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.

 

 

Wherever You Go: Self-Representation and Williams Syndrome

July 14, 2015 at 5:04 pm

Jess Libow is currently a summer intern at the Bellevue Literary Review. She is a rising senior English major at Haverford College interested in disability studies.

Nader and Josh at the Wildhorse

All photos courtesy of camp staff

Looking out over the dance floor at Nashville's Wildhorse Saloon as other members of our group line danced with the crowd below, Mark told me "It's good for us to get out into the community so that people know we exist." As a counselor this past June at Lifting Lives Music Camp at Vanderbilt University, run by the Academy of Country Music, I lived in a dorm with Mark, who is 51, and seven other men with Williams Syndrome. After this experience, I couldn't agree with him more.

Lifting Lives is a weeklong musical experience for people ages 16 and older with Williams Syndrome. Over the course of the week, campers from all over the country come together to write a song with renowned Nashville songwriters and, after much rehearsal, record and perform their original work at the historic Grand Ole Opry.

Recording Studio

While performing a song written only a few days earlier at the Opry might be intimidating to most, many people with Williams Syndrome thrive in this sort of setting. Williams Syndrome (WS) is a congenital neurodevelopmental disorder caused by the deletion of 26 genes on chromosome 7. WS is an extremely rare condition: the NIH estimates it occurs in 1 in 7,500 to 10,000 live births. In addition to mild to moderate intellectual disability and a range of medical issues, including cardiac conditions, people with WS are likely to have a number of distinct social qualities. Studies have shown, for instance, that people with WS have a strong predilection for music. People with WS also tend to have remarkably little social inhibition; they are eager to meet and please others and are deeply attuned to the emotional states of those around them. Their profound desire to connect lends itself easily to musical performance - people with WS are natural storytellers.

As an English major interested in disability studies, I was drawn to Lifting Lives because I saw it as an opportunity to witness people with disabilities telling their stories through songwriting. This year, the campers wrote a song with Ross Copperman and Heather Morgan titled "Wherever You Go." It's an uplifting song about aspirations and supporting one another. The most notable part of the song is the bridge, which is both universal and incredibly specific to people with WS. "Thunder roars and the rain might fall," the song goes, "but together we're unstoppable." This brief moment in the song addresses two significant characteristics of WS. People with WS have extremely high levels of anxiety, particularly about events beyond their control. Thunderstorms are a common stressor for a number of the Lifting Lives campers, and were a constant topic of discussion throughout the week. Because of the extent to which the "roar" of thunder produces anxiety in people with WS, when the campers sing this line many of them are essentially referring to their highest possible level of emotional discomfort - it is both a metaphor and a reality. The second half of the line, "but together we're unstoppable," speaks directly to the value people with WS place on human connection. The lyrics suggest that through interdependence, the campers are able to to withstand anxieties and other obstacles. This celebration of community support not only resonates personally with the campers, but is applicable across differences and abilities.

lifting lives camp

Songwriting and singing provide a creative and exciting way for the campers to tell their stories. David, for example, told me that he'd "always wanted to write a book about Williams Syndrome," but after a songwriting workshop with songwriter Odie Blackmon, "might have to change it up. There should be a song about this!" Like David, however, many of the campers have a propensity for self-representation off-stage as well.

I was struck by the ease with which campers would share stories from their past and especially intrigued by how many of their stories had to do with Williams Syndrome directly. The ever-enthusiastic Gary told me over dinner that he once encountered two nurses in the ER who'd "never met anybody who had Williams Syndrome! And they said what in the world is that? And I said to look it up, 'cause it's a really cool thing to know about!" Trevor, who works with People First, a disability advocacy organization in his home state of Washington, added that "people judge us sometimes, but they just don't know. We're friendly."

Their stories weren't always so straightforward. Some of the campers readily used simile to represent their experiences. For instance, while waiting at the gate to board his flight home, Trevor told me how he felt about my accompanying him. "It's like Barack Obama," he explained, "he’s the most powerful man in the world, but the legislative branch still sometimes helps him. So you're helping me right now." For Trevor, having a counselor wait with him at the airport wasn't insulting; it was merely part of a system of interdependence not unlike one of checks and balances. Similarly, Mark, who loves doing impressions, drew on his love of old movies to teach me about his past. "I identified with Frankenstein’s monster when I was younger," he shared after an impromptu impression of the character, "the neighbors weren’t very nice to me because I had this disability. But I found a way and I made friends."

