Submission Medium: written

The Desperate Son

Witnessing his father's decline from cancer, an oncologist wrestles with his own fears and desperation. The story illustrates what happens when roles are flipped and a health professional finds himself at the centre of a family health crisis. What would you, as a health professional, do when faced with a similar situation? The story could be used to promt discussion about care at end of life and provider-patient communication.

Amid the Wait

This personal essay, appearing in JAMA's regular "A Piece of My Mind" feature, details a health care provider Cia Merin Bishop's experience of going through unsuccessful infertility treatment while practicing medicine and caring for patients in a pediatric intensive care unit. The essay poignantly portrays the emotional experience of undergoing infertility treatment. It also speaks to what it is like to be both physician and patient and the coping, support, and resilience she marshalls in order to continue to function at work while dealing with the physical and emotional impact of her own medical treatment. The author points out that this experience is not uncommon, citing studies that suggest about a quarter of female physicians experience infertility and 31% of female oncologists reported infertility requiring counseling or treatment. As she says, "I write this piece in solidarity with other women physicians. I write this piece as an anthem of our strength. And I write this piece to acknowledge the suffering within us, as we tend to the suffering around us." The dual focus of this moving and readable essay would make it equally useful for discussions of infertility and reproductive health as well as physician stress and resilience. It could also be a useful in a course or unit on narrative medicine as an example of how physician's writing their own stories helps to humanize medicine.

Bibliography: Patient-provider communication stories

A student got interested in patient-provider communication in a part of a course devoted to health narratives. I pulled this together for them as a starting place for them to look further.

Skin & Bones

Skin & Bones is Renée Watson’s novel about the experiences of Lena, a 40-year-old African American woman in predominantly white Portland, Oregon. Health, body image, weight, diet, and beauty standards are prominent topics throughout the book and these are contextualized within larger themes about race, gender, gentrification, work, love, faith, and friendship. There are many passages in the book that show how beliefs about health are communicated through interactions with Lena’s friends, family, romantic partners, co-workers, and service providers. For example, the book opens with a chapter entitled, “the weight I carry,” that problematizes assumptions about health and weight in an interaction with a healthcare provider. Lena’s observations about the interaction (e.g., the too-small gown, unfounded assumptions and problematic statements from the health care provider) are woven with reflections on her lifeworld. Immediately following this chapter is a brief reflection on “morbid” as a word used in relation to weight; it concludes with the statements, “Comment on my appearance. But tell yourself it’s about my health.” Health-related themes are prominent enough that one might assign the entire book and this would provide opportunities to see "big" or "fat" as an identity that intersects with race and gender and to discuss health themes in relation to sex, social support, family, and community. However, the book is also written in chapters (some only a paragraph long) that could be excerpted to explore specific topics. For example:

the aforementioned “the weight I carry” and “morbid” focus on a health care interaction
“Sunday supper” includes a reference to a mother who died from a failure to diagnose breast cancer because she was “a poor Black woman”
“shopping while fat” and “back to school shopping” address finding plus-sized clothing
“macro microaggressions” details lunch with younger white co-workers and concludes with the line, “...they sat there and basically admitted—in my presence—that of all the cares and worries to have in life, their greatest fear is having a body that looks like mine.”
“aunt Aretha” examines “soul food” and its complicated connections to health, family, race, and class
A sequence of chapters--“fat girl, dance,” “how whiteness killed the body positive movement” (an excerpt from Kelsey Miller), “debriefing,” “positivity,” “positive,” and “body positivy” address how fat acceptance intersects with race and this is taken up later in two chapters describing Lena and her friends’ experience at a “Fat Girl Wellness Conference”

One especially powerful recurring storyline involves messages about self-acceptance, health, and diet that Lena received from her own mother and what she communicates with her daughter. These are difficult chapters and include a near overdose on diet pills that is initially taken as a suicide attempt. A strong bond between Lena, her mother, and her daughter sustains them and the book addresses the complexities of communicating about health, race, gender, and beauty in our personal relationships.

