Narrative Matters

As I struggle with how best to respond to recent events, one thing has become clear to me: narrative matters. People’s stories matter. Words and how they are presented in written and spoken form matter. I am just a mother, just a doctor, just a writer. My daily life consists of changing diapers, getting my kids to school, managing diabetes in my patients, picking up scattered toys, treating depression, doing laundry, writing blog posts, weathering tantrums, listening to the news. It’s mundane. It’s commonplace. It feels insignificant beyond my family, beyond my little corner of the world. But recently I’m seized by the enormity of the need to respond, of the urgency to do something. It feels as if we’re ushering in one of those times: a time that tests our resolve, our character, our unity, our faith. What can one person do?

I remind myself: I am a mother, I am a doctor, I am a writer. I am a citizen of this nation and of this world. My words matter. My stories matter. My voice matters. And so does yours. This is what the world needs: our stories. I am the daughter of an immigrant and a person who welcomed a young Iraqi refugee family into her home. This family, made up of brave, intelligent, hardworking people, left behind what remained of their home, of their family and friends to come here to build a better life for their children. Their story matters. And if you sat with this father, who wants to pursue graduate level studies in the U.S., who cares about what food he eats and laughs easily and plays soccer on a grassy park lawn on a summer day with his son, maybe his story would change your perspective and mitigate your fear.

So we must start here, with our stories. Share your story. Listen to one another. Narrative is needed to break down walls and build bridges of empathy; stories are required to combat fear and xenophobia. Words matter. Truth matters. Listen to words, discern truth, share stories. This is the antidote to being paralyzed by indifference, it is the cure to saturation with propaganda, it is the remedy to “alternative facts.” Narrative is the answer to the call of such a time as this.

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Free Write Friday: Dressing

The stomp of his feet as he clambers upstairs, whiny pitch to his voice as he exclaims: “Mommy, where my clothes?” His big sister is dressing and he’s beside himself. He wants to follow suit. Three years old, he can choose his clothes and dress himself, but an older sister trying to be helpful stifles his independence by doing it all for him. 

When he was a toddler he writhed this way and that, twisting his torso with wild intention as I tried desperately to diaper and clothe him. I was surprised he was so particular about what clothes he wore. The shirt had to hang just so, the waist of the pants a specific elasticity, the fabric itself not too textured, not too rough. 

Now we lay all the next day’s clothes out the night before in a green laundry basket. After bedtime bath, they each choose clothes for the following day. Sometimes an argument ensues: a sleeveless dress in the chill of winter, pants that have long been outgrown, a shirt already stained and dirty from wear earlier in the week. The compressed morning requires this evening ritual, whether mommy is working or not. I’m either tasked with getting the oldest out the door to before school care or hauling all three to morning drop off by the the elementary school bell at 7:55 a.m. 

The baby is easy. No choice in the matter, she wears what I choose, what the nanny decides. On work days I arrive home, sometimes surprised at what the nanny has chosen, more or less layers than I would have picked out, leggings matched with a top I hadn’t considered. If I’m home for the day, often I’ll leave the baby in her pajamas; an easier non-choice for a harried mama of three.

After dressing, my eldest moves on to accessories. She carefully selects a headband, brushes her hair, the front part at least, to a gleam, considers her reflection in the mirror. She tries on a turquoise ring, takes it off. She adorns herself with a beaded necklace, or two. Sometimes she practices her ballet moves on the blue step stool in the bathroom, lifting a lithe leg, pointed toe, reaching up behind her like a flamingo’s pink neck, extending to the sky. The elegance and simplicity of the moment gives me pause before I rush her, rush us all, finally clothed, out the door. 

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Narrative Medicine Monday: Monday Morning

Audrey Shafer, an anesthesiologist and mother, writes of medicine and motherhood in her mesmerizing poem “Monday Morning“. Highlighting two simple moments at home and at work, Shafer explores the contrast and commonalities between motherhood and her work in medicine. No wonder I love this piece!

What do you think of the juxtaposition of the narrator’s young son and the cool sterile environment of the operating room? The OR is a glaringly lit, predictably ordered, pristine place. As a mother, I could picture the incredible contrast of her preschooler son’s soft body clutching his favorite blanket in the dim early morning. A home with young children is often unpredictable, littered and intimate.

