Tabula Rasa and Post Call, 2017 by VUSM Literature, Arts, and Medicine

Tabula Rasa and

Post Call

Copyright ÂŠ 2017 All rights reserved. No part of this book may be reproduced in any form, except for the inclusion of brief quotations in review, without permission in writing from the authors/publisher. Printed in the United States of America

Editor-in-Chief Michelle Izmaylov

Managing Editor Samantha Gridley

Prose Editors Amalie Chen Henry Quach

Poetry Editors Jennifer Miao Rebekka DePew

Art and Photography Editors Andrew Perez Vishesh Jain

Faculty Advisor Dr. Daniel Birchmore

Contents Part One: Tabula Rasa Untitled Dr. Gary Strong.............................................................. 3 Bruceâ&#x20AC;&#x2122;s Dock Dr. Richard Davidson ..................................................... 3 Origin Dr. Joseph Little, III ....................................................... 4 Tree Pose Vishesh Jain ................................................................... 5 First Dissection Rebekka DePew ............................................................. 6 Solitude Dr. Richard Davidson ..................................................... 7 Untitled Dr. Pinar Polat ............................................................... 7 Cadaver Donor Speech Will French ..................................................................... 8

Color in the Lines Vishesh Jain ............................................................... 11 A Medical Studentâ&#x20AC;&#x2122;s Frustration Dr. Akshitkumar Mistry .............................................. 12 Palm Drive Vishesh Jain ................................................................. 14 Great Dane Puppy Ayaka Sugiura ............................................................. 15 Untitled Dr. Allison Martin ....................................................... 16 Flight of the Butterflies Dr. Gustav Blomquist ................................................... 18 Pregnancy Henry Quach ................................................................ 19 Two Vases on a Table Dr. Gustav Blomquist ................................................... 20 Voices of Experience: Stories about Healthcare and the Elderly Dr. Jane Brody and Dr. Samuel Brody .......................... 21 Untitled Dr. Pinar Polat ............................................................. 26 Death is a Seductress Chris Wallace ............................................................... 27 Untitled Dr. Pinar Polat ............................................................. 29 Brain Dr. Niki Thran ............................................................ 30 Untitled Dr. Gary Strong............................................................ 30 Non-Accidental Trauma Samantha Gridley ......................................................... 31 Domestic Violence Happens . . . Even to Me Anonymous ................................................................... 32

Untitled Dr. Ron Bronitsky ........................................................ 33 A Mess Ayaka Sugiura ............................................................. 34 Water Droplet Ayaka Sugiura ............................................................. 34 Bitter and Jaundiced Dr. Ben Trappey ........................................................... 35 Home Vishesh Jain ................................................................. 50 Today Professionalism for Me Dr. Susan Hata ............................................................ 51 The Illuminated Death of Melinda Sanchez

Lynne McFarland ......................................................... 52 Iris

Ayaka Sugiura ............................................................. 58 Your Soul is Not Concrete Michelle Izmaylov .......................................................... 59

Part Two: Post Call Untitled Dr. Joseph Little, III ..................................................... 67 Circlet Vishesh Jain ................................................................. 67 This Will Make It Better Rebekka DePew ........................................................... 68 Mikiaâ&#x20AC;&#x2122;s Seasons Gwen Moore.................................................................. 70 Individual Bows Henry Quach ................................................................ 71 House in Mapleton Andrew Perez ............................................................... 87

vii

Hi There Vishesh Jain ................................................................. 87 Water Carving Vishesh Jain ................................................................. 88 Autumn Dr. Blair Erb ............................................................... 89 Leaves on a Rock by a Creek in Forest Andrew Perez ............................................................... 92 Untitled Dr. Gary Strong............................................................ 93 The Blue Heron Dr. Mark Petrik .......................................................... 94 Big Blue Dr. Richard Davidson ................................................... 95 The Passing of the Cup Dr. Mark Petrik .......................................................... 96 King Vishesh Jain ................................................................. 97 Therapy Ayaka Sugiura ............................................................. 98 Psyche Rebekka DePew ........................................................... 98 Untitled Dr. Mary Harbison .................................................... 100 Astral Luminaries Dr. Richard Hutson .................................................... 101 Solar Flare Vishesh Jain ............................................................... 102 Untitled Dr. Joseph Little, III ................................................... 103 The Receptacle of Soul Gwen Moore................................................................ 104 Untitled Dr. Joseph Little, III ................................................... 106

viii

Lily Vishesh Jain ............................................................... 106 Blue Mist Vishesh Jain ............................................................... 107 Winter Morning Rebekka DePew ......................................................... 108 Mirkwood Vishesh Jain ............................................................... 110 Light Robert Tauscher .......................................................... 111 The Lamp Dr. Richard Davidson ................................................. 112 Wishing Robert Tauscher .......................................................... 113 Untitled Dr. Gary Strong.......................................................... 115 In Pig Latin Dr. Marvin Cohn........................................................ 116 A Feather in His Cap Dr. Gustov Blomquist ................................................. 117 Untitled Dr. Pinar Polat ........................................................... 118 Seven and Four Dr. Susan Hata .......................................................... 119 Walkway at Winter Dr. David Thombs ...................................................... 120 Mother Dr. Pinar Polat ........................................................... 121 Write She Says Dr. Pinar Polat ........................................................... 122 Red Rock Canyon Dr. John Cobb ............................................................ 124 Breakneck Vishesh Jain ............................................................... 124

Untitled Dr. Pinar Polat ........................................................... 125 The Orchard Dr. Richardson Davidson ............................................ 127 Hallstatt, Austria Ayaka Sugiura ........................................................... 127 Marinerâ&#x20AC;&#x2122;s Compass Dr. Mary Harbison .................................................... 128 Untitled Dr. Rajnish Gupta...................................................... 128 The Shape of Things #1 Gwen Moore................................................................ 129 Untitled Dr. Gary Strong.......................................................... 130 The Shape of Things #2 Gwen Moore................................................................ 132 Fallen Angel Vishesh Jain ............................................................... 132 One Dr. Pinar Polat ........................................................... 132 Angels Rebekka DePew ......................................................... 133 Norway Whale Dr. Rajnish Gupta...................................................... 135 Photo Opportunity at Sunrise Dr. Richard Davidson ................................................. 135 About the Authors ........................................................... 137

Part One Tabula Rasa

Post Call AT Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Bruceâ&#x20AC;&#x2122;s Dock Unknown switch Dr. Richard Davidson argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown3 switch argument.Error! Untitled Dr. Gary Strong

Post Call AT Error! Unknown switch argument.Error! You are our origin Unknown switch and how we take our argument.Error! measure Unknown switch as we pulse like cells through lives nourishing the organsargument.Error! Unknown switch that are our chosen pastures argument.Error! Unknown switch only to rush back through veins of anniversaries argument.Error! to the heart that is ourUnknown common switch ground replenishing what we argument.Error! lose by relying on the memoryUnknown of helicesswitch to dress the tattered wounds of explorations argument.Error! Unknown switch it is knowledge of your presence argument.Error! that gives us strength Unknown switch argument.Error! to find new ways to leave you Unknown switch and be ourselves for the heartbeat that is our time argument.Error! switch and now we watch as Unknown those around us do the same argument.Error! and wish that they will know the love Unknown switch that sends them on their way argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown4 switch argument.Error! Origin Dr. Joseph Little, III

Post Call

Tree Pose Vishesh Jain

AT Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown5 switch argument.Error!

Post Call AT Error! Unknown switch argument.Error! switch On the first day, GodUnknown created shadows, on the sixth day they argument.Error! moved. I thought it switchfeel would feel stranger, I Unknown thought I would argument.Error! less strange. It is a choice between dying Unknown switch and dying slowly. What sustains us also kills argument.Error! us, this was always evident but we forget. Unknown switch See, I am different, I am alive, I can get argument.Error! caught in the rain andUnknown laugh. The sixth day switch was for stargazing andargument.Error! oyster-catching and credit cards and sunscreen. Before then any Unknown switch serious conversation had to be held outdoors. argument.Error! Every day He said thisUnknown is good, but already by switch the second day He had created heaven so He argument.Error! wouldnâ&#x20AC;&#x2122;t have to lookUnknown too close. switch The sixth day argument.Error! was for making someone else with eyes and Unknown memory, someone else to take a switch scalpel to a argument.Error! dead body and pull back the skin. To know what switchis a type will not help and do itUnknown anyway. There argument.Error! of beauty that is denser than heaven, that must Unknown switch be felt with hands that come from the earth argument.Error! and go back to the earth and know what it is Unknown switch like to grow old. Before us, or so Iâ&#x20AC;&#x2122;ve heard, argument.Error! beauty was for grandness, for sunsets Unknown switchand the under-surface of the ocean. Now it can argument.Error! be held, can be flattened betweenswitch fingertips, Unknown thick and fibrous and argument.Error! so easily gone. Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown6 switch argument.Error! First Dissection Rebekka DePew

Post Call AT Error! Solitude Dr. Richard Davidson Unknown switch

Untitled Dr. Pinar Polat

argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown7 switch argument.Error!

Post Call AT Error! Cadaver Donor Speech Unknown switch Will French argument.Error! Unknown switchOnes of the Donors for A Speech to the Families and Loved the Class argument.Error! of 2019 on August 26, 2016 Unknown switch argument.Error! I want to thank the families and loved ones of the donors for Unknown switch being here today, and I am grateful for this opportunity to argument.Error! speak. I want to share about my experience with the donors, Unknown switch and the lessons I haveargument.Error! learned from my time with them. The anatomy lab is a relatively unique experience for Unknown switch medical professionalsargument.Error! compared to other career paths. For this reason, the majority of people have little familiarity with Unknown switch cadavers, and most, I argument.Error! believe, like to keep it that way. When talking about it with others you get responses like, “I could Unknown switch never do that” or “How do you not pass out?” People often argument.Error! Unknown switchto describe this taboo use adjectives like “gross” or “creepy” argument.Error! part of the medical school curriculum. Even among the Unknown switch medical students, myself included, the anatomy lab conjures argument.Error! up thoughts of a cold, steel cellar hidden away from the switch world, more similar toUnknown a graveyard than a classroom. A place argument.Error! you wouldn’t want to be alone in the night; a place that Unknown switch belongs to the dead. argument.Error! I recall a memory from my first day in the lab standing Unknown switch with my team, three other medical students, awaiting the argument.Error! beginning of our first Unknown lesson. With the steel casing still switch covering our donor, one of the medical students on my team, argument.Error! a former army medic,Unknown asked if I had ever seen a dead body switch before. I, wide-eyed and most likely a little pale, replied that argument.Error! no I had not. Well, I could talk to her if I needed to after the Unknown switch lesson was over. I appreciated the kind gesture; however, I argument.Error! felt additional gravity Unknown fall on the switch situation and my initial argument.Error! Unknown switch argument.Error! Unknown8 switch argument.Error!

Post Call ATinto Error! nerves quickly escalated fear. Could a dead body injure Unknown me in such a way? Could it send switch my mind to the point where argument.Error! it needed help from what my eyes had seen? I did not know Unknown switch the answer, but I started to fear the grim introduction that argument.Error! was about to take place. Unknown As soon as the fear set in, theswitch casings were opened and argument.Error! the feeling dissipated. What lay before me intended me no Unknown switch harm. It was something much more peaceful, someone much argument.Error! more human. So began my introduction to the anatomy lab. Unknown switch So far it had met all ofargument.Error! my expectations, but that would soon change. Unknown switch The initial differences from my preconceptions were argument.Error! obvious. The Vanderbilt Anatomy Lab is not buried in the Unknown switch ground. It is located on the 10th floor with Âž of the walls argument.Error! being windows. Shades protect Unknownagainst switch outsiders who otherwise have been tempted to look in either inadvertently argument.Error! Unknown or from intentional curiosity, butswitch not from the insiders looking out. All thoseargument.Error! within have a clear view of the rain, the Unknown switch sun, and the sky. Our workspace isargument.Error! bright and open, and we are Unknown switch encouraged to walk around and talk with other teams, teach argument.Error! each other, and learn from other donors. Within the first day, Unknown switch our somber silence and palpable nervousness turned to argument.Error! conversations, discussions, teachings, arguments, and, at Unknown switch times, even laughter. This was not a place of continuous pity, argument.Error! as I had halfway believed. Rather,switch our days were spent Unknown spinning the wheel ofargument.Error! emotion, ranging from moments of frustration to moments of awe. On exam days you could Unknown switch practically feel the excitement and tension vibrating through argument.Error! the air. It even became normal toswitch occasionally work in the lab Unknown alone, and yes, it would often be at night. During those hours argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown9 switch argument.Error!

Post Call AT Error! alone, I would sing, letting the sound fill the room, because switch silence somehow felt Unknown inappropriate. argument.Error! Your loved ones gave us the gift of knowledge and Unknown experience: the knowledge of theswitch inner workings of the argument.Error! human form, the machinery of life, and the experience of Unknown handling, with patience and withswitch care, the body of another argument.Error! human being. These lessons alone will be of unbelievable Unknown switch value moving forward in our careers, but for me at least, there argument.Error! was a deeper lesson that was learned. One, I believe, that is Unknown switch vastly more fundamental to the art of medicine. argument.Error! Towards the end of the course I searched for the Unknown switch presence of that thingargument.Error! that I had so feared toward the beginning. It was never truly theswitch dead body that was the Unknown object of fear, but it was death itself. In my youthful glow argument.Error! straight out of collegeUnknown it was death that I feared, and it was switch death that I had been argument.Error! expecting. Deathâ&#x20AC;&#x2122;s presence was there Unknown switch and had been there the whole time, but there was something argument.Error! else there that was powerful and unexpected. Unknown switch The presence of death may have been our introduction argument.Error! and our expectation, but the presence of life quickly Unknown switch overwhelmed it. Life is what I felt surrounded by towards the argument.Error! end, and life was what I realized I had been experiencing all Unknown switch along. Life was lived alongside your loved ones. Life was lived argument.Error! because of your loved ones. We were the first people who Unknown switch benefitted from their donation. We were the first people to argument.Error! experience the gift of Unknown life where switch we thought we would only find death. I want to assure you, thanks to what we have argument.Error! learned and what we have experienced, Unknown switch we will not be the last to benefit from their donation. argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! 10switch Unknown argument.Error!

Post Call Color in the Lines Vishesh Jain

Post Call AT Error! A Medical Student’s Frustration Dr. Akshitkumar MistryUnknown switch argument.Error! switch They only had to lookUnknown at each other to smile. Some memories backargument.Error! then, no one knew. Unknown switch She remembered every single detail, And he couldn’t reallyargument.Error! remember the tale. Unknown But he only had to look at her toswitch smile. argument.Error! Some memories back then, he just couldn’t tell. Unknown switch argument.Error! The doctor walked in with his long white coat. Unknown switch I rushed behind, as he cleared his throat, argument.Error! “He’s deteriorating from Alzheimer’s Unknown switchdisease.” It was the area of his expertise. argument.Error! The shock and disbelief zapped her numb. Unknown switch She was in complete denial; she did not want to succumb. argument.Error! Unknown switch But he continued in an unusual quest, argument.Error! switch In the clear voice thatUnknown he possessed. argument.Error! “He doesn’t remember anymore—not this, nor myself. “He will forget one byUnknown one—firstswitch you, then himself.” argument.Error! She snapped with hostility towards him, Unknown “No, he wouldn’t!” she grabbed switch his coat at whim. argument.Error! Unknown switch But he remained calm and steady. argument.Error! Not to be rattled from his dire mission already. Unknown switch He looked straight in her eyes, argument.Error! “His will be a painful Unknown demise, switch “Not knowing why heargument.Error! ever lived, if he ever loved. “To whom to say his Unknown goodbyes before switch he dies. “My dear, he has onlyargument.Error! a few years.” That did it: She slumped in tears!switch Unknown argument.Error! Unknown switch argument.Error! 12switch Unknown argument.Error!

Post Call AT Error! I stood behind perplexed, what was right or wrong? Enraged that I wasn’tUnknown yet strong switch argument.Error! To break free of my fears To share a few tears. Unknown switch argument.Error! He gently left, but I couldn’t follow. Unknown switch I stood behind distraught and sorrow.

argument.Error! Unknown switch Now, they only had to look at each other to weep. argument.Error! Some miseries were coming by, they both knew. Unknown switch She remembered every single detail, argument.Error! And he couldn’t reallyUnknown rememberswitch the tale. But he only had to look at her to weep. argument.Error! Some miseries were coming by, he just couldn’t tell. Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! 13switch Unknown argument.Error!

