Ars Literarium Volume VIII

VO LU M E V I I I 2 0 2 2

ARS LITERARIUM

Fr o nt C o v e r : To r s e X O i l o n C a nv a s K e n Pe y s e r M D PGY-2 R u tg e r s Ne w Je r s e y Me d i c a l S c h o o l , D e p a r t m e nt o f P hy s i c a l Me d i c i n e a n d R e h a b i l i t at i o n

A R S LITER A RIUM Vo l u m e V I I I Jo u r n a l o f A r t a n d L i t e ra t u r e 2 0 2 2

A R S LITER A R IUM Ars Literarium seeks to express the medical narrative through the creative voices of the members of the Rutgers Biomedical Health Sciences Campus in Newark, NJ. The journal provides an outlet for members of the community who spend endless hours managing the stresses and responsibilities of patient care to find peace through creative expression. Transforming memories or emotions from an intense day spent with patients into words or visual art allows for a stronger, healthier connection to the self and a deeper appreciation of the patient perspective.

The journal is published annually by the Healthcare Foundation Center for Humanism and Medicine at Rutgers New Jersey Medical School.

For information, inquiries, and submissions, please email us at: arslit@njms.rutgers.edu.

council members Editors-In-Chief

Parisa Thepmankorn, MS-1 Ariana Shari, MS-1

Manasa Ayyala, MD Director of the Healthcare Foundation Center for Humanism and Medicine, Rutgers New Jersey Medical School Tanya Norment Program Administrator of the Healthcare Foundation Center for Humanism and Medicine, Rutgers New Jersey Medical School

Editors

Christina Vyzas, MS-1 / Graphic Design Ishani Patel, MS-1 / Graphic Design Cathy Daichang, MS-1 / Art Editor Olivia Scott, MS-1 / Art Editor May Nasr-Haq, MS-1 / Literary Editor Kiley Timmons, MS-1 / Literary Editor Rebecca Zaritsky, MS-1 / Literary Editor

Faculty Advisors

Beth A. Pletcher, MD Associate Professor of Pediatrics and Medicine, Rutgers New Jersey Medical School Andrew Berman, MD, MHA Professor of Medicine, Rutgers New Jersey Medical School

Ars Literarium’s annual publication is possible due to the support of The Healthcare Foundation Center for Humanism and Medicine at Rutgers New Jersey Medical School.

acknowledgements

With special appreciation and gratitude to The Healthcare Foundation of New Jersey for their generous support.

Thank you to Tanya Norment, Dr. Pletcher, and Dr. Berman for their advice, mentorship, and guidance throughout the year.

welcome to volume V III of ars literarium Dear Reader, Welcome to Volume VIII of Ars Literarium. From the perspective of two young medical students, the world has been busy shuffling its cards these last few years. Together, we’ve been dealt a hand that most of us could never have imagined. Between a pandemic that still continues its relentless spread to numerous threats to equitable healthcare access, we have had to collectively reckon with our past and carve out a new understanding of what our present and future may look like. Perhaps more importantly than ever, then, Ars Literarium offers a space for members of the RBHS community to reflect, create, share, and implore. To meditate on issues that impact us on individual, community, and global scales. To try to see things in a new light, or to simply indulge in old, nostalgic memories.

In our eighth issue of Ars Literarium, we are overjoyed to share with you works of art and literature that encompass themes that we all are familiar with, although surely in different ways. They span various emotions and experiences—hope, fatigue, gratitude, and anguish, to name a few—as conveyed through, for example, a personal essay grieving the loss of a family member or a snapshot of the moon during a moment of contemplation.

Indeed, these works of art and writing do the necessary work of reminding us of the different dimensions of humanity that tie us all together. Medicine is inherently a humanistic endeavor, and these pieces emphasize the vulnerability and strength that medical encounters demand from both patients and providers. We hope that you, reader, will take a moment to celebrate with us the small mundanities and grand complexities of our lives, both in health and in illness, which are captured so brilliantly by the artists featured in this edition of Ars Literarium.

As always, we remain incredibly grateful to our contributors, the many physicians, students, residents, instructors, and other health professionals who generously shared their work with us. We are humbled and overjoyed to now share their work with you, and we hope it makes as much of an impression on you as it has on us.

