2020 Voices from the Residents, Introduction

A collection of 55-word stories from residents at the University of Utah

Voices from Residents 2020 is a forum for residents from the University of Utah School of Medicine to share stories of their experiences in medicine; to promote resilience and prevent professional burn-out by normalizing vulnerabilities experienced in medicine; to provide role-modeling for medical students; and to showcase the creative talents of residents.  Through (roughly) 55-word narratives, Voices from Residents transmits emotional knowledge about the art of medicine gained through caring for patients, interacting with family members, and navigating changing and demanding schedules. Resident writing bears witness to experiences that occur when operating in the space of expert yet learner, and how to navigate the emotional, psychological, and existential challenges often confronted yet frequently silenced in the culture of medicine. In the curation of this collection, three themes emerged: a focus on learning, handling emotion, and struggling with limitations of medical care.

Part One: The Learning Process
Pleomorphism
Multiple Hats
Residency Drifting by
The First Day
Medical School: A One Act Play
Just Keep Breathing
20/20
Room by Room

Part Two: The Handling of Emotion
Inadequate
Q&A
Dear Mike,
Okurimono*
New Patient Visit: Sibling Exam after Death of Sister
Wake
Crossed Wires
Running His Mouth
Hospice

Part Three: The Inadequacy of Care
Mrs. T
Mangled Hand
Palpable Fine Needle Aspiration, Left Thigh, Huntsman Clinic 2C
Full-time Job
Laundry
Safety Symbiosis
Nursery (After Jack Gilbert)

Editorial Staff: Ben Drum, Kathryn Schmidt, Britt Hultgren
Faculty Support: Amy Cowan, Susan Sample, Sara Lamb

Pleomorphism

Forgive the cliché, but I think of Oppenheimer watching the bomb whenever I examine a highgrade tumor under the microscope. Stained with hematoxylin and eosin, the reckless cells blossom in deep purples and reds, their distorted shapes abstract and breathtaking, monstrous and absurd. The destroyer of worlds, the physicist wrote.

Year Created: 2020

Multiple Hats

“Is the patient delirious?” staff question. The psychiatrist arrives.
Staff relax.
“Nope! Nurse, call a rapid!” I holler. I’m watching the vitals—they’re stable but the patient isn’t responding. Everyone arrives. I initiate orders.
Head CT, clotting factors, and versed. STAT.
“You’re the psychiatrist? Thanks for orders.”
Eyebrows raised.
I take a breath and smile.

Year Created: 2020

The First Day

New badge says, “Physician,”
White coat down past my knees.
“Hi, I’m the brand-new intern.”
“Send in the real doctor please.”

Eight years of school to earn this?
The healer’s lot, indeed.
But today’s the day I prove it,
I’m ready. Set. MD.

Fast forward an hour later,
“CODE BLUE,” staff looking at me.
A small voice in my head begs,
“Send in the real doctor…please.”

Year Created: 2018

Medical School: A One Act Play

ATTENDING

What did you find out?

STUDENT

I did the entire neurologic exam like they just taught us in Foundations of Clinical Skills class and asked questions for an hour. But I still have no idea why he fell.

They enter the exam room.

ATTENDING

Mr.Anderson, have you been drinking again?

The patient grins sheepishly.

Year Created: 2020

Just Keep Breathing

Breathe in,
Breathe out.
Sanitize.
First patient.
Push aside my anxieties
To make room for theirs.
Sanitize.
9 more patients.
Breath in,
Breathe out.
Attending rounds.
Sanitize.
Present.
Sanitize.
Repeat.
Breathe in,
Breathe out.
Notes, orders, consults.
Update nurses.
Social work.
Finally, break time.
But, wait…
Familiar buzzing.
Breathe in,
Breathe out.
Code blue.
Run.

Year Created: 2020

20/20

Many people have asked—”Why the eyes?”
I’ve often replied at length with my reasoning
But perhaps it’s best to keep things simple and say…20
20 minutes to dilate; to peer directly into vast,
intricate vascular and neural networks
20 minutes for cataract surgery to restore sight
20 minutes to refract—to provide glasses for
someone in need

Year Created: 2020

Room by Room

You never forget the howl of a woman just informed that her unborn baby is dead. You hold her hand, cry, feel the physical pain of loss. You are the messenger to her nightmare. Then you walk into the room next door and deliver a baby, smiling and celebrating with the family. It is not disingenuous; it is just the job.

Year Created: 2020

Inadequate

I tried to answer your question the best I could, but again you ask it. “Will my dad suffer? What happens when he chokes and he’s unable to breathe?” We stand at your father’s bedside as I fumble my way through an answer, failing to name your emotion – fear. You tug at your baseball cap again as I step back, make some excuse to get back to rounds.

