Honoring the Messengers of Grief: Thinking deeply about what haunts us by poet and nurse practitioner Katherine Seluja, ARNP

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.

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A Reflection on Hands—in Art, in Medicine by Pamela Hart

Pamela Hart is writer in residence at the Katonah Museum of Art where she teaches and manages the Museum’s Thinking Through the Arts program. Her poem " Dorothy's Hands"  is in the Spring 2018  Intima: A Journal of Narrative Medicine

Pamela Hart is writer in residence at the Katonah Museum of Art where she teaches and manages the Museum’s Thinking Through the Arts program. Her poem "Dorothy's Hands" is in the Spring 2018 Intima: A Journal of Narrative Medicine

Field Notes on Hands: A Reflection by the writer of the poem "Dorothy's Hands" on Meagan Wu’s artwork titled "The Surgical Stage" in the Fall 2017 Intima

Hands are among the most expressive parts of the body, connected as they are with gestures of tenderness and violence. They caress and slap. They hold instruments, surgical or musical. They cradle weapons. Hands signal affection, distrust, anger.

They are conduits for ideas traveling from brain to language. They articulate the gap between thought and word. Before speech, hands gave shape to hunger and fear. They warn of danger. Handprints on cave walls are signatures or ancient algorithms linking past to future.

Hands mend wounds. Translucent hands hover like birds over an unseen patient, light radiating from the center of the image, while all the hands weave back and forth stitching skin to skin.

Heart line, head line, relationship line. Hands can be read like poems. Decipher the line on a palm to understand your life. What about memory lines. I think of my father’s hands struggling to attach dry fly to tippet. I remember stroking my mother’s veiny hands in the hospital as she died. My hands have cupped fireflies and embraced cigarettes. They plunged into the Sound on summer nights, pushing into dark water as plankton streamed tendrils of light through my fingers.

Hands give and take. I am here, say the hands. Look and listen.


Pamela Hart is writer in residence at the Katonah Museum of Art where she teaches and manages the Museum’s Thinking Through the Arts program. Rowan Ricardo Phillips selected her book, Mothers Over Nangarhar, for the 2017 Kathryn A. Morton Prize; it will be published in 2019 by Sarabande Books. She was awarded a National Endowment for the Arts poetry fellowship. She received the Brian Turner Literary Arts prize and her poems have been published in the Southern Humanities Review, Bellevue Literary Review and elsewhere. Toadlily Press published her chapbook, The End of the Body. She is poetry editor for the Afghan Women’s Writing Project and for As You Were: The Military Review. Her poem "Dorothy's Hands" is in the Spring 2018 Intima: A Journal of Narrative Medicine

What Color is Your Stethoscope? A Reflection on How Art and Colors Affect Us as Caregivers by Alice Wang

Alice Wang is a third-year undergraduate student at Stanford University studying Materials Science & Engineering. She is interested in the importance of interpersonal narratives in both art and medicine, and seeks to better understand the healing potential of narrative medicine. Her artwork " Beyond Blue " appears in the Spring 2018 Intima.

Alice Wang is a third-year undergraduate student at Stanford University studying Materials Science & Engineering. She is interested in the importance of interpersonal narratives in both art and medicine, and seeks to better understand the healing potential of narrative medicine. Her artwork "Beyond Blue" appears in the Spring 2018 Intima.

In her Field Notes essay “The Lady in Pink” (Spring 2013 Intima), Anne-Laure Talbot writes of a formative patient encounter she had as a medical student. She meets a delightful elderly woman dressed in a bright pink sweater, who carries with her a known diagnosis of dementia.

Talbot’s preconceptions of dementia are challenged by this woman’s personable and pleasant demeanor, by her affectionate and smiling engagement. The writer ends with a moving statement on how this encounter impacted her understanding of illness as a caregiver and empathetic individual.

This reflective essay has inspired me to think more deeply about the various facets of the illness experience, from the patient’s clinical presentation to the clinician’s worldview and biases.

Color blends the boundaries between art and medicine, serving as a fundamental element of both practices. The juxtaposition of the patient’s pink sweater with Talbot’s white coat in “The Lady in Pink” creates a vivid image that captures the dynamic of the characters and the relationship between the two. My studio art piece “Beyond Blue” (Spring 2018 Intima) similarly reflects on the ways color shapes health narratives, though we may not consciously recognize them. Inspired by Joan Didion’s memoir Blue Nights and a patient I met in clinic, this drawing seeks to tell a story through the emotional, individual, and cultural meaning embodied in color and aesthetic. I attribute my sensitivity to color to my training as an artist, just one way medical humanities have helped me become a careful and connected observer of others.

"Beyond Blue" by Alice Wang. Spring 2018 Intima: A Journal of Narrative Medicine

"Beyond Blue" by Alice Wang. Spring 2018 Intima: A Journal of Narrative Medicine

Whether manifested in clothing and medical garb or used in the process of diagnosis, color is another avenue through which illness narratives can be conveyed and understood. By reflecting on the stories that surround us, especially those we have the privilege of shaping, we as clinicians may begin to see the humanism that lies in the details, in the colors and sentiments not conveyed through a textbook diagnosis.

 

 


Alice Wang is a third-year undergraduate student at Stanford University studying Materials Science & Engineering. She is interested in the importance of interpersonal narratives in both art and medicine, and seeks to better understand the healing potential of narrative medicine. Alice enjoys portrait drawing and her artwork has been exhibited in student exhibitions at the Museum of Contemporary Art San Diego and the San Diego Museum of Art. She is involved in biomaterials research for regenerative medicine at Stanford and will be applying to medical school this summer. Her artwork "Beyond Blue" appears in the Spring 2018 Intima.

Unconscious Memoir: Seeing My Medical Emergency from Others' Perspectives by Elisabeth Hedrick-Moser

In “A Life Less Terrifying: The Revisionary Lens of Illness,” a non-fiction piece published in the Spring 2016 Intima, writer Ann Wallace notes that “The act of living and of moving forward requires a constant recursive motion of looking back and re-visioning.” I’m newly aware of that recursive motion, as my essay “Fluid” opened an unexpected conversation with my family around my bout with sepsis pneumonia.

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Time of Death: How Clinicians Cope with A Patient's Final Moments by Anna Belc

I found so much comfort in Thomas J Doyle’s non-fiction piece "To Pronounce." He writes so vividly of entering a patient’s room to quietly declare time of death that I find myself standing right next to him, feeling the sadness he is describing. He has learned over time to honor the moment.  I hope that one day I will feel less lost when faced with the end of someone’s life.

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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. 

 

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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Secrets We Keep: Gaining a Perspective on Love by Kim Drew Wright

“A Mother’s Life” is part of a linked short story collection I’m working on. The collection involves how we often lose our true selves but always come back to our essential essence in the end and how often we hide parts of ourselves from those people closest to us.

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How Meta-Narratives Protect and Serve Us by Maureen Hirthler

As I was writing my MFA thesis this summer, I thought daily about narrative. After all, both medicine and memoir are about stories—ours, our patients—and my MFA has been about learning how to tell stories well. Stories should move us forward; occasionally they hold us back. Sometimes the true meaning of stories takes years to uncover.

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