PsychSIGN Magazine. Roots and Bloom Edition. Volume 3. May 2023.

PsychSIGN Magazine

Contributors

Cover Art and Chief Editor: Tasmima Tazin, Rutgers New Jersey Medical School

Editors:

Temitope Ali, Rutgers New Jersey Medical School

Kelly Huynh, Eastern Virginia Medical School

Bryan Cabezas, Rutgers New Jersey Medical School

Allison Zuckerberg, Hackensack Meridian School of Medicine

Parisa Thepmankorn, Rutgers New Jersey Medical School

Halle Sarkodie, Rutgers New Jersey Medical School

Rebecca Zaritsky, Rutgers New Jersey Medical School

Shayan Hosseini, Rutgers New Jersey Medical School

Writers:

Arellano Rivera Esteban

Antonio Igbokidi

Hany El-Adle

Anurag Modak

Bryan Cabezas

Emma Alai

Lexi Singh

Madeline DiGiovanni

Michelle Nosratian Zarrin

David Killilea

Artists:

Sara Alattar

Ahmed Sabra

Sahar Ashrafzadeh

Christina Vyzas

Dulce Alejandra Acosta Sánchez

Vanessa Ocon

Dr. Aayusha Dhakal

Anurag Modak

Nivetha Srinivasan

Michelle Cornelio

Photographers:

Sara Alattar

Jaskaran Singh Dhillon

Bryan Cabezas

Emily Anne Gansert

Dear Readers,

Letter from the Editor

Thank you for taking time to support our community of wonderful writers, artists, and photographers. This magazine was originally started as a passion project by Dr. Chaden Noureddine, now a rising PGY-2 at Mt. Sinai in psychiatry, and was handed down to me as a previous editor and contributing artist. Originally a collection of artwork from American medical students, I am excited to say with the help of National PsychSIGN, we have submissions this year from medical students and physicians all over the world as well. It is refreshing to see the paintings and writings of fellow health professionals from Mexico, Ireland, and Nepal. I hope our community continues to grow.

I’d love to thank our editors as well, who have worked with great effort to polish these beloved pieces. As I graduate and make way for a new team, my only wish for you all is to continue your love for creating.

Sincerely,

Tasmima Tazin Editor in Chief

The Virtue of Seclusion by Sara Alattar

Elegía by Arellano Rivera Esteban

En medio de una sala pequeña en un hogar anticuado, lujoso y vacío, se miraba, revoloteando como bailando, una lucecita del tamaño de un hombre promedio. Se llamaba Elegía. Elegía cantaba, en medio de giros y destellos de libertad: Elegia

In the middle of a small room in an old-fashioned, luxurious, and empty home, there was a little light, the size of an average man, fluttering as if dancing. His name was Elegy. Elegy sang during twists and flashes of freedom:

Me recuperaré, mantenme con vida. ¿Puedes verme? Brillaría. Es a ti a quien he estado esperando encontrar. Soy aquel a quien tu amor puede curar.

I will recover, keep me alive. Can You see me? I would shine. It’s you whom I was waiting to find. I am the one whom your love can heal.

Cantaba desde sí mismo y para sí. Entonces, en medio de la protección del aire helado, la soledad y de un abrigo de rayón, la voz fermentada y estridente de un niño del pasado se coló por el corredor y desnudó el cuerpo de aquella creatura dulce, intentando apropiarse de su luz para devorarla. El miedo, la confusión y la agonía invadieron el apartamento y en medio de un grito sordo de terror se consumió el aire, se deformó el mobiliario y se precipitó una nube gris de incertidumbre sobre aquellos cabellos acitrón dulce.

He sang from himself and for himself. Then, during the protection of the icy air, the loneliness and a rayon coat, the fermented and strident voice of a child from the past slipped through the corridor and stripped the body of that sweet creature, trying to appropriate its light to devour. Fear, confusion and agony invaded the apartment and in the midst of a deaf scream of terror the air was consumed, the furniture deformed and a gray cloud of uncertainty precipitated over those sweet citron hair.