Post Call Palm Drive Vishesh Jain

Post Call Great Dane Puppy AT Error! Unknown switch Ayaka Sugiura

Post Call AT Error! Unknown switch argument.Error! Unknown I wrote the passage that followsswitch in the winter before my final argument.Error! year of medical school. Iâ&#x20AC;&#x2122;m leaving it in its original (and Unknown unfinished) form to preserve theswitch authenticity of the emotion I argument.Error! felt when I first wrote it. My aunt was dying from lung cancer Unknown switch and the impact on our family was obvious and especially argument.Error! harsh given the proximity to Christmas. My aunt chose to die Unknown switch at home, and I am absolutely convinced after nearly 4 years of argument.Error! surgical residency that the way you die can completely Unknown switch transform the mourning process for both patients and their argument.Error! families. Although it isUnknown sad to reflect on this time, it also gives switch me hope. I think she argument.Error! died the way she wanted to die and that was and still is a comfort for those of us who loved her. Unknown switch argument.Error! Christmas presents areUnknown sitting onswitch the ground, still in their giftwrapped boxes and argument.Error! shiny, paper bags. Spread out in an Unknown switch organized pile, not knowing that their hidden trinkets will argument.Error! never be enjoyed by the intended recipient. The television is switchof the programs playing turned on, but muted,Unknown so the sounds argument.Error! go unnoticed by anyone near enough to have the harsh light Unknown switch cast by the brightly-lit screen reflected on them. Hands are argument.Error! folded in laps. Lips closed. Ears piqued for more important Unknown switch sounds. They are ready to catch a hint of a throat being argument.Error! cleared that signals theUnknown next round of coughs that are about to switch unfoldâ&#x20AC;&#x201D;the heart-wrenching swan song of lungs that can no argument.Error! longer protect their human from the polluted environment Unknown switch and seemingly harmless microbes that float through the argument.Error! blanket of air that our lives depend Unknown switchupon. Images of harsh anatomy atlas pages painted in primary colors briefly make an argument.Error! Unknownmind. switch appearance in my distracted Feelings of helplessness argument.Error! Unknown switch argument.Error! 16switch Unknown argument.Error! Untitled Dr. Allison Martin

Post Call AT Error!the heft of a down coat during are difficult to shake offâ&#x20AC;&#x201D;like Unknown an especially temperate winterâ&#x20AC;&#x2122;s switch day. Lights are dimmed now argument.Error! to spare the eyes, but the soft glow of the television remains, shedding light on the Unknown frown linesswitch that grace the faces of those argument.Error! of us who sprawl on couches and chairs in the small living Unknown room. Eyes dart to old framed switch photos of loved ones, some argument.Error! leaving, some departed, some soon to be departed (which no Unknown switch one says aloud, but many suspect, deep down). argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! 17switch Unknown argument.Error!

Post Call AT Error! Flight of the Butterflies Dr. Gustav Blomquist Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! 18switch Unknown argument.Error!

Post Call AT Error! Unknown switch Pregnancy argument.Error! Henry Quach Unknown switch argument.Error! Sometimes you’re pregnant and don’t even know! Unknown But you’ll get symptoms that willswitch surely show. argument.Error! The most obvious one is gaining weight Unknown switch From the baby growing at a fast rate. argument.Error! The rapid growth will also zap your strength. Unknown switch You’ll tire fast and can’t walk a great length. argument.Error! Also make sure iron isUnknown in your food; switch Anemia will tire you out, dude! argument.Error! Baby can also push onUnknown your bladder. switch You’ll pee a lot more argument.Error! than you ever were. Speaking of pee, there’s other fluids too! Unknown switch Bleeding and discharge coming out of you. argument.Error! switch You’ll also have someUnknown really weird cravings. Duck’s feet smoothieargument.Error! with chocolate shavings? Unknown switch Now to talk about hormonal changes. argument.Error! There are many symptoms with wide ranges. Unknown switch First you’ll get nausea, worse in the morning; argument.Error! Avoid crazy foods, that’s just my warning. Unknown switch Progesterone slows intestines down; argument.Error! You’ll be constipated and surely frown. Unknown switch Progesterone can cause bad heartburn too; argument.Error! The sphincter’s relaxed and acid switch gets through. Unknown Estrogen can mess upargument.Error! all your taste buds. You’ll taste metal evenUnknown when eating spuds! switch Your breasts will prepare to make milk some day, argument.Error! So they’ll be tender inUnknown every which way. switch And you’ll have moodargument.Error! swings to add to the list . . . switch But now your baby is Unknown soon to exist! argument.Error! Unknown switch argument.Error! 19switch Unknown argument.Error!

Post Call Two Vases on a TableAT Error! Dr. Gustav Blomquist Unknown switch

Post Call Error! Voice of Experience: AT Stories About Healthcare and the Elderly switch Dr. Jane Brody and Dr. Unknown Samuel Brody argument.Error! Unknown switch Foreword argument.Error! Unknown We have been married for switch close to 40 years and have argument.Error! been health care providersâ&#x20AC;&#x201D;Jane, a nurse and Sam, a Unknown switch physicianâ&#x20AC;&#x201D;for almost as long. We often share our argument.Error! professional experiences with each other to help ventilate our Unknown switch feelings and to think through the extraordinary events that we argument.Error! are presented in our Unknown work. Ourswitch experiences dealing with the declining health and deaths of our parents have also added a argument.Error! personal dimension to our continued Unknown switch exploration of how to provide the best health care for people as they age. argument.Error! We will try to impart someswitch of the knowledge we have Unknown gained from the patients and families whom we treat, the argument.Error! switchand family and friends residents and studentsUnknown that we teach, who seek our council.argument.Error! This book is another way to share what Unknown we have learned and have switch been taught through our argument.Error! interactions within the health care system. The stories reflect switchto maintain privacy and actual events but haveUnknown been modified argument.Error! to help present the ideas we wish to communicate to the Unknown switch reader more clearly. We hope that each reader will find a story argument.Error! or two that resonates with them and addresses an issue of Unknown switch concern. argument.Error! We do not claimUnknown to have switch a crystal ball to predict the future. Any advice argument.Error! given in this book is based on our experiences with other people. It is practical and not clinical Unknown switch and not meant to replace care by your health care providers. argument.Error! Our own beliefs and Unknown values about life and death inform our switch thinking. They may not be the same as many who read this argument.Error! book. What we want Unknown to share isswitch our voice of experience that argument.Error! Unknown switch argument.Error! 21switch Unknown argument.Error!

Post Call AT and Error! we hope will assist you your family as you navigate the Unknown difficult task of providing healthswitch care for your elderly loved argument.Error! one. While we tried to make each chapter focus on one issue, switch many of the ideas in Unknown each chapter are interlocking and build argument.Error! on material in other chapters. This reflects the complexity of the real life situations Unknown we all face.switch argument.Error! We hope that reading some of these stories will motivate Unknown switch you and your elderly loves ones to have a heart-to-heart argument.Error! discussion. This book is not meant to provide all the answers. Unknown switch We hope its starts a dialogue. argument.Error! Unknown switch

“She should live another 20 years.” argument.Error!

Unknown switch For several years Sam cared for a wonderful woman, Mrs. argument.Error! Katz, who had beenUnknown remarkably healthy in mind and body switch until well into her nineties. She was Jewish and had grown up argument.Error! switchShe came to America, in Eastern Europe Unknown during WWII. argument.Error! married, and was able to see her daughter become a Unknown successful health care executive.switch Now she was experiencing argument.Error! the frailties and general decline that come with extreme old Unknown switch age. Despite whatever treatments modern medicine had to argument.Error! offer, there was nothing that would prevent the continued Unknown switch downward progression of her aging body. She had made argument.Error! peace with her situation, but her only child, an unmarried Unknown switch daughter, who could be considered a senior citizen herself argument.Error! and who had remained quite close to her mother, refused to Unknown switch accept this. argument.Error! One technique we use whenswitch talking with families about Unknown treatment options andargument.Error! prognosis is to ask, “How long do you see your loved one Unknown living?” This is a gentle way to begin switch looking at end of life issues by laying a foundation for argument.Error! Unknown discussing how to make these switch last years the best possible. argument.Error! Unknown switch argument.Error! 22switch Unknown argument.Error!

Post Call AT Error!a person in their nineties will Most people when discussing Unknown switch say a few years. Some have the goal of their loved one argument.Error! reaching the major milestone of 100 years. Unknown switch When making decisions about health care, thinking about argument.Error! age and life expectancy should enter the picture as one but Unknown switch only one of the variables. After the age of 70, how healthy an argument.Error! older person is will reflect more on the overall quality of life Unknown switch and level of function than age. The care provided a relatively argument.Error! healthy, active 90-year-old may not differ much from the care Unknown switch for a much younger person. Conversely, the choices made for argument.Error! a person in their Unknown early 70â&#x20AC;&#x2122;sswitch with severe neurological impairment and limited functioning should look quite argument.Error! different from the choices made for a healthy 70-year-old Unknown switch because the needs are much different. In former cases, the argument.Error! best course of action is goodswitch supportive care, continued Unknown treatment of chronic argument.Error! health problems, and the avoidance of Unknown major complications such switch as falls and resulting argument.Error! hospitalization. Unknown When a frail elderly person switch reaches the state when these argument.Error! supportive and preventative measures are not enough to switch must be made about maintain the patientâ&#x20AC;&#x2122;sUnknown health, a decision argument.Error! how aggressively the patient should be treated. For both the Unknown switch underlying chronic and the acute conditions that arise, argument.Error! aggressive treatments that would be better tolerated in Unknown switch younger people are more likely to cause negative argument.Error! consequences in the older adult. switch Unknown The term aggressive is very emotional and value-laden. argument.Error! But it must be acknowledged that many interventions, such as Unknown switch surgery, chemotherapy, and mechanical ventilation, come argument.Error! with high risks for iatrogenic Unknown switch(health care caused) complications. In this age group especially, iatrogenic argument.Error! Unknown switch complications can lead to increased pain and suffering. In our argument.Error! Unknown switch argument.Error! 23switch Unknown argument.Error!

Post Call Error! experience, intensive AT health care in the frail elderly is unlikely switch to achieve the aim of Unknown an extended period of time with a good argument.Error! quality of life. Again, the term “good quality” is value-laden Unknown switch and may have different meaning for different people. Pain, argument.Error! immobility, nausea, lack of appetite, loss of independence, switch are all factors that loss of privacy, andUnknown social isolation influence a person’sargument.Error! perception of “quality of life.” For Unknown switch example, just keeping an intravenous line going for fluids and argument.Error! medications may require frequent multiple sticks. If the Unknown switch person has confusion,argument.Error! restraints–which are frightening—may be applied to preventUnknown the personswitch pulling out the intravenous line. The insertion of other forms of intravenous access argument.Error! increases the risk of infection because Unknown switchthe elderly have weaker immune systems, which make them more more vulnerable to argument.Error! infections. Unknown switch Often the choiceargument.Error! between aggressive acute care and Unknown options switch and outcomes against quality of life pits contradictory each other. The moreargument.Error! you do to achieve one goal, the less you Unknown switch of this contradiction, can do to achieve the other. Because argument.Error! making decisions becomes much more complex. This is a Unknown switch and discussion about major reason why advanced directives argument.Error! them with your loved ones is so critical. Unknown switch The thought of a loved one’s death is frightening to most argument.Error! people, even as their loved one reaches the age of “life Unknown switch expectancy” and beyond. Although it is difficult to argument.Error! completely eradicateUnknown feelings switch of fear and abandonment, having a discussion about values, beliefs, and goals regarding argument.Error! health care and end-of-life issuesswitch can be extremely helpful. Unknown In this story the argument.Error! daughter, who had been a health care provider herself, answered the question, Unknown switch “How long do you see your 94-year-oldargument.Error! mother living?” with the statement, “Twenty years.” Did Unknown she actuallyswitch think her mother would live argument.Error! Unknown switch argument.Error! 24switch Unknown argument.Error!

Post Call to be 114? No, we doAT notError! think so. What she was saying was switchwas too frightening to the thought of her Unknown mother dying argument.Error! accept. The daughter was in her late sixties. Perhaps the 20 Unknown years represented how long the switch daughter thought she would argument.Error! live and she did not want to live without her mother. While Unknown these feelings and fears are veryswitch understandable and natural, argument.Error! they prevented her from accurately assessing her mother’s Unknown switch health status and prognosis. This in turn prevented her from argument.Error! making decisions that would best serve her mother by Unknown switch preserving her mother’s dignity and minimizing her mother’s argument.Error! suffering. Unknown switch Mrs. Katz, who argument.Error! had some mild cognitive decline but would still have been Unknown deemed competent, switch went along with her daughter’s wishes forargument.Error! more intensive treatment. She rallied for a few months Unknown and then switch her health deteriorated on multiple levels. Over the next 8 months there was a argument.Error! Unknown switch downward progression of acute episodes from which she argument.Error! would never completely recover. Although there were a few Unknown good days, they became fewer switch and farther between. Finally, argument.Error! 10 months after the initial conversation about how long her switch daughter thought sheUnknown would live, Sam was able to refer Mrs. argument.Error! Katz to hospice. With his support and the support of the Unknown switch hospice staff, Mrs. Katz’s daughter sadly accepted that her argument.Error! mother’s life was nearing its end. Without repeated trips to Unknown switch the emergency department, hospitalizations, and intensive argument.Error! treatment, Mrs. Katz Unknown died quietlyswitch in her apartment having just turned ninety-five. argument.Error!

Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! 25switch Unknown argument.Error!

Post Call Untitled Dr. Pinar Polat

Post Call Death is a Seductress AT Error! Unknown switch Chris Wallace

argument.Error! Death, that deceptiveUnknown whore, switch argument.Error! salaciously veiled in tight, dark lace glides into the room. Unknown switch argument.Error! Caressing the door, the wall, the curtains Unknown switch playing coy. argument.Error! Unknown switch “Everyone knows you’re here,” they thought, argument.Error! refusing to look her inUnknown the eye. switch As she made her way argument.Error! around the room, quietly finding her place in a Unknown lonely corner, switch twirling her hair. argument.Error! Unknown switch And replacing that sterile musk, argument.Error! her perfume saturatedUnknown the air. switch argument.Error! A scent wholly unknown to them, yet Unknown switch remembering immediately recognizable, like suddenly a long past dream. argument.Error! Unknown switch argument.Error! That enticing smell, that sensual look, Unknown switch promised magic and glamour. argument.Error! It called them all to embrace in a revelry Unknown switch of reverence, excitement, wonder, and despair argument.Error! as the tired man would pass on. switch Unknown argument.Error! But death, she had them fooled. switch Unknown Pulling back the veil, they thought to gaze argument.Error! into the face of that eternal seductress. Unknown switch As she stepped into the light, leaning over the deathbed argument.Error! She was but a hag. Unknown switch argument.Error! Unknown switch argument.Error! 27switch Unknown argument.Error!

Post Call There was no peace. AT Error! There was no magic. Unknown switch Death came and went,argument.Error! Unknown switch taking her prize. argument.Error! Leaving no one satisfied.

Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! 28switch Unknown argument.Error!

Post Call Untitled Dr. Pinar Polat

Post Call Brain Dr. Niki Thran

Untitled Dr. Gary Strong

Post Call AT Error! Non-Accidental Trauma Unknown switch Samantha Gridley argument.Error! Unknown switch Brain is argument.Error! Everywhere. Spilling out the space Unknown switch No longer barricadedargument.Error! by temporal bone. Unknown switch Tissue balloons beyond recognition argument.Error! Following orders of glutamate, lactate, Unknown switch Arachidonic acid, histamine, and more. argument.Error! A constellation of Unknown switch Red bursts argument.Error! Stains the tapestry of Unknown switch Your retina. argument.Error! Child of a child, Unknown switch Thorns in your familyargument.Error! thicket â&#x20AC;&#x201C; Unknown switch Too knotted to be a tree â&#x20AC;&#x201C; argument.Error! Arrive to spout medical half-facts Unknown switch And add color to erroneous stories That may have made argument.Error! sense Unknown switch Except argument.Error! That you are lying here Unknown switch Scathed, still, silent. argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! 31switch Unknown argument.Error!

Post Call AT Error! Domestic Violence Happens . . . Even to Me Unknown switch Anonymous argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! 32switch Unknown argument.Error!

Post Call Untitled1 Dr. Ron Bronitsky

AT Error! Unknown switch argument.Error! Unknown Shattered hope cuts my feet as I switch walk barefoot. argument.Error! I wash my wounds with tears. Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! 1 Composed after the first time I had patient die under my care as a new Unknown switch doctor. argument.Error! Unknown switch argument.Error! 33switch Unknown argument.Error!