“Final del juego” por Julio Cortázar

The story revolves around a young narrator, her sisters Holanda and Leticia, their mother, and their aunt Ruth. Leticia suffers from an unidentified back ailment and often directs their play. Told from the point of view of a child learning to understand disability, with emotions ranging from pity to envy: Leticia is excused from chores and catches the eye of an appealing stranger. Could begin discussion of how people with disabilities are perceived and responded to by able-bodied peers and family members, portrayals of relationships. 8 pps (4500 words); Argentinian dialect; some very funny moments.

Para vivir con salud: Leyendo la salud y la literatura.

This open-access resource describes itself this way: "Para vivir offers an introduction to reading different literary and cultural texts from the Spanish-speaking world with a thematic focus on health. It can be used as an alternative to the standard Introduction to Hispanic Literature course texts, as it also teaches techniques of close reading. It incorporates authors from seventeen counties, has an almost even representation of male and female authors and diverse communities in the Hispanic world (European, Creole, Afro Hispanic, Latinx, Indigenous, Jewish). In addition to introductions to reading different genres (narrative, poetry, theater, and film) we have scaffolded supporting material such as biographies, notes on the historical contexts, pre and post-reading questions." Although framed in terms of its uses for literature courses, the literary selections here could be incorporated into many other intermediate and higher level Spanish courses in which reading and composition are central activities. Much primary source material is included in the book itself; when not available due to copyright, there are suggestions on how instructors might be able to access them on their own. Beyond the readings themselves, the book includes a great deal of pedagogical material (introduction to genres and reading strategies), a bibliography that introduces health humanities and links literature to the work of health professionals; ideas for syllabus construction. It is downloadable.

“Rosario Tijeras” Jorge Franco

"Rosario Tijeras" by Jorge Franco is a Colombian novel that explores the world of drug trafficking and its impact on individuals. The story follows Rosario as she grapples with the trauma of sexual abuse, which has driven her into a life of crime within the violent drug trade. The novel also delves into Rosario's mental health and the relationships she forms. Additionally, it sheds light on the effects of child sexual abuse and the physical toll of her criminal lifestyle as they lead to hospitalization. Undergraduates would be highly motivated by the storyline, dialect and characters. 160 pages, only available in print or electronic (paid) edition, but inexpensive ($10 used) and readily available.

‘Oppenheimer’, mi tío y los secretos que a EE.UU. aún no le gusta contar

The film "Oppenheimer.” which won seven Academy Awards shows both the triumph of scientific ingenuity and is a cautionary tale of unintended consequences.This opinion essay describes reckless exposure of Americans to radiation during the atomic tests that created the bomb. Soldiers, pilots, and sailors - and a military band, the leader of which is the focus of this story - were exposed to high levels of radiation that caused serious illnesses and cancer later in life. They were forbidden to disclose their participation in the nuclear testing, even to spouses and doctors, for decades, making it difficult to trace exactly what impact the exposure had on their health. 5 pps, upper intermediate readers; good for discussion of environmental health issues.

Siete voces que cuentan cómo superaron sus adicciones

This article provides seven different stories from recovering drug addicts with the intention of reducing the stigma behind drug addiction. Each story provides a glimpse into the life of each person, past their addiction. They discuss how their addictions started, as well as how they have been recovering from their addictions and beginning to reclaim their lives. Intermediate level, 4 pages.

“Una puerta se abre” por Adolfo Bioy Caseras

Almeyda considers suicide through internal dialogue that evokes the struggle to weigh life-sustaining alternatives against death. His contemplation turns surreal in an encounter with the idea that "time heals everything" and the possibility to sleep for 100 years. Theme throughout the story is that even in the darkest moments, there are options and opportunities to overcome life's challenges. The final twist, with the reappearance of a key character, emphasizes that love and human connection can overcome even the most desperate times, making clear that suicide is not reasonable or desirable. 10 pages, upper intermediate readers; Argentinian dialect. Useful for a Latin American literature course.