Sincerely, Editors of Ars Literarium

table of contents viii A Small But Fierce Perspective / Afif Hossain 7 The Deep Blue / Ahmed Sabra 8 pulse / Parisorn Thepmankorn 9 Mr. Edgars: A Solitary Death in a Global Pandemic/ A. Reema Kar 10 Healer / Ebunoluwa Ogunnowo 12 The Weight of the World / Emily Balog 13 Hang In There! / Jhillika Patel 14 to my cousin / Irene Martinez 15 Finding the Right Questions / Arman Sawhney 17 Dress Up / Nandina Mishra 18 Lost Before You Can Be Found / Kajol Shah 20 The Donor Heart / Juliana E. Kim 21 The Journey of Life / L. Nandini Moorthy 22 Resilience / Nisha Ali 23 The mirror / Eloy Ruiz Mendoza 24 The Birthing Room / Rasheena Wright 25 The 1% / Kamil Sochacki

27 New Friend in Med School / Lauren Hutnik 28 Pandemic Beloved / Sharon Gonzales 29 Gram Neutral / Paul Brennan and Christina Vyzas 31 Natura sanat, medicos curat / Lena Kheir 32 Insomnia Night- Walks - Trapped in the Head/ Meghan McMullin 33 Death / Michaell Teters 34 A Grand Grieving / Darshan Kalola 35 Just One More Day / Darshan Kalola 36 Under Anesthesia / Nivetha Srinivasan 40 Remembering / Vaishallli Ravikumar 41

Fundus Fun / Nivetha Srinivasan 42 Hospice / Kyla McLeod 43 Memories / Yelizaveta Gribkova 44 ¿Qué puedo decir al paciente que murió? / Anurag Modak 45

nature Untitled / Jorge Aldo Barajas Ochoa 47 Aged Red Rock / Afif Hossain 48 MoonRise during COVID / Jerrold J Ellner 48 Us / Ge Yang 49 COVID- and Yet There is Hope / Jerrold J Ellner 49

community Buttons of Love / Maryna Layendra 51 “Thank you Healthcare Heroes” / Lissette M. Céspedes 52 Brisk Meditation / Susan Sawler 52 Day & Night / Wei Qian 53

A Small But Fierce Perspective Photograph

Afif Hossain MD Resident Physician - Department of Medicine Rutgers New Jersey Medical School 7

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The Deep Blue Acrylic Painting

Ahmed Sabra MD Class of 2025 Rutgers New Jersey Medical School 8

pulse i. when I was in kindergarten, we learned about blood: how it carried oxygen, and was red when it left the heart, and returned as blue as ice. we used crayons to color in worksheets, a river of deep cherry and a stream of popsicle blue, and I went home to my mother to teach her about how life worked. how simple. one gear turned another and another and then we inhaled. exhaled. my mother, a nurse, laughed indulgently – ii. when my baby cousin was four, we were in our run-down family home in Nang Loeng in Bangkok, where she fell over a glass bottle of coca-cola and slit open her wrist. here, rivulets of blood ran amok, unrestrained. her body coming undone in seconds, pale creamy flesh marred by sweet brown syrup and strawberry blood. she sobbed and I sat there, frozen, as my father carried her out towards the hospital. we sat there afterwards, watching cola pool around our ankles, simmering. iii. my hands are sterilized, double-gloved, my gown secured. the surgeon begins the show – here, trace the artery. listen for the melody that the body sings when the leg still lives. here, throw a stitch, a tie, feel the pulse. watch the blood ooze and spray and scream and tame it over and over again. days later, we watch the patient stand again, a child taking their first steps. for once, I see how it is to feel close to creation, to salvage flesh and blood, to see how the doctors in Thailand saved my cousin’s wrist, and understand that, in time, all that remains is a jagged scar, and a distant memory.

Parisorn Thepmankorn MD Class of 2023 Rutgers New Jersey Medical School 9

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Mr. Edgars: A Solitary Death in a Global Pandemic Pan Mr. Edgars loved airplanes, ham radios, and, most of all, his daughter Annie. At a spry 84 years old, he was a proud New Englander: fiercely independent and frustratingly stubborn. A diabetic foot infection brought him to the Emergency Department just a few weeks after COVID struck. If not for the pandemic, Mr. Edgars would have had a small procedure in the OR, completed a course of IV antibiotics, and gone home in time for his weekly dinner with Annie. In March of 2020, however, nothing was quite that simple. Despite a successful operation, Mr. Edgars had been in the hospital over a week, and showed little hope for a meaningful recovery.

In his dark single room, Mr. Edgars’ six-foot frame was awkwardly folded into a chair facing the window. As I entered, he turned with difficulty, squinting through his glasses. I watched him search for something familiar about my appearance. There was no recognition even though we had gone through this ritual every morning and afternoon for nine days. With mild authority, he stated, “I’m waiting for my daughter. Is she coming today?” I shook my head, explaining to him again that the hospital was not allowing visitors due to the COVID pandemic. I promised to call Annie and update her on his progress, just like every day. He blinked slowly and turned back to the window.

I changed his surgical dressing and reassured him that he was recovering well. He nodded wordlessly. The grandfatherly chatter had stopped days ago. I knew, despite the healing wound and normalizing lab values, the real Mr. Edgars was slowly disappearing with every passing moment. When I reached for the door, he looked up and asked, as if the past twenty minutes hadn’t happened, “Do you know when my Annie is coming?”

Four days later, Mr. Edgars was dead.