Me recuperaré, mantenme con vida. ¿Puedes verme? Brillaría. Es a ti a quien he estado esperando encontrar. Soy aquel a quien tu amor puede curar.

I will recover, keep me alive. Can You see me? I would shine. It’s you whom I was waiting to find. I am the one whom your love can heal. Cantó, moribundo, Elegía. Y abrazó, con ello, los sueños imposibles que se gestaban en su interior de hombre promedio.

Elegy. Sang, dying, And he embraced, with it, the impossible dreams that were brewing inside him as an average man.

Visceral by Ahmed Sabra

The Postpartum Well by

Antonio Igbokidi

It was the color of dawn. Chilled grass tips pranced about the morning lawn, Giggling at the rising sun.

The reverberation of our baby’s giggle Engulfed our home like a full moon. Bloody,

Like how red vessels seep through your eyes from lack of sleep, Lack of oxygen, and lack of moments to breathe.

For a moment — I forget how much of a blessing our baby is, Because of the pain that you are in.

Pain that cannot be seen and only vaguely understood by onlookers. Cousins of confusion are squatters in our walls the nights that she squeals the best. Feeding and nourishment are times that reflect your frustration the most.

You scorn at your body for being ornamental — a dried manger, Instead of a cup overflowing.

Can’t you see that you’ve brought life into the world?

You’ve poured your blood to crowning — crowning to cord — cord to placenta Generated a galvanic world in your belly and merged her atmosphere with ours now Our lives circulate around and through her lungs. You’ve put the breath of life into our existence.

Yet to you, your stretch marks do not reflect a championing of miracles

They reflect battle scars, Your tears of not good enough— Your cackles of self-deprecation— Your somber thoughts of no longer belonging to unconditionality.

Can’t you see that you’ve brought life into the world? When you— alone — are all baby and I need. Until grass tips no longer prance in the dawn, Until the waters run dry.

The Deep Blue by Ahmed Sabra

“To Themselves, Others or Property” By

Hany El-Adle

Let us consider involuntary commitment and the standards which physicians use if someone is defined as a threat “to themselves, others or property.”

Physicians use these criteria to basically hold someone against their will. So, if someone is defined as a threat to themselves, others, or property, they may find themselves involuntarily committed. Or perhaps if this person has a mental illness or, a suicide attempt or something where their capacity is questionable. So, there are certain standards which we use to ultimately benefit a patient but, in the process, restrict the patient’s autonomy, and restrict the patient’s freedom. Freedom is an especially poignant topic because we are not only physicians but citizens of the United States of America and the very First Amendment of the constitution pertains to freedom (and really all of the Constitution does). In other words, I’d like to further explore the concept of being involuntarily committed in America, rather than anywhere else in the world. In the US, impinging on someone’s freedoms and their rights to live is incredibly important and shouldn’t be taken lightly.

But on the other end of that, I’m from Jersey City.

If you look at some people from Jersey City, just on the spectrum of autonomy and on the spectrum of things that you can do, you can use that definition of “threat to themselves, others or property” very loosely and you can apply it to so many things.

For instance, if you look at boxing and Arturo Gatti, who was fighting out of Jersey City, this person is by virtue of his profession, stating, “I’m going to be a threat to this other person when I get into the ring and they’re going to be a threat to me. So, I’m going to put both of us in harm’s way.”(1) And obviously there’s a contract and there’s the legal aspect of it, and there’s the sport aspect of it and this person is a prize fighter, fighting for glory and pride and for titles and all these different things. But the very simple fact of the matter is if you look at Arturo Gatti’s fight against Floyd Mayweather, that fight needed to be stopped and I think everyone in attendance, for several rounds, including the referee and the ring-side physician would agree that this person is now putting themselves in harm’s way consistently, in a way that is not safe for them to continue this fight, and we need to stop the fight. Ergo, we need to take to the person’s autonomy away for their own good i.e. this person can’t fight any more, we’re not going to let him come out of the corner anymore. (2) And although the corner can throw in the towel, the referee can also make the decision, the ringside physician, in certain states, can also make that decision.

