Connective Tissue 2017

LITERATURE & VISUAL ARTS JOURNAL

VOLUME X • 2017

Cover Art

“McDonald Observatory� by Jayme Trevino see page 64

For entry guidelines, to view past journals, and for more information about joining a committee visit: https://www.texashumanities.org/connective_tissue Contact the CT Editorial Staff at CT@livemail.uthscsa.edu

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 at San Antonio, the Center for Medical Humanities & Ethics, or the editorial staff.

VOLUME X • 2017 EDITORS IN CHIEF Sara Noble Jane Yoon MS4

MS4

EXECUTIVE EDITOR Hilary Hopkins

EDITORIAL STAFF Elizabeth J. Chan

EVENTS COORDINATOR Cindy Yang

Alexia Ramos

MS2

Nursing Student MS1

Kelsey Roberts

MS2

Nursing Student

DIRECTOR OF DESIGN Lina Mahmood

FACULTY ADVISORS Jerald Winakur, MD Lee Robinson, JD Ruth Berggren, MD

MS1

COPY EDITOR Sheila Hotchkin SELECTION PANEL Ralph Bauer

Tiffany Chen

Mia Gonzales

Lauren Kraut

Narine Wandrey

Jefferson Bedell

Grace Cheney

Cristin Harper

Tran Nguyen

Maggie Zhang

Bryan Brockman

Connie Cheng

Luyang Jin

Chavernay Perron

Amanda Cruz

Jason John

Alexis Tracy

MS3 MS3 MS4

MS4 MS4 MS1 MS1

MS4 MS4

MS3 MS3

MS3 MS3

Nursing Student MS3

MS3 MS1

E D I TO R ’ S N OT E SARA NOBLE JANE YOON Co-Editors-in-Chief

In biology, connective tissue supports and binds other tissues of the body.

That is precisely what this journal aims to do, and therein lies our mission: Through creative expression and reflection, we nurture our collective humanity and cultivate meaningful connections among students, faculty, staff, patients and friends of UT Health San Antonio.

This year, we saw the most diverse group of contributors to date submit a record total number of entries. The growth of the publication since its first issue ten years ago is a testament to the importance of reflection and community in health care. This journal has truly been a connective tissue for us both throughout our medical education, allowing us to reflect on the human experience and build connections with our community.

We would like to offer special thanks to our mentors, Dr. Jerry Winakur, Ms. Lee Robinson, and Dr. Ruth Berggren for their continued support and guidance year after year; to the editorial staff and selection committee members who have given their time and energy to create this journal; and to the artists and authors who shared their work with Connective Tissue.

We hope this year’s issue of Connective Tissue brings together the members of the UT Health San Antonio community by promoting humanity in medicine through the arts.

Warmly,

Sara E. Noble

Editor-in-Chief, Connective Tissue Vol. 10 Student, Long School of Medicine, Class of 2017

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Jane Yoon

Editor-in-Chief, Connective Tissue Vol. 10 Student, Long School of Medicine, Class of 2017

IN MEMORIUM Christine E. Petrich, MD

13 September 1985 — 24 January 2017 It is an honor to dedicate this volume of Connective Tissue to the memory of Christine Petrich—brilliant psychiatrist, beloved colleague, and dedicated mentor.

Her time here was far too short, yet her impact on students, colleagues, and patients was profound.

The Connective Tissue that binds our community together will forever be strengthened by her warmth, laughter, insight, and compassion.

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PAT I E N T C O N N E C T I O N : B I L L V I N S O N An assembly of two hundred medical students gathered in a crowded auditorium to see the school’s most popular professor, Bill Vinson. As the lecture began, Bill was obstructed from view as he rested in his mother’s lap. Bill was a 6-year-old boy and had a two-year tenure at the Long School of Medicine. Some students leaned forward to get a better look at Bill’s white wrappings stretching from underneath his blue shirt as Bill’s mother, Anim Vinson, introduced him. She told the class that Bill was diagnosed with a rare dermatologic condition called epidermolysis bullosa in the first year of his life. The friction of childbirth, which leaves most children unharmed, caused lesions that covered the majority of Anim’s newborn baby. Bill was rushed to the NICU and it seemed as though no one could give an Anim a definite answer about what would happen.

Anim explained how difficult it was to be told the diagnosis, the prognosis and that her son would not

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need to wear clothes because his wrappings would cover his whole body. She explained the difficulties of preventing infections, of changing dressings, and managing pain. And then, Anim stopped and smiled as she looked out onto the audience. She began to talk with a sense of sincere gratitude and a positivity that could only be inspired by something remarkable.

She spoke about the things that her and Bill would do together. The music they would listen to, the topics they would read about, the dinners that Bill insisted on having but did not need because of his diagnosis, and how blessed she was to have a son who is so intelligent.

She laughed as she recalled Bill reading science book and said, “Mom I think I am a hormone, and you are my microtubule because you carry me around.” For the first time in the lecture, Bill looked up at the two hundred and smiled.

Shortly after Bill’s lecture, students sent cards and a care package of books to express their thanks to Bill...

Dear Bill, A hormone is something that has an unbelievable capacity to make change despite its small size. It leaves the tissues different despite its brief contact. The fact that you made the metaphor that you are a hormone is incredibly accurate. I know that I speak for my class when I say that we are forever changed after our exposure to the Bill hormone. The effect that you have had on our medical careers has been nothing short of profound. Thank you for the incredible lessons you have taught us, your kind instruction, and for being as strong of a microtubule as you are. I hope that if we can ever help, you do not hesitate to call on our student body.

With love, Luke Seeker Student, Long School of Medicine, Class of 2019

Self Portrait Bill Vinson

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C O N T E N TS CATEGORY WINNERS P PHOTOGRAPHY

L LITERATURE

WINNER

WINNER

Hands 8

On Being a Woman

Bryant Huang

HONORABLE MENTION

The Last Rodeo

Vinh-Son Nguyen

9

Shaoli Chaudhuri

A VISUAL ARTS WINNER

10

Touch 12 Naji Elmogtaba

HONORABLE MENTION

HONORABLE MENTION

Night/Shift 11

Flor de Corazon

Chris Yan, MD/MPH

Keerthana Pakanati

13

COMMITTEE SELECTIONS L The Realist Blair Lenhan

14

A Skull 15 Gilberto Vazquez L The Wisdom of Makahiyas Jelina Marie Castillo

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P Life and Death Aliya Sharif

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A UT Tower Zaid Mahmood

18

L Wings of Architecture:

Vessel of Experience Janice De Surmont & Henderson Jones

to the Ganges

Helen Heymann

25

L Secrets 26 Alexis Tracy P Strangers No More

Compassion Hope 28 Veronica Bove

P Better at the Beach Omar Akram L The Sublime

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within the Ordinary

30

Pamela Camosy, MD

P The Window Jose Torres

20

A Contemplating Science Edwin Calderon

32

A The Window Hye Ryung Yang

20

P Bridge the Connections Nicole Mathis

33

L Gift of the Aurora David Shockey

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L Bricks and Feathers Aliya Sharif

34

A Pachamana

San Tatonka

Hector Garcia, MD

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19

P Pilgrims en route

24

P Thomas 35 Mai Luk, DDS P Early Birds Mai Luk, DDS

36

P Cobblestones & Streetlamps 37 Spencer Cope L Untitled 38 Elizabeth Allen A Shatter 39 Lina Mahmood L Tobacco Tears Monica Sok

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P Feed The Birds Janina Rodriguez

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L First Death Mia Gonzales

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P Light In The Shadow Casey Cazes

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L Call 44 Diana Labrada P Fathers, Brothers,

Sisters, Mothers Vinh-Son Nguyen

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P Live Oaks Park Sunset Casey Cazes

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L The Patient Devin Quiroz

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P Pu’uhonua o Honaunau NHP 49 Raj Sehgal, MD

L Tuesday, August 16th 57 Hilary Hopkins

P The Perch Grace Cheney

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A Best of Both Worlds Michael Metzner, MD & Jordan Hayes

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L Viraha 58 Shaoli Chaudhuri

P Vickie’s Dome Padraic Meehan

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L My Sweet Sister Hannah Korman

