A Fullness of Uncertain Significance is Now an "Award Winning" Book

This week, the Council for Wisconsin Writers announced its annual awards. My book received an Honorable Mention! I mention this because, of course, I am honored. I am also humbled to be in the company of recent Wisconsin Poet Laureate, Margaret Rozga, and Wisconsin's favorite historian and regular on Around the Corner with John McGivern, John Gurda.

Below is the announcement:

COUNCIL FOR WISCONSIN WRITERS ANNOUNCES CONTEST RESULTS FOR 2021 WORK

Sixteen Wisconsin writers won First Place Awards and Honorable Mention Recognition in the Council for Wisconsin Writers contests for work published or produced in 2021.

Award winners were celebrated on Saturday, May 14, 2022 at the Arts + Literature Laboratory, 111 S. Livingston Street #100, Madison, Wisconsin. Below is a photo of the winners.

Apparently, we were so amazing that the Council for Wisconsin Writers dissolved almost immediately after giving these awards. In the future, the Wisconsin Writers Contest will be administered by the Arts + Literature Laboratory (ALL) in Madison, Wisconsin.

NORBERT BLEI/AUGUST DERLETH NONFICTION BOOK AWARD

Lawrence Tarak

FOXCONNED: Imaginary Jobs, Bulldozed Homes, and the Sacking of Local Government

University of Chicago Press

Bruce Campbell - Honorable Mention

A Fullness of Uncertain Significance: Stories of Surgery, Clarity, and Grace

TEN16 Press | Orange Hat Publishing

EDNA FERBER FICTION BOOK CONTEST

Anthony Bukoski

The Blondes of Wisconsin: Stories

University of Wisconsin Press

Shannon Schuren - Honorable Mention

Where Echoes Lie

Philomel Books

EDNA MEUDT POETRY BOOK AWARD

Dewitt Clinton

Hello There

Word Poetry Press

Margaret Rozga - Honorable Mention

Holding My Selves Together: New and Selected Poems

Cornerstone Press

ZONA GALE SHORT FICTION AWARD

Jennifer Morales

“The Doorman”

Fire & Water: Stories from the Anthropocene

Black Lawrence Press

Kathie Giorgio - Honorable Mention

“Recipe”

Evening Street Review

LORINE NIEDECKER POETRY AWARD

Jenna Rindo

Five poems published in various journals

Lora Keller - Honorable Mention

Five poems published in various journals

KAY W. LEVIN AWARD FOR SHORT NON-FICTION

Craig Reinbold

“What WE Might Salvage”

AGNI Magazine

John Gurda - Honorable Mention

“Education of a Southside Barfly”Milwaukee Magazine

TOFTE/WRIGHT CHILDREN’S LITERARY AWARD

Rochelle Melander

Mightier than the Sword: Rebels, Reformers, and Revolutionaries Who Changed the World Through Writing

Beaming Books

Jon Etter - Honorable Mention

Yet Another Dreadful Fairy Book

Amberjack Publishing/Chicago Revie

w Press

YOUNG WRITERS

Cara Wreen

Poem: “Tea Assortment”

Addison Rahmlow - Honorable Mention

Poem: “Nobody, etc.”

Talking About the Book with Surgeons (and Others)

I have been grateful to talk to groups about my life, surgery, ambiguity, narrative medicine, and A Fullness of Uncertain Significance: Stories of Surgery, Clarity, & Grace. Recent talks and reflections:

February 18, 2022 - Albert Einstein College of Medicine Department of Otorhinolaryngology

This was a virtual presentation. The residency program director, John Bent, MD, read about the book in ENToday, a national newsletter for the Triological Society (the only national print coverage the book has garnered, by the way). He emailed and asked if I would talk to the department.

It was a wonderful experience! I did some reading and conversation. A surprise was the presence of Marvin Fried, MD, chair emeritus of the department and an early role model of mine from residency.

I had some great email interactions with a couple of the Einstein residents and faculty after the talk.

March 14, 2022 - Johns Hopkins Department of Otolaryngology Head & Neck Surgery

I have known and admired many of the Hopkins faculty over the years and, in preparation for this presenation, discovered that I also had connections with two of the residents, as well. One of the current fellows was an MCW resident. Nick Rowan, MD helped coordiante the session.

