Ars Literarium Volume IX by Rutgers New Jersey Medical School

Volume IX Summer 2023 Journal of Art and Literature

ARS LITERARIUM The literary journal of Rutgers New Jersey Medical School and Schools for Biomedical and Health Sciences 1

Ars Literarium Volume IX Ars Literarium is published annually by the Healthcare Foundation Center for Humanism and Medicine at New Jersey Medical School

Ars Literarium Volume IX

Ars Literarium Council Members 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

Faculty Advisors Andrew Berman, MD Professor of Medicine, Rutgers New Jersey Medical School Manasa Ayyala, MD Associate Professor of Medicine Director of the Healthcare Foundation Center for Humanism and Medicine, Rutgers New Jersey Medical School Editors-In-Chief Rebecca Ho, MS-2 Editors Mingzhuo Pei, MS-2 Sindhura Kolli, MS-2 Sowntharya Ayyappan, MS-2

Acknowledgements 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. With special appreciation and gratitude to The Healthcare Foundation of New Jersey for their generous support. Thank you to Tanya Norment, Dr. Ayyala, and Dr. Berman for their advice, mentorship, and guidance throughout the year.

Ars Literarium Volume IX

Mission Statement Ars Literarium seeks to express the medical narrative through the creative voices of the members of the Rutgers Biomedical Health Sciences Campus. 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. For information, inquiries, and submissions, please email us at: arslit@njms.rutgers.edu

Dear Readers, Welcome to Volume IX of Ars Literarium. In these pages, you will find a wide variety of gifted individuals channeling their emotions into universally relatable narratives and visuals within healthcare. Art has always served as a potent instrument of healing and a reflection of our shared humanity. This was shown to us clearly as we curated a remarkable array of the pieces of art and literature that were sent to us. Notes of rebirth, rejuvenation, spring and bloom, were found woven amongst many of the pieces. It became clear to us that in the aftermath of a global pandemic that disrupted our lives, there was a calling for collective healing along with a new ray of hope for the future. In this issue of Ars Literarium, we are delighted to share with you works of art and literature that evoke strong emotions such as hopefulness, nostalgia, and perseverance. As we cautiously return to a new normal, the works of art in this edition portray the readjustment following a global pandemic. While we are now approaching a time that is similar to our lives prior to the pandemic, our future experiences will still be affected by the past hurdles. However, we are excited to share with you works of art and literature that encompass comfort in finding solace through the community as well as coping mechanisms through diverse and unique artistic mediums. It is our great pleasure to introduce the ninth edition of Ars Literarium to you. We are incredibly grateful to all our contributors who took the time to share their work with us, and now with you. We hope you have as much fun going through it as we did putting it together. Sincerely, Editors of Ars Literarium

Ars Literarium Volume IX

Table of Contents Cover Image by Ruhani Mumick 1 Beauty Lies Within by Isabel Silva 10 Lines of the Body by Ruchi Biswas 11 Imposter by Veer Patel 12 Imposter by Ruhani Mumick 13 The Evolution of the Brain by Zahra Adahman

The Ultimate Gift by Mary Salim 15 Crochet Heart Art by Emily Balog 16 Brain Tree by Ivo Back 17 The Old Heart Doc by Anurag Modak 18 Lab Meeting by Aslihan Sen 19 Sweet Sorrow by Tzeidel Brown Eichenberg 20 The Day My Stethoscope Heard Nothing by Nicholas Bellacicco

Birds know by Nancy Klepsch 22 I Was a Seamstress by Gina Nobile 23 Our Entire Existence by Danielle Hope 24 The Clock by Ahmed Sabra 25 Self-counseling by Dipti Wakode 26 “Physician Burnout” by Lavern Agyei-Nomafo 27 Glycogen Storage by Nivetha Srinivasan and Nikita Reddy 8

Transition from Pre-clinical to Clinical Years by Danielle Lee

Scaffold by Christina Vyzas

Natural tooth vs Dental implant by Afsoun Adibi

Wish and Wisp by Sonya Elefante

Life Herself by Nayna Shah

Work by Rohan Hublikar

A Ray of Hope by Ankita Punetha

Grinning skulls by Vanessa Akelian Ocon

Untitled by Evan Spivack

Live for others by Priyanka Agarwal

Disillusion by Genee Rubio

St Johns Wort by David Goteiner

The Parting Leaves by Joseph Legaspi

Growth by Rebecca Ho

Emotions of the White Coat by Srishti Kumar

Ars Literarium Volume IX

Beauty Lies Within

Isabel Silva Class of 2025 Rutgers New Jersey Medical School 10

Lines of the Body

Ruchi Biswas Class of 2026 Rutgers New Jersey Medical School 11

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Imposter I gaze deeply into my reflection floating between my constructs of the past and future mocked by the insurmountable distance in between the details reveal scars that paralyze me in the present solidifying a weight within my chest that glues me to the ground can I enter a space free of any identity seep like water into its crevices until I feel like I belong the peaceful flicker of a flame casts a shadow behind me I lean into my reflection shedding doubt and uncertainty into the darkness behind

