© 2020 Pulse - Voices from the Heart of Medicine, Inc. All rights reserved.
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
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
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
To red dust. Weeds pierce the interstices of paths slowly
Giving themselves up to trackless overgrowth
Or is this slant just as proper to a cupola as symmetry?
Not if it lets the rain in, I suppose
from all this–from machines
and plastic tubes, from the shooters
with their dyes, from the guys
who scan your organs
for the truth, from waits in cold rooms
whose lights illuminate your life
and make it…nothing. I respected
the darkness in you–your son
dead in a senseless crash, the stroke
itself, your husband’s absence.
from its suitcase of slightly sweaty skin
across to the diaphragm, a divide keeping
him from me, now breached, the world now open
crawling up a well-used black rubber tunnel
to my ears, calling to me, waiting to begin
knowing, albeit briefly, the mysteries within.
in, out, in, out, in, out, the rhythm of breath,
filled with meds both past and present
and read out loud the labels of those we stopped,
why he needs oxygen at night, and the rescue inhaler.
Between pills it’s my job to ask in a generic way
because his story needs a prop.
If you had told me thirty years ago,
when I took call on endless sleepless nights
on incandescent AIDS wards full of fear
on which I tried to do the healing work
of drawing blood and packing leaking wounds
and viewing films of microbes gone berserk
in lungs and brains of patients wasted frail
to postpone certain death from HIV,
if you had told me then
The door opens, we pause again.
Voices singing in the lobby drown out
her parents and the specialists alike.
I think they added bells this year,
the cheerful carols carefully chosen
to celebrate the season, not a faith.
A guitar picks up a riff, the same
one my daughter played so long ago
in her one embarrassed solo
on the school stage. A song both
My first day on the wards,
the senior resident handed me a white coat
emblazoned with the twin serpents of Asclepius,
and a stethoscope I proudly draped around my neck.
I thought I knew everything
about the dying patient assigned to me.
I listened studiously to John Doe’s lungs
filling rhythmically from a little machine
with a red diaphragm that pumped up and down