Black Diamonds 2024

AN ARTS & LITERARY MAGAZINE GEISINGER COMMONWEALTH SCHOOL OF MEDICINE VOLUME 11 | 2024

Cover Image Black Diamonds Iris Johnston

Black Diamonds is an arts and literary magazine of Geisinger Commonwealth School of Medicine. All content is the property of each respective author/artist. No part of this magazine may be reproduced without the permission of the author/artist of each submission.

Geisinger College of Health Sciences is committed to nondiscrimination in all employment and educational programs or activities. Concerns or questions may be directed to the Title IX coordinator whose contact information is available at geisinger.edu/titleix.

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or thousands of people living in northeastern Pennsylvania (NEPA) during the 19th and 20th centuries, coal was precious. It was the black diamond they mined and the substance that supported their

lives. Formed in ancient times under the massive pressure of the sediment above it, coal became the foundation of an entire economy in NEPA. That economy has all but vanished from this part of the country, but today, NEPA is witnessing the formation of a new and valuable resource. Created under the pressure of a great need for future physicians, Geisinger Commonwealth School of Medicine now exists. New students are coming into NEPA every year to begin the process of being transformed into physicians through the steady, constant pressures of medical school. And like the rich veins of coal that extended through the region, these future physicians are now stretched across counties in northeastern and central Pennsylvania. For many of these students and their teachers, the arts are an important part of life outside of medicine. Our hope is that this journal can serve as a showcase for their expression and be an inspiration to those who read it.

Zachary Wolfe, MD MD Class of 2015

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Storytelling: Humanity’s Currency 6 Home is a foreign place 7 UKhahlamba-Drakensberg Park 8 W h at L i l i t h s a w 9 A Simple Pond 10 Shakti 11 So much to Explore 12 A n t i c i p at i o n o f A b s e n c e 1 3 Rose 13 Smell the Roses 14 Sunny Side Up 19 My Castle 20 Drinking it in 21 C o n t e m p l at i n g L i f e 2 2 T r u ly H u m a n M e d i c i n e 2 3 T h e S i m u l at i o n C h o i r 2 4 Praia de Gelo 25 Migraine 26 Silky Shore 27 Looking for endless horizon 28 W a v e s a n d W at e r D r o p l e t s 2 9 N at u r e ' s P a s t e l s 3 0 The Inner Turmoil of An External War 31 Sunset Butte 32 Shadowing a Shadow 33 Barred Dreams 34 She's a Hard Stick 35 W i d o w ' s L a m e n tat i o n 3 6 Ta l k i n g i n C i r c l e s 3 7

38 23 39 Deeper Meaning 40 Transcending Mediums 4 1 S t. C r o i x 4 B at t e r e d b u t s t i l l s ta n d i n g 4 2 R a d i at i n g s o m e y e l l o w l o v e 43 Strolling through the gardens of V 44 Garden 45 Serenity 46 Diagnostic Dialects 4 7 A M e d i c a l S t u d e n t i n P at i e n t ' s C l o t h i n g : A Personal Reflection 50 Back Country Pinnacles 5 1 M i l k y W ay P i n n a c l e s 52 Community Immersion 5 3 O f f S e a s o n S a n ta 5 4 D u a l i t y o f C at s 55 Season of Color 56 Finding the Well 5 8 M o r n i n g S u n i n t h e M o u n ta i n s 59 Thanks Mom 6 0 S o m e d ay 6 7 S t. C r o i x , C o A s t l i n e 68 Before I die 6 9 D a i s y B u t t e r f ly 70 Living like Lupines 71 Noor 72 Quién Eres 73 Cracked Egg and Ant 7 4 I n Ta l l B u i l d i n g s 5

Storytelling: humanity’s currency Amanda Caleb, PhD, MPH Editor-in-chief Writer-physician Dr. Emily Silverman describes storytelling as “medicine’s currency,”1 the medium of exchange and

Storytelling is a journey of discovery, one that can lead to painful and poignant insights that move us to feel and to do.

value that bridges gaps, fosters relationships, and helps to make meaning of one’s experiences with health and illness. Perhaps more accurately, storytelling is humanity’s currency, our means of trading bits of ourselves for bits of others as a reminder of our interdependence. As poet Amanda Gorman notes, “We tell stories because we are human. But we are also made more human because we tell stories.”2 If humans are at the heart of medicine, surely storytelling is too.

From its inception, Black Diamonds has provided a space for the Geisinger community to share their stories that are foundational to who we are and who we want to be as an institution and as people dedicated to the care and health of others. As this year’s cover image suggests, storytelling is the fabric of Black Diamonds: the submissions are stitched together as a journey through storytelling—from feeling lost to finding home—and finding oneself. The editorial board invites you on this journey of discovery: be

To tell a story—whether through words or images—is to

vulnerable, embrace others’ vulnerability, and invest in the

expose that which is obscured, which includes not only the subject matter but the storyteller and listeners as well.

very human exchange of stories.

The storyteller’s vulnerability is rewarded with the catharsis Silverman E. Sharing and healing through storytelling in medicine. JAMA Intern Med. 2017;177(10):1409-1410.

of the process; as twentieth-century author Henry Miller

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once reflected, “along the way one discovers that what one

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Blow P. The big question: why do we tell stories? The New York Times. December 5, 2022.

has to tell is not nearly so important as the telling itself.”

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Miller H. Reflections on writing. In: Miller H, The Wisdom of the Heart. New Directions; 1941:17-30.

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Home is a Foreign Place

Sofia Muniz MD Class of 2027

Maybe years, months, or simply days have passed.

But at one point, you may have to go back.

And even though you hit pause when you left that place, People ignored you and continued on at the same pace.

So, to put it simply: things have changed.

And you are left wondering what to do in this case.

The simple act of talking brings on new phrases that you did not know, And so the same language becomes a foreign one, With every conversation bringing the fear that you will not understand.

People do not dress the same, and the food somehow has also changed.

There are a million stories they want to tell, And they keep reminding you that you have changed.

But how can that be true, when you were the one that left, But they were the ones that did not stay the same.

What to do when the so familiar place Becomes a foreign one too, And the image you had in your mind Does not reconcile with the one you came back to.

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UKhahlamba Drakensberg Park Rakhi Ratanjee MD Class of 2027 Just after a summer drizzle, a mix of foliage glistens in a magnificent valley in the uKhahlambaDrakensberg Park in South Africa.

Deemed a world heritage site, this park separates Lesotho and the Eastern Cape of South Africa and it is named in both Zulu and Afrikaans to reflect its complex colonial heritage: “uKhahlamba” means “barrier of spears” in Zulu, and “Drakensberg” means “Dragon Mountains."

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What Lilith Saw

Amanda M . Caleb, PHD, mph Professor of Medical Humanities

was nothing less than hell enclosed by the unruly emerald leaves, the pink flecks of azaleas against a sky of wedding white dogwoods. Entrapped by ancient acacia, catching her naked form with every wrong gesture, holding her prisoner, capturing a body, not a soul.

A seductive whisper of false intentions to the man behind the forest walls, the threat of leaving him to prepare his own food, feed those holy creatures he loved so, tend the lush internment camp.

The flash of blemishfree skin, the blur of beauty, running fast past wild hibiscus, ruby roses, razor thorn guards pulling her back.

Without the forlorn look of a lover glancing over a trembling shoulder, she split the sea of baby’s breath with the knowledge that He didn’t throw her out; she chose to leave.