It's hard not to wonder what drives this impulse to self-narrate. When does the desire to share one's story stop being a symptom and start being political? Does this distinction even matter?

Self-representation is a crucial aspect of disability politics today. As self-advocates, people with disabilities around the world are making sure their voices are heard. As the critical field of disability studies indicates, self-representation is a crucial aspect of advocacy efforts. This kind of political action embraces something that comes naturally to so many people with Williams Syndrome: telling your story. And a lot of the people I met at camp know that this matters. Echoing Mark's sentiment at the Wildhorse, many of the campers want others to "know [they] exist." Like David, who wanted to write a book, or maybe a song, about WS. And Kurt, who has a radio show every week. Josh, who told me he plans to write a blog for the Williams Syndrome Association. And Trevor and Dara, who are both self-advocates in their hometowns.

In my experience, people with WS challenge how we think about narrative and storytelling. They force us to reconsider what motivates us to share, to speak up, and to put ourselves and our stories out there. Biology and politics both come into play. It can be tempting to write off someone's unsolicited story as a symptom of their disability. It can also be tempting to romanticize their efforts to speak up for themselves with an overzealous "good for you" and a pat on the back. But at the end of the day, there's something powerful about someone sharing their life experience and perspective. The people I met at camp, whose stories I've tried to recount here, want to put everything on the table. I think they might be onto something.

To learn more about Williams Syndrome, please visit https://williams-syndrome.org/
To learn more about Lifting Lives, please visit their website

The Social Construction of Cancer - Part 3

November 27, 2012 at 11:22 am

Editor's Note: This is the third of four installments from guest blogger Dwai Banerjee, a doctoral candidate in NYU’s department of social anthropology. Images illustrated by Amy Potter, courtesy of Cansupport.

Part III

In a later visit with the homecare teams, I met Rajesh - a 29-year-old man who has been battling cancer since his teenage years. The walls of his room in a dense middle-class neighborhood were bare but for two pictures - one of a Hindu deity and another of his parents who had passed away in an accident when he was still young. Rajesh had contracted cancer while working in a chemical factory in his late teens. The cost of his treatment led him to lose the little property that his parents had left him when they had died. The relatives that he lived with now took him in, but refused to extend any form of empathy or care. The stigma of the diagnosis of 'cancer' along with fears of its communicability saw to his isolation in the small verandah of the house. Yet, Rajesh's will to live was strong; on his own, he would travel to the All India Institute for Medical Sciences (AIIMS) early in the morning, negotiate the intricacies of the bureaucratic processes and make himself available for treatment.

As it stands, effective public health insurance is by and large absent in the Indian health scenario. In its place, the only financial respite for the poor comes in the form of subsidized treatment at government facilities. The bureaucratic procedures involved in procuring these government grants are daunting at best; very few cancer patients are able to transact the opaque bureaucratic process within the time allowed by rapidly progressive malignancies. Fortunately in Rajesh's case, where kinship had failed, a local network of knowledge and care stepped in. Cansupport and a sympathetic AIIMS doctor collaborated together to procure both a part-time nurse to care for Rajesh, while also taking him through the process of applying for a set of government grants.

In my conversations with Rajesh, it became clear that the years battling both the disease and the public health system and spent him. Time and again, his upbeat demeanor would collapse; at the end of one of our conversations as I made to leave, he stated baldly that if the disease returned he would not fight it again. It had deprived him of years of income and left him at the mercy of a family that had not cared for him at his most vulnerable. He had become the errand boy of the locality, earning his room's monthly rent by doing chores for his family and neighbors. His resentment towards his family was something that he had been forced to learn to hide; working for them allowed him to transact the complicated business of 'living on' with the disease. Over the next few weeks, Cansupport would try and work with its funders to set Rajesh up with a food-cart, to gain him the monetary security and independence he needed. While the biology of the disease was now in remission, the collapse of the infectious life of cancer had spread outside the body, jeopardizing his will and ability to carry on.

