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
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.
Last Day
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.
His ex called yesterday, Only one ex, one’s enough,
Training During the Plague
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 that I would see
a family with an AIDS tale just as bad—
today, two parents with disease but well,
their uncontaminated child, alive–
my doubt would equal that of Didymus
who disbelieved the Resurrection tale.
Like he who needed proof with sight and
Holiday Concert
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
fitting and ironic, about keeping up
the fight. Down the hall, their daughter
listens to the voices rise and fall.
The doors open, and the doors close.
The Journey
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
and made a hissing sound that reminded me
of the snakes embroidered on my collar.
I grew to know him over weeks,
to speak in code through a system of lid blinks–
the only muscles intact after a brainstem stroke.
Heightened Awareness
No power-down switch to arrest
That incessant activity of the mind and senses
Not even for our wedding anniversary
Getaway.
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.
The Best Storyteller Award
Daniel Becker ~
At the clinic retreat everyone gets a prize,
and the Best Storyteller reminds us of those times
a man goes on a journey. Not just any man: Dr. William Osler,
the doctors’ doctor, the professors’ professor, the textbook author,
and this Canadian in Philadelphia crosses the Delaware to Camden
where Walt Whitman, the great American poet, the poet’s poet,
endures fame and poor health.
Every case is supposed to be interesting, but Whitman,
according to Osler, suffered only from what his age could explain
plus or minus the usual slings and arrows,
the wear and tear of gravity,
the side effects and worries,
Riven
Martha Carlough ~
In medical school
I learned the particular sensitivity
of the breastbone
The rub of a knuckle
awakens even one deeply asleep
beckoning back to the present moment
Grief has the potential
to show us how cramped–
even deadened–we’ve become
Chest riven with pain
my fingers are now free
to explore the stories