ASCENSUS : Journal of Humanities at Weill Cornell Medical College Vol. 7

Ascensus Weill Cornell Medicine Journal of Humanities

volume vii 2018

Ascensus Journal of Humanities Volume VII August 2018 • Weill Cornell Medicine

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Ascensus

Ascensus Co-Directors: Anu Goel & Alex Huang Editor-In-Chief: Alex Huang Visual Media Editors: Paolo De Angelis, Melody Ho, & Bethina Liu Written Media Editors: Shellie Ann Dick, Benjamin Jackson, Xiang (Grace) Li, & Anika Nabila Design Editor: Amanda Buch & Wooram Jung Events Director: Anu Goel Events Team: Elvisha Dhamala, Anthony (Jung) Mok, Sophie Mou, & Anika Nabila Public Relations: Sophie Mou Advisors: Susan Ball, MD, MPH, MS Randi Diamond, MD Allison Lasky Layout: Alex Huang & Wooram Jung With special thanks to the Liz Claiborne Center for Humanism in Medicine and support from the WCM Office of Academic Affairs Contact us at wcm.ascensus@gmail.com with submissions or questions Follow us on instagram @ascensus_wcm

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To Our Readers: The work that went into producing this Journal is only made possible by the talented souls of the Weill Cornell community who have chosen to share their work with you.

From the perspective of two young medical students, American society appears to have changed in front of our very eyes this past year. For those of us in careers that increasingly demand our undivided attention to maintain a competitive edge, it is now easier than ever to let social media influence our thoughts and beliefs. Making time for the humanities, to explore complicated questions and express our own thoughts, has become an anxiety-inducing struggle for many of us in the medical community.

Therefore, our goal throughout a year of presiding over this Journal has been to combat this trend, and to encourage our community to find their creative outlet. Following in our predecessors’ footsteps, we called on you, our community, to share your perspectives and creativity with us.

This Journal is your response.

Students, researchers, health-care providers, administrators, and more, told us their stories at spoken-word events, attended writing workshops by veteran physician-authors, traveled around NYC on photography tours, and submitted to this Journal. We learned about your experiences, your hopes and fears, and your passions. We are grateful beyond expression.

When we started, our goal for the year was to grow. Not just grow the Journal in size, but also in variety, in reach, and in meaning. We accepted more submissions than ever before, embraced multimedia works, welcomed our friends at WCM-Qatar, and did our best to make Ascensus synonymous with humanism at WCM. We hope that this Journal serves as a reminder of humanism and its importance in life and medicine. It has a capacity to enrich our lives that can never be forgotten. We hope as you pause and spend time with these works, you see how the humans of WCM express their views of the world, and are maybe inspired to create yourself.

If you enjoy this year’s volume, we encourage you to share it with as many people as possible and spread the joy of the humanities as it exists at Weill Cornell Medicine.

Warmest Regards, Anu Goel & Alex Huang Ascensus Co-Directors

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Table of Contents Deep Blue

Tasheika Grizzle | Patient Registrar, NYP

Front Cover

Reflections on the Cold Medical Culture

2

Rainbow Roads Lead Everywhere

4

No One Path

5

Moonlight

6

Reflecting on the Day

8

Canyonlands

9

Karol Silla | MD Student, Class of 2019, WCM-Qatar

Benjamin Jackson | MD/PhD Student, Entering Class of 2017, Tri-I

Yuna Oh | MD Student, Class of 2021, WCM

Christine L. Frissora, MD | Associate Professor of Clinical Medicine, WCM

Natasha Smith | MD Student, Class of 2021, WCM

David Chang | MD Student, Class of 2021, WCM

Anatomy Class - A Progression

10

Shivan

12

Three Years

13

Cowboy Captive

14

Take Flight

16

Surf 's Up

16

Anonymous

P.S. Nandini | BMRI Internship Student, WCM

Zhenzhen Shi | MD Student, Class of 2019, WCM

Lauren Kelly, MD, MPH, MS | PGY-1 Internal Medicine, NYP

Jaimie Uva, RD, CDN | Clinical Outpatient Nutritionist, NYP

Jaimie Uva, RD, CDN | Clinical Outpatient Nutritionist, NYP

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Puzzled

17

Flowerfly

18

Shadows in the Last of the Light

19

Physician a Victim of Medicine

20

Angst

22

Fountain

23

Sea Prints

24

Hummingbird

25

Arabian

26

i Apart

27

Now, In Your Kitchen

28

Chasm

29

Microstory

30

The East River is a Tidal Strait

31

Brienne Lubor | MD Student, Class of 2021, WCM

Yuna Oh | MD Student, Class of 2021, WCM

Erika Quinones | Registrar, Center for Special Studies, NYP

Renuka Gupta, MD | Assistant Professor of Medicine, WCM

Wooram Jung | MD Student, Class of 2021, WCM

Brienne Lubor | MD Student, Class of 2021, WCM

Tasheika Grizzle | Patient Registrar, NYP

Hanof Ahmed | MD Student, Class of 2019, WCM-Qatar

Christine L. Frissora, MD | Associate Professor of Clinical Medicine, WCM

Anonymous

Zhenzhen Shi | MD Student, Class of 2019, WCM

Sonia Iosim | MD Student, Class of 2021, WCM

Benet Pera-Gresely, PhD | Postdoctoral Associate, WCM

Maureen Kelly, RN | Patient Flow Specialist, WCM

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Uinta Ground Squirrel Striking a Pose

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King's Landing, Dubrovnick

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The Unexpected Consequence

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By Night

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Survival

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Time

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The Time In-Between

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Atlantic Coast Lighthouse

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White Coat

42

Heavy Heart, Light Music

44

Music in the Park

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When Words Don't Come Easily

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Horizons of Glistening Tranquility

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On Doctors: Hurry

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Kevin Ackerman | MD Student, Class of 2020, WCM

Jennifer Akl, MPH | Office of Research Integrity, WCM

Anu Goel | MD Student, Class of 2021, WCM

Herie Sun | MD Student, Class of 2020, WCM

Shahnaz Mohammed | Administrative Assistant, Volunteer Resources, MSKCC

Aretina Leung | MD Student, Class of 2021, WCM

Natasha Smith | MD Student, Class of 2021, WCM

Duncan Hau, MD | Assistant Professor of Pediatrics, WCM

Benjamin Jackson | MD/PhD Student, Entering Class of 2017, Tri-I

Yuna Oh | MD Student, Class of 2021, WCM

Natasha Smith | MD Student, Class of 2021, WCM

Daniel Choi, MD | PGY-2, Internal Medicine, NYP

Madeleine Schachter, JD | Assistant Professor of Medical Ethics, WCM

Karin Charnoff-Katz, MD | Assistant Professor of Clinical Radiology, WCM

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The Last Day of Summer

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Serenity

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A Step Up

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Faith in Medical Training: What's the Use?

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Pena Palace, Sintra

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Untitled

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Moon Dance

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Chagrin

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Growth

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Dusty Grooves

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Old Puzzles Made New

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A Moonlit Night On the Spring River

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Before the Concert

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Xiang Li | PhD Candidate, WCM

Keith A. LaScalea, MD | Associate Professor of Clinical Medicine, WCM

Keith A. LaScalea, MD | Associate Professor of Clinical Medicine, WCM

Marissa A. Lombardo, MD | PGY-3 Internal Medicine, NYP

Jennifer Akl, MPH | Office of Research Integrity, WCM

Montreh Tavakkoli, MD, MA | PGY-1 Internal Medicine, NYP

Jaimie Uva, RD, CDN | Clinical Outpatient Nutritionist, NYP

Mohamud A. Verjee, MBChB, MBA | Associate Professor of Family Medicine, WCM-Qatar

Anonymous

Paolo de Angelis | MD Student, Class of 2021, WCM

Benjamin Jackson | MD/PhD Student, Entering Class of 2017, Tri-I

Meng Ouyang, MD/PhD | Postdoctoral Associate, WCM

Shahnaz Mohammed | Administrative Assistant, Volunteer Resources, MSKCC

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Island Dreams

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I Choose You

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The Commute

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Light Verse, Easily Digested

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Serenity

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Adrift

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Uncertainty

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Night Vendor

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Happy Accident

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The Return

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Don't Stop Me Now

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Reflections

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Chinatown

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New York, NY

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Tasheika Grizzle | Patient Registrar, NYP

Heta Ladumor | MD Student, Class of 2021, WCM-Qatar

Maureen Kelly, RN | Patient Flow Specialist, WCM

Lawrence Palmer, PhD | Professor of Physiology and Biophysics, WCM

KH Miao & JH Miao | Volunteers, NYP

Melody Ho | MD Student, Class of 2021, WCM

Eliza Gentzler | MD Student, Class of 2019, WCM

Freddie Scott | Audio Visual Technician II, WCM

Jacquie Howard | Administrative Assistant, WCM

Mauricio Vergara, RN, BSN| Nurse, NYP

Paolo de Angelis | MD Student, Class of 2021, WCM

Yuna Oh | MD Student, Class of 2021, WCM

Herie Sun | MD Student, Class of 2020, WCM

Lauren Jonas | PhD Candidate, WCM

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The Decision

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Imagination

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A Sunset and a Dream

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Untitled

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An Elk's Breakfast Among Fumaroles

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Nello

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Glass, In a Study of Blue and Orange

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After the Darkest Night Comes the Brightest Day

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My Bedroom

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How to String Along (Effortlessly)

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Paul Miskovitz, MD | Clinical Professor of Medicine, WCM

Mohamud A. Verjee, MBChB, MBA | Associate Professor of Family Medicine, WCM-Qatar

Erika Quinones | Registrar, Center for Special Studies, NYP

Jingjing Qi | Research Assistant, MSKCC

Kevin Ackerman | MD Student, Class of 2020, WCM

Natasha Smith | MD Student, Class of 2021, WCM

Zhenzhen Shi | MD Student, Class of 2019, WCM

Anna Cheung | PA Student, Class of 2019, WCM

June Chen, MS | Clinical Lab Technologist, NYP

Maria Carrera-Haro | PhD Candidate, CUMC

Metamorphosis of a Charm Dangling Part 1: Stereotactic Biopsy 100 Karin Charnoff-Katz, MD | Assistant Professor of Clinical Radiology, WCM

Metamorphosis of a Charm Dangling Part 2: Preparation for Mastectomy

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My Shoes

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Karin Charnoff-Katz, MD | Assistant Professor of Clinical Radiology, WCM

Brienne Lubor | MD Student, Class of 2021, WCM

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Stonerunner

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Gonggong

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Casual Dating, Or Why We Need a New Flu Vaccine Each Year

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Bison Grazing Beneath the Teton Range

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Shoe Repair

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Across a Rise

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Question Why

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Dendrites of Manhattan Avenue

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Liquor Store

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Yellow Happiness

114

Pinkie Tropicate

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Keith A. LaScalea, MD | Associate Professor of Clinical Medicine, WCM

Sophie Mou | MD Student, Class of 2021, WCM

Maria Carrera-Haro | PhD Candidate, Columbia University

Kevin Ackerman | MD Student, Class of 2020, WCM

Freddie Scott | Audio Visual Technician II, WCM

Mohamud A. Verjee, MBChB, MBA | Associate Professor of Family Medicine, WCM-Qatar

Lakshmi Menon | MD Student, Class of 2019, WCM-Qatar

Samantha Shetty, MS | Assistant Research Coordinator, WCM

Freddie Scott | Audio Visual Technician II, WCM

Jacquie Howard | Administrative Assistant, WCM

Jacquie Howard | Administrative Assistant, WCM

So Many Are the Questions We Are Left With When We Know We Can No Longer Ask Them 116 Paolo de Angelis | MD Student, Class of 2021, WCM

Cloud

P.S. Nandini | BMRI Internship Student, WCM

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The Color of Home is Blue

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The Plans We Made

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Skeleton

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The Little Flamingo

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The MRI Tech

125

Spring Field

126

Snow of April 2018, New York

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'MERICA

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First Kiss

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Benjamin Jackson | MD/PhD Student, Entering Class of 2017, Tri-I

Herie Sun | MD Student, Class of 2020, WCM

Paolo de Angelis | MD Student, Class of 2021, WCM

Yaniv Kazansky | MD/PhD Student, Entering Class of 2017, Tri-I

Rachel H. Kowalsky, MD, MPH | Assistant Professor of Clinical Pediatrics, WCM

Shahnaz Mohammed | Administrative Assistant, Volunteer Resources, MSKCC

Vijay Soni, PhD | Postdoctoral Associate, WCM

Wooram Jung | MD Student, Class of 2021, WCM

Brandy Holman | Administrative Assistant, WCM

Abstracted Remarks Made at the Fellows Graduation at Brooklyn Methodist Hospital, Division of Hematology and Medical Oncology 130 Richard T Silver, MD | Professor of Medicine, WCM

Untitled

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Untitled

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On the Prowl

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Tara Pilato | MD Student, Class of 2021, WCM

Montreh Tavakkoli, MD, MA | PGY-1 Internal Medicine, NYP

Tasheika Grizzle | Patient Registrar, NYP

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Changes

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Read

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Nature's Color Palette

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On a Rainy Day

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Manic Pixie Dream Girl

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Snowman

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My Friend the Doctor

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Summer Train

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Mountain Bluebird Atop Its Perch

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The Sky and Water Acting As a Mirror for Each Other

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Rows of Metabolism

149

Buffer Glitch

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Basilica, Venice

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Sarita Ballakur | MD Student, Class of 2021, WCM

Hanof Ahmed | MD Student, Class of 2019, WCM-Qatar

Sohaila Cheema, MBBS, MPH, CPH | Assistant Professor of Healthcare Policy and Research, WCM-Qatar

P.S. Nandini | BMRI Internship Student, WCM

Steve Stay | Student Academic Counselor, WCM-Qatar

Yili Zhao | MD Student, Class of 2021, WCM

Susan Clark Ball MD, MPH, MS | Professor of Clinical Medicine, WCM

Shahnaz Mohammed | Administrative Assistant, Volunteer Resources, MSKCC

Kevin Ackerman | MD Student, Class of 2020, WCM

Sohaila Cheema, MBBS, MPH, CPH | Assistant Professor of Healthcare Policy and Research, WCM-Qatar

KH Miao & JH Miao | Volunteers, NYP

Sean T. Pompea | Senior Research Informatics Software Engineer, WCM

Jennifer Akl, MPH | Office of Research Integrity, WCM

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Cheni

153

Albrecht Dürer at the Met

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Darkness

154

Esteban Fridman, MD/PhD | Assistant Professor of Neuroscience, WCM

Suzanna Schmeelk Ed.D. | Information Security, MSK

Ramez Bodair | MD Student, Class of 2021, WCM-Qatar

Winter 20xx

Davinder Sandhu | PhD Candidate, WCM

Back Cover

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ascensus journal of humanities

Reflections on the Cold Medical Culture Essay

Karol Silla There were numerous encounters during clinical rotations that I found myself torn between striving to be the fantastic student and the ideal doctor. But really, what would daunt me more fiercely later towards the end of my rotation was my disillusionment about the crumble of cultural sensitivity and competence in the hospital. Recognizing the helplessness of my position as a medical student—hanging out at the lowest rung in the medical hierarchy—would really make me uncomfortable at times.

