There lies my mother on the sidewalk blood pouring everywhere. The blood is everywhere dripping across one side of her face drenching her neck glaring red. There lies my mother with strangers bending over her. Here. Put this on it. Don't move. Hold your head down. Some people are part of a staring background.

I am running into a tall building with two or three names I don't see as I read through the glass windows I run past the front desk I've already called an ambulance says a nice lady with red lipstick as she is hanging up a receiver but I keep running my tears are flowing like the blood on mothers face I am running into elevators and up stairs and on to another floor 'til I realize I am in the wrong place and don't know where I am going or why I'm standing here at the head of a long narrow hall with office doors on both sides of a never ending grey carpet.

So I find another elevator and go back outside where a nice lady hands me her card and says you can call me I saw the accident the ambulance is carrying mother and grandfather on two stretchers inside I ask a young man in short sleeves can I ride too. He says OK so I am about to climb a stair but a man with a belly says wait give me the keys to your car so I can tow it out of the intersection. So I say OK holding up the keys. It's this one and he gives me his card as arms pull me into the ambulance and slam the doors.

I am standing in a hospital room and a young man with shiny black hair is asking too many questions. I am using my hands to tell him what he wants to hear. He keeps wanting to know about the windshield. I sometimes answer yes, sometimes no looking at the name of the hospital stamped all over his green pants like K-mart. He is getting impatient with my shyness and awkward smiles. Maybe he knows I'm lying and one's really sick. Did she pass out or not? His mouth is flooding like a spring river.

I.
Dirt stains, clutter, and chaos
in every corner, and you said
"This is where I'd like to die."
Surrounded by a riot of things.
But, when the hallucinations come
they will all begin peering at you
moving closer and closer...
It may not matter though since
it's said that every death is suffocation.

II.
Cancer creeps up your spine
and you say, "I don't feel no pain nowhere."
Six little bottles open on the card table—
is that all? Six little bottles and no pain.
"Even though I'm dying, even though I miss my children
already, even though I wanted there to be a lady that I loved
holding my hand."

III.
"Yeah, I was the meanest man in Carpenter, Mississippi."
Tell me something else, something fit for history.
"I'll tell you some good jokes, if you promise
to write them down." Tell me and I'll laugh—'til I cry,
'til your hands spread over your gray eyes and I wonder
if I should leave and if I have ever been this close.

IV.
"I'm going up on the rough side..."
I will even sing a little if you want, if it helps.
He says, "Just let the record lead you."
Sing even though you feel like shouting, like praying.
What's the difference now. There is a God—and I believe—
with a powerful hand—and you believe,
So hold on tight.

V.
Bananas, grapes, and butter pecan ice cream.
Brother will get whatever you want.
What you can still have. The throat went first.
Throat to lung to stomach to bone to spine to brain
as if it had a right to colonize your body.

VI.
You said, "Take three dollars in food stamps from the Bible."
So that's what is left. But you shouldn't have to die with
just that. Something is wrong. Which thing?
Which thing?
Tell me what this next goodbye means.
Let me know if this is an acceptable way to die.

I tried to concentrate despite the din outside the room.
    A heart pumping. A heart pumping. A heart pumping. A heart pumping. I look at the screen with the image of Helen's heart upside down. I couldn't understand anything the tall, dark-haired tech was doing. His face was fixed on the screen in stern concentration. I leaned over the railing of Helen's bed in the dark room and touched her withered brown hand.
    "Looks like an anterior wall MI," he announced matter-of-factly. I strained my eyes to see the hypokinetic tissue in Helen's heart that made her sleepy, uncomfortable, and close to death. I imagined where it could be on the black and white outline of her heart.
    "What makes you sure she has mitral and aortic regurgitation?" I asked haltingly.
    "Well, basically, when you look at the Doppler scan...."
    My eyes trailed off from the babbling tell tech and his ECHO monitor to Helen's old hand and stared at the wedding band on her ring finger. I asked her earlier who she lived with, and she had remarked that she was alone at home, always had been.
    "...and if you look at the directional flow of blood in and out of the ventricles..." The tech was doing color graphics on his portable ultrasound machine for me. From his calm posture one might have thought that he was standing in line at the bank his lips moving in an unfaltering tone that was droned by this woman's heart beats. My ears traveled from his monologue to a gallant, booming alto outside our glass door, "I'm dreeeaaming of a whiiiite Christmas!!"  The bellowing voice rose and fell like Helen's heart with the beginning and end of each word, rolling like waves off a senile, old tongue.
    Inferior wall MI.  Anterior wall MI.  The room echoed the words.  The nurses.  The tech.  The resident.  The cardiologist.
    "Do you want us to call anyone?" I asked.
    "No, I don't have anyone." She smiled at me warmly. She raised her head from her pillow and nodded at me, shrugging her eyebrows in affirmation.
    She saw my eyes drift sadly to her ring finger. "It's my parents'...."
    "Left ventricular wall motion...."
    "I'm dreaaming of a whiiite Christmas!"
    "...what the hell is this, the Opera?!! We have an inferior wall MI in here." For once the tech seemed to attempt an exhibition of life with his wry humor.
    Helen must have noticed my open month. "You see, I never married. Just never met the right guy I guess." She paused, her eyes fixed thoughtfully before her. "You know as a young girl, I always thought of love as something best kept away from marriage."
    I felt like sitting with Helen till she died at that moment. This friendly parched old woman who had annoyed me with her loquacious pointless parley less than one hour ago.
    Throughout my questioning I had shifted uneasily, as she told me about her second cousin's husband's friend's daughter's pet poodle. The nurses who entered her room had rolled their eyes as she spoke.
    She lay between me and the man with a hundred electrodes. The lines in her wrinkled forehead echoed my shame.

I used to walk uprighteously
Then tripped over pebbles, rocks, & boulders
with more passion than a first love.
So inseparable, as if til death do us part—the highs—
But the lows hated me.
Calculated sins afforded brief moments of that wedded bliss
But still, the lows hated me more.
My love stoned me—sacrificial crack in my worn
body & soul.
Would I succumb to "'til death"?
No, yet there was no divorce.
I belabored twelve steps to walk away.
Unfortunately, those deserted pebbles, rocks, & boulders
forever stalk me.

You couldn't even catch a ball—
The last one picked and the first one pecked.
You were a pigeon-toed featherweight
who disappeared from the playground;
Returning new, in front of me.
With your hands of stone.

My father would never have approved of you.
Brow-beaten and throttled, you'd have
Brought your hands to your own chest.

You like the attention from the women a bit too much.
I'd tell you to put your game face on, but you never had one.