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A 10.1 59 Sruti Nuthalapati

L Mania 67 Narine Wandrey

P Floating Village Zachary Tran

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P Santa Monica Pier Jayme Trevino

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P Archipelago in Color Bryant Huang

P Laundry Day in Jaipur Elizabeth J. Chan

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P Flamingo Sunset Padraic Meehan

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L Goodbye 69 Michael Miller, MD

L Pediatric Oncology Nurse Jorgie Contreras

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A The Heart Lina Mahmood

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P Parched 70 Spencer Cope

A Spring Blooms Sammar Ghannam

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L Experiment II Mo Saidi, MD

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P End of 2016:

P From the Caribbean Sky Rebecca Nekolaichuk

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P McDonald Observatory Jayme Trevino

The Land of David Bowie Kimberly Vogelsang, MD

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71

55-WORD STORIES WINNER

Silent Delivery

Sadie Trammell Velasquez, MD

72

55

55

Serena Michelle Ogunwole, MD

55

73

My Waitress

73

55

55

Two Worlds

74

55

Her Mind’s Eyes

74

55

Conflicted 74

55

The First Time

75

55

The Soldier

75

Colton Rice

55

Jaswanth Raj Kintada

55

Lauren Michael

2-Year Memorial Natasha Mitra

Regret 74

Untitled 73 Anonymous

Raj Sehgal, MD

55

Kevin Ozment

L LITERATURE

A VISUAL ARTS

P PHOTOGRAPHY

55

55-WORD STORY

Busy 75 Julia Kirsten

The Flashlight

76

Trauma Call

76

Jason John

Noah Bierwirth

Cassie Chan

55

Misunderstood 75 Austin Sweat

Gilda Digman

55 55

55

Harriet King

HONORABLE MENTION

Untitled 72

Rewired 73

Rotations 76 William Pipkin

A Carefree

Twenty-Something 76 Alexis Ramos

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W I N N E R, P H OTO G RA P H Y

Hands

Bryant Huang Student, Long School of Medicine, Class of 2019

NOTE

8

from the

Sometimes all we have is hope — Gaoyou Village, China

H O N O R A B L E M E N T I O N , P H OTO G RA P H Y

The Last Rodeo Vinh-Son Nguyen

Student, Long School of Medicine, Class of 2020

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W I N N E R, L I T E RAT U R E On Being a Woman Shaoli Chaudhuri

Student, Long School of Medicine, Class of 2017

I’m bleeding she pleads.

25 years old 8 weeks pregnant and terrified.

Drowning in a colorless hospital gown.

I stained my jeans, she says sheepishly As if there is shame to the unpredictable ways our bodies Wreak havoc.

She stands up And out it drops.

Inconspicuous I almost miss it.

Dark brown, the size of an orange You passed some tissue when you stood up.

Spoken as if discussing the light rain we got on Sunday.

Ushered into an excuse for an exam room, paper-thin curtain for a door She sits in the chair eyes the exam table and metal stirrups No dear, you have to lie on the table, the midwife coaxes.

The dark rings around her eyes intensify in those seconds A stark contrast to her bloodless face Her dyed red hair

I’m still bleeding, she says again Desperate now

The midwife must still ultrasound to make sure no trace of life remains in the uterus No. None.

It’s ok. It’s ok, we see this all the time.

I think to myself: I don’t know if that should be comforting.

I am so sorry Reassuring her this wasn’t her fault The words hollow and useless, falling from my mouth half-heeded

She is pale from blood loss And from the one thought that besieges her mind Takes up residence in her brain Quivers and sharpens before her eyes Trying to come into focus no matter how hard she struggles away

We step out Staccato sobs bounce off the four walls of gyn triage She disappears into her boyfriend’s tattooed arms Swallowed up by grief

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I start to tape together the ultrasounds Of nothing there.

H O N O R A B L E M E N T I O N , L I T E RAT U R E Night/Shift

Chris Yan, MD/MPH Alumnus, Long School of Medicine, Class of 2016

Sometimes there’s a lull between the nurses calling, and I’m on the old sofa in the lounge— soft, beaten, and purple, like a pulpy bruise in which dozens of young doctors before me must have sat.

I’ll think of patients from upstairs or downstairs whom I’ve been called about in the last five to six hours: the man who had a heart attack, then woke up and shat on the floor; the young anorexic man slowly starving to death, body all but crumbling under the weight of IV nutrition; the woman upstairs with lung cancer seeding her brain, now bleeding from it; or the woman downstairs who drinks eight hours each day, in and out of the hospital every other week with pneumonia.

Chances are I’ll never see any of them again.

They say that doctors are made by the number of patients they see. Not that it’s ideal to know them solely by room number and chief complaint on an alphabetized list of 80, but that this is what good training is. One day, I suppose it’ll come in handy when someone collapses in front of me and I know nothing except that they felt dizzy.

But sometimes, halfway through the night, trying to filter names from horrific stories and images while on the old purple sofa, I wonder what this costs us.

The price of one shift, for example, perhaps being equal to a dreamless sleep the next morning— six hours of the mind in purgatory, and a cleansing of the patient list to make a fresh one each day.

It adds up, day by day, to what can’t be bought back.

Not that it matters much at the hour I think of these things.

Just that it might make a difference later, when everyone’s out getting the most bang for their buck, for me to remember that the anorexic patient’s name was Sean. He was 26.

And he listened to Nirvana.

Intern year of residency is filled with days that challenge your resolve to get out of bed the next day and go back. Some days, I get up before my 1-year old daughter wakes up, and get home after she is already asleep--there have been weeks when I haven’t seen her at all. But there have also been countless encounters and micro-encounters that were revelatory to me about why medicine as a career is so satisfying. In caring for the patient, their joys become our joys, their sadness our sadness. The anorexic young man is your brother, the cancer-ridden woman your mother. It doesn’t always happen, but on the rare moments that it does, you begin to understand that medicine is a gift to us all. It may not feel like it on a night when you’re alone on the hospital floors and every patient seems to be crashing, but I like to think that medicine rewards us for being patient with it, if only we occasionally pull ourselves up to look at how.

Special thanks to Dr. Ruth Berggren and the Center for Medical Humanities & Ethics. School of Medicine, proud graduate, 2016.

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W I N N E R, V I S U A L A RTS

Touch

Naji Elmogtaba Patient

NOTE

from the

A human internal form; where muscles, bones, and tendons all intertwine to make it possible to move flexibly and stand firmly. Muscles are networks of huge body cells, controlled by calcium ions, that contract together to move the body parts.

On the other hand, bones form the rigid part of the body which support structure and shape. It’s a complex microsystems that resides within everyone of us; everyone who lives here in earth. Essentially, it’s all part of a micro solar system that has been orbiting for 4.6 billions years around the milky way and yet hasn’t completed 1/10th of an orbit. How complex and small are we?

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H O N O R A B L E M E N T I O N , V I S U A L A RTS

Flor de Corazon Keerthana Pakanati

Student, Long School of Medicine, Class of 2020 NOTE

from the

This piece depicts the juxtaposition of nature and man; the flora serve as the vessels through which blood is being transported.

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The Realist Blair Lenhan

Student, Long School of Medicine, Class of 2018

How did she do overnight?

The mother responds with such uncontained, infectious joy.

My fingers are still chilled from the sanitizer perhaps that is why I feel immune.

She smiled at her sister and rolled her eyes!

My smile feels strained like my suspension of disbelief.

The doubt seeps in.

My patient, a comatose child, has not moved in weeks.

Now I feel weak.

My heart feels heavy, stomach filled with guilt.

I am conflicted between giving caution or congratulations.

I am a dichotomy of desires.

Faithfully treading water until logic and doubt makes me heavy and pull me under.

Once, my grandfather- the artist- proudly proclaimed me a dreamer, beyond the grasp of the practical, rational lot.

Now the realist is emerging, overpowering and discarding my former self.

In such a small hospital room I realize I have lost something.

I do not know if I will ever get it back.

