Literature

Gender dysphoriaEvery minuteIn every mirrorSo they tried to end itTwice 11 years oldIn the adolescent unit“High Suicide Risk” On the long waitlistHoping forPuberty blockersUntil SB 16 On the West sideWith a single momFour siblingsCannot afford to travel Affirming careImpossibleIllegal Now what

You are entering the medical record of a deceasedpatient.Are you sure you want to proceed?Click OKDid you know we gray-out the patient photo?When you publish this chart reviewAnd you tack first author to your nameWe will stand behind you at your TriumphAnd whisper into your ear:Remember…

I started losing hair when I was 17.Ten years, a thousand doses of minoxidiland a single moment of acceptance with a razor in handlater,I walk in, bald, with a pamphlet on alopecia areataas you stare at the floor with tear-stained cheeks.You look up at me and grin,“Nice haircut.”

By definition, an adjective.Relating to disease;Gruesome or grisly A patientBy definition, a BMI of 45“Morbidly obese”Not a surgical candidate“Too high risk”Comments between providers“Weight loss needed”Dismissed by doctors in clinicOn roundsNot identified by their nameRather, by theirBMI of 45Is that notMorbid

Everything is ready to go.The orders are in, the discharge papers are signed.The comforts from home packed up away into hospitalbags.But we waitWe wait for the insurance companyFor their seal of approvalSo that my patient can go home with oxygenThe price we payThe price to breathe.

Med student’s journey, a script of mishaps,Pimp questions stumbled, like a maze without maps.Patient plans faltered, never totally right,Feeling lost in the script, chasing knowledge’s light. A year’s evolution, a metamorphose,From doubt’s shadows, some wisdom arose.An unconscious ascent, not realizing you grew,Now new students ponder, how to emulate you.

My team’s running across the hospital to respond to acode.What is my role?“Do you know how to do compressions?”“I think so.”I hear “push deeper,” as ribs are breaking underneath myhands.We call it. Tired and sweaty, we resume rounding.Someone throws me fruit snacks.“For the adrenaline,” they say.

MS4.ERAS submitted.Apathy.Advanced IM.Intense attending.Outrageous pimping.Team bonding under tyranny.Sunday, high hopes for early exit.Chill senior gives green light.Enjoying afternoon.Phone rings.Attending calling.“Hello”“Aren’t you supposed to be here?!”“Senior said I could leave.”“Come back for a paracentesis?”“No, I’m good.”“Really?”“Yep…”Apathy confirmed.

To the resident who insists on sunshine and coffee breaks,Who plays medical charades behind your attending’s backwhile they pimp you on rounds,Who credits you with their thoughts,Who sends you home early,Who unmasks hidden curriculum,We appreciate you,We love you,We idolize you,And may we become you someday soon.

Voices on the wardsFalling silentA commitment to do no harmBut trapped in the webs of hierarchyToo afraid to fallToo afraid to failTo speak Voices amongst friendsSpeaking upSharingSayingIt will be different one dayOnce I am a residentOnce I am a doctorBut will it

She had been assigned to PICU RED.That was my team.A shunt was to be placed,to remove the pressure from her brain.Her long-term prognosis?A short-term lifespan.Palliative neurosurgery.My attending pulls me aside—he empowers me to sit this one out.The patient is my best friend’s daughter.My twin.Jane1.

You sang with your brothers,louder than the harsh fan swirling hot hospital air andgriefthrough my hair, across your body and graying beard.Eyes bright like starlight. I wasn’t ready, but you wereTo go with the wind, as you said. “It was good to see you.”“It was good to be seen.”

It was a rainy dayAnd through the skylights in the pediatric ICUI felt salty rain hitting my cheeks A little girl was dying.Her family hugging her edematous bodyThat had once run, jumped, and played There were no other options, the medical team saidAs if we were talking about the rain

“Hail Mary full of grace,” the opening to a prayer that Ihad said many times throughout my life.I seldom pray in the hospital, but I also seldom satholding my mother’s hand while she was in a coma in theICU. I finished my prayer, said, “Amen,” and startedagain from the beginning.

“Today is a good morning.”How did I not feel it?Phone rings, stomach knots, answer it.“Are you sitting down?”I don’t sit. I sink, then float, looking down at the scrub-cladgirl shivering on thehospital floor.Footsteps approach, tentative hands on shoulders.“I don’t want to be the girl whose mom died.”

Jaundiced, she presented with acute hepatitis C.Pre-contemplative but concerned, she asked for clean needles.Unable but determined, we offered the 18-year-old mother offour a Nexplanon instead.Implant in place, she proclaimed “now I am invincible!”Later, withdrawing, she quietly left with an IV still in place.Embarrassed, we chuckled and claimed “harm reduction.”

In extremis, her husband deposited her in the ED while bloodpoured from her mouth.Mortified, I wrapped myself in plastic and said “Do you need ahand?”Tremulous, my hands cramped as the Yonker struggled to keepup.Dissociated, I looked at the ceiling and dreamt of red Blakemoreballoons floating to the sky.

Hungover, she presented with her pancreas inflamed.Lucid, fluids and morphine went into her veins.Obtunded, she went to the ICU with an overlooked Tylenollevel.Humbled, my attending said, “This is the part that sucks.”Suppressed, her son caught my eye through a glass-door as Ished a tear and went back to work.

People crowdingPatient is crashingI stand in lineHeart pounding My turn is upI feel crackingRibs fracturingI hear the resident sayLet’s consider stoppingBut next roundROSC was obtained PatientNow intubatedPosturingBruisedTime of deathCame much later Makes me wonderIf we did more harmThan good

Patient on swallow precautionsBecause of a recent trip to the MICUFor aspiration pneumonia I go to examine herLifting her sheets gingerly,to not disturb her sleep And there, right by her mouthIs a Lindt chocolate bunnyWith the head bit right off When you’re 85,Some things are worth aspirating for