Neurologist Kendra Peterson explored reactions to “The Difficult Patient” in her poem (Fall 2017 Intima) nearly a decade ago. Long before chart cloning and copy forward worked their way into the documentation of the clinical relationship between patient and physician via the keystrokes and dot phrases of the electronic medical record, caregivers have developed shortcuts of stereotyping and rapid assessment that make their lives easier. Clinical gestalt is often celebrated, while bias is treated as something separate from it. And is the label “difficult” any different than the convenience of using yesterday’s assessment as the foundation for today’s decisions? Is propagation of a name or a label such as ‘difficult patient’ a type of plagiarism?
Read moreWhat the Midwife Knew and I Learned by physician Guilherme Coelho
Nancy Glass’s Field Notes essay “What Did La Abuela See?” (Fall 2019 Intima) put me back inside a room I had stood in once, half a hemisphere away, on a wooden floor that smelled of cedar and boiled water.
Read moreThe Voice that Lingers: On role models, inheritance, and the impact that outlives us: A reflection by emergency medicine pioneer Kenneth Iserson
No one decides to become a role model. That is rather the point. As psychiatrist Jacob Freedman observes in his Crossroads essay “I am not a Role Model,” only a Charles Barkley can disown the title; the people who actually shape us—parents, grandparents, the half-remembered branches of a family tree—never get the option. Freedman’s father did not announce himself as the reason his son became a physician. He simply was the reason, the best person in his son’s entire world, and the choice followed as naturally as breathing. The acts of the forefathers, an ancient maxim holds, are symbolic for their children. Identity is inherited before it is chosen.
Read moreThe Evolution of Anecdote to Story and Beyond by Angus Woodward
My father was a raconteur, and as his dementia advanced, he often got caught in anecdotal loops. In the middle of a familiar story, he would forget that he had told the beginning, repeat it, then charge through the middle before backtracking again, cycling through the tale until some kind of interruption saved him and his listeners.
Reading Samantha Stewart’s poem “Stingray” (Spring 2022 Intima) made me think about how experiences can become anecdotes, which may turn into stories, which may evolve into legends. And I saw how personal legends connect the dying to the living.
Read moreWhat Remains When the Body Is Taken Apart: A reflection on the educational ritual of anatomy class by Elli Lee
© Seeds of Life by Elli Youngeun Lee. Oil and colored pencil on canvas
“The first time I saw a dead body was in the cadaver lab. Behind fogged glasses, I felt my chest tighten as I faced my willed donor. But soon after, I found myself dissecting layers of skin and rifling through organs with the detachment of studying pages of a textbook. Anatomy lab is a pivotal step in our medical education. In fragmenting the human body as deidentified pieces of knowledge, it guides our hands through the otherwise unseen subjects of disease and reinforces our interconnectedness. In ‘Seeds of Life,’ the flowers honor these physical bodies as vessels of the donors’ time on earth—reminders that, through their gift, our growth and our future patients’ healing take root.”
In “Seeds of Life,” I reflected on the first time I encountered death—not as a moment of mourning, but as an educational threshold. In the anatomy lab, my donor’s body became a site of learning: layers to be dissected away, structures to be identified, systems to be mastered. Standing before the body, I dreaded the day we would come face-to-face with our donor and dissect his facial structures. Yet when that day arrived, the emotions I anticipated were absent. Without my noticing, a transition had occurred: this encounter with death was no longer about loss, but about participation in an educational ritual. Though this shift felt necessary and even expected, it left behind a quiet unease. In learning to see the body clearly, I wondered if I was learning to stop seeing.
Read moreBaselines, Self-Exams and Thoughts about Mammograms: A reflection by Rebecca A. Efroymson
We all approach mammograms differently. For most of us, they’re a necessary annoyance. Others dread that genetic probabilities and possibilities will catch up with them. Still others don’t think about mammograms. They focus on the problem of the day rather than on prevention.
My breast cancer was detected with a self-exam. My doctor felt nothing abnormal and sent me home. After some self-doubt, I saw evidence of that tumor on a mammogram. The spider image changed my relationship with regular scans.
Read moreMeet Your First Patient: A Reflection on Medical School’s Anatomy Lab by Pallavi Kenkare
Anatomy lab is a medical school rite of passage. Every year, as summer cools into fall, thousands of naïve, eager First Years across the country meet their very first patient. Facing one’s donor is an emotional moment for many. It can be a carousel of apprehension, fear, gratitude and peace, but there is also an inevitable feeling of loss as the semester progresses and those poignant aches settle into a cooler, business-like approach.
Our donors are our first patient, our teachers—and they can also be our loved ones, our family, our friends, ourselves.
Read moreOn Laughing Through the Pain by Albert Einstein College of Medicine medical student Moshe Gordon
Perusing Intima's last issue, I noticed some overlapping themes between two very different pieces: my own fictional piece “Sweet Dreams,” and “Humor As (Narrative) Medicine,” an autoethnographic study by Alyse Keller Johnson, an associate professor of communication studies at CUNY Kingsborough Community College in Brooklyn.
