A diverse group, including physicians, a transplant nurse, and first-year medical students shared stories of their creations before an audience at the 11th Narrative Medicine Story Slam on October 4. The designated theme was transformation and discovery.
The 10 presenters, which included Naomi Rosenberg, MD, the Director of the Narrative Medicine program, were given a loosely-enforced five minutes to share their stories. At the conclusion of the session, the audience voted for their favorite.
That honor went to Fatema Hashem, who delivered a profound account of her first weeks as a medical student trying to come to grips with the startling reality of gross anatomy.
“Somewhere along the past grueling eight weeks, I begin to wonder when I stopped seeing a human corpse,” Hashem read. “At what precise point did I start seeing the body as an indiscernible pile of muscle, bone, tissue, nerves, vasculature?
“This fills me with a lot of shame, and, truthfully, anatomy lab has felt as much a dissection of my character as our cadaver.”
With this statement, she broke from her measured cadence, looked up from the tablet she was reading from, and said, with genuine surprise, “I think I just admitted to having an existential crisis. But that is for the next Story Slam.”
Fellow first-year medical student Ayse Guvenilir’s essay, “Mi Abuelita,” was the runner-up. Guvenilir revisited meeting her maternal grandmother, Angela, for the first time when she was four and couldn’t understand Spanish, the only language Angela knew. She also recalled an episode in 2012, when a doctor of a friend at their local mosque saw an ailing, uninsured Angela and treated her at no cost.
“Lately, I’ve been thinking a lot about my abuela, who passed away last year,” Guvenilir read. “I think about the care she received from ‘Dr. R’ that summer in 2012 and I remember who I am doing this for: I want to be rooted in my community, forming true connections, and helping those who do not know where else to turn to, just like ‘Dr. R’ did for my family and my abuelita.”
“Code T,” a story by Najya Williams, and a poem by Anushka Shah titled “July 26, 2023” tied for third place.
In “Code T,” Williams, a third-year medical student, describes her first day on her surgical clerkship at Lancaster General Hospital, which was “fairly mundane” until she and her team we called to treat an incoming 70-year-old man who was unresponsive. Things escalated quickly from there.
“While I was consumed by my own thoughts,” Williams read, “the team discovered that the patient was bleeding out into his chest, and they needed to give back what was being lost as soon as possible.”
The attending called for a thoracotomy tray to open the patient’s chest right there in the bay.
“Once the first incision was made, the blood began to spill from his chest. And spill. And spill,” Williams read. “Until a small river flowed beneath the team’s feet.”
More than an hour later, the trauma attending yelled “Stop!” and called the time of death.
“This,” Williams read, “marked the first time I watched someone die in front of me.”
In intensifying verses, Shah, a second-year medical student, chronicled a similarly unrelenting scene that stretched across an entire shift at Temple University Hospital – Episcopal Campus.
“The resident hasn’t had lunch yet, and it is nearly 4 in the afternoon.
Three nurses talk about Cheesecake Factory, the first time I’ve seen them sit.
And an attending arrives for his shift with coffee in his glass jam jar.”
Spent after the long day, Shah read, “I get home and I get myself a glass of water and I forget to change out of my scrubs for hours.”
All too often, transformation and discovery comes to healthcare providers during their darkest hour.
John Mulligan, RN, MSN, an abdominal organ transplant nurse, shared a moment from early in his career that he admitted to being unable to talk about for 20 years.
Three months out of nursing school, Mulligan was charged with caring for a patient in a step-down unit, a place he had never worked before, who had just been told he had lung cancer that was metastasizing, “and he was physically and emotionally reeling.”
“I knew with my limited experience that this was going to be clinically challenging,” Mulligan recalled. “I figured that what I could not provide for him in clinical expertise, I would try to make up in effort and doing whatever I could in providing him with emotional support. I would also be as kind to him as I possibly could, despite how he treated me.”
The next night, the patient’s wife told Mulligan, who was still physically and emotionally exhausted from the experience, her husband said he was the best nurse he’d ever had. They cried and hugged.
“The interaction with James’s wife may have saved my nursing career,” Mulligan said.
In illustrating the influence of a mentor, Dr. Rosenberg recalled a moment when, as a staff member of the nonprofit Partners In Health, she flew to Miami to arrange for the burial of a young Haitian girl who died following a heart surgery she helped coordinate. With the girl’s death, her mother left the hospital room, never to return.
Dr. Rosenberg said she became overwhelmed by selecting a dress for the girl to be buried in, her emotions from the episode seeping into, then bursting through the mundane act.
As the Chief Patient Experience Officer for Temple Health and a volunteer chaplain, Jocelyn Edathil, MD, PhD, FACP, recounted calls that came in the middle of the night from patients near the end of their lives or their families seeking guidance and comfort. Bleary-eyed from another long shift, Dr. Edathil somehow managed to summon the energy and compassion to meet the moment.
“My father told me once that a patient is called a patient because they need to be patient,” she read. “I’m grateful to be patiently experiencing what our patients experienced here at Temple. We all try to do our best for them, and this is the Temple experience.”
Susan Gersh, MD, FACP, DABIHM, last participated in a Story Slam three years ago, following the death of her mother. She returned for the most recent edition to memorialize her father, who died a month earlier.
“I’m officially an orphan,” Dr. Gersh read. “It’s a hard concept to realize that there’s no one left on the planet who’s known me my whole life.”
In the absence of her mother, Dr. Gersh said she spent more time with her father over the last three years than she had at any previous point in her life. They talked about a lot of things, including how he’d die.
“I’ve spent my life as a doctor, as did my father, taking seriously my abilities to navigate the system well,” she read. “And all I can say is that, despite my efforts, at the end of his life, the system failed him on so many levels.”
There were also those who described their journey to uncover a true identity. In the case of Jean Lee, MD, it was a dialysis technician she worked alongside for the last 30 years at Dialysis Clinic, Inc. She described him as the center’s “lifeline,” but only within the last year did Dr. Lee discover the scope of his life prior to his arrival in Philadelphia.
A native of Vietnam, he fought alongside American soldiers in the Vietnam War. With its unceremonious conclusion, he was sent to a communist re-education camp. After he managed to escape from there, he was homeless for several years. Eventually, he fled to Thailand by traversing the dangerous countryside of Cambodia. In Thailand, he managed thousands of displaced people at a refugee camp.
After securing the position at Dialysis Clinic, Inc., he sent for his wife in Vietnam. Later, they had two daughters, one of which recently graduated from the Lewis Katz School of Medicine.
Taara Prasad, a first-year medical student, wrestled with how her many experiences – investigating whether people cited by NYPD for prostitution were actually victims of human trafficking, helping homeless women restructure their resumes, and spending five months abroad learning about plant medicine – jibed with the tight confines of a medical school application.
“All of these opportunities, the people I met, shaped the way that I approached medicine and the world,” she read. “These were far from intentional moves geared toward medical school admission. They really were just pieces of me living my life during all of those years.”
On the eve of her anatomy final, Prasad was struck by how little she knew about her donor. Clinically, she was prepared for the test. Still, she read, “there was this entire segment of questions that was never asked, but these were ultimately the questions that made up our donor’s life.”
She contemplated what would happen if someone dissected her.
“What one-line descriptor would be given to me?” she read. “I’d be reduced to my structural similarities with other bodies and ignored for my differences.”
Prasad said she’s come to appreciate the need to learn the vast amounts of knowledge needed to save lives. “But,” she read, “there also exists a power in acknowledging the indicators that show that our donor was only human.”