birth

c-section
peel back the slit layers of flesh,
cauterize capillaries like so many cigarette burns,
lift out the bloody fruit of the uterus
needles bite into the thick muscle
this part ends in a neat row of staples


I returned to the nicu, met a nurse who had been there 23 years ago, thanked her for taking care of me when I was a tiny, intubated doll in a plastic box

to hold a newborn is to know that your life is no longer your own

For You

frank blood spurts over your cupped hand
Get the doctor, run

clots fall from your lips
Hold onto me, don't look down into the basin

some water to rinse your mouth, a fresh gown
The taste forgotten, the stains unread

more platelets, oxygen, salem sump on way to OR
Reach beneath my ribs and break off half my liver, take it still warm into your outstretched hand

Intro to Peds

• one cannot assume that any tube taped/stitched in place will remain so secured (NGT vomited out, CT "fell out" 2x, IV slipped, GT leaked)
• anticipate that meds may be hidden, coughed up, refused, thrown in face
• screaming child = vocal cords adducted = block route to lungs?
• super sick kids make the world seem a terribly unjust place
  

end of med-surg rotation

The elevator doors close tightly,
the metal box cuts through the hospital floors,
passengers, like potent medication, are released
to wade through hallways of blood choked with microbes,
to circulate into rooms/cells
all this an effort to stave off organ dysfunction, paralysis, coma, death

...

I strip away my uniform,
this thin cloth that weighs so heavily on me
with the responsibility of sustaining life-
but grief has already penetrated my skin

RED

At code RED the staff ran the halls, offering reassurance to patients and closing doors. I asked a nurse what further actions we should take should we see actual smoke. Her ready answer was, “If I see flames, I’m running out and saving myself.” I at first rejected her advice- confident that I would stay behind and help patients to escape incineration. Then I imagined myself struggling to help my patient (on his one good leg) down the 10 flights of stairs. At this point any altruistic impulse was replaced by an instinct for self-preservation. I was surprised at how quickly my supposedly “kind" heart turned to lead...

sight

What would I give
to enter into that torturous passageway?
anything
to comprehend that map of faint blue lines?
anything
to spare pain
to better life


yet I fail miserably.
I am not sure who is more blind- myself or my patient with glaucoma.

"patient is no longer a candidate for lung transplant"

a cruel euphemism for "we are sending you home to die"

Again he faces death as he did in Vietnam-
but these wounds are surgically incised,
these bruises from heparin,
the choking off of air from the build up of scar tissue within and the heavy hand of bureaucracy