Poetry On Healing by Elizabeth Markowitz

for Ben

This place could be beautiful, right? You could make this place beautiful.

–Maggie Smith

Cover photograph by Katie Osgood – Maplecrest, NY, July 2022

Introduction: Our Medical School Summer as Poets

How can poetry help us heal?

After finishing our first year of medical school, we attempted to answer this question by writing and reading poetry in conversation with each other. We each wrote ten poems about professional and personal experiences – Camila’s father’s sudden illness and death, and my husband’s cancer diagnosis and treatment – and one joint poem. Our poems intertwine medical terms with emotion, unearthing what gets cut from clinical summaries. Our writing process demonstrated the rich human connections that poetry weaves for the writer and the reader. We want to share our process to inspire other medical students to use poetry to deepen their relationship to healing.

On poetry

I had written poems before starting this project. Poetry is the form of writing I crave when I need to process emotional experiences. It helped me figure out that I wanted to pursue medicine and marry the person who is now my husband. I love the freedom of poetry. It’s like snapping a photo of an experience, then playing with the zoom, contrast, color, until the scene is captured as I see it. In the process, the poem’s pixels catch the light, entering dialogue with the space around it. Observing this conversation is enchanting.

Camila on language

Before this summer, I read poetry but never attempted to write it. The daughter of two literature and language professors, my childhood was surrounded by words and books. I was taught the importance behind each word, and the power of translating thoughts and stories into an accessible form. Growing up in a bilingual home, I would say, “Be cuidado. Te forgaste. No quiero anymás.” I find beauty in this “Spanglish” – a representation of my bilingual, bicultural home and mind that views English and Spanish as one. Language is part of my identity. Why does it have to be binary?

A year ago, we started medical school.

We’d heard of the medical school information “firehose,” but were still shocked by the intensity of the water pressure.

We donned our white coats for the first time feeling like fakes, but as sweat and dirt accumulated on the cloth, our identity as “MS1” began to feel natural. We learned the language of medicine, dictionaries of disease and treatment, and how to translate these terms for patients. In our earliest clinical interactions, we

also intuited the emotion and humanity that is consumed by “chief complaints” and the “history of present illness.”

The firehose didn’t relent

not even when my husband and I were struggling to figure out his mysteriously high tumor markers. Ultimately, he was diagnosed with stage 1 testicular cancer, and treated quickly and competently. The good kind of cancer. We exhaled.

The firehose didn’t relent

not even when my dad, age 50, died. He was undergoing a minor surgery and had a malignant hyperthermia reaction that led him to the ICU for five days. It was a strange out-of-body experience for a first-year medical student. My body was present in that ICU room in Wisconsin, but my mind couldn’t process that this patient was my dad.

Conceiving our project

As the weeks of first unknown diagnoses and then grieving dragged on, we alternately found ourselves at a loss for words. How were we doing? The loose aim of this project was “healing” – to ask, more than answer, the question of how we heal, and hopefully end our writing and reading period with a greater sense of ourselves as student-doctor-healers.

On writing Me:

By the time I sat down to write about my husband’s illness, I didn’t feel very emotional about it. The cancer was out. He had had two clear follow-up scans. Writing wasn’t cathartic, but it did afford closure. I zoomed out and appreciated – wow, we

Camila:

Since most of my poems revolve around my dad, I kept coming back to the question of how writing was helping me heal. Writing helped me organize my chaotic and cluttered thoughts into words. Instead of answering the question “how are you?”, I illustrated my emotions in metaphor. I found that by transforming my pain into poetry, into something physical that I could go back and read, I felt lighter. I was telling my body that it was okay to let go of these emotions because I’m placing them in a safe space.

had a year. I was surprised, though, by how emotional my husband was when I shared a few poems with him. I didn’t realize he needed to hear my reflections maybe more than I did.

In contrast, in writing about my past clinical experiences, I was surprised by the strength of the thread between myself and certain patients I’ve served. I remembered the crack of the voice of a hospice patient’s son over the phone, the canaryyellow of another’s kitchen. I wanted to hug these families, or at least understand how their lives filled around their aching loss. Poetry helped me do so.

