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What We Bring to the Practice of Medicine: Perspectives from Women Physicians. Editors: Kimberly Greene-Liebowitz and Dana Corriel

July 2, 2023 Guest User

In 1960, women comprised 6.7% of practicing physicians; today, that number is 37%. Women often face different difficulties from their male counterparts; even today, misogyny, discrimination and societal expectations affect training, health, specialty selection and academic progress.

In What We Bring to the Practice of Medicine, a collection of essays published by Kent State University Press, women share stories from their careers that altered how they saw themselves and their patients. These authors have no fear of vulnerability; they recognize their emotional responses as not only acceptable, but necessary for them to be the physician they want to be.

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In Biography, Caregiving, Essays, Health Tags Women in Science, #womeninstem, doctor stories, narrative medicine

Second-Generation Healing: The Holocaust poetry of Yerra Sugarman in "Aunt Bird" by Robert C. Abrams

December 19, 2022 Intima: A Journal of Narrative Medicine

The subject of Aunt Bird, a collection of poems by Yerra Sugarman, is the last year of the life of her aunt in the Kraków ghetto during Nazi occupation of Poland (Four Way Books, 2022). The book is a collection of impassioned poems about the lost hopes of a spirited, once-vital young adult.

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In Biography, Book Reviews, Co-Constructing Narrative, Death, Memoir, Narrative Medicine, Poetry Tags poetry, Holocaust, healing, narrative medicine

Interview with poet Chris Martin about Multiverse, a new poetry series from Milkweed

August 9, 2022 Intima: A Journal of Narrative Medicine

Earlier this year, Milkweed Editions, an independent non-profit publisher based in Minneapolis, launched Multiverse, a literary series devoted to different ways of languaging, curated by neurodivergent poet Chris Martin, whose new book May Tomorrow Be Awake: On Poetry, Autism, and Our Neurodiverse Future just came out from Harper One. The first book in the Multiverse series was Hannah Emerson’s debut poetry collection The Kissing of Kissing, which fulfills a key tenet of the imprint: To showcase editorial voices that emerge “from the practices and creativity of neurodivergent, autistic, neuroqueer, mad, nonspeaking and disabled cultures.” Creating this kind of series is a transformative act that enriches, enhances and transforms our current literary landscape. I interviewed Chris Martin about how Multiverse will open up a chorus of voices and sensibilities that our medical humanities community needs to hear and witness. 

Thank you for getting together to talk about Milkweed’s Multiverse series that explores different ways of languaging. Could you explain that term and also speak about how the clinical community can learn from this core concept of your series.

‘Languaging’ is a term I got from Adam Wolfond, who is a non-speaking autistic writer from Toronto; his book “The Wanting Way” will be the series’ second title coming out in the fall. Adam likes to emphasize movement, emphasize how something is rather than what it is. One of Multiverse’s intentions is to disrupt the monolithic ways of seeing people and conditions and to bring out the wild variety of forms that language and autism and neurodivergence and disability take. When we’re speaking of non-speaking autistic writers, there is a tendency to think of them as ‘exceptions’ and have one stand in for everybody, whether it’s Tito Rajarshi Mukhopadhyay or a book like “The Reason I Jump” by Naoki Higashida. But when one or two people stand in for everyone else, we forget there’s this amazing amount of variety. By giving a range of neurodivergent writers, we give them a platform to express themselves exactly how they express themselves and show how much they diverge from each other. [It’s limiting to] think we sum up a condition or way of life with one particular set of ideas.

The Kissing of Kissing by Hannah Emerson is the first in Milkweed’s Multiverse series, curated by Chris Martin.

That’s one of the challenges for the clinical community: Learning to differentiate and do a ‘close reading’ of each patient provides a chance for clinicians to be creative and open, rather than relying just on symptoms, tests, data. Most clinicians are taught to be so by the book and what feels embedded in Multiverse as a concept, and in Hannah Emerson’s poetic universe as well, is learning to be open to a different language or point of view. The question is if clinicians can adapt to that discipline of puzzling out a new language in the hospital room or ER—poetry teaches patience and openness to a different language but will that skill be transferable when confronted by a patient’s weird blood count or cough that won’t go away?

