Connective Tissue 2016 by Cheever Center for Medical Humanities & Ethics

LITERATURE & VISUAL ARTS

JOURNAL

VOLUME IX â&#x20AC;¢ 2016

COVER ART

Union Station, StL Raj Sehgal, M.D.

School of Medicine, Division of Hospital Medicine, Clinical Assistant Professor

Submit your art and literature for consideration in the 2017 journal to: ConnectiveTissueJournal@gmail.com For entry guidelines, to view past journals, and for more information about joining a committee, visit: https://www.texashumanities.org/connective_tissue

The works published in this journal were selected based on their artistic and literary merit and do not reflect the personal views of the UT Health Science Center San Antonio, the Center for Medical Humanities & Ethics or the editorial staff.

VOLUME IX â&#x20AC;¢ 2016 EDITOR IN CHIEF Chris Yan, MS4

Center for Medical Humanities & Ethics, Fellow of Medical Humanities

EXECUTIVE EDITORS Arielle Ferris, DPT III Patricia Stievo, MOT II

DIRECTOR OF DESIGN Jacob Ferris, MS4

EVENTS COORDINATOR Inez Leal, MS4

EDITORIAL STAFF Mazen Hassan, MS2 Luyang Jin, MS2 Hannah Korman, MS2

COPY EDITOR Sheila Hotchkin

FACULTY ADVISORS Ruth Berggren, M.D. Lee Robinson, J.D. Jerald Winakur, M.D.

S E L E C T I O N PA N E L S

VISUAL ART SELECTION PANEL

LITERATURE SELECTION PANEL

Maleeha Ahmad, UTHSCSA Affiliate Bryan Brockman, MS3 Tiffany Chen, MS3 Spencer Cope, MS2 Nella Dornbluth, UTHSCSA Faculty Cristin Harper, MS3 Bryant Huang, MS1 Jessica Liu, MS2 Dorothy Long Parma, UTHSCSA Faculty Zaid Mahmood, MS1 Elsa Moreno, MOT II Angela Saul, MOT II Rob Schonhoff, PA2 Andrea Schorr, UTHSCSA Staff Jayme Trevino, MS1 Nikita Viswasam, UTHSCSA Affiliate Narine Wandrey, MS2 Alice Yang, MS2

Maleeha Ahmad, UTHSCSA Affiliate Bryan Brockman, MS3 Pamela Camosy, UTHSCSA Faculty Cristin Harper, MS3 Hilary Hopkins, MS1 Bryant Huang, MS1 Jessica Liu, MS2 Zaid Mahmood, MS1 Rob Schonhoff, PA2 Andrea Schorr, UTHSCSA Staff Nikita Viswasam, UTHSCSA Affiliate Narine Wandrey, MS2 Alice Yang, MS2

E D I TO R ’ S N OT E I’m filled with pride each year when I see the work of our community come together in Connective Tissue. In my final year of medical school, I’ve reflected much on how we evolve as students, beginning school in awe of our seniors and teachers, and then one day becoming the professionals that new students look to for wisdom and guidance. This is a journey I have made with Connective Tissue in my backpack each year. Likewise, Connective Tissue has evolved, and my role has evolved with it. When I signed on as a first-year student, my main concern was finding the “best” art and literature the Health Science Center had to offer. Now I realize that my main concern is ensuring that our Health Science Center community is perfectly represented in each volume. When we watch our predecessors in action, I think there is a certain notion we are prone to believe—that they are the best, and that we too, should strive to be the best. But “best” implies superiority. In fact, “best” becomes a relative term after finishing some of the most challenging academic training one could ever endure. You don’t see “the bests” of the world in the end. What you see instead are colleagues from every facet of the health professions, who go to remarkable lengths to care for the sick and destitute, who hold each other up in times of hardship, and who, though imperfect, strive to be the best version of themselves they can be. You see people who bring beauty and art into the world. Perhaps capturing that picture of ourselves in Connective Tissue is the nobler goal to aspire to. And perhaps that is what really captivates the hearts and minds of those who come after us.

CHRIS YAN Editor in Chief Connective Tissue Volume IX

I extend an enormous thank you to Dr. Ruth Berggren, Dr. Jerald Winakur, and Ms. Lee Robinson, for their unwavering support and guidance; to the editorial committee and selection panelists who volunteer their time to create this journal; and to the artists and authors who have so thoughtfully shared a part of themselves with Connective Tissue. Our mission, to nurture our collective humanity and build meaningful connections within the UT Health Science Center at San Antonio, is accomplished through the images and stories within these pages each year. Collectively, they tell the story of who we are, and who we hope to be. I hope you will continue to take part in this story, and I hope that you are as proud of it as I am. It has been a tremendous honor to serve this community. I now present to you, with sincere pleasure and gratitude, the 9th volume of Connective Tissue.

iii

C O N T E N TS AWARDS

Tulip

INTRO

WINNER, VISUAL ART Violet Daydream

WINNER, LITERATURE Poland, Day 4

Peonies I Untitled

Kryptonite Color Theory

Explore

Joseph Dylan Peterson

James Liu

Blue Sea of Texas 14

Pedro Pablo Gomez, MD

Narine Wandrey

Sunset at Arches 16

Mai Luk

Desert Hues

Alyssa Laurel

Margaret E. Brown

Spencer Cope

In Good Hands Stephanie Lopez

Weiran Wu, MD, PhD

Jayme Trevino

Moments

Narine Wandrey

COMMITTEE SELECTIONS

Summer Camp Haiku Series

Mai Luk

A Night in Salzburg

Hilary Hopkins

Orange Horizon

Happy Hour

Lauren Kraut

Narcissistic

Pamela Camosy, MD

Sara Springfield Schmit

“Fisherman” - Cartagena, Colombia - 2013

Janina Rodriguez

Sheikh Zayed Grand Mosque, Abu Dhabi Hidden Conversations

Shaoli Chaudhuri

Vacillating

Sammar Ghannam, CPhT

HONORABLE MENTION, LITERATURE The Ant Killer

Kimberly Vogelsang

Eithan Kotkowski Baca

HONORABLE MENTION, VISUAL ART Bone Window

Tran Nguyen

Valeria’s Team

Stephanie Lopez

Hanna Blaney

The Harp and the Dying Woman

Rachel Walker Vandermeer

Peonies II

Kimberly Vogelsang

The Stroll

Evan Grodin, DMD

Native Irish

Heidi McDonald

What Gravity Reveals

Kamala Platt, PhD, MFA

Untitled

Ralph Bauer

Code Ashley Romage

Connected

Alexis R Tracy

Impressions through a scope 45 Joseph Dylan Peterson

Camping Under the Stars

Jayme Trevino

The Me Within (Transformations through 47 Bariatric Surgery) Richard M. Peterson, MD MPH

New Patient Visit

Shaoli Chaudhuri

Golden Canopy

Spencer Cope

“Grab Shell”

Veronica Bove

Stop and Smell the Roses

Anisha Guda

Timeless

Maleeha Ahmad

Driving beneath an orange sky

54 55

Rachel Walker Vandermeer, MD

In Sickness and In Health Ciera Kaylynn Ward

INTRO

Mr. H. B. 58

From Amputation to Acceptance via Occupational Therapy 59 Kimatha Grice, OTR, CHT

Lonely Boy

The Last Meal at Home Together

Gilda Digman

Hiking with Dad –

Jessica Liu

In the Work Room

Thomas Hanson

Bridgett Piernik-Yoder, PhD, OTR

The Practice of Medicine

Family Portrait

Chandlar Michelle Knutzen

Bridgett Piernik-Yoder, PhD, OTR

Are they taking enough with them?