I know now that when we open ourselves to listen fully, patients’ stories become a part of us. I’m interested in digging down into that imprint, understanding the way in which our stories –patient and doctor, friend and friend – weave together.

AMNIOSMOSIS (THE JOURNAL ENTRY I MAY NEVER WRITE)

My Body crossed oceans Africa to France to Harlem

My Body birthed children four beautiful babies

My Body does the caring the cooking, the cleaning, the buying, the singing, the organizing, the hugging, the kissing, the wiping, the weaning, the loving when they are away I move furniture, reorganize bookshelves. My Body has long forgotten how to be still

their text messages fill my days they listened when I said you can’t call me at work my phone can’t ring with a needle in a patient’s vein so the text messages

Mommy, can I go to the beach this weekend? Mommy, when are you coming home? Mommy, I love you!

my eyes roll up to the heavens but I am laughing

I love them with my whole heart but I’m exhausted my first job: 9-5 my second job: 24/7

I close my door and say one minute 6 seconds later has it been one minute?

my eyes roll up to the heavens but I am laughing I was set on going through with it the abor tion can I say it out loud? better not. can I write it here? better you than me.

they placed the seaweed sticks in my vagina nestled up against the growing fetus I felt the contractions but the pain wasn’t enough to be named it was supposed to be between us Me, and Me.

my Husband he will never know but God must he already? you see, in our faith, it is a sin

I felt it like bile bubbling up in my throat condemnation for all eternity

I don’t think there’s a pill for this kind of acid reflux

I had to believe there was some exception for overwhelmed mothers? what about protecting my sanity? my strength? My Body?

Me. and therefore, my children. with the seaweed sticks still poking I panicked I asked my holy Him what the law says hoping for forgiveness hoping for healing

I can read I can write I can think I can feel I can heal I am a mother but I needed to hear it so I was told from Him

my youngest already sent away no longer speaking the same language isn’t there some exception?

the answer came like fire in my bones: too late.

the ensoulment has happened. Hell to pay.

UNDO IT IF YOU CAN.

so now I sit here with my eyes closed and my legs curled beneath me hospital gown pulled tight my clothes bunched in a plastic bag below. I feel the waves of tension and release

talking to someone who has never felt that fear nor that tidal squeeze who knows not what it’s like to live with eyes cast downward the secrets I carry dragging me underground this life on earth is so short why rot in hell for all eternity? can’t you just pull out the sticks, can’t I start over? I change my mind

Doctor, I’m calling you now Doctor, I change my mind Doctor!!!

Doctor, unless there’s a risk of problems, I change my mind. my mind, I say your mind?

is it really yours?

what do you want to do for you? for you?

and the doctor: I can’t guarantee there won’t be problems this has happened fewer times than I can count on one hand are you sure?

Doctor, don’t you understand what that means for me? of course you don’t of course you don’t can’t you give me certainty, at least?

but I didn’t say those words instead: ok. do it.

and so I walked myself to the operating table what music do you want to listen to?

I don’t know. I don’t have time to listen to music, really. You choose. I’ll pick something relaxing…

I was dreaming of a scorched earth when out came the sponge out came the seaweed sticks in went the tenaculum in went the metal dilators in quick and careful succession out came the suggestion of you bit by bit

the fluid leached out by the stinging salt of it all: kids. husband. work. religion. and then it was over and I was empty so sterile I was dirty alone, if only for a minute still, if only for a minute the irony of it clear to me still, if only under sedation if only for a fistful of minutes.

