Free Write Friday: Pay Phone

We hardly see them anymore, the free standing booth a novelty. A friend’s son once asked, “Mom, why do they say ‘hang up’ the phone?” Well, this is why: the dangling silver cord like a techy serpent, tethered to a bulky handset.

Now we’re all cordless, no need to connect other than with head down, blue screen filtering. Everything is shiny, posed, captured. No hang ups, strings attached, call waiting. All is instant, polished, curated.

I remember anticipating a call at home, phone ringing in the kitchen, my dad answering hello soon after I picked it up in my basement bedroom. “I GOT IT!” reverberating through the house, high pitched preteen voice anxious for privacy.

I remember fumbling with silver coins at the pay phone, flipping through weathered white pages skimming for the right name, pen scratches and coffee stains marking the tissue-like paper.

I remember a friend’s dad’s car phone, brick handset centered between the front seats of their Chevy Suburban. The wonders of a phone call made from a moving vehicle, away from a stationary box without foundation, without directional bounds. It was fancy, magical, very nearly unheard of. I watched in awe as he answered, mid-errand and corresponded, communicated, then moved on about his day.

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Narrative Medicine Monday: And Still We Believed

Emergency physician Dr. Rebekah Mannix relays the story of her teenage goddaughter who developed vomiting and eventually a dire diagnosis of metastatic cancer in JAMA’s “And Still We Believed.”

Mannix finds herself researching experimental treatments, hoping for a “miracle,” but unable to find any in the medical world: “We did not comprehend that someone so healthy and vibrant…could succumb.” Even after the patient was transferred to comfort measures only, Mannix admits she “still wasn’t ‘there’ yet.” “Even as I knew she would die, I believed she wouldn’t.”

Mannix speaks to the idea that even as physicians, as scientists, we “know better” but still our humanity takes precedence over logic and understanding. There is a lesson here for medical providers. Patients may comprehend what we tell them, but they might not always believe it: “Even as they sit holding the hand of a loved one on a morphine drip–whose organs have shut down, whose words have ceased–they still may not believe death will come.”

Writing Prompt: Have you ever experienced a dire diagnosis for your yourself or a loved one and not believed it? If you’re a physician, how can we best navigate supporting a patient or their family when, despite clear evidence to the contrary, they “still believe.” Write for 10 minutes.

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Home

In so many ways, this is my place, my home. I’ve been traveling to the north shore of Kauai for 40 years and spent my childhood summers there. It’s changed so much in the decades since, but the breathtaking landscape and wonderful locals remain. Thinking of those affected by Hurricane Lane this week. I remember when Hurricane Iniki hit Kauai in 1992. My family and I had been visiting shortly before the devastation of Iniki. Hoping Lane will take its lumbering self and veer far away from the Hawaiian Islands before more destruction occurs.

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Narrative Medicine Monday: Solving for X

Author Pam Durban tries “Solving for X” in her nonfiction piece in Brevity. Durban tells us that she’s “never been good at word problems,” the kind that involve trains and “variables of time, speed, and distance.” At seventy years old, she is now able to “manage the simpler calculations” such as knowing that she “doesn’t need a dental implant that lasts fifty years.” At her current age, though, she finds some of these “word problems of life” are riskier and “always end with an unsolvable X–the date of her death.”

Durban muses on how to manage these unsolvable Xs. She experiences a bout of amnesia in an E.R. and recalls an uneasiness with the concept of eternity, finds her “multiplying Xs” just as unnerving. Durban masterfully gives us a glimpse into the mind of a woman in the last part of her life, but highlights that even nearing the end, the question of time can be perplexing, unsettling and stretch out into the future.

Writing Prompt: Have you calculated, like Durban, your need for a thirty-year roof or if you’ll be around for the next solar eclipse? Can you relate to Durban’s unease with “multiplying Xs?” Why do you think she “sees a way” in the memory of returning to her father’s grave? If you are a medical provider who cares for elderly patients, what can you take from Durban’s essay that might be helpful in how you approach patients who are making decisions about medical care and treatment plans? Write for 10 minutes.

