highly anticipated, fully orchestrated and well rehearsed – on everyone’s part but my own.”

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On Sinatra, Bach, and Daughters: The Power of True Joy in the Face of Illness

A medical student reflects on the loss of their father to a devastating neurodegenerative disease as well as the power that music can hold during the illness experience.

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The Importance of Providing Compassionate Palliative and End-of-Life Care

A writer reflects on her own mother’s experience with death and dying and argues for the greater recognition of palliative care in the clinical encounter.

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Scripting Death: When Words Fail – In Conversation with Liana Meffert’s “Death is Usually an Easy Diagnosis” by Paula Holmes-Rodman

In reading Liana Meffert’s “Death is Usually an Easy Diagnosis,” I was intrigued by her reflections on the learning and limitation of choreographed roles and scripted dialogue in pronouncing death and informing bereaved families.

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Objectivity versus Art: A Reflection on Technology in Medicine

A physician-novelist ponders the troubling implications of the increasing technologization of health care and its encroachment on the art of medicine.

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