I Should Have Said No

Can you see this patient today?
His appointment is tomorrow,
he came all the way from Nebraska.
Can you work extra tomorrow,
we are short, just four hours extra?
Would you be able to work Christmas this year?

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Flashback

I notice the name on the waiting room
tab; it’s not a remarkable name,
but one I remember
from elementary school

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Blue Book

Days before she died

my mother stood in line,

took a picture for a passport—

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Walnut Shells and BRCA

If I was going to write a poem,
It would be–
It probably shouldn’t be–
About how much I hate the dog.
The way he licks his paws for hours
In the middle of the night
When the baby is no longer crying.

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Things My Wife Left in the ICU

A pacemaker and defibrillator

Sheets pressed hard with suffering

Seven fingers and one arm, gangrenous dead

Unknown liters of blood

Failed kidneys

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Decision

B546 wants to die
eight years after they saved her.
Cervical-cord injuries are cruel.
For Maria it was a gunshot,
but it could have been a car wreck, a fall,
or a drunken misstep off a roof.
The reasons seemed to matter; now they

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Medical Home

A model or philosophy of primary care that is patient-centered, comprehensive, team-based, coordinated, accessible and focused on quality and safety.   –Patient-Centered Primary Care Collaborative

It’s a philosophy
not a place.
I get it.
Certainly we never used that term
to describe what we offered
there

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Early Morning. Again

I sit on the sofa,
alone in the sunroom,
stirring a cup of mocha-coffee,

Soon it turns cold.
Your mother’s quilt, an heirloom
pulled off our bed,

wraps my shoulders.
The corner touching my cheek
is soaked in

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Bone Loss

Whisper me

into the chambers

of bone,

honeycomb of marrow,

talisman

bleached,

rib      of      grey      dove,

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Back Pain

Back Pain

A 77-year-old woman presents with back pain.
No trauma. No radiation. No red flags.
ROS* otherwise surprisingly negative.
Her exam is unremarkable, actually pretty darn good.
FROM, negative SLR, full distal strength, sensation and DTRs.*
After the usual cautions I reassure her,
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A Short Explanation of Everything

A Short Explanation of Everything

Our patient says she’s burning up, burning up.
We sponge her off. This student is learning how blood boils,
how shaking chills and drenching sweats punctuate fever,
how water moves in and out of cells
along concentration gradients, how nerves talk,
how some circuits turn all

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