Heightened Awareness

No power-down switch to arrest
That incessant activity of the mind and senses
Not even for our wedding anniversary

At the airport my eyes reflexively dart
From the cashier’s cheery smile to fix on her arm
Laid bare by her Dunkin’ Donuts uniform
And the glaring track-mark trail
As she carefully hands me my scalding hot coffee.

On board American Airlines my ears instinctively pinpoint
That paroxysmal brassy cough of the man in seat 20C
Debating whether it could be pertussis.

Waiting to board the Norwegian Cruise ship
I automatically analyze the biomechanics
Of the slender attendant as he squares his shoulders, tightens his core
To push up 30-degree inclined ramp
The woman in wheelchair three times his weight
Wondering if he is in pain.

Onboard I can’t help but take notice
The antalgic gaits of elders nursing painful knees and hips
The unmodulated volume and sloppy enunciation of drinkers
Circling the bar puffy-eyed at 10 AM
The thrust and parry of couples arguing viciously

And your breathlessness as you pause
Climbing that third flight of stairs
Worrying if it could be some subtle sign of coronary disease–
You know how deceptive it can be in women….

But it’s also this inescapable heightened awareness
That prompts me to pause and relish the sensate intensities
Of afternoon ocean breezes tussling my hair
And chaotic rhythms of blue-green Caribbean waves
As we sit secluded on our private balcony and read side by side

And to savor that evening
The familiar warmth of your hand
As we slice our anniversary passion-fruit cake
Hand over hand
Just like the first time.

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Carl V. Tyler Jr. is a family physician, medical educator and researcher. He is on the faculty of the Cleveland Clinic family-medicine residency, where he teaches geriatric medicine and evidence-based medicine. His poems have appeared in Pulse–voices from the heart of medicine and in the Journal of Medical Humanities.

About the Poem

“The deliberate and lengthy training of physicians forever changes how they perceive and think about the world around them, whether they are in a hospital or clinic, at home or, as in this poem, on a thirtieth wedding-anniversary cruise in the Caribbean. This heightened awareness of the mind and senses can at times prove both exhausting and rejuvenating.”


9 thoughts on “Heightened Awareness”

  1. Dr. Louis Verardo

    This was a very charming piece to read. Sometimes the inability to stop seeing life in a medical context appears to be a burden we bear as part of our training; you lightened that load with your poem and demonstrated other benefits to that sensitivity.

    Thank you, and happy anniversary.

    Dr. Lou Verardo

  2. Thank you. It is comforting to be reminded that others are watching.
    For nurses watch too – and see – and then there are stories and poetry. My husband and I have been married since 1965 and now – even more – I am ever watchful.
    Thank you MAM

  3. I really enjoyed your poem. I could visualize all the scenes you described and I particularly enjoyed your lovely description of the cake cutting. Belated Happy Anniversary!

  4. Martina Nicholson

    I love this! Exactly true, the extra attention to symptoms and signs… I loved the pointing to the slender young steward pushing the heavy woman’s wheelchair up the ramp, and the tenderness in watching the slightly breathless take on the 3rd set of stairs, in a beloved wife, now entering the time in which we watch for cardiac symptoms automatically, surreptitiously… and I love that it makes you also sense more deeply the wind in your hair… have you read Wallace Steven’s poem “In that November off Tehuantepec” — slight variations in his description of the sea, and “Chinese chocolates and green umbrellas” are like that fine-tuning of atttention… THANK YOU!

  5. Loved it ! Thank you! Empathize as a 40 year family doc who also cannot and shut down medical thoughts in non medical situations!

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"On Being Different"