Tag: narrative medicine

The Intima: A Journal of Narrative Medicine

IMG_0678In case you haven’t run across this journal before, I encourage you to check out The Intima: A Journal of Narrative Medicine. It was created by some of the students in  the Narrative Medicine Master’s Program at Columbia University. They state, “…we seek an ongoing mode of self-expression as a group, to continue outside the classroom that which was created within. With that in mind we call ourselves and our efforts The Intima, resonating on the concept that Narrative Medicine defines itself as the intimate interface between two people, one as healer, one as being healed, yet both yielding and both gaining from the experience. (…) The Intima is an electronic journal dedicated to promoting the theory and practice of Narrative Medicine, an interdisciplinary field aiming to enhance health care through the development of effective communication and understanding between caregivers and their patients. By providing an online venue for the expression of personal experience within the medical arena, The Intima creates space for caregivers, professionals, patients, and families to share their narratives in a format that fosters empathy, reflection, and deeper understanding of the diversity inherent in effective delivery of care.”
In their Spring 2014 edition under Fiction, I have an essay “Steps to Footcare” about my work as a faculty preceptor with the University of Washington’s Teeth and Toes Clinics, where we provide basic foot and dental care to Seattle’s homeless population. This particular essay takes as its form the actual list of instructions we give students to follow when providing care. I fictionalized it by creating a composite female character based on several ‘real’ patients.

Green Beyond Death

indexThis is a shout-out to the work of a former nursing student of mine, Hunter Marshall. He is now a hospice nurse, as well as an environmental and death with dignity advocate, community activist–and a  talented writer! Check out his recent article “Dying to give back to the earth” in Waging Nonviolence (3-3-14).

Hunter told me that he is actively pursuing writing as a mechanism for continuing his patient/policy advocacy: “I particularly enjoy using narratives about individuals that intersect with larger policy issues.” Another rebellious nurse (and writer) in the younger generation warms the cockles of my older nurse/writer heart!

The Ultimate Writing Prompt

English: Golden Gate Bridge and San Francisco ...
English: Golden Gate Bridge and San Francisco at sunset (Photo credit: Wikipedia)

Yesterday we wrapped up the student-led group presentations in our narrative medicine course. There were eight in total over a period of four weeks. As I mentioned before, I chose the eight topics: aging, cancer, death/dying, disability, drug addiction, infectious disease, mental illness, and racism. During our first class session students signed up for one of the eight topics. My instructions for the group projects were as follows: each group will do a class presentation on their topic for 45 minutes. For your presentation please include a one page (front/back) handout that includes your main references on the topic as well as two in-class writing prompts. The group project/presentation was worth 40% of their final grade. I referred them to the excellent website/resource NYU Literature, Arts, and Medicine Database as a starting point for resources, but asked them to expand upon this, bringing in different arts and literature examples they found particularly helpful.

There are two things I would do differently with the group presentations the next time I teach this narrative medicine course. One is that I would set some parameters around the main focus of their presentations. All eight groups used PPT for their presentations, but more than a few had many ‘busy’ PPT slides with statistics on the ‘dis-ease’ topic of the day–stats such as prevalence of suicide. And their writing prompts reflected this clinical gaze, for instance showing a video clip of a person about to commit suicide by jumping off the Golden Gate Bridge; their writing prompt being “How would you feel if you were on that bridge with them, and what would you say to them?” Which leads to the second thing I’d change in the course, and that would be to find a way to help guide the groups in writing good writing prompts. I wouldn’t want to be too controlling with it, but I would want to help students develop more artful/less clinical writing prompt and response skills. For instance, for the above student-generated writing prompt I’d suggest changing it to, “Write about a time you worked with a patient who was in despair.” But I mostly resisted the temptation to step in during class and refine the student’s writing prompts.