Post Call A Mess Ayaka Sugiura

Water Droplet Ayaka Sugiura

Tabula Rasa Bitter and Jaundiced Dr. Ben Trappey I reach for my phone, trying to silence the alarm but knocking it to the floor instead. When I stand to retrieve it, I’m so tired that I’m dizzy and have to lean against the bed for a moment to let my inner ear catch up with the rest of me. I think I might vomit. I’d set my alarm earlier than usual in order to shovel the sidewalk and driveway of the three to five inches of new snow that was forecast to fall overnight. I peek out the window, hoping that the prediction was wrong. Hoping that I’ll see an empty sidewalk outside and can reset the alarm on my phone and curl back up under the covers and doze for an extra twenty minutes. 5:30 may still be early but at 5:10 it seems like a luxury. This early in the morning, time seems to work exponentially. Twenty minutes can mean everything. No such luck. The streetlights outside illuminate a world covered in a fresh coating of snow. I pause for a moment and gaze down upon the scene below. The gray branches of the tree in my front yard are sagging under shrouds of newly heaped precipitation. They look as though they might snap if challenged with the weight of even one more insult. I understand them fully. I know I’m not alone. It’s May, but it feels more like January. The burden of a seemingly never-ending winter seems to lie heavy on even the most stalwart Minnesotans. But this has been my first experience of real winter and my first taste of a spring that isn’t, so I have no basis of comparison, no insight, and no confidence that it will end anytime soon. My fellow residents assure me that this is an

Tabula Rasa unusual year and that things will get better. But by the smirking way that they usually say it, I suspect that deep down they know that I’m not built to endure this kind of weather. They’re right, of course. I’m not made for this. My southern blood has never had to try to circulate in such extreme cold. My phone tells me that the high back home today is 87 degrees. Not for the first time since starting residency, I think about packing up my car and driving south. And not for the first time, I realize that I can’t quit. If only because if I do, my classmates will be stuck with all the work I’m leaving behind. One less intern means more call for the rest, and I can’t do that to them. Only obligation keeps me here. That and a lot of medical school debt. So, I stay and suffer through the second coldest and snowiest May on record and listen to everyone talk about how historically cold and snowy it is. I’m sick of talking about the weather. But then, I’m sick of everything. Sick of being stuck inside. Sick of paying ridiculous heating bills. Sick of wearing snow-boots. Sick of winter parking restrictions. Sick of the house that I, for reasons that I can no longer fathom, bought in a city that I now resent. Sick of shoveling snow. Sick of work. God. Am I sick of work. **** As I scoop up the dense snow and heave it out into the yard, I mentally run through my patient list. There were twelve patients on the team when I left last night. Most of them were extremely sick. A couple of them were actively dying. I wonder how many will still be on the list when I get in. Did any get sicker and get transferred to the ICU? Did any die? For a moment, I catch myself hoping that some of them

Tabula Rasa did. It would mean that I’d have fewer patients to round on by myself, since my senior resident has the day off. Ashamed, I chastise myself for the thought. Recently, thoughts like that have been bubbling up more frequently, and I don’t know how to stop them. When I finish shoveling, I go back inside and take a shower in the dark. The hot water cascades down on me and makes my slightly numb fingers tingle. I lean against the cool tile wall and close my eyes. Resting them just for a moment. Letting my mind shut down. Not quite asleep. Just steeling myself for the day ahead and whatever it might bring. Hoping I’ll be up for the challenge. I get dressed. I haven’t done laundry in weeks and don’t have it in me to try to coordinate a clean shirt, pants, and tie. Scrubs will have to do. I stuff a pair of running shoes into my bag and put my wet coat and snow-boots back on. As I walk to my car parked behind the house, I press the keyless entry button. Nothing happens. I push it again. Still nothing. I use the key to open the door. No dome light. Oh no. I put the key in the ignition. No chime reminding me that the door is open. S***. I turn the key. Nothing. F***. I look at the switch for the headlights. Of course. I was stuck at the hospital until 11:30 admitting new patients. I barely remember driving home before stumbling in and going straight to bed. I’m not surprised that I didn’t notice that the lights were still on. I walk down the alley looking for lights in neighbors’ windows to see if anyone is up and can give me a jump, but

Tabula Rasa of course no one else is awake at 6:00 on a Sunday morning. I pull out my phone and take off my mittens to check the bus schedule. One will be coming in fifteen minutes. I will have to make a transfer and will be late, but I will make it. It is four blocks to the nearest bus stop, and as I tramp through the snow, I call the night-float intern to let him know that I will be late for sign-out. He gives me a brief update on my patients over the phone. No one died. No one went to the ICU, but it was a close call. Two of my patients kept him busy all night. One dropped her blood pressure and required multiple boluses of IV fluids, some of which made their way into her lungs and led to an escalation in respiratory support. Another started bleeding rectally and required transfusion of several units of blood products to keep up with his losses. I can tell that my fellow intern is at least a little bit pissed off that my patients kept him so busy, even though we both know that there was nothing I could have done to prevent any of it. I tell him that Iâ&#x20AC;&#x2122;m sorry that my team had been such a problem. We hang up. I wait. The bus is late. Iâ&#x20AC;&#x2122;m just about to call for a cab when it finally arrives. Itâ&#x20AC;&#x2122;s empty. When I get downtown, I transfer onto a line that passes through the University. Riding this bus are only a teenager and a homeless man. The teen is sporting a food-service uniform and a sparse mustache and is asleep in the back row. The homeless man is sitting behind the driver in a seat facing the aisle reserved for riders with disabilities. He is tall and thin and registers as barely conscious. He is slumped down in his seat, and his legs, along with his grimy backpack and a gathering of shopping bags, are spread haphazardly out into the aisle. He opens his heavily lidded eyes and mumbles

Tabula Rasa something incoherent, briefly registering me as I say “excuse me” and carefully insinuate myself around his legs and bags in order to get to a spot in the middle of the bus. I take a seat, and we all bounce in unison and in silence as the bus collides with newly formed potholes on its way towards the University. About a mile before my stop, the homeless man completes his slump, collapsing onto the floor in a tangle of cachectic arms and legs. The driver notices as soon as I do and pulls the bus to side of the street. “Great.” I think. “Now, I’ll be even later.” I approach the maze of limbs lying in the aisle. Obviously noting my scrubs, the driver looks at me expectantly. I check to make sure the man is breathing. He is, but more quickly than I would have expected for a drunk. I check his pulse. It’s fast but strong. His yellowed beard is crusted with bits of food and spittle which coalesce around his mouth. He doesn’t respond to voice or the pain of a sternal rub. His breath reeks of the sickly-sweet scent of liquor. “He’s just drunk. I’m sure he’ll be fine.” I declare. “Can we just get him back in a seat and let him ride until he sobers up a bit?” The driver looks at me skeptically and shakes his head “No. It’s policy. I’ve got to call for an ambulance.” “Dammit,” I think. “How long is this going to take?” “Listen, can’t you just drive on to the hospital and drop him at the ER?” I ask. “It’ll be quicker than waiting for an ambulance anyway.” “No way. We’re not moving until he’s in an ambulance,” he says, again shaking his head, this time, I suspect, in disgust, as he walks toward the front of the bus to radio for the ambulance.

Tabula Rasa I check the bus schedule again. There won’t be another one going my way for at least thirty minutes. I consider walking the last mile to the hospital, but the sidewalks haven’t been plowed yet, I’m in scrubs, and I can imagine how I will feel watching the bus blow past me when I am halfway there. So, I sit and wait and stew in frustration and resentment. I can’t help it. I’m angry. Angry that the car wouldn’t start that morning. Angry that it’s still winter. Angry that the poor decision-making of a man who is drunk before 7 am is making me even later for work. Furious that this inconvenience will mean an even later night at work than what I was already expecting. The ambulance finally arrives, and a paramedic and an EMT board the bus. They put on purple nitrile gloves as they approach the man on the floor. Like I did, they check his airway, breathing, and circulation. They comment on his tachypnea and tachycardia. Then they check his blood sugar. I can see over the paramedic’s shoulder that the machine reads “Critical High”, meaning that his blood glucose is so high the machine can’t accurately read it. “Oh, shit,” I think. “That smell wasn’t alcohol. It was ketones. He’s in DKA.” The medics obviously have the same thought. After several attempts, they gain IV access and start a rapid infusion of IV fluids, inject a bolus of insulin under the skin of his abdomen, then carry the man, still completely nonresponsive, out of the front door and load him into the ambulance. The ambulance pulls off and makes a U-turn, lights flashing and siren blaring, heading for the county hospital. Well, he won’t be my problem, then. Not today, anyway.

Tabula Rasa Thirty minutes had passed since we’d stopped. I should have walked after all. I get off the bus a few minutes later when we finally arrive at campus and walk the last three blocks to the hospital. When I get to the entrance, I pause, waiting for the giant automatic rotating door to sense my presence and begin to turn toward me. When it does, I start to step into the building but find that I can’t. I can’t bring myself to pass through the swing of the door. I don’t feel like I can face what’s waiting inside. I don’t think I can deal with all of those broken people that I know that I can’t fix. I don’t want to see 60-year-old man who just wants to go home but can’t because his heart is wrecked and the tubes inserted into his chest won’t stop draining. I don’t want to see the septic octogenarian with dementia who barely has any blood pressure but somehow manages to make her way out to the unit desk cursing at the nurses every night. I don’t want to see the 30-year-old woman who drank her liver into such a scarred and shriveled puck that she has less than a 30% chance of surviving three months unless she gets a liver transplant. (A transplant for which she’s ineligible because she had been drinking right up until the time she came into the hospital.) I definitely don’t want to see the four patients with chronic pain who, no matter how much narcotic I agree to pour into their veins, still hate me because it’s not enough. It’s never enough. But mostly I don’t want to see Mrs. White, the 55-year-old mother of six (and grandmother of who knows how many) whom, last night, I had to tell had pancreatic cancer. Fucking cancer. I hate it. The door continues to spin. I think of all of the work I have done to get to this point. I think of the hundreds of hours of I spent volunteering and shadowing doctors during

Tabula Rasa high school and college. Of sleepless nights cramming for organic chemistry and molecular biology courses. Of a summer spent doing nothing but studying for the MCAT. Of hours spent perfecting my medical school application. Of the thousands of dollars spent traveling the country to interview for the opportunity to sacrifice 4 years of my life. Of the twohundred thousand dollars plus rapidly accruing interest owed to Sallie Mae. Of even more thousands of dollars spent flying all over the country to go on interviews to find the right residency program. All along the way, in every volunteer opportunity, in every personal statement, at every interview, I professed a deep desire to be able to help people, to make a difference in their lives. It wasn’t bullshit. I did really, truly, care about people and felt that I was called to improve their health and their lives. I did really, truly, feel that a career in medicine was the best way to do that. I try to remind myself that I did all of those things to get to this door in front of this hospital. I reach back and try to recall those feelings, that desire to help people, and to summon some motive to propel myself through that door, but all I can think about is how I feel right now in this moment. The anxiety. The exhaustion. The dread. I think about the day ahead of me and wonder what’s the point. Will I truly be helping anyone? Will I be able to get that 60-year-old home? Or keep that elderly woman alive? Will I be able to keep that 30-year-old alive long enough to get a new liver? Or help those four people with their chronic pain? Can I cure Mrs. White’s cancer? Of that list, I count one “maybe” and seven “fuck no’s”.

Tabula Rasa But I know that I can’t stay out there forever. I know that I have to go through those doors and do what little I can. Because it’s my job, and, today, there’s no one else to do it. I close my eyes for a few moments, take a few breaths, and when the door rotates open to me again, I will myself forward and follow the leading edge of the door out of the cold and into the heat, the fluorescence, and the chemical smell of the life I’ve chosen to lead. **** An hour later, I find myself looking down from the expansive windows of the sixth floor of the hospital and resenting everything I see. I’d been about to page my attending to let her know I was finally ready to round when I was distracted by the improbably white panorama below. Trees that should be budding are sagging with fresh, wet snow. The river below is swollen and choked with chunks of ice that churn languidly past its banks. In the time since I’d forced myself through the doors, I’d finished my pre-rounding. I’d seen most of my patients and had gathered all of the available data on each of them, dutifully filling my rounding sheets with their most recent lab and imaging results, vital signs, and comments from nursing and social work notes. The pockets of my white coat bulge with the papers filled with details and numbers. I roll my neck and shoulders, trying to shrug off the weight of the papers even if I can’t shrug off the load of all of the patients I’m carrying. Someone clears his throat behind me. I pivot sluggishly to investigate the source of the “ahem.” I know that I should at least pretend to be more animated than I feel. One never knows who’s watching in the hospital. I don’t want to be

Tabula Rasa labeled as an intern with an attitude problem (even if I am), but the ponderousness of my team and the scene outside seem to hang on my every movement. Luckily, it’s just the Oncology fellow. “Oh, hi, Amar,” I say, trying to smile and failing. “Hi, Peter. I just saw Mrs. White.” Mrs. White had “never been sick a day in her life” until last week when she’d developed a gastrointestinal illness that she’d thought had been a stomach virus. Her daughter had to force her to come into the ER two days ago when she noticed that her skin had turned yellow. Last night I told her that she was dying. Rapidly. The pancreatic mass seen on CT scan was, as we’d feared, adenocarcinoma, and it had spread to her lymph nodes, and probably to her lungs. She and her family (of which there were never fewer than five members present in her small room) took the news about how one would expect, particularly given that as far as she’d known, she’d been fine until five days before. I held her hand in mine as I broke the bad news. Her skin was cool. I could feel her shaking. I squeezed her fingers gently and tried to chase from my mind the realization that she could easily be my own mother. I provided what information I could. I knew that the prognosis was bad and treatment options extremely limited, but, as an intern, I didn’t know enough to provide answers to her or her family’s questions about treatment options or a timeline. She’d need to talk to the oncologists about the details. Even at the time, I felt that I should have stayed longer. That I should have just sat with her for a while. But I kept focusing on the two admission notes I had to finish and the

Tabula Rasa five daily notes I had to write before I could go home. And I kept thinking that it would just be easier to leave. So, I did. I made the excuse that I had some other patients to see. I backed out of the room, leaving her with her family and her tears. I went to the workroom and finished my work. According to the notes her nurse left in her chart, she’d spent the hours since waiting to talk to the oncologists and wondering aloud how long she had left. This morning, I’ve been telling myself that since I have no new information, there is no reason for me to see her again before I round with the staff physician. But, deep down I know that I’m avoiding her room, because I’m dreading the sorrow that I’m sure will fill it. I turn my head to glance briefly out the window again at the snow-laden trees below. I have serious doubts about whether I can bear the weight of her grief again. “Thanks for seeing her. What did you tell her?” I ask the oncology fellow. “I told her that she isn’t a surgical candidate and we could only offer palliative chemo.” “How long do you think she has?” “I told her that she could reasonably expect to have two to three months left.” “Okay. That’s about what I was expecting.” “Put in a consult for palliative care. We’ll see her in clinic next week. You can discharge her whenever you think she’s ready.” “Okay. Thanks for seeing her so quickly.” “Of course.” My excuses for not seeing her have vanished. I know that my attending will now ask how she’s taking the news of the

Tabula Rasa prognosis and will want to know what we need to do to get her ready for discharge. Plus, I have to let Mrs. White and her family know about the palliative care consult before they show up in her room to talk about hospice and where she’d prefer to die. I have to go in there. I turn back to the window, taking one last look at the scene outside before trudging down the hall to her room. I pause briefly outside her door. I sift through the loaded pockets of my white coat until I find the rounding sheet with her name and room number hastily scribbled along the top in my increasingly haphazard script. If anyone sees me hesitating outside her door, they’ll think that I’ve stopped to review her morning labs and vitals. In reality, I need a few moments to steel myself before knocking and going inside. I think through what I’ll say to her, and I pre-plan my excuse to leave the room when things get too heavy. When I feel that I’m ready (or as ready as possible), I stuff her paper back into my pocket. I know it’s impossible, but it seems that I can detect a noticeable increase in the load borne by my shoulders when I add her sheet back to the pile. I take a deep breath, knock, and, for the second time today, force myself to walk through a door. Just as I expected, the small room is again packed with family members, eight this time. They’re all leaning or sitting with varying degrees of comfort against whatever fixed structure they can find. What I never could have anticipated, however, is the number of smiles that fill the room. Mrs. White’s jaundiced face, which last night held so many tears and so much fear, is beaming. I suppress the urge to ask what she could possibly have to be happy about. Instead, I compliment her and wait for her

Tabula Rasa explain. “You look wonderful,” I say. “It’s great to see you smiling.” And I mean it. “I feel wonderful, too! You just missed the oncologist,” she says, wiping away tears, this time of joy, as they collect in the corners of her icteric eyes. “I actually just ran into him in the hallway,” I say. “He said I have two to three months to live!” “That’s what he told me.” I reply cautiously, still baffled by her response. “Not weeks!” she says. “Not weeks! Months!” She must be able to see that I still don’t understand her elation. “Don’t you see?” she asks. “I have months! I can plant my garden and sit on the porch in the sun and eat pineapple and cucumber! I get to have another summer!” Even though I know that, realistically, much of the last few months of her life will be filled with appointments and chemotherapy and so much pain, I can’t help picturing her sitting in a rocking chair on an open porch, basking in the warmth of an early July afternoon. I envision her surrounded by her children and grandchildren and sipping lemonade. Her feet propped up on a stool, and her knees grimy from kneeling in the freshly tilled soil of her garden. I can see her in front of a neat little home in rural Minnesota. Summer is unfolding on the landscape around her. The birds have returned and are loitering around her feeder. Flowers are blooming. The trees are lush and proud and green again. She’s comfortable. Painless. Drifting off to sleep. Just a brief nap while those she loves watch over her and the rays of the summer sun beam down on her face once more. Even if it is an oversimplification, a fantasy, it’s one in which, for the moment, I am more than willing to be

Tabula Rasa complicit. Discussions about the realities of palliative chemotherapy and pain-control can wait. I hold on to the image of her summer for a moment. As I blink away the beginnings of my own tears, I look past her and out of the window of her room. Perhaps her startling optimism is contagious or perhaps the warmth from my imaginings is seeping into my reality, but, somehow, the same landscape, which just minutes earlier had done nothing but add to my despondency, seems a bit less bleak. I notice that the waters of the river below, though still congested with ice, are no longer frozen solid and are flowing past their banks again. And, though there is snow along those banks, maybe it isnâ&#x20AC;&#x2122;t quite as deep as it once seemed. And, though they are bent, perhaps the limbs of the trees arenâ&#x20AC;&#x2122;t really so in danger of fracturing after all. Turning back to Mrs. W, I sit on the edge of her bed and place my hand on top of hers once again. She squeezes my fingers gently. Her grip is strong. Her skin is now as warm as her smile. I return her squeeze and smile back at her. I ask what questions she and her family have, and I do my best to explain hospice care and the shift in goals from diagnosis and treatment to comfort. We talk about will need to happen to get her home. To get her to that porch and that garden that for now exist only in our minds. She and her family tell me about all the family and close friends-who-might-as-well-befamily who live nearby and can be there around the clock to help her. I sit and listen as their conversation devolves from discussion of the care skills each of these people bring to jokes about having to keep some of the more unsavory friends and family out of the house. I enjoy being present amongst them. Rounds and notes can wait awhile.

