Angels and Phantoms
Joanna Dognin
“Mama,” a little voice pipes from the back seat. “Why is that boy in a chair?”
The sun is beaming into the car as we sit at a stoplight, waiting to exit a store parking lot. My two-year-old daughter has spotted a young man, barely twenty, who smiles weakly as he rolls by in an electric wheelchair, collecting money for muscular dystrophy.
“He’s in a chair because he needs help moving around,” I say.
“Why?”
“Because his legs need help.”
“Why? Because they don’t work?”
“Well…”
“Why are they broken?” she asks. “Is he broken? Why is he here? Where is his mama? Mama, where is the boy’s mama?”
* * * * *
“Dr. Lobozzo, you got any kids?” Gabriel asked, calling me by my maiden name rather than the married name I’d only recently begun using.
“No,” he continued with a sly smile. “Don’t tell me. I already know. You have two sons.”
I was newly married (without children), living in one of New York City’s boroughs and working in the Manhattan HIV primary care center I’d joined after getting my psychology license. The center integrated mental health and social services into » Continue Reading.
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Dissolution
Jocelyn Jiao
the articles went first.
then the pronouns, the verbs,
nouns. they melted away, leaving
only memories of warmth
cradled by salivary glands.
adjectives flutter behind
my front teeth, ready for flight.
only adverbs remain,
curled beneath my tongue–
yawning, drowsy:
the softest words of vocabulary.
the lilt of my voice has left too,
soapy Californian vowels
scrubbed clean.
when i speak to my mother,
she complains of my consonants,
how they have begun
to iron out cadences, climb
over inflections, ride
them into deep sand. she says
only my whisper remains whole.
but not for long;
already the throat whistles.
it all started at your
bedside, when your lips
were parted, straining
to form one first, final word.
a sudden embrace of cold
concrete made you into
some bright thing with eyes
translucent, gasping
for the comfort of
water, empty and clear–
when ebullience
once spilled from your lips
as a sun warms an earth.
do you see? words are meant
for creatures of air. i have no use for them;
even fish can sing.
gently, carefully, tenderly,
night arrives; it pivots and
provides no answer. i feel your name
coil in my mouth, watch
as it ebbs
James and Bob
Paul Rousseau
I think his name was James, but I can’t remember for sure. What I do remember is the day’s heat, the metal cart and a rust-colored dog.
Like many homeless people, James carried his belongings in a grocery cart–a sort of mobile home for the homeless, but without the protection of a roof, the support of four walls or the security of a front door.
I’d just walked out of the local Safeway store into its parking lot. He ambled over from a park across the street. His eyes were narrow, his face tanned and his clothes dirty brown from weeks of sleeping in the streets.
Being a dog lover, I found my eyes drawn to the dog–a mixed breed with matted hair, worn eyes and gray hairs on his snout. He looked underweight; I guessed he weighed no more than thirty or forty pounds. He stood obediently by James’ side, tethered by a rope leash.
“What’s his name?” I asked.
“He’s Bob–best dog there is. In fact, best friend a man could have,” said James in a deep smoker’s voice. He smiled and rubbed Bob’s back.
Then he asked, “Can you give me some money so I
The Cruelest Month
Ray Bingham
One day in April, I took the assignment none of the other nurses wanted: Baby Michael. A hopeless case.
Born almost four months premature, weighing barely a pound, he was now all of six days old. His entire body wasn’t much longer than my open hand. As he lay motionless on a warming bed with the ventilator breathing for him, the night nurse gave me report: serious intestinal infection, bowel surgery, septic shock, multiple antibiotics, infusions to support his failing heart, transfusions to replace the serous drainage seeping from the surgical incision on his darkened, swollen belly.
“Take good care of him,” she finished. “He’s been through so much already.”
As experienced nurses, we both knew that a premature infant rarely survives so many medical complications.
Tiny and sick as he was, his parents Frank and Tonya loved him. Midmorning, they came to visit. They were a young African-American couple–he, tall and wiry; she, shorter, with thick, wavy dark hair. They both looked so weary.
