Volume 12

eleven forty four
she announces
to a dozen
now frozen
despite the epinephrine
still dancing
in their veins

a stand-still
so abrupt
that all eyes affix
on level lines—
asystole

slowly the
exodus begins—
dragging feet crush
once-sterile paper covers
of desperate interventions—
fallen confetti
harrowing the
loss
of another

The Tumor

…bing…bing…bing…
In the ICU, the alarms bring pain.
As physician and parent.
Someone’s not breathing well.
It’s not ours. Right?
Our first-born didn’t graduate.
In the darkness are moans and cries.
My second-born.
The surgeon said the brainstem biopsy was normal.
The tumor remains.
“Daddy, why did you do this to me?”
“I don’t know.”

The Miracle

“We need to irradiate.”
It will give him a better life.
For one year.
Then it will be over.
We learned of two others that died within that year.
We didn’t irradiate.
He has a good life; no signs of decline.
The tumor is smaller.
“There are no miracles.”
I can introduce you to one.

“Hair isn’t everything” my mom told me once.
As I looked at her through tear soaked, fuzzy eyes.
Gazing out from under the shadows of my new, unwelcome, too-short bangs
“It’ll grow back, it always does.” She offered.
And
“You’re beautiful no matter what.”
And
“You are more important than your hair.”

“Will I lose my hair?” my mom asked the oncologist.
As I looked at her through surprised eyes.
Gazing out from under the hair that did as she promised, 13 years later.
“It’ll grow back, it always does” I offer.
And
“You’re beautiful no matter what.”
And
“Your life is more important than your hair.”

From abundance to watching the hand tick
Plans interrupted, violently, without empathy
Now discussions
So many hard discussions
It’s almost funny, well not quite, but that would help

I feel fine, we feel fine
But we are told we are not
I hope the scans are make believe
A picture my daughter would draw
A silly monster in the background
Max the Monster, a friend
Please please please, I would love to see it as a friend
Or most importantly, a creature I can rid
One that can’t hurt my family
Or take me away
A fleeting bad dream, oh please

But we know it is sneaky
We see its thorns speared in my body
So tight, intertwined
It takes killing me to unravel it
Its an unrelenting fight
Yet the aggressor has no mind
I am not special
Not in its eyes

But I am, I am
To my daughter
I am
So we fight
We fight my silly monster.

Excitation, anticipation, what we’ve been waiting for
White coats, beginning our journey
Brilliant, talented, motivated
Experiencing moments of awe, reminding us why we started
All with the goal of reducing suffering, restoring health, prolonging life
Saving people
What if I’m not good enough?
Stress, pressure, late nights, competition
Patients, looking to us for hope, for healing
What if I can’t save them?
We are supposed to reduce suffering, restore health, prolong life
Save people
What if we fail?
What do we do when a future physician dies?
What do we do when one of us dies?
And we couldn’t save her?

*In memory of Alysha, our brilliant, sarcastic, supportive classmate and friend. She loved penguins, her favorite color was blue, and she was going to be an amazing physician.

Plans, dreams and promises made, but time too quickly taken away.
Now shades of blue, fading to grey.
A long braid, clever and wise.
“I see you in the skies,” where the heart cries.

I think of you in snowy hills, surrounded by penguins and seas of blue.
Oh, how I wish this couldn’t be true.
A lasting friendship, I surmise.
“I see you in the skies,” where love perpetually defies.

A radiant, remarkable soul, a masterpiece in every bind.
Never afraid to speak her mind.
One of the most heartbreaking goodbyes.
“I see you in blue skies,” where your memory lies.

Use sanitizer
No wait – that’s the soap
Ok, wash your hands now
While cracking a joke

We’ll start with a history
Look at the patient
Why are you pausing?
Remember the basics

Ask open questions
And don’t interrupt
Acknowledge emotions
Please don’t be abrupt

“When was your last period”
“What about condoms?”
They don’t have a uterus
What is your problem?

Now let’s do a physical
Where should you listen?
No, that is the sternum
The heart isn’t missing

Feel the carotids
But don’t choke them out
Describe what you’re doing
There’s no room for doubt

What’s on the problem list?
Order some labs
How should we treat them?
What meds should we grab?

Documentation
Let’s write up a note
Include what is relevant
Don’t over-quote

Now we are finished
Good work with that case
On to the next one
Let’s keep up the pace

---

You’re a med student
You’ll bumble and stumble
And learn many lessons
From patient room fumbles

It’s all part of learning
You’re doing your best
That’s all we can ask for
So don’t sweat the rest

On the train, a stranger touches my thigh—low
enough that it’s not technically inappropriate,
high enough that my skin crawls.
He tells me that I’m easy to talk to,
that he loves me, that he has a ring for my bare left hand,
while I list names in my head of who I trust
to pretend to be my boyfriend if I call.
I’m on my way back from a clinic
where I explained to a girl younger than me
what a pap smear was, where we would touch her,
showed her the brush and speculum,
gave her everything to expect.
“If you feel uncomfortable at any point, tell us.
We’ll do all we can to help.”
He tells me, again, that I should spend the night
while I wonder how fast I could run through the cold
in my trying-to-look-official skirt and flats.
I told the girl on the exam table
that she was doing great,
that we were almost done,
that the worst was over.
When I finally get off, he follows,
yells through the cold about
what he would do to my body,
how he wants to open me up.
My heartbeat doesn’t slow unJl I deadbolt
the front door.
The girl in the gynecology clinic
asked me if it would hurt. “No,” I said,
“It’s uncomfortable, but there shouldn’t be pain.”
I still don’t know if she was asking me
as the one with badge and stethoscope
or as a woman.

i spend a lot of time hating myself
for someone who loves living so much
i think i forget the me of it all
until i am forced back, blinking
into my own body
watched by others
and i realize i do not know what they see

How quickly we get bored of flying.
At 40 thousand feet we do not look out the windows.
At four thousand feet above sea level
And four years in, I no longer glance
At the valley view from the hospital top floor.
The shine wears off
Like a once new toy
Or a lover of 8 months
Or the miracle of instant jello
Or of a brain and a body and a soul and life itself.
The Shine wears off and we do not look out the windows
Until something goes wrong.
You cannot see; there is sleep in your eyes.
So you stop
And listen. Up here,
There are murmurations of valves and starlings.
The beating of wings and of blood.
You will hear rhythms to the voices
And the rising rotors heralding hope and fear
For one more brain and body and soul.
Very soon, many will make the climb
Because we are at the summit.
How disappointing it will be
If we seem bored when they arrive.