Veer Patel Class of 2024 Rutgers New Jersey Medical School 12

Imposter

Ruhani Mumick Class of 2023 Rutgers New Jersey Medical School 13

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The Evolution of the Brain

Zahra Adahman PhD biomedical science student Rutgers School of Graduate Studies/Rutgers New Jersey Medical School 14

The Ultimate Gift For all that medicine has gifted me, I hope that I can look back on my years to see all the things I intended to be... A teacher to my patients A servant to my community A healer to the sick A caretaker to the crippled A strength to the faint-hearted A calm to the chaos A laughter to the weeping To all those who seek me in need, may every part of my body be used to fulfill a good deed... Let my ears hear the stories of those suffering Let my lips relay a token of kindness with a smile Let my mouth speak truth and wisdom to those troubled with confusion Let my hair be worn by my patients with active lupus Let my eyes intently inspect every aching muscle, joint, rash, and wound Let my mind be filled with knowledge so I may educate Let my hands serve all those who need a lending hand Let my arms embrace the disheartened children at the orphanage Let my legs give me strength to walk my daily path to the hospitals and clinics To all those who yearns to receive spiritual kindness, May every perceived sense of my nature manifest Let my mind’s ticking thoughts bring about answers Let my beating heart feel the love with all those around me Let my hands touch the aching bodies of those in pain Let my sense of smell help identify DKA on my patient’s breath Let my ears hear the cries of a newborn baby Let my eyes be the window to my soul so that all those whom I meet receive a token of my being allowing my spirit to live eternally beyond my time in this world is freeing Mary Salim PGY-4; Rheumatology Fellow Rutgers New Jersey Medical School 15

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Crochet Heart Art

Emily Balog, PhD, OTR/L Assistant Professor Occupational Therapy Doctorate Program 16

Brain Tree

Ivo Back Fellow in Neuroendovascular surgery Rutgers New Jersey Medical School 17

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The Old Heart Doc With case files in his hand, but not a hair on his head – clearly an old man Sitting in front of his patient, chewing on his stethoscope’s earpiece, under bright fluorescent lights Shaking his head, he hums a rhythmic tune, much to his own delight Seeing this unusual display, isn’t it natural to think, Ah, yes, how erudite? Whatever he mumbles, I can’t make heads or tails: “The swan floats on the tall v-waves, that’s why the steps go up.” Beads of sweat start running down his shining bald head, Angrily he yells, “Who even understands the meaning of this nonsense?” “Oh God, these students are so blind! They understand nothing and only waste my time! Which wave is the spikiest, they know not the theory, And why on the ides of March does the S2 seem weary?” On his files, he scribbles and scrawls illegibly Intervals and segments, sounds and enzyme levels, the dosage calculations go on infinitely Which sound is good, and which one is evil Which valve stenoses are likely to cause global upheaval With a tap-a-tap-tap on the left sternal border, He exclaims, “I know how this sound can be subdued! Having squished and squashed, mashed and moshed, I know it clearly. This heart’s axial deviation, I vow to correct!” “Which P-wave makes a good pet, which S-wave is most serene, Which T-wave is timid, and which one might even be alive, Which QRS complex lacks knowledge of what is true and false... I know it, indeed, why some holes exist inside hearts!”

