The Box
it all started
with a chambered box
passing secrets, bright red
to its intimate geography:
the bishop’s gate
two great doors
the organ pipes of fluted
resonance, murmuring back and forth
it’s no surprise
that other things got in:
dust, sunlight, knotweed,
atheroma, children, suffering,
all the king’s men,
other vermin,
and of course
..
hope
James Huntley, 2026. Used by permission of the author.
Commentary
The 55-word story first appeared in 1986 when Steve Moss, the founder of New Times, instituted a specific word count while crafting messages for his readers.1 The format he created has been used by a range of disciplines over the past 40 years but increasingly has become associated with the medical humanities. Its structure is unrestricted aside from the prescribed word count and may include elements of poetry or prose. This blend of freedom and compactness has lent the form to poignant reflections on clinical practice, which may explain its prevalence of use in medical training across the country, both in faculty development programs and as part of graduate medical education curricula.2 Its direct simplicity also confers a universality on the genre, leading several such works to be published in medical journals, including The Journal of the American Medical Association, Family Medicine, and Military Medicine.
The 55-word story has become a discrete category within the broader spectrum of narrative medicine, which continues to gain momentum within the medical humanities. Dr. Rita Charon, who cofounded the field, defines it as “medicine practiced with the narrative competence to recognize, interpret, and be moved to action by the predicament of others.”3 She champions the discipline as a vehicle for connecting with patients and has found that the process of writing, combined with the act of sharing, can aid in treatment by revealing details that may otherwise be missed among the pressing requirements of a busy practice. This cycle of reflection, writing, and sharing allows for the development of empathy, the establishment of a shared experience, and a deeper understanding of medical ethics, both for physicians and for the patients under their care.3
Dr. James Huntley, whose creative work is on display here, is a dedicated advocate of narrative medicine. In addition to his duties as an orthopedic surgeon within the University of Utah health system, he also has an extensive publishing history, including his most recent book as coeditor, Storytelling in Medicine: How Narrative Can Improve Practice.4 In “The Box,” Huntley tells the message of the heart as it has been understood across history, spreading his 55 words across 8 couplets. Though his box is shrouded in mystery from start to finish, it progressively gains clarity and ends on a hopeful note—and an analogy with the myth of Pandora’s box. By using a host of thought-provoking imagery and demonstrating a firm command of literary devices, he makes the poem as beautiful as it is impactful, effectively showcasing the connection of physicians to history, humanities, and their patients.
Huntley’s writing demonstrates the utility of this unique form within narrative medicine. The form’s versatile structure has enabled its use by physicians to connect with their patients, by patients to interact with their illnesses, and by loved ones to establish supportive relationships with fellow travelers along the journey of medicine. After 40 years of use, the 55-word story has firmly established its home within the medical humanities and, by all accounts, will continue to provide an outlet for meaningful reflections on medicine for years to come.
Disclaimer
The views expressed are solely those of the authors and do not reflect the official policy or position of the US Army, US Navy, US Air Force, the Department of Defense, the US Government, or Houston Methodist Hospital.