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A Simple Pond Ashley E. Kimble MBS Class of 2025 A small pond would seem so ordinary, but from up close, it is a soothing and beautiful sight.

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Shakti Divya Sundararajan MD Class of 2027 This piece draws from Hindu mythology, especially that of the goddess Parvati, who resides on Mount Kailash of the Himalayas and includes the tiger among her sacred companions.

The title, “Shakti” is one of her many names, symbolizing the energy contained by the entire universe.

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So much to Explore Ashley E. Kimble MBS class of 2025

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The city of Pittsburgh, Pennsylvania, can be seen from the top of the rail station. The view shows the city from a whole new perspective.

Anticipation of Absence

Zachary Rieker MD class of 2027

In Loving Memory of Rosemarie Rieker Everything is as it was before, Maintain the working order, It feels the same but I’m not sure, That we’ve crossed that border Longing for something not quite gone.

Last time you were just resting.

Slowing breaths after such a lovely one, A day we won’t be besting.

The garden is empty and plot prepared, But the only thing I know is, all my thoughts, despite what is there, are of how I’ll miss the Roses.

Rose Zachary Rieker MD class of 2027 On the anniversary of my grandmother's passing, I found myself drawn to draw the one flower that reminds me of her. Though she was "Grammy" to me, to my grandfather and her friends, she was "Rose."

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Smell The Roses

Sagar S. Patel MBS Class of 2024

Beep! Beep! The alarm clock buzzes at 5:00 AM. I wake up and bounce out of my bed. I become laser focused on one thing: brushing the germs out of my mouth. All the salad and asparagus I ate got stuck inside my pearly whites. Soon, I gaze outside the oval-shaped window, streetlights beaming back into my eyes as cars pass slowly. The only lights glaring into the pitchblack sky are those of the hospital and the Sunset Diner. To someone else, waking up at 5:00 AM may seem like madness. To me, this seemed like another Tuesday morning.

Soon after looking at the blinding lights, I grab my shoes and walk out the door to run. I take a breath of fresh air and the air smells different. Instead of the crisp cool breeze, I smell honey and fruit. My nostrils search for the smell. Luckily, they found it within two seconds and noticed that a plant was in its presence.

“These flowers feel so fresh and luscious,” an old lady said to herself. “Would you like to take a closer look?”

What the heck? I questioned myself. Who would be up this early to check on flowers?

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I look for the voice that vibrated against my ear drum. Soon, I

Slowly, I had a fresh scent of sweet honey and citrus pass by my

slowly realized that it was my crazy neighbor.

nostrils. My amygdala was trying to capture where I smelled this, but I had no luck. Once the pedestrian sign lit up, I turned on the jets

And her cats are just staring into my soul, I thought to myself.

below my legs and left. I tried to shake off the scent that my nostrils

Great.

encountered moments ago, but my mind was trying to process what it experienced.

“No, thank you,” I reply softly. “I have a busy day ahead of me.”

I eventually reached my apartment and got ready to go to work. I “Okay. Well let me know if you change your mind, sweetie.”

threw on my navy-blue scrubs and scurried to my all-white 2008 Honda Accord with black coffee stains on the seat and Big Mac

“Sounds good.”

wrappers lying on the floor mats. Green and blue M&M’s were lying on the passenger seat with cans of Sprite and Celsius in the cupholder.

And I took off from my apartment without turning back.

“Oh no. I am going to be late! It was those stop lights! I need to get to As I ran, I kept on reaching every crosswalk, but missed the walk

work ASAP.”

sign every time.

I start my car and rush over to work. I visualize a streetlight that is Aw man! I thought to myself. This needs to be turned back on to

about to turn red.

the pedestrian! I have a long day ahead of me!

“Not on my watch!” I just made it past the red light.

“You okay, man?” a stranger asked me.

A few seconds later, my life flashes before my eyes as I see not only “Yes, I am.”

red lights, but blue as well.

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“You got to be kidding me. Ugh! I cannot catch a break today.”

“Thinking does not mean anything, sir. License and registration, please.”

I pulled over to the side of the road and stopped the car. I slowly wait for the daunting police officer to walk up to my car. He looked

I went digging in my glove compartment looking for my vehicle

as if he was a police officer forever. His old wrinkly skin was

registration. After a couple of minutes of the police officer awkwardly

intimidating me. His beard was covered in gray.

staring at me, I eventually found it.

“I just got pulled over by Santa Claus,” I said to myself.

“Here you go sir,” I said. “Sorry for taking your time.”

Knock, knock, the police officer raps with his knuckles on the

“This is my job. You are not taking any of my time. I will be right back.”

driver window.

He slowly walks back to his car, taking his time. I turn around and it “Now, do you know why I pulled you over today, sir?” he asked.

looks like he does not know how to operate the computer system in his Ford Crown Victoria.

“Why, sir?” I asked. “I thought I was obeying the law.”

“Why me?” I ask myself.

“Unfortunately, that is not what I saw. I saw you cut that light right back over there.”

After ten minutes of waiting at the wheel, the police officer eventually came back.

“Well, I thought I was okay. I am a healthcare professional trying to get to work. I work at the hospital down on Green Ridge.”

“I will let you off with a warning,” he stated. “But, please, just smell the

“Thinking does not mean anything, sir. License and registration,

roses. Thank me later. Have a good day.”

please.”

“Thank you,” I replied. “Wait, smell the roses?”

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“Yep. You heard me.” And the police officer that looked like Santa

I stop in the middle of the hospital and lock eyes with the physician.

Claus went ahead of me and waved good-bye.

“You know, it’s funny, Dr. Smith. I keep feeling this scent of citrus and “I guess I was naughty this year,” I said to myself. “This ticket is as

honey surround my body. It has chained up my amygdala! Where

heavy as a lump of coal.”

is this scent coming from?! I just want to wake up, do my workout routine, go to work, and sleep. Is that too much to ask?!”

Soon, the smell of citrus and honey came back to haunt my brain as my car window was open. And as per usual, my amygdala

“Trevor, just relax. It’s okay. Let’s just see these patients and help

could not figure out where the scent had come from.

them out. They want to see a ‘happy’ Trevor, not a ‘panicked’ Trevor.”

“That scent will never leave! Eh whatever. I got to get to work.”

I take the stairs with Dr. Smith to the neurological unit, and we make small talk as we go up the stairs. Soon, we reached our destination.

I put the car back in the driving function and parked it at the hospital. I looked at the warning slip that the officer gave me, and I

“Alright, this is the list,” he said. “Only a few patients. Nothing crazy.”

put it in the backseat of my car, where there was a heaping pile of

I look at the list, and everything seems doable.

paper just sitting there, staring into my soul. I jumped out of the car and immediately locked it to make sure no one got inside. I

Okay, this is great. I think to myself. Only a few patients. I will walk in

open the door to get inside the hospital.

with Dr. Smith, help the patients move and talk to them, and then I am out.

“Good morning, Trevor!” the lead physician exclaimed. “You’re late.”

Everything was going well, until the last patient. Dr. Smith was “Yes, I know,” I said. “I had a rough morning.”

trying to help the patient talk about their life, but the patient was not budging.

“It always happens. Just breathe.”

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“Where are you?” Dr. Smith asked.

“Thank you. That was really touching. The nurse and I are going to leave now. If you need anything, let the staff know.”

“Prison.” The patient said firmly. “I need to get out of this place.”

“Thank you.”

“Why are you angry? Why do you want to leave so badly? The people here want to take care of you.”

I just stood there, and my pupils dilated. I finally made my realization.

