Connective Tissue 2014 by Center for Medical Humanities & Ethics

Connective Tissue Art and Literature Journal of the UT Health Science Center at San Antonio

2014 w Volume VII

Submit your art and literature for consideration in the 2015 journal to ConnectiveTissueJournal@gmail.com For entry guidelines, to view past journals, and for more information about joining a committee, visit http://www.texashumanities.org/connective_tissue

Connective Tissue 2014 w Volume VII

Faculty Advisers Ruth Berggren, MD Lee Robinson, JD Jerald Winakur, MD

Editor-in-Chief Amanda E. Lipsitt

Literature Chief Editor Chris Yan

Junior Editor Jane Yoon

Committee Members Abby Coldren Suzanne Davis Danish Jaffer

Myra Liu Stephanie Lynch

Andrew Mark Jason Rocha Sarah Yang

Visual Arts and Photography Chief Editor Whitley Aamodt Committee Members Stephanie Acosta Arielle Ferris Jacob Ferris Maggie Gainer

Michael Herzik Myra Liu Stephanie Lynch Melody Munoz

Mark Paulick Jason Rocha David Rodriguez Sarah Yang

The faculty, staff, and students of the UT Health Science Center at San Antonio are one body with one common mission: â&#x20AC;&#x153;We make lives better.â&#x20AC;? Yet we often seem individual, separated by different specialties. This journal aims to provide the fiber that binds us; to draw out and reunite all the artistic and literary minds of our community; to bring together all fields of health care and science with one Connective Tissue. We express our sincerest gratitude to those who constantly encourage us and provide the opportunities and inspiration that ultimately lead to the development of this journal. Thank you to those who came before us and began this saga, and to those who continue to support us and provide us with the means to keep Connective Tissue going year after year. Special thanks to the Center for Medical Humanities & Ethics for making this journal possible; to Jerald Winakur and Lee Robinson for their inspiring ideas and moral support; to Sheila Hotchkin for her amazing editing skills; to the editors and committee members who gave the gift of their time to help create this yearâ&#x20AC;&#x2122;s journal; and to all of the authors and artists who provided the most important part of all. Thank you all for adding your life and passion into Connective Tissue! For more information, including past issues and details on how to submit your own original and unpublished work, please visit our website: http://www.texashumanities.org/connective_tissue **The works published in this journal were selected based on their artistic and literary merit and do not reflect the personal views of the UT Health Science Center San Antonio, the Center for Medical Humanities & Ethics or the editorial staff. Front Cover: Kim Vogelsang Visual Arts and Photography Category Winner You Will (Not) Escape

Back Cover: James Liu Milky Way

Contents Jessica Hollingsworth Bookworm .................................................................................................................................... 1 Abbie Sabrina Ornelas RANGOLI ..................................................................................................................................... 2 Danish Jaffer Untitled ......................................................................................................................................... 3 Colleen E. Boehme In Ice and Snow ........................................................................................................................... 4 Nathalie Kolandjian Untitled ..................................................................................................................................... .... 5 Thomas Bosen La Recoleta .................................................................................................................................. 6 Shannon Baldwin The Bus People ............................................................................................................................. 7 Caitlin Fearing Deep in the Heart of Texas .................................................................................................... 10 Veronica Bove Kick It in the Sticks.................................................................................................................... 11 Eduardo D. Flores, MD Wasteland ................................................................................................................................ 12 David Baker Rio Grande Telemetry .............................................................................................................. 13 Kim Vogelsang Paternalism ............................................................................................................................... 14 Susan Seale Jarvis, JD Quid Pro Quo .......................................................................................................................... 15 James Liu Jellyfish ...................................................................................................................................... 19 Krista Young Clinic No More ......................................................................................................................... 20 Weiran Wu, MD, PhD Reviving ..................................................................................................................................... 20

Jason Rocha Lost ......................................................................................................................................... .... 21 Patricia I. Wathen, MD The Trumpet Player .................................................................................................................. 22 Calen Kucera Untitled ...................................................................................................................................... 23 Kristopher R. Koch Baile de la Anatomía ............................................................................................................... 24 Angeline Mariani Gross Origami........................................................................................................................... 25 Whitney Haseman El Maestrito Con Su Librito .................................................................................................... 26 Sonal Sathe Visually Impaired ..................................................................................................................... 27 Myra Liu We Will Never Forget ............................................................................................................ 30 Alexander Bullen Clarke, MD “My Name is Esperanza- Hope” ............................................................................................ 31 Abbie Sabrina Ornelas Marina Beach............................................................................................................................ 33 Austin T. Smith Portland Head Light ................................................................................................................. 34 Colleen E. Boehme The Silver Ship .......................................................................................................................... 35 Patricia I. Wathen, MD Zilker Park ................................................................................................................................ 36 Caitlin Fearing Untitled ...................................................................................................................................... 37 Colleen E. Boehme In the North................................................................................................................................ 38 Elizabeth Allen Patient Lesson ........................................................................................................................... 40 Lanna Little Glowing Sanctuary .................................................................................................................. 41

