Ascensus XII

Ascensus

Ascensus

Editorial Board

Nathan Ashe, General Manager

Joanna Lin, General Manager

Rahma Ibrahim, Writing Editor

Daniel Tay, Writing Editor

Sarah Wozniak, Writing Editor

Amy Lu, Art Editor

Caroline Young, Art Editor

Jamie Kim, Layout Editor

Nuran Golbasi, Event Coordinator

Zion Iverson, Soical Media Editor

Advisors

Randi Diamond, MD

Rachel Kowalsky, MD

Daniel Shalev, MD

Allison Maritza Lasky

Brittney Parillon

Special thanks to the WCM Alumni Association.

Contact wcm.ascensus@gmail.com with questions.

Table of Contents

Dear

A Breath of Fresh Air

What is Healing?

Peggy Murphy, LCSW, APHSW-C, WCM

‘After the surgery, you should go somewhere, you know, to heal.’

She did not know what that meant. All of her life was spent getting injured and then healing in its midst. Healing during school, Christmas, after a tonsillectomy….

This healing sounded different. It was large, an event. Tasks had to be assigned, arrangements made. A wounding and a retreating. Adults go off, stop their business. Children continue, they play. Could she continue?

Would the healing mean that there would be a big, final, all-encompassing scar that would put an end to any openings, any seepage?

Would there be reminders every so often? Scans, ablations, more surgeries?

Is healing a onetime event, a reactive process or both?

She had to slice the word in half, heal/ing. She had to understand what was being asked of her, the patient, to go off and heal. Healing, ceiling, feeling, willing…. rhyming.

Letters up close look out of place. The word healing has a soft underbelly. The word heel, bottom of foot, sole of a shoe, walk heel to toe.

To call someone a heel is to point out that they did something wrong, they are a person who should stay back and away. The head should hang low, and the posture should present as crestfallen.

Yet somehow, shouldn’t a person who is in the midst of healing be a heal? Or a well or a health?

She stood on a small lake by a small house, many miles distant from the cool, worn surgeon’s office. There was fluttering around her ankles. She looked down to see a small school of fish. Tiny ones, clustering, moving back and forth. Again, she placed herself in her memories as a child, during Springtime, standing in the icy cold, stream water. Reaching down, she would attempt to grasp a minnow. They were always out of reach.

My Sunflower

Sasha Garcia, Clinical Administrative Specialist, WCM

A thought of her made me smile in reminiscence.

Her heart was made of gold as bright as the leaves.

The love for her children was as strong as the stem.

For her, it meant long-life lasting happiness, It was her lucky charm.

Despite knowing She will not be here for long

Yet she still chooses to live

Her brightest of days.

She never got to age like everyone else did, It was as though she only lasted a season.

How have our lives changed so quickly before our eyes?

No one could lift someone’s spirits quite like you did.

You were bright, cheery, warm,

and inviting as the sweet summer sun.

That is when I knew you had become my favorite Sunflower!

Ascensus

Pathways

Walk Along the White Cliffs

Caroline Young, MD Student, WCM

Ian Nykaza, MD Student, WCM

Saying Goodbye

Mohamud A. Verjee, Assistant Dean, WCM-Q

The usual journey, familiar route, park the car

Find a trolley, load baggage, sadness looms afresh

Check-in counter, discussions on upgrades

No room, “Sorry Madam”, even if you wanted to pay

Bags weighed, please don’t let it be too heavy, accepted

Slow walk to immigration, queue ahead, final embraces

Cleared, now to security, “Laptops, iPads out”

Orders barked, “Belts off, empty your pockets”

Everyone complies, some mumbling, others fumbling

All well, cleared X-ray, repack, moving out of sight

No end to the queue, strain to see, recognize faces

One last glimpse, waves from the family, smiles too

Now, alone, standing in the airport, at Departures

Watched your family go through immigration

In a flash, gone, out of sight for now

Wishing you could be with them on the flight

Praying for their safety during the journey

They should be fine, calm yourself, have faith

Going home alone now, subdued, heading out Missing them already while walking to the car