Alyssa Laurel

How Could This Happen?

Maggie Gainer

Time

Michael O. Cotton

Code status confirmation.

Alexa Rodin

Paige Seeker

Cost-Benefit Analysis

Paige Seeker

Adolescent Cancer

Iris 68

Job’s Tears

Eight-Thirty Impression

Collected

Transit

Ciera Kaylynn Ward

Rhythm Jackie Moran

Until Tomorrow Stephanie Jensen

Eval and Treat Becca Espey, SPT

EDITORS’ SECTION

Jorgie Ann Contreras, MSN, RN

“Why Is it Morning?”

Tran Nguyen

The Story

55-WORD STORIES

Patricia Stievo

Luyang Jin

Arielle Ferris

Jacob Ferris Chris Yan

AWA R D S WINNER, VISUAL ART: Stephanie Lopez I’m an MS2 here at UTHSCSA and painted “Violet Daydream” this past winter break. Painting has been an on-and-off hobby that I recently picked back up again. I’m a pretty huge Bob Ross fan and fondly remember watching his reruns as a kid on PBS. This is my first piece in oil, and I really struggled in the beginning. Regardless, I’m looking forward to painting many, many more happy little trees and sharing what I love.

WINNER, LITERATURE: Eithan Kotkowski Baca Eithan Kotkowski was born in El Paso, TX, to a multicultural family. His father was born in Israel (son of a Holocaust survivor) and raised in Mexico, and his mother comes from Juarez, Chihuahua. As a child Eithan was raised culturally both Jewish and Mexican with his two younger brothers. His thirst for knowledge of other cultures and the world led him to attend the United World College of Southern Africa during his senior year of high school. He later completed a BS in Psychology from UT Austin, worked for 2 years as a bilingual elementary school teacher, and finally ended up in UTHSCSA’s MD/PhD program, where he is pursuing a degree in Neuroscience Imaging under the tutelage of Dr. Peter Fox.

HONORABLE MENTION, VISUAL ART: Sammar Ghannam, CPhT Sammar Ghannam is a second-year UTSA/UTHSCSA Facilitated Acceptance to Medical Education (F.A.M.E.) 7-year Joint BS/ MD Program student. Sammar expresses her passion for medicine and the humanities through oil painting, acrylic painting, watercolor, 3D art, photography, and sketching. Sammar is excited to join UTHSCSA as a first-year medical student in 2017. After shadowing multiple doctors in various specialties in Cairo, Egypt, during the summers, Sammar has decided to pursue a career in endocrinology or dermatology.

HONORABLE MENTION, LITERATURE: Sara Springfield Schmit Sara Springfield Schmit has been published in “Chicken Soup for the Soul” and “The Daily Palette” and owns an editing business in Boerne, TX. Sara was a member and officer of the UTHSCSA Alliance and her husband is an attending physician in the Department of Internal Medicine. Follow her on Facebook at “Keep Calm. Edit On.” and keepcalmediton.com.

W I N N E R, V I S U A L A RT

Violet Daydream Stephanie Lopez

School of Medicine, MS2 NOTE

from the Dedicated to the family and friends who have always encouraged me to pursue my creative ventures. Love you!

W I N N E R, L I T E RAT U R E Poland, Day 4

Eithan Kotkowski Baca School of Medicine, MD/PhD Program, Department of Radiology, GS1 MD/PhD Student

Dear Friends and Family, These are the final words of the mourner’s Kaddish, the traditional Jewish prayer of mourning. I could not say these words, I did not utter them, I remained silent in my mind and in my lips. ‫רֹומיו‬ ָ ‫עֹושֹה ָשלֹום ִב ְמ‬ ֶ (May He who makes peace in high places) ‫הּוא יַ עֲ ֶשֹה ָשלֹום עָ לֵ ינּו‬ (Grant peace upon us) ‫וְ עַ ל כָ ל עַ ּמֹו יִ ְש ָֹר ֵאל וְ ִא ְמרּו ָא ֵמן‬ (And upon all His nation Israel; and say Amen) We entered. The site of the camp is located in the middle of a beautiful lush green pine forest teeming with life. It felt inviting, nothing like the concrete slabs that make up the famous Holocaust memorials of Terezin or Yad Vashem. Barely taking a few paces outside of the car, I was immediately swept into a daze. Looking up, the sun could barely be seen through the immense canopying trees above. I walked along the main trail and found myself staring down an unpaved, untended path leading deep into the woods. It was a magnetic feeling, the feeling of being sucked in, as if experiencing a horizontal form of vertigo. I took a few steps forward before turning back. Seeing my perplexed face, Yankel, our guide, told me

that it was the path the train took from the Ghetto to Treblinka. My heart suddenly dropped. Instantly, I knew exactly where I was.

As we continued onward toward the monument’s main site, Yankel kneeled down to pick something up from the dirt trail. He quickly collected pieces of what seemed like very white bits of chalk and quietly handed them to me. A few second later my eyes widened, I recognized them as bones… human bones. Uniform-sized pieces of them were scattered everywhere, especially in the tiny streams and canals formed by the morning’s rain. It was an unfathomable feeling to see so many bits of white all around, every other one having once been a part of someone. The memorial itself is comprised of a central granite monument surrounded by a total of 17,000 stones (the largest number of people exterminated in Treblinka on a single day). Many of the stones had the name of a city, town, or village, the homes of those who perished in the camp. For about half an hour I separated myself from my uncle and Yankel to walk amongst the stones and trees in solitude. At this time I said to myself, “It’s time to say the mourner’s Kaddish.” I had even brought my yarmulke for the occasion. But I couldn’t.

Somehow it didn’t feel right, I did not feel anything compelling me to act in any way religious. Praise God? Here? I remembered what the liturgy of the Kaddish says and I could not bring myself to recite those words, as much as I had done so countless of times in the past. Instead I remained silent in my mind and in my lips. I thought of my great grandparents, Abraham and Enta, I thought of Dorenka, I thought of my grandfather visiting the final resting place of his parents and sister, standing right were I was exactly 30 years ago.

Instead of reciting the prayer, my mind became transposed into that of my grandfather in 1985. A nauseating and suffocating feeling began to overtake me. Instead of seeing my great-grandparents and great-aunt, I saw my own parents, I saw my own brothers. I could see the four of them so vividly. They were there, I could see them! On the train, removing their clothing, gasping for air, and then… ashes. Summoning these thoughts now in the final resting place of my grandfather’s family, among their very bones, it felt real. My body trembled. For that brief moment I caught a glimpse of what extreme loss must feel like, a feeling most of us may never and hopefully will never come to experience. 19 years I spent listening in awe to my grandfather’s stories of his childhood and his adventures during the War. But now, 7 years since his passing, I felt like I finally knew my grandfather. ‫ז״ל‬

My trip during the summer of 2015 was my first visit to Poland, the birthplace of my grandfather. I had long known of my grandfather’s misadventures as a young Jew surviving the turmoil of WWII. His life and stories have come to define who I am as a person.

H O N O R A B L E M E N T I O N , V I S U A L A RT

Bone Window

Sammar Ghannam, CPhT School of Medicine/UTSA FAME Program, Sophomore

NOTE

from the Bone Window is a black-and-white charcoal drawing on black paper. Sammarâ&#x20AC;&#x2122;s curiosity about anatomy coupled with the inspiration from seeing a real a cow hip bone led her to create this drawing that captures the hip bone from a unique angle.