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Skull

Gilberto Vasquez Student, Long School of Medicine, Class of 2017

NOTE

from the

Jan, 2017 - Forensic Pathology Rotation

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The Wisdom of Makahiyas Jelina Marie Castillo

Student, Long School of Medicine, Class of 2020

When I was young I used to play with these leaves Common plants found at the edges of roads Called makahiya, or shy, in my language This was because at the lightest touch These tiny leaves would collapse on themselves I would laugh and touch all of them with my feet And then squat at the side of the road And watch them carefully unfold It would take a long time Minutes My mom would try to pull me from my vigil But I would not leave until I could be convinced that they would actually open again

I thought maybe I needed things And then maybe people A lover perhaps Or maybe accomplishments Yes, maybe enough motivation Enough hard work This was all I needed to open up again But I have since learned from the wisdom of makahiyas I have learned that maybe all I need to slowly, but surely, unfurl Is patience And a little bit of stubborn faith

This was a time When I found laughter in every nook and cranny When I would stretch my arms to the sky and easily silence the world in my head When my youthful observations seemed important And when I wore my hair messy and my skin dark But I don’t know when it happened Maybe a singular moment or maybe a progression over time But the other day after taking a shower I looked in the mirror and I too collapsed Shame clouded my mirror with layers of doubt I’ve became so engrossed in fixing the world That I forget that I am part of the piles on the broken I only truly understand myself in the context of my Filipino roots.

Thank you to my supportive parents for creating a piece of their homeland 8,500 miles away.

Maraming salamat

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Life and Death Aliya Sharif

Student, Long School of Medicine, Class of 2020

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UT Tower

Zaid Mahmood Student, Long School of Medicine, Class of 2019 NOTE

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from the

A pencil rendering of an all-time favorite Texas landmark.

Sister: Physician:

We need to tell Mom in person. Let’s leave now and come back.

In the meantime if his heart stops what should we do?

Wings of Architecture: Vessel of Experience [pause]

Do you want us to do everything to save him?

Shocks and chest compression, or do you want to let him go?

Janice De Surmont & Henderson Jones

Student, Long School of Medicine, Class of 2018

Brother:

...just let him fly.

Physician: He can’t stop seizing.

Pentobarbital, our last medicine, is not working.

Brother:

He wouldn’t want this. If he can’t come out…

Sister:

We need to tell Mom in person.

Let’s leave now and come back.

Physician: In the meantime if his heart stops

what should we do? [pause]

Do you want us to do everything to save him?

Shocks and chest compression,

or do you want to let him go?

Brother:

...just let him fly.

Note from the authors: This is an homage to the beautiful experience of architecture in the University Hospital’s Sky Tower.

This is an homage to the beautiful experience of architecture in University Hospital Sky Tower.

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The Window

The Window

Student, Long School of Medicine, Class of 2019

Student, Long School of Medicine, Class of 2019

Jose Torres NOTE

from the

Hye Ryung Yang

Labor day weekend, a group of classmates and friends decided to make the drive to Big Bend National Park. After having driven for 7 hours and struggling to find our campsite, we arrived to set up our shelters in complete darkness—with only the stars illuminating the night sky. We woke up the next day to a magnificent view of the Chisos Basin. After a grueling hike to Emory Peak in a torrential downpour of rain, a few of us decided ignore the pain from our blisters and trek our way to The Window at sunset the next day. We hiked for a couple hours and were rewarded with a glorious, ethereal view. Because of the rainfall from the day before, there was a small current of water coursing through the narrow canyon, flowing from its mouth into a vast expanse at the heart of Big Bend National Park. The setting sun irradiated the walls of our window and painted the sky with brilliant hues of yellow, orange, red, purple, and blue. The view, which cannot be done justice by our pictures and drawings, made us immensely grateful for being alive—the ability to feel the pain from our raggedy soles, have legs for walking, lungs for breathing, brains for thinking, and friends with whom we could share moments like these.

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Gift of the Aurora David Shockey

Student, Long School of Medicine, Class of 2019

With the aurora borealis flaming coldly overhead, the stars leaping in the frost dance, and the land numb and frozen under its pall of snow, this song of the huskies…

“We are now cruising at 30,000 feet”, the pilot announced over the intercom, interrupting me from my literatureinduced coma.

I finished the paragraph, … this song of the huskies might have been the defiance of life, only it was pitched in minor key, with long-drawn wailings and half-sobs, and was more the pleading of life, the articulate travail of existence.

I placed my worn and faded copy of The Call of the Wild back into my backpack and pressed my face up against the cold airplane window, peering down at the Arctic Ocean.

Not even the illuminating full moon could erase the black emptiness of the water. My gaze shifted to the sky. I focused my eyes and strained to find a sign of the elusive Aurora Borealis. The sky appeared as empty as the sea. I wasn’t surprised though – the Arctic would not reveal its secrets so easily. With no view outside to distract me from my stiffening legs, my thoughts turned to my destination: Tromsø, Norway.

Three hundred kilometers north of the Arctic Circle, Tromsø was one of the most northern cities in the world.

The frozen tundra hadn’t seen the sun in months. By all accounts, it was one of the most inhospitable places on the planet. My friends and family – all of whom elected to stay home in Arizona rather than brave the Arctic – thought I was crazy. I can understand their reasoning.

But since reading Call of the Wild in grade school, I’ve had dreams of the land of eternal darkness and snow.

Dreams of the sobs and the howls of huskies. The Arctic may be desolate, but in my dreams, beauty arises from this desolation.

There is also the primeval mystery of the Aurora Borealis.

Some ancient people believed the ethereal northern lights to be the lost souls of ancestors who died violent deaths.

Others believed the aurora to be the reflection of a fire made by Nanahbozho, the Creator of the Earth, made to remind the people he hasn’t forgotten them. This storied curtain of light has haunted my dreams the past few years, calling me to come witness its alien tapestry draped over the roof of the world.

Lost in thought, I failed to notice the flight attendants standard landing routine and was jolted out of my revere when the landing gear made contact with the icy Tromsø airport runway. I left the plane and quickly boarded the city bus to take me to my hotel. The city was a ghost town. It makes sense though; an Arctic winter’s cold is unforgiving and a people accustomed to the climate would know better than to be out walking the streets this late at night.

My hotel was a microcosm of the city. In typical European fashion, it was clean, quaint, and modern. But it was also as quiet and lonely as the streets. I walked into my hotel room, flicked on the TV, and looked out the window to check for the aurora. Unfortunately, the sky had turned cloudy eliminating any possibility. Stiff and tired from the plane travel, I rolled into bed. The movie Her played on the screen. The man on the television laid alone in a bed resembling my own, staring up at the ceiling. The last thing I remembered before falling asleep were his musings: “Sometimes I think I have felt everything I’m ever gonna feel. And from here on out, I’m not gonna feel anything new. Just lesser versions of what I’ve already felt.”

The headline in the morning newspaper – Sun Emits Enormous Solar Flare! – snapped me wide-awake.

Scientists believe the Aurora to be generated from

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still exist. That some ancient magic of the aurora could awaken something ancient but powerful within me. I had traveled the globe alone for this chance to let the cold flames of the aurora ignite some part of me. Never mind the unlikely odds of the lights actually showing – would they even compare to what I had already witnessed in my dreams?

Turo, the Norwegian dogsledder, picked me up from my hotel promptly at 8. Despite his hardened appearance – a completely shaven head, grizzly white stubble, three knuckles missing from frost bite sustained hiking in the Andes – his eyes were kind and his smile was trustworthy.

Forty minutes later we arrived at his cabin, deep in the Lapland Mountains and sufficiently removed from any sign of civilization. If the lights appeared, there would be no light pollution to diminish their intensity. charged particles jettisoned from the sun slamming into our planet’s atmosphere. The Earth’s magnetic field pulls these particles to the poles, making the lights an exclusively Arctic and Antarctic phenomena. Tonight was my last night in the Arctic and this solar flare is exactly what I needed.

I passed the rest of the day in anxious anticipation for the night. Eager to recreate the scene in my dream, I hired a local dogsledder to pick me up at 8 p.m. to drive a dogsled through the frozen terrain. The musings from the night before echoed endlessly in my head. Had I already, in my twenty-two years of life, experienced every emotion of the human condition? I had felt love, loss, joy, agony, elation, and sorrow, hate, rage, pity and peace.