Anurag Modak Class of 2024 Rutgers New Jersey Medical School 18

Lab meeting

Aslihan Sen Post-doc Rutgers Cancer Institute of New Jersey 19

Ars Literarium Volume IX

Sweet Sorrow It was almost midnight as I sped over the slick freeway, racing against the flood waters that were wont to flood my exit ramp with every heavy rainstorm. My gaze focused solely on the small patch of pavement just ahead of me; the only thing illuminated by the meek headlights of my aging hatchback. A hairy ending to a particularly rough call shift. That was the day I ‘pronounced’ someone for the first time, my own dear patient, Mr. K. I’d come to know Mr. K through jokes cracked during my morning pre-rounds and afternoon visits. Through breathless divulgences of his wishes as he got sicker. Through relaying messages of love from his chosen family, who were barred from the COVID floor where he would live his last days. As I circled my block, looking for parking, I savored the quiet darkness as the rain lightened up. I reminisced on the moments of levity I had with Mr. K; moments that made him a difficult loss. I relived our first conversations— witty banter back and forth, a smile cracking below his nasal cannula. Then, giggling conspiratorially after a particularly stern scolding from a nurse after I removed his BiPAP just long enough for him to sneak a spoonful of Jell-O. I smiled as I thought of him sitting regally on the hospital bed, stating in his best posh London accent “I feel like Cleopatra,” as I fanned him through the sweats of a breaking fever with a rough towel. As the sand-papery cotton sent ripples of air through his hair, he looked every bit the role of a great ancient queen. We had kindred senses of humor, and bonded easily. It was our bright moments that made us feel so close that it hardly felt strange to hold his hand and say “I love you” one last time on behalf of a dear relation. It was a comfort to have happy memories with the first person who I shepherded through life’s end. Weeks later, I looked his obituary up, and as I read one line in particular, I felt a soft chuckle shake my shoulders. Prior to his retirement, he had owned a cheese shop that he hilariously named “Who Cut the Cheese?” What a blessing it was to laugh with Mr. K one last time.

Tzeidel Brown Eichenberg PGY-2, Internal Medicine-Pediatrics Rutgers New Jersey Medical School 20

The Day My Stethoscope Heard Nothing I walked in and he was still A physician for a few months now Doc- I don’t feel a pulse... I placed my stethoscope on his chest And waited For the hum Like jazz music at a rooftop bar a rhythm, mixed into the wind. My years taught me this To listen and hear To listen to the workings of life. But on that day, I heard nothing. No one ever taught me to hear nothing.

Nicholas Bellacicco, D.O. PGY-1 Neurology Resident Rutgers New Jersey Medical School 21

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Birds know Birds know Where to build How to find food Who to partner Birds know When to take flight What to bring Who to sing and dance with Even birds know Who is prey Who is predator When to break free Where to fly Where to nest Birds know

Nancy Klepsch Student support specialist University Behavioral Health Care at Newark (Rutgers Health) 22

I Was a Seamstress She called for difficulty breathing. A 90-year-old woman who was getting off the bus and heading home called 911 because she was short of breath. I helped her inside and couldn’t help but notice her worn, stained, and faded button down blouse. On her left breast, she had her house key pinned to her shirt. How clever, I thought as I sat down to start writing the report. It was my partner’s turn to do the assessment and although she seemed like a nice lady, I was too tired to engage in any conversation. After finding nothing significantly wrong we began our trip down town to the hospital. More than likely they will run some basic tests and discharge her later in the day. At least a 10 minute drive ahead of us I began to feel tired. I sat across from her and kept an eye to make sure she was not progressing to a worsened state. I listened as she just kept repeating “I must be dehydrated, I must be dehydrated, I don’t drink as much as I used to.” I looked at her and asked “What do you mean you used to?”. “I used to drink water all day when I was at work because the cooler was right there next to me.” With a sudden interest, I perked up and asked what she did for a living. “I was a seamstress” she replied. In that moment, I instantly pictured my grandmother sitting at her sewing machine in the corner of her basement hemming my pants that were too long for me. I knew my grandmother to be an amazing seamstress and having had mastery of a skill that is often forgotten about until we have a wedding dress that needs tailoring or a pair of pants that need hemming. Considering the advances in technology sewing has become an antiquated art form and much less a career choice. The woman proceeded to tell me how she was a seamstress in a flag factory that made American flags and she was responsible for sewing the stars onto the flags. The American Flag. Today people are stepping on flags, taking offense to flags, and starting wars over flags. I couldn’t imagine a time where there existed individuals who sewed together American flags, let alone the existence of an American flag factory. I was brought back in time to a generation of people that believed in our country, took pride in hard work and struggled to make a life worth living for themselves and their families. I saw before me a woman who has lived through the Great Depression, experienced wars and changing presidents, watched the development of technology, and managed to survive here and now with a lighthearted spirit and a firm grasp on reality. “It must be old age she added”. I saw my grandmother in this patient and from that moment until the moment we bid farewell I treated this woman like a queen. To me, meeting this 90-year-old woman who is living on her own in a tough city carrying American history in her very being was a complete privilege and I felt honored to be in her presence.