Open the door, close it, sit quietly, pondering

Wait for news of their safe arrival, hours to go yet No one to talk to on the way back home, radio on Comforting knowing you will soon be reunited

Phone rings “we are fine, just waiting at the gate”

“Flight is leaving on time, seems quite full”

“Missing you already,” you smile “And I miss you all too”

“Love you,” “Love you too,” aches in your heart

Back home, phone rings, “flight delayed an hour”

Robbed, why we could have had an hour longer together

Amy Lu, MD Student, WCM

Mrs. Winslow’s Soothing Syrup

Nicole Milano, Head, Medical

Center

Archives of NewYork-Presbyterian/Weill

Cornell Medicine

Have you been hoping for a miracle cure-all to improve your complexion, to get rid of those pesky kidney stones, or perhaps even to prevent balding? If so, you’re not alone! In the 1800s, U.S. Americans were targeted with advertisements for what were often considered “cure-all” medicines. Known as “patent medicines,” they claimed to cure a variety of ailments from the common cold to constipation.

Patent medicines were advertised through eye-catching trade cards, which used new lithography printing techniques and were easily circulated to consumers. Created in an era before the 1906 U.S. Pure Food and Drug Act, which was the first federal law to enact a wide variety of regulatory activities, these patent medicines were unregulated products. Manufacturers were not required to list ingredients on the packaging.

The Medical Center Archives of NewYork-Presbyterian/Weill Cornell Medicine preserves a collection of 197 colorful trade cards promoting late nineteenth- and early twentieth-century medical services and products. One of these products is Mrs. Winslow’s Soothing Syrup, advertised to help weary mothers rest by reducing pain felt by teething and colicky infants, first produced in 1845 by pharmacists Jeremiah Curtis and Benjamin A. Perkins of Bangor, Maine. Patent medicine trade cards often employed imagery meant to appeal to contemporary consumer tastes, and this trade card includes an eye-catching image of a healthy mother with her rosy-cheeked children. Looks can be deceiving, however, as Mrs. Winslow’s Soothing Syrup contained morphine and alcohol and was eventually linked to infant addictions, comas, and death. Because the United States government had very little regulating power to oversee the safety of medications, this dangerous medication continued to be advertised into the 1930s!

In addition to offering a glimpse into the visual culture of the 1800s, patent medicine trade cards like the one for Mrs. Winslow’s Soothing Syrup offer insight into medication advertising and attempts to influence consumer interests at the time. For more information about historic and modern Direct-to-Consumer Advertising, visit the online consumer health information resource “Snake Oil to Social Media: Drug Advertising and Your Health” by the Samuel J. Wood Library and Medical Center Archives at library.weill. cornell.edu/snakeoil!

Eye-Opener

Aparajita Sarkar, MD Student, WCM-Q

Indian Doctor’s Association Medical Camp, WELLKINS Medical Centre

Doha, Qatar

Friday, February 10, 2023

7:00 am

As I entered the Wellkins Medical Center in Doha, Qatar, my mind swirled with thoughts. First, I would see patients with actual problems; for a change, I would be on the other side of the encounter. I was excited yet nervous. What kind of complex diseases was I going to see? What kind of signs and symptoms would I be able to see? Hear? Touch? How different would our simulated labs with standardized patients be from the real world?

Walking in the hallway, I found a long queue of men waiting for their turn to register and be seen. They were going to be my patients. I looked at them with curious eyes, trying to discern the purpose of their visit from their appearances. Each one of them seemed to be a mystery waiting to be solved. All two hundred had different body shapes and sizes. Some looked healthy, while others looked undernourished. Some looked happy, while others displayed mixed emotions.

