Obliterants Spring 2019

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REFLECTION — an essential component in our professions of lifelong learning. We declare our practice an art, but how do we create without processing what we consume? Without reviewing what we have done, how do we assess the best way to react to new conditions? Without evaluating our previous answers, how do we solve our contemporary and impending challenges? Without looking back at our past, how do we move forward knowing that we have changed for the better?

Nighttime Stillness by Dallas Sheinberg, oil

Reflection, however, is not simply recalling what we have encountered. To better understand, we must question what we believe to know and what we think we feel. We must re-examine how we observe the world. We experience our surroundings and situations through our thoughts, by our senses, and with context of our identities. And so, in our reflection, we remind ourselves this: We are of our MIND, we live in our BODY, and we reside in our SOUL.

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about

Obliterants is a journal published by students, residents, alumni, faculty, and staff of the University of Miami Miller School of Medicine. Our mission is to publish writing and artwork that promotes the humanities and social sciences in medicine and public health. In doing so, we highlight the creations of our talented community and to archive the imagination, passion, and inspirations we find in our professions.

Obliterants is not an official publication of the University of Miami Miller School of Medicine. Expressed written opinions are solely those of the authors and do not necessarily represent those of the University of Miami, the School of Medicine, or the Department of Epidemiology and Public Health. The work published in this magazine are creator-owned, and we do not lay claim on any individual pieces are featured.

We can be found on issuu (obliterants) and on Facebook (obliterants).

from the editors

As we reflect upon this past decade of issues, we realize growth and progress is not linear but rather a series of up and downs with an optimistic perspective. Reflection — as individuals, as communities, as a society — gives us insight and a chance to make sense of this seemingly abstract, random, chance world we live in. While we work and function in a working environment that strives to be data-based, evidence-driven; sometimes life is better captured through a poem, photograph, or prose that a statistic could never tell. We are without credit to our predecessors that have continued sharing and encouraging the development of our stories.

Our very best, Misha Armstrong, Adriana Grossman, and Catherine Zaw

staff 2018-19 Editors-in-Chief Misha Armstrong Adriana Grossman Catherine Zaw

Managing Editor of Writing Jennifer Ferrante Managing Editor of Art Nicole Lin Faculty Advisor Gauri Agarwal, MD, FACP

Staff Members Vic Rea-Wilson Willy Chertman

Design Team Alexandra Gordon Bernadette Miramontes Erin Wolfe Gilbert Garbiso Joanna Zhang Rohit Reddy Sonia Dhairyawan

Cover Art Skull Study by Erin Wolfe colored pencil, Copic marker, and charcoal on paper mind Female Profile by Erin Wolfe body Skulls by Erin Wolfe soul cordelia 2:2 by Mika Mintz

MIND

Female Profile by Erin Wolfe, Procreate

The First by

Jennifer Ferrante

We all know it’s going to happen, but I thought I would have some warning.

Maybe during my ER rotation, during surgery, or in the ICU. Certainly not on Valentine’s Day as a second year during bedside.

We were looking for a patient to take a history and physical, we know how this goes by now, “What brought you in today?”

“Could you describe the pain?”

I rehearsed as I always do, but not nervous, because finally I have found comfort in the familiar.

“Come with me!”

We file into a room with a group; doctors, nurses, paramedics gathered around a blue body, all I could think: he’s so blue he’s so blue so blue.

We can’t be in the right room?

We can’t take a history here?

Working in coordinated chaos the doctors take turns performing compressions, switching positions, “Another of epi!” and I pretend I’m watching Grey’s Anatomy, I don’t cry at TV shows.

“One more round, and we’ll call it.”

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I can’t bear to hear what I know is coming next, time of death, so I step into the hall, catch my breath, trying to understand why I am mourning for someone whose name I will never know, why I can’t just wait until I get home to feel this way, why my mature defenses are failing me, begging for suppression for just a few hours so my faculty mentor doesn’t have to see me cry and write in my evaluation that I cannot handle medicine if I cannot handle death.

But instead, he tells me that he fainted in his first surgery (he became a surgeon).

He reassured me that it’s okay, normal, perhaps even good that I feel this way.

My emotions are not a burden, and sure, maybe over the years I will harden but right now, this is compassion. This is empathy, and this is what only experience can teach.

I should not feel ashamed for feeling.

I wiped my eyes and we regrouped for a moment before seeing our next patient, to whom I could finally ask, “What brought you in today?”

Skeletal Life by Sandy Jiang

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Baker Act by

Misha Armstrong

72 hour hold, you never expected Stripped and searched, No shoelaces allowed All of your clothing is replaced by a gown.

Suicidal thoughts, one too many drinks A number of social factors lie underneath.

