Narrative Medicine Monday: Poof

This elegy by poet Amy Gerstler was selected by this month’s Poem-a-Day curator, Maggie Smith. I wrote about how Smith’s poem “Good Bones” hangs on a nondescript bulletin board in our clinic, though I never did figure out who posted it there. Each morning this month, I’ve been eager to see what poem Smith selects.

It’s no surprise that I think poetry provides much needed perspective to the world of medicine, and Gerstler’s “Poof” is no exception. Gerstler begins with a small bag of ashes on her lap, a gift from her late friend’s family. She recalls the service, the details of “staring at rows of docked boats” and the woman’s “impossibly handsome son.”

Gerstler speaks directly to her old friend, remembering that “You were the pretty one. / In middle school I lived on Diet Coke and / your sexual reconnaissance reports.” She imagines an alternative storyline where “your father never hits / you or calls you a whore.” Through Gerstler’s memories, both real and imagined, we get a glimpse of their bond, of the woman she, and this world, lost, even though we never learn her name, her vocation. (Why is it that these are the first things we ask? Always: What’s your name? What do you do?)

Gerstler gives us a remembrance that is more: a cinematic illumination of who this woman was: “You still / reveal the esoteric mysteries of tampons. You / still learn Farsi and French from boyfriends / as your life ignites.”

I like that Gerstler considers alternate storylines of their history together. Our formative years can be like this, wondering what different versions of us might transpire. I imagine (and, reaching middle age myself, have already succumbed to such reveries) our later years might also be prone to wondering what other tributaries of life paths might exist in the universe.

Ultimately, we learn that their lifelong relationship remains much as it is was in their adolescence: “I’m still lagging behind, barking up all / the wrong trees, whipping out my scimitar far / in advance of what the occasion demands.” Gerstler’s tender flashes of moments between the two is a tribute not only to her late friend, but also for all of us who are lucky enough to have kept company with cherished friends over the decades.

Writing Prompt: Think of a person (or patient, if you’re a medical provider) important to you who was suddenly gone. Write them an elegy in second person, or, alternatively, a letter. What are the memories, the moments, that stand out to you? Did this person vanish, as they did for Gerstler, with a “poof,” or would you use a different way of describing their absence from your life? Alternatively, consider writing an elegy or a letter to a long-time friend or patient who is still alive. Write for 10 minutes.

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Narrative Medicine Monday: GUTS

I previously featured author Janet Buttenwieser’s essay, “The Colostomy Diaries,” on a Narrative Medicine Monday post. Today, I’m pleased to highlight her similarly humorous and heartfelt memoir, GUTS.

Buttenwieser writes with a comfortable familiarity, weaving candor into her story of misdiagnosis, treatment and loss. I felt like I was reading the words of a dear friend; Buttenwieser is authentic and relatable. She navigates the foreign and often perplexing world of medicine as a young patient, stricken with a debilitating illness. She finds herself getting regular CT scans and under the care of a surgical resident, contemplating operative measures: “I decided right then that I liked the resident better than my regular doctor. In my growing survey of medical professionals, I’d begun to notice a trend. The younger the doctor, the more he or she listened to me. They asked questions …”

I was particularly struck by a passage where Buttenwieser describes her overhearing a paramedic relay her emergency case to the hospital where the ambulance is transporting her to. He uses the common medical term “chief complaint.” She bristles at the phrasing, stating “I feel angry at the way we patients are portrayed by the medical establishment as whiny toddlers who need a nap. Patient complains of gunshot wound to the head. Patient complains of missing limb following leg amputation.” There is phrasing that becomes commonplace during medical training, traditional wording that is passed down in the name of congruity. To an outsider, though, I can appreciate how unfeeling much of this must seem. Medical-ese leaves much to be desired in the realm of patient-centeredness.

I was privileged to meet the local author briefly at a book signing and will attend a book club this week where she will also be in attendance. I admire her writing skills as well as her contribution to an important perspective – that of a young patient. GUTS has solidified its place among my favorite narrative medicine memoirs, including In Shock, When Breath Becomes Airand On Call.

Writing Prompt: Have you encountered a certain trend among medical professionals, as did Buttenwieser? Do you agree that younger medical providers are better listeners? As a self-proclaimed rule follower, Buttenwieser finds it difficult, especially early in her bout with disease, to advocate for herself or question her initial physician’s diagnosis and treatment plan. Have you faced a similar challenge in the medical world? Write for 10 minutes.

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