Simple Complexity

"Simple Complexity" -sculpture by Zachary Fender

“Previous to my becoming a medical student, I worked as a welder and mechanic. That being the case, metal is something of my natural element. During a sculpture course my senior year of undergrad, I brought together my passion for science with my skills as a metal worker by creating among other projects this DNA double helix cast in bronze. DNA as a concept is fascinating to me because of the fact that with altering combinations of only four distinguishable bases, it gives rise to all the complexity we find in nature – a principle that I have attempted to capture in the title of the piece.”


When I was a medical student,
I was like a tadpole.
I swam around with little idea
about how the pond worked.
I looked at frogs, wondering
how they grew legs and learned to hop,
how they commanded the pond with a ribbet,
how they breathed outside of the water.
How I longed to be a frog one day.

One day I sprouted legs.
It was in my DNA, I suppose.
I showed them to all my tadpole friends
And we studied them in hopes
that it would help our patients someday.
We memorized the bones and muscles;
we took arduous tests about this.
I still didn’t know how to use my legs.
How I longed to be a frog one day.

One day my tail started to shrink.
I started feeling short of breath.
I was convinced I had heart failure,
still I pressed on in my training.
My teachers started putting me out of water,
and it almost felt like I could breathe better.
I felt my knowledge coalescing, my limbs advancing,
longing to spend more time on land.
And one day, I became a frog.

It felt so good to do frog things.
How I hopped from stone to stone,
how I started catching flies with my tongue.
I was so proud.
I remember my first ribbet, so strong and powerful.
And then a frog came to me.
He could no longer walk or eat.
He asked if there was anything I could do.
How I longed to be a tadpole.

I became despondent.
Frogs that couldn’t ribbet,
tadpoles that couldn’t swim.
The pond had so many problems.
One day I hopped near a French chef.
He promised he would fix me.
He took me back and put me in water.
It felt so good to swim again,
I never noticed the water boil.

Hippocratic Souls

Meditation. Yoga. Meditation. Yoga.
Today I came in contact with my own selfishness.
Years of scrutiny and rumor laid bare.
Their projections.
Their selfishness.
Is it kind to keep the other’s sleeping?
Protect the innocence of the babes?
Or is kind to rock the cradle and wake them from their graves?
My projections.
My selfishness.
Play polite and paint the smile.
Curtsy now and stay a while.
Persona of professional.
Hippocrite or fanciful?
The social masks we play the game.
Pretending they are not the same.
Wait a moment, forget her name.
And dance away the tears.

Perspectives felt and heard today.
Across the seas their pain won’t stay.
Feel for them.
Wash it away.
The innocence of babes.
My story is as my story goes.
Twisting now in rows it flows.
Project on me while they don’t know.
Mix of emotion there she goes.
Her selfishness revealed.
Hide your pain so we won’t see.
Avoiding accountability.
No punishment threatened and then we’ll see…
Will at last you stand with me?
The answer’s no and now I’m free.
The bastard of this family.
Cut loose from this very tree to leave the others hanging. I feel their pain.
They are the same.

They learned her name.
They stopped the game.
Without a fight she won their rights.
Now sailing off into the night forgiving them once more.

Compassionate, confused they’d be.
Reveal to them what they wish not to see.
Is it you or is it me?
Our selfishness revealed.
Every man fights for himself.
Expecting close to nothing else.
Leave the money on the shelf and wipe away the tears. Drama, rumor, and intrigue.
How boring must their stories be?
To waste time thinking about me?
They were your friends.
Just let it be.
Grateful to be free of me.
The boundaries of insanity.
Play pretend sit quietly.
This story you can’t win.

Our masks revealed.
Their faces flushed.
Leave her lying in the dust.
Starting over now she must.
They’re so lovely and unjust.
In our doctors place our trust.
Please the masses now we must.
Chop her down to size.
Certainly it’s an illusion.
The one sane soul in this delusion.
But darling it’s not their confusion.
Let them live in their pollution.
The truth will set you free.
It pissed them off.
And rightly so.
Telling what they wish not to know.
Wrap the blanket and rock them tight.
Remember they are full of light.
These Hippocratic souls.
Do no harm the oath we’ve made.
Your words can cut make me your slave.
Bury it all inside the grave.
And resurrect the corpse.

This broken body now restored.
Send them love.
Move on once more.
They’re so lovely and unsure.
The awkwardness you’ve caused.
I cannot like you it’s too hard.
You must be something disordered. Point the finger and mock it more.
Finally walking through the door.
She leaves the lesson learned.
She loves them so in their own way. And they do too, well she’s ok.
Making jokes now walk away.
And dance away your fears.