Tell me he will live or tell me he will die,
you would run if you were able to.
Your smile is not warm—it grins.
your laugh is not reassuring—it giggles.
There are no furrows in your forehead for a foothold, but
Just one small gray strand to cling to

I'm feeling the pressure that's around me:
Stuporous gases that swell inside my mind
leave me faint and unable to fight
Dead-weight tears at the pit of my abdomen
and I wonder if the bowels will bleed.
...how can I love if unable to know it?
I see the yearning in her eyes and I want
to give myself to her and absorb the tears
But I fear she takes me for who I am not,
if only my body would allow me to feel...
I taste the salty wetness on my lips now
to tell me that my numb brow heralds fear
And a heavy electricity sends surges of shakiness
through my body in orbit around its center.
...where did I lose the control over this!?
An adult with education and all of that
I should not be falling for traps
for a brief moment I exit my person
to contemplate the dawn of these shackles...
In the final moment energy grows from chaos
to find all hurt love, burnt hope, dashed
dreams, and fear of premature extinction,
To focus on an organ beating though my chest
So that at these times I know my very death.

You awaken
to an even darker morning
in a house on a small farm,
where your father once reaped
corn from the fields,
then abandoned
to weld GM chassis
and now, laid off, drinks beer
in his broken chair again,
gripping his leather belt,
ready to let it snap
and reopen the gashes
on your still stinging thighs.

Instead you slip out your window,
across the porch roof,
and jump to the safety
of the overgrown fields below,
whose weeds caress your body
like your mother's hands used to,
for one more day as you walk away
mile after lonely mile,
your misery is a map
followed anywhere but home.
But light fades all too soon.

Your thoughts return to your father,
beginning to hear his footsteps,
louder than the rustling leaves,
closer with each whisper
of your name in the wind
like his chilling breath on your neck,
summoning you to the flashing heat
of what home means.
Turning your head and running faster,
on to a country road,
his burning eyes are everywhere
even inside the pick-up truck
that ploughs you over
and shatters your leg and ribs. And fearing his punishment
for running out so carelessly,
so much now like the sissy he said you were,
gasping for breath
you peel away your body from the pavement,
and like a wounded animal
grinding bone against bone,
tearing muscles and skin from a trap,
dragging your useless leg behind,
you limp back into the safety of those fields
where the weeds reach out familiar arms
and softly cradle you to hidden sleep at last,
until they find you basking
in the morning sunlight
that thaws the frost
from your bloodless lips.

    He was a sea creature, an inhabitant of deep currents, the depth of his passion like swift hidden ocean currents under calm seas. His love spoke not with words but in gestures, in a lifetime of small actions and habits of the heart. This sea creature, this blue whale, is now caught under white sheets of ice, unable to burst forth but with lungs near bursting, unable to breathe.
    Home from the hospital for the last time, he gasps for air as his wife of fifty years wonders how to help his pain. Feet at the end of long legs untuck white sheets from a tiny bed set crammed into the family study. He remembers this room where one son studied for the bar, where priests and finances have slept, where his mother spent her last year. In fact, she died in this very bed, relieving him as much as his wife after that long year of progressive infirmity and confusion. He had been the only one she knew in those last days twenty years ago, and it had taken a real effort for him to connect her desperate face then with that of the mother whom he remembered and loved.
    Now his task is to breathe. He feels he is suffocating, just can't get air into his lungs. And his thoughts are getting cloudly from lack of air; like a baby trapped in the birth canal, his whole being is hungry for air.
    The wife tucks in the sheets around his blue feet again, props him up somewhat in bed, doesn't know how else to help his pain and breathing. She wonders what he wants and needs; perhaps it's time for more pills. His writhing pauses, and he looks up at her with desperate eyes, too busy breathing to talk and too focused on inhaling and expiring to hold a pen. Does he know her, she wonders. Yes, there's that look of affection and recognition when she calls his name and tells him that everything will be okay. How soon, she asks, will the end come?
    He looks into this woman's face. Who is she? I need to breathe, he thinks. His mother stands over him. He is in her bed, having sought refuge from the night and the closet mondsters. She tells him that everything will be okay. He swims in her shadow; she will protect him; she will love him.
    They climb together to the sunlight above....

Before
you ask me to unravel
my silk peels off
the form of my nakedness is revealed...
Say please.

Before
Your cold hands dice my body
I succumb to your demands
there is no privacy, only shame...
Ask please.

Before
you penetrate my walls
breathe into my loins
my sexual violation...
Beg please.

Mom, I have a cold and sore throat.
Take some goose grease out of the frig, warm it and put some
around your neck. Then, take some cod liver oil and a teaspoon of
honey and lemon.
No thanks. I'd rather take some Robitussin and Vicks vapor rub.

Mom, what's that smell?
Oh, that's my garlic water. I've been taking it almost everyday for as
long as I can remember. It helps my blood pressure and diabetes.
No thanks. I'd rather take a multivitamin.

How was your dentist visit?
He pulled the tooth out. He gave me some pain pills and penicillin.
How many days do you have to take the antibiotics?
I am not going to take them.
Why?
Well, one of my aunts has diabetes. She had to take penicillin. She
got sick and was rushed to the hospital. So I am not taking the
penicillin because I have diabetes also.
Have you taken penicillin before?... Well, you can't become allergic
to it just because you have diabetes. You need to take it to prevent
infection.
OK. I'll take them.

    Hell naw! I ain't never seen no black docs up in here before. But when she opened her mouth and started talkin' I knew she was a wanna-be. Here she go askin' me "do you smoke, drink, or use any recreational illicit street drugs." She really pissed me off with that one, but I shoulda known better. I guess there's a whole lot more "white" about her than that jacket she got on. "No, I ran out two months ago and I ain't git no mo.," What's up with her grillin' me bout those iron pills? "Huh? OK uh huh I am anemic that's what they told me after I had my first baby in May and in July when I got pregnant again they told me I was still anemic." Then she started telling me about how anemia means low blood levels and by being pregnant I have to have enough blood for myself plus make some for my baby. Since blood is made up of a lotta iron I have to take these iron pills to help me out keeping my blood turnover rate where it's, sposed to be. She told me that it's not unusual for a woman to get a little anemic after having a baby because you lose some blood to the baby and you lose some more blood when you go through delivery. She told me that it's best to wait about four months after having one baby and getting pregnant again because you have to give yourself enough time for your blood levels to level off. There she started telling me that if I breast feed my baby, I'll be smarter and I'll lose weight faster. Before I knew it we was talkin' and she ended up hookin' me up on all kinds of things.
    So now I'm standing in line waiting to make my next appointment. I feel refreshed after today's visit and I'm actually looking forward to my next.

They traveled from far away.
Looking for a priest.
Father, please baptize our baby.
He does not have long.
Please, hurry. Please, hurry.
The infant's eyes were sunken,
Almost lifeless.
His shriveled tiny body was hidden in a blanket.
The priest ran from the church.
With holy water he blessed the child.
Just then as the Amens were said
The infant passed away.
His grandmother began to chant
—an old song to release his spirit to the heavens.
Everyone was crying.
His mother finally said
Do not be sad
For now we have another angel
And he will always guard us.

