Lincoln in the Bardo in the Bardo/ by Russell Teagarden

April 5, 2017 at 11:36 am

Russell Teagarden is an Editor of the NYU Literature Arts and Medicine Database and helped lead the Medical Humanities elective at the School of Medicine this past winter. In this blog post, he experiments with creating a text collage from recent reviews of George Saunders novel, Lincoln in the Bardo.

Author's note:
George Saunders is well known for his inventive and affecting short stories. Lincoln in the Bardo is his first novel, and as described by Charles Baxter in his review in the April 20, 2017 issue of The New York Review of Books, it "doesn't resemble any of his previous books…nor does it really resemble anyone else's novel, present or past. In fact, I have never read anything like it." The story is told by a chorus of spirits or ghosts in a "bardo," which is a Tibetan limbo of a sort for souls transitioning from death to their next phase. Saunders rarely gives any individual spirit more than 2 or 3 lines of dialog, and he intersperses short snippets from historical texts- some real, some not-to provide contextual background. Of particular interest to the medical humanities community will be the focus on the well-trodden subject of grief through this experimental approach. The book has attracted the attention of many serious critics, so many in fact, that they can be assembled into a chorus to derive a review of the book in the book's format. I have thus taken excerpts from published reviews, most real, a few not, to produce a review that covers how the book is laid out (I), how the bardo works (II), how the story flows (III), and how it's critically received (IV) as can be told by a chorus of reviewers in a bardo of their own.

I.

The entire book seems to consist of nothing but epigraphs, which themselves turn out to be either historical sources (some real, some invented) or the chatter of spirits, indiscriminately mingling with one another. After a while, the reader begins to recognize the unique cadence of each spirit. The purposefully confusing form adds a disorientating but dramatic element to the book, and forces the reader to focus.
anon/ the economist, march 23, 2017

Readers with conservative tastes may (foolishly) be put off by the novel's formait is a kind of oral history, a collage built from a series of testimonies consisting of one line or three lines or a page and a half, some delivered by the novel's characters, some drawn from historical sources. The narrator is a curator, arranging disparate sources to assemble a linear story.
colson whitehead/ the new york times, february 9, 2017

The Lincoln of the title is not Abe but Willie, the president's 11-year-old son, who dies of typhoid just hours before the novel begins.AWillie may be the Lincoln in the bardo, but the bardo is really in Abe.
benedict jamison/ u.s. presidents in literature quarterly, spring, 2017

Lincoln in the Bardo is set in a Washington cemetery in 1862, amid the resident population of ghosts. Using a format that combines a playlike assemblage of voices alternating with chapters composed of quotations from historical sources, it depicts how the ghosts respond to the arrival of Willie Lincoln, the president's son, who died of typhoid at age 11.
laura miller/ slate, february 6, 2017

The cemetery is populated by a teeming horde of spiritsadead people who, for reasons that become an important part of the narrative, are unwilling to complete their journey to the afterlife and still hang around in or near their physical remains.
hari kunzru/ the guardian, march 8, 2017

The novel is told through their speeches, the narrative passing from hand to hand, mainly between a trio consisting of a young gay man who has killed himself after being rejected by his lover, an elderly reverend and a middle-aged printer who was killed in an accident before he could consummate his marriage to his young wife.
hari kunzru/ the guardian, march 8, 2017

Those voices, and Willie's, come to us in snatches, usually brief, little bursts of subjectivity and consciousness tumbling over one another, sometimes conversing, sometimes interrupting, squabbling, contradicting.
alex clark/ the guardian, march 5, 2017

The novel operates like a cross between a film script and an oral history, much of it narrated by two woebegone ghost pals.
tod wodicka/ the national, march 22, 2017

It moves from collages of quotes from historical documents and textbooks about Willie's death (some of which Saunders appears to have invented) to a riotously imagined story of the ghostly inhabitants of the graveyard.
alex preston/ the financial times, march 3, 2017

To deepen the novel and give it context, Saunders regularly interjects bits of history and reportage (some of which he has created)aanother layer of voices, as it were.
david ulan/ the los angeles times, february 9, 2017

Are the nonfiction excerpts from presidential historians, Lincoln biographers, Civil War chroniclersareal or fake? Who cares? Keep going, read the novel, Google later.
colson whitehead/ the new york times, february 9, 2017

It may take a few pages to get your footing, depending. The more limber won't be bothered.
colson whitehead/ the new york times, february 9, 2017

 

 

II.

 

When someone dies, Tibetan Buddhists believe that they enter the bardo of the time of death, in which they will either ascend towards nirvana, and be able to escape the cycle of action and suffering that characterizes human life on earth, or gradually fall back, through increasingly wild and scary hallucinations, until they are born again into a new body.
hari kunzru/ the guardian, march 8, 2017

The bardo is an element of Tibetan Buddhism, a way station between incarnations in which souls prepare themselves for their next life.
laura miller/ slate, february 6, 2017

It's in the nature of the bardo, which exists, in Tibetan Buddhism, as a kind of purgatory, a transitional space for souls that can't give up their former lives. All the characters here are trapped, prisoners of the past, "bellowing their stories into the doorway, until it as impossible to discern any individual voice amid the desperate chorus."
david ulin/ the los angeles times, february 9, 2017

Time and space in the bardo Saunders conjures are the same for its inhabitants as they were for them in their former earthly domains. This bardo restricts its inhabitants to the geographic area of their burial grounds they were buried in Georgetown and so their bardo is in Georgetown. They measure their time in the bardo in "years." I was expecting something more other worldly.
alexis leigh/ buddhism and literature, february, 2017

This is not a straightforwardly Tibetan bardo, in which souls are destined for release or rebirth. It is a sort of syncretic limbo which has much in common with the Catholic purgatory, and at one point we are treated to a Technicolor vision of judgment that seems to be drawn from popular 19th-century Protestantism, compounding the head-scratching theological complexity.
hari kunzru/ the guardian, march 8, 2017

This grey purgatorial state is the 'bardo' of the novel's title. It has little in common with the Buddhist concept of that name, which envisioned a sort of metempsychotic wormhole that connected successive cycles of rebirth. In Saunders's bardo, a Dantean contrapasso transforms the ghosts in accordance with the moral ailments that afflicted their lives.
robert baird/ london review of books, march 30, 2017

For non-Buddhists, it is a recognizable limbo, full of milling entities who for one reason or another will not take the next step of the journey. Like the ghosts we know from stories, they are tied to their former existences, trapped by an idea of themselves, and can't leave until they are ready.
colson whitehead/ the new york times, february 9, 2017

 

III.