“I just want to go home to see my family. Now leave me alone.”

“We’re done, right?” I asked.

“But I just want to talk to you. It is just me and nurse Trevor here.

“Yeah, we’re done,” Dr. Smith replied. “You can go home. Just

You can tell us anything. Now, just breathe. Now do you want to

remember –”

talk to us?”

“Yes, I got it. I am not even going to let you finish your sentence.”

“Only because you have been patient, I will allow it. My child and my wife just want me to come home. They miss me. I took them

I walk out of the hospital and sit in my car. I turn my car on, and

for granted. My wife always told me to ‘smell the roses,’ but I

the radio immediately turns on. I turn the radio off and enjoy the

never knew what they meant. Now, I know what it meant. I should

silent drive home. My car has a weird scent of hamburgers, honey,

have embraced their love for me even more than what I did

and Sprite. Soon, I reached my apartment. I got out of my car, and I

originally. My sweet Margaret always cared for me and showed

walked to my front door. I see the flowers staring at me in the face.

me how to interact with others without yelling. My sweet baby boy

They were bright red, like a heart. I soon realized that they were roses.

Christopher has always made me proud. He inspired me so much.

I lean in towards the vase as my neighbor’s cats stare at me. The

His smile was contagious, not only around me, but with his friends

roses smelled like citrus and honey. My amygdala finally remembered

too. I should have been a nicer person.”

where the scent finally came from. They smelled like the memories I had back at home with my family. My mother would come outside as

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my brothers and I would run around playing in our treehouse. She would come to look at us and smile because we built a bond with each other that was so strong that not even Thor’s Hammer could break it. She would look and smell the roses that grew in our garden. These new roses smelled no different: fresh, honey-like, and citrus-like.

“I miss you every day Mom,” I said softly. “I am always thinking about you.”

I teared up a little bit, knowing that she was in a better place looking down at me. She placed these roses near me as a sign knowing that she would always be there for me.

I smiled as I walked into my apartment, rushed to my bedroom, and put my head on the pillow, knowing that my mind reopened the doors to happiness. I dreamt of eating family dinners and lighting scented candles to absorb the odor of cooked spiced meats. I imagined my mother reading my brothers and I bedtime stories, as we all curled up on the same bed together.

Suddenly, my alarm came to life, and I prepared for Wednesday morning with the fresh scent of honey in my mind.

THE END

Sunny Side Up Jessica Fanelli MD class of 2025 The beauty of late summer in a sunflower.

Red blends the change of the seasons as we move from summer to fall.

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My Castle

Jordan Salvato MD class of 2026

If I were a King, I’d build my castle far away.

I’d build my castle far up high.

I’d build my castle in the sky.

As I build, I stop and ponder. Why? Why build my castle in the sky?

I could look over lakes and trees.

Never be annoyed by bees. No dirt to destroy my clothes. No empty threats from anger foes.

Why, yes, I would build my castle in the sky.

Brick by brick would be laid until came that fatefully day.

I’d sit on my throne and breathe it in...

The sweet smell of a lonely grin.

But I could see fields of white. That will always shine bright.

But I can see the tiny oak trees and all the people look like fleas.

I am free. I am free. I am free from pain and misery.

I am free to be King of only me.

I am the king way up high...

The clouds were my solution.

Why be removed from pain and gloom?

Far from my subjects pleas for hope and dignity.

How could I rule a land so far?

No grandeur here while I am King...

If I were a king, I’d build my castle in the sky. As I build, I stop and ponder.

Why?

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Drinking It In William Jeffries, PHD Provost The appreciation of awe has been linked to better health.

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Contemplating Life Erica Kuo MD Class of 2026 Tire-like tracks vanish with the passage of time as the sea breeze and crashing waves accompany the rising sun. The crab hides in the shadows of its sanctuary, contemplating on a crab's life.

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Truly Human Medicine

Jacob Kornilow MD Class of 2027

Studying Away in med school Looking at what is becoming of my time

The Glow of lectures and medical facts on my

So busy and Family so far away

computer screen

Despite not feeling like I’m

Countered by the slow and steady Sunrise

Moving fast

As my gaze switches between the

Despite being humbled by this process Despite the worries and troubles my

Two worlds before me

Imagination places on the road ahead

I feel honored

A purple twilight outside my window followed by a

Honored to practice the art of being

Golden dawn

Truly Human

Fills my racing mind with tranquility

Honored to practice the art and science of

As I take in the moments and

Medicine

Breathe Breathe Breathe

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The Simulation Choir William Jeffries, PHD Provost After hours in the Sim Lab

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Praia De Gelo Sonia Lobo, PHD Associate Dean for Research & Scholarship Volcanic sand holds ice's gleam.

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Migraine Iris Johnston Library Specialist

A monster’s wrapped my eyeball up in cloth, poured compost in my tummy, squirted gravel slurry in my brain.

If Buddha is to be believed, we must have boiled babies to deserve this.

Or did we, once, unborn and floating, beg for it?

Did God, in a visor, shirtsleeves rolled up, carry the six, divide by four, and say, “my darlings, something must hurt?”

Did we then raise our wings, push inside us thoughts of beavers skinned or miners crushed, and say, “I volunteer”?

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Silky Shore Mario Cornacchione, DO Department of Medical Education Image made of weathered shoreline at sunrise along coast of Acadia National Park, Maine.

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Longing for Endless Horizon Mathura Thileepan MD Class of 2025 28

Waves and Water Droplets Rakhi Ratanjee MD class of 2027 Temporary rock sculptures created by beach visitors sit quietly on a boulder overlooking the Pacific Ocean as water drips down from the saturated cliff above.

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Nature's Pastels Jessica Fanelli MD class of 2025 The pastel palette produced in the wake of a storm just before the sun sets.

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Inner Turmoil of an External War

Dawn Zieger, MPH Vice President, Behavioral Health

Families destroyed, escalating tragedy, loss, pain with wounds that will not heal.

War is the ultimate failure of compassion and

Where is peace?

How do we come back from terror and

compromise.

Can it be found in the depths of manmade

devastation?

For what cause is it JUST to end the lives of

turmoil?

Let humans see humanity.

innocents?

Where is God in the midst of devastation?

Let our LOVE surpass our HATE.

For what cause is WORTHY of killing enemies?

Is my God a different God than the God of my Let the gates of division be torn down by an Every story has two sides and truth lives in the

adversary?

insatiable desire for peace, for respect for life

chasm of opposing views.

If my and my adversary share a God, is it

of those we may disagree with.

What is right?

the will of man who leads us into battle and

As Your LOVE has done before, DO IT AGAIN.

Who defines right?

destruction?

Is “being right” a cause for death?

Is death an appropriate result for “being right”?

Calm the seas.

Where is God in the midst of

Stop the battle.

Let repentance quench the thirst of injustice.

What is the cost of war?

BOMBS DROPPING.

Is it worth creating GENERATIONS of trauma?

PEOPLE DYING. CHILDREN'S FUTURES ENDING.

Let our cry be Amen — IT IS FINISHED.

TEMPERS FLARE ROCKETS LAUNCH

How did mercy escape us?

SILENCE

How did hate de-humanize the enemy?

SCREAMS

God is good, but MAN HAS CHOICE. How has our CHOICE defiled your GRACE?

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Sunset Butte Mario Cornacchione, DO Department of Medical Education Image made of a butte at sunset off the beaten trail in back country Moab, Utah.