I guess only time will tell where I end up when this short life is through for now I work and I wait praying for a pardon but preparing for punishment my body awash in antiseptic secrets and sin

ODE TO MY MOTHER

perched at the top of my crumbling stoop

I sip muddy coffee as my mind percolates & my slice of the neighborhood morning action unfurls

a mother power-walking her children to school cajoling a slowpoke, scurrying to catch a tiny-feet-powered scooter whizzing ahead. they round the corner on Smith and I lose sight. I wonder how their days diverge how they come back together at night. do they assemble around the kitchen table, eating grilled chicken breast and broccoli and rice? does she cut the tender meat into right-size bites? (how does she know what size is right?) does she pass round a wooden spoon to signal no ifs, ands, or buts–it’s one child’s turn to tell a story & the other’s to listen? shhhh. it’s your turn next, one minute! seven minutes later

I see the mother’s face as she heads back home, brows furrowed, eyes cloudy with emails, errands, Zooms; scooter folded into a spatula-sliver of metal. I am flipped out of my reverie. I land softly, sunny-side-up. I catch her clouded eye & smile. with my eyes maybe I convey what I can’t say: I am thinking about your dinner table. I want you to cut your child’s chicken breast tenderly. I want you to know the dimensions of their mouth, the diameter of their esophagus and cut accordingly. I want you to place their favorite fork beside their plate. I want you to pass the spoon until it’s splintering, until it’s soaked with saliva and feelings, and listen really listen to your child.

PARTS, STILL BORNE

I squelch gel on the taut belly skin while the resident grips the ultrasound probe like a stick shift back and forth and side to side until the fetal gray is visible on the dash.

She drove to Bellevue from Mass, the state at 25 weeks, she was almost too late. false eyelashes and foundation on thick, I held her hand and squeezed as the prick of digoxin-needle piercing flesh produced a plea:

forgive me, forgive me, forgive me.

Now she is anesthetized on a table legs angled in metal stirrups, surgery-stable I march for women, cried at the regression of Roe, so Why is my cortisol flowing, my digestion slowing?

Attending to me: you may see parts and react emotionally Attending to Resident: asystole.

but still, let’s keep the parts intact, it’s safer, smoother every poke and prod by metal risks a gear slip, a uterine rip.

grease the speculum good, you got it we’ll try with our hands first you, then me the forceps only if need be. pull now, full throttle yes, you can.

I’m not sure what I’m holding onto wait yes I got something! a hip? a leg?

first toes (yes, toes)

I’m pulling now, round the bend.

I counted: 5 x 2 = 10 of course, toes, dead toes little pink spark plugs still pink, petal pink.

then the body, the head, an autonomous leg parts, intact a success 250 ml of fluid in the bin Do you want to see it?

(yes, the parts, in a round metal dish)

I peer under the blanket-hood watch as jet-black ink on bleach-white branding the mother’s name forms a plastic fistula connecting salvaged arm to leg parts off to pathology, then to the morgue, for a final service check before they gather dust and begin to rust.

In the recovery room, I hold her hand and wait, study the line of erased foundation an oxygen mask memento when she opens her eyes, groggy and empty, I wonder: will she wish to see the parts?

parts off to pathology, then to the morgue just parts now but still

WHAT IS HOLY?

we dressed in spandex and fleece repurposed backpacks grinding trapezius like pilgrims? (please)

muscles screaming noses streaming rationing water rationing food until the next town, at least like pilgrims?

welcome back, Ms. Blister (I didn’t miss her) rain whipping words into 21-mile silence

sopa, pulpo, tortilla, repeat “peasant” food, again, again (not so pleasant)

first sleep on pads of rubber, 2x9 suffocating snores and celsius heat soundlessly, 18 of us awaken

sneakers on, sleeping bag stuffed instant coffee in, and begin can you feel it?

wordlessly wondrously walking before sun

(it’s not a race but a rhythm)

/ centuries-old capelas vegetation sprouting from their stone seams our signal to stop and stamp ink into days-old paper

pilgrims clutching crosses, guided by beliefs embedded in their being stacking capelas into catedral what is holy? (they seem to know)

I see footprints carved into the soil wild grasses blanketing B.C. walls gnarled trees knitting their branches into canopy mariposas flickering their arcadian flutter

I hear cows mooing, birds chirping I hear stories: what came before (not what is to come) families subdued by communist rations then sickened by capitalist sweets

what is holy?

/ la catedral finally, after 200 miles my plantar fascia battling bone la catedral an imposition but if I miss it, inquisition?