One day, a morbid thought passed by my mind upon seeing an attending manage a patient's case during patient rounds: if this was my father we were treating, I would be ready to wreck his brains for being too lax. It was concerning to see how evident a patient’s race and social status heavily affected the quality of care provided—such as the laxity for the medical team to seek for a translator to communicate accurately with a patient, who happened to be a construction and migrant worker, regarding his diagnosis and prognosis to start with.

I thought I’d say something. Just something.

I then pleaded an unsure pigeon-hearted line, "but doctor this doesn’t seem right."

Later, I reflected that I could have just bluntly asked him "but doctor, is this ethical?" to directly question his principles as a physician. But, wait.

I was a medical student who was in a delicate position. At the mercy of the consultant’s evaluation. So cross out being blunt—not an option. I was expected to be impressive and meek as a lamb.

What is problematic in this scenario is that the attending had the dual privilege of defining “professionalism” and evaluating students and residents on the basis of these definitions. With this power, unprofessional behavior could be maintained and reinforced in this manner.

Aside from this physician-student power dynamic that ruled, the hierarchies ruling both patient-employer and the patient-physician would further wrestle and heighten the patient’s vulnerability. In

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this particular patient encounter, the patient’s sponsor immediately requested the patient to refuse any further means of treatment and to be sent back to his native land. The attending, who could be pushing for proper documentation regarding the patient’s diagnosis before the patient leaves the hospital so he could receive appropriate medical management back in his home country, did not opt for anything that required sensibility and mindfulness. Even the conversation between the patient and the physician was based on gestures and hardly any few exchanged words in broken English.

Maybe the consultant… was busy? Overworked? Exhausted? Not concerned? (Ahh, maybe there were more important patients closer to the verge of death. This patient, on the other hand, had 98% SpO2. He was, therefore, doing fine.)

On the brighter side of being a medical student who is able to make written accounts like this regarding a hostile or an intense human emotional reaction after a patient encounter, I am able to deconstruct an event in the hospital that struck me ethically and morally. This inspired me to pay more attention to, establish connection with, and get to know the narrative of our patients from that early point in my clinical year onwards. Furthermore, I realized that choosing to be proactive could probably even be the edge of a medical student in the medical team—something to bring to the table that would be more positive than critical. There must be an appropriate and less condemning way to raise concern about patients in the clinical setting to a chief resident or an attending. If done effectively, advocating for the patient tackles two important goals which are: our patient receiving quality patient-centered care, and the medical team striving for effective communication and accountability for patient safety outcomes.

I look back to this patient encounter and see the value of discovering my agency in patient care. And as an aspiring physician, I see the importance of addressing the human condition holistically—including the existential states of suffering and social deprivation—and preventing the epidemic erosion of empathy pervading the medical wards. I think this is the kind of medical culture we ought to strive for everyday that we are in the wards, wherein our actions are impelled not out of fear but mindfulness.

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ascensus journal of humanities

Rainbow Roads Lead Everywhere Photography

Benjamin Jackson

Seyรฐisfjรถrรฐur, Iceland

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No One Path Photography

Yuna Oh

Interlaken, Switzerland

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ascensus journal of humanities

Moonlight Poetry

Christine L. Frissora, MD A pretty girl in the moonlight laughing drinking daring playing trusting simply perfectly carved white marble skin in the shade against the black rock silk marble curvy smooth soft toned perfect now flaunting beauty youth power to the night to the angels the Heavens God me to herself prancing holding kissing touching a woman child in my arms now gazing up into my face the sweetest voice intently explaining what I don't understand I listen I still don't understand Does she?

She is somewhere else craving something else missing something else wanting something else time passes quickly easily happily She just wants to play She wants to play with me She is safe here so she plays I watch her She is rapturous manipulative captivating Innocent as a child. Guilty as sin She makes it as hard as she can Against my will I touch her breast It is smooth round silky with baby powder She will tell me later that her princess hair can cover her chest I will ask her to prove it She stacks images purposely She is remembering a moment about a wine glass I am lost I touch her skin quickly lightly I am dismayed surprised not surprised not dismayed I forget any simple touch imprints on her forever forget her memory Forget the power of my words with this one Forget each weapon arrow thoughtlessly insensibly fired into the heart

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of the angel voice pretty girl with the soft supple thin body of a virgin who is mine no more left cut wounded harmed angry wrathful gone She does not forgive me for what I do not apologize She cannot forgive me for making her bleed for leaving her bleeding alone I was unprepared I did not mean to make the soul of an angel bleed

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ascensus journal of humanities

Reflecting on the Day Photography

Natasha Smith

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Canyonlands Photography

David Chang

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ascensus journal of humanities

Anatomy Class - A Progression Poetry

Anonymous Part I. Chest I cut through her red velvet cake; her Georgia clay; her earthen body; her lipstick blood.

I wanted to reach out and taste her wanted to tell her I saw her for the first time for the last time.

I know your body better than I know my own.

Part II. Lungs I held all the air we breathe in the palms of my hands I lifted it in time with my chest — marveled at the rise and fall.

I have never before held such a delicate and lovely thing.

And believe I never will again.

Part III. Pelvis Nothing felt more private or intimate than finding her pubic hairs stuck to the blue latex of my gloves.

Part IV. Face Silent bride, I knew your face before I saw it but even still your hair cropped short

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caught me off guard.

I wore my hair like that once.

I have just one more piece to take from you, but I will cherish your name if you will forget mine.

Part V. The Final Dissection He pried your skull apart in an act so satisfying and violent it stole my breath away.

Inside, your ruby red grapefruit took me by surprise.

Who colored you a sunrise?

Who ran their brush across the inside of your mind?

In a second act, more gentle than the first, he scooped out your memories but still broke your stem.

This summer, the pink roses in my garden will remind me of you.

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Shivan Painting

P.S. Nandini

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Three Years Painting

Zhenzhen Shi

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ascensus journal of humanities

Cowboy Captive Poetry

Lauren Kelly, MD, MPH, MS Hands of a gentle cowboy are fumbling with this zipper.

How does one get the hooded sweatshirt onto one's legs?

I tell him it will not fit because he is too tall.

He wears a ball cap that belongs to another man, an unfamiliar name scratched beneath the brim.

Only the outsiders are preoccupied with what belongs to whom.

Within this place, they each try on what it's like to be the other never to know the difference.

Each tries the shower water of their neighbor, or a respite in someone else's bed, maybe unwelcome.

Not much harm done by Lucy's gummy gnaw.

We all forgive and forget in this place.

There are times when he leans in, the cowboy, to see if his companion senses him there.

Looking only for a response of any kind.

How are your legs? He asks Sal, thin stems wrapped in pressure boots, elevated.

I've found him many times, silent, sharing an edge of the bed with a lonely comrade.

His back weathered, bowing down as though to warm his hands upon a quiet fire between the two of them.

There are times when the cowboy is in the scorched woods.

Nothing to orient him save the small circular sliver of sky, letting down onto the tall tree growing through the middle of the structure where he lives.

No photo, no ball cap, no eclair could help.

He grips my hand with his large leathered hand and he cries.

I have nothing, he howls. I don't belong here.

I can only hold him for a while until another movement takes him elsewhere.

Soon enough he has other plans, to lead an invisible ragtime band or to deliver a lecture on organizational effectiveness.

His audience always a captive one.

Some cells must be impervious to the protein snarls, I know this.

The tender ones that send signals deep into the gut, to the tear ducts,

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to the tips of the fingers and toes that curl to remember the ground beneath.

On a day with a red blazing sun, I will take you from here barefoot.

Swing open the coded doors and we'll howl at the sky for our damned fate, running as far as poorly oiled joints can bare.

In there or out here, at least we'll have each other.

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ascensus journal of humanities

Take Flight Photography

Jaimie Uva, RD, CDN

Eagle Beach, Aruba

Surf 's Up Photography

Jaimie Uva, RD, CDN

Ditch Plains, Montauk

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Puzzled Sketch

Brienne Lubor

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Flowerfly Photography

Yuna Oh

Luang Prabang, Laos

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Shadows in the Last of the Light Photography

Erika Quinones

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ascensus journal of humanities

Physician a Victim of Medicine Essay

Renuka Gupta, MD The panic first set in on my way to work. The day had begun like any other: awake at 4:45 am, quick trip to the gym, and then into the city to see my patients. But as I approached the Bronx River Parkway, I knew that something was wrong. I tried to write it off as premenstrual cramps — at least that’s what my husband had suggested — but this was different. I could feel something gnawing at my organs, ripping at my belly. In between waves of nausea, I managed to examine patients, write notes, and take my daughter to swim lessons. Despite being a physician, however, I never thought about consulting one. Why? A burgeoning body of research suggests that men and women view medical care quite differently. Women my age often put off a trip to the doctor, and the reasons are familiar. Most of us are stretched so thin dealing with kids, work, family, school work, activities, doctors’ appointments and play dates that we have little time for ourselves. For many of us, chatting with a doctor is a luxury we think we can’t afford.

I was raised in a traditional Indian family where I witnessed my mother going through similar pains. For her, home remedies were the way to go. There was never a mention of seeing a doctor. I happened to be the only girl amongst thirteen cousins. I had learned to fend for myself and prove it to my cousins so I could be involved in their activities. Another reason to support myself for not getting care earlier is that I have worked in the Indian Army and the training that I went through has made me tough so it seemed petty to seek medical attention for something like belly pain. Being a physician, I felt odd and uncomfortable being examined by someone else. It felt as if I was exposed and my privacy was taken away. The irony was not lost on me.

After my daughter’s swim lessons, the pain had become unbearable. My neighbor popped in and said, "You look awful," before forcing me to go to the ER. A CT scan revealed the answer: a ruptured hemorrhagic ovarian cyst causing peritonitis. I was given two doses of IV tramadol with Zofran and was shortly discharged home with follow-up gynecology appointments. The prescription was pain control and rest.

I had a diagnosis and plan; everything appeared resolved — or so I thought.

A few days later, I was seen by my regular gynecologist. A pelvic exam was unrevealing and he recommended starting an OCP to prevent future cysts and help with dysmenorrhea. He stated that I could start off

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the cycle and expect the pain to dissipate in a day or so. Unfortunately, the pain did not improve. Over the next week, I saw two more gynecologists — both evaluated me as a professional courtesy — and both performed ultrasounds and prescribed birth control pills and analgesics. By then, I was bleeding heavily with severe cramping that was unrelieved by NSAIDs or opioids. I called my gynecologist, who admitted that he was not sure what was happening but explained that he might need to perform a hysteroscopy, incision and drainage if there was no improvement.

Everything seemed so utterly wrong. I was depressed and crying. My two kids, four and 6 years old, had never seen me in bed like this. They would sweetly try to help me to the bathroom since I fell from the opioids.

I was not comfortable with the plan and reached out to my old obstetrician, who had delivered my kids, to get his opinion and advice. He remembered me right away and after hearing my story, his first reaction (with the caveat that gynecology was not his main specialty) was to stop all hormonal therapy as he suspected that the prescriptions were wrong. I went to his office at lunch time the next day. He personally performed my ultrasound and said, "In my opinion, there’s nothing actually wrong. There is no role for surgery at all.” I could not believe my ears. He referred me to another gynecologist, who also had the same response: the treatment for ruptured cysts is pain control and rest, and they resolve in two to four days. Hormonal therapy is not recommended and even then, the dosing and timing being proposed to me were not correct. My doctors had just been busy chasing the complications of the treatment and made a simple issue into a catastrophic one. There was no role for the surgery they were suggesting. I was dumbfounded. Consultations with three toptier doctors had resulted in two and a half weeks of bedridden pain, depression, and suffering that were avoidable and nearly culminated in an unnecessary surgery. Why? Are we so focused on treating symptoms and complications that we forget the real person who experiences them? This time, the tables were turned, and I was the one on the butcher paper, terrified and alone. In retrospect, I still have so many questions. Why did they push pills on me? Could this have been avoided? Did my profession play a role in all of this?

