Narrative Medicine Monday: Disaster Relief

Today’s Narrative Medicine Monday is a bit different. In light of recent catastrophic hurricanes in the U.S., there have been many stories about disaster relief and people stepping up to help in ways they’re not used to. One such person is Dr. Jennifer McQuade. This NPR story describes how McQuade, a melanoma oncologist, dropped off basic supplies to a shelter following hurricane Harvey and discovered the medical aid there severely lacking. She then found herself in charge of a medical shelter, enlisting the help of other physicians and medical providers via a physician moms social media group. Often in such situations we’re called upon to help each other in ways we might not imagine possible. As Texan Claudia Solis notes in the story, “There’s a kindness…. They’re your neighbor, and you have to help, and it’s beautiful.”

Writing Prompt: Have you ever found yourself in a situation where you had to provide medical care beyond your normal area of expertise? Have you ever been the recipient of such care? Describe the situation and how you felt. How did it bring you closer to the people around you? Write for 10 minutes. 

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Free Write Friday: Eggs

We used to have chickens. We housed them in our backyard, in several iterations of a homemade chicken coop. We got three chickens at once, learned it was better for them to not be alone. Our neighbor girls had raised chicks in their classroom, they were looking for takers to adopt the fuzzy creatures. We were childless, homesteading was en vogue. Why not?

They came to us with names already; I can’t remember them all. I do remember Becky. White feathers, she was unassuming, not the leader, not the most endearing; a ready follower. 

Raccoons roamed our city neighborhood like a carnivorous gang, looking for trouble. Sometimes I’d turn on the back porch Iight to catch a glimpse of their panda-like fur, eyes glinting in the sudden illumination. They didn’t seem to scatter like other animals, held their own. They were arrogant, behaved as if they belonged there and wouldn’t be deterred by a human intrusion.

One night we woke to horrible screeching. At first it sounded like a child, a dramatically tortured innocent. I realized it was the chickens, our chickens, crying into the night air, desperate for escape. They were trapped by our carefully placed chicken wire, the sturdy boards of our coop.

My husband went into the backyard to witness the carnage, chase away the culprits, recover plume and innards strewn across the lawn. I would discover feathers weeks later, flown to corners of our yard unnoticed that first night, that next day. I don’t know all the details of what he found, couldn’t stomach the specifics. 

The next morning I heard a familiar noise, distinctly bird-like. Over on the neighbor’s roof was Becky, injured leg, hobbling and whimpering but alive. Becky was a survivor. How she escaped the raccoon’s rampage is a mystery. Quiet and unassuming, still, she had the grit to somehow endure. We took her to the bird vet and spent weeks painstakingly feeding her antibiotics for her wound infection. 

We adopted other chickens over the years, nine in total. Some were lost to faulty gendering (roosters out themselves quickly with their incessant crowing), others succumbed to subsequent raccoon attacks. Becky survived to the end. When she finally surrendered we decided to close up shop on chicken rearing. We enjoyed some very expensive eggs and learned a justified wariness toward savage raccoons. 

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Narrative Medicine Monday: The Permanent

In “The Permanent,” Amy Burke Valeras takes us back to the 1980s when perming your hair was a thing. In the first half of the poem, Valeras opens up about her struggle with her hair; I could relate. I similarly begged for an ill-advised perm the same year, the same age as the author. I like how Valeras makes her hair a central character of the poem. We battle along with her preteen self as she tries to tame the “frizzy poof.” We can understand when, two decades later, she is told she has cancer but all she can think of is: “My hair!”

Writing Prompt: Think of an every day aspect of your life, of your body, that you took for granted or had a different relationship with until you became ill. Consider level of energy during a bout with the flu, walking with a sprained ankle; maybe you have lost your hair to chemotherapy or a breast to invasive cancer. Write about your relationship with this aspect of your body before you became ill and after. How did things change? Write for 10 minutes. 

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Free Write Friday: Eclipse


1991

I remember standing in a small field on Kauai, thick kelly green blades of grass underfoot. The square glasses, opaque cellophane-like lenses didn’t seem to do much at all. I was told to look up, face skyward. My older teenage brother had built a box, a contraption that revealed a projection of the eclipse. It was all underwhelming, the tiny crescent in the sky, projected on the cardboard. I remember thinking, ungraciously: This is it? I don’t remember it getting cold or dark or being moved in any significant way. After the novelty of the moment wore off, I wanted to get on with it, proceed with our vacation day. Head to the pool, play at the beach. I had only a vague concept of what I was looking at, looking for. 

2017

He starts to cry as the temperature drops. I want to take it all in, but he’s a heap on the wet grass, weeping beneath his paper solar eclipse glasses stapled to the back of a child’s tiger face mask. Why does the sun have to disappear? Why does it have to happen only today? He wants to ride his bike around the perimeter of the park but Dad says let’s wait until after 10:20 a.m., the point of maximal partial eclipse, 92% in these parts. He collapses into the whimpering mess of a typical three-year-old: unpredictable, unintelligible wailing. 

