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Creative Reflections

Medical students in the Carver College of Medicine have a unique perspective on the current pandemic. Participants in the Sub-Internship in Internal Medicine course last month were given the opportunity to reflect on their thoughts and feelings about COVID-19 and express them in whatever form they chose.


 

Brooke Jennings - illustration.

Reflection: I drew this picture to highlight the new challenges we face with patient connection during the COVID-19 pandemic. While I can’t overemphasize enough how important it is to keep safe and wear our PPE, it has also changed our interactions with our patients. One of my favorite aspects of healthcare is providing compassionate care and connecting with my patients. While I know that these PPE measures are necessary to protect everyone, at times they feel like barriers between me and my patients. Sometimes I find myself wondering, can my patient tell that I care? Do my words feel genuine? I continue to work every day to adapt my nonverbal communication skills with different techniques and more verbal communication. At the same time, I also wonder when I see a patient or their family member with a mask on, are they really okay? Are they understanding what’s going on? I miss being able to see their faces, gauge their reactions. I dream of a day where it will be safe to be face to face with my patients and their families and appreciate a moment of silence together. Sometimes a moment of silence and a look of compassion means more than you can put into words.


Dhruv Kothari wrote a poem describing his work with patients and his team, along with a written reflection.

Lens

Patients
Rounding
Let's get it
Done

Patience
Gone with-
In this rush

Sleeping
Is all I'm
Dreaming of

Stressing
About not
Knowing
Enough

--Flip--

A person
A father
A mother
A son

A person
An ocean
A cany-
-On

A journey
Not a
Presenta-
tion

Forces
Colliding
Let's laugh as
One

Bleary
Sunken
Let's heal as
One

Reflection:

This poem is a reflection on my experiences of both working with the team and interacting with my patients. As a medical student, so much of pre-rounding and getting my presentation ready for rounds felt like a rush. Writing down all the vitals, labs, imaging results and thinking of an assessment and plan for each patient I was responsible for felt more an exercise to show my team that I am capable than a real patient connection.

PDF iconRead the rest.


Mahek Shahid - poem.

We come shuffling in,
The assembly line forms,
“Stay the course, working with hepatology”
Your eyes dart back to the tv screen
“Have a good day patient 18.”

As the assembly lines marches out,
One by one,
I see the pictures you hung up
Of your son
I notice the drawings in the other corner,
The only colorful thing in the room.

We come shuffling in,
The assembly line forms,
“Stay the course, walk with PT”
Your eyes gaze off toward the window,
Have a good day patient 18.

I sense the words at the tip of your tongue
Yet they do not escape,
I watch your eyes fill with despair
Maybe you’ll wait another day.

We come shuffling in,
The assembly line forms,
“Stay the course, continue to eat”
The assembly starts to fold in, ready for departure
“That’s it? This is torture!
I can’t just sit here all day,
Everything changes and only I remain
What did the transplant committee say?”

The assembly looks left and right,
Unable to comment as they haven’t a clue
“They haven’t gotten back to us yet,
But you’re the first person we’ll tell when they do.”

We come shuffling in,
The assembly line forms,
“Stay the course, we are working with the transplant team.”
Your eyes regress back to the tv screen,
“Have a good day patient 18.”


Anonymous

Reflection: In terms of COVID experiences, I think mine is unique.  We have many shared experiences of COVID as medical students, but I experienced COVID in different ways over the past year and thus would like to share my story from different viewpoints, besides that of a medical student.

Employee:  I remember hearing of vague whispers of a new virus, one with a high mortality rate, one that was not controlled, one that China was denying.  I was a pathology extern on Transfusion Medicine at the time, spending day-to-day with patients and afternoons with my resident, an intern; writing notes, making plans, and discussing life, we lived blissfully unaware of what was to come. We laughed about the ridiculousness of the virus, and he made plans to visit his family in the middle east in the coming months.

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Sawyer Kieffer wrote a haiku inspired by a patient.

I don’t want to die

Before a nice root beer float

Not here, not like this

Reflection: This Haiku was inspired by one of my patients - a 74 year old veteran who was admitted for failure to thrive in the setting of newly diagnosed stage IV small cell lung cancer. I’ve spent the last 10 days with this man and have gotten to know him well. He’s my favorite patient (are we allowed to have favorites?). He’s funny, quirky, insightful and a tremendously positive person. This poem was inspired by a conversation I had with him one morning before rounds. Despite having been impressively stoical about his circumstances he admitted to me that he had felt really afraid for the first time last night. He told me this: he said,”I realized I was afraid, and I said to myself, ‘Why are you afraid of dying, Frank? You know none of us are supposed to be here forever’. And I realized - I’m not afraid of dying. I’m afraid of dying here, like this, without ever again tasting a nice root beer float”.

I thought this was brilliant and powerful. In just a few sentences he showed me so much about who he is and what his goals are. Sometimes life is about the simple things and enjoying what we have while we have it. I was able to get root beer float supplies and we enjoyed one together before he started chemotherapy a few days later. I’ve learned that, although not all problems are fixable, victory comes in many forms. Curing cancer may be difficult but making a rootbeer float is easy.


Jennifer Poncelet reflects on working with veterans.

Reflection: My medicine sub-I experience was at the VA medical center. The flag represents working at the VA with veterans, and the silhouette is of a patient that could be any veteran. I drew the silhouette in the background to represent how veterans’ experiences serving have influenced their health and life experiences. The silhouette is a shadow behind the American flag for this reason. Some of my patients shared stories with me from their lives and some about their time serving. I could hear in their voices the passion and emotions they had decades ago that are still within them. I incorporated EKG rhythm strips within the flag to represent healthcare and the intertwining of veteran’s health with their passion and service in the armed forces. Although many of my patients shared some of the same diagnoses, some had unique mental and/or physical health challenges associated with their time in the armed forces, and each veteran was affected uniquely by these challenges.


Gabriel Conley - poem and reflection.

Another life ending, another family tragedy
Six days in a row can test your sanity
From being taught to heal, to being sought to feel
The pain of all these families
They need to know it’s okay
That palliation is the way
When body and mind and health all give way
To endless time, and a peaceful lay.

We’re great at aiding the young and the recently well,
charging disease like the Americans at Normandy
But are we so great at recognizing,
when continued life brings only suffering?

Reflection: This little poem reflects a sizable portion of my time spent during in-patient medicine in Iowa City this month. It seemed that 10% or more of our newly admitted patients entered palliative-focused care plans during their hospitalizations, which simply meant that my team and I became ever more exposed to the death of our patients and the heavy emotions of their loved ones. It can be extremely rewarding to help families think about how best we can serve their loved ones, and what’s truly the most important goals at these junctures. It is an honor to spend time with families as they grieve for their loved ones, but these occasions are always sobering. On one day, I arranged and attended three separate family meetings for the three patients I was handling. All these patients and their families ended up choosing hospice cares going forward. A sobering honor.