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Shadowing a Shadow

Carolyn Young MD class of 2026

You’re losing your vision He’s losing this fight With each passing moment The shadow grows quickly in its plight.

I watch and listen

No one can stop this, and try a few They worked rigorously for decades And I feel an unparalleled sense of empathy, pure and true For all who are impacted in their life with this field, where a growing shadow pervades

Witnessing the demise He’s quick and talks rushed You misguidedly apologize.

In whispered sighs of fading hope I stumble and finally find my call Witnessing the slow decline, I finally feel why

I finally feel I have found my way You can never see clearly again And I go study the heart, the liver, and the brain Until one day I can study the eye and find a way to subside a bit of the pain.

To cherish sight and give my all.

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Barred Dreams Rakhi Ratanjee MD class of 2027 Rays of sunlight slicing through fence bars in Los Angeles serve as a bittersweet reminder that some dreams can only be beheld and never achieved.

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She's a Hard Stick

Iris Johnston Library Specialist

A smudge of khol without a face comes to juice me like a calamansi like she’s making sangria and I’m the Garnacha.

If she told me her job is to jab and to dig, like, for nothing? The tests are a sham?

I’d believe her.

This Capri Sun is empty but she’s got pockets full of straws.

Or maybe she’s knitting, she’s weaving my palmars my median cubitals making a bracelet of red string like it’s 本命年 and I need the good luck.

Well, I do.

Because everything’s popped, my antecubitals could teach color theory, even under my arms, you’d think I lost at paintball, and when she hooks the hollow of my wrist, this place below my thumb that has no name, that should be kissed, that has no business being plumbed, yes, I need good luck.

Wish me luck the paper where they write the list of sicks I do not have runs out.

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WIDOW'S LAMENTATION Divya Sundararajan MD class of 2027

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This piece was inspired by South Asian mythology, in particular Kannagi from the epic historical poem “Silappathikaram,” a character that endures great trials but represents righteous justice and loyalty.

TALKING IN CIRCLES Preya Patel MD class of 2027

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zachary Rieker MD Class of 2027 Broken branches bent beneath bare brittle brass, how crass, Fools fall faithfully, flaunting fabricated fame, what a shame How hurt his heart heaves, happiness hewn, scattered, strewn Twist, twist, twist.

Bend over backwards, breathless, beaten.

Shy, not sensitive; lies, not commemorative, Celebrate, serenity. Blissfully, melancholy.

Why do I hurt?

Grasping for nothing, Gasping for nothing.

Witting, unremitting; faithless trust.

Listen, listen, head to heart.

Listen, listen, stop, restart.

Listen, listen, one leaves a mark, To distract from what was and to cover the scars.

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Deeper Meaning jacob Kornilow MD Class 2027 A photograph from a half-submerged camera focusing on the blue skies and shores in the background. You can see the bottom of the lake, but only you can find the deeper meaning for yourself.

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Transcending Mediums Selena Kattick MD Class 2027 In capturing the first snowfall of the season, the camera created the illusion of an oil painting and transcended the boundaries of digital photography.

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St. Croix 4 Battered but Still Standing Ronnie R. Reynolds, MHA Director of Quality Improvement and Compliance The only lighthouse in St. Croix, USVI.

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Radiating Some Yellow Love Mathura Thileepan MD Class 2025

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Strolling through the Gardens of V Mathura Thileepan MD Class 2025

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Garden

Jin Hyeok Nam MD Class of 2027

Find joy in every moment All the wonders are here with you Smile to your happiness and sorrow All things come and go Make every day an adventure You are the main character Listen to others, open your heart Let the world come to you Remember why you are here Trees fall without roots Let go and release You will find freedom Do not look away to other gardens, but Care for your own Your flowers will certainly bloom Refuge for many Is this beautiful garden

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Serenity Maura M. Sheehan MD Class 2025 Boats docked in Port Frederick in view of Sleeping Lady Mountain off the coast of Hoonah, Alaska.

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Diagnostic Dialects

Amanda M. Caleb, PHD, MPH Professor of Medical Humanities

The physicians speak of you in medical terms: a VACTERL baby.

Tracheoesophageal fistula, repaired at 1 day old.

Esophageal atresia, repaired at 1 day old.

Tethered spinal cord, repaired at 4 months old.

Imperforate anus, repaired at 9 months old.

In sharing your story, I become the daughter of a doctor, parroting their language.

We still have bi-monthly esophageal scopes.

I cannot put meanings to these words because meaning only reminds me how close we were to losing you.

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Across from your bed in the NICU two parents are learning how to clean their newborn daughter’s trach. The father whispers faintly, “I didn’t sign up for this.”

I watch you run with your sister, laughing, screaming, sobbing.

I tuck you in at night with soft kisses and tender cuddles.

I bathe you. Feed you, cut your food, blow on it until it’s cool.

But every meal we watch carefully, in case you can’t swallow Each night we listen to you cough and think, Will it ever get easier for him?

After your sixth surgery, I sit in the waiting room, listening to a doctor tell two parents that exposure to cigarette smoke will cause more severe asthma attacks for their eight-year-old daughter. After the doctor leaves, the father grunts, “Like hell I’m giving up smoking.”

A Medical Student in Patient’s Clothing: A Personal Reflection Erich Miller MD Class of 2026

Defend your position. As an individual with a mental health condition, these three words served as a foundational feeling in my interactions with healthcare providers. To defend your position in this context is to equip yourself with an armament of knowledge and mental fortitude to justify the complaints that have brought you to a provider; to avoid the dismissal of your concerns as an anxious product of your mental health condition; to be viewed as nothing more than a single label. For those of us with mental health conditions, defending your reason for coming into care can be as worrying and arduous as seeking care itself, producing an unfortunate compound that only worsens outcomes.

Yet, in the past 18 months since I became a medical student, I have gotten to experience something remarkable: healthcare interactions where no defense of my position was needed.

I can recall my first interaction where I began to realize the power of being recognized as a medical student, as a colleague, as an in-member, and how it impacted my healthcare experience. As life decided I needed another challenge, I began having random periods where it felt like my heart was hitting hard against my chest with HRs going up above 140. I became concerned: could it be PSVT, something causing increased PACs, PVCs, or something else? This concern drove me to schedule an appointment with my PCP, which to my relief was scheduled as an emergency sick visit for the following day. As I prepared for this visit, I worried whether my provider would view the problem as the new and strange issue I did, or whether she would default to a diagnosis of anxiety as the explanation for the symptoms. Anxiety is a pervasive thing with the power to physiologically aberrate us in a way that can be symptomatically similar to cardiac issues, as well as a number of other pathologies. But if there is one thing medicine teaches us, it is that simply because two things are similar does not mean they are alike.

On the day of my appointment, instead of defaulting to a diagnosis of anxiety, my physician pulled out my ECG and went through it with me, not as a provider would a patient, but as a teacher would a student, as she asked me what I thought of what I was seeing and where a problem could be. She finished by saying she understood my worry and put in a referral for cardiology, labs, and some imaging.

From there, we spoke for the next 35 minutes about medicine, ACE/ARBs in blood pressure management, sepsis guidelines, and a slew of other topics in a way two colleagues would converse. It was in these moments that I felt a sense of acknowledgement, comfort, and rapport with my clinician beyond what I had ever felt before. Now, rapport with my physician was pretty good prior, but it was never at this level, a level that felt more like how a colleague would help another colleague in need rather than a patient and provider. This marveling experience is one that would continue when I went to the cardiologist.