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Free Write Friday: Hula

She always wanted to learn hula, admired hips swinging, grass skirt swaying. Bare brown feet, toes kissing the earth, arms outstretched, calling out a narrative. As a spectator she pieced together a story told long ago, tethered to form and melody.

The girls wear magenta lipstick, long hair swept to the side with a plumeria, a hibiscus, an orchid for adornment. She longed to be made up too, tell a story with her movements, with her hands raised heavenward.

Ballet never appealed to her; such delicacies were not in her constitution. She did like tap dance, clipping the hard floor, reverberating sound. Tap, though, still possessed a harsh edge: a clank of form, of function. Not a gentle sway, like the hula, like this place: fluid, fragrant. Here she relaxes into her bones; the breeze, the rolling waves smooth and synchronous to her heartbeat, to her soul.

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Narrative Medicine Monday: Why Doctors Should Read Fiction

Sam Kean’s article in The Atlantic, Why Doctors Should Read Fiction,” highlights what many medical schools, residencies and medical groups are realizing: medical providers and patients alike benefit from physicians taking an interest in literature. Kean asks, “if studying medicine is good training for literature, could studying literature also be good training for medicine?”

Kean’s article outlines a study in Literature and Medicine, “Showing That Medical Ethics Cases Can Miss the Point.” The study found that “certain literary exercises…can expand doctors’ worldviews and make them more attuned to the dilemmas real patients face.”

Students rewrite and dissect short stories that expose an ethical case study, such as physician-writer Richard Seltzer’s “Fetishes.” The study’s author, Woods Nash, argues that “short stories are far more effective means of teaching students and health-care professionals to wrestle with the mess, to pay attention to narrative perspective and detail, and to become more comfortable with ambiguity.”

Writing Prompt: Have you read a piece of fiction that outlined a certain bioethical dilemma? Do you agree with Kean’s assertion that doctors should read fiction? How might the practice prove beneficial to a medical provider? Read Seltzer’s “Fetishes” and rewrite the story in short form, as a poem or case study. What new insight do you gain from this exercise? Write for 10 minutes.

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Deadlines

I have several deadlines looming this week, so my regular posts have gone by the wayside. In addition to a final rewrite of this essay for an upcoming anthology, I also had a big assignment due for my Hugo House Finish Your Book class this week, as well as putting the final touches on my AWP Writer to Writer application. Not to mention a new narrative medicine program I’m getting off the ground this fall, modeled after Dr. Suzanne Koven’s Literature & Medicine program at Massachusetts General Hospital in Boston.

I wrote about grace with the blogging schedule and the importance of fluidity here, but I also want to stay true to my regular writing practice. Sometimes though, deadlines take precedence. Come back Monday, with deadlines in check and blissfully on vacation, for a new Narrative Medicine post!

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Free Write Friday: Swing Set

The swing set in their their backyard was evergreen, angled legs buried among the smooth stones of a playground’s gravel. Their mother would shoo them out the sliding glass doors, the house couldn’t contain two growing boys and their spirited sister.

She’d scamper down the grassy hill, passing the roses, transplants from their previous rambler in another affluent suburb. That house was too small for their growing family but she remembers the room she shared with her baby brother fondly. The tiny dresser with yellowed fabric, decorative flowers and overlapping plaid; just flashes, fragments of memories.

This new house was bigger, each child their own room, a greenbelt bordering their backyard. She liked to explore among the sticker bushes, pretend to make a meal from the salmon berries that lined the creek each spring.

Two swings hung from the top bar of the modest play set and she usually started here, choosing the one on the left if she beat her brother to it. Skinny legs pumped high, leaning back and letting go at the top of the arc; just the right timing to jump far, ever farther, trying to beat her previous sneakers’ impression in the gravel.

Then she’d move on to the face-to-face glider, tiny backed seats allowed swinging with a friend. They’d hold on to chained ropes on either side, leaning back, leaning forward, mirrored and synchronized.

Eventually they’d grow too big, knees touching. Other activities took precedence as outdoor play receded into childhood. Green paint peeled, rust emerged. Too many years neglected in the damp Northwest air.

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