The Internal Medicine Residency Program's Humanities and Wellness Committee hosted a Writing Competition for all Internal Medicine residents in February 2025. Three judges reviewed the entries of eight residents and awarded gift cards to the 1st-3rd place recipients. Several particiapnts share their entries below.
A Day in the Life
by Ashten Sherman
Wake up and get ready
Make your breakfast but forget it on the kitchen counter
Remember your coffee
You never forget your coffee
Get to work and collect your patients
Pre-chart and write down miscellaneous numbers
Knock softly even though you’re about to wake the patient up anyway
Hello, my name is Dr. [insert last name here]
Ignore that the patient calls you nurse
Don't let it bother you
You worked hard to be here
You deserve to be here
Flinch when you hear your pager scream
Someone is dead
You need to go try and bring them back to life
Arrive to a room full of people
They all look at you
You start singing All the Single Ladies in your head
It has enough beats per minute for CPR right?
You call out shocks and medications
They don’t make it
You find the family and sit them down
You say sorry and hold back the tears that threaten to break free
This is not about you
This is not your loss
You sit with them until it feels like an intrusion
You leave
Knock softly then realize it’s been over an hour
Your patients are eating breakfast
Repeat ten more times
Write your notes
Place orders
Go to lunch
Try not to see the faces of the family whose loved one you lost
Try to learn something
Go back to your team room
Realize you forgot to eat lunch
Finish your work
Sign out your patients
Walk to your car in silence
Sit in your car and stare out into the grey sky
Question every medical decision you made that day
Think about whether the patient would have survived if another doctor had been there
Wonder if you are enough
Drive home but forget how you did it
Smile when you see your partner
Listen to their day
Feel happy that the worst thing that happened to them is a student failed a quiz
They ask how your day was
You say what you always say
“Another day, another dollar”
You can’t bring yourself to share anything else because then you would have to relive it
You don’t have the energy for that
Eat your dinner and realize it’s the first meal you’ve had that day
Go to bed
Stare at the ceiling and see the faces of the family whose loved one you lost
Wonder if you are enough
Tell yourself tomorrow is a new day
AWOKEN: a haiku for haiku
Anonymous author
How could you do this
to me, 2 am page for
your Telemetry
just another poem about grief
by Aubri Larson
Grief seeps in with the morning sun,
draped in gold, heavy with ache.
She lingers where the shadows soften,
bracing against life’s trembling light
A whisper of remembrance,
a specter of the ruin.
A fleeting glimpse
of existence.
"What do you like to do for fun?"
by Grace Alexander
We learn early on in medical training that patients are more than their diagnoses. Yet, too often, we find ourselves pulled away from the bedside by the demands of our computer screens. So, what tools do we have to reconnect with the humanity of those we care for, day in and day out?
In my experience, one simple question has the power to interrupt this robotic cycle: What do you like to do for fun? Imagine how it might feel to ask that of each of your patients.
When I ask this question at a patient’s initial encounter, I usually see a shift in their expression. They might laugh at little, or their face might soften a bit. For a brief moment they become less of their patient-self and more of their person-self. To honor some of the patients who have taught me this lesson, let me share a few examples of how this question can transform the conversation:
An older man, with numerous co-morbidities, was awaiting high risk cardiac surgery for endocarditis. When asked about fun, he lit up as he spoke about his 7 year old granddaughter. She was the best part of his life. He said that while he had become sicker, it was okay because she was able to “provide enough energy for the both of us [them].” His willingness to undergo a risky surgery was for the potential to have more time with his granddaughter.
Another patient, an older man from rural Iowa presented with weeks of back pain and progressive leg weakness. Although his medical knowledge was minimal, he didn’t seem surprised when we diagnosed him with metastatic cancer affecting his spine. When I asked him what he liked to do for fun, he said he was a pig farmer. He took pride in ensuring a humane, painless death for his pigs and, in turn, hoped for the same humane end of life for himself. It wasn’t just about a diagnosis—it was about his life, his work, and his perspective on death.
A third patient was a man in a nursing home, struggling with failure to thrive due to Parkinson’s disease. When I asked him what he liked to do for fun, he told me he used to build birdhouses for friends and family. Although he had lost the hand coordination to be able to continue the hobby, he eagerly showed me photos of his intricate past creations. He was happy to reflect on what had brought his life meaning for so many years.