 

Unfolding over one night in a graveyard not far from the White House, it tells a story that is, by turns, simple and complicated, tracing both a father's grief and its effect on the Republic he serves.
david ulin/ the los angeles times, february 9, 2017

His father, already beset by internal doubt and external uproar a year into the American civil war, was propelled by restless grief to walk the dark and stormy Georgetown cemetery where Willie's body lay.
alex clark/ the guardian, march 5, 2017

His presence upends the order of the cemetery. For one thing, "young ones are not meant to tarry" unburdened by a lifetime's accumulation of failures and regret, they usually pass over quickly. But a visit by his grieving father agitates the boy, as well as his graveyard neighbors.
colson whitehead/ the new york times, february 9, 2017

Willie, like other children, is expected to pass on quickly to the afterlife proper, instead of remaining in the cemetery, but because of his father's grief he is tempted to stay.
hari kunzru/ the guardian, march 8, 2017

The boy's ghost wishes to stay in the purgatory of the graveyard, desperate for a few last moments with his father.
alex preston/ the financial times, march 3, 2017

There is a touching trio of eldersanames deliberately written lower-case who take Willie under their wing: roger bevins iii, a young gay man covered in eyes; hans vollman, who lugs around a "tremendous member", having been taken ill while anticipating his marriage-bed; and the reverend everly thomas.
alex christophi/ the new humanist, march 9, 2017

When the ghosts find that they're able to pass into Lincoln's body as he sits in the mausoleum, the reader is suddenly privy to the president's thoughts, and the novel discovers new depths.
alex preston/ the financial times, march 3, 2017

The father must say goodbye to his son, the son must say goodbye to the father. Abraham Lincoln must stop being the father to a lost boy and assume his role as a father to a nation, one on the brink of cataclysm.
colson whitehead/ the new york times, february 9, 2017

Willie's mother, Mary Todd Lincoln, does not figure in this story much more than descriptions of her taking to her bed. This is about a father's grief.
teresa slominski/ chicago american, february 24, 2017

 

IV.

Lincoln in the Bardo is part-historical novel, part-carnivalesque phantasmagoria.
alex preston/ the financial times, march 3, 2017

Saunders' primary intention in the novel: to take these whirling and disparate voices miserly widows, violent grifters, drinkers, doting mothers, licentious young men, abused slaves (even in this realm cast into a less hospitable portion of the graveyard) and unite them in their common humanity.
alex clark/ the guardian, march 5, 2017

The polyphonic narrative of the spirits is interleaved with constellations of artfully arranged quotation from primary and secondary sources about Lincoln's life, which Saunders uses to show that observers can be unreliable about the motivations and mental state of the president, and that even such questions as whether the moon shone or not on a particular night can be distorted by memory.
hari kunzru/ the guardian, march 8, 2017

And they lend the story a choral dimension that turns Lincoln's personal grief into a meditation on the losses suffered by the nation during the Civil War, and the more universal heartbreak that is part of the human condition.
michiko kakutani/ the new york times, February 6, 2017

In Lincoln in the Bardo, the immense pathos of the father mourning his son, all the while burdened with affairs of state, gives these sections of the book a depth that isn't always there when Lincoln is off stage. The busy doings of the spirits are entertaining, and Saunders voices them with great virtuosity, but the tug of Lincoln's griefAis sometimes too strong for them not to feel like a distraction.
hari kunzru/ the guardian, march 8, 2017

In the midst of the Civil War, saying farewell to one son foreshadows all those impending farewells to sons, the hundreds of thousands of those who will fall in the battlefields. The stakes grow, from our heavenly vantage, for we are talking about not just the ghostly residents of a few acres, but the citizens of a nationain the graveyard's slaves and slavers, drunkards and priests, soldiers of doomed regiments, suicides and virgins, are assembled a country.
colson whitehead/ the new york times, february 9, 2017

Saunders presents Willie's death as a turning point for Lincolnawill he be able to move on from his grief, to draw on it as a source of strength in the battle ahead, or will it crush him, the acuity of his own loss meaning that he sees Willie in every dead soldier?
alex preston/ the financial times, march 3, 2017

One of the novel's conceits is that byAoccupying the same space, the spirits can experience a dissolution ofAinterpersonal boundaries, understanding and feeling sympathy for each other in a mystical way. It is hard to be specific without spoiling the plot, but Saunders uses this device to imply a cause for Lincoln's later signing of the emancipation proclamation, a move that seems glib and reductive, a blemish on a book that otherwise largely manages to avoid sentiment and cliche. This is a small quibble.
hari kunzru/ the guardian, march 8, 2017

A portrait of Lincoln is not the point of this novel…the book provides slightly hidden away, but still quite visible a form of instruction concerning acceptance and grief.
charles bbaxter/ the new york review of books, april 20, 2017

It's tempting to trace some sort of connection between Lincoln and the Bardo and the political climate in which it has been published, but to do so, I think, is to miss the point. Rather, its concerns are existential, metaphysical, even when politics enters the work.
david ulin/ the los angeles times, february 9, 2017

Saunders's beautifully realized portrait of Lincolnacaught at this hinge moment in time, in his own personal bardo, as it were that powers this book over its more static sections.
michiko kakutani/ the new york times, february 6, 2017

Life is chaos and history a story, and even the greatest of our leaders are merely humans, after all. The recognition sits at the center of "Lincoln in the Bardo," which is a book of singular grace and beauty, an inquiry into all the most important things: life and death, family and loss and loving, duty and perseverance in the face of excruciating circumstance.
david ulin/ the los angeles times, february 9, 2017

The supernatural chatter can grow tedious at timesathe novel would have benefited immensely from some judicious pruning.
michiko kakutani/ the new york times, february 6, 2017

The novel is funny, poignant, and smart. But it's not an escape, just like it's not really about history.
theodore yurevitch/ the southeast review, february 21, 2017

This is a novel that's so intimate and human, so profound, that it seems like an act of grace.
alex preston/ the financial times, march 3, 2017

…………………………………………

Lincoln in the Bardo | 360 VR Video | The New York Times

 

Reading Lolita in Residency

March 23, 2017 at 11:23 am

Howard Trachtman, MD
Department of Pediatrics
NYU School of Medicine

Throughout history, reading books has often been viewed with deep suspicion by figures in authority. The Dominican priest Girolamo Savonarola collected and publically burned thousands of objects including books on February 7, 1497 in Florence, Italy, an infamous episode that has been recorded as the Bonfire of the Vanities. The books were condemned as temptations to sin. Russian dissidents put their lives on the line to gain access to books smuggled in from the West because they had been banned by the Communist politburo during the height of the Cold War. People have been imprisoned in Iran for reading Lolita. All high school students are familiar with Ray Bradbury's novel Fahrenheit 451, a science fiction novel that depicts a futuristic American society in which books are outlawed and "firemen" are authorized to seize and burn any book judged to be subversive. So even though reading books by the beach on a warm summer day is considered an innocuous activity, there is more to it than meet's the casual eye. It can be an act of great power.