Dwaipayan Banerjee is a doctoral candidate at the department of social anthropology at New York University. Prior to his doctoral candidacy at NYU, he graduated with an M.A. and an M.Phil in sociology from the Delhi School of Economics, India. He has recently completed ethnographic work concerning the experience of cancer, pain and end-of-life care in India. His research follows the circulations of these experiences across different registers - language, medicine, law and politics. His broader interests includes working at the intersection of philosophy and anthropology, as well producing and studying ethnographic film and media.

The Social Construction of Cancer - Part 2

November 14, 2012 at 3:54 pm

Editor’s Note: This is the second of four installments from guest blogger Dwai Banerjee, a doctoral candidate in NYU's department of social anthropology. Images illustrated by Amy Potter, courtesy of Cansupport.

Part II

However, at this point, Shambu and Rohini's story took a sharp turn. The palliative care team I was visiting with discovered that, partly because of not collectively acknowledging the extent of the disease, Shambu and Rohini had started visiting a new neighborhood private 'ayurvedic hospital.' This hospital claimed to be able to completely cure cancer, provided that the patients pay whatever was the breaking limit of their financial ability. Perfectly aware that it was not her place to recommend or dissuade a line of treatment, the counselor restrained her own opinions. As the family talked, it became clear that to avail this therapy, they were considering risking their son's future as well as their ability to remain in their home. Shambu had been the sole breadwinner in the family, and given the imminent possibility of his passing, such decisions could have catastrophic consequences. The counselor still remained non-committal on the viability of this promise of cure, but skillfully urged Shambu and his wife to talk and think through what they were doing.

Soon, as they talked about their options for the first time, Shambu and Rohini started complaining bitterly about the treatment they had received at this hospital. The self-purported physician had refused to come into contact with the patient, or even take a medical history. Instead, their conversation had revolved around the staff ascertaining what the family could afford. (The counselor was to later tell me that many such 'alternative' hospitals had sprung up around lower-income neighborhoods, and for the urban poor at the margins of an overcrowded public health system, these were unsurprisingly seductive lures.) Soon afterwards, Shambu began to narrate his own life, telling the story of how he had planned his own insurance policies based on an astrological prediction that he would contract cancer, but how that prediction had fallen short by two years and wrecked havoc with his plans.

To my surprise, I began to see how the counselor's decision to listen patiently had allowed the space for these narratives to develop, and how the family now began the slow process of coming to terms with the prognosis. This would certainly not be the last word on the matter, but the team's skilful handling of the sensitive ways in which illness knowledge circulates ensured two vital things. On the one hand, they were careful not to heavy-handedly tear the web of careful ruses that continued to bolster the family and the relations between them and the social worlds around them. But at the same time, they laid the groundwork so that these partial denials would not financially ruin the family in the near future. Thus, the team facilitated the process through which Shambu and Rohini could place the illness within a comprehensible narrative of their lives, while beginning to prepare for what was to come.

Dwaipayan Banerjee is a doctoral candidate at the department of social anthropology at New York University. Prior to his doctoral candidacy at NYU, he graduated with an M.A. and an M.Phil in sociology from the Delhi School of Economics, India. He has recently completed ethnographic work concerning the experience of cancer, pain and end-of-life care in India. His research follows the circulations of these experiences across different registers - language, medicine, law and politics. His broader interests includes working at the intersection of philosophy and anthropology, as well producing and studying ethnographic film and media.

The Social Constructions of Cancer

November 2, 2012 at 12:03 pm

Editor’s Note: This is the first of four installments from guest blogger Dwai Banerjee, a doctoral candidate in NYU’s department of social anthropology. Images illustrated by Amy Potter, courtesy of Cansupport.

