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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; she is also codirector of the school’s Biomedical Ethics and Medical Humanities Scholarly Concentration and cofounder of The Pegasus Physician Writers at Stanford. She has written a children’s novel, The Mailbox, 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.

About the poem:

“Each year, poets from Pegasus Physician Writers collaborate with Stanford’s remarkable ensemble-in-residence, the St. Lawrence String Quartet, for an evening of poetry and music. When the quartet chose Robert Schumann’s Third String Quartet, Op. 41, 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

Call for Entries​

Pulse Writing Contest​​

"On Being Different"

About the Poem


16 thoughts on “Falling Fifth: The Neurosurgery Patient and the Anesthesiologist”

  1. I came across this poem via NPR. Instantly fell in love. We medical students who show interest in poetry crave for such.
    Thank you so much. I wish to read more from you.
    Love from India.

  2. Ernestine Carmenatti

    “Humanity” at it’s core! The appropriate adjective has not been formulated. The closest would be Melville’s character in Bartleby

  3. Ronna L. Edelstein

    Audrey, I have had four jaw surgeries in the past eight years (and now face a fifth). Only once did I experience a bond with the all-important anesthesiologist–a painful smile from me in gratitude that I had made it through the surgery and a gently squeezed hand from her, letting me know she cared. Your hug deeply touched me; what a beautiful, compassionate gesture to make!

    1. Oh my, 4 surgeries and a fifth upcoming. Warmest wishes for an uneventful and smooth recovery. Thanks for your kind comment.

  4. I love this poem! It is so elegant and elegiac. What a talent you have. I will be following your other work. I am so heartened by health professionals who have a sensitivity to that other world- the interior one.
    Thank you so much.

  5. Thank you for this, huge thanks. This intersection of the vulnerability of both patient and physician, with the beauty of art (music and words) that gives life so much meaning, well, just took my breath away.

  6. Margaret Fleming

    This is beautiful work. But what I admire even more is that the patient dared to ask, he received, and he read the message so clearly. I have never asked for a hug at a hospital, even from my own daughter. But I remember the hugs I got from my wonderful primary MD in CA, who taught me I was in a healing place.

  7. This poem is beautiful. I love how musical it is. The resolution of the surgery and the resolution of the poem is like a chord resolving, a sigh of relief. The use of language is as delicate and precise as neurosurgery that repairs vessels as intricate as the crazing on other vessels. Thank you.

      1. I have been an anesthetist for 35 years. This was beautiful. I often compare us to the lighting crew in a play or concert. The performance cannot go on without us but we are seldom noticed. You touched this man and it brought to light that, yes, we do have a very important connection and we are not unseen and unfelt. thank you.

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