Let us then analyze Gatti vs Mayweather juxtaposed with Gatti vs Ward. How do we objectively analyze the threat “to themselves others or property,” when Arturo Gatti fought Micky Ward three times? Meaning it was so close the first time and the second time that they needed a third time to determine who was the best fighter. For that fight, both fighters

essentially indicated “OK I don’t want you to stop the fight because even if I’m in it within an inch of my life, I can win if the other person is within 1/2 inch of their own life.” That’s the point of the sport, and we can debate the aspects of boxing and its merits, but whether we like it or not it, boxing exists and thousands of people box and thousands of people fight. My opinions and other people’s opinions about it won’t really make a difference because there are individuals in the world who enjoy fighting, and individuals in the world who will continue to fight and individuals in the world who will continue to referee those fights and be the ringside physician at those fights. So it’s an important conversation to have about what’s actually going on in this community of people, and how we can protect this community of people and how we can do our best to make sure that these people, their freedoms and their autonomy, is respected as not only citizens, but as patients. (Please bear in mind that if a fighter gets knocked out they almost always go to the hospital directly afterwards due to a preponderance of concern.)

I also wanted to include another Jersey City native: Brian Donnelly aka KAWS, the artist. This person got his start in art by going around billboards or advertisements and basically graffitiing and tagging it up with spray paint. So this person was, by definition, vandalizing and destroying property. These advertisers had paid for billboards which were subsequently altered by KAWS.

So when KAWS added something to the ad, we celebrated that destruction of property and we actually say it is not destruction property, it is actually creation of art. Whereas if someone is a threat to property in terms of arson we say that is not a form of art. In fact, we acknowledge that is not a creation of something good, instead we say that that’s now harm and something bad and we should involuntarily admit this patient and we should see what’s going on with this person because this is concerning behavior. So where do we draw the line of “good behavior and we should encourage this and celebrate this and we should let this person continue fighting, or at least let this person continue doing their craft, their art, or do whatever it is they want to do”, versus, OK now “this person is not doing something good, this is now something bad and we should no longer let this person continue, since this is a threat to themselves others and to property?”

So the real crux of the matter is what if you also now have a mental illness on top of it? Someone like Van Gogh, a very famous artist who also suffered from mental illness, found himself in a psychiatric facility at various points of his life voluntarily. Or perhaps involuntarily. That’s what I mean.

There’s some things that aren’t clear cut and just understanding where that line is and what’s on either side of that line, whether this is good, whether this is bad, whether this is something that needs to be addressed, something that doesn’t need to be addressed. And whether, central to this person’s behavior, is there a mental illness or something which needs

to be psychiatrically addressed which would then lean us towards an involuntary admission, voluntary admission or no admission at all.

Dedicated to Dr. Cheryl Kennedy and her lifetime of commitment and service to the citizens -and patients- of New Jersey.

References

1. 5/18/02, 11/23/02, 6/7/03, Gatti, Arturo. “Arturo Gatti.” BoxRec, 2007, https://boxrec.com/en/box-pro/3999. Accessed 4 Jan. 2023. https://www.youtube.com/watch?v=UM0bpk6pSBw

2. https://www.youtube.com/watch?v=THojnKPFpFA

Scaffold Plasticine by Christina Vyzas

Born to Bloom by Emily Anne Gansert

Do not fall down 2 meters by Dulce

Alejandra Acosta Sánchez

It is a strange creature, The one that proliferates below.

I

Latent Destiny by Anurag

Modak

t spreads like a fire

Like a virus

Like a fungus

Hungry for food.

It leaves behind a network, A web of glowing embers

Of straight lines

Of order

Of chaos

Of life

And, of death.

Yet, looking upon the growth of the human creature

One must indeed wonder:

Did the power that created the Universe imprint upon it a certain pattern? Did it leave instructions for us on how to find him/her/it/all/none?