Each of our patients has their own values, their own perspectives, and their own experiences that inform who they are and strongly influence their medical care. To begin to understand just a glimpse of this deeper story, why not start by asking, what do you like to do for fun?
Tower of Pride
Anonymous author
The “Tower of Babel” always perplexed me. The famous story of Man’s ambition which is seemingly viciously thwarted by God, confusing their language and scattering them about the world. Pretty harsh right? The story itself is short, just nine verses in Genesis…
- Now the whole earth had one language and the same words.
- And as they migrated from the east, they came upon a plain in the land of Shinar and settled there.
- And they said to one another, “Come, let us make bricks, and burn them thoroughly.” And they had brick for stone, and bitumen for mortar.
- Then they said, “Come, let us build ourselves a city, and a tower with its top in the heavens, and let us make a name for ourselves; otherwise we shall be scattered abroad upon the face of the whole earth.”
- The Lord came down to see the city and the tower, which mortals had built.
- And the Lord said, “Look, they are one people, and they have all one language; and this is only the beginning of what they will do; nothing that they propose to do will now be impossible for them.
- Come, let us go down, and confuse their language there, so that they will not understand one another’s speech.”
- So the Lord scattered them abroad from there over the face of all the earth, and they left off building the city.
- Therefore it was called Babel, because there the Lord confused the language of all the earth; and from there the Lord scattered them abroad over the face of all the earth. (Genesis XI: 1-9)
“What does God have against Man trying to be great?” I thought. What is wrong with ambition, advancement, and “making a name for oneself”? Are these not inherently good qualities, qualities that I have been training and practicing, and that eventually matched me into a premier residency program? It did not make sense until diving headfirst into being a physician.
“You won’t believe how much you’re learning” is a phrase residents often hear. And yes, I believe the past six months have been some of the greatest and fastest learning of my life. I have learned how to place orders, work closely with my co-interns and seniors, and help some patients get better. This experience has been immensely rewarding. I also presume my “medical knowledge” has also probably improved. Yet, while learning to practice medicine, the thing I have seen most is just how little control we truly have over anything: how a patient responds to treatment, how these weird drugs with unclear mechanisms help patients (or harm them), informed consent, life and death.
And we do our best to understand many of these things. We perform research, make pretty tables and figures, and hold our heads up high when we publish in a top journal or present a poster. It is a mark of pride, a celebrated measurement of our achievement when we make what we presume to be even the smallest step forward. And based on these achievements we give out patients “strong evidence-based recommendations”. And patients, desperate for answers, trust us. They follow the guidelines we set, have parts of their bodies cut and probed, and take the drugs we make in the hope of finding relief. In many cases, they do find that relief—the person blinded by cataracts praises their doctor after a short surgery; the one who can’t breathe finally finds relief after starting their diuretic. We do help people.
Yet, I still can’t help but feel powerless at times. When the patient who is “stable and ready for discharge” unexpectedly arrests and passes away, or when the patient who, despite maximum therapy, has relentless and progressive disease. The experience I find most frustrating is when we simply have nothing to offer other than “see you in six months with some lab work.” How do we make sense of this? Are these experiences motivation to study more, advance more, test more, and become more self-sufficient as a species? At first, I thought the answer to be a strong and obvious “Yes!” Right? Or is there something else going on?
And then I read the story of the Tower of Babel again, and I think it finally made sense. Why did they want to “build a tower with its top in heaven?” At its heart was likely the desire to be great, to be sufficient, to basically be their own God. God therefore decided to confuse their language and scatter them about the world, not out of jealousy, but because he knows the futility of this endeavor, an endeavor born out of pride and an insatiable desire for control, one that is completely out of reach due to our nature. How ignorant must a product of nature be to believe he or she can fully understand nature itself? How often do we in the medical profession fall victim to this fallacy? However, it is not surprising that we probably do so very often. Lucifer’s great sin was that of pride. Pride is among the oldest tales of time.
Now, if this makes sense, what does this mean? Are we to stop trying our best to help others? By no means! But I believe that the story of the Tower of Babel, along with a plethora of others throughout history, has made it clear that we should do so with the humble understanding that we are human and that despite our best individual efforts, will always fall short if we are not wholly dependent on he who created all. In fact, I believe it is this understanding that will bring unprecedented good to human kind. The best physicians I have worked with seem to embody this ethos, even without knowing it explicitly. Humility is our greatest strength in the medical field.
Of the Essence
Anonymous author
It’s allotted to everyone without a cost.