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On the day of my cardiologist visit, I began the visit similar to how I began the one with my PCP by mentioning that I was a medical student and then providing the HPI that followed. Once again, the dynamic shifted in a way that felt less patient-provider and more colleague to colleague, or at least student to teacher.

The cardiologist began showing me several shots of my ECGs, echocardiogram, etc., sparing no medical jargon and explaining what gets cardiologists excited. We talked more then about medicine, and ultimately, finished the visit on a positive note where once again, I felt satisfied with my visit in a way I never felt prior.

Now, before we move on to the next pivotal stage of this reflective discovery, I feel it imperative to preface that my problem did turn out to be benign; the old motor engine is not missing three pistons. What is important to consider here though is that even though the problem was benign, a fantastic outcome, it was not treated as though it was benign by anyone from the outset. The problem was not dismissed, it was not immediately attributed to anxiety, it was not supplanted of the appropriate medical merit that it deserved at the time. This experience, and feeling is something I came to truly experience when, again, as life would have it, I required yet another challenge.

You turn 26 years of age and suddenly your body begins an internal revolt against you, because life simply needs a little more spice in it. My body at times has felt like it was constructed with the integrity of a Range Rover. As fate would have it, I began to develop a neuromuscular problem with a very annoying symptom that at times made it feel as though my muscles had obtained sentience and were attempting to

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embark on their own independent journeys; truly riveting in a disconcerting way. Now my particular set of symptoms had a differential that included a few benign conditions, but also included a particularly nefarious player: ALS. It does not make for the best mental environment when one of the possibilities for your symptoms is ALS. As such, out of concern, especially given how prolific the symptoms initially were, I sought out medical care and ultimately got referred to neurology.

I remember this neurology visit vividly and fondly. I was sitting in the exam room, anxious of what my symptoms could be and anxious from my muscles having had a rave without my consent for the past 3 months. The neurologist, a specialist in neuromuscular medicine, walked in, and said that he saw I was a med student and said that I was a colleague, even going as far as to say I could address him by first name if I desired.

We then engaged in the process of me giving him the HPI and we engaged like two academics seeking a common answer, exchanging jargon, clarifying findings using medical descriptors, and ultimately communicating as though we were on common ground. It was a profoundly fascinating experience, one that only evolved as we progressed further in the visit.

After HPI came the physical, as it commonly does. Now a brief side note, as someone who has done a neuro exam and has now had one done on them: it really is an intriguing experience to know exactly what is going on and what the physician is looking for; it is for this same reason that it is also terrifying.

Knowing what it could have meant for my diagnosis if I suddenly was Babinski sign positive or hyperreflexic was extremely disconcerting but was also immediately relieving when those tests came back normal. Once the physical exam was done, we

came back together and went through the diagnosis.

The neurologist began by saying right out the gate, it isn’t ALS, which I knew from the physical exam, but it was also very reassuring given this was a specialist with many years of experience diagnosing and managing that condition. He then proceeded to walk through the diagnosis he most suspected, doing so in a conversational but educational manner as one would expect from a colleague or a teacher. Ultimately, there was a problem afoot, but it was nothing serious. I was relieved, but more so, I felt satisfied — satisfied that I had received medical care by a fantastic physician and received it in the way medicine should be practiced. I didn’t have to defend my position, I didn’t feel as though I was being dismissed, I didn’t leave feeling like I was burdening someone with my problems.

And it is this experience that hits at something fundamental that has arisen since I became a medical student: The role of being a medical student eclipsed the role I held as someone with a mental health condition.

Now, it would be easy to read what has been written prior and come to the conclusion that providers who are dismissive or show differential treatment because of being a medical professional are bad, unempathetic, etc., but I would say that would be oversimplifying the issue at hand. I would say every provider I have interacted with, including all those a little bit more predisposed to dismiss, were competent, compassionate physicians who wanted to help; they simply were a product of associations that all of us humans form: heuristics and patterns. Heuristics and patterns are necessary: they help us consolidate the world into manageable pieces of information that we can use to navigate it effectively, ultimately serving as

the backbone to our ability to make quick clinical decisions.

However, they also are our sources of implicit bias, particularly if the heuristics or patterns are not formed well. It is these implicit biases that lie at the heart of the problem. When I made it explicit that I was a medical student, I activated a different subconscious heuristic, an override that dispelled any preexisting associations that otherwise would have altered the visit. This in and of itself is a form of implicit bias, but one every single one of us, providers and non-providers alike, shares: we connect better with those we are similar to, in whatever way that similarity may exist.

I have been given the opportunity to experience what it is like to be a patient before and after being given significant medical knowledge, and it is one that has given me a profound degree of perspective. Perspective into how complicated and intricate we as humans are and how such small changes can alter the lens we view each other through. Perspective into how much better clinical outcomes can be when biases and factors limiting care are minimized. And above all, perspective that I am not immune to implicit biases. Rather, it is this recognition of non-immunity that has compelled me to adopt my own goal of maintaining a heighted awareness to my thoughts, emotions, and feelings in the moment, in order to spot and modify my own biases.

By bringing the unknown into the known, the unconscious into the conscious, I can ensure I don’t propagate the same fears, negative feelings, or outcomes, that I worried would be propagated onto me. I want to be the best provider I can be, and with the perspective gained from my medical experiences I am one step closer to making that a reality.

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Back Country Pinnacles Mario Cornacchione, DO Department of Medical Education Image made after Jeep 4 wheeling 1 hour into the back country of Moab, Utah.

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Milky Way Pinnacles Mario Cornacchione, DO department of medical education Image made in unencumbered light in back country of Moab, Utah.

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Community Immersion Selena Kattick MD Class 2027

“I have no prejudice against you.”

“I had a friend just like you,” “Black hair like yours, black skin like yours.”

I nod, a tight-lipped smile adorning my face.

In that moment, all I could think of Is giving him grace.

When the dementia that has corrupted his brain Compels him to return every 15 minutes Like clockwork to single me out, To remind me that he has no prejudice, Almost pre-emptively, Who do I hold accountable?

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He knows not what he says.

And I cannot take his dementia to task Yet his words pierce my skin Like a thousand needles tipped with a toxin So potent that my senses are heightened, And I feel my shield go up ever so slightly Then fully, brick by brick.

My first instinct is to Fold into myself, To become smaller, My second thought is to Redirect his attention, And crack a poorly timed joke.

But a voice breaks through, Amid the chaos of my mind “Stand tall.”

And so, I do, With shoulders pulled back And my head held high, I meet his glazed eyes, With a nod, I acknowledge the man in front of me Who seems desperate to make me understand That he has no prejudice against me.

Off Season Santa william Jeffries, PHD Provost

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The Duality of Cats Amy L. Kennally, MBS MD Class 2027

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Season of Color Jessica Fanelli MD Class 2025 One road in a colored wood, but you can still choose your own path.

