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Decision
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.
Medical Home
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
Early Morning. Again
I sit on the sofa,
alone in the sunroom,
stirring a cup of mocha-coffee,
Soon it turns cold.
Your mother’s quilt, an heirloom
pulled off our bed,
wraps my shoulders.
The corner touching my cheek
is soaked in wild grief,
Bone Loss
Whisper me
into the chambers
of bone,
honeycomb of marrow,
talisman
bleached,
rib of grey dove,
Back Pain
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 has been going on for a long time.
She talks. I listen.
She says, “I should call her, shouldn’t I?”
I let her answer her own question. She does.
A Short Explanation of Everything
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
how sleep is not as simple as it looks.
During general anesthesia the operating room enjoys music.
On the Grounds of a Former State Mental Hospital
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
Whatever Else
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.
Sounds
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,
repetition, ancient, magnificent, humble,
sucking in precious oxygen, grabbing it softly,
a deal in exchange for recently used air
now full up with carbon dioxide mostly,
a winning deal though the oxygen doesn’t care.