H O N O R A B L E M E N T I O N , L I T E RAT U R E The Ant Killer

Sara Springfield Schmit Friend of UTHSCSA

Bud knew she was gone before he opened his eyes. He could just feel it. The air felt different, the sheets felt different, his mind was numb. He gently touched the top of her cold hand and held it for awhile, thinking back to the day before, to the argument they’d had. It made her seem more alive, as if he could just glance out the window into the garden and there she would be, waiting for him. The day before, Marie wanted to walk around her garden to inspect for ant beds. At age ninety, she still gardened, with the help of a few local kids, and everything was in full bloom. The lemon and lime trees were bursting with flowers, and their citrusy scent spread throughout the entire backyard. The oak trees provided shade for the large pots of fuchsia bougainvillea and the massive green hostas underneath. Tiny marigolds and zinnias were just beginning to sprout from the ground. Bees hummed around the red, pink, and deep orange roses that dotted the garden. When she reached the back fence, Marie grabbed a handful of the honeysuckle that grew over it and inhaled deeply. It was her favorite scent in the world. She had worn a small bunch of honeysuckle in her hair the day she married Bud, and made him wear another bunch in the lapel of his blue plaid shirt, the nicest thing he owned at the time. He’d brought her vases of honeysuckle and rose blossoms every time she gave birth, every time she accomplished a goal, and every time he just wanted to say he loved her.

She glanced at him over the top of the flowers, his blue eyes still bright among the craggy wrinkles covering his face. He smiled at her and sat down on a small bench next to the honeysuckle fence. “Marie, the garden is beautiful. You amaze me more and more every year, but I think this year we have the best flowers yet. You’ve put so much of yourself into this place, and it really shows.” Marie looked at her proud husband admiring his surroundings. The garden was truly remarkable this year. Different, more lush and alive than usual. She turned away, suddenly angry. Burning tears threatened her eyes, but instead of letting them fall, she pointed to a spot on the ground. Jaw set, face flushed, she turned back to Bud. “Look at that. Look at it! I thought I told you to get rid of all the ant beds yesterday. Well, what is that?” Bud, who had been watching a ladybug carefully climb over a pink rose, stared at the spot. He was confused. There was nothing there, and he told her as much. She was not ready to let it go. “Anyone can see there’s a hole forming. There’s probably an entire network of ants under there, just waiting to chew the leaves off all of my plants. I’ve worked hard for this garden, Bud. Too hard to just see it go to waste. The whole thing will die if it’s not properly taken care of.”

He was angry now too. How dare she, after he had spent half a day killing ants, digging into the beds to sprinkle poison, sustaining more than a few ant bites in the process. “Now listen, I worked hard yesterday. I did everything you asked and killed all those ants. It was a massacre! Your garden is fine. If it dies, it’s your own fault, not mine!” Bud stood and started walking away down the stone path. Her next words hit him square in the back. “You’re the worst ant killer I’ve ever seen. If one leaf in this garden so much as withers, I am holding you responsible. You need to fix this, Bud. Fix it! It’s all on your head now.” He turned around, ready to fire back, but Marie’s stance stopped him. She was still clutching the honeysuckle, trying to form a fist with her other hand. Her chin was up, indignant, but her lips were quivering and her nose was red. For the first time, she couldn’t hold back the tears. Bud made his way back to Marie, grabbed her, and held on tight. Her tears stained his shirt. He could smell the honeysuckle crushed in her hand.

Bud did not want to go on living without her. He had prayed that whatever God was out there would take him at the same time, but his prayer hadn’t worked. He systematically made the funeral arrangements, if only to busy himself. The service only lasted half an hour, and he walked the half mile back to their home, to her garden, straight to the honeysuckle fence. The dewdrops on the flowers resembled her tears, and for a moment he wondered if she was there. The sun shone on that cool morning, touching every plant in the garden. There was still life here, he thought. Life that Marie had planted, nourished, and kept alive. For as long as he could, he would keep that garden alive for her. She would forever live in those flowers and trees, and he didn’t want to miss a second of it.

END

“I’m sorry, Marie. I’ll take care of this ant bed tomorrow and make sure there are no more. Please don’t worry, your garden will be alright.” They stayed in each other’s arms until dusk, the sky pink and purple and gold above them. There was nothing left to say, only that last embrace under a perfect sky.

C O M M I TT E E S E L E C T I O N S

Fisherman - Cartagena, Colombia - 2013 Pedro Pablo Gomez, MD

School of Medicine, Department of Surgery, General Surgery Resident

Happy Hour Alyssa Laurel

School of Health Professions, MOT2

NOTE

from the Waist-deep in the waters of Magens Bay, St. Thomas, at sunset

Summer Camp Haiku Series Margaret E. Brown

School of Medicine, MS4

Camp Dermadillo is a summer camp in Burton, Texas, devoted to fostering positive human development in children with chronic skin conditions. I had the pleasure of spending a week as a camp counsleor at Camp Dermadillo, where I had 9 brilliant girls in my cabin. The following 9 haiku are dedicated to each of them. Indoors most her life never been to camp â&#x20AC;&#x2DC;til now trying something new

Miss independent love for lip gloss, sunscreen, ugh time for a selfie!

Camp songs on the hour save the top bunk for her please endless giggling

Big laugh, small package a friend to everyone photobomb on three

A little homesick sometimes shy but brave at camp where is the zip line?

Summer reading list smart and wise beyond her years sunscreen on her ears

Most responsible water bottle, sunscreen, hat her future is bright

Talent show diva takes her spot on center stage encore next summer

Cowgirl boots on feet by the way she has XP natural leader

Tulip

Tran Nguyen School of Medicine, MS2

Valeria’s Team Shaoli Chaudhuri

School of Medicine, MS3

At 5 AM, Valeria wakes, heart thumping against her chest. It’s been two days since the surgery for her cancer—the one that began in her kidney, then threw its satellite tumors into her left leg, her columna, her right arm. A petite girl in a short white coat stands in her doorway. “Ms. Ramos? Good morning! I’m Jean, and I’m a student on your medical team. How are you feeling this morning?” Her medical team. Valeria’s Team. Sometimes she dreams her team is a troupe of superheroes who might whisk away the cancer, bring her back the stolen weeks of hospital stays, of nights away from her children. Valeria smiles at the girl, timid but eager to please, allows her to examine her wound, listen to the steady but racing lubdub of her heart, the labored respirations. “Do what you need to do, linda,” she says kindly. The next member of Valeria’s Team, a nurse named Ana, arrives with ice chips and green Jell-O. Valeria has never been so happy to see the neon gelatinous goop before. “I’ve been so hungry,” she confides to the nurse, who smiles and draws some blood before Valeria begins to eat. At 7 AM, her doctor and sidekicks (or so they seem to Valeria), come by to talk to Valeria about plans, the goal of getting her to walk around, the goal of watching her blood levels in case her quick heartbeat is from anemia or a bleed. Her chemo treatment for later on. Shyly, Valeria asks if she can be out of the hospital by the end of the week.

