Posts Tagged ‘medicine’
April 7, 2014 | by Merve Emre
When Leslie Jamison and I met outside the Glass Shop, an airy café in Crown Heights, I noticed her left arm was sporting a wide, wordy tattoo. It was in Latin, and she spared the embarrassment of translating it—“I am human; nothing is alien to me.”
Too often, Leslie says, people treat tattoos as an invitation to intimacy. Strangers on the subway ask her to relay the story of her tattoo without a second thought, much as they would, in offering a seat to a pregnant woman, ask for the details of what’s growing inside of her. But in Leslie’s case the tattoo does point to an intimate story—or rather, to a whole constellation of intimate stories that Leslie offers in her essay collection The Empathy Exams.
“I am human; nothing is alien to me” is the epigraph to the collection. It is a quote that has been casually misattributed to Montaigne, John Donne, Karl Marx, and Maya Angelou, but it actually comes from The Self-Tormentor, a play written by Terence, the ancient Roman slave turned playwright. It is the thread that connects such different yet equally luminous works as “Grand Unified Theory of Female Pain,” “Pain Tours,” and “The Devil’s Bait”—meditations on how to feel pain, both physical and psychic in nature, and how to regard the pain of others in a way that respects their humanity. Having read The Empathy Exams, I can begin to appreciate why Leslie has made the small, if painful, jump from writing about the body to writing on the body.
Leslie and I circled this conversation so many times at the Glass Shop that we decided to revisit it one morning in late October at my apartment in Brooklyn, and later that day, on the Metro-North to Yale University, where we are both finishing Ph.D.s in English literature. Most of the time, the tape recorder was on, but sometimes I switched it off so we could gossip idly, and forgot to switch it back on until Leslie was already halfway into a thought on feminism I wanted to preserve. But if this interview reads like the midpoint of a conversation that’s been taking place for some time now, that shouldn’t prevent you—the reader—from making sense of it. After all, you are human. This will not be alien to you.
The most ungenerous criticism of the collection that I could imagine is, Oh, she keeps putting herself in these positions to experience pain or woundedness so she can have something to write about. How narcissistic. I can see people thinking as they’re reading, She’s a real glutton for pain.
I guess that’s why it felt right to put “Grand Unified Theory” at the end of the collection. That idea of being drawn to pain is starting to emerge as a pattern in the essays themselves, and the final essay speaks to that directly. What position of pride do I have in relationship to these experiences?
There’s a basic and important distinction to draw between positions I inhabit as somebody who has experienced some kind of trauma and somebody who’s seeking out pain. Going to the Morgellons conference is a choice in a way that getting hit in the street isn’t. But the collection chooses to bring all of those experiences together in a certain way—what kind of appetite is being spoken to there? In certain ways, as a writer, you do profit off your own experiences of pain, and there’s a way of seeing that profit that’s wholly inspirational—in terms of turning pain into beauty—and a way of seeing it that’s wholly cynical—in terms of being a “wound dweller” in a corrosive or self-pitying way. The honest answer—to me—dwells somewhere between those views. Read More »
March 13, 2014 | by Paul Kalanithi
Remembering Sherwin Nuland, the author of How We Die, who died last week.
I attended the Yale School of Medicine when Shep Nuland taught there, and despite our both being surgeons, I know him best in my capacity as a reader. I don’t recall when I first read How We Die—I was just finishing high school when it came out—but I do know that few books I had read so directly and wholly addressed that fundamental fact of existence: all organisms, whether goldfish or grandchild, die. His description of his grandmother’s illness showed me how the personal, medical, and spiritual all intermingled. As a child, Nuland would play a game in which he indented her skin to see how long it took to resume its shape—a part of the aging process that, along with her newfound shortness of breath, showed her “gradual slide into congestive heart failure … the significant decline in the amount of oxygen that aged blood is capable of taking up from the aged tissues of the aged lung.”
But “what was most evident,” he continued, “was the slow drawing away from life… By the time Bubbeh stopped praying, she had stopped virtually everything else as well.” With her fatal stroke, Shep Nuland remembers Browne’s Religio Medici: “With what strife and pains we come into the world we know not, but ’tis commonly no easy matter to get out of it.” Read More »
October 30, 2013 | by Rebecca Buckwalter-Poza
The doctor asks you to bend down, then waddle a few steps as he watches you. You might be ten but could be fourteen, at the pediatrician or in the school nurse’s office, probably a girl but maybe a boy. It might be the last item on a long checklist of routine things: height, weight, blood pressure, pulse, and temperature, check; vision and hearing, check; mumps vaccine, chickenpox history, tetanus shot, check; then, finally, the duck-walk diagnostic test.
Me, I was in the school gym. I’d waited with friends for my turn in the locker room with the doctor who’d volunteered to give physicals for the middle-school athletes. He knew my mother, so we made polite conversation between routine questions. Then, he asked me to bend and take a few steps. I did so, staring at the cracked concrete beneath my bare feet. When I was allowed to straighten, I could see that the doctor’s face had changed completely.
Locked on my torso, his now-serious eyes ticked left-right-left-right, then fixed on the planes and angles of my shoulders and hips. Trusting that I trusted him, the doctor placed one of his hands on my shoulder and his other hand on my hip. After a moment, one of his hands moved to my back and traced the misaligned knobs of my spine. That sensation, a man’s hand running down my spine impersonally, as if I were no more animate than a mannequin or cadaver, would become very familiar to me.