My colleagues offered their analysis at the following week’s M&M. Mr. Edgars’ unexpected death had to be explained. What was the reason for his respiratory arrest? Had I considered a PE? Did his antibiotics cover hospital-acquired pneumonia? I didn’t need decades of experience to know that none of those usual suspects had taken Mr. Edgars’ life. He never tested positive, but it was COVID that killed him. He was collateral damage. Deaths like his were not meticulously tracked by the CDC, but the numbers were just as tragic. However optimized and independent he had been prior to admission, once in the hospital, Mr. Edgars deteriorated rapidly without the familiarity of his routine, and the therapeutic presence of his daughter. Like countless other COVID-negative patients, he was sequestered purposefully from the virus, and inadvertently from everything he knew and everyone he loved.

It was the isolation of COVID that unmasked his age, comorbidities, and, most significantly, the dementia that had been lurking just under the surface.

In hindsight, Mr. Edgars didn’t need antibiotics. He needed Annie. She was the glue that held his life together.

Without her, he fell apart. At first, his mild disorientation manifested in repetitive questioning. Next came nightly sundowning that devolved to florid delirium. Finally, the creeping dementia held at bay by a devoted daughter was fully revealed: the unintended consequence of a viral infection that he did not even have. Mr. Edgars likely aspirated, arrested, and died alone in his hospital room, scared and struggling to break through a fog of antipsychotics and the firm grip of physical restraints.

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As medical students, we were always taught, “Treat the patient, not the disease.” Unfortunately, there was never a corollary to modify this mantra to a pandemic. What if everyone were a potential patient? Should we extrapolate to, “Treat a hundred patients, not just one?” In a matter of days, medicine went from patient-centered to population-focused. The health of the wider community had to be weighed in every clinical decision for an individual patient. Physicians everywhere faced the daily moral distress of placing the needs of the public over those of their patients. I wondered every day as we fought so hard to save the thousands at home, did we fail the few in our care?

The sad reality was that in a pandemic, I was almost as powerless as Mr. Edgars. The greatest ethical challenge I encountered in the COVID era was knowing exactly what my patients needed and not being able to provide it. I could not wholly fulfill my Hippocratic duty of doing no harm to Mr. Edgars when I knew that his cure could be our community’s curse. Even if it had been within my purview to allow Annie to visit the hospital, could I risk the inevitable chain reaction of exposures that might trigger? In a pandemic, with whom did my professional responsibility lie? Mr. Edgars? Annie? All of their extended family, friends, and neighbors? Could I disregard the greater good to heal one man?

Of course not. Instead, I became the medical mercenary that COVID required. I could not heal, nor could I comfort. My only weapon against the raging pandemic was quarantine. I kept patients, with COVID and without, away from their families, severing the most basic of human connections in their time of greatest need. I did everything I could as a physician and surgeon to help Mr. Edgars, except the one thing that I knew would save him. I told Mr. Edgars every day that he would see Annie soon, knowing how unlikely that was. I held his hand, realizing that I was just another anonymous automaton under layers of impersonal PPE, a poor substitute for the daughter he desperately needed. I heard Annie’s voice break over the phone every evening, crushed by the realization that she would never hug her father again. I watched father and daughter, and so many others, say goodbye over FaceTime, deprived of the human contact they so deserved in their dying hours. I hated that there was nothing else I could do.

The world called us “heroes.” What they didn’t know is that we were just helpless.

A. Reema Kar, MD, FACS Department of Surgery Rutgers Robert Wood Johnson Medical School

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Healer I could remember it like it was yesterday The day I died from the inside out Body was small and almost lifeless Sounds ring and voices shout But they were nonexistent Arms were enclosed by a jungle of tubes Swords came in cylinders and pierced me often days after day Pressure made my veins crawl up and down but I couldn’t escape it Simple sentences became a jumbled word puzzle My mind went from a concrete ground to a leaky faucet White coats traveled in and out of my presence Words murmured away from me Their smiles and gestures comforted me in the daytime But loneliness crawled between my sheets at nighttime Day in day out ordinary healers changed the procedures and routines remained I was hanging in the balance Times I was feeling able Then out of nowhere I was unstable I couldn’t understand Though my days were young There was one healer who could do something The healer who could control everything He was my healer For many men do noble things But He surpasses them all Health was restored at the blink of an eye I was cured with no stretch of time My healer up above He saw me through with love Dressed in white like any other physician Did the impossible but He’s no magician With His strength I better And I improved by the letter My healer took care of me Even when I could not see Ebunoluwa Ogunnowo Student - Post-Baccalaureate Certificate Program Rutgers School of Public Health 12

The Weight of the World Watercolor Painting

Emily Balog PhD, OTR/L Assistant Professor - Occupational Therapy Doctorate Program Rutgers School of Health Professions 13

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Hang In There!

