Narrative Medicine Monday: Brain Biopsy

Pathologist and poet Dr. Srinivas Mandavilli illuminates the microscopic, and the universal, in JAMA‘s “Brain Biopsy.”

Mandavilli lets us know that in “neuroradiology they have a gift for reading the mind.” In moving a glass slide, he learns to “bow in silence and see an underworld / —an otherworld where planets improvise like nuclei.” The narrator alternates between the microscopic and the broader cosmos. Through this, Mandavilli evokes a sense that we are all part of a grander whole, even the minuscule and aberrant parts of us.

His poem ends with the relational, with a hint at the journey we travel: “While we drive on a summer evening, she rests, / her long fingers intertwine, the heft / of her dark tresses strewn carelessly like the road ahead.”

Writing Prompt: Think of the smallest and largest components of life, of existence. How are they connected? Alternatively, pull out your old histology textbook or your child’s microscope. Examine a slide and write what you see, how this observation makes you feel. Write for 10 minutes.

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Narrative Medicine Monday: Titanium Seed

Poet Judith Skillman’s “Titanium Seed,” published recently in the Journal of the American Medical Association, describes the new “part of flesh inside” that is hers “to carry through / airports, not setting off / any alarms, they assure me, / not anything other than / a placeholder for cancer.”

She depicts the experience of getting a breast ultrasound, “the technician rubbing her wand / over and up hills of black / and white.” Skillman’s poem illustrates the anxiety associated with waiting for a diagnosis, the uncertainty of the pause that occurs after an aberrancy is found but before a definitive answer is revealed.

The seed represents an alteration of Skillman’s body, this reality of the possibility of cancer she harbors in her flesh unseen. She outlines how the patient is at the mercy of the medical diagnostician, describing how she lies “between two triangle pillows – / placed like an offering / to this Demi god who may / or may not find what appeared / on his screens.”

Writing Prompt: Think of a time you had a biopsy or lab test or imaging done and had to wait for the results. Sit in that space of uncertainty. Describe the experience. Did colors return, as they did for Skillman, when she receives a benign diagnosis? How did knowing contrast with the period of waiting? Try writing about this space of waiting from both the patient and medical provider’s viewpoint. Write for 10 minutes.

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