“I have a family event this weekend,” she explains quietly. Her Eduardo is graduating high school, and she would move heaven and earth to be there, though she hesitates to say this to the imposing woman with her rectangular glasses. But the face framed by the glasses softens. “Ms. Ramos, your goals are our goals. You need to go to that graduation--that’s a special day. Our team is going to make sure you can do what you want to do.” Valeria’s lips turn up gratefully. In the way back of her mind, she wonders if any physician would be as lenient and kind with a woman who has more than a September to live. At 9 AM, the physical therapy people come, slowly walking her around the room like their delicate china doll. Her bones are fragile, she knows. She wonders if her team has any flying capes or carpets that might overcome her breakable bones. At 11 AM, Valeria is distraught with pain. 10/10 pain in her arm, crushing, radiating, throbbing like the cancer wants to erupt from her bone. She stifles a cry and rings Ana into the room, trying not to beg for Dilaudid, but begging for Dilaudid nevertheless. At 12 PM, Valeria does not eat. The pain is consuming her, not the other way around. At 1 PM, she asks to see the hospital chaplain. The pain is fading, an unpleasant pulse in her arm, but her head hurts now from her anxieties. He enters her hospital room and pulls up a teal chair. He is a soft-spoken old man who lets her just talk about the worries she has—about what will

happen to her children when she is gone, the doubts she has about a religion that would give her such trials, about her need for answers. About the wall of despair she encounters from time to time. At 3 PM, the chaplain leaves and Valeria pulls the bed covers close around her and faces away from the door. She loves her team, but she needs to cry right now.

places a hand on her non-tender arm. And wishes she could be on her team for a little while longer. And I smile. Because I know they cannot keep me here forever. Another weekend, yes, but they can’t keep me here forever. I will take their bad medicine. I can recover. What they tear down, I will rebuild. And I will get out of here. I have work to do.

At 3:30 PM, the most important members of Valeria’s team arrive. “Mamá, you dropped Jell-O on your gown!” Priscilla laughs, greeting her mother with a hug. Valeria’s only grandchild sits restfully in Priscilla’s belly, swelling it up each and every day like a balloon. Valeria rubs her daughter’s abdomen for luck. Eduardo looks at his mother over his glasses . “Y tú, ¿por qué no estás en la escuela?” she demands. “Ma, I got out of school early today, chill!” So Valeria chills; but not before affectionately tugging on her son’s ear. When their father left so many years ago, Valeria didn’t know if she could raise two children on her own. Well, here was her proof, one with a college degree and a baby, the other about to graduate high school. I’d say I did pretty well, Valeria thinks to herself. At 5 PM, Jean the medical student returns to check on Valeria. She makes perfect small talk, of new restaurants in San Antonio, of the beautiful flowers Valeria’s family has sent. “How are you doing overall, Ms. Ramos?” Jean asks again. “I’m okay. I’m okay,” Valeria repeats. “I’m going to fight this thing,” she whispers, half to Jean, half to herself. Jean

Peonies I

Kimberly Vogelsang School of Medicine, MS4

Untitled

Hilary Hopkins School of Medicine, MS1

I wonder what it looks like that look on my face when I’m feeling and hoping for a pulse. A slow drag- prod- press Drag- prod- press As I chant the necessary incantation to make your heart beat under my fingertips. That look on my face when I’m not looking at you or at anything really—just feeling and following that flutter. When I no longer notice my white sleeve stiffly trailing behind my probing fingers. No longer aware of the uneven weight of the stethoscope slung around my neck. When I forget this is all a fake, a farce, a phony imitation of a real hospital, a real patient and a real doctor. But it’s a real heartbeat. He asks me “Do you feel it?” well— I’m not sure if it’s mine or yours.

Vacillating

Janina Rodriguez School of Medicine, Department of Radiation Oncology, Administrative Assistant

NOTE

from the Life isnâ&#x20AC;&#x2122;t an ordinary step. Photo taken at Pearl Brewery, May 2015 Special Thanks to Carolina Hinojosa for providing the title and phrase to the photograph.

Kryptonite

Pamela Camosy, MD School of Medicine, Family & Community Medicine, Adjunct Assistant Professor

Victim of cruel evil forces, you lie sideways across my exam table as if tied to railroad tracks. Neurotransmitters run amok, unrelenting pain is your villain, and I, your imagined hero. Ground rumbling under us, the inky-black locomotive approaches from the shadows. Its rumble never stops. Agony personified, your suffering is ceaseless, and again a hero’s rescue eludes you. The strongest magnets, sharpest 11-blade, pharmacopeia—these provide you no relief. The years drag on, reft of life’s pleasures. Again and again you return, with your questioning eyes, unsettled spirit, still seeking a hero. I collapse into the chair next to you, my white cape tangled behind me. The agony radiates its sickening languor. Your pain is my pain, your suffering, my weakness. Where will I find the power to heal you?

Color Theory Narine Wandrey

School of Medicine, MS2

Is it order or is it chaos? Paint fading in water, red bleeding into turquoise wisps, my bowl intent on reaching purple steady state A system of equations can predict by initial conditions how these colors may dance wink and frown But if those initial conditions alter each moment, how then do I predict intrinsic change? A system of non-linearity, attempted with pencil (and brush) in hand These colors are purposed with kinetic frustration, chasing shade beneath a surface so smooth, if chaos seems the winner, why does violet always hear its cue?

Explore

Joseph Dylan Peterson School of Medicine, MS4

Orange Horizon James Liu

School of Medicine, MS4

NOTE

from the Camelthorn trees in Deadvlei near Sossusvlei in the Namib-Naukluft National Park, Namibia.

Blue Sea of Texas Mai Luk

School of Dentistry, DS4

Desert Hues Narine Wandrey

School of Medicine, MS2

My youth was full of roadtrips Piling in the car, watching mountains race by We were lost to New Mexico badlands They werenâ&#x20AC;&#x2122;t so bad thoughâ&#x20AC;Ś Skies like stacked painted plates Kivas heating their celestial kilns No, these were not badlands They are landscapes of another life. I learned of green and red salsa Turquoise jewelry with as much history of man as of earth Cacti which are prickly to touch but so soft within And what it meant to fall in love with place. I used to think the trucks were following me along I-10 Now I know obligations were calling them too I followed those trucks back to Texas Draped in desert hues.

Sunset at Arches Spencer Cope

School of Medicine, MS2 NOTE

from the The renowned â&#x20AC;&#x153;Delicate Archâ&#x20AC;? located near Moab, Utah, is illuminated by the last rays of the setting sun.

In Good Hands Stephanie Lopez

School of Medicine, MS2

NOTE

from the I worked on this recycled piece over the winter break of my first year. I picked up the canvas for 50 cents at a thrift store, sanded it down and painted a fresh white layer of gesso over it before starting. It was a fun project that encouraged me to recycle art more.

Sheikh Zayed Grand Mosque, Abu Dhabi Lauren Kraut

School of Medicine, MS2

NOTE

from the This mosque is the key for worship in the United Arab Emirates. It brings together countless tourists, all of whom are present for the same reason: to learn, respect and appreciate the culture.

Hidden Conversations Mai Luk

School of Dentistry, DS4

Narcissistic

Weiran Wu, M.D., Ph.D. School of Medicine, Department of Psychiatry, Adjunct Clinical Faculty

Born with humble inadequacy, defends for lingering inferiority, Oversensitized by illegitimacy, overreacted with exceptionality. Abused by doting sentimentality, erupts with volcanic grandiosity. Overindulged by unpredictability, overevaluated with unreliability. Baseless self-esteem elevates with blindness of othersâ&#x20AC;&#x2122; existence. Yearning for unrealistic admiration gnaws interpersonal balance. Temperamental like a prima donna, prostrates to self-absorbance, Manifesting childhood fixation on insufficiency of painful tolerance. Once upon a time, a Wunderkind was created by shared delusion, Entitled to envy Brobdingnag, defective with empathy for Lilliput. Omnipotence of fantasy superimposed by omniscience of illusion, Sick and tired of it! Before sucked dry, disentangle from the cult. Narcissistic sociopath, horrifible certainty, dwells in deity duplex. Pathological narcissism, crucifible reality, builds in god complex.

