The cold, hard flat top awaits my back.
I assume the position of the ages,
"knees out,"
routine nightmare,
only this time am I afraid
He'll find no evidence of woman,
only empty cavern, slippery walls,
"no place for a child."
"Plumbing's fine," He, expert, tells us.
I am spared my head today.
"And your boys are ready to shoot, pal,
Don't worry, you two,
I got a few tricks up my sleeve."
We nod, compliant to our new God.
He adds another morning ritual,
My lipstick shares my mouth with this fine intruder
Measuring the rise and fall of my well-tended hearth,
In primitive communication with ovarian messengers.
We wait, a few more degrees close our separation,
The Timed Fuck replacing old notions of merging souls.
Monday's special,
turkey baster syringe,
He penetrates me with leftovers of my husband's dignity,
I wait, eyes closed, for the Miracle of Life.
Days pass, but
Time does no healing,
As once again, my womb sheds fertile grounds
and we shed no tears,
These biological betrayals the ultimate of our species.
We race on,
our barrenness growing us apart,
our destiny not yet to be conceived.
Sarah Woolsey
Class of 1997
Gestation
Cinnamon Bradley
Class of 1998
Aurora Borealis
Many train for years to see it.
Each unique experience
Intensely mimics the sun,
Warming the antiseptic air.
Sometimes lasting minutes,
perhaps only seconds—
Visible to the faithful
who can "feel" its presence.
Once again, it was to be Nature's fury—
charged particles push through magnetic fields.
Her painful crisis in my routine—
tight nuchal cord, Apgars 9 and 9.
I could see them in her eyes
Those Northern lights,
Brilliant—silent, yet ever grateful,
Addictive and revitalizing.
Patty Bledsoe
Class of 1999
First Impressions
It's 3 AM in the Labor and Delivery
Ward as the security guard arrives with yet another woman in labor. Another
ten minutes and I would have been fast asleep and the intern wouldn't have
awoken me. Oh well, H&P machine back to work.
Great, another urban nightmare,
she's G10 P9. I'm sure the world needs another one of her offspring. Aren't
we doing enough to support her brats without her bringing another one into
the world? I'll bet I could write this H&P without even talking to
her. I've seen her kind before.
I introduce myself as the medical
student and ask to take her history. Her appearance is nothing out of the
ordinary. All of these expectant mothers begin to look the same to me.
At this hour I no longer see the excitement in their faces or sense their
fear of what's about to happen. She's thirty-three years old. I'm surprised
she's made it this long, considering her probable lifestyle. Thirty-three
with ten kids. I wonder to myself if she's a grandma yet. Surely some of
her kids are in the family business.
"Any complications during the
pregnancy?" I ask, as if she'd know.
"No," she replies without hesitation.
"Pre-natal care?" I inquire,
however unlikely.
"Yes, when I could make the
appointments."
Yeah, it's tough to find time
when you're so busy like her. She probably doesn't even work, probably
never has. Let the government support her.
"Any problems with your other
pregnancies?" ("besides DCFS involvement," I want to ask.)
"They were all normal deliveries."
"And their ages now?"
"Let's see, 13,12,11,9,5,4,
and 2."
Not bad. Didn't even need any
help with that. But that's only seven kids.
"And your two other children?"
I ask.
"They both died. There was
nothing the doctors could do." There's a feeling of remorse in her voice
but also calm acceptance. Normally I would feel awful about this. The discussion
of a child's death is always awkward for me, but for some reason I have
a little less compassion with someone like her—especially when it happens
twice.
No pertinent past medical or
surgical history. She has refused tubals before. Social history should
be fun. "Did you drink alcohol before or during the pregnancy?" I ask,
sure of the answer.
"I may have had a few beers
and some wine, but that's about it."
Yeah, right.
"Do you smoke?" other than
marijuana or crack I'm thinking.
"No, never," she answers confidently.
"Any other drugs?"
"No."
I'd like to ask her to be honest
with me, tell her we're not the police. But I don't want to overstep my
bounds. I'll let her doctor, the baby's pediatrician, and child welfare
worry about that.
"Ever been exposed to any sexually
transmitted diseases?"
"No," with a look of amazement
that I even asked the question.
"Standard question," I assure
her.
I'll let the nurse take over
now and get her ready for the delivery. It shouldn't be long since this
is her tenth kid. I'll be catching this one, which I'm sure is a much more
valuable experience than catching some ZZZs. Big shock the dad's not around.
Word at the nurses station is he's out on the streets somewhere. That's
nice. I guess he already did his part anyway.
The delivery goes off without
a hitch. The baby boy is pretty big and appears healthy, although I hear
these babies sometimes are pretty tough at first. I'll leave it for the
pediatrician to plot the declining growth on the curve and record the missed
developmental milestones along the way. Society will pay the cost.
But at least now I can get
my thirty minutes of sleep before rounds. As I leave the room I give the
usual "you did a great job" without the usual enthusiasm. Must be too tired.
"Congratulations, Mom."
Dan Maloney
Class of 1998
The First Soldier
of the Trojan War
He sat, quiescent. Anticipatory.
Cephalo Megalic both his name and his pride.
One legged through no fault of his own,
possessed with the boundless energy
of those who have but one purpose
in this world.
Raised within the dense structures of his homeland,
never alone, but in the company
of millions,
he could, as he developed,
hear and feel the rumblings
as those by sixty days his
senior, rushed from their home
to an uncertain fate.