Were these emotions and their derivatives all that there was to existence? And with each use, were these feelings worn and faded until they were no more than a fleeting shadow of what they once were? Call of the Wild had infused my dreams with the idea that mystery and novelty

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Turo ushered me into his cabin and let me borrow his thickest coat, sturdiest boots, and furriest hat. After dressing, I followed him outside. The cold licked and froze any inch of exposed skin. The sky was clear with a full moon. Positioned squarely overhead, the Milky Way glowed as the backbone of night. The surrounding stars, peppered across space, sparkled in the floating ice flurries – like something off a Robert Frost poem.

As we approached the dog kennels, we were greeted with a cacophony of yelps and yips. The soft-spoken Turo shouted over the chaos, “We will be out for a few hours and will travel twenty kilometers. Stay close behind me and make sure to use the brake. Do not worry about the dogs – they love driving the sleds and their fur keeps them warm. Just make sure they know you are the pack leader.

Show no fear.”

We hitched up the dogs to their sleds and the husky hybrids cried out in excitement. With a nod of his head, Turo shouted, “MUSH!”

His sled sprang to life as his dogs drove their paws into the soft and deep snow, their leg muscles rippling with effort. Before I had a chance to shout my own command, my dogs bolted after Turo’s sled team, nearly throwing me from the back of the sled. It was clear that Turo was the pack leader, not me.

Our sleds flew through the Arctic tundra. I was surprised how naturally the controls came to me. Was knowledge from some primal subliminal pool of memories guiding my hand as I commanded my sled team through the snowdrifts and icy turns? Then I remembered – driving a dog sled team was familiar because it was just like pushing and riding a shopping cart through a food mart.

The magic of the moment did not escape me. The moon’s light reflected off of the pristine and unpolluted snow causing the landscape to glow. The only sound was the crunching of the snow, the excited yips of the dog pack, and the quickly clouding exhalations from my lungs. The aurora had yet to appear, but I was content.

We stopped at the halfway point of our journey to give the dogs a break. I laid down amid the huskies and rested my head on the back of the lead dog. In one of the most cold and desolate places on the planet, I had never felt more alive.

Without warning, the dog I was resting on raised his head to the stars and let out a silence-breaking howl. In unison, the other dogs joined in. I looked at Turo to see if something was awry, but he was relaxed as ever, looking up at the stars and smiling. I listened closely to the sobs and howls of the pack. I had heard this symphony before, haunting my dreams. I remember how the song was described in Call of the Wild: it was invested with the woe of unnumbered generations… when the huskies moaned

and sobbed, it was with the pain of living… and the fear and mystery which was to them the cold and dark. The description felt true.

As if in answer to this canine composition, the Aurora Borealis burst into being. A wavy curtain of green, yellow, red, and pink exploded directly above me. Gazing up into the sky, my self-awareness faded. It was like I was looking into a fire, mesmerized by its chaotic patterns. But, instead of feeling the calm that comes with the warmth of the fire, my hair stood on end. An excitement, deep inside me, began to grow. I had never felt anything like it. The colors didn’t just hypnotize me – the huskies grew silent as well. The Arctic and all its inhabitants had to stop in wonderment and awe at the lights.

I’m not sure how long I laid there, warmed by the huskies, far above the Arctic Circle, bewitched by the sky. Long enough for icicles to begin to form from the whiskers on the dogs. Turo eventually motioned for me to once again take up the sled and return to the cabin. The Aurora was kind enough to guide us on our way. I felt changed. The lights had given me the gift of an entire new emotion. I’ll call it wonder.

On my return flight home to Phoenix, I managed again to secure a window seat. I stowed my carry on, placed my worn and marked copy of “Call of the Wild” into my lap, and closed my eyes. I imagine at some point over the Arctic Ocean the pilot announced, “we are now cruising at 30,000 feet” and a flight attendant shuffled by to ask, “what would you like to eat?” But, I never heard the pilot nor saw the attendant. My mind was elsewhere. All I could hear was the haunting song of the huskies. All I could see was the shimmering cold flame of the northern lights. All I could feel was the gift of the Aurora.

A true story of my adventure to see the Aurora.

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Pachamana

San Tatonka

Assistant Professor, Dept. of Psychiatry

Assistant Professor, Dept. of Psychiatry

Hector Garcia, MD

NOTE

from the

Hector Garcia, MD

The artist grew on the US—Mexico border in El Paso, Texas and in Nogal Canyon, New Mexico, riding horses and roaming the hills alongside the Mescalero Apache Indian Reservation. Ethnically he is what is known as “Mestizo” or someone of mixed Native American and Spanish Heritage. He traces his ancestry back to the Raramuri Tribe, the Running People of Copper Canyon, Mexico, and to the Spanish Conquistadors, some of whom arrived to this continent as part of Don Juan de Onate’s expedition—a man who, in the name of the Catholic Church, branded himself into historical infamy by chopping off the feet of all the Indian men living at the Pueblo of Acoma. His work reflects the legacy of his ancestors, the complexities of cultural identity, religious conquest, moral bias, and his connection to mother nature. He is also a clinical psychologist specializing in the treatment of combat related posttraumatic stress disorder, a scientific researcher, ultramarathon runner, and author. His latest book Alpha God: the Psychology of Religious Violence and Oppression, is a highly acclaimed exploration of the biological roots of religious violence

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Pilgrims en route to the Ganges Helen Heymann

Student, Long School of Medicine, Class of 2018

NOTE

from the

Varanasi, India

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Secrets

Alexis Tracy Student, Long School of Medicine, Class of 2018

6:15, I’m running late The kids are soaked, no one ate Forgot to take the dog out, or the overflowing trash bin at any rate No one told me how overwhelming this could be Sometimes I can feel a breakdown coming for me The days are long, the nights are sleepless Drowning in other peoples’ secrets Covering my own, like a mountain in snow Big house, lonely spouse Mind is spacing, tired from late night paperwork chasing A trail that never ends, canceled date night once again Time to bury, for others I make the profession to worry Looking round, pulling up to the hospital now Breathe in, breathe out Time for results, so many worries, burdened with doubt Among the silence, my gritting teeth are on surround sound The anxiety has me in strands, looking down, tremors creeping into both hands Staring blankly at a magazine, pretending to read what they displayed in front of me Is today the day I’ll be beckoned to be hooked up to machines?

These results stand between me and being free The docs rush in, they rush out carrying news with life-changing clout I’ve been alone in this, too scared, carrying secrets from my wife and kids Patient in. Patient out.

Handing out diagnoses like I’m on a paper route Two patients deep Already speaking of metastases A heaviness I always carry in my sleep My name is called, the time is near Standing to my feet, inner strength all but deplete Saturated with fear, a smile from the nurse seems ironic in here

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Room 8, is this but another life I watch desiccate I wash over the chart, I recognize the name The words on paper come as a shock For once today, I am not tearing lives apart I have good news, days like this seem far and few Doc, just hit me with the news, no need to dance around it My wife and kids don’t know of my concealment Tell me the truth, hit me with it Unravel my secret, I can no longer keep it His head is down, shoulders hang low Face deprived of any glow, awaiting the blow The scans are clean, the cancer is without trace I’m here to tell you, it’s going to be okay Cling to your family, seek shelter and strength in the ability to communicate In times of need, this is one heavy secret to keep The tears are pouring, the pain in my chest no longer boring I hug her tighter, I feel a dozen pounds lighter This secret has had me drowning, doc Things have been hard at home, isolation from my loved ones too well known Concealing truth like swallowing a slow acting poison Hidden, guilt masking my every thing What can I say, thank you for the peace you bring Patients confessing disguises to strangers in white coats Wide-eyed hoping for antidotes Handing out life advice, if not only to remind myself You and I both have secrets Mine aren’t yours, but yours are mine Safe with me, with the seal of time and these four walls to bind But just like you, I need a release I need my patients, just like they need me When the going gets deep, they remind me to open my heart and share my secrets Dedicate this poem to my mother for always inspiring me to express myself.

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Strangers No More Compassion Hope Veronica Bove

Medical Office Staff Receptionist, Dept. of Plastic & Reconstructive Surgery NOTE

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from the

Sharing my view of hope and compassion with the world and our community

Better at the Beach Omar Akram

Student, Long School of Medicine, Class of 2021

NOTE

from the

In Western society, we romanticize individualism, associating it with a carefree lifestyle; hence the idea that “life is better at the beach.� Realistically, such a lifestyle often stems from abject poverty and the absence of the pleasure we seek.