Monica Pi帽贸n A Perfect Day at Sunset .......................................................................................................... Jacob Ferris 36 Views ................................................................................................................................... Joanne Wright Cereus Night-Blooming Cactus .............................................................................................. Philip Valente, MD An Ode To Dandruff................................................................................................................. Taddy McAllister To Jump ..................................................................................................................................... Veronica Bove Sweet Nature ............................................................................................................................ Featured Artist: Jon Karl Dawson Holly Heinz and Bryson Brooks Portrait ...................................................................................................................................... Jon Karl Dawson View From Bonnet Rock............................................................................................................ Jon Karl Dawson Ballroom De Los Muertos ........................................................................................................ Jon Karl Dawson Glassware ................................................................................................................................. Editor Section Amanda E. Lipsitt, Editor-in-Chief The Face of Trisomy 21 .......................................................................................................... Whitley Aamodt, Chief Visual Arts and Photography Editor Verf Deur Die Aantal............................................................................................................... Jane Yoon, Junior Literature Editor The Crucifixion ......................................................................................................................... Chris Yan, Chief Literature Editor After Midnight on the Obstetrics Ward ...............................................................................

42 43 44 45 46 47

48 49 50 51

52 53 54 55

Jessica Hollingsworth Bookworm

Abbie Sabrina Ornelas RANGOLI 2

Danish Jaffer

Untitled Tell me about yourself, Sarah. “There’s not much to say.” … While David stands in Florence, does he think of Goliath? He is numbered blows with a chisel. Several gaze and analyze. … Tell me about yourself. “I am uninteresting.” Sarah, you are the brushstrokes of a thousand artists: neighbors, friends, acquaintances, strangers, sisters, cousins. Tell me about yourself, Sarah. You moving, talking, feeling figure, You impossible culmination of infinite reasons, You are the most fascinating creation: A manmade moon reflecting countless beams of light. 3

Colleen E. Boehme

In Ice and Snow We were born in ice and snow Where flowers dared not chance to grow We were cut with shards of glass And healing has not come to pass Thus we walk these lonely streets With broken hearts and listless beats Our eyes, now old, do not see much Our battered nerves won’t rouse to touch But I still hear you when you weep And I still see you in my sleep So in my dreams I’ll hold you fast And in your dreams we’ll chase the past Oh there we’ll laugh and there we’ll mend And there I’ll keep you till the end

Nathalie Kolandjian Untitled

Thomas Bosen La Recoleta

Shannon Baldwin Literature Category Honorable Mention

The Bus People The H8 barrels down Rock Creek Church Road like a huge boulder down the side of a mountain. The bus people and I hold on tight to our groceries, our bags, our children. The bus route to my apartment is flanked on both sides by cemeteries. On one side, there is the United States Soldiers’ and Airmen’s Home National Cemetery, perfect rows of pristine white tombstones undulate with the roll of the ground. It is one of only two national cemeteries (the other being Arlington). On Memorial Day, someone took care to stick a small American flag in front of each headstone that lined the perimeter of the acreage. Like flawless teeth, the headstones jut out of the ground marking the end of the road for many of the Union Army as well as some Confederate prisoners of war. Across the street, the Rock Creek Cemetery sprawls across 86 acres of rolling hills. Owned by St. Paul’s Episcopal Church since 1719, the cemetery is one of Washington’s oldest. Unlike its neighbor, Rock Creek Cemetery feels more like a gothic garden than a sterile memorial. Statues, monuments and mausoleums dot the landscape. People visit the graveyard like one would a park. I even went for a jog through the cemetery one afternoon, half expecting the dead to push away their headstones and say, “Hi.” Unlike the underground bodies nearby, the bus people are very much alive. The old gentlemen with fedoras and thick black mustaches wearing long sleeves and corduroys in the summertime, grocery bags in hand, cackle and joke about the Redskins, jobs, and women. Young couples speak softly to each other. Babbling toddlers are glued to their mothers’ legs and hips, squirming. I’m among them. I put my black backpack between my legs and my purse in my lap, my arms folded on top, happy to rest. The bus is usually packed around 7pm, standing room only by the time it picks me up at the corner of 11th and Park. People can get testy when it gets crowded, especially the large, sweaty woman with her walker. She simmers and sighs when a young man is sitting up front in the spot designated for the handicapped, like her. 7