Ocean Heart

I had been sick with a cough for a week
before it happened.
Sea water rose in my throat and coated the inside of my nose with the smell of salt
and decay
issuing forth from me, pouring out, black and green and stinging my eyes with its force leaving
me to gasp
and gasp
and gasp to catch the tattered edge of my breath

I knew that I was in the eye of the storm when the water stopped
And I could feel it in the back of my throat
Hard and soft, like an oyster

I coughed and spluttered—the delivery was easier than I had thought it would be—and when it
was done,
I looked down on my heart
Which had begun to totter on little colt-legs


"Diabetic" - eassy, photography by Margot Porter

As a young adult living with Type 1 diabetes, I have heard more misconceptions about diabetes than I care to remember. When a new acquaintance learns that I have diabetes, they often can’t resist making some misinformed comment about how I do not fit into their preconceived notions of a “diabetic.”

“You’re a diabetic? But you’re not fat…”
“Isn’t it ironic that you’re eating candy? Diabetics shouldn’t eat that.”
“You should just exercise more, my uncle did that and now he’s off insulin.”
“You really should try this essential oil; it can reverse your diabetes.”

The word “diabetic” is unfortunately associated with many unflattering stereotypes, even within the medical community. Some of these presumably well-intentioned comments are quite rude, incredibly frustrating, or just so blatantly false that it takes all my strength not to respond with sarcasm.

As I have considered ways to increase public education about diabetes in a more positive way, I realized that a simple solution was sitting in my desk: an upcycled insulin pen. This insulin-penturned-ink-pen has been far more than a creative way to avoid medical waste; the simple act of removing the empty insulin reservoir and replacing it with an ink cartridge has transformed this pen into an interesting educational tool. When I have used this upcycled pen in class, at work, or in social settings, it instantly sparks conversation. This pen facilitates public diabetes education in a more organic way as I share my experiences as a diabetic with curious observers. Using this pen as a catalyst, I am able to dispel some of that negative stigma that all too often accompanies the word “diabetic.”


bedsheets and socks on their feet and wrappers strewn like cigarette butts on the street. it was never satisfying, wishing you were anywhere else-probably better off dying. sometimes they choked you and sometimes they poked you but they always made sure to give a final huff before you realized they’d used you.

Anniversary Day – Based on a Conversation

“My daughter killed herself today
And I’m in so much pain.
How do I live the rest of my life
When my world died that day?”

As she tells me her life
Of unimaginable pain
Slowly she says,
“Today’s a heroin day”


An 11th birthday present,
his first pocket knife.
His first time cutting with the blade,
an apple dripping juice.
The doctor says, “you’re up!” –
my first suture kit.
My first time driving the needle,
skin dripping blood.
“How are you doing?” the doctor asks.
we both reply.

Mass Effect

I do not know

What it is like

To wait 13 years

While a lump on your arm

Grows and grows and grows.

I cannot imagine what it must be like

To hold that fear inside yourself for so long.


I was not the last to touch her,
But I was the first to touch her after she had died
Everyone in the room looked over to me and I stood
And played a makeshift coroner. My fingers read
A boundingly absent pulse

She’s gone-gone, she’s gone-gone, she’s gone

and they let the kids go home afterward,
No sense in keeping us up after we had cried.
so she might feel us there. I still wonder if it was good
her last hours lying in bed;
perhaps we made It worse

We buried her a few days later
She would have liked the service
she might have joked that she
would get a bigger turnout than any of her boys.
but I guess she wasn’t there

or maybe that wasn’t really her.
Perhaps, I have too soon forgot the words
or most things she would have said or done
Even now I cannot remember her voice
nor what she used to wear.

She’s gone, she’s gone-gone, she’s gone-gone

Gallbladder Pain

Those were her words
with the triage nurse.
She had consulted
Dr. Google
and she knew
that her gallbladder
was the culprit.

It was agonizing,
she said,
worse with eating,
a gnawing on her
right upper side.

I tried to find
a Murphy’s sign,
and elicit the pain,
but failed.

Three small scars
over her liver
and another
tucked into her
gave her away.

I verified the history
of cholecystectomy
in her chart.
When I broke the news,
she was shocked.
She still didn’t remember.
“It must have been forty years ago.”
She felt so silly,
her pain resolved.

We still scanned her:
no abnormalities,
no gallbladder.

Hope Springs Eternal

"Hope Springs Eternal" - essay by Michael Prestgard-Duke

"Hope Springs Eternal" - drawings by Michael Prestgard-Duke


“This piece is dedicated to my dear friend Maddie, who was diagnosed with Stage III Melanoma at the age of 23. Her hope is to provide a success story to other young adults who are struggling with cancer. The narrative is entirely her own, and the individual pieces are based on photos that she provided.”


Morning (G)rounds

"Morning (G)rounds" - drawing by Riki Aquino