Fall 2019: The Health Humanities Journal of UNC-CH

the Health Humanities Journal THE UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL

FALL 2019

exploring illness, caregiving, and medicine

MISSION STATEMENT The Health Humanities Journal of UNC-CH aims to inspire and facilitate interdisciplinary thinking and collaborative work while developing and embodying a variety of ideas that explore the interface between arts and healing.

This publication allows for dialogue, meaning-making, and multiple representations of the human body, medicine, and illness.

To learn more about the publication or to submit, visit http://hhj.web.unc.edu.

DISCLAIMER The Health Humanities Journal of UNC-CH adheres to legal and ethical guidelines set forth by the academic and health communities. All submitters maintain patient privacy and confidentially according to the Health Insurance Portability and Accountability Act (HIPAA). The University of North Carolina at Chapel Hill and The Health Humanities Journal of UNC-CH do not endorse or sponsor any of the viewpoints presented in this journal. The opinions presented in this journal are those of the corresponding authors.

SPONSORS

The Carolina Parents Council

The Health Humanities Journal

of The University of North Carolina at Chapel Hill

FALL 2019

EDITORIAL TEAM Elizabeth Coletti Editor-in-Chief Class of 2021

Shraya Changela Editor Class of 2020

Alex Ballard Design and Layout Editor Class of 2020

Rabab Husain Graduate Editorial Adviser M.A. Candidate

Jillian Nguyen Marketing Director Class of 2020

Jillian Shiba Editor Class of 2020

Alice Peng Art Director Class of 2021

Alexandra Mao Editor Class of 2022

Malik Tiedt Treasurer Class of 2023

Olivia Delborne Editor Class of 2022

Jane F. Thrailkill, Ph.D. Faculty Adviser Co-Director, HHIVE Lab Department of English and Comparative Literature

Anna Covington Editor Class of 2021 Kristina Alton Graduate Editorial Adviser Medical Student

TABLE OF CONTENTS Editor's Note 6

Elizabeth Coletti

Fairytale 10 Carly Onnink The Drought 11 Carly Onnink Intensive Care Unit 12 Regan Curtis My Grandmother and Mike Roglia 13 Joshua Trent Brown Insurance Fees 16 Lucas Thornton Tina's Garden 20 Maia Sichitiu Pointing to the Future 22 Jhoan Aguilar Anterograde 24 Jared Williams Pain Management 28 Taha Lodhi Meeting Dr. Lamb 29 Ben Ashby On a Scale of One to Ten 32 Ben Kaplan Hands-On Learning 36 Abby Carey-Ewend Toxicity 37 Abbey Walker To My Future Client 38 Alleigh Wiggs Marrow 39 Khaki Loughran Such Is the Life of an EMT 40 Zachary Schwartz On Miraculous Healing 42 Allison Ruvidich Aftergrowth 43 Rhea Jayaswal

COVER ART

by Alice Peng

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EDITOR'S NOTE Dear Readers, This year has seen the second hand-off of the Health Humanities Journal to an editorial staff comprised of both new and familiar faces, all of them eager to continue exploring what this interdisciplinary venture can bring to the campus of UNC. We seek to combine the analytical mindset and difficult questions of medical experiences and studies with the creative and expressive medium of the humanities in order to bring these stories of health, wellness, and caregiving into a format from which readers like you can both empathize and learn. For this fall edition, we received one of our highest submission counts in the journal’s short history, and it was a delight to carefully go through these wonderful pieces of art, fiction, narrative, poetry, and more with the Editorial Staff. I have deeply enjoyed becoming familiar with these works through in-depth group discussions that ranged from meticulous debates on punctuation, to complicated workshopping of meaningful topics, to sheer awe at the unique perspectives and beautiful writing of our fellow UNC students.

The capacity for empathy within the pieces published in this journal continues to impress me. In these narratives, a volunteer at a senior living center looks past a prickly exterior to sympathize with a difficult resident, a grandson tries to understand his grandmother’s Alzheimer’s disease through both the medical research and their personal relationship, and several medical students struggle with the dread of sharing bad news. Poems cover the heart-breaking account of a friend’s overdose and a sibling’s love through sacrifice with a marrow donation for her brother. We can’t help but notice the theme of using these literary outlets to explore compassion and empathy for others. As an EMT reports vignettes of his patients and a student explains her struggle with depression in metaphor, we are invited to live for a moment in the frustration and inner strength of others.

Through these works, authors reach beyond a limiting conception of self to ask questions about how friends, patients, relatives, and peers experience health

7 and illness, and they offer their services in sharing these stories, making them accessible and meaningful for any who devote enough care to give them a read.

I would be remiss to neglect sharing my gratitude with all those who have contributed their time and effort to create this edition of the Health Humanities Journal. To Dr. Jane Thrailkill and Dr. Kym Weed, thank you for your support and guidance. To our generous sponsors, thank you for granting us the means to bring this publication to greater audiences around UNC. To previous Editor-inChief Emily Long, thank you for your trust in handing off the journal and your willingness to answer my numerous questions. To the Editorial Staff, thank you for your diligent work, your invaluable insights, and your inspiring commitment that truly made this journal what it is. And to our authors, thank you for the mind-blowingly vulnerable act of sharing your work with us. We can only hope that we, as editors and readers, deserve it.