“We are starting,” someone said. There were twelve students, and we were ushered into the offices in pairs. We introduced ourselves to the attending doctor already seated. He asked us a few questions. Before he could fully introduce himself, our first patient walked in. We sat down quietly to the side to observe the patient-doctor interaction. I looked at our patient, who sat silently on the chair before the doctor’s desk. He handed a card to the doctor, who read it before passing it for us to read. A question followed. “What do you think might be wrong?”

The card had the patient’s demographics, blood pressure, and blood glucose results, and confirmed elevated blood pressure. Performing a cardiovascular examination, our doctor asked us to listen to the patient’s heart, telling us to focus on the A2 heart sound. Putting my stethoscope into my ears with glee, I followed and listened to his chest’s four heart valve areas. I am always excited to listen and hear new or atypical findings. So, I was amazed to hear the A2 sound was louder than S1 and P2. I presented my findings to the doctor and learned that the A2 is louder in patients with systemic hypertension. I locked away that new piece of information in my curious brain.

The men were mostly blue-collar workers with limited access to healthcare. The “medical camp” provided free check-ups. Some features observed were notably consistent. Many had normal body mass index ratings (BMI) and seemed asthenic. Blood pressure readings and blood glucose levels were normal. Interestingly, their appearance told us more about them than the laboratory results and physical exam findings.

The next patient in the group arrived. The doctor asked if he had any problems. His feet hurt, pointing to a heel. Examining his foot, our doctor asked us, “Well, what do you think?” Being first-year medical students, we were unsure of what to say. I had heard that excess uric acid crystals in gout could also affect heels, so I guessed. The doctor paused momentarily, smiled, making me nervous, and said, “Yes, it could be that, but not here.” He pointed out the thickened heel tissue. The diagnosis was plantar fasciitis. Another new piece of information!

With a small break before seeing the second group of patients, we met the distinguished guest of the day. His Excellency Dr. Deepak Mittal, Indian Ambassador to the State of Qatar, officially opened the event, and we joined a group photo.

We resumed consultations with another physician, a WCM-Q faculty member. Unfortunately, the next few patients’ ability to speak English was limited. So, I jumped in and took on the role of a translator.

One of the patients complained of non-specific chest pain. On questioning, he mentioned that he had some ear discharge. The physician examined his chest and heart and assessed his neurologic responses as a different demonstration. He taught us the normal Achilles heel, knee-jerk, and Babinski reflexes, explaining how to interpret the tests if they were abnormal. I was very enthusiastic and eager to gain every piece of new information I could in the little time we had left before the end of the session.

The whole camp experience built knowledge and understanding. It included more than learning about different conditions and physical examination findings. We also learned how to understand patients’ issues, deciding how to approach those and others that the doctor’s skill elicited.

Last, I learned that it is important to be versatile and adapt to the dynamic interaction of a doctor-patient encounter. Patients can be a mystery at first, but as student doctors, our task is to solve and treat problems with the utmost care!

Amy Lu, MD Student, WCM

Nature versus Architecture

Ilana Kotliar, Postdoctoral Associate, WCM

Sunflowers that are wild at heart. A paved road and houses. Dense foliage growing to its heart’s content. A castle on a hill. Interweaving the nature with the creations of man leads to the landscape we visually feast on here. Mixing nature with structure can also create excitement and a coherent sense of self within us.

Giraffe

Emily Mei, MD Student, WCM

What is Healing?

An obvious, unsatisfactory answer to the question, What is healing?—Daniel Tay’s inaugural question of this new, themed section within Ascensus—is that healing is the process of restoring health. This response is akin to answering the question, “What is a constellation?” by drawing stick figures. Such directness obscures the fact that a constellation lies in the emptiness between stars as much as in the lines one might draw to connect them. This section forms its own constellation. We hope you will both draw connections between the pieces that compose it and see each as its own answer. Using my editor’s prerogative, I hope to add one dot to this configuration by way of this introduction.

