Narratives of medicine or medical narratives?

I have long been fascinated by stories of and from medicine,  and medicine’s patients. This fascination has been since childhood, really, with a respite in late high school and college. Now, I have been writing some of those myself. Regularly, and sometimes virtually nonstop. They are all recollections that I have had in various encounters that I have had in and around medicine.

I have been on the edge of medicine since graduate school, in ways that few others have done. I’ve had a mixture of conscious and unconscious motives. It’s partly wanting to help, and partly a fascination, and partly a desire for close contact with patients, And I realized that there’s a place for somebody like me–somebody not right in the system, but somebody not outside of it either. Somebody who sees the good and the bad, with very little hidden, but can set it in context–including the professional context of public health. I’ve spent hundreds of hours if not more in operating rooms, and more in emergency departments. Hundreds heading up the clinical ethics consult service at a local hospital, and I don’t know how many riding the paramedic units in Seattle for my first large research project. I’ve walked the slums in Accra, Ghana, with some special people, helping as we could, spending time in clinic there, spending some time on the AIDS ward just as antiretroviral treatment was first introduced. I’ve gotten to know patients and the diversity of their feelings–the variety of their feelings, as they approach death, or as they get stronger and stronger, and are discharged from the hospital. I’ve watched hope turn into despair as a family member dies suddenly.

I have seen dramatic deaths and deaths as uneventful as somebody who is already asleep passing invisibly into another stage of sleep. It was discernible only on the cardiac monitor–a regular rhythm turning into a life threatening arrhythmia and then into asystole: the rhythm of death. That’s what happened to my mother after she threw a pulmonary embolism in the medevac jet as I was flying with her from Milwaukee to Seattle, post stroke. We landed in Bismarck and she was admitted to one of the local hospitals. She kept on deteriorating. Nothing was working, and I watched in the beautiful sunset as that transition into asystole took place with the setting Bismarck sun shining in the picture windows, and I watched the monitor, and then the sun, and then realized that I was an orphan, though hardly a child.

Some of the stories that I write are about me. Some involve me in some way, and some are fiction. But one thing that is happening is that I feel a deep connection with my writing that has not been there before. It is not a scientific or scholarly remove. It is life. It is about life. It is about my life, and about others’ lives, and it is about death. Much of it is not the drama of ER or other doctor shows, but about routine. But there is something inexplicably rich there. My friend Nancy calls it “the rich tapestry of life,” and that captures it.

It feels now like somehow I have found my “voice.” I hope to be able to keep writing as I have been. If–when–some of these pieces get accepted for publication, I will post it here. The meaning, though, is in the doing. I realized that acutely 30 minutes ago as I finished that piece about my own mother’s death.

Through all of this, I have discovered a deeper meaning to life, and if that is all that this has bought me, then there is a beauty right there that has made it worth it.


About epihealth

Professor Emeritus of Epidemiology and Medical Geography, University of Washington, Seattle. Formerly Adjunct Prof, Depts of Medicine (Div of Infectious Diseases), Family Medicine, Health Services, and Global Health. President, Health Improvement and Promotion Alliance-Ghana Expertise in infectious diseases, epidemiology and clinical epidemiology, epi. of pain, community health, travel medicine, tuberculosis, disease control.
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