The Editorial Staff and I are proud to present the Fall 2019 issue of The Health Humanities Journal of UNC-Chapel Hill. We hope it inspires you to live through these shared experiences of others and find empathy for struggles unknown to you. The power of the health humanities lies in this opportunity for understanding, and we are honored if this journal can serve some small part in that endeavor.

All my best, Elizabeth Coletti Editor-in-Chief

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10

Fairytale Carly Onnink

Every fall

this before.

the leaves would

These feelings could

go frail and

turn like the seasons,

let go

more of a cycle than a curse.

and like clockwork, spellwork,

Maybe it’s just

the air seemed

a really bad case—

to crawl

like the hottest of summers

into my lungs and constrict

and the coldest of

my heart.

winters trapped in one place.”

And I couldn’t find a god—

and while he mixed his potions

so I asked a magic-man

I said It’s strange

in a white coat: because I Can you give me

used to really,

a potion to drink?

dearly love

It’s getting so hard

winter.

to feel and think.

“Of course, He thought for

as you should—

a minute, winter is a part then told me, “I’ve seen

of you.”

11

The Drought Carly Onnink

Depression waits. It waits for the phone to stop ringing and the deadlines to roll by like deadweight too heavy to pick up. Too much to deadlift the heft of lunch dates outings reunions exams errands trips to the grocery store. The mail outside the door.

Circles under your eyes as purple as deadnettle— the heart locked in a deadbolt, deadened round the edges the way a fruit that bloomed from flowers starts to rot from its skin to the core.

But Depression worms its way from the inside out, like a parasite nestled deep. Your peel is a fragile armor, ready to bleed when Depression decides to bite through the bruises. It consumes you like a silent blight—and it takes its time.

It carefully whittles you hollow. It rots you slowly and waits. It waits relentlessly and brutally, like the longest and driest of droughts, waiting for your heart to shrink and give out— but Hope is more patient still. Like a seed burrowed deep under the dirt and debris, huddled in the dark and waiting for the rain.

-Carly Onnink is a senior from Pisgah Forest, NC, pursuing a major in Earth Science.-

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Intensive Care Unit Regan Curtis

Your grandma’s hair is white and wispy but her hands are tough, swollen with veins and rough at the fingertips, maybe from scrubbing turnips.

Your hands are velvety and small, a pink Dora-the-Explorer Band Aid wrapped around one thumb.

I’d rather crush my own thumb— or even yours— than deliver this news that will cleave your life like a guillotine.

Three breaths and two strides forward.

As I open my mouth, the two of you squeeze the blood out of each other’s whitening knuckles.

The familiar words slash my tongue.

You’re both silent, two mutes stunned in waiting room chairs.

I wish I could say he’s in a better place now.

But what place could be better than the home clouded with turnip steam rising in the kitchen, a white wispy halo atop a wise head, and a girl’s warm kisses that heal?

-Regan Curtis is a sophomore from Raleigh, NC, pursuing a major in Hispanic Linguistics and minors in Chemistry and Biology.-

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My Grandmother and Mike Roglia Joshua Trent Brown

My grandmother forgot who most of us were.

She forgot who her caretakers were, leading her to accuse a registered

nurse of stealing jewelry. She forgot who my mother was multiple times and left my mom in a sobbing panic afterwards.

She couldn’t remember how to cook her famous Crisco-fried chicken.

She couldn’t remember her battle with diabetes and the long walks that she used to take every day to lose weight. Some days she couldn’t remember my grandfather Horace was dead.

But she didn’t forget who I was. She hugged me the same way she always

did, possibly because she thought I was my uncle Frank—at 14, I looked just like him. She might have stared at me a little longer than usual, but she always liked to stare at me, even up to the day she died. She still saw me as a child, her baby, and just wanted to be around me. I was lucky, not having to see much of what had been taken from her.

My grandmother had Alzheimer’s Disease.

What we saw on the outside was a mix of blissful interactions with

so many new people around her and occasional discomfort and anger at her inability to remember. What was happening on the inside was a complex disease of proteins that form plaques and tangles in the brain.

Those plaques and tangles starve the brain cells and nervous system

pathways, killing them. When those brain connections go, so do memories and other functions.

Dr. Carol Colton, a professor of neurology at Duke University who

researches the brain’s immune system, explained that science’s understanding of the disease is imprecise. What prompts the onset of the disease and the formation of the proteins is still mostly unknown. Dr. Colton laments other scientists’ focus

14 on attacking specific proteins instead of looking at the bigger picture of its overall cause.

One of the biggest questions she has about the disease is a controversial

one: Does the immune system attack those proteins because they are harmful to the brain, or is the immune system what causes them to form?

This is the question that Dr. Colton says could unlock the Alzheimer’s

mystery.

In fact, she was one of the first scientists to discover a cell that acts as the

first line of defense in the brain—the microglia. When I went to her office, Dr. Colton handed me a sticker: “You should take it, it’s so adorable.” On the front was a cartoon depiction of a janitor-like cell with multiple squiggly arms named Mike Roglia.