“Son, you need to move back,” the bus driver says, tired. The young man moves to the back, swaying with the motion of the bus. The lady with the walker shuffles to her new seat, feeling triumphant and entitled. Old women with leopard print bags whisper to each other about other bus people, scolding: “If you can’t stand getting bumped into every now and then, it’s time to buy a car.” The H8 is unpredictable, like every bus. Jerks, bumps, and tight turns make riding the bus a lot like riding in a snow globe someone is shaking. Standing while the bus is moving is hard, walking while the bus is moving takes athleticism. During one of the bus’s unexpected halts, a hefty woman walking to her seat is catapulted forward, losing all her balance. She grasps desperately for something to stop her impending fall, eyes wide and crazy. As a reflex, I shoot my hand out to meet hers. Our fingers link. The whole bus holds its breath. The woman braces herself on a pole with her other hand and is able to balance. The bus exhales. I’ve been the faller as much as I’ve been the catcher, maybe more. I’ve gotten used to depending on the firm grip of a stranger’s hand followed by the, “It’s alright, honey.” A very large beanbag of a woman rides the H8. She’s got Amazon height and the width of a chest of drawers. Her skin is dark and shiny, and her little head is topped with short braids that end in beads that clank like a shaken cup of crushed ice when she walks. Every time I see her, a small baby girl is strapped to her chest in a front carrier. The baby’s feet bounce as the woman walks on the bus. It looks as though the straps securing the baby will snap off at any second, catapulting the baby across the bus. The baby has no idea of her place in the world, no idea that her carrier is the largest woman I have ever seen in person, and no control over any of it. All she can do is dangle, head tilted back a bit, and stare wide-eyed and open-mouthed at the woman’s face, which coos and smiles back. My red brick apartment sits at the intersection of Hawaii Avenue and Fort Totten Drive, across the street from weathered brick row houses with worn-out porches lain on by wornout dogs. Mary lives in the apartment next to mine. She also rides the H8 often. Mary sometimes wears a navy blue T-shirt that has, “You are an idiot,” written in Scrabble tiles on the front, except the vowels are missing. Underneath the sentence it says in sassy white scribble, “Do you want to buy a vowel?” Mary could be anywhere from thirty years old to sixty. She is thin, bony, and barely five 8

feet. Lines of cornrows stick to her head and trail down her neck, stopping just before her shoulder blades. The word scrappy comes to mind; she makes me feel safe. Almost every evening, around dusk, she can be found outside the apartment, smoking. Because you have to have a key to get into the main hallway of our building from the outside, Mary uses her red lighter to keep the door wedged open while she exhales smoke wisps into the humid air. “Too damn hot,” Mary barks, cigarette lit, each night when I come home from work and pass her while going inside. Sometimes her grandkids are with her, and her woman friend, too. Tonight we all got off the H8 together: Mary, her woman friend, her three young grandkids - two boys and a girl all around six years old, and I. Their hair is twisted into knots, just like Mary’s, ending in black and white beads that clack as they run off the bus. It is about to storm, lightning cuts the sky open while distant thunder grumbles after. We all walk together across the street to the apartments. “Yeah, looks like rain. Any minute now,” Mary predicts. “Looks like we just made it in.” The kids flit in front of us. Mary carries grocery bags full of sugary cereal, mac-and-cheese, and soups. I unlock the main door for us and we all file inside and climb the flight of stairs to our shared landing. “You live here?” the girl asks. Her white T-shirt was long on her and her blue jean shorts baggy. “Yep, I do,” I reply. I unlock my door and step inside. The little girl takes a step forward into my apartment and her eyes survey the space and then lock back on mine. She has wide eyes. Mary barks for the girl to let me be and get out of my apartment. We all say good night and I close my door. My heart is full.

Caitlin Fearing Deep in the Heart of Texas

Veronica Bove Kick It in the Sticks

Eduardo D. Flores, MD

Wasteland There is a vast wasteland One does not need to travel far Those visiting and things left there May never be seen Nor heard from again It grows and looms larger daily As though alive One cannot work there But only visit until weary It is my desk.

David Baker Rio Grande Telemetry 13

Kim Vogelsang Paternalism 14

Susan Seale Jarvis, JD Literature Category Winner

Quid Pro Quo Quid Pro Quo: “Something for something.” Black’s Law Dictionary The cell phone rings, right on time. The calling number may be blocked but the caller’s ID is no mystery. Answer the call and the game begins; the stakes are high. Agree to the terms and the coveted position is assured; renounce the terms and the chief resident’s professional career takes a nosedive. Dr. Bernard Hayes, the caller and chief of surgery, holds the power to control his future and Mark Jacobs knows it. “Mark, my boy, just calling to tell you what a fine job you did assisting me this morning. Strengthens my inclination to recommend you for that position you applied for. No doubt you will fit right in at one of the best clinics in the country—can’t get much better than that. You do a good job for me, and I do the same for you. I think the lawyers call it ‘quid pro quo.’ Anyway, we need to talk.” Mark reads between the lines. Keep quiet about this morning in the OR and the chief will assure him the position he wants. Report the incident, and he’ll be blackballed from every decent clinic in the country. “I’ll keep your message in mind, sir. If you’ll excuse me, my beeper’s going off. I’m still on call. I’ll have to call you back later.” Mark’s way of buying time. In another month he’ll be out of here, away from the city teaching hospital, away from the complex cases the inner city patients present, away from what happened this morning. Why should Mark get involved? What difference will it make in the long run? This morning’s patient was a 17-year-old male with a gunshot wound to the abdomen, the result of an early-morning shooting in one of the projects. The bullet was lodged near the patient’s heart. Dr. Hayes was the attending on call and Mark was to assist. The first thing Mark noticed when the chief came in to scrub was the disheveled appearance. Quite a contrast to the usual GQ demeanor. The odor of breath mints permeated the air. The boisterous voice was unlike the usual smooth tones of speech: 15