Digital

Jhillika Patel MD Class of 2025 Rutgers Robert Wood Johnson Medical School 14

to my cousin I always thought I would see your face in the inpatient psych unit. Every tall, handsome, young, tan-skinned man became you, for just a second. I would double-take every time to see if that new admit was you and my heart would sink every time it wasn’t. If you were there, it meant you were off the streets and out of harm’s way. We would know where you were, we would have an answer. And yet, seeing you there meant you would need to face your demons all at once.

The hallucinations, the psychosis, the addiction, the withdrawals. You were sick, but no one was ever able to tell you or help you in the way you needed.

You were “the bad one” growing up - the one who got into trouble, who couldn’t follow directions. You stayed out late and got into fights. You fell into alcohol just like your father, just like so many of our family members whose struggles we still refuse to acknowledge to this day. The drugs and crime followed soon thereafter. But who is really to blame? You were just a child struggling with your inner demons, screaming for help. The only ears that heard you were the streets’ and they took you in, as they do with so many other lost kids.

When I got the call saying you had been taken to the hospital, I felt the adrenaline kick in. I was in doctor mode: locate the patient, stabilize them, send them home. “He had a heart attack.”

My mind immediately created differentials: overdose, cocaine-induced vasospasm, drug withdrawal. I listed all the diagnoses that could present with chest pain, but I refused to consider anything that would kill you. You always felt immortal. As we scoured the ED track board, the unnamed 30-yo in trauma bay 05 called to me, CC: cardiac arrest. And then we saw the note, intubated on the field, multiple rounds of CPR, asystole, dead upon arrival. My heart sank, just as it had all those times on the psych ward. If it was you, you would be off the streets, out of harm’s way. We would know where you were, we would have an answer. And yet, if it was you, it meant facing the harsh reality that the addiction had finally won. I pulled every string, found anyone and everyone in the ED to check you The tunnel vision set in; I had a new task: identify this body. The nurse said no one ran to your bed because you were already dead. The tech said that the tattoos we described matched the ones on your arms, she thought anyway. The resident said that unidentified bodies are processed by the police, not the hospital. The student who has found the morgue for us said it was closed on the weekends.

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to my cousin (continued) I hadn’t seen you in years, 5 to be exact. I scour my memory to think of how you were that day, and nothing comes to mind. I don’t know whether to be relieved or more hurt. You were always chill, so cool, calm and collected. I knew what you could do and what you had done. I heard the whispered stories from my Abuela, and other family. And yet, when you were standing in front of me, none of that mattered. All that mattered was the massive buffet of Thanksgiving dinner in front of us, the usual banters between the adults that we had all seen growing up, your dad’s meatloaf, and the same holiday stories that were shared every year.

And now, you’re gone. Lying in a dark, quiet morgue. Alone. Alone, just as I’m sure you’ve felt many times before, for years. I pray you have peace, that the voices in your head are no longer tormenting you, that the grapples of addiction are no longer suffocating you. We always talked about all your mistakes, but did we ever really consider what you were facing.

When I go back to the hospital, and I see another human struggling with addiction, with their demons, lost to drugs and alcohol, will I think of you? Will I still double take at every tall, handsome, young, tan-skinned man who comes in with hallucinations? With drug-use? With chest pain? Will I finally have the guts to stand up to those around me when they call them “just another druggie”, “good for nothing”, “a complete psycho”. Will I be able to remind them, that this is someone’s child, someone’s best friend, someone’s cousin? Because I admit, I haven’t been able to so far. So now that you’re gone, does that change anything?

I don’t know.

I don’t know anything.

All I can do is hope and pray you’ve found peace. That you are no longer hurting.

And I’m so so sorry.

I love you; we all do.

Irene Martinez MD Class of 2022 Rutgers New Jersey Medical School

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Finding the Right Questions Digital Art

Arman Sawhney MD/PhD Class of 2025 Rutgers New Jersey Medical School

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Dress Up I didn’t like playing dress-up as a kid Not because I didn’t like playing pretend I could imagine it all just fine without having to change out of my favorite shirt (It had a squirrel on it)

When I walk into the hospital It’s clear I don’t know what I’m doing I don’t know where anything is My white coat is blindingly white and stiff I didn’t hem my nice dress pants even though my mom told me to (Twice)

Holding my ophthalmoscope I might as well be holding A magician’s wand Trying to convince my audience that this foreign object Can be used by a select few, and I am one of them, And I will prove it now (Just watch)

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I pull a chair up to the bedside and ask questions That I’m supposed to ask for my benefit, not the patient’s He’s already been seen by a doctor and a nurse He’s already being treated And I pull up my chair to ask him, again, If anything helped the pain – no, I mean before the treatment (That the doctors gave you Specifically to help the pain)

He can kind of tell I have no idea what I’m talking about But when his brother calls he tells me That I should speak to him, tell him what’s going on (I have no idea what’s going on)

I keep myself from saying “He probably wants to speak to a real doctor” And instead say “He probably wants to speak to your attending” Just in case he thinks I’m some random kid (Who snuck into the hospital to play dress-up)

Nandina Mishra MD Class of 2024 Rutgers New Jersey Medical School 19

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Lost Before You Can be Found There was something different about the sunrise here The colors were familiar yet had a sense of disfiguration I can hear the beeping from a mile away How can a crowd of people feel so far away?