When you say ‘by the book,’ it’s such a powerful phrase, because it is by the book! If Multiverse could be by the book writ large as a resource for different voices, that is amazing. The more nonspeaking writers I engage with the more my understanding of autism grows, and the more my understanding of myself grows, learning about what it means to be me, a human animal. The difficulty you point to is really interesting, and we often misapprehend where that difficulty arises. Primarily, it is that the language isn’t transactional, it doesn’t follow neuro-normative patterns that allow it to be instantly consumed and that arises in medicine too. We’re living in a capitalist ableist society, a neuro-normative society trying to get everyone on a conveyor belt where they will be, inevitably, crushed, at least the way I see it. But who’s to say we have to move at that pace? There are other ways to communicate, other ways to be together, and if those ways feel challenging at first, it’s because they’re pushing in the opposite direction of the conveyor belt. We have to work hard to step away and to take things on their own terms rather than follow preconceived ways of how language should work or how people should work and I think there couldn’t be anything more important than that.

One concept taught in Narrative Medicine at Columbia University by Dr. Rita Charon, is co-constructing a narrative. Along with close reading and understanding tone of voice and point of view, there’s also how the self and the other construct a shared story in the clinical encounter. There’s the doctor’s point of view and the patient’s – and the idea of coming together to create this story involves a ‘shared power’ – not just, ‘I’m the doctor, the authority figure, and I hold the power here.’ How does your series speak to this concept?

One of the things we think about at Multiverse is “can we foster and cultivate consensual futures together?” By that, we’re going back to the roots of that word to think about how we feel together in the world that emerges between us. We’re also interested in consent—a consent that is a constant process, to involve the writer on their own terms or at least in a place where we can ‘find’ each other instead of making them answer things in a neurotypical way. Like with Adam: His visual acuity doesn’t allow him to fix the words on the screen—they swim on it—so when it came to making line breaks we had to think of the accommodations to allow Adam to do this. From the beginning Adam totally questioned the authority that comes with authorship –so he also commissioned about a dozen poets, writers and thinkers to participate in this experiment of line breaking. Then he figured out which ones he preferred – his own or theirs. Also, he doesn’t see them as breaks but as windings like a river – so he would have writers unwind the poems, then rewind them and bring their own sensitivity. Other writers liked the idea and adopted the practice of commissioning others (not me, I love doing line breaks, it’s one of my favorite things). But what started out as an accommodation became this methodology that others did too.

“Unwinding” as a way of disrupting in a creative way – it’s a great metaphor that clinicians and caregivers can use when feeling out of control of a situation. The idea of looking at a clinical encounter and unwinding it in order to make the breaks (or rewind the circumstances) is useful.

May Tomorrow Be Awake: On Poetry, Autism, and Our Neurodiverse Future by Chris Martin was just published by Harper One.

It’s so important to ask ourselves what we’re trying to fix, because of the non-normative linguistic approaches these writers have. In Hannah’s book, there’s a lot of repetition, there’s no punctuation, there’s a lot of anaphora, starting lines with the same words, ending lines with the same word, those are literary devices used by many people, but I think Hannah does it in a particular way that it takes one awhile to figure out how the poems move, and once you do, it becomes really seamless. There is a way of reteaching yourself how to read and for each of these books, I hope that’s the experience on some level, the sense of ‘Oh I have to relearn how to read because I’m encountering something so true to its own patterns that I have to listen very closely and be humble and figure out how this is moving.’

That’s the experience a doctor has when meeting a new patient. That level of engagement is what NM tries to teach so clinicians feel comfortable instead of bothered by newness. Speaking of new, let’s focus on The Kissing of Kissing. How should someone new to poetry and to Hannah Emerson’s work engage with this new collection? 

