Volume 10

face down
in bed
sheets and
chucks changed
as he can’t hold
enough air
to eat or walk
or sleep
but just stare
into space.

his daughters
framed by iPad
weeping his
bed frame rails
up to keep
him from falling
his future framed
by breaths left
as he says his goodbyes
while he can still
talk It sounds like
the future
isn’t too bright
he says between
gasps before
propofol dreams
of a simpler
time without
restrictions without
virus without
needless death
without—

three days later
his life ends
as we take out
the breathing tube.

The bed alarm sounded at 2 AM
And there she stood upon the stool
Dusting the place above
Where the pillows are kept
Where the motes have gathered
Unremembered
Except by the old woman
Whose family is frightened
By what she cannot remember

We clamor in whispers
As not to wake the others
But she is steadfast
Someone must see
To the unseen places
And she has never fallen before.

“Oh Abuela, you can go to bed
We will finish the cleaning tonight
There is much to do tomorrow”
Finally
She alights and smiles
At our hands rushing to slow her descent
And lays at the edge of the bed
Staring into the dark upper corner

And so we climb
Knowing that someone must see
To the unseen places
To the unspoken-of shelves
Where the many motes
Are at risk of falling
Returned unto dust before their time

We clean until the cheap wood gleams
And replace the pillows
Tuck the chair safely away
She nods
And closes her eyes
There is much to do tomorrow

Scuttle into the dimly lit room.
Quiet save for the whisper of her shallow breaths.
Eyes catch glistenings scattered across the hospital room walls.
A dozen lines of oil smeared into stout crosses shimmering in the faint light.
No one has come to visit, remnant from the previous tenant.
Were they left in final farewell? Or to aid in healing
Feel the slow creep of awe and superstition.
Do you wash them off?

Do You Really Need to Spiral Right Now? A Quick Self Check-In Guide
Go in order. No skipping or cheating. Just pick what’s closest to your current state and analyze if you really need to be spiraling out of control right now.

1. Has today been particularly bad?
Yes, it’s been awful.
Fair enough. Go to Q2
Maybe, every day is rough here.
I hear you. Go to Q2
No, today’s normal except I’m spiraling.
All right, it could be something else. Go to Q3
It has truly been the worst day of my life
You know what? Go to Q11

2. Did you get enough sleep last night?
What, is this a joke?
All right, all right, go to Q4
Yes! I slept well!
Wow, must be nice. Go to Q5
No. And I seriously need more sleep. Like it’s bad, I’m seeing sounds.
I’m concerned for you. Go to Q4

3. Is there something bothering you besides the usual?
Yeah. But I can’t make it stop.
Go to Q6
No, I don’t think so.
Go to Q5

4. Just go to bed. Seriously. Take a nap or just find a safe soft spot and pass out.
I legitimately cannot, it’s not an option right now.
Debatable. Go to Q5
I’m already asleep, fam.
Congrats! No need to spiral, just sleeeeep. You’re done.
I don’t want to/don’t need to sleep.
Sometimes it’s like that. Go to Q5

5. Let’s talk nourishment. Have you eaten today? Had enough water?
I think I’m dehydrated or over-caffeinated.
Drink some cool water slowly. Give yourself an hour and reassess.
I probably should eat something.
Great! Go get a snack or a whole meal and see if that helps.
I’m under-caffeinated for sure.
Do NOT get an energy drink. Have some coffee or tea and check back in.
I’m properly nourished, that’s not it.
Understandable. Go to Q7

6. It’s time to talk to Wellness. I don’t care if it’s an emergency appointment,  you should unload with someone who can unpack that with you.
You’re right. I’m gonna go call them.
I’ll be here if you need me.
I really don’t want to talk to wellness. I don’t have time or don’t like them.
Ok, time to talk to someone you trust. Friends, parent, mentor.
This is not a Wellness issue or they didn’t help.
All right. Go on to Q7

7. Ok, let’s talk substances:
I forgot to take my meds today!
Go take them and maybe go back to Q6
I haven’t been taking them regularly.
Hmm. Time to talk to your PCP and maybe wellness. Go back to Q6
No, no, nothing like this.
On to Q8

8. How’s the social support network?
The family is stressing me out.
Family can be hard. Go back to Q6
My friends are stressing me out.
Friends go through things too. Talk to them. Go back to Q6
I’m so lonely, I have no one to talk to.
I’ll be your friend. But go back to Q6 and/or sign up for some clubs
I really don’t think this is it, and I’m still freaking out.
It may be your time to spiral. Go on to Q9

9. When was the last time you did something that had nothing to do with medical school?
Long time. Uhhhhh…let’s see it was… 2007….
Put the Anki down. Go for a walk, call someone you love. Reassess.
Not too long ago, but maybe I need more.
Listen. Do some more self care. Go start a new podcast and hit the gym
I really can’t afford a break. Like truly.
Ok. Go to Q10

10. Ok. Last question. Is Mercury in retrograde?
Omg yes. This is it. The universe is out of alignment.
So glad I could help, go hang out with someone whose moon is the same as your 5th house and just vibe out
I don’t even know what this means.
It was a last ditch attempt. Go to Q11.

11. Welcome to Spiral-ville, population: you. You can freak out for as long as you need, you are now totally validated and completely justified. Maybe it’ll help, maybe it won’t. Maybe you’ll only have to spiral for 5 minutes. Whatever you do, please be safe and remember that there’s lots of people here for you. But maybe your version of spiraling is eating a pint of ice cream and sitting on the floor while staring into space. In any case, be kind to yourself.

Bacteria settled onto the valves of your heart
It sat there and grew over time
The textbooks tell me
It might have something to do with your dental procedure
But you sit here in front of me with your son and husband
Smiling, joking, worrying, reading, watching, living
It doesn’t really makes sense
“The bacteria may have broken off and showered into your kidneys”
“The beans?” you ask
“The beans”

Sink toward the door
day-weary and
full

of the eyes and pains of 15-minute
acquaintances
whose real questions I couldn’t answer.

Shoes off
Phone down
Backpack off (not for long)

Sink toward the piano
weak against the gravity
of the familiar, safe black

Black wood
Black keys
Black space—with stars
Familiar, predictable, wild beauty
from me.

Back to the backpack.

Call upon the augur
to tell the man if he should stay or go
Pluck the feathers and see
if in the steam from strewn entrails
weave roads that lead away from home
If after pricking, the trickling blood
wends anew in the cobblestones
a thumping pulse

What think we of the haruspex?
The soothsayers and organ oracles?
Elbow-deep ungloved, unproved
Elbow-deep divining death or drought
or just another dark winter
Come
scoff at the backwards ways of pig fat and crow liver
to weave a tale of woe or hope
for a stricken village hanging
on every breath
of the white robed priest

Now go
Waltz in and out of the ivory halls of knowledge
Elbow-deep, scrubbed, step-tested
Elbow deep, delivering prognoses, predictions
and prideful certainty
You, with the white drapery, the shining headgear
and shining and sharper still instruments
You, who comes to the temple door
to tell what the organs speak
and if the blood still flows
May as well be a haruspex

She gardened bald,
trimming the dying lavender
to grow back for the living.

Planning beauty
for the future that wasn’t hers
and she knew it.