Within the stifling, persistent heat of his environs
he became what others told
him to become,
following their influence,
and through them
discovering his own capacity.
Fed the nectar from the bosom of his nurse, Sertoli,
induced by her rich nutrients
to grow in size
he became singular in function.
Having drunk the waters
of Lake Tig his mind was cleared,
focused on a singular
destiny.
"Oh...oh, sight ... guide me on my tortuous journey
as I swim the sea men have
long since charted.
That I may leave my home with
such force
that I am propelled nearer
my goal.
"Let me be the one of the millions, victorious in this
battle, acrimonious in my attack
on the
Straits of Pellucid, but stealthy
in my crossing
the boundaries. That I might
risk death, or
may miss my mark, I simply
ask that I choose
the right path."
Late one eve, hearing the murmurs of others, he awoke.
The earth swayed beneath him,
and he knew the
moment of battle had arrived.
Quickly he marched
to the gates of his land, gathering
his strength
for the hours-long assault.
Helmet in place,
prepared to do his best to
be the first soldier out.
Prostrate before the gates
he prayed that he might
withstand the acid-scorched
battleground before
him.
With a mighty thrust he hurled himself from his homeland.
Only to be crushed against a latex wall by his countless comrades.
Samuel Blackman
M.D.-Ph.D. Program
Chicago
Lost and Found,
Lost—Part I
"Tracing My Body"
Speaker #1:
I hear it whispering as I caress the soft hair that warms my skin.
It comforts me.
I see my distorted rib cage extending far beyond my shrunken stomach.
With one finger,
I etch lines along each protruding rib.
Wrapping myself into a fetal position,
I take my hand and interrogate my body.
Searching for signs of Fat.
Found—-Lost
The coiling serpent of decay tightly embalmed me,
and squeezed until I seeped out of my body into
Nothingness.
Bones lay twisted in anarchy.
Speaker #2: "Accessibility to what?"
Jennifer Ann Harris
Medical Scholars Program
Urbana-Champaign
Soaring
The last thing my father told me before I died
was, "You have no feelings and everyone
knows it, even your wrinkled aunts who give
you a hug and a dollar every report card."
Soon after his stupored confession
He took off.
I don't know what he thought he saw as
he ran heavy footed—
each earthquaking footfall rocking the porch—
I just remember the bat to ball crack of the
spit-gray banister as he clumsily broke through,
desperate yet triumphant like the last man to cross the finish line.
Remembering
I see him floating through the air like some flying African of legend.
For a moment it seemed like he might cinch gravity;
The wind whispered seduction as the leaves
of the tall oak applauded in congratulations and I,
I stood open mouthed because this was revelational yet somehow common
like becoming conscious of the beating of one's heart.
Eventually,
he fell.
As I watched him plummet to the ground,
his face politely receiving the broken glass and gravel of the empty
lot
I knew he would never have a chance to take it back.
So, this was spite.
The ambulance sirens whined their arrival
I was almost dead when they got to me.
But it wasn't fair. I was only a child.
It wasn't the killing, it was the absence of regret.
I chain this memory to my bed some nights.
It helps me sleep.
Cinnamon Bradley
Class of 1998
Popsicle Medicine
Kisses and popsicles are what
I would have given him had he fallen at home. But no, the accident happened
at school.
The school secretary paged
me while I was attending a biochemistry lecture. Poor Scott had fallen
against an oak bench while playing a game of chase. He had a bump the size
of an egg on his right forehead. Ice had been applied. He had been able
to answer all their questions: who he was, where he was, what holiday was
coming up. But still, the bump was big. She and his teacher had debated,
should they, shouldn't they, but in the end they called an ambulance, just
in case.
The ambulance arrived while
I was on the phone. Messages were relayed to me. The ambulance attendants
felt that he was acting too calm for a four-year-old. The school staff
tried to convince them that Scott was an easy-going, good kid who listened
to instructions. He was drowsy now, past his nap time and he had not had
his lunch. He was acting normal. But the paramedics would not be dissuaded,
they expected hysteria, so there must be something wrong. The secretary
was apologetic. They had set so much in motion. Ah well, I comforted, best
to err on the side of caution.
I abandoned my lectures to
meet him at Children's Memorial. I was calm about his physical condition:
it sounded just as Scott would act. I was more concerned that he would
be scared about the ambulance ride and the hospital environment. Friends
or family were not allowed to accompany him in the ambulance. The principal,
who knew Scott well, would follow, of course. Legally, a school representative
had to be present since he was a minor.
When I arrived at the emergency
department, all was relatively calm, and rather nonchalant. There was no
crisis. They, too, had come to the conclusion that Scott was fine. They
seemed relieved that there was no hysterical mom to deal with. His good
nature has gotten him into trouble, the attending joked. We're just waiting
for the results from X-ray, and we'll get a CT scan before we send him
home. Was that necessary, I questioned. But of course, just in case. The
principal apologized and extolled Scott's virtues. He had been so good
through all of this.
Scott looked woefully small
strapped to an adult-size stretcher. His head stared up from the cervical
collar. Hello mom, he said mournfully. I stroked his head and kissed him.
You are a good, brave boy. How are you doing? Mom, why did they have to
cut off my clothes? They needed to, to take care of you, now close your
eyes and rest my sweetie, mom is here. But why my pants, I hit my head?
Despite the numerous monitors, wires, and IVs attached, he was most affronted
by the way the hospital staff had removed his pants.