Shafer comments that the one who is exposed and vulnerable in this poem is the author herself. Would you agree? What do you learn about her as a person and as a working mother by reading this poem?

Writing Prompt: Think of a moment at work that reminded you of or seemed in direct contrast to a moment at home. How does your personal life inform your work and vice versa? Write for 10 minutes.

 

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Free Write Friday: Cafe


The glass door swings open awkwardly; it easily gets stuck. It’s slow today, rainy outside and indoors is a refuge. Roasted coffee grounds suffuse the air, I breathe deep for the caffeinated aroma to wake me. Glass display case houses delectables. I like the cinnamon roll scones, butter and spice infused pastry crumbles at the touch. 

They know me here. “The usual?” One barista dark haired, glasses, someone I might be friends with if we were contemporaries in college. She usually has her hair pulled back, a ready smile. She inquires about my kids, about my weekend. The other is more quiet, still friendly but I find a kinship in her introversion. They trade off working the espresso machine, making the savory crepes and manning the register. They work well together.

Music is varied, dependent on the day. Today it is soft, vibratory melodies, barely perceptible. The other day it was David Gray, flashbacks to the 90’s and early 2000’s. I liked the melancholy music; it triggered memories of a transitioning millennium, a time of before and after, when we were all ushered into a dark and divided new norm. 

They remodeled the coffee shop recently, adding wood panels, copper lighting. The concrete floor rings cold and is polished roughly. Anywhere else it would chill me, this floor, but here the soft bare light bulbs overhead, the steam rising from the espresso machine, the friendly conversation between neighbors, the head down seclusion of the newspaper reader: it warms me.

I like the quiet, the bursts of gentle laughter, the sound of sipping coffee, of cups resting on square tables, of tip-tap typing, of a clanking of dirty dishes as we each take a morning pause, collective and caffeinating into the new day.

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Dissatisfied

“Somewhere somebody must have some sense. Men must see that force begets force, hate begets hate, toughness begets toughness. And it is all a descending spiral, ultimately ending in destruction for all and everybody. Somebody must have sense enough and morality enough to cut off the chain of hate and the chain of evil in the universe. And you do that by love.” – Martin Luther King, Jr., 1957

Today, this week, this year especially, it seems important to heed the words of Dr. Martin Luther King, Jr. I’m particularly struck by his call to “divine dissatisfaction” in his 1967 speech “Where Do We Go From Here?” May we all meditate on his words today and may they stir us to action. Let us all be dissatisfied.

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Free Write Friday: Makeup


She pulls out the shiny magenta case, like a tackle box but smooth at the edges, a mirror secured inside the lid. “I have to fill it with my makeup!” She exclaims, moving from room to room, collecting her beauty things. “Mom, have you seen my mermaid lipstick?” No, I haven’t. I hid it away somewhere and promptly forgot where I put it; a parent’s prerogative. It’s not really lipstick, just rose tinted chapstick, gifted to her by a well meaning friend. I got rid of it as soon as I was able to without her immediate protest. 

I suspect she suspects me as the thief, the culprit discarding of her treasured beauty trinkets, but I have to accept her eventual disdain for my actions. She’s five. She loves long flowy dresses, she’s gravitated toward high heels since she was two. She collects hair accessories like they’re candy, items to be savored and adorn her mousy brown locks. I worry. Will she be superficial? Will she self-scrutinize? Will she be consumed by what she looks like, how she appears to herself and to the world? Of course she will. But I want to temper the inevitable, preemptively find a way to help her emerge from the challenges of girlhood with the foundation of a healthy identity intact. 

She watches me hawk-like when I put on my own paltry morning makeup, scrutinizing every move: sponge applies a tinted moisturizer, brush of peachy blush, a swipe of eye shadow. I just started wearing mascara again a few months ago, conscious of my aging beauty regimen and tired mama eyes. She studies me like an artist regarding a celebrated sculpture, trying to deduce the method of craft. I’m self conscious as she analyzes me, defensive at my feminism and wondering at my hypocrisy in wanting her to avoid the trappings of the beauty counter world.