Read it out loud. One of the amazing paradoxes of Hannah’s work is it’s so incredibly, entrancingly lyrical it begs to be read aloud. When it’s read aloud, you’re experiencing it and that’s the best possible thing to do.  Also, trust that the book will meet you in the middle. If you spend a little time with it you’ll find yourself being addressed in really direct ways. That’s what I love about Hannah’s book: while on some level it’s difficult, there’s also this incredible connectivity and directness toward the reader and those who do connect will get hit with a lightning bolt.

In an interview you did with Hannah, she voices the following remarkable passage:

“Nothing is the stillness that is the moment that is now yes yes. Please try to go to the place that is in all of our dark places that we try to run away from every moment of our great great great beautiful lives yes yes. Please try to understand that these thoughts go directly to the place that we need to go to deconstruct the freedom that we think is the way to a comfortable life that has brought us to the brink of extinction yes yes.”

Talk about how readers, especially clinicians, can be open to the ‘nothing’ Hannah speaks of when many have been trained in suppositions about normalcy.

For one thing, resist that quick grasping or groping after categories and the way we want to fill the space quickly with things we think are productive but may instead cover up and smother an authentic connection with someone that would lead to authentically learning who they are. I was just reading “How to Do Nothing,” a remarkable book by Jenny Odell who talks about the philosopher Martin Buber, and his idea of the I-it relationship – one of instrumentality where you’re treating someone like an it so you can get what you want when moving through your own experience, and I-thou relationships, where you truly behold someone on an equal plane, and are ready to learn from who they are. I feel like that’s the space of the ‘nothing’ and one thing Hannah is saying is there’s a kind of plane where we can meet each without those preconceptions and humbly slowly carefully learn about each other and what arises there will have an authenticity and realness to it that will be nourishing and hopefully, in clinical terms, will be incredibly useful.

Why is poetry such a potent tool to disrupt our ways of thinking?

One of the things I’ve tried to figure out is what is this incredible reciprocity between autism and poetry. Hannah writes a lot about freedom – it’s not a traditional idea of freedom, but rather it’s that “dreaming kissing life.” One of the things that carries that freedom is, I would almost say, a love—the pattern of love. For me, every poem is a love poem, no matter what it’s about. The patterns you infuse that poem with communicate a number of things. One is that the author cares about how the poem meets you; in prose, there are a lot of patterns but a writer is often so hemmed in by grammar, right? It’s sometimes hard to feel the care in the way language is shaped, whereas with a poem there are so many strategic choices being made you really feel like someone has made something for you—there’s such an intimacy to that. And the word poesis, the origin of poem, is ‘to build or compose, to make.’

In The Kissing of Kissing, there’s such an intimacy in the way a poem meets you, greets you, kisses you, that’s hard to find in other places. But it’s also a place where you can take off everything that’s extraneous, you can drop all the standardizations or make all your own choices— whether it’s punctuation, capitalization, the shape of the poem, there are just so many potential choices you can make. It’s analogous to moving through the world and something I’ve had to learn—how do I unmask as I move through the world as a neurodivergent person, a disabled person, how do I allow who I really am to meet other people and where do I find spaces that are safe enough. A poem I feel takes all those aspirations of unmasking and meeting people in direct and consensual spaces, and it combines with our love of song.

You’ll find that all through Hannah’s work, and one of the things clinicians might be interested in is that Hannah is echolalic – she’s nonspeaking but she’s often always singing. Song, I believe, is where language originates, language began as song, and then coalesced in other forms associated with story and then written language. But poetry returns us to the original impulse of song, which is something we use to celebrate and come together in communities, something that enjoins us.—Donna Bulseco


Donna Bulseco, MA, MS, is a graduate of the Narrative Medicine program at Columbia University. After getting her BA at UCLA in creative writing and American poetry, the L.A. native studied English literature at Brown University for a Master's degree, then moved to New York City. She has been an editor and journalist for the past 25 years at publications such as the Wall Street Journal, Women's Wear Daily, W, Self and InStyle, and has written articles for Health, More and The New York Times. She is editor-in-chief of Intima: A Journal of Narrative Medicine, a literary journal recognized as a leader in the medical humanities world.