The images of the superstructure of the Universe reveal an unusual network: Matter clustered into nodes and filaments, With voids in between.

How similar this superstructure is to the handiwork of human city-building And how closely human city-building resembles the brain.

Perhaps, we have an inherent geas to replicate this pattern? To build a brain?

After all, can we not understand human cities in terms of neurons? They are connected by highways of sorts: Super-fast flows of information, Linked by numerous branches, all cross-communicating Certain ones are responsible for administration: Executive decision-making, passing judgments, creating formal and informal rules of operating Certain ones are known for problem-solving and innovation

Some are critical for communication and the flow of information, goods, and services Others are known for appreciating the fine arts:

Music, painting, sculpture, literature, and architecture

Yet others are simply tasked with cultivating the next generation.

We must thus wonder:

To what end are these cities constructed?

Shall the Earth become as though a brain? Is this the latent destiny of the Universe? The answer One way or the other, Is equally exciting

Frightening

And, strange…

Just Comments by

Bryan Cabezas

As I scoured my room for any hint of my past and scrolled through my phone for any indication of a former life, I couldn’t find one. Not that the evidence wasn’t there, I have plenty of damning footage and a collection of trinkets and trophies, just, I couldn’t bring myself to label them as moments of a previous life. I wasn’t ready for the ultimate graduation of my years as a pre-med student, where existence meant only trying to keep my head above water and adventuring excitedly into this novel world of medicine. I believe my hesitancy comes from the fact that… as a med student, I still see the medical world with just as much novelty, and to say that any of my past experiences can be differentiated from the experiences I am accumulating now, would probably be a miss categorization on my behalf. As a second-year student, my outlook and interaction with the field of medicine has not changed, and had my undergraduate self been placed in the same circumstances, studied and taken the same tests, I would be none the wiser. I believe that the world of medicine is a realm that can perpetually keep me in a state of excitement, giddiness, and novelty like I was during “roots,” and that the only “bloom” I can hope to ever receive or experience is one where… well… I guess I don’t know.

Beautiful Things by

Emma Alai

After Sei Shonagon

Your eyelashes flutter just a few times before you unmask your eyes and present them to the day. It is surprisingly simple to come to consciousness when the sun is your alarm. You sit up tall and spread your body out as far as it will reach. One big stretch and it is time to start your day. What a beautiful morning. It is a cool summer night. You are sitting with your closest friends around the fire. You wrap yourself in your sweatshirt that smells like smoke. You look up at the dark sky and see many stars and realize that there are many more. Your friends laugh, the fire pops, and the crickets sing. This is a very ordinary, but very beautiful moment.

You are walking through the hall thinking about your schedule, your responsibilities, your stress, your day, your tomorrow, your yesterday when, suddenly, you see another person walking toward you. You move left, but so do they. You move right, and they follow. You both share a laugh as you realize that you are stuck in this moment to acknowledge each other. To see each other. You smile at the awkward situation as you finally part to go on with your day. What were you thinking about again?

You are sitting on a plane on your way home. You got the window seat, your favorite. The plane accelerates and you are pushed back into your seat. As the wheels lift up from the ground, you look out the window and see the airport getting smaller and smaller until it looks like it could fit into your hand. There are so many buildings down there. So many cars. So many lives. You, along with everybody on the plane, and everybody on the planet are living your own stories. They are all complex and developed, yet, thirty thousand feet up in the air, everything feels peaceful. Simple.

The timer goes off. The whole room smells of chocolate and sugar. You only spent ten minutes making them, but you have been waiting for them all week. He tells you not to eat them yet because they are too hot and will fall apart. You grab one anyway and shovel it into your mouth. It is almost too hot to eat and there is chocolate all over your hands and face. He says, “I told you so,” which you knew he was going to say. He stares at your eyes and wraps his arms around your waist. He smiles. You try not to laugh with cookies in your mouth.