"No, I'm sorry."
"But he's a good student. He's done this many times." "I'm sorry, I just don't feel comfortable having a
student in the room."
"I understand. Thank you," I say.
But do I?
How can I learn the delivery process and procedures
without being there!
I feel frustrated.
What's the problem? I've seen plenty of female patients
and deliveries.
I don't understand—or do I.

Now I'm in their shoes: the patient (well somewhat).
And even as a student, I question if we will
allow a "stranger" watch/help with one of the most
important times of our lives.
Seeing the two of us exposed.
The possibility of the stranger doing something wrong.
Am I a hypocrite?
I'm confused...
but now I am a stranger in their shoes.

Three months into medical school and his first patient is dying. A man he hardly knew, yet so important to his life. "What is my role," the student asks himself. Give moral support, but come on, anyone can do that. "I should do more!" But what? He can't even answer their questions.

Why is he yellow? "Well...uh..."
Why won't he eat or pee? "You see...uh..."
But I heard morphine can be bad? "Well it's addictive..."
They try to extract information from his brain
like a mosquito sucks out blood on a hot August day. Angrily, he
wonders why don't they ask what innerrates the trapezius or the
insertion of the iliopsoas. The frustration is overwhelming.
The self-doubting begins.
"I'm going to be a doctor, for God's sake. Do something."
He lies there helpless.
Soon the patient's spirit leaves its organic counterpart.
Time passes....

It's three years later; the student is almost no longer a student. Looking back, he realizes that he did practice good medicine. Giving moral support is part of being a doctor. He realizes that these past four years were not only helping him grow to be a physician, but more importantly he is growing as a person.

The Firebird picked me up
at the curb of the towering tomb
where pledging M.D. occurred.
Last night's call hurt to the bone.
Firebird and fantasy were palliative—
In my mind the eleventh hour savior.
Easily nestled in, suddenly Lady Luck smiled.
The Jackpot!
The falling coins sounded like
gravel under a moving car.

Someone cheered my name
On easy street, I was floating.
Then we hit the grassy embarkment.
The Firebird hatched the firebird within.
A glass christening bore an appendage
on the crest of the crown
that flapped in the air as he flew.
He fell at my feet:
now I was the eleventh-hour savior.

His presence is here to heal
"The patient is a 28 y.o. African American woman with a L/o AML"
His presence is here to heal
"She was treated with chemotherapeutic agents and given a bone
marrow transplant, which held her in remission for 1 ½ yrs,
until 4 months ago."
For I am the Lord
"Then she became more fatigued, lost weight, and blood tests
revealed leukemic cells. She's currently obtunded and in real failure
with an Anasarca, maintained with respiratory and pressor support."
That healeth thee
"At this point our efforts are merely supportive. Her husband,
pastor, and family friends are in the room with her, praying..."
His presence is here to Heal

"I think she'll die soon..."

we know that by Your stripes we're healed...
We release her spirit to You.

I cry but nobody hears me,
Why are they sticking me so much?
They are taking all my blood.
They filled up millions and zillions
of tubes and they want more....

Aw wo, Awo, that hurts
let me go! Let me go!
and then I kick and scream
and then I cry no more...

Sometimes I can't breathe,
then I get really hot,
I'm too tired, I can't play anymore.
They say I have phlemonia.
They think it is bad...
I don't wanna eat either,
and I won't talk anymore.

Because they keep sticking me
with needles. They are mean people
they say things I don't understand.
Granma looks sad. I never see
my mommy. Aichaibee?
Grandma what's that?

I sat there watching him, this man, my grandfather.
Sitting on the couch, cigarette in hand.
Not really knowing what was on TV, not really caring.
Eyes closed, sleeping. He told us he was resting them.
Holding onto his cigarette. Smoke coming out of his nose.
He smiled.

I stood there watching him, this man, my grandfather.
Lying on the hospital bed, no cigarette in his hand.
IVS in his arm, oxygen so he could breathe.
Eyes half closed, mind half awake, body half alive.
Machines beeped, ventilators pumped.
Sitting up, trying to breathe, not liking his food, missing home.

I knelt there watching him, this man, my grandfather.
Lying in his coffin, arms folded, so peaceful.
Fingers curled as if holding a cigarette.
Wearing suit, old tie, old shirt.
No struggles, no worries
Once again with his wife, separated for eight long months.
Eyes closed, lips together, hair combed, skin cold.
No longer saying anything.

We met in the shadows—
The shadows slowly melting
Before we drifted away.

Again we meet in shadows,

Voices bridging an ampty sea.
Discussing what is easy,
Leaving what is difficult.

In the darkness, I still search.
Sometimes gazing at the sky above,

Sometimes staring at the ground below,
And sometimes just closing my eyes.
Seven straight days in the hospital spent fighting to give them a chance to go home again. And now, I'm home. The furniture is gone, the dishes are gone, the clothes are gone—she is gone. Only a poem scribbled in pencil on a crumpled piece of paper remains.

No more silence,
Screaching violins.
Disco lights fire.
I scream of its betrayal.

White clothed girl exposes twin pink pills.
"Just say no."
White clothed girl summons
The Man
Shoots me up higher.
He carries me to The White Room
Nestles me into bed
Mmm.
                            But
Straps tie me down,
Bondage violates my soul.
Perspires,
Slips off His brow
Onto my naked forearm.
Videocamera consumes the act.
Exists The Man.
The White Room is bolted.
Siren expire.

Violence ends.
Silence returns.

The apartment you were rebuilding for you and your wife
Located right behind your parents home, it was really quite nice

Halfway completed just one year ago
Renovations since then have been put on hold

One might wonder why, for things appeared to be going so well
And basically they were, except for your health

It all began six years ago, as you turned twenty-one
When that tiny lump located above your knee proved to be malignant

Having found the sarcoma so early, after surgery everyone expected the best
A beautiful new wife then a new baby boy, followed by a routine radiograph of the chest

That same little tumor which had been removed from your leg year's ago
Had now spread throughout your body, barely twenty-seven years old

You retaliated bravely, armed with chemotherapy, radiation,and prayers
But after many months, you ceased your fire, resorting only to palliative care

As a hospice volunteer, I visited at least once a week
Were you comfortable, was your pain well controlled, were you eating, how did you sleep?

