Narrative Medicine Monday: Anatomy Lesson

Poet Nellie Hill illuminates the process of learning anatomy in her Bellevue Literary Review poem, “Anatomy Lesson.” She notes that to “understand the heart you’ve got to memorize…” I remember searching for ways to memorize, as one professor put it, the “firehose” of information required as a new medical student. Anatomy is especially daunting, with all the blood vessels, nerves, muscle origins and insertions. Dissecting cadavers in anatomy lab is a rite of passage for every medical student, but we also drew pictures, color-coded organ systems, made up songs and stories to help us remember the essential information that is the human body. Hill starts with memorization, but takes the reader on a journey down the “snake path” of the body “to where thoughts become memories or dreams.” I like the imagery of “anatomy stacked like a ladder from your toes” and how Hill hints that the functional organ itself may also hold an intangible purpose.

Writing Prompt: Think about when you first learned anatomy. Even if you’re not in the healthcare field and never took a more intensive course in the subject, we all learn about basic bones and organs as children. Did learning about anatomy help you to see the body, and your own body, differently? When was the last time you thought about anatomy? What are your thoughts on how the physical body or certain organs might be connected to a greater or hidden purpose (acupressure points, the mind-body connection)? Write for ten minutes.

 

Continue Reading

Free Write Friday: Ski

She looked up the mountain, the hill she learned on. Remembering the rope tow, gripping tight with mittened hands, chapped cheeks from chill winds. She wore a patterned hat, pulled it down over her ears, lobes pink. Her toes and fingers instantly numb to the freezing temperatures.

***

Her grandfather took her to buy new skis when she was in high school. She had never had new equipment before, always hand-me-downs from older relatives. It felt luxurious, the shiny new blades strapped to matching boots, electric blue with neon yellow accents. She sat compact on a wooden bench in the family owned ski shop, the only acceptable place in the well-to-do suburb to buy skis. The employees fit her feet to the restrictive boots. They felt tight, compressing, oppressive. Everyone assured her the fit was right but her long toes would burn with every run for decades to come.

She never took lessons, only her father giving instruction same as when he taught her to ride a bike or tie her shoes or scramble an egg with rice and just the right amount of soy sauce. He was matter of fact, detachedly patient, waiting for her to overcome her fear. She remembers the swelling of anxiety, looking down the sloping hill, the enormity of getting to the bottom an overwhelming task welling in her chest.

***

The beginner lift slows to a crawl, allowing novices to sit their layered bottoms down onto the cushioned seat, warily grip the arm rest, avoid looking down as they are lifted skyward, skis dangling, boots weighty, gravity pulling like a string taut to the ground.

Looking down, through ski tips, there’s nothing to keep one from slipping: a wayward glove, an aberrant pole, dangling then falling, floating, to the silent impact of snow drifts below. The silence, the stillness of the buffering snow soothes while coasting upward past white coated evergreens, tiny skiers like miniature figurines expertly weaving curves this way and that far below. There’s calm in the severity of the landscape, a numbing peace inherent in the crushing steepness and chill.

Continue Reading

Merry Christmas

Here’s a holiday poem, compiled by author Kwame Alexander, consisting of contributions from NPR listeners. This community poem is made up of lines about what listeners like most about this time of year. However you celebrate, or ache, on this day, may you find light and hope as a new year dawns. Peace and joy to the world.

Continue Reading

A Day

Yesterday was one of those days that derailed quickly. One thing after another, nothing major or too traumatic. Just one mishap exacerbating another making for a terrible horrible no good very bad day. So no free write today. Instead, I attempt to regain some composure, some perspective and wish you a wonderful fabulous all great very good day.

Continue Reading

Narrative Medicine Monday: Someone Else’s Pain

Brenna Working Lemieux’s poem “Someone Else’s Pain” illustrates the struggle to understand what others are feeling, how challenging it can be to fully grasp another’s suffering. The patient experiences “some driven-screw anguish that flares” that they attempt to explain. Lemieux can only “nod or shake [her] head.”

I can relate to Lemieux; medical providers regularly face the challenge to decipher a patient’s explanation of illness or pain. I delivered babies for many years before I had my own children. After I experienced labor for the first time myself, I cringed recalling many of the comments, modeled after other medical providers, I had made to laboring patients prior to experiencing that pain myself. I had been sympathetic to their pain but could not embody empathy in the same way I could after I had gone through a similar experience. I had no reference point to the crushing agony of contractions that I would later understand. Of course, we can’t fully experience everything our patients go through. However, we can become better at listening and responding to the story they are trying to tell.

Lemieux likens listening to the patient describe their pain to the focus she had in art class, “trying in vain to capture” an image of her hand. Her poem illustrates the nuances and importance of narrative to medicine, the need to hone our listening and storytelling skills to improve the relationship between patient and physician and, ultimately, medical care as a whole.

Writing Prompt: What is the biggest challenge in understanding another person’s pain or illness? Have you ever tried to describe such an experience to a friend or healthcare provider? Think of a time you were on the explaining or the listening end of such a conversation. Write for 10 minutes.

Continue Reading

Till Chapbook

I didn’t get a free write done this week but did attend the launch party for the 2017 Till Chapbook. This local organization supports writers, builds community and hosts a writing residency at Smoke Farm each summer. Last June I attended the residency and spent several days reading books on craft, floating down the Stillaguamish River, attending workshops by the likes of the Jane Wong and Claudia Castro Luna, ate homemade fare by our fabulous chef and wrote, among other things, my first published poem Instead, which you can find in the 2017 Till Chapbook. I’m grateful for the talented writers I met and enjoyed hearing several of them read their work at the release party this week. Here’s to Till and the writerly community they cultivate.

