Narrative Medicine Monday: #3 In Line

Eliza Callard imagines a lung transplant in her vivid poem “#3 In Line.” She begins by describing the surgeon’s actions lifting “the sodden lungs out,” but then pauses to wonder about the patient: “Where will she be for all this?” Callard touches on the desperation following any transplant to get the foreign object to “stay, stay,” to trick a body into accepting an imported organ as one of its own. 

Writing Prompt: Imagine an organ transplant: liver, lung, kidney. Write about the transplant from several different perspectives: that of the patient, her body, the transplant surgeon, the patient who donated the organ, even the organ itself. Write for 10 minutes. 

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Free Write Friday: Lockers

You have nightmares about lockers. Narrow gray sheets of metal from ceiling to floor, endless rows line the halls. You circle the maze of corridors. You’re turned around, pressured, panicked, late. You can’t find it at first, the one that belongs to you. You pause at one, then the other: all wrong, all empty. 

Others watch you, they laugh. Or, worse yet, they ignore you. You’re insignificant. If you finally find what you’re looking for, it’s shut, impenetrable. You spin the lock to the right, to the left, to the right again. The white notches of the knob blur and you realize your numbers are wrong, it’s all wrong. 

Something’s off, you can’t remember. You missed whole assignments, entire courses, a full year of your life passed by all wrong; you forgot to pay attention. You rush for help, but it’s no use. You can’t recall time and now it’s too late. You won’t resign yourself to fate, so instead you struggle. You keep spinning the lock back and forth, back and forth until it clicks open. But it doesn’t matter now. Instead of relief you feel grave, an ominous weight when you unlock what you’re looking for. The moment, the urgency, the purpose, it’s passed you by. 

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Narrative Medicine Monday: An Expert in Fear

Author Susan Gubar writes about cancer making her “An Expert in Fear” in her timely essay. She asserts that this anxiety has become more acute in the recent political climate, with debates about major changes to healthcare, Medicaid and insurance coverage in the forefront of our national discourse.

Gubar contends that cancer fears fuel other fears and that cancer patients become “experts in fear.” If you’ve dealt with cancer, has this been your experience? She also highlights the detrimental impact fear can have on our health, and that severe financial distress has been found to be a risk factor for mortality in cancer patients. Gubar feels there is no appropriate word for the dread she experiences today. It is a “fear of fear spiraling into vortexes of stunning trepidation” and has, in fact, become all-pervasive and metastatic. 

Writing Prompt: What fears do you harbor related to health and illness? Have you found that the political climate impacts that anxiety? Do you agree with Gubar that fear is pervasive in today’s world? Write for 10 minutes.

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It’s a Book!

Looking for some great summer reading? The 9 Lives: A Life in 10 Minutes Anthology makes for an entertaining beach or bedtime read. This collection of creative nonfiction stand-alone pieces is authored by writers (including yours truly!) from all over the world. You can pick up your own copy from Chop Suey Books online here and “advance through the ages and stages of life, from birth to death, from our first breath to our last.” Don’t miss my essay “Fired,” written about one of my last moments with my beloved grandpa Gar.

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Free Write Friday: Track


On rainy days they start in the smaller gym behind the high school, line up on the basketball court for drills: high knees, butt kickers. They stretch into a runner’s lunge as sweat beads inside their hooded polyester tracksuits. 

She heads out with the sprinters for a warm-up run, worn sneakers pounding on the asphalt. Up the street, past the 7-Eleven, winding through trails on the office business complex, then back to the track, powder blue with white accents, modeled after school colors. 

They run drills, the sprint coach standing on the football turf, stopwatch in hand. He shouts instructions, encouragement, critique of form. They stretch and socialize in between. She watches the teenage boys, tries to be nonchalant. Their skin is greasy, awkward bodies too short or too thin. The stench of dysregulated pubescent odor is far enough away to still render them somewhat appealing to her adolescent eye.

On meet days, her stomach churns, she hardly eats. She forces bites of bagels and grocery store fried chicken (someone told her chicken was good: protein) and Power Bars. Sips of Gatorade colored unnaturally green, blue, red make her feel athletic and replenished. Unfortunately, her events are always near the end of the meet. She has to wait in gastrointestinal distress, rushing to and from the bathroom, for the 400 meter dash, the 4 x 400 meter relay. 