Despite the fact that I am a physician, I am human after all. I should be willing to accept care. Also, I should stand up to my colleagues and have open discussions about patients’ treatment plans if I disagree with their plan or have a different approach.

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Angst

Photography

Wooram Jung

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Fountain Photography

Brienne Lubor

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Sea Prints Painting

Tasheika Grizzle

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Hummingbird Watercolor

Hanof Ahmed

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ascensus journal of humanities

Arabian Poetry

Christine L. Frissora, MD Clear blue sky dry wind rolling hills crest of deeper darker lustrous blue beyond where the hills meet the horizon we trod plod calmly easily readily happily willingly stop at an invisible wire fence see him prancing his head large body compact neck ripped with muscles at an angle like an accordion sun kissed copper freely flying over the prairie hoofs are up he dances flaunts muscle youth power strength joy freedom everywhere He sees me watching him breathless stunned stilled watching seeing absorbing memorizing the most beautiful animal ever seen not an animal a stallion He is the Arabian, she says I stare at him he glances at me I stare at him he turns away leaving coyly he glances back eyes at me one last look as he leaves my heart breaks just a little and I think he did it on purpose the next day there is something small fast and yellow green high flying over to my right I turn a bit cross leap reach strike free effortless volley smash a beauty they laugh I think of Arabian

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i Apart Poetry

Anonymous I’ve always been alright with words and saying what is true. And yet there’s you who makes it clear how little they can do How can I capture what I’ve known when touching you when nothing else can touch that truth Nod is too cheap and quick a word for how your head affirms that girlie yes you hum to bless the things that are Gaze sounds so static and sedate for any eyes that radiate intentions like the ones you make to impact time and space And smile is a curvy line while what you beam does not have shape. I sense it with my own glad grin, not even with my eyes These sounds, these marks, they know too well how little they can give.

They are the the children of apart, but maybe the parents of with

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Now, In Your Kitchen Painting

Zhenzhen Shi

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Chasm Painting

Sonia Iosim

Antelope Canyon

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Microstory Short Story

Benet Pera-Gresely, PhD There was a time when our once mighty empire ruled the whole world.

With our shock units we sieged and later obliterated entire cities and countries, we crossed vast oceans and conquered ancient civilizations. We shaped human history!

But the enemy learned, and one day it struck back.

The declaration of war came without warning. Our troops were mobilized and the best defensive positions were engaged. We thought we were invincible. After all, we were the first to populate this land once we abandoned the seas. Our culture builds on a strong sense of community and fight. Thus, there is not going to be hope of mercy! Or at least that was what we thought.

We were not prepared for the chemical warfare.

This is a war like no other. Never before our army had experienced such a massive number of casualties and lost battles. We hide and tighten side by side among comrades every time the enemy launches its vile chemical attacks and hope that our turn has not come yet. It has been a long time since we set foot on No Man’s Land.

But finally the tables are turning.

We are diminished and outnumbered, yes. But now we are the strongest.

The youngest generations have been raised during wartime and war is all they know. There is fear no more. The coward and weak ones have been swept away without trace. Our time has come. The victory is close.

---------The CDC officer dropped a pile of files in the table and adjusted the microphone. The room was full and some reporters sat on her feet aiming their lens towards her.

"Good morning everyone and thank you for coming on such short notice. This is clearly a topic of much interest." She cleared her throat and continued. "CDC is the common defense of the country against health threats and clearly one of the biggest threats facing us right now is antibiotic resistance."

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The East River is a Tidal Strait Poetry

Maureen Kelly, RN When I sleep, the rain is the sky’s way of shooting its arrows And water need not a hill to go downstream When I wake the tide comes out and the ocean goes to its bed Movement turning towards the opening widening my expanse I pass by the same tree at the same time Watching rain fall on its leaves and land on the pavement I recall the words I heard as people leaned over rails and spoke Watching the light reflecting off me Living inside the skyscrapers

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Uinta Ground Squirrel Striking a Pose Photography

Kevin Ackerman

Grand Teton National Park, Wyoming, USA

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King's Landing, Dubrovnick Photography

Jennifer Akl, MPH

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The Unexpected Consequence Short Story

Anu Goel Ava: “Omg. You sent me a brain plush toy. I love it!”

Mark: “Aww I’m glad you like it” Ava: “It’s adorable and you didn’t even know that I need to sleep with a pillow tucked under my arm, and now I can use this! Why are you the best?”

Mark: “Wanna know the best part about the gift?”

Ava: “Inside is says ‘someone to make memories with.’ This is the best gift I’ve gotten in a long time” Mark: “I hope it makes you think of me” Ava and Mark met shortly after Mark started medical school in New York. Before long, they’d developed a strong friendship, no longer simply two strangers who randomly met in a crowded city. Not long after meeting her, Mark learned that Ava struggles with body image issues. She has anorexia. Since Ava and Mark met, Ava has had one flareup of her disease.

Ava’s relationships change during these periods. She doesn’t want to interact with people if she can’t be her best self for them. Part of Ava’s role in Mark’s life was to be a constant source of comfort amidst the stress and chaos of medical school. During Ava’s episode, Mark was shut out.

After two weeks of no contact without any explanation, Mark didn’t know what to do. His instinct as a friend was to give her the space she seemed to need. His instinct as a medical student was to intervene.

These roles were similar in many ways, but that of the medical student carried a not-so-subtle sense of investigation. Mark started eliciting a history via text-message. Did she have any idea of what brought this episode on? Was she in pain? How had she been helping herself? Had she reached out to her doctor and therapist? Mark wanted as much information as possible, not because he wanted to be a friend, but because he wanted to take a complete history. It was his training. The acronyms “OPQRST” and “OLDCARTS” were rehearsed, first with classmates, then with actors, then in front of patient after patient until became second-nature to squeeze every last bit of information out of someone so you could impress whoever you’d be presenting the patient to that day. He couldn’t magically shut it off.

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Ava replied with a single sentence. “I’m ok. We’ll talk later.”

The next day she texted him again: Ava: “I’m sorry I was short with you last night. There isn’t an excuse but my anorexia is flaring badly and it’s making me all around miserable. I don’t really want to talk about it or anything but I promise I’ll reach out the moment I feel like I can talk to anyone” Mark: “Are you ok?”

Ava: “I’m fine. I’m going through a phase. I won’t eat for a while” … … …

Mark: “Do you have to go through this alone” Ava: “It’s how I deal…It’s been a dark few weeks…I appreciate the concern, but I just can't right now” After that, Ava and Mark never fell back into their old relationship.

Mark would occasionally check in on her to make sure she was doing ok, Ava would respond in a few words, and then nothing would happen for a couple months. Despite the occasional contact, Mark couldn’t help but obsess over wondering what was wrong. In the shower, on the subway, any idle moment was consumed with thoughts, trying to rationalize the progress of events that somehow started with two people in a strong friendship who communicated every day and ended with two almost-strangers in a crowded city who never spoke more than a few infrequent words to each other.

Was she not reaching out because she was struggling with anorexia and was forcing space? Was there something he could be doing? Was she feeling better but just didn’t want to talk to him anymore? Had she recovered and gone back to normal with her other friends, and he was the only one who remained shut out? Had he done something wrong?

Was their friendship over? Would he ever connect with someone that closely ever again?

Mark would never learn whether the relationship changed because of that one night or some other change in Ava’s life, but either way he had experienced an unexpected consequence of being a medical student.

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By Night Photography

Parc Saint-Viateur, MontrĂŠal, QuĂŠbec

Herie Sun

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Survival Photography

Shahnaz Mohammed

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Time Poetry

Aretina Leung I. I thought I knew what time was had years of it, watched it pass through my fingers, could guess how the numbers change on a brightly lit screen a constant not constant in your brightly lit eyes.

Hours are too short but weeks are years and the failure to find the rules hidden behind familiar eyes frustrates me, but maybe it’s your fingers filling the spaces between mine catching those seconds and minutes and returning them as lifetimes.

“Time passes differently here,” you say and I only hum in reply.

II. “Like clockwork,” you say, “we fight every week, like clockwork.”

And here I stand, draped in details and circumstances of an isolated crime on a quiet night in suburbia And there you stand, wrapping string around pushpins revealing red wounds across the map of a town that I had once known.

When did I stop knowing?

Maybe it was when I started calling you “home” Maybe I consented to this clockwork circus and cast off my own stories, a runaway no longer recognizing my own scars.

I’m not afraid of scars.

But I’m afraid of that moment when I fall turn myself over, scanning elbows and knees sharp intake of breath when soft skin reveals the angry

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bubbling just underneath the surface.

I’m afraid because I never feel the impact, just the dripping of consequences on dirty carpet revealing red wounds across a body that I had once known.

III. I drew Death whenever I thought about us.

I’ve never really believed in fate, or at least thought that we could change it but as much as I shuffled and split the deck Death remained a constant.

I had tried to turn you into a constant.

As I untangle myself from your fingers I look down to see the spaces between mine My hands, alone, piled high with minutes and months And I understand time again.

And I understand death.

And I know where home is, and this town And my body, with fresh scars, is still mine And I know it separate from yours.

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The Time In-Between Photography

Natasha Smith

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Atlantic Coast Lighthouse Photography

Duncan Hau, MD

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White Coat Short Story

Benjamin Jackson The medical student’s white coat. Short, crisp, with a bright red logo embroidered on the shoulder and large pockets overflowing with notebooks, pens, and the paraphernalia of the physical exam. For me, this coat was the paradox of my first year of medical school. We received these white coats in August at the beginning of our medical education. We were inducted into the profession of medicine with all the privileges and responsibilities that entails. We were unleashed— wearing these same coats—into the hospital, where in groups of two or three we followed around physicians wearing similar but longer, more worn coats that somehow sat more naturally on their shoulders than ours. We wore these bright new coats we had been given, but were otherwise completely unchanged and wholly unqualified to do anything more.

Occasionally, we ventured beyond the walls of NYP to learn at other clinics around the city. On one such occasion, I found myself at a small primary care office on the Upper West Side. As I arrived, I pulled my folded white coat out of my bag: hidden, not worn so as not provide the illusion of competence in the event of a medical emergency on the bus. Over the course of a Monday afternoon I was expected to follow a physician around, take histories—and maybe, just maybe—learn something about medicine. As the second patient of the day came in, the nurse dropped by with a special request. “He doesn’t want the medical student in the room”, she said, “He said he doesn’t want anyone else seeing his hiney.” Laughing, my preceptorship told me to relax for a while. I was secretly relieved; to be honest I didn’t really want to see this patient’s hiney either. But my break was short lived, as 2 minutes later my preceptor called me in. “I was just joking, the patient—named Mr. Smith—cheerfully exclaimed—“Just don’t take any selfies”. All smiles, we continued with the appointment.

There was in fact another reason I had been less than excited to join the medical team that day. Mr. Smith was here today for a prostate massage—having presented with a slightly enlarged prostate, my preceptor had recommended a 6-week course of physical manipulations to hopefully reduce its size without other medical interventions.

This seemed fine to me, until after introductions had been made my preceptor handed me a pair of gloves. It quickly became painfully

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obvious to me that Mr. Smith and I would soon become much more intimate.

I’ll spare you the details of what happened next. Medicine, after all is private (we all completed HIPAA training after all), and it’s hard to imagine something more private than what transpired between me and Mr. Smith. We were both somewhat unwilling participants in a relationship between doctor and patient that stretched back centuries.

But as I rode the bus back home that day—white coat not folded neatly, but now stuffed haphazardly in my bag—for the first time I felt somewhat deserving of that garment. The first time I felt like a medical student was not in that auditorium where I received it, it was not in anatomy lab or in lecture learning pharmacology. It wasn’t even wearing my white coat for the first time in the hospital. It was not particularly beautiful or poignant. It was as I stood next to Mr. Smith lying on the exam table, my finger deep in his rectum, and it is indelibly etched in my brain.

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Heavy Heart, Light Music Photography

Paris, France

Yuna Oh

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Music in the Park Photography

Natasha Smith

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When Words Don't Come Easily Essay

Daniel Choi, MD The diameter of the endotracheal tube never seems impressive until it finds itself within the confined space of the trachea. Within there, the plastic tubing incarcerates the laryngeal muscles, silencing them under its cumbersome weight. Communication no longer happens by the coordinated vibration of vocal cords, but rather through quivering, deconditioned fingers scribbling illegibly on a notepad. Patients’ thoughts are condensed into one or two words in hopes that they can convey their desires. “Itch me.” “Wife here?” These are the more fortunate patients though. Most patients lay obliviously sedated with hopes of extubation someday.

My first interaction with an intubated patient was unusual; he was congenitally deaf and fluent in American Sign Language (ASL). I was a sub-intern, not practiced enough to understand how profoundly unique this experience would be. In fact, it wasn’t until I finished intern year that I even remembered meeting this wonderful patient and his family. By this time, I had already rotated twice in the ICU and endotracheal tubes merely meant an extra set of vitals to record on morning pre-rounds. I grew accustomed to the communication void with my ventilated patients until this memory suddenly resurfaced.

This patient presented to our ICU several summers ago as I began my sub-internship. He was on last line chemotherapy, meant to postpone his death by several months. Instead, he became an UpToDate percentage, one of the few on this drug to develop rhabdomyolysis. His clinical status quickly warranted intubation, pressors, and renal replacement therapy.