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The Sublime within the Ordinary Pamela Camosy, MD

Adjunct Faculty, Dept. of Family & Community Medicine

As a family physician, the patient stories that I remember with ease are those that book-end the extremes of emotion: the exuberant victories and the tearful losses.

These recollections represent the highs and lows of my medical practice, and are often the ones I use to teach medical students. But there are hundreds, even thousands, of everyday experiences that far outnumber the memory-stickers. They are mundane, routine, even automatic, with pattern recognition playing a large part.

Here is what I mean.

An adult patient tells me that he has had lateral elbow pain for two weeks, a pain that is worse with pronation of the arm. I briefly examine him, find the telltale tenderness over the soft tissue, and easily diagnose epicondylitis. I prescribe naproxen, ice, rest, and a tennis elbow strap. Every time. I do not mull over the pathophysiology of overuse syndromes and tendon inflammation, or the prostaglandin-fighting properties of nonsteroidal anti-inflammatory medications. And I almost certainly will not remember this one man’s visit to my clinic in a year’s time.

But tucked inside such ordinary activities can be sublime moments, if one is open to recognize them and to receive their grace, if one can remember that the elbow is connected to a person who is in pain, who needs my help.

Take a look at my busy Monday clinic schedule: blood pressure follow-up, twisted ankle, child with cough, adult with cough and sore throat, annual physical, cholesterol and diabetes follow-up, another blood pressure follow-up, knee pain, headaches, sports physical, then lunch. Then repeat a similar schema for the afternoon. My hospital ward list may look like this: pneumonia, failure to thrive, pyelonephritis, gastroenteritis, bilateral heel fractures.

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All of these diagnoses are actually patients, of course, people who have entrusted me not only with the health of their bodies but also with the well-being of their mind and spirit. So, the patient on today’s clinic schedule with the twisted ankle is actually a muscular 26-year old black man, Andre, who greets me with “Hi, Mom!” as I enter the exam room. As only he and I would know, he is referring to our last visit, when he told me he never uses condoms because he did not like the way they feel. What ensued that day was my standard unprotected sexual intercourse spiel, which I had given dozens of times before. On that day, Andre had responded by telling me that I sounded like his mother, and we both agreed that this was not necessarily a bad connection on his part. He needed advice from someone who cared about him. So, I get “Hi, Mom!” today, and my heart feels a bit happier. Just two short words—sublime.

My patient with knee pain is Mr. Thompson, a 43-year old businessman, who seems different today. Quieter? Sadder?

I ask him if something is wrong, and he freezes. Sitting in the exam room chair, he says nothing and I say nothing. I settle down a bit more into my chair, hoping that he feels my unspoken invitation to tell me anything he wants to.

More silence. I notice the hum of the lights and I am sure that he does not.

He looks at me with tired eyes and says tentatively, “I think . . . I think my wife is about to leave me.”

From there flows his story, imbued with a sense of his hopelessness and helplessness. Our silence opened the door to his crushed spirit, and he reaches out to me for help. Just a moment of silence, then trust—sublime.

Juan is a six year old boy on the ward, whom I am treating with intravenous antibiotics and nebulizers for

pneumonia. His mother has been frantic with worry, and has not left the hospital in four days. During rounds this morning, I show her a much improved chest x-ray. Her eyes meet mine, mother to mother, and the bliss of the moment flows between us and then settles placidly into our hearts. Just a chest x-ray—sublime.

When I was a resident, the pediatrics department held annual “birthday parties” for the babies who had been cared for in the newborn intensive care unit over the past year and were now at home, for the most part thriving.

Some children were less than a year old, being held in the protective arms of a parent. Many were toddlers running around the room as toddlers do. That morning, I was able to re-connect with Amelia, a nine-month old baby whom I had cared for after she was born. The mother and I recalled together the weeks of lines and tubes, the ultraviolet light treatment with the requisite eye-patches, our reaching through the holes of the incubator to touch the baby’s tiny hands. Today I held the baby girl in my arms, as I was never able to do in the ICU, and looked at her sweet face. At that moment her precious pink face was as grand to me as the frescoes of the Sistine chapel. Just chubby baby cheeks—sublime.

“Forward Air Control,” he said with excitement, “now those were the real heroes of the war. Their lives were on the line every second that they were in the air.” He went on to explain that these pilots—my father, I thought—flew O-1s, which were very small aircraft. Their mission was to fly low over enemy territory in order to identify targets in advance of the large bombers. The FAC pilots would drop white-phosphorus smoke bombs before “getting the hell outta there,” as my patient put it. The planes were in the cross-hairs of the Vietcong surface anti-aircraft weapons, and many of the pilots were killed. After my father returned from Vietnam, he never told us about any of his combat experiences. Dad had been dead for a few years now, his story seemingly lost. As Mr. Truesdale spoke, I had goose bumps. Just a brief history lesson—sublime.

Ordinary events in my practice become sublime if I am careful not to feel too rushed, if I am comfortable with silences, and if I am focusing on this particular moment and not the last or the next. These sublime moments have elements of awe, surprise, and exuberance, all wrapped up in the thought: “I’m so glad I chose to be a family physician.”

I spend a lot of time talking to my military veteran patients, asking about their experiences. Mr. Truesdale had been in the Army, a “ground-pounder” in Vietnam.

Since the 1970s, he had fashioned himself into an expert, of sorts, on the military action in Vietnam. In the course of our conversation I mentioned that my father had been a FAC pilot.

This essay is excerpted from Dr. Camosy’s book, Healer’s Heart: Preserving the Art of Medicine in a Changing Landscape.

NOTE: I have changed all names to protect the confidentiality of my patients.

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Contemplating Science Edwin Calderon

Student, School of Nursing NOTE

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from the

This is where dreams and discoveries will be accomplished.

Bridge the Connections Nicole Mathis

Student, School of Nursing

NOTE

from the

I had just recently learned a new technique that uses long exposures to capture the trail of light and was excited to try it out. I was on my way home from a family gathering and passed this beautiful bridge in Junction. I decided to stop and watch the sun set low on the horizon and admire the deep blues and oranges. Something stirred me to grab the camera and I sat it up on the median facing the sunset. The photos don’t do just of that clear twilight sky. I put the exposure at 20 seconds and would get out of the way of oncoming traffic as it meandered across the bridge. There were few cars, so I would click the shutter and wait. Click and wait. I had no idea if the photos turned out good or bad until I brought this one up on the computer. Blown up and printed, the sky looks phenomenal and it was an excellent way to spend 30 minutes.

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Bricks and Feathers Aliya Sharif

Student, Long School of Medicine, Class of 2020

She was born With laughter in her eyes And flowers beneath her skin I wonder where she went She lived In a dream like haze With a heart that beat a little too fast I wonder how she survived She learned She was stronger than she knew With a soul made of bricks and feathers I watched her as she grew

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Thomas

Mai Luk, DDS PGY-1, School of Dentistry

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Early Birds Mai Luk, DDS

PGY-1, School of Dentistry

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Cobblestones & Streetlamps Spencer Cope

Student, Long School of Medicine, Class of 2018

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Untitled

Elizabeth Allen Senior Public Relations Specialist, University Health System

How can I drown sorrow?

Sorrow is a lake.

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Shatter

Lina Mahmood Student, Long School of Medicine, Class of 2020

NOTE

from the

I was researching a portrait online for my drawing class project when I stumbled on this picture. Her eyes struck me so I decided to draw this portrait for the project. It was a challenge, but I wanted to portray that look as accurately as I could.

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Tobacco Tears Monica Sok

Student, Long School of Medicine, Class of 2017

A wretched white cylinder, pernicious and cruel; the gateway to death; the hole of poison.

His wrinkled skin and limestone fingers are a living testimony of addiction.

My auntie, I hear, she shouts in despair.

Her voice a shrieking cacophony, her throat scratching strident raw, as those wicked tobacco tears

A puff of swirling, gray smoke polluting the sweet midnight air He puffs, his face crinkles as he laughs, and that smog fills my nose.

flow mournfully down her jaded cheeks.

The tears, they engulf her, suffocating her mind as black grief overtakes her, and I can’t help but sadly stare

Restless nights, I hear, she spends alone in her room trying beyond trying to not shed a tear.