Using the stickers as characters in her story, Dr. Colton gave a long and

detailed explanation of what may have happened to my grandmother’s brain and why it killed her. She knows the story well, not just because of her research, but also through her own experience with her mother who died of Alzheimer’s.

She explained that my grandmother had most likely carried the

APOE4/4 gene, or two APOE4 alleles. Having one allele means that your risk of getting Alzheimer’s disease are slightly raised, so having two meant that my grandmother’s chances were multiplied by twelve. Her diabetes didn’t help either.

With her body’s poor production of glucose, the starvation of her brain cells and neurons was most likely accelerated.

There’s a good chance that I have at least one of the APOE4 alleles as

well: something to think about, but not dwell on.

While she took me through an explanation of why the brain is susceptible

to the tangles and plaques, Dr. Colton waved a sticker in the air and tossed it

15 in a pile of a few others. Myrtle Tangullis, a female character, looked like a squid version of Medusa. Cute, admittedly, but a little morbid. She’s one of the ‘anarchy aggregates,’ as titled on the sticker, a mysterious bunch that may have killed the brain cells in my grandmother and many others.

As morbid as it may be, I’ve decided to keep that little Mike Roglia

sticker on my desk as a memento, right beside a Mr. Rogers bobblehead. My grandmother was my first line of defense—my microglia—when I was a child, telling my mom to let me off when I was a bad kid sometimes. She was sweet on me like only a grandma can be.

Mr. Roglia gave me something tangible to hold onto, if nothing else.

On Christmas Eve of 2012, three months before her death, I brought

my friend Chris to a family party. When we entered the kitchen doorway, my grandmother met us there, smiling with arms wide open. She told me how beautiful I was, like always. Then, she turned towards Chris, smiled, and hugged his neck just as hard. She told him how much he’d grown since she last saw him.

“Thank you, ma’am,” said Chris.

She had never seen him before, but in the moment, she truly believed

that he was just another grandchild, one of her beautiful babies. Plaques and tangles would starve and kill my grandmother’s brain, but she never forgot how to hug her children.

-Joshua Trent Brown recently graduated from the Hussman School of Journalism and Media with a B.A. in Reporting and a minor in Christianity and Culture. He is from Cerro Gordo, NC and is currently a reporter at the News & Observer.-

16

Insurance Fees Lucas Thornton

My mother finally paid off my nose. It took four years, several thousand

dollars, and a whole lot of frayed nerves, but we finally did it, the three of us. To celebrate, my parents took me to my favorite Thai restaurant. I refrained from getting Thai iced coffee, opting instead for a complimentary glass of water. I also ordered veggie pad Thai instead of my personal favorite, shrimp pad Thai, because shrimp cost a whole four dollars extra. At the end of the dinner, my dad tipped the waitress a five-dollar bill, approximately fifteen percent of our thirty-seven-dollar meal. My mother wanted to give her a dollar or two more.

We went there often enough and we considered this waitress sweet, but my father dissuaded my mother by proudly showing her the dark confines of his empty billfold.

On the way home, I sit in the backseat of our minivan with my head idle

against the headrest. As I watch the few bright lights of my hometown whip past my eyes, my mother, a silhouette, suddenly says, “I can’t believe those doctors.”

Which doctors? There were so many, but my dad beats me to the

question.

“Who are you talking about, hon?”

I see my mother’s outline shift toward me. The digital red light of the

radio reveals her moving lips.

“The county doctors, the ones at the ER. The ones who said we couldn’t

get any indigent pay because we didn’t live in the damn county.”

“They weren’t any better than the principal. We were just a liability to

him. He didn’t want a claim on his hands,” my dad says.

And here they are, going at it again. They have been complaining like

this for four long years. Of course, they have every right to complain, and it’s certainly cathartic in some instances, but it wears thin, especially for third party spectators who are not as adept in the art of the complaint. I feel far removed from the conversation in the backseat, shrouded in incomplete darkness, struggling to remember all these people who apparently swindled me while I was

17 still a freshman in high school.

That day four years ago was strange, remarkably different from any other

day in my life. I awoke at a normal time, I went to school at a normal time, yet I blacked out at a most inopportune time. I can only describe it as an annihilation.

I was standing in the bathroom, looking at my boyish freshman face in the mirror, and then nothing. Complete darkness surrounded me. When I came to, I thought I was in bed. Time rewound itself. I was sleeping soundly in my bed. Yet, why was my mattress solid and cold? And why did my nose hurt?

Truly strange, I had never unwillingly lost consciousness before. I was not

one for taking impromptu naps, but this was no nap. The darkness that engulfed me had been so sudden, so complete, and so direct. I was scared. I didn’t know what to do. I ran back to my classroom and scared everyone. I was a mess, blood dripping down my nose and my skin white as a sheet.

Then, the ambulance arrived, “ambalamps” as my dad calls it. But

the school nurse inspected me first. I had no history of passing out. Was I on something, drugs? No. Had I drank and ate that morning? Yes, ma’am. Did I have night sweats? Why? Leukemia can make you pass out and you get night sweats with Leukemia. Oh God, my room gets pretty warm at night.