Scoliosis curves your spine into an S, a biological scarlet letter glaringly visible by X-ray but also perceptible to the naked eye. Read More »
September 16, 2013 | by Adam Leith Gollner
What have we not done to live forever? Adam Leith Gollner’s research into the endless ways we’ve tried to avoid the unavoidable is out now as The Book of Immortality: The Science, Belief, and Magic Behind Living Forever. Every Monday for the next two weeks, this chronological crash course will examine how humankind has striven for, grappled with, and dreamed about immortality in different eras throughout history.
In the late 1700s, a Scottish quack named James Graham, Servant of the Lord O.W.L. (Oh, Wonderful Love), became the talk of London for claiming anyone could live to 150 simply by making regular visits to his private clinic, the Temple of Health. Graham encouraged valetudinarians to rub themselves with his patented ethereal balsam. He also advocated earth baths, in which naked patients climbed into holes in the ground and were covered neck deep in mud. He spoke of the salutary effects of thoroughly washing one’s genitals in cold water or, even better, in ice-cold champagne. His most in-demand device, however, was the celestial bed, a massive stallion-hair-filled mattress supported by forty glass pillars that administered mild shocks of electrical current. Graham’s clients hoped the effects of “holding venereal congress” in the bed would cure barrenness—or at the very least help them live longer, if not forever.
Graham was only forty-nine years old when he died in 1794—a pivotal, auspicious year in the history of immortality. It was the same year that Blake engraved his Songs of Innocence and Experience with lines about being a happy fly whether he lives or dies, about immortal eyes in forests of night, about “that sweet golden clime / where the traveler’s journey is done.” What Graham sought in the physical, Blake found in the mystical. His visions showed him “what eternally exists, really and unchangeably,” that “which liveth for ever.”
April 16, 2013 | by Casey N. Cep
It was Eid al-Adha, the Feast of Sacrifice, so the bazaars in Istanbul were closed. We walked along the silent streets, wondering how thirteen million city dwellers could go so quiet and how we were going to spend our leftover lira before our departing flights in a few hours. Toward the Galata Bridge, we found a commotion of doves and pigeons by the Yeni Cami.
Birds of a feather do flock together: leading from Eminönü Square was an avenue lined with animal stalls. A menagerie of birds—cranes, ducks, fancy chickens, peacocks, and pheasants—called from their cages. In other wire cages, puppies, kittens, and rabbits formed furry masses. Another set of aquatic stalls had turtle hatchlings and goldfish. Bags full of seed, dry food, and wood shavings spilled into one another—supplies for every sort of pet.
We stopped before a collection of three-gallon drums. “Prof. Dr. Sülük,” read placards at the top of all the drums, each of which was two-thirds full of cerulean-tinted water. A man stood beside the drums, resting his weight on one of them, shifting his baseball cap with the other hand, gray hair falling from underneath.
“I saw a Man before me unawares: / The oldest man he seemed that ever wore grey hairs.” This was not the Lake District, but in this busy market I thought of William Wordsworth’s “Resolution and Independence.” Facing these tiny barrels of leeches and their keeper, all I could think of was the Romantic’s leech gatherer.
Several hundred leeches writhed. They gathered like a black belt round the middle of each container, near the water’s surface. A few ambitious leeches left the waistband, inching their way toward the lid; a few fell from those curving heights to the bottom of the barrels. Read More »
August 28, 2012 | by Maureen Miller
According to every epidemiological study of medical-student mental health ever published, a large percentage of us suffer from, well, something. The discussion sections of these research papers generally propose we educate one another in mental hygiene. They suggest we should practice more “mindful medicine.” And, good students, we oblige. A medical student may not come into med school knowing how to handle a “high-functioning” anxious type in clinic, but the diagnosis doesn’t require an office pamphlet. It’s visible right there in the room.
At my school, we first learn to integrate this understanding of acute and chronic anxiety into clinical practice via the required six-week psychiatry clerkship. Six weeks of immersion in “ICU psychiatry,” the psychiatry faculty argues, is not enough time to master the management of anxiety disorders, but at least it is something. Third-year medical students spend six weeks on one inpatient psychiatry ward as well as several night shifts in a CPEP (Comprehensive Psychiatric Evaluation Program), the ER for the ill at ease.
In these settings you learn to triage threat and fear until you know from anxiety. There you learn the difference between anxiety and agitation. Panic-attack patients stay in the ER for a while for cardiac and thyroid workups. Anxiety in the CPEP counts as psychosocial stressors, or Axis IV on the DSM-IV: losing your edge, losing your family’s support, your job your benefits, your place to live. Maybe you will have an adjustment disorder on Axis I, or existential anxiety that keeps you off your axis. Agitation is losing your cool, and sometimes losing your hospital gown if you’re especially feisty. For anxiety there is benzos and SSRIs; for agitation, benzos and antipsychotics and sometimes four point restraints. They call the agitation cocktail a 5+2, for 5 milligrams of Haldol and 2 milligrams of Ativan, though I saw one “frequent flyer” get a 10+4.