I haven’t posted in a very long time, but hope to remedy that soon. so much is happening in narrative medicine at temple. we are hosting our sixth story slam on October 16. we are starting a podcast, narratives of north broad. we have holding workshops with 7 residency programs. We have a annual writing contest, a student literary magazine, a bustling electives program. Several doctors and students are writing reflections and stories for publication. We are truly trying to build a culture of stories at Temple. So Stay tuned! If you want to read our latest work, some of the stories we’ve been writing at temple, go to our narrative medicine page and check out our work.

students write with power about their experiences from charlottesville during the violence incited by white supremacists. Do stories heal? I submit these reflections are cathartic for both the authors and readers alike.   

https://www.nytimes.com/2017/08/13/opinion/university-virginia-uva-protests-charlottesville.html?action=click&pgtype=Homepage&clickSource=story-heading&module=opinion-c-col-right-region®ion=opinion-c-col-right-region&WT.nav=opinion-c-col-right-region&_r=0

 

I’m walking in  early in the afternoon to check on one patient I want to write about -- heroin overdose the night before, no pulse at first, no identification, what is to become of him? -- and on my way in I meet this man coming out! That's Temple -- the full range of humanity and human emotion. Stay tuned for the story on the heroin overdose, incredible in many respects, but enjoy this one for now. Even the smallest moments can be epic.

https://medium.com/temples-narrative-medicine-program/a-walk-in-the-park-2ece46d1583c

 

Should I Help My Patients Die?

https://www.nytimes.com/2017/08/05/opinion/sunday/dying-doctors-palliative-medicine.html

 

Dr. Amy Goldberg is the heart and soul of Temple University Hospital and as a trauma surgeon has treated gunshot victims in Philadelphia for 30 years. What follows is a powerful profile of her in the Huffington Post. But this excerpt alone should break your heart :  “As a country,” Goldberg said, “we lost our teachable moment.” She started talking about the 2012 murder of 20 schoolchildren and six adults at Sandy Hook Elementary School. Goldberg said that if people had been shown the autopsy photos of the kids, the gun debate would have been transformed. “The fact that not a single one of those kids was able to be transported to a hospital, tells me that they were not just dead, but really really really really dead. Ten-year-old kids, riddled with bullets, dead as doornails.” Her voice rose. She said people have to confront the physical reality of gun violence without the polite filters. “The country won’t be ready for it, but that’s what needs to happen. That’s the only chance at all for this to ever be reversed.”

 http://highline.huffingtonpost.com/articles/en/gun-violence/

 

Congratulations to Erin Barnes. She wrote a great little narrative on physician burnout and how she plans to avoid it! 

 

https://www.statnews.com/2017/04/05/physician-burnout-document-medical-success/

I'm still high from the success of the first Temple Story Slam, which we held Wednesday night at the Five faculty physicians, a resident, a fellow and five medical students each shared a five-minute story with an audience of about 100 fellow students and doctors. As one friend wrote me, “They shared stories of their own doubts, failures, and struggles; they looked inside of themselves and brought out things that were very unexpected and, in fact, exhilarating and surprising,”
Tyler Ranier, a fourth year medical student, won first prize for her story, Tattoo Graveyard, about the death of a young man with 12 gunshot wounds at 2:30 on a February afternoon. Part poetry, part narrative and pure passion, her fresh, raw, heartbreaking look at such a tragedy wowed the audience, which voted her the winner. Here is a link to her story on You Tube,
And one by her classmate Matt Trifan:

To hear an audio of all 12 stories, click here: https://capture.temple.edu:8443/…/0fe9bf7a-04ee-40b8-8afe-5…
To watch the first five on Facebook, click here:

