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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Narrative Medicine Monday: New York Lungs

In her poem, “New York Lungs,” medical student Slavena Salve Nissan writes of the intimacy of knowing a patient “underneath her skin fascia fat.”  Nissan notes how her beloved city left a mark on her patient’s lungs. She thinks about the people who loved her patient and how even they didn’t know that the patient looks “like a frida kahlo painting on the inside.”

Place is a central theme in this poem. I like the subtle imagery of the medical student and her patient breathing the same air, from the same city, in and out of their lungs. This commonality, too, connects them.  

As a medical provider, we experience intimacies with patients that are both strange and surreal. It is a great privilege that our patients allow us, for the purpose of diagnosis or treatment, to perform these intrusions: cutting into the skin, sampling cells from the cervix, looking into the ears, listening to personal stories, palpating the lymph nodes. Over time this can become routine to the medical practitioner, but I do still wonder, and hope I never lose keen curiosity, about the lives of my patients beyond the exam room. 

Writing Prompt: Reflect on the vulnerability between a patient and physician. Is it surprising that we can be so open and trusting with a near stranger? Think about such a time, perhaps a surgical procedure or mental illness or embarassing symptom, when you put your complete trust in your medical provider. What was that like? Write for 10 minutes. 

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Narrative Medicine Monday: Falling Fifth

Anesthesiologist and poet Audrey Schafer aruges that anesthesiology is actually an incredibly intimate medical specialty. In her poem, “Falling Fifth: The Neurosurgery Patient and the Anesthesiologist,” she tells NPR’s Sara Wong that her speciality is incorrectly viewed as more “knob-and-dial oriented than people-oriented.” Her poem outlines a poignant moment between her and a patient, hugging over “wires, bandages, the spaghetti of tubes, the upright side rail” in the sterility of the OR.

I think of the specialties that seemingly don’t interact as much with patients: radiology, pathology. I can see a familiarity that goes beyond even my most personal interactions with patients as a primary care physician. Radiologists see beyond a person’s skin, through their muscles, bones and vital organs. Pathologists meet a patient on a microscopic tissue level. I like how Schafer displays the connectedness between the anesthesiologist and patient: the physician serves as a trusted guide out of and back into consciousness. 

Writing Prompt: Have you ever had anesthesia? What was your experience both going under and coming out of a conscious state? Alternatively, are you in a medical speciality or type of profession that doesn’t traditionally interact much with people? Is there a component of your daily work that’s surprisingly intimate or keeps you connected to others? Write for 10 minutes. 

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