Always so cheerful, you had good days and bad
At times, strong enough to leave your parents' house and visit the one you had worked so hard to rehab

Unfortunately, most of the remodeling you had completed was on the second floor, out of your sight
As you describe the finished work upstairs. I knew the best medicine I could provide was "one single flight"

I worked for weeks trying to find a way to transport you safely up those steps
For a terminal illness had selfishly robbed you of your breath

Your desire to lie down and die inside the bedroom you had planned for decades to live in
Transformed that one flight of stairs into a stairway to heaven

Sadly, your condition deteriorated rapidly over the Thanksgiving weekend
Surrounded by loved ones, you passed away peacefully on the first floor of your parent's home

Although your life ended before ever making 'it upstairs' you are no doubt in heaven
I thank you for teaching me more about life and medicine than my textbook ever could have

"You never talk about literature,"
Was all that she said
Five minutes and thirty seconds
After we went to bed.

"Before, you would discuss Chekhov
In lieu of being fed.
While on reciting Keats,
Tears would you shed.

"And reading William Carlos Williams
Would make you see red.
For literature brimmed in your soul
Before you were pre-med.

"Recall that it was only for literature
That I thee wed;
Otherwise, I would've run off
With that law student, Jed.

"Now, talk is about how much
So-and-so bled,
And about bullets with which
Bones are shred. "Hours are wasted on germs
Or other things I dread
Now that only medicine
Has a hold on your head.

"And every night at dinner
I choke down my bread
For I've enjoyed more simulating talks
With our dog, Fred."

I turned to face her
And seeing that her eyes were red
All thoughts of sleep
From my mind quickly fled.

Visions of how to appease her
Came to me instead
However, I had to bite my tongue
Before I hastily said,

"In my heart, dear,
Literature is not dead.
Why, there was a wonderful article
In JAMA I just read!"

José is in the hospital
Nurses, doctors, residents came for information
Nadie te entiende

You sit quietly
Unsure of yourselves
And very shy
No one understands you

Why did they bring José?
Why can't they answer our questions?
Why don't they speak english?
Nadie te entiende

They "only" visit once a week
Do they know they can't bring their other children?
Why don't they get a babysitter?
No one understands you

Their children are so dirty
And where are their socks?
Nadie te entiende Dr. Reyes says you speak a different dialect.
Dr. Vincente says she can't speak to "those kind of people."
No one understands you

José is not gaining weight.
What did they feed him?
Did they feed him?
Nadie te entiende

Send DCFS
Have a nurse monitor the mother
You ask politely,
Why did those people come to my house?
No one understands you

You ask, why is José not getting better?
You want to take him home
He will be three months old the 10th
Nadie te entiende

    I lost my way only once on the unmarked and haphazard streets and highways of New
England on my way to Boston from my interview in a town just north of there. I was going to stay with an old friend from college whom I hadn't seen since his wedding in Philadelphia eighteen months before. After navigating obscure and random Boston streets, I arrived at a pretty house with leaves covering the lawn and masking tape around the borders of the garage-door windows.
    When she came to the door, I didn't recognize her at all. Only later when I picked up their
wedding album was I able to connect my memory of the petite and joyous bride I'd met once eighteen months earlier with the tired and very pregnant woman who greeted me at the door. While we waited for Seth to return from the hospital, Lauren brought me up to date on her and Seth's life together. They had just moved into the house in West Roxbury, and would be furnishing it as they went. Saying that a decent lamp would be their next purchase, she uncovered a garnish and shadeless yellow lamp for me to view the album picture. In the past month the pregnancy kept her from working, and she spent her days occasionally talking to neighbors or waiting for Seth to come home. She had been looking forward to this weekend, the first in months during which Seth would not be working.
    I'd met Seth early in college; as physics majors we'd spent countless late nights together
finishing problem sets and preparing for exams. As our study group became more comfortable we spent more time talking about ourselves and occasionally about our futures. Seth had always wanted to become a doctor; I was sure that from grammar school onward he'd always held himself to an enormously high standard, and I never knew him to fail that standard. I remember how easy it would be to trust his competence as a physician; he shared with us his dream of being a country doctor, known and trusted in some small town in middle America. In our last semester we'd had a very memorable heart-to-heart conversation; saying that I would make a good doctor, Seth urged me to consider medicine. And in fact that's what I'd done.
    When Seth returned home later that evening he looked fresh despite having been on call the night before. It was clear that he loved his job. While he showered, Lauren told me of the vision of their living the romantic dream of being a doctor family in a small town, a dream that had faded considerably when Seth's surgical residency began. Over dinner he told me a little about his schedule. He'd have the weekend off because the three residents on his team divided weekend responsibilities such that every third weekend would be an "Iron Man" weekend: the Iron-Man resident was on call from Saturday morning through Monday evening, but had the following weekend entirely off. But, he added, an attending physician had asked him to come in this Saturday anyway, "just for the morning." Lauren did not look pleased.
    Seth was in love with his job as a surgery resident. Recently he'd been allowed to insert the catheters into the great vessels of a patient in order to begin cardiac bypass. Once, while on call alone, Seth had decided to and then performed surgery on a cardiac patient in intensive care whose recent surgery had caused him to lose blood in this chest cavity. "He walked out of the hospital later that month," Seth told me.
    He wanted to stay in academic medicine "to be with people smarter than me who know more or less than I do." He was planning to take three years off to explore the way cells organize themselves into organs by applying concepts from physics and chaos theory. This would mean that he'd be a resident for about ten years. I imagined the chaos that this devotion to science and medicine and his patients might cause in his married life.

I'm searching for a piece of myself.
Checking charts—birthdates, addresses,
or an aspect of her history.
Just looking for me—in her.
It helps me stay grounded.
I don't feel so different
When I find a similarity.
We are more alike than not?
Sisters, sisters, I do know, I have ailed and
I have rejoiced.
Realize that first I am your sister and let that bond
fuel the rest.
I'll help you heal your body.
You'll help me heal my mind.
Fuel! Body and mind.

The ring is still on her hand, the gold shines as bright as ever.
His love has outlasted her, just as she had always hoped.

Her face, rouged with a brush, reddened by laughter, and blushed by
his touch, is kept moist grey under plastic over gauze on top of oil.

Her breasts, full of lust and full of ache,
were removed on the way to deeper, flatter, testable structures.

Her back, which bore the strain of five children and their burdens,
was halved by our hacksaw.

And her heart, broken a thousand times, was dissected perfectly,
and shows no want of blood, no mark of disease.

Her soul will remain alive in the eyes of her children,
and her heart will be burnt.

Somebody who loved her is left somewhere to grieve,
but none of us will mourn the death of our first patient.