 

One year ago, we started a reading group open to all the pediatric residents at NYU devoted to reading and discussing works of fiction. The selection process is open and consensus-driven, not particularly radical. We are receptive to non-fiction books but we have agreed to avoid literature expressly addressing medical problems or topics. The objective is to pick books that are high-quality literature. We are partial to books that are multi-dimensional and timely, expecting that they will push boundaries and stimulate thoughtful discussion. The senior member of the group prepares questions and gets the discussion started but no one has to raise their hand to speak. It quickly gets lively. We have read short stories by Edith Pearlman and novels by Jenny Offill, Kate Walbert, Kazuo Ishiguro, Edna O'Brien, and Ben Fountain.

Ms. Walbert joined the group for the discussion of her book, AA Short History of Women The books, which have been modest in length so we can finish them in time, have often been honored on lists of Best Books of the Year or Notable Books.
We meet bimonthly in the home of one of the faculty members and have a light dinner and desserts as we sit around in a tight circle to discuss the book. In part, we do this because it is worthwhile to find a friendly place outside the day-to-day hospital environment and away from the bustle of patient care for the group to get together. It is conceivable that it fosters a samizdat atmosphere among us. We can imagine that we are taking part in something that is outside the box, an underground activity that is a bit revolutionary compared to our day job as pediatricians. But apartments across the street from the Metropolitan Museum of Art are not hotbeds of revolution. If that is the case, where is the subversive element?

For starters, we read a book in hand. The Department of Pediatrics purchases the books and a hard copy is distributed to whoever wants to attend the group. No one brings a Kindle or reading device. Moreover, no one gets by reading a capsule summary or abstract of the book. We read the book from start to finish. This is a distinctly uncommon behavior in an age when most people routinely get their information online in easily accessible, abbreviated formats that can be easily read and digested. It may be considered a quiet act of rebellion when we show that an author's work deserves to be read and considered as a whole entity when we devote time and effort to understand what the author has in her or his mind.

Second, for attendings to see residents as more than a means to patient care and for residents to see attendings as more than the people who give orders and occasionally teach upsets the normal view of the residency ecosystem. The reading fosters a sense of community, a feeling that everyone in the department of pediatrics is a person with an interesting life outside the walls of the clinic or hospital. Each member of the reading group brings a unique perspective to the discussion that is worth listening to and taking into consideration. There is genuine camaraderie and free exchange of ideas between people who have usually kept apart in the hospital. We plan to open the reading group to more interested faculty because we think it promotes a type of interaction that is difficult to foster during rounds and provision of care. Instead of a hierarchical structure, the reading group promotes the revolutionary idea that residents and attendings share a common goal and can work together to achieve it.

Third, with the growing emphasis on evidence-based medicine, there is a worrisome tendency to think that everything worth knowing can be found within the pages of high-impact-factor medical journals. There is nothing to be gained or worth spending time on besides up-to-date summaries of validated clinical guidelines. Acknowledging that reading quality literature adds to one's knowledge and is time well spent goes against the grain of current residency training. There are many medical schools that have incorporated an appreciation of literature and narrative structure into patient care. These programs link medicine and the humanities and represent a welcome addition to the medical school curriculum. But they are pragmatic and primarily aim to help the residents become better doctors. Our reading group is designed to make reading good literature a worthwhile aim on its own merits, a distinctly different valuation for most residents.

Finally, it opens the possibility that reading good books can make residents better people. In a recent profile of Martha Nussbaum (New Yorker, July 25, 2016, 34-43), Rachel Aviv refers to a lecture in which Nussbaum writes that we become merciful when we behave as the "concerned reader of a novel," understanding each person's life as a "complex narrative of human effort in a world full of obstacles." The direction of Nussbaum's thought is from people to a literary mindset. The unspoken mission statement of the reading group is that Nussbaum's assertion can be made in reverse, namely, that a devoted reader of literature will become a more compassionate individual. Those who have chosen a career in the humanities have always known that the ultimate purpose of their study is to become better human beings. Physicians may have forgotten that charge in the struggle to become good doctors. Reminding them of the value of reading novels in residency may be disorienting at first. But we are optimistic. We meet and read together in the hope that introducing reading into residency will help trainees and faculty become better people. If the reading group makes us better doctors, we will take it.
If you have read this far, we want to reassure you that we do not take ourselves too seriously. We have a good sense of humor and have mostly enjoyed our careers so far in pediatrics. But we think we are on to something, a simple thing that may make any residency program a bit stronger and more meaningful for faculty and trainees. As Arlo Guthrie sang in Alice’s Restaurant if one or two residency programs start a reading group they may be considered sick or weird.

If three programs do it, the accreditation boards may think it is an organization. If fifty programs do it, it might become a movement. So go out with some resident friends, buy a book, and get together to talk about it. It is not as dangerous as it sounds.

ACKNOWLEDGEMENTS
We thank the leadership of the Department of Pediatrics for supporting the reading group.
We thank Lolly Bak for her thoughtful comments and suggestions about the essay.

PARTICIPANTS
Denis Chang, Deanna Chieco, Svetlana Dani, Patricia Davenport, Jasmine Gadhavi, Michael Goonan, Shelly Joseph, Sabina Khan, Marissa Lipton, Kira Mascho, Bridget Messina, Mary Jo Messito, Claire Miller, Shira Novack, Roshni Patel, Gabriel Robbins, Jessie Zhao.

 

 

The Knick by Gregory Clark

February 22, 2017 at 10:17 am

"The More Things Change, The More They Stay The Same"

When I first watched The Knick two years ago, it seemed like a show about the past and the rapid pace of medical discoveries in the early days of modern medicine, before antibiotics, when patients were still brought into the hospital on an ambulance pulled by horses. When I watched the fictional Dr. Thackery using electricity for the first time in his operating room, I couldn't help but sit back smugly and marvel at how far we have come since those early days of modern medicine.

Now, re-watching the first season of The Knick as a first year medical student in NYC, I've found myself focusing more on the similarities between medicine at the turn of the 20th century and today than the differences. Part of my excitement is particular to being in NYC. I get a thrill when I recognize street names, or when they mention the hospitals where I am slowly learning how to be a doctor. In a deeper way though, I no longer see the characters in The Knick as distant, historical figures. The problems that they confront are many of the problems we face in our medical culture today: the pervasiveness of racism; the stigma surrounding mental health issues; birth control rights for women; doctors becoming addicted to their own drugs; and even how to pay for the treatment of uninsured patients.

