Capturing the condition

Emilee Herringshaw

Sorry I’m a little slow today, she murmured, eyes lifting as if seeking confirmation that the delayed pace was acceptable. Layla started down the hallway, returning for another follow-up: stubborn psoriasis, which claimed a manifestation with a stronger sense of aggression than I’d previewed during my 13 month stay at the practice.

Layla was in search for conclusiveness, a sentiment that was unfamiliar. Amongst numerous co-morbidities and conditions, she had unresolved complexities with her home life, support system and recent transition to a group facility at the young age of 59.  

And how’s everything going, I asked, wondering about the progress of her condition.

Better, it’s better, she broke into a slight smile, excited to deliver the news about the new medication prescribed by her rheumatologist.

Otezla, I knew, as it stuck out to me bolded as a feature on her long list of medications, but I welcomed the chance for her to share this promising change.

I want pictures. I want to see my progress. The before and after. And I don’t want my face in them. Please, she murmured with a rather shy tone.

I noted her request on the cover sheet, which I dropped in the translucent plastic frame on the door, face forward.

The visit proceeded with Ms. Campanella’s evaluation. I moved onto tasks for the next patient and returned to the room to take the pictures.

Layla stood adjacent to the right wall of the exam room as I entered to take the pictures.

Seven pictures were taken, some of them directed by her preference, so the detail could really be seen. I retook the picture of her right ankle, making sure to crop acutely between the knee and the ankle. I then confirmed each of the remaining pictures did not include her face, but were captured at a distance to appreciate the features of her psoriasis, which was now clearing. 

Instead of redressing, Layla stood there in her drape. She reached for her bag.

I want to show you something, she motioned, reaching deeper into the side pocket of her bag and retrieving a different set of pictures. This is my son.

There was a surge of bravery, patience, comfort and acceptance with the passing of the pictures from her hands to my own. It had been a year since he committed suicide.

The first picture was taken three weeks before that May. She remarked on the pain in his eyes. And also his love of selfies. More moments were captured, and Layla provided commentary with each, specifically with the timeliness of each photo in relation to his death.

Thank you for sharing with me.

Layla then packed them away in her small purse, smiling with a sense of comfort that encompassed more than the resolving yet unresolved psoriatic condition that accompanied her each time she walked through the doors of 65 Walnut St.  

Emilee Herringshaw is a first-year medical student at UMMS. She co-founded The Medical Humanities Journal of Boston College with the intention to develop a platform to interrogate issues of health, illness, bioethics and caregiving through multiple genres. She enjoys narrative medicine as a means to explore the patient voice, as well as the representation of the complexities embedded in the health care setting.