Smoggy tears, filled with smoke of everlasting memories.

She trembles as another tear betrays her eyes, and I cannot help but grieve along with her

This is the vignette of the smoggy devil

I see him fleeing into the dark, denying the obvious tragedy; burying, throwing himself outside.

Oblivious to the cold, frozen up inside as the smoky colored night swallows him whole; drowning, a black tear drips, falls, slides down his white cheek, and I do nothing to ameliorate the pain

It saddens me when I see people lighting up a cigarette, particularly when I see someone with a family do it just because of personal experience. This poem is to show how the consequences of smoking reaches not into the patient’s life but into all those around the patient. It’s the story of how a single cigarette can cause everyone’s lives involved to go up in smoke.

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Feed The Birds Janina Rodriguez

Administrative Assistant, Dept. of Radiation Oncology

NOTE

from the

Life is a struggle no matter your status. We either decide to beat it or we accept it.

Old San Juan, Puerto Rico 2016

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First Death Mia Gonzales

Student, Long School of Medicine, Class of 2017

Enter the room A skeleton raises her hand Tells me she needs help She has to pee Lift her body off the bed Ask her to take some steps Tired smiles at me and tries And fails Upstairs she’s getting better Then she’s getting worse Fat stranding around the pancreas Ileus Floating lungs The coffin of her body slowly folding closed I wasn’t there when she went Wherever she wanted to be My day off My brother in town Goodbye, dear old bones, I’m sorry I missed you

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Light In The Shadow Casey Cazes

Student, School of Dentistry, Class of ???

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Call

Diana Labrada Student, Long School of Medicine, Class of 2018

A page comes in “self-inflicted gunshot wound.”

It had happened before, but this one was different.

Patient was 3T. This wasn’t going to end well. Paramedics roll into the pit “unknown female, attempted suicide.”

That’s a subtle way of putting it. Effectively, her brain is coming out of the right side of her head. She had shattered her parietal bone.

It’s my turn to compress again. I can see her eyes rolled back, already lifeless. “Pupils dilated and fixed” was tossed out earlier. I see that now. Her eyes, I think they’re blue, don’t stare at anything. There is nothing behind them anymore. As I compress I can’t bear to look at her face.

The tube is still in her throat. There is a terrible sucking sound every time I compress, but I know that means I’m doing it right. Another hip pat, it’s someone else’s turn.

She is intubated, semi-lifeless, but came in with a pulse.

There is a lot of blood. Blood coming out of her mouth, covering her face, her skin starting to look more pale, cold without touching it. The real doctors yell for epi, blood, to get ready for CPR.

Nurses are still compressing. My friends stand in line to wait their turn. There’s a morbid sense of excitement in finally getting to practice what we have been trained to do. Perhaps it was more a sense of optimism that the measures we take might actually make a difference.

It’s my turn to compress. I’m trained in this. I taught people how to do this. I begin humming “Stayin’ alive” to keep myself in rhythm because I can’t force myself to count to 100 at a steady pace. I feel her rib, maybe her xiphoid, crack underneath my hand. I hear it and her chest has more give. I curse to myself as I keep compressing on her chest. I can only do it so long.

Someone taps my hip, “I’m ready when you want to switch.” I count to 3 and step aside.

I get more gauze and bandage for my resident to bandage our patient’s head. He mentions how more blood and brain are leaking out with every press on her chest. I watch as he subtly bandages over her eyes so he won’t see them looking up at him as he stands at the foot of the bed. I would have done the same thing. He borrows my shears to cut the bandage. They get bloodied and he accidently drops them. My shears hit the ground with a clang, I can’t see them in the chaos.

A pulse. Someone mentions there is a faint pulse. I think to myself, “Maybe we can do it! Maybe she’ll live!

Maybe we’ll actually save her life!” But it hits me. Even if we manage to get a continuous pulse, she’ll never be the same. She’s probably ischemic from the blood loss, even if she isn’t losing brain matter just from it falling out of her head. My thoughts quickly turn to, “Maybe we should stop. Why are we doing this? She wanted to die anyway.

And if she comes back, she won’t be the same.”

We do compressions for half an hour. I get back in line, for what I know now, is the last set of compressions. My hands aren’t shaking, but I wonder if they should be. Our attending calls it. We stop compressions.

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The residents and nurses jump to the next bed. This patient needs bilateral chest tubes and we’re just waiting on another patient to come in.

Looking from the doorway, I understand what my friend was talking about now. None of this is normal. I see my patient’s dead arms hanging off the side of the gurney, a sheet finally over her entire body. She lies between a detoxing man who didn’t stir once during our code and the other patient we are currently working on. I understand we can’t allow ourselves to think about what happened for too long because someone else needs us.

If we think about it too long, we won’t be able to keep it together. We must keep moving.

I tried not to think about her the rest of the night. But when I walked into the dark supply closet I was haunted by her eyes. I filled out the rest of her paperwork because that’s protocol. Even though it doesn’t matter what her labs were or even if she took any drugs. She’s gone now.

On the top right corner of the screen was her name.

No longer an “unknown” my patient had a name. It sends some shivers down my spine, but I keep the name to myself. It wouldn’t do anybody any good, would it? Would it make the experience any lighter to know the name given to her at birth? To know her birthday? We were there on her last day, but I don’t know anything in between except that she wanted to be dead for a very long time. I hope she finds the peace she was looking for. Even in death, I hope she knows she was never alone. I get why we had to do compressions for so long. We don’t give up on people even when they give up on themselves. We have to try.

I walk back to my patient’s bed, pick up my shears, sanitize them, and place them back in my pocket.

Our next patient is brought in and I go to the bedside.

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Fathers, Brothers, Sisters, Mothers Vinh-Son Nguyen

Student, Long School of Medicine, Class of 2020

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Live Oaks Park Sunset Casey Cazes

Student, School of Dentistry, Class of ???

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The Patient Devin Quiroz

Student, Long School of Medicine, Class of 2020

“Who are you?” The Patient asks with confusion in his eyes. I ignored the question, and applied the razor to his face. It has only been a week since his last shave, but The Patient’s grizzled beard was already coming in thick.

“You’re my son”

Halloween was coming up, and my mind was on days long past. Father was a fanatic for scary stories, and my youth was riddled with tales of monsters that creeped in the night. His imagination would get the best of him, and Mother’s feigned anger towards would turn real when her husband’s lack of self-control caused me to ran crying into their room in the middle of the night eager to escape the monsters that creeped under the bed.

The clarity passes, and the confusion returns to his eyes.

I called The Patient “dad”, but my father has been lost to me since the dementia took his mind. Here laid an unfinished doppelganger, with all the matching parts that have not been properly connected.

“Who are you?” The Patient repeated. An empty smile appeared on my face. Taking the time to explain who I was would be an empty gesture, as my words would never reach their goal.

As I got older fears of monsters were replaced with much more real concerns. Thoughts of bills, insurance, and proper dieting have long replaced zombies, werewolves, and demons on the forefront of my mind. As an adult, you tend to get use to the level of anxiety that follows you around, but if you are lucky it never transitions to the fear experienced as a child afraid of what lurks in the dark. Anxiety is a dull reminder, fear takes a hold of you, strangling you until you cannot breathe.

“Wait, I know you, don’t I?” The Patient asks. In a rare moment of clarity, The Patient smiles and looks directly into my eyes.

48

“Yeah dad, glad you remembered. I just finished your shave, and will be back next week to come see you.”

“Who are you?” The Patient asked once more as I got up to leave the room. I didn’t answer as I gathered the shaving material and headed for the door. A quick glance back at The Patient and the razor that sat on the table where I had left it. How many times have I been to this room to shave The Patient? In all those times, not once had I left the razor behind. My mind was distracted, I am sure of it. But what if I forgot? What if I am forgetting more than I should? The fog of fear grips at me like it did in my youth, as I try my best to not let it engulf. It was when my breath did not come to me that I realized there are worst fears in this world than ghost and ghouls.

Pu’uhonua o Honaunau NHP Raj Sehgal, MD

Associate Professor, Dept, of Medicine

49

Best of Both Worlds

Michael Metzner, MD & Jordan Hayes Resident, Dept. of General Surgery

NOTE

from the

Many people will say opposites attract.

