Narrative Medicine Monday: Air Hunger

The narrator visits her mother in the hospital in “Air Hunger,” a striking short essay found in University of Virginia’s narrative medicine journal Hospital Drive

Two months have passed since she last saw her mother, but in the interim the narrator notes her mother has “become a patient.” The details the writer shares give us a glimpse into how her mother’s illness has changed her over time. Her mother barely touches the lunch tray beside her hospital bed: “She picks at her food, but it’s air that she’s hungry for.” The narrator wants to ask her mom how she feels, but already knows the answer: “I can see what I see, I can hear what I hear.”

Writing Prompt: Have you witnessed a loved one’s deterioration of health over time? What was it like to see them in one light and weeks or months later note a dramatic change? Do you remember a moment when they became, either to themselves, to you or to others, “a patient?” Write for 10 minutes. 

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Free Write Friday: Pumpkins

Pumpkins reign this time of year. Pumpkin spice infuses dense breads, pumpkin syrup sweetens lattes thick with foam, bulbous pumpkin costumes cushion costumed kids, oven roasted pumpkin seeds sprinkled with coarse salt are browned to a satisfying crunch. At the pumpkin patch my son collects them in his wheelbarrow like he’s hoarding for hibernation, rolling the lumpy gourds along the uneven ground, raising the smallest with handled stems above his head triumphantly. He’s working, intent on his task, unaware of the futility; we’ll only need a few of the treasures he amasses. 

We’ll carve them, paint them, light them from the inside. Set them out on the front porch steps. They’ll rot from the bottom up, browning and reeking, black mold creeping up the sides like sinuous coils of vines, a ruinous infestation. The children will dress up, pretend to be, gather their eager plastic tubs, pumpkin shaped with garish black triangles for eyes, nose, teeth. 

They like the flickering glow as jack-o-lanterns wink from neighbors’ homes. Each unique, each decaying from the moment they are chosen. Plucked from the earth, carved and admired for a fleeting celebration, a macabre exultation, as darkness descends into shorter days and longer nights, as the curtaining chill causes retreat into fireside evenings, woolen socks, cups of steaming tea cupped in chapped hands. 

Pumpkins serve a transition: the yellow summer glow into the crimson of the winter season. The jarring contrast tempered by this orange intermediary, tolerated, even embraced, if only for a month or two.

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Narrative Medicine Monday: Feeding Tube

In “Feeding Tube” author Susan Kelly-DeWitt relays a memory of paper birds that a patient’s family hung over the hospital bed “wild tropical birds, macaws and toucans, parrots and cockatoo.” The visual that Kelly-DeWitt provides is vivid. The reader comes away feeling that humanity reigns over the mechanical devices that tend to dominate the hospital landscape.

I remember very little about the physical details of the critical care hospital room where I participated in my first code as a medical student. I do remember sitting by the resident physician as he wrote his note in the patient’s chart at the nurses’ station just after the man had died. I looked across the desk into the patient’s glass-walled room, my eyes fixed on an elaborate dream catcher hung carefully, just over his bed.

Writing Prompt: The hospital can sometimes feel a like a sterile, mechanical place. Think of a moment or an item, like Kelly-DeWitt’s paper birds, that struck you as out of place or particularly telling about a certain patient, their family and their life. Write for 10 minutes.


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Free Write Friday: Lists

I’m the kind of person who likes to make lists. Grocery lists, to-do lists, lists for work tasks, home tasks, personal tasks, lists of things I should do today and this week and this year and this lifetime. Yellow post-it notes litter my work desk, stuck to my computer monitor, clogging up the fabric tackboard mounted along one wall. I’ve tried different techniques in the past to manage my lists, but paper is still my preferred method. My purse is peppered with scraps torn from a gardening store mailer or a cafe napkin, reminding me to pick up milk and tampons and cough drops on my way home. We have an app now to keep the convoluted family schedule straight, each of five family members assigned their own contrasting color, but the to-do list blankly staring back from a palm-held screen doesn’t work well for me. I forget to check it, there isn’t the same satisfaction with crossing off, tossing a scrap of paper, purging the item from my mind and my day.