He dozed in and out as he was
jostled to and from the CT room. Have to keep him strapped in until the
neurologists check him out. Have to wait for their okay, in order to leave.
We were sent to a small holding room for the wait. There was no worry,
so we were ignored.
I felt discouraged and betrayed
by this system. The staff had been skilled and kind in executing their
kid-with-bump-on-his-head protocol, but where was their professional judgment?
The almighty history that first-years practice so diligently had been ignored.
What difference was knowing epidural versus subdural versus no hematoma
when litigation and insurance reasons were calling the shots. I rationalized
that I was privy to better baseline information about Scott. I also knew
that I felt some comfort with a CT scan and cervical X-ray; but a lumbar
view, I think not. Three numbers had separated home from health. The ride
had begun with the ambulance, and there would be no stepping off this Ferris
wheel until it went full circle. So much for clinical decision making.
Scott slept fitfully for about
a half hour. We talked about his ambulance ride. Sometime during the discussion
the tears fell. All the troubles of his four young years came spilling
out. Why did Duncan have to move? Why did Auntie Barb get sick? Why did
they have to cut off his clothes? He sobbed, and I lay over him, stroking
his head until he had purged all his worries.
We were playing a game of I
Spy, when the neurology resident finally came in. All was well, no sign
of damage, but return in forty-eight hours for a follow-up with the neurology
staff. I found this incredulous, and maddening. In your professional opinion,
after having witnessed other cases similar to this do you really think
this case warrants a follow-up with a neurologist? His conviction never
swayed.
The resident came around with
discharge papers. I questioned him about the neurology follow-up. His assessment
was more honest. The resident lifted his papers to the side of his face
as if giving an aside in a play. Off the record, just follow-up with your
pediatrician, to be sure.
In the end, they gave him a
popsicle, a blue-raspberry twin pop. It was not a benevolent act, just
a test whether he could swallow and not vomit. Since there were no spare
clothes, he was wrapped in two blankets as I carried him out of the hospital.
He looked triumphant. This was his mom and he had been rescued.
Michelle Watters
Class of 1999
Innocence
Sunny little girl with multiple braids
Adorned with colorful barrettes
Plays on her hospital bed with her imaginary pets.
Mother felt a mass on her abdomen the other day;
Little one was soon on the floors for chemo to help the mass plus one
go away.
After therapy was done, and two days past
Chemo presumably went well, though total prognosis was not so good
Little one only saw all her braids gone, that is all she understood.
Only minute strands of hair were to be seen
Little one only gazed into my eyes with a tearful sheen
Her favorite shows then appeared,
Quickly thoughts of her missing braids fled and she began to smile
Whose comfort is really found through this child who is unaware about
her state so vile?
Reyna Zelaya
Class of 1998
The Child
In the stark, sterile room
Lies a boy.
Routine check-up. One more procedure.
The worst is over?
The nurses and doctor inform and instruct,
While the students stand watching with hopes
to learn.
A stick and a burn to help with the pain,
Then a larger needle going straight to the bone.
The child screams. A shriek so sharp
it pierces my soul.
I, the student, can't bear his pain.
First, hot, then cold and hot again,
Deep breaths for composure.
But the pain continues as the world around
me becomes distant and strange.
I quietly leave, searching for a chair,
Closing the door and shutting out the pain.
But the shriek does not leave me as I silently
question my worth.
For, I as the observer and a child who must endure.
Nancy Hammond
Class of 1997
A Special Patient
There she lay resting so innocently in her crib.
No smile, no grimace, no expressions whatsoever,
She was abandoned early and left with an unconquerable burden.
She was dealt a bad hand, unknowingly and unwillingly.
HIV they called it. "Your patient, Dr. Patel," they told me,
"For they next four weeks at least."
They knew my efforts would be futile.
After all, who was I? A rookie third-year medical student.
The daily ritual had commenced.
Vitals, physical exam, progress note, baby O.K.
However, she was unlike others, almost emotionless,
Hardly cried, smiled, played or complained—
A result I suppose from social deprivation and medical
incapacitation.
Over the weeks, I followed many patients.
Most came and left the service, but not her.
I had become accustomed to seeing her everyday.
And she used to me.
She seemed to be smiling and playing more often,
All the while becoming sicker.
She was, through time, becoming attached to me,
A desperate attempt, perhaps, at a cry for help.
The end of my final week of pediatrics.
She would be my very first patient of my medical career,
Often a special designation for physicians.
I knew that she would always remain a special patient.
But not for being first.
As I realized her stay would be short lived,
I wondered and hoped that I had, in some way,
done her some good.
Piyush Patel
Class of 1997
Lost and Found,
Lost—Part II
| MEDICAL CHART 12/3/97 |
| Name: |
anorexia nervosa |
Causes:
|
dysfunctional family
alcoholic father
depression
rejection of womanhood
perfectionist |
Symptoms:
|
over 20% body weight loss
obsessive exercise
lanugo hair on body
self-starvation
ritualistic eating patterns |
Treatment:
|
closely monitored re-feeding
reward-incentive system
psycho-therapy
family therapy |
| Outlook: |
frequent relapses
10% fatality rate |
Comments:
|
patient appears agitated
patient is intractable
patient commonly found exercising |
| Accessibility to WHAT? |
Jennifer Ann Harris
Medical Scholars Program
Urbana-Champaign
The First Year
We took the sip,
From the open fire hydrant.
Thinking we could drink,
So easily.