Writing good writing prompts is a more advanced skill and one that only comes from lots of trial and error. I don’t know of any specific guides or sources of narrative medicine-type writing prompts, but here are two books I turn to when I’m stuck for ideas. The main one is Kim Addonizio and Dorianne Laux‘s The Poet’s Companion: A Guide to the Pleasures of Writing Poetry (WW Norton & Company, 1997). For instance, at the end of their chapter “Images” they have this excellent writing prompt: “Describe a pair of shoes in such a way that a reader will think of death. Do not mention death in the poem.” (Perhaps Joan Didion used this writing prompt for the powerful shoe portions of her book The Year of Magical Thinking). A second resource is Susan Zimmerman’s Writing to Heal the Soul: Transforming Grief and Loss Through Writing (Three Rivers Press, 2002). A prompt she includes in the chapter “Experiencing Death” is a common but still effective writing prompt: “Write about your own first experience of death, the awakening to the fact of death’s reality.” My students used this one in their presentation on death/dying. It was an effective prompt based on the quality of student writing.

For the ultimate writing prompt–one that I haven’t used in class but plan to try out is “Write your own obituary.” A twist on this one is included in Brenda Miller and Suzanne Paola‘s Tell It Slant: Writing and Shaping Creative Nonfiction (McGraw Hill, 2005–second edition 2013). In their chapter “Last Words” they include the writing prompt: “What are your ‘last words’? What would you write if you knew your time was up?” There’s a recent example of a Seattle-area writer who wrote her own obituary, which her family paid to be published in the Seattle Times on July 28th. It was written by Jane Lotter, age 60, who died at her home on July 18th from uterine cancer–under our state’s Death with Dignity Act. Michael Winerip wrote about it for the NYT “Dying with Dignity and the Final Word on Her Life” (Aug 5, 2013).

A Place To Stop

 

Stop
Stop (Photo credit: Swamibu)

 

In our narrative medicine course we have moved into group presentations. On the first day of the quarter I had students sign up to be in one of eight groups to work on group projects and to do a group in-class presentation. I picked eight topics, using the list of topics (keywords) from NYU’s Literature, Arts, and Medicine
database as a guide. The eight topics I chose this summer were: Aging, cancer, death/dying, disability, drug addiction, infectious disease, mental illness, and racism. The group assignment was to research and expand upon the topic resources listed in the NYU database—to approach this as if they were doing an in-service training on the topic at their work site. I asked them to produce a one-page (front and back) handout of their favorite resources, along with two to four possible in-class writing prompts and reflective questions. Each group was given 45 minutes to present on their topic and to lead the class in discussion and reflective writing. (Note: our class sessions are four hours long, although we don’t typically go quite that long).

This past week the first two groups did their presentations (on aging and cancer) and both did an excellent job. The groups used an interactive PPT presentation, weaving in poetry, prose, artwork, comic books, YouTube videos, and movie clips. I was impressed by the range and depth of their presentations and class discussions, as well as their application of the close read drill adapted from Dr. Rita Charon’s work. Group members also shared some of their personal stories related to their health topic and did this in a moving but professional way.

 

When I was planning this narrative medicine summer course, I was resistant to the idea of building in group projects. As a student I always preferred to have individual assignments since I could then control the time commitment and the outcome. I knew that the majority of my students in this course would be busy with their nursing jobs and families as well as with school. But a colleague convinced me to use group projects, saying the students were used to them and that what they came up with was typically of high quality. I have purposefully allowed time at the end of each class session for students to meet in their groups for planning purposes and I stay around to answer any questions that may arise. Some groups have also set up online discussion boards on our course website to facilitate their group planning. (In my mind, this is the only really useful function of online discussion boards.) That seems to have worked well for them so they don’t have to meet in person outside of class.

 

Two things particularly struck me from the in-class presentations and discussions. One was the number of students who had personal experience with either a close friend or family member or a patient who was given a diagnosis of a serious cancer over the phone or in a voicemail message. We talked about how insensitive that is and what nurses can do to influence physicians, nurse practitioners, and other healthcare providers to think through how to give bad news in a more supportive way. The other thing that stood out to me in the class discussion was a comment a student made that this narrative medicine class is “A place to stop and to process these things we don’t get to process.” Other students said they agreed with what she said and talked about how nurses are so much into the care giving role, not only at work but also in their personal lives, that having a time and space to stop and reflect on how it is affecting them is a powerful thing.