“Why don’t they all just go out, kill each other off and get it over with? This one will probably be back within the year, depleting our blood bank again. Or next time he may be the one pulling the trigger. What a waste of time and resources. I should be out of here and on the golf course by now.” Out-of-character patient analysis from the chief. Mark was relieved to see Marion Brown, one of the most experienced and respected OR nurses in the hospital, standing beside the prepped patient. She brought no patient biases to the OR. As the chief made the initial incision, Mark noticed the slight tremor in the right hand. A raised eyebrow told him Marion noticed it too. By the time the surgeon was ready to reach in and remove the bullet, the tremor was constant. One slip and the patient would bleed out. Mark spoke up. “Dr. Hayes, I really could use the experience in this sort of procedure. Would you mind, sir, if I take it from here?” The reply was pompous, in contrast to the chief’s former respectful attitude toward residents: “Be my guest, Doctor. Always like to let you young physicians get the practice. Just remember I’m here to guide you. Nothing can replace experience, you know, and I’m the best.” Twenty minutes later the bullet was safely out, the wound sutured and the patient on his way to the recovery room. One catastrophe avoided. Why initiate another? One phone call and there is no turning back. Statements would be taken from Mark, Marion and all the others in the OR. No doubt the chief would call in a powerhouse attorney and bring a defamation suit against the chief resident. Mark looks at the hospital handbook of operating procedures again. The language is clear: all faculty, staff and residents have a duty to report concerns about possible impairment in themselves or others to the proper authority. Sounds noble, but why open up a can of worms? The patients the chief treats are mainly from the inner city, many busy terrorizing and shooting up their neighborhoods. No future Nobel or Pulitzer candidates in the lot of them. Sure, the chief resident knows the principles of medical ethics include nonmaleficence (do no harm to others) and justice (do what is right and fair), but why should he, Dr. Mark Jacobs, risk his own future career for these welfare patients? Why shouldn’t he 16

move on to a clinic renowned for both its patient care and its research? Think of all the good work he can do there, all the lives his future research may save. Stay quiet and the new position is his. Speak up and his entire professional future is in jeopardy. Which call will he make? A call to the chief can assure a lucrative future, a call to the head of the Residency Program and who knows the future? The phone call is short. Mark agrees to meet with the Residency Program Director with a summary of the facts. No turning back now. Later in the day the charge nurse on the surgery floor approaches: “Excuse me, Dr. Jacobs. Mrs. Ryder, the mother of the young man operated on this morning, is asking to see one of his doctors. It seems no one came out to speak with her after the procedure. She’s in her son’s room.” No surprise here. This isn’t the first time the chief has recently failed to talk to family members after a procedure. Always says he has more pressing matters and asks an assistant to take care of it for him. Only today he didn’t bother to ask Mark to take care of the task. “No problem. I’ll go up and see Mrs. Ryder now. Thanks for telling me.” Mark heads toward the patient’s room. His knock is answered by a soft-spoken voice. A small middle-aged woman opens the door. “Come in, please. You must be Dr. Hayes. Somehow I missed seeing you after Derek’s surgery this morning. I’m so sorry, but thank you for coming. I’m Cora Ryder, Derek’s mother.” Mark takes the small, calloused hand she extends. A name tag on her black dress identifies her as a maid at a nearby hotel. “I just wanted to thank you for saving my boy’s life. I heard the nurses talking about what a challenge it was to remove the bullet. You must have one of the steadiest hands around.” Mark looks at the tired face, noting the pallor from too much time spent inside the pricey hotel, scrubbing toilets and mopping floors. “Thank you, Mrs. Ryder; I will pass your kind words on to Dr. Hayes. I’m Dr. Mark Jacobs, the resident who assisted Dr. Hayes this morning.” “Well, I’m sure all of you in the OR get credit for saving my boy. As soon as he’s able to leave here, he’ll be staying with my sister in the country until fall. Then he’ll be entering his program. I just want to keep him away from the old neighborhood, away from the gangs until then.” 17