Gina Nobile Pre-med student and former paramedic of University Hospital Newark Rutgers School of Graduate Studies 23

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Our Entire Existence

It has been many months since I said goodbye to my first patient with a terminal diagnosis. Even after many months and dozens of other patients since our final session, I still think of her often. I wonder if she pursued additional treatment or opted to forgo all interventions. I wonder if she finalized her travel plans with her adult children. Did she go to that meditation class she desperately wanted? In our final session together, she told me about her short-term plans and her dreams for the afterlife. I can only hope she achieved both. This patient viscerally showed me how people come into our lives when we least expect it but need it most. And how surprising, yet not random, it is for people to leave an impact on our lives. We worked together for over half a year. While we worked on her mental health and coping strategies for her stress, she shared many of her stories. She described her weekly social groups and growing plants for the new season. She talked fondly of her closest out-of-town friend who supported her during treatment. She recounted stories of her youth and creating art. When I logged on for our final telehealth session, I knew it was our last session; this is when the therapist recaps all the work the patient has done and the skills the patient has developed. The end of therapy also includes my favorite part: expressing how proud I am of their growth. What I had not known was how final our goodbye would be. Even as I write this now, my throat gets tight, my head gets strained, and my jaw clenched. My patient shared her new terminal diagnosis: she was dying and did not have long to live. Her diagnosis meant more than the end of therapy. She had limited time left in this life. As a person training in aging healthcare, I also have training in grief, death, and dying. Those three domains became our focus for our final session. We talked about her expectations, her goals, her fears, and her spirit for this ultimate stage. My patient shared she was curious about what the next life would be like, as she believes her consciousness goes on to something else. I told her, “It sounds like you have hope; hope for what the next part will look like.” She agreed and laughed in her raspy, alto voice, a smile growing on the edges of her face. I have finished therapy with dozens of patients before her. It tends to feel generally pivotable when the patient is done with their therapy goals. With this patient, it felt more momentous. It felt like a shift in how I will continue my therapeutic work. This patient taught me how therapy is not always about interventions but conversations. She was a quick-witted, tough lady who always had a joke ready to use. She was eager to sharpen her problem-solving skills and regain confidence in her value. Medical diagnoses sometimes take that away from people. Therefore, we worked on centering her self-confidence through mindfulness, distraction, and art. She continued to lean on her friends, and I reminded her to take time for small moments of joy. All of these things she is taking with her into her next chapter, however long it may be. People come and go in our lives. Sometimes they are present for short periods; other times, it is our entire existence. The impact people have on us tends to shape how much a relationship matters. The time with my patient really mattered. And now, I have the honor of thinking about what she continues to accomplish, not only in this life but in her next one too.

Danielle Hope Research Coordinator & Counseling Health Psychology PhD Student Rutgers School of Public Health 24

The clock

Ahmed Sabra Class of 2025 Rutgers New Jersey Medical School 25

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Self-counseling

Dipti Wakode Preceptor Rutgers School of Dental Medicine 26

“Physician Burnout”

Lavern Agyei-Nomafo Nursing student Rutgers University-Newark 27

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Glycogen Storage Diseases Von Gierke Disease Lactate, Fats, Uric Acid Growth is Affected Second is Pompe’s Heart Failure Because Big Heart Check Acid Maltase Cori in the House Can’t Debranch the Three Branches Dextrins on the Loose Type Five McArdle’s Rhabdo, Cramps with Exercise Also, Second Wind

Nivetha Srinivasan and Nikita Reddy Class of 2024 Rutgers New Jersey Medical School 28

Transition from Pre-clinical to Clinical Years

Danielle Lee Class of 2025 Rutgers New Jersey Medical School 29

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Scaffold

Christina Vyzas MD/PhD Class of 2028 Rutgers New Jersey Medical School 30

Natural tooth vs Dental implant

Afsoun Adibi Class of 2024 Rutgers School of Dental Medicine 31

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Wish and Wisp

Sonya Elefante Mental Health Clinician Rutgers University Behavior Health Care (UBHC) 32

Life Herself She is as unique as a snowflake, glistening and absolute Yet so easily destroyed under the weight of a boot She is as ephemeral as a dandelion, soft and at ease Yet dismantled instantaneously by a single sneeze She is as fragile as silence, gorgeous and mysterious But even the slightest of sounds proves to be deleterious She is as delicate as trust, singing with her golden voice Shattered by just a single choice Why is it that these two are so contrasting? That life is so cursory, and death is everlasting? A woman going for a C-section, a wife and mother of one Who would never get to hold her newborn son A talented artist who struggled with the demons in her mind Whose bathroom cabinet held the best solution she could find A grandmother whose body decided at last That it had no more sand left in its hourglass Stories unfold as we turn her pages She takes us through the years and the ages She nurtures us, guides us until that time When she places us on death’s door without reason or rhyme She has slipped so easily through our fingers And now with the finality of death we will eternally linger Why can’t we stay longer with her light so alluring? Why is life so transitory but death so enduring? Do we ride life’s train, hitting milestones at temporary stations Only to be delivered one day to our final destinations? I can’t help but feel betrayed by life herself How she knows us and grows us then drops us off to someone else When it’s that time, how does she know?