Two days into his stay, he was weaned off sedation. By this point, I had already met his family. His wife, also congenitally deaf, remained eventempered at her husband’s side throughout the hospitalization regardless of whether we delivered good or bad news. Her eyebrows and hands were extremely expressive while the rest of her body was stoic. In physical and emotional contrast, her son was a hefty, six-feet, often facetious character who was not deaf though fluent in ASL. He was candid with his emotions and quick to verbalize his father’s needs — likely from years of practice.

Everyday, on morning rounds, we had an in-person translator stop by to facilitate conversations and in the afternoons, the son would be present to translate on his father’s behalf. I was still naïve, unaware of how rare

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it was to present multisyllabic subjective information on my intubated patient on daily morning rounds. On some afternoons, I even heard the son chuckling in the room with his father. I assumed they had shared an inside joke and I thought nothing more of it.

Unfortunately, over the next several days, despite aggressive efforts, our patient’s clinical status continued to decline. An inevitable fate was soon approaching. One day we broke our daily routine at the patient’s request and called the in-person translator for an additional afternoon session.

He had struggled long enough. Over the next hour, speaking with his forearms and fingers several inches at a time, he was able to articulate his wishes for withdrawal of care. He reiterated that his metastatic cancer and rhabdomyolysis challenged his pain tolerance with increasing frequency, consistent with his grievances on daily rounds. While the folds of his weakened hands couldn’t proportionally emphasize the gravity of his decisions, we recognized the urgency and significance of the choices he made. His family in the room also seemed to understand as they communicated back with him, the specifics of which I wish I could remember now.

As a non-speaker of ASL, I wonder what subtleties I missed in this delicate moment. Language forms so much of one’s thought process and perspective. I find the most fascinating words are those embedded so deeply into one’s culture that they do not have direct translations. Inuit, the Eskimo language, has over fifty different words for “ice” and “snow” so that there is an incredible nuance in the ways that they conceptualize and converse about weather. Similarly, the Korean word han simultaneously conveys patriotism, sorrow, and resentment for South Korea’s turbulent history and cannot be adequately substituted by any single word in the English language. In our patient, how did he emphasize and intonate certain phrases? Were the pauses in between words intentional or was that a product of his disease? Did he use more precise words with his family that were better able to capture his raw emotions?

We turned off the ventilator the next day. He passed minutes after. In his eyes, I saw fear become diluted with sadness and then become placid.

With matching tears in my eyes, I closed the curtain behind them. His passing was a victory of visual over auditory language, able to give him dignity in death and conclusion with his loved ones. An unintended consequence of respiratory failure is that it cruelly severs our capacity to connect with others in crucial medical moments. I wonder how much less burdensome the tubing would feel if only our ventilated patients could retain the powerful capacity for language.

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Horizons of Glistening Tranquility Painting

Madeleine Schachter, JD

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On Doctors: Hurry Short Story

Karin Charnoff-Katz, MD Hurry by Marie Howe We stop at the dry cleaners and the grocery store and the gas station and the green market and Hurry up honey, I say, hurry, as she runs along two or three steps behind me her blue jacket unzipped and her socks rolled down.

Where do I want her to hurry to? To her grave?

To mine? Where one day she might stand all grown?

Today, when all the errands are finally done, I say to her, Honey I’m sorry I keep saying Hurry— you walk ahead of me. You be the mother.

And, Hurry up, she says, over her shoulder, looking back at me, laughing. Hurry up now darling, she says, hurry, hurry, taking the house keys from my hands.

That poem resonated with me when a young patient’s brother sent me an email the week she died. Her angiosarcoma of the breast was aggressive, missed by so many wise clinicians. Camouflaged by breast tissue engorged and distorted by pregnancy changes. Her cancer masqueraded as mastitis refractory to antibiotics.

Her brother wrote: Hi Dr. Katz, I've been up since 5AM....not really sleeping much. Its been so difficult without Emma to talk to. I was just reading some of her emails to me and saw your email address and felt compelled to write. You had such an incredible impact on Emma, thank you for taking such an interest in her. I feel that I failed her as a doctor and a brother sometimes. I deal with bones and joints all day, so I truly never even conceived that the pain in her breast could be anything other than mastitis during her pregnancy. We had her memorial service in at a friend's house just yards away from her front door in Bronxville and did the burial in Cotuit, MA, a place she loved so much. I want you to know of all her doctors, some were good, others terrible, you were one of the best. She talked so highly of you and felt that you and Dr. Maki saved her by taking the extra time and

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helping her and gave her time to see her children grow. Despite the chemotherapy, radiation, surgery, we all thought it she would have beaten the cancer. We are all truly heart broken. When I think about some of the care she got from her doctors it reminds me of what Osler said so many decades ago...“Hurry? Never hurry – hurry is the devil.

More people are killed by hurry than disease.” Or maybe some of them truly didn't care, but you did, and we are grateful for that. She had a beautiful and kind spirit and we will forever miss her.

Take care, Henry I cried when I read and reread the email. I loved that young and exquisitely beautiful woman. Oscar Wilde’s sentiment that “More people are killed by hurry than disease,” resonated. I thought about my daughter, Elly’s doctors who took the time to really listen, the time to think. The doctors who took the extra moment to prudently discard blinders and attempt to see the bigger picture, regardless of how specialized their training. I thought about her adolescent medicine doctor, the master at revising failed fusions, and the pain doctor at Maimonides where she had her second fusion.

They were never in too much of a hurry regardless of how busy they were. They always had time to ask “the unscripted question,”* to look something up if they were uncertain, to ask for a second, and even third and fourth, professional opinion. They never looked at their watch when speaking to us, or inched toward the threshold of the examining room as if eager to exit. They were not afraid of the pauses, the silences, in the context of our discourse with them. They took the time to ride on a long subway journey to pay a house call when Elly was in pain.

They even toyed with models of the spine to try so hard to understand the source of Elly’s pain and to assess the amount of mending necessary to heal her. They thought hard about how to manage controlling her pain without making her toxic from pharmaceuticals administered.

They took a precious moment to conjure how to stay ahead of the pain, rather than lagging behind it, thereby, being in a position with potential to control it. To harness it. Otherwise Elly’s pain was a wild pony run astray. Lost and frightened. Galloping at too rapid a pace to be caught and tamed and assuaged. They listened not only to me, but to Elly’s voice, recognizing that the best assessment came through the words she strung together attempting to communicate pain that was beyond language.

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When we shared company with doctors who were not in a hurry, they took part ownership of Elly’s pain, relieving it, in small portion, just by caring so much. They could see beyond the susceptibility artifact on MRI and the beam-hardening artifact on CT limiting the imaging. A certain humility on their part was central to their healing powers. Second opinions were welcomed with open arms, open minds.

Creativity is not an impulse; it requires patience and an immeasurable investment of time. The physicians we met along Elly’s journey of more than half a decade, who were unclocked were the most effective at the task at hand. In taking their time, or rather in the giving of their time generously, they eliminated a large piece of the complexity of her medical picture, gradually reversing the trajectory of her journey making it possible for Elly to ultimately reclaim a healthy body and mind. Our experience indeed confirmed Oscar Wilde’s sentiment that “…hurry is the devil.”

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The Last Day of Summer Poetry

Xiang Li I haven’t heard the nightingales sing But you already completed their song The melody in your silence Already made the summer night jealous So many roads reaching towards me Every one leading to the same destiny The bridge, like a glowing flute We are the dancing notes over the river The light in your eyes Flowing into my endless night sky Are you still looking for The palm to hold the moonlight for you All words fell asleep In the end Do you remember that star passing by Or did you turn around And see eternity *written for my friends B.N. and L.W.

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Serenity Photography

Keith A. LaScalea, MD

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A Step Up Photography

Keith A. LaScalea, MD

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Faith in Medical Training: What's the Use? Personal Letter to a Young Medical Sudent

Marissa A. Lombardo, MD My testimony is quite an odd one, similar to my pre-med journey.

I came to believe in God on a medical mission trip in Honduras when I was about twenty-one years old. A staunch atheist at the time, I was truly only interested in beefing up my medical school application. For my college group’s mission trip, my local church donated thousands of dollars. I was stunned. I had never even attended church! “Wow,” I thought. “These people are pretty cool.” So I decided to start listening instead of fighting about whether or not there was a God. It’s a rather long story and a bit of a blurry one, but ultimately, I did accept Jesus as my savior amongst a lot of pain and personal distress I was experiencing at that time. I realized that eventually the tests would cease, the money would be spent and the hours would be lost to hours of study. But what about my soul? What was going to happen to that?

No doubt I had one. I just didn’t know what to do for it. I was spiritually bankrupt. I was completely empty on the inside. Soul-searching wasn’t something I could study or learn. It wasn’t something I needed to figure out (phew, what a relief. I was tired of everything else as a premed anyway). Taking care of my spirit was an “inside job.” This was something that I had to tap into. Terrified at first, I had good Godly men and women around me who showed me where to start.

Since that time, I have completed multiple medical mission trips with my local church. I will never forget what the mission leader said on one of my most recent projects: “The medicine will run out, the doctors will go away, but faith in God lasts forever.” Again, I was blown away.

It seemed so simple and basic to others, but to me, it was a revelation.

I wanted to learn more. Eventually, my faith motivated me to get more involved with mentorship today. I believe that helping not only patients but other physicians, is part of my calling. I not only wish to serve others who are sick, but I look forward to speaking with young women and men like myself who begin this enormous undertaking with a lack of direction and guidance. The students I mentor remind me where I came from. I get a huge dose of humility every time I have the honor to go to speak at local colleges, pre-health fairs and high school events.

There are many, many ways to help another human outside of medicine.

Mentorship is one of the ways I have chosen to push the envelope and give every ounce of my gifts as long as I am here on Earth.

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One day, I won’t be around anymore. One day, all of my patients won’t be around anymore. But, through the lives of the young men and women who I speak to across New York, I have palpable potential to reach a hundred-fold more lives by simply sharing my past experiences in an effort to encourage others to pursue this incredible profession.

This is what makes me excited to wake up every morning. We only have one life! We are physicians, we are role models in the community. We have a duty to serve all humankind in any way we can. As a physician and a believer, this is what my faith-filled life continuously teaches me to do.

No matter what your personal religious beliefs may be, there is so much beauty and peace that having faith through this crazy journey offers.

Our faith truly does give us an extra edge. If you ask me, faith is the most important edge we can have at all! I attribute a lot of my success to trusting in a power greater than myself to pull me through. My brothers and sisters in the faith remind me constantly that God did not put a calling in my life so that He may not see me through it. Personally, I still have many moments of doubt! Believe me! I am full of fear and discouragement. Other times, I am full of downright self-destruction.

However, faith carries me through. Hope is patience with yourself, Love is patience with another and Faith is patience with God. When the rapper 50 Cent (one of my favorite modern-day pop culture figures, shout out to Queens) first started out, Opera interviewed him and asked him about his faith. She asked if he believes in God. He replied, “Yes. In fact, my grandmother tells me ‘Either pray or worry.

Don’t do both.” 50 Cent, my friends and family in the church, all of them are right! They are SO right. Faith carries you through ALL things. With man, many things are not possible. But truly, with God all things are. When I get anxious, I remind myself “Either pray or worry.

Don’t do both.”

I think being a pre-med is one of the most rigorous and arduous human experiences one can ask for. Second only to military men and women, we are constantly under fire. We are thrown into an extremely difficult, challenging, competitive atmosphere. We are told that the standards are high and the odds are slim. We are brainwashed into believing that we aren’t rich enough, we aren’t smart enough, we aren’t sharp enough.

It’s a complete illusion. The world and its delusions of grandeur can be quite convincing. We can look at a pill bottle and see results and immediately, we subsequently come to believe that pills are the answer.

However, there have been more instances where my faith has served me

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in connecting with my patients than any prescription ever could.

I will leave you with this one story: There was a man who was dying suddenly, imminently and tragically before my and his family’s eyes in the Medical Intensive Care Unit one beautiful sunny morning of my intern year. I came into the room and explained that he was actively dying in front of us due to fulminant strongyloides, a disseminated parasitic infection that was misdiagnosed for months by several specialists repeatedly.

His family stood there horrified. I watched as he began to lose consciousness and I wanted to break down and cry. But I couldn’t, I needed to be strong. I was his physician and I had to be a pillar of strength for this family. With no more answers and no more treatments left to offer, I could only just stand there and watch them say goodbye.

They asked if they could pray. I encouraged them to do so. They asked me to join their prayer circle. I did. This man’s son began to pray with such passion and fervor, I was shaking and light on my feet. I thought I was going to faint. I closed my eyes and offered them my presence.

I thought it was the polite thing to do. Expecting a routine prayer, I stood stunned. This man’s son began to pray for ME. Expecting to hear his son pray for his dying father, that his father may be saved, that they may witness a miracle, I instead began to hear them pray for MY hands, that they may be strong for their tasks in taking care of others who will survive, for MY head, that it may remain clear for my patients who I WILL save, for my well-being so that I may continue to take care of those people who have time left on this earth. As he continued, he did not pray for his father’s miraculous recovery. Neither did he pray that his father may go to heaven because their faith was strong. This son knew that that is exactly where his father, my patient, was going. Their faith carried them through. I want that kind of faith.

That was one of the most powerful moments of my life. That is what faith does for you. It transcends all boundaries. It will serve you most.