Read moreMemories of Home: A Reflection about Alzheimer’s and a Mother Who Wanted to Go Home by writer Annette Leddy
The imagery in Beyond the Threshold by Emory MD/PhD candidate Aubrey Reed, reminds me of my mother when she had Alzheimer’s, of which my story “Mirella”(Fall 2025 Intima) is a fictional portrayal. My mother, displaced in a memory facility, talked often of the homes where she had lived. She got them all confused, but one thing was clear: She wanted to go home.
Read moreWhat Do Doctors Get From Name-Calling? A reflection about our reaction to ‘difficult patients’ by nephrologist and educator Joseph Zarconi
Palo Alto neurologist Kendra Peterson's poem “Difficult Patient” (Fall 2017 Intima: A Journal of Narrative Medicine), and the patient who inspired my “American Sonnet for an Addict” (Fall-Winter 2025-26 Intima) are prototypical victims of name-calling – a ubiquitous clinical behavior taught exclusively in the so-called hidden curriculum of medical education. These patients are our albatrosses, another name we ascribe, recalling the curse that befell the entire ship’s crew of Samuel Taylor Coleridge’s famous mariner following his killing of an albatross in the poem, “The Rime of the Ancient Mariner.” They curse us. They burden and encumber us.
Read moreWhy are patients hesitant to tell the truth? A reflection on communication by public health scientist and activist Mariana Mcdonald
Communication. Open and forthright—what we want as patients and what providers require of us. But that can be difficult, as reflected in my short story “The Vent,” (Intima Fall 2025), where I explore a seriously injured man’s thoughts in the ICU. He complains: “Every time I went in to the clinic, they started asking the exercise question, no matter what I was there for. Got the flu, feverish and coughing, and there they are quizzing me about exercise.” His frustrations lead him to respond dishonestly to his providers’ questions: “It got so I would tell them what I thought they wanted to hear just to get them off my back. Said I took a walk every day, hardly ever drank... All lies, or fibs...”
Read moreWhere Fear About Living and Dying is Held: A reflection by UC San Diego internal medicine resident Tulsi Patel
When I read the Field Notes essay “Letter to My Oncologist” (Fall 2025 Intima), I was struck by how the writer, psychologist Julia Dobner-Pereira, watches her physician for the smallest fracture of a moment in composure—and how the physician watches her for the same. Their exchanges sit on a narrow ledge—two people trying to hold each other’s fear without admitting how much weight they’re carrying. I recognized that terrain immediately. As a clinician, I’ve felt patients monitor my breathing, my pauses, my half-smiles.
Read moreIn Story Lies the Cure by MD Ron Turker
“Young doctors are young for a blink, and they age with their patients. My advice to my young colleagues: knock first and then, most importantly, listen for the response. Listen for their story. In story lies the cure.”
Read moreReaching Across Death: A letter to my grandmother by Stanford medical student Madison Palmer
“In this reflection, I explore the barriers between understanding grief and communicating with ancestors beyond life…. I particularly focus on what it means to ‘reach’ out for an ancestor across the barrier of their death.”
Read moreThe Narrative Medicine Promise: Why It Pays to Listen. A reflection by McGill University researcher Homa Fathi
“I believe educators should remain steadfast in integrating the humanities into health professions education. There are many—particularly systemic—barriers to such efforts, but the outcomes can be deeply rewarding.”
Read moreOn Inter-Pathology Envy: A reflection by writer and neurologist Ann Bebensee
“I have found that [breast and colorectal cancer patients] share the same labyrinth and my new, uncertain life is not quite as frightening. The blue of a colon cancer ribbon is lovely. So is pink.”
Read more"Who knew that time was the biggest factor in compassion?" A reflection about effective clinical care by writer Lisa Simone Kingstone
“The center was my rest stop in my trek through cancer. It shimmers through my own understanding of how to care for people…But over a decade later, what I remember most is a feeling of restoration. … Being a patient makes you feel like a baby in a basket floating down a river with rapids.”
Read moreListening to Ordinary Things Can Get You Through the Day by cancer advocate and writer Robert McEachern
“Godfrey’s piece … reminds me how stories get told and re-told in many ways, in many layers. Like medicine in a glass bottle, sometimes our stories stay inside us, waiting to be opened, waiting for the words.”
Read moreThe Scars of Our Silence: Medicine’s Discomfort with Dying by palliative care physician Lindsey Ulin
“Years later, I still wonder what story the family of my patient carries of that death. The one thing they most needed to hear—that their loved one was dying—remained unsaid.”
Read moreRemembering in the Rain: A reflection on anxiety and OCD by Cynthia Miller, MD, MPH
“Psychologist and writer Faith Galliano Desai provides a solution, but it isn’t an easy one. She instructs us to remember that anxiety is energy that must move. If we let it pass through us, it will lose its power.”
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