/

what is holy?

stained glass and scallop shells ancient saints and altars of gold

what is holy?

digging my wearied feet into earth swapping stories with strangers turned friends

greeting the wildflowers wriggling the cows, the sheep the towns asleep

what is holy? we asked like pilgrims

yellow, not yellowed, are her kitchen walls, canary yellow like the bird with wings, the bird that sings. musical chatter blanketing nonna like a quilt home health aide & daughters, grand and god feeding her breakfast, slowly, the eggs she likes best no pain so we took time to explain, slowly, what is to come to elicit questions: can Eliquis be covered? and respond, slowly, to their tangled root: how do we watch her die?

it was winter in Brooklyn, snow’s gray feathers slipping instantly to sludge but when I think of death I conjure the warmth of her canary kitchen the hand of her aide leading her back to bed to rest the chorus of her family and friends, telling her story as theirs, unafraid of emotion. embracing as they brace slowly, softly, for what will come as they sit there, right there, beside her

IF I WERE A WILDFLOWER

wriggling in the wind fragile beauty free and alive with possibility a single speck until round the bend a technicolor tapestry rippling with glee wee!

my friends and me electric alight oh what delight dancing the wildflower wiggle the photosynthesis saunter

a speckled sea unabashedly moving with me

instead

I snap photos pinch pixels into poses by incubated light

I record videos stunt seconds into scenes a stop-motion stupor

I am not a wildflower / instead

I pluck them from their sweet soil and plop them

into tempered glass

I feed them: water (fistful) sunlight (paneful)

feast, finite / wild beauty wilted simple feeling stilted gone, so fast

(wildflowers were never meant to last)

HOSPICE “CHARITY” PATIENT X

when I see him I know it is too late too late for treatment too late for hospice to offer anything other than the illusion of comfort to comfort always our slogan goes its fulfillment who actually knows we spoke over Zoom, me and his wife the WiFi connection like a plug dangling precariously from its outlet

gathering my clinical facts a detective going through the motions my magnifying glass blurred by the desperate sweat of ticking time

Bedside assessment and chart review of this 50-year-old male: primary hospice dx of diffuse stage 4 B cell lymphoma with metastasis and hypercalcemia

she brought me into the bedroom pointed the camera to his face I saw the agony in his scrunched eyes and hollow cheeks his body, crumpled and cachectic

At present, patient is lying on right side… has difficulty responding because in severe pain pain assessed verbally and nonverbally through grimaces and inability to speak more than a few words.

the strength of his wife astonished me but the steely focus of their 26-year-old son in the corner of the frame took my breath away

muscling through his corporate workday while his dad dies in the next room his role: “breadwinner” (his dad wasn’t eating)

Pain in legs and feet. Patient using diapers. Patient has difficulty swallowing. Patient no longer eating.

Patient meets hospice eligibility criteria for this dx and supporting documentation sent to office.

when you come to this country out of necessity each day is uncertain guardrailed by fear anonymity essential

Course of illness: patient underwent two non-diagnostic biopsies and one diagnostic excisional axillary LN biopsy. Hospital stay extended because patient suffered unwitnessed fall.

health (not wellness) a luxury to be meted out in makeshift thimbles checking, checking rearview mirrors suspicion close to the chest

CT scan showed right hemispheric subdural hematoma. Patient discharged and then missed multiple outpatient appointments over the ensuing 2 months.

blinkers on and blinkers off checking, checking, rearview mirrors take the next highway exit the backroads are safer

¿qué es el linfoma? she asked

¿qué es el linfoma? she asked, when it’s already stage 4

diffuse

stage 4

B cell lymphoma with

metastasis and hypercalcemia

how do you learn to speak the language of a system with nouns inverted adjectives only vaguely akin

linfoma

difuso etapa 4

célula B con

metástasis y hipercalcemia

On X/XX/XX liaison spoke with wife X who reports family unclear on diagnosis and prognosis.

its syntax sterile and thin a language so soulless all you register is needles piercing your skin

Liaison spoke with Dr. X who affirmed that XX Hospital has done everything they could for patient including arranging transportation for patient to come to clinic but patient refused to return to hospital for treatment. how is it a choice when it’s already been made? with empathy absent there’s only pokes and prods and pain and falls

Dr. X affirmed that hospice is best option for patient now since… the window for aggressive treatment has likely passed.

how is it a choice when it’s already been made?