Although all of the pre-med checklist is important, please remember to continue to pray. No matter what. God is first, then you, then everything else. Anything in your life must understand that it will always come third and only those who understand that are those that you should keep around.

Peace be with you always.

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Pena Palace, Sintra Photography

Jennifer Akl, MPH

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Untitled Photography

Montreh Tavakkoli, MD, MA

Ho Chi Minh City, Vietnam He always knew what she wanted, and she loved the smile that grew on his face when she let him take the lead. They worked in sync. A perfectly oiled machine that never grew tired. Their energies were so alive and connected, almost tangible.

She looked off as her mind wandered to their next adventure. He carefully chose her meal and his own. Never had I seen such effortless partnership that made me yearn for roots such as these.

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Moon Dance Photography

Jaimie Uva, RD, CDN

Riviera Maya, Mexico

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Chagrin Poetry

Mohamud A. Verjee, MBChB, MBA I suffer not from delusions myself Rather am prone to illusions of fantasy Hallucinate as I fall asleep, or wake, Enjoying the lush of sheer phantasm What, me pedantic, inclined to mockery, Aware of mirages, tricks or artifices Use a ruse, or wile, sneaky snares Circumvent, manoeuvre, machinate Why not promulgate gentle stratagems You cannot arraign me for my thoughts Leave me to my own devices, visions I want my mind to flourish, thrive, enrich Do not accuse me of being prosaic, ever I am lively, always sober, not tame or vapid If I have to answer to you, I will, decently, With modesty, decorum, respect and grace

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Growth Poetry

Anonymous I would have opened my heart if I could have— not with a whisper but with a bang.

And I would have dug my toes into the rich, dark earth and planted myself among the trees.

Who am I to know that fingertips cannot drink in sunlight?

Have I ever tried to surrender myself to this world?

Perhaps the trick is to not reach upwards at all but simply to reach outward: to touch and taste the ethereal and let the universe in.

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Dusty Grooves Photography

Paolo de Angelis

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Old Puzzles Made New Photography

Athens, Greece

Benjamin Jackson

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A Moonlit Night On the Spring River Calligraphy

Meng Ouyang, MD/PhD

But hear the river say to its water adieu

We do not know tonight for whom she sheds her ray,

From year to year the moons look alike, old and new.

Ah, generations have come and pasted away,

When did the moon first see a man by riverside,

Who by the riverside first saw the moon arise,

An English Translation of this excerpt is printed below:

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Before the Concert Photography

Shahnaz Mohammed

volume vii

Island Dreams Painting

Tasheika Grizzle

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I Choose You Poetry

Heta Ladumor The nights are alive nowadays Lectures leaving my mind ablaze Chaos is what comes to mind When I fail to find How it is all aligned Lectures, people, life It is all so intertwined Donning my white coat I walk down the halls With the purest intention I yearn to pick the right intervention I live for the drama The late nights and early mornings For the joy on a mother’s face As I deliver her good news It’s what keeps me going Feeds my hunger Keeps me growing Such is the path of life I have chosen And it has Chosen me

volume vii

The Commute Poetry

Maureen Kelly, RN Now, enough peace To fit inside a sparrow Staring at the center of the brownstone’s Steps — only silence inside its beak And the hum of the motor Leads to the thought of a war — To the thought of a tank — if not, Then this bus, if not a bus, Then a blue whale Sounding through the darkness I watch the condensation forming New borders — a map of A world made of rain, Until the end of the line When I am the only citizen Inside a body of windows Now, my sight adjusts To lit devices If not digital, then fluorescent, If not fluorescent, then candle light If not, then an ambulance Moving across a bridge — There are acorn ornaments And green pods the trees present I have to see That is their wealth I have to hold on to The white ladder of a crosswalk Or to a giant cylinder Of nitrogen that passes Leaves that brush Along the bus’s body To a flashing hand as it vanishes To perfect shadows of waiting passengers

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Light Verse, Easily Digested Poetry/Multimedia

Lawrence Palmer, PhD

Light verse, easily digested.

Even aTer my wad’s been well chewn, Spit’s too loose when it comes from Paro>d.

I can never quite hit the spitoon From 20 feet out like my Pa did.

When shoes or boots need a good polish Use the fluid made by the sublingual.

All the scuff marks you’re bound to abolish Where leather and mucous co-mingual.

I’m a-was>ng away It’s the >me of the day To get some food into my body It’s not nearly enough Just to swallow the stuff I must open my Sphincter of Oddi There is many a diges>ve phenom, At Nathan’s in Brooklyn you’ve seen’um.

The last hot dog slips in, Then lipase and trypsin Must squirt into each duodenum.

An earthworm to great lengths can grow, Though it hasn’t a head or a toe But mainly consists of jejunum.

When chopped into bits by a hoe, It rarely protests at the blow, But cries out “e pluribus unum!”

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When preparing to talk or to sing, You should salivate from the mandibular.

Your voice will come out with a ring, And your speech will be wiYy and glibular.

We seek out a primeval pleasure Pu1ng nourishment down the esophagus.

It drives our travails and our leisure, From first cry un>l the sarcophagus.

Our hunger grows louder by tocks and >cs.

And ghrelins are ever less placid.

Saliva is flowing and oxyn>cs Are ready to pour out their acid.

An Indian-food lover named William Had his stomach wall lined with beryllium.

“This curry’s deluxe, And no acid reflux, But it burns when it gets to my ileum!”

The condor has never made anthrax, No nuclear secrets has stolen, Its weapons of mass destruc>on, Are released during flight from its colon.

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Serenity Photography

KH Miao & JH Miao

Kampong Phluk Floating Village, Siem Reap, Cambodia

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Adrift

Photography

Melody Ho

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Uncertainty Essay

Eliza Gentzler Good morning, Ms. Roberts. I’m Eliza. I’m a medical student.

I’ll be observing?

I’ll be there for the procedure?

I’ll be helping the doctors out?

I’ve experimented with different wordings of this introduction that assure them that I am not personally performing their Cesarean section without surprising them when I do, in fact, touch things.

Then, I stand with them while they get the epidural. It’s oddly intimate, and they talk to me while hunched over “like an angry cat” as the anesthesiologist instructs. They tell me about their hopes for their child.

They apologize for breaking my hands (they won’t). And once, while I am standing in front of her, a woman set to get her tubes tied during her C-section says, “Can I still change my mind?”

She had a month to think about it, her doctors say, why didn’t she know already what she wanted?

I understand her indecision, because there are questions I am supposed to consider while I plaster myself to walls, trying to be as small as possible, wishing I had some role, any role, that isn’t superfluous. I keep my inner monologue hidden behind smiles and nods, forever perky and available, trying my best to give the impression of never having had a difficult day.

Are you fascinated by lungs, or kidneys, or brains?

(They all seem pretty important to me.)

What kind of attending do you want to be?

(Do I want to be like this unattainably impressive person, or that one?)

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And, you know, you’re a woman.

(Aware.)

You’re going to have to think about where your family fits into all of this.

(I’d like one of those? But so would a lot of the men in my class. Do you ask them, too?)

So what do you want? Follow your heart.

(Am I fascinated by hearts?)

I want to take care of people.

I want it to make me come alive.

I want to feel, somehow, that I’m not an impostor on this team, in this profession, in their lives.

My answers always seem way too simple, and yet — way too much to ask.

Ms. Roberts gets one final choice, once the baby is out and swaddled, her fallopian tube in the surgeon’s hands — “Tying your tubes, yes or no?”

“No!” she says, and there is nothing indecisive about it now. Tools are dropped; uterus and tubes replaced intact.

Maybe I will know what I want.

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Night Vendor Photography

Freddie Scott

Photo taken with my cell phone by accident at my desk while filling out forms

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Happy Accident

Photography

Jacquie Howard

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The Return Essay

Mauricio Vergara, RN, BSN Our little house was situated on a sandy platform near the Pacific Ocean, in an early coal-mining settlement. We heard the news that day from “Panchita”, our neighbor and voice of the town. She somehow managed always to be the first one to know everything about everyone.

“Panchita” reminded me at times of one of “Botero’s” sculptures. She was voluptuous and had a round pleasant face.

She barged into our house through the back door, inconveniently the only entrance to our house, where the kitchen was located. I guessed it made sense since we didn’t have a living room or furniture to display. I do remember a big window by the kitchen that during the day would let as much sunlight and energy into the room as it possibly could. Mom was stirring the stew; her yes quite lost on that act, like disappearing in time. Maybe she knew, maybe she had a feeling.

My father was from an indigenous descent with rich, dark brown skin.

Warm eyes the color of coffee and strong manly features. He was braced with strong hands that were a result of physical labor; whether mining coal, working the earth, fishing or splitting wood. His weathered skin reflected his exposure to all the elements, below ground or above.

Abandoned since childhood, he took care of himself and found a job as a coal miner to support his family.

He left that summer morning to work in a mine called “The Devil’s Chiflon,” one thousand two hundred meters under the ocean floor.

“Chiflon” refers to a very subtle flow of air or wind. The “Chiflon” had a bad reputation among miners as a result of the precarious support in tunnels. “Please stay home today,” my mom said. He stood stoically, wearing nothing but an old work shirt, overalls and steel-toed boots. He kissed my mom, hugged me goodbye and left. I can still hear the cage, the elevator, the gate and the sound of the bell, warning that they had begun their descent into the mine, deeper and deeper into the earth.

When we heard the news of the explosion, I turned to face my mom and saw tears rolling down her cheeks. She collapsed to her knees, sobbing. The sunlight on her face had been dimmed by heartbreak. I ran outside to the front of the house toward the beach, sat in the sand and looked at the ocean. It was humid. I decided to close my eyes and

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not think about what just happened. Tears and sweat melted down my face. My chest hurt; I felt ill and could barely breath. I could only smell the salt from the ocean and the burning of the coal. To this day, the smell of burning coal evokes memories of this explosion.

I lay down for a while, the sun burning my skin. I felt I could’ve reached the sun with the palm of my hand and ripped it apart. Time passed. I am not sure how long. Distant, inaudible voices mixed with a splash of the waves brought me back to the present. I opened my eyes after a while. I looked around at this muddy, forested landscape, enclosed by high mountains, feeling the wind out of the west and northwest as if it were the first time.

I got up and tried to walk toward my house. My pace was slow and heavy. I finally came closer and saw him. My father was there, waiting for me, standing stoically, just like the way he left that morning.

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Don't Stop Me Now Photography

Paolo de Angelis

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Reflections Photography

Murano Island, Venice, Italy"

Yuna Oh

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Chinatown Poetry

Herie Sun Scents soaked into the sidewalk Jets of water from a hose will not scour these away Fish, vegetables, and garbage Cigarette smoke and frying oil Somehow, it all comes together Somehow It is incredible It is dark And the fish market has packed up for the day Gone Are the grandmothers sitting on plastic lawn chairs And the old men with the yellowed, missing teeth Hawking spit onto the sidewalk Gone But their spirits will never leave here And neither will the fish market It is water on dry land Life mingled with death In pale lips In glossy eyes In burnished scales There is nothing worse in life Than trying to walk down Canal Street Duck into the side streets For a moment’s respite And hear ringing harmonies Resonant with the shouts of the counterfeit purse sellers, the peddlers The singers just out of sight Hidden in the shadows of apothecary shops And deep, crooked, gouged-out alleyways Here, these beautiful people settled They built new paifangs and community centres Spread wide across the landscape of this city and country Wide enough to welcome the world They billowed smoke from woks and chimney tops

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Blew it high, high, high into the sky High enough to see home And with each splash of fish guts and oily water They sunk stains deep into the earth Deep enough to make roots

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New York, NY Photography

Lauren Jonas

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The Decision Essay

Paul Miskovitz, MD The Mittlere Brücke crosses the swiftly flowing Rhine River just upstream of the Grand Hôtel des Trois Rois in Basel, Switzerland. A symbol of the city and important for European commerce for centuries, most recently rebuilt in 1905, it connects downtown Basel with Altstadt Kleinbasel on the right bank of the river, the location of the Mustermesse, the large international conference center. This is one of the several Swiss cities “accidentally” (or was it on purpose?) bombed by the allied air forces late in the course of World War II. This is believed to have occurred due to Swiss wartime economic cooperation with Germany as well as delivering to Germany allied aircraft personnel who had parachuted to safety in supposedly neutral Switzerland.

A very important and personal meeting took place in the center of this bridge one cool October morning during a well-attended international congress of medical scientists.

The two-year post-residency training program was small and personal.

The division chief had been kind, attentive and persuasive. His basic science laboratory, known to those who worked there as “the kitchen”, was the center of his universe. Any consideration of clinical training was secondary but this did not matter since clinical opportunities were in abundance at this large metropolitan East coast university teaching hospital. Nevertheless, the trainee had found time to co-author an unusual clinical case report in a prestigious internationally recognized journal with his chief and perhaps as a gesture of his independence had undertaken the task of co-authoring a lengthy clinical monograph with another faculty member (without first seeking the permission of the chief).

The trainee, married in the third year of medical school and now the father of two small children born during his residency, with medical school loans to pay back, and struggling with a mortgage on a newly purchased suburban home, had been invited to present the results of his two years of basic science research done in his chief ’s laboratory to this austere group of international basic science researchers. The division chief, a moderator on the conference panel, had been instrumental in deciding that the conference should be held in Switzerland, rather than in nearby Freiburg, Germany as was the sponsor’s original intent.