She and her brother used to stand below me as I regarded myself in the mirror, applying my cosmetics for the day. They’d ask for a makeup sponge and imitate my movements, swiping over their face and neck. Eventually they’d bore of this and use the sponges to “clean” the bathroom walls; perhaps a more appropriately concrete activity to occupy their imagination. 

She doesn’t really have any makeup of her own, so she fills her plastic box with sparkly headbands and large hair bows. She corrals her tiny hairbrush and her brightly colored elastic bands. I want to protect her from the self-scrutinization, the self-criticism of being a girl in this superficially focused world. I want to adjust her own lens, swap it out with one that filters with self-acceptance, appreciation of variation and an ability to discern a deeper beauty, the kind essential to all that matters.

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Narrative Medicine Monday: Family Summons

When rotating through the Intensive Care Unit in medical school or residency, one of the most significant skills learned, in addition to adjusting mechanical ventilation settings and how to run a code, is how to conduct a “family conference”. This is where loved ones, preferably including the patient’s designated medical decision proxy, gather to discuss the patient’s status, prognosis and treatment plan. As these patients are severely, sometimes suddenly, ill, these can be very challenging conversations. 

In “Family Summons” Amy Cowan illustrates how she was surprised to have a patient’s family gather in the middle of the night, wanting to speak with her as their family patriarch’s physician. Her piece highlights how important it is to listen and extract the true identity of the patient, the life they lived beyond the ICU. Establishing this portrait can help inform the care team as well as free the family members to make decisions in line with what their loved one would want.

Writing Prompt: Have you ever attended or conducted an important medical family conference? How was it run? If not, can you imagine what questions you might ask to best get to know the patient? Think about if you were the patient in the ICU; who would you want to gather on your behalf and what might they say when asked about you and your life, what’s important to you? Write for ten minutes.

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Free Write Friday: Resolution

She’s a goal setter, a rule keeper, a list maker. She pulls out the worksheets early each January, looks back, plans forward. There are questions about finances and fitness, family and work. She found this simple form years ago and it’s her favorite. Straightforward and practical, with New Year’s Eve reflections and promptings for concrete steps to be taken in the unblemished year to come.

Light streams in through the dining room windows, tainted with tiny handprints and a subtle layer of accumulated muck. The answers flow this year, falling out of her head and onto the page. 2016 was a crucible of sorts and it’s time to rise from the ashes. 

Midlife reached, she’s realizing the truth: that everyone hides in their cocoon of facades, that we share too little of ourselves, that authenticity is a rarity and an unexpected gift to those around you. Life isn’t just messy, it’s cruel at times. But the beauty, astounding magnificence, really, is in the sharing, in the connection that comes from journeying through the valleys together.

This all pours out, onto the page, infusing her goals, her plans, her lists. And what stands out: grace, boundaries, sleep, kindness, gratitude. So she starts with these as she binds herself to her tribe, stepping a little more boldly, a little more bruised, a lot more vulnerable into the new year. 

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Narrative Medicine Monday: Published!


Starting the year off sharing some great news! I recently received in the mail the Fall 2016 Edition of OUHSC’s Blood and Thunder Journal, which includes two of my essays. I’ve had several pieces published in online journals but there is a special kind of excitement that comes from seeing your name in print on a tangible page. I’m humbled that two of my favorite shorts “Expectant” and “Burst” found a home in this narrative medicine collection.

“Expectant” chronicles the very first delivery I witnessed. Obstetrics was a revelation to me as a young medical student, especially never having had children myself. I was in awe of the entire process and this short essay reveals my own insecurities as I was christened into the world of medicine.

“Burst” is about my first continuity delivery in residency training: a pregnancy meant to be followed throughout all nine months to completion. I was a new physician and had much to learn about the unpredictable nature of obstetrics.

One of my writing goals for 2017 is to make significant progress on a book-length collection of narrative medicine essays.  I’m starting the year off taking Creative Nonfiction’s online course “Writing Your Nonfiction Book Proposal”. Finding time to edit and submit my work has been a continual challenge but writing classes provide encouragement and structure to make the time, harness the energy and muster the gumption to keep at it. I’m eager to let go of the draining and perfectionist tendencies of 2016 and write on in 2017. Holding a palpable culmination of my writing efforts is an encouraging way to embark on a new year and I’m grateful.

 

 

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