(it’s not a choice when it’s already been made)

patient refuses to return for treatment

50-year-old patient with the beautiful wife, the hardworking son patient refuses to return for excruciating spinal taps and unwitnessed falls

¿qué es el linfoma? she asks, when it’s already stage 4 cancer clogging his nodes cancer breaking his bones ¿el linfoma es cáncer?

the immunological army has revolted its soldiers uncomprehending commands el linfoma es cáncer.

let’s try again, entiendo ahora I’m sorry but the window for aggressive treatment has passed

Liaison explained that hospice cannot treat the underlying cancer only help keep him comfortable. Wife affirmed this is what her husband wants. nothing left to do but comfort.

Patient assessed for shortness of breath. Wife reports that patient only occasionally has trouble breathing, which she believes is related to his newfound inability to swallow.

I can send oxygen and a bed now, I say can we get a nurse to come tonight? it’s too late, I know, but I check anyway no, but first thing in the morning

call me if you need, I say I wish we could send pain medications tonight but we can’t without a nurse she will be there first thing in the morning in the morning

I get a call from the solemn son struggling to stay calm the nurse is on her way, I relay a few minutes later, another call confusion first at the sound of mechanical beeping but it’s the hardworking son’s number the breadwinner

X, I say? what’s going on? sobs from the solemn son panic from the solemn son

I called 911, I didn’t know what else to do It’s OK, I say, it’s OK they’re trying to resuscitate him but I think he’s gone

beeeeep beeeeep I hear then CLEAR

beeeeep beeeeep CLEAR

he’s gone says the solemn son through a sob I have to go says the solemn son time of death 9:33 am I hear I have to go

the line goes dead and my gut fills with dread too late to offer anything, anything other than the illusion of comfort

he died in pain I know he died with paddles breaking his fragile ribs naked lungs with air disappeared I did what I can, I know

but the solemn son doesn’t have a dad anymore and I don’t even remember his name

No treatments for pain or SOB currently in place.

THE DIAGNOSIS

there’s cancer and then there’s cancer and in the space between: thirty trillion cells of worry

worry like a child monster clawing your brain worry sinking its fangs into your attention worry slobbering on you from head to toe

old “worries” (ha) like saliva-soaked clothes discarded. while you’re left wearing a paper gown butt cheeks on display as you pace the hallway

waiting.

there’s a room for waiting containment: an inside joke clean walls, magazines, plush pillows

a funhouse amplifying worry silence and somber stares the worry room (get me out)

waiting long enough that doctors’ words their nods smiles eye contact get dissected again and again for clues

I worried for what the scans weren’t showing I worried for the suffering of chemo and radiation and then I worried treatment wouldn’t be enough

my life before him was vibrant but falling in love was like switching on the light I didn’t know it could be so bright

my human journal

I write my thoughts and feelings into him and his become mine

his night sweats turned our bed into a furnace but I fell asleep with my slick ear against his heart the beats a lullaby of life our life

my forehead pressed against his, eyes closed wrapping my arms so tight around his torso home.

“I do” had seemed like a forever ribbon of time its end inevitable but invisible, like the seam on our rings eventually: a rambling farmhouse, sagging skin, ripe tomatoes after decades decades together, decades now

dangling frayed with uncertainty

/ months later the diagnosis came: testicular cancer, not cancer we inhaled certainty exhaled with giddy relief

testicular cancer, not cancer cancer, the good kind cancer, the good kind

FAMILY BRUNCH IN BROOKLYN

a late November family brunch in Brooklyn: so cozy, right? our neighborhood haunt, patio heaters, glass walls steaming with conversation and light the aim was to soothe (our aching & anxiety) and to detox (from PubMed & UpToDate)