Introduction

The contemporary landscape of healthcare in Delhi inspires very little confidence. The lack of public insurance, scarcity of resources and rising cost of care in the vast network of private hospitals has ensured that for much of the city's poor, the diagnosis of cancer comes without any hope of treatment. Even at the best public health institutions, waiting lines for chemotherapy extend for months, compounded by the fact that over 80% of patients present at incurable stages. In the four-part entry that follows, I show that palliative care -far beyond its commonplace association with comfort at the end of life - is an urgent, irreplaceable and imaginative intervention that seeks to both diagnose and treat the social costs of the disease amongst the urban poor in India. I show that in its understanding of the form of the worlds that both collapse around and emerge through the disease, palliative care is really the condition and prerequisite of therapy, rather than its failure.
The anecdotes here come from a year of ethnographic fieldwork following intensive care, public health and oncology in India. Specifically, I describe some of my experiences working with and studying Cansupport, a pioneering palliative care organization in Delhi that provides home-based psychological and physical support to lower-income advanced stage cancer patients.

Part I

One of the first things that came to light when exploring cancer care in India was that knowledge of the prognosis was an extremely convoluted matter. From my first days in working with home-care teams, I was told to never mention the word 'cancer': the understanding was that patients hardly ever 'know' that they have the disease. Needless to say, this came as quite a surprise. Later on, analyzing the intake forms of about 2000 patients while working as a consultant at India's largest public hospital, I realized that about 85% of cancer patients were indeed recorded as 'not aware' of either their diagnosis or their prognosis. Delving into the emergent literature on 'psycho-oncology' in India, I began to realize this was a well-recognized problem within the emergent discipline. But it took several weeks of ethnographic work in the homes and neighborhoods of patients before the meaning of "awareness" and "denial became clearer to me.
In one of the early days of the Delhi winter, I accompanied a team on a visit to the far eastern borders of the region. We were greeted by the patient's wife - Rohini - and taken inside a room with two beds. On one lay Shambu, a former life-insurance salesman who presented with an advanced stage of the disease. In a pattern that often repeated itself, once Shambu's initial physical discomfort was taken care of, the counselor turned her attention to the question of the family's 'awareness' of the diagnosis. It was during interactions such as these that I realized the stakes of 'knowledge' around cancer. First, in a public health system in which oncologists see over a hundred patients in the space of a few hours, the communication of a diagnosis and prognosis - often across barriers of class and language - is often a half-achieved ideal at best. Second, even if a sense of the diagnosis is communicated and therapies undertaken, I realized that beyond the space of the hospital, just the hint of the word 'cancer' has the powerful potential to ostracize the patient from social life. Landlords would evict cancer-marked families, neighbors would suspend social interaction, marriages in the family would be jeopardized, and cremators would refuse the body.
Shambu and Rohini's case captured this double elision. The counselor's tactful conversation with Rohini elicited that she had a hazy but more-or-less accurate picture of the bleak prognosis, but that Shambu himself had not been explicitly 'told'. A separate conversation with Shambu revealed that he too was not as much in the dark as Rohini imagined. In a situation that recurred almost inevitably, both partners had tried to keep each other in the dark, firm in their conviction that putting the diagnosis into words would collapse the world of their loved one. They each recognized not only the power of the diagnosis to inflict psychic harm on the self of the patient, but also the threat of being marginalized and isolated from their extended family, their neighborhood and their friends. The world they had built around cancer, a world they had lived in for almost two years, had no place for its acknowledgement in language. To label this complicated work of living together as living in ignorance or denial would do it a great disservice. The work of home-care that took shape recognized this and often pulled back from pushing the disease blindly onto the surface of words.

Dwaipayan Banerjee is a doctoral candidate at the department of social anthropology at New York University. Prior to his doctoral candidacy at NYU, he graduated with an M.A. and an M.Phil in sociology from the Delhi School of Economics, India. He has recently completed ethnographic work concerning the experience of cancer, pain and end-of-life care in India. His research follows the circulations of these experiences across different registers - language, medicine, law and politics. His broader interests includes working at the intersection of philosophy and anthropology, as well producing and studying ethnographic film and media.

Island Time

August 15, 2012 at 2:46 pm


As one might expect, much of medical training occurs in the inpatient setting. Teaching hospitals, brimming with an elaborate hierarchy of trainees and supervisors, offer a critical mass of patients and pathology. Typically these patients present with exceptionally complex histories and comorbidities enriching the substrate of the teaching environment. Counter-intuitively, most doctors do not work in inpatient settings. This is especially true for psychiatry wherein the great majority of practitioners work in the outpatient setting, practicing various forms of psychotherapy.