    Just a few more steps. Come on. Wait! Stop! Pleeeease? Damn! Too late. Missed the 'el' again, and this time I have to catch a plane. I am in my fourth year of medical school about to embark on a two-day journey to New York City for residency interviews. It's Chicago, it's December, so it's freezing. And I just may have missed my plane.
    I look around, and see others slowly filling up the cement-roofed platform. The usual type—city walkers with Nikes and pantyhose, white-bearded, leather-briefcased professor-looking types, and the few young, over-consumed-with-appearance college students. I venture a look down the hollow tracks, and am suddenly slapped by a brutal wind. Punishment for my impatience. Punishment for being a Chicagoan. I retreat in humble surrender.
    Five long minutes later, the tracks shake, the people on the platform rush about, and the train arrives. I quickly choose my seat, naturally in an empty row. Everyone and their cousin in this country respects space. It's an unwritten and widely-practiced law. One simply does not sit next to another passenger when there's an empty row nearby. Alas, seated and on my escape trail.
    The train dwindles along, stopping as needed. I stare at the lights everywhere, most of them clouded by the winter intensity. I occasionally focus on a fellow passenger, when he/she is not looking of course. Unwritten social law number two. My thoughts run without a pause and without an order. I imagine an oil massage on a Maui beach, a sunset that's happening about a mile above me at this very moment. Wonder if New York City will be sunny? Will I survive its chaos, its numbing overstimulation, its charm? Oh, oh, where's my ticket? My portfolio? Extra underwear? Alas, a sigh of fatigue and impotence.
    "Washington mumble static static mumble." Can't beat the technology of communication on an antiquated Chicago train. The train comes to a halt at the busiest station. Yes, it's Monday rush hour. Yes, it's forty below with windchill, too cold for cars. And yes, it's a downtown stop. But, why did the most rotund of the commuters have to occupy the seat next to me? This triple-coated, double-gloved, wool-hatted man glues the right side of my body to the metallic 'el,' and declares in a husky, baritone voice, "Dang, it's cold out there." His big brown eyes look at mine for a brief second, eager for a response. "Yup," I respond. Short and succinct, I adhere perfectly to the protocol of a response by a young woman traveling alone on a city train to an unacquainted member of the male species.
    Then, a few moments of perfunctory silence. Even the most decent well-intentioned gentleman avoids the overzealousness at the start of a conversation. I re-withdraw into the view from my window, now that I am even closer to it. We are heading west, and within minutes the glimmering Chicago skyscrapers are replaced by colorful, neon sign of chain stores in strip malls. The stops are fewer and farther apart now. I expect to have the seat to myself pretty soon. After all, he doesn't have any suitcases, and the airport is the last stop on this line.
    I turn away from the window and observe my cold-weather-loathing seatmate rubbing his knees vigorously with his mighty hands. Somehow he catches my stare. Caught in the act. My crime is my curiosity. "Zero and below, and the blood don't reach my knees," he tells me. "Zero and below," he echoes sing-songedly.
    Is he clotted? Is he status-post fem-pop by pass? Degenerative joint disease? And what is this `zero and below' correlation? Could it be studied double-blinded and controlled? Should I tell him about anti-inflammatories, steroids, knee surgery? Is it may place? Do I have a right?
    The train arrived at O'Hare, its final respite, and I excused myself. The 'knee-rubber' stopped his self-massage, and with the aid of the handrail, lifted himself off the seat. I freed my left arm in a gesture to re-acknowledge my space. "Take care," I said, looking at the stranger directly. I hurriedly disembarked. I passed my old familiar window, and took a quick look at my old seat. I saw him sit down slowly, this time, next to the window. A few more steps, and I lose sight of him. I head towards my gate.

    The woman in the hospital bed looked older than the forty-some years documented on her chart. Her fleshless shoulders poked landmarks in the otherwise formless hospital gown. Her face was gaunt and pallid. Thin, mouse-colored hair, efficiently short, hung flat against her scalp. Intravenous lines dripped medicine into her veins, and a nasal tube provided her with oxygen. Her colorless lips were parted, revealing discolored teeth.
    This patient had systemic lupus erythematosus. If I were to sum up my first impression of this woman with a single word, that word would be "grey." Not grey as in dapple-grey, or silver grey, but rather the grey of pavement or a November sky. If black represents death, perhaps grey is the color for the terminally ill.
    In the dim light, the woman merged with her surroundings. She did not create a sense of presence in the room. It would have felt the same had she not been there. She was seemingly only one small part of the bed and the room. Certainly the room was a part of her, with its tubes running into her arms and nose. Standing at the foot of the bed, I felt my own physical boundaries were sharp and overly defined.
    The woman's breathing difficulty, so efficiently described by "s.o.b" in her chart, took on a different meaning as I watched. Her entire concentration was on filling her lungs with oxygen. The television was still and black, and no reading material was in sight. Breathing was a demanding, conscious process.
    The doctor asked if I wanted to listen to the patient's chest sounds. She had a "pleural rub," a sign of fluid accumulation in the lung cavity. The distinct noise is produced by the resulting friction between membranes.
    I took the proffered stethoscope, placed my hand on the woman's shoulder bone, and listened for the lung sounds that the doctor had described to me.
    Hopefully I hadn't gotten the earpieces of the stethoscope in backwards again. I'd been handed the stethoscope countless time in the past few days, but there was still a fleeting panic that I would fumble this extension of the doctor, or that I would be unable to hear anything. I, however, had the requisite tool and the doctor's guidance to aid me in this exploration of the patient's inner condition. It was exciting stuff for a pre-medical student.
    The doctor said that she had to step out of the room for some reason. She suggested that I remain and discuss the patient's disease with her. She then left, leaving me alone with the woman in the hospital bed.
    I did not ask her about lupus. Instead, I commented on her untouched tray initiating a discussion on the unappealing aspect of hospital food. When we'd reached that universal conclusion, I glanced around the room for another topic. I admired her poinsettias. Christmas was two weeks away. We talked about food, flowers, and the weather. I like to think the woman enjoyed the non-medically oriented conversation.
    The doctor returned. She turned to me and asked, "So, what did you find out?" Offhanded I replied, "Oh, we were just talking about her poinsettias." The doctor did not pursue the subject further; she had enough on her mind.
    I felt an aura of mild disapproval, whether real or imagined. I felt, however, and still feel, satisfied with my actions. Even more, I foresee that such conflict is only a small taste of what is to come. I hope that I will be able remember this day. Medicine, and the education that is so much a part of it, exists because of the patient, and the patient's willingness to place trust in the health care provider.

