| They say |  |
| I have gone too far | |
| They know not | |
| I have just begun | |
| Against the Wind | |
| I walk toward the Sun. |
I looked out on the wing
and thought of the old woman in morphine stupor
whose large eyes gazed in different directions
her thin dark body
nestled in peaked white sheets
the bed, an iceberg
floating on the sea
and her
the old eskimo waiting
except she was warm and could not
see the blue sky or hear the water lapping
at her soul
Breathless, having run up the stairs. "You paged for an interpreter?" Looking up from the nurse's station, only another detail to be handled on a busy day. Dull grey-blue scrubs, impatient eyes, flying angel-wing hands arrested briefly in pursuit of paperwork and doctors' orders. "Oh yes. Room 302." And eyes back on the paperwork.The corridor is full of life, an odd kind: busy and desperate in its rush. Patients shuffling along, some tethered to IV lines on rolling poles: who is the dog and who the master? Housestaff and nurses syncopate steps in a hurried ballet. This is seen quickly, negligently, in the search for room 302.
There. In the first bed. Grey hair, possibly in her early sixties. Clinically obese, maybe morbidly so. Slightly yellow tinge to the sclera of the eyes, to the skin. Breathing somewhat shallow. Bet her blood pressure's high - wish I could measure it. Alert - probably oriented times three. Time to check.
"Buenos días, señora, hoy voy a servirle como interprete. Me llamo Jenny. En quéle puedo servir?"
"Mire, señorita, es que ya no quiero que me hagan estas cosas. Ya estoy cansada. Ya no quiero el diálysis, ni las drogas. He hecho mi paz. Me quiero morir."
Her orientation no longer the question - she seems clearly aware of her surroundings and of herself - it is time to answer a plea I have no right to answer. I turn to the woman's resident physicians, standing by me with anxious and uncomprehending eyes. "She says she doesn't want the dialysis anymore. Nor the drugs. She says she wants to die."
The doctors, both young, turn briefly to each other, baffled. "But she asked, onlyyesterday, whether there wasn't a new drug that we could try. She asked her daughter to find out."
"Where is her daughter?" It is only now that I become aware of a muffled weeping sound outside the door, a hesitant and quiet intrusion of grief into this efficiently sterile and mechanized room. I am irritated with myself for having rushed into the room, for not having seen, for not having looked. What's so important about my job that I have to rush all the time?
"Outside. We weren't sure what was going on with her" - indicating the patient - "and wanted to get someone unbiased up to talk to her first before we involved the daughter." The two doctors somehow interchangeable, despite a difference in sex and race.
"What's wrong with her?"
"End-stage renal disease."
"How do you want to handle this? She doesn't seem to be disoriented - seems to have thought it out."
Puzzled, backtracking, uncertain, maybe even afraid. "We can't authorize that - we're only her residents. Tell her that only the attending can allow us to stop treatment."
"Señora, los doctores me han dicho que entienden, pero que no pueden permitir que se pare el tratamiento. Es que el doctor que supervisa su caso es el único que puede autorizar eso."
"Ay, señorita, ya estoy harta. Me duele todo. He hecho mi paz. No lo aguanto mas. Déjenme ir."
I turn back to the residents. "She's begging you to let her go. Sick of it all, says it hurts all the time. When will she see her attending?"More puzzlement. Stepping slightly away from me as if it would separate them from the problem. Or maybe it's only because of my brusqueness.
"It just doesn't make sense. She wasn't like this before. Tell her we can give her some medicine for the pain, but we can't decide anything else until the attending comes to see her tomorrow morning." Voices blending, unhappy eyes evading meeting those of the patient, but a stealthy hand or two occasionally reaching out to the woman's arm, her leg, to caress gently and briefly.