The whole world knows about the burnout associated with medical school and residency and the good news is change is coming. That was the promise delivered at Grand Rounds at Temple University Hospital today by Dr. Jonathan Ripp, an internist at Mount Sinai in New York City. Hospitals and institutions will need to embrace this change because burnout will and does effect the bottom line, patient safety, and patient satisfaction, all three vital to the health of any hospital. There is also the moral imperative, the well being of the doctor. In the ten years he's been studying this issue, the citations have gone form hundreds to thousands. There is great interest and awareness, and he believes the solution is to incorporate changes -- narrative medicine, reflection, mindfulness, discussion, exercise, and many others still being explored -- into the curriculum of medical schools and residency. Don't make it an add-on, but part of daily life. A true culture change. That is the only way to remedy the extensive problem. He says there is even talk and hope of expanding the big three pillars of health care -- improved population health, higher patient satisfaction and lower health care spending -- with a fourth, better physician well-being. The demands on medical students and young doctors are immense. But as Ripp says, the good news is change is coming. 

Here is a story about a man who lost three limbs and still built a beautiful and meaningful life for himself as a hospice physician.  I was struck most by his own challenge to find that balance between serving others and savoring his own life. As he says, “The lessons I get from my patients and their families, and from this work,” Miller said, “is to enjoy this big, huge, mystical, crazy, beautiful, wacky world. And I’m too often not doing that. That can feel distressing to me.”

http://www.nytimes.com/2017/01/03/magazine/one-mans-quest-to-change-the-way-we-die.html?smprod=nytcore-iphone&smid=nytcore-iphone-share&_r=0

 https://medium.com/temples-narrative-medicine-program/habit-of-the-heart-9cdf249e5110#.sgxyuhlk1

This is my latest story about a physician nun, Dr. Jocelyn Edathil. Her faith nourishes and sustains her as a physician, and her love of medicine and science and helping patients is the ideal way for her to put her faith into action. She was brave enough to let me into her life and tell her story.

Interesting story by a physician-writer and journalism professor about the ethics of the patient stories he tells. I am a career journalist, now working in a medical school, so the mission and the rules are changing for me, and how I handle patient stories is evolving as I adapt to my new role. My values and approach remain journalistic. I never make up any facts. I never build in any fiction. I always strive to identify the patient if the patient is willing. I always strive to protect the patient's dignity. As more and more physicians write, there is much room here for a rich discussion.  

http://magazine.hms.harvard.edu/ethics/morality-tales?utm_source=SilverpopMailing&utm_medium=email&utm_campaign=11.30.2016%20(1)

"We kind of take these cases nobody else will take on," the nurse manager told me. "So while we do have to look at the bottom line, it's not always about the bottom line....With him, we took a chance. "  What it takes to make one life better, and the gratitude this patient feels. A slice of life about Miracle Joe.

https://medium.com/temples-narrative-medicine-program/it-takes-heart-temple-gives-miracle-joe-a-new-heart-and-he-spreads-the-love-at-philly-heart-walk-8da3282e3684#.ekio5js32

My Daughters Kitchen cooking program, now in 35 urban schools, comes to medical school, cooking with Temple medical students. This will help these future doctors help their patients. 

 http://www.philly.com/philly/hp/news_top/399573861.html?mobi=true

 

http://www.philly.com/philly/hp/news_top/399573861.html

 

After her great essay was published in the NYT, Dr. Naomi Rosenberg came and spoke to medical students about the experience -- why she wrote her piece. Temple Now did a short story about her visit, and here it is, with a link to the original essay.

https://news.temple.edu/news/2016-09-20/temple-doctor-emotional-side-emergency-room?utm_source=Emma&utm_medium=Email&utm_content=92216&utm_campaign=Temple-Now

 

Here is a story about narrative medicine and what I'm trying to do written by a Temple medical student for a blog: http://www.doctorswhocreate.com/pulitzer-prize-winning-journalist-focuses-on-narrative-medicine/

 

I was a newspaper fund college intern at the virginian-pilot in Norfolk Va in 1978. The folks at the newspaper fund, run by dow jones, tracked me down because they were interested in my new life as director of narrative medicine at the Lewis Katz School of Medicine at Temple Unv. Go to page 4 of the link below to read the story.