Finally her turn, she strolls out to the starting blocks, placed with the stands mercifully behind her. She sets them up to her specifications, right foot back, left foot forward. She checks her spiked shoes, slim white with a neon green detailing and magenta Nike swoop. Her wide feet and long toes always feel overly compressed in the racing shoes, like she is trying to squeeze herself into something that doesn’t quite fit.

The gun sounds and she’s off, pumping arms, cycling legs. She’s ahead going into the first straight away. But they’re staggered, it’s deceiving. She never was good at pacing without someone in front to follow. She always goes out too hard, too fast. She sees opponents emerge from behind her: one, two, three. Heading into the second curve she begins to hear the crowd, their voices register in her ears as one dull roar. As if surfacing from underwater, the wave of sound is suddenly upon her, the cheers. 

Sometimes her dad stands small at the chain link fence, right before the final straight away shouting, “C’mon! C’mon!” She hears his words echo in her head as the lactic acid takes over, rounding the final curve. From behind more emerge: one, two. She slows. Out too fast again, there’s just nothing left to give. 

She keeps moving, somehow, to the finish line, crosses over without her legs giving way. She leans forward, hands on knees, lungs burning, legs screaming with fatigue. The release then comes, a dissolution of tension as the stress, now behind her, lifts. She always thinks after: I could have run faster, could have tried harder, could have given more. 

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Narrative Medicine Monday: Bedside Rounds

John L. Wright’s poem, “Bedside Rounds,” speaks to the apprentice-like training of physicians. It is a passing on of skills from the experienced to the inexperienced, from the knowledgeable to the clinically naive. Most medical students, unless they have a background in another medical field, have little to no real experience in the hands-on component of medicine. They take years of study – biology, anatomy, pathophysiology – and translate that book smarts into skills of diagnostic touch, suturing skin, prescribing treatment. 

One method of transforming head knowledge to a practical skill set is through bedside rounds: a gaggle of medical students and resident and fellow physicians (still in training) following after an experienced attending physician. Each morning this group travels from bedside to bedside, discussing the patient’s disease, the patient’s prognosis, the patient’s progress, the patient’s treatment plan. In recent years, medical schools have worked on making this process more inclusive of the patient who, after all, is the subject of the discussion. 

Wright’s poem touches on the experience of that patient, ill and incapacitated, being talked over in a cryptic language, determinations being made about the status and plan while the patient may still be steeped in a cloud of confusion. 

Wright finds himself in a comparable situation when his landscape architect brings her intern along with her one day. As this professional passes on her skills to her protégée, discussing his yard in detail, Wright begins to feel something he hadn’t expected: “I begin to resent them—the little games they play.”

Writing Prompt: Think of a time you’ve experienced bedside rounds as a physician, as a patient or while visiting someone in the hospital. If you were the patient, how did you feel when the medical team discussed your case in front of you? Did they include you in the discussion or explain what they talked about? If you’re a medical provider, choose a memorable bedside rounding experience: running rounds for the first time, being a brand new medical student, noticing something significant with the patient’s demeanor while their case was being discussed. Write for 10 minutes.

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Free Write Friday: Pool

2017

I hold her squirming, slippery toddler thighs, evasive like slick eels. She clomps her feet down, uneasy steps in the little pool, even with the extra buoyancy of the chlorinated water. She likes to open her mouth, like a great whale, letting the pool seep in, then out through her widely spaced teeth, two on top, two on bottom. She, surprisingly, exults in going under, seems to fall purposely: Oops! Silly me! Throwing her head back, eyes squeezed tight shut as she leads with her upturned chin, mouth open, nostrils flared, beckoning the water toward her until she is fully immersed, sinking, trusting that I’ll catch her, lift her upright to breathe clear air. As she emerges, a look of unadulterated glee followed by just the faintest hint of melancholy. A mermaid she wishes she could be.

1990

She is so thin and graceful, wearing an electric blue bikini, mousy hair. I’m surprised when she approaches me poolside. Overweight and awkward, I wear my pudginess like armor; it keeps me humble, it keeps me introverted. I long to be charming, liked. Don’t we all at this preteen age? (At every age.) I can’t believe it: friends with me? She’s inquisitive, chatty, polished. I feel more elegant just being near her. It is revealed eventually, this is the truth: I am just a means to her end, a conduit for connection to my tall, older brother. He has reached the golden age: past gangliness, past acne, post-braces. I’m in awe of him too. 

