Narrative Medicine Monday: Vicious

Tim Cunningham gives us a glimpse of Abdul, a teenage Rohingya refugee he encounters in a Bangladesh camp, in Intima‘s “Vicious.” Cunningham notes that his “belly was swollen like the rice fields” and “[t]hough described by many as non-literate because he had no official access to school, he could read the Quran with ease. His recitation of its Surahs was exquisite.”

When Cunningham meets Abdul in clinic, his pain is “everywhere,” as if “[h]is genocide had shifted internally, an annihilation of his once-healthy cells.” Abdul had lost his appetite entirely, did not “miss dahl and rice, mangos and bananas, though he knew that he should. ”

Cunningham imagines where he might transfer Abdul, had he the resources: “They would have diagnostics for his hepatomegaly and cachexia. They would have 24-hour staff, teams of nurses and physicians to treat and listen his life-story. The providers would all speak Rohingya. These thoughts were but daydreams. For extraordinary diseases, with extraordinary measures and extraordinary means, there are ways to treat illness.  If you are Rohingya, there is nothing.”

Cunningham’s prose elicits a visceral response to his patient’s physical and emotional trials, but it is Abdul’s word of response to a difficult intravenous stick that give both Cunningham and the reader pause: “Vicious.”

Writing Prompt: If you’re a medical provider, are there certain assumptions you make about a group of patients you see? How did you feel when Abdul repeatedly says “vicious?” What do you think that word might mean to him? What does it mean to you? Have you worked in a resource-poor setting or with a marginalized group of patients before? Recall an encounter with a patient. Write for 10 minutes.

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Free Write Friday: Pump


She’s pumped in bathrooms, in locker rooms, in economy class on a six hour flight wedged between the narrow aisle and a couple on their honeymoon. She’s pumped on a Washington State Ferry, in the passenger (and driver’s) seat of a car, at her desk at work over a harried lunch. She’s pumped at writing conferences and medical conferences and her own weekend island retreat just to get 24 hours away. She’s pumped while consulting an orthopedist, a psychiatrist, a radiologist; she paused her pumping before calling a patient with the difficult diagnosis of breast cancer. 

She’s pumped to get colostrum while her newborn was in the Special Care Nursery, to avoid clogged ducts while at a national bioethics conference, to build up a freezer supply of breast milk for the long days she’s at work. She’s pumped while reading books, while eating soup, while watching bad cable TV in a hotel bedroom. She’s pumped through frustration, through ambivalence, through hot desperate tears of new motherhood.

She’s spent the last six years pumping, off and on. She’s pumped for her three children: willful and strong, eager and growing. She’s pumped for herself: time to work, time to write, time to be something other than Mother, an unclipping of the tether, if only for a few hours. She’s hated pumping, championed pumping; she’s become indebted to the contraption. It’s allowed her to be free, to be connected, to be a distributor of sustenance and maintain her vocational and social and creative aspirations. She gives thanks for the pump, pays homage to it, lays it to rest with gratitude and an easy goodbye.

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Free Write Friday: Chair

I found the chair on sale at a furniture store on the Eastside. Strolling past birch bunk beds and white washed dressers, I pause to consider the price and design of each rocking chair. Tucked in a corner in the back of the large display room, I sink down in the buttery striped cushions, rocking gently in a natural way. A bonus! Pulling a concealed lever reclines the entire contraption; head back I can snooze, envision holding my first baby in my tired arms. 

*

A carefully orchestrated nursery in my parents’ basement bedroom, painted a gender neutral green. Mid-winter in a chilly basement, as a new mom I dutifully get up every couple of hours to feed my newborn, wearily lower myself into the reclining chair, sturdy in the corner. Freezing, chest uncovered, I shiver uncontrollably in the black hours of the night, hormones swinging hot and cold. I lash out tearfully at my unsuspecting husband, begging for space heaters to warm my weary body.

*

The chair fits two: a toddler and a newborn baby boy, story time for extra cuddles. It sits comfortably in the newly remodeled bedroom corner, flanked by a large window and floor lamp. We know better now, use it mostly for reading and rocking, not for middle of the night feeds. It’s still the most comfortable place to nurse, cocooned by cushy armrests, a gentle flex of my toes provides the soothing back and forth. I look out the window at our backyard, a hill of our city beyond; I look down and find my two arms full.

*

It’s wedged at the edge of the baby’s crib, a twin Jenny Lind bed frame lodged against the opposite wall. The two girls share now, eventually the oldest will turn preteen and retreat to the basement bedroom but for now she savors sharing space with her little sister. My youngest baby is almost a baby no more, a few short months and a toddler she’ll be. I savor the early morning and bedtime nursing, rocking gently in the dark quiet room. Occasionally the door bursts open with exclamations from my three year old about treasure maps, from my six year old brandishing school artwork to admire. My baby and I pause for a second, then resume the rocking, suckling. She gazes up at me through long lashes, wrapped in a patterned throw my grandmother crocheted of flowers and hexagons decades ago.

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