However, it is not until you get to know one another that you find we are all so connected.

Acrylic on wooden board 40�x60�

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My Sweet Sister Hannah Korman

Student, Long School of Medicine, Class of 2018

I’ve made you a sunflower, in my mind and on this paper.

I see you as this beauty, one that will not taper.

I see your shapes and colors, your vibrations and your wavelengths.

I hear your sounding laughter, while I hide and while I take things From your room the deepest ocean in the canopy of night, small windows barely opened — one can hardly see the light.

The sister is a mystery so close but seldom open, building what between us we had thought was surely broken.

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Floating Village Zachary Tran

Student, Long School of Medicine, Class of 2018

NOTE

52

from the

Vung Vieng Fishing Village, Ha Long Bay, Vietnam

Laundry Day in Jaipur Elizabeth J. Chan

Student, School of Nursing, ABSN Class of 2017

NOTE

from the

Backpacking in India

53

Pediatric Oncology Nurse Jorgie Contreras

Clinical Assistant Professor, School of Nursing

“Osteosarcoma,” Is a word that resonates in my head.

“Cancer of the bone,” That’s what the doctor said.

How could this have happened, They did everything right.

He’s only 6 years old.

He still sleeps with a light on at night.

As a parent, along with being their nurse, I assume their worst fear has come true.

To “save a limb” or “cut it off.”

Seriously!?

That is what’s left for them to do?

A choice has to be made, But how can they choose?

Of course they want to fix him, right?

How can they refuse?

His smile and innocence illuminates pure joy.

He gives lots of kisses.

Loves to play.

This is their little boy!

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“Rotation plasty,” “Amputation, “Chemo,” “Limb Salvage,” What does this all mean?

Confusion, fear, too many words to comprehend.

As their nurse, comfort and education is key.

Be at their side, Guiding them through.

Nobody said this job would be easy, But that is what’s left for us to do.

Spring Blooms Sammar Ghannam

F.A.M.E. Student, Long School of Medicine

55

From the Caribbean Sky Rebecca Nekolaichuk

Student, Long School of Medicine, Class of 2018

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Tuesday, August 16th Hilary Hopkins

Student, Long School of Medicine, Class of 2019

Yesterday I was here in the morning and at night.

In between she left and it was just me.

She took us on a long drive this weekend—out west.

We didn’t stop for sleep, only snacks.

They love sunflower seeds, not me.

They eat them and I’m left with the shells in my teeth.

Inspired by Dissociative Identity Disorder

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Viraha — The realization of love through separation Shaoli Chaudhuri

Student, Long School of Medicine, Class of 2017

Fill the crevices between my fingers with yours Snug, safe, and natural as waves flowing into a bay Before receding into ocean Sandpaper mandible brushing my cheek between shaves Freckles seen up close Your shampoo fresh in my senses as I wake up to an empty hotel room Your nearness aches as delicately as your distance.

Bright jokes through the phone Fill the corners of this temporary abode Upbeat, goofy, perfectly flawed like me A weekend here, a holiday there Days snatched up like precious stones in a sea of steel Interspersed between flights, fake smiling interviews, lonely nights I drift back into dreams.

The grill’s smoke tipped with Texas bourbon You, glowing in the half-light I feel the slow burn creep up my arms

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At night, I unfurl into you Absorb your heart’s warmth and rhythm And I think: I could paint the ceiling with black and stardust, stretch this night out so long that I would never have to leave Fears of the words: “This is too hard. You’re not worth the distance.”

Instead, you offer reassurance and security I have never felt Instead, you say: “I will always take care of you. We will figure it out.”

Whispers I didn’t know I needed to hear Whispers spoken a hundred miles away Filled to the brim with your heat and your smile And the truth That you can’t appreciate sweetness Without tasting the bitter

10.1

Sruti Nuthalapati Student, Long School of Medicine, Class of 2019

NOTE

from the

Inspired by pionees and red blood cells Acrylic on canvas, 48”x24”

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Santa Monica Pier Jayme Trevino

Student, Long School of Medicine, Class of 2018

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Flamingo Sunset Padraic Meehan Patient

NOTE

from the

Between Maxixe and Inhambane in Mozambique, Inhambane Bay boasts a colony of indigenous flamingos. This tropical sunset in the former Portuguese province was captured from a local fisherman’s dhow. Perhaps his secondary motive for taking us was to scout the competition for the bay’s shellfish.

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The Heart

Lina Mahmood Student, Long School of Medicine, Class of 2020

NOTE

62

from the

Drew this when, for a second there, I wanted to be a medical illustrator.

Experiment II: December 2015 Kauaim, Hawaii Mo Saidi, MD

Retired Professor, Dept. of Obstetrics & Gynecology

It took five flashes to create the universe: the nebulae, black holes, galaxies, all the septillion stars and their planets, and the solar system lay isolated at the edge of space.

And then to launch a new planetary globe of simmering gas circulating round the sun---the mass of vapor to morph into immense storms, and a havoc of floods, the massive rivers that carved the land, shaped valleys, canyons, and the mountains all came about at the last flash.

In the blink of an eye the planet turned blue, plumes of fire and lava plunged into the vast oceans: islands rose, quakes fractured the enormous landmass, its fragments moved north, south, and sideways; and then a spark stirred water, earth, fire, and air and from the mix, a fragile loveless life to form and promptly vanish.

Alas, life without love, creatures without mates, the myriad experiments have gone awry.

O, an imperfect life lasting only awhile.

Unexpectedly, on a twinkling, the seeds of love formed and curbed the demise of infinitesimal creatures, saved the endangered life; flora and fauna bourgeoned; timberlands formed; and large and small animals roamed through the forests of life.

NOTE

from the

On the rolling planes the primates began to walk upright; facing deep drought and seeking sustenance, man crossed unknown peaks and islands, camped in the green paradise.

And then genius man, creative and insular, crowned the experiment.

Lasting for barely a flash, columns of poisonous gas, toxic waters and sizzling heat created a black hole in the promising experiment.

The fateful battle between the world and man charred the meadows of waving wheat and golden apple orchards.

As for the dinosaurs, the experiment lasted a blink, turned the green to brown, winters to scorching summers, man to dust, life to naught, love to wander with the universal wind searching to land in another world, and stage another experiment.

It took five flashes to create the universe, a few sparks to build this world, a blink for the blue plant to glow in the universe, yet a wink to end the experiment―alas, the depleted air, polluted waters, fire and charred earth annihilated man, filled the catacombs with lifeless flesh and bones, an ark burdened by creatures’ skeletons.

It all ended in a wink.

When 11, I asked Mom, “How long did it take God to create the universe?” “A blink of the eye.” The answer bewildered me. Then I read the Holy Book, Darwin’s “The Origin of Species.” I reconciled: So a day can be one hundred million years or just blink of an eye.

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McDonald Observatory Jayme Trevino

Student, Long School of Medicine, Class of 2018

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The Perch Grace Cheney

Student, Long School of Medicine, Class of 2017

NOTE

from the

Lionesses lounge at sunset in Kenya’s Maasai Mara.

65

Vickie’s Dome Padraic Meehan Patient

NOTE

66

from the

The Dome at Victoria Square is the center Belfast’s reboot following the Good Friday accords. Its blue mood lighting serves as a color neutral to the Troubles that once defined the city. The Dome’s modern, futuristic appearance showcases Northern Ireland’s path forward from its violent past.

Mania

Narine Wandrey Student, Long School of Medicine, Class of 2018

She left without a word her racing mind confounded dumb-founded thoughts ablazed, she lay astounded Clang speech weaves her dreams her poetry—his smile—her impulsivity her distractibility—his laugh across the miles It’s invading her subconscious a manic mental haven a grandiose reflection of her psychiatric maven

This poem is dedicated to the person who has reminded me of order amidst mania.

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Archipelago in Color Bryant Huang

Student, Long School of Medicine, Class of 2019

NOTE

68

from the

Burano, Venice

Goodbye

Michael Miller, MD PGY-4, Dept. of Psychiatry

Do you remember Goodbye?

Bright, and tall And blithe and lithe And light and life.

Goodbye, Goodbye.

How she was taken by Insidious autism of Alogia and fear, With shades who spoke Of everything and nothing?