Now when I watch The Knick, I wonder how could it be possible that we are no closer to solving these problems a full century later.

The same racism and disrespect that Dr. Algernon Edwards faces as a black doctor is still present today. Minorities are underrepresented as doctors, and underserved as patients. For example, a study from researchers at the University of Pennsylvania found that African Americans were 34% less likely to be prescribed opioid pain medication for common chronic pain problems than white counterparts with similar problems. Similarly, when Dr. Thackery becomes addicted to cocaine, a drug used as an anesthetic at the turn of the 20th century, it is easy draw parallels to the opioid epidemic that our nation is currently facing.

One of the scenes that struck me most was the opening of the first show. It begins with the suicide of a surgeon after a failed operation. Since entering medical school, I have heard about physician and medical student suicide. Medical training is extremely challenging and stressful. Doctors are no less susceptible to depression than anyone else, even though it sometimes feels like people think they are invincible. Thankfully, these days, many institutions are striving to provide as much support as possible for physicians and students struggling with anxiety and depression. It was no accident that the writers of The Knick chose to begin their show with a scene addressing this.

Of course, we have made a tremendous amount of progress in medicine and society since the time of The Knick. I would never claim that medicine is the same today as it was a century ago. The most obvious plot points in the show demonstrate a stark contrast to our modern healthcare system. Yet, as someone within the medical community, I see The Knick as a call to arms. Medicine has come a long way, but many of the issues in the show are still extremely relevant today. The story of The Knick is not a story of medical history but a story of medical progress, and there is always room to move forward.

Gregory Clark is a member of the NYU School of Medicine Class of 2020.

 


Links to some of the studies I mention:

Time to Take Stock: A Meta-Analysis and Systematic Review of Analgesic Treatment Disparities for Pain in the United States
>>Read here

Depressive symptoms in medical students and residents: a multi-school study
>>Read here

Link to the an annotation by J. Russell Teagarden in the The Literature, Arts and Medicine Database (LitMed)
>> Read here

 

 

 

Posthumous Portraiture Exhibit at the Folk Art Museum

January 27, 2017 at 3:11 pm

By Gabriel Redel-Traub

There is something eerie about walking into the Folk Art Museum's posthumous portraiture exhibit. The last line of the introductory panel to the exhibit reads: "We cannot help but hear them whisper 'remember me.'" This sentiment rings true.

Baby in Blue by William Matthew *

The exhibit is split into three rooms and filled with portraits of apparently posthumous subjects. I say apparently, because to a 21st century viewer, nothing in these portraits would indicate that the subjects were dead at the time they were painted. Informative panels, however, inform us that there are visual clues, motifs, and allusions in each portrait which would suggest to a 19th century viewer that the subject had passed away prior to the portrait being painted. This explains why many of the portraits have subjects with only one shoe on and why there are cats in many of the pieces.

The large majority of the pieces on display in the exhibit are simple portraits. The onlooker is directly confronted by the subject. In this way, these folk-art portraits differ drastically from the canonical depictions of death in the works of our greatest artists. In these works, death is taken as an opportunity to grapple with life, futility and grief: Michaelangelo's Pieta and Edvard Munch's By the Deathbed come to mind.

 

Edvard Munch's By the Deathbed

The simple mimetic nature of these folk-art portraits, on the other hand, is in part explained by their purpose. Many of the portraits on display in the exhibit were originally meant to hang in the home of the family of the deceased, a visual representation of a lost loved one serving the purpose a photo would today. As such, the portraits show their subjects as what they are not, vivacious: children play with dolls, a young girl picks flowers, a young boy fishes in a lake.

In stark contrast to the paintings' vivacity, the exhibit also includes 80 daguerreotypes with haunting black and white images of dead adults, or parents with bleak expressions staring out at you, their dead children strewn across their laps. The images arranged together in a small room of the exhibit force the viewer into a direct confrontation with the dead and are particularly haunting.

And yet, still, even though most of the portraits don't show explicitly posthumous subjects, there remains an eerie feeling throughout the exhibit.ASome part of that strangeness can be explained by the fact that the artists of many of the pieces in the exhibit were untrained giving their work a medieval feel- namely, the tendency to paint strangely adult faces on young children

However, the greater contributing factor, I think, is the mere knowledge that each portrait- and most of the portraits are of children- was made posthumously. This forces uncomfortable questions: was the deceased arranged as a model to be painted from? Or was the subject drawn from memory? How exactly did this process work? The information provided by the museum only partially answers these questions.

The Farwell Children by Deacon Robert Peckham *

The exhibit forces the modern onlooker into an empathic interaction with the deceased and with the story that the onlooker creates. In one particularly haunting piece The Farwell Children, five children look on demanding you take them in. Did all five of these young children die? Where did they come from? Where are the mother and father and how could they possibly endure this? The exhibit thrusts us into a more intimate conversation with death; one which our ancestors- for whom death was constantly looming more ominously over- were often preemptively forced into.

In the 21st century, the overwhelming attitude towards death is to push it away-out of sight, out of mind. This is, frighteningly, true for medical professionals and students studying medicine. The D word is taboo, everything a doctor is fighting against, so why should it even be brought up? And yet, death is also an invariable part of a medical student's experience. As Laura Ferguson, artist-in-residence at NYU School of Medicine writes:

 

"For most medical students today, the dissection of a cadaver represents their first confrontation with death, and with the visceral reality of the human body. They come to the experience with great curiosity but also with a degree of discomfort, even fear, about what they may encounter. They bring a sense of empathy and caring to their relationships with these "first patients" - but because it requires cutting, this rite of passage is their first experience of having to "hurt to heal." So, for many students, their time in the Anatomy Lab begins a process of emotional detachment."

Looking at the posthumous portraits- and at art more generally- serves as a way to reconnect, to reestablish the humanity and individuality of the deceased. It obliges us to find beauty in death and to acknowledge that death is an intimate part of life.

Securing the Shadow: Posthumous Portraiture in America is on at the American Folk Art Museum through February 26th A

Gabriel Redel-Traub is a 1st year medical student at NYU School of Medicine and a Rudin Fellow for 2016-2017.

