The Permanente Press, in conjunction with The Permanente Journal presents this medical literary and arts e-journal, leaflet -- to open greater opportunity to share the creative visual and written works of physicians and nurses.


Health care professionals and employees are encouraged to submit original poetry, prose, and artwork for future issues.

On The Cover

15 025A lunar love09


Lunar Love
by Kamran Nikravan, MD


Lunar Love was painted in 2009, with mixed media on a 20” x 20” wood panel. It is a depiction of moonlight’s grace and beauty. Dr Nikravan has enjoyed and practiced meditation for many years, and this has influenced his practice of medicine and life in general in a very substantial way. His art, whether landscape or abstract, is a byproduct of this influence.

Image Diagnosis

Image Diagnosis: Worm-Induced Biliary Obstruction
Andrew W Phillips, MD, MEd; Joanna Ready, MD; Gus M Garmel, MD, FACEP, FAAEM

A 57-year-old woman, who was born in the Philippines, presented to the Emergency Department with 6 hours of epigastric and right upper quadrant abdominal pain radiating to her back. She denied fever, nausea, and vomiting. An endoscopic retrograde cholangiopancreatography showed the presence of a worm, extending from the ampulla into the bowel lumen.





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