Narrative Medicine Monday: In Shock

Although I’ve never met her, author and critical care physician Rana Awdish on some level feels familiar. Not only are we both part of a supportive online group of physician-writers, but I just finished reading her wrenching memoir, “In Shock: My Journey from Death to Recovery and the Redemptive Power of Hope.” Awdish’s gripping account of her near-death experience, subsequent hospitalization in her own ICU and revelations about the shortcomings in both support for and education of medical providers in the realm of empathy are illuminating. Her book is infused with challenge and hope and a call to transform the way we train physicians and care for patients.

Awdish is thrust from the world of providing medicine into that of receiving it – a patient under her own colleagues’ care. The contrast of these positions of power and vulnerability are striking and Awdish describes the jarring experience and her own enlightenment as she pivots between these two roles. She shares with the reader her revelations regarding how we provide medical care to those in crisis and inspires us to find a better way.

I was particularly convicted by Awdish’s insight into how medical training encourages physicians to suppress many of our emotions. She traces this ideal back to the father of modern medicine, Sir William Osler, who encouraged “‘aequanimitas.’ Osler regarded this trait as the premier quality of a physician. It represented an imperturbability that was described as manifesting in ‘coolness and presence of mind under all circumstances, calmness amid storm, clearness of judgment in moments of grave peril.'”

Awdish asserts that as physicians “we aren’t trained to see our patients. We are trained to see pathology. We are taught to forage with scalpels and forceps for an elusive diagnosis buried within obfuscating tissues. We excavate alongside our mentors in delicate, deliberate layers, test by test, attempting to unearth disease. The true relationship is forged between the doctor and the disease.” Do you agree with Awdish’s assessment? Why or why not?

If you’re a physician, if you’re a patient: read this book. Discuss it with your colleagues, mull over it with your book club. The questions Awdish raises, the challenges she poses are vital to improving the way we care for each other in our most acute times of need.

Writing Prompt: If you’re a physician, did you learn to develop “aequanimitas” through your training? Did you feel this trait was a requirement, overtly stated or otherwise, to be a “good physician?” Have you yourself ever been a patient feeling, like Awdish, “powerless in a way that is impossible to imagine, from a privileged position of wholeness and well-being?” Awdish lists biting phrases that were directly said to her or that she overheard when she was a patient. Have you experienced similarly painful words from a medical provider? Have you said such words to a patient before? Try writing from both the patient and the medical provider’s perspectives. Write for 10 minutes.

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Narrative Medicine Monday: The Colostomy Diaries

With humor and candor, Janet Buttenwieser writes in “The Colostomy Diaries” about awaiting her gastrointestinal surgery and the aftermath that leaves her with a colostomy. 

I like Buttenwieser’s use of visual details, putting the reader in the room with her, receiving this disappointing news: “‘You’ll have to have your entire rectum and anus removed,’ my surgeon told me over the phone as I sat in my living room, an unread newspaper on the table, cherry blossoms blooming on the tree outside my window.” 

Buttenwieser faces difficulty getting the trash can she needs to dispose of her colostomy bags at work. The humiliating barriers she encounters illustrate the ridiculousness of much “beurocratic red tape.” After her surgery, she struggles with how many details to disclose about her sensitive change in physical status, even to friends. 

Buttenwieser’s candid anecdotes of everyday challenges post-surgery, such as shopping for clothes and dealing with an emergency malfunction of the colostomy bag while out with her small children, show why her new book Guts, set to be released in 2018 by Vine Leaves Press, is likely to be an entertaining and enlightening read. 

Writing Prompt: Think of a time you’ve dealt with “beurocratic red tape” in relation to a medical condition or the medical field. List all of the obstacles you encountered. Can you infuse some humor into the piece, despite the frustrating experience? Write for 10 minutes.

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Free Write Friday: Goodnight Moon


Her sister loved the book, requested it every night. Her brother, not so much. He wouldn’t sit still to listen to any board book; made me worried about his attention and future schooling prospects. The words rush back to me now with this littlest one, memorized at some point years ago with the repetition I endured. Every night: “In the great green room…” I rock the baby and read. 

She tries to eat the thick pages, colored with orange-red, yellow, kelly green. She too takes to the silly story of bidding goodnight to the bears, to the mittens, to the bowl full of mush. I discover I now find comfort in the rhythmic cadence, the sentences fall out of my mouth sing-song, lyrical and pleasing. 

Maybe that’s why she listens quietly, transported to the simplicity of a warm room, a rocking old rabbit, a nightly ritual of farewell to all the little things that surround us – the comb, the brush, the little toy house, and all the big things too vast for us to comprehend – the stars, the air, nobody, the moon. Goodnight to it all. Goodnight to the immediate and the immense. Maybe this still appeals at a time when everything seems virtual, intangible, rushing by. It’s nice to stop and acknowledge, step into the present space and recognize the greater cosmos above. 

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Free Write Friday: Book Club


I imagine we meet monthly, in the evenings, after dusk. People trickle in, peeling off their Frye boots and stylish rain coats, scattered with droplets from the evening drizzle. They hold tea cups with three fingers, china inherited from a grandmother, delicate gold rims. Or maybe wine glasses without stems, cupped securely in hand. A cheese plate laid out with warm Brie and rosemary crackers, plump purple grapes on the vine. The lighting is dimmed just barely, warm glow overhead illuminating the minglers.

Maybe it’s just women: friends from a church group or a baby group or a local elementary school; tethered by shared stage of offspring and the need to get out of the house for adult conversation. Or maybe it’s a neighborhood group: gathered from one street, connected by locale but varying in age and marital status and recreational interest. 

I imagine some have read the book, a few all the way to the end. Most have found time to make it only part way through, returning it to the library a week after the due date, resigning themselves to the fact that they won’t actually finish it and accumulating a small fine is not going to push the cause further. 

We take our seats, glass in hand, fruit tart on plate. Circling round, small talk continues in twos and threes. We’re friendly and interested. The host begins, we each rate the book on a scale of 1 to 10. I never choose 10, no matter how much I like the book. Extremes make me wary; there’s always room for improvement. Someone’s off on a tangent, dissecting the weather or their sister or the last movie they saw. 

Most like the book, a few dissent. We all wrote book reports in high school and college, but this is less analytical, more a social interaction, a question of how much one succumbs to group think. I imagine the conversation weaves through topics as they relate to our children, our jobs, our neighborhood. There’s a pause, pregnant with silence, and someone checks the time. I imagine we’re all a little hesitant to leave. Eventually we scatter, back to our homes and our bedside stack of novels and manuals on child rearing in the modern age. 

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