You, yes you, the one with the white coat Are you even listening to me?

There is a shadow moving without my consent Words begin to trickle from my mouth It is becoming easier and easier to lose track I find myself chasing the whispers of those around me I can see it in my folk’s eyes, the pride they share But I have not been able to recognize my own reflection You must be lost before you can be found

Kajol Shah MD PGY-2 -Department of Medicine Rutgers New Jersey Medical School 20

The Donor Heart Blood and Acrylic on Newspaper

Juliana E. Kim MD Class of 2024 Rutgers Robert Wood Johnson Medical School 21

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The Journey of Life Painting

L. Nandini Moorthy, MD MS FAAP Professor of Pediatrics Rutgers Robert Wood Johnson Medical School 22

Resiliance While they were strong, they overestimated.

The tiredness spread ‘til they felt sedated.

In the beginning, they were taught what to expect; Yet, in the end, they carried on ‘til they wept.

No well-intentioned advice or careful instruction Could prepare them for this chaotic production.

They pretended to remain unperturbed, But inside they were disturbed.

They start their day, burdened by heavy eyes.

Their only solace is one look to the skies.

The ones they meet tell them, “I am beat.

Are you sure this is something you can treat?”

Every day they think, The world puts too much on my shoulders.

Why did I think I could be one of these soldiers?

In my world, sickness is normalized.

This is the thing I did not want immortalized.

But amongst the uncertainty, exhaustion, and pain, They remind themselves of their mantra again: I am here to be the caretaker.

It is not their time to meet the maker.

Nisha Ali Graduate Student Rutgers School of Graduate Studies 23

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The mirror When I see you, I see me That is what one of my patients told me I did not understand it right away But then I realized what he was trying to say He was from South America, mi compadre from overseas He came in the search of bigger dreams, gumption I see He spoke Spanish, just like me But here I am dying He mumbled fearlessly I saw his scars And listened to his lungs I felt his pain And yet he smiled again You remind me of a younger self, he said Don’t forget the world is at your feet Find things that make you feel whole Myself from the mirror spoke Hungry for air He was able to say his farewell Ready to leave his pain But the guy from the mirror remains

Eloy Ruiz Mendoza MD Department of Medicine Rutgers New Jersey Medical School 24

The Birthing Room The big room goes dark Doctors stand all around me Wahh, the baby cries.

Rasheena Wright Graduate Student Rutgers Graduate School of Biomedical Sciences 25

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The 1% Digital Media

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Kamil Sochacki MD PGY-1- Department of Anesthesiology & Perioperative Medicine Rutgers Robert Wood Johnson Medical School 27

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New Friend in Med School Drawing

Lauren Hutnik MD Class of 2023 Rutgers New Jersey Medical School 28

Pandemic Beloved I have no want, just the need to invade to exist A force of nature, a storm that hits like a fist.

Infinitesimally smaller than that, yet I do greater harm.

When I became, you were late to sound an alarm.

But humans are so big and what, 8 billion or so strong?

I am much more, I thrive in you, trillions in a throng.

When I started to spread, you gave me a name Yet there are many questions about how I became.

Some say from within white walls, or from a bat’s mane...

It matters not from whence I began my campaign.

I am here to challenge humankind, just the same, And now we are entangled in this deadly game.

Really, you should thank me for all I have done Not that I can really care, since I lack emotion.

I revealed so much love, so much hatred, so much fear A society so fragile, the deepest imperfections made clear.

See what brings you together, and what tears you apart?

I have revealed the best and the worst human heart.

The weakest shall perish, the poor will have it hard To steal away your breath is my deadly calling card.

The strong, the rich, and the young may survive And so will the lonely, but they will suffer alive.

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Pandemic Beloved (continued) Your insatiable need to be social I also hold dear, It is the just the ticket I needed to spread far and near.

But, while blame fired sharp from pointed fingers of man I went about my business, infecting human after human.

And as talking heads squawked and doubt clashed with fear I traveled in bodies unhindered through hemispheres.

Impatience, ignorance, politics, and greed Are the roads I travel forward with breakneck speed.

Weapons you waged against my voracious onslaught With vaccines, pills and infusions, together you fought.

Mutable I am, so in that manner I countered back, Everything you did, I changed, and continued my attack.

But wait…

My goal can’t be to kill you all, my hapless hairless apes, My sweet reproductive apparatus, I need you...like a mate.

If I grow too strong, oh no, I will kill the hand that feeds, And my genes cannot replicate, and I cannot stay freed.

So, I’ll weaken, and change until I am but a nasty cough, Just an inconvenient flu, my dears. For me, that’s enough.

Endemic I will become, established in my parasite ways…

My beloved humans, we will be together for countless, countless days.

