Narrative Medicine Monday: Brilliance

Poet Mark Doty’s “Brilliance” shows a dying man changing his perspective near the end of life. In Doty’s poem, the man has “attended to everything, / said goodbye to his parents, / paid off his credit card.” He gives away his pets, finds the risk of owning too great, realizes that he “can’t have anything.” When someone suggests he get a bowl of goldfish, he replies “he doesn’t want to start / with anything….” For just a moment, the man allows himself to imagine the goldfish he might like: “hot jewel tones, / gold lacquer.” The fantasy, though, is fleeting because “I can’t love / anything I can’t finish.” Eventually he recants that decision, saying “Yes to the bowl of goldfish. / Meaning: let me go, if I have to, / in brilliance.”

Writing Prompt: Have you ever been at a place in your life when you didn’t want to start with anything new? What prompted that feeling? If you’re a medical provider, think of a time you’ve seen a shifting perspective in patients near the end of life. Write for 10 minutes.

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Narrative Medicine Monday: Primum Non Nocere:

Emma Barnard is a visual artist and researcher focusing on fine art and medicine. Her latest installment, “Primum Non Nocere,” reflects the patient experience. Barnard’s work is influenced by her own interactions with the medical world as a patient and her research into this arena, including Michel Foucault’s term ‘medical gaze,’ used to “denote the dehumanizing medical separation of the patient’s body from the patient’s person or identity.”

I’m interested in Barnard’s method of creating art, where she follows a patient into the exam room and questions them right after, producing a drawing based on their response. She notes that many of the physicians are surprised at the resulting artwork: “During the consultation process patients show little emotion; it’s quite difficult to read how they really feel about the impact of the words spoken during the clinical encounter.”

Barnard also incorporates the physician and surgeon perspectives. Could you relate to her images of a physician’s experience in a busy clinic practice?  I could certainly identify with the depiction of others superseding the “self” and various demands of work and home life feeling compartmentalized. Do you agree with the neurosurgeons’ statement that as physicians we view a division between us and patients and that we have to understand this alienation “if we are to find ways to soothe it and become connected to our patients and to the essence of medicine?”

Writing Prompt: As a patient, have you ever experienced Foucault’s ‘medical gaze,’ where you perceived a provider as seeing you only as a body, rather than recognizing your personhood? What did that feel like? As a medical provider, have you ever caught yourself interacting this way with a patient? How can we work to overcome this tendency? Write for 10 minutes.

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