I say “our” because ours is the family that feels things big things, at least together

a post-Thanksgiving satire, featuring forced gratitude reflections (and we sat, and we were tired too, ha) my sister having nightmares, my dad awake at night; worry a long sharp bread knife through our breakfast chaotic chatter replaced by politeness. please pass the pepper, thank you, love you. (but really: what is happening)

the CT scans were clear while the markers signaled something serious. what could you be, beta HCG? answer me. I wanted to shake the Sloan website and scream; instead I hypnotized myself with refresh, refresh, refresh. I dreamt of a choriocarcinoma Everest, b-HCG hiking up, up through the thinning atmosphere, O2 empty over omelettes and toast, we swapped scraps like hungry reporters, scrounging for the inside scoop my sister’s classmate gets chemo every other week, diagnosis still unknown. she goes to class! all of us craving a perfectly salted story, or at least a reliable source. trading hypotheses like amphetamines, struggling to stay awake

outside the leaves were falling dead, the air laced with the beginnings of ice, pricking our eyes with raw onion tears inside the glass-walled garden I should have felt safe, surrounded by my family. instead I felt scared and stifled by the sound waves on glass, ricocheting midair, without a care. words scrutable, sentences strange.

fearful eyes and squeezing hugs crystallized that I the medical student, the wife was in charge. my duty to find the right doctors, ask the right questions, press and keep pressing for answers. we finished our eggs, downed coffee dregs, and I tugged my scarf tight for the seven blocks home. curled on the couch we had carried up our wobbling stairs together, I held him as he cried. and then we wiped our tears, and planned our next steps.

BRUNCH FAMILIAR EN BROOKLYN

translated by Sergio Fernández Martínez

un brunch familiar en Brooklyn a finales de noviembre: qué acogedor, ¿verdad? nuestro lugar favorito del barrio, estufas de jardín, cristaleras que humean conversación y luz el objetivo era aliviar (nuestro dolor y miedo) y desengancharnos (de PubMed y UpToDate)

Digo «nuestro» porque nuestra es la familia que siente las cosas las grandes, al menos juntos.

una sátira postaccióndegracias que incluye ecos de forzada gratitud (y nos sentamos, y estábamos también cansados, ja) mi hermana con pesadillas, mi padre despierto por la noche; pedir un cuchillo largo y afilado en una conversación caótica reemplazada por la cortesía, por favor pásame la pimienta, gracias, te quiero. (pero en realidad: qué está pasando)

los TAC eran claros pese a que los marcadores indicaban algo serio. qué podrías ser, beta-hCG? respóndeme. quería golpear la web del Sloan y gritar; pero me autohipnoticé actualizando, actualizando, actualizando. soñé con un coriocarcinoma Everest, la b-hCG escalando, hasta la fina atmósfera, oh, vacía.

con las tortillas y las tostadas intercambiamos sobras como reporteros hambrientos, buscando la primicia. una compañera de la clase de mi hermana tiene quimio cada dos semanas, diagnóstico aún desconocido. ¡y va a clase! todos nosotros esperando una historia con chicha, o al menos una fuente fiable. trapicheando con hipótesis como anfetaminas, luchando por aguantar despiertos

fuera las hojas caían muertas, el viento espolvoreado con los primeros hielos, hiriéndonos los ojos con lágrimas de cebolla cruda dentro del jardín acristalado debería haberme sentido segura, rodeada de mi familia. pero estaba asustada y ahogada por las ondas sonoras que rebotaban en el aire, sin cuidado. palabras escrutables, raras frases.

ojos temerosos y abrazos apretados cristalizados de los que yo estudiante de medicina, esposa era la responsable. mi obligación de encontrar a los médicos adecuados, preguntar las preguntas adecuadas, presionar y presionar para conseguir respuestas. terminamos los huevos, apuramos los posos de café, y me apreté fuerte la bufanda para recorrer las siete manzanas que me separaban de casa. acurrucada en el sofá que habíamos subido juntos por unas escaleras inestables, le abracé mientras lloraba. y nos secamos las lágrimas, y planeamos nuestros próximos pasos.