How thirsty were we?
From rejection to denial,
To necessary acceptance.
Overwhelmed, overcome.
Information overload.
Texts, review books, notes.
Incessant comments and chatter,
Just trying to survive.
Little time for all else,
Friends and family a need.
Worrying always worrying,
I have to study some more.
Trying to get organized,
Sitting in lecture,
And falling asleep.
Trying to focus,
Trying to remember.
Anatomy, physiology, histology.
Facts, facts and more facts.
Not getting enough sleep.
Not eating well.
Test time ...
Then it is all over ...
It was a piece of cake ...
Ready to do it all over again.
Marcelo Venegas-Pizarro
Class of 2000
October 27
This was no ordinary day at
Michael Reese Hospital. Today was a day of economic reality. The scrub
nurses and cleaning crews worked hard to set up the five operating rooms
by 7:30 A.M. Today's board of fare was a lap chole, a hemorrhoidectomy,
a left AV graft, a CABG, and a right inguinal herniorraphy. The bread and
butter of a surgeon; that is, if this bread and butter should really cost
five grand. The evil stench of managed care and corporate greed permeated
the OR as the circulating nurse quickly applied the yellow stickies onto
the operating sheet so that the patient and their insurance company might
be appropriately overcharged for supposedly "needed" equipment. This is
more than just a 500-dollar hammer.
It is now 8:00 A.M. and the
rooms are just about ready. The patients have all signed their informed
consent, are starving after their ten-hour fast, and thoroughly anxious
to get the damned thing over with. Just before the patients are wheeled
into the OR, a group of overzealous medical students swoops down on any
and all available surgical patients in a Herculean effort to hone their
examination skills. A rectal exam on a patient with external hemorrhoids
was quickly curtailed by an alert intern. The patients are brought into
the pristine OR, strapped onto the table, and told to follow the directions
of the anesthesiologist. But where are the damned surgeons?
It is 8:45 A.M. and the stock
market has been open for fifteen minutes. All eyes are glued to the TV
set in the surgeon's lounge as the announcer says with shocking disbelief
that the Dow Jones Industrial Average has just plunged 542 points—the largest
single point drop ever. Most of the surgeons are biting their lips in despair
while some are running over to the nearby telephones and buying up any
bargain stocks. The heart monitors in the nearby OR beep synchronously
as the patients succumb to the vapors of the halothane.
By 9:00 A.M. the mystified
surgeons enter the O.R. and check to see if the patient is prepped correctly
and Foley placed. While the 15 blade scalpel is meticulously handed to
the surgeon for her paramedian incision, the prospect of 500 shares of
Boeing Aerospace doubling in the next six weeks gives our gallant surgeon
some goose bumps.
Ted Stern
Class of 1999
Why Am I Here?
I agree with Ralph Waldo Emerson:
"To know that because of you someone has breathed easier
this is to have lived and succeeded."
Medial Lemniscus, Paravertebral Sympathetic Chain Ganglion,
Glucose-6-Phosphate, PFK, Tibia, Ventricular Hypertrophy.
All books, no humanity.
I go along with Yoda, Jedi Master: "Try not; do or do not.
There is no try." So, I keep doing it and push on.
Parietal Cell, Membrane Potential, Nuclear Localization Signal,
Transferases, Glomerulus, Zonules of Zinn, Dermatomes, Vagus Nerve.
Still no sight of humanity, but the words of Maimonides energize me:
"I have chosen to watch over the life and death of men, women, and
children.
I prepare myself now for this calling."
Anterolateral System, Erector Spinae Muscles, IgA, Brachial Plexus,
Alveolar Gas
Equation, Dorsal Mesogastrium, Limbic System.
For Crying out loud where are the patients? How does all this relate
to them?
"Study hard, son. We know you'll make us proud."
Okay. But, I don't know how long I can keep this up.
Coagulation, Adenosine, benzodiazepines.
"You don't have time for me anymore; I think that we should part."
No. Wait.
Autolysis, Congestive Heart Failure, Exudate.
"Your blood pressure is a bit high; you should exercise more."
"Dear Student, the current unpaid balance on your loan is . . ."
I can't stand it anymore!
Suddenly, the prophet Gibran speaks:
"And what is it to work with love?
It is to weave the cloth with threads drawn from your heart . . .
You are a flute through whose heart whispering of the hours turns to
music."
ACE Inhibitors, CBC, Type I Hypersensitivity, Bowel sounds, Thrombocytopenia,
Anaphylactic Shock, Helminths, Helicobacter Pylori, Trypticase Agar.
Ah! Music to my ears. Strange, how I never noticed it before.
Manu Chander
Class of 2000
Why I Sleep at Night
Everyone is running
hands wrapped around their heads!
in front of them, spurting ripe blood...
on the way to the hospital.
Floors white and blinding: pure?
lonely death behind every door
and I wonder what I came here for.
A fat bald man, dead-tired, drops his head in my palms,
eyes stare up: "FEAR makes us do it."
and the body, gargantuan, grotesque, collapses
on the way to the hospital.
And one year down I stand,
watching her fade out, leave this place
for the fast dark life: nights and nights
deep gray under her eyes
"Ready to give up my life!" she cries,
and suddenly I am alone like her
but without fear
because I never knew why
a four-year journey, questions.
on the way to the hospital.
Corey Hochman
Class of 2000
White Coat; White
Flag
With elbows straight I am positioned,
He looks at me without seeing,
I press his chest in perfect rhythm
His soul is long gone.
