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.
Read moreThe Thing About ‘Good News’ at the Doctor’s Office by neuropsychology postdoc fellow Sarajane Rodgers
In theory, whenever we go to the doctor, most of us want to hear “good news.” The test is negative. You don’t have ___. Your results are inconsistent with ___. There are times where we take that in and walk away with an emotional weight removed. Other times, we are left with a void. The diagnosis we thought we could hang a hat on is taken away. Now where do we put our hat?
Read moreScripting 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.”
Read moreThe Luxury of Walking Away: An MS4 meditates on time, isolation and the comforts of home
A medical student contemplates her roles as a physician-in-training and learns to appreciate the privilege she possesses—unlike her patients—in walking away from the clinical space.
Read moreExploring End-of-Life themes in "Nay Nay's Rebirth," a short story by Sara Lynne Wright
A retired surgeon reflects on a short story published in this journal—and in doing so, also contemplates how a comfortable and humane death can be fulfilled at the end of life.
Read moreBedside 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.
Read moreRooms 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.
Read moreConnecting 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.
Read moreLauds: 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.
Read moreA 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.
Read moreThe Shit Poems: A Reflection by Drea Burbank
I am interested in the juxtaposition between my use of poetry to shed traumatic experiences and memories from medicine, and the description of William Carlos Williams by Britta Gustavson (“Re-embodying Medicine: William Carlos Williams and the Ethics of Attention,” Spring 2020 Intima).
Read moreShakespeare, Stanzas and How We Think About Death by Albert Howard Carter, III, PhD
When my sonnet “All Tuned Up” appeared (Spring 2021 Intima), I was asked to write about another piece published in the journal. I chose “I Picture You Here, But You’re There” (Spring 2020 Intima) by Delilah Leibowitz. Her poem and mine both explore how we think and feel about death.
Read moreHow a Doctor Learns to Act: A Reflection by Claire Unis, MD
“Am I becoming / something unfamiliar?” asks Lauren Fields in her poem “My First Mask Was a White Coat” and in that simple question she brings back for me the struggle of becoming. With our first medical school clerkships we don white coats and mimic our preceptors: some false confidence here, a prayer for invisibility there. Silent reassurances never spoken aloud: It’s okay to pretend at doctoring. That’s how you learn.
Read moreDoctoring and Disobedience: Speaking an Important Truth, a reflection by Kelly Elterman
Sometimes, the truth can be uncomfortable. It can be difficult to hear and often, even more difficult to say. In her Field Notes piece entitled “Doctoring and Disobedience” (Spring 2020 Intima) Dr. Lisa Jacobs recalls her struggle with being told to hide the truth of a prognosis from an elderly patient with metastatic disease. Despite the instruction of her attending physician, and the decision of the patient’s family and ethics team to not speak of death to the patient, Dr. Jacobs feels compelled to let her cognitively-intact patient learn the truth. So strong is her conviction that she takes on considerable risk to her own career for the sake of bringing the truth to her patient.
Read more