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This was done out of sensitivity for the feelings of some American, British, French, and Canadian scientists who balked at the idea of visiting Germany. With the slide content committed to memory the well-rehearsed presentation delineating a new metabolic pathway in the body would be a breeze, the three-minute question and answer period with the top international scientists in the field would be a different story.

It was well-known that back home, the new department chairman had recently dated the division chief ’s resignation letter in a house cleaning effort within his department of medicine. All division chiefs were granted their positions and served at the pleasure of the department chairmen. Overtures had been made to the trainee’s division chief from a neighboring university hospital for him to relocate his laboratory and personnel and it was likely that this being the best available option, he would accept. Although, no longer having the title of division chief, he would retain his research laboratory, federal and private funding and be given ample laboratory space with little to no clinical responsibilities. This latter prospect suited him fine.

It was while walking across the bridge on the way to the conference center that the conversation took place. The chill morning wind descending from the nearby Swiss Alps could be seen to cause whitecaps in the swiftly flowing river. “So, you have heard that I am considering a position at our neighboring medical school? “ “Yes, that is what they are saying” replied the trainee. He was well aware from medical center corridor gossip that in recent months the division chief had been criticized by many of his colleagues regarding his research interests, his in their opinion esoteric publications and his lack of clinical presence on the wards of the hospital. He had also failed to recruit new senior full-time faculty members unlike more robust divisions in the department and as his nationally renowned predecessor had done a decade earlier. The divisional teaching responsibilities were largely carried out by an enthusiastic junior faculty member and by a series of visiting professors’ lectures and conferences. Funding for these activities had come from the department’s coffers, a fact that the other division chiefs were acutely aware of. Funding for trainee stipends was dependent upon a National Institutes of Health training grant with a “pay back” clause for the trainee, to be satisfied by either clinical service in a Federally sanctioned position (the Public Health Service, employment in a hospital clinic in an underserved area of the United States) or cash. “Moonlighting” to supplement the trainees’ stipends

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was not encouraged but was also not prohibited. Attendance at annual national meetings was encouraged (and funded) only if abstract presentations or poster sessions had been submitted and accepted.

Despite this, the trainee was proud of his division, his chief and his accomplishments and the fact that he had secured this subspecialty training position.

“I have valued your work in the laboratory and feel you will make a fine researcher. As you are aware, grant funding is difficult to come by but I have confidence in you and will assist you in writing research proposals” stated the chief. Finally, the question was posed. “Will you be coming with me?”

Feeling particularly vulnerable while being in Europe alone, six time zones away from family and colleagues, about to present research results from work done in the chief ’s basic science laboratory at an international conference, the trainee was hesitant to directly answer the chief ’s question. He had spent his entire medical career devoted to and enamored with the medical college that had accepted him a decade earlier starting from a summer research internship in a basic science department prior to enrolling in the first year class through four years of medical school and three years developing clinical skills in a prestigious and competitive internal medicine residency.

“I have enjoyed our relationship, your mentoring and working in your laboratory. I appreciate the offer. I do however, have a strong and longstanding commitment to my medical school and will need some time to think about it,” he responded…

volume vii

Imagination Poetry

Mohamud A. Verjee, MBChB, MBA Celestial bodies glint, stars give way to sunlight What did you dream of if you can remember?

Were you ever afraid of the dark, silently frightened?

No fear now after night, and day starts, no despair Rays of steady warmth spread with golden fingers Caressing, chasing away delicate drops of dew Akin to scattered, precious, pretty pearls Balanced on sharp angled blades of grass Scent emanates when flowers open, petals freed Providing freshness in the morning air Gentle winds blow tree music, branches sway Leaves rustle with each gust, twigs wave as wands Tell me, can you catch the wind in your hand?

Diamonds of light dancing on surface water Colors bursting, false flames ablaze, reflect Red, orange, golden yellow as sunrise prevails Have you ever met an angel in your dreams?

Did you feel the comfort of a loving touch, On your brow, stroking away frowns of worry Peacefully, leaving you with a glowing heart?

Mindful wishes capture one’s imagination Only for night to resume its place later With the promise of a new dawn tomorrow Can you hear music ring in the ears of your soul?

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A Sunset and a Dream Photography

Erika Quinones

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Untitled Clay Sculpture

Jingjing Qi

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An Elk’s Breakfast Among Fumaroles Photography

Yellowstone National Park, Wyoming, USA

Kevin Ackerman

volume vii

Nello

Photography

Natasha Smith

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Glass, In a Study of Blue and Orange Painting

Zhenzhen Shi

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After the Darkest Night Comes the Brightest Day Photography

Anna Cheung

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My Bedroom Painting

June Chen, MS

volume vii

How to String Along (Effortlessly) Poetry and Photography

Maria Carrera-Haro

A vaccine is not a virus; it is in disguise, Posing as a virus, telling its white lies.

Your body thinks you’re sick, but your body here is wrong; It’s just that the vaccine is stringing it along.

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Metamorphosis of a Charm Dangling Part 1: Stereotactic Biopsy Poetry

Karin Charnoff-Katz, MD A lonely breast fits through the hole On the cold stereotactic table.

A petite, taut breast, cupped A perfect fit in a loving man’s palm.

Or a pendulous, pillow–like breast.

Or both once fondled aimlessly By a tiny person’s hand, The breast suckled Swollen with sweet milky fluid That enables others to grow.

Or a breast softened with age A flower long after its been plucked A balloon after it bursts.

Nipples with the subtle convexity of anthills Or the pointedness of a thumbtack Or inverted, invisible– A small child hiding in the hollow of his father’s knee.

Shades of pinks Or salmon.

Pale brown and not-so-pale brown.

Monochrome.

Kodachrome.

But all who own the breast Are united by the tight weave Vulnerability and fear As the breast hangs through the hole On the biopsy table Patiently waiting.

Secrets lurking in the guise of small white dots of calcium Fragments of a fractured snowflake That resist melting.

Instead, they linger, loiter Forging cliques

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“Groupings” that are indeterminate.

Or lines on the Rorschach of a mammogram Criss cross and double cross Distorting tissue that once grew Impeccably, in perfect form On the chest of a small girl Wandering through pubescence.

Cul de sacs open Into terminal ducts Spilling into progressively wider corridors As they approach the nipple Forming a segment.

The quintessential maze Rudely interrupted by cells that go askew Grow askew.

Patient prone Breast dangling. A charm on a bracelet Until it is compressed.

Incised.

Needled.

Blood pools under the table.

The clock turns.

Tissue samples are taken at 1 o’clock 3 o’clock, 5 o’clock etc…

We go back around to sample the even numbers.

Repeating the task with precision Daring not to skip Or to disrupt The clock that ticks for each of us.

The precious gift of time.

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Metamorphosis of a Charm Dangling Part 2: Preparation for Mastectomy Poetry

Karin Charnoff-Katz, MD A momentary fantasy.

An erotic striptease.

Hawthorne’s scarlet hoards my landscape.

Bright stage lights highlight uncoy gestures in an otherwise candle-lit room where passions are stirring.

A flawless reverie rudely excised as the nondescript hospital gown falls to the floor. A colorless puddle near my bare feet (the only hint of scarlet that remains is on my freshly polished toes.

Who doesn’t get a pedicure before a mastectomy?)

The gown that should have at least been pink is instead a faded blue, the color of water reflecting none of the natural light that creeps with trepidation through the small hospital window.

He takes a neon purple maker. Boldly one my daughter would have sketched with mindlessly for hours and deliberately draws geometric x’s and arcs simulating a pirate map for a treasure hunt.

His head cocked just so.

His surgical mask is worn like a scarf around his neck as he stares at my naked chest for an eternal moment waiting for inspiration.

Small breasts but they once, nonetheless, appeased the insatiable appetite of lovers and innocent offspring.

I was privy to watch them grow in my pubescent bedroom mirrors sprouting like anthills under construction in the cracks of sidewalks

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the process barely observable.

A scrupulous, meticulous endeavor.

Both gradual, and rapid all at once.

When fully formed the parade of silent ants swarm to celebrate the mound intoxicated by estrogens.

Nipple prominent.

Posture erect as if saying “Drink me� like the bottle of milk in Alice in Wonderland.

His eye, however, was cold and calculated devoid of even a trace of Wonderland stripped of uncontained lust of new lovers or an accepting embrace of a spouse or the glee of children who grew beyond suckling into squealing as my small daughter squeezed my nipples in a bath of lavender bubbles.

A strange grin on his face embarrasses me so do his purple marks.

Confident he can surpass Nature.

A self-absorbed artist conjuring his work in its conception.

The cancer lurking in my breast is not at all his concern.

That I own alone.

Branded with his purple ink I begin to understand the Jew tattooed with hot irons.

Numbered. Chickens readied for market.

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My Shoes Sketch

Brienne Lubor

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Stonerunner Photography

Keith A. LaScalea, MD

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Gonggong Short Story

Sophie Mou My mom was speaking in that incredulous tone of voice again. “Can you imagine? Gonggong thought that the soap was a bun, so Popo had to throw all the food in the steamer out!” My gonggong, my maternal grandfather, has had Alzheimer’s for the past decade, but his cognitive ability has been declining more and more rapidly since 2015. His life has been reduced to eating, sleeping, and going to the bathroom, and his world has become confined to our house.

Every day, he sits on his favorite seat at the kitchen table, where he can enjoy the year-round California sun, and he stares blankly across the room at the game of mahjong that my popo, my maternal grandmother, is hosting. It was a game he once knew how to play; though he was never the best, he’d had a strategy and a mind for obscure point combinations. But these days, when he substitutes in, his mahjong tiles are haphazardly arranged without continuity of suits. Though he still mutters the same phrases as before, like, “The dealer does not keep the east,” as he discards the east tile, he is not looking multiple turns ahead to maximize his chances of winning. But after the guest returns from the bathroom to resume playing, my grandfather is no longer needed and can return to his seat in the sunshine.

My gonggong was never an easily lovable man. My popo’s and his marriage had grown strained over the decades, and his children all have upsetting memories of his thorny disposition. Today, when he refuses to shower, my popo fumes at his stubbornness, but she is too tired to carry the grudge of caring for him in their old age. When he arrives to the toilet too late, my mother scrubs the bathroom floor clean with annoyance on her face, but she still prepares him his favorite breakfast. My mother and my popo constantly refer to taking care of him akin to looking after a toddler without any hope of respite. Still, the earliest resentment has long since faded to resignation, to a new daily ritual. They are resolute about the decision to keep his care at home, to be assured of maintaining his humanity and his dignity in his deterioration.

Today, Gonggong sits quietly, not speaking unless addressed, but his eyes are fixated on the steamer, as the fragrance of his favorite buns waft out.

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Casual Dating; Or Why We Need a New Flu Vaccine Each Year Poetry

Maria Carrera-Haro I can’t be all things for all people All I can do Is target you The way you are right here and now But you’ll grow strange You’re gonna change And I won’t be the one for you Anymore I cannot be your everything I’ll be the one You think is fun I’ll make you happy here and now But when you sigh Although I try I cannot be your forever On and on

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Bison Grazing Beneath the Teton Range Photography

Grand Teton National Park, Wyoming, USA

Kevin Ackerman

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Shoe Repair Photography

Freddie Scott

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Across a Rise Poetry

Mohamud A. Verjee, MBChB, MBA Who was the person that wrote this note?

And tossed expressions of love with abandon Across an ocean perhaps, it travelled a distance Hither, thither, wherever the current took it Prize open the crusted cap, it pops off as in relief Pent up stale air dispelling like an unseen genie Inside, a curled paper ready for extraction Will its written words reveal a deep dark secret?

Who knew I would find it, purely by chance Do I have a duty to release bottled up passion?

The date seen is the first shock, over thirty years ago Script apparent and faded, stylish, still legible Not in jest were some tender words of love voiced Or was it a cry from a wounded heart?

Try to imagine the mood of the person A slipped friendship or a partnership broken And the love of one knows no bounds for another Willing to embrace all the exigencies, committed Loyal, dedicated, unflinchingly giving, loving Parting from a shared heart is not without cause

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Question Why Poetry

Lakshmi Menon Question why A patient posed On our burgeoning quest To keep her afloat Question how A nurse rose To the occasion and Carried the family to shore Question who A child blinked rapidly At the surgeon’s face, Obscured by rubber gloves Question where Accident in the night Line could get cut Please stay awake Question when Waiting to see him, A final test to review, A bomb in their clasped hands Question you The couple at the ER, Watching their baby With a halo of action Question you Will you commit your life to me?

Thank you.

Thank you?

Thank you.

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Dendrites of Manhattan Avenue Photography

Samantha Shetty, MS

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Liquor Store Photography

Freddie Scott

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Yellow Happiness Photography

Photo taken at the 2017 Orchid Show at the New York Botanical Garden

Jacquie Howard

Photo taken at the 2017 Orchid Show at the New York Botanical Garden

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Pinkie Tropicate

Photography

Jacquie Howard

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So Many Are the Questions We Are Left With When We Know We Can No Longer Ask Them.

Short Story

Paolo de Angelis October We waited, and waited, and waited some more, compressed within a tiny room in the hospital’s busy Emergency Department. I was there with my patient, her family, and with her cancer too; lately, in its advanced stages, her disease had metamorphosed into a human-like presence. I felt it following us relentlessly at her appointments; I felt it waiting with us as a silent spectator, as a constant reminder of what was fast approaching. The doctors sensed it too, just like the nurses; you could see it on their faces.

It was probably 8 pm, but I couldn’t tell; time had mutated into a fluid, almost foreign concept that now seemed to carry very little meaning.