A one-way ride to the county hospital cost us $472. I told the medic I

didn’t want to cost my parents any more money than I had to, but he just stuck a cold IV needle into my arm. The moment the medics wheeled me into the ER I was struck with a $500 flat fee for stepping foot inside the place. After the EKG was administered, a CT scan was given, and a couple more IVs were put into me, I was left with something more than a flat fee. My mother loves enumerating her woes, so I’ve been told many times that she had to pay thirty percent of the visit’s overall cost ($1500) in addition to a $3000 deductible, as dictated by her policy.

And then there was the operation. A real simple surgery that just involved

putting me under, shoving some forceps up my nostrils, and rearranging some septum-bone so I could breathe correctly. This thirty-minute procedure cost us $3000, thirty percent of the total amount.

Six thousand dollars for two minutes of impromptu darkness seems a

18 bit strange to me, very strange considering how long this unwholesome amount stayed with us. Four years. Forty-eight months of payments: one to the county hospital, one to the surgery center, and about a half dozen to a handful of elderly nurses and anesthesiologists whom I can’t even recognize in public. But we’re here, riding and complaining.

I try my hand at the complaint.

“Remember that old nurse who played IV tic-tac-toe on my arm at the

ER? She didn’t deserve her twenty-five-dollar monthly check.”

“She wasn’t as bad as that idiot ENT who thought rebreaking your nose

was a good idea. That was a sixty-dollar conversation right there,” my mom responds.

We are almost home now. The lights of the town are all gone. We are on

a backroad and everything is pitch black again, except for the red radio. I think everyone’s had their fill of complaints, but I am still annoyed for some reason. I could have gotten shrimp pad Thai and Thai iced coffee tonight, but breaking my nose four years ago prevented me. That’s scary; it’s a butterfly effect almost. My eyes drift toward the window, and I see a willful darkness, one that I expected.

-Lucas Thornton is a sophomore from Teachey, NC, pursuing a major in English.-

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Tina's Garden Maia Sichitiu

She caught me on the way out to lunch. Usually I ate tucked away on

my phone or reading in the corner of the upstairs lounge next to the stereo that played the same two Ella Fitzgerald songs on repeat. Before I could settle into my normal position, my manager stopped a cart in front of me with a desperate look in her eyes.

“We have to be quick,” she said, providing no context—she had a

dramatic flair for someone who had chosen to be a recreational therapist at Sunrise Senior Living. I followed her even though I had no idea where we were going (I was a good intern).

“Quick with what?”

“You’re gonna help me go to Tina’s room and pick up all the vases.”

I didn’t even try to keep the grimace off my face. Tina was not my

favorite resident, and I certainly was not her favorite worker. I did, however, enjoy: •

Charlie, a wisp of a woman trapped in a wheelchair who spoke to me in whispers underlined with Southern grit and sweetness.

•

Harriet, an extension of Charlie. She pushed Charlie’s wheelchair and bent her creaky knees to listen to her speak carefully before announcing in her loud (slightly shrill) voice what Charlie had just said. She was also an excellent winker.

•

Toby, who sat in the lounge and told anyone who asked that he had sung with Frank Sinatra in Europe (this did not happen) and would launch into a raspy rendition of "Fly Me To The Moon" unprompted.

•

Anyone else who acknowledged my existence.

Tina did not make the list. Tina looked at me like she did the other

workers: with her nose slightly upturned as the only acknowledgment of our existence. She was a control freak who did not appreciate any attempts to help her maintain order because she wanted to do it on her own. Even at the ripe age

21 of eighty-seven, she took her daily strolls alone (not allowed) and refused dessert at every dinner. She only came to flower arrangement activities and preferred to sit in the lobby for the rest of the time. She would not respond to me when I was sent down to ask futilely if she wished to join us for yoga. Instead, she stared at her crossword through thick lenses while ignoring my needling—“Tina? Tina?

Just checking, that’s a no?”

And yes, it is worth mentioning: she was entering stage four of

Alzheimer’s which means that she had every right to be an asshole.

We were not each other’s favorites. She also scared the shit out of me.

But we headed down. I was vaguely aware of what might await us in

her room. My manager had complained all week about how our vases and the arrangements we had made last week had all disappeared. But I was not prepared for the magnitude of Tina’s thievery.

Before we even entered, I could smell it. The moist smell of mold hung

thickly in the air. We walked in. The room was filled to the brim with wilting roses, gardenias, violets, and lilies. On and under her counter were dozens of vases, the sides crusted with week-old mold.

“She yelled at the cleaning crew last week for taking some and told them

she would wash them but, you know...she probably forgot.” My manager was an expert at dancing around the topic of Tina’s state. She whispered this as though Tina might be lurking somewhere in one of the vases herself, ready to jump on anyone who accused her of forgetting to do something.

We gingerly grabbed as many vases as we could. It was somber work,

cleaning out an old lady’s comfort because she could no longer remember to take care of it. It is the kind of thing that makes you think that humans are surely not supposed to live this long, that our bodies should give out before our minds do.

