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...”

This pressure to give providers positive answers is echoed in Jacqueline Redmer’s poem “Overdue EPIC Health Maintenance” (Intima Spring 2022). “I receive several email notifications regarding my overdue health maintenance,” the poem begins. Rather than comfort her with welcome reminders, these messages become a kind of battering about a wide range of health conditions, the total effect of which is dizzying. Furthermore, the computerized system can present confusing or contradictory information: “EPIC says I do not need a depression screen. I have scars on my body from wounds that were self-inflicted.”

Like our patient in “The Vent,” the narrator in the poem feels compelled to equivocate: “If I am being honest, I will admit that I often tell lies to make people happy,” continues the honest commentary in the prose-like poem written by Redmer, a family medicine physician in rural Wisconsin. “I tend to under-report my smoking history…” The impact of EPIC’s dizzying reminders and assertions? “The truth feels like it is ripping me open.”

Why are patients hesitant to tell the truth? Fear and denial certainly play a role. But hurried, incomplete or inappropriately posed questions can make the patient feel unheard, gaslit, or pressured. Racing through a history can feel like a standardized test. Patient surveys allowing only quantitative responses can completely miss patients’ realities. “On a scale of” is only a helpful measurement if the statements posed are valid, a basic research tenet that survey writers may not be trained in. Computer-generated text can be incomplete or inaccurate, glossing over nuanced circumstances. As AI increasingly intervenes in human communications, the need only grows for careful listening and the ability to hear what is being said in the silences.

Perhaps we need to update the oath to add: “Do no rushing, gaslighting, or dismissiveness.”

Mariana Mcdonald (she, her, they) is a poet, writer, public health scientist, and activist. Her poetry, fiction, essays, and journalism have appeared in numerous journals and anthologies, including Crab Orchard Review, Ceasefire Now!, Sargasso, Antología de la Poesía Viequense, About Place Journal, and Anthology of Southern Poets: Georgia. She co-authored with Margaret Randall “Dominga Rescues the Flag” about Puerto Rican heroine Dominga de la Cruz. She was named a Black Earth Institute Scholar/Fellow in 2022. Her short story “The Vent” appears in the Fall 2025 Intima. She lives in Atlanta.