http://www.adviserupdate.org/

 

Dr. Naomi Rosenberg, an emergency room physician,  wrote this (link) today for the New York Times. Last spring when I came to Temple, and started building this program in Narrative Medicine, she told me she wanted to write.  She finished her three-year residency on June 30, slept for two weeks, and then went for a week to the Iowa Writers Workshop where she wrote this. The assignment that prompted the piece was, "Tell somebody how to do something you know how to do," and this is what came out.  This piece was terrific from the start, and my only role was recognizing how good it was and suggesting she send it to the Times, where an editor responded to her submission in 42 minutes!  The editor called it "moving and heartbreaking," and you will see for yourself.

http://mobile.nytimes.com/2016/09/04/opinion/sunday/how-to-tell-a-mother-her-child-is-dead.html?_r=1&referer= 

I received a wonderful gift this week, the following letter:

Aloha Michael,

For nearly 20 years, I have kept a copy of your Valentines Day story about Jim and Wynne Way, mostly because I have collected good writing for many years. But I am about to teach a college class in feature writing and I want to tell  you that I plan to start the first class next week by reading the beginning of this story. As a long time journalist, I know how hard it is to find the extraordinary in the ordinary. Reporters often get assignments to find a way to mark what they view as a boring holiday or anniversary and in the process fail to see the beauty of the human spirit. You found that in the Ways and shared it with us. 

Mahalo,

Mike Gordon

Honolulu Star-Advertiser

I loved the story so I included it in my new book, Great Americans. Here it is:

25 TRUE LOVE IS MADE OF THIS

Still crazy about her

And ever near, one man’s daily visit

 

Feb 13, 1998

 Fifty-five years ago, Jim Way went to the library to borrow a book on telescopes.

“I borrowed the librarian instead,”' he says.

 It was London. The war was on. Things happened fast. A few weeks later, she wrote him a note and signed it: ``Yours as long as you wish, Wynne.''

 ``It was the wish that endured,'' he says.

 Tomorrow, as he has done nearly every day for nine years now, Jim Way will drive the five miles to a nursing home to spoon-feed lunch - pureed chicken, spinach and apple sauce - to his beloved librarian, his valentine of 53 years, a woman who hasn't recognized him, and barely uttered a word, in six years.

 His wife is one of two million Americans with Alzheimer's disease.

 Jim, 81, cared for Wynne, 79, for eight years in their Drexel Hill home before moving her to Saunders House, a long-term care facility next to Lankenau Hospital in Wynnewood.

 He only relented when he could no longer lift her out of bed himself, when she'd wander outside in her pajamas the moment he went to the bathroom.

 ``It was impossible,'' he said. ``I had to wash her. I even had to wipe her bottom. I'd put her to bed. Before I was out of the room, she was out of bed, falling over. ''

 He arrives every morning at 11:30. Coming to see his wife is anything but a burden. As he walked in on Wednesday, carrying old, beautiful pictures of Wynne, he explained:

 ``I enjoy coming. I look forward to seeing her. '' He spread the photographs out on a table in the lobby. ``I'm still crazy about her even though she . . . ''

 His voice trailed off.

 For the first four years, Jim never took a day off. He'd come seven days a week, feeding her lunch and dinner. ``We had a really tough time getting him to do anything but this,'' said his son, Geoffrey, who visits with his father here on Monday nights.

 Now Jim will take two weeks off a year, one to return to London, one to visit a warm beach in winter for a few days with his sister and cousin. He also faithfully rides his exercise bike, walks the malls in winter and reads voraciously. And every Thursday now, he spends the day at the Philadelphia Art Museum attending lectures (yesterday's was on Van Eyck) and then lunching with his old colleagues from Wanamakers, where he rose from floor sweeper to merchandise manager, traveling the world buying merchandise, and always taking along his wife.