We placed the vases on the cart until it was packed. There were still some

left on her window sill, but we left those there. The room seemed too empty when we left it. Less of Tina was in it.

After that day, I always slipped extra flowers to Tina during our weekly

flower arrangements. She did not appreciate it.

-Maia Sichitiu is a first year Pre-Med student from Cary, NC, pursuing a major in English and Comparative Literature.-

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Pointing to the Future Jhoan Aguilar

The ambiguous nature of the future can be an intimidating entity

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that drives us to push our limits in this life.

-Jhoan Aguilar is a Post-bac student from Asheville, NC, with a B.S. in Biology and a minor in Neuroscience.-

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Anterograde Jared Williams

“Mrs. Henson’s in room five—why don’t you go ahead and see her?

Sweet old lady, she’ll be a great practice interview. The only new thing I see is a little vitamin B12 deficiency.”

In her room, I recite the incantation: “Hi-I’m-a-second-year-med-

student-at-UNC-mind-if-I-ask-some-questions-before-the-doctor-comes-in?”

“Sure, go ahead.”

As the room comes into focus, I see an elderly woman with what looks

to be her daughter. They’re both smiling at me. There’s a calendar on the wall behind them featuring a B-21 stealth bomber. It prominently features the logo of the local VA hospital, and the caption underneath the photo reads, “The greatest casualty is being forgotten.”

“How are you all doing today?” I venture.

“Pretty good, not too much has changed,” the younger woman replies.

“I’m Barb—I’m not actually the patient today; that would be my mom, Barb Senior. But I’ll help out where I can.”

I turn and address her mother, “Okay, great, tell me about your health

conditions.”

“Well, I have the COPD but that’s been pretty good recently. I had to

go to the hospital for it a couple years ago, but now I got my face tubes for my oxygen tank at home and an inhaler for when I go out, so I’m pretty much set up.”

“Oh, you should see her with those little tubes on her face,” Barb says.

“She looks like a crazy person!”

They both laugh, and after a second, so do I.

“You’re awful young to be a doctor, aren’t you?” asks Barb Sr., eyes

narrowed in joking mistrust.

“Not too young to figure you out!” I return, now engaged in light

flirtation.

“Well then you better just ask me some more questions.”

My mind is now completely blank, so I just ask, “Do you have any other

kids?”

25

“You think I’m young enough to be having kids? Seriously though, I

do, just one other son. He’s pretty much 100% disabled, from the army. It’s the PTSD. But they take good care of him—we’re not too worried.”

I stammer, “Oh I’m…so sorry to hear about your son. I’m glad you can

all support each other though, that’s so important.”

Right the B12 thing.

Strafing the awkward silence, I turn and fire off a list of symptoms.

“Any pins and needles in your hands or feet?”

“No, not really.”

“Shortness of breath?”

“Well, I have COPD.”

“Right, right, next question: any confusion or dizziness?”

Her daughter answers for her, “She’s never dizzy, but she gets confused

all the time! Isn’t that right, Mom?”

“Just a tiny bit, but I always figure it out in the end.”

“Oh, it’s a little more than that,” Barb jumps in. “It seems like she can’t

remember anything these days—what day it is, where she lives, where she needs to go.”

“Are you still driving?” I tentatively ask Barb Sr.

“Oh yeah, I’m totally fine. Why are you asking me all these questions

anyway?”

She’s still smiling, but it’s strained.

“Just a few more, then I’ll stop bugging you. Let’s start by doing a little

word recall. Can you repeat after me—'Eraser, Sunset, Daylight’—and then remember these words for later?”

Smiling, Barb Sr. shoots back: “Eraser, Sunset, Daylight.”

“Can you tell me today’s date?”

She pauses. “I’m…I’m not totally sure. Is it the 11th of March?”

“Oh, I’m not sure I even know either.” I write down an X that only I can

see. “Can you tell me what state we’re in?”

“North Carolina—now that was an easy one!” She’s smiling again.

“What year is it right now?”

The pause is longer this time. She looks down at the floor sadly. “2009?”

Another X. “It’s actually 2019.” Her face falls. Am I supposed to correct them?

26 “Um, ok, sorry about that. Now can you just write a sentence—any sentence--on a piece of paper?”

Her hand slowly spells out: “Isn’t. It. Time. For. You. To. Go?”

I manage a laugh with Barb at this purported joke, but Barb Sr. is not

smiling.

“Alright, talking to y’all has been great—thanks for helping me practice.

I’m going to leave now and talk with the doctor. We’ll be back in just a minute.”

When we return a few minutes later, he turns and says to me, “Why don’t

you take the lead on this one?”

Yeah, just great. The Barbs both smile up at me. It seems we’re friends

again.

“Well, good news, Mrs. Henson. You have a condition that’s super easy to

treat, a deficiency of vitamin B12. You just need to come in and get a shot once a week—“

“I have to get shots now? What are you trying to do to me?” she laughs.

“—Just for four weeks, then you should honestly be feeling a lot better.”

“Alright, fine, I guess I’ll do it—just for you though.”