 

Ah yes. There were really three things that struck me during last week’s class session. The third was that this is all heavy stuff to process and write about and how much environmental context matters—as in the actual physical classroom setting. We have a nice smallish amphitheater classroom with excellent acoustics, state-of-the-art audiovisual equipment that is easy to use, reasonably comfortable chairs and tables, and a full bank of windows looking out over a grassy marsh full of birds. I’d forgotten what a pleasure it is to teach in a classroom with windows. It also helps that it is one of the loveliest summers in Seattle’s history. Teaching this narrative medicine course in a windowless classroom in the middle of a Seattle winter would have a much different feel.

 

 

Of Poems, Hearts, and Hands

hand.
hand. (Photo credit: bambola_world)

Last week in my narrative medicine course I had two local authors come to class to read some of their writing and lead class discussions. The first guest speaker was Suzanne Edison, a poet and psychotherapist. She also leads Seattle-area workshops
on therapeutic poetry writing with parents of children with chronic illness, as well as with adolescents with chronic illness—at Seattle Children’s Hospital
and at Odessa Brown Children’s Clinic. Suzanne read poems from her two poetry chapbooks Tattooed With Flowers (2009) and What Cannot Be Swallowed (2012).  In our first class session this quarter we had done a close reading of her powerful poem “Teeter Totter.” Students had questions about some of the metaphors and lines in her poem, so last week they were able to ask Suzanne about them directly. (“Teeter Totter” also appeared in Ars Medica, Fall 2009).

Suzanne led the class in a poetry-writing session that she has developed. First, she asked students to write about a time they had an interpersonal conflict of some sort. Then they went through their prose piece and circled four to five words that stood out to them. Suzanne had them do some other tasks in order to come up with an expanded list of words (a dozen or so). Finally, Suzanne asked them to write a poem (in any form) using all of their words. Several students wanted to share part of or the entire poem they had written, and one student commented on how powerful it was to ‘get it out there.’ Students pointed out that reliving the stressful, difficult interpersonal interactions through the poetry exercise brought on stress responses (sweaty palms or changes in heartbeat and breathing), but that writing the actual poem gave them some distance from it and left them feeling more peaceful. Suzanne explained that the poem is a way to create a container for these powerful memories and emotions. One student wrote of this
as “framing the event in the bubble of a poem.”

I prefaced this poetry-writing exercise by letting the students know that what
they wrote was for their eyes only—that I would not ask them to turn in this
writing to me. Suzanne and I had incorporated the same writing exercise last
fall in my undergraduate community health course, when I did ask students to turn in their poems to me. I got feedback from some students that they found this to be intrusive into their personal lives when they didn’t really know me. Duly noted, and very true since it was a class of 150 students (vs. 40 students in the narrative medicine course). So this time around I set the parameters upfront that they wouldn’t have to share their poems with me. Instead, the first writing prompt I gave them for in-class writing was to share a fragment of their poem, or a key word, and to reflect on what surprised them most about what came out of the poetry exercise. This seemed to work out much better. It probably also helped that this class is specifically on narrative medicine, and students expect to do more creative and personal writing in it than they typically do in a more traditional nursing course.