Tabula Rasa I know that, eventually, I’ll get paged out of the room and will have to get back to the demands of the hospital and the rest of my patients. But for a few more minutes, I settle in and listen and observe and continue to smile. Every once in a while, I catch a glimpse of the frozen world outside the window, but when I do, it no longer holds the dread and despair that it did earlier. As I laugh along with inside jokes I don’t get, I allow myself to believe that, as it must, winter will eventually give way, and spring and summer will arrive as they always have, even here so far from home. It will only take a few warm days before the snow will melt away completely. Soon I’ll be able to put away the snow shovel and the ice scrapers, for good this time. Maybe I’ll buy some spades and trowels and hoses and start a garden of my own. Maybe I’ll get a couple of rocking chairs and a bird feeder too. When I do, I’ll think of Mrs. W. I’ll envision her sitting on her porch, surrounded by family, eating pineapple and cucumber, and I’ll allow myself to believe that she’ll be forever basking in the glow of one last glorious summer.

Tabula Rasa Home Vishesh Jain

Tabula Rasa Today Professionalism for Me Dr. Susan Hata Is standing in a bathroom stall Down the hall from U4 in the Peds ER Pressing my tearstained palms Into my flushed cheeks And choosing to believe That the woman whose words sting Surely loves her daughter very much And somehow may be more frustrated and tired than I am.

Tabula Rasa

The Illuminated Death of Melinda Sanchez Lynne McFarland Day 1 The east light fills the living room. You finally fell asleep near dawn. “I want clarity,” you said, dropping off. Marina, nina amada, eyes dark, Crawls into her childhood bed. And Shadow whines to go out. When we return, he silently Shakes snow from his coat, Then moves from room to room, Nails clicking on the wooden floors. He sniffs your breath, and touches Her closed eye lids softly with his nose. I settle in your rocking chair And enter The circle of clarity You’ve gathered to surround you--An archipelago of journals, Zen books, Watercolors, old letters From El Leon, padre de Marina (El ya esta meurto. Triste.), I’m thinking Nights here are Not Good. Last night not even Gary Oldman Could match your intensity:

Tabula Rasa “Help me!” Flying out of bed Astonished by pain, Beautiful Marina grabbing your shoulders and Holding you face to face Your eyes locking like fierce animals Till the dilaudid kicked in. Dilaudid or clarity Dilaudid or clarity. For Marina, it’s a no-brainer. Day 2 The cancer nurse in jeans shows me How to set the PCA pump. “You can go up to 4,” she says, clicking through the buttons. I nod, uncertain. You say you’ll die when Sharon comes. Sharon, Older Daughter, is estranged. I think That’s bad. That’s good. That buys you Lots of time. In plastic containers, Marina has ordered The stuff of dying at home. Pre-filled syringes, tubing, alcohol, Each in its own tray, like lingerie. Ativan is in the frig. And carrot juice— Your only sustenance these days, Though you plan the meals for us— Telling me to steam the rice Your Way. Su forma . . . Is the only way.

Tabula Rasa Day 3 Suddenly, like a light coming on: “I’ve had six years to prepare,” you say, Your eyes connecting so directly I feel I’m in an intimate place after years of absence. Day 4 Doug, su mejor amigo, comes daily. His visits have gravitas; You sit regally, Holding up your finger for us all to wait In silence While a wave of pain passes. He is gently embarrassed— The invisibility of his mother’s death (His haunted adolescence) Now replaced by the Illustrated Illuminated Version. Day 5 Dilaudid or clarity . . . Today brings clarity. Sitting beside you, I read all your poems, 174 pages: Leo, Leo, Leo. . . . And the mountains where his ashes are . . . Now Marina will lose her mama too. She says she plans to move to the ocean. This hits you hard—there’s life after you are gone.

Tabula Rasa Day 6 After the pain, you meditate While I play with Shadow And look for a stone To slip into my pocket. He is happy to run after sticks Thrown far into the silent sky. I haven’t upped it And you haven’t said to. Day 7 One of Marina’s old boyfriends Has camped out in the living room, Hoping her need for comfort will relight sparks. She hates him loudly from the middle Of your big four-poster. You hold a finger in the air To say silencio. ?Por que causan dolor? Sunday morning Light and silence. Sunday afternoon. Marina puts on something white, A la Kahlo, For a nearby neighbor’s party. You cry. You’re afraid you’ll die while Marina Is eating barbeque. I promise to call her right away Should I notice this is happening. After she goes, we laugh, giddy girls.

Tabula Rasa Dilaudid or clarity. I hold the small stone, Worry stone or rosary . . . Day 8 It is even brighter next morning by the chair. The rich chocolate coffee you can no longer drink... You are shutting down. Last night the ileostomy tube Came flying out, The stoma was a pursed mouth blowing. We looked, shocked. What was that? At the ER you flirted with the doctor. (Marina and I could not believe You flirted with the doctor.) On the other end of the phone Your oncologist Must have said, “She won’t last long,” Judging by the stillness of the nurse’s face. (We drove back home, your stoma Symbolically repaired with a Foley.) Dying is like a Fellini movie; We are present and watching, Watching from inside. Day 9 You say you’re cold. Doug climbs in bed, And holds you close to warm you. Marina drives to pick up Sharon.

Tabula Rasa Her plane is sinking through the clouds As you are breathing/not breathing in his arms. Home in Tennessee, Small stone in my window sill Catches morning light.

Tabula Rasa Iris Ayaka Sugiura

Tabula Rasa Your Soul is Not Concrete2 Michelle Izmaylov Nobody kisses here. His wife is a shadow fallen over the chair beneath the ever-curtained window. Their love forms the silksoft threads of a noose hung around her throat. When I come in to preround on her husband, she smiles as if waiting for the moment when I will kick the stool out from under her. The metastases to his brain are incurable, she knows. I lay my stethoscope on his chest but feel the draft between my own heart valves from a window left open somewhere in my soul. Her eyes on the back of my neck are the cold wind blowing through me. He’ll be okay, won’t he? Looking at her is glimpsing ten thousand ways a soul can bruise. I check on his room again in the afternoon. He greets me with a sunlight smile. His wife sits by his bed, lost in a gray moment. Her hand rests on his bone-fingers splayed against the sheets. Her eyes ask if I know how much it hurts her to touch him, knowing in the morning she may wake up alone. Love on the wards predisposes to a special kind of hemophilia. She gently holds his hand and is still bleeding from the contact when I check on them the next day. Is the radiation working? I read something technical off a warm, freshly-printed hospital record. I suddenly feel white-blue fingers on my wrist. Two silver bangles clink on her arm. She repeats the question. This time, I hear the unspoken: Reprinted from: Izmaylov, M. The Gold–Hope Tang, MD 2016 Humanism in Medicine Essay Contest: First Place: Your Soul Is Not Concrete (Survive, Anyway). Academic Medicine. 91(12):1640-1641, December 2016. 2

Tabula Rasa He’s dying, isn’t he? Later, on rounds, the attending asks how she’s feeling. She says I’m okay a little bit too loudly. The following morning, I find her husband sitting all alone. I ask: Where is your wife? She went home. I told her to go home. I miss her. But I can’t stand seeing her look so hurt. The morning after, she’s sitting in her chair again. I say hello too quickly because I’m afraid of the silence here. I’m afraid of the pauses between our words. I’m afraid of breathing. The air is saturated with too much sadness for us to swallow. I keeping telling her to go home, he jokes. Already there, she keeps telling me. Love on the wards is wet-wet eyes, but instead of tears, seeing strained smiles and people beating their hearts unconscious, pretending they don’t feel anything. I see her scratch at her eyelashes. I offer her my stethoscope so she can hear his heartbeats for the music that they are. She takes the instrument from my open palms. It’s a little harder waking him this morning, but she places the eartips in his ears and lets him listen to her heart. She lets him listen to her belly, too. Pregnant, she tells me. She thanks me with a small bundle of song-soft words. A few hours later, a blown pupil is identified. The team goes in to tell her. I follow to the door. I follow until I see her eyes bleeding heartbreak. Love-induced hemophilia. The attending goes in. The resident goes in. The intern goes in. I do not go in.

Tabula Rasa The door is closing, closing, closed, and still I do not go in. After, my resident asks if I’m okay. I ask for a few minutes before I continue rounding. I’m given the rest of rounds off to breathe. For the space of one small hour, I take the long way to a nearby urban park and its little lake. I dip bare feet into clean and quiet water. I look at the sun-glint surface and remind myself if these waters can calm themselves, then so can I; we are both air and fluid mixed with light. I try to remember this despite the dull ache beneath my sternum from a heart beating so hard it bruises against the bones caging it. I sit by the lake, and my skin wrinkles from the truth slowly seeping into me. Sometimes, our patients die. He is my first patient with a soul already half-extinguished. He is my patient. My first one. Dying. I write this sitting by the water. I write: Love hemophilia. Someone dies, someone we cannot save, and sometimes we never stop bleeding. Being a doctor is knowing your hands will sometimes feel like a magnet for white bones. Being a doctor is walking every day in halls where is turns into was. This is the price of healing. Your spine will creak under the weight of what your hands can’t stitch together. In the breaths between seeing patients, sometimes you will be a river swollen outside its banks. You will feel like too much muddy water. You will find yourself somewhere between swimming and slow drowning. But being a doctor also means taking a moment to come up for air when you need it. It means taking a breath to cough up the water filling you. It means taking a pause to

Tabula Rasa remember your bones are still strong arches even when the bridge of your body sinks somewhere underwater. Your femur is stronger than concrete. Your femur is stronger than the buildings our despairing colleagues keep killing themselves in from the perceived weight of their own failure. Remember this. Remember you are human, too. Remember that momentary absence is not the same as leaving. Take a moment when you must. What matters is how you return after the rest you take. I write this standing outside the ICU room where he was transferred. I write this as she sits at her husbandâ&#x20AC;&#x2122;s bedside. Heâ&#x20AC;&#x2122;s dying, she tells me. She asks if I will let her hold my fingers. I swallow air into my lungs and hold the memory of the calm lake inside me. I breathe, I hold out my hand, I let myself be her tether to solid ground. I watch her kiss his forehead. I watch her kiss him, finally.

Part Two Post Call

Post Call Untitled Dr. Joseph Little, III

Circlet Vishesh Jain

Post Call AT Error! Unknown switch This Will Make It Better argument.Error! Rebekka DePew Unknown switch argument.Error! This is what I want you to remember: collecting pieces of Unknown styrofoam and soda can tabs andswitch small stones from theargument.Error! fraying edges of gravel parking lots. Unknown switch No, I want you to remember after, argument.Error! Unknown switch a key in a lock of the box you used to keep these shards of a argument.Error! shattered-glass world Unknown switch and rummaging for a argument.Error! half-inch of purple ribbon. You wanted something to hold Unknown switch argument.Error! even if it wasnâ&#x20AC;&#x2122;t real. You still do.switch But remember an October Unknown morning, the darknessargument.Error! pushing from behind Unknown your eyes, switch leaning back against a argument.Error! plastered-over wall, the still unfamiliar Unknown switch argument.Error! feeling of wearing a face other than your own. Remember Unknown spring, fluorescent lights and switch argument.Error! formaldehyde mixed with salt brine, and later that evening Unknown switch with your smile a argument.Error! Unknown switch flimsy scalpel for dissecting stories, sharp enough to slip to argument.Error! your own spine, remember Unknown switch this. Remember counting down the quicksilver-droplet argument.Error! minutes until morning. Remember this: Unknown switch argument.Error! crumpled slips between glossy pages and the sticky sweet of Unknown switch words you swallowed,argument.Error! the Unknown switch argument.Error! Unknown switch argument.Error! 68switch Unknown argument.Error!

Post Call ATmornings Error! when you could see chalk dust and the early switch through the shadows Unknown cast by locked argument.Error! Unknown switch glass doors. You’ve known all this before, these teeth have argument.Error! bitten down Unknown switch on damp air in the darkness, a metronome for your staccato argument.Error! heartbeat, that the wind Unknown switch argument.Error! changes us forever though it couldn’t be expected to Unknown switch remember. That sometimes there is argument.Error! nothing to hold, nothing even toswitch breath and you swell like Unknown lungs with water just to hold back argument.Error! Unknown switch the empty air. But youargument.Error! have been empty, you have been a shell of skin and helium inside and Unknown switch still your fingertips have kept their shape. So now on a bus argument.Error! Unknown ride on a late fall night, gripping switch a cold argument.Error! Unknown switchremember all those old metal railing to hold yourself upright, fears, try to slip them argument.Error! on again, Unknown and when you can’t – rememberswitch that. Remember buoyancy argument.Error! and backstage Unknown switch argument.Error! whispers, the geometry of intersections, remember the Unknown switch boundary between earth and argument.Error! morning, waves on a seawall, a satellite Unknown switch shrouded in silver mist, remember this. argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! 69switch Unknown argument.Error!

Post Call Mikiaâ&#x20AC;&#x2122;s Seasons Gwen Moore

Post Call AT Error! Unknown switch argument.Error! Unknown Redswitch argument.Error! Ketchup. I angrily squeezed the bottle until my fries were completely drenched.Unknown That guyswitch couldn’t even follow my argument.Error! simple instructions. I asked for a BLT, and somehow ended Unknown switch up with a bacon sandwich. Just two slices of bread and a sad, argument.Error! lonely piece of bacon between them. I only realized this after Unknown switch I left and sat down at a table. There was no point in going argument.Error! back now, especially at the dinnertime Unknown switch rush. It would take far too long to get a flimsy piece of lettuce and a soggy piece of argument.Error! tomato for my sandwich. Unknown switch I angrily bit into the bread and was at least rewarded with argument.Error! the crunch of the bacon. Not that any of it really mattered. I Unknown switch could barely taste it. I’ve basically been a zombie for the last argument.Error! Unknown switch week. Ever since Philip disappeared. He was an oddballargument.Error! cousin, but my favorite. He was a few Unknown years older than me, but alreadyswitch off to take on the world at argument.Error! 25. Apparently this time the world fought back. I should have told him not to go onUnknown that boat.switch I should have told him that argument.Error! there would be a storm. I should have told him that sunken Unknown switch treasure wasn’t worth it. Now he’s gone. And no one knows argument.Error! where he is. Unknown switch My other cousin, Eden, couldn’t handle it. She refused to argument.Error! eat until Philip cameUnknown home. Not that her sacrifice would switch actually do anything. I’m on my way to visit her now. argument.Error! I finished my so-called sandwich Unknown switch and fries, tossed my trash in a nearby bin, argument.Error! and continued on my way. I stopped at a gift shop. I might asUnknown well buy her something. switch I picked out a shirt and put it over my shoulder as I argument.Error! switch looked at a teddy bearUnknown Eden might like. But out of the corner argument.Error! Unknown switch argument.Error! 71switch Unknown argument.Error! Individual Bows Henry Quach

Post Call of my eye, I saw someAT guyError! who looked awfully suspicious. He Unknown switch had the hoodie and sunglasses combo, his entire face argument.Error! essentially covered. Maybe I shouldn’t judge. Maybe he was crying and covered hisUnknown face with switch sunglasses. argument.Error! The man was standing in front of a candy display, reading Unknown the description on the back of switch one of the bars. He held the argument.Error! bar in his left hand, while he grazed his right hand over the Unknown switch rest of the candy on the display. I watched as he seamlessly argument.Error! slipped some candy from shelf into his right hand and then Unknown switch instantly up his sleeve.argument.Error! I glared at him. I Unknown guess he was a thief after all. Although switch why would he steal candy? It’s not very expensive. He put the argument.Error! candy bar from left Unknown hand backswitch onto the candy display and then walked out of theargument.Error! store with the hidden candy bar still in his right sleeve. No one was the switch wiser. Except me. Unknown I slowly walked out after him, trying to be discrete. I was argument.Error! Unknown switch about ten steps out the door when I heard a voice behind me argument.Error! scream out, “You need to pay for that!” Unknown switchthen took off running. The man froze for a second, argument.Error! Without thinking, I chased after him. He wasn’t a particularly Unknown switchand lunch weighed me fast runner, but my saddened mood argument.Error! down. Over the confused shrieks of the people he pushed Unknown switch aside and my own heartbeat and breathing, I heard someone argument.Error! running behind me, still screaming for us to stop. Unknown switch As the man ran, he grabbed some papers or fliers off a argument.Error! nearby table. The next thing I knew, Unknown switchI was covered in papers flying through the air.argument.Error! I squinted my eyes, afraid of getting an eyeful of paper. But Unknown I should have switchkept my eyes open and aimed at the ground,argument.Error! as it was a loose piece paper on the slippery ground that was my undoing. Unknown switch I hit the ground argument.Error! hard and winced in pain, immediately Unknown switch clutching my right arm. That’s when I felt the shirt that I had

argument.Error! Unknown switch argument.Error! 72switch Unknown argument.Error!

