Connective Tissue 2009 | Volume 2

Connective Tissue art and literature at UTHSCSA

2009 • Volume II

Connective Tissue 2009 • Volume II

Editorial Board: Shweta Murthi Aoyoade Olorunlero Anna Schlechter Debra Wheelis Jennifer Collins Cristina Gonzalez Ben Franscisco Zara Oakes Layout Design: J’aime Jones

Editor in Chief: Julie Wibskov

Special thanks to the Center of Medical Humanities and Ethics for making the journal possible, to Amanda Evrard for her considerable assistance and patience, to Jerald Winakur and Lee Robinson for their professional advice and financial contribution, to J'aime Jones for pioneering and continuing with the project and to the Student Government Association for its financial support.

The works published in this magazine were selected based on their artistic and literary merit and do not reflect the personal views of the Center for Medical Humanities & Ethics or those of the editorial staff.

Front Cover: Lois Bready Kayaks

Back Cover: Catherine Reppa Dr. Leon Jones

Contents Kristi Vogel, Vermilion Flycatcher ............................................................................................... 1 Olivia Lemelle, Pendulum ............................................................................................................. 2 Daniel Rivas, Taj Mahal................................................................................................................ 3 Bryan Bayles, Cliff Palace ........................................................................................................... 4 S. S. Jarvis, A Little Lagniappe .................................................................................................... 5 Ben White, A Long Walk in the Snow ........................................................................................ 11 William Miller, Cherry Blossoms ................................................................................................. 12 Jody Tep, Untitled ......................................................................................................................... 13 Lea S. Lopez-Fagin, Ashes to Ashes ........................................................................................... 14 Erica G. Jarrett, Baptized with Water ....................................................................................... 15 Daniel Rivas, Nepal 2 ................................................................................................................... 16 Bryan Bayles, Untitled .................................................................................................................. 17 Betty Alajajian, Friedrich Wilderness Park ................................................................................ 18 Laura Collins Theisz, Dahlia 3 ..................................................................................................... 19 Cynthia Purcell, I Watched My Parents Dance Today ............................................................. 20 Bryan Bayles, Flight ...................................................................................................................... 21 Rene Renteria, Climbing Apparent Dome .................................................................................. 22 Cristi Garcia, Sand in Small Hands ............................................................................................ 23 David Baker, Blue Swift ............................................................................................................... 24 Sheridan Fielding, The Last Patient............................................................................................. 25 Nameer Kirma, The True Christmas Gift .................................................................................... 26 Barry Bridges and Harry Burge, And the Wind Whispers, Mary ......................................... 29 Arti Allam, Seattle ......................................................................................................................... 30 William Miller, Daddy’s Shoes .................................................................................................... 31 Matt Jackson, The Clock............................................................................................................... 32 Bryan Bayles, Study in Charcoal................................................................................................. 35

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Kristi Vogel

Vermilion Flycatcher It has been a dry year, Bleached bones, lean cattle, burn bans, An endless succession of cloudless blue skies.

The parched earth can only whisper and fragment As the chestnut mare circles, trot and canter, Quick hooves awaken vagrant dust Desert-dispersed by boxcar winds.

And on the rust-red roundpen panel One perfect bird alights Flame bright body, coal smoke wings Heedless of the burn ban.

It has been a dry year But the wind bears the hopeful scent of rain.

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Olivia Lemelle Pendulum 2

Daniel Rivas Taj Mahal

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Bryan Bayles

Cliff Palace This world, Whose face shines green and gold, Is clothed in red clay and fire From the heat of a merciless sun.

Mercy comes from elsewhere : From prayer-feather songs, chants, and Heart-felt rhythms stamped hard In the dust of our ancestors.

Only then does the Sun smile, Only then do pregnant clouds rain, Born not of a conjurer’s will, But of the blood and bones of a God Whose love rains down like fire On this Cliff Palace.

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S. S. Jarvis

A Little Lagniappe Alex awakened from the recurring dream, the dream that had haunted him for the last three nights. Once again he heard that same authoritative, precise female voice drone on and on, “Alexander, don’t give me that excuse. You can be whatever you choose to be. Why? Because I say so, that’s why!”

