Narrative Medicine Monday: Feeding Tube

In “Feeding Tube” author Susan Kelly-DeWitt relays a memory of paper birds that a patient’s family hung over the hospital bed “wild tropical birds, macaws and toucans, parrots and cockatoo.” The visual that Kelly-DeWitt provides is vivid. The reader comes away feeling that humanity reigns over the mechanical devices that tend to dominate the hospital landscape.

I remember very little about the physical details of the critical care hospital room where I participated in my first code as a medical student. I do remember sitting by the resident physician as he wrote his note in the patient’s chart at the nurses’ station just after the man had died. I looked across the desk into the patient’s glass-walled room, my eyes fixed on an elaborate dream catcher hung carefully, just over his bed.

Writing Prompt: The hospital can sometimes feel a like a sterile, mechanical place. Think of a moment or an item, like Kelly-DeWitt’s paper birds, that struck you as out of place or particularly telling about a certain patient, their family and their life. Write for 10 minutes.

 

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Those Winter Sundays


I was at the Write on the Sound Writers’ Conference all weekend, so wasn’t able to prepare a Narrative Medicine Monday post for today. I’ve been reflecting, among other worthy writerly thoughts, about how I attended WOTS last October, just one year ago, as my first ever writing conference. At that time I gingerly entered each room, compressing myself into an imposter, sure that I would be discovered as a fraud. I imagined my fellow attendees, accomplished published authors thinking, “What are you doing here?” The entire writing world, culture, was foreign to me. I struggled to fit pumping in between conference sessions, even nursed a four month old baby in the car briefly while my family was passing through town. I’m now done with the harried, urgent stage of pumping; have retired my trusty Medela Freestyle and all its various plastic components for good. It’s remarkable to me that it’s only been one year. In those twelve months I have developed detailed writing goals, including a complete nonfiction book proposal, a regular blog and platform plan and have my eye on contests, training programs and retreats and residencies to further my work and aspirations as a writer. 

I’m currently taking an online poetry class, which is stretching my every writing muscle. I’m back to basics, learning about sound and syntax, metaphors and consonance, iambic pentameter and anaphora. Both my poetry class and one of the weekend conference sessions highlighted this poem by Robert Hayden: “Those Winter Sundays.” As a mother myself, entering middle age, reflecting on much of my perceptions and misconstrued moments of my youth, this poem spoke to me this week. Try reading it out loud and note the tools Hayden uses to portray his father and his perception of his father, both in his youth and looking back as an adult. What speaks to you in a poem? Have you tried reading poetry out loud? I’m grateful to be learning more about poetry this fall and hope to share more with you in the coming months. 

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Narrative Medicine Monday: Lithium and the Absence of Desire

Virginia Chase Sutton’s wrenching poem “Lithium and the Absence of Desire” warns of what may be lost in taking a necessary medication. She deftly describes the world before starting lithium and the reader is entranced along with her, “dozing in light and soaked color.” Despite side effects causing a graying of her world, the author dutifully takes “the medication as prescribed.” Written in second person, the reader is drawn into her longing for what she has lost and together we collectively struggle in vain: “Strain all you will but you have given desire away.”

Writing Prompt: This poem describes a negative, even devastating, side effect of a medication, yet the writer recognizes there was “No choice since you must take the pills.” Have you experienced a minor or life-altering side effect from a medication? Describe life before and after starting the medication. Did you keep taking the medication as prescribed, or did you search for a different treatment? Write for 10 minutes.

 

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Narrative Medicine Monday: Erasure

Student and poet Thomas Nguyen writes of memories and loss in “Erasure.” In his poem Nguyen is instructional, warning how time affects our connection to those we’ve lost: “Accept that time makes things distant, that his absence doesn’t bleed into your memories as much as it used to.” There are only a few significant people in my life who have died, but I can identify with Nguyen who needs to try “harder and harder to remember the last time” he saw his mentor.

Nguyen notes that the patient speaks of his melaonmas as if they were part of his garden: “My dermatologist taught me how to care for them.” Nguyen goes on to contrast this with the green moss on the windows of his home. Do you agree with Nguyen that “life always adds?” Do you find this contention comforting or suffocating, or both?