Post Call picked out for Eden,AT stillError! over my shoulder. The one I had forgotten to pay for.Unknown I lookedswitch to my right and saw the argument.Error! suspicious man running off, never to be seen again. Then I switch looked to the left andUnknown saw the store employee, headed straight argument.Error! for me.

Unknown switch argument.Error! Orange Unknown switch Pumpkin. I drove up to the elementary school where I saw a argument.Error! whole class of kindergarteners sitting on the sidewalk, each Unknown switch holding their own pumpkin. My own kindergartener, Denise, argument.Error! was in the middle ofUnknown the line, her short little arms clutched switch around the fattest partargument.Error! of the pumpkin. Today their class went to theswitch pumpkin patch and each got Unknown to choose a pumpkin argument.Error! to bring home. I was relieved to see that Denise had picked a Unknown good-looking pumpkin. The kid next to switch her picked somethingargument.Error! that resembled more of a giant carrot Unknown switchthe strangest looking than a pumpkin. But apparently argument.Error! pumpkins are the ones that are the most satisfyingly scary in Unknown switch the end. argument.Error! I parked and walked over to Denise, who had stood up Unknown switchI tried to pick up the when she saw my car approaching. argument.Error! pumpkin from her, but she immediately told me she wanted Unknown switch to carry it herself. What a cutie. She carried the pumpkin, argument.Error! which was almost as big as she was, and waddled all the way Unknown switch to the car. She only let go of it when she realized she could argument.Error! not climb into the Unknown car with switch her hands full holding the pumpkin. She allowedargument.Error! me to take the pumpkin and place it in the back seat, and then help her into the car, where she Unknown switch immediately put her hand on the pumpkin and refused to let argument.Error! it out of her reach. Unknown switch I smiled to myself and watched her from the rearview argument.Error! Unknown switch mirror for a few seconds as she continued to admire her argument.Error! Unknown switch argument.Error! 73switch Unknown argument.Error!

Post Call AT how Error!her day was, and she talked pumpkin. I asked her Unknown nonstop about how fun it was switch to go to the pumpkin patch argument.Error! and play in the hay and ride a tractor. switch I pulled out of theUnknown parking lot and began the drive home. argument.Error! We were able halfway there when I heard sirens coming up Unknown switch from behind me. I glanced in the mirror and saw the familiar argument.Error! flashing lights of an ambulance about three blocks behind Unknown switch where I was. I pulled to the right curb and stopped, as did argument.Error! most people on the road. But there was one old blue car that Unknown switch did not. It kept driving along as if nothing was going on. argument.Error! It only took the ambulance about thirty more seconds to Unknown switch reach us, and it was soon right behind the blue car, but in the argument.Error! adjacent lane on the Unknown left. Suddenly, switchthe blue car swerved to the left, crashing rightargument.Error! into the ambulance. The next few seconds wereswitch a blur. There were so many Unknown lights, both from theargument.Error! ambulance, but also from the brake Unknown switch lights of the blue car. And of course the sounds were deafening. The sirens,argument.Error! alarms, and the sound of metal being Unknown destroyed against other metal. Iswitch closed my eyes and ducked argument.Error! my head, in case any metal came flying through the air towards my car. ButUnknown luckily it switch didnâ&#x20AC;&#x2122;t. I immediately looked argument.Error! over at Denise, who seemed to be confused but looked ok, Unknown switch her hand still on the pumpkin. Then I looked back at the argument.Error! collision. Unknown switch The ambulance had stopped, with only a small dent. The argument.Error! blue car was completely destroyed in the back, but looked Unknown switch okay in the front where the driver was. There was a few argument.Error! seconds of silence, Unknown then the sirens switch started again and the ambulance continuedargument.Error! on its way. I sat there stunned, unsure of what to do next, especially Unknown switch with the destroyed blue car blocking the path we needed to argument.Error! Unknown switch a second ambulance, get home. Over the next few minutes, argument.Error! Unknown switch argument.Error! 74switch Unknown argument.Error!

Post Call ATand Error! along with a fire truck police cars, arrived. They seemed Unknown switch to make quick work of the scene, carrying the driver into the argument.Error! ambulance and then slowly guiding all of us in our cars to go Unknown around the accident. Even after Iswitch was several blocks away and argument.Error! could no longer see the accident, my heart was still beating Unknown switch out of my chest. argument.Error! Then Denise said, “Mommy? When can we make my Unknown switch Jack-O-Lantern?” argument.Error! I froze for a second, and then smiled. “Right when we get Unknown switch home, sweetie.” argument.Error! Unknown switch Yellow argument.Error! Popcorn. I held the oversized Unknownbucket switchin my hand and walked over to the butter dispenser. I added exactly three squirts of argument.Error! butter and smiled triumphantly. I always imagined that I was Unknown switch a superhero pumpingargument.Error! butter from the depths of the earth to defeat an evil popcornUnknown monster. switch That’s actually how I imagine argument.Error! they get oil out of the ground, with huge pumps. Not that Unknown switch they ever teach us these things in high school. Maybe after I argument.Error! graduate. switch I held the bucketUnknown of popcorn in my left arm, with the argument.Error! soda in my right hand, and walked up to the theater listed on Unknown switch my movie ticket. Luckily they check tickets before the argument.Error! concessions stand, otherwise I wouldn’t have had enough Unknown switch hands to hold out my ticket. Carrying everything myself is argument.Error! always the struggle with going toswitch movies alone. Unknown But I do like going to the movies by myself. It’s so argument.Error! peaceful and I don’t need to worry about anyone judging my Unknown switch reactions. I can laugh and scream and cry whenever and argument.Error! however I want. No one judging Unknown switch me on how loud or obnoxious my laughargument.Error! is, or how I cry at scenes that are Unknown minimally sad. I mean, I guessswitch other people in the theater argument.Error! Unknown switch argument.Error! 75switch Unknown argument.Error!

Post Call ATnot Error! may judge me, but it’s anyone I know or will ever see again, so it’s no bigUnknown deal. Plusswitch it’s dark so they probably argument.Error! wouldn’t know it was me anyway. Unknown switch I chose a seat near the back so I could see the entire argument.Error! screen without having to strain my neck. I began enjoying the switch on my popcorn. Of previews and trailersUnknown as I munched course, I always end argument.Error! up eating most of my popcorn before Unknown switch the movie even starts. argument.Error! When the movie finally started, the lights in the theater Unknown switch dimmed and a few stragglers ran inside to find seats. One of argument.Error! these stragglers actually sat in myswitch row, a few seats to my right. Unknown I didn’t actually noticeargument.Error! her again, until a particularly scary part of the movie whereUnknown I reflexively pulled back in my seat, switch causing my left kneeargument.Error! to jerk up, thus kicking a bunch of popcorn through the Unknown air towardsswitch the woman. I sheepishly looked over, ready to apologize, but she argument.Error! Unknown didn’t have any popcorn on her.switch What I did notice was that argument.Error! she was holding a camera. Unknown switch and it was pointed It was a small portable camcorder, directly at the screen.argument.Error! She was holding it in both hands, with Unknown switch her elbows braced on the armrests for support. argument.Error! I wondered what I should do. Obviously this was not Unknown switch allowed, but am I supposed to be the one to do anything argument.Error! about it? The hero in the movie definitely would have. He Unknown switch would have pulled this lady aside and told her to hand over argument.Error! the camera, and thenUnknown he would switch have crushed it in his hands before handing it backargument.Error! to her. But there’s no way I could have done that. First of all,Unknown there’s noswitch way that she would listen to a kid like me, and second of all, my hands weren’t strong argument.Error! enough to crush a camera. Unknown switch I frowned, but argument.Error! turned back to the movie, both for inspiration, and also Unknown to distractswitch myself. Hopefully I would argument.Error! Unknown switch argument.Error! 76switch Unknown argument.Error!

Post Call AT Error! learn what the hero would do and then decide if I could do Unknown switch that too. Or maybe the movie will be so entrancing that I just argument.Error! forget about the camera. Unknown switch I didnâ&#x20AC;&#x2122;t really learn anything from the movie, and I argument.Error! certainly could not forget about the camera. The hero in the Unknown switch movie did call for help from some of his buddies, so I also argument.Error! thought about telling one of the theater employees. But by Unknown switch the time I found one, the lady would be long gone. What argument.Error! should I do? Unknown switch I was frozen by indecision. I had no idea what to do, and argument.Error! not very much time toUnknown do it. switch Suddenly, I saw some movement argument.Error! in the darkness of the theater, and a figure Unknown walked into my row from the left. He switch walked past me and argument.Error! I saw the flash of an employee badge. The employee sat next to the woman Unknown switch and they talked for a few seconds before they both stood up and walked out of the argument.Error! Unknown switch theater. argument.Error! I guess the universe fixed itself. Without my help. I was Unknown switch useless. Iâ&#x20AC;&#x2122;ll never be a hero.

argument.Error! Unknown switch Green argument.Error! Grass. I held a blade of grass between my fingers and stared Unknown switch at its alluring lines and contours, set against the deep blue sky. argument.Error! I was in the park, laying on a bed of grass, and just enjoying Unknown switch the beautiful day. argument.Error! I have already been here for an hour, and saw many Unknown switch wonderful things. I saw the trees blowing in the wind, their argument.Error! branches not blocking the movement Unknown switch of air, but rather embracing it. I saw argument.Error! the clouds forming into shapes, both recognizable and amorphous. saw the birds flying around, UnknownI switch both alone and in formation. I saw the squirrels looking for argument.Error! Unknown switch food and scurrying back to their homes with their bounty. argument.Error! Unknown switch argument.Error! 77switch Unknown argument.Error!

Post Call AT Error! And I saw the people, walking, running, looking around, Unknown staring at their phones. It was aswitch wonderful ecosystem and I argument.Error! was right in the middle of it all. Unknown As I sat there admiring theswitch grass, something caught my argument.Error! attention. There was a woman running through the park and Unknown switch she was going extremely fast. I had seen many joggers in the argument.Error! park, but she faster than all of them. She was wearing a dark Unknown switch shirt and jeans, and was covered in sweat. argument.Error! I watched her for a few more seconds as she began Unknown switch running down a particularly hilly area of the park. I frowned. argument.Error! I hope she would Unknown be careful.switch There were a lot of tree branches and weeds toargument.Error! look out for on that path. The moment the Unknown thought crossed switchmy mind, the womanâ&#x20AC;&#x2122;s foot caught on a strayargument.Error! tree branch and she went flying straight into the tree. I winced, and pulled myself up from the grass, Unknown switch jogging over to her. argument.Error! Unknown switch It was running down I could see the blood immediately. argument.Error! her face and she looked unconscious. I had no experience Unknown switcharound for help. A few with this kind of scenario, so I looked argument.Error! nearby people were already headed in our direction when they Unknown switch saw her fall. One of the men who came up to the scenario argument.Error! immediately took off his shirt and wrapped it around her Unknown switch head to attempt to stop the bleeding. Then he screamed at argument.Error! some of us to help carry her over to a flat part of the park. Unknown switch Now that, I could help with. argument.Error! We carried her aUnknown few yardsswitch down the hill, and laid her down on the grass. Someone else was checking her pulse and argument.Error! screamed out that she had a pulse. Unknown switch She still had her eyes closed. argument.Error! At this point all six of us were standing in a circle around Unknown switch the woman and all looked around at each other, unsure of argument.Error! Unknown what to do next. I looked at theswitch man who had wrapped his argument.Error! Unknown switch argument.Error! 78switch Unknown argument.Error!

Post Call ATand Error! shirt around her head had told us to move her to the switch grass. He looked backUnknown at me with the same look of confusion argument.Error! that I had. Unknown switch but what was probably After what seemed like an eternity, argument.Error! five seconds, someone asked, “Did anyone call 911 yet?” We all looked around the Unknown circle again.switch argument.Error! “I’ll do it”, I exclaimed when it was obvious that no one Unknown switch had already called. I dialed the number and explained what argument.Error! had happened to the person on the other line. He assured me Unknown switch that they would send argument.Error! help and I relayed this message back to the group. Unknown switch We all continued argument.Error! to stand in that circle, waiting. I looked back at the spot inUnknown the grassswitch that I was laying on just moments ago. I thought about how peaceful it was then. argument.Error! How did everything change so suddenly? Unknown switch argument.Error! Unknown Blueswitch Ocean. I closed myargument.Error! eyes, took a breath, and submerged Unknown myself in the clear blue water. Iswitch swam forward a few strokes argument.Error! before resurfacing and looking around the beach. It was Unknown packed today, with people everyswitch few steps in any direction. argument.Error! But you can’t really blame them. This is one of the most Unknown switch beautiful beaches in the world, or at least in my humble argument.Error! experience. Unknown switch I came here with my family, as my dad decided to argument.Error! spontaneously take usUnknown to the beach today. I guess he decided switch it was just too nice a argument.Error! day to stay inside. And I have to say, he made a great decision. The sun was warm, the water was Unknown switch refreshing, and even the seagulls were staying away from our argument.Error! food. Speaking of food, my dadswitch also bought us enough food Unknown to feed an army, evenargument.Error! though we were just having a picnic on Unknown switch the beach. He’s the best. argument.Error! Unknown switch argument.Error! 79switch Unknown argument.Error!

Post Call Error! I went up to the beach and After a bit more AT swimming, switch who was building a joined my younger Unknown sister, Karen, argument.Error! sandcastle. She was quite the artist, having already made the Unknown basic shape of a castle, and was switch currently trying to add details argument.Error! like doors and windows. I didn’t want to mess up her creativity with my sadUnknown excuse forswitch artwork, so I instead began argument.Error! digging a moat around her castle, to help protect it when the Unknown switch tide comes up. argument.Error! As I dug through the soft white sand, my finger brushed Unknown switch against something that provided some resistance. I frowned argument.Error! and dug it out, revealing an openswitch package for instant noodles Unknown that someone had carelessly tossed onto the beach. argument.Error! I stood up, holding the plastic in my hand as I looked Unknown switch around for a trashcan. I didn’t see one nearby, which was argument.Error! probably why this person chose to just throw it on the Unknown switch ground. I sighed, and began walking down the beach in argument.Error! Unknown search of a proper place to throwswitch this trash. It took me about argument.Error! five minutes to find a trash can, and was Unknown switchoverflowing with trash. dismayed to find that it was already Even my little piece ofargument.Error! plastic would not fit on top of this pile Unknown switchback onto the beach. and would just be blown by the wind argument.Error! I saw another trashcan a little bit down the beach, and Unknown switch thought I would walk to that one instead. While I was argument.Error! walking, I saw that the second trashcan was also overflowing Unknown switch with trash, but there were two kids trying to empty the excess argument.Error! trash into their own giant blackswitch trash bag. I jogged over and Unknown helped them push theargument.Error! trash into the bag. I dropped my piece of plastic into their bag as well. switch Unknown “Thank you sir!” one of the kids said to me. argument.Error! “What are you two doing?” switch Unknown argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! 80switch Unknown argument.Error!

Post Call AT Error! “We’re volunteering and trying to empty the trash cans switch and put up trash bagsUnknown around the beach so people will have a argument.Error! place to throw their trash.” “What do you do Unknown with all of switch the trash that you collect?” argument.Error! “We usually just throw it away at a nearby mall, since there’s not really anyUnknown dumpstersswitch around the beach for us to argument.Error! throw things away. It’s also nice because then we can also get Unknown switch lunch at the mall when we’re done.” argument.Error! “Wow, that’s great! Thanks for keeping the beach clean. Unknown switch Good luck with it!” argument.Error! I smiled at them and walkedswitch back to my family, watching Unknown them walk to the firstargument.Error! trashcan that I encountered. It was so nice to see people doing good inswitch the world. Unknown I played on the beach and in the ocean with Karen for a argument.Error! few more hours before our parents called us up to go home. Unknown switch When we got back, Iargument.Error! saw that my dad was finishing a bag of Unknown chips. He looked around for a switch second, and then tossed the bag onto the ground,argument.Error! using his foot to cover it with sand. Unknown switch “Ok, let’s go.” argument.Error! Unknown switch Indigo argument.Error! Flower. I held the bouquet in one hand and knocked on the Unknown switch door with the other. A voice inside told me to enter, so I argument.Error! walked in with the flowers. I didn’t know this man, but I was Unknown switch told to deliver these flowers to him. That’s the life of a argument.Error! hospital volunteer. We’re told switch what to do and we do it, Unknown usually not even knowing the people we’re interacting with. argument.Error! I smiled at the man and told him, “Hi sir, your family Unknown switch brought these flowers for you. They should hopefully be argument.Error! coming by in person later.” Unknown switch He smiled backargument.Error! and said, “Thanks kiddo. Much Unknown switch appreciated.” argument.Error! Unknown switch argument.Error! 81switch Unknown argument.Error!

