Who doesn’t love a good list? Whether it’s TheNew Yorker’s “Top 10 Books for the Summer,” or end-of-year best movies, we click on lists to learn something new, seek affirmation of what we know, and populate conversation. We make lists of our own to carry us through all sorts of moments, whether positive reminders during a moment’s anxiety, shopping for the long weekend ahead, or necessary reminders during early stages of cognitive decline. Lists are ubiquitous, hopefully helpful, sometimes overwhelming.
Our latest Case Repertory publications are both titled, “The List.” Our editorial team was taken with how well these pieces complement each other and, while there are obvious similarities, the differences create spaces that offer new perspectives.
Amita Dayal, a frequent contributor to the NBM Lab, begins by printing out an in-patient list: “This Saturday, there are twenty-two names.” Over the following week there is an accumulation of extra tasks and new lists added to the original (“the list is constantly in flux”), before ultimately taming it and handing it over with some sense of satisfaction. “It is an imperfect system yet hopefully, by the end of the week, every box contains a check mark.”
Additions to and subtractions from the list conjure wonderful moments where medical observation meets private reflection; “We may think we have all the answers, but we rarely ask the right questions.” One question asked of, instead of by, Dayal, “Why do you still do it?” is pause for self-reflection and consideration of our resilience.
Charles Hayter also struggles valiantly through a list, albeit one he is presented with by a patient. Describing a ridiculously busy clinic for patients undergoing radiation therapy, the language conjures all-too-familiar siege imagery in terms of both geography, “It’s held in a windowless rabbit warren of rooms adjacent to the radiation bunkers,” and psychology: “[the clinic] serves as convenient landing spot for any patient, not just my own … It’s basically the ER of the radiation department.”
Hayter’s patient relationships evolve over months of treatment and describe inevitable pits and troughs of disappointment and helplessness. He is “on a teeter-totter familiar to most doctors as I straddle a pivot between giving them adequate time and attention while being mindful of those who are waiting,” and he struggles with classical training of staff physicians in context of team dynamics and flattened hierarchies: “Part of me is grateful for… help, but another part resists it… I can deal with this…. To suggest I need help means I’m weak, inept.” Hayter’s description of a clinic nurse remind us how some colleagues grow to embody the values of a ward, clinic, practice: they read like a weather map of pressure-currents, they walk like a list titled “How shit gets done.”
When patients are reduced to mere collectives of symptoms, Hayter and Dayal’s writing reminds us to avoid depersonalization at all costs. We know the cycle never ends so, let’s be kinder to ourselves and treat “The List” as a record of what we accomplish rather than damning indictment of things we failed to achieve. I made a list of my own last week (Top 10 Movies of All Time); so far there are twenty-seven films on it…
Conor Mc Donnell
Editor-in-Chief, Case Repertory