Before and After: In Response to “The Face as an Organ of Identity” by California community doctor Katie Taylor

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.

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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 Clown Doctors See and Don't See: A Look at Healthy Humor by Phyllis Capello

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. ferlinghettigirls.com 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” appears in the Fall 2023 Intima: A Journal of Narrative Medicine.

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.

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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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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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