"Señora, el doctor va a venir y hablarle mañana. Pero hasta entonces, solamente le pueden dar medicina para el dolor. Estará bien así?" Hoping this will be enough, I explain what they've just said, tell her that she can only have medicine for the pain but that we can't let her go, don't have the say-so. I don't want to let this woman go either, but what do I know of her? Of her pain? What right do I have to convince her to live one more painful moment, when nothing can be done? And even as I'm asking myself this last question, I am irritated again, but this time by the melodrama of the whole situation.
"Por favor, señorita, le ruego, déjeme ir." Eyes steadily gazing at me, why does she think I have the power to do this? I have never seen someone calmly ask me to let them die. How am I going to handle this when I'm the doctor? I feel so frightened that I step back a little bit too. I'm only studying to be a student, haven't even reached the quiet clean book-lined walls carved with centuries-old sayings and caduceae, not yet a "real" student. They must have the answers to this somewhere on those walls, or in these halls: these young doctors must just have forgotten the answers to this dilemma while involved in the swamp of medical minutia which constitutes the overload of a resident's professional life, must just have forgotten the appropriate way to handle this for a moment, right?
"Señora, entiendo, pero no puedo hacer nada. Mañana su doctor va a venir y hablarle, y ojalá todo se podrá decidir entonces. Perdóneme, señora, no puedo hacer nada mas..." Begging me with a dignity I have never seen before, an inviolable wall which becomes her shell. What a lame answer I make, to tell her that I understand, but can do nothing more. I don't believe in this stalling gambit, why should she? I think she can see inside me, that those steady calm black eyes reading me with an unspoken contempt for this unfinished and rudimentary text of which I am made, can tell that I'm only spouting a party line, that I think she ought to have her own autonomy. But the doctors have left the room. After a final pat on the woman's shoulder, so do I. I just don't have any answers, and wouldn't be allowed to offer them if I did."What will you do?" Since I don't have any answers, I challenge those who do: the residents seen surprised at my arrogance, at my daring to question their treatment plan, but at least they're willing to answer. They even seem to be relieved that someone is free enough from the medical chain of command to ask the questions they want answered.
"We'll talk to the attending tomorrow. But something must have happened. She changed her mind so abruptly."
"I have to go back to work." Suddenly I remember that the text I had been proofing deals with the ethics of how to handle an irretrievably comatose patient.
"Thanks for coming up to help us talk to her." Now I am the one who can't meet their eyes. Our clothes rustle as we shift from foot to foot in sticky uncomfortable uncertainty, words blocky and awkward. There is an empty plastic syringe, with no needle, on the floor - I kick it under the bed before thinking. Then the female physician's pager lets out a shrill, disruptive complaint, and she jumps, clawing at her belt to turn the damn thing off, already walking to the nearest phone to obey the pull of her electronic leash. And it is only now that I see how drawn she looks, how pale and unhappy. The left elbow of her long white clinic coat is smudged with some dark substance, and somehow this makes her more endearing to me - she seems more real and less of a constrained pawn. For a second or two, I wonder about what she has to go home to at night. I wish I knew her name.The male doctor watches her walk down the hall, arms dangling down at his sides, seeming loose, without purpose. He turns to me, hesitates for a moment, and then looks at me. I know this guy. He's paged me many times before, sometimes late at night. We know a little about each other, his plans to do a fellowship in geriatric medicine, my upcoming entry into medical school, his recent marriage and a few normal adjustment problems, my recent illness and tentative recovery. He's a good guy but I don't remember seeing him look quite so burned out before. I give him the old slant-wise glance out of the corner of my eyes, trying for a note of levity. "Getting to you a bit, is it, Matt?"
His face changes immediately - he scowls and looks away, then steps closer to me, looks directly into my eyes. "What's the matter with you, Jenny? How did you get so hardened? What do you have to be so cynical about?" He looks at me again, and I can feel the contempt. We stand in the corridor, face to face, neither of us backing down. Matt's respect and teaching have sustained me, a simple hard floor under my feet for the last few years. All of a sudden, it's as if that had never existed and there is a huge distance between us - I realize how little I really know and understand the residency process.