Post Call Error! “Do you mind meAT asking why you’re in the hospital?” switch “Oh yes, I passedUnknown out. Doctors think I might have had a argument.Error! seizure.” switch “Oh wow, well Unknown I’m glad you made it to the hospital argument.Error! okay.” Unknown “You and me both, kid.” switch argument.Error! I laughed and waved at the man as I walked out of his Unknown switch room. I really liked meeting people as I worked. That was argument.Error! always the highlight of my day. Unknown switch I walked back to the desk that the other volunteers stood argument.Error! at, our “home base,”Unknown as we liked to call it. There were three switch other volunteers hereargument.Error! today, but no one was at the desk. I guess all of them wereUnknown called away to do something else. switch Right when I reached the desk, the phone began to ring. I argument.Error! picked it up and the person on the other line asked me to go Unknown switch to the kitchen and deliver two cartons of milk to room 203. I argument.Error! Unknown switch confirmed that I would do that and then hung up the phone. argument.Error! I wrote down the room number and walked to the Unknown hospital’s kitchen, which I foundswitch to be completely empty. argument.Error! “Hello?” I screamed out. Unknown switch and looked around, No one answered. I frowned, argument.Error! wondering if I could find the milk myself. But then I saw Unknown switch someone come towards me from the back. He was one of the argument.Error! employees in the kitchen, but he very clearly had been just Unknown switch crying. His eyes were bloodshot and his face was wet. “Yes?” argument.Error! he asked me in a broken voice. switch Unknown I hesitated for a second, and then asked, “Could you get argument.Error! me two cartons of milk?” Unknown switch He nodded and went to a refrigerator where he handed argument.Error! them to me without another word. I took them and turned to Unknown switch leave, when I stoppedargument.Error! and said out loud, “Are you ok?” Unknown switch argument.Error! Unknown switch argument.Error! 82switch Unknown argument.Error!

Post Call AT wife Error! “Yeah I’m fine. My just told me that my cat died. I had her for 15 years.”Unknown switch argument.Error! “I’m so sorry. Is there anything I can do to help?” Unknown switch “No, but thank you for asking. I’m just on my break right argument.Error! now. You should get going.” I nodded and tookUnknown the milk switch to room 203. The patient and argument.Error! his wife each grabbed a carton and downed their milk in less Unknown switch than ten seconds. They thanked me and then I left. argument.Error! I headed back to the kitchen and sat with the employee as Unknown switch he processed his loss.argument.Error! He initially didn’t want me there, but then ended up tellingUnknown me storiesswitch about his cat for almost an hour. He looked much better by the time he needed to get argument.Error! ready to get back to work. Unknown switch I walked back toargument.Error! home base, and saw that the other volunteers had returned. They asked Unknown switchme where I’d been for the last hour. I thought about the man with the flowers, the argument.Error! switchthe employee with the couple with the milk,Unknown and of course, argument.Error! cat. Unknown switch “Oh you know, the usual. Just helping people.” argument.Error! Unknown switch Violet argument.Error! Grapes. My mouth was watering, even as I paid the merchant Unknown switch at the farmer’s market for a box of them. I saw his stand argument.Error! from the parking lot and immediate went straight for it. I Unknown switch could never pass up good-looking fruit, and grapes were my argument.Error! absolute favorites. Unknown switch As I munched onargument.Error! the grapes, I continued walking through the market, looking Unknown to see ifswitch anything would catch my attention. I saw one particularly colorful stand and headed in argument.Error! that direction. It wasUnknown some sortswitch of fortuneteller, as an older man sat behind a crystal ball. argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! 83switch Unknown argument.Error!

Post Call I knew this stuffAT is Error! all fake, but then again, I was also Unknown curious. I stepped into his standswitch and sat down at the chair in argument.Error! front of the table. Before I could say anything, the man said, Unknown “I will tell your fortune. Pleaseswitch put your right hand on the argument.Error! crystal ball and focus.” Unknown switch I frowned, unsure if I would suddenly be charged an argument.Error! outrageous amount of money for this. He would probably tell Unknown switch me something really generic like, “You will have some good argument.Error! days and some bad days.” I’ve had plenty of experience with Unknown switch fortune cookies. argument.Error! While I hesitated,Unknown the fortuneteller switch gave me no choice and grabbed my right hand, placing it on the crystal ball. “Focus,” argument.Error! he said again. Unknown switch I sighed and closed my eyes. What was I supposed to be argument.Error! focusing on anyway? Was I supposed Unknown switchto be thinking about my future? But how am Iargument.Error! supposed to know what’s in my future? Unknown switch It’s supposed to be his job to tell me. And he can’t tell me argument.Error! unless I’m thinking about it? It’s a paradox. Unknown switchof me sitting there with After an excruciating few minutes my eyes closed, tryingargument.Error! to “focus,” the man spoke again and I Unknown switch opened my eyes. argument.Error! “You are a very insightful person,” he said. “You like to Unknown switch find connections between things, and you can see threads argument.Error! between people and events that others may not recognize. It Unknown switch is a gift. And you will use that gift today.” argument.Error! Then he picked Unknown up a jar that was on the ground and switch placed it on the table argument.Error! next to the crystal ball. The jar was filled with five-dollar bills. IUnknown frowned. switch He didn’t say what he wanted me to pay, but I guessargument.Error! people in the past have given him five dollars, so I should do the same. Then again, he could have Unknown switch just put a bunch of argument.Error! five-dollar bills in the jar to make me Unknown switch think that very thought.

argument.Error! Unknown switch argument.Error! 84switch Unknown argument.Error!

Post Call AT aError! Whatever. I fished five-dollar bill out of my wallet, Unknown placed it in the jar, thanked him,switch and then walked out of the argument.Error! stand. I thought about what he told me. That I can see connections between Unknown people andswitch events. As I suspected, this argument.Error! was just a generic fortune that could relate to anyone. In fact, Unknown switch he was describing apophenia. Apophenia is theargument.Error! human tendency to see patterns in Unknown switch randomness, and it affects us all. It’s the reason we have good argument.Error! luck rituals. We wear a new pair of socks and our team wins a Unknown switch game, we see a pattern, and then we refuse to wear a different argument.Error! pair of socks for future games. But again, it happens to Unknown switch everyone, not just me.argument.Error! As I walked andUnknown thought switch about how I just lost five dollars, I saw anotherargument.Error! booth where people could spin a wheel and win prizes. The wheel had switch stickers of different fruit and Unknown you had to spin a match within three spins. As I walked by, argument.Error! Unknown switch out to someone who the woman behind the booth screamed had just spun, “Grape!argument.Error! You win a free shirt!” Unknown switch I paused when she said grape. Was this the connection argument.Error! that the fortuneteller said I would make? I ate some grapes Unknown switch and now I’m supposed to play this fruit game? argument.Error! I shrugged and got in line behind a group of high school Unknown switch students and a man munching on a chocolate bar. What did I argument.Error! have to lose? Unknown switch argument.Error! Rainbow Unknown switch Once upon a time, onargument.Error! a beautiful fall day, BLUE went to the beach and saw someUnknown high school students picking up trash. switch These students tookargument.Error! the trash from overflowing trashcans and threw it away at trashcans a nearby mall. This included Unknownatswitch a particularly large trashcan at the movie theater. The theater argument.Error! Unknown switchwas later monitoring a employee who emptied this trashcan argument.Error! Unknown switch argument.Error! 85switch Unknown argument.Error!

Post Call movie being watchedAT by Error! YELLOW. The employee caught a woman in the theaterUnknown who wasswitch trying to record the movie argument.Error! with her camcorder. However, this woman sprinted away, Unknown switch hoping to escape in the park. Unfortunately, she tripped and argument.Error! hit her head on a tree, requiring immediate medical attention. switch Luckily, GREEN andUnknown several other people in the park were argument.Error! able to help her. An ambulance came and took her to the Unknown switch hospital, running into a blue car along the way, which was argument.Error! witnessed by ORANGE. The driver of the blue car was a Unknown switch man who had a seizure while driving and needed to be taken argument.Error! to the hospital himself. He received Unknown switchflowers from his family that were delivered by INDIGO, who also met a cafeteria argument.Error! employee whose catUnknown recently switch passed away. The cafeteria employee was so distraught that he goofed up several dinner argument.Error! orders, including a BLT order for RED, who later chased Unknown switch after a candy thief. This candy thief eventually made his way argument.Error! Unknown to a local farmerâ&#x20AC;&#x2122;s market whereswitch he stood in line behind the argument.Error! high school students who had picked up trash from the beach Unknown earlier that day. VIOLET, with aswitch gift for finding connections, argument.Error! stood in line behind them.

Post Call House in Mapleton AT Error! Unknown switch Andrew Perez

Hi There Vishesh Jain

Post Call Water Carving Vishesh Jain

Post Call AT Error! Unknown switch argument.Error! switchmore than a tiny dot of Odell lake. For years Unknown it was nothing argument.Error! blue high in the mountains of the Pioneer range on my maps Unknown switch of Montana, but it haunted me. You see my earliest memories argument.Error! of struggling with a fly rod were formed in high mountain Unknown switch beaver ponds in Colorado. That was a time when I could argument.Error! work a string of those small, log-jammed fish nurseries for an Unknown switch entire day and not argument.Error! see another human being: just one voracious, innocent brookie after another. It was also a time Unknown switch when I would keep the last two of the day for my campfire argument.Error! supper. The edges of Unknown ancient memories switch like these tend to lose their sharpness with time, but the emotions evoked seem only argument.Error! to become richer. I wanted to switch feel once again that which I Unknown had felt during my youth in Colorado. I wanted to fish an argument.Error! Unknown isolated, high mountain pond switch before my birthdays would argument.Error! prohibit it. Unknown At five miles away, Odell switch was just far enough up the argument.Error! trailhead that I couldn’t consider it when the kids were young. Unknown switch That hike was beyond their reach, and my time with them argument.Error! was far too limited for me to take off on a solo jaunt for Unknown switch something so selfish as fishing. So I studied that blue dot on argument.Error! the maps for years while on family camping trips and seeking Unknown switch shelter in our camper during rainstorms or during a buggy, argument.Error! wet July night. Someday, I wouldswitch think to myself, someday. Unknown Life is different now. I can’t remember when I last kept argument.Error! “the final two” of the day. The children are gone and are Unknown switch creating their own adventures and memories without my argument.Error! guidance. Our camping trips have dwindled to just my wife, Unknown switch our dogs, and me. Last fall, in early October, the weekend argument.Error! switch unusually warm days. I weather forecast was Unknown for two beautiful argument.Error! Unknown switch argument.Error! 89switch Unknown argument.Error! Autumn Dr. Blair Erb

Post Call AT but Error! knew it was time to go, my wife was away caring for her ailing father, so this Unknown trip wouldswitch be just me and my canine argument.Error! children. Unknown switch as the camper came The dogs watched with curiosity around, but when theargument.Error! travel kennels went in the bed of my switch I loaded our gear. I pickup they became Unknown positively ecstatic. loaded them. We wereargument.Error! off to our special part of Montana. Unknown switch While the dogs ran, swam, and enjoyed the smells of the argument.Error! wild, I set up camp in our usual secluded spot at dusk on a Unknown switch Friday afternoon. That night, after a simple supper and a few argument.Error! glasses of wine, the Unknown maps came out. There it was—Odell switch Lake. It was time. argument.Error! The next morningUnknown was routine; coffee, feed the dogs, feed switch me. I knew it would be 10 miles round trip but it was only a argument.Error! gentle thousand-foot Unknown climb to the lake once we reached the switch trailhead. Two of the argument.Error! three dogs were 12 years old but I knew Unknown their spirits and I knew that theyswitch would stick with their Dad. I argument.Error! loaded a daypack with some treats for the dogs and some Unknown treats for me. A small box of dryswitch flies joined the goodies and argument.Error! a 5 weight was strapped to the outside. Unknown switch My “children” were euphoric as we set off. Toby, the argument.Error! border collie, ran five miles for every one I walked. I drove Unknown switch the other two like a drill sergeant; we would not rest until we argument.Error! reached our objective. As we came over the final rise and I Unknown switch saw the lake for the first time, I knew at once the trip had argument.Error! been worth the effortUnknown even if I never unsheathed my fly rod. switch The dogs and I argument.Error! shared a shoreside lunch in the warm autumn sun while lounging in a switch patch of changing kinnikinic. Unknown As I scouted the lake, I was at first disappointed to see a argument.Error! broad border of waterUnknown lilies that switch would challenge my ability to get a fly to open water. Finally, I spotted an area along the argument.Error! southern and lee end Unknown of the lakeswitch where there were fewer lilies. argument.Error! Unknown switch argument.Error! 90switch Unknown argument.Error!

Post Call AT Error! Scattered large boulders, easy hops, could get me to the edge switch of the lilies. I paused Unknown and watched the water. Soon I saw the argument.Error! rings of sipping fish within easy reach of my cast. Unknown The dogs were defeated and switch sought out resting places as I argument.Error! rigged my rod. They were unaware I had left their sides when, switchthat served as a casting perched on a smoothUnknown granite boulder argument.Error! platform, I began my work. On my fourth cast, my fly Unknown switch fluttered to the lake surface. In an instant, the Royal Wulff argument.Error! disappeared in a boil that was at once both violent and Unknown switch delicate. Next came the familiar tug; the dogs were oblivious argument.Error! as I worked the fish toUnknown shore. switch As I watched that beautifully colored 12-inch cutthroat argument.Error! swim away from my hands to feed again, I knew my day was Unknown switch perfect. There was no need for another cast. I broke down argument.Error! my rod, roused the dogs, and we bid farewell to Odell Lake. Unknown switch The canines anticipated food: I anticipated celebratory scotch. argument.Error! I smiled as we walked.Unknown I think myswitch dogs did too. argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! 91switch Unknown argument.Error!

Post Call Error! Leaves on a Rock by aAT Creek in Forest Unknown switch Andrew Perez argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! 92switch Unknown argument.Error!

Post Call Untitled Dr. Gary Strong

Untitled Dr. Gary Strong

Post Call AT Error! Unknown switch argument.Error! Unknownshe switch Her gracile neck outstretched, seeks a victim along the argument.Error! mossy bank. Glacial, deliberate. Unknown switch argument.Error! She pauses, now motionless. Unknown switch Her head flashes below the surface, then up again. argument.Error! Wriggling quicksilver in her sharp beak unceremoniously Unknown switch swallowed. argument.Error! She sees me. Unknown switch A black eye regards me: one part hatred, two parts fear. argument.Error! Broad wings whisper,Unknown lifting her switch across the pond. She draws her neck into an s-curve: some trick of argument.Error! aerodynamics and evolution. Unknown switch Her flight traces shallow arcs as she skims just above the argument.Error! Unknown switch water. argument.Error! The recoil of the air stirs ripples in the pondâ&#x20AC;&#x2122;s green surface, Unknown switch meteoric blaze. lit by the morning sun into an evanescent A tall sycamoreâ&#x20AC;&#x2122;s bareargument.Error! white arms receive her. Unknown switch She protests my intrusion in a voice mismatched to her argument.Error! beautiful form. Unknown switch Piscine Vishnu. The Aquatic Destroyer. argument.Error! One predator eyes another, Unknown switch Dubiously longing for peace. argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! 94switch Unknown argument.Error! The Blue Heron Dr. Mark Petrik

Post Call AT Error! Big Blue Dr. Richard Davidson Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! 95switch Unknown argument.Error!

Post Call AT Error! The Passing of the Cup Unknown switch Dr. Mark Petrik argument.Error! Unknown switch Like the impenitent child who sits, petulant, argument.Error! Amidst the wreckage of deliberately broken gifts And demands they beUnknown repaired . switch .. argument.Error! That all be restored as it was in the beginning . . . Unknown switch I, too, cry my crocodile tears argument.Error! As I beg for this cup to pass. Unknown switch But I am met with silence. argument.Error! It is far closer to the end than theswitch beginning. Unknown It is now, leading to ever shall be. argument.Error! And if there were to have been any glory in my potential Unknown switch triumphs, argument.Error! There must now be ignominy in switch my actual failures. Unknown argument.Error! switch Asking for the cup toUnknown pass Was a proper request argument.Error! only from a perfect child, Unknown Though even He had to drink. switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! 96switch Unknown argument.Error!