1983

I’m learning to swim in the side pool, previously a hot tub but converted to what we call “the baby pool.” A bridge of dark brown tiles, just an inch under the surface, divides the tiny pool from the larger. Like a stumpy appendage, a bleb of an outgrowth, the small pool protrudes. The older kids like to coast back and forth on their tummies, sliding like monk seals. I can barely touch the bottom, on my tippy toes I bounce along, suspended for just a moment, like a moonwalking astronaut. A perimeter ledge for seating, I leap from side to side arms outstretched with orange inflated “muscles,” skinny legs flailing behind me. Sometimes I sink under with the effort, sour liquid up my nostrils, eyes stinging from chlorine. I grab the a handhold of smooth tile, turn, and try again.

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Narrative Medicine Monday: Architecture of Mental Illness

This fascinating National Public Radio story by Susan Stamberg reviews an exhibition at the National Building Museum exploring the links between architecture and mental health. It outlines the history of Washington, D.C.’s St. Elizabeths Hospital, first opened in 1855 and championed by Dorothea Dix, a pioneering advocate for more humane treatment of mental health patients.

The article states that Dix “‘believed that architecture and landscape architecture would really have a role in curing people.'” Do you agree? Have you witnessed physical surroundings play a significant role, either positively or negatively, for a patient or loved one with mental illness?

Some of the photos included in Stamberg’s story conjure up a dignified 19th century hotel. Dix was a proponent of having beautifully manicured grounds and St. Elizabeths was designed specifically to have “natural light and views of the outdoors” and “heat, tall arched windows and screened sleeping porches where patients could catch summer breezes.”

Writing Prompt: Use one of the photos from Stamberg’s story as a writing prompt for a free write. Imagine you are one of the patients (or nurses) in the St. Elizabeths Hospital of the 19th century. How does the space make you feel? Alternatively, if you’ve visited or worked in a contemporary inpatient mental health facility think about the design of the place. How could it be improved on? How do you think the features affect the inpatients? Write for 10 minutes. 

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Mothers in Medicine

I’ve long been a fan of Mothers in Medicine, a collaborative blog of supportive mama docs. Many of the contributors are still in medical training and the community is made up of various different specialities. I’m delighted to come onboard as a regular contributor to MiM. You can find my posts under “MP.” I’m so grateful for this community of mama docs who get it. If you’re a mom or momma-to-be and at any point in your medical training or career, I recommend checking out Mothers in Medicine as the candid posts are honest and instructive about the challenges of holding these two important roles. 

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Free Write Friday: Cliff

Note: This week I’m trying something new with the free write – a prose poem incorporating synesthesia. I was inspired by a Till writing workshop I recently attended, presented by poet Jane Wong. As always, feel free to use the photo above as a prompt for your own free write. Consider joining me in experimenting with an unfamiliar format this week. 

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Crackling of palm tree, fronds brushing carmine in the breeze. Squawk and tweet of birdsong, just beyond ear’s reach, punctuating high above. The turquoise wash of crashing waves below, colliding onto ebony rocks stoic as the spray recoils, resorbed by the expanse. Memories of jumping off, sound muffled, then expanding beyond into the greater sea. I climb the cliff, handholds of familiar crevices. I swim into the current, decades of tracing the reef map a mind’s fingerprint of coral phalanges. Thick blades of grass underfoot infuse the yellow taste of papaya. Nenes swoop in, then saunter through air thick with humidity. Specks of snorkelers flap fins, return to lie beached, their skin leathered like dragon fruit. Cloud shadows caress the ridged mountains, marking them like a bruise, feeding them with rain. One drop, then two trickles. The sea turtles gulp the air then dive into dry sweetness. They disappear but I never saw them, only heard shells cracking from a memory decades old. Momentary waft of plumeria, ginger, coconut, lilikoi, banana leaves suspends in the air just long enough for it to roll on my tongue, breathe into my lungs, absorb through my skin leaving an imprint, marking me home. 

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