Monthly Archives: January 2011

Or do they? This week in Poetry and Prose Rounds we wrestled with this question, and read a chapter by the same name from Rachel Naomi Remen’s Kitchen Table Wisdom.  It is one of the shortest chapters in her book, which is partially what motivated me to use it for the Rounds. It intrigued me to have us read her chapter and discuss some of the different ‘cultures’ surrounding crying within different health-related (or other) professions. This week we had group members from medicine, nursing, social work, public health, anthropology/women’s studies, and please forgive me if I missed anyone. Our group expanded to two tables as the hour progressed.

We started off the session by writing an instruction manual for newbies to our particular professions: “The Rules of Crying.” What I heard from the pieces people shared, and then the from ensuing discussion about the reading, was that social work has a lot to offer the rest of us in terms of building in debriefing sessions and ways of processing grief. People discussed different types of tears in professional work environments, with the most common being tears of grief and tears of anger/righteous indignation. I also wrote about tears of joy, which probably don’t happen enough in health care settings.

Burn out prevention: we touched on this as part of our discussion, since Dr. Remen talks about tears in the context of burn out prevention. A family medicine faculty member discussed the use of Balint Groups to support practicing physicians who want to enrich their physician-patient healing relationships, and help prevent burn out. I brought in a copy of Graham Greene’s A Burnt-Out Case, which is purported to be the source of the term “burn out.” Although not his strongest work, I like this book for it’s psychologically and spiritually nuanced description of the process and consequences of burn out. Used as a metaphor in the book, the literal burnt out case is a leper who, while cured of the active disease of leprosy, is so altered that he or she cannot leave the leprosarium and return to normal life. We ended the session by writing about our own rituals of grieving. This naturally leads into next week’s reading from Terry Tempest William’s Refuge: An Unnatural History of Family and Place. A beautifully written book, she writes of the personal, intertwined with environmental loss.

On another note, our group discussed ways of improving and growing the Poetry and Prose Rounds Blog and group sessions. A common suggestion was to have more narrative medicine content in the blog posts, including links to other resources around the University of Washington, Seattle and even the Pacific NW. I’m working on growing that list and will post it as it becomes available. Another request was to have some writing workshops related to narrative medicine, since there are group members who are writers and want to hone their skills. All great ideas and I’ll see what I can do to work on them. One local UW-based group is the Critical Medical Humanities Research Group who maintains a list-serve you can join (there’s a non-UW affiliated link for joining as well). They are sponsoring a medical humanities/narrative of/for/by medicine event at UW on April 29^th, so stay tuned for more information. Here’s their link:

http://mailman2.u.washington.edu/mailman/listinfo/criticalmedhumanities.

~Josephine Ensign

The six of us who attended the second meeting of Poetry & Prose Rounds were a mixed group from different disciplines: Social Work, Nursing, Rehab Medicine, Anthropology/Women Studies. We began with each writing a short narrative on a person we admired who had gone through adversity, and shared our stories at will.

The close reading aloud of this week was “God’s Bones” by Yasunari Kawabata, the first Japanese novelist to win the Nobel Prize for literature in 1968. The short story written in the late 1920′s is part of his collection of “Palm of the Hand Stories“. Yumiko, who miscarries a child, sends 4 men portions of the child’s ashes since she is not sure of paternity, and claims the ashes are the bones of God. It is a story of loss and responsibility.

We finished with each of us writing a brief narrative of the same incident we wrote about in the beginning of the hour, but wrote in a different voice – an interesting exercise.

It is not necessary to do the short weekly reading in advance, so drop in whenever you have time. No writing experience or literary cricism expertise required! For me it was a worthwhile hour to “escape” the scientific and technical world and briefly enter a world of words and thoughts.

-Janet Schnall

Poetry and Prose Rounds officially launched with eight people in attendance representing a range of health disciplines, including social work, medicine, environmental and occupational health, nursing, pharmacy, and public health genetics. I opened with a common saying from the Southern US where I am from: “The three most important things you own in this world are your name, your word, and your story. Be careful who you tell your story to.” (also included in Vanessa Gamble’s essay “Subcutaneous Scars” from Narrative Matters).

In keeping with the narrative theme, we wrote the story of our names and briefly shared these by way of introduction. I reviewed some of the basic aspects of the practice of close reading as they apply to narrative medicine, and added the idea of punctum to this. According to Arthur W. Frank (The Wounded Storyteller), who is an expert in narrative research, the punctum of a photograph is a wound, an element of surprise, something that has slipped in to the frame—it distracts you but isn’t the main focus. He looks for these puncta in narratives of illness, as they can aid in understanding the story more fully.

We then did a close reading of Chapter 10 of Leo Tolstoy’s The Death of Ivan Ilich, when Ivan is lying on his divan, conscious of his impending death, asking himself what his torments are for and if he has lived properly. “There is no explanation! Torment, death—Why?” he asks at the close of the chapter.

An intriguing question arose in our group: Do most people who are facing death feel satisfied with their lives?

–Josephine Ensign