In Biography, Book Reviews, Essays, Health, Narrative Medicine, Poetry, Transgender Tags poetry, autism, neurodivergent, neuroqueer, nonspeaking, disabled
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A Lab of One's Own: One Woman's Journey Through Sexism in Science by Rita Colwell, former director of the National Science Foundation

May 9, 2021 Intima: A Journal of Narrative Medicine
A Lab of One’s Own: One Woman’s Personal Journey Through Sexism in Science  was published in 2020 by Simon & Schuster

A Lab of One’s Own: One Woman’s Personal Journey Through Sexism in Science was published in 2020 by Simon & Schuster

By cleverly playing with the title of Virginia Woolf’s pivotal feminist essay, “A Room of One’s Own,” Rita Colwell informs us what this book will be about on its very covers. Colwell is a pioneering microbiologist and the first woman to lead the National Science Foundation. She is a Distinguished University Professor at both the University of Maryland and Johns Hopkins University’s Bloomberg School of Public Health. A professional rather than a personal memoir (although for a passionate scientist like Colwell, the two are one and the same), A Lab of One’s Own chronicles and humanizes the female experience in the scientific community over the last half a century.

There is much to admire in this account, co-authored by science writer Sharon Bertsch McGrayne. Riveting chapters describe Colwell’s groundbreaking fieldwork on cholera in Bangladesh, while the exciting role she played in the CIA’s efforts to find the person behind the Anthrax letter attacks in 2001 makes for a thrilling read. Still, it is Colwell’s well-documented female experience of the pursuit of science that elevates the book into a uniquely excellent read.

I was well aware of the fact that what we today easily identify as sexism was “simply the way things were” some fifty years ago, but I must confess I was truly shaken by reading about how far and deep this sexism went. I was distraught to find, in the very first chapter, a young, driven student being told by the late Austrian-born microbiologist and professor Henry Koffler: “We don’t waste fellowships on women.” I’m not certain what I expected, but I did not expect to read a story in which another scientist Robert Steiner simply didn’t allow Colwell to finish her talk at a symposium.

Nor did I expect to read how colleague Einar Leifson yelled at Colwell over post-conference dinner, asking loudly in front of the entire room whether her husband knew where she was and why she wasn’t at home and pregnant. I most certainly did not expect to read that Francis Crick, one of the men who claimed the Nobel Prize for the discovery of the molecular structure of DNA—with no acknowledgement that a photograph taken in chemist Rosalind Franklin’s lab was instrumental in the discovery—casually grabbed molecular biologist Nancy Hopkins’ breasts when they first met. Then there was the shock of reading that Hopkins, after having been a tenured professor, wasn’t allowed to teach a genetics class based on her own discoveries, but instead was asked to teach the material to her male colleagues who would lecture instead. The reason for the switch? She was told male students wouldn’t believe any science explained to them by a woman.

Two aspects of this memoir are striking.

First, Rita Colwell has no fear when it comes to name dropping. No matter who they are, how well-respected, how highly ranked, alive or dead, the men who were part of the agenda to keep women out of science are identified and quoted. Some, like Koffler, for instance, even had the opportunity to deny or at least apologize for their actions. (Koffler, who went on to be University of Massachusetts Amherst Chancellor, refused.)

Secondly, the memoir lacks bitterness. Colwell tells the story of her passage through the system, warts and all. But her tone is not vindictive. If anything, she uses every opportunity to focus on people, both men and women, who played key roles both in helping her personally, and in changing the world of academic science into a more fair and inclusive one. She never dwells on her achievements or toots her own horn: Instead, she dedicates pages and pages to other women who have themselves overcome many obstacles and, despite men, managed to make incredible contributions.