The second guest author was Mary Oak, author of Heart’s Oratorio: One Woman’s Journey Through Love, Death and Modern Medicine (Goldenstone Press, 2013). (see my previous post/book review “Heart’s Oratorio” from 3-24-13). She read passages from her book and answered student questions. As one of the selections she read was about her stay in the ICU and how disorienting it was, students had questions for her about this. They also asked her what motivated her to write the book and about her development as a writer. Since Mary writes about her genetic heart condition and is a mother, students also asked what the ramifications are for her children, and what that feels like now that’s she’s lived through serious cardiac complications. Much of Mary’s book is set in Seattle and she mentions specific hospitals (Northwest Hospital and University
of Washington Medical Center) and some medical personnel by name. This led to an interesting class discussion on the ethics and legalities of nonfiction medical-related writing. Several students mentioned recent ‘compliance trainings’ they’ve had to go through in their jobs as RNs in Seattle-area hospitals, where the message was that ‘they could never ever write about their work in any context whatsoever!’ They were concerned since they were asked to write about their work for class assignments (like for my course). We reviewed the basic parameters on this for academic writing: 1) no patient identifiers such as name, age, super-rare medical condition, etc.; and, 2) no specific names of providers, hospitals, clinics, care facilities—although I acknowledged this can lead to strange permutations, such as “a large Level-I Trauma Center in the Seattle area” (there is only one Level-1 trauma center in Washington State—in fact within a four state radius—and that would be Harborview Medical Center). And then I briefly discussed various legal and ethical parameters as designated by specific journals, differentiating what I was asking them to write about versus writing for publication. I got on my soapbox briefly to rant about how hospital administrators try hard to intimidate nurses (and others even lower in the food-chain) into not writing about their work—but the intimidation is real and nurses can and do lose their jobs over this stuff—and it is easy for me to rant from the relative security of my tenured academic soapbox.

Back off my soapbox, Mary read them a lovely poem by a nurse poet friend of hers, Lise Kunkel, who works in hospice nursing in New York State. The poem had to do with her hands while caring for a hospice patient. So for my last writing prompt I had students think of a significant patient-nurse interaction they had had and to write it from the perspective of their hands: Tell the story your hands could tell. Since I was really stuck back on my soapbox and hadn’t thought through the specific writing prompts I wanted to use for that class session, this one was completely made-up on the spot. I had no idea what students would do with it until I read through their writing this week.

Wow—just wow! That prompt worked, as nurses most definitely identify and
communicate with their hands. Some students wrote from the perspective of their hands: the punishing abuse from the frequent application of hand sanitizer; the uncertainty of where to place their hands during certain patient-nurse or healthcare team interactions; the patient assessment of skin warmth or clamminess or bulges where there shouldn’t be bulges—and, as one student stated, providing “a loving touch, not a medical touch.”

Addendum: I received an e-mail from hospice nurse Lise Kunkel with a link to one of her published poems, “Reading Aloud to Dad (for Jiggs)” in Oncology Times, 3-10-09, vol 31(5),p. 34. She also told me the name of the poem that Mary Oak read to my class last week: “The Hands of a Hospice Nurse.” She uses some of her poems in trainings she does for hospice volunteers through the Care for the Dying Cooperative in NY State. Lucky volunteers and lucky patients….

Close Reading Drill Simplified

This past week in the Narrative Medicine course I am teaching, I introduced students to the approach to close reading (she refers to it as a drill) as taught by Dr. Rita Charon and her colleagues at Columbia  University’s Program in Narrative Medicine. I then had students apply this to do their own close reading of JD Salinger’s short story “To Esme, With Love and Squalor.”

As a way of introducing them to close reading I had them read Rita Charon’s chapter “Close Reading” in her book Narrative Medicine: Honoring the Stories of Illness (Oxford University Press, 2006). This is a weighty chapter in a weighty book and I have discovered that many of my students were simply overwhelmed by it. So here is my streamlined version of ‘doing’ a close reading drill as applied to narrative medicine. I present the elements of close reading in the order I like to do them myself because it is more the way I read and analyze what I read.

1.     Desire (Dr. Charon’s term). What appetite or emotion is satisfied by reading this? What bodily sensations do you have while reading this? What intellectual or emotional desires arise? Put more simply: what is the overall feeling you have when reading this? (A related and interesting question would be: And what does this reveal about you as the reader?)