Continue Reading

Narrative Medicine Monday: Heroin/e

In Cheryl Strayed’s essay “Heroin/e” she writes about our ways of facing death, dying, grief and the will to live. Strayed loses her mother to cancer and suffers her own descent into addiction. Strayed’s love for her mother is evident and the loss she feels is acute. When her mother first learns of her diagnosis, Strayed recounts them silently entering the restroom, “Each of us locked in separate stalls, weeping. We didn’t say a word.” Strayed describes the numbing of pain and the warping of time for each of them: “The days of my mother’s death, the morphine days, and those that followed, the heroin days, lasted only weeks, months–but each day was an eternity, one stacked up on the other, a cold clarity inside of a deep haze.”

Writing Prompt: What does it feel like, in a physical sense, to suffer from addiction? From grief? Do you think addiction and grief are linked? Why or why not? Think of your own experience or a time you’ve witnessed this in a patient. Write for 10 minutes.

Continue Reading

Free Write Friday: Starbucks

They line up outside the first storefront: the trim an earthier green, the logo more organic, subtly suggestive, less polished. They take selfies and wait patiently to order grande peppermint mochas. I shuffle by them onto the cobblestone street, eager to reach the Chinese bakery to collect barbecue pork filled humbow, sticky rice wrapped in lotus leaves, buttery almond cookies that leave a residual crumble. I admire the fruit stands: large trays of plump grapes, squat persimmon, rainbow carrots gathered with twine. The flowers and the flying fish are, like the coffee shop, iconic, each wrapped in waxy paper, rubber-banded for the journey home.

***

I spot the familiar logo from across the street. Sweat sticking to my back, a rushing wall of air conditioning bowls me over as I step inside the coffee shop. The decor is the same, artwork familiar, stout brown chairs circle round veneer tables. I step back home, into anytown Starbucks despite being thousands of miles across the Pacific Ocean on a tiny island of an idyllic archipelago. It’s the brand, what people expect, what they want to see. But I bristle at the cookie-cutter likeness, even as it comforts me. I order an iced latte from the awkward Thai barista, clad in the familiar bright green apron with emblazoned mermaid. I grab my cup with my head slightly down, a kind of apology. But I sip the milky caffeine eagerly, my American thirst quenched.

***

In college I would study at the one on the Ave, in medical school at the one in Madison Park. I’d order my drink and settle down at a table, spread my textbooks and notecards out just so, like surgical instruments lined up for an important procedure. I’d highlight and underline: red, green and blue. Star and paraphrase, chart and summarize. After hours of sitting I’d grow stiff, have to stand to stretch my muscles, hinge my joints. One time my strained neck raised to the hum of whispers: Howard Schultz, the owner of the ubiquitous coffee chain had stopped in for his own caffeinated drink. Someone mumbled that he lived in the neighborhood, came into this particular Starbucks from time to time. Tall, with an open confidence, he didn’t linger. I wondered what his drink of choice would be.

Continue Reading

Narrative Medicine Monday: The Second Floor

Poet Rachel Hadas describes how those near the end of life grow distant before they pass in “The Second Floor.” She begins with a dream, consisting of “a harried pilgrim to a shrine.” She states that “[a]s quickly on their short legs toddlers move, / tall parents lumbering in slow pursuit, / so they speed onwards, people whom we love.” I like the unexpected juxtaposition of the unsteady toddler at the beginning of life to the dying loved one at the end. She paints an image of Sam and his daughter cradled together in “[s]leep and love, the quick, the nearly dead.”

Writing Prompt: Do you agree with Hadas’ assertion that the terminally ill are “somehow out of reach well before the grave?” Why or why not? What role do dreams play in our processing of ill or dying loved ones? Have you experienced such a dream? Write for 10 minutes.

Continue Reading

Free Write Friday: Trains

We ride the monorail to the city center, food court and live music on stage, families milling around on a holiday weekend, heading to the children’s museum or playground or bringing tourists to the iconic needle in the sky. Their dad is hungry, so he peels off to peruse the menu of greasy gourmet burgers, poutine doused in thick sauce, a grilled cheese dripping in butter for the kids. I veer the little ones to the centerpiece, the electric train. Every winter it’s set up in the center house, a pretend village sprinkled with snow and Christmas cheer. I never noticed the details before. My children now old enough to pause, stand still in wonder long enough for me to explore. Tiny figurines placed carefully, carrying wrapped boxes, firewood, bundled babies in their arms. My four year old’s excitement builds as the train speeds toward his face pressed against the plexiglass. It’s a wistful display of a bygone time but, modern boy though he is, the old fashioned train still holds charm.

***

My older brother had a train table growing up: handmade, wood, painted a mossy green. Tracks laid down across the entire span, chin level to my 8-year-old peering eyes. I remember a tunnel, trains traversing through a plastic snow topped mountain pass. The contraption took up most of his large bedroom, meant to be a downstairs family room or den. There was an opening in the middle. We’d climb under and pop up in the center as if underground moles. He conducted the whole display, detailed greenery sprouting on the landscape. I’d watch in wonder as the trains sped by.

***

My grandfather had a train computer game he liked to play. When we’d visit his tidy rambler in a well-to-do suburb in the early 2000’s we’d sit in his den, this octogenarian navigating down the pixelated tracks on his desktop monitor, clicking keys to make the trains whistle and stop. It wasn’t the most entertaining way to spend our time with this beloved elder of the family, but we indulged him and his enthusiasm for the simple program. He took computer lessons in his last decade of life, he traveled the world, he went sky diving when he turned 80, showing up on my parents’ front porch proudly wearing a t-shirt and holding a VHS tape record of the tandem free fall as proof. He must’ve always loved trains too. I like to picture him as a little boy, nose pressed to the glass at Christmastime, as a teen piecing together the intricate parts of a model train, placing the finished product triumphantly on winding tracks.

Continue Reading