This poem depicts narcissistic personality disorder.

A Night in Salzburg Jayme Trevino

School of Medicine, MS2

Moments

Hanna Blaney School of Medicine, MS2

The Harp and the Dying Woman Rachel Walker Vandermeer, MD

School of Medicine, Hospice and Palliative Medicine, Fellow

The harp and the dying woman It sounds like a beautiful baroque painting The cracked oils, gold and crimson, glimmering The museum spotlight elegantly illuminating the canvas skin The harp and the dying woman Maybe it is a classic 19th-century novel about love and loss Pages filled with foreign-named heroines and grand old cities A stack of tiny, neat block print bound with engraved leather The harp and the dying woman It could be a modern local ballet perhaps A young ballerina, masked in glittering gray tulle A haunted score with pirouette and arabesque perfectly timed The harp and the dying woman She was a picture of depression with a prickly chemo hairdo Her autobiography brimming with guilt, anger and grief Her melody a breaking heartâ&#x20AC;&#x2122;s last overture The harp Its strings reverberated with sound The dying woman She stretched to glimpse The harp It gave a siren call The dying woman Her body slumped

Peonies II

Kimberly Vogelsang School of Medicine, MS4

The Stroll

Evan Grodin, DMD School of Dentistry, Department of Periodontics, Resident and Teaching Assistant

Native Irish Heidi McDonald

School of Medicine, MS3

What Gravity Reveals Kamala Platt, PhD, MFA

Friend of UTHSCSA, Educator & Independent Scholar

I When it all became too much, I stopped fighting gravity—if something falls and there’s no pragmatic reason for it not to be on the ground, I don’t pick it up. Making conscious decisions about whether to engage with minutia helps me clarify and organize priority thoughts and actions. The horrific absurdities, ironies and crises stand out, and the mundane, personal slights fall to the wayside as mere creative clutter.

II “All this cutting and scraping and hoping and praying, all this pain is going to be for naught if the insurance won’t pay for the hospital’s oxygen treatments.” “But your new doctor, the surgeon you met when he recognized your wife as his patient assistant for years, he did your latest surgery, he won’t let that happen. He’s the one who happened by on New Year’s Eve when you were back in the emergency room after two weeks’ of increasingly excruciating pain, following the last cut toe— your new doctor will care. He cares about you, and about his work coming undone if you don’t get the treatments.” “But he’s done his job. It is out of his hands. Now the decision on the oxygen tank lies with the insurance company, with Medicare and if they deny me…” “Well, if they don’t authorize the treatments, can you say you’ll bring in a lawyer? I can look for someone.”

“By then it will be too late.” His wife got on the phone, then, and said assuredly: “No worries now. We are in the hospital for the weekend, and nothing will happen until Monday.” We laughed.

III Soon after moving to San Antonio, I was shuffling bookshelves around my office on a Sunday afternoon and pinched my thumb. Worse than the throbbing was my panicked realization that I had no idea where in this town I’d go for medical care. Nearly 20 years later, I still don’t know. My work now brings in little financial compensation, not enough for me to have any insurance access given that I’m not old enough for Medicare and living in a state that didn’t expand Medicaid. So, a few years back, I dusted off an old college textbook from a course in rural development: Where There Is No Doctor; later, I supplemented the worn but rugged hardcopy with a free copy I found online. I prefer them to the medical websites that so often—like most of society, these days— have ulterior monetary profit motives when offering advice. While I live in a neighborhood down the street from renowned hospitals, one with a tiled angel mosaic on its high walls and another lit by revolving colored lights at night, I live in a neighborhood that exists in the shadows of those metropolitan health care systems. I am grateful that my parents have health care access, even if the nurses in their small town are forced to work shifts that would be illegally long if they were truck drivers. I am as worried for those nurses as for my family. I am

grateful that I have no children for whom I could not afford a doctor; I barely managed emergency vet bills when my cat got an abscess that would not go away, this fall.

IV When I was growing up in Kansas, my great-uncle was my doctor. Once he tickled me so hard that when he subsequently took my blood pressure, I had laughed so much, it was high. I had to go back later, and it tested normal. I felt apprehension, then, because, unlike in school, I didn’t feel like I had control of how well I did in the doctor’s office. The doctors during our family’s sabbatical—my dad teaching in Orissa (now Odisha), India, were often my parents’ previous co-workers—they were friends. During a college class in Guatemala we met with doctors practicing in small crowded cement casitas on pastoral hillsides, doctors who were part of the communities they served, not unlike our family’s doctors growing up, but since then doctors have often felt out of reach for me.

V My dad just called. I haven’t told you that my mom is in the hospital for a bout of atrial fibrillation this week. My concerns for her health are behind my current preoccupation with the odd logic of our medical facilities. When she was in critical care, there was a high nurseto-patient ratio. My mom was in pretty good spirits on a

floor with very ill patients. The nurses talked and laughed with her; they took my mom for a walk and wheeled her down to their station rather than leaving her alone while preparing her new room. Outside critical care, my dad said, there were fewer nurses with more patients and less healing downtime to spend. I mentioned my friend’s worry about his Medicare insurance not granting time in the hospital for continuing the oxygen treatment his legs needed. My dad reminded me he’d had to sign a paper the first day as my mom was admitted stating that they’d been told they could appeal if Medicare was requiring the hospital to dismiss her before they thought it was advisable. “Oh thank you, that’s it then, I’ll let my friends know they can appeal to stay for the oxygen treatments the doctors are recommending.” I replied, happily.

VI As I prepare to call my friends, I am thinking about the near fifty years of changes in medicine since my childhood, about medicine here and in faraway places, about the enormous increases in medical technology and bureaucracy. All that falls away though, as I realize that the connections that count, the basis of healing, medicine’s community, these remain intact despite the profit-driven clutter, through friends, among family.

The story’s postscript is that my neighbor’s Medicare comes through a private company & thus he didn’t have access to the appeal process. Nonetheless, both he and Mom are home & healing, gravity is still dropping clutter, and I am grateful for those who take time to help folks heal.

Untitled

Ralph Bauer School of Medicine, MS3

NOTE

from the Ko Tao - Thailand

Code

Ashley Romage School of Nursing, Student, Class of 2016

Six nurses, one physician, two students, two family members Large rooms full of people, the hustle and bustle of movement Your first time is one that you will always remember The last to go, the last to touch him, only a student Stop compressions now, check for a pulse, begin again A person I have never met, the sounds of cracking bones Supplies all over the room, an IV in every vein Tears, lump in your throat trying not to let out that moan Fear strikes, it’s now clear, you now know, the lump grows Again you hear, stop compressions, family should come in But No it’s not time, it can’t be over, this I can’t disclose Stepping off the stool, open yellow eyes, this can’t have been Now the family walks in, I try not to make eye contact They think I’m rude, not willing to look, I can’t do this part If only they knew if I look I couldn’t hold back Finally out of the room, rushing to find a place to fall apart

Connected Alexis R Tracy

School of Medicine, MS2

Living, breathing, beating Sit still for a second and listen My heart is pumping Beating like a little drum A melody that never quits My eyes are blinded Blazing in the sun Only to readjust To morph and become My lungs inflate over and over again Without even thinking The moist air rushes in My skin is warm to the touch Rosy cheeks blushing And like a river The blood is rushing My ears constantly scan the nearby surroundings But for now the wind is only humming I touch the ground beneath me My body waits for direction And in a transit of silent communication Signals go awry And here comes the motion My brain is a vessel hungry to learn And one that aims to please My limbs bend beneath me and now itâ&#x20AC;&#x2122;s all within reach The sand slips through the slits of my fingers so smoothly I feel every grain and grit As it sinks between It just takes a moment To take it all in What a beautiful machine Iâ&#x20AC;&#x2122;ve been given To ponder, to breathe, to sit I would like to dedicate this to my mother and father. Thank you for always fostering a sense of creativity and wonder within me.