It is getting late. The yelling comes and goes like the tide of the ocean. You no longer remember how you started arguing. How did this happen? He slams the door and the piercing noise shatters your ears. Your heart skips a beat. Your chest becomes so heavy that it pulls your body to the floor. The tears come all at once and then not at all. Your face burns and the salt offends your tongue. You let out one loud scream that drives out the rest of your energy. The release of such raw emotion feels freeing. You lay on the floor staring at the ceiling. Everything becomes very still.

The first wave just barely reaches your feet. It feels cold and wonderful. The water is so clear that you can easily see the sea glass and shells that decorate the floor. You take three big steps and dive into the next wave that comes crashing onto the shore. It is a shock to your system. You swim toward the skyline, giving in to every wave that threatens you. When your arms become too tired to carry on, you look back and see the waves behind you. You lift your toes out of the water and rest your head on the surface. The ocean gently rocks you to the rhythm of the waves.

You heave the glass bottle toward the wall. The fragments fly toward every end of the room. Your hands shake as you pick up a piece. You look around the room and see the reflection of the light sparkling off of the thousands of crystals scattered on the floor. The whole room glistens. Now it’s time to clean it up. It is way past time to clean your room. You look at the piles of clutter that have collected on your dresser, your nightstand, your desk, and even your bed now. “It isn’t messy, it’s just lived in,” you think to yourself. You know this is a lie. You scan the room for several minutes deciding where to start. You finally rest your eyes on the top drawer of your dresser. Upon opening it, you find old toys and games that you haven’t seen since you were a child. Your eyes widen with nostalgia and you take everything out. You forgot you had that one. It was your favorite.

You play with it for hours in the pile of junk that you will get to later.

You come home to find a box of chocolates on the counter. There is a note on it addressed to you! An unexpected gift is always a beautiful thing.

They say that people look peaceful when they pass away, but you cannot help but think of how violent it must actually feel. The transformation they undergo from something to nothing cannot be fully understood. It feels unfair, but you know that this is everybody’s fate. You wonder what happens now. Where do they go now? The emptiness that the world will feel without them is immense, but you would like to believe that they are moving on to more beautiful things.

Dim lights are the most kind to the eyes and to the soul. You light a match and touch the flame to the wick of the engine. The hot air fills the lantern and it slowly levitates away from your hand. It joins the other hundreds of lanterns as they fly up into the sky to meet the stars. The small flames fill the night sky with a warm orange hue.

There’s a message on your voicemail telling you, Thomas, to come home because dinner is ready, except you are not Thomas and dinner is certainly not ready. It must be a wrong number. You giggle at the threatening tone of voice and abrupt ending. Although it is such an impersonal message, it feels somewhat invasive to have this glimpse into someone else’s life. You wonder about Thomas and what he will have for dinner.

As a matter of fact, he might miss dinner tonight.

A small ant crawls onto the porch. It heads straight for the cracker crumb that you dropped earlier in the evening. The crumb is probably ten times the size of the ant, but that does not deter it. It approaches the piece of cracker and effortlessly hoists it over its head. It is amazing how strong the ant is for its size. Where is the ant taking the crumb? Who will he give it to? Bugs live entire lives that we don’t think about.

You place your mug on an old wooden coffee table. Next to the mug, you notice several scratches. Yet, these blemishes do not ruin the table, but rather add life to it. Imperfections are a beautiful thing.

You look at her eyes and her entire face morphs in front of you. You never noticed the complexity of her appearance before now. The purple smudges on the sides of her nose show loss and her eyes tell stories. Her dark hair is neither straight nor curly, aside from the small ringlets of fluff that frame her face. Her smile creates small wrinkles on the corner of her mouth and constructs shallow dimples about an inch away. She exposes slightly crooked, but clean teeth.

Her eyes squint with pleasure and three lines on the corner of her eyes validate her maturity. She seems to age, not with time, but with life. She is naturally beautiful.