The residents had a Book Club the week before my presentation. They found three of the essays most compelling, including "Harbinger," an essay about the excitement of a first medical experience and how it impacted an early moment in a personal relationship. I also read "Ending Your Career with Grace Means Letting Go of the Knife," whic is an essay about retirement. Great conversation.

Thanks to Chris Gourin, MD for being such a wonderful advocate for my book!

March 16, 2022 - Rush University Department of Surgery

I graduated from Rush Medical College in 1980, so this virtual visit was a bit of a homecoming. I found some old pictures and told some stories, warning people to nice to medical students because, you never know who might come back in thirty-five years and talk about you."

I called out the influence of Steven Economou, MD, a general surgeon who was also an accomplished artist. I also mentioned that I had won second place in an essay contest on, "Why the Medical Humanities are Important to Medical Education," my first foray into the topic back in 1977.

Here's a Rush photo of me standing over the shoulder of Ronald Weinstein, MD, the chair of Pathology and later pioneer in telepathology. Preparing the talk was a great opportunity to remember how influential many of the surgeons and other medical school teachers were in shaping my career.

March 22, 2022 - Medical College of Wisconsin Department of Otolaryngology and Communication Sciences

A presentation to the home team crowd. This was a tag-team talk with fellow MCW book author, K. Jane Lee, MD. She talked about the process of writing her amazing book, Catastrophic Rupture: A Memoir of Healing. We had read sections of each other's work as we were moving toward publication, and it was a delight to share a reading, compare notes, and discuss what we had learned along thw way. We talked to our residents and faculty about the process of writing and how helpful it can be to read and reflect.

March 30, 2022 - Medical College of Wisconsin Department of Surgery

I have been fortunate to work with the general surgeons and surgical specialists at MCW for four decades. My session shared some of that admiration both for their work and for many of them, both current and past. The photo shows a Surgical Grand Rounds presentation, likely from the early 1990s with one of the residents being quizzed by Robert Condon, MD the department chair.

My talk focused on the benefit of including the humanities and reflection for students and residents rotating through surgical rotations. One study showed that 90% of third-year medical students on surgical services were "stressed" or "very stressed," and they found that reflective sessions were very helpful.

April 5, 2022 - Theological Ethics in Helathcare - Mount Mary University - Milwaukee

I was invited to spend time in Professor Shawnee Daniels-Sykes' class at Mount Mary University, speaking in conversation with Sister Shawnee and

her undergraduate students about the book. The students had each been assigned one of the essays in the book to read and be able to summarize. They each had to come up with a question to ask me. The questions were wonderful, ranging from wondering about my own faith to what medical school is like to dealing with dying patients.

Also attending the class was Mary Fran Otterson, MD, an MCW colleague, colorectal surgeon, Mount Mary alumna, and friend of Professor Daniels-Sykes. Having her in the class to provide perspective as a woman, an alumna, and a surgeon was wonderful.

Friday, February 8, 2022 - Creighton University Department of Surgery - Omaha, NE

My long-time head & neck colleague and friend, William Lydiatt, MD, invited me to come to Omaha to speak to his colleagues where I was honored to be the Albano Distinguished Visiting Professor. I gave a book reading and talked about Narrative Medicine. In addition, we had a writing workshop with about forty residents, faculty, and medical students, doing close readings of "Girl," by Jamaica Kinkaid and "Midsummer Rain," by Ted Kooser.

The group was very welcoming and the writing experience excellent. The residents appeared to really work at the opportunity to reflect. I was impressed by what they shared.

The afternoon session, the Dan Lydiatt, MD Symposium on Cost-Effective Care in Head and Neck Cancer, was headlined by Chris Holsinger, MD from Stanford University. Below are some photos from the day.

Thanks to all of the groups who have invited me to share my book, my experiences, and my thoughs about the value of reflection and narrative in a surgical life.

Here's looking forward to more conversations.