“Program, Mrs. Ryder?” Mark assumes it’s some type of rehab facility--drug or anger management. He remembers one of the local judges has been sending first offenders into special programs instead of incarcerating them. Relieves a little of the overcrowding in all the penal system. “Oh, I’m sorry, Doctor. No way you could you know about Derek’s plans. He just graduated from the local magnet school for the arts and has been accepted to Juilliard to study piano in the fall. Thank goodness the bullet didn’t come near his hands. He says his hands are his future. I suspect you doctors feel the same way about your hands.” Mark looks toward the bed. The patient’s hands lie still on either side of the lanky frame. Long slender fingers, an artist’s fingers. The picture doesn’t add up. A talented, ambitious young pianist with a proud, hard-working mother ends up nearly dying in a gang war? What’s missing in the puzzle? “Mrs. Ryder, I’m puzzled why Derek was mixed up in this shooting. The gang members don’t seem like the type of young men someone with Derek’s future would choose as companions. The mother frowns, “Oh, Doctor, you misunderstood. Derek isn’t a gang member. He was shot when he ran out to pull a neighbor’s three-year-old boy to safety. The child was chasing a ball right into the line of fire. The police are so impressed they are talking about some sort of award for Derek. Can you imagine that?” Mark can easily imagine Derek receiving the award. Just as he can imagine what can happen the next time an impaired chief of surgery goes into the OR and no competent physician is around to take over and complete a procedure. The cell phone rings. The calling number is from the head of the residency program. “Dr. Jacobs, just wanted to update you. Dr. Hayes has requested medical leave to enter a rehab program. Said he was actually relieved to learn you had filed that incident report with us. He knew he had been on a downhill spiral since his wife’s death but just couldn’t face the truth. Praised you for having the courage to risk having your own career derailed in order to protect the patients. ` “Also said he was sending a strong letter of recommendation for your clinical appointment before he leaves. The last thing he said was quite puzzling—think he was a little confused by then. Something about a ‘quid pro’quo’, whatever the heck that is.”

James Liu Jellyfish 19

Weiran Wu, MD, PhD

Reviving Cherry blossoms vanish before a chance to appreciate, Gone with the wind without sighs for the lost. Just missing a prelude to the vernal season, More buds stretching and more roots crawling. Unwithered youth reappears after a decade to initiate, Comes with the spring without signs of the mist. Just dancing a finale for the eternal reason, More hues moistening and more stars twinkling. As if on blurry windows, uninvited strangers are knocking, Moody jitters flickering, belie your serene minds To ditch the moment and retrieve the goal. As if through willow twigs, tranquil moonlight is piercing, Curly lashes blinking, unveil your crystal eyes To touch the heart and revive the soul.

Jason Rocha

Lost I was Lost. Torn between shame and stardom, past and future, Absent in the present. Lost, until I found you nestled in the nebula obscured by the black hole. It was you waiting to be seen, waiting to be made whole. Like an infant discovering his hands it was a silent surprise to realize you were there all along. If only you had a voice, if only I had ears… We could have met sooner, combined our strengths, and become one with the universe. At last, we have clashed in a spontaneous dance, exhausting our enthalpy and tempering our romance. We were meant for each other like light and absorbance, waves and resonance. Now that you—my spark—have been found Life will fulminate and resound.

Krista Young Visual Arts and Photography Category Honorable Mention Clinic No More

Patricia I Wathen, MD

The Trumpet Player for my son The young man sees the storm clouds crouched on the horizon. He lays his trumpet down; he knows his notes cannot punch through. But the old man knows the song is in the striving. The climbing up and falling back. Until one note, pure and yearning, finds the smallest crack and makes it through. It rises, expands and rises and fills the space above.

Calen Kucera Untitled

Kristopher R. Koch

Baile de la Anatomía You know you’ve been studying anatomy too long when you’re dancing and you don’t see the shoulder of the couple next to you. Instead, you see the supra and infraspinatus running parallel along the spine of the scapula. Underneath you can envision the circumflex and suprascapular arteries anatomosing as the suprascapular artery runs over the notch and the nerve goes under. As I look at my partner I subtly notice the nerve conductions traveling down the brachial plexus through the trunks and cords to the median nerve, contracting her flexor digitorum superficialis as her fingers and thumb wrap around mine in a perfect mold. You can’t help it, but you do more than feel the tango. As you take a step to the side before initiating a backward ocho, you feel your leg abduct, but you know it’s more than that. Your tensor fascia latae contracts, pulling up on the illotibial band while the adductors in your thigh give way. You push against your partner, but you’re not pushing against her. Rather, you are pushing against the extended triceps and forearm extensors, trying not to push them over, but to meet them with an equal, yet opposite force. As you dip her, her latissimus dorsi and triceps prevent her from falling and keeping her hanging in a delicate, yet perfect equilibrium. Whether I dance to the rhythm of the violin in this tango, or the clave in my salsa, I am amazed. Amazed at the complexity, yet the simplicity of the human wiring that allows me to not only be connected to the human experience, but to express the artistic wishes of my soul as I dance this night away.