With the attending physician, Dr. Moore, I joined them at Michael’s bedside. Trying to be compassionate but honest, we described the progress of Michael’s infection and his grave prognosis.
Still, when Tonya held
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Third Party
Mary E. Moore
Tipping forward to escape
the wheelchair’s confines, the ancient one
pleads with her feet, “Go home.”
It’s her companion who volunteers
the Chief Complaint: “Ever since her stroke,
Mother’s back seems to hurt.
Her doctors say there’s nothing can be done,
but I thought that perhaps a specialist ….”
She strokes the old woman’s shoulders.
“Does it hurt here, or there, or if I touch this?”
My fingers probe among birdish bones.
Ignoring me, the patient whimpers, “Home.”
When the daughter’s eyes register pain, I say,
“I’ll inject this spot near her sacroiliac joint.
It may provide relief, in any case do no harm.”
I fill in the charge sheet attached to the chart.
Low back pain. Trigger point injection.
Return PRN. But how should this be billed?
With the old woman’s medical insurance?
With the daughter’s?
Or should I pay for this one?
_______________
Editor’s Note: PRN is an abbreviation of the Latin phrase pro re nata, which in English means “as needed.”
About the poet:
Mary E. Moore earned a PhD as an experimental psychologist, but after working in a hospital, she decided to study for an MD. She became a rheumatologist, ultimately heading the division of rheumatology at Albert Einstein
Trauma in the ER
Michael Gutierrez
It was 5 pm on a cold November day. I was a third-year medical student heading into my first night on surgery call.
Changing into my scrubs, I wondered what it would be like. I knew that we had to carry a “trauma pager” and, when paged, get to the ER as fast as possible. There my job would be to listen as the ER physician called out his exam findings and enter them on a history-and-physical form.
I felt a mix of things. I was excited about the learning possibilities, but I also knew that whoever gets wheeled through the ER doors is someone’s daughter, son, mother or father. I decided not to think too hard–I’d just take what came my way and organize my thoughts later.
The night started off slowly. I checked on a patient our team had operated on earlier and added a couple of people to the next day’s surgery list. If the evening stayed this mellow, I might have time to study in the call room and get some sleep before rounds the next morning.
Around midnight, my pager went off: “29 y/o female; head on motor vehicle collision; laceration of head;
The Winner
Majid Khan
I pull up on the side of the road on this rainy British summer’s day. The rain doesn’t make it easy to get my doctor’s bag out of the trunk, which I do in a hurry so I can make my way to the house where I’ve been asked to visit a 37-year-old man named Kenneth.
This really isn’t ideal. Now my bag is wet, my papers are wet, my trousers are wet and my mood is wet. I didn’t want to do this visit anyway, but I’m still in my last year of training before becoming a full-fledged GP, and I’ve been given the task by one of the senior GPs in the practice.
“Cough/temperature” says the note the receptionist has scribbled. But while reviewing this patient’s records at the surgery I’d also spotted the words “demyelination” and “bed-bound”–words that had triggered my resistance to coming at all.
I knew this visit would upset me. Kenneth has an autoimmune disease like multiple sclerosis that is slowly destroying the sheaths covering his nerves. Kenneth is only nine years older than me.
The brown wooden door opens, and a plump, smiling lady wearing an apron welcomes me in, tells
Sleep Hygiene
Daniel Becker
Outline the night and all its objects
in black magic marker.
The world through closed eyes
needs texture
the way tires need tread,
brains need wrinkles, and hypnosis
needs the power of suggestion–
traction, surface area, and control
might also apply to a cat
buried alive underneath the sheets;
if so, don’t forget the one on top.
Stay up for several nights before
the night you plan to sleep.
Oil the ceiling fan.
True or false: the bladder
is on a separate circuit?
Don’t eat in bed, especially chips.