Post Call King Vishesh Jain

Post Call Therapy Ayaka Sugiura

Post Call AT Error! Unknown switch argument.Error! switch It may have been the Unknown ants who first asked So what if it rains? argument.Error! They separated the seeds anyway, perhaps just thought it Unknown switch was something that she should keep at the back of her mind. argument.Error! She didn’t respond, which they took as an admission that she Unknown switch hadn’t thought about it much. And maybe she hadn’t. And in argument.Error! the background of the reed music was yet another question, Unknown switch what if the wind was onlyargument.Error! air after all? Is arrow-poison love that strong? And perhaps the doubts started then, perhaps Unknown switch she wondered at the difficulty of crossing so shallow a river, argument.Error! knowing that they’d only get deeper and darker, perhaps she Unknown switch thought that really golden fleece was meant to be the end of argument.Error! someone else’s story. Unknown They always said the soul was something switch immaterial and therefore it was pure arrogance to touch even argument.Error! Unknown switch her own skin. By the time she got to the underworld river it argument.Error! was far too late for invulnerability, and she wasn’t really the Unknown switch type to want it anyway. So she sat among the daffodils and argument.Error! asked what they had learned. They had looked only inward Unknown and missed all echoes of beauty. switch They warned her away from argument.Error! the water, said if you look too long it’s sure to take everything. Unknown switch She stood and walked to the edge of the river of unbreakable argument.Error! promises, and she knew what it would ask and she had an Unknown switch answer ready. And on her way home, when Persephone said, argument.Error! you know, the box might Unknown be empty. And what will you do then, switch she replied, I will put itargument.Error! out in the rain and let it fill with what is far more beautiful thanUnknown I am, and Iswitch will fill myself with his promises, his eyes reflectingargument.Error! lamplight back at me, his stories of oil-burned skin long healed over. switch Unknown argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! 99switch Unknown argument.Error! Psyche Rebekka DePew

Post Call

Untitled Dr. Mary Harbison

Post Call AT Error! Unknown switch argument.Error! Unknown switch O friend, if in your somnambulistic peregrinations argument.Error! A consecrated and inviolate land is discovered, switch name Bring with reverentialUnknown praise its hallowed argument.Error! To the assembled communicants so their burdens Unknown switch May be lifted unto the stars . . . windswept and silent, argument.Error! Astral luminaries bereft of meaning, Unknown switch Save such as imaginedargument.Error! on this remote dust. Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! 101switch Unknown argument.Error! Astral Luminaries Dr. Richard Hutson

Post Call

Solar Flare Vishesh Jain

Post Call Untitled Dr. Joseph Little, III

Post Call AT Error! The Receptacle of Soul Unknown switch Gwen Moore argument.Error! Unknown switch Folded into itself Bent against all threatsargument.Error! and fears Unknown switch Defended from feeling argument.Error! So locked and intertwined Unknown switch That nothing can reach the center argument.Error! Hard Unknown switch argument.Error! Tense with grief withheld Unknown switch Unexpressed fury argument.Error! And unfelt pain, Unknown switch My heart argument.Error! Was hidden Unknown switch Inside all that argument.Error! Unknown switch Oppressed beyond describing argument.Error! Unknown switch Slowly argument.Error! Patiently Unknown switch Calmly With gentle attention argument.Error! Unknown switch We witnessed the unfolding argument.Error! So many layers, so thickly woven Unknown switch With stories and feelings argument.Error! And nameless fears Unknown switch argument.Error! As we watched, Unknown switch The invisible basket between us argument.Error! Filled with moments and meanings Unknown switch Collected here argument.Error! Unknown switch In this safe space argument.Error! Unknown switch argument.Error! 104switch Unknown argument.Error!

Post Call AT quiet Error! Surrounded by attentive The parts and pieces Unknown switch argument.Error! Lovingly placed switch Into the receptacle ofUnknown soul argument.Error! Unknown switch Until I realized argument.Error! Iâ&#x20AC;&#x2122;m no longer folded in on myself Unknown switch I can reach argument.Error! And stretch Unknown switch And lie wide open argument.Error! Undefended Unknown switch argument.Error! I can sit and stand andUnknown walk switch Unhampered by the weight of words argument.Error! So lightly spoken but Unknown deeply felt switch My heart, once buriedargument.Error! and hidden from sight, Unknown switch argument.Error! Is resting by a riverside Unknown switch Free and wide argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! 105switch Unknown argument.Error!

Post Call Untitled Dr. Joseph Little, III

Lily Vishesh Jain

Post Call

Blue Mist Vishesh Jain

Post Call AT Error! Unknown switch argument.Error! Unknown switch I. argument.Error! Unknown switch Last January, I woke up next to you argument.Error! several hours before dawn, shrugged on Unknown switch a heavy coat and walked outside in search argument.Error! of fire. And the next week also, and the one Unknown switch after, early morning dark-eyed, I ran my argument.Error! hand along your face,Unknown promised to be back switch sometime after sunrise. You took my promises argument.Error! with no response andUnknown I left thinking of warmth, switch of your body pressed argument.Error! against mine. I stirred the newly-lit coals with numb hands,switch sparks Unknown disintegrating easily into frigid air, eyes wet argument.Error! Unknown switch from the sting of white smoke like warm frost. argument.Error! Unknown switch II. argument.Error! switch I learned to stay close,Unknown to warm my hands argument.Error! on the dimpled surface of the clay Unknown switch that covered the flames. I learned to argument.Error! watch the white first-fire source, the sparks Unknown switch dancing on coals quickly greying, the argument.Error! dull glow of the last embers cooling. Unknown switch argument.Error! III. Unknown switch argument.Error! The flames speak in tongues for switch so short a Unknown time but the remnantsargument.Error! linger, burnt charcoal seeps down to stain Unknown switch argument.Error! Unknown switch argument.Error! 108switch Unknown argument.Error! Winter Morning Rebekka DePew

Post Call AT Error!poised the ground. The sun hesitates, Unknown switch for morning and I lean towards the fire as argument.Error! it breathes. And at the center the growing heat, Unknown the climbing orange fingers withswitch their life argument.Error! that takes in cold air and dry wood and gives Unknown switch back stars in miniature.

argument.Error! Unknown switch IV. argument.Error! Unknown switch Gold light slipped through the barren trees argument.Error! in the momentary stillness of those late Unknown switch winter mornings. Andargument.Error! as I watched the dawn fade in slowly, the fireUnknown radiating its heat, the guilt switch in the empty spaces next to you pulled at me, argument.Error! you were waiting and Unknown you had never loved me switch for loving life. With the sputter of snow turning argument.Error! Unknown to steam, I let the coals smolder switch but I didnâ&#x20AC;&#x2122;t leave. argument.Error! Unknown switch V. argument.Error! switchin the The next winter, I seeUnknown these mornings argument.Error! flicker of a candle flame, soft and terrifying. Unknown switch Or the last embers of someone elseâ&#x20AC;&#x2122;s fire slowly argument.Error! dying, resting in the ashes consumed utterly Unknown switch by this raw mimicry of starlight. The memory argument.Error! of charcoal stains left Unknown on my hands, the scars switch on your wrists, the forgotten side of fire argument.Error! that burned and knewUnknown the cost. switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! 109switch Unknown argument.Error!

Post Call Mirkwood Vishesh Jain

Post Call AT Error! Unknown switch argument.Error! Unknown switch “Who are you?” asked the Moon as she rose, silent as a argument.Error! secret, in the darkened sky. Unknown “I,” said the streetlamp, “amswitch a streetlamp.” argument.Error! The Moon pondered this for a moment, observing the Unknown switch sweet, clean brightness of the lamp, then asked, “Why do you argument.Error! choose to remain in one spot? Do you not yearn to see the Unknown switch world, to have an adventure?” argument.Error! The streetlamp pondered thisswitch for a moment, observing to Unknown strange, shadowed light of the Moon, then asked “Why do argument.Error! you choose to travel?Unknown Do you switch not long for the comfort of home?” argument.Error! The pair sat in silence after switch that, lost in thoughts of what Unknown might have been, whatargument.Error! was, and what still could be. Unknown Dawn was approaching byswitch the time the Moon spoke argument.Error! again, saying “I do feel at home, with every new place I see Unknown and every new person I meet –switch each day’s new adventure is argument.Error! my home.” Unknowncasting switchhis light from one side To which the streetlamp, argument.Error! of the road to the other, responded, “Every day at my home Unknown switch is an adventure – you could travel across the planet and never argument.Error! see the worlds I’ve seen on this perfect stretch of asphalt.” Unknown switch As the two glowing orbs said their farewells, the stars argument.Error! beyond – that polite,Unknown everlastingswitch audience of the heavens – nodded solemnly to argument.Error! one another, knowing that it is far too easy to confuse thingsUnknown like homeswitch and adventure and world for places when, moreargument.Error! often than not, they are simply perspectives, and quiteUnknown malleableswitch ones at that. argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! 111switch Unknown argument.Error! Light Robert Tauscher

Post Call AT Error! The Lamp Dr. Richard Davidson Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! 112switch Unknown argument.Error!

Post Call AT Error! Unknown switch argument.Error! switchto what it’s like to live No one seems to giveUnknown much thought inside a magic lamp,argument.Error! but if pushed on the matter, almost everyone agrees that Unknown it’s likely aswitch drab, cold place, a metallic argument.Error! prison consisting of nothing but curved walls and empty Unknown switch space, which is a rather bleak portrayal that would be quite argument.Error! sad if it weren’t so thoroughly inaccurate. Ask any genie and Unknown switch they’ll tell you that most magic lamps come sensibly, if not argument.Error! lavishly, furnished, with a canopied Unknown switch bed, wooden dresser and—if you’re in one of the newer models—a small but argument.Error! functional kitchen. No, furnishings aren’t the problem—the Unknown switch real nuisance is the lighting. argument.Error! Take Baalim, forUnknown example. switch A perfectly professional and eminently competent argument.Error! genie, he was nevertheless trapped by a Unknown switch disgruntled cobbler in the Middle Ages, long before magic lamps were equippedargument.Error! with electricity, so he was left with Unknown nothing but matches and a few switch candles to provide light, and argument.Error! both those ran out in 1815 when Baalim – whose lamp was, switch at that point, residingUnknown in a hollow log just outside of Paris – argument.Error! stayed up late every night awaiting news of Napoleon’s latest Unknown switch march across Europe. argument.Error! This left the meager glimmer of light coming through the Unknown switch spout as Baalim’s only source of illumination, which gave him argument.Error! just a touch of Seasonal Affective Disorder – unsurprisingly Unknown switch common amongst lamp-bound genies – and a desperate argument.Error! longing to be freed from his tastefully Unknown switchdecorated confines. Like many genies,argument.Error! he frequently dreamed of this coming freedom and had prepared forswitch every possible scenario. He Unknown had learned all 6,851argument.Error! living human languages (well, except Unknown Wukchumni, the vowel soundsswitch always gave him problems argument.Error! Unknown switch argument.Error! 113switch Unknown argument.Error! Wishing Robert Tauscher

Post Call AT5Error! and besides, only about people in the world still speak it, so switchhe had studied every he figured heâ&#x20AC;&#x2122;d takeUnknown his chances); argument.Error! fairytale ever written, just to prepare some responses to the Unknown switch for more wishes? not more common human wishes (wishing argument.Error! on his watch); he had even kept up with current events in Unknown switch case he needed to make small talk for a bit. He had rehearsed argument.Error! every imaginable circumstance, scenario, and outcome, and Unknown switch thought himself prepared for anything. argument.Error! Of course, genies always fancy themselves prepared, and Unknown switch never truly are â&#x20AC;&#x201C; imagination, after all, rarely matches the argument.Error! complex, absurd, delightful reality of life outside the lamp. Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! 114switch Unknown argument.Error!

Post Call Untitled Dr. Gary Strong

Post Call AT Error! Unknown switch argument.Error! Whatâ&#x20AC;&#x2122;s so dear about Unknown Countrilifyswitch Musifilic? argument.Error! Serious authors must learn to suffer without Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! 116switch Unknown argument.Error! In Pig Latin Dr. Marvin Cohn

Post Call A Feather in His Cap AT Error! Dr. Gustav Blomquist Unknown switch

Post Call Untitled Dr. Pinar Polat

Post Call AT Error! Unknown switch argument.Error! Unknown switch This moment argument.Error! You are switch Running outside, hairUnknown floating, eyes bright argument.Error! Laughter pealing Unknown switch With you argument.Error! As you rocket sweaty, chests heaving, into my arms. Unknown switch argument.Error! I inhale you deep Unknown switch Into the place that savors. argument.Error! Oh heart. Hush. Unknown switch Let this moment be argument.Error! The shooting star of joy Unknown switch It is. argument.Error! Unknown switch argument.Error! You’re off Unknown switch Bare feet falling soft in cool lushness Voices calling to trees.argument.Error! Summer light fading. Unknown switch No one can catch you.argument.Error! Unknown switch argument.Error! Let’s lash ourselves to the present Unknown switch I’ll keep my arms open argument.Error! You keep running through the grass Unknown switch Manna will continue to fall. argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! 119switch Unknown argument.Error! Seven and Four Dr. Susan Hata

Post Call Walkway at Winter AT Error! Unknown switch Dr. David Thombs

Post Call Mother Dr. Pinar Polat

Post Call AT Error! Unknown switch argument.Error! . . . my “other” self Unknown switch argument.Error! the barely audible whisper Unknown switch the phantom breeze gliding through my stillness argument.Error! Unknown switch Why, “I” ask? argument.Error! Do it, “she” says Unknown switch argument.Error! It is a blood letting, a Unknown cure switch But there is no blood argument.Error! here, I plead It is dry and forlorn Unknown switch Every last warm dropargument.Error! milked by slender fingers Unknown switch Leave me, I desire to argument.Error! decay switch To shrivel up into theUnknown nothingness I feel like argument.Error! I turn away, my foot poised on the murky banks of oblivion Unknown switch argument.Error! Her hand, I feel on my shoulder Unknown switch Gentle, assured, knowing argument.Error! No, she says, I will not let you go Unknown switch argument.Error! And she grasps Unknown switch Onto my listless limbs, dangling waywardly like mad tentacles argument.Error! With a burly embraceUnknown switch Carries me, holds my argument.Error! shivering body through the impenetrable hours ofUnknown night switch through the blood letting argument.Error! Unknown switch In the morning light, argument.Error! Unknown switch I am here argument.Error! Unknown switch argument.Error! 122switch Unknown argument.Error! Write She Says Dr. Pinar Polat

Post Call AT Error! Unknown switch argument.Error! Unknown switch I, a husk argument.Error! a discarded shell Unknown switch a cast (empty) argument.Error! of what was Unknown switch old and dingy, yet loved argument.Error! Unknown switch I, a plant argument.Error! roots unearthed, torn,Unknown ripped apart switch yet still, in tact argument.Error! soft and green Unknown switch sprout argument.Error! Unknown switch write, she says argument.Error! Unknown switch and you will bleed it out argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! 123switch Unknown argument.Error! Where is here? What is I?

Post Call Red Rock Canyon Dr. John Cobb

Breakneck Vishesh Jain

Post Call AT Error! Unknown switch argument.Error! Unknown One yawning winter night I was switch walking down this road and argument.Error! you opened your door . . . Unknown switch inside, luminous and enchanting. I was timid, but your argument.Error! silent invite beckoned invisible. I Unknown switch approached your door, bold and brave. And you faded into argument.Error! darkness. Unknown switch Standing at the steps of your house, I peered in for you. But I argument.Error! could not see you, hear you. Unknown switch I called your name, first a whisper, then louder. The only argument.Error! reply was the silent echo of my voice Unknown switchresonating from unseen walls inside. So . . . argument.Error! I waited as the night sunk into itself and silence blanketed the Unknown switch earth. argument.Error! Unknown switch I waited . . . argument.Error! The stars ducked behind thick clouds and the gentle breeze Unknown switchthe night open. morphed into a gusty wind, whipping argument.Error! I waited . . . Unknown A shard of light pierced throughswitch the viscous black and argument.Error! I waited . . . Unknown switch Her majesty raised a rosy face coyly from behind endlessness, argument.Error! soft and demure at first. Then her unbridled radiance flooded Unknown switch the banks of night. argument.Error! I waited . . . Unknown switch and I waited as the cool rain mixed with my hot tears. argument.Error! I waited at your open Unknown door whichswitch you neither closed nor attended to. argument.Error! Hope was my dearestUnknown friend andswitch most unforgiving foe. She would not let me go. argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! 125switch Unknown argument.Error! Untitled Dr. Pinar Polat

Post Call ATspring Error!of my eyes was a drop of your But each drop from the Unknown switch memory, your hope, your promise expunged from my soul argument.Error! . . . floods and torrents . . . I thought it would never end . . . the bottomless ocean.Unknown switch argument.Error! But there is an end. Ay, there is a change disguised as an end. Unknown switch Now in the bashful red and orange waves of the autumn sea argument.Error! the leaves of hope fall crimson gold to the ground giving way Unknown switch for the blossoms that shall steal in the lacey twilight of Bahar. argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! 126switch Unknown argument.Error!

Post Call AT Error! The Orchard Dr. Richard Davidson Unknown switch

Hallstatt, Austria Ayaka Sugiura

Post Call Marinerâ&#x20AC;&#x2122;s Compass AT Error! Unknown switch Dr. Mary Harbison

Untitled Dr. Rajnish Gupta

Post Call The Shape of Things AT #1 Error! Unknown switch Gwen Moore

argument.Error! Crowned in fall glory Unknown switch argument.Error! She watches with consternation Unknown switch As the nation she represents argument.Error! Flails and moans Unknown switch argument.Error! Will the darkness that threatens Unknown switch Overtake us, or is something argument.Error! New about to be bornUnknown switch Amidst this show of blood? argument.Error! Unknown switch I hate that Jefferson said, argument.Error! “The roots of liberty’sUnknown tree switch require the blood of patriots,” argument.Error! Unknown switch Or some such lofty nonsense. argument.Error! Unknown switch What we need is clarity of thought, argument.Error! Not hot rushes of passion, Unknown switch Kindness and a listening ear argument.Error! To restore the shape of things. Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! 129switch Unknown argument.Error!