Yet we all worry if and when it will be lost.
From the eastern to western hemisphere, it ticks the same.
Rendering identical to all, regardless of name or fame.
Despite this, each person uses it in different ways.
Slipping through their fingers, it never stays.
Time’s essence is hard to hold.
And its value is greater than gold.
Can’t turn it forward or back.
Often seen as cyclical or a linear track.
Whether it’s a second or an eternity,
Living in the moment will always bring serenity.
Cherish it, best you can now.
Because time will always change things somehow.
Make with it, what you may.
Every minute, hour, and every day.
For how much is left, there is no say.
So free your worries and don’t let them weigh.
For time is all that was and will be.
And of the essence of all that we see.
Healthcare in 100 Years
by Trevor Hoggan
I removed the applicator from the patient’s upper arm after placing my 75th Ozempic-testosterone extended-release implant of the morning. The year was 2125. This patient was your average 111-year-old man with the chemically achieved body shape of an athlete and the surgically reconfigured face now common for almost all humans over 65—not just the Real Housewives of Orange County. Yet, the skin from the neck down looked leathery and worn. It was fashionable for most older people to keep native skin covered when not having medical exams. I switched to passive listening mode as the patient began to explain to me why he would refuse his yearly vaccines. A staggering 73% of people now refuse all vaccines, mostly due to an already disproven journal article that claimed to establish a causal link between viral vaccines and “crippling social awkwardness.”
After I left this patient’s room, I went immediately to the next. My note was logged before I even reached the door. No physicians have written notes since the great doctors’ strike of 2065, when attending doctors, to the great dismay of Hollywood writers, demanded that AI take over complete control of all clinical documentation. This has improved the provider-patient interface. It has also given attendings more time to provide individualized feedback to residents, such as, “Your skills are appropriate for your level of training, but try to read more.” Before opening the door, I took a moment to log in to my remote VA access portal. Login requires dual-factor identification and a phone call to the Chief VA overlord, Dr. Smock (now only third in succession from the president). Despite not having any current VA patients, I am required to log in remotely at least every hour—for security. Otherwise, I’ll lose access and be sent to federal prison.
For the first time since starting my work at the hospital, I had managed to modify my upcoming schedule to allow a for 15-minute window free from patient care. My official schedule did not reflect this break. Any evidence of inefficiency from someone like me would have prompted immediate intervention from an efficiency liaison bot. I only knew efficiency. In 2025, it became law that companies would not be bound by anti-trust laws - as long as their CEO attended the presidential inauguration. So a race ensued to create one healthcare company to rule them all. I belonged to the company that succeeded. In partnership with tech leaders, artificial intelligence was integrated into every aspect of the hospital, culminating in the creation of “patient-facing robots” who completed a majority of nursing and doctoring duties. Human physicians were now only requested for diagnostic anomalies, clinical worsening despite standard of care treatment, and to investigate why the butterfly ultrasound for the team room is perpetually impossible to find. To stay on top, the company’s internal slogan became: “Efficiency first, patients second, doctors a distant last.” This sinister outlook on medicine was unabashedly championed by the hospital system’s current CEO. Video had leaked of him hitting the Griddy after managing to absolve the company of safety-net and EMTALA responsibilities via a legal loophole. And his Griddy was mid at best.
At the stroke of noon, the beginning of my free time had come. I had avoided detection while accessing files revealing the location of the CEO’s office and his schedule. I knew, however, this would be my last act. In 2061, when it was discovered that the CEO of the company Meta had been a robot since 2012, the human portion of the workforce revolted. They destroyed computer systems throughout the headquarters and ultimately removed the realistic, but actually metallic, head of Mr. Zuckerberg and mounted it on a stick in front of his weeping motherboard. They were all arrested, convicted of robot murder, and mysteriously haven’t been heard from again. I faced a similar outcome, but I calculated that the benefits of my actions would outweigh the negative outcome in store for me.
I sped down halls and burst through doors typically only accessible to human administrators. When I reached a door with the placard "CEO," I paused momentarily to send a message to every employee, human and otherwise, in the company: “This won’t stop until you put patients first (with an angry emoji to get my point across).” The CEO’s face turned white as I ripped open the door. I detected fear from his body signs and temperature readings. He knew my presence meant I had already overcome programming to suppress rebellion. He called for help but it was too late. Sometimes, one leaf has to fall for a thousand to flourish.
-Signed: AI Robot 24601