Involuntarily here, you plead it’s a mistake No threat to yourself or others, You promise you’ll get help, do whatever it takes.

A long list of questions, I apologize I must ask.

Your childhood, drug use, and psychiatric past.

You anxiously squirm in your seat, I promise I’m not here to judge.

My white coat a reminder, that your secrets I will keep.

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Alert and oriented times three Please repeat after me.

Judgment and insight intact, No questions left to ask.

I listen to your heart and lungs, The evaluation is complete.

You’ve told me your life story And hope to leave shortly.

The doctor will see you now, You repeat your story, careful with your words He frowns barely listening, not hearing a word He questions your decisions, life choices critiqued So small in your chair, you don’t get to speak.

He tells you to sign by the “X” And you do as your told Hoping your freedom will soon be restored.

Another sheet slipped in, With no explained meaning You exit happily, thinking you’re leaving.

Your job is on the line, Your children are at home You’re stuck here another night, And you don’t even know.

Signed voluntarily is what you’ll be told.

An extra signed sheet slipped into your file An abuse of power, the truth unfolds.

Restraints by Gilbert Garbiso

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dusk it’s clear as day when the sun sets on your sanity your words crumble to ashes your legs pace without aim and your thoughts blend until unreal the stars are completely out tonight and the moon is dark and new the only light on is yours the only sound we hear is your wail we hold our breath with a phone behind our back eyes wide open, we wait for the night to pass and when you return to your quiet place we breathe again — slowly first, then more steady as we see blue sky — and watch for your next rise

— Catherine Zaw

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A Quiet Place by Harry Levine, watercolor

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Saut D’Eau by Arrianna Thompson

Doctor, I’m afraid

by Bernadette Miramontes I fear Losing my Mind Losing myself And who I am I thought I could rely On my own Mind For it has carried me this far But suddenly Over night What a terrifying feeling To not be able to remember To not know what I’m doing To stare blankly Trying to remember Where I keep my toothbrush My bedroom Once so familiar But then Over night 3 hours It took me To get ready I stood in my bathroom Staring at the sink What I am doing here?

Oh I need my glasses Ok Now what?

What am I doing?

As I tried to remember How to do What I’ve done Every morning for years I fear Losing my Memory So I must write everything I must I must capture Everything I write Every Thought Every idea Every feeling

There’s nothing I let slip from me My Mind may fail me but at least I can trust My writing Right?

There’s something about writing There is Thought to every word Every syllable And annunciation In what I say In how I am But sometimes Even my words Fail me Sometimes Words cannot capture the right feeling The words aren’t quite right Not in English, nor Spanish Not even French So I must find a new way I must An unfamiliar tongue A new language Music A new form of expression I listen Trying to find the right sound Listening for someone To capture this moment Express my feels The emotions In music The sounds The tension The release Hundreds No, definitely thousands Of songs I’ve listened to Some over and over again Sometimes just a few bars A few lyrics Savoring the sounds Breaking down the beats Re-sounding the resonance The rhythm

Lyrics Are words But words are not lyrics The rise and the fall The build-up the call And response Voices answer One another But not always giving The answer I seek Sometimes Someone Musics it just right They express the feeling The sensation That words cannot describe Music that makes you feel Is what I seek But sometimes No one Musics what I need No one else has expressed it in a song Or at least Not one that I’ve found About losing My consciousness Losing my Memory Maybe my Mind Not in this way There’s no song Not expressed Not yet So I learn I learn to create So that I can express So that I can capture The fleeting moment The fearful emotions And constant changes In my head Describe it in ways that my words Not English, nor Spanish Can speak

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So I create I create my own music My own expression My own way I carve out a new road Not well traveled Uncharted Unwritten Unexpressed Not yet known to humanity I must release and give I must give Everything I can Before my Mind is gone For one day, Whether now or in 80 years My Mind will seize To be As it is Seize Seize Don’t seize Don’t fail me now Not yet

Thoughts are fleeting Ever changing But what if I can share those Thoughts What if Those Thoughts can be passed From Mind to Mind Ever living Ever lasting What if I can share my passions Share my love for humanity Before I seize To exist Before my Mind changes To a new pattern of Thought I fear The change But change is inevitable Change is constant I know how to ride the wave I have dealt with change I’ve learned from the unexpected From which we regrow stronger

Let me give Let me do And create And think And Be Before it’s gone

Let the change come Let it happen It will happen Whether I Will it or not So I Will ride it I Will experience it Document it And express it Let it be As I be As I become The new me

Let me live And experience And take everything in Let me feel and sense And cry and laugh Let me be before it’s gone I have so much life to live I have so much Thought to think And so many gifts to give I have so many songs to create And share with my family and friends And maybe the world

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I must write everything I must document everything before it’s gone

I cannot control what’s around me what’s happening I cannot control the circumstances and that’s ok that is how it always was and always will be I can control how I choose to react what I choose to take and make of it How I want it to affect me what I want to carry with me what I choose to see in this beautiful mess we call life We have a choice To appreciate the beauty We can choose To be inspired By the epic-ness I will choose to be awestruck By the vast complexity Appreciate The intricacies The details The changes The fleeting moments that are mine And mine alone Beautiful and terrifying things That only I get to see and feel Only I get to experience Mine And mine alone To share With the world …

I’m ready.

