In Larry Oakner’s poem For My Father, Lost (Fall 2017 Intima), the poet remembers his deceased father and shares a memory of them picking raspberries at a farm. Oakner’s vivid writing transports me to a farm as an intruder upon a private moment:
“Cardboard quarts in hand, we raided the canes,
raking ripe berries from trellises with stained fingers.
Summer-heavy and red as blood drops,
we hardly filled our containers
for the handfuls of fruit we ate.”
I thought about the joy that picking raspberries brought Oakner’s father— “he was a boy again on a Colorado farm, happy and free of the tyranny that time imposes”—and how memorable and moving it is that Oakner was able to co-create this joy with his father. In my poem The Devil Overhead, I similarly share memories of my experiences co-creating joy while volunteering with an elderly woman who loved poetry, religion and birds. By engaging her joys, we can look through the opacity that disease creates to really see her.
Sickness often brings “misery,” as Oakner writes, while snatching away what makes people feel like themselves, obscuring their own identities from themselves and compromising their ability to do the things they love, either slowly or all at once. In my training, I’ve been thinking more about how to better respect patients’ personhoods just as much as we respect their patienthoods in the hospital: Part of that involves knowing about patients’ joys.
“OLD CARTS” is an acronym we’re taught in medical school to guide us on questions to ask to elicit a history of the patient’s illness: Onset, Location, Duration, Characteristics, Aggravating or Alleviating factors, Radiation (of pain), Treatment, and Significance. Although OLD CARTS is a helpful checklist initially, over time it begins to feel perfunctory, done to check off a requirement on the rubric. We ask many questions, and I am keenly aware I’m asking because I want something from the patient—I want telltale signs, any clues on the diagnosis, any information that the care team can act upon and use— I feel greedy.
But the questions when I veer off script, improvise and explore and become better acquainted with the person’s joys and loves, those are the ones that give me an understanding of who they are. These are the questions where I ask not because I have to but out of curiosity, and they are the most rewarding ones. There is great depth, if only we are willing to care, dig deep and appreciate what is shown to us. After all, illness makes it easy to obscure who we really are, and for others to see that.
Although our genuine interest and concern for others may not be included in an acronym or checklist and thus not deemed “utile” to borrow an economics term, its importance isn’t diminished by being immeasurable or non-objectifiable. I also know that my own joy is derived from hearing about others’ – whether it’s raspberries, birds, religion or other wondrous things.
Tulsi Patel is a second-year MD/MPH student at Northwestern University Feinberg School of Medicine. She graduated from Columbia University with a BA in Neuroscience and Behavior in 2019. In her spare time, Patel enjoys listening to podcasts, visiting art museums, hiking & running outdoors, and being a plant mom to 15 houseplants (only somewhat successfully).