Sometimes I’ll find an old list in a rarely-used purse or backpack. I’ll remember that particular week, the mundane tasks I felt were so urgent, so important at that time. Order cupcakes for my son’s birthday, send that email to my boss, finish editing an essay for the submission deadline looming, now long past. Once I found an old list from my wedding, the endless tasks for that momentous event crossed out carefully. There were a few things still left, that never got done. There always are. 

I’m the kind of person who likes to color code. I’m a splitter, not a lumper. In medical school I had an infamous binder: two inch white with a clear slotted cover, brightly colored tabbed dividers for each course. Red for Histology, green for Pathophysiology, orange for Intro to Clinical Medicine. I had a separate binder for Anatomy; all those organs and nerves and blood vessels, origins and insertions of muscles to memorize: they deserved their own separate filing. Colored pencils used to sketch out each organ, each nerve pathway, the sequence of events mapped out for optimal memorization. 

I’m the kind of person who likes to plan for every contingency. Futile, I know. Futile, I’ve realized. Futile, I still plan meticulously, despite knowing better. Now, I at least have the realism to not expect as much from my planning, know it all may be in vain, know that lists and organization and planning ahead only achieves calm for the now. Eventually chaos ensues and chaos, despite best laid plans, ultimately reigns.

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Narrative Medicine Monday: The Dilemma Doctors Face

The spotlight has recently been on the opioid epidemic ravaging our country. As a primary care physician, I’m acutely aware of this issue and the challenges it poses to individuals, medical providers and the public health system as a whole. NPR’s The Takeaway recently did a program on understanding this crisis and approached it from many angles. Dr. Danielle Ofri wrote short a piece in Glamour magazine that gives a primary care physician’s perspective. In “The Dilemma Doctors Face,” Ofri notes that chronic pain is very real but differs from other chronic disease in that there is no definitive test or measurement for pain, it is subjective. “Chronic pain is real. It can ruin people’s lives. But the anvil of addiction and death can’t be ignored.” Ofri asserts that one challenge is that a system that doesn’t often pay for other ways of treating pain, such as physical therapy, acupuncture and massage, makes it easier for the medical provider to “just write a prescription.” Can you relate?

Writing Prompt: Have you or a loved one struggled with chronic pain? What were the challenges you faced when trying to find appropriate treatment? Have you or a loved one struggled with opioid addiction? What was the first sign that this had become an issue? If you prescribe opioid pain medications, how do you approach counseling patients about the risks and benefits of taking these medications? What are some of the challenges you’ve faced in having this discussion? Write for 10 minutes.

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Free Write Friday: Exercise Equipment

She’s tried gym classes, Jillian Michaels DVDs. She’s run around the track, jogged over wooded trails studded with stones. She’s done two-a-days, eager teens taking turns running drills, hard stops at the line, lifting barbells in the weight room behind the lunch room behind the theater where they held the high school dances. 

She’s bought stretch bands, barbells, balance balls, plastic steps with risers. She found a pull up bar for free on the local mom’s list serve. They buy and sell fancy rain boots and football tickets and ask each other for advice on family-friendly resorts in Zihuatanejo and the best estate planning attorneys and drop-in childcare and ways to get kids involved with climate action and places for Santa photos over the holidays. She fits right in.

She’s taken yoga classes – not hot – that seems unnecessarily suffocating. Spongy mats laid out on the hardwood floor, downward dog and sun salutations with arched backs into flexed toes. Tree pose her favorite: upright and accomplished, easily mastered with her gift of balance and big feet. 

She’s taken pre-dawn boot camps, meeting a group of head-lamped women exclaiming encouragement as they huff up dozens of stairs, breath billowing into the chill morning, sweat trapped under layers of workout gear. She liked having others to exercise with, run hills or jump into burpees, but the classes just weren’t sustainable after having her own children. The other demands of the morning, of harried family life took reign. 

She’s had an online trainer, focused and encouraging but intimidating with her exposed washboard abs. She’d never dieted but for the first time in her life she paid attention to what she ate, limited her junk food, her evening snacking; stopped eating sweets and bags of chips and salsa and glasses of wine whenever she wanted. She stopped indulging in huge bowls of homemade popcorn, puffed and crunchy, doused in hot butter, sprinkled with salt, handfuls melting unceremoniously in her eager mouth, absently stuffed while watching another Netflix episode of Breaking Bad or The Wire or Game of Thrones. She got enough sleep. Felt strong, empowered. 

