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Editor's Comments on 'Stories on a Whiteboard'

 , February 24, 2017

When I first read Jacobs’ “Stories on a Whiteboard,” I was frustrated. The patient unfairly “trapped/beneath a vast and oppressive sea,” robbed of a voice by the inhuman tubes and beeping machines meant to sustain life, remains voiceless throughout the poem itself: we hear the patient’s “tales” paraphrased by the narrator, and the final “two simple words” are left unwritten, remaining only a suggestion. I longed for more access and resented the narrator for standing between me and the patient’s experience.

But I realized this silencing is unavoidable: just as an intubated patient is left muted by the ventilator, so are all of our patients muted by our memories and recollections of them. Each stanza begins with an act from the narrator, either “remembering,” “looking,” or “wondering.” I am reminded over and over again as a reader that I will never meet this patient and that my access to their story is through the narrator, just as most of the patient stories I encounter in my medical career are presented to me by colleagues and not the patients themselves.

For the most part, this second-hand storytelling serves its purpose of teaching illness scripts and jump-starting conversations about pathophysiology. But what about the more unspeakable parts of medicine? For example, we can only ever guess at the “unseen tempest” patients in the ICU must weather; how could we possibly fathom the struggling desire for peace and simultaneous desperate hope for more time if we ourselves are not experiencing it? Even if our patients could speak clearly, even if we could always know the “pitch” and “cadence” of their voices, how could we grasp the full weight of their words? At times it seems as though there is an uncrossable ocean between us.

But this is where Jacobs’ piece really got me. In the poem, the narrator holds up a whiteboard for the patient to express their “inner turmoil.” Ruminating on this image, I have come to realize that Jacobs’ poem is itself a whiteboard. It is through these written words, potentially scribbled as a draft in a “cramped and scrawling hand,” that the narrator is able to express and explore his own inner turmoil. Yes, we may not be able to fully imagine the struggle of our patients, but we have to try. In writing and reflecting on our patients, attempting to give (our memories of) them voices, we in turn engage with the difficult questions that confront them (and us) daily. Here, Jacobs explores the heartbreaking work of letting go at the end of life. In doing so, he has inspired me to continue to work to understand this heartbreak and the unfathomable experiences of countless other patients, some of whom I have met and some of whom I will hear about from others. His poem also reminds me that this work is difficult. That this work is frightening. That this work is illuminating, empowering, and essential. All at once.

Mara Feingold-Link