“Tell her the possible good news this could mean,” my preceptor

prompts.

She’s only 20 points below the normal B12 value and has no other symptoms. This is

clearly early dementia, but I guess I’m supposed to give her some false hope now—need a good

evaluation after all. I take a breath. “I don’t want to promise anything, but you could even get back some of your memory. This condition can affect some of the nerves in your brain, and fixing it can give them a boost.”

“Is it...likely?” Barb Sr. asks.

I’m the one pausing and looking away this time. “I...”

If I suspend my disbelief for long enough I can almost convince myself

that I see the stealth bomber on the calendar moving. I wish it would fly off the wall and take all four of us far away. It would soar beyond the mountains that this town nestles in, somewhere where there’s no false hope and no decay and nothing is lost and nothing ever ends.

“Eraser, Sunset, Daylight."

-Jared Williams is a third year medical student at the UNC School of Medicine from Greenville, NC.-

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Pain Management Taha Lodhi

The warmth of her hands wrinkled eyes when she smiled

abuse, trauma, depression

She’s not the 15-year-old who OD’ed Wednesday night

She didn’t need treatment she needed help

The distant, cold touch as I trace her name

the stone the soil the solitude

Six feet under a tombstone is no way to greet a friend.

-Taha Lodhi is a junior from Fayetteville, NC, pursuing a major in Biology and minors in Chemistry and Medical Anthropology.-

29

Meeting Dr. Lamb Ben Ashby

I wasn’t sure what to make of Dr. Lamb when we first met. He had a

clunky face and a tall, jerky frame. His deep brown eyes obscured his pupils, pinpoints behind small wire-frame glasses that clung to his nose. His thick black hair fell into messy sideburns that travelled just a bit too far down his cheeks.

Dr. Lamb greeted me with a big wave and slow, lisp-filled speech. He laughed at his own corny jokes with a sort of high-pitched shout. I saw a leather jacket and a motorcycle helmet hanging from the wall. A golden plaque on his door read “Jackson Lamb, D.O., Psychiatrist”. I decided that Dr. Lamb was a work of compensation, a man retelling his life after having finally made it somewhere. I was unimpressed, and it showed. My normally timid, deferring clinical demeanor became loud and confident. I found myself trying to finish his sentences early, and often being right.

I sat along the wall and watched Dr. Lamb conduct his first interview

of the morning. The girl was in all black and angry. She was hurting herself, regularly skipping school, and trying a lot of drugs. Her mom was getting desperate; they fought all the time. I imagined myself as the psychiatrist, finding a medicine to tone down the child’s behaviors and giving clever parenting tips to her mom. I would be cordial, but firm. Instead, Dr. Lamb was energetic and friendly, in an awkward sort of way. He nodded enthusiastically to their every answer. He seemed to completely ignore the family dynamic and push forward with unearned optimism. About twenty minutes into the interview, the girl smiled.

By the end of the appointment, she had said thank you to her mom. They left with a plan, medicine, and confidence. On the way out, the girl turned and asked, “Do you have a motorcycle?” Dr. Lamb chuckled, “Oh no, it’s a moped! Better for the environment, and still quite zippy if you’re going downhill. My wife and I share it; purple wasn’t necessarily the color I would have picked.” The family laughed again and left.

The next girl we saw had tried to commit suicide the day before. She

lay curled on the couch, hardly talking. I felt sadness push its way into every

30 corner of the room. Instinctively, I walked through the questions I’d have to ask to see if she would be hospitalized: What kept her from killing herself ? Was she thinking about doing it today? Did she have a plan to try again? “Oh no!” Dr. Lamb sounded almost childlike in his disappointment. The girl looked up, for the first time in the interview. He smiled at her, “I’m glad you’re still here.” She looked away, but I felt her posture change, infinitesimally. She began speaking in sentences instead of in words. By the end of the interview, she was sitting up, albeit slouched over and crying. He let her go home, with a different kind of plan.

She got better.

That first week, I was continually confused by Dr. Lamb. He seemed

spacey and his approach often didn’t make sense. He smiled when I would frown.

He left pauses where I would have spoken with authority. He gave gangly high fives to kids I thought needed restraints. I kept expecting an appointment to go wrong, but they never did. Every patient seemed in a better place, and better prepared for the future by the end of their thirty minutes. It felt as if we were in the same room, but seeing a different doctor.

Later in the week, Dr. Lamb hosted our medical school’s weekly

continuing education session. At one point, the discussion veered away from pure psychiatry into the effects of alcohol on the body’s response to insulin. Eventually, we landed in an obscure conversation of receptors and complex endocrine mechanisms. After each medical student, fresh from taking the most difficult and expansive test of their future career, had exhausted their knowledge base, one turned to Dr. Lamb and asked, “Maybe the only actual doctor in the room knows?” We all expected him to wave a hand and move on, as other physicians always did when asked about non-clinical minutiae. At least a decade out from this same test and dedicated to practicing in another field, Dr. Lamb drew out the feedback pathway we’d been stuck on and gently explained what was going on. His unexpected response was met with open mouths and a smattering of applause. Dr. Lamb chuckled, gave a small bow, and sat back down. After class, many of my friends whispered in disbelief, “He’s a D.O.?” I wondered if I had gone to the wrong type of medical school.