* The Farwell Children Deacon Robert Peckham (1785-1877)
Fitchburg, Massachusetts c. 1841
Oil on canvas 53 1/2 x 40 1/2″; 62 1/2 x 48″ (framed)
Collection American Folk Art Museum, New York
Gift of Ralph Esmerian, 2005.8.11
Photo © 2000 John Bigelow Taylor

* Baby in Blue William Matthew Prior (1806-1873)
New England c. 1845 Oil on paper on wood 23 3/4 x 17″; 29 3/8 x 22 5/8 x 1 1/4″ (framed)
Collection National Gallery of Art, Washington Gift of Edgar William and Bernice Chrysler Garbisch, 1953.5.58 Photo courtesy National Gallery of Art, Washington

Learning Empathy through Chekhov

July 26, 2016 at 3:26 pm

Guy Glass, MD, MFA, Clinical Assistant Professor
Center for Medical Humanities, Compassionate Care and Bioethics
Stony Brook School of Medicine

I am a psychiatrist who writes plays and has several professional productions and published plays to my credit. Having recently earned an MFA in theater from Stony Brook University, I am now affiliated with the Center for Medical Humanities, Compassionate Care and Bioethics at Stony Brook University School of Medicine. At both Stony Brook, and starting this fall at Drexel, I teach an elective entitled "Theater and the Experience of Illness" in which medical students both read plays and write their own dramatic monologues.

I dedicated my master's thesis to finding ways that plays might be used in medical education. This involved creating dramatic adaptations of two of Chekhov's "doctor" short stories, including "A Doctor's Visit." In April 2016, I was invited to bring "A Doctor's Visit" to the Arts and Health Humanities Conference in Cleveland. There, I was fortunate to have the opportunity to create a piece of theater with five medical students who happen to be very fine actors and who contributed the blog post below. I'm delighted to see that the exercise gave the students insight into what the arts can contribute to medical training. Moving forward, I hope to find other institutions that will allow me to bring this program to their students.

Reflections on the Importance of Dramatic Arts in Medical School Curricula

Alicia Stallings, DaShawn Hickman, and Nick Szoko

clevelandclinicIntroduction

As a part of the Medical Humanities conference held at the Cleveland Clinic on April 9th, 2016, we were asked to perform a dramatic reading of an adapted short story by Anton Chekhov entitled, "A Doctor's Visit." The piece, thoughtfully developed by Guy Glass, MD, MFA, takes place in a factory town outside of Moscow in the 1890s. It features a diverse group of characters: Dr. Korolyov, a middle-aged physician working to jumpstart his struggling practice; Boris, his eager apprentice; Christina Dmitryevna, a caricaturized spinster; Liza, a seemingly spoiled heiress; and Madame Lyalikov, Liza's frenetic and overbearing mother. The story centers on the encounter between Dr. Korolyov/Boris and the inhabitants of the Lyalikov mansion. Dr. Korolyov is called upon to tend to the needs of Liza. Motivated by the prospect of compensation, Dr. Korolyov and Boris make their way to a gritty industrial town outside of Moscow where the gaudy mansion is situated. They arrive to find a hysterical young woman, Liza, nearly bed-bound for no apparent reason. Initially, Dr. Korolyov operates in a detached, business-like manner when examining and interacting with Liza. He is eager to perform his duties and exit, having excluded any true disease process; however, when Madame Lyalikov invites Korolyov and Boris to spend the night at the mansion, Dr. Korolyov achieves a moment of profound insight when he stands in the property's garden and gazes at the glowing factory lights beyond. In this setting, Korolyov recognizes his lack of compassion and revisits Liza in her room, finally able to connect with the young woman and "cure" her by acknowledging and validating her unique narrative. In reading, rehearsing, and performing this work, we extracted three important themes: empathy, justice, and professionalism.

 

hickmanJustice, as told from the perspective of Boris (DaShawn)
Case Western Reserve University School of Medicine

At the start of the play, Boris attempts to wake the doctor, but we quickly learn that Korolyov would rather the student learn more of the basic science and medicine on his own. He is told to "memorize all the books on my bookshelf, dissect all the rats and frogs you can find. And come back at noon." As outrageous as this sounds coming from the doctor, many schools have taken to this self-directed learning style. Students are spending more time reading and learning on their own or in groups than with professors during their first two years of medical school. The play also makes it abundantly clear that although students need patients to learn from, patients are not always as willing to allow students to learn from them. One of the characters in the play, Christina Dmitryevna, bans Boris from seeing the patient with his teacher. She expresses how she is displeased to be "running a medical school." Being able to act in this role allowed me appreciate all the time I am able to spend with patients during my formative years as a student doctor.

Although the doctor doesn't appear interested in directly teaching Boris basic sciences, he does take the time to teach him about communication skills, history, and society, all topics that will have an impact on the quality of doctor that Boris will become. A theme that emerges from interactions between Dr. Korolyov and Boris is justice. As the doctor and Boris travel away from Moscow to the industrial town, the socioeconomic disparities become more pronounced. The doctor teaches Boris how poor and hard-working the factory workers are. He tells Boris that even though they are poor like the factory workers, because they are doctors, and thus in a higher social class, "[the factory workers] will always hate us."

The town is covered in soot from the factory, and so many people have health problems, including the limited life expectancy of 35. Despite this, the doctor lectures, "it is a pampered rich girl we have been asked to care for." Dr. Martin Luther King, Jr. summed up his teachings nicely when he stated "Of all the forms of inequality, injustice in health care is the most shocking and inhumane." The doctor not only points these injustices out to the student but challenges them in front of the student. He asks about the well-being of the factory workers and implies that it is subpar to the wealthy he has come to visit. These are bold actions that not only teach Boris to recognize injustices but to confront and work to dismantle them.

Without future doctors being taught these lessons the injustices that exist today will continue to permeate our healthcare system, stifling advancements in this realm for the betterment of mankind overall.

 

Professionalism, as told from the perspective of Madame Lyalikov (Alicia)
Cleveland Clinic Lerner College of Medicine

In the reading, I portrayed Madame Lyalikov, the mother of the patient in the play. In this role, I found that many principles of professionalism were highlighted during the preparation and enactment of the dramatic reading. One component that stands out was the principle of responsibility to colleagues. During my preparation for the role, it gradually became clear to me how different I was from the character. I could not relate to her in her stage of life (I am not a mother), nor her walk of life (I am not wealthy), nor her personality/disposition (I am neither of the anxious variety nor passive). Yet, despite my lack of similarity to this character, for the sake of the audience, to learn from the play, and for the sake of my fellow student-actors, so that they could also portray their characters well, I needed to work to understand this characteraher perspective and her mindsetato meet my responsibility to the group.

