I work at a community clinic with patients who are homeless–there is the stigma of homelessness, and then there is the stigma of looking homeless.
Some patients of mine do not–or do not yet– appear unhoused. It is usually those who still have family that support them, who live in a car, who hold a job—running food for Doordash, picking for Amazon, sitting security—or who have not been homeless for so very long. But many of my patients do appear frankly homeless: a shuffling gait, a blanket draped around their shoulders, belongings pushed in a stroller, blackened teeth, leg wounds.
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.
Read moreThe 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.
Read moreFear and Compassion: At the Heart of Panic Attacks by Lisa H.D. Napolitan
Fiction and visual art are a natural pairing, one digging deep through words, the other a profound visual exploration. Both genres allow ways to explore the issue of mental health.
Read more"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.
Read moreWhat Clown Doctors See and Don't See: A Look at Healthy Humor by Phyllis Capello
For thirty years, my hospital work (I’m a clown ‘doctor’/musician for Healthy Humor) has included meeting and entertaining families in clinic waiting rooms, Pediatric ICUs, triaged Emergency Departments and in out-patient, in-patient rooms. Clown-doctor encounters can, if invited, also extend to physical therapy and treatment rooms, hallways, nurses’ stations and elevators. In ED and in out-patient and in-patient rooms permission comes from the medical and childlife staff first (and pertains to situational or isolation status). After that, the child’s permission (being our ultimate “boss”) to enter is strictly respected. In a hospital environment, we are one thing a child can prevent from entering their room.
Knowing when to present ourselves and when to exit means we are not often present for the trauma of Emergency Medical procedures unless specifically requested by staff. I do not see the immediate medical aftermath of a bullet wound. The hands of professionals as they seek to save a life as in Kirilee West’s drawing of hands entitled: “6:21 P.M.” That is why the piece really speaks to me of the drama and humanity inherent in the moments before a medical clown can be of any use to a patient.
Her drawing resonates with me as my poem, “The Ballad of a Harlem Boy,” was written after a nurse shared her distress about a child’s death. Telling us (we work in pairs) of her direct experience, I could only think of her hands and their expert ministrations during that terrible time and of the depth of her humanity for the mortally-wounded fourteen-year-old and his mother.
We all want our hands to be of use: I, in my small way, making music or writing poems; medical staff whose hands take on the most difficult and tender of roles; the artist’s hands who can capture with a charcoal stick the enormity of what we might see if, after the fact, we can allow our creativity to take a step back and tell a story.
Phyllis Capello, who is a writer and musician, is a NYFA fellow in fiction I and a winner of an Allen Ginsberg Poetry Award. Her collection “Packs Small Plays Big” is from Bordighera Press, 2018. Cantastoria work (sing/storyteller) has taken her from Ireland-to-Istanbul. She has presented at the International Oral History Conference in Rome, Italy and has been a musician/clown since 1990 with Healthy Humor Red Nose Docs, as well as a member of the poetry/activist trio, The Ferlinghetti Girls. In 2023 she was honored with People’s Hall of Fame Award for teaching artistry for her work in New York City schools. Her poem “The Ballad of a Harlem Boy” appeared in the Fall 2023 Intima: A Journal of Narrative Medicine.
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.
Read moreCrossing the Line: The Power of Touch by Catherine Humikowski
A pediatric intensive care physician advocates for crossing the imaginary line and using the power of touch to comfort those in need.
Read moreThe Individual Nature of Care by Joanne Clarkson
A nurse examines a clinical encounter through her poetry and appreciates the individual nature of care.
Read moreOn 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.
Read moreThe Third Ear: Listening for Intergenerational Trauma
A psychiatrist uses her skills of close listening within the clinical encounter to uncover the enduring effects of intergenerational trauma.
Read moreOn Knowing
A nurse ponders the role of hope in the clinical encounter and whether the holy can be found within the realm of medicine.
Read moreOn Being Confined
A retired hematologist explores the importance of clinical communication and health literacy by close reading two pieces published in this journal.
Read moreOn 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.
Read moreThe 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.
Read moreLeave Work at Work
Which story is heard, and by whom? Which story do people want to hear, and why? A COVID nurse provides explanations as well as recommendations about storytelling.
Read moreThe Embodied Connection in Patient-Provider Interaction
A former PICU nurse examines the power of both embodiment and gaze in the clinical encounter.
Read moreScripting 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.
Read moreReligious Moments in Medical Practice by internist John Pierce
A retired physician reflects on his glimpses into religion and spirituality while confronting his patients’ illness and suffering—as well as his own.
Read moreObjectivity 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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