Sitting up in his king-size bed, Alexander Arceneaux, MD, FAAFP, glanced at the blank screen of the state-of-the-art plasma TV hanging on the opposite wall. Half a dozen oversized, underused chintzy pillows lay on the floor where he had thrown them. Besides selling Alex the oversized house on the undersized lot, the housing contractor had told Alex he was including the services of an interior designer as a “little lagniappe.” It turned out that the skinny designer with the frozen smile had two passions-big pillows and Botox. The Botox was none of Alex’s business, but the big pillows were. The nearest Goodwill store, less than a mile away, would be getting a bulky bundle tomorrow morning.

“A little lagniappe.” How often Alex heard that phrase growing up in southern Louisiana. He wondered if the Boston-born contractor even knew what the term really meant—a little something extra a New Orleans merchant would throw in as a gift to a valued customer.

In Alex’s mind,

an extra beignet would classify as a little lagniappe; an oversized pillow would not.

Alex learned first-hand about lagniappe years before from the unlikeliest of sources -- Miss Emily Boudreaux.

He lost count of the times

she’d slide a small book into his hand and whisper, “Just a little lagniappe, Alexander. Read it—it’s yours.”

Why did he remember Miss Emily tonight, two decades after sitting in her freshman high school English class? Throughout the rest of his 5

high school years, she had a way of showing up in study hall and slipping “a little lagniappe” into his hand—a book, sometimes slightly used, sometimes more than slightly used and more often than not so new that the binder was not fully pressed. Somehow she knew what was going on in his life—his rapidly growing interest in medicine, his rapidly diminishing family support and his constantly fluctuating self-esteem.

Usually the book was slim enough to slip right into the back of his three-ring notebook binder. That is, except for that one special book—the book that left no doubt in his mind he wanted to become a doctor. Aequanimitas with other Addresses, by Sir William Osler, Bt., M.D., F.R.S. Alex remembered Miss Emily’s hands shook a little the day she handed him the hardback volume. It was right before the Christmas break in his senior year.

“Read this over the holidays, Alexander. Then decide what you’re going to do with your life. Remember, you can be whatever you choose to be. Why? Because I say so, that’s why!”

Before he could thank her, she was bustling down the hall to her next class. Miss Emily strongly disapproved of tardiness and laziness, especially on her own part. Alex doubted she had ever been guilty of either.

He watched the back of the tall, thin, figure dressed in the black anklelength skirt and the long-sleeved, Niagara-starched white blouse. Once more he wondered where she purchased the thick-heeled sturdy practical shoes she wore day in and day out. The only variety was in the color.

Mondays and Fridays were black days. Tuesdays and Thursdays were brown days. Wednesdays, for whatever reason, were always navy blue days.

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Miss Emily must have known the impact the Osler book would have on him. He read it twice during that Christmas break. The first reading was to satisfy Alex’s curiosity: Who was this doctor/author? Why was he so popular for so many decades? And what did this book have to do with Alexander Arceneaux’s future? The second reading answered all the questions, especially the last. Closing the last page on the second reading, Alex knew he had to be a doctor. After all, Miss Emily said he could, didn’t she?

He still read the Osler book. Lying beside his office computer, the volume was well worn and well marked by now. First published in 1904, the book was still relevant to twenty first century medicine. Using Miss Emily’s yardstick for judging literature, this would make it a true classic.

He had to get some sleep. Tomorrow morning he would meet with Terrence Brookehaven III, Certified Public Accountant, Certified Financial Planner and, in Alex’s opinion, certified jerk. Terrence, the junior member of the accounting firm of Brookehaven, Brookehaven, and Brookehaven, was hoping to add Alex’s clinic to the growing list of medical facilities using the firm’s consulting services.

Alex and Terrence may have sat in the same classrooms through twelve years of public school but Terrence never acknowledged knowing the kid who grew up in the projects until Alex returned with an M.D. after his name.