I felt something crumple inside me, wither irreparably. What does he want me to say? We've watched a lot of people die, him and me. And no matter what afterlife they've concocted for us in frothy or austere scenarios, I like this life here a whole lot better than the vague promises some guy who said he heard God or some wacky philosopher's projections.
I see in Matt's expression that he thinks I've become more bitter and embroiled within a vicious-circle fatalism of my own than he would ever have believed possible. Well, hey, it happens. So few cures. And so many demeaning, agonizing deaths, or surgical mutilations done in the almighty name of Health.
He's right - how am I supposed to become a doctor when I feel like this? Worse. It's worse, now. This tough, husky, brilliant clinician - this man already accruing a hospital-wide reputation for his quick, clear-headed assessments of problem situations - he refuses to stop looking at me. What am I doing wrong, damnit? What? He puts out a hand and holds my face for a minute - I can feel him looking for answers - and then the strangest thing happens. I can see his eyes watering a bit. "You have no right to put everything into such black and white dichotomies, Jenny. It's always changing. Maybe tomorrow she'll" -jerking a thumb towards the woman in the room - "see some soap opera, listen to Phil Donohue, and decide almost without thinking that maybe another day isn't so bad." His hand rises again, stops halfway. I think he remembers feeling like I do now. But he shakes his head and walks into the next room.I rush back to work, feeling colored and twisted by the woman's pain. And as I'm running down the stairs, for no evident reason, it occurs to me that I never even learned her name. I wonder what will happen to her, and why she supposedly changed her mind so suddenly. And, most of all, I wonder what was lost in my translation, what my curt summation of her words has left unsaid. My pager goes off again. But this time I turn it off without answering it.
Breath can only be taken away once
I think you've got some time yet.
Now to your heart - any pounding in your chest?
has your heart skipped a beat? Kindly focus
on the questions - your loves & hopes are
addressed in a different section.
Appetite? Hunger? Thirst?
I mean for solids and liquids.
Really we will never finish
if you continue these digressions.
Spleens do not vent - or did you say rent?
Be certain - we will need a lavage or CAT scan at least.
No doubt you are very brave
still I say you look a bit yellow.
We'll take a look at your bile -
but you must control your temper.
Can a man take such offense at his liver?
That shaking, call it tremors if you would
of intention - I never said it was willful.
And this swelling of ascites is nothing
to be proud of.
As to 'pouring your guts out' as you say,
or 'your heart in my hands,' or anything of the sort -
it happens of course
but I don't think that will be necessary
in your case.
forty-two years together
sharing secret cups of tea
new york times crossword puzzles
potting plants
watching the yellow finned swordtails swim back and forth
popping out baby swordtails every two months
forty-two years of waking together
for fried eggs
and his six stewed prunes
not five
and not seven
but six stewed prunes every morning
the lines etched in their foreheads
tell stories of the nights
worrying about their children and the grandchildren
and the days together in the sun
beaming at the other
soaking in the rays of light
every saturday we drove into Chicago
to visit bobbi and aunt marlene
always a table full of food from the jewish deli
bagels, corned beef, lox, cream cheese
dietetic cookies for bobbi
(and us if we wanted)
mandel bread, too
which always tasted like wood to me
bobbi spent hours and hours with me
playing and singing
teaching me potchie kichelach
bobbi talked to me all the time
so i spoke real words when i was
six months old
but she could never hold a light to Nana
Nana had blond hair
a dark tan
lived in florida for half of the year
bought me matching outfits and talking dolls
took me to her penthouse apartment in Miami Beach
and to disney world
she drove me everywhere in her white convertible
she told me she was twenty-nine
and i never knew how she could be younger than my dad
bobbi had white hair was overweight, had diabetes, high blood pressure
was always in the hospital for her heart
bobbi was from the old country and never learned to drive
bobbi has been dead now for fifteen years
Nana became old after an aneurism sucked out
her blond hair and dancing legs
she lives alone in florida
and watches game shows most of the day
my two little cousins only know the Nana
who walks with a cane and is sometimes forgetful
they've never seen her blond hair
both of my grandmother are gone
and I long to hear the yiddish hour
Now look here young man
Watch the edge by the flower bed.