You pick up a smooth beige stone near the river. It has a few dark grey specks on it and it is stained with mud. You throw it into the river, but it is too thick to leap off of the surface. You look down to find a flat one that could be skipped. Upon searching, you realize how different every rock is. In fact, there may not be any two rocks that look exactly the same. You begin to wonder how many rocks there are in the entire world. Is a mountain considered a rock? Is the planet considered a rock? You pick up another stone and throw it in the river. It skips.

Your stomach is fluttering and your hands are almost numb. He slowly moves closer and your excitement builds. He rests his hands below your ears and gives you one last look. Then a kiss. His touch is soft at first, but builds in pressure as he draws you in closer. This moment is the only one that exists and the whole world melts away. This is a beautiful thing.

Your body feels heavy, but your eyes are glued open. You sit firmly against the headboard grasping your blanket. You open your eyes very wide and then squint them until they are shut. It does not make a difference. There is nothing, but there could be anything. This might be the darkest dark that you have ever experienced. Your mind has deprived your body of its right to sleep and your body has deprived your mind of its ability to relax. Your heartbeat quickens and you move your hands in front of your face in a defensive move. Panic sets in.

There is nothing, yet there is everything. Something in your chest jolts violently and you gasp. Your hand flies spastically until it reaches the lamp. The light brings the reality of the room into your mind and gives you relief.

You are swinging gently on a rainbow knitted hammock. As it swings, all of your troubles become small. Back and forth. Back. And forth.

After everything you’ve experienced, you wonder how a God, a benevolent God, could actually exist. There cannot be a God that allows this to happen. It is cruel. A feeling of anger, and then emptiness overcomes you. There is nobody to answer your pleas for mercy. You are absolutely and utterly alone. There is nothing good. There is nothing beautiful. This moment of rock bottom is, in fact, a beautiful milestone of life.

You have endured a particularly cold winter. You put on your coat to brace for the freezing temperatures only to find that a warm breeze hits you as you leave the door. The sun shines on your face and a wave of relaxation moves through your body. It is warm.

A deep breath can heal even the worst of pains. You inhale what you imagine to be a bright, glowing, peaceful breath. You exhale the sorrows and heaviness of yesterday’s troubles. There is nothing wrong with this moment. You inhale again and hold the air in your lungs for five, ten, maybe twenty seconds. You release it and you feel much lighter.

Lifted 2 by Sara Alattar

Lifted 4 by Sara Alattar

Blueprintsby by Lexi Singh

Ms. E had an early blueprint of me

I want to be who she wanted me to be—

Someone who can see beyond positivist science and the echo chambers of large lecture halls

Someone who seeks out literature and films that challenge my worldview

Someone who knows that advancement in learning is more about questions than answers

Since I left the space I shared with Ms. E—

I have stopped thinking about how Carl Sagan and Annie Dillard influenced me

I have placed my self-worth into percentages I have walked away from moments where I could have shown hidden aspects of myself

I have learned vulnerability is a skill we must practice

Each day is a chance to try out a new lens

Consider the early blueprints others have made of you And take from them what you can

I am not Ms. E’s blueprint I am not even my own

by Jaskaran Singh Dhillon

Grinning Skulls by

Ventilation by Madeline DiGiovanni

Regarding CO2 transport, plasma bicarbonate helps carry CO2 to the lungs. They say bicarbonate is the most important buffer in the body. The body inspires O2 and expires CO2.

My body is in the park. My elbows are on my knees. My hands are on my face. My lungs are my lungs; they are doing their job.

At the lungs, increased minute ventilation blows off the CO2, leading to a decreased PCO2 relative to normal, and an accompanying hypocapnia. The consequence is respiratory alkalosis.

This is respiratory alkalosis. I am in respiratory alkalosis. It is important for me to remember respiratory alkalosis. I should know these things. They are expecting me to know these things. I am two blocks from the hospital. I am not strong enough for this. Is it possible that I am unintentionally doing this on purpose; I wonder every time. I will be late if I keep this up.

