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 don’t.
Thirty-two, alone, paralyzed, on a vent,
she mouths “no” to the antibiotics, the heart meds.
“I want to die,” she shouts in a whisper.
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 in the broken heart of the city
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.*
prescribe activity, no meds and the tincture of time.
She is fine with that, appreciative and pleasant.
Then she says, “Should I talk to my sister?”
They are estranged, as usual about who got Mom’s whatever.
Her sister is 86, this
We sponge her off. This student is learning how blood boils,
how shaking chills and drenching sweats punctuate fever,
along concentration gradients, how nerves talk,
how some circuits turn all the lights on and all the lights off,
and in sequence, how the life of the mind
is beyond understanding in the same way that a kidney