David Rosania
Class of 1998
Smoking with Guy
Fawkes
| Sprites and faerie folk |
|
|
live within the flames |
| Where embryonic cigarettes |
|
|
slip off natal skins |
| And let loose those many |
|
|
lit ashen bodies of death |
| Unto heaven some sail |
|
|
into hell sink others, |
| And fallen heroes sleep well |
|
|
where fleeting fame has gone |
| Bright flames burn away |
|
|
the vestiges of my birth |
| Absolute absolution |
|
|
the flames purify all |
| And into my mind |
|
|
come memories unbidden |
| My virgin experience |
|
|
so very vivid in mind |
| Rushed burning of throat |
|
|
spasms wracked the remains |
| Of body never tainted |
|
|
never again to be new. |
| And the will-o-the-wisp |
|
|
watches from flames, |
| Such alluring lights |
|
|
lead only to pain. |
| And I am left standing |
|
|
smoking my cigarette. |
Meetul V. Shah
Class of 1998
The Novice
I enter into Green, White and Blue
The royal colors of this kingdom
A wintry realm governed by precision; no place
For the sudden clumsiness of my untrained limbs
"Don't touch that!" "Shut the door."
"Put your mask on." "Reglove!"
These words I leave unheard
As my virgin eyes stare in astonishment
Naked, pale, flabby: her body lies on the table,
Arms strapped out at each side
As if in supplication to the rulers
"Heal me, doctor!" "Stop my pain!"
Enter the rulers, joking, with wet hands
I watch them from the corner,
Hoping not to be noticed
An apprentice with a quiet mission to learn
But why is it only I who hears her pleas, or
Sees her helpless immodesty?
It's too late; the machines whir and drown her out;
The drapes place her in anonymity
Suddenly, the first cut is placed
And she becomes a red square bordered by blue
My eyes widen at the thrill and I readily bend
To these rulers' will, their devoted subject
Reena Dhanda
Class of 1998
OUTSTANDING!
from a nurse's or well-recovered patient's viewpoint
The battle lines are drawn.
The guns are taken off safety. Kill or be killed with no holds barred.
The combatants are mostly twenty-four and twenty-five years old, fearful,
anxious, and crudely brainwashed. They are motivated yet vengeful. They
are all part of the worst kind of war, that is the one which no one will
admit exists.
It is 4:30 A.M. and most of
the patients are asleep. The medical students slither in from all sides
of the unassuming hospital grounds. The next two hours will make or break
a student's surgery recommendation but will never, unless through the miracle
of chance, benefit the patient. The goal is simple enough: Make yourself
look knowledgeable, industrious, enthusiastic, and brimming with intellectual
curiosity while secretly making your colleagues look like Bart Simpson,
M3.
White coats and brown noses
sniff out all the available data for the previous eight hours of the patient's
biologic activity. IV and PO food in, urine and NG tube out. Temp, BP,
pulse, and respiratory rate. Their brief H and P consists of barging into
the room, turning on the bright lights, and demanding to know whether the
patient had any bowel movements during the evening, if they vomited, and,
if time allows, how the patient is feeling. They have twenty more seconds
to physically examine the patient, barely enough time to swing their stethoscope
in the air twice like a lasso and feel that they have successfully auscultated
all lung fields, all heart sounds, and all abdominal regions. Shut off
the lights and bolt the room with a trite yet ceremonial departure message:
"We'll be back in an hour" (after these messages?).
This process is then repeated
for as many patients as each eager medical student can get his or her hands
on. The more patients that each student sees, writes a note for, and presents:
the better it makes them look in front of the head resident (the Gatekeeper
of the 'outstanding' Recommendation Letter). Perhaps the most humorous
display of medical student posturing (also known as securing a "pole position")
is that which occurs during the resident rounds at 5:45 A.M.
Pole Position: "Being properly
positioned around a patient's bedside during resident 'rounds' so that
medical students can physically box out their colleagues and be the first
to offer assistance to the resident in dressing changes, nasogastric tube
removals, central line placements, and the quick presentation of pilfered
patient data."
Meanwhile, back in the patient's
room at 4:45 A.M. a voice says, "Two young people in short white coats
just came in my room, badgered me with silly questions, pushed my stomach,
and didn't even get me the glass of water that I asked them for."
Ted Stern
Class of 1998
A Great Day for
Dying
Our journey was eternal, as most of us can testify,
We lived for the love of most that loved to live.
At moments we saw nothing, but the ground beneath us,
And at others the heavens above us.
Those around us either smiled through red rosy eyes,
Or gleered through red rosy windows
With green moldy eyes. We worked and troubled,
Toiled and bubbled to make these days have meaning,
But as most of us know,
All things must come to an end,
To lie down one final night,
And to awake to our life's demise.
It's graduation.
Grady Garner
Class of 1997
The Death March
With an awaiting nervous smile
He greets the shuffling parade
I nod and look professional
We have lost again
David Rosania
Class of 1998
Midnight Encounters
I
"You'll die sooner or later
if you continue to stick dirty needles into your arms."
"You're right doc. I promised
myself to get signed into the rehab program this week." "Have you ever
tried the program ?" I asked.
"Yeah, lots."
"Why is this time any different?"
"Because you told me that I
was going to die."
"OK, OK, let me see your arm."