    "He's pretty bizarre. I think you'll enjoy it."
    My psych resident asked me to take on the case of a University of Illinois college junior who had been admitted through the emergency department the previous night.
    "What do I do? A physical?"
    It was my second clinical experience in medical school and the first exposure to hospitalized psychiatric patients. I was aware that I might be interested in psych but had no clear idea of what to expect, much less what to do.
    "They did all that stuff last night. Just talk to him."
    Great, I thought with sarcasm, real precise directions. I'll just slide right in next to the patient and start some serious analysis.
    Jeremy was sitting in the day room of the inpatient ward, a locked unit that requires a key to get in, or out. The patients shared rooms, two apiece, but spent most of the day in this common area or simply floated around the two hallways that extended from a central nursing station. The day room had a few couches, T.V., card table, and refrigerator, but the white, tiled floors and sparsely decorated, yellowing walls lent an institutional feel. I was nervous about entering the room and being an obvious outsider, not only a non-patient but a new staff member. Another staff member pointed Jeremy out to me.
    "Hi," I introduced myself by name and as a medical student assigned to help take care of him. "Can you tell me about why you're in the hospital?"
    He was sitting yoga-style, alone, on one of the couches, a blondish kid with short hair and the blondish stubble of a beard beginning to form on his face. He had a tall, slender build and the hospital jams fit loosely over him, adding to the picture of a Tai-chi student in uniform, mediating. His eyes, gently closed, the face, expressionless but serene. "The images are in technicolor and move as if a kaleidoscope, but it's the back of my eyelids and I'm really afraid my friends are right, did I kill her, I'm really not sure, or are they playing a trick on me?"
    He had taken "magic mushrooms" with a few other people over twenty-four hours ago and apparently experienced a bad trip. His friends had brought him to the ER because almost a full day had elapsed and he was acting very weird. He was worried he had attacked a girl during this time, or at least that's what his friends told him at one point. His parents, who lived around Peoria, were going to kill him—or worse, make him move back home.
    "Can you interpret for me the following proverb: People who live in glass houses should not throw stones." The 'normal' person, falling into certain ranges for I.Q., education, and literacy, and being of an appropriate cultural context should answer by generalizing the proverb's interpretation to humanity. For example—people should not hurl insults at one another because they themselves are sensitive and can be personalizing the saying, making it self-referential, with a sometimes extremely abstract interpretation or even a very concrete one, like, 'the glass window will shatter.' "If my emotion is expressed to the world," he said, "the deception is uncovered, and I'll be punished for being a bad person, too hateful, selfish, sexist, and racist. Pure evil."
    The initial picture of Jeremy, sitting serenly and speaking loosely, tangentially, describes a profoundly psychotic person. A kid on a bad trip or someone with mania or depression with psychotic features probably would not present so calmly under those circumstances. Defining psychosis, Jeremy's ability to test, to even understand his reality, or more exactly ours, was absent. His diagnosis was Brief Reactive Psychosis, although the team consensus was that the hallucinogens precipitated the reaction, despite their chemical effect having worn off. The idea that many of us may go day to day with a predisposition to some kind of mental 'break' or to extrapolate, somatic one, and require some environmental, social, chemical, or traumatic precipitator is well known in medicine but its expression is so varied and unclear. That's one thing I love about psychiatry: it teaches us that we are all in for some surprises in life, some devastating, but all intimately linked to how we perceive, process thoughts, and feel the world.