Sharon Gonzales MD Assistant Dean for Careers in Medicine Rutgers New Jersey Medical School 30

Gram Neutral

Acrylic on canvas

Paul Brennan and Christina Vyzas MD Class of 2025 Rutgers New Jersey Medical School 31

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Natura anat, medicus curat (The physician treats, nature cures) Oil Pastels on Paper

Lena Kheir MD Class of 2023 Rutgers New Jersey Medical School 32

Insomnia Night-Walks - Trapped in the Head Charcoal Drawing

Meghan McMullin MD Class of 2025 Rutgers Robert Wood Johnson Medical School 33

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Death Painting

Michael Teters Assistant Professor, Department of Medical Imaging Sciences Rutgers School of Health Professions 34

A Grand Grieving Digital Art

Lydia Rebello Pharmacy Student Ernest Mario School of Pharmacy 35

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Just One More Day Let’s go over this one more time. The inferior mesenteric artery originates above the aortic bifurcation.

From it branches the left colic artery, sigmoid arteries, and inferior rectal artery. Wait, was it the superior rectal artery or the inferior rectal artery? God, I always get them mixed up. Let’s just hope they don’t test it on the practical tomorrow. Why couldn’t they just ask us where the gallbladder is and let us get going. It’s not like all of us are going to become bloody surgeons anyway. As an aspiring psychiatrist, the way I see it is if I can tell you where the brain is (hint, it’s in the head) and the heart is (hint, it’s in the chest), I’ll be okay.

But here I was, peering through the contents of my cadaver’s abdomen, pushing aside the small intestines to identify vessel after vessel in the intricate maze that constitutes the human vasculature. It was 3 am. I was exhausted. I cursed myself for procrastinating on yet another exam. I had dismissed our practical as being an easy 100, that is, until my upper classmate roommate implored me to take it seriously, given how tricky they could be and how much they contributed to our final grade. So here I was, stuck in a room with 22 bodies, 21 of them being dead and the other being me. Although, if I failed my practical and had to redo the entire school year, my mother would personally take care of my embalming.

I didn’t even want to stay in the lab this late. I intended on going home and coming in early tomorrow morning after a few hours of sleep. But it was just my luck that tonight was the largest storm in New Jersey for the last 100 years. If I left now, I would have to wade in knee-deep water for a good 20 minutes. I’d probably step on a shattered glass bottle too and end up hobbling back to University Hospital for a quick round of IV antibiotics and some stitches courtesy of an enthusiastic albeit clueless third-year.

So I stayed put and went over the anatomical landmarks of the GI tract for the fourth time. I had finally found the appendix again when the lights went out. I took a step back from my cadaver. For a few seconds, I stood still in complete darkness. Then, the emergency light across the room turned on, casting a faint orange dim in the lab. I breathed a sigh of relief. Then I promptly choked on my spit as I saw what was in front of me.

“Dear God man, your lab group hacked through my portal triad like you wanted to give me a transplant.

Too late for that, anyways. Didn’t you bother reading the lab guide? You were supposed to lift my liver, not sever it completely. By the way, you nicked my kidney while doing so, and somehow my gallbladder ended up next to my pancreas. You’ve got some explaining to do.”

“What the...how in the hell...what’s going on here?” I muttered. My cadaver, a gray-haired man in his 60s, had sat up and was trying desperately to keep his organs from spilling onto the floor.

“Am I dreaming? This can’t be happening.”

“If this was a dream, could I do this?”

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He reached into his chest, pulled out his heart and tossed it from one hand to the other, high in the air.

Then he put it back.

“Umm...if this was a dream, you could do that. That’s the only time any of this could be happening. I mean, you’re dead!”

“Don’t need to rub it in, kid. I know I’m dead. Besides, I just came to check in on you and see how you’re doing. Are you ready for your practical tomorrow?”

“Definitely not after all this,” I said.

“Alright then, guess I’ll just go. Last thing I want to do is sabotage your studies.” He began to lay back down.

Wait!” I shouted. “I’m sorry, it’s just that this is crazy. I’m losing my mind. I know I’m sleep-deprived, but I didn’t know it was this bad. I’m sure you understand why I’m so freaked out, right? Imagine if you were in my shoes and this happened to you.”

“You’re right. I know this is all a bit overwhelming. But I’m only here to help, in any way I can. That’s why I donated my body to your school, after all.”

“Yes and thank you so much for that. It’s truly a generous thing to do and it’s helped us learn so much.”

“Don’t mention it. I was glad to. Not much use for it after death. Anyways, let’s get back to your practical.

Tell me, what are the four lobes of the liver?”

“Oh, that’s easy. Right, left, caudate, and quadrate.”

“Ah, very good. I didn’t drink a drop of booze my entire life so glad to hear my liver still looks textbook.

My heart on the other hand...Now tell me, what branches off the celiac trunk?”