2.     Frame. What’s included and what’s left out of this narrative? Where did this first appear—what was the intended audience of the work? For instance, Salinger’s short story first appeared in the New Yorker in 1950. What can we surmise about his intended audience?

3.     Temporal scaffolding. How is time handled in the narrative?

4.     Form. Structure, genre, narrator, use of metaphor, allusion (especially what other works are referred to either explicitly or implicitly?), and diction

5.     Plot. What happened.

Dr. Charon makes the case that learning the skills of close reading as applied to narratives, whether written or in plays, movies, etc, can help health care providers learn to be more attuned to the illness narratives of their patients. Careful reading, careful listening, it makes sense at some level and I am teaching that to my students. Salinger’s short story that I had them read and analyze through close reading is a complex but engaging piece of writing. It has enough content about the health effects of war—PTSD especially—that nurses and others in the health professions find it interesting. Salinger’s use of frame, time, diction, and metaphor are exquisite. So this short story makes for a good—but sufficiently challenging—narrative on which to practice close reading. I found that most students did well with this assignment and really dug in. Since class this past week fell on July 4th, this was an individual take-home assignment, so I have not yet had the opportunity to discuss it with them in class.

I always have these nagging questions in the back of my mind: Does close reading detract from the pleasure of reading? And by extension, does ‘close reading’ a patient’s illness narrative detract from the pleasure of the patient-provider interaction? Do we start thinking about patients less as people and more as stories to be analyzed, stories to be recorded in our heads and then later used as material for our own written stories? Does that start to distance us from our patients? Is it like walking up a familiar flight of stairs—pleasantly distracted—then thinking about walking up the stairs and by paying attention to it, tripping? If writers consciously try to pay attention to the craft of writing, does the art of their writing suffer?

I’ve been re-reading one of my favorite books, David Ulin’s The Lost Art of Reading: Why Books Matter in a Distracted Time (Sasquatch Books, 2010). He raises these questions as well—for writers and readers in general. He states, “(…) I recognize this as one of the fallacies of teaching literature in the classroom, the need to seek a reckoning with everything, to imagine a framework, a rubric, in which each little piece makes sense. (…) leaving us with scansion, annotation, all that sound and fury, a buzz of explication that obscures the elusive heartbeat of a book.”

If I used this class assignment again I would add the personal reflection writing prompt: Write about a time when you were so overwhelmed by emotions that you had difficulty communicating—or write about a time when you were caring for a patient experiencing this.

 

 

A Patient Named Noname

IMG_0787I once had a patient named Noname. She was a thin wisp of a young woman who came to the community health clinic where I worked as a nurse practitioner. This was back in the late 1990’s soon after I had moved to Seattle from the East Coast. I was still having a bit of culture shock, getting acclimated to Seattle’s rain, tree-huggers, and serial killers. When I first met Noname I was dating a man who was a tree-hugger but thankfully was not a serial killer. He was way into natural food and meditation, so I had Namaste continually playing in my head like an annoying Bee Gees song. So when I looked at the new patient name ‘Noname’ on the patient chart and entered the exam room, I greeted her as Noname, pronouncing it as if she were a cousin of Namaste. She laughed nervously and corrected me: her name was no name. As in she didn’t want to give her real name, so it was just a placeholder of sorts. It wasn’t as if she was in clinic that day for any sort of health complaint that would make her concerned for her privacy. I never did get the story of her name, of her no name.

I remembered Noname this past week as I began teaching an eight-week Narrative Medicine course at the University of Washington, Bothell. I have close to 45 wonderfully smart and creative nursing students, all in their BSN-completion program. That means they all have their RN either from diploma or community college programs and are back to take the courses necessary for their BSN. They are all working full or part-time as nurses so they have a lot of ‘real life’ experience to draw upon.For the first in-class writing prompt I used one of my favorites learned from Dr. Rita Charon and her colleagues at Columbia University’s Program in Narrative Medicine: Write the story of your name. Everyone has rich stories to tell about their names—including the patient named Noname. I find this writing prompt to be an excellent starter prompt, as well as a way of allowing people to introduce themselves in a unique way. Of course, with 45 people in class we didn’t have time for everyone to read their stories out loud, but I have had the privilege of reading all of them and it helps me to get to know the class. I pointed out that this writing prompt can even be used effectively with patients. For instance, I’ve found that it is so much better to ask a patient (with a strange to me name), “Can you tell me the story of your name?” versus the usual “What country are you from?”