Angeline Mariani Gross Origami

Whitney Haseman El Maestrito Con Su Librito

Sonal Sathe

Visually Impaired “Congenital glaucoma” Words I’m all too familiar with A file the size of my dresser drawer Lying around somewhere in the eye care clinic, Complete with all the exams I’ve had since being diagnosed with it “You see the arch connecting the tubes? You see she cannot see past the big E with that eye.” I wonder, Can’t you see that other stronger one of mine? In elementary school, teachers were oblivious. Most noticed nothing different “Why can’t you do gymnastics? Get on the mat,” the PE teacher demanded. Classmates did not at all understand it “It just means she can’t wear mascara.” “She should stop reading so much; that’s why her eyes are bad.” I was born with this, you know, and I’m smarter because of books, you cad… High school and college reactions varied Most clueless, others sympathetic, some merry, like: “Sweet! You’ve got it made! You have an excuse to be stoned all day!” But I see other things to do with my time Though contact sports, gymnastics, tap dance, and woodwind instruments I am denied, I can still do a little Zumba and ballet And this disease doesn’t stop me from going through my day I will get my master’s degree I will achieve the most I can In all the aspects of my life Despite my babyhood being full of strife 27

Eight surgeries, 19 EUAs, and countless pressure checks Have enabled me to lead the life I do I inform others each January via flyer And presentation, so awareness, and not eye pressure, is higher Astigmatic and amblyopic OS I may present But look again, all of you, and you shall see me From the Florida shores to the big Texas sky And even though sometimes I ask, “Why?” I try not to do so often, For I have much to be thankful for The Internet, healthy family, friends near and far And that my condition does not prevent me driving a car Nor reading, usually, and never needing Braille Nor using the computer And iPhone, many, many times daily, That I am 20/20 with glasses OD That I need no guide dog, nor white cane That I have had good care thus far That I can now raise my voice Against the illness, and make it a choice To live my life as I know I deserve— Fully, and without trepidation That my eye problem will in any way hamper me I am not deterred so easily Yes, I’m labeled “visually impaired” But when that is said, I have to wonder Whether those who are supposedly with normal sight Really see themselves and life in the proper light Those who have a disability one way or another Are so often thought to be “down and out” 28

But give us “broken ones” more than a passing glance Look at your own faults, and give us a chance None of us are invincible All have different challenges So before you slap on a “special needs” label Ask yourself in what ways you’re disabled And when you’ve done that, come to us again Learn what our needs are and do your best to accommodate Then step back and see what we can do Whether or not we have perfect sight OU Do not pity us; we are who we are We will learn, like you, to find our way in this world All of us have our vision, our skills and our view We see possibilities, not limitations, coming from it and from you And, as for me, How can I miss or acknowledge what I cannot see?

Myra Liu We Will Never Forget

Alexander Bullen Clarke, MD

“My Name is Esperanza- Hope” Her eyes remained glued to the screen of her favorite telenovela, the Achilles’ heel of Mexican women, until the commercial break when she would acknowledge my presence with a courteous “Buenos días, doctor.” Glancing through the laboratory data I had analyzed outside of room 403, I realized the new tenant’s condition was far from better. Señora Esperanza had lived a hard life, her tired eyes, wrinkled hands, and slightly bent back attested to that—such frailty. It was sad to think she might not live to finish her telenovela. Just one month before I had seen her for acute pancreatitis. At that time, she was undergoing a workup for a mass developing on the side of her neck – highly suspicious for cancer. Señora Esperanza met with a consultant and discussed her treatment options. To this day, I cannot forgive myself for remaining quiet as I listened to an absurd recommendation- begin chemotherapy immediately. I have no doubt in my mind that she did not truly understand all it encompassed, I am sure she did not envision the quick downward spiral into the purgatory of chemotherapy for an infinitesimal chance of recovery. But as the unwritten intern code dictates, I kept my head down in reverence to the veteran consultants. The daughter would surely say something—but she did not. Here was no hope for Señora Esperanza at her age and frailty for chemotherapy to be successful; she was given a false safety net, sold the fairy tale that medicine was the only alternative. What about quality of life? Shortly after receiving the first session of chemotherapy she had to be hospitalized. Profound weakness and intractable nausea and vomiting took a toll-she was pancytopenic. Though her heart kept beating, she was unable to talk to her loving family, take care of her curious grandkids, feed herself, or even watch her telenovela. Her spirit had left her and a vacuous vessel took its place. Two days later, an ominous page blared the message “911” … for room 403. Señora Esperanza had coded and the admitting physicians were nowhere to be found; the intern was the last resort and first responder. No amount of epinephrine in the world could bring her back. Compressions over and over again-to no avail. Her delicate body did not resist the chemotherapy piercing her body in a million atoms. The next day resumed as normal, no one cared that “one more patient” had died; it felt as if the only one who cared was me. Yet I did not do anything about it when I had the chance, the guilt was unbearable. I failed to be an advocate for my patient. As life