“Okay. Left gastric artery, splenic artery, and common hepatic artery.”

“Correct again! Tell me, why are you even here studying? Seems like you know your stuff to me.”

“Thanks but just wait until I get to the IMA. I keep getting its branches mixed up. But I’ll figure that out later. What happened to your heart?”

“A smart chap like you should have noticed what was wrong in a second.”

I cursed myself for slacking off during cardio.

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Just One More Day (continued) “See this dark, black area around the left ventricle.”

He plucked his heart from his chest once again and pointed to an area of prominent discoloration.

“Yea, I see it now.”

“Well you don’t suppose that just happens to everyone, do you?”

“No, you’re right. It looks ischemic to me. Did you have a heart attack?”

“Precisely. Three weeks before my 64th birthday.”

“I’m so sorry.”

“Thanks, kid. I have to say, I’m awfully proud of you and your classmates. I know school isn’t easy, especially during COVID, but your class has been doing one heck of a job.”

“Thanks, but honestly some days it feels like there is just too much to learn. Every lecture we hear about ten new diseases, ten new ways our loved ones could suffer or even pass away. Our treatments and therapies, in comparison, seem so weak. I can’t believe how even in 2021, if our patient gets cancer in their pancreas the best we can do is palliative care.

“You’re not wrong, but you’re ignoring all the progress medicine has made. Sure you guys can’t cure every illness. I’m a living example. Or uh, dead example. But you can help a whole lot. I’m sure I would have kicked the can years earlier if not for what your colleagues had done for me.”

“But what about something like Crohn’s disease? One of my closest friends got it a few years ago and the best we can do is shut down his immune system and pray he doesn’t catch an infection. So much of the time things seem so hopeless, like are we even making a difference?”

“If your friend’s life is better because of the medication, then yes, you, meaning healthcare, are making a difference.”

“And I don’t mean to sound selfish but let’s put aside patients for now. What about us? We’re going to be a quarter of a million dollars in debt by the time we graduate, already four years behind our friends in other industries. Then we’ll grind away a handful of more years working for less than minimum wage, only to become attendings at 29 and find ourselves drowned in paperwork, fighting through red tape, and homicidally enraged at our EHR systems, all while getting reimbursed less for what we do. Sometimes I seriously wonder if it’s worth it.”

I waited for his response. He sat still for a few seconds, saying nothing. Then he took a deep breath in and spoke.

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“You ever wonder what a single day is worth in dollars? Just some random, ordinary day if you were to put a price on it. Some people say you can’t put a price on something like that, but that’s bullshit. People make that assessment themselves when they offer to work for someone for $5 an hour, $15 an hour, or $50 an hour. Most people’s days are worth a couple hundred dollars at most. If you’re a surgeon and pull off a surgery that saves 10 years of a person’s life then bam, think about the value you brought back to them.”

He stopped for a second and studied my face. He knew he hadn’t convinced me of anything.

“Look kid, let me say one last thing. The day I had my heart attack, I had taken my granddaughter to the river near our house. In fact, I took her there nearly every day that summer. It’s a small river, no more than 10 feet at its widest. But it’s beautiful, really. Sometimes we’d just sit on the banks and watch the water go by. My granddaughter would ask me questions, questions only a child has the innocence and curiosity to ask. Other times we’d go up close and try to find fish. No matter how many times she spotted one in the water, she would smile and beam with excitement.”

I noticed that he began tearing up. His eyes were far from the glass, life-less objects the other cadavers had.

They were real eyes, filled with real tears.

“Do you know what one more day on the river with my granddaughter would be worth to me right now?

All the money in the world wouldn’t be enough.”

“I won’t ever get another day with her, and I’ve got to make my peace with that. But as a doctor, you can help your patients get another day with their granddaughters, their families, their friends. You can give them life, opportunity, and time, all through your efforts. Not an infinite amount, and not for everyone, but for a lot of people. Tell me then, is there anything more worthwhile than what your training to become?”

I stood quietly, lost for words.

“I have to get going, kid. I’m sorry we couldn’t go over the other structures. Remember, the ascending colon is on the right, descending is on the left, and the transverse is in the middle.”

He shot me a quick wink and began to lay back down.

“Wait!” I shouted. “Is this real? Or am I just dreaming?”

He paused. Then smiled.

Darshan Kalola MD Class of 2024 Rutgers New Jersey Medical School

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Under Anesthesia Mixed Media

Nivetha Srinivasan MD Class of 2023 Rutgers New Jersey Medical School 40

Remembering Do you remember Multiplying: x and y/ 15 percent by the bar tab/ Dunbar’s number because you do not believe it/ gamete to zygote to morula and onwards/ And upwards until haploid becomes diploid and diploid becomes aneuploid?

Multiplying: interest by debt/ wisdom/wild prions in the nooks of your brain/ cells that refuse to stop,

going going going,

Til their death becomes preferred to life?