Unlike in other fields of medicine, residents in psychiatry experience virtually no outpatient psychiatry until their third year (PGY-3). Most psychiatry residents therefore spend a minimum of six years of training before they venture beyond the frontier of outpatient psychiatry, into a wilderness they will eventually call home. For many, this is the moment they have been waiting for since deciding to become a doctor: their first therapy session.

Angst is perhaps the most suitable name for the escalating feeling leading to that first 45-minute office visit. Beyond simple anxiety or worry, there are existential elements implicating one's life, career, and purpose in the world. Additionally, there is both hope and dread- hope that salvation will eventually come (the patient will get better), and dread that you will be unable to bring it. Unlike the inpatient setting, befit with teams of providers embedded in elaborate systems of care (however under-funded and uncoordinated), the outpatient office can be a shockingly lonely venue, a small island where you sit naked waiting to be eaten by a large animal.

From one perspective, there is not much difference between a typical 20-30 minute encounter or "therapy session" on an inpatient unit and a 45-minute office based session. Yet there is an irrational pressure put upon oneself to make the most of an outpatient visit and a simultaneous intense fear that 45 minutes will be way too long (never in the hospital does one have time to worry about running out of things to say). Undoubtedly connected to the well-intentioned (and yet grandiose) identity as healer, this pressure suggests you alone will be in charge of saving your patient's life. Adding to this self-conscious uncertainty is the loss of anonymity afforded to inpatient providers. No longer able to hide behind the tribal masks and dress of the hospital ward treatment team, one's nakedness is more viewable in the outpatient setting.

Most concerning is the realization that, unlike inpatients who often draw from a more familiar cast of acutely ill characters (the demented elderly woman who screams all night after a recent infection, the manic psychotic young man from another state off his meds, the chronically homeless schizophrenic with a recent decompensation…), outpatients can come from anywhere. Fresh off the inpatient unit, I remember once thinking in early July, "Who is this stranger?" I was sitting opposed to a fashionably-dressed middle-aged man on a single antidepressant discussing his upcoming trips for business and summer vacations. Several years since a recent major depressive episode and suicide attempt, it was as though we sat chatting, comfortable by a campfire, the specter of his disease far from our minds.

It wasn't until I returned to the hospital that I appreciated the outpatient setting for what it truly is. Amidst the reverse culture shock of a long call night in the emergency room, I found myself between three newly admitted and screaming patients; one in withdrawal begging for more benzos, another acutely manic and irritable, the third demanding discharge despite a near-lethal overdose just hours afore. I missed my verdant, tranquil island.

It was at this point that I could look back at the thick, threatening, overgrown paths I had traversed and appreciate the open air of my surroundings. It was a few weeks later until I realized who else had been through those woods, lived even deeper in the dark recesses of the forest.

Now sitting in my office I strategize with patients on how to maximize their island time. I wonder how to keep the campfire burning so that we may "talk" as long as possible. And most importantly I try to mentally prepare for the day when a patient must return to those deep dark woods and how I can best make that journey with them.

-Arthur Robinson Williams

Arthur Robinson Williams is a PGY-3 Resident in the Department of Psychiatry at New York University specializing in addiction psychiatry, ethics, and research. He earned his M.D. and a Master in Bioethics at the Perelman School of Medicine at the University of Pennsylvania and the Penn Center for Bioethics.

Medical Humanities and Live Theater. See It Now!

October 6, 2010 at 2:33 pm

For those living in or near New York City, there are unusual opportunities to attend plays that bear directly on individual experiences of illness, altered bodily states, and the cultural and social context in which those alterations occur.

Still playing is Tony Kushner’s Angels in America at the Signature Theater Company."This play explores "the state of the nation"-the sexual, racial, religious, political and social issues confronting the country during the Reagan years, as the AIDS epidemic spreads. .. Characters in the play struggle to find meaning in a world apparently abandoned by God."
See annotation

Through December 19 is Harold Pinter’s A Kind of Alaska, together with The Collection at the Classic Stage Company. The play is partly based on Oliver Sacks’s book, Awakenings.

Recently closed: Wings, by Arthur Kopit: See annotation; Three Women, by Sylvia Plath: See annotation; Photograph 51, by Anna Ziegler (The race to understand the structure of DNA, with scientist Rosalind Franklin as a central character).