Rain, still falling,
filled the daffodil cups
till the stem snapped.
His bed clothes were growing
damp as the earth.
Never mind about that now
I want this hedge cut back
not rounded like this. I want it squared off.
The lilac was thick with blossoms
The heavy scent irritated him
She's no more alive than that
Maybe some spring rain would do her good.
God damn it didn't I tell you
to square it off. I don't care if
you have to cut it back to the skeleton.
His bed shirt was wetted
to his skin. His gnarled chest
heaved a cough.
Spring rain can spare me that.
Arid eyes, globes of warmth,
and hope.
Fingertips extending from terrain
endlessly beaten,
weatherworn,
ninety-three years.
Blood trickling through veins
like rain on a window pane.
A blanket,
a song sung softly,
a small vase of flowers,
a bible
with a brown leather cover,
large print,
and a bookmark with a picture of Jesus,
on the bedside table.
A wistful sigh
carried by the breezes
of what has not yet been.
"Lord, have mercy."
Exhale. Inhale.
Exhale.
And here, I purchase my eleventh sweater—
to go along with my new jeans.
The barefoot woman
steps over the passing rat,
on her way to the town well,
carrying an empty vessel on her head.
She waits patiently
for the queue consists of fifty-three
other women and a two-hour wait
in the merciless sun.
She makes her way home quickly,
before the temperature of the water
makes it unsuitable for drinking.
And here, I casually turn on the water
for my morning shower.
A fifteen-year-old girl
puts her apron on over her petticoat,
combs her hair, glances back
at the prone figure on the bed,
and shuts the door of the straw hut.
When she returns from her seven-mile walk
to the doctor,
her mother makes a strenuous effort
to sit up and swallow her medication.
And here, I take an Advil.
A dying man
recalls his rampant childhood,
his first love,
the growth and changes he underwent as a youth,
the family he once had,
and his best friend.
He also recalls the last time he swallowed food—
five days ago.
And here, I have trouble
deciding between Domino's and Pizza Hut.
There seems to be no Peace or Rest
For this unfortunate Soul, tormented
By the "shoulds" and "musts" of our mad Society!
When we reach out, she deals correctly with us,
Then, left alone, she returns to her agony once more.
Compulsion is her jailer, Guilt her constant torture.
Pride is a barrier to friendship or compassionate aid
Her neighbors offer, from their hearts.
There's no respite from the relentless pressure,
As, sorrowful and helpless, we watch the tragic play go on.
Sensing the crouching explosion waiting to occur,
When, at the last push, she will promptly self-destruct!
Meanwhile, her family thrives, under her loving care.
Her husband and her children pace through their usual day,
Seemingly unaware that she is so, so ill.
And we are kept away, just out of reach!
Incisions now blemish the flesh, Your creation
They spoke of the blood loss that I had sustained
How could I resist in my weakness this flood
The soul of another now runs through my veins
Their laws have acquired a sacred complexion
They deemed me incompetent, then gave me blood
Such sacrilege wantonly rendered forsooth
Offends You, Jehova, all-powerful God
Jehova, Jehova, recall my convictions
For years have I faithfully witnessed Your truth
Transfusions corrupt me, I fail to resist
Good God, O Jehova, Your mercy let loose
When faced with the choice of entrusting my life
It's all predetermined what's top on my list
So do understand since the hand is all-fallibly human
I'd rather entrust it to something that may well or may not exist
I coughed out
bits of language
trying to explain
and when the story was done
you asked me
when dinner would be ready
Memories of the days during
your hospital stay...
I remember how much
we laughed as we made our way,
And oh yes, the CT scan of your chest
revealed a shadow around your heart,
Stress thallium was next...
And I remember yes,
the smile on your face
as you told everyone,
your daughter is in medicine.
