Writing from multiple perspectives

Marjorie Rosenthal, MD ’95, MPH, is a pediatrician, scholar, mother, widow, and cancer patient. She is also a writer and artist who explores the strange territory between her identities as doctor and patient—what Rosenthal calls “writing from both sides of the stethoscope.”

“We are hardwired to be storytellers … It’s how we connect,” she said during a Grand Rounds early in 2018. An active proponent of narrative medicine, which she defined during her talk as “a medical approach that utilizes people’s narratives in clinical practice research education and advocacy as a way to promote healing,” Rosenthal has published multiple essays in medical journals and mainstream publications.

“I’m not the first person to write my experiences as a patient, nor … as a health care provider,” she told the audience. “What I think that I’ve had to do [is think] about different connections—putting things together that weren’t there.”

One such unlikely juxtaposition: chemotherapy and poverty, which Rosenthal explored in a true-story cartoon op-ed published in the January 2016 issue of Forum, a journal of the Society of General Internal Medicine.

“Chemo that day started out like any other day,” it begins. As the healing poison enters the port in the narrator’s chest, she listens, as usual, to the other cancer patients’ friendly, humdrum conversations. Then one exchange turns ugly, as several begin to make cutting remarks about poor people. Rosenthal, who in that moment is both a doctor who is passionate about serving the poor and a tired patient, wrestles with whether to speak up.

In another essay addressing the Las Vegas gun massacre, Rosenthal noted a certain similarity between the nation’s stock reaction to mass shootings and the lasagnas, warm blankets, and kind words that supportive friends have provided since her diagnosis.

“Thank you for your thoughts and prayers … I need those things. They help,” she read aloud. But, she went on, “it's hard to imagine why anyone might think this is enough.” The essay calls upon the federal government to fund both cancer and gun-violence research. It appears on CNN’s website.

Later that day, in the John P. McGovern Lecture of the Program for Humanities in Medicine Spiro Lecture Series, Rosenthal brought a deeply personal perspective to the topic of medical error.

One incident occurred shortly after she received her metastatic colon cancer diagnosis, Rosenthal told the audience. She was about to undergo a biopsy. A nurse sterilized the surgical site, then absently rubbed her nose, putting Rosenthal at risk for later infection. It took the doctor-patient some minutes to gather the courage to ask the nurse to wash her hands, and the exchange didn’t go well. Her account of that incident later appeared on National Public Radio.

In another disturbing moment, the gastroenterologist slated to conduct a colonoscopy opened their conversation by reminiscing about an encounter in 2005, which Rosenthal didn’t remember. Then the specialist said, “You are here because your mother has a history of polyps?” Stunned, Rosenthal realized the doctor was completely unaware of her cancer and had the wrong chart in her hands. After being set straight, the doctor avoided Rosenthal’s eyes, retrieved the correct chart, and did not apologize.

“When I am a patient in that hospital, I am a white female doctor. I have so much empowerment—and I still have a really hard time,” Rosenthal said during a question-and-answer session. “How must it feel for other people who are not health care providers, and who don't have my other demographics?”

Rosenthal attended Harvard University, then the Yale School of Medicine, followed by a pediatrics residency at Johns Hopkins University. She completed her MPH at the University of North Carolina Chapel Hill in 2005—just two years after her husband Amal Murarka, MD, a pediatric intensivist, died in a car crash, leaving behind daughters who were just 7 weeks and 2 years old. Over the years that followed, Rosenthal wrote about that tragedy as well. In an essay in Academic Pediatrics, she discussed easing the children through conversations about their father. In JAMA, she urged fellow pediatricians to be more culturally humble in dealing with single parents.

An associate professor of pediatrics and former Robert Wood Johnson Foundation Clinical Scholar, Rosenthal is current co-director of the National Clinician Scholars Program (NCSP) and director of the NCSP Community Research Initiative. In addition to her essays, she has published clinical research on such topics as caring for the underserved, childhood obesity, and video games for HIV prevention. She was recently awarded the University Annual Award Lectureship in Humanities and Medicine for being a humane, caring scientist and physician.

“I do a fair amount of writing my stories, but let’s remember where this all begins,” she reminded her fellow physicians at Grand Rounds. “As health care providers, the biggest storytellers that we’re listening to all day and that we’re thinking about all day are our patients.”