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Finding the Well Maura M. Sheehan MD Class 2025

"The practice of medicine is an art, not a trade; a calling, not a business; a calling in which your heart will be exercised equally with your head." — William Osler I ran into the resident room, out of breath. I had missed sign-out again. I had forgotten my badge for the third time that week, and I needed to wait for the night intern to leave to get into the room. It was my third week of clinical clerkships during my third year of medical school. I had started on internal medicine. On other rotations, you could focus on learning one complete body system at a time, like on the neurology or obstetrics services. In internal medicine, you had to be an expert on it all: heart, lungs, kidneys, just to name a few, not to mention how they interact. I had only done 300 out of 1200 practice questions; I didn’t know how I would ever pass our exam; I was exhausted. I couldn’t get the hang of rounds. I presented 2 patients a day to the attending physician out of the 15 on our service; the residents did the rest. It seemed that every time I finally understood the attending’s desired presentation style, the team got a new attending. The residents tried to help; they gave me mostly easy bread-and-butter cases: COPD and CHF exacerbations, viral gastroenteritis, pneumonia. The interns took on the more complicated patients We gathered for rounds with the new attending for the week. None of us had met her before. “I haven’t been on a teaching service in the last 10 years,” she warned us, “I’m very laid back. I’m wrong sometimes, and it’s okay if you’re wrong too.” We started to go through our normal flow of presentations, catching her up to speed on the familiar list of patients we had all been seeing together, as well as some new additions. She listened intently, asking questions when she didn’t understand the details of the plans we had laid out. Finally, we came to the last patient on our list, “Mr. Smith.”

All the residents and I smiled in frustration and rolled our eyes. Mr. Smith was a medical mystery. He had been on the service before any of us had come on, and there was no unifying diagnosis to explain all of his ailments. He came in originally for shortness of breath, then he developed an empyema, and now we were evaluating him for pancreatitis. He had no terminal diagnosis, like cancer, but he was very ill. He was only in his 30s. His parents had died. He had no siblings. He had no friends. He had no loved ones to speak of. None of the interns wanted to take care of him because his case was so sad, and his medical picture was so complicated. The attending stopped us as we discussed his case. “I saw the notes,” she said. “Has anyone told him this may not end well?” That was a sobering question.

With it being my first rotation of third year, and with Mr. Smith not having some clear-cut terminal disease, it had never occurred to me that he might die. She went on, “I think we should pay him a visit.”

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We hadn’t seen Mr. Smith as a team in the entire three weeks I had been on service. The reason given was always that there were no pertinent physical exam findings for teaching. I had met him once. Now, all 10 of us crammed into his room. He looked a little bewildered. He was weathered and cachectic. He had a full, gray beard and long, scraggly, gray hair. He looked like a slave from an old movie about the middle ages. “We just came to see how you’re doing,” the attending explained. She knelt by the bedside and looked into his eyes. I had heard about this technique a lot, something we were taught to make us seem less intimidating than standing over the bed, but until now I had never seen anyone do it in real life. “I’m okay,” he said, looking surprised. The attending looked straight into his eyes, and told him we thought he may die. She was direct, but compassionate. Mr. Smith started to cry. Suddenly, he opened up and all his fears and anxieties came spilling out. Our attending just stayed there and listened.

She didn’t judge. She didn’t react. She was just there.

She handed him tissues when he got upset. They talked about the things that were bothering him most. He had been plagued by nausea and vomiting, and he hadn’t been able to tolerate solid food for a month. He was so hungry, and he felt like giving up. They stayed there like that for 40 minutes, just talking. We all stood and watched, our feet fixed to the floor with the weight of our own fears and insecurities reflected back at us. Finally, the attending focused Mr. Smith back on the things we could control. We could make sure his meals all contained his favorite flavor of a nutritional drink that he could tolerate. We came up with a plan for next steps in his medical care. It turned out he went to high school with one of the social workers. So, he did have a friend. We all agreed that she would handle his placement in a nursing home as soon as he was stable.

Mr. Smith thanked us for talking to him that day. The next morning, we saw him in the hallway working with physical therapy. It was the first time I had ever seen him out of bed. The nurses informed us he had had three peach-flavored Boost nutritional drinks for breakfast that morning. He had a new hunger and tenacity that he hadn’t had the day before. He seemed to be working to get out of the hospital, and ultimately, to heal. He was stabilized and discharged to a nursing home later that week, where I hope his recovery continued.

That experience taught me the true difference a simple conversation can make. You can practice medicine from behind a computer.

You can look at labs, put in orders, write notes, and consult other teams. But there is an unspoken piece of medicine that cannot be practiced that way. There is a will to live and heal that cannot be put into words. It may come from the love of a family member or friend, the feeling your life has purpose, or some debt to a higher power. Whatever it is, that piece serves as a well of strength in your darkest hour. We helped Mr. Smith find his that day, and it made all the difference for him. That night, I went home. In witnessing Mr. Smith discover his will to heal, I found the will to continue my training, focusing not on test scores, but on the difference we as physicians can make. I packed my bag for the morning, and I remembered to include my badge.

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Morning Sun in the Mountains Erica Kuo MD Class 2026 Dew-kissed grass dances in the refreshing breeze as the rays of sunshine bring the warmth of summer back into the mountains.

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Thanks mom william Jeffries, PHD Provost

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Someday Sagar S. Patel MBS Class of 2024

“Honey, you have to get out of bed,” my wife said. “We’re going to see Peter today to cheer him up.”

“Okay,” I sighed. I knew my son needed me. It was hard to see him laying down in the hospital.

I struggled to get out of bed. Candy wrappers that were lying on my shirt fell onto the carpet. My Captain America pajamas were covered in Hershey’s chocolate wrappers and colored stains from the two pounds of Skittles that were devoured as part of my midnight snack turned into a midnight meal. When the wrappers fell onto the ground, the nutritional value logo stared back at me.

We got inside her car: a 2019 matte black Cadillac Escalade. It was one of the few cars that could fit me. Being on the heavier side has not been easy. And the worst part of it all is that I do not want to talk about it with anyone. Not even my wife. Not even with my therapist. These thoughts talked back and forth multiple times a day.

My wife started the car, and we began heading to the hospital.

“What did the doctor say, honey?” I asked.

“She said that Peter has not been feeling like himself,” my wife replied sadly. “He needs us now.”

“Yeah, I hope so.”

“Forty-five grams of sugar?” I asked myself. “I gotta stop eating these foods. Just not today.”

Two minutes passed as Maureen stared directly ahead at the other cars. I wanted to break the awkward silence as all I was thinking about was about Peter and my weight issues.

I stepped inside my bathroom, yawning loudly. I stepped on the scale, and it read 260.6.

“Hey honey, let me ask you something,” I questioned. “Am I okay?”

“Oh man,” I said to myself. “I gotta lose weight. Just not today.”

I looked at my teeth, and they looked like colors of the rainbow rather than pearly white. After two minutes of vigorous brushing of the teeth and tongue, I spit a muddy rainbow of brown, red, and purple into my sink. I threw on a clean Polo Ralph Lauren

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collared shirt that looked vibrant and Dockers khakis with boat shoes and rushed out the door with my wife.

“Of course you are. Why?” “I don’t know. I have just been feeling off. That’s all.”

“Look. This has not been easy for us. You saw the photos of Peter after his accident. Seeing your child not feeling or doing well is a parent's worst nightmare."

The hospital was bustling with activity. Cars were coming and going as if it were a tourist attraction. Maureen followed the directions and parked her car at “Physical Therapy and Rehabilitation,” taking one of the few open spots.

“You ready, Dante?” Maureen asked.

“Ready as I will ever be,” I replied.

Plop, my two feet hit the ground, and my bones vibrated throughout my body.

Maureen and I started walking toward the hospital. Inside it was busy as ever. We saw people coming in and out of the hospital The line for “The Morning Bird,” the hospital’s coffee and pastry shop, was overflowing. The line was filled with people in white coats and scrubs to suits and shorts.

Maureen went up to the front counter and made direct eye contact with the lady at the front desk.

“Hi!” she politely stated. I was looking for my son. Last name is Tomlinson. First name is Peter.”