Do you remember Sun: rises barefoot, chilly, & romantic/- In to bleach your hair/ daes with a sloppy cherry on top/ flowers, With their glorious heliotropism and thick stems that reach desperately towards the sky until they can reach no longer?

Sun: downing/ ken bags under your eyes/ screen even on cloudy days/ lamps to keep the S.A.D. away,

Thymidine dimers that cannot be fixed, even if the sun will rise again tomorrow?

Do you remember Skipping: class/ rocks/ periods/ up the stairs, your bones made of rubber/ and stepping on all the cracks at amusement parks, Wondering casually, how many unexpected backs you have broken?

Skipping: birthdays/ Friday night happy hours/ exons/breakfasts and desserts/heartbeats,

You wonder for real now, how many herniated discs? Compression fractures? Burst?

Do you remember The rule of 3: bacon lettuce tomato, location location location, life liberty the pursuit of happiness, Your 2 best friends from your hometown with whom you exchanged blood and love and loss

The rule of 3: Beck’s, Cushing, Whipple’s, Unwept, unhonored, unsung Do you remember Falling: ochre crimson leaves fraternizing with the scent of an enveloping tonic/ from the sky on a parachute/ in&out&in love, Thinking time moved when you told her to, that you had eternity ahead of you?

Falling: in love with just yourself, muscle mass, dopamine, white matter, hair in clumps,

companions one by one,

Leaving you wondering, where the time went?

Do you remember? I remember, am dis—membered and re— membered

Vaishali Ravikumar MD Class of 2023 Rutgers New Jersey Medical School 41

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Fundus Fun Acrylic Painting

Nivetha Srinivasan MD Class of 2023 Rutgers New Jersey Medical School

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Hospice These hands feel the heartbreak of a lovers blow They elicit healing from the overhead slow crow Callous parts that have worn away Fists of fury rage out of war led betray These hands send messages of embrace Open arms bring shelter in the darkest days Closeness comes as experiences interlock Caressing softly through touch and thought, little talk These hands can amend damages woe Delicately sewing together the pieces lost long ago Licking a finger to turn the page White knuckling while awaiting future's change These hands wrinkle and wane with age Pronounced veins still provide comfort for no wage While Nature preserves biological authenticationthese hands are left to wither in alienation

Kyle McLeod Rutgers Scool of Physical Therapy

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Memories

Acrylic on Canvas

Yelizaveta Gribkova MD Class of 2023 Rutgers Robert Wood Johnson Medical School 44

¿Qué puedo decir al paciente que murió?

Como hubo dicho el famoso médico House: “¡Todo el mundo miente y todo el mundo muere!”

Su declaración tiene razón, su sentimiento es verdadero.

Pero, ¿qué puedo decir al paciente que murió?

En el caos de los últimos momentos ante mortem, Entre la oleada de actividad apremiante, Nunca nos dimos por vencido.

Pero, ¿qué puedo decir al paciente que murió?

Después, fue un reposo bajo las luces fluorescentes brillantes y estériles.

Un reinado de tranquilidad, un olvido sereno Se canturreaba la canción de sosiego santificada y grave.

Pero, ¿qué puedo decir al paciente que murió?

El alma flotaba arriba, hasta el cielo coronado por las estrellas resplandecientes Hasta la ultratumba, la próxima vida o la última liberación espiritual Hasta un plano de existencia nuevo y desconocido.

Pero, ¿qué puedo decir al paciente que murió?

Rezo que halle un nuevo mundo trazado por sus sueños Deseo que obtenga las frutas de sus acciones Espero que encuentre el cristal de paz.

Pero, ¿qué puedo decir al paciente que murió?

Anurag Modak MD Class of 2024 Rutgers New Jersey Medical School 45

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nature

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Untitled Photographs

Jorge Aldo Barajas Ochoa MD Chief Resident - Internal Medicine Rutgers New Jersey Medical School 47

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Aged Red Rock Photograph

Afif Hossain MD Resident Physician Rutgers New Jersey Medical School

Moonrise during COVID Photograph

Jerrold J. Ellner MD Professor of Medicine Rutgers New Jersey Medical School 48

Us

Photograph

Ge Yang Graduate Student Pharmaceutical Science Program

COVID - And Yet There is Hope

Photograph

Jerrold J. Ellner MD Professor of Medicine Rutgers New Jersey Medical School 49

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community

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Buttons of Love Photograph

Maryna Layendra Medical Health Technician - Women’s Center/GYN Department Rutgers Cancer Institute of New Jersey 51

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“Thank You Healthcare Heroes” Photograph

Lissette M. Céspedes MD Rutgers New Jersey Medical School - Assistant Professor of Medicine Division of Endocrinology

Brisk Meditation Photograph

Susan Sawler, CRSP, CPRS Peer Supporter NJ Suicide Prevention Hopeline (Access Center - UBHC) 52

Day & Night Photograph

Wei Qian MD Class of 2024 Rutgers New Jersey Medical School