Posted by Felice Aull, Ph.D., M.A.

A Summer of Books

July 6, 2010 at 2:51 pm


Commentary by Felice Aull, Ph.D, M.A., Editor, Literature, Arts, and Medicine Database
. Now that summer is upon us, I hope you have access to a cool, restful place where you can burrow into a book and get lost in it. Here are some books I read during the past year or so that I found particularly absorbing, listed in no particular order. Perhaps some will appeal to you as well.

Novel, Await Your Reply, by Dan Chaon. A suspenseful, dark story of identity in which three parallel narratives eventually find each other. (Now available in paperback)

Nonfiction, Zeitoun, by Dave Eggers. A harrowing story, told simply and directly but with growing menace, of what happened to one Muslim American family during Hurricane Katrina in New Orleans. The hurricane was the least of their traumas. (Now available in paperback)

Novel, A Gate at the Stairs, by Lorrie Moore "Ms. Moore has written her most powerful book yet, a book that gives us an indelible portrait of a young woman coming of age in the Midwest in the year after 9/11 and her initiation into the adult world of loss and grief." Michiko Kakutani, New York Times book review. (Now available in paperback)

Novel, A Person of Interest, by Susan Choi. "…say[s] something about what it means to live in a society that is simultaneously tolerant and suspicious, inclusive and all too ready to punish its citizens for the crime of being their authentic selves . . . making us feel deeply for characters who are profoundly flawed. . . . beautifully written. Choi's precise, cadenced prose alternates between plain-spokenness and lyrical dazzle." Francine Prose, New York Times book review. (Available in paperback)

Short Story Collection by Jhumpa Lahiri, Unaccustomed Earth. "Most of Lahiri’s insightful writings concern the betwixt and between challenges associated with immigration and with generational shifts. This collection of engaging and beautifully written stories examines both challenges." Lois LaCivita Nixon, Literature, Arts, and Medicine Database. (Available in paperback)

Novel, Then Came the Evening, by Brian Hart. The author’s first novel is a story of people living harsh lives in the harshly beautiful landscape of Idaho. "Quietly exceptional". . . short review in the New Yorker.

Poetry: Unincorporated Persons in the Late Honda Dynasty, by Tony Hoagland. Hoagland is witty and observant as he focuses relentlessly on contemporary American culture.

Poetry: My Life As a Doll, by Elizabeth Kirschner. The speaker spins out "a narrative of embattled childhood" and its long-range effects.

Interdisciplinary Arts Project in a Family Medicine Residency Training Program

May 24, 2010 at 9:32 am

Photograph of pregnant woman with gold painted hand of partner on her abdomen

Commentary by Maureen Rappaport MD, FCCFP, Assistant Professor of Medicine, St Mary’s Hospital Center, and McGill University, Montreal, Canada

I am trained as a family physician but one third of my practice is as a clinical supervisor and teacher of residents in a family medicine teaching unit. I am based at St. Mary’s Hospital, a small community hospital in the heart of urban Montreal. Our residents have to do a "research" project as part of their training. Like most of our clinicians, I am not a trained researcher but I have had extra training as an educator (McGill Scholar in Medical Education 2004). A research project was a requirement of that program and through the courses I took in the Department of Education I discovered academic researchers were exploring different theories of knowledge and research (Barone and Eisner, Clandinin and Connelly, Cole and Knowles, and Patton)): i.e. Qualitative Inquiry, Interdisciplinary Artistic Inquiry, and Reflexive Inquiry. I used these methods in my own research project and although I initially met with skepticism, in the end my project was well received.

Past resident projects at St. Mary’s Hospital were mostly literature reviews and chart audits and, though interesting, the topics tended to repeat themselves year after year. My experiences in the Scholar’s program gave me the idea to propose an "Interdisciplinary Art Project" stream to my colleagues. I was excited about this new development, other staff members became inspired to develop other projects, and best of all, the residents engaged wholeheartedly with this new project paradigm.

I developed the guidelines for the Interdisciplinary Art Project based on work done by Dr. Ruth Martin, at University of British Columbia Family Medicine, who was generous enough to send me her documents. (Draft guidelines for Interdisciplinary Art Resident Project,Version #7, September 2005).