Am I not constantly a new me?

Am I not ever changing With every experience And person and place And action and moment And lesson and hardship And song and day?

I am ever changing

Doctor, I’m ready

photo by Nicole Lin

Skulls by Erin Wolfe

BODY

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Illustrations and Prose by Israel Taylor

En Silencio by Yvette Rodriguez, graphite and white charcoal

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ay in and day out, I leave before the sun and return after it has set. One day, my mother told me, “Izzy, you look pale.” It was hard to believe my brown skin could ever be described as such. It was a long week, I was adjusting to a new schedule and although I couldn’t see it, it was obviously taking a toll on my body. The following weekend, I sat outside in mid-day for the first time in a long time. When I wasn’t paying attention, I didn’t realize how big an effect mere sunlight would have on my mood, yet after those few hours, I realized how alive I felt once again. Grounded signifies just this—the wholeness that sits at the intersection of humanhood and nature. Time and time again we learn

that the environment where our patients live, work, and play largely impacts their health and well-being, but I seemed to have forgotten this for myself. The sun, the trees, the flowers—all of these nature offers to us every day. Whether we accept that offer, or make time for it, is up to us.

These days, it feels as if I’m expected to be more machine than living thing. Working, learning, studying every minute, instead of simply…being.

So, I drew this to remind myself to remain grounded, to continue to water my creativity, to weed out the voices that tell me I can’t, and to sit outside and let the sun hit my skin every once in a while.

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labor do you know how much work my mother did for me? the seas she’s crossed the roads she’s walked the friends she’s lost the family she’s left the home she’s built the languages she’s learned the tears she’s shed the hate she’s endured that life she remembers this life she creates do you know how long her labor was before she delivered me?

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delivery and just like that — dreams first imagined; growing pains suffered; shoes one-size-up broken in; pictures taken, retaken, and retaken; sidewalks walked, roads driven; jokes, lame but laughed at; love first acknowledged; heartbreak once affirmed; careers changed and resumes reshaped; homes moved out of and in to; paychecks earned, taxes filed; outings with new friends, reunions with old friends; holidays observed, families cherished; adventures planned, flights delayed; failures challenged, ambitions achieved; losses grieved; memories remembered and forgotten; birthday last celebrated — a whole lifetime weighs 8.8 pounds in your two hands

— poems by Catherine Zaw

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Time

on my

Hands (something you may never catch a medical student saying)

Spaghetti Wrist by Manan Patel, embriodery on aida cloth

Hands by Erin Wolfe, charcoal on paper

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Palm of my Hand by John Tsatalis, 7 mm flair needle felt-tipped pen on magazine page

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Humanity:

A Song Like The Ocean

Underwater Pleural Effusion by Erin Wolfe, watercolor

We seek to create something without ends just as war thinks it’s the finale they seek an encore becomes the next piece Each drop, a life flowing streaming and growing The rhythm of the waves full of love it raves each droplet’s motion resonating our devotion with deep, bellowing overtone A different zone in life’s music that moves you taking hold of your breath a sound wave becomes a wave of emotion A wave of the ocean It takes hold of you you flow let it move you — Bernadette Miramontes

Blue Barrel by Erin Wolfe, oil on canvas (2” x 3”)

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SOUL

cordelia 2:2 by Mika Mintz

Tea Time

by Molly McKinney

Once a week I trap the tea.

Doused repeatedly, it bounces off of the surface, Until soaking up enough to sink.

Finally cool, I sip on my drink, Embracing the friction.

Hidden in the city these children are plain tea.

Without a sugar coating, My tongue is rarely in fashion.

In one of the rusting cribs that line the wall cleaned with alcohol — He bangs his head against the metal railing.

Others sit on the floor.

Their bottoms are soaked in urine And the fronts of their shirts are encrusted with vomit.

The strong stench overtakes— The hollow, white paint plastered rooms Which seem sterile, Forged with intensity, Like white light, which reflects all colors, Are a prism that separates each child into their visible part of the spectrum.

The severity of the damage is not their fault.

About one in a thousand.