The following morning Alex couldn’t miss the new six-figure red Porsche convertible parked in the “Reserved for Physician” slot in the clinic parking lot. Terrence was obviously early and eager.

None of Alex’s

patients owned such an expensive vehicle and the newest car driven by his three-person staff was four years old. Alex himself had no plans to trade in his own ten-year-old compact in the near future.

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Entering the clinic from the back door, Alex heard Terrence lobbying Martha Broussard, the clinic office manager, on the merits of the accountant’s latest plan for increasing the bottom line. Other physicians and clinics had already adopted the plan.

“Remember, Mrs. Broussard, business is all about turning a profit, and, to be honest, this clinic’s profit margin is not very healthy. It doesn’t speak so well for a medical clinic to have a sick profit, now does it?”

Alex knew he could count on Martha to refrain from joining the consultant in his noisy laugh. He was right: the room was silent.

Terrence turned toward the door as Alex entered.

“Well, the good doctor arrives at 10. Good game on the golf course?”

“I had hospital rounds.” Alex didn’t bother to explain he had spent the last two hours in the ICU until he was convinced his ten-year-old patient was out of danger from a sickle cell crisis. He knew Terrence would immediately ask if the patient had insurance.

The accountant opened his leather attaché case, making certain Alex and Martha didn’t miss the upscale logo on the handle. “Well, Alex, I’ve gone over your office procedures and billing practices. I can guarantee that if you adopt this financial plan you’ll see your profit margin double within the first three months. That’ll make for quite a vacation, now won’t it? And you’ll still have change to get better wheels. Image is everything, you know pal. Look rich, and you’ll get rich. That’s my motto.”

“Hand me the plan, Terrence. I’ve got lots of patients sitting in the waiting room and I’m running late.” Alex picked up the packet. The paper itself looked rich—heavy linen and heavy watermark.

Alex quickly scanned the first two pages. The third page caught his eye. “Immediate Steps to Take.” He was right—the recommendation was number four, in the middle of the page.

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“This fourth recommendation, Terrence, what the hell is that all about? You know how many senior citizens in this area are barely surviving on their fixed incomes. They have no private insurance coverage. And three of our local family practice doctors just retired. If I follow your recommendation and quit taking any new Medicare patients, who’s going to take care of these patients?”

“Not our worry, doc. Business is business, and I’m here to help you run a healthy business, pal.”

“Damn, medicine is not a business, it’s a profession. I’m here to help my patients, not my bank account. I think you’d better leave now, Terrence. Thank you for stopping by.”

“But what about my financial plan? I spent dozen of hours on this.

Time is money for me, you know.”

Alex turned to his office manager. “Martha, please make out a check to Terrence’s firm for the correct amount. I’m sure you can easily calculate how much time his secretary spent in filling in the template used for this particular financial software program.

“You’ll get what you have coming, Terrence. Business is business, as you say.”

Walking down the hall a few minutes later, Alex heard the voice from the dream again. Only this time he was awake and the voice somehow sounded older.

“Well, Mrs. Broussard, I just moved back to town you see and I’d like for Dr. Arceneaux to be my doctor. The problem is that I only have Medicare. And I understand most doctors in this part of the state are no longer taking new Medicare patients. I’ll understand if that’s the policy here too. I was just checking.”

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The speaker’s back was toward Alex. He noted the ankle length black skirt, the long-sleeved Niagara-starched blouse and the shoes. Especially the shoes. They were thick-heeled, sturdy and navy blue.

Alex walked up behind the figure. “Mrs. Broussard, explain to my new patient here that I take new Medicare patients. And she can pass the word on to her friends.”

Slowly Miss Emily turned around. “Now, Alexander, you’re not going to make much money this way. There are a lot of us seniors with no private insurance coverage who are looking for doctors. Are you sure about this?”

“I’m sure, Miss Emily. It’s just a little lagniappe.”

Alex knew he’d sleep exceptionally well that night. Just as he knew without looking at the calendar the day was Wednesday.

10

Ben White

A Long Walk in the Snow It’s beautifully cold outside. The trees are mostly empty, but the grass is beginning to peak through the melting snow. Brisk. They can’t see the sun anymore, but the hints of its light lie just down the road.