Impressions through a scope Joseph Dylan Peterson School of Medicine, MS4

Camping Under the Stars Jayme Trevino

School of Medicine, MS2

The Me Within (Transformations through Bariatric Surgery) Richard M. Peterson, MD MPH FACS FASMBS

School of Medicine, Department of Surgery, Associate Professor

There was a time when I was me Before this time when you could see A time when I may have hidden there A time when I avoided your stare

Surgery to some is the “easy way out” I’ve heard the naysayers often shout But here I am to prove them wrong The journey is hard and the path is long

Life was not what I wanted it to be I was not the person that you now see Life was quickly passing by But I could not enjoy the ride

I watched from afar so many years And wiped away those countless tears I’m looking forward, I’ll not go back This change in me is my final act

I made a choice to move from there To be the best me, I’d like to share This change of mind and body too Sustains my new life, gets me through

The me you see has always been here The shell I wore amplified my fear But now that I have shed that skin This happier me is The Me Within

A journey begins with a single step I made that move and a promise is kept And now this new me is here to stay Living with vigor each new day

This piece is dedicated to all those brave individuals making the choice to take control of their disease of obesity and gather as many tools (including surgery) to ensure their success for the long term.

New Patient Visit Shaoli Chaudhuri

School of Medicine, MS3

What brings you in today? Tell me about your pain. About how it radiates back to the day you ran away, fast as an Olympian, from your Mom’s 1-bedroom in the Valley 20 years ago. How you’ve always had a bum knee since you twisted it that night, pinpoint stars your only light once you got on your way to the bus station. You caught the next bus North, like you were a migrante from San Luis Potosí, gazing up and onward to the promise of El Norte, beautiful dreams painting your vision of a big city and fancy schools with real track teams and sober people to love you. Describe the pain to me. Tell me how it burns, singes your soul sometimes, when you close your eyes and think back to the days of looking after your Mom, passed out on her bed, simultaneously drunk and hung over. How an ice bath can soothe the burning, but even the sight of a bottle of Jack Daniels cuts into you real bad. How the day it all overwhelmed you, climbed into your chest and suffocated you, you packed up three outfits and a toothbrush and didn’t look back. Tell me about your epilepsy. About how it dates back to the day you turned 12. That first seizure, you were running towards the corn fields, towards your older brother Juan Carlos, to make sure he knew he was supposed to be home at 7 for your birthday party. How you felt so light and happy, almost hopping like a little grasshopper, as JC sometimes called you. How green-gold blackberry bushes rose up around you, the soil burgundy and loamy beneath your racing feet…then darkness. Next thing you knew, you were buried in the leafy blackberry plants, coated in purple juices, with the workers crowded

around saying, “Mija, you ok? You were having real bad conversions!” You’ve been seizure free for 3 years, thanks to the magic Keppra tablets, but just the smell of blackberries makes you worried you’re going to wake up, jeans wet, your brain in a fog and a crowd of Mexicans howling at you about your “conversions.“ Tell me about your diabetes. How your sugar started slowly, insidiously rising like a shark from the water, probably since you dropped out of high school. How it’s been your constant companion from the gas station job, all those years cleaning other people’s elegant, Frenchwindowed houses, the time you almost married Eddie (who had diabetes too), the time you kicked Eddie out because he didn’t treat your girls right, the time you went back to school, and now, with this new promising job at a doctor’s office, the time you hope, at 34, your life’s on track. Tell me how you hate pricking yourself to test your sugar, how you always run out of strips because they’re so damn expensive, but how Yanet makes you do it anyway, because she loves you or something. Tell me about the vertical scars on your abdomen. About the 3 girls that were a product of those surgeries. Tell me about your family, how they are your support system, and take care of you like no one has before. Tell me about Yanet, your morena who plays the violin with quick, hummingbird hands and just got into a Big University and who makes your heart swell with pride. Tell me about your youngest, Perla, the baby who’ll do anything for her Ma, who’s fast and wiry like you were at her age. And your middle girl? Tell me about Victoria, beautiful, sarcastic Victoria, who is pregnant by an idiot cholo at

17, just like you were with her. Tell me how you hate the dizzying cycle your family is stuck in. Pregnant and poor, pregnant and poor. Tell me about your family history. How your Mom, along with the booze, was definitely some kind of crazy, you just don’t know what. How JC has the diabetes too, but is up in Michigan with his family, who you suppose takes care of it since you can’t and never see him. And your father? You don’t know. Let’s not talk about it. Tell me about your allergies to coconut and bullshit. Tell me about your medicines. The Keppra for your seizures, the metformin for your sugar. Tell me about the té de árbol, the “tree tea” you take when you feel your aura is “out of whack”; a home remedy that dates back to your great-great-grandmother, who they say was a famous curandera in her village in Mexico. According to the stories, Victoria Sanchez-Villanueva once defended the whole village of Valle Esperanza from Spanish soldiers with only her sharp wits, courage from her te de arbol, and a machete made of elephant bone. But who can tell, right?

I hear a faint murmur with my stethoscope. Tell me about the small hole in your heart your doctor found a few years ago. How when he told you about it, you laughed and probably offended him, but didn’t he see the irony of a physical manifestation of all the crap life had thrown at you? Before you leave, tell me about your new job working the front of a doctor’s office, how your girls almost tackled you from joy when you got hired. How you were just on the edge of being evicted when the opportunity came along. How Yanet and Victoria bought you a new charcoal suit with pinstripes, like Hillary Clinton would wear. Tell me about your hopes for the future that you’ve pushed aside for so long. Tell me what else I can do for you. A referral and refills? Sure. Sure, I can do that.

Tell me about the joint you smoke “once in a while” for your nerves, the sounds of your boyfriend’s yells playing out in the background. How you tried heroin once and were scared out of your mind by the high, so never again. Tell me about how you’ve never touched alcohol in your life and don’t fucking plan to.

Golden Canopy Spencer Cope

School of Medicine, MS2

NOTE

from the The picturesque autumn foliage of quaking aspen trees along the Uinta mountain range create a golden canopy that shimmers in the afternoon sunlight overhead.

â&#x20AC;&#x153;Grab Shellâ&#x20AC;? Veronica Bove

School of Medicine, Division of Plastic and Reconstructive Surgery, Medical Office Receptionist-Intermediate

Stop and Smell the Roses Anisha Guda

School of Medicine/UTSA FAME Program, Sophomore

Tick tock, tick tock, tick tock the clock goes Each minute passes by as the wind blows People scurry through the streets Places to go, places to fleet Meanwhile, a sapling begins to grow But no one seems to know Inadvertently, they step on its branches And dash through its patches But the sapling continues to rise Although wary of its imminent demise Time passes by The old grow older as the years go by But people fail to see What the sapling has proven to be A strong cherry blossom develops in its place With a radiance that can be viewed from space And it is now that people finally begin to notice it Not for its beauty or for its strength But for the mere fact that it blocks the road at armâ&#x20AC;&#x2122;s length

It is easy to forget about the simple pleasures of life, as we become absorbed with the stressors of each day. However, it is these simple factors that help us to keep going and to persevere, despite the odds that surround us.