Post Call Untitled Dr. Gary Strong

Untitled Dr. Gary Strong

Post Call The Shape of Things AT #2 Error! Unknown switch Gwen Moore

argument.Error! Unknown switch Jazz chords argument.Error! Black guitar switch Throbbing red in the Unknown dark Thereâ&#x20AC;&#x2122;s a black-hairedargument.Error! vamp Unknown switch Blowing smoke from her argument.Error! French cigarette Unknown switch While the Statue of Liberty argument.Error! In the corner Unknown switch Is looking perplexed argument.Error! In her green patina. Unknown switch argument.Error! I think I spy Leonard Unknown Cohen switch On the wall argument.Error! Unknown switch Turned sideways in his Melancholy black andargument.Error! white Unknown switch And the colors start to swirl argument.Error! Like fall leaves Unknown switch Caught dancing in a breeze argument.Error! Unknown switch Itâ&#x20AC;&#x2122;s Greenwich Village, 1959 argument.Error! And the saxophone man wails Unknown switch While the guitar player lays out argument.Error! Eyes closed, listening Unknown switch To the shape of things. argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! 131switch Unknown argument.Error!

Post Call Fallen Angel Vishesh Jain

One Dr. Pinar Polat

Post Call AT Error! Unknown switch argument.Error! Unknown Sometimes mid-January decides switch to try on early spring for size argument.Error! and river ice sees a side of the sun generally reserved for daffodils. It makes us Unknown forget, butswitch argument.Error! maybe winter is always like that, turning cold like waves collapse, Unknown switch and tell me beautiful things. The sky is more like glass in early argument.Error! afternoon, as angels mirror us running barefoot on winter-brown Unknown switch grass. Sometimes loveargument.Error! is soft and stays between your toes. Keep this. Unknown switch argument.Error! After every thunderstorm, youâ&#x20AC;&#x2122;dswitch remind me of a painting Unknown with angels riding down from some sort of heaven on rays of argument.Error! light, a painting that perhaps onlyswitch existed in your mind and Unknown your words and one sunset from a car window, and argument.Error! Unknown switch maybe I will never write about what I would saturate myself in. argument.Error! It is vacuums that pulsate and quiver, full of the most tangible Unknown switch form of nothingness that holds itself in inflationary phases, put in argument.Error! place by angels and definitions of grace and rays of light given lines by brushstrokes, lightUnknown seen for itselfswitch for once and not its reflection. argument.Error! Unknown switch And this was when I hovered at the end of August one final argument.Error! time by a lake that my summer had saturated with sunsets. Unknown switch Tightly angled sunrays, remembering argument.Error! the one thing I felt certain to always settle into. Thinking of angels Unknown switch only in reverse. Memories as pumice-stones made of light, too argument.Error! beautiful to hold. How different things are now, how much more Unknown switch solid. argument.Error! Unknown switch I was never sure why argument.Error! I held on to so many small pieces of another life. Webs lit Unknown from belowswitch look different, and argument.Error! Unknown switch argument.Error! 133switch Unknown argument.Error! Angels Rebekka DePew

Post Call Error! sometimes it takes us AT awhile to unstick the dewdrops from Unknown past mornings and distill them toswitch something less easily argument.Error! understood switch and even after all thisUnknown time, God still lives in the top left corner argument.Error! of the room. Even on our own, our hands cast spidery shadows switch on the sky and we setUnknown up Easter egg hunts in graveyards. Leaving argument.Error! me sitting in an empty theater with God and seventeen angels Unknown switch and forgetting every name except my own. argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! 134switch Unknown argument.Error!

Post Call AT Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Photo Opportunity atUnknown Sunrise switch argument.Error! Dr. Richard Davidson Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! Unknown switch argument.Error! 135switch Unknown argument.Error! Norway Whale Dr. Rajnish Gupta

About the Authors

About the Authors Dr. Gustav Blomquist did his undergraduate work at Brown and Harvard; he is a proud member of the Vanderbilt Medical School Class of 1973. He completed his Neurological Surgery residency at the Montreal Neurological Institute and Hospital, McGill University. Later he trained in Plastic, Reconstructive and Hand surgery. He earned his MFA in Rembrandt Studies at the Getty in L.A. He has completed over 600 paintings in oil on canvas and his work can be viewed in more than thirty states as well as in Sweden, Paris, France, the U.K. and Italy. Dr. Jane Brody is a psychiatric nurse clinician who has been a nurse educator for over 30 years. She is a graduate of Skidmore College, Vanderbilt University School of

137

About the Authors Nursing, and Adelphi University School of Nursing. She was awarded the SUNY Chancellor’s Award for Excellence in Teaching. Dr. Samuel Brody is a graduate of the Vanderbilt University School of Medicine where he completed his residency in internal medicine. He is boarded in internal medicine, gastroenterology, and geriatric medicine. He is currently a clinical assistant professor at Mount Sinai School of Medicine and practices in one of their satellite offices. He has had articles published in many professional and news journals and has been recognized as a “Top Doctor” in NYC for several years. After being raised in Albuquerque and completing his undergraduate degree at University of New Mexico, Dr. Ron Bronitsky arrived at Vanderbilt medical school in 1973. Seven years later, he left with his MD degree and residency in Internal Medicine. He spent two years in Shiprock NM as chief of medicine for the Indian Health System. From there, he completed critical care/pulmonary fellowship at Oklahoma Health Science Center. Since 1984, he has been back in Albuquerque practicing Pulmonary and Critical medicine. Along the way, he has performed in musical theater, played bassoon, swam the La Jolla open water swim, and developed a knack for making championship pies. He now looks forward to his retirement this summer to explore what else life has to offer. Dr. John Cobb is an ophthalmologist in Atlanta, Georgia. He is proud to be a VUSM graduate of the Class of 1978, which established the first Class Scholarship. Since 2002, he has pursued mountaineering and rock climbing in various locations including Grand Teton, Mt. Rainier, and the French and Swiss Alps, including Mt. Blanc and the Matterhorn. Dr. Richard Davidson went to undergraduate and medical schools (class of ‘72) and trained in Internal Medicine at

138

About the Authors Vanderbilt. Active in the Student Health Coalition in the early â&#x20AC;&#x2DC;70s he practiced medicine for several years in Appalachia, then became a Robert Wood Johnson Clinical Scholar and received an MPH at the University of North Carolina and joined their faculty. In 1984 he moved to the University of Florida where he chaired the curriculum committee for 12 years and developed one of the earliest interprofessional education programs in the country. He retired three years ago as the Vice President for Health Affairs for Interprofessional Education. He is a licensed Coast Guard captain and enjoys photography and playing bluegrass music, a result of spending many years in Nashville. Rebekka DePew is a first-year student who enjoys biking, music, and everything about springtime. She is interested in primary care. She grew up in Tampa, Florida and has loved her first year in Nashville. Dr. Blair Erb graduated from Vanderbilt School of Medicine in 1983. Phil Felts and Grant Liddle (google them) decided his internal medicine residency and chief residency would be served at UCSF. What a fabulous experience! The lure of the black and gold proved powerful and brought him back to Vanderbilt for his cardiology fellowship. His two daughters were born at Vanderbilt and he spent nearly a decade practicing with Page Campbell Cardiology. A celestial convergence in 1999 resulted in his decision to move west start in the cardiology program in Bozeman, Montana. The ride has been interesting . . . medicine is his profession. Fishing is his passion. Writing has provided him comfort since he was a teenager. Will French is a second-year medical student at the Vanderbilt University School of Medicine. He was born and raised in Hot Springs, AR and received a B.S. in Biology from the University of Arkansas. He serves as his class Vice President on the Council of Class

139

About the Authors Officers and on the leadership board for the student organization Physicianâ&#x20AC;&#x2122;s For Human Rights. Samantha Gridley is a fourth-year medical student who will soon be starting her Pediatrics residency in Seattle, where she will be joining her husband David after many years of dating long-distance. She majored in English at Harvard and is thankful to have had the opportunity to continue nurturing her love of literature and writing in medical school. She plans to specialize in Adolescent Medicine and looks forward to a career that intertwines research, creative writing, and clinical medicine. When she is not working or writing, she can often be found on the tennis courts. Dr. Rajnish Gupta is an Associate Professor of Anesthesiology at Vanderbilt University Medical Center and an avid hobbyist photographer. He and his wife, Sonal Saraswat Gupta, graduated from Vanderbilt Undergraduate in 1998 and Vanderbilt School of Medicine in 2002. They completed their residencies at the University of Michigan before moving back to Nashville area in 2006. Dr. Gupta enjoys travel, landscape and nature photography in addition to pictures of his two daughters, Kiran and Jaya. Dr. Mary Harbison is a Nashville native and comes from a long line of seamstresses. Her mother taught her to sew at age 4, and she pieced her first quilt while in medical school in the early 80â&#x20AC;&#x2122;s. She practiced medicine at Saint Thomas Hospital in Nashville and is now a physician appeals reviewer for the Tennessee Medicaid program (TennCare). She has two grown children and one grandchild, and lives on a farm in Williamson County. Dr. Susan Hata practices primary care Medicine and Pediatrics at Mass. General Hospital in Boston. She facilitates a reflective practice curriculum for Pediatric and Med-Peds residents there, and enjoys creating space for physicians to process their experiences and support

140

About the Authors one another. She graduated from Vanderbilt Medical School in 2003 and completed her Med-Peds Residency at Vanderbilt in 2007. Dr. Richard Hutson is a VMS graduate, Class of 1966. He was born in Western Kentucky, andattended Murray State University in his home town as a pre-med student. After a Rotating Internship and FamilyPractice Residency he practiced Family Medicine in Paducah, KY, retiring in 2000. He and wife Jane, a classical pianist, moved to Fort Collins, CO in 2004 where they are enjoying and exploring the Rocky Mountain West. Dickâ&#x20AC;&#x2122;s other interestsinclude Fly Fishing, Hiking, Photography, Watercolor Painting, Archaeology, and a wide array of good Literature and Music. Michelle Izmaylov is a fourth-year medical student excited to stay at Vanderbilt for residency in internal medicine. In addition to medicine, she is passionate about creative writing and wrote her first novel when she was eleven. She has published four novels and has been working on her fifth novel since her first year of medical school. She won first place in the 2016 Gold-Hope Tang Humanism in Medicine essay contest, and her medical creative writing is forthcoming in Annals of Internal Medicine and has been published in the Journal of the American Geriatrics Society, the Journal of General Internal Medicine, Academic Medicine, and Intima: A Journal of Narrative Medicine. Outside the whirlpool of VMSII, Vishesh Jain enjoys cooking, reading, digital art, and photography. Nature is a common presence in his creative work, inspired by an enduring love of life and biology, as well as his gardening girlfriend. He also favors geometric patterns, from rotation and spirals to symmetry and fractals. Dr. Jospeh Little, III graduated from Vanderbilt Medical School and completed his Pediatric residency at Vanderbilt Childrenâ&#x20AC;&#x2122;s Hospital. He has been a

141

About the Authors practicing pediatrics for almost 40 years. When not in the office, he spends time at his woodland property, in his gardens at home or with his grandchildren. His writing and photography are probably related to the importance of careful observation in clinical practice. Dr. Allison Martin is currently an NIH Fogarty Global Health Fellow through the VECD (Vanderbilt) consortium at the University of Rwanda in Kigali, Rwanda, and a General Surgery Resident at the University of Virginia, Charlottesville, VA. She is a 2013 graduate of the Vanderbilt School of Medicine. She is currently researching access to cancer surgery as well as the epidemiological and environmental factors associated with stomach cancer in Rwanda. Lynne McFarland is an Advanced Practice Nurse in the Department of Psychiatry. She has been with Vanderbilt 24 years! She loves poetry as a compressed form: a lot can be packed into one line. She feels the same way about music. They are the zip files of our minds. Dr. Akshitkumar Mistry is a PGY-4 Neurosurgery Resident at Vanderbilt University Medical Center. He was raised in India, Africa, and the U.S. He attended Vanderbilt University School of Medicine. Growing up in L.A. and living in Texas, Arkansas, Connecticut, Germany and Israel, Gwen Moore has made her home longest in Nashville. Inspired by the medical students, she is thrilled to have completed an MTS from Vanderbilt Divinity School, one class at a time. Andrew Perez is a second-year medical student at Vanderbilt University School of Medicine. He majored in Neuroscience and minored in Spanish at Brigham Young University. He has always loved photography, but has never advanced further than a smartphone for his image-capturing needs. He always tries to find the

142

About the Authors place of greatest potential in his photo-taking and loves finding the vantage point that reveals what before was hidden or unnoticed. Dr. Mark Petrik, Bellarmine University class of 1979, Vanderbilt Medical class of 1983, is a retired orthopaedic surgeon who suffers a fixed delusion that he is capable of writing. He has afflicted family, friends and a very limited reading public with the fruits of that delusion in the form of two novels: The Ensouling, and The Book of Toby, available on Amazon. He does his best to keep his Parkinsonâ&#x20AC;&#x2122;s disease from interfering with his enjoyment of woodworking, gardening, and various crazy projects on his small Indiana farm. He delights in the company of his long-suffering, intelligent and beautiful wife, Sarah; his three brilliant, accomplished and always interesting daughters: Elizabeth, Caroline, and Kathryn; and his two adorable granddaughters: Rory and Remy. He can be contacted at mpetrik@aol.com Dr. Pinar Polat is a PGY5 Child Neurology resident who is moving to beautiful Colorado in July, 2017 to pursue her dream of specializing in Sleep Medicine. Art has been a part of her life since an early age. As a 4 year old, she would spend hours upon hours with pencil in hand, drawing and doodling. She made art wherever and whenever, her grandmotherâ&#x20AC;&#x2122;s plant pots, doors, walls ... Recently, she started learning a form of painting called ebru or water marbling. It is a classic Ottoman era style of painting wherein your canvas is water. Painting on a fluid surface, literally, speaks to her soul in countless ways. She hopes to keep exploring her world and creativity through this medium. Her love of writing started when she was eight, the day her father gave her the gift of a hardcover notebook and told her this was a diary and she was to write in it every day. And she did, write in it every day. And, thus began a lifelong love affair with expression through words. Writing in the

143

About the Authors form of journaling and prose is a lifeline of sorts, a medium for self expression and reflection, allowing access to her subconscious and a space where she can ponder life, love, beauty, and truth. Life is art. Love is art. We are art. Henry Quach is a second-year medical student from San Diego, CA. He attended UC San Diego for his undergraduate degree in Biology, where he also took a fiction writing class that inspired him to continue creating and sharing stories. His other interests include learning about novel technologies, trying new food, and reading. He especially loves to read a good mystery, thriller, or conspiracy theory. Ayaka Sugiura is a third-year MSTP student at Vanderbilt. She turned to painting as a way to cope with a difficult time in her life. Since then, she has come to truly enjoy painting as a new way for her to connect with others. Robert Tauscher is a fourth-year medical student who has matched into an ophthalmology residency at northwestern. When he’s not at the hospital, he enjoys being outside, playing sports, exploring used bookstores, and shopping at Costco. Dr. David Thombs graduated from Amherst College, Vanderbilt Medical School and received his residency training at Vanderbilt Children’s and Cincinnati Children’s hospitals. Dr. Thombs served in the US Navy at the USNH Portsmouth, Virginia and returned to Nashville where he practiced with Old Harding Pediatrics for 37 years. Subsequently he was the Medical Director for the peer review organization, KEPRO TN, for eight years. After retirement Dr. Thombs has been active in community service, golf and being a student of art under nationally prominent artist Charles Brindley. Born Alexandra Nicole Vorhaus in NYC in 1962, Dr. Niki Thran’s parents raised her with a love and deep appreciate of art in its plethora of pluralistic forms.

144

About the Authors After studying under the NYC artist Satish Joshi in high school, Niki went on to Tufts University in Medford MA. Though she received her BS in Biology, Niki continued studying art, both in the classroom and studio. After graduating from Vanderbilt School of Medicine (where she was known for her elaborate and colorful class notes), Niki completed a residency in Emergency Medicine at the University of Massachusetts Medical Center. She is currently practicing Emergency Medicine with Gifford Health Care in Randolph Vermont. She continues to create multimedia art, most recently through the medium of digital drawing of her photographs. A digital art piece was recently published, as was a recent essay titled, â&#x20AC;&#x153;Burning Man - A Full Thickness Family Vacation.â&#x20AC;? When she is not creating art, Niki can be found harassing her three beloved children, traveling or working on issues close to her heart, primarily issues of inequality and environmental sustainability. She resides in Quechee, Vermont, and hopes to return to graduate school one day for an MFA degree. Dr. Ben Trappey is originally from Louisiana and currently lives in Minneapolis, MN where he works at the University of Minnesota as a Med-Peds hospitalist. The road trip from Louisiana to Minnesota included a four year stop in Nashville during which he was fortunate enough to become a member of the VUSM class of 2008. He has an academic interest in medical storytelling and moral distress. He lives daily with the existential dread that comes with realizing that he will probably never finish that novel.

145