By Fátima Reynolds, M.P.H.

Dr. Fiona Fonseca is a consultation-liaison psychiatry fellow at the Mayo Clinic in Rochester, MN. Their current fellowship focuses on transgender medicine and reproductive psychiatry. They have a special interest in cultural psychiatry, psychotherapy, medical ethics, physician well-being, and advocacy. Dr. Fonseca has also served on the APA board of trustees as the 2022-23 chair for the APAF Diversity Leadership and SAMHSA fellowships.

Q: You have moderated film discussion sessions for the Association of Gay and Lesbian Psychiatrists (AGLP) and presented at the APA Annual Meeting screening of the documentary Cured. Do you think of film as an advocacy and informational tool for clinicians, and can it impact and support mental health and well-being?

In short, my answer is a resounding yes. Film can be such a powerful medium through which to share perspectives. Beyond education and advocacy, it is a medium that has vast cultural influence. We know that movies, ranging from One Flew Over the Cuckoo's Nest to Girl, Interrupted to Shutter Island to Silence of the Lambs to…you name it, have had significant impacts on how the public views our profession. We also know that film and media can impact mental health and well-being, particularly for more vulnerable and/or impressionable populations, such as children.

Each time we consume a piece of media, we filter it through our own lens, and it in turn leaves a mark on us, however negligible. It is important that we think critically about how we choose to invest our time and the impact of doing so, and use this medium as a tool through which to connect, rather than disconnect, from ourselves and the world around us.

Q: We came across some of your poetry, what inspires you to write, and how do you think poetry and the arts can help patients and clinicians? Are there any pieces you would like to share for the newsletter?

Let me start by clarifying that I am by no means an expert in this matter—not even close. I am guessing you're talking about the pieces in Psychiatric Times (“Shelter in Place,” “Grief,” and “Winter Walking Meditation”). Submitting those was a leap in trust, following in the footsteps of Dr. Frank Clark who is such an inspiration. Poetry for me has always been deeply personal—a way of doing my best to paint a picture of my internal process using words. Other than taking some piano lessons as a child, I have no training in the arts or poetry.

However, the act of putting words to paper is cathartic. It is more about the practice than the outcome. Poetry and the arts in general offer folks a way to create, interpret, and express in ways that can be honest, humbling, and healing. I wrote my first poem in second grade and have been writing since, though I don’t usually hold onto what I write. I wrote several poems along with the one in the Psychiatric Times about processing grief. Here is one that touches on legacy—both of the grief and of the person who is no more:

What do I do with all this life
Overflowing paddy, sprawling
Vast field of dreams, wildflowers,
Longing... It feels like so long ago.
And who, how am I, still- holding on
To your calloused, hardworking hands:
Source of home-made sweets, discipline
That once built cities, fortresses, continents,
Once built whole worlds and universes our own,
Painted galaxies on your canvas of wrinkled skin
One-way letters stretched thin over years, over drums.
Foot-tapping out of sync. You are not remembered for that.
But my toes are your toes, pressing deep into waves,
Running without travelling, breathing in sea smells.
My palms empty except for a soft, sticky center
Of store-bought sweets and unruly abandon.
Inhaling the sky, the water, the palm breeze,
The evening closes its tired evil eye slowly
Sensing, scanning, scenting the air with
Dry chili, night jasmine, turmeric, salt
Between us quiet, oceanspray tears,
Breathing out mists of longing for
Warm embrace, garden plants,
Bolinhas, tea. Waste nothing.

Q: You’ve shared that you engage in meditation practice. How did this come about, and how does your meditation practice inform or support your work as a psychiatrist?

My patients are my teachers. I learned about Vipassana meditation in medical school from one of my first patients. Vipassana can be loosely translated as “insight,” a way of seeing things as they really are. It is one of India's most ancient techniques of meditation, and is truly more than just a coping skill or a healthy activity. Meditation is a full-being experience, and the practice of it, much like the practice of psychiatry, is to transmute individual efforts for the benefit of others. Meditation is not a replacement for psychiatric treatment—psychotherapeutic, pharmacotherapeutic, or otherwise—but is certainly a foundation that can support such intervention for both the patient and clinician. Meditation helps me know myself better by burrowing deep into the immediate moment, rather than finding a distraction or escape.

A huge part of our role as psychiatrists is to bear witness to the patient’s experience, and that’s impossible to do without being able to bear witness to yourself. In short, meditation is freeing. It helps me be a more effective human, and therefore, a better psychiatrist. To be perfectly honest, it has been a while since I maintained a daily meditation practice, and I am currently working to re-establish that routine. However, I am privileged enough to take some time off between fellowship and my new job to attend a 10-day silent meditation retreat.