Timeless

Maleeha Ahmad Friend of UTHSCSA, High School Student

Driving beneath an orange sky Tran Nguyen

School of Medicine, MS2

NOTE

from the This was taken in Wyoming as my brother was driving toward the end of our first road trip. There was a moment as the sun was setting when it hid behind the clouds such that it illuminated the sky in a golden glow.

The Story

Rachel Walker Vandermeer, MD School of Medicine, Hospice and Palliative Medicine, Fellow

I heard a wife’s story today I listened It was moving and heart-wrenching She cried and I hugged her It was such an intimate moment She lay bare the loss of her husband’s function, the disappearance of her previous life, The stress of caring for the ill and fear of what was to come yet She was a human being, talking And I was a human being listening I sat in a white coat by a hospital bed But it could have been a park bench Or a church pew Or a sedan before a cozy hearth We were just two gals talking about hard times I typed a patient encounter I documented It was lifeless and emotionless She gave me a beautiful story, and I wrote nothing It was such a cruel dissection I discussed the timeline of his illness, the medical support he received in his home, The caregiver burnout and lack of advance directive She was a patient’s wife And I was a physician I was stifled by my white coat, confined by the dictums of the hospital But should it be a park bench Or a church pew Or a sedan before a cozy hearth Into whatever homes I go I will enter for the benefit of the patient My beautiful story was lost But where did it go?

In Sickness and In Health Ciera Kaylynn Ward

School of Medicine, MS3 NOTE

from the After being in surgery all day, I raced down the hallway while simultaneously checking emails. My pace slowed as I looked up to see an elderly couple holding hands, each helping the other with every slow, difficult step. What a joy to witness their promise being kept. â&#x20AC;&#x153;In Sickness and In Health.â&#x20AC;?

5 5 - W O R D STO R I E S

55-word stories are bite-sized pieces of creative writing that offer an opportunity for therapeutic reflection. This form of medical narrative has been published in JAMA and other medical journals. I recently attended a workshop titled “Building Resilience: An Innovative Reflective Writing Method for Clinical Palliative Care— the 55-Word Story” at the 2015 American Academy of Hospice and Palliative Medicine Annual Assembly. I certainly don’t consider myself a writer, but I left the workshop feeling empowered—and I hope that sharing this method can help other “non-writers” try their hand at the medical narrative. The process is simple: 1.

Reflect on a pivotal experience.

2. Write freely for 10-15 minutes. 3. Take another 5-10 minutes to edit down to exactly 55 words—no more, no less. The 55-word story is a novel, time-efficient and powerful self-care tool for clinicians to reflect, reduce the potential for burnout, and mitigate the stress of caring for our patients.

—Sara Noble, MS3, Connective Tissue 2017 Editor in Chief

From Amputation to Acceptance via Occupational Therapy Kimatha Grice, MOT, OTR, CHT

School of Health Professions, Department of Occupational Therapy, Associate Professor

At her first therapy session, a pretty young woman sat in front of me, crying—grieving the loss of her index finger….. “No one will want to date me,” she said. At her last therapy session, laughing…… “I will get a ten percent discount on my manicures!” Signed her Christmas card: “Love, Lisa and ‘Peg’!”

Lonely Boy Maggie Gainer

School of Medicine, MS4

Young boy brought in by CPS. He has a fatal disease, but you would never know it. Plays with toys, watches television, normal kid. He was found alone in his home. No care taken. Where are his parents? Dealing with their own problems. No time for him. Disease destroys his body, they destroy his heart.

The Last Meal at Home Together Bridgett Piernik-Yoder, PhD, OTR

School of Health Professions, Department of Occupational Therapy, Associate Professor

We had worked with him in rehabilitation. Dressing, toileting, strengthening. He was convinced he could return home. We drove the van to their farmhouse surrounded by live oaks and his cows. Every activity was halted for safety. â&#x20AC;&#x153;Momma fixed lunch.â&#x20AC;? Ham, potatoes, cake eaten in silence as cows peered in the window. They knew too.

Are they taking enough with them? Bridgett Piernik-Yoder, PhD, OTR

School of Health Professions, Department of Occupational Therapy, Associate Professor

It is their final weeks on campus after years of study. What have they learned in our time together? Conditions, assessments, interventions, clinical skills and problem-solving. Advocacy, compassion, empathy. I hope. Have I been the teacher they needed me to be, so they can be the practitioners their clients and families need them to be?

The Practice of Medicine Paige Seeker

School of Medicine, MS2

An open letter of sincere gratitude To all patients who have allowed me To poke, to prod, and to practice: It is because of you that my clumsy fingers and stammering questions Have become fluid actions and true conversations. You have taught me to heal And I owe my learning to your patience and trust.

Cost-Benefit Analysis Paige Seeker

School of Medicine, MS2

He sat alone. It was cancer, but it was treatable. I gave him the news. “I’ve done a cost-benefit analysis, and I haven’t contributed much to this world.” I reminded him of his military service, his children, and his legacy. “I am homeless and alone.” These words pained him more than any diagnosis could.

Adolescent Cancer

Jorgie Ann Contreras, MSN, RN School of Nursing, Department of Family and Community Health Systems, Clinical Assistant Professor

16-year-old patient, confused and alone. The prognosis isn’t good, and he just wants to go home. He refuses treatment and is willing to deal with the pain, if it means spending his last days with family and no more anger or blame. No more meds. No more lines. No more tears. Free.

“Why Is it Morning?” Ciera Kaylynn Ward

School of Medicine, MS3

He arrived with back pain, my first admission. He left with an inevitable fate, my first farewell. He loved the Salisbury steak, my first chuckle on wards. He asked me, “What if it isn’t cancer?”, my first difficult discussion. He will not see his grandchild born, my shoulder was cried upon. He was, my lesson.

Rhythm

Jackie Moran School of Medicine, MS4

Again, she sat two seats over. Though a stranger, she captivated him with her happy-go-lucky spirit. That day’s class topic covered On Death and Dying. “How vivid life choices become as our book closes,” echoed from the podium. A short interlude explained the increasing chatter. Time waits for no one. Bravely, he finally said “hello.”

Until Tomorrow Stephanie Jensen

School of Medicine, MS2

Hours have passed, All of the words on the page, Have started to look the same. Seldom far away, Self-doubt reappears “You will never remember all of this.” Shoes on and headphones in, Worries fading with each stride, The pavement disappears behind me. I will remember it all, Just not today, And that is ok.

Eval and Treat Becca Espey, SPT

School of Health Professions, Department of Physical Therapy, DPT II

How hard it is to forget that One. The One with everything to lose, all to gain The One you tried so hard to teach, to explain Where patient education took an actual human name. “If you could only make these simple lifestyle changes,” you cried But upon every return visit, no attempt was tried.

Mr. H. B.

Alyssa Laurel School of Health Professions, Department of Occupational Therapy, MOT2

His determination is the quiet kind as he returns to the hospital’s rehabilitation unit minus another leg. Increasing endurance is his biggest hurdle as he gingerly scuffs his new transtibial prostheses against the burnished floor. The therapists hustle to keep him busy—which he welcomes. “I’m gonna dance again,” he asserts, and I believe him.