There were no clocks in sight, no windows that could help determine how late it was. All I could do was guess. I did not have to be there yet I found it almost impossible to leave; she was sick, her family was too, and despite providing little care, I felt my presence sometimes served as a distraction, a way for her to fantasize and wander back into the past.

I felt lost, almost wanting to burst out of the claustrophobic room we were relegated in, frustrated and angry at what I felt was a paralyzing inability to help. Though, an illogical sense of guilt kept me there, frozen in a corner.

Useless, I stared at the monitors, and followed the squiggly lines of her heart rhythm. Normal sinus. As a 1st year student, in my first months of school, I lacked most, if not all means of tending to others; nurses where puzzled, seeing me donned in a white coat yet passively observing. And so, I stayed, quietly waiting for those who knew how to help to offer both of us some relief. *** They waited, and I with them. It had become our routine: I causing her to have unpredictable crashes, and him coming along to witness the grim spectacle; he showed up, time after time, almost like a faithful dog strolling alongside his owner, quietly following in the background.

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I was surprised when I first saw him, a pleasant new addition to the carousel; he appeared right as the semester began, and it took me little to understand he was new to the game. His attitude continuously oscillated between that of a naĂŻve, curious pupil, and that of a deeply melancholic old timer, with his gaze first jumping across the room, excited by the novelty of the situation and then abruptly pausing projected into nothing, eyes emptied by the realization that his learning was coming at a cost. The promising excitements of medicine quickly receded in the background, crushed by the understanding that I was eventually going to prevail.

I could see through him, his emotional struggles evident and poorly hidden behind what he thought was a calming and reassuring presence; the boy had a lot to learn, and what a pleasure it was to know that I was his puppeteer. I was glad I had a new toy to play with. Her family had become too accustomed to the drill. After all, it had been almost two years since I had made my first debut into their life. Unexpected, I wreaked havoc, careful to disguise any sign of my coming; I burst into life within one that was far from being finished. Whatever the doctors did, I found a way around it; surgeries, drugs, trials all failed repeatedly.

Experienced, and playful, I feigned remission, and then exploded back again, like a colorful firework. I caused pain, excruciating at times; I consumed her from within, spreading relentlessly into the distant recesses of her body. Yet, every time I thought I had finally broken her, she bounced back, more determined than before. The nausea, the hair loss, the cachexia seemed only dent her frail body, leaving her spirit wounded but intact. He saw it too, and from it he drew the courage he needed to go on. Today was no different; waiting was the only constant in their unpredictable drama.

January It had been a while since I had last seen her. Time had passed but the constant notes kept me updated with her inexorable decline; urgent care visits, requests for home hydration, and the failed experimental trial were all entries I found stacked in her EMR. Months of uncertainty smoothly reduced to a few lines. The aseptic language, the concise and almost nonsensical acronyms, and the overall brevity of the writing transformed what I knew were grueling and often agonizing experiences into a sterile sequence of events; in it there was no place for pain, and no acknowledgment of her impending parting. I was anxious as I waited, uncomfortably shifting positions in the plastic chair.

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*** She walked in, braced by her older daughter, and slowly shuffled towards the front desk. The warmth and grit I had grown accustomed to were gone; the cancer had left behind an empty shell. Her mind seemed to have migrated to a different place, detached from its crumbling casing, away from the oversaturated white spaces of the clinic.

Shaken more by the damage that appeared to have been done within than I was upset by the changes in her physical appearance, I slid, respectfully, in the background, once again quietly decorating the room we had been placed in. Time had taught me what my role entailed, and I no longer agonized over what at the beginning of my journey I felt were deficiencies on my part; silence and composure now felt safe.

I let my mind wonder, imagining to observe the room from above, then moved around, closed-up and cut back out, like a director piecing frames together for a movie. Whenever the opportunity to talk or to connect with her presented, or my clinical attention was required, I snapped back to reality, only to then drift back out. Waiting was no longer painful, and time seemed less dilated than it had once been.

March She had cancelled her last two appointments. Notes of phone conversations between family members and the doctor’s secretaries suggested she was too sick to make the usual journey from home to the Upper East Side.

I imagined her in bed, peacefully wasting away, surrounded by family; her hair was still there, short but resilient. I imagined no pain, or at least hoped for none. Weeks passed, entries on her medical chart became scarcer and no appointments were being scheduled. Things had settled in, no more treatments, no more trials; I wondered whether she had decided it was time, or if it had been the disease deciding for her.

I kept checking the schedule, I needed to know she was the one who had chosen. I kept checking the schedule knowing too well nothing was going to pop up. She never came, and I never called, perhaps too scared to hear the answer.

Day after day, I logged in, until one morning, an unfamiliar message appeared: “This chart is locked. You are trying to access the record of a deceased patient. If you wish to continue press OK.� A somber epitaph.

I was not shocked; death was a sad, though inevitable conclusion.

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We had all been preparing for that message, perhaps in different ways.

I had convinced myself passing was the solution to her cancer; in the last few months, therapies had become a futile exercise, a bitter and hard to swallow placebo pill with barely any physical benefit. She had been my first patient, and one of my first true teachers; what she taught me consciously and unconsciously, and what I learned through being let into her life will be with me for the remaining of my journey in medicine.

I called her daughter and left a message; my first condolences as a doctor in training were artificially easy, with no one on the other side of the line. My first experience with death had been too distant, lived remotely from the comfort of my chair.

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Cloud Painting

P.S. Nandini

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The Color of Home is Blue Photography

San Francisco, California, USA

Benjamin Jackson

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The Plans We Made Photography

Sunset Beach Park, Vancouver, British Columbia

Herie Sun

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Skeleton Photography

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The Little Flamingo Poetry

Yaniv Kazansky The doctor says that since your last visit Your body has gained an entire kilo.

As he talks, I look you up and down And among the bruises of your chemo Try to figure out where it could possibly be.

It isn’t hiding in the thick, pink, fluffy jacket That you can’t take off in the indoor heat, Or in the bird legs it hangs over, The knobbly knees and tiny feet That leave me amazed that you can still stand.

It isn’t cradled in your little arms, Wrapped around your father’s knees, Or your thin fingers forming a nest of twigs, Ready to break at the slightest breeze, Though with strength enough to hold him.

It isn’t in your head, I can see that most plainly, How feathery wisps fail to hide your pale, dry skin, Or the little neck beneath it, ice cream about to fall off its cone, Or the big cheekbones that make your smile look thin, Although you still smile from ear to ear.

So where is the extra kilo? And what chance can it give you?

Perhaps one in nine, says the Kaplan-Meier, But you’ve yet to learn the math to know what that means.

After half your years fighting, do you ever tire?

Even in the exam room, you still play with such life.

I am thrice your age, will you make it to mine?

Or are you a bird that will never fly?

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The MRI Tech Poetry

Rachel H. Kowalsky, MD, MPH It’s 11 PM and the tech clocks out at 11:30, So he is angry that my patient needs an MRI. “I want to go home,” he says, dreaming of dinner and bed and perhaps his wife.

But then he sees the boy: an eloquent tangle of limbs, Bent and folded at amazing angles, The vectors all wrong.

“I thought you had to leave,” I say, And he says, “That was before.”

Off they swish through the yellow hallways, The boy perched on his cot like a poem, The modern sort without the proper punctuation and yet you understand exactly what it means.

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Spring Field Photography

Shahnaz Mohammed

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Snow of April 2018 New York Photography

Vijay Soni, PhD

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'MERICA Photography

Wooram Jung

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First Kiss Sketch

Brandy Holman

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Abstracted Remarks made at the Fellows Graduation at Brooklyn Methodist Hospital, Division of Hematology and Medical Oncology Speech

Richard T. Silver, MD What are some of the attributes I think important for success in medicine? The first are the three As developed by me from observation.

Basically the 1st is for “availability”. How often in your career have you heard a physician or nurse reply, when asked by a patient or colleague with a problem, “who should I call?” The answer is “call Dr. X, he or she is always around and he/she is such a nice person. No one ever says: “yes, he or she reads Blood and the Journal of Clinical Oncology each month” or his class rank.

Several months ago, I tried to call one of our busy gastroenterologists to discuss a patient referred to me by her, whether or not we could start a certain drug because of an underlying complication. I am still waiting for the call back. This is not a good way to maintain a consultation practice, let done develop one.

The second A is for…. affability. One of the most successful physicians I ever encountered was a dapper, charming, impeccably dressed medical attending. He had a huge practice! He had office hours in the morning, and played bridge and poker in the afternoon. He knew very little about medicine but he loved to practice it. He accompanied his patients whenever possible to a consultation. Today we would say he had a concierge practice. He was always available, and he was superaffable, but he really lacked the last “A”.

The last A is for ability. Ability may be more important in the surgical specialties where personality in the OR is less important.

Bearing a relation to ability is being “smart”. Never worry about whether or not people are smarter than you, or if you know enough…

I guarantee you, there are many people smarter than you and you will probably never consider yourself smart enough to satisfy yourself and feel absolutely secure. Indeed, a letter in the NEJM by Dr. Susan Coven in May 2017 describes the problem as the “imposter syndrome”, an insecurity syndrome young physicians feel about understanding such things as 2nd generation sequencing or the coagulation cascade. Since

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in your mind, you may think you may not be smart enough or know enough, accept the fact that you will never know everything. Just realize that you live in a world of ignorance, and do not be frustrated by it. Having come this far, you are smart enough and know enough and do have the ability, to advance your career.

Now, accepting the fact that we live in a world of ignorance, don’t take it personally, as you advance, if someone makes a snide remark because you didn’t know something. Never be afraid to say “I didn’t know that”, or “thanks for telling me”, no matter what your rank or position, I do it all the time. I still remember many years ago, the dumbest guy in my medical school class. He was a person who kept constantly asking questions and kept saying “I didn’t know that, I don’t understand this”.

How surprised we were at graduation when he gave the AOA address as the number one in our class.

Remember that even after all your great training, it is just the start. You are still exploring. One of the remarkable things about medicine as a career are the opportunities available to you. Try new things. The best opportunities happen by chance and often, one doesn’t realize they were coming. On the other hand, if you push too hard for things to happen, most often they will not. Likewise, you must feel that you are doing well even if you’re not, or many of the things you are doing.

Remember that your professional career and life is a series of experiences. Embrace and take advantage of new things as they occur by chance or otherwise.

Whatever you do, you will have to continue to work hard. As Mark Twain said, the only place where success comes before work is in the dictionary. But, hard work doesn’t end with fellowship. Don’t believe that anyone owes you anything just because you have been certified by several specialty boards. And beware of institutional affection; you may love your new hospital, but it won’t love you back.

People always speak about having a “passion for your work”, it is great if you do, but it is tough if you don’t. But you must remember not to quit when things go bad. If you want to build your career, be prepared to go through dark and painful moments when you are trying to build something. Engage in the struggle. Nothing comes out of easy days.

Be very conscious of how you spend your professional time and try not to waste this very precious commodity. Make your work meaningful and do not fool around. If you do any research as clinicians, carefully make sure it is meaningful even if it is a simple project. Plan how you will be included as a co-author, and not as a footnote, and how your effort related to the paper will be included before you get involved.

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You should always feel that you are continually growing. Remember, success is not a race. Some of my best research work occurred when I was more than 60 years old. But when you try new things, and you have done you level best and it is not working, learn when to let things go, especially before age 50.

If you believe you have found a meaningful calling, and you commit to it because of your enthusiasm for your work, all good things are possible in medicine. Nothing is more meaningful, and if you can adjust to the external trivia of today and its limitations, you will have a very satisfying professional life. And professionally, that’s remarkable.

Not many folks can say that.

In these past moments, I have tried to share with you some of my thoughts, ideas, and experiences that I believe appropriate on the completion of your fellowship. Later when you have a coffee together and share this talk with your friends or spouse, I hope when asked “What do you think of Silver’s presentation?” you don’t reply “same old stuff ”.

If it was the same old stuff however, it was not an accident, because there are generational truths, true for our fathers and mothers and grandfathers and grandmothers, physicians or not, who were basically no different from us. If it was not entirely the “usual stuff ”, it is because my professional and personal life is colored by its own unique features as yours will be in the coming years.

Hopefully and more likely, it is a combination of both, because the more things change the more they remain the same. But they do change. We all share as physicians and human beings, a common set core of values, but modified by our own personal experiences and beliefs. And that, ladies and gentlemen, is as it should be.

Above all else, have as much fun for yourselves as possible.

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Untitled Painting

Tara Pilato

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Untitled Photography

Montreh Tavakkoli, MD, MA

Dubrovnik, Croatia There was no laugh like hers. It left her mouth as bright and pure as the rays of the sun. Enveloping everyone around her in its warmth.

This woman who gave him freedom. Everything about her was bold and he cherished each moment she chose to be his. Thanking her every day for that beautiful laugh, that reminded him how lucky he was to know a love like hers.

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On the Prowl Painting

Tasheika Grizzle

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Changes Essay

Sarita Ballakur Since I can remember, I have spent my summers in India with my maternal grandparents. These summers were spent in a lazy bliss: watching tv dramas at their flat, going out to my favorite restaurants, and cutting vegetables for my grandmother. This past summer was no exception. This time, I had gone as a soon-to-matriculate medical student – something that my grandparents were extremely excited about, especially my grandfather. As the lone doctor in the family (cardiologist/internist), he was so happy that I would get to experience the world that he lived in everyday.