In Western cultures, there is a long tradition that conceives of healing as a process of making whole that which has been diminished by injury or disease. It’s a line of thought that I once shared. In my own experiences with loved ones who have confronted serious illness, though, I have found that returning to wholeness is an impossible goal. Indeed, the very presumption of its possibility approaches cruelty. This return-to-wholeness mentality mistakes the nature of the injuries from which we seek to heal. The critic Elaine Scarry argues that pain unmakes the world by destroying language: attempts to articulate extreme pain dissolve into mere babble. Illness, too, I would suggest, unmakes the sufferer’s world, paring the transcendent self to blood and bile and bone. Whether living with illness or through it, the world no longer means what it once meant.

Perhaps healing, then, is a process of making new meaning out of bare matter. The healing I have seen does not take place in the clinic or on the operating table—even if these places may provide the necessary foundation of future health. Instead, it begins at home, returning from the hospital, terrified of further deterioration, anxious to avoid alienating already busy doctors with possibly frivolous worries. I have seen healing in tentative steps on newly unfamiliar feet and heard it in the arduous construction of words that were once easily formed. I have seen healing in furious attempts to make sense of a world in which some bodies suddenly break as others seemingly bloom.

These attempts toward sense-making bring to mind a favorite passage from the medieval mystic Richard Rolle. Apostrophizing to Christ, he says, “Then was thy body like heaven: for as heaven is full of stars, so is thy body full of wounds.” For Rolle, the light of this embodied constellation pierces the clouds of sin. As a secular reader, I am struck by the analogy, which suggests that even open wounds can orient us in unexpected ways, pointing toward a pole star that may yet be hiding behind clouds. I do not know what it means to be healed, if such a past tense is even possible, but I see healing in the act of making provisional constellations from the stars we are able to see and in the perhaps obscured ones we otherwise manage to perceive. We thank the contributors to Ascensus XII for providing many possible constellations, which we hope you will join us in tracing.

—Nathan Ashe, General Manager

A Journey to Healing

Sasha Garcia, Clinical Administrative Specialist, WCM

Questions

KT Tsang, MD-PhD Student, WCM

Is now a good time to talk About the things that lie Between the lines of our lives

And the words that have nowhere left to run?

Can healing be: A friend’s couch, a firm hug, Long walks on the streets, A laugh between those who were lovers?

The way you nestle on the window sill and fall asleep on the floor, Safe among the warmth

Of a space full of friends?

Can healing be: A plane to a place far away from here, And bereft of those comforts too?

Blood is oozing through the gold

Which is sealing up the cracks Which is keeping it all together. (It looks bad now, but this is part of the healing process. That’s what I say, anyway.)

Can it ever be enough?

I ask these questions to understand, Can love outpace hurt? Do we die lonely?

If I let go will we be okay?

I stepped across this threshold to ask Questions.

And because I couldn’t choose Between sustaining the heart And dissecting it.

What are we capable of My brothers and sisters

In my journey to finding my true purpose and healing, I came across this fantastic view. I took this picture on a beautiful small island I call home. I was so focused on the view that I didn’t notice the couple walking their dog. After looking deeply into this picture, I figured out one part, and I smiled because I have a passion for what I do.

“You are important because of who you are and matter to the end of your life. We will try to do all we can to help you feel comfortable until you fall asleep peacefully but still live until you close your eyes.”

I can’t forget the look on your face When you opened the door. (It broke my heart to think that the world could be so cruel To you and I.)

And beloved in-betweeners — my dream-shakers, world-ragers? What brings you in today? And what keeps you here when all is said and done?

I think we need to believe That we can change the world. So let us hold hands in the tides As the world changes us too.