The man and his wife, walking back home to the farm, taking a long and plodding trip back from the village. No cart or wagon today, though the path is littered with tracks. The short fences that line the road are like giant railroad tracks—big enough for giants, and big enough to hold what’s hanging over their heads.

Maybe she is sick today; perhaps they went to the doctor. Or maybe it’s Sunday and they’re returning from church. The sun is setting, and the couple is walking towards it, the two side by side but seemingly separate. I wonder if they realize how beautiful it is outside, with the white of the snow, bark of the trees, bits of green dotting the path like so many puddles.

Though the farm is in the distance, they still can’t see it. Their journey is impossibly long, but they can’t stop to look at the scenery; they just plod on through the mush, the road whose snow is packed down hard by countless wagons and countless feet. His blue coat, and her white bonnet blend in with the view, almost as if they belong no where else but on the road. Spring is coming, but as they walk towards the setting sun, it still feels like winter.

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William Miller Cherry Blossoms

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Jody Tep Untitled

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Lea S. Lopez-Fagin

Ashes to Ashes Mundane structures Human particles Walking bodies Fine dispersions Aimless, timeless, Silent, levitations Ashes to ashes Walking shadows, Drifting particles, Finite molecules Ashes to ashes, Earthling’s treasures, Timeless measures Gone, gone, particles, molecules Mundane, Structures

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Erica G. Jarrett Baptized with Water

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Daniel Rivas Nepal 2

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Bryan Bayles

Untitled Years ago, Before I feared the weight of memory, I watched a frog perch by the river’s edge, His breath fluttering, seat firm, In love with mud.

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Betty Alajajian Friedrich Wilderness Park 18

Laura Collins Theisz Dahlia 3

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Cynthia Purcell

I Watched My Parents Dance Today I watched my parents dance today, Not with the steps of newlyweds, But with the grace and flow of longtime love...

Steps practiced over time in the dance of life.

I watched my parents dance today, As one supported the other; too weak to walk.

Their movements - tender and slow To music of hope, sadness, loss.

I watched my parents dance today As one clung to the other; feet unable to move.

Yet, somehow in the movement – Somewhere in the struggle, came Beauty.

As I watched my parents dance today, I saw Love.

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Bryan Bayles Flight

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Rene Renteria

Climbing Apparent Dome She’s asking how my summer's spent.

Blame Graco, Evenflo, And, "Everywhere that Mary went, the lamb was sure to go," For fading lists of climbs unclimbed, Summits gone untrodden.

Life’s milky bibs, stuffed rabbits slimed, Huggies smelly sodden.

Twelve months of sleepy dawns gone by That granodiorite, Marmot nooks o'er which ravens fly, Echoed cries in the night.

Quartz-nicked gear strewn on the rug That filled my pack once, tight, Became blocks, rings, and squishy bugs For him to shake and bite.

How lonely is the coiled rope!

These bitter, misplaced draws!

Their Siren song, their biting tropes, Mutes by cooing in-laws.

Friends gape, "All's lost!", lament Red-lacquered summer's sun, But for the happy parent now Youth must withstand the young.

Oh, laugh that sparkles, wonderment, Watch eyes and smile grow wide!

Read, "Everywhere that Alex went, His dad was by his side," Until he must be on his own, And we're the ones who cried.

Wax-dipped wings, rising thermals, sun, Like domes we must abide.

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Cristy Garcia

Sand in Small Hands What a cruel trick Life plays to enter the world, Virgin to all War, plague, fumes for what looms overhead is but a dream Reminiscent of the old When, suddenly! Made aware we are“How do eyes ever unsee the hurt, How do knowing minds ever unknow the worth, How does a soul remain unstained from this world?�

A solider must wonder for himself, those on foreign land, and all he leaves behind.

For the latter see days without It begs to see that Time is but borrowed It cannot be stolen It is precious and sand between small fingers. . . will land again on Earth until a Single grain becomes valued, in the Eyes of the Beholder, they say.