Rita Colwell

Rita Colwell

What’s fascinating about A Lab of One’s Own are the inside stories of how monumental events unfolded. She explains how the Women’s Equity Action League (WEAL) managed to file a class action suit against the University of Maryland as well as 250 other American colleges for sex discrimination, leading to the Educational Amendments Act of 1972. Focusing on the factual, strengthened by her personal observations, Colwell gives detailed accounts of landmark moments in gender equality, including the passing of Title IX, the phenomenon of the “revolving door” and the “Birgeneau Bump.”

Although the fight against sex discrimination and the gender pay gap is not over, the memoir ends with positivity. The book is at times quite a dense text, packed with names, titles, years. Colwell documented the careers of dozens of female scientists alongside her own, giving each one as much space on the page as she gave herself. As a true feminist, Colwell uses the gravity of her platform to give others a voice. A Lab of One’s Own is essential reading for all genders; however, women in the sciences will find the history especially eye-opening. —Alekszandra Rokvity


Alekszandra Rokvity is a Serbian-born writer and PhD candidate working on her doctorate between the Karl Franzens University of Graz in Austria and the University of Alberta in Canada. She specializes in cultural studies and medical humanities. Her academic interest lies in the experiences of women with endometriosis within the healthcare system. Her doctoral dissertation is a case study of endometriosis that explores the connection between gender bias in the medical community and the social discourse surrounding menstruation.

Ms Rokvity has previously taught in Austria, Canada, Vietnam and is currently teaching in Belgrade, Serbia. An avid activist for women's rights, she cooperates with various NGOs such as the London Drawing Group (UK) and Vulvani (Germany).

In Biography, Co-Constructing Narrative, Medical Research, Memoir Tags STEM, Women in Science, DNA, #womeninstem

The Psychiatric Biography: A Review of "Staring Night: Queen Victoria's Late-Life Depression" by Robert Abrams

March 7, 2021 Intima: A Journal of Narrative Medicine
Staring Night: Queen Victoria’s Late-Life Depression was published by IPBooks in Fall 2020. For more information about the International Psychoanalytic Books imprint, go to ipbooks.net

Staring Night: Queen Victoria’s Late-Life Depression was published by IPBooks in Fall 2020. For more information about the International Psychoanalytic Books imprint, go to ipbooks.net

Interest in the royals may well be at an all-time high, with the popularity of the Netflix series “The Crown” and attention to the two-hour CBS interview by Oprah Winfrey of Prince Harry and his wife Meghan Markle, who caught the Palace off-guard last fall when they announced they were stepping back from their royal duties. Yet a few months later, news about another royal appeared in the form of Staring Night, an insightful new biography by psychiatrist Robert Abrams, who chronicles Queen Victoria’s final five months of life. In it, Dr. Abrams writes a biography that not only draws on historical documents but understands these through the lens of contemporary psychiatry, medicine and psychoanalysis. Staring Night: Queen Victoria’s Late-Life Depression deserves as much attention as today’s current entertaining but less insightful royal coverage.

Robert C. Abrams, MD, a graduate of UC Berkeley and the Icahn School of Medicine, practices psychiatry at Weill Cornell Medicine, where he has received awards for clinical teaching as Professor of Psychiatry in Medicine. Dr Abrams' research has been…

Robert C. Abrams, MD, a graduate of UC Berkeley and the Icahn School of Medicine, practices psychiatry at Weill Cornell Medicine, where he has received awards for clinical teaching as Professor of Psychiatry in Medicine. Dr Abrams' research has been focused on old-age psychiatry, including personality disorders, depression, suicidality, and the humanities. Staring Night stems from his lifelong interest in 19th and 20th-century English history and from a series of published papers on the last years of Queen Victoria's reign.

Initially, when approaching it, I wondered if another biography of Queen Victoria was needed—there are no less than fifty. A quick scan of these accountings shows that her late-life decline was either ascribed to a relapse of her protracted mourning for Prince Albert, or just the decline of old age. Abrams, a geriatric psychiatrist with a deep knowledge of British history, lays out the case for a severe late-life depression.