After presenting them with some basics of Narrative Medicine—what it is, where it came from, Dr. Charon’s approach to close reading—we practiced close reading together using a variety of short pieces of poetry and prose and film clips. The poetry I used was from Cortney Davis (I Want to Work in a Hospital), Raymond Carver (What the Doctor Said), Rachel Haddad (Stereotactic Biopsy), and Suzanne Edison (Teeter Totter). For the film narrative/close reading I showed them clips from the movie Magnolia (1999)—specifically two clips that are available on YouTube. One clip is the regret deathbed soliloquy by Earl Partridge (played to perfection by Jason Robards), and the second clip is of the male hospice nurse (played also to perfection by Philip Seymour Hoffman) on the phone trying to track down Earl’s estranged son (played—OK—also to perfection—by Tom Cruise). I love these two clips because they portray hospice care and hospice nursing so truthfully. They lent themselves to some rich class discussion and close reading skill building.

For the last in-class close reading and writing exercise I turned to writing by one of my favorite local authors, Judith Kitchen (Distance and Direction/ Coffee House Press, 2001); Half in Shade: Family, Photography, and Fate/ Coffee House Press, 2013). I used her sample short essay F-Stop, which is surprisingly complex for such a short prose piece (available on her website). We first did a close reading of this essay. Then I showed them a photograph of a man reading to three small children around a campfire. I asked them to write the story of this photograph—to just make one up—thus pushing (or pulling?) them into the realm of fiction writing. I could tell that many of the students struggled more with this writing prompt. Some told me they had never been asked to write fiction before in nursing school. But they persevered and came up with some wonderfully rich stories.

I’ll be writing a series of posts over the next seven weeks of this Narrative
Medicine (for nursing) course. Since Narrative Medicine isn’t ‘done’ very much in nursing schools—and I think it should be—my hope is to share my experiences with others who may adapt it for their own teaching.

Cornbread Therapy and Sweet Survival

James W. Borton has edited an anthology entitled The Art of Medicine in artofmedicineMetaphor: A Collection of Poems and Narratives (Copernicus Healthcare, 2012). At 156 pages and including 78 poems and short nonfiction essays, the anthology will be available for purchase ($14.95) at the end of January 2013 from both Amazon and Ingram Books.

I met James Borton in 2011 at the University of Iowa’s Examined Life Conference: Writing, Humanities and the Art of Medicine. Mr. Borton is a career journalist who teaches English at University of South Carolina/Sumter Campus. A year or so prior to our meeting, Mr. Borton survived a major complication of heart bypass surgery that left him in a coma for close to a week. After his own life-threatening illness, he turned to the healing power of writing. He maintains a blog All Heart Matters and teaches courses and workshops on Narrative Medicine. His anthology includes the work of a diverse group of people—doctors, nurses, other healthcare professionals, patients, family members—who have taken his workshops or courses in South Carolina. With only a few exceptions this is an anthology of work by non-professional writers—which I consider to be one of the book’s greatest strengths. It makes the anthology fresh and highly accessible to a broad audience.

