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.
Read moreFear and Compassion: At the Heart of Panic Attacks by Lisa H.D. Napolitan
© How a Heart Grows. Susan Baller-Shepard. Fall 2018 Intima
Fiction and visual art are a natural pairing, one digging deep through words, the other a profound visual exploration. Both genres allow ways to explore the issue of mental health.
Read moreHow to Write About Cancer: How Poetry Can Break the Rules by writer Lynne Byler
Recently, I read Adam Conner’s short story “How to Write about Your Cancer” (Fall 2022 Intima) with amusement and recognition. And if I transform the rules in it to a scorecard, my poem, “Minds Go Where Bodies Can't” ends in the red.
Read moreWhat Great Literature Taught Me by internal medicine resident Teva Brender
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.
Read moreWhat 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.
Read moreWhere do you turn for comfort? A reflection on Popsicles, Tater Tots and hospital gift shops by internist Ben Goldenberg
“Sometimes the job we do isn’t about fixing what’s wrong but rather helping each other survive within the confines of our brokenness.” Artwork: The Art of Being Here by Kirilee West Spring 2022 Intima
Read moreOn Imagined Boundaries: A reflection on "the body as a narrative instrument" by Tony Errichetti
A medical educator reflects on studio art recently published in the Intima and examines the boundaries—real or imagined?—often constructed between mind and body.
Read moreThe Chance to Say Goodbye... or Not: Thoughts about being prepared—or surprised— by death by end-of-life doula Virginia Chang
An end-of-life doula reflects on their experiences with dying patients and concludes by offering three life lessons.
Read moreThe Sincerity of A Great Story: A Reflection on “A Life” by Judith Hannah Weiss
A writer analyzes a piece of fiction published in this journal—and comes to discover the power contained within each line of writing.
Read moreWho Knows How the Body Turns? A Reflection on Lyme and Rheumatoid Arthritis by Sheila Luna
A writer living with rheumatoid arthritis finds companionship in another writer living with Lyme disease. Although these two diseases may be different, they continue to manifest in similar ways.
Read moreWhat's a "Good Patient"? A Reflection by Jacqueline Ellis
A scholar wonders if and how she can become her doctor’s favorite patient—and what that may mean for the sacred patient-physician relationship.
Read moreOn Caring and Suffering by Michael Evans, William Doan, Kiernan Riley, Kalei Kowalchik, and Logan DeSanto
A nurse offers a plea in the face of a worsening pandemic and increasing burnout among healthcare professionals.
Read moreBedside Mannerisms: Finding the time to care by pediatrics resident Vidya Viswanathan
In medical training, there is an increasing didactic focus on empathy and professionalism. In many of these sessions, I have learned certain skills: Sit down at the patient’s level. Ask them open-ended questions. Don’t interrupt. Use an in-person, video or phone interpreter. These skills are helpful. But often, they run up against the great limiting factor in many of our clinical encounters: time.
Read moreBeyond Acronyms: Contemplating what 'OLD CARTS' really stands for by Tulsi Patel
“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.
Read moreOut of Time? A reflection about illness and its toll on our past, present and future by Sophia Wilson
In her observant poem “Brain as Timepiece (Administering the Clock-Drawing Test to My Patient With Dementia)” (Intima, Fall 2018), Jennifer Wolkin describes the disordered clockface drawn by a patient with dementia: each number stands outside its perimeter like lost digits. The patient’s subsequent drawing of an ‘X’ over the wayward numbers suggests an erasure, not only of cognitive function, but of time itself. Time’s toll equates to a ‘crossing out’ of past, present and future as the ‘disease devours …organ tissue’.
Read moreWhen Medical Professionals Care for Their Own: A Response to “Of Prematurity and Parental Leave,” by Mason Vierra
“Of Prematurity and Parental Leave” (Intima, Fall 2021) describes the harrowing experience of giving birth to a premature baby during residency. It’s written by doctors married to each other —Dr. Campagnaro and Dr. Woodside—who co-construct a narrative by telling it from their own perspective.
Read moreWhen the “Clock of the Living” Runs Down: A Reflection by clinical social worker and chaplain Betty Morningstar
The fractured stories at the end of life often reflect an ineffable but powerful experience of creativity, insight or even revelation. These opportunities arise because the dying person doesn’t see time according to the clock of the living. Imagine how much one could conceive of were time not of the essence.
Read moreShakespeare, Stanzas and How We Think About Death by Albert Howard Carter, III, PhD
When my sonnet “All Tuned Up” appeared (Spring 2021 Intima), I was asked to write about another piece published in the journal. I chose “I Picture You Here, But You’re There” (Spring 2020 Intima) by Delilah Leibowitz. Her poem and mine both explore how we think and feel about death.
Read moreDoctoring and Disobedience: Speaking an Important Truth, a reflection by Kelly Elterman
Sometimes, the truth can be uncomfortable. It can be difficult to hear and often, even more difficult to say. In her Field Notes piece entitled “Doctoring and Disobedience” (Spring 2020 Intima) Dr. Lisa Jacobs recalls her struggle with being told to hide the truth of a prognosis from an elderly patient with metastatic disease. Despite the instruction of her attending physician, and the decision of the patient’s family and ethics team to not speak of death to the patient, Dr. Jacobs feels compelled to let her cognitively-intact patient learn the truth. So strong is her conviction that she takes on considerable risk to her own career for the sake of bringing the truth to her patient.
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