Reading Patients, Not Just Textbooks

Diksha Brahmbhatt, MD Student, WCM

Mini notebook and “I Voted” pen in hand, I shuffled up to the giant labor & delivery monitor, now in the routine of writing down mom’s name, room number, parity, and details of the last pelvic exam. Three weeks into the OB-GYN rotation, I was finally growing wings of independence, no longer awkwardly shifting my balance from heel to toe while standing behind my resident. I had a newfound confidence that came with learning how the hallways connected to one another, where the supply closets were, how to unlock and drive the hospital beds, and how to explain the stages of labor to laboring patients. With the perkiness this confidence had infused into my step, I popped into room 12, prepared to introduce myself to Rachel, who was a first-time mom with a cervix dilated to 8 cm, nearing the nerve-wracking time to push. Rachel, her husband, and I established our roles in this journey through our introductions to one another, and I quickly picked up the personality traits and dispositions we were all bringing to the experience. Rachel explained she was a lawyer, having quickly climbed the ranks of her firm in her early 30s. She was wide-eyed, soaking in every detail from my spiel about the relative lengths and characteristics of the stages of labor and what to expect from each step. Her questions were quick, pointed and methodical ones of the “if then” nature. How many hours, on average, would it take to get to 10 cm based on her progress? What was the optimal position for pushing? Should she be holding her breath during pushes? What was the contingency plan if something didn’t go as planned? All the while, her husband, Jason, remained in the chair beside her, almost afraid to utter a single word, as if he were a side character banned from speaking in the presence of protagonists. Reading in between the lines, I painted a picture of their relationship in my mind in which Rachel was the decision-maker and Jason was the dutiful and agreeable supporting character.

When I returned to Rachel after an hour of “speed dating” in other rooms on L&D, the time to push had arrived. With each set of counting to 10, we refined and perfected our method, with Rachel eager to “get it right.” After 1.5 hours of diligent effort on her part, and awe and stunned silence on Jason’s part, it was becoming clear that her pushes were not paying off. The experienced PA suspected that the baby’s head was not positioned ideally, and she came back with a slew of new positions to try, hoping they would help baby reorient. Another hour went by and I became painfully aware of Rachel’s glistening eyes, full of fear, doubt and disappointment, giving way to frank tears. It seemed she was embarrassed to show this kind of emotion, no longer able to tightly control her reaction to hours and hours of pain and promise. She had wanted to avoid a C-section, determined to accomplish what she had set out to do. It was becoming more and more clear that we may not have another choice. I instinctively reached out to place a hand on her shoulder, conjuring up the most understanding yet reassuring countenance I could. I had sensed

earlier that she was not used to warm, sympathetic physical touch, or perhaps that she did not prefer it as a display of connectedness. Yet, I could see the wrinkles at the corners of her eyes soothe as my hand lightly squeezed her shoulder. It was a highly uncertain, unfamiliar situation she found herself in, and perhaps it only seemed right that an unfamiliar mode of comforting would bring her calm.

Not being able to articulate this at the time, I now realize I had been interchanging different versions of myself to mirror the styles of the moms on the L&D floor, hoping to be able to speak a shared language despite never having gone through the experience of pregnancy myself nor having had more than 1 week of experience participating in deliveries. When we began to near hour 3 of pushing with Rachel, I knew I needed to dig for the correct version of reader within myself, one who would not only be able to process her fear, guilt, and sense of failure, but also translate the medical scenario into explanations that would ease the confusion, uncertainty, and culpability. When between tears Rachel expressed, “I really want to try. I really want to bring her into this world,” I immediately interpreted those words in the context of the bits and pieces of her life outside room 12 that I had gathered earlier. It seemed to me she was used to being able to problem-solve and achieve what she set her sights on. She was trying to define herself, declare herself through how she handled this ordeal. She was determined inside of that room and outside. When the call was made for an emergency C-section, her eyes betrayed her sense of defeat, the fear that she had failed, that this was the result of lack of effort.