This fact alone is of interest, but several factors makes this book unusually compelling: a closely observed end-of-life decline; the presentation of this decline in its historical context; and finally, a biography written with the utmost attention to language—sentence after perfectly balanced sentence flows.

The main material source is the Queen’s journals, which she assiduously wrote through her life. “The Queen’s accounts of her last five months of life present an often-moving ‘Book of Pain,’ in which her physical decline and person losses are described, elaborated, and lamented,” states Abrams. These last journals begin 17 August, 1900, ending on 13 January, 1901, nine days before her death. We learn of the day-in and day-out last concerns of the Queen. She struggles to maintain her official functioning, yet a lady-in-waiting returns to service after a two-month absence and notes, “The Queen is growing very old and feeble, and each time I see the change, even since August.”

The family made major edits to her writing. Abrams notes, “Whatever may have been lost the overall style and authenticity of the Queen’s writing are likely to have been preserved . . . and appear to have survived the conflagration of the original volumes.” He later writes, “Within the pages of her Journal she felt a freedom to express her genuine self . . . and in so doing she was able to find an authentic literary voice.”

The Queen’s decline is not without some rallies. She rises to official duties: “At that Council meeting, the Queen masterfully oversees the elaborate protocol involving the exchange of seals required by changes in the Cabinet.” Abrams notes this is not unusual for the course of a vascular depression, and moves between resurrecting the Queen’s history, as an historian, and understanding it as a contemporary geriatric psychiatrist. And in this, among many insights, Staring Night makes the case for the medical and/or psychiatric biography. While this genre of biography might maintain too narrow a focus, Abrams’s biography is justified on every page. He writes as if we were in attendance and witnessing the progressive demise. These five months are a window into a universal condition (late-life depression) and its “Victorian” presentation.

Abrams selects details that bring to life the court. Lady-in-Waiting Marie Mallet, a confidant of the Queen, brings her young son for a visit:

Victor danced by my side shouting, “Go to Queen, Go to Queen.” Once in the Queen’s sitting room he focused immediately on a portrait of the Prince Consort’s favorite greyhound, “Bootiful dog.” When he was presented with a small gift, he replied: “Thank-oo kind Queen.”

The documentary source for the last nine days become the notes of Sir James Reid, her physician. This material is more clinical and provides a transition to the final chapters, which include more contemporary science on late-life depression. Abrams notes, “Sir James Reid understood that Queen Victoria was depressed, but he did not fully appreciate the contribution of depression to her decline.” We are left with a glimpse into the doctor-patient relationship and the importance of positive transference and hope. Although the biography focuses on just five months, we close the final chapter as if we’ve lived through the saga ourselves.

I left this book saddened. The end of a life is difficult. That life has to end is difficult and must be confronted again and again. In hindsight we are often tempted to think—had a loved one died in a different medical era . . . This biography accomplishes something similar to Atul Gawande’s Being Mortal and Paul Kalalithi’s When Breath Becomes Air—all three express a profound experience of the end of life, a more deeply felt appreciation of life, and a sense of humility about medicine’s capacity, whether in the Victoria era or in our contemporary days.—Owen Lewis


Owen Lewis

Owen Lewis

Owen Lewis is the author of three collections of poetry, Field Light (Distinguished Favorite, 2020 NYC Big Book Award), Marriage Map and Sometimes Full of Daylight, and two chapbooks. best man was the recipient of the 2016 Jean Pedrick Chapbook Prize of the New England Poetry Club. His poetry has appeared in Nimrod, Poetry Wales, The Mississippi Review, Southward, The Four Way Review and Stay Thirsty Poets. He is a professor of psychiatry at Columbia University, where he teaches Narrative Medicine in the Department of Medical Humanities and Ethics.

In Medical Research, Narrative Medicine, psychiatric biography, Biography Tags royals, Queen Victoria, depression, mental health, mental illness

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