First Story Slam at Temple Hospital and school of medicine

I'm still high from the success of the first Temple Story Slam, which we held Wednesday night at the Lewis Katz School of Medicine at Temple University 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:…/0fe9bf7a-04ee-40b8-8afe-5…
To watch the first five on Facebook, click here:…/657025167838610/…


resident and medical student burnout

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. 

great profile

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.”

whose story is it?

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.

Nowhere Man to Tin Man to New Man -- the many meanings of heart

"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.

Dr. Rosenberg comes to speak!

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.



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.


An amazing and powerful piece of writing by a Temple ER doc

Dr. Naomi Rosenberg

Dr. Naomi Rosenberg

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. 

A gift

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. 


Mike Gordon

Honolulu Star-Advertiser

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


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.


 “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.


People, not patients

Joe miller and his cases for scrap

Joe miller and his cases for scrap

I am always interested in the people I meet on the streets around Temple University Hospital and the Lewis Katz School of Medicine. I caught up to Joe Miller, 60, on Erie Avenue, just as he was steadying this load on his bike. Joe cruises the streets looking for things he can sell as scrap metal. He said he found these empty aluminum cases in the trash outside Temple University’s music school, and was on his way to sell them down on Hunting Park Avenue. “I guess the old horns don’t work,” he said. Cruising for scrap is only one way he makes a living, he says. “I do a lot of painting, and cut a little hair,” he adds. I watched him mount up and start pedaling. After a wobbly start on a very wide sidewalk, he steadied himself and headed west.

A mother calls...and reminds me of the power of stories!

This morning, I made a presentation to the chiefs and chairs at Temple University Hospital, trying to explain to them what I hope to do as director of narrative medicine, the culture of stories I hope to create at Temple Hospital and the Lewis Katz School of Medicine.

Maybe I should have just told them the story of Nellie.  What better way to convey the power of stories to heal, to lift people up, to provide dignity to even the frailest among us.

I got a call this morning from her mother, telling me Nellie had died peacefully.

Years ago, for the Inquirer, I wrote a long profile of the Rev. Elinor S. Greene _ Nellie to all who knew her. Nellie was like Katharine Hepburn in The Philadelphia Story. She lived in Chestnut Hill, attending boarding school, was beautiful and full of life and beloved with a million suitors, with a radiant smile and lively mind and irrepressible spirit and generous heart.  She earned letters in five varsity sports in high school and was president of the service club and sang like an angel.  On her way to Hampshire College in the 70s, she had been to a dance the night before, was asleep in the back seat, and her mother, attempting to change lanes on the highway, suddenly changed her mind, swerved back, and lost control of the car. Nellie at 18 was thrown. She suffered extensive brain damage, ruptured both lungs and her heart stopped twice on the operating table. But she not only survived, she persevered. After three years of rehabilitation, she went back to Hampshire College and graduated in four years, and then attended Yale Divinity School, where she was ordained a deacon.

Serving God became her salvation, changing her life from one of misery to one of joy. But over the years, her physical abilities continued to deteriorate, and her body became a tomb to her irrepressible mind.  As the years went by, she lost her speech, and her ability to walk or even stand, or swallow. She was too weak to blow out a candle, and was utterly dependent on others. She lived in a nursing home room at Cathedral Village. I met Nellie one day in 2004 at the Rocky Steps of the Philly Museum of Art, while working with Tom Gralish, who took this photo, on our book, Rocky Stories. Friends had brought Nellie there, in her wheel chair, for her to pose for her annual Christmas card photo.  “Rocky wishes he could have had the strength, the inner strength, of Nellie Greene,” said one of her companions.

I included Nellie in our Rocky book, but I wanted to write a longer story, a profile, and did in 2007. I will never forget watching Nellie in that nursing home room type a sermon. Her vision was blurry and her hand would shake horribly. With an impossibly shaky index finger she’d move slowly across the keyboard to strike a key, but invariably she’d strike the wrong one, and then slowly move that shaky hand back across the keyboard to hit backspace, and try again. It would literally take her four or five tries to strike the right letter _ letter after letter. It would take her five weeks, a grueling, exhausting marathon, to type 2000 words.  But it was through these sermons that her clever mind and soaring spirit could connect with the outside world. A parishioner would read them to the congregation on Sunday mornings.

Gradually Nellie declined further, and became entirely a prisoner in her own body, unable to communicate at all. And to those who didn’t know her, a stranger, and worse, someone without a story.

Nellie’s mother this morning left me this voicemail:

“Nellie died last night. Peacefully. You know, your article in the paper has done so much good for her because we pinned it up in her bathroom, and the nurses could know what she had done. Because you see they had no idea what Nellie had done or anything.”

Here is a link to my story on Nellie from years ago, and below that a link to my stories so far at Temple.

A great surprise!

I recently wrote the story linked below at Temple University Hospital about a young mother who couldn't afford a car seat. The other day, I got this email from the neonatologist:

"When I came to work today, I found an envelope from a lawyer in the my mail box (yes, I thought that I was being sued).  Instead, there was a check inside it for $10,000 ...from a trust for car seats and other items for the Infant Intensive Care Unit.  It was a complete surprise....


A great surprise!

I recently wrote the story linked below at Temple University Hospital about a young mother who couldn't afford a car seat. The other day, I got this email from the neonatologist:

"When I came to work today, I found an envelope from a lawyer in the my mail box (yes, I thought that I was being sued).  Instead, there was a check inside it for $10,000 ...from a trust for car seats and other items for the Infant Intensive Care Unit.  It was a complete surprise....


A jewel in many ways

Maryanne Wurst holds up her heart-shaped stone

Maryanne Wurst holds up her heart-shaped stone

Maryanne Wurst was holding onto her walker with one hand, and leaning over to pick up a stone in the street with the other.

I asked her what she was doing.

 "I make hearts from ordinary street stones," she said.

She held up the treasure she had just collected – a weary, homely rock, one of a million on the crumbling streets of North Philly.

“See the vein here,” she said, pointing to a curved line in the rock. “This is going to be a beautiful heart."

She may have health issues aplenty, but her vision is, well, rock-solid.

She lives in senior apartment building two blocks from Temple University Hospital, and was on her way to the bank machine across from the hospital to get money for breakfast. Her Social Security check had arrived and she was taking the bus to her favorite breakfast place.

She was happy to talk, but turned her walker around so she could sit on the seat.

She is soon to be 74.  She has 8 great-grandchildren, 22 grandchildren, four children, and “one verbally adopted daughter.”

She saw my confusion.

“I verbally adopted her and she pays more attention to me than anyone else. She’s the only one who calls me every day.”

“I used to work with mentally and physical retarded,” she said. “Up until 1993 I was lifting 200 pound women by myself.”

That in part may explain why she has a large ventral hernia, as well as many other health issues, but was utterly cheerful and positive.

She pulled a beautiful black heart-shaped stone from a plastic case she carries. She found that stone on the street, and used a coarse piece of cement, also picked up in the street, to smooth it into the heart.

She uses rougher stones and cement to smooth all her stones.”

She said that despite her health issues, and need to sit often on her walker, she can still run, and often does for half a block or so.

Even though I urged her not to, pleaded with her not to, she was not to be denied.

“Here I go,” she said, and holding firmly onto her walker ran down the street and disappeared around the corner.

I hope she had a great breakfast.