Principles of professionalism specific to the practice of medicine were also highlighted in the play. Most notably, the issue of bias was an important theme, which was illustrated by Dr. Korolyov's negative comments to the student about the patient and her mother. In my role as Madame Lyalkiov, I had an interesting vantage point, being both privy to Dr. Korolyov's bias, as an actor, as well as the object of his prejudice, as the character. In this unique position, I found myself reflecting: is Korolyov aware of his prejudice towards her and her daughter? Can she feel how he feels about them? Does she feel that his prejudice is impacting his care of her daughter? Is his prejudice hurtful to her? It was very interesting to reflect on these questions from the vantage point of a future healthcare professional. One likes to think that her attitude towards others can be isolated from how she treats them, and that one can even hide their prejudice, so that the other party is not aware. However, is this true? Are we as medical professionals, and as people in society at large, able to separate how we feel about others from how we treat them? And perhaps more importantly, if how we feel about them is based in prejudice (as in the case of Dr. Korolyov), is it acceptable to continue to harbor these biases, even if we think we can separate them from how we treat patients? These are important questions for students to consider as move forward in their development as medical professionals. My role as Madame Lyalikov brought these questions to the forefront, and gave me much to reflect on with regards to professionalism in interacting with and caring for patients.

 

Empathy, as told from the perspective of Dr. Korolyov (Nick)
Cleveland Clinic Lerner College of Medicine

"You will learn, if you are to be a doctor, you do not always have to do a thing." As Dr. Korolyov prepares to depart from his visit at the lavish Lyalikov mansion, he offers these reflections to his young assistant, Boris. As medical students, the words of Dr. Korolyov surely resonate with us. We embrace ignorance, thrive in discomfort, and accept inaction. We feel dually limited and protected by our positions as trainees. We are told that the greatest gifts we can give our patients are not medical expertise or surgical acumen, but rather our time, humility, and empathy. So what happens when these fail?

It is no secret that the ability of medical professionals to empathize declines over time. We are cautioned from the first day of medical school regarding this well-cited trend. When we examine Korolyov, we see the familiar vices of the burned out physician. His initial motivation to visit the Lyalikovs is financial. He forms a prejudgement of his patient based on socioeconomic class and lets this guide his diagnostics. There is an unspoken aroma of efficiency and industriousness that hovers over the encounter. As medical students, we face a similar climate. Our attitude towards learning and career choice is tinted by the haze of student debt. We train in tertiary care centers that venerate evidence-based medicine and cost-conscious care. We aim for concision and efficiency in our interviews and presentations. Amidst this, we strive to temper our own arrogance so as not to become hardened to the pain of those around us. With each day we spend on the wards, we are tempted to limit our vulnerability and minimize our emotional presence so as not to compound physical exhaustion with psychological. We ask ourselves, "Am I becoming a professional?" or, "Am I losing my humanity?" We become less of Boris and more of Korolyov.

For Korolyov, it takes a revelation, an "Aha!" moment to arrive at the proper diagnosis. Indeed, it is not until his liminal experience in the garden that Korolyov finally overcomes his psychological barriers to connect with his patient, recognize his biases, and act as a healer. Romanticizing such transformative moments is not unfamiliar in our profession. Our attendings often recall patient encounters that made them stop, reflect, and even reform. As medical students, we remember our first patient death, the first child we delivered, or our first "thank you." These moments, though rare, do more than just provide subtext for television dramas or ignition for research funding campaigns. In some ways, these instances and the act of recounting them eternally bind us to the humanism of our craft while allowing us to mature in our profession. Storytelling, whether it by play, article, or interview, remains powerful, not only for those who listen, but also for those who share. In reliving these experiences, we evoke our emotional self, and this is often done from a place of greater experience and wisdom. The value of this exercise cannot be understated, because beyond connecting us to the ethereal concept of "emotion," it allows us to reflect, critically and honestly, about how this experience and others like it have shaped our practice today. By participating in a dramatic reading of "A Doctor's Visit," I told a story that, over time, became my own. This opportunity offered a space for vulnerability and introspection, and I am thankful that I could engage in this dialogue alongside my colleagues.

Conclusions

For many students entering medical school, it has likely been years since they have taken part in a traditional stage play. Although many may have participated in variety shows or other short dramatic works in college, these dramatic engagements are notably different from traditional plays. The content of variety shows is written by the students themselves, and therefore generally presents contemporary issues from contemporary lens using contemporary language (most of which are shared by and native to the students). Other works of drama present the opportunity to explore diverse settings, subject matter, and perspectives. Utilization of selected plays and short scripts as teaching tools for individual students as well as groups of students has great potential. Indeed, for many medical students, there is great power in silencing our own voice to fully walk in the shoes of another and experiencing the world from their eyes. Script readings can offer students an opportunity to do so again, while providing a reminder why it is important to do so in life as well.

Other members include:
Anne Runkle and Megan Morisada, Cleveland Clinic Lerner College of Medicine.

Richard Selzer and Ten Terrific Tales

July 20, 2016 at 9:23 am


Richard Selzer and Ten Terrific Tales
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by Tony Miksanek, MD
Family Physician and Author, Raining Stethoscopes

If there were a Medical Humanities Hall of Fame, physician-writer Richard Selzer (1928-2016) would be a first-ballot selection. And likely by a unanimous vote. The diminutive doctor had a very large presence in the field. He energized the medical humanities movement in the 1970's and 1980's with his lectures, readings, writing workshops, commencement addresses, correspondence, personality, and kindness. But it was his writing - earthy and elegant, whimsical and wise - that masterfully mingled the world of medicine with the world of the arts and highlighted the necessity of humanity in health care.
His literary output includes more than 125 published short stories and essays, a work of nonfiction (Raising the Dead), an autobiography (Down from Troy), a novella (Knife Song Korea), and a diary (Diary). Many of his stories reflect an interest (even an infatuation) in decay and death, the beauty of the body, how illness beatifies the sick individual, the power and fallibility of doctors, and the great panacea/contagion - love.
"Writing came to me late, like a wisdom tooth," Selzer proclaimed. Indeed, he was 40 years old when he began writing seriously. His early efforts at crafting stories dutifully occurred between the hours of 1:00 and 3:00 AM. His initial focus was creating horror stories because it was an "easy" genre to handle. That fondness for the macabre and otherworldly never dissipated as he continued to utilize horror (and humor) in many tales. The majority of Selzer's stories involve doctor-patient relationships, surgery, and suffering. Some of his literary work is weird ("Pipistrel"), experimental ("A Worm from My Notebook"), and an exercise in reimagining ("The Black Swan Revisited").
Surprisingly for an MD, he seemed a bit unconcerned about facts in his writing. Rather, he was deeply interested in creating impressions. For Selzer, facts weren't necessarily equivalent to truth. After all, facts change but impressions endure. Still, Selzer stubbornly searched for truth (and love) in his stories. He was enticed by language and the sound of words. From time to time, he manufactured his own words. He disliked gerunds but appreciated onomatopoeia. His favorite doctor-writers were John Keats and Anton Chekhov both of whom died from tuberculosis - Keats at age 25 and Chekhov at age 44.
I don't know which story Richard Selzer considered his best or most beloved, but I suspect that "Diary of an Infidel: Notes from a Monastery" was at or near the top of his list. The rest of us, however, definitely have our favorite Selzer stories. And while there are so many wonderful tales to choose from, I recommend the following 10 not-to-be-missed selections. My list is divided into two sections. Part 1 includes personal favorites and stories that don't get nearly the attention they deserve. Part 2 is comprised of stories and an essay that I find very useful in teaching.
Part 1: Five Fabulous Favorites:
1. "Tom and Lily"
2. "Luis"
3. "The Consultation"
4. "Toenails"
5. "Fetishes"
Part 2: Five Fixtures for Teaching:
1. "Brute"
2. "Imelda"
3. "Sarcophagus"
4. "Wither Thou Goest"
5. "The Surgeon as Priest"
So there you have it. The two greatest stories by Richard Selzer are "Brute" and "Tom and Lily." Of course, that's just my opinion. How do you see it? You are invited to post to the blog with your favorites. (I have a hunch that "Imelda" is going to vie with "Brute" for the top spot.) In the meantime, The Doctor Stories by Richard Selzer is a perfect place for readers to roost - either as an introduction to his work or an opportunity to reacquaint with some notable tales.