And how happy you were!
to have me near,
as the catheter was placed in.
If you could only have seen my face,
as we unveiled the reason
for your fatigue...
Cardiac pressures equal everywhere,
good LAD function, No CAD
Constrictive pericarditis
turned itself in with a
Kussmaul's sign of no retreat.
Eight long hours of battle,
our agony too, as you fought
for your life, and...
crying in silence
I asked for my dad.
Speaking to you softly,
though you couldn't hear me,
I reached out for the warmth
of your hand,
Seeing you with tubes in every orifice,
swollen three times your size,
crying within me,
I asked for my dad.
Multiple organ failure,
I watched as your kidneys gave in,
no improvement through the night,
Mother watched me closely,
for hope in my eyes.
Slowly, very slowly,
I had to say Good-bye
As I reached for your hand
and there was no warmth...
No more laughing, no more long drives together,
no more sharing of our dreams,
my vision becomes blurred
as sorrowful tears leave me,
I miss you daddy...
Lately there's been a rash
of medical name-dropping in various
multi-media
works of art.
At the museum, intriguing, funny
in an unabashedly scientific
way terms, cold
mysterious, exotic
hip to know
terms that bumble off the tongue.
Art is form.
Felicidades, Twin A, more precious than those
wide load full term babies, three smiles already.
Brand new color dreams to you,
Your nightmares put to rest.
All I noticed was that it tingled that Friday,
then by the next day it had turned,
cold and blue,
and hurt like hell.
I'm working two jobs now,
running the register,
and I just can't do it with my thumb like this.
The doctor seemed really worried at first,
and asked lots of sneaky questions,
but he says things will work out all right.
I'm used to a rough life.
The second day they took me down to X-ray
and had me lay down on this steel cot
with a big machine sitting just inches over my face.
All the doctors and nurses put on lead aprons and
hid behind concrete walls while this machine took pictures.
They sort of explained it,
but I din't understand it.
The nurse tried three times to get the needle in,
but I didn't even flinch—
this is nothing compared to childbirth.
The next day my thumb was better?
The med students, nurses, and doctors
were all impressed—they didn't expect it...
they poked and pushed, but my thumb
was just rosy and warm!
Why me? Why now? they said.
They wanted some credit for helping me,
I guess, but in the end they admitted that
I just helped myself by not smoking for two days.
They told me to stop smoking forever,
and they sent me home.
But it's not easy with this daughter and
the divorce and all.
Nay. Instead, a single
character of space and line
melded in novel delivery,
the period of the "i,"
turns of the "b."
Yeah. An alphabet solitaire and
fine,
blended in timely history,
a momentary sign,
notes of harmony.
Hey! The fading letters of
thine and mine
shared in passing glory,
elements of perfect rhyme
themes of melody.
Over the past nine years, entries to Body Electric have continued to grow in both quantity and quality. This year we received a far greater number of entries than any recent year, including prose, drawings, music, and photography. Due to a limited budget, and the incredible talent expressed in this year's profusion of poetic pieces, these alternative art forms have been underrepresented.It is humbling to edit a publication such as this, the contents of which represent such outstanding accomplishments by the part-time poets among our colleagues. For others who have felt the swirling waters of poetry about their ankles, it is time to take a swim. However, we would again like to encourage the exploration of alternative forms of artistic expression, and look forward to all of your entries in the future.
As always, we would like to thank Suzanne Poirier, PhD, our faculty guide, who has helped Body Electric to grow tremendously since its inception. We are continually indebted to Hyman Muslin, MD, for judging the final selections. Once again, we are grateful to the untiring hands of Bernice Coleman, which have typed the final manuscript. Finally, the Senior Editor would like to express his thanks to the Junior Editor and confidence in him and in incoming editor for next year.
Editors: WALTER WILLIAM
DALITSCH III
College of Medicine 1993
S. DAVID LO
College of Medicine 1994
Advisor: SUZANNE POIRIER, PhD
Associate Professor of Literature and Medicine