    I began working for Mr. Johnson when I was thirteen years old. My friend Rob was his
neighbor and had worked for him before, leaving for a more lucrative position mowing riding trails for the Kensington Saddle club. Rob and I worked together the first few weekends, and he showed me where the pruning shears were kept and how Mr. Johnson liked the enormous garden hose coiled in long loops rather than in a tight circle. When Rob left, I got that first-day-on-the-job neverousness again, but Mr. Johnson was a kind man and easy to work for. He was about sixty, balding on top with grayish-blonde hair, and an old-time thick moustache. He was an executive of some sort, but I could tell he had had a country upbringing. His wife was also friendly, though quiet, and prepared wonderful lunches for us.
    Mr. Johnson took an active interest in the care of his place. It was a large piece of land, even in our area, hidden far from Donlea Road by thick woods. The house itself was of the midwestern farm style, and sat behind an old hedge. There were many birch and maple trees scattered among small, well-tended gardens. Across the drive was a small corral adjacent to the huge wooden barn, and a long shed containing the vast supply of tools and equipment. Behind the house was a giant, sloping lawn that curved gently against the thick oaks and weeping willows, like a soft green pond. Further off was an old pasture and the dark, silent lake where Rob and I fished for bass and big northern pike. All this was Mr. Johnson's, cared for first by him and his son, then by him and Rob, now by him and me. It was really very beautiful.
    I settled into a routine pretty quickly. I would ride my bike over in the cool early morning, and get right to work trimming the hedge. Mr. Johnson would leave the trimmer out on the porch for me so I could start with this quiet chore while the house was still sleeping. I would glide the trimmer over the protruding, upstart leaves, with dew still stuck to them, cleaving them neatly. Afterward, Mr. Johnson would come out with a list and tell me where to begin. He might say, "Some branches fell down in the back pasture. What I want you to do is haul them way back in the woods, so they can't be seen when the leaves turn brown."
    He always explained why he wanted things done a certain way. He would make sure I understood, then leave to tend to a chore of his own. Sometime mid-morning, when the grass had dried, I would begin cutting. Halfway through that first summer, he taught me how to operate the tractor. It was an enormous machine, an ancient International Harvester, with only a little of its faded red paint remaining. It had a large and intimidating mower deck underneath. Mr. Johnson had been using this to cut the big area of lawn beyond where I had cut with the hand mower. He showed me the levers for raising and lowering the deck, and how to adjust the choke to start the thing under various conditions.
    "When she's cold, you'll have to choke 'er all the way," he yelled over the din, "And watch those belts there. You get a hand caught there and she'll rip your arm out the socket."
    I climbed 'way up onto the little seat, which gave way with steel-spring tension, startling me a little. Mr. Johnson laughed, "She don't have any shocks. That's the only shock she got."
    My muscles tensed, and with nervous hands I put the tractor in gear and took my foot off the clutch. It lurched, then stalled, and I stomped back down on the clutch. "Easy, now," said Mr. Johnson, and I eased out the clutch, slower this time. It lurched forward again, but caught, and I rolled ahead. "You got 'er," he yelled.
    I rolled along toward the lawn with a proud smile. There was a strong gasoline smell, and the machine coughed out black smoke now and again. After I had finished mowing, I stopped to examine my work. I smelled the fresh-cut clippings, and walking along, stained my tennis shoes green.
    Arriving one Saturday in October, I found sitting in the drive a big, gasoline-powered roto-tiller. Mr. Johnson had rented it to mulch the dead plants in the vegetable garden. The air was cool by now, and the leaves had turned. I could taste the rich scent of autumn, the brooding power of this fleeting season. I first gathered the bulk of the plants for the compost heap. They had already begun to rot, and were wet with a pungeant, organic smell. I also collected the dead, half-grown squash and eggplant that had already begun to decompose and mingle their soft flesh with the black earth. The tiller was a powerful machine, with menacing blades protruding from the front, and wheels covered with dried mud in the back.
    "This beast'll pull itself," instructed Mr. Johnson.
    I stood behind the tiller and held the handles tightly, without fear. "Let her chew on that dirt awhile, then lean on her a bit. She'll move ahead. Greener pastures."
    With awesome power, the blades tore through the soil, churning the mulch in its revolving course. I made my way slowly back and forth under the raw, gray sky.
    Around noon, Mrs. Johnson rang the bell by the back door. Her father, who lived nearby, would sometimes join us for lunch. He was old and somewhat feeble, but still pretty sharp. Though not appearing overweight, he was bulky, and I remember thinking he must have been very strong at one time. He had bushy eyebrows and was very friendly. When Mr. Johnson and I came in that day, he was sitting at the kitchen table, talking with his daughter. The kitchen was warm, and thick with the smell of beef stew.
    "It's nippy out there today, huh fellas," said the old man. "I don't believe it's getting any warmer."
    "That's right, Pop," said Mr. Johnson. He looked at me with a smile. "We'll be pruning back the rose bushes this afternoon and covering them for the winter." He had warned me a few weeks before about this particularly tedious chore. "You'd better dig out the iodine, Sally. The kid may need it before this day is over."
    The stew was hot and delicious. We ate it with warm bread and big cups of cold milk. Suddenly, Mrs. Johnson's father began coughing violently, struggling to inhale. I was sitting closest, just on his left, and watched not knowing what to do. He wasn't completely choking, but obviously suffering. He coughed out chunks of food and spit. Swaying forward, he inhaled deeply, easier now, his face bent over his plate. Something clear, tears or saliva, fell from his face. Mr. Johnson helped walk him to the bathroom to clean up. I was sweating.
    "Growing old," muttered Mr. Johnson. "Growing old is hell."
    After a couple of years, I left Mr. Johnson's to work as a busboy in town. Now, years later, I am struck with the clarity of these reflections. At the time, these things just happened. They seem to mean more now, to give some twist to logic, some sort of insight. Now just four weeks away from graduating from medical school, I am still trying to understand these things.
    During the first two years of medical school, the students never even touched a patient.  In June of our third year, we took the National Boards exam, and started in the hospital soon after. We had had an introductory course in clinical medicine where we practiced the physical exam on patients who had varying degrees of tolerance for fumbling students. My first real assignment was internal medicine at the nearby Veteran's Administration Hospital.
    The medicine rotation at the VA was notorious for breaking the spirit of many a medical student. We all knew beforehand what we were getting into?- to 100-hour work weeks, on call overnight every fourth night, and a team of only one resident, one intern, and one student to take care of up to thirty patients. Menial labor-intensive tasks, known as scut, performed at other hospitals by paid employees, was done here by the team. These things trickle down, of course, and the intern and the student typically started all the IVs and drew blood in the middle of the night. Patients came to the VA because they had served their country and had no insurance. The VA was considered a step above the county hospital, or maybe half a step. Our patients, coming from the west side of Chicago, were mostly poor as hell. Regular health maintenance was not a priority in their tough lives, and the bloated, poorly-funded federal system did not particularly encourage a change. Admitting a patient with a tumor like a softball sticking out of the side of his neck was never a surprise.
    We met that first morning, the eight students, outside the designated conference room.  Our short coats were clean and white, and the men wore their favorite ties. We showed each other our stethoscopes and made nervous jokes about bringing in a toothbrush for whoever was scheduled to be on call that night. One of the high-ranking attendings gave us a brief pep talk, then the chief resident took us to meet our teams. One by one we were swallowed up into the tiny residents' rooms where the teams were meeting for teaching rounds. My attending was Dr. Patel, an older man from India. He had a rough, expansive face and shiny eyes. He alternated between being very serious and very jolly. He would sit with his palms on his thighs, then lean 'way back in his chair with an enormous laugh when something amused him. The senior resident was a Czech called Theo. He was stern at first, but relaxed some after a few weeks. The intern was short, with a young-looking face and a loud mouth. His name was Mike, and he had just graduated from my school. "You live around here?" He boomed, "We're on call tonight." He turned out to be a really great guy.
    After rounds, Mike showed me around the ward. He showed me the bandages and syringes kept in the locked supply room, and how to use the computer. Patients walked up and down the hallway pushing IV poles and talking loudly. Others crowded around the nurses' station, laughing or complaining about something. There were stuperous patients sitting in wheelchairs along the walls with bags of urine strapped to their armrests. There were a few small patient rooms along the hallway, but most stayed in the big room at the end of the hall. This room had sixteen beds and four televisions. The odor was terrific. It varied in character, but was always there. Sometimes the strong feculent odor of waste or the acrid smell of urine dominated. Other times it was just the unwashed, diseased flesh or the sharp chemical smell of disinfectant. The antibacterial soap was also distinctive, and lingered, so that even if I smelled my hands at home the whole ward would come rushing into my mind.