Family Portrait Gilda Digman

School of Medicine, MS3

Like the frame that held this family portrait, he promised security and stability. Once that ring was on her finger, she was his inconvenience. With three beautiful children, something was calling: heaven. Three beautiful orphans he doesnâ&#x20AC;&#x2122;t want now under the care of his sister. Life continues in a cold, loveless home. The frame shatters.

Hiking with Dad â&#x20AC;&#x201C; Jessica Liu

School of Medicine, MS2

A time when silence is okay because The trees, creeks, and mountains speak majestically and in harmony, guiding us into solace with Mother Nature. Still, stories have yet to be told to us in our journeys through valleys and to peaks and every point between. There are many more hikes ahead, some to be repeated.

How Could This Happen? Chandlar Michelle Knutzen School of Nursing, Student

First day in the ED. Terrified, shaking, sick, self-doubt. Gunshot wound-she’s okay. Motor vehicle accidentshe’s okay, too. Cardiac arrest-he’s not. Is this real? The team works, and then it’s over. They call it. Time of death? I can’t remember. His chest is cracked open, every inch exposed on the table. She runs in. She crumbles.

In the Workroom Thomas Hanson

School of Medicine, MS3

“Wild Bill’s back!” “Who’s Wild Bill?” “Wild Bill is a legend.” “Saddest guy you ever saw, man. ALS. His wife just won’t let him die.” “Military benefits, you see.” “Look in his eyes. He wants to die.” “He coded once; I resuscitated him. I can’t believe I did that to him…what was I thinking?”

Time

Michael O. Cotton School of Medicine, MS2

Glance at the clock. How long until the residents arrive? Wipe the sleep from my eyes. Patient’s name again? Soon forgotten. Knock on the door. Glance at the clock. What time is surgery again? Sleepless night, an endless stream of forgotten faces. They don’t question my disease, but I do. A knock at the door.

Code status confirmation. Alexa Rodin

School of Medicine, MS3

“DNI/DNR,” she replied. “Today is our anniversary,” he whispered, and I tried not to cry. “May you find as much love and joy as this marriage brought me,” she comforted both her husband and a stranger. They had five children, twelve grandchildren, twenty great-grandchildren, two great-great-grandchildren, and 38 years and one day of marriage.

E D I TO RS â&#x20AC;&#x2122; S E C T I O N Iris

Patricia Stievo Executive Editor School of Health Professions, Department of Occupational Therapy, MOT II

Parched lips and pale skin... Regardless, you are beauty Never forgotten. In memoriam- Nan Tugwell. She was the very existence of grace. It only seems fitting that she be remembered in a collection of peopleâ&#x20AC;&#x2122;s thoughts, expressions, and lives.

Job’s Tears Luyang Jin

Editorial Staff/Treasurer School of Medicine, MS2

As I look out of my car window at the mountains gliding past, stirrings of uneasiness drown out the contentment of the past few days. The mountains before me take me back to a painting hanging in our hotel room, of a preindustrialized Hawaii with locals living on the beach going about their daily lives, armed for survival with straw huts, boats, and other constructions crafted with material procured directly from nature. The current scene before me is much changed, with human civilization wholly dominating the earth. Tracks of concrete and asphalt spider web the earth, and the car I am in morphs into a monstrosity that feeds ceaselessly on Mother Earth’s resources and spews out toxins in return. Though I trek the same paths as the earlier Hawaiian inhabitants from hundreds of years before, an awareness intrudes that my steps, in contrast, trail heartache in their wake. There is an instant recognition of Her grief, and the approaching, glistening expanse of undulating sea that is Mā‘alaea Bay seems as if a physical manifestation of Her tears. Yet, as I step out of the car to an observatory point, the calm tranquility of the waves and sea breeze pacifies the perturbations. The rustic, wooden stand of a local jeweler captures my best friend Isabel’s and my attention, especially that of a trinket fashioned entirely of pearly, variegated grey seeds, termed Job’s tears, that are anchored with a sea bean. The jeweler in her soft, velvety voice chronicles the whimsical history of the piece: the droplet-shaped Job’s tears are native to Hawaii and handharvested by her after the seeds ripen and dry, whereas the sea bean originates from Africa, having fallen into the ocean off of a tree from a distant shore and were then swept by the currents all the way to the grassy beaches in Hawaii that stretch before me today. Cradling the piece in my palm, I am struck by the interconnectedness

of the world. The Job’s tears and sea bean, unassuming byproducts of nature, become suffused with a richness, tying me to stories, like Job’s, that are as old as time and to events in faraway places. In this moment, the history of a stranger who I do not know and may never meet has floated from Africa to collide with my own, and reminds me of how the world is simultaneously vast yet small. When a marine biologist ushers me away to search for the elusive whales, Isabel lingers behind with the jeweler. A few moments later, she saunters over with matching seed bracelets and proclaims that they are for us to commemorate this trip to Hawaii, imbuing the Job’s tears with a deeper, personal meaning of friendship and belonging. As we gently pull the bracelets onto our wrists and make a sugary sweet heart sign with our fingers in the ways of children, I realize that this is one of those moments to which nostalgia will take me to in my later years. As the car slides back onto the road, the lingering disquiet from earlier has all but dissipated, and the car which had formally seemed so predatory and rapacious is now but a car. As my fingers glide across the smooth surface of the seeds of the bracelet, they evoke the story of Job, of a man with an unending and incorruptible faith in God despite the repeated inflictions and loss sent to test and plague him. Does Mother Earth, like Job, remain steadfast in Her faith? Does She have hope that Her children will do right by Her in the end? As I glance at the retreating back of the naturalist who has dedicated his life to the conservation of whales and dolphins, and at the artist who is carving out a living through nature by collecting and transforming seeds into personal creations, I am comforted.

To my family and best friend, you have been there for me again and again. You mean the world to me.

Eight-Thirty Impression Arielle Ferris

Executive Editor School of Health Professions, Department of Physical Therapy, DPT III

Collected Jacob Ferris

Director of Design School of Medicine, MS4

Transit Chris Yan

Editor in Chief School of Medicine, MS4

At 30,000 feet, we are all the news of the world we have. An Italian man returning from the Ponte Vecchio sidles up next to a dark-haired woman with olive skin. He discusses things loudly enough for us to hear, booming words that bounce off the tongue and slide the old bridge and other salacious structures into our daydreams. Next to them, a man from Texas yanks at his belt buckle and orders gin. A Greek girl by way of London sits next to me, reading medical literature. She is anxious about a job interview, but of course I tell her she will be a great doctor, because if memory serves correctly, it’s tradition for strangers to wish well when packed together on ships to the new world. Someone asks for a cappuccino. One row back, a man reads Henry Kissinger’s World Order in Chinese. Boston, by way of Rome, by way of the Mexican Revolution, by way of French Impressionism, by way of the Beatles. Maybe one man sells rosewood, another sells walnut, another mahogany, another perhaps dried mango, speckled trout, coffee, bushels of apples, and so on. Morocco, the Hindu Kush, priests of the order of Melchizedek, Dharma, Israel. No port of the future could be so optimistic. A mother and child murmur in their sleep. A man from Kuwait is going to see his father who is ill. I shake his hand, and he offers me perfume from his bag. In some worlds, it’s acceptable to kiss a stranger’s head in goodwill. We drift through the clouds at midnight, mesmerized by a dream in which we walk onto the streets each morning, looking to anoint one another in the open light of day. Inspired by various plane rides taken for residency interviews this past year.

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