 On Wednesdays, Wynne gets her hair done in the beauty salon at Saunders House. At noon, Jim greeted his bride. His voice was sweet, soft.

``Hello, Dear . . . Wynnie . . . Wynnie . . . ''

 He pulled her chair into the elevator.

 ``Come on, Sweetie,'' he said. He gently touched her cheeks, then lifted her jaw, trying to get her attention, to let her know he was here.

 This woman whose children insist she could once spell anything and who was so robust she could out-wrestle her oldest son - now a black belt in karate - until he was 15, a woman who always had perfect hair and perfect nails, sat in a geriatric recliner, beneath an afghan blanket, pink slippers on her feet, her blue eyes still soft and clear. Her mouth hung open. Her face was red with a rash, a reaction to a medicine. She looked at her husband, but her expression was as blank as the elevator wall. She was silent.

 The doors opened on the second floor and down the long hall he pushed her, greeting all the nurses and staff, of whom he is so fond.

 ``Every lunch, every dinner, you can kind of set your watch by him,'' said Pam Kamariotis, the registered nurse on the floor. ``He's so dedicated. He will sneak kisses. What he does is incredibly uncommon. Just a really nice thing to see. ''

 Jim pushed the recliner past his wife's room, which he fills with stuffed animals and flowers and photographs of their three children and seven grandchildren, just in case, somewhere inside her diseased brain, she recollects these things that were once so dear and familiar.

 He pushed on to the solarium at the end of the hall to feed her lunch.

 ``This thing gets heavier and heavier,'' he says.

 Jim is a small man, 138 pounds, who suffers from osteoporosis and only this winter - after a bout of shingles impaired his vision - gave up night driving and his dinnertime visits this time of year.

 A tray of food is waiting. He puts a long paper bib over her head that covers her chest and lap. He grabs a handful of napkins. He stands beside her and begins to spoon-feed her at 10 minutes after noon, mixing the chicken with the applesauce and putting a little lemon water ice on the tip of the spoon.

 ``The lemon makes her pucker and helps her swallow,'' he says.

 He spoons it back in as it keeps falling out of her mouth, down her chin, over and over. He spoons it in, scraping it back up her chin, or off her bib, back into her mouth. So gentle and faithful.

 ``Come on, Sweetie. ''

 He kisses her and cuddles her, even when she's covered with glop. He is happy to kiss her. Delighted to have the chance.

 ``Maybe I didn't do enough of it when she was home,'' he says.

 He carries two poems in his wallet, poems about the endurance of love. The final line of the second poem reads: ``over time and grief prevail recollections - all she is. ''

 She starts to choke. He gingerly wipes her mouth. They keep a suction pump in her room now for emergencies, a recent development.

 ``They say the smile is the last thing to go,'' he says. ``We've already decided - no tubes. ''

 After the pureed solids, he cleans her up, carries away the dishes and dirty napkins, and turns to glasses of apple juice and iced tea. He puts on a new bib and, spoon by spoon, feeds her the liquids, both the consistency of honey. Anything thinner or thicker and she will choke.

 At 1:13 he puts down the spoon. One hour and three minutes. He cleans her up again. Kisses and cuddles her.

 Then he sits beside her, quietly, and holds her hand.

 After a few more minutes, he wheels her back to her room, where he leaves her in the recliner. A nursing assistant will change her and put her to bed. He puts on his cap and zips his jacket and heads home to Drexel Hill.

Postscript

 “I am a teacher who is forever searching for present day 'heroes' for my students to learn about,” Chris Detwiler, a 5th grade teacher, wrote after this story appeared. She talked to her pupils about loyalty, love, and the effects of Alzheimer's disease, then 13 fifth-grade students at Walton Farm Elementary School wrote to Jim Way. He responded with thank-you notes to each, leading to a yearlong exchange of letters.

Wynne Way passed away in the spring of 1999, and Jim, who had been healthy, died two months later. That prompted me to research and write another story about the very real phenomenon of dying of a broken heart.