When the frenzy and mayhem of rushing to the OR and bringing her baby girl into the world had calmed, I tapped into my newfound sense of independence once again the next morning and found her room number on the postpartum floor. I had been unable to stop thinking of Rachel even when I sat down to study UWorld questions that night. I couldn’t shake the thought that someone needed to tell her it wasn’t her fault! Having read her story and sensed the weight of her world on her shoulders, I couldn’t help but walk away fearing that she blamed herself for how the labor and delivery process had unfolded. I needed her to know she did the best anyone could, that so much in the hospital leans on the crutches of chance and happenstance. I gently but assuredly knocked on her door, opening it to find her baby in the bassinet, Rachel sitting next to Jason on the couch. Her eyes were tired and unsure. I offered all I could in the way of the medical circumstances that had made a vaginal delivery difficult – the asynclitic presentation, the need to use a special suction cup, the inevitability of the C-section despite powerful efforts to push effectively. In the end, knowing she would want all the details she could fit into her logical mind, I still felt that the best I could offer her was a simple but firm “it was not your fault.” She replied, “Thank you. Really.” I still think about her, hoping she will trade the trauma of the birthing experiences for simple moments of joy with her daughter, that she will come away with not a sense of culpability, but the knowledge of the power she relentlessly displayed for hours on end.

*Names, locations and certain details have been changed to protect the identities of the persons in this reflection

What is Healing 1

Hannah Cramer, PA Student, WCM

Alternative Focus Healing

Ilana Kotliar, Postdoctoral Associate, WCM

Flowers usually get all the focus in macro nature photography. Here, we are instead invited to focus on the intricate subdivisions of the sunlit leaf, undoubtably undergoing the first stages of photosynthesis many times over. Sometimes, when things are out of focus in our lives, we can heal through redirecting our attention in an intentional way.

Dear Donor

Zion Iverson, MD Student, WCM

Recited at the annual Weill Cornell Medicine Anatomy Memorial Service on December 14, 2022.

Dear Donor,

Who are you to me?

I feel an odd sense of protection over you. I call you my cadaver. My body. I say our lung has a tumor and my person has really small muscles. I would not share you with just anyone, because you’re under my care. When other students want to touch you, they ask permission. They ask if they can see your pacemaker and I proudly show them your secret tech. I’m not sure what this protection means. I’m not sure what our relationship is. When you’re gone, will I think of you? Will I remember the time we shared in our noisy basement surrounded by your friends and mine? Is it crazy to try and define our relationship when I am alive and you are dead and we are nothing but the most intimate strangers?

I don’t know, but if I’m being honest, I think we are something. I know we’re not friends. Not peers. Not acquaintances. But we have to be something. I’ll explain at the risk of rambling. You are a reflection of me. Everything I have thought about during my exploration with you has come from me. You offered no verbal input, no minute changes in body language, no expression of opinion whatsoever, and yet with you I had the deepest conversations. Your mirror showed me my grandpa. I never met him, but he, like you, died from lung cancer. When I saw your lungs you offered a moment of intimacy with a lost part of myself. I held your lung in my hand and wondered if my grandpa’s looked like yours. Your mirror showed me my grandmother. By the time I knew her she was already in a wheelchair. And eventually she had to stay in bed.

I wondered if your small muscles, that were so hard to dissect, looked like hers. Your mirror showed me myself, aged up. Gray all over. You broadcasted my discomfort with aging and death. I shrank away from the parts of you that revealed my own fate. You didn’t like that and I get it. You’re here ready to show me everything, and I’m sitting at the edge of the table too afraid to look. Your mirror played my memories and there I was bathing my great grandmother. You shamed me for my discomfort then and asked if I had really grown so little. So I found the beauty in life lived long enough to grow old.

I’m not sure if that’s what you thought would happen when you donated your physical self to me. Did you know you would come to me in fleeting moments as people I knew and loved? Did you know your donation was to more than scientific knowledge? Did you know I would ask you how your day was, and tell you I was tired, and apologize for the all the times I was too wrapped up in myself to appreciate your gift?

Who knows? I thank you regardless of your intent.

Your student, Zion

What is Healing 2

Hannah Cramer, PA Student, WCM

Open Wound

Joanna Lin, MD Student, WCM

I: Hemostasis drop everything, ice cream sob in bed, anything to close.

a thousand condolences pats on the arm are a million spiky platelets. it does the trick for now.