Two days before orientation, I was still in India, saying my yearly farewell to my grandparents. I touched their feet and gave each a hug.

“See you soon,” I said and then gave a line about how I was waiting for them to come and visit me. “Sure, sure,” they replied, though we all knew it wouldn’t happen. I would just see them the next summer. It was the usual, casual goodbye – everyone was healthy, Devaru and our gurus were looking over us, and we were all very secure in that.

In January, I found out my grandfather died twenty minutes before the first cardio exam. I woke up to a text of condolences from my aunt. “Oh no…” I kept repeating as I hurriedly showered, threw on clothes, and headed to my exam. “Oh no.” I was numb. Halfway through the exam, I started crying and left the room to call my dad, to ask if it was really true.

During the next three months, my family went to India to conduct the death rites and I made a conscious decision to lock my grief away and get lost in the stresses of school. When I returned home during spring break, my mom gave me a big, long hug, and I began to feel the sharp, consuming emotions of grief and sadness yet again. She then let go of the hug, to give me my grandfather’s stethoscope. The one I had seen around his neck for years – while sitting in the car, while examining my sister, while sitting in his clinic. At this moment, it all felt real.

Right now, his stethoscope is sitting on the corner of my desk. I used it yesterday, to listen to the heart and lungs of a jaundiced patient. It’s surreal that it’s with me, but also heartbreaking, as I keep realizing that when I go to India this summer, I won’t be able to tell him that I used it. I feel unsettled. Things have changed, but I don’t think I’ve fully accepted it yet.

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Read Painting

Hanof Ahmed

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Market Place, Helsinki. Color your plate with nature's palette. Eat "real food" for optimum health and sustenance.

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Nature's Color Palette

Photography

Sohaila Cheema, MBBS, MPH, CPH

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On A Rainy Day Painting

P.S. Nandini

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Manic Pixie Dream Girl Cowboy Poetry

Steve Stay Maybe you've seen a film or twelve Of the type I'm about to describe.

It involves a man who's content enough, But I guess he's not really "alive."

See, his way of life needs fixing.

It's clear he needs to be saved, So manic pixie dream girl Shows up to save the day.

Named something carefree like "Summer" She turns his world upside down.

Every day with her is a montage Of wine and daisy crowns.

She's small, cute, artsy, and quirky, And in bed she's like a fox.

Her only purpose is to open his eyes To beauty outside the box.

Oh manic pixie dream girl, How could you do me wrong?

I wore your lousy daisy chains.

I sang you lots of songs.

But life ain't like the movies, And girl, neither were you.

Oh, manic pixie dream girl, You broke my heart in two.

The movies sold me this story.

I believed it with all my heart.

So when I started dating, I knew just where I’d start.

I'd fall for a Barbara Streisand Or a Zooey Deschanel-My own manic pixie dream girl-And she'd fall for me, as well.

Perhaps it won't surprise you That's not quite how things worked out.

Oh, I fell for a pixie dream girl, But let's just say... she had her doubts.

I pined for her for ages Before I finally asked myself,

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"Are you really the kind of guy Who'd be happy married to an elf?"

See I like life predictable, Routine suits me just fine.

Messes drive me crazy, And we Mormons don't drink wine!

I wrote poetry and danced just fine myself Before you came along.

I didn't need some manic Muse To inspire me to write a song.

Oh, manic pixie dream girl, You walked out of my life.

But then I got to thinkin' "I don't need you for my wife."

I never understood you Anyway, so I guess it's true: Oh, manic pixie dream girl, I'd gotten over you.

So I looked for someone normal; I consciously changed my aim.

Reshuffled my priorities To search for someone sane.

And now I'm happily married To a dream girl who's serene.

She works really hard and gets things done, And she's the prettiest you've ever seen.

She doesn't ride a scooter Or put flowers in my hair.

But we've got three beautiful children, And their art is everywhere.

We're happy to think inside the box, We don't need to be carefree.

And is she like a fox in bed?

Well... that's between her and me.

Oh manic pixie dream girl, You never were for me.

I'm sure some other fella Needs a woman who's wild and free.

I married someone mellow, And I'm happy without you.

Oh manic pixie dream girl, Well, I hope you're happy, too.

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Snowman Sketch

YiLi Zhao

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My Friend the Doctor Essay

Susan Clark Ball, MD, MPH, MS My friend is an obstetrician. My friend is a little unusual in that she is in solo practice, delivering her pregnant patients and not sharing this responsibility with a group of other doctors. Because of this she often develops intense and meaningful relationships with the women she cares for. In their work obstetricians witness the most joy, by far. But when they witness sorrow it is of the deepest kind. Rarely is there any way to bridge the two extremes. But sometimes there is a kind of grace.

My friend was taking care of a woman whose pregnancy was not going well. The baby was too small and seemed, on sonogram, to have some odd deformities. The parents declined further evaluation of the possible fetal abnormalities. On sonogram, it was also clear that the patient’s uterus was too small, either bicornuate or with a septum, something restricting the baby’s growth in addition to whatever may have been intrinsically wrong with the baby.

She saw the patient for frequent monitoring but of course had other patients progressing in their pregnancies and she delivered new New Yorkers every week or so. In early April the patient’s uterus was too full and labor began despite the baby being three months from its destination delivery date. Steroids and bed rest in the hospital did not arrest the eventual labor and delivery. A little boy was born. Too, too little. Under two pounds, a possibility, a little breeze of promise. And initially, with the heroics that are now so possible in sophisticated neonatal intensive care units (NICUs), he did all right. A little baby boy.

She was not happy that the birth had come so soon but she visited the patient and the baby and like everyone, she hoped that things would go well.

She delivered a few more patients.

Two weeks later the little baby boy deteriorated and my friend went to the NICU to sit with the mother, her patient, and the baby’s father, the boyfriend. They were bewildered. They’d watched for two weeks as their tiny son had lived under the lights and with the tubes in arms and nose and they had not even held him, their little, tiny son whose name, I will say, was Clive. They called her from upstairs; another patient had come in so she left her patient and the father and went to the labor room where the next patient would deliver in a few hours. The patient’s parents were there and the nurse assigned to the woman had

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established a good rapport, an important asset, as the patient had over the months of her pregnancy been challenged to accept the medical recommendations of my friend as she navigated the complexity of pregnancy and trust. But now the baby was on its way and the nurse would be a valuable help for the patient to deliver her baby.

My friend went back to the NICU. She stood next to the bassinet which held Clive and all the attached equipment gathered like a campfire around that bassinet, the parents sitting in chairs next to the campfire.

She watched the vital signs, the blood pressure, the heart rate, the oxygenation. All started to fall just as she stood there watching. Lower, lower and then the code was called and the crowd gathered to do what they would do to try to keep Clive alive. She went to be next to the parents and they watched together as the code went on and the tiny child was given more oxygen and more drugs and pumped and prodded and who knows what else behind those doctors as they hovered over that tiny, tiny little life.

Clive died.

The mother did not want to hold him. She had never held him. She’d sat by his bassinet for many hours, not all day but most days and many hours. She didn’t want to hold him but one of the residents who had taken care of tiny Clive for these last two weeks knew that mothers suffered and that while holding a dead child is inconceivably suffering, it can help mothers and help fathers and help families to believe their own unimaginable grief for the death of a child. My friend took the baby from the resident, once the tubes and lines were removed, and she put the baby wrapped in a blanket into the arms of his mother, who bent her head over her son’s head and gave him his first little forever kiss. And after a moment my friend passed the child to the baby’s father. This young man, generously tattooed and silent, held his dead son as gently and tenderly as any flower is touched by morning dew.

With a quiet heave of his shoulders, suppressing his sob, he looked down into the still, little face and he whispered to him, his face nearly touching, “I always wanted a son. I always wanted a little boy. Here you are my little boy. I had such a hard life and I messed up so much but I wanted you. I wanted a son. And I’m so happy I had a son. Thank you Clive, thank you. I’m so sorry. I’m so sorry.”

She stood near them and they passed the dead baby back from one to the other and murmured to him and tears came down. After nearly an hour she went and got a chair and then went and got one of the NICU nurses and sat her in the chair next to the mother and the father holding their child. She asked the nurse to sit there for as long as she

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could, to just sit with that grieving couple as they held their dead baby.

Then she went back to the labor room to see her patient and bring into the world a new baby. The patient pushed hard and worked with my friend, her obstetrician, and the great nurse that had been assigned. The husband was holding his wife’s hand and supporting her. They hoped for a daughter. My friend communicated with the parents who were in the delivery room sitting behind a curtain and the patient’s father mentioned that long ago they’d lost a son in childbirth. And now a new baby was born. A boy. Normal, crying, healthy, fine.

At one point my friend realized that the new mother’s initials, SH, were the same as her own and that the patient and she shared the same birthday. The mother held her newborn son and commented that she wished her older brother had been there to see the new baby, she was naming him after this brother, who had died.

Downstairs was a male child born at twenty-eight weeks who had died whose mother had a bicornuate uterus.

My friend went to find the grandparents behind the curtain and to tell them that all was well and the baby was a boy. She remembered when she’d first interviewed her patient and gotten the detailed obstetrical history from her and what that had revealed about the patient’s mother.

A bicornuate uterus. Three decades ago a woman had lost her baby boy at twenty-eight weeks. Now this same woman had a new grandson. And the baby’s mother had the same initials and birthday as my friend.

She went back downstairs to check on Clive and his parents. But they were gone. One of the nurses in the NICU commented that she’d thought my friend was a grandparent of Clive because why else would she be spending so much time with this bereft couple and their dead child. Doctors don’t usually, or ever, do that. My friend takes care of her patients in a way that is a little unusual these days. She sees a lot of joy, mostly joy. And sometimes she sees profound sorrow.

How life can breathtakingly surprise us, even in its inscrutable complexity.

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Summer Train Photography

Shahnaz Mohammed

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Mountain Bluebird Atop Its Perch Photography

Yellowstone National Park, Wyoming, USA

Kevin Ackerman

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The Sky and the Water Acting As a Mirror for Each Other Photography

Inner Harbor of Baltimore, Maryland

Sohaila Cheema, MBBS, MPH, CPH

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Rows of Metabolism Photography

KH Miao & JH Miao

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Buffer Glitch Poetry

Sean T. Pompea White wine on the back porch in August— Was that the time you said that thing to me?

I see it so clearly, we were by the sliding door, and The sun was going down And it was sad and beautiful like these scenes always are But I don't know if this memory is real Or something I saw in a family feature film Recorded in SLP mode on the Hitachi VCR— I was the only one growing up who could program it— I'd stay up late to record songs off the radio: Technotronic, the KLF— The color composition with its golden palette The decanter, the long shadows, someone leaving with a suitcase Such a sad scene—snowy, distorted: VHS Would they ever come back?

Moments like these let me know That one can't trust one's mind entirely That time we kissed while Pressed against a wall in the tight corridor Near the bathrooms while people pushed past In that crowded, sweaty nightclub Somewhere in Denver—our sprawl— All those screens glowing— That monotonous resonance punching the air— You had to press your lips against the base of my skull to tell me that thing At 1 a.m. we took the rail to your apartment Two years in Taipei That stroller I could never get folded up correctly That lock of hair that was wet and matted on your temple While we waited at Songshan One September afternoon I held our daughter with one arm While I dug for formula in the diaper bag A small hand patting the stubble on my chin That airport terminal that felt like The indoor soccer complexes I knew as a child The high ceiling, the tall concrete walls

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The bar was next to these rows of plastic tables featuring Video poker and blackjack consoles I sipped my sidecar Alone in a bath of fluorescent light In the middle of the night I'm sitting at my desk I took the battery out of my phone days ago The T.V. dinner—two enchiladas and a burrito With beans and rice—uneaten beside me This Toshiba word processor with its yellowing plastic Might break down any day now The sound of it whirring like an old mainframe Mingles with the air conditioner's white noise and A copy of Music for Airports on the turntable Meaning comes from not knowing From not needing to know Gibberish streams across the black-and-white L.C.D. screen

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Basilica, Venice Photography

Jennifer Akl, MPH

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Cheni

Musical Piece

Esteban Fridman, MD/PhD

Albrecht Dürer at The Met Data Visualization

Suzanna Schmeelk, Ed.D.

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Darkness Video

Ramez Bodair

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Ascensus Volume VII Ascensus is a student-run organization at Weill Cornell Medicine whose mission is to bridge the humanities and medicine through publishing an annual journal, along with holding events including lectures, workshops, and open-mic nights. Ascensus was founded by a group of medical students in 2011 to provide a space for students to reflect on the practice of medicine. Since then, it has grown to engage all members of the Weill Cornell community, including medical students, graduate students, faculty, house staff, nurses, social workers, administrators and more.

Over the past seven years, our Journal has featured rich visual, written, and multimedia work by these members of the Weill Cornell community.

The Ascensus Staff takes pride in the quality and diversity of the creative pieces showcased each year and hopes to continue serving the community through this publication and our events for many years to come.

We would like to encourage all members of the community to continue pursuing their creative passions as they reflect on their professions and the human experience. We look forward to receiving submissions for next year’s journal!

Lastly, we would like to thank our advisors, Dr. Susan Ball, Dr. Randi Diamond, Allison Lasky, and Jasmine Lucena. Ascensus is published with the support of Weill Cornell’s Office of Academic Affairs and the Liz Claiborne Center for Humanism in Medicine.

If you have any questions, would like to submit, or want to know how to support the journal, contact us at wcm.ascensus@gmail.com Follow us on instagram @ascensus_wcm