Snoring + sleep apnea + restless legs
+ hemorrhoids + lumbago =
the human condition. The winter itch
as well would be unfair.
Use pillows to solve or suppress all of the above,
a pillow shaped like the horizon
or the supine profile of your partner, or even better
a partner who won’t mind being used as a pillow–
together you become the mountains and their clouds,
between the two of you a hidden canyon,
lost in your slopes there are deep limestone caves,
hot springs, the occasional tremor
of tectonic plates and knees.
About the poet:
Daniel Becker practices and teaches general internal medicine (an endangered specialty) at
Stuck
I have never told this story to anyone.
It all started one night about ten years ago, three months into my internship. I was on call, having just admitted a man with a possible meningitis.
He now lay curled up in fetal position on the bed in front of me, looking thin and ill. Preparing to administer a lumbar puncture (a diagnostic test that involves removing fluid from the spinal canal), I gently pushed his head further down towards his legs.
Ms. Taylor
Remya Tharackal Ravindran
Ms. Taylor was one of three newly hospitalized patients I saw that morning. She was a previously healthy woman in her forties, single and childless, who worked in the fashion industry. As I scanned her admission notes, three things stood out: shortness of breath, elevated calcium level and kidney failure. I read on, thinking of possible causes, then something caught my eye. Her breast exam had revealed multiple breast masses, and her chest x-ray showed fluid-filled lungs.
Everything fell into place: cancer, first in the breast and then spreading to the lungs. I was spared a diagnostic challenge, but I now had to face something more difficult–talking with Ms. Taylor about her diagnosis. Did she even know what it was? It didn’t seem so.
For me, breaking bad news is an elusive art. As I walked to Ms. Taylor’s room, I tried to recollect some of the strategies I’d been taught, like finding out what the patient thinks is going on and asking how much he or she wants to know. Still, I didn’t know how Ms. Taylor would react. I felt nervous.
Ms. Taylor was sitting upright in bed, wearing an oxygen tube. She was a
Grandmother
Elizabeth Kao
Today, her head is spinning, just like yesterday,
And the day before that. She is dizzy, experiencing
pain we can’t know unless our heads have hurt like
she hurts now. All she wants is to lie down, and
when we tell her she just woke up, she says she
can’t sleep, because we don’t understand that
she’s not concerned with the sleeping. She’s the
same with food, telling us everything tastes bad,
merely eating to keep from being hungry.
She felt nothing to be worth doing after the fence fell,
just another part of a neglected house, but not
so neglected as to scream injustice to the world.
No one would mind that she did nothing, nor
would she–or more accurately, she didn’t care.
So she turned inward, after seventy-three years of
War, raising a daughter and two sons, watching the
grandchildren for them, then left alone because
she seemed strong, for their convenience.
Tomorrow she will get up, eat breakfast, and sit
in her chair. By the afternoon, she will lie down in
her bed again, staring into space, wishing the pain
but not-pain will go away. And we blame a
chemical imbalance and wonder whether we
Pearls Before Swine
Kate Lewis
I’m a third-year medical student, and I’m starting the second day of my new rotation–a month that I’ll spend with a family physician, Dr. Bauer, in his small, efficient home-based office.
Yesterday, my first day, a young woman named Sara came in for “strep throat.” She had dark Latina eyes, broad cheekbones and a delicate tattoo of the Chinese character for “dream” on her left wrist. She was 17 and seeking out a primary-care doctor for the first time in her life; I applauded her for taking responsibility for her own health care. Her tonsils were big and purple, covered in pus, but the rapid strep test was negative. She also reported a vaginal discharge. Dr. Bauer wanted to do a pelvic exam to check for a sexually transmitted disease (STD). He started her on antibiotics, ordered some blood tests and told her to return today to discuss her lab results and have the pelvic exam.
Now Sara returns with her mother, wanting to know why the exam was scheduled. Impressed by Sara’s thoughtfulness, I tell her that we recommend the test, but assure her that the choice is hers. She looks me in the eye, confidently reports
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