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Falling Fifth: The Neurosurgery Patient and the Anesthesiologist

based on Robert Schumann’s Third String Quartet, Movement 1

Audrey Shafer

We meet in the holding room; a paper dress covers your tattoos

At any moment, your craze of fragile vessels
could spill, fill the sea cave cradling your mind

Your wife holds your hand until it is time for us to go

I guide you as you blow through a straw
swimming across your long day of surgery

Five hours, and five more: surgeons untangle
a crevice of your brain, clamp the feeder, reassemble your skull

You re-surface, blinking like a newborn
ride in your wide white boat to intensive care;
nurses and doctors give and take report
you speak but I do not understand

Hhhh-m you say, and louder Hhhh-m!
Head? I ask Hurt? Hand? Heart? Does your chest hurt?
I am wrong and wrong again–

You smile and try once more:


Hug you? I repeat, and the entire team turns
to stare silently:
I lean over wires, bandages, the spaghetti of tubes, the upright side rail
and give a most awkward hug

The team resumes its buzz: monitors bleep, pagers bark,
phones ring, keyboards clack, bellows wheeze, alarms blurt
the unit dins in unscored discord

But for two notes, harmony presided over all–
in a falling fifth, a two-toned sigh, you told me you know;
you know you landed on the warm sands of recovery:


About the poet:

Audrey Shafer, professor of anesthesiology, perioperative and pain medicine at Stanford University School of Medicine/Veterans Affairs Palo Alto Health Care System, directs Stanford’s Medicine & the Muse Program [1]; she is also codirector of the school’s Biomedical Ethics and Medical Humanities Scholarly Concentration and cofounder of The Pegasus Physician Writers at Stanford [2]. She has written a children’s novel, The Mailbox [3], about posttraumatic stress disorder in veterans. Her poetry on anesthesia, medical humanities and parenthood has been published in journals, anthologies and in her collection Sleep Talker: Poems by a Doctor/Mother [4].

About the poem:

“Each year, poets from Pegasus Physician Writers collaborate with Stanford’s remarkable ensemble-in-residence, the St. Lawrence String Quartet [5], for an evening of poetry and music. When the quartet chose Robert Schumann’s Third String Quartet, Op. 41 [6], I wrote this poem in response to the sigh of the falling-fifth interval prominent in the first movement. The neurosurgical patient in the poem is an amalgam of patients of mine who have undergone potentially life- and personhood-changing surgeries. Anesthesiology is a humbling, intimate profession. I remain ever grateful for the trust my patients place in me and am honored to provide care for veterans.”

Poetry editors:

Johanna Shapiro and Judy Schaefer