We begin to feel a chill, our friends put on sweatshirts. I’m unprepared and goosebumps emerge on my bare arms. There’s a festive feel, the large field peppered with strangers in lawn chairs, blankets splayed out with picnic foods, cardboard contraptions and eclipse glasses at the ready. My son is hugging his knees, sitting on the gravel path. His wails drown out the crowd, focused skyward, as they start cheering. 

I’m anxious about my one year old, afraid she’ll gaze directly at the sun. All faces turned upward, leering at the spectacle. She’ll follow suit. But I have to attend to my three-year-old, whimpering about the sun, the moon, a desperation in misunderstanding. I think about the historic panic about such an event: the sun disappearing momentarily. Of course it would feel like an omen, a harbinger of doom. He’s channeling that historic angst, knowing that the sky darkening midmorning is unnatural, feels off. 

I crouch beside him, rubbing his back, trying to convince him it’s all right. I can’t tell if he’s upset because the sun is disappearing or because I can’t keep the eclipse from remaining for another day so he can see it tomorrow. It doesn’t matter. It’s the illogic of a three-year-old tantrum. 

The air seems filtered, a hazy Instagram “Nashville” tainting the late summer morning. Time speeds up and suspends, as if the eclipse causes a filtering of moments, a sifting of time. As if heavenly bodies aligning requires all to pause ceremoniously, a recognition of our minisculeness. And yet nothing waits for the three-year-old angst. He rocks in my arms until the typical light returns and all is as it should be again. 

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Fluidity

I was camping last week in the glorious San Juan Islands and realized I wouldn’t be able to finish my regular Free Write Friday post since I was, blessedly, without any WiFi connection or phone reception for several days. Our family returned late Sunday night and, after four days of swimming, kayaking, exploring and sitting around the campfire, I also realized that mountains of laundry and back-to-school prep would take precedence over my usual Narrative Medicine Monday post. So I’m letting these goals lapse, like my hope to read any of my book club book (The Glass Castle, in case you were wondering) this past weekend. 

I’m approaching a year of blogging and initially chose a biweekly schedule of narrative medicine and free write posts somewhat arbitrarily, knowing that it would keep me accountable to have a set schedule. It’s been good for my writing and my overall well-being to write regularly and press publish even when my work isn’t completely polished. At this juncture, I’m giving myself a pass to forego a post here and there when on vacation or at a conference or finishing another piece of work. 

This fall I’ve signed up to take a poetry course and I’m actively pursuing a home for my nonfiction book. Blogging has been a salve, a selfish pursuit of craft and vulnerability. I’m not looking to give it up, but I am ready to give it more fluidity. 

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Narrative Medicine Monday: A View from the Edge

Dr. Rana Awdish is a critical care physician turned advocate for training in compassionate care following her incredible near death experience in her own hospital. Her essay “A View from the Edge” in the New England Journal of Medicine provides an overview of her 2008 experience as a critically ill patient cared for by her colleagues.

In her book “In Shock,” out this October by St. Martin’s Press, she outlines her harrowing near-death illness and recovery. I’m eager to read Awdish’s book and hear more about how her experience led to advocacy for “compassionate, coordinated care.” In her NEJM essay she describes how “small things would gut me. Receiving a bill for the attempted resuscitation of the baby, for example…. A trivial oversight, by a department ostensibly not involved in patient care, had the potential to bring me to my knees.” After recovering, Awdish channels her grueling patient experience into a drive to transform the way we receive and provide medical care. She contends “we need to reflect on times when our care has deviated from what we intended — when we haven’t been who we hoped to be. We have to be transparent and allow the failure to reshape us, to help us reset our intention and mold our future selves.”

Writing Prompt: Have you noted an erosion of empathy among medical providers? If so, think of a specific example and write about how you felt as the patient. If you’re a medical provider, have you ever been cared for by colleagues at your own hospital? What was it like to be on the “other side,” as a patient? Did you come away from the experience with new knowledge and empathy that you then incorporated into your own practice? Write for 10 minutes. 

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Free Write Friday: Candy


Her favorites were just candy canes, really, root beer and cherry, ribbon of contrasting color twirled around the candy stick. She liked how they were organized by flavor into sturdy glass jars, fanned out, as if leaning, calling to a child’s eager hand. She’d struggle with the wrapper, ask a parent for help. She was the type of child to keep the wrapper on, roll it down slowly, avoid sticky fingers and prolong the treat by keeping it intact. She never bit into a Tootsie Pop until the last minute, resisting the final satisfaction of the chocolatey core. 

She liked Smarties, similar to Sweet Tarts. Smooth discs of sugar cradled on her tongue, easy to savor incognito. She could keep a roll in her pocket, swing across the monkey bars and pop another in her mouth. Portable and practical. Anything gummy was appealing too: severing bear’s heads with her tiny teeth, the novelty of a cola flavor in chewy candy form. 