    Later that afternoon, we got very busy with admissions. I watched Mike start an IV on a new patient. "You'll do the next one," he said. "See one, do one, teach one."
    The next one needed to be done pretty soon. Mike took me into the supply room and began putting stuff into my hands. "You'll need this, and this. And this." My arms were full with tubing, catheters, guaze pads.
    "You'll also need this," he said, stuffing a tourniquette into my pocket. "Don't lose it. This is the VA and I doubt you'll be able to find another one. Go ahead and get set up. I'll be in in a minute."
    I introduced myself to the patient, and set all the things down on the bedside tray. I connected the tubing and laid out a chux pad to protect the bedding from blood. I opened the catheter and guaze as I had seen Mike do. He came in and rearranged a few things.
    "The key to this and all procedures is to have everything positioned right before you begin.  OK, go ahead. Wait, don't forget gloves."
    I wrapped the tourniquette around his arm. I was nervous and dropped the catheter, contaminating it. As if expecting this, Mike pulled another from his pocket and handed it to me without a word.
    "He's got great veins," said Mike. He pointed to a big blue-green bulge. "Try that one."
    I wiped it down with alcohol, making it shine and stick out even more. "Little pinch," I said.
    I plunged the catherter in, pushing firmly and looking for a return of blood. I pushed
further, but still nothing. "Pull back and try again," said Mike patiently.
    This time a drop of blood appeared in the plastic window. "In a little more," he said. "You got it."
    We finally went to sleep that night around three. It was still dark, though very late when
the PA went off.
    "May I have your attention please. Code blue, six north. Code blue, six north."
    Mike was already reaching for the door while I tried to shake off my sleepy confusion from on the top bunk. "That's us," he said as light flooded the room. I jumped down; everything was rushing. My mouth was sticky, my hands suddenly cool and damp. I fumbled for my glasses and darted after Mike, the hallway like some weird fluorescent tunnel. As we approached the dark ward, I could see at the end of the hall light pouring out of the room on the left, and nurses hurrying about. There was a crowd around the bed in the corner, and the other patients lay with wide eyes under their covers. The dying man lay naked, jerking rhythmically with each thrust made upon his chest. At his head, a resident was holding a mask over his face, squeezing a bag with a hissing sound. Another resident, a tall man, stood with his arms crossed, calling out orders.
    "Epinephrine, please. Someone get a gas—try that left arm." He laughed. "No. The other left arm."
    Everyone seemed busy, precise. A nurse was placing EKG leads on the man's chest while
another was carefully writing on a clipboard. There was a strange, earthy smell in the room.
    "Let's shock him," said the resident. "200 joules please."
    A nurse made an adjustment on the machine on the crash cart. The resident took the paddles and untangled the wires. "Hold CPR," he said. He placed the paddles on the man's chest. "Clear." Everyone backed away. He pushed a button on one of the paddles and the naked man jerked violently and was still. Someone placed his fingers deeply into the man's neck. "Nothing," he said. "Resume CPR."
    I stood outside the circle, watching. Someone had to get by me, and I backed away from the scene. An older man, I never knew what his position there was, leaned close and said passionately, "You got to get in there. You got to grab all you can."
    He walked over and whispered something to the tall resident, who looked over at me. The
older man motioned to me, and I squeezed my way up to the beside. The resident who had been doing compressions was sweaty.
    "Ready to switch?"
    I moved as though through water. Stepping up, I bent over the man and placed my hands on his chest. I began rocking down and up firmly. His ribs gave way like a spring, and I could feel cracking somewhere inside.
    "A little faster," someone said gently. "Watch the monitor and get a nice, even rhythm."
    All my muscles were taut and I was soaked with sweat. It dropped on the inside of my glasses. After awhile, I heard, "I'm gonna call it." I felt a hand on my arm and I stopped. The man lay still on the bed, and someone moved to cover him. As we silently left the room. I could see out the window the pale light of morning moving over the city.
    A few days later, Mike and I were going over a list of things to do. We had our feet up on the desk when Theo came in. "What are you doing?" he asked. "Stomping out disease and saving lives," replied Mike.
    He looked at us. "I hope I don't get sick."
    "We are pacing ourselves," I said.
    "Well Mr. Stewart is asking about you. He says he needs a CBC checked and you're the only one who can do it."
    I reached for my tourniquette.
    "Oh, we are getting an admission, you may want to pick him up.  He's got a head and neck CA. Dehydration, calcium of 17."
    "Otherwise healthy," added Mike sarcastically.
    Cancers of the head and neck are killers, and Mr. Stevenson's was the size of a grapefruit. I learned about him mostly from his chart, as he wasn't able to speak when he came to us. He had been diagnosed about a year and a half ago and treated with chemotherapy, but had stayed away from the follow-up clinic after that. We later learned from his family that his right check had slowly swollen up, and he had become thin and weak. But he refused to come back. "I ain't gonna take that," he'd said. "Bringin' everything back up and runnin' off from behind. Just leave me be."
    The oncology consult service regarded a calcium of 17 as a therapeutic challenge. They tried a variety of drugs, but if it went down any, it soon came right back up. We put a tube down his nose to feed him. His sister wanted that, but consented when we asked to make him DNR. We saw him every morning on rounds, looked at his chart. What were we going to do? Sometimes his eyes were open and tears rolled down his face. I wondered if his tears were a physiologic response to his being unable to close his eyes, or if he was crying. Was he thinking? Was he feeling?
    We were on call July Fourth. Late that evening, after helping take care of our new admissions, I was sitting in the residents' room. I knew the routine, and had earned a few minutes' rest. Maria, one of the nurses, came in and told me that Mr. Stevenson's IV was out. It had taken me an hour to start his last one, as the chemotherapy had fibrosed all of his veins. Walking into his room, I saw the IV catheter with a piece of wet tape stuck to it hanging from the pole beside his bed. His roommate was reading the newspaper by a beside lamp, casting a shadow into the corner. I looked down at Mr. Stevenson. His eyes were open, blank, and his skin was very pale. I felt his wrist for a pulse. It was faint, distant and very slow. There was a thick and pungant smell. I moved the IV pole out of the way and adjusted his pillow. There wasn't any point in restarting his IV now.
    Mr. Stevenson's roommate looked over at me. He was old, with sallow rough skin. I had seen him before, but he was on another service. His checks were drawn, and his IV bag was wrapped in brown cellophane. Another cancer patient. I wondered where it was.
    "You can see the fireworks," he said, looking out the window.
    "Yeah," I replied. "Happy Independence Day." He knew what was going on, I could tell.  I sat down. He put down his paper.
    "We used to get the big ones, when we'd go on leave to Hong Kong. We'd send 'em right off down the street." He paused and looked at me. His face was impassive, and he held still the newspaper in his lap.
    "We used to get them in Wisconsin," I said. "Me and my friends would have wars with the roman candles. Nobody ever got hit, of course, you never knew where those things were going when they fired. Actually, I did get hit once, on the sleeve. My mom was pretty mad. It was one of those Izod shirts—remember those?"
    "With the alligator?"
    "Yeah. She'd got it as Marshall Fields and all. She was pretty bent outta shape."
    There was a sudden gasping sound from the next bed. I got up and stood over Mr.
Stevenson. His eyes were open, not looking at anything. There was spit running from the corner of his mouth. His chest did not move. I placed my stethoscope over his heart. Slowly, yes, and softly, but it was still beating. I stepped back. He inhaled violently, and began slowly breathing again. I sat back down.
    "We used to take the streetcar down to Marshall Fields," said the old man. "That was the easiest way to get around in those days."
    The dark smell seemed to fill the room.
    "When did that stop running?" I asked.
    "1940. Of course the buses were running extensively by then."
    I looked over at Mr. Stevenson. He was still. I got up, listened again. There was a faint, distant beat, a long pause, then another. I kept listening. Dumt. Dumt. Then, nothing. I put my stethoscope in my pocket. The old man was looking out the window.
    "I'm gonna do that when I get outta here," he said. "Go shopping for some new clothes."
    "What's wrong with what you have on?" I asked, indicating his VA issue maroon polyester pyjamas.
    He looked at me and smiled weakly. His face still held a stoic expression. He looked out the window again.
    "It's finished," he said. "The fireworks are over."
    "Yeah," I said. "They're over."

ACKNOWLEDGEMENTS
 

The monstrous task of maintaining and perpetuating this literary journal required the time and energy of many extraordinary people. Our sincere gratitude goes to Suzanne Poirier, our advisor and mentor, as well as Rafia S. Farook for her abundant efforts at typing, re-typing, corresponding and re-corresponding.

Our judges Raymond Hart, Robert Molokie and Hyman Muslin also get our warmest thanks.

This 12th issue of Body Electric couldn't have been born without all of you.

Thank you once more.

Sincerely,    Editors  

Editors:        NIPA R. SHAH
                        College of Medicine '96

                        RAJ SHAH
                        College of Medicine '97

                        KIM BROWN
                        College of Medicine '99

Advisor:        SUZANNE POIRIER, PhD
                         Department of Medical Education