Nayna Shah OB/GYN PGY-2 Rutgers Robert Wood Johnson Medical School 33

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Work What does it matter? When cold sweat fills your gloves, and you push and count. When you squeeze the bag and ignore the crying and the talking So you can remember to squeeze it again, and then again. Not too much, not too little. There is always something to do better. What does it matter, when they are hopeless, or doubtful, or broken? When they think there is no time to heal. Time is money. We could use more of that. There is an art to it, a language. He’s an MI, she’s a CVA. Another OD, she left AMA. Why not say the words? Why teach the letters? What does it matter? Make an incision. Wow, you’re sad. Why’d you do that? Didn’t you hear, it’s smiles all around! No, we don’t get the weekend. They need us. That’s why they run from the ambulance on broken legs. Evidence suggests that we can keep you alive. Science says it’s your fault. Just this once, we’ll bail you out. Then again. No, it’s our fault, of course. There’s always something to do better. But, hey, they were pretty kind. It’s not every day you get to save a life. Or is it the joke you told? A few words shared between letters? You did a good thing. You know good people. That baby was so cute. We did more than we could. More sleep would be nice. But we can make it work.

Rohan Hublikar Class of 2026 Rutgers New Jersey Medical School 34

A Ray of Hope

Ankita Punetha Postdoctoral fellow Department of Microbiology, Biochemistry and Molecular Genetics Rutgers New Jersey Medical School 35

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Grinning skulls

Vanessa Akelian Ocon Class of 2026 Rutgers New Jersey Medical School 36

Untitled The clock, ticking time Staring out past pale curtains Sun sets in the west Three in the morning: No good comes late in the night I fear the phone’s ring Old clock on old wall Ticking away each moment until the sunrise

Evan Spivack, DDS Professor in Pediatric Dentistry Rutgers School of Dental Medicine 37

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Live for others Nothing in the nature lived for itself. Rivers don’t drink their own water. Trees don’t eat their own fruit. Sun doesn’t heat for itself, then why us, a human being live for ourself. Why we not follow the nature’s rule to live for others. Let’s oath to start the year to live a bit for others and accept a little change in us.

Priyanka Agarwal Class of 2024 Rutgers School of Dental Medicine 38

Disillusion

Genee Rubio Research Teaching Specialist V Rutgers Cancer Institute of New Jersey 39

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St Johns Wort

David Goteiner DDS, FACD, FICD Clinical Professor Periodontics and Oral Medicine Rutgers School of Dental Medicine 40

The Parting Leaves Energy between you and me Stirred leaves on a bleak branch. Though fragile, they blossomed, Somehow unforced and free. As the earth gives water, They refreshed each other, Cherished each last drop, Until the watering was gone. When it came time to wither, Part ways to the soil and air, They can now rejoin by Nature, Closer than ever before.

Joseph Legaspi Grants Coordinator Rutgers New Jersey Medical School 41

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Growth

Rebecca Ho Class of 2026 Rutgers New Jersey Medical School 42

Emotions of the White Coat Sitting in my mother’s cabin She’s wearing her white coat Watching her patients come in With words of gratitude and praises My eyes welled up Giving me a proud feeling That my mom made life better For so many people out there And I was lucky that I was her daughter! Watching her on the bed Seeing men and women in white coats again Coming in day and night Trying to make her feel better But all attempts go in vain Giving her several medications But nothing relieves her pain My eyes well up but it’s not the same! A lady of about her age walks in An immediate resemblance I go over every detail To strike a balance between her life and her pain And two weeks later I see her again Words of gratitude and praise For putting her off the pain I close my eyes and thank her I hope she’s watching me too I hope she’s proud of me too My eyes well up again!

Srishti Kumar Clinical Preceptor in Oral Medicine Rutgers School of Dental Medicine 43

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“Rivers know this: there is no hurry. We shall get there someday.” - A.A. Milne