Rx: Literature | A Reading to Celebrate Bellevue Literary Review's 30th Issue

May 5, 2016 at 11:27 am

PLEASE JOIN US Monday, May 16th | 6pm
Bellevue Hospital, 462 First Avenue at 28th St. - Chapel Hall

BLR spring reading 2016

Our readers:

Sonni Aun had the great fortune of growing up all over the world and is now a painter and writer in New York City. She holds a BA in Biochemistry and Art from Rice University and is currently studying writing with the poet Philip Schultz at the Writers Studio.

Katy Lederer is the author of the poetry collections Winter Sex (Verse Press) and The Heaven-Sent Leaf (BOA Editions), as well as of the memoir Poker Face: A Girlhood Among Gamblers. She is currently at work on a collection of essays around apocalyptic themes and a book of poetry about autoimmunity, deformity, and motherhood titled The Engineers.

Susanna Nguy is from Brooklyn, New York. She graduated from the City College of New York in 2013 where she developed a passion for oncology research. She is completing her medical degree and will be doing her residency in Radiation Oncology at NYU. "The Lump," from this issue of BLR, is her first published story.

Adam Young was born and raised in Providence, Rhode Island, where he attended Classical High School. He is currently studying English Literature and Creative Writing at New York University and he is volunteering at Writopia Lab, a creative writing organization offering workshops for kids and teens. His work has appeared in the Zine Play(ed) Boy: Volume II and he hopes to continue to participate in the creative writing community.

States of Grace: From Doctor to Patient and Back Again

April 5, 2016 at 3:39 pm

Katie Grogan, DMH, MA and Tamara Prevatt, MA,
Master Scholars Program in Humanistic Medicine, NYU School of Medicine

 

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Before the accident, Dr. Grace Dammann was a caregiver through and through, in every aspect of her life. A pioneering AIDS specialist, she co-founded one of the first HIV/AIDS clinics for socioeconomically disadvantaged patients in San Francisco at Laguna Honda Hospital. She was honored by the Dalai Lama with an Unsung Heroes of Compassion Award for her service and devotion to this population. Grace was also the primary breadwinner and parent in her family with partner Nancy "Fu" Schroeder and adopted daughter Sabrina, who was born with cerebral palsy and HIV. She lived and worked in such close proximity to illness, death, and disability, but nothing could have prepared her for the devastating injuries she sustained when a driver veered across the divide on the Golden Gate Bridge, crashing head on into her car.

Grace spent seven weeks in a coma, hovering on the precipice between life and death, like so many of her own patients. Ultimately, she awoke with her cognitive abilities miraculously intact, but her body was irreversibly impaired, leaving her wheelchair-bound and dependent on others for simple daily tasks. States of Grace, a documentary film about her profound transformation, picks up Grace's story when she is discharged following a thirteen-month stay in rehabilitative hospitals. Members of NYU Langone Medical Center, including medical and nursing students as well as faculty and staff across all disciplines, were invited to attend a screening of the film and talkback with Dr. Grace Dammann and the filmmakers, Mark Lipman and Helen S. Cohen of Open Studio Productions.

States of Grace captures the expansive and rippling effects of the accident, how it left every corner of Grace's life radically altered-personal, professional, psychological, spiritual, and economic. The family dynamic is turned on its head. Fu becomes the primary caregiver to both Grace and Sabrina, and as Grace says, "Sabrina's position in the family was radically upgraded by the accident. She is so much more able-bodied than I am." Fu struggles with the enormity of the role she has signed up for. Grace wrestles with her gratitude for having survived and the frustrations of her new life: "I feel like I've lost a best friend-my body . . . When I first woke up, I was just glad to be alive, plain and simple. Now I'm just annoyed-annoyed at the limitations. I'm bored." In one scene we see Grace argue with Fu about her right to die if she continues to be so impaired.

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Grace grieves for her old life, for how effortless things were. We watch as her fierce resilience pulls her through to acceptance. She credits her Zen Buddhist practice for her ability to keep moving forward: "Nothing lasts forever, even great pain and sorrow." Though some of her ultimate goals-to walk again, to dance again, to surf again-remain unattainable at the film's conclusion, Grace sets, meets, and exceeds new ones. Acknowledging that she only felt completely whole when practicing medicine, she "comes out" as a disabled person to the medical community, returning to Laguna Honda Hospital as its first wheelchair-bound physician, where she is appointed Medical Director of the Pain Clinic. She resumes the caregiver role, but with an intimate knowledge of the lived experience of pain, suffering, and disability. In the talkback Grace remarked, "Once you disrupt the integrity of the body, you're disrupting the integrity of the psyche, and I don't think any of us think about that. I certainly didn't as a physician. I hate to admit how many times I discharged people without even getting them up to see that they could walk." She also brings her Buddhist training to the clinic, where she promotes wellness among the staff and patients by teaching meditation.

As the talkback ended, attendees lingered, eager to chat with the filmmakers and shake hands with Grace, awestruck by her story of triumph, adaptability, service, and the lessons learned on both sides of the doctor-patient divide.

Sabrina will graduate this May with her Bachelor's degree. Grace partnered with the driver who hit her to advocate for a median barrier on the Golden Gate Bridge to prevent similar accidents from happening in the future. The barrier was installed in January 2015.