It was too late at night to be having such an in-depth conversation with
a drug user. I began to take the dressing off his forearm and all I could
think about was that someone should take pictures of this guy and show
it to high school students. This is what drugs do to you. Not your brain
frying in a pan but physically disforming your body. Holding you captive,
only to let you out at 2:30 in the morning so that you can come into the
ER and wake me up. Just then the smell of his dying arm woke me from my
dream. I had to step back so I wouldn't vomit.
"Haven't you been taking care
of this?"
"I change the bandages every
couple of days. Even more pus is coming out," pointing to the hole in his
arm.
"Are you still taking antibiotics?"
"Yeah, I guess so."
"What's the name of them?"
"I don't know. Some yellow
pills the doc gave me."
"Did you finish taking all
of them? Never mind, I'll get you some more." I couldn't get over how swollen
both of his arms were. Every inch of skin, every vein and artery, was covered
by scabs and scars. It looked like Grand Central Station. I began to laugh
to myself, thinking anything can be funny when you're this tired. "Do you
shoot up your legs too?"
He nodded and lifted up his
torn jeans. The legs were just as good as his arms. I had the urge to vomit
once more. I took out a scalpel and started to cut away some of the dead
tissue on his arm. This guy didn't even flinch.
"When's the last time you used?"
I asked.
"Tonight."
Well if he didn't mind the
pain neither would I. Then the thought crossed my mind. This guy needs
to be in the hospital for IV antibiotics but I know he'll sign out AMA
as soon as he gets the urge to use. I asked anyway,
"Do you want to stay in the
hospital?"
"Na doc, got things to do.
Just wrap it up and I'll be on my way."
Under his breath I heard him
muffle something about doctors just wanting to get more money. I finished
the dressing and told him thanks. Thank you for making the decision.
"See ya later doc."
He picked up his prescription
and left. I went back to sleep.
Gary Fontan
Class of 1997
The Wait
I lie in sheets that do
not warm me, I cannot sleep. In a barren room.
The curtain is drawn between my sanity
and my roommate. She claims she is the president.
My first pain replaced by
another. In submission to agony I bow.
What will they find, when will I know?
Roommate sings Buffalo Gals, as I wait.
In enter doctors, calmly with servants in tow
in a sea of white. I wait for disclosure.
"To surgery." I only hear two moving lips.
Heart beating hard in my chest, ready to vomit.
Again left with my suffering and
imagination. How long this time?
The curtain is no longer
drawn, I hum to Buffalo Gals, as I wait.
Reyna Zelaya
Class of 1998
"I Believe I Can
Fly"
"A fourteen year old boy in
the Bronx collapsed and died while singing 'I Believe I Can Fly' in music
class." Wow, the song does have some high notes, but not that high. I wonder
what really killed him. Probably a cardiac arrhythmia combined with a vasovagal
response. Maybe even a ruptured cerebral artery aneurysm. Perhaps only
my weary and bored eyes even noticed this tiny article in a small comer
of the Cleveland Plain Dealer. I feel oh so privileged to receive news
of all the world's tragedies right in my little Emergency Room cafeteria
at four-fucking-thirty in the morning.
"Dr. Sheikh to the Emergency
Room. Dr. Sheikh to the Emergency Room STAT!" Damn! It was Nurse Debbie's
screechy voice again. I'll never know how a scrawny lady like Debbie can
have such a mouth. Her five foot, hundred pound stature even appears in
my nightmares yelling my name in that unmistakable raspy loudspeaker voice,
"Doctor, you forgot to sign your charts. Doctor, you forgot to throw away
your sharps." Aargh! She was the commander-in-chief, i.e. Charge Nurse,
of the ER, and seemed to have a personal vendetta against all the intern
doctors, especially me. She never let me rest. A final gulp of my fifth
disgusting cup of vending machine coffee, and I was on my way.
The walk to the ER was long
and I thought of the last time I heard that song—only two weeks ago. It
was sung by a patient who presented quite a moral dilemma for me. There
is a rack of charts in every ER ranked in order of most urgency. Your gun
shots and blue babies are triaged to the top, and then your heart attacks
and broken ankles, and last your pesky drunks and psych cases. As a doctor,
you don't really choose; just pick up the top chart in the rack and start
your business.
That night, two charts were
on the rack—Elsie Knockhatter, age eighty-two, and Capitan Rodriguez, age
twenty-seven. Elsie's chart was on top, but Capitan was, well..., a hunk—bronze,
twenty-seven, and a fine piece of creation. Elsie was in bed amidst her
urine. Capitan had a big gash on his head. Elsie just needed some anticholinergic
medicine. Usually, I shouldn't have to choose. I am not supposed to choose.
But, but Capitan—I peeked into the waiting area, and Capitan was humming
"I Believe I Can Fly." His lips were bright magenta, and the words of the
song never looked so luscious.
Morality, shmorality. I gave
a quick glance around and the annoyingly omnipresent Debbie was for once
nowhere nearby. The next second, I walked over to young, beautiful, ex-sanguinating
Mr. Capitan Rodriguez. OK, doctors are not supposed to be attracted to
their patients, but even Queen Victoria, mistress of prudishness, could
not resist Capitan, despite a beet-red capitus.
"Hello, I'm Dr. Sheikh, " I
said nonchalantly. "Can you tell me what happened?"
Capitan's big brown eyes looked
up, and suddenly, a strong fist came rapidly towards me, shying away from
my face at the very end. I didn't budge. "Pow!" he yelled.