Interdisciplinary Art Project Stream Guidelines

Goals:

To integrate an artistic activity that includes photography, painting, sculpture, music, poetry, drama, film, or creative writing in a project that contributes to the existing knowledge base of Family Medicine

  1. To increase clinician self-understanding and/or understanding about the physician patient relationship
  2. To produce an oral/visual/audio/performance presentation which consists of the work of art itself AND
  3. To produce an abstract and a report written in a format similar to scientific research, however, you may write this report in the first person like a personal diary or field notes

Objectives:

  1. Demonstrate an academic understanding of the integration of the chosen artistic discipline with the discipline of family medicine
  2. To produce a scholarly work that attempts to understand, explain, and/or interpret a clinical question or enigma and to explain your motivation for choosing an artistic medium
  3. To include a historical and contemporary overview citing past examples of interdisciplinary work
  4. To explain how your project relates existing interdisciplinary knowledge or published literature
  5. To outline the ethical considerations encountered. ( Physician artistic activity can lead to ethical conflicts between what is research, art, or journalism, or when artistic activity interfaces with clinical care)
  6. To fully explain your methods ie. why, when and what materials/medium were used and if other participants were involved what consent process was used and did they have input in editing
  7. To present your results (the work of art) and a summary of the written report on resident day
  8. To have a full discussion about the impact and limitations of your project
  9. To demonstrate how the process of completing an interdisciplinary art project resulted in your personal growth or increased understanding

Preliminary Project Excerpts for Research Day June 16, 2010

Four projects are in the Interdisciplinary Arts Project stream this year:

1. The Exploration of a Patient’s Experience with Injury, Illness and Healthcare in Montreal -A short documentary film (Dr. Isaac Berman)

2. Poetry Therapy (Dr. Anne-Marie Leblanc)

3. Narrative Medicine, A Reflection (Dr. Tara McCarty)

4. Life-casting Project of Pregnant Woman and Her Partner (Dr. Tim Lussier)

Below are excerpts of three projects in their preliminary form:

Poetry Therapy: Anne-Marie LeBlanc

"As [Arthur] Lerner [is reputed to have] said, ‘poetry has the potential to help you be your best possible self… it brings us back to our own humanity’. I think I could say this is exactly what poetry brings me: humanity."

Outline of Project

  1. Intro
  2. Development
    1. History of Poetry Therapy
    2. Poetry and humanity
      1. Presentation of poems
    3. Research Method
    4. Four beneficial effects
      1. "Finding the Words to Say It"
      2. "It Takes a Whole Doctor to Treat a Whole Patient"
      3. "Paying Witness to the Unfolding Occurence of Life Itself"
      4. "Becoming a Better Professional"
  3. Conclusion

"The poem named ‘Une Femme Morte’ was written during my palliative care rotation."

Une femme. Morte.

Et moi qui entre

Devant elle

Un regard, en fait deux

L’un eteint et l’autre en peine

Deux coeurs

Qui ont aime… et cesseAd’aimer.

Trop difficile cette vie

La-haut ce sera plus calme…

Et la musique quiAla transporte

Je souffle sur son ame

Et reviens sur Terre

Lui ouvre les yeux…

Rien.

Que du vide. Que du vitreux

De l’ordinaire extraordinaire

Incroyablement effrayant.

Saisissant.

Le rideau derriere moi

Je le saisis. Un dernier regard

Trite, livide.

Je la laisse

Et je marche hors de moi.

Narrative Medicine, A Reflection: Tara McCarty

"This is a little piece I wrote in the call room last week after a particularly difficult night. Small reflections such as these are known as narrative medicine. AThe doctors, nurses and staff who care for the ill are exploding with stories of beauty, sadness, and unique information that they are privileged to know about their patients’ lives. Narrative medicine, as described by Rita Charon, internist and writer, is a way of practicing medicine that enables the physician to practice it with empathy, reflection, professionalism and trustworthiness. It can be conceived as a model for a new way to practice medicine, a way that perhaps is a form of reincarnation from the old."