Minute ventilation is increased, respiratory rate is increased, tidal volume is increased. Tidal volume is the volume of air that is inhaled during a normal breath at rest. Diaphragmatic breathing is encouraged. C3, 4, 5 keeps the diaphragm alive. You should have a normal breath at rest. There is no reason you should not have normal breaths at rest.

Over a prolonged period of time, respiratory alkalosis can arise as a compensatory mechanism for metabolic acidosis. What acidosis led me here, what acrid metabolite of something I do not yet understand seeps into my interstitium, seems insidious. You idiot. You should know these things. Why aren’t you stronger than this? You are doing this on purpose. My body is in the park. My elbows are on my knees. My hands are on my face. My lungs are my lungs. They are doing their job. This is respiratory alkalosis. My eyes are not opening. My hands will not move. I must look ridiculous just focus on breathing. What will they say? How will you ever make it? Breathe. Breathe. Let them know you will be late. This is unprofessional. You must let them know. You must. You must breathe. One. Two. Three. Four. You must keep your carbon dioxide. Keep it. Keep it.

My body is in the park. I am two blocks from the hospital. Respiratory alkalosis is breathing out too much carbon dioxide; bicarbonate is the most important buffer in the body.

My lungs are my lungs; they are doing their job.

The body inspires. The body expires.

I tell them I’m sorry. They tell me, “Go home. It’s okay.

Take care.”

Reflect VI by Jaskaran Singh Dhillon

Reflect VII by Jaskaran Singh Dhillon

Questioning. Questioning. Questioning.

Mama, papa, tatang, What am I doing here?

A seedling blows into a field of unfamiliar territory. What am I doing here?

Finding my roots. Finally i see I am not lost. but exactly where I am meant to be.

Force of Nature by

Rachel Felix

Yes, I am different. Yes, no one looks like me, but therein lies the beauty of diversity. A breath of fresh air to breathe life into all that can be.

Blossoming, becoming, believing. I know what I bring.

Something so special. For I am a forest of endless possibilities.

Untitled artwork by Dr. Aayusha Dhakal

What They Gave by Michelle Nosratian Zarrin

The things they gave are not things you can touch. Well, maybe some of them are. Homes, careers, friends left behind. Bank accounts abandoned only to be drained by the government. Stories,languages, ingredients, flora, and fauna. they gave those things up and they crossed lands and seas, like so many before them, in search of something newer, better, and brighter. The promise of a future with fewer limitations.

America.

A land they had only seen on the television, or in dubbed John Wayne films. They gave their childhood and youth to the American dream. which may only be real in their minds. Jobs,racist bosses, late nights, and scholarship funds. things—tangible and intangible—they gave, and gave up. For me and my siblings.

Who now stand on these shores surrounded by the ghosts of what they gave. The price of this strange new land.

Oh How We Grow by Bryan Cabezas

Drowning in Clarity by Anonymous

CW: grief, “extreme sadness”, illness, SI, violence, death

It’s been said that I’m finally somewhere between surviving and thriving

And it’s nice to think of that as living

Because for the first times in over a year

It doesn’t feel like I’d be better off

Not like it’s unknown that pressure makes diamonds but

I’ve been pulverized

Atomized

Physically and otherwise

Like fine sand or dust

Swept up at the

Sure I’ve been drowning

In several occasions I requested a hand or a vest

“You are not doing enough” and “You are too much”

Somewhere along the lines

Closed fists and bullets of those glaring moments internalized

Blasting over the chest worn on my white coat sleeve

Alluding to the skin picked raw

From the oozing of purulent

Grief

“Take initiative”

A profound command from the environment that takes no account of the traumas inherent to

Loss of home

Loss of loved ones

Isolation

Chronic pain

Insomnia

Disordered eating

Lethargy

Meloncholy

Well fuck

Yeah, it’s easy to open your ears

Though empathy takes courage I know you are lacking so At least if I say what needs to be said even with my words shaking and my mind racing I can maybe put my hearts at ease

And I try to laugh because sometimes that is all that you can do to avoid the other thing

And I try to keep busy because sometimes being occupied keeps me from being preocupada

And I try to say that I’m okay because sometimes I would rather keep my blips of 幸幸

But maybe sometimes

The downpour is hydrating

The sun scorches the ground a new

The clouds provide simple comforts so

The silver lining reveals that The rainbow is enough

And so am I

With gratitude

And relief

I am still here.