“C’mon honey.”

“Coming!”

I saw Maureen start to job past the people that were in line for pastries and coffee, and I tried to keep up with her.

“Ugh,” I groan. “Maureen, just go without me. I need some time. My body hates exercise.”

“Dante!” she exclaimed. Soon, all the eyes in the hospital directly locked eyes onto her. “Fine! You can take the elevator. I will take the stairs.”

I was waiting for the elevator as Maureen took the stairs. Once the elevator came to pick me up, I walked in and pressed the “2” button to go to the second floor. The button shined brighter than the day I was having.

Once the elevator reached the second floor, I waddled out to find Maureen and Peter.

“Oh my gosh!” Maureen exclaimed.

“Okay, let me put it in the registrar.”

Well, I know where to find them, I thought to myself.

The front desk lady waited patiently as she saw the screen buffer.

“Dante!” Maureen exclaimed. “Dante, look! Look what they did to our poor baby.”

“Found it! He is on the second floor. Room 2039.”

“Perfect! Thank you. Have a good day.”

“Thank you!”

Peter did not look well at all. At first, I thought he went through a meat grinder and was spat out. He had cuts all over his face and his legs. Gashes of blood were covered in wrapping tape and petroleum jelly.

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“Mom,” Peter sobbed. “I’m sorry. I just wanted to go for a bike ride. I’m training for that big race in a couple of months. And now look. I can’t even walk, let alone ride a bike!”

“Peter,” I stated confidently. “Don’t worry. Focus on getting better.

I want you to be able to walk soon. Just try to focus on that.”

“Thanks, Dad,” Peter replied as he grabbed tissues by his side to wipe the tears off his freckled face and blew his nose. “But, if I can’t race, then what do I do?”

Everyone sat in silence for what felt like an eternity.

Beep, beep, the nurse’s call bell screeched as we all stared into space.

“Peter,” I cautiously proceeded. “What if I did the race for you?”

“Honey,” Maureen said incredulously. “You can’t even take the stairs. Now, you want to cycle fifty miles. Who are you?

Superman? Coppi? Bartali? Wait, let me guess. Eddy Merckx!”

“It’s for our son,” I said. “You know that I would do anything to help him and feel good about himself. Plus, I have been feeling beat up about myself lately. My PCP said that I need to find something to do to help with my physical and mental health. This might be the thing.”

“Okay,” Maureen said. “But I’m not convinced yet. I need you to be training with me every day. Until then, you are not ready.

However, I am more than willing to help you do this if you really want to see yourself grow as a person. I want the best for you.”

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“I understand,” I replied with confidence. “I need to give it my 110%.”

“Thanks Dad,” Peter said. “I love you. Just be careful on the roads.

Cars are ruthless.”

“I will be extra careful and thinking about you.”

Maureen put the car into the driving function and got home in the blink of an eye.

“It’s time to bike!” Maureen happily exclaimed. “And just like how I taught Peter how to ride, now you’re going to ride too.”

“That sounds like one heck of a plan,” I agreed.

Eventually, Maureen parked the car. I was nervous about this task, but I was willing to do anything for my son. My heart beat out of my chest thinking about riding a bicycle, but I knew that this was normal. This was going to be a huge step out of my comfort zone.

I went into the garage, and I grabbed one of the many bikes that were in there. The one that looked the most appealing was a bike that had a metallic blue frame and tires that looked like I was going for a ride outside at the local park. Maureen grabbed her racing bike.

“All right, are you ready to go?” Maureen asked. “We don’t have much time before the sun goes down.”

“Okay, let me just hop on this,” I said. “Ah! This is not comfortable at all! Where are the cupholders and the heated seats on this?

Maureen! How do people enjoy riding this? My gut! My back!”

And I struggled to ride at first. Big time. To me, a bicycle was a foreign object. I always looked at bicycles as if they were a mode of transportation. Instead of the cupholder being next to me on a couch, it was below me. Instead of arm rests, I had handlebars. I was holding onto dear life, praying that I did not get a concussion from learning how to ride.

“Ah, Maureen!” I exclaimed. “This hurts!”

“Dante,” Maureen replied calmly. “I know. The first ride always stinks. But give it some time. I am not leaving this area until you feel comfortable.”

This may take a little longer than expected, I thought to myself.

I slowly started getting used to riding. It was painful, but in a good way. Soon, my T-shirt was drenched in sweat.

“Woah!” I exclaimed. “Coming through! Maureen, move!”

“I’m ready!” I exclaimed.

Maureen casually moved out of the driveway. And I held onto the handlebars for dear life.

“Okay, let’s go!” Maureen happily exclaimed.

“Pedal, Dante!” Maureen exclaimed. “Pedal! There you go! You’re a natural!”

And now I was getting the hang of it.

“Okay, Dante,” I said to myself. “Breathe in and breathe out.

You’re a moving vehicle now. Visualize.”

“Follow me,” Maureen said. “We’re going to do a route that Peter and I normally do. Just follow me and everything will be okay.”

“Sounds good! Ahh. This is so tiring.”

I was gripping onto the handlebars and making sure I did not fall off. My lower body was slowly feeling the burn from pedaling in a counterclockwise fashion.

I followed Maureen throughout the whole town. I felt like I had seen the whole town after living here for over two decades. But there was more that I have not seenThe beautiful oak trees and fresh vibrant flowers were pleasing to all my senses. The trail was filled with people who were casually walking and talking with their significant others and their children.

“Ooooohhhh Mommy! A bicycle!” one of the children smiled.

“Yes, Catherine!” the mother exclaimed. “A bicycle.”

Maureen and I casually biked past them. I smiled and reminisced about times when Peter was learning how to ride a bike with Maureen. I used to stare at them through the square window and smile because I saw my son was so happy just being outside with his mother. A mother’s bond with their children is unbreakable. He developed a bond with hismother and cycling that no one could ever take that bond away from him, not even me.

I should have been there more for Peter, I thought to myself. This

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is my second chance. I am not going to let this slip away from my fingertips.

As time flew by as I reminisced and put myself in autopilot, we reached back to the house.

“Oh my gosh!” I exclaimed. “I did it! How far was that?”

“That was about six miles,” Maureen replied. “Let’s get back inside.

This cold and pitch-black sky is making me shiver for no reason.”

And so, Maureen and I went back inside and cranked up the heat.

The thermostat read 77.8°F. “Ahhhhhhhhh,” I yelled. “The indoors. What a beautiful sight. The couch, the fridge, and the television.”

“Oh brother,” Maureen replied.

“What? That was tiring for me.”

“Oh, I know. But remember your end goal.”

After fifteen minutes of silence, I broke it.

“Maureen, can I ask you something?” I asked.

“Yeah sure,” Maureen replied as she opened the fridge to grab a Chobani yogurt drink. “What’s up?”

“Do you think that I can do this race?”

“Dante. Of course you can. You can put your mind to anything you want to. That’s what I always taught Peter, especially when it came to racing bicycles. I was not the most athletic person in the world. But I always believed in myself. My mom had this quote that stuck with me: ‘[the] greatest foe you face every day is the one that stares at you in the mirror.’ Remember that. "It will go a long way.”

“Thank you. I did not realize how much I needed to hear that. Good night sweetheart. I love you.”

“I love you too. We rise tomorrow morning to burn some bike rubber.”

I walked over to the kitchen and pondered my thoughts. I knew this I slept well knowing that these days of training for Peter would be was an easy day in the cycling realm, but this was a big step for worth it in the end. me.