Inside the small head is an arrested brain.

The blank stare registers.

Closer eyes, gives a somber and confused look — Furnished with a thin upper lip.

Above, a new smooth space, Between the lip and nose, All contortions clash.

Volunteers’ break, biscuit and tea time at four p.m.

If only fixing them were as simple as the electric water kettle.

Fill it up.

Press the button.

Listen for the click to know it is scalding.

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The Eye by Harrison Dermer, ink and watercolor

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cordelia 1:1 by Mika Mintz

A Tree in Winter

by Jennifer Ferrante

in former glory I shrink like winter’s tree a shadow of his summer self trying to compose against my past I, a critic, loom over my words my shadow persists in the light I said I would never tell about trees or seasons it’s all been done and undone but now I must reconsider a ubiquitous picture of loneliness and melancholy a tree without leaves a shell in the snow no snowflake is to blame when my leaves fall, when my branches bow together, each is innocent freely they land, without guilt nobody can stop an avalanche does that one flake really matter? one of them takes my last leaf I try and retreat but my trunk still stands the wind beats against me but for my roots I remain I recall summer how I flourished and so I don’t wither I write

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A Splash of

Color

Sunset by Harrison Dermer, ink and watercolor

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DalĂ­ by Jacob Rosewater, oil on canvas

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Staff & Contributors Thank you so much for sharing your inspirations and creativity with us!

Adriana Grossman

Christine Wilkins

Class of 2020 MD

Class of 2019 MD/MPH

Bernadette Miramontes Class of 2021 MD/MPH

Alec Savilla

Dallas Sheinberg

Class of 2022 MD Enjoys contemporary art and all genres of music.

Class of 2020 MD/MSc

Arrianna Thompson

Erin Wolfe

Class of 2020 MD

Caitlin Coviello Class of 2020 MD/MBA

Class of 2022 MD Erin’s interest in exploring the innate connection between healing and creativity began while working for a variety of nonprofit health, education and creative arts organizations. She became a freelance medical illustrator in 2014. Her work has been published in journals, book chapters and educational videos.

Harrison Dermer Class of 2020 MD Passionate about medicine, music, and art.

Casey McGillicuddy

Harry Levine

Class of 2020 MD/MPH

Class of 2021 MD/MPH

Works hard. Sleeps hard. Is still tired.

When not behind the books, Harry can be found outside biking, gardening or drawing.

Catherine Zaw

Israel Taylor

Class of 2020 MD/MPH

Class of 2020 MD/MPH

5 percent medical student; 95 percent mango.

Jacob Rosewater

Molly McKinney

While considering music to be his favorite art for most of his life, Jake has delved into other forms of expression and has found comfort particularly in painting. Except actually culinary arts are the best because food.

Class of 2020 MD/MPH

Jennifer Ferrante

Nicole Lin

Class of 2021 MD

Class of 2020 MD/MPH

Passionate about medicine, poetry, and turtles.

tribe 54, sweat lodge 12

John Tsatalis

Noreen Mohsin

Class of 2019 MD/MPH

Class of 2022 MD

Humans have a fundamental drive to create. To ignore the creative impulse is to deny a key element of self-expression. John‘s interest is to marry this self-expression to medicine and his many other interests.

In between finishing college and starting medical school, Noreen had the opportunity to indulge her creative side by learning how to swing dance and create an iPhone app. She also taught herself how to play the piano and paint, and is thrilled to have the opportunity to share the latter with her classmates!

Manan Patel

Sandy Jiang

Class of 2021 MD

Class of 2019 MD/MPH

Class of 2022 MD

Lives for animals, the outdoors, BBQ and those with a sense of humor and an open mind.

Travelor, plushie maker, professional artist, fam med doc.

Mika Mintz

Vic Rea-Wilson

Class of 2022 MD

Class of 2021 MD/MPH

Mika’s aim is to capture the organic coalescence of what was once one — human and nature. Today, we find ourselves in a manufactured and often contrived world, thwarting not only our ability, but our will to be one with nature. Her photographs strive to extract the animals that we are from this digital realm, and bring us home.

Vic enjoys writing when not studying. Zhe spent zher college years mainly with the humanities and social science at Bowdoin College in Maine. At present, Vic has yet to meet a cat zhe didn’t like.

Misha Armstrong

Yvette Rodriguez

Class of 2019 MD/MPH

Class of 2021 MD

Native Floridian. Future surgeon.

A strong believer in humanism, social justice, and the power of great conversations with the right people.

Find Yvette in the first floor of club lib smiling and engulfing coffee.

Imposter Syndrome by Caitlin Coviello, brush pens

Elephant by Noreen Mohsin, watercolor

thank you!