I am still here.

The Long Way Home by Emily Anne Gansert

What Lies Beyond by Emily Anne

Gansert

Reflect I by Jaskaran Singh Dhillon

Inwards by Ahmed Sabra

Rays of Diversity by Nivetha Srinivasan

The Revelation of the Hymns Anurag Modak

Saint Dymphna – A Long Dead Teacher of Psychiatry by David Killilea

There are times when it pays to take advantage of coincidence. I am a final year medical student at University College Dublin and was walking past the National Gallery when I saw an advertisement for an upcoming exhibit entitled “St Dymphna: The Tragedy of an Irish Princess”. It was only a few months back when a member of my family told me that Saint Dymphna was Irish and is the patron saint of mental illness (also psychiatry but naturally that only arrives on scene after the first). I filed this fact away and let it degrade alongside some anciently imbibed anatomy. It sprung free on seeing this notice, however, and was further justified in its breakout when I read that PsychSIGN was seeking pieces for its upcoming publication on the theme of “Roots & Bloom”.

Let me introduce psychiatry’s patron saint and her short, though significant life. Born the daughter of the King of Oriel in modern-day Northern Ireland in the 7th century, Dymphna was regarded as nothing short of prepossessing and grew to become something of a doppelgänger of her mother. Her death early in Dymphna’s adolescence fuelled her father’s search for a replacement of equal beauty. He was unsuccessful, and, so Dymphna was chosen as the only possible option to him and pressed into an incestuous relationship. This was at odds with Dymphna’s sense of decency and her Catholic faith, which she shared with her mother but not her father. At 14, Dymphna had taken a vow of chastity to enable her to be free of worldly desires so she could focus on charity and good works. With her celibacy at risk, she fled to the continent with a priest and entourage, plus as much gold and silver as they could carry. Arriving in the Belgian town of Geel they established a proto-hospital for the mentally ill and homeless. In order to be venerated a saint, one is required, amongst other criteria, to have performed ‘miracles’. This, apparently, was Dymphna’s forte. So many were ‘cured’ that her treatment centre became a place of pilgrimage. Her father soon discovered her and demanded she return to Ireland and wed him or suffer death. She chose the latter and was martyred. A church of veneration was erected in 1349 in Geel which continued to draw those suffering to the town. Care of arrivals was undertaken by clergy, townspeople and, more often than not, within family homes–an early example of institutional and community care working symbiotically. This evolved to a tradition that still exists where arrivals, termed ‘boarders’, are given work within the community and in the surrounding fields. Stigma does not occur within Geel, it is kept at the municipal boundary never to enter.

When one thinks of where great advances have occurred in European psychiatry, one’s mind turns to the Maudsley Hospital, Bethlam Royal in England, the Salpêtrière in Paris, and the Burghölzli outside Zürich. But this overlooks the dialectic that is inbuilt in psychiatry. Treatment is but a step; acceptance on return to family, friends and a community is of arguably greater importance.

Success of this kind has occurred in Geel and, more famously in Trieste and their celebrated model of psychiatric care. Before the great institutions of psychiatry, the unwell were either outcast or welcomed, despite Dymphna’s supposed feats, as cures were in short supply. Care and understanding by a person’s community was the closest to intervention they might ever receive. Setting aside religion, Saint Dymphna’s legacy has much to offer the reflecting psychiatrist on where we should place emphasis in our interventions. The hangover from deinstitutionalisation remains in much of Europe and North America because of this lack of acceptance. Our Everest will be to facilitate and engender this amongst the communities we work in, and build on the tradition of Geel.

The Veiled Lady Michelle Cornelio

Lithium by Ahmed Sabra

Rooted by Ahmed Sabra

The Clock by Ahmed Sabra

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