#AFullnessOfUncertainSignificance #AFoUSBook #NarrativeMedicine #NarrativeSurgery

Why I Try to Know My Patient's World, in Addition to Their Body

Published on the website, Doximity - March 8, 2022

Illustration by April Brust

She was from my parents’ generation; he was from mine. Her childhood was dominated by the Great Depression, his by the Cold War. She was in her early 20s during World War II; he spent his early 20s in Vietnam. Her oral cavity cancer was likely related to radiation treatments for her teenage acne; his was, no doubt, from his smoking. Although they never met each other, they will forever be inextricably linked in my memory.

Let me share their stories:

She developed a small, superficial cancer under her tongue, which I removed with a limited procedure when she was in her late 70s. Ten years later, I excised another small cancer. Although she healed completely, the second operation affected her swallowing and articulation for a few weeks. The surgery made her, as she said, “feel old.” “It was,” she informed me many times, “the worst thing ever! I will never have another surgery!”

Her reaction was consistent with her personality. She carried herself like many of the adults of the Greatest Generation, and her clinic visits were always memorable. She was a bit combative, skeptical, sure of herself, and ready to share her opinions. She mentioned her husband and son, but always came to her appointments unaccompanied. She was shaken when her husband died three years after her second surgery but, as I recall, never spoke of him again.

I followed her for many years, checking her surgical scars and offering suggestions to help with her dry mouth symptoms. Then, in her early 90s, a new, large cancer blossomed in her throat. “This is much more dangerous,” I told her.

Without hesitation, she drew herself up and pronounced that she would have no further treatment. “Nothing! No surgery! And radiation probably got me into this mess,” she said. “Just let me go.” She permitted no discussion.

During her final months, she refused hospice consults, allowed no visitors, and left the house only for medical appointments. When the home health aide brought her for a visit, she let me know that, “You people don’t do much to help me.” Her son, she said, was attentive, but he traveled for work and wasn’t around much. She canceled her next appointment and I never saw her again.

***

My other patient’s story also begins with a small oral cavity cancer that I removed with a simple procedure. At the time, he was in his early 40s, yet several areas of his mouth were already red and thickened from smoking. He knew he should quit but never quite managed to do it. I kept a close eye on him, taking a sample of a new nodule or ulcer at almost every visit. Pre-cancers evolved into superficial cancers, and then into deeper cancers as things worsened. His tumors became more aggressive. About three years after his first visit, he underwent successful surgery, radiation, and chemotherapy. Things finally settled down.

I never met his family. His long-standing problems with narcotics and alcohol predated his cancer and were, he admitted, responsible for his estrangement from his ex-wife, his two children, and all his siblings. He never mentioned them. It didn’t seem as though he had any close friends. He always came alone.

Several years later, he developed a new, large cancer of the tongue. His treatment options were very limited, having already had radiation, chemotherapy, and surgery. In those days before immunotherapy and checkpoint inhibitors, we had little to offer other than supportive care.

Both the man, now in his late 50s, and the woman, now in her 90s, were patients of mine for over 15 years by the time their dangerous cancers appeared. With no treatment options, their conditions steadily worsened. The notifications from their home care agencies came in rapid succession. They died six days apart.

***

As I reviewed their charts, I confirmed I had never met any of their relatives or friends. Throughout my career, whenever one of my patients dies, I try to share with the family how honored I was to accompany their loved one on their journey. I don’t reach out every time but, whenever possible, I call one of the relatives. I send handwritten notes, realizing how touched I was when the doctor sent a card after my father died. I have gone to many visitations. Much as I was lifted by being allowed in the presence of grieving families when I was a student, I have learned the importance of intentionally reaching across the chasm between the family and the physician. Doing so helps everyone process their grief and profound sense of loss, including me.

For these two, however, I was unsure what to do. Although there were family members listed in their charts, it seemed odd that our lives had nearly touched over such extended periods of time, yet we had never met. Somehow, it did not feel right to address my own loss by making contact. Even a word of condolence seemed intrusive and, to be honest, selfish. Perhaps I was more aware of the disconnect because they died within a few days of each other. I still remember the emptiness. It felt as though I was watching from a distance as they walked through a door that never closed behind them.

As Longfellow wrote, “There is no grief like the grief that does not speak.” Since losing those two patients, ten years ago now, I have tried to connect whenever possible with the people that surround my patients. By understanding the collective narrative of their lives, I hope I will always be equipped to be present if, and when, the time to speak a word of comfort arrives.