Only to be again lostBegs the questionHow do knowing mindsknowing of value of time of love of life, ever unknow The Worth so as to Live as if We could forever be Virgin?

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David Baker Blue Swift

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Sheridan Fielding The Last Patient 25

Nameer Kirma

The True Christmas Gift Georgetown wasn’t that far But a drive along I-35!

Dusk yielding a cool Texas night, As winter grayness etched itself about.

Bringing Christmas treats, Fresh pears, wine, and a toddler’s gift, Invited in with delight, We were met with warm greetings And merry smiles with heart.

The den inside Exalted tiny halos and orbs, colorfully, Blissfully dancing alight.

The decorated Christmas tree Stood tall and proud Seemingly, dreamingly, hoisted up By ornate gifts with secrets abound.

Rolling around, the little child, With his beautiful curly golden hair And a throaty, huffy gurgling noise, Reached with his intent-full hands For his round and oddly-shaped toys.

Rolling down his temples Were scars that beheld the past, But the one on his chest, tucked Under his shirt, was invisible to our eyes.

His ears held a secret! Had you called him, He wouldn’t have heard your call.

His lips, intricate and delicate, Showed little signs of the Palate that had once been split apart, A cleft that had been repaired by A surgeon’s delicate hands.

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How difficult it was, his mother said, When he was born, That I couldn’t touch him, Tucked away behind Plexiglas, Under wires and an oxygen mask.

She signed for him that it was time For a diaper change.

Obeying, he stayed on his back, Following with his eyes her expressive fingers Hoisted by motherly eyes Only a few months back, She’d spend with him the nights In his hospital room.

She’d tell his caregivers that he would survive!

Give him a fighting chance!

The surgeries didn’t dampen her spirit Even though they may have weighed on her morale.

Then, one would say, let him be!

It’s best that he should be hospice bound Nay, the mother would respond.

No, she did say, The key for his destiny is not in your hands.

He’s my child!

I’ll do all I can!

In my feeble head, I would ask, Did you not at any time Raise your hands in resignation?

Not once did you cry, I give up!

The question didn’t rise beyond my mind For I saw in textured tangible hues The love between Mother and Child.

Faith is when you throw yourself

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Into the arms of life, armed With love in your heart And mindful intent in your eyes.

Not a question there, Nor doubt!

Not mindless instinct, But rather what makes our human race.

Without it we will collectively die.

As we left, the tired, sleeping little child Snuggled against his mother’s chest, She sitting, in her eyes lived a contented smile.

I patted her shoulder good bye.

This child was truly a gift.

And, in his blessed little heart, She, his mother, Was his true Christmas gift.

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Barry Bridges and Harry Burge

And the Wind Whispers, Mary Distant eyes see as one My pasture sisters sharing beauty sameness The wind whispers Styling gentle waves And I Cry Gale force traffic bend me to thy will Pot my face wave my hair tilt me on my base The wind rages Rule my life And I Die Camera eyes see rare beauty Circumstance luck of birth my median home The wind snarls Twist my hoary head And I Sigh 29

Arti Allam Seattle

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William Miller Daddy’s Shoes

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Matt Jackson

The Clock Tick, tick, tick, tick…the clock in my hospice room asserts a perpetual dominance.

With unrelenting precision, it plays the role of grim reaper, maintaining a constant, audible presence in this small room. Its pale white face blends perfectly with the forlorn tints of the linoleum floor and cheap, cotton draperies. Those draperies separate me from a vibrant, living world of which I am no longer a part. This sickness has cruelly removed me from that brilliant world beyond those draperies and sequestered me here in this purgatory. My attention returns again to the clock, as it always does, and I perform some quick mental calculations to figure out just how many seconds make up the two weeks that the doctors tell me I have remaining. Despite my withered, wasted body, my mind remains sharp and nimbly shuffles and manipulates the figures, “Sixty seconds in a minute multiplied by sixty minutes in an hour again by twenty four hours in a day…” I am neither surprised nor horrified to learn that I have approximately 1,209,600 seconds left according to the cold science of modern healthcare. That damn clock will taunt and remind me as each of those seconds erode and slip away. One million more vicious ticks before I succumb to a disease I can’t even pronounce and doctors won’t even explain. Science has never been my strong suit. I was always a numbers guy: fact and figures, math, equations, debits, and credits. Six months ago, I lived the life of a successful accountant with some of the wealthiest clients in town. Business poured in, my IRA continued to grow, and I began to consider retirement to the Bahamas. But that was all before the disease struck, and I realize none of it matters now. As I drift off into a tortured sleep, the clock reminds me that my ultimate account balance is steadily reaching zero.