"Pow?" I echoed. I looked back
at the rack of charts nervously, and saw that no one had picked up Elsie's
chart yet.
"Pow! Right in the head with
a beer bottle." He raised his left hand, and picked some dry blood from
the right temporal region of his scalp. He had a three-inch laceration
that was mostly covered with long, thick black hair, but had scattered
dark red clots. That had to hurt.
"Right this way." He picked
up his leather coat, and followed me to the Suture Room. We strolled in
stride through a maze of patients, some in hallway beds, some with bewildered
looks on their faces, and others in a mini-comatose state. My entire focus
was on this man with Herculean good looks who was still humming "I Believe
I Can Fly." I became the envy of the ER, as all the XX chromosomes including
Debbie, my arch-enemy nurse, kept staring at Capitan's structured physique.
That's right, he's mine—at least for the next hour. I tried to catch the
rest of the words to that song from my incredibly gorgeous patient, but
the EKG monitor beeps, the screaming paranoid schizophrenic, and the overhead
pages for doctors to the trauma room made it very difficult to catch the
rest of the words to the song.
We made it to our room now,
and I asked him to undress. A rivulet of blood had come down his face to
his lips. He stopped singing and glided his big, strong hand gently over
the side of his mouth.
"How did this happen?" I asked
casually.
He determinedly plopped himself
down on the black-leather examining table covered by a slippery white paper,
making a rumpling, crinkling sound. He seemed surprised by the sound he
made, and adjusted himself quickly and gracefully to stop the ruckus. He
then shifted his muscular body, and in a quick, athletic move, lay on his
stomach. "An after-hours party that got out of hand. I got some guy with
a Michelob, and his brother got me with a Bud—Pow!" He repeated the same
fist motion, this time towards the otoscope on the wall.
I unwrapped the sterile instrument
tray, and began my hand-washing. Not once did Capitan take his eyes off
of me. "Just do what you have to do, doc."
"OK, are you allergic to anything?"
"No, ma'am."
"Good. I'll draw up some lidocaine,
so you won't feel the pain...."
"No," he interrupted. "I don't
want any of that."
"Mr. Rodriguez, your wound
will require at least twenty stitches, and lidocaine will make it tolerable.
The suture needle is very sharp," I said, hoping to be convincing. No one
ever refused pain medication, especially for this procedure.
Capitan leaned his head sideways,
and peered directly into my eyes. The words from his rich lips came forth
slowly and succinctly, "I said no." It was clear that he did not want the
anesthetic.
"Suit yourself," I sighed,
and started gloving up. I held up the curved 4.0 suture needle in front
of me, hoping the sight of it would frighten him into wanting the pain-killer.
But Capitan was no longer looking.
He lay there on his belly, and slowly clenched both his fists. "OK, I'm
ready."
How could he possibly be ready?
I hesitated for a moment, and then made my first needle entry, expecting
a cry, a groan, or at least a flinch. Capitan lay perfectly motionless.
I writhed in and out with my hands swiftly placing the thirty-eight needle
sticks and about a yard of silk thread into his scalp. All of his perfect
body lay motionless throughout. I had been working for about an hour, and
the buzz of the ER had died down a bit. By now, the paranoid schizophrenic
got his antipsychotic medication, and the heart attack victims got transferred
to the Intensive Care Unit. Only then did I notice Capitan still softly
singing the song. This time, though, the lyrics became clearly audible.
I believe I can fly.
I believe I can touch the sky.
Think about it every night and day.
Spread my wings and fly away.
"Excuse me, I'll be right back."
I needed to get the antibiotic ointment from the Storage Room. Actually,
I was wondering what had happened to Elsie. She probably needed some cleaning
up and some anticholinergic medicine. Elsie was nowhere in sight. Her chart
was no longer on the racks, so she must have been seen by someone. Suddenly,
I regretted bypassing her. Old people are fascinating, full of stories,
and plenty of good advice.
I headed back to the Suture
Room, Bacitracin in hand, deep in thought about what really makes a man
attractive. I thought about Capitan's carefree life—goes out drinking on
the weekends, spends his days watching sports and lifting dumbbells aimlessly
into the air. This refusal of lidocaine is probably some macho thing, and
now he'll have stories to tell all his brainless, buffed buddies. I felt
a shudder inside me, and all of a sudden, Capitan had lost his appeal.
It was then that I absentmindedly
bumped into a stretcher with a body covered in a white sheet. "Ouch," I
mumbled, furiously massaging my right knee. There was a strong stench of
urine emanating from it. I felt my heart skip a beat and I knew even before
I slowly turned the identifier tag on the corpse's wrist. 'Elsie Knockhatter.'
Numb, I went to Capitan.
"Here," I handed him the ointment.
"Stay away from beer bottles," I said contemptuously, both at him and even
more so, at myself. I turned and left, without waiting for a response.
I finally reached the ER. "What
took you so long, Doctor?" It was four thirty-two. Debbie watched me unforgivingly
as I headed towards the rack of charts, and picked up the top one without
looking at the name.
Nipa Shah
Class of 1996
Life, and
Death, Color
A line we made—not we of the present but we of the past—
tells us whether we are alive or dead.
And amidst the true wonders surrounding, we ponder only life and death.
Are we trapped?
Simply remember: as life begins,
so too begins death.
One, but moving together in opposite directions, perhaps tinted differently.
A quirk of nature—that we primates distinguish colors as we do—
propels us towards war, no solution but the constant answer.