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Over time, I learned who Dr. Lamb was. He was a depression killer;

a puppy in wolf ’s clothing, relentlessly hopping and licking and yapping at stubborn, hurting teenagers until eventually, they cracked. He knew when to sit with someone in their suffering and not say a word. He knew when to push for a laugh. His dark eyes, without the twinkle I had come to require in my imagining of intelligence, absorbed more pain in a day than I could handle in a lifetime.

His messy hair and bouncing movements were a base upon which near-absolute trust was built within minutes. An abundance of hope shone through his posture, his smile, his words, and his pauses. He was brilliant and humble. He was good.

When we first met, I had wondered if he should be a doctor at all. Now, I wondered how I could ever become a doctor like him.

-Ben Ashby is a third year medical student at the UNC School of Medicine from Omaha, NE.-

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On a Scale of One to Ten Ben Kaplan - ARTIST'S NOTE I started cartooning again at the end of my third year of medical school in an effort to process and reflect upon my clinical experiences. As a medical student, I live in the gray area between opposites: day and night, healing and suffering, hope and despair, rational and emotional, professional and personal. In preparing to accept the honor and responsibility of healing others, I have learned what it feels like to be a part of someone else’s pain.

In these scenes, I sought to represent the need to keep up a “professional” appearance in the face of frustration, exhaustion, and internal conflict. By capturing this tension in a familiar form, cartooning has helped me to feel a bit more at home in my changing identity.

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-Ben Kaplan is a fourth year MD/MPH student at the UNC School of Medicine and the Gillings School of Global Public Health from New York, NY.-

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Hands-On Learning Abby Carey-Ewend

“Of course, you can do my nerve block,” I said to the anesthesiology

resident standing nervously to the left of the head anesthetist.

He has to learn somehow.

“Absolutely, you can try it again,” I encouraged hours later as the block

catheter fell out of my leg, leaking anesthetic fluid and blood in a pool around my pelvis.

He’ll get it right this time.

“Third time's the charm,” I joked, holding the catheter out to the

resident as the pain in my leg escalated to levels uncharted and a knot formed in my throat.

This’ll be you in a couple years, Abby. You’ll need the practice, too.

-Abby Carey-Ewend is a junior from Chapel Hill, NC, pursuing a major in Biology and minors in Chemistry and honors Interdisciplinary Studies of Medicine, Literature, and Culture.-

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Toxicity

Abbey Walker

“You’re fine.

Just take an Advil.”

“It’s probably just cramps.

Try taking a Pamprin.”

“Maybe it’s ovarian cysts.

You don’t really need to see a doctor for that.”

Standing.

Falling.

Black.

Fluorescent – “She just collapsed.

We thought she was fine.”

6 months.

12 doctors.

1 in 323 cases.

“You should have brought her in sooner.”

-Abbey Walker is a sophomore from Wrightsville Beach, NC, pursuing a major in Anthropology with minors in Food Studies and Medicine, Literature, and Culture.-

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To My Future Client Alleigh Wiggs

You can eat bread. You can eat rice. You can eat the chalky protein bars

with fake sugar. You can eat cake, or cheese puffs, or ice cream. You can eat an entire cereal box, cardboard included, with the prize inside. This doesn’t mean all of these do the same thing inside your body, or build your healthiest self, and to be honest, it is probably not your fault if you don’t know that. An entire industry is built on making us addicted to lab-made foods. Another industry solicits diet culture: selling bars, shakes, books, and diet plans to vulnerable individuals.

You don’t have to run. You don’t have to be as fit as that one girl on your

timeline you envy. You don’t have to do the “at home booty workouts” you see on Instagram. You don’t have to go to the gym at all. You can sit on the couch. You should know what this does to your body, though. The average American diet is so calorically dense that without much physical activity, it becomes difficult to manage a healthy weight. I’m 5’3”, and the average American diet and portion size has never been kind to my small frame. You should know that regular exercise strengthens your heart and that weight-bearing exercise may prevent osteoporosis.

Self-care is deeper than your desire to sit on the couch, eat ice cream,

and watch It’s Always Sunny with your roommate. Self-care is deeper than mental health days. It is taking the time to prepare food that nourishes your body.

It is moving in ways that make you happy, even when you feel exhausted. It is prioritizing your health with your votes, dollars, and time. It is choosing whole foods, shopping around the perimeter in the grocery store. It is going to yoga, learning to move.

You don’t have to care about health; you don’t even have to take care of

yourself. If you don’t, make it a choice. Don’t fall into the trap of the American lifestyle. Make it a choice to give yourself the chance to age gracefully, play with your children, walk upstairs. Know what goes inside your bag of chips, your cereal, your soda. Know why you squat, why you stretch. In all cases, be mindful.