I DON’T RUN LIKE THE WIND

soundless and slow I start settling my muscles into motion in sun, rain, fog: joining forces with my medium

the sidewalk doesn’t give but it grants me the concrete ability to plant my feet and push when I see the expanse of trees, I breathe with each inhale I tune my limbs like an orchestra string a cello, today bass clef bouncing from my bones

runners moving ahead and behind my tempo buds nestled in ear, their breath the only music I hear pants & heaves punctuated by the shine of trickling brine

the dirt path traces an improvisational edge clockwise or counter, I choose the final hill a crescendo of arms, legs, breath, core encore?

if I’m feeling good, really good I go again and the synchrony feels like soaring every molecule of mine screaming into silence

WORDS FOR THE WORDLESS with Camila Hernández

Blanco

My mother is sitting in a chair, laughing at a text message.

As I waited with my husband I couldn’t help but laugh at his ears sticking out of his surgical cap.

A simple genitourinary surgery, in and out. General anesthesia.

A simple genitourinary surgery, in and out. General anesthesia.

I wish I was with her when those three surgeons stepped into the waiting room, with faces as pale as their white coats.

I might buy an $8 latte to study here, in this white room–endless outlets, pillowy chairs, so many chairs but in them only one person, per patient, is allowed to sit on a firm pillowless couch by the window, we strap into our seats for the next five days a rollercoaster of emotions, struggling to unbuckle and not ready to release

I hear a husband updating his children by phone: “Hi honey, mom just went into surgery.” His voice is clear and steadied

Entering the ICU is like falling into a nightmare

The air is heavier, the space tighter The sterile walls alive with machines.

Tubes like slithering snakes, wrapping around my neck My footsteps unsteady

As he glances at the neat notes beside him, I startle at his eyes – ablaze with emotion –sorrow-singed fear only strangers like me can see. faces, faces, so many faces racing in, racing out

I step inside his kind eyes and see his grandchildren racing to greet him at the door, asking him to read one of us “sleeping” in the ICU the others in the waiting room the monitors like a bedtime story

a bedtime story, please, grandpa, just one more!

But when I felt my body drifting into sleep

I awoke, panicked: still breathing? Still beating?

My textbooks lay beside me, unopened. when will I hear my phone ring when will I hear the voice of the doctor in my ear saying: it went OK.

I can still hear the steady beeps, the rhythmic ventilation craving: he is OK

Buenas noches Papa, I would say

I can’t bear to let my eyes seek this stranger’s gaze. he will see my fear and waste his steadiness on me.

I study his steadiness – the still of his hands –and will myself to imitate. time to let go a circle of hands grasping each other, a circle of love we hug him goodbye

If imitation is the sincerest form of flattery, then flattery is lying, lying to myself with my husband laying flat on an OR table. I can’t believe this is happening.

I can’t believe this is happening. I lay my eyes on him for the last time, electric candles laying by the door the nurses gift us a beautiful vial of his last heartbeat, to hold with us forever

Finally, the call from the surgeon it went perfectly, he is in recovery a 42-minute forever, finished

The chapel says it fits 100 300 came for his Celebration of Life how many people he touched from all corners of the world–it was surreal but their stories were real

The pathology report says stage 1 seminoma active surveillance recommended: not radiation, not chemo, just scans, scans, scans

I feel disbelief,

I feel disbelief, and loved, and relief, relief, relief

He was so loved, loved

There are no words

but here’s a few words, between us, from us

There are no words

Conclusion: Writing Towards Healing

Writing, together

“Words for the wordless” is a braiding of our reflections on our personal illness experiences. As friends, Camila and I supported each other with immediate text messages and then the richer language of inperson communication and acts of kindness, like lending study materials.

Our writing began by rereading our text messages to each other as first the cancer and then the malignant hyperthermia unfolded. We realized the scariest part was the intensity of the unknown, and the spaces that amplified it: the ICU, the pre-op room, and the waiting room. We decided to juxtapose the two waiting rooms and write towards each other: Camila on the left, me on the right. Over FaceTime and a shared Google Doc, we started writing, bolding overlapping terms as we went, stopping to ask each other questions and flesh out ideas.