Year Created: 2020

Q&A

“So, what are we going to do about this?”
Her eyes move from me to her husband, asleep
again between us.
“That is the question,” I answer
without answering it.
Our eyes are all kind, calm, patient, wanting the same thing.
She goes home to rest. Did she already know?
There is nothing to do.

Year Created: 2020

Dear Mike,

I met your grandparents. Both sets, actually. I cried in your room once. I laughed in there, too. Monitors always on. Your heart rate went up. Your heart rate went down. I never met your parents. Never. Never. Then I did, and you were gone. I met your body, but not your soul.

Year Created: 2020

Okurimono*

Him, breathless, handcuffed to the oxygen tank in tow. “Chest pain again,” he recounts, “but it’s mostly gone now.” Her, sitting, head hanging low, toiling hands making the crumpled jacket dance on her lap. She never looks up – could she be that apathetic? Finally, an utterance, a smile, and her extended hand. “Merry Christmas.” An origami Santa.

*Okurimono is a Japanese word meaning “gift.”

Year Created: 2020

New Patient Visit: Sibling Exam after Death of Sister

This fits
The career I envisioned:
Escorting a boy,
Legs like springs,
Bouncing back to the waiting room
Where children and parents
Point at fish
And books,
Safe and healthy.
Yet I never envisioned
How he passes unseen,
How his young grandmother
Steadies herself
With his unsuspecting hand.
The childhood they shared
Cut from beneath them.

Year Created: 2020

Wake

Did you know, when I called 911, I was put on hold.
For 10 minutes.

It wouldn’t have made a difference. He died right in
front of me
in our room.
He was gone.

Her hands run over her forehead, her eyelids.

I’ve been having trouble sleeping.
Do you think it could be our mattress?

Year Created: 2020

Crossed Wires

“But I’ve never had this happen before.”
I pause, for the umpteenth time.
Explaining your kidneys aren’t working.
And you will require dialysis indefinitely.
It must be hard to hear.
Can’t imagine what you’re going through.
I wish it were different.
All my tips and tricks.
“But I’ve never had this happen before,” I said.

Year Created: 2020

Running His Mouth

I’m trapped in the room—twenty-minute visit turning to sixty. He has singlehandedly cared for himself better than nurses, diagnosed himself better than doctors. He is, he tells me, an expert in PICC lines. He calls his neurosurgeon simply, “Paul.”
“Open your mouth, please.” He blushes, gums full of cavities, then leaves, quietly and compliantly.

Year Created: 2020

Hospice

Driving in the dark to a South Jordan funeral home. Batman robe framed in a shadowbox. When I saw him alive last week, I told him he was charming, and he said, “Why, thank you.” Arrest at dinner on Christmas Eve. Now he is a pale body, cushingoid cheeks. I wait for him to breathe.

Year Created: 2020

Mrs. T

“I don’t feel worth a damn.”
Head pounding, can’t breathe. Bright eyes plead beneath tattooed brows. 79 years with COPD, pulmonary hypertension, atrial fibrillation. On three liters. Diurese? AKI. Cardiovert? Back in a day. Tinker with meds…I just want to mend her paper bag lungs.
Two weeks pass. How do you feel? “I don’t feel worth a damn.”

Year Created: 2020

Mangled Hand

Kneeling at your bedside, I see your mangled hand. The trauma you suffered brings tears to my eyes. To hear you say, “I feel like a caged animal,” a rock in my gut. How can we raise you up, honor you the way you deserve? Your mangled hand is healing. Who’s the patient now?

Year Created: 2020

Palpable Fine Needle Aspiration, Left Thigh, Huntsman Clinic 2C

I apologize for the needle’s sting, jabbing in quick fine motions beneath your skin. Under the microscope, the cells look back at me with red, violent eyes, angrier than ever in their return. I hide behind the microscope. Would you want to know? The thought of it, something like a ruined voice singing a hymn.

Year Created: 2020

Full-time Job

Trademark stickers, grigri, and plushie keychains adorn her walker. We get off at the same stop, both shivering in the morning chill. A few hours later, I meet her in my clinic, talk about chronic pain. After my long day at work, I run to catch the bus home. She smiles from across the aisle.

Year Created: 2020

Laundry

The call comes in,
they’re at it again
X-year-old male,
diabetic foot wound.
Fluids and ‘bocs,
“We’ll take him” I say,
File and sign and move on.

The call comes in,
still at it I see.
“X-year-old gal,
pneumonia we think.”
Fluids and ‘bocs,
“We’ll take her” I say.
File and sign,
rinse and repeat

Year Created: 2020