-Alleigh Wiggs is a sophomore from Hampstead, NC, pursuing a major in Nutrition.-

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Marrow

Khaki Loughran I see the marrow in the bag deep red, thick as molasses flowing through the tube into that little sleeping body young in age but old in experience my little brother sleeps on as a war between cells erupts in his body I tenderly rub my lower back the bandage is large, all-consuming I pray my marrow does the job

-Khaki Loughran is a sophomore from Atlanta, GA, pursuing a major in English and a minor in Statistics.-

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Such Is the Life of an EMT Zachary Schwartz

Your first shift back is never easy. When you leave for work at 0515 hours,

the only things running through your system are coffee, anxiety, and thoughts of what you could’ve done differently. Before you can produce any logical answers, you find yourself at the station, ready to relieve yesterday’s EMS crew.

Such is the life of an EMT.

As you sit down in the far corner of the room, you notice eyes following

you like those of a hunter tracking deer. They know what happened on your last shift, but they won’t mention it until you do. You close your eyes and try to rest, but the dark abyss your eyes are accustomed to seeing is replaced by fragments.

Gloves. Blood. A mother’s look of dread.

Such is the life of an EMT.

An hour creeps by at a snail’s pace. When you awaken from your quasi-

sleep state, it is just you and your partner. You realize you have woken up for a call as a dispatcher spits out an address and a complaint. You stumble into the ambulance and the memories come flooding back.

Such is the life of an EMT.

The screams of a mother in the front seat. The bewildered, panicked

look of the young firefighter. The desperate attempts to start an IV. The frustration. The agony. The anger at other cars who refuse to yield. The feeble fantasy that the hospital will be able to perform some other intervention that you didn’t consider, when in fact there exists none.

Such is the life of an EMT.

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But now, sitting in front of you is your new patient. One of your regulars,

her putrid odor infiltrating your nostrils. You shrug this off, along with her claims of your incompetence as you treat her. Fifteen minutes later, you have delivered the patient to the hospital and you are cleaning her vomit off the floor.

Such is the life of an EMT.

After you have cleaned up, you begin to doze off. You are roused by

a knock at your door. You open it and are met by a young man and woman, accompanied by their newborn. They tell you eight days ago you delivered their newborn child at home, saving both the baby’s and the mother’s life. You weren’t working eight days ago, and this would have been one of your coworkers they’re thinking of, but before you can relay this information, the father embraces you, tears cascading down his face. “Thank you,” he says.

Such is the life of an EMT.

-Zachary Schwartz is a junior from Waxhaw, NC, pursuing majors in History and Peace, War, and Defense.-

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On Miraculous Healing Allison Ruvidich

She talks about a miracle she saw Once in an Orthodox church: a Cross That struck, and shivered—stuck— Upon some poor believer who was healed.

It made her dwell upon those hallowed lines: If I may touch his clothes, I shall be healed.

And so she prays it comes to pass for us, That our faith be some sweet and healing gift.

But I have walked in holy cities, too, And drunk the sacred waters where they flowed, Have listened to the saints and known them true, Have asked for healing and been told, “Not you.”

What is a miracle but a lightning change That snatches us from one form to the next?

She has some perfect form in mind, and blessed, That she would trade my earthly dwelling for.

But she did not pray for these writing hands Or for the pen that pressed these words.

Perhaps for miracles, I’ve been over-served And have not faith enough to cure the rest.

I will not be her passion play, but would Prefer to whip faith-lenders from my door And stack the last five years and cry, “How much more Am I to ask the one who gave me wit, Or words, and ask them why or where?”

(I tire of shaking holy water from my hair) But let this be enough—and seek no more Holy spring for me, or some old rite.

We change not in lightning but in life.

She says she prays for healing, but she’s wrong.

She prays for change, but I’ll take my miracles long.

-Allison Ruvidich is a senior from Chatham County, NC, pursuing majors in English and Classics.-

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Aftergrowth Rhea Jayaswal

She brought me golden tomatoes every Tuesday. I tried to refuse them—

it was unnecessary, truly—but she had a smile so sticky sweet, I couldn’t say no.

My kids enjoyed popping them in their mouths like grapes, especially my 12-yearold girl. I munched on the tomatoes occasionally, in the two-minute lulls between finishing a chart and running to the next patient.

Six full boxes were stacked high on my office counter one day. I noticed

a handwritten note left on top. The ink told me there had been an ample reaping this year—enough to fill Fort Knox—and she was looking forward to seeing me in three weeks. The sweet lady had been coming for five years now, for knee pain, back pain, chest pain, and the like. But from that day, it only took two weeks and one quiet foe for her to never visit again: stroke.

Her garden went to the senior center, though they weren't prepared

to take care of it, she wasn’t prepared to let it go, and I wasn’t prepared to say goodbye. She sank heavily into the earth, while in her garden, new roots took anchor. Beans and sweet potatoes and cucumbers grew, sometimes bitter. She disappeared yet became as eternal as the morning dew that falls from the rains and rises from the oceans only to cling to those sprouting leaves. It was magic to witness the creation outlive the creator, to sit outside and watch my daughter chase the rabbits, and to savor a golden tomato.

-Rhea Jayaswal is a first year from Cary, NC, pursuing a major in Nutrition and a minor in Creative Writing.-