The bolded terms shaped our lens on the next part of our stories, and we realized we were writing towards this overlap, seeking more words that connected us. We were surprised by the physicality of certain connection points – hands clasping in silent meditation, the pallor of shock and hospital sterility. We appreciated the abstractness of others – the jarring speed and slowness of time, the subjectivity of ‘forever.’ We added the twice-spoken line, “A simple genitourinary surgery, in and out…” after finishing the first draft of the poem. Only then did we realize the eerie similarity between the two outpatient surgeries.

Writing towards our connection points didn’t feel reductive, it felt natural. We put our scariest moments on paper, together, and in doing so, their weight shifted. We felt understood. We worried that in writing a “braided” poem (inspired by Terry Tempest Williams) [1, 2] – giving equal space to each experience – we would be equating them. But poetry, we learned, is a creative whole greater than its parts.

The breadth and depth of healing, when we took the time to sit with it, is immense, and it is always a conversation, a human braiding. And isn’t braiding – like braiding a sister’s hair, something we both used to do growing up – always an act of love?

Poetry as healing: broader strokes

We use poetry to transform pain and fear into something akin to beauty, and to offer our oftenoverstimulated minds a creative outlet. Both medicine and poetry connect people intimately: doctors get to ask and hear the most personal stories, and poets tell them viscerally. Many poems are about one person, but they could be about anyone. Our self-consciousness lessened when we read our drafts aloud to each other and realized their resonance.

As medical students, we wrote poems that speak to where we are in our education: learning how to be present with our patients, to offer them something physically and emotionally healing as we struggle to master their diagnosis and treatment, and to maintain our humanity in the process. Poetry doesn’t turn the medical firehose off – nothing can – but it allows us to find places where the stream is not so forceful, “eddies” where we can hear ourselves feel. Poetry is not reductive, but it forces us to choose our words carefully. It is not stagnant, but it is borne of stillness. In medicine, we relay snapshots – chief complaints

and “pertinent” positives and negatives. Poetry allows us to add back the “impertinent” humanity that clinicians are forced to cut for efficiency.

How can we use poetry to deepen our humanity as we progress through clinical training? We found that poetry can bridge stories and expose beauty in otherwise sterile or dark moments. From our summer as poets, we learned how to see poetry in our patients. If patients were to write a poem about their medical experience, what would they say? If we – patient and doctor – were writing jointly, what words would we bold, together? In this way, our summer was an exercise in empathy.

This poetic lens helps us craft more healing experiences for our patients, and a more empathetic, resilient mindset for ourselves as doctors-in-training. Poetry can help fill the gap between the clinical and emotional realities in which we operate. We must fill this space of “what exists and isn’t named” with expression, or else risk the self- and patient- “harm” [3] of burnout, exhaustion, and dissociation. From our summer as poets, we believe poetry is a form of individual and collective healing.

As future physicians, we will continue seeking the words to describe the “wordless.” In doing so, we hope to be more empathetic interpreters of our patients’ stories, integrating the patient with their personhood.

References

1. Williams TT. Braided Essay: Workshop [unpublished lecture notes]. ENVS 80: Writing our Way Home, Dartmouth College; lecture given 2016 Apr 28.

2. Williams TT. Refuge: An unnatural history of family and place. New York (NY): Vintage Books; 1992.

3. Olivares, J. Promises of Gold. Ruano González D, translator New York (NY): Henry Holt and Company; 2023.

Acknowledgements

Thank you, Camila, for sharing, and listening, and for going on this literary journey with me. You inspire me.

Thank you, Ben, and my family, for your unwavering love and support.

Thank you, Dr. Nuria Mendoza-Olivares, our fearless leader in this writing fellowship and a doctorwriter Camila and I both admire.

Thank you, Dr. Abigail Winkel, for your thoughtful guidance in the conception and editing of our narrative piece.

Thank you, Dr. and Dean Victoria Dinsell, for your steadfast support of us as students and humans.

Thank you, Jordan Reif, for your editing help, co-construction of our fellowship, and tireless furthering of the humanities at NYU Grossman School of Medicine.