would have it, I was given a second chance to right my wrong… One week later. “This… this can’t be happening to me, I’m only 34!” Maria’s tears pierced the blue sheet in her hands as they began to drop incessantly from her brown melancholic eyes. She too received the news she never thought she would hear. Her husband embraced her while she looked to the window in hopelessness, as if wanting to escape through its small orifice. I simply stood there in uncomfortable silent minutes, my right hand shaking while holding a cheap plastic clipboard. I did not know what to do. All I had learned about delivering bad news had not prepared me for this moment. Maria’s sobs disrupted the hushed busywork of the hospital halls, awakening in us desperation, hopelessness—defeat. Maria had visited her primary care physician on several occasions over an uncomfortable constipation lasting for weeks on end and generalized abdominal discomfort; but although she returned frequently with the same complaint, more laxatives were prescribed, and Maria was sent on her way home as she silently died unbeknownst to all. The 15x35cm mass stunned the medical staff, how could we not have known? I was not yet prepared for what came next, Maria asked: “What do you recommend that I do?” She looked at me, not the consultant. Responding in the way I wish I had with Señora Esperanza, I mustered the confidence to reply, “The choice is yours, but if you decide to receive treatment, be aware that these are the risks and benefits...For one...” I stayed with her until her last question was answered. Maria had a higher probability of surviving; she was still young and she could undergo surgery and chemotherapy. I genuinely thought she would make it. “I would rather leave this world the same person my husband, my three children, and my friends have known- not a beat-down shadow of what I once was.” I was stunned and could not fathom why such a young woman would only opt for comfort measures. To be honest, I had wished for her to try, but I had to step back and realize that I do not dictate my patients lives—I can only advise, ensure they receive unbiased information to aid their decision. Unmatched is the gratification of knowing she is content with her choice and I had the immense privilege to serve as a vehicle through which she was able to make that intelligent choice on her own. I understood that the sometimes esoteric, elusive, and unfortunately forgotten concept of autonomy meant more than merely allowing the patients to make their own decisions, but rather, making decisions once they understood at their level of knowledge what a certain treatment entails and the other alternatives at their disposal.

Abbie Sabrina Ornelas Marina Beach

Austin T. Smith Portland Head Light 34

Colleen E. Boehme

The Silver Ship It was upon a bright white beach With morning daybreak just in view That I kissed and held you close And said my last goodbye to you I put you on the Silver Ship And watched it sail into the rain Far beyond this old, worn land Where I was bound to still remain And many days indeed have passed My face has greatly bent and changed But if you would not know me now I’ll still know you; you’ll be the same I’ve worked hard labor dawn to dusk And day by day I’m growing old A once sharp, young and ready mind Is dropping all it used to hold So I’ve played this game with Time, to try to keep a place for you But the game is growing harder now, and soon I know he’s going to win For nothing else but Final Loss Can find for me white shores again Again, there is a breaking dawn And all my fear is passing now For the Silver Ship makes haste my way And can I see you at its bow!

Patricia I Wathen, MD

Zilker Park This is not the trail that I remember. The junipers split the rocks. Their bark hangs down like streaming tears. The ash trees are bent double, pained survivors of unnumbered floods. In the distance I hear hammer falls, and then a bell tolling. I know now these are portents. The last time I walked this trail, I was pregnant. I was married. How then was I to know that the distilled essence of wisdom is simply letting go.

Caitlin Fearing Untitled

Colleen E. Boehme

In the North I lived in the North when I was young When it was cold. I kept hope in my pockets Bread rolls too And tried out living life in a protracted lull. The trees were losing their leaves I sat beneath them. I stared up at the mess of orange and red and brown And watched as it all fell over me. Sometimes I walked the quiet street with all the centuries-old historical houses With all the people dressed in costumes -A lovely and deliberate anachronism that delighted the tourists. I was quite alone when I walked. I looked in I wandered in I made idle conversation. But all the time I was out Until one day I just leftâ&#x20AC;Ś I came back to you. Only you werenâ&#x20AC;&#x2122;t you anymore. There was just a body--sick and diseased 38

And yellowed flesh. And yellowed eyes. And yellowed blood That tasted sour, and stung my throat. There was a stomach that grew bigger and bigger And limbs that grew smaller and smaller. And some bones that shone through a near-translucent skin. Then one day the stomach finally exploded And everything else disappeared. And all of this was years ago And still I am here. Sometimes Iâ&#x20AC;&#x2122;m sure I will forget you But I will not go North again.

