Tag: medical school

Body of Work

Anna Dovre’s story “Body of Work” is a meditation on the various ways she has encountered death through her medical education: learning to intubate on a cadaver, witnessing death in the emergency department, sitting with a hospice patient. Her essay reflects on the ways death is experienced and understood in the process of medical education and the connections and disconnections with one’s own understanding of mortality.

She starts her reflection with a description of her practice time in a cadaver lab and the physical benchmarks for competency when performing an autopsy. The following section about her time as a hospice companion juxtaposes personal experience with a discussion of clinical terms for ways and stages of dying. “To die actively means the pauses between breaths lengthen and stutter; the mind slips into unconsciousness; the skin begins to mottle into starbursts of purple and blue. To die inactively—well, that becomes a question of semantics, of philosophy.”

The story raises questions about how we honor life and make one’s last moments and after death a respectful and respected process. How can we, as the living, be more appreciative of the gift of life while caring for those around us? This quotation, “If anything, the scene on the table has become more gruesome, but perhaps that has rendered her less real, less human to me,” from after the autopsy is a stark realization that will inspire feelings and emotions in readers.

Power With Anthology: Storytelling for Social Justice

From the website:

“POWER WITH is a collection of multimedia stories that uplift the lived experiences and perspectives of community members, patients, and health care workers and trainees. Specifically, POWER WITH spotlights how our experiences with oppressive (or “power over”) structures impact us individually, while also demonstrating that we are all connected through a greater shared human project. These stories inspire us to imagine what a system that embraces relationships and collective change (or “power with”) could look like.”

As of 10/25/23, some of the examples from the website were as follows:

1. “Ariah Tesema, a pre-med student, shares her journey of pursuing a career in medicine and embracing her multicultural identity. This begins with immigrating from Ethiopia to the United States as a young child and discovering that her multicultural life does not fit neatly into the boxes American society tries to place her in.”

2. “Andrea Morgan, a doctoral student at OHSU, shares her experience moving to Portland from Southern California and her dream to share her love of science with children who come from similar backgrounds.In addition to her studies, Andrea is leading a Racial Equity & Inclusion grant called Black Like Me 360, a project that allows viewers to see and hear in a first-person experience the day-to-day lives of Black Portlanders on campus and in the city in an art installation.”

3. “As a college student, Toren Ikea-Mario helped his father through a difficult cancer diagnosis and treatment. In the process, he realized that the healthcare system was broken, especially for people like his father, and was determined to be a part of the solution.”

Teaching with “The Nocturnist”

Podcast series created by physician Emily Silverman that focuses on humanizing medical practice through healthcare workers’ storytelling. Some topics: interview with author of a book on forced sterilization, “Black Voices in Healthcare” and “Post-Roe America”. Episodes run 35-55 minutes; first 10-15 is story, the rest is wide-ranging interviews about (e.g.) why did you become a doctor? With related interview (see Farrell, 2022) could be used both to discuss storytelling as a way to address burnout, and to introduce oral history interviews.

Heart Sounds

In this 5 minute read, a first year medical student discusses treating a patient whose family had to overcome indifference in the ER in order for him to receive treatment. Additionally, the medical student illustrates managing the unknown when assisting a patient with an advanced and nuanced condition. The student decides that the best treatment they can provide is listening to the family’s complaints, fears, and happy moments in order to encourage them to keep believing in this patient’s future.

The story touches on cardiology as a specialty and would benefit pre-medical undergraduates as well as professional students recently starting their health profession. It highlights the importance, and difficulty, of active listening.

Do no harm: Stories of life, death and brain surgery.

Very human memoir from a neurosurgeon nearing retirement who tells stories from his experiences of doing (and deciding against) brain surgery. He’s expressive, emotional and even poetic about the beauty and hardship of neurosurgery: p.8 “There is a fine, surgical poetry to (the names of the parts of the brain) which, combined with the beautiful optics of a modern, counterbalanced microscope, makes (pineal gland tumor surgery) one of the most wonderful of neurosurgical operations – if all goes well, that is.” p. 14, observing his first brain surgery: “I had the strange feeling that this was what I had wanted to do all my life … it was love at first sight.” p.25: “I have not yet lost that naive enthusiasm with which I watched that first aneurysm operation 30 years ago. I feel like a medieval knight mounting his horse and setting off in pursuit of a mythical beast.” Marsh also recreates many conversations with patients, giving his own emotional backstory – “His anxiety made me more nervous as I tried to reassure him” “I wasn’t sure she was really taking seriously the risks of the operation, but in the end it was her decision.” He’s brutally honest about his own shortcomings and failures, breaking down the barrier between physicians and patients in healthy and illuminating ways.

Chapters are short and self-contained, making it easy to assign 10-12 pps for a topical reading in many kinds of courses: interpersonal communication, relationships, health communication, medical student life. The particular conditions recede in importance; what matters are the human beings, their relationships, communication and love for medicine. This is well-written enough to be a model for creative writing courses.

The emperor of all maladies: A biography of cancer.

This book won the Pulitzer Prize for nonfiction in 2010. It is written by a physician who interweaves his clinical experiences as a medical oncologist with the history of cancer, including how humans came to understand that it wasn’t one disease but several and how treatments were developed as scientific understanding of human bodies progressed. For example, realizing that bodies were made up of cells and that cancers were also cells rather than viruses was a big step forward in the 1840’s.

The work is constructed as within stories within stories, including cases of patients, biographies of scientists and doctors, and Mukherjee’s own learning to become an oncologist through the inevitable trial and error of medical education. Written (almost) as engagingly as any novel, it’s still a big commitment for a student or layperson and not easy to assign in small parts. It might be most useful as a background reading to get a sense of medical history generally and a somewhat soothing answer when it seems like every third person you know is dealing with cancer (partly because we’re all living so long, partly because – all that other stuff).

Penn State Collection of Graphic Medicine Narratives

Organized by each year the class has been taught, this is collection of graphic narratives illustrates issues medical students face with details of med school life: imposter syndrome, harsh criticism, feeling insecure vs thinking they can save a patient’s life if they go with their instincts, etc. Amazing range of writing and drawing styles, very candid, some quite powerful. Some use medical terminology beyond interest or understanding of lay reader.

To be a good doctor, study the humanities

The author makes the case for why the study of humanities is necessary for a complete medical education. Humanistic study helps to answer questions that are essential to being a “good” doctor, such as “how best to support a patient who is dying. Do you cry with the patient? Is it acceptable to be detached? Is it OK to resume your life and laugh a few hours later?” Humanistic study also helps physicians appreciate social determinants of health. The article also provides statistics on medical humanities programs, med school acceptance rates for students with humanities background, correlations between humanities background and positive and negative physician attributes, and patterns of residency choices.

The essay could be used as an introductory reading in a medical humanities course.