Goodbye, Goodbye.

They let her out, Returned, but not.

No more tears, no smiles, A shade without shades, But stiffness and shivers.

Goodbye, Goodbye.

She frightens others, Slanted gazes, shifting feet, Evading briskly.

Goodbye, Goodbye.

I sit and hold her hands— Trembling when moved, Stiff now, and still— And we look: A photo of her smiling, Some medal for something, With friends so long deserted.

Goodbye, Goodbye.

She looks beyond the picture, A soft, plump tear, Warmly rolling Down a pale, hard cheek.

Goodbye, Goodbye.

A smile struggles, Tight shoulders wrench, Two heads clink together.

We stare in our endless, private world: No clear horizon, But not alone.

Hello, Goodbye.

Aseptic quiet in her grotto.

She looks at things, old and hers, Now strange and fake.

Goodbye, Goodbye.

69

Parched

Spencer Cope Student, Long School of Medicine, Class of 2018

70

End of 2016: The Land of David Bowie Kimberly Vogelsang, MD

Alumnus, Long School of Medicine, Class of 2016

NOTE

from the

To commemorate the greats of 2016

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5 5 - W O R D STO R I E S The 55-word story is a form of “micro” literature that provides an opportunity for time-efficient reflection and serves as a tool for self-care. Over the past two years, hundreds of students, residents, and faculty have participated in Project 6-55, a reflective writing workshop that teaches this approach to narrative medicine. We are pleased to share this collection of 55-word stories.

W I N N E R, 5 5 - W O R D STO RY Silent Delivery

Sadie Trammell Velásquez, MD Assistant Professor, Dept. of Internal Medicine

He gave one last kick, then he was gone. The doctor said there was no heartbeat.

He was born an angel. I lost my baby, but I am still his mother. I am just like the women in the grocery store with a baby in their cart, but mine is empty and they don’t know.

H O N O R A B L E M E N T I O N , 5 5 - W O R D STO RY Untitled

Serena Michelle Ogunwole, MD Resident, Dept. of Internal Medicine

My patient doesn’t like my natural hair. He wants me to go back to being beautiful.

Doesn’t know the history of this hair. Of black women gathering in sanctuaries called beauty shops, straightening their natural hair to become something they were not.

His words, open wounds, bring pain, and I.Woman.Black.Doctor. Offer him healing anyway.

72

2-Year Memorial

Palliative Care

Student, Long School of Medicine, Class of 2019

Student, Long School of Medicine, Class of 2018

We relentlessly resuscitated. He craved death, carrying the weight of a military bracelet on his right wrist – carrying the weight of his best friend’s corpse.

He said to just euthanize him. I expressed genuine empathy.

Natasha Mitra

The bracelet read: RIP Zach Bloom October 23, 2013.

Today’s date: October 23, 2015. Patient found swerving off I-10, stomach full of pills and alcohol…empty of reasons to live.

Anonymous

He asks why even bother sending him somewhere to die without pain. He doesn’t care about pain. “I’m dying.

That doesn’t matter. Nothing matters.”

We sat in silence. Now what do I say?

“I learned a lot from you.”

What a stupid thing to say.

My Waitress

Rewired

Student, Long School of Medicine, Class of 2020

Student, Long School of Medicine, Class of 2018

The sunlight beamed through the polished blue glass, my hand shielded my face as I looked down, the floor was checkered, the table vintage, two delicate hands appeared, setting the coffee on the table, my waitress carried an uncharacteristic odor, with curiosity I looked up, finding the face so familiar, the face of my cadaver

My teacher explains, “Often people with expressive aphasia retain their most primitive expressions.”

Jaswanth Raj Kintada

Harriet King

Her shouts of “Bob! Bob!” reverberate through the ER as the t-PA drip starts.

Bob stands quietly by her side.

I wonder how five decades of marriage could rewire someone’s brain.

This is a dream I had three weeks into anatomy during my first semester of medical school

73

Regret

Her Mind’s Eyes

Student, Long School of Medicine, Class of 2018

Student, Long School of Medicine, Class of 2018

He said he wouldn’t have touched heroin had he known how it would end. The pain was unbearable as he cried into his bandaged, infected arms where years of needles penetrated and rotted. Disowned from family and permanently labeled by healthcare, he was alone. His only best friend ruined his life and was killing him.

Stroke alert!

Gilda Digman

Colton Rice

Garbled speech. Arms flailing.

She was intact not long ago; now called a shadow of herself.

But even shadows can dance in the light of hope.

Reflections of life. I wonder?

Searching, hoping for something; her hand touches mine.

I look!

“I’m still here” her eyes say. “I know” my heart mutters back

Two Worlds

Conflicted

Student, Long School of Medicine, Class of 2017

Student, Long School of Medicine, Class of 2018

Two worlds, same age.

You lost thirty pounds in six weeks.

I reported my findings to the team.

Let us do some imaging to be sure.

Sure enough, you had a large mass.

Why was I being praised? This does not bode well for you.

Should I feel proud? I feel conflicted.

This is surely the most bittersweet end.

Lauren Michael

The future is mine; a graduation, a wedding, a fulfilled career.

Her lips are blue, body is weak, a hole in her heart beyond repair.

She carries her only chance for a future, but we have to take it away.

The prognosis is bleak regardless.

One life beginning, two lives ending.

74

Cassie Chan

The First Time

Misunderstood

Associate Professor, Dept. of Medicine

Student, Long School of Medicine, Class of 2018

Thanksgiving morning, 2 a.m.

I found a number and called We were trained to avoid the word To just say “We need you to come to the hospital” So I did, and so they did The whole family, twenty strong in the waiting room His wife up front Waiting for me to deliver the verdict

We always assumed that if you could have talked, you would have wanted to. Every patient wants to get better.

I think there was a reason that we did not see, but only heard about your efforts – trying to wave, to form words, smiling - when Natasha, the night nurse, was wiping your brow.

The Soldier

Busy

Student, Long School of Medicine, Class of 2018

Student, Long School of Medicine, Class of 2020

A man of few words; a life of many sights,

Boy, seven years, pupils fixed and dilated—an arrow through the temporal lobe.

Raj Sehgal, MD

Kevin Ozment

Evaluated for a simple crash, only to learn of his new upcoming fight.

A terminal diagnosis has thrust him into the unknown.

With his wife on his left, family to his right, and uncertainty hovering above, He chooses positivity and happiness as his favorite drug.

Austin Sweat

Julia Kirsten

We’re busy.

“I didn’t see him!” Big brother pleads to his parents’ untuned ears. A family broken.

All attention on the patient, when little can be done—and none on prevention of the brother from becoming the next one.

But we’re busy.

75

The Flashlight

Rotations

Student, Long School of Medicine, Class of 2018

Student, Long School of Medicine, Class of 2018

Laura’s life surrounds her as I perform my ritual.

Pupils sluggishly acknowledge a flickering, bedside flashlight. A devastated husband and four sisters pace about; the last has finally come around. Laura needs to be comfortable now.

Rotating through the PICU

Jason John

“Take this,” a sister says, presenting a new flashlight.

“Now whenever you face darkness, you will have a light.”

William Pipkin

Two third year students and one fourth year Traumatic brain injury from motor vehicle collision in the corner room Child is declared brain dead The corner room is empty Deceased was an organ donor Three new patients arrive on the floor Two kidney transplants, one liver transplant Rotating through the PICU

Trauma Call

A Carefree Twenty-Something

Student, Long School of Medicine, Class of 2018

Student, Long School of Medicine, Class of 2020

She says she’s pregnant before crashing, but the uterus is empty.

We all slowly learn, we all quickly grow, we all travel to new, exciting places. We all loudly laugh, we all surely know we forget a few names and faces. But when the time has come to meet the maker of you, Will you be able to say I was once a carefree twenty-something too?

Noah Bierwirth

The resident says grab extra shoe covers. This is going to be messy.

“Is that a femur on ultrasound...”

The team works frantically. Sterile field is fucked.

Watching from the corner.

The baby is right there but never breathes once.

This isn’t fun anymore.

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Alexis Ramos

Through creative expression and reflection, we nurture our collective humanity and cultivate meaningful connections among students, faculty, staff, patients and friends of UT Health San Antonio.

We are

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