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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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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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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Great books can guide us in every day life, and I found it fitting that Dean Schillinger, MD and I both invoke works of literature to describe the experience of realigning our values with those of our patients. In his essay, “The Quixotic Pursuit of Quality,” (Spring 2015 Intima) Dr. Schillinger compares himself and his patient, Mr. Q, to Quixote and Sancho Panzo from Miguel de Cervantes Saavedra’s Don Quixote. With only misplaced medication lists, no-show appointments, and a stubbornly elevated hemoglobin A1c to show for his repeated efforts to help Mr. Q better manage his many comorbidities, Dr. Schillinger’s frustration melts away when Mr. Q unexpectedly gives him a massage. From then on, “the duel was over.” There would be no more tilting at windmills.
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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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A pediatric intensive care physician advocates for crossing the imaginary line and using the power of touch to comfort those in need.
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A nurse examines a clinical encounter through her poetry and appreciates the individual nature of care.
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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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“A medically assisted death, such as I recount in my essay “Mercies, Or, the Mostly True Tale of a Narratively Assisted Death” (Intima Spring 2023), is the antithesis of a traumatic ending in an ER. It is highly anticipated, fully orchestrated and well rehearsed – on everyone’s part but my own.”
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A psychiatrist uses her skills of close listening within the clinical encounter to uncover the enduring effects of intergenerational trauma.
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A nurse ponders the role of hope in the clinical encounter and whether the holy can be found within the realm of medicine.
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A retired hematologist explores the importance of clinical communication and health literacy by close reading two pieces published in this journal.
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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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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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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.
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A former PICU nurse examines the power of both embodiment and gaze in the clinical encounter.
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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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A retired physician reflects on his glimpses into religion and spirituality while confronting his patients’ illness and suffering—as well as his own.
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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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A testimony and tribute to one writer’s mother who passed away from COVID-19.
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