Beep! Beep! my alarm clock went off at 6:00 AM for the fifth day in I need to be stronger, I thought to myself. Not only for myself, but for a row.

Peter. There are so many things happening in my brain, but Peter is distraught. How bad do you want it, Dante? My mental and physical “Ugh!” I groaned. “It’s so early! But I need to move!” strength needs to exponentially grow if I want to be ready to shock the world someday.

I struggled to get out of bed, and I put on my workout clothes were

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that were buried deep beneath my other clothes. The soreness from the past couple of days had been killing me, but I need to remember my end goal. Peter is watching my every move in spirit. I hopped on the scale, and it read 255.2.

Yes! I mentally exclaimed. Progress!

I slowly went down the stairs and opened the garage door. I got my trusty metallic blue bicycle and grabbed my helmet. A few minutes later, Maureen was right behind me.

“You ready, partner?” she asked.

“I was born ready.”

She got her bicycle too and we took off to ride as the sun rose from its slumber.

“Maureen, why am I so happy?” I asked.

“It’s because you’re doing something that gives you a purpose in this life,” she replied. “Let’s go for a little longer. That sunrise is beautiful.”

Yes, you can,” she said. “Let’s head back. We should visit Peter.”

And so, that is what we did. We rode our bikes back home and hit the brakes as soon as we saw our tan house welcome us. Maureen hopped into the shower; I followed soon after, as the hot water was soothing my muscles and washing away the sweat and stench of the morning ride.

“You got this Dante!” she exclaimed. “I believe in you.”

“I am going to make sure I keep this up,” I replied. “For Peter.”

Maureen and I got into her car and drove to the hospital to see Peter.

We immediately parked and rushed up to his room. However, this time, I treated this visit a little differently.

“Maureen,” I whispered in her ear. “Can I take the stairs with you?”

“Oh, I thought you would never ask,” Maureen smiled. “Let’s do it together.”

We took the stairs together and slowly made our way to Peter’s floor and room.

She was not kidding. As someone who usually sleeps in, this was something that I admired. The crisp golden color as the sun smiled to show its true colors lit up not only the sky, but my mind as well. The rays of this star gave the trees, houses, and the trail a bright aura.

“Hey Mom and Dad,” Peter said. “I’m glad to see you two. Dad, you lost some weight! What’s going on?”

“Maureen, I am loving this!” I exclaimed. “I can do this!”

“How so?”

“I’m prepping for the race son,” I joyfully said. “You have been inspiring me every day.”

“I know how much this means to you. I should have been outside

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riding bicycles with you and Mom. I want to be a better father. And this race is allowing me to connect with you, even though you are not physically riding with me. You’re there in spirit Peter.”

“Wow,” Peter shed a tear. “That is…beautiful.”

“We’ll see you later, okay,” Maureen said. “Give us a call if you need anything.”

Maureen and I walked down the stairs and drove home. All I thought about were my family and this race. I was determined to be the toughest person on race day.

And I did not let anything get in my way. For the next couple of months, I lived the same routine: I brushed the strongest bones in my body, threw on my workout clothes that soon turned into a jersey and skinsuit, and grabbed a new racing bicycle that Peter had used before he got hurt. Before I knew it, it was racing day.

I threw on my cyclist outfit and took a couple of deep breaths. I weighed myself this morning: 230.6.

“I remember I told myself that I would someday lose enough weight and race for Peter,” I said to myself. “And that someday is today.”

I went down the stairs with one of the biggest smiles that the world has ever seen. As I walked down the stairs, I saw Peter in his wheelchair as his eyes glistened to the man I have become today.

Having Peter at home for the past week has been boosting my confidence. He was giving me pep talks and tips on how to pass people on the bicycle. He has been getting help trying to walk by going to physical therapy with Maureen. As I trained and tried to find my true self, Maureen helped Peter get back on his feet.

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“Go Dad!” Peter exclaimed as I came down the stairs. “Remember our training!”

“How can I forget?” I asked Peter. “Glide and smile!”

Maureen came up to me and kissed me on the cheek.

“Show them what you’re made of,” she said. “I have never seen so much grit and determination in anyone.”

I shed a tear, knowing that the journey that I have traveled was a tough one. All the early mornings and biking around the town have led up to this moment.

She smiled and gave me a hug.

I walked out the door and opened the garage door. I unlocked Maureen’s car and hooked my bike to the back of it. I had so many emotions traveling throughout my body, but I knew that I was ready. I turned the car on and immediately turned on the radio. I connected my phone via Bluetooth and immediately played “Don’t Stop Believin’” by Journey.

When I arrived at the race start, I saw all the other cyclists who were serious. They also had their skinsuits, helmets, and sunglasses on. Each cyclist had a bottle of water attached to their bicycle. A select few were even chewing energy bars to stay extra focused before lining up at the starting line. But so did I. Even though I was not as talented as any of them, I was not going to let them stop my momentum. I was going to show the world what I am made of.

I was determined to finish this race. For Peter.

St. Croix, Coast Line Ronnie R. Reynolds, MHA Director of Quality Improvement and Compliance A view from the west end of the island of St. Croix.

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Before I Die Ronnie R. Reynolds, MHA Director of Quality Improvement and Compliance Bucket list from the pier in Christiansted, St. Croix.

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Daisy Butterfly Zachary Rieker MD Class 2027 The combination of a butterfly, leopard eye, and a daisy.

Though they may seem unrelated, they remind us that everything is connected, one way or another, to everything else.

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Living Like Lupines Rakhi Ratanjee MD Class 2027 After a year of drought in California, the succulent lupine (Lupinus succulentus) did not fail to bloom and share its beauty in spring, reminding us that resilience is about finding the beauty and strength to continue growing, even during hardship.

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Noor Divya Sundararajan MD Class 2027 This piece is titled “Noor,” meaning "light" in Urdu and Arabic. The patterns of her hijab are inspired by the designs of South Asia, including those from mehndi (henna) and kolam, geometrical patterns drawn on the floor using rice flour.

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Quién Eres Sofia Muniz MD Class 2027

Nunca olvides cómo se siente caminar por las calles de tu alma, o el olor de tus pensamientos cuando se encuentran con el deseo.

Por favor, siempre recuerda la caricia de tu madre Y el despeine de tu pelo cuando el viento lo tocaba.

No saques de tu mente cómo era la vida en aquella casa o como el niño que llevas dentro siempre se alegraba.

Pero sobre todo ten presente lo que llevas en tus entrañas.

Y siempre ten en cuenta que a donde quiera que vayas llevas contigo tu propia esencia, tu historia y tu alma.

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Cracked Egg and Ant Iris Johnston Library Specialist The ant benefiting from the broken egg reminds me that there are always happy endings, even if they're for someone else.

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In Tall Buildings ian McCoog, EDD Department of Medical Education A friend wrote a song titled "In Tall Buildings" about the important parts of life we can miss if we're too focused on our working lives. The spider in the foreground from my office window served as a reminder to appreciate the larger world around

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COMMIT TEE Amanda Caleb, PhD, MPH Editor in chief T. Riley potter Managing Editor Jacob Kornilow Layout Designer Katie lee Layout Designer Saishravan Shyamsundar guest editorial assistant

Iris Johnston Staff Editorial Assistant Janice Richardson Staff Editorial Assistant Karen Ephlin, MD Staff Editorial Assistant Abigail norwillo student editorial assistant rakhi ratanjee student editorial assistant Caroline virone student editorial assistant

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