This screening was co-sponsored by the Master Scholars Program in Humanistic Medicine, the Office of Medical Education, and the Department of Physical Medicine and Rehabilitation. Special thanks to Drs. Pamela Rosenthal and Marianne Sommerville for bringing the film to NYULMC. For more information on States of Grace and to arrange a screening, go to: www.statesofgracefilm.com

 

NYU Center for Humanities Event Imagining Illness: Pulitzer Prize Winners on Truth and Fact in Narrative David Oshinsky and Paul Harding

March 29, 2016 at 1:30 pm

By J. Russell Teagarden
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On a recent winter's evening, Pulitzer Prize winners David Oshinsky and Paul Harding appeared together at the NYU Center for Humanities in an event cosponsored by the NYU Division of Medical Humanities and the Bellevue Literary Press. Erika Goldman, the publisher and editorial director of the Bellevue Literary Press, moderated the session. Jane Tylus, faculty director of the NYU Center for Humanities, provided opening and closing remarks. The evening also had support from the Pulitzer Prize Campfire Initiative.

David Oshinsky's book, Polio: An American History (Oxford University Press) won the 2006 Pulitzer Prize in History, as well as the Hoover Presidential Book Award in 2005. It became the basis for a 2009 PBS documentary on polio. In 2010, Paul Harding's book, Tinkers (Bellevue Literary Press) won the Pulitzer Prize in Fiction and a PEN/Robert W. Bingham Prize. Drawing from their respective genres in the humanities, the authors shed light on how chronic illnesses can affect individuals and their families, in the case of Harding's novel, and on how epidemics can affect populations and national responses in the case of Oshinsky's history of polio.

In her annotation of Oshinsky's book in the NYU Literature Art and Medicine Database, Dr. Janice Willms notes that the narrative was written in a way that readers were easily able to grasp how it was "real people fighting a battle that swept from certain success to likely failure and back again many times, often almost overnight." Dr. Tony Miksanek, in his annotation of Harding's book, focuses on how the "story presents some exquisite impressions of seizures along with the aura that precedes them," and how it "masterfully represents how we measure life."

Oshinsky

Both authors spoke of creating narratives that convey a truth, yet their sources for truth are antipodal in nature. As an historian and documentarian, Oshinsky goes to archives and other sources of objective facts and occurrences to build his narrative. He told the audience that in creating his narratives, "not only am I telling a story, but I am fitting into a larger mosaic of other stories." He read a section from his book about a particular polio victim, Fred Snite, that interweaves both the personal suffering and social responses his plight generated.

He had lost the ability to cough so his throat had to be regularly suctioned. He had to be fed in rhythm with the respirator which caused his chest to rise and fall every four seconds, 21,600 times a day. But that was only part of the story, the lesser part. What kept Snite in the public eye was his determination to lead "an otherwise normal life." He became a tournament-tough bridge player, reading the cards in a rearview mirror placed above his head. He traveled to race tracks and to college football games in a trailer equipped with a spare iron lung. "His arrival at Notre Dame Stadium was one of the events of the afternoon," a friend recalled, "Enter the visiting team, polite cheers, enter the home team, loud cheers, enter Frederick, pandemonium." (p. 63)

Oshinsky lamented that as an historian he can't take the liberties availed to novelists, but Harding noted, in referring to this passage, that he is actually "deploying the same tactic as a fiction writer." Harding was allowing that the historian must work from facts and documents, but like the fiction writer, must create compelling narratives if the goal is to reach the general public.

harding_reading

As a novelist, Harding builds his narratives from what he calls "imaginative truth." He starts by "imagining my way into the lives of people…whose lives might otherwise pass by unremarked. The value of their lives would not be witness to." In Tinkers, he imagines his way into the life of a person with severe epilepsy and what it must be like to experience a seizure. He gives witness to the experience in the section he read (or "tone poem" as he called it):

The aura, the sparkle and tingle of an oncoming fit, was not the lightningait was the cooked air that the lightning pushed in front of itself. The actual seizure was when the bolt touched flesh, and in an instant so atomic, so nearly immaterial, nearly incorporeal, that there was almost no before and after, no cause A that led to effect B, but instead simply A, simply B, with no then in between, and Howard became pure, unconscious energy. It was like the opposite of death, or a bit of the same thing death was, but from a different direction: Instead of being emptied or extinguished to the point of unselfness, Howard was over-filled, overwhelmed to the same state. If death was to fall below some human boundary, so his seizures were to be rocketed beyond it. (pp. 47-48)

Harding said he assiduously avoided doing any research about epilepsy, and had only some family mythology and his own close call with electrocution to inform his writing. But, although the seizure experience he describes was mostly mined from his imagination, it covers basically the same scope as a traditional biomedical description of seizures that can be found in Harrison's Principles of Internal Medicine-minus the literary splendor:

Some patients describe vague premonitory symptoms in the hours leading up to the seizure…The initial phase of the seizure is usually tonic contraction of muscles throughout the body, accounting for a number of the classic features of the event. Tonic contraction of the muscles of expiration and the larynx at the onset will produce a loud moan or "ictal cry." Respirations are impaired, secretions pool in the oropharynx, and cyanosis develops. Contraction of the jaw muscles may cause biting of the tongue. A marked enhancement of sympathetic tone leads to increases in heart rate, blood pressure, and pupillary size. After 10-20 seconds, the tonic phase of the seizure typically evolves into the clonic phase, produced by the superimposition of periods of muscle relaxation on the tonic muscle contraction.


Thus, Oshinsky and Harding compose compelling narratives about illness experiences originating from different places and evolving from different forms. In her forward to Humanity in Healthcare: The Heart and Soul of Medicine, Iona Heath captures the essence of what the varied approaches Oshinsky and Harding use when she states, "skilled writers help us to see the world and our own place within it in a new light-a light that falls from a slightly different direction revealing subtly different detail." (p. iv)
These are just a few of the many insights the authors provided during the session.
A video of the entire program is available at: https://www.youtube.com/watch?v=w-l86fOAsLY&feature=youtu.be.

Oshinsky_Harding_panel

 

Cortney Davis - When the Nurse Becomes a Patient: A Story in Words and Images

March 23, 2016 at 1:17 pm

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NYU Langone Medical Center welcomed author/painter Cortney Davis to the Smilow gallery for the opening of "When the Nurse Becomes a Patient." Laura Ferguson's interview with Ms. Davis appears here.

Exhibition presented at the NYU Langone Medical Center Art Gallery by the Art Program and Collection.
Photo: Art Program and Collection.