Writing Prompt: Have you spent time with a loved one or patient who was nearing death? If time has passed, how have your memories of this person been affected? Recall the last time you saw them. Outline the details, like Nguyen’s memory of “neatly-pressed khakis.” Write for 10 minutes.

 

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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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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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The Summer Day


I’m camping with family today so taking a hiatus from Narrative Medicine Monday. Instead, enjoy this classic poem by Mary Oliver. May you be “idle and blessed” this summer day.

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Narrative Medicine Monday: #3 In Line

Eliza Callard imagines a lung transplant in her vivid poem “#3 In Line.” She begins by describing the surgeon’s actions lifting “the sodden lungs out,” but then pauses to wonder about the patient: “Where will she be for all this?” Callard touches on the desperation following any transplant to get the foreign object to “stay, stay,” to trick a body into accepting an imported organ as one of its own. 

Writing Prompt: Imagine an organ transplant: liver, lung, kidney. Write about the transplant from several different perspectives: that of the patient, her body, the transplant surgeon, the patient who donated the organ, even the organ itself. Write for 10 minutes. 

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Narrative Medicine Monday: Bedside Rounds

John L. Wright’s poem, “Bedside Rounds,” speaks to the apprentice-like training of physicians. It is a passing on of skills from the experienced to the inexperienced, from the knowledgeable to the clinically naive. Most medical students, unless they have a background in another medical field, have little to no real experience in the hands-on component of medicine. They take years of study – biology, anatomy, pathophysiology – and translate that book smarts into skills of diagnostic touch, suturing skin, prescribing treatment. 

One method of transforming head knowledge to a practical skill set is through bedside rounds: a gaggle of medical students and resident and fellow physicians (still in training) following after an experienced attending physician. Each morning this group travels from bedside to bedside, discussing the patient’s disease, the patient’s prognosis, the patient’s progress, the patient’s treatment plan. In recent years, medical schools have worked on making this process more inclusive of the patient who, after all, is the subject of the discussion. 

Wright’s poem touches on the experience of that patient, ill and incapacitated, being talked over in a cryptic language, determinations being made about the status and plan while the patient may still be steeped in a cloud of confusion. 

Wright finds himself in a comparable situation when his landscape architect brings her intern along with her one day. As this professional passes on her skills to her protégée, discussing his yard in detail, Wright begins to feel something he hadn’t expected: “I begin to resent them—the little games they play.”

Writing Prompt: Think of a time you’ve experienced bedside rounds as a physician, as a patient or while visiting someone in the hospital. If you were the patient, how did you feel when the medical team discussed your case in front of you? Did they include you in the discussion or explain what they talked about? If you’re a medical provider, choose a memorable bedside rounding experience: running rounds for the first time, being a brand new medical student, noticing something significant with the patient’s demeanor while their case was being discussed. Write for 10 minutes.

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Free Write Friday: Cliff

Note: This week I’m trying something new with the free write – a prose poem incorporating synesthesia. I was inspired by a Till writing workshop I recently attended, presented by poet Jane Wong. As always, feel free to use the photo above as a prompt for your own free write. Consider joining me in experimenting with an unfamiliar format this week. 

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Crackling of palm tree, fronds brushing carmine in the breeze. Squawk and tweet of birdsong, just beyond ear’s reach, punctuating high above. The turquoise wash of crashing waves below, colliding onto ebony rocks stoic as the spray recoils, resorbed by the expanse. Memories of jumping off, sound muffled, then expanding beyond into the greater sea. I climb the cliff, handholds of familiar crevices. I swim into the current, decades of tracing the reef map a mind’s fingerprint of coral phalanges. Thick blades of grass underfoot infuse the yellow taste of papaya. Nenes swoop in, then saunter through air thick with humidity. Specks of snorkelers flap fins, return to lie beached, their skin leathered like dragon fruit. Cloud shadows caress the ridged mountains, marking them like a bruise, feeding them with rain. One drop, then two trickles. The sea turtles gulp the air then dive into dry sweetness. They disappear but I never saw them, only heard shells cracking from a memory decades old. Momentary waft of plumeria, ginger, coconut, lilikoi, banana leaves suspends in the air just long enough for it to roll on my tongue, breathe into my lungs, absorb through my skin leaving an imprint, marking me home. 

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