I’ve read the entire anthology twice over the past several days and have enjoyed it. Each time I read any of the entries I am transported back to my Southern roots. There are the frequent religious references to angels and prayer (this is the buckle of the Bible Belt after all), mixed in with mentions of Mississippi Mud Pie, cornbread, chopping cotton, fixing trucks, and reading Southern Living magazines in chemotherapy waiting rooms. There’s a lovely essay “Learning to Breathe” by Patricia Dale about her psychiatric hospitalization experience. Sam Watson’s poem “Another Reason to be Pleasant” should be required reading for anyone working in the OR or pre or post-op. Mailaika Favorite’s poem “Snake” has changed my relationship with my spinal cord and vertebrae. Selena Larkin’s poem “Sweet Survival” about living with diabetes, and Jennifer Bartell’s essay “Cornbread Therapy” about her chemotherapy experience, both conjure up the scrappy, witty and warm Southern women I know well. And finally, Debra McQueen’s two essays, “The Roundup” and “Alternative Medicine” are beautifully written and are ones I can see myself using in my teaching. So ring in the New Year by eating black-eyed peas with ham hocks and placing this book on your ‘to read’ list.

As usual, Arthur Frank says it well in his endorsement of The Art of Medicine in Metaphor:

“This anthology will be of particular use to people who want to write about illness and healthcare but are having trouble getting started. These poems and short stories show how writing teaches observation, observation precipitates understanding, and understanding can be a form of healing.”

—Arthur W. Frank, author of The Wounded Storyteller: Body, Illness, and Ethics (expanded edition forthcoming, 2013)

Where to Get Your Words Out

American Journal of Nursing
American Journal of Nursing (Photo credit: random letters)

Here are some specific resources for where to get published. This is primarily intended for writers of personal essays, short stories and poems dealing with health and health care-related issues. I’ve geared the list towards nurses, but all of the journals included here accept writing from any type of health care provider, as well as from patients and family members.

Remember to do your homework before submitting to any of these journals or blogs: follow their current submission guidelines and read their published content to make sure it is a good fit for your work.

Good general all-around resources for writing and publishing:

  • Duotrope. They have recently added a nonfiction category to their excellent searchable database of literary journals and magazines, as well as information on small presses open to book manuscript submissions.

Good resource for almost all things related to medical humanities (intersection of medicine/healthcare and creative work):

Journals:

  • American Journal of Nursing. I’ve linked to their editorial manager page that has information for potential authors. Check out their Art of Nursing, Viewpoint, and Reflections sections as these are the ones accepting more creative types of writing. (They also pay a $150 honorarium for each published piece!).
  • Bellevue Literary Review/NYC Langone Medical Center. Excellent print publication. Highly selective and they can take up to six months to review a submission, so I don’t recommend them for first-time authors. But I highly recommend the journal for reading good narrative medicine type writing. They also have really cool archived historical photos from Bellevue Hospital, the oldest continuously running hospital in the U.S. (although Hurricane Sandy seriously affected their buildings and operation).
  • Creative Nonfiction. This print journal is highly selective, only includes creative/narrative nonfiction, and is not primarily geared towards health-related writing. But the editor, Lee Gutkind, has his heart in medical narratives.
  • Pulse: Voices from the Heart of Medicine. “An online magazine that uses stories and poems from patients and health care professionals to talk honestly about giving and receiving medical care.” You can sign up to get a weekly short essay (800 word limit) or poem (they currently are closed to poetry submissions as they have too many to review).
  • The Examined Life Journal/University of Iowa Carver College of Medicine. A relatively new (now biannual) print journal from the medical school linked with the most prestigious writing school in the country. This is where Abraham Verghese honed his writing skills. They have a new annual writing contest/deadline is January 10, 2013.

Blogs can be a good place to get started as a writer. Consider submitting to an existing group blog to have your work included as a guest blogger. An excellent one is HealthCetera at the Center for Health Media and Policy at Hunter College. Joy Jacobson, MFA (health care journalist and poet) and James Stubenrauch, MFA (writer and editor) are both Senior Fellows at the Center for Health Media and Policy, Hunter College School of Nursing. They both have worked as editors for the American Journal of Nursing. I ‘spoke’ with them via e-mail this past week and they wanted me to encourage my students (and other nurses) to consider submitting a guest blog post.

So no excuses! Get your words out and get them published.