It’s late in the evening and I’ve been paged by the attending who asked me to see Mr McDonald. He hadn’t been doing well and the attending wanted me to check on him and re evaluate his pain control later on tonight. Actually, I knew this patient from a couple months ago when I was on call- a sweet 91 year old man who still had all his mental capacities and a great photo of his nine grandchildren by his bedside. He came with pancreatic cancer and a CVA, and when I saw him, he was desatting and short of breath from a likely aspiration pneumonia. On top of that, he had gone into fast a fib at around 160, and at 4 am, alone on the eighth floor, I put him on a monitor and pushed some IV metoprolol until he slowed down.

Once my heart rate and his were both down to the double digits, he smiled at me, amused. "It’s Ok, my dear", he said, "You don’t have to look so worried anymore". When I left later that morning he was satting well, had a heart rate of 70-90 and he patted my hand gently when I left.

Tonight, I go in to check on him. Much has changed. He has had two more CVAs, and he is now Level 5 care, existing on that lovely trifecta of nasal prong O2, morphine and scopo. I walk into his room, introduce myself, explaining that we have met before. He is breathing at about six during the minute that I count but seems to be focusing on my eyes. I realize the sound that is coming from his throat is what we doctors so eloquently call "the death rattle". I am holding his hand and with my free one press the call bell to ask the nurse to phone his family, but once she answers, the only one left breathing in the room is me. Mr McDonald, the sweet man who only a couple months ago had told me to "stop being worried", had just died, here in front of me, his hand in mine.

In a haze, I did the usual, the exam needed to pronounce, the papers, the signatures, the call to the family, helped the nurses clean him up, take out the IVs, take out the foley, take off the EKG stickers. I left his peaceful body in his room, waiting for his family. But his spirit stayed with me for a while. I left his room and walked down the dark hall, Mr McDonald’s ghost floating beside me, calm. And so he walked beside me, holding my hand, all the way from 5 main to 5 south, and then he let me off at the elevators. I pushed the down button for me, and the up button for him. His elevator came first, and he waved softly and smiled as the doors closed, his eyes once again telling me that everything was OK.

Life Casting of a Pregnant Woman’s and Her Partner’s Hands

Resting on Her Belly: Timothy Lussier

Introduction: The bond between a family and the unborn fetus is not very well discussed in the medical profession as the pregnancy is quickly reduced to a checklist of symptoms and signs. Art can help to capture this relationship in a way that is informative and powerful for the observer whether it be a patient, passerby or the responsible physician. Objective: Use sculpture to help capture the bond between the mother, partner, and the unborn fetus. Design/Method: Research aspect-to explore what is known concerning the bond between the mother/family and the developing fetus; Creative arts aspect-life-casting project of a pregnant woman and her partner symbolically representing the connected union. This will be followed by a survey of observers to verify the art assists in the intended purpose. Results: 1) Written report 2) Sculpture 3) SurveyADiscussion: Art can be a transforming experience and has shaped minds and history through time. It is our way of expressing complex ideas or emotions and communicating this to others. The nine months of pregnancy is a powerful experience for the family not formally recognized by the mother’s interaction with the medical profession. A life-cast sculpture of this bond may help us to better understand this experience and promote this experience within the family.

The above excerpts are just tastes of what these projects hold. I can’t wait for research day, to hear my residents present these works to their peers and my colleagues, to see poetry, stories, and art next to evidence- based searches. Medical Humanities has taken yet another place in the Academy.

Note: Although the projects are in various stages of development the residents have generously agreed to share their work so far.

References

Barone, T.E. & Eisner, E. (1997). Arts-based educational research. In R.M. Jaegar (Ed), Complementary methods for research in education. (2nd Ed.) (pp.73-116). Washington, D.C.: AERA.

Clandinin, D.J. & Connelly, F.M. (2000). Narrative inquiry: Experience and story in qualitative research. San Francisco: Jossey-Bass.

Coles, A. & Knowles, G.J. (2000). Researching teaching: Exploring teacher development through reflexive inquiry. Boston: Allyn and Bacon.

Lerner, Arthur. Cited by McARDLE, S. and BYRT, R., in Journal of Psychiatric & Mental Health Nursing. 8(6):517-524, December 2001. p. 521.

Patton, M.Q. (2002) Qualitative research and evaluation methods. Sage Publications: California