Tick, tick, tick…I’m not sure what woke me up; the clock or the nurse clumsily removing another tray of food that I did not eat. As she leaves the room, she looks back at me with an expression of forced pity. Despite its contrived nature, it’s the most human response I’ve received since my arrival here. The nurses, doctors, and orderlies here all seem immune to death, as if it were a tired re-run of an old sitcom they have seen so many times already.

Nurses record my vitals twice a day without any hint of a smile or personality. Each morning,

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a physician comes in to read my chart, usually frowns, and promptly leaves with perhaps a forced pat to the blankets covering my withered legs. Once in a while, an orderly will come by to blandly ask if the air conditioning is comfortable. Without family or any real friends to come by and visit, I feel alone on this island of death. Alone with the robots and mannequins that deliver my healthcare and try to prolong the inevitable.

Tick, tick…I wish I could tear that sneering clock off the wall but I do not posses the energy to rise or even throw something at it. As I lay here in disgust, another doctor enters. I prepare myself for the same boring routine, but something is different about this one. Seeking eye contact from the moment he enters my room, he flashes a smile that seems remarkably genuine. I can’t help but return the simple, yet rare gesture. Instead of hastily rushing to the chair in the corner, he walks across the room and pulls back those dismal draperies, flooding the room with golden, natural sunlight. He then asks permission to take a seat on my bed. I grant the request and he introduces himself as he sits down. He tells me he just started at this hospice center and it’s his first day on the job. He makes a joke at his expense and we both laugh. The first time I can remember laughing in weeks. While perusing my chart, we make small talk about accounting and baseball. On the third page of my chart, he finds a blood test done last week that somebody had forgotten to properly review. Concerned, he admits that I’m low in some sort of vitamin that can help combat my depression. He prepares to go issue an order for an injection and remedy this deficiency. As silence returns on his way out the door, I express my disgust with being left alone again with that vociferous clock.

Knowingly, he reaches up toward the timepiece and removes the batteries from the back.

We share a smile as he tosses that miserable machine into the wastebasket.

Tick…I awaken, horrified at the sound of what I believe to be that haunting clock.

Yet, I’m relieved to realize that the wall is still empty and the sound was only the opening of the door as my new physician from the day prior comes to check on me. I have felt much better since he ordered that last injection. He takes the time to patiently explain why the vitamin worked so well. My body is so incredibly sick that it fails to produce not just muscles and nerves, but also chemicals necessary for the proper orientation of my psyche. The simple

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vitamin, the exact name of which I cannot recall, helped restore my brain chemistry to a certain positive energy that I have not felt since before the diagnosis. It is difficult for me to articulate the exact nature of this peaceful feeling. Optimism is not the word, I still feel as though that is impossible in the face of my impending demise, but I have come to grips with my plight. I am beginning to develop a certain acceptance.

Perhaps not unlike the legendary Samurai felt in ancient Japan before seeking what they termed an honorable death. Instead of regressing into a bitter attitude of loathing and self-pity, I make a conscious decision to celebrate life instead of abandon it.

My doctor has a TV rolled in and, although he can only spend twenty minutes with me, we cheer and watch the Olympics together. After some contemplation, I realize that perhaps it was not just the vitamin injection that improved my spirits but also the manner with which it was administered.

With genuine concern and upbeat compassion,

that physician shed radiant light onto my darkest hour. When my time was running out, it only took his small prescription of human goodwill to turn back the clock.

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Bryan Bayles Study in Charcoal

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2009 • Volume II