II: Inflammation it’s warm, the neighborhood at the doormat.

daily casseroles gift baskets from california. are swelling that needs ice, good intentions just add pressure.

III: Proliferation smile convincingly, and questions fade. lay down a new foundation but it’s faulty. like sound-proofing fibroblasts, only muffles the cries.

IV: Remodeling “just today” by “just today,” nearly as strong again.

once in a blue moon reminders push through the scar tissue of memory, all too aware of the resistance.

Flexible and Resilient

Jenny Yau, MD Student, WCM

Forgetting Statue

Allen Lu, MD-PhD Student, WCM

When I was younger, Grandma left with her memories and gave me Statue. I tried my best to etch Grandma’s features on the stone face. Her hair, like thatch-roofed towns. Those riverbed eyelids draining down into lukewarm brown.

I still trace wrinkles on Statue’s hands because there is history there. There is still singing and blood deep beneath the pale bone. I still rehearse daily plays with Statue, but she forgets her lines. We recite “Breakfast Menu” and her favorite, “What’s your name?” I play grandson or stranger or ‘You,’ and Statue plays scenery. Instead of sleeping

Statue sits by the windowsill long before dawn, frowning at the overgrowth, the blank portraits on the wall.

It was 2 pm on a Tuesday when Statue and I watched turkeys climb trees. We marveled as they leapt up from each branch until they rested heavy on the pinetop, safe finally from foxes

but not hawks. I remember that day, when we both learned something new. And Statue handed me what probably was a photo of the two of us, but I couldn’t bear to look at it, just folded it in half and tucked it loose in my back pocket for crows to pick away at.

Wedding Speech to Silence

Daniel Tay, MD Student, WCM

Note: After my friend Annalise asked me to say a few words over the weekend of her wedding, I sat down and wrote this speech. It is, as far as I can tell, a wedding speech. And it is framed by the poem “Enough Music” by Dorianne Laux, which I recited before delivering the text that follows this note. Given questions around reprinting the poem in this journal, here is a link: https://www.poetryfoundation.org/poems/58676/enough-music

As far as I know, this is the second wedding I have been to in person, and it is the first I have attended for a friend rather than a family member. Even still, I have watched and listened to enough wedding and pre-wedding speeches, in person and on video, to know that, as a genre, the wedding speech can be tricky if not completely trite and annoying.

It is especially hard for the wedding speech to resist the sentimentality of the wedding itself, which tends to ignore or at least poorly traverse the gap that separates what we call love from what we call marriage. Annalise, of all friends, knows that two people need not be married to love one another. And I would guess that everyone here could provide a unique example from popular culture of a couple that has had a wedding without actually being in love.

You might notice, as I say this, that I have opened this particular wedding speech by invoking a poem that venerates what we don’t say. Aside from recapitulating the poem’s paradox, using words to construct an ode to the wordless, I have also backed myself into quite the corner: while the poem adds a shot of aura to this speech, I must now justify its use and perhaps even explain, given the strong value it seems to place on the unsaid, why I am talking at all. Perhaps I should have just left things at the poem.

Well, my name is Daniel, and Annalise is my longest-tenured and most faithful friend. We have known each other almost thirty years, since preschool. Our fathers share the same birthday. Her fiancé Zach is a newer, more recent friend. And in him I see traces of the same good intention, humility, humor, and extraordinary faith that Annalise has always offered and elicited.

Now when I say faith, I am borrowing a word from the philosopher Emmanuel Levinas, who says of faith that it “is not a question of the existence or non-existence of God. It is believing that love without reward is valuable.” Faith, at least according to Levinas, is a belief in love in the absence of something.