Elizabeth Allen

Patient Lesson “The time I got my stomach taken out, I was at the hospital in a shared room. The doctor, a resident, came to take out my staples. My roommate was getting potassium and that really hurts, and they weren’t doing anything to help her. They could have added saline and it would hurt less, but that would slow it down. I could hear her crying on the other side of the room, and I started crying. “The doctor laughed and said that didn’t even hurt; he hadn’t even started yet. I said, ‘No, that’s not why I’m crying, can’t you hear her?’ Then he got real quiet and just kept working. When he was done I said, ‘Can I go now?’ And he said yes, and I went over to comfort her.”

Lanna Little Glowing Sanctuary

Monica Pi帽贸n A Perfect Day at Sunset

Jacob Ferris 36 Views

Joanne Wright Cereus Night-Blooming Cactus

Philip Valente, MD

An Ode To Dandruff Why is dandruff so maligned? Uncleanlinessâ&#x20AC;&#x2122; telltale sign? Why not a cause for celebration Of our nonstop regeneration? If skin and scalp refused to shed, You would no doubt be very dead. Be thankful that youâ&#x20AC;&#x2122;re making scales, And Head & Shoulders making sales. So when you catch a flake on your lapel, Brush it off but bid a fond farewell.

Taddy McAllister This poem was written on September 13th, 2001 in almost a paralysis of grief following the terrorist attacks two days before. It is dedicated to all the people who jumped out of the World Trade Center. To Jump The halls are blocked, the floor is hot, Dark and dust the sudden landscape. Crawling from their desks they look for holes and Find none. They draw themselves a line Before which is infinity. Their minds step over the line in a White wave of wonder, agreeing to Their fates more easily than if there Had been a decision to be made. Now, fire lapping at their backs they Think of pets unfed and love unsaid. Pushed by gusts of heat they dance on Sills too hot. They hug and make their choices To trust the air, the summer sky. A skirt, a shirttail, the pennant of a Tie waft first like leaves then plummet. Hearts of fear gain light and fly, then Stop before they break.

Veronica Bove Sweet Nature

Featured Artist: Jon Karl Dawson San Antonio artist Jon Dawson was fond of entertaining innumerable friends and acquaintances with a tall tale about being born in a bathtub during a Texas tornado. This tendency to embellish, to make life’s narratives more vivid and colorful, to push the limits of credibility for the sake of fun, is highly evident in Jon’s art. He began formal instruction in oil painting at age 7, and was constantly involved in art projects throughout his early education. He explored a variety of media, including photography, sculpting, performance art and videography, attending Texas Tech University for three years as a design major. In the mid1980s, Jon moved to San Antonio and added jewelry design to his ever-expanding artistic repertoire. He met his life partner, Lionel, in 1995; they lived together until Jon’s untimely death in 2013. Jon’s long battle with illness was largely fought in the outpatient clinics of University Health System. He was universally loved by the doctors, nurses and medical students, on whom he lavished his whimsical humor. His work was primarily shown at San Angel FolkArt Gallery at the Blue Star Arts Complex in the historic King William District. Gallery owner Hank Lee, who sold Jon’s art for 15 years, remained fascinated with the ever-changing media Jon chose to express his view of the world. -Contributed by Ruth Berggren, MD, and Lionel Lollar

Portrait of Jon Karl Dawson (left) with domestic partner of 18 years Lionel L. Lollar (right) Portrait by Holly Heinz and Bryson Brooks

Jon Karl Dawson View From Bonnet Rock (Photo by Marisol MacĂas) 49

Jon Karl Dawson Ballroom De Los Muertos (Photo by Marisol MacĂas) 50

Jon Karl Dawson Glassware (Photo by Marisol MacĂas)

Editorsâ&#x20AC;&#x2122; Section

Amanda E. Lipsitt, Editor-in-Chief The Face of Trisomy 21 52

Whitley Aamodt, Chief Visual Arts and Photography Editor Verf Deur Die Aantal 53

Jane Yoon, Junior Literature Editor The Crucifixion 54

Chris Yan, Chief Literature Editor

After Midnight on the Obstetrics Ward She lost the baby. That was the first story. But then the second telling, around the coffee creamer in the break room, involved a good deal of bleeding: A woman standing in the hallway, screaming. This baby was coming. Then more pieces—she was a heroin user, someone who reeked of garbage and waterlogged flesh, who stood crying in the hallway while we were behind veils measuring bellies, looking for heart tones, asking other women things like “Is this your first baby?” While we trafficked from room to room, passing bellies from care to care, she stumbled in, bleeding from the crotch, yelling for a bed and someone to catch. And finally, the last bit that a team of four students and three doctors gathered from the shards of her broken story—that she had gone to “a clinic” earlier that day, told them to get rid of it. Pills, maybe. So that he came out whole, 20-week limbs grappling with invisible hands that had already let him go. She never named him. The stories materialize slowly, a trickle of details alternating between taut bellies and nervous fathers. Then the night staggers on, jobs checked off and funneled onward. Membrane. Fetus. Fluid. Check. Check. Check. Here is the part nobody tells, about the team that came for the last job: Catch him. Hold him. Hold him close until he dies.