On Halloween she’d sort her sweet lot, save the best for last. Some years she waited too long, and the prized candy bar would be lost or forgotten. She was good at self-discipline, sometimes to a painful fault. Her best friend’s mother rationed their Halloween candy, doling out one treat a week. It lasted her well into the other holidays, Thanksgiving and Christmas peppered with the distant memory of a costumed past. 

She never liked Snickers, any nutty interruption to the palate seemed intrusive, unwelcome when enjoying a sweet. Instead, she preferred caramel, coconut. Almond Joy and Mounds, 100 Grand and Three Musketeers. She knew this wasn’t a popular opinion, that she should prefer Snickers like all the rest. 

She watched Willy Wonka & The Chocolate Factory in awe, wanted to float via Fizzy Lifting Drinks with Grandpa Joe, savor an Everlasting Gobstopper, dance with the Oompa Loompas, search for a golden ticket with the rest of the world. Years later, she’d visit Harrods’ shiny Candy Store in downtown London, stroll through the sleek abundance of Disneyland’s Main Street Candy Palace. Even as an adult, she’d savor the innocence in indulgence of pure sweetness, find comfort in an overwhelm of treats in a world that often runs sour. 

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Narrative Medicine Monday: Wernicke-Korsakoff

Poet and medical student Sarah Shirley describes an evolving interaction with a patient in “Wernicke-Korsakoff.” The patient initially finds complaint with everything: “the too soft too hard bed, the lunch that came with only one spoon though clearly two spoons were required.” Shirley struggles to connect with the disgruntled patient, who clearly wants nothing to do with her as an intrusive medical student.

Throughout my medical training and career I’ve encountered patients, like in “Wernicke-Korsakoff,” where “everything is thrown back.” They were angry at their disease, angry at the medical providers, angry at the system, angry at the world. At times, I’ve been one of those patients myself. There’s no doubt health and illness affect our mood. Many of those who are suffering build a shell to cocoon themselves off from the damaging world. Often they are rightfully skeptical of a medical system that has many failings. Shirley finally breaks through to her patient in the end, after searching for the right connecting point. 

Writing Prompt: Think about a time you were sick. How did being ill affect your mood and interactions with others? Were you inclined to cling to others for support or did you find yourself “raging against the world?” Perhaps you experienced both. What about a time when you were caring for someone who was sick? Did they allow you to connect with them right away or was it a struggle? Write for 10 minutes.

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Free Write Friday: Camping


We move by the light of the skies. Time untethered to seconds, minutes, hours. 

Shadows cast onto nylon tents, faded grays and greens meant to blend into earthy surroundings. Toothpicks of trees stretch heavenward, branches and bark punctuating a pale sky. Bikes laid flat on their sides, like fallen dominoes, line the campsite. Brightly colored helmets are scattered asunder. 

They grab their bikes and pump legs up the hill to the playground nestled in the trees. They twirl and slide, climb and spin, dust rising underfoot. Teeth bared, faces upturned with glee, taut with playful exertion.

They return to home base, tumble in the dust, twist in the hammock, balance on the yellow slack line situated between two sturdy tree trunks. Footprints of sneakers and toddler Crocs pepper the campsite. Dirty feet, caked with dust, the reminder of an earth long forgotten by more bourgeois days spent indoors: at school, at work, at homes walled off from such grime. Here, we can’t get our feet clean, no matter a 3 minute token shower, no matter a towel wiping down, no matter a dip in the cold ringing canal, uneven stones and oyster shells underfoot. Still the dark mark of filth between toes marks us. 

Down at the water they zig-zag across the rocky beach, search for colorful stones, treasures of abandoned sea creature skeletons, slimy seaweed. Our backs align straight in the kayak as we glide through the seafoam green toward the hazy hills beyond. A little one dips an appendage or two in the water, leaning from the front unexpectedly as I struggle to stay balanced and centered on the stand up paddle board. 

A burn ban has a dampening effect; we gather around the citronella candle as the skylight fades, skin graying to ashen. Headlamps alight, artificial and glaring. Canvas camp chairs unfold around the would-be campfire. It’s too dark and we succumb to the arc of the heavenly bodies, one seceding as the other takes reign in the sky. 

Camping is a children’s glory: timetable discarded, dirt embraced, leisure activities and food prevail unencumbered. They chase each other through the brambles, swing gleeful in the hammock, unearth large stones to discover tiny crabs frittering sideways, eager to find a new hiding place. Grime accumulates under their fingernails like dust clinging to the mantle at home. It marks them unconcerned, free from the shackles of the modern urban childhood of after school activities and rationed screen time. 

We wake to birds rustling, charcoal light reversing gray to green to sky. I arise despite myself, soak in the soreness of my bones. The light, the earthen air call me to get up, get out, move myself into the surroundings I was meant to inhabit.

We move by the light of the skies. Time untethered to seconds, minutes, hours. 

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