In this way, falling into rhythmic silence is a bit, I think, like falling in love. It occurs after we’ve had enough—enough driving, enough talking, enough music. Of course, silence is not the opposite of these things but the ground of them. It exists within and between the driving, the talking, the music—underneath them. Falling into it suggests that these other things fall away, that they become absent, at least for a time, perhaps so that we might open ourselves or return to what is left, to a new variation on the eternal essence that remains.

And to be married, I think, is to make an analogous pledge to remember this—to vow to listen faithfully to and for a rhythmic silence that underlies and outlasts what often fills the shared life of two lovers. To promise to remind our beloved to do the same if ever they forget. I doubt I am alone in saying it is Annalise’s faithful ear for this silence that inspires my presence here today. And it is the ancient oath she and Zach will take to fall again and again into their own unique, ever-changing rhythms of silence that nourishes life, and saves a world.

Penciling in Dreams of Healing

Surin Lee, MD Student, WCM-Q

A Breath of Fresh Air

Ilana Kotliar, Postdoctoral Associate, WCM

This piece highlights the healing power of a lush green landscape and a blue sky. The photograph invites the viewer, no matter where he or she is in the world, to breathe a little deeper, and picture themselves in this setting, roaming the valley.

The bird’s eye view we are granted here empowers us to simultaneously feel awe and peace, and hopefully regenerate our energy in the process.

Caroline Young, MD Student, WCM

Choosing

Stephanie Tam, PhD Student, WCM

This for sure, but not quite That. This face does not match That. My eyes tell all, I must not belong. That I – cannot be That.

I am That, though! That counters your first thought… You assumed This when you saw, My face. My eyes.

Aiyah, what’s This?

Warbled words, misplaced tones, My mother tongue is trapped. A symbol of familial failings, How could I – allow That?

I am This, too!

That is only me, Some of the time. Please let me prove, How much of This I am.

Enough!

I will never be. Be tough and persevere. Bear not the gaze placed on you, Make peace with who I see. Only then, can you be free.

This-That, The Other.

I know now I am whole, But I am still choosing, How to see me.

Un Abrazo

Brittney Kate Chong, MD Student, WCM

A High Meadow in Bloom

Ian Nykaza, MD Student, WCM

Tangled in the Web

Ranad Beitelmal, MD Student, WCM-Q

Rain is falling

So are tears

I never felt more helpless in these past years

Our paths different

Not opposite

Not parallel

But a zig-zag

Of circles and intersections

Always speaking but missing

Always trying but never achieving

How did things deteriorate so quickly?

Sometimes it’s hard to think you care

Sometimes it’s easy to see the way you feel hurt

Every day is a new conclusion, a new insight

The rain reminds me of the beginning

This could be an end though

How do we work through something that’s already become so twisted?

I myself don’t know.

Waves

Amy Lu, MD Student, WCM

Epiphany

Koianka Trencheva, Dr.PH., BSN, M.S., WCM

I fear you not, darkness so mighty

Not even the shadows on your eerie walls

Reflecting thousands of blue meteors

Neither the shadows on the window’s rim

Singing the song of the imminent stint

The light I dread behind that knob

Ingress and egress of dainty life

With its bright countless tints

And their so many altered streams

I fear you not, darkness so mighty

Comforting zone fondly embracing

And gently spellbinding so many

Inconsolable abandoned souls

Train Ride

Rahma Ibrahim, MD Student, WCM

Stairwell of Resilience

Nasser Al-Khawaga, MD Student, WCM-Q

Broken bone or broken heart?

I may have felt it from the start

It truly took a bit of art

With time I’ll see what life has brought

I admit that it has been hard

Who to blame or who’s at fault?

Pieces away, far apart

With trust I open the door; unlocked

At long last, I am not ignored Pains and hardships have been washed Worth the wait or what I have explored?

With faith I have claimed the reward

Untitled

Mackenna Mejdell, MD Student, WCM

To New Voyages

Ian Nykaza, MD Student, WCM

Please visit ascensusjournal.com to see more music and multimedia submissions

Empowerment, Surin Lee

MD Student, WCM-Q