No one is white. That is the color of anemia, nausea, pus;
the hue of milk and semen; the shade of bone and budding teeth and
hair—
after bleaching.
No one is black. That happenstance decrees as the color of gangrene,
melena, eschar;
the hue of a human pupil; the shade of part of the brain and rotting
teeth and hair
after dyeing.
Yet the ersatz barrier persists, both sides claiming tradition or honor
or purity,
the impure forced to choose weapons and sides.
Are we imbecilic?
Merely recall: where white starts,
there too starts black.
One, ripped together in the same direction (no direction at all), tinted
almost the same.
For we are all shades of melanocytes, breeding together, breathing together,
our lungs filled with the truest color,
clear, for life,
and lungs emptied of equally transparent air in death,
fading into the crystal vacuum together.
Shuvo Ghosh
Class of 1998
Code 99
I see the knowing smiles—well, not quite smiles
As they shake their heads and chuckle
Because I cover up this patient lying naked
While the world outside the open curtain
Looks on with TV-set glassy-eyed stares,
Just one more episode of ER,
Only this one smells like Jack Daniels
And feces, and blood from the gunshot wound.
The white-haired man with his wife—
I wonder which is the patient today?
The young couple with their asthmatic child,
And the smell of cigarettes like a cloud rolling
From their room, have never seen a real gang-banger,
And still have not, although they don't understand
I cover him because he's somebody's son,
Somebody's brother, and ask to have the curtain closed.
The patient relaxes almost imperceptibly,
Even agrees to move his toes and flex his neck,
Until the x-ray tech re-opens the barrier to suburbia
And the mother hides her child's eyes with her cigarettes
As the patient protests, no rectal exam for me, you heah?!
"Sir," I explain, and I see the heads shaking,
One paramedic even goes so far as to say
"Yeah, we used to be like that, too," as he pulls out the leathers.
"Hey, I'm a nice person," I say, and to my surprise, defensively.
"Yeah, we used to be like that, too," as the security team descends.
We work out a deal, no restraints if he cooperates,
And through his inebriation and his fear, the patient understands.
Rectal exam over, x-rays and police report taken, he looks at me.
There's a tear in his eye, and he takes my gloved hand,
"Doc," he pleads, "am I gonna live? I ain't never been shot, see,
I was jus' walkin' out the door wit my brother, and some dude
Saw his wife wit some other guy, just pulled out a gun an' started
Shootin' an' I ducked but he caught me an' I was so scared, doc,
So scared I shit in my pants—is my brother all right? Am I gonna live?"
I choke back my humanity, and I tell him in lawyer-speak
What he most fears to hear, that we have to wait and see.
The distance between us grows—me, the enemy with forked tongue,
Saying many words with no meaning, him sensing the maneuver—
But I smile, and the human being in this man understands my eyes.
And when the smile fades and the curtain stays open,
When they're all gang-bangers to me, I'll be just like the others,
Shaking my head to laugh at someone who cares
Because that reminder of lost humanity is too painful,
So many patients treated like animals a weight on my soul.
So I go to the waiting room, find his family and bring them
Back behind the curtain, a mother's worst nightmare,
And I stay with them until her questions are answered,
Give my patient one last smile, feel my soul alive, intact.
Five years of residency, on call every third—
Will my humanity survive? Will my soul?
Kim Brown
Class of 1998
The bigger they
are...
His license requires only his presence
He's as green as the folded curtain
He gulps and looks over my shoulder
... the harder they fall
David Rosania
Class of 1998
Midnight
Encounters II
During my psychiatry rotation
in medical school we were required to take a couple of night calls at the
university medical center. In the middle of one, the resident and I were
called down to evaluate a patient in the emergency room.
"SOB, why are we being called
to evaluate the patient?" I asked.
"I don't know, maybe he feels
short of breath when he's dreaming," answered the resident. We both tried
to laugh but it was too late in the evening or too early in the morning,
about four o'clock. Either way I was becoming annoyed with seeing this
patient. Aren't there any Internal Medicine docs that can see this guy,
I thought to myself. Feeling impatient, I knew all my questions would be
answered as soon as we got there. We walked into the room to see a middle-aged
male dressed in a dark suit and tie, sitting on top of the stretcher, hunched
over, clearly out of breath, with an oxygen line to his nose.
"We need to know what this
guy's 02 saturation is."
"Yeah," the resident responded.
Just then the nurse walked
in and said,"98%. 98%—normal."
The resident then asked, "Why
does he have the nasal cannula on?"
"Oh, he came in with that,"
she said with a chuckle as she left.
Becoming more and more impatient
and angered, I went up to the patient to examine him. Obviously no one
else had a serious interest in him. After looking around the room I noticed
that the oxygen tubing was not connected to the wall.
"I can breath easier when I
wear it," the patient announced.
Systematically, I followed
the tube from his nose, down around his neck, across his back, and straight
into his back pocket. I pulled the tube out and showed it to the resident.
"I guess that's why they called
us," he answered.
The nurse popped back in and
said, "He always acts like he's out of breath when a new doctor comes in."
We spent over an hour discussing
why the patient came in, his past medical history, social history, medicines,
and everything in between. We learned that the day program he participated
in did not open until 6 a.m. In the end I think he just needed a place
to stay for awhile. The sun was just beginning to peek through the windows
when without saying a word he got up, put on his hat, coat, and left. I
went back to sleep.
Gary Fontan
Class of 1997
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