She’s pushed an unwieldy jogging stroller around the lake, 3.2 miles of sneakers pounding on damp asphalt, muddy gravel, swerving this way and the other to avoid the deep ruts, the many pools of murky water that coalesce after a spring rain. She got to know each curve of the path, each puddle, each turn of season that marked the route like an aging backyard maple, imperceptibly swelling trunk, leaves changing and falling and budding again.

And maybe that’s fitness: fits and starts and seasons and patterns. Lately she’s fallen back into her flesh, into her routine, into her strength and stamina; the muscles build, the mind clears and her body is her own again. 

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Those Winter Sundays

I was at the Write on the Sound Writers’ Conference all weekend, so wasn’t able to prepare a Narrative Medicine Monday post for today. I’ve been reflecting, among other worthy writerly thoughts, about how I attended WOTS last October, just one year ago, as my first ever writing conference. At that time I gingerly entered each room, compressing myself into an imposter, sure that I would be discovered as a fraud. I imagined my fellow attendees, accomplished published authors thinking, “What are you doing here?” The entire writing world, culture, was foreign to me. I struggled to fit pumping in between conference sessions, even nursed a four month old baby in the car briefly while my family was passing through town. I’m now done with the harried, urgent stage of pumping; have retired my trusty Medela Freestyle and all its various plastic components for good. It’s remarkable to me that it’s only been one year. In those twelve months I have developed detailed writing goals, including a complete nonfiction book proposal, a regular blog and platform plan and have my eye on contests, training programs and retreats and residencies to further my work and aspirations as a writer. 

I’m currently taking an online poetry class, which is stretching my every writing muscle. I’m back to basics, learning about sound and syntax, metaphors and consonance, iambic pentameter and anaphora. Both my poetry class and one of the weekend conference sessions highlighted this poem by Robert Hayden: “Those Winter Sundays.” As a mother myself, entering middle age, reflecting on much of my perceptions and misconstrued moments of my youth, this poem spoke to me this week. Try reading it out loud and note the tools Hayden uses to portray his father and his perception of his father, both in his youth and looking back as an adult. What speaks to you in a poem? Have you tried reading poetry out loud? I’m grateful to be learning more about poetry this fall and hope to share more with you in the coming months. 

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Free Write Friday: Bike

We walk the bike to the cul-de-sac, center the powder blue contraption in the middle of the street. My dad’s leathered hand holds the back of the white banana seat. I clamber on, gripping the handle bars till my knuckles whiten. I lean too far forward as the bike teeters precariously side-to-side. A white wicker basket hangs from the front, adorned with plastic daisy flowers in bright colors; it is the consolation prize for a hand-me-down bike from my brother, meant to transform it to an acceptable level of femininity.

I push one sneakered foot down, then circle the other. My ankles waver as my dad trots behind. I glance anxiously over my shoulder; is he still there? Pumping my legs, the sudden transition to stability is exhilarating. Wind slapping my face, wisps of dark hair waving behind. I’m flying!

I suddenly panic, remember: I’m unsteady, I’m unsure, this is new. Is he there? I turn just slightly, a glance for comfort. But he’s gone, far behind me. As he grows smaller in the distance, the angst in my own chest expands. “Keep going! You’re doing it!” He shouts. But the trembling, the uncertainty have already taken hold. Anxiety disrupts and I topple: bloodied knees, gaping frustration as I crash down.

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Narrative Medicine Monday: Lithium and the Absence of Desire

Virginia Chase Sutton’s wrenching poem “Lithium and the Absence of Desire” warns of what may be lost in taking a necessary medication. She deftly describes the world before starting lithium and the reader is entranced along with her, “dozing in light and soaked color.” Despite side effects causing a graying of her world, the author dutifully takes “the medication as prescribed.” Written in second person, the reader is drawn into her longing for what she has lost and together we collectively struggle in vain: “Strain all you will but you have given desire away.”

Writing Prompt: This poem describes a negative, even devastating, side effect of a medication, yet the writer recognizes there was “No choice since you must take the pills.” Have you experienced a minor or life-altering side effect from a medication? Describe life before and after starting the medication. Did you keep taking the medication as prescribed, or did you search for a different treatment? Write for 10 minutes.


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