Narrative Medicine

Narrative Medicine Monday: What the Nurse Likes

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Cortney Davis’ poem “What the Nurse Likes” reveals what it’s like to care for patients. She notes in her commentary about her poem that she realized “it is necessary for caregivers to say shocking things occasionally about the type of work that they do”. This poem has helped me reflect on what I enjoy about my work and consider what may seem interesting or odd to those outside of the medical field.

Writing prompt: What do you like about caring for patients? What do you dislike? What do you like about receiving medical care? What do you dislike? Write for ten minutes. Think about if any of these things may be shocking to others. Did you surprise yourself?

*Cortney Davis’ website has some more excellent prompts to try.

 

 

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Ramblings

Free Write Friday: Reading Peter

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The cream cord spiraled on the Formica counter. My mom lifted me up as I held the receiver to my ear. My grandmother was on the other end, eager to hear what I had to say. I balanced the book on my lap, turned the worn pages with sage lettering and delicate drawings of a defiant rabbit, an angry gardener and a new jacket left behind.

The letters still swam, but I sorted them out, plucked each from the recesses of my mind: a pool of shapes and lines intersecting and crossing, curving around. Then I linked them together, like one boxcar to the next. I paused with each sound so they were connected but staccato, not quite cohesive.

I remember it being difficult, and then all of a sudden it wasn’t. Some synapse connected and I could read. I could make sense of the shapes strung together like Christmas lights. Like magnets they drew themselves together; like a baby babbling they sounded themselves out. I didn’t have to work at it anymore; it was automatic. Like breathing or the beating of the chambers of the heart: involuntary and subconscious. I only thought about it if I stumbled, skipped a beat.

My grandmother listened patiently as I read each page, pondered each picture. I later wondered if I was actually reading, if it was all a farce, if I simply memorized the whole thing, not knowing what memorization really was; it only came as the vaguest sense that maybe I was an impostor, deceiving my loved ones. I felt uneasy.

I still feel unsettled sometimes, like maybe I am an imposter in this life of mine, pulling a ruse over all those involved. My insecurities linger, from that five-year-old sitting on the counter, grandmother on the line. I wonder have I really achieved what I think I’ve accomplished, or is it simply an elaborate mimicking of all that I should know.

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Narrative Medicine

Narrative Medicine Monday: My Patient Doesn’t ‘Do’ Vaccines

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The New York Times Well column features many excellent pieces about medicine from the patient, physician and public health perspectives. Danielle Ofri’s “My Patient Doesn’t ‘Do’ Vaccines” is a snapshot of an every day encounter for a physician: a patient disagrees with the recommended care plan. Although immunizations are one of the most common areas of disconnect these days, this can and does happen in many other situations as well: a patient requests antibiotics for a viral illness, a physician recommends a procedure that a patient doesn’t want, a patient requests labs or studies that aren’t indicated, a physician recommends a medication that a patient is hesitant to take. Instead of just letting the situation pass by during a busy clinic day, Dr. Ofri decides to become curious, to engage her patient and educate him on the medical science. He, in turn, is able to voice his concerns and viewpoint.

Writing Prompt: Write about a time there was a disconnect between you and your physician or your patient. Were you curious during the encounter to understand the other person’s fears, concerns or hesitation? Why or why not? As providers, how best can we address valid concerns while staying true to evidence based care? How do our backgrounds color our perspective and ability to engage others?

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Writing

Free Write Friday: Practice

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Each Friday I’ll post an Instagram photo and a short piece based on a free write inspired by that photo. Consider using the photo as a prompt for your own free write and link back here. I’d love to see what you come up with!


I used to practice right before heading to my piano teacher’s house. She lived next door so that provided me a few extra minutes of practice time. Japanese-American and of petite stature and serious countenance, she was superficially strict, but in a forgiving kind of way. She never seemed to notice that I didn’t practice throughout the week, that I only put my time in with the keys immediately before this test with the teacher. To me it seemed the most efficient process: the finger muscle memory of the those notes stored only for the short term. It was unlikely that it would get lost in the quick walk across our front lawn and hers.

I liked playing piano; the black dots and tiny flags translated into an appealing melody, not like the screechy tentative sounds coming from a beginner’s violin. The piano was straightforward and predictable in a way that the rest of my preteen life wasn’t. I just wasn’t dedicated to it like I should have been. Maybe if my piano teacher had called me out, seen through my farce, I would have been shamed into actually practicing, truly investing my time and honing this musical skill.

Skimming over the hours of work required to really learn a piece meant epic failure when it came to recitals. I’d practice right before, clad in my starchy white tights and flowered boat neck dress. I’d pump out the notes, willing them to be seared into my brain synapses, if only to avoid recital stage humiliation. The added irritant of anxiety though introduced a potent variable, making my short term memory less reliable. This led to many awkward moments sitting on the stage, staring down at the rented baby grand, my fingers touching the keys but not connecting to my cerebral cortex other than to signal a panicked fight or flight response, my palms slick with the sweat of shame. I’d bow my head with a silent curse: why hadn’t I practiced more? Usually, over the few years I took piano lessons, I could muddle through; at least passably finish the piece I was playing.

Eventually I entered high school and stopped taking piano lessons. Academics and a slew of other anxiety-producing extra curriculars took over. I’m considering taking lessons again now, with my five-year-old daughter. I wonder if, at this seasoned stage of life, I’ll be compelled to practice more. Sometimes now I’ll just sit at the piano, my piano. But nothing will come back; no notes recalled, no melodies linger. I feel that the music is buried just beyond my reach, deep in the grey matter, ready for dedication, a commitment to take hold. Maybe it will. But I suspect only if I take the time to practice.

 

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Narrative Medicine

Narrative Medicine Monday: The Grand Hotel Mackinac Island

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Welcome to Narrative Medicine Monday. Each Monday I’ll post a narrative medicine piece, a short discussion, a few questions and a related prompt. I hope this will provide a place for thoughtful reflection and discussion about medicine and how narrative medicine can help tell patient and provider stories in a meaningful way.

Thomas Gibbs’ The Grand Hotel Mackinac Island is an intense braided essay by an obstetrician, published in Hippocampus Magazine. From the very beginning, we are thrust into Gibbs’ crisis: his obstetrical patient is hemorrhaging and her life is in danger. He intersperses these events with details about the vacation, long awaited, he was supposed to leave for that same day. Gibbs touches on what it means to be a physician invested in your patients, and the inherent sacrifices therein.

If you are a medical provider, have you ever been in a situation where you felt you just couldn’t leave a patient, even for a significant personal or family event? What are the privileges of being a medical provider? What are the sacrifices?

All of us have had to sacrifice an aspect of our personal life due to our work, be it inside or outside of the home. What have you let go of because of your work?

Writing Prompt: Think about a time your life was disrupted by an unexpected medical diagnosis or outcome, either as a patient or as a medical provider. Write for 10 minutes about this disruption. Did you have to let go of anything to be present?

*A note about prompts: When writing from a prompt, consider a “free write”, where you set a timer and write for the full 10 minutes and don’t edit while you write. There’s always time to return to editing later. Free writing is about getting your story down on paper; you may be surprised what your writing reveals.

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