To Let Go.

Despair.

Asphyxiated by the device
meant to grant you life

you pleaded to be released.

Lines running
through your veins
fighting to give you strength-

they only imprisoned you.

You-
always present
aware of the
commotion about you.

Bustling nurses
weeping children

through it all
your eyes were
locked onto mine.

“Help me let go” was your plea.

You grabbed my hand
shook your head

as if you knew this act
had been playing
long enough.

As if someone had
interrupted your journey
toward the place

you were meant to go.

So we released you.
Withdrew your tube
diminished your drips.

Severed the chains that bound you.

We comforted you.

You turned
toward your children.

Through a surge of strength
you assured them

it would be okay-
that through your going on
they would go on.

Then you turned back to me.

Though undeserving
of your last moments

you entrusted them to me.
You held my hand
held my gaze.

“Thank you,” was what you said.

And then you took your last breath.

And let us go.

 •       •       •

This patient has been in my heart lately. This post is a re-sharing of an account of our last encounter. A gentle reminder to treasure each moment given. 

 •       •       •

The Background Story

A Memory of Ground Beef.

Once when I was on a specialized heart failure service, I took care of a teenage boy. He had a form of idiopathic dilated cardiomyopathy (a weak, enlarged heart), and he had a huge heart…in more ways than one.

He loved baseball, pumpkin pie, and horses. His family owned a farm, so before he got sick, he would often go horseback riding. He also loved to draw.

We—a team of five physicians—took care of him for a month while he was waiting for a heart transplant. He liked us. We liked him. So he drew us as well.

I thought he was clever. But he thought I was even more so. All because he liked my joke:

“What do you call a cow with no legs?”

“Ground beef.”

That was it. He was just a great kid, trying his best to live the life given to him.

It used to be, that at the end of our visits, we would both say to each other, “Ground beef!” with a wink and a huge smile. It perplexed the other physicians, but we knew exactly what we were talking about.

It was just a silly joke. But for the two of us, it somehow meant something more. 

I found out recently that he passed away. And today I found the drawing he gave me. And I wept.

So here’s to you, dear buddy…

Ground beef 😉

Tomorrow.

Cheer that blossomed within our hearts,
stirred by your presence at each day’s start,
yearns to wilt when you depart.
But our song will sing again, tomorrow.

The smiles that pierced through saddened guise,
the rays which conquered thundered skies,
they ache to dim neath heaven’s cries.
But the sun will rise again, tomorrow.

For many years our lives you blessed,
but the hour has come for you to rest,
to soar upon hills on golden crest.
So have no fear, tomorrow.

For on that day, I know we shall meet again.

Dedicated to Pam, in memory of Sammy ♥

Ophelia.

Chant of thunder, orchestra of wind,
a breath of heart’s unrest.
Lightening flash in half moon’s glow
unearths laments repressed.
Raindropped streams upon her face
masking moistened eyes,
lead her gently by zephyr’s call
into awaiting skies.

I’m Sorry I Couldn’t Do More.

You took your life.

I’m sorry I was only
fifteen feet away.

The doctors were only fifteen feet away.

You didn’t know this.
But I spent days and nights
next door to where you decided
to end your life. Where the doctors
gather, pondering over differentials…
treatments…dissecting our every move
to ensure that we are doing the
right thing for you.

The right thing…

If I had known you,
I would have fought for you.
I know you weren’t my patient;
I know we had never even met.
I am just the person who found
you. Who pronounced you.
You were already cold,
but still, I placed the
stethoscope against
your chest and
listened.

I didn’t hear anything.

Did you hear me as
I wept for you?

I’m sorry.

I’m sorry
you were suffering.

I’m sorry you felt
as if
you had
no way out.

I’m sorry I couldn’t do more. 

This is a reflection over an event that happened during residency.
An event I still think about at times. 
A lingering guilt.

The Drowning.

Anguish
as waters frosted by twilight
weigh upon gossamer wings.
Deceived by a thirst unquenched,
I descend upon a reflection,
sinking into myself.

Imprisoned
within bitter tides,

I reminisce of a life relinquished–
where pinions sway unfettered
above blossoms coaxed by spring,
flittering from bud to bloom,
each bead of nectar
a fragrant haven.

Peering above to
heavens turned black,

tapestries of stars taunt
as they unbraid before me.
Below bitter waters,
shadows enshrined
whisper silently,
beckoning.

By the lure of
exhaustion

I succumb
to the abyss’
waiting embrace,

the warmth within now
a quivering of a fading flame.

I enter into the void.

When the Heart Stops.

A cardiac arrest. A resuscitation made. A life recovered.
One patient tells me his experience.
This is his story.

Death.
Amid the chaos enclosing,
beseeched by an ambiance of ages to come,
I hear the seraph’s dulcet calls.
Immured by words 
divine and bittersweet,
they sculpt the frigid air,
and I am comforted.
As flesh is pierced, poisons forced,
I am held in tender embrace–
its whispers an oasis to the fears
that boil within my breast.

A skyward calling, its promised hope
glistens the starlight above me.
Memories, regret, longings and dreams–
a cycle ripened to revolve anew
cascades within my being.
I then behold a fleeting sight–
a son, wife, a father, my life–
their love commanding,
gazes imploring.

Therefore
with a strength untold

I fight
until with the sun
I am ushered
out of the grasp
of the ebbing eve.

I open my eyes.

 

•      •      •

◊ The Cardiac Arrest – A Physician’s Perspective ◊

•      •      •

 

The Arrest.

A code called.
She races
as the seas part
for her crossing.

Reposed before her–
rhythm without pulse,
fluid without flow,

substance without life–
is you.

Invaded
as lines in your thigh

penetrate a pump paralyzed,
as tube between ashen lips
thrusts into stagnant air.
Poison pushed into a heart
quivering, she watches as

your chest rises
with the force

of each counterfeit breath.

The symphony begins.

Thump
Shock delivered.
Strike through the breast.
Voltage down your limbs.
Buoyant, jerking,
Each retort
a life feigned by lightening.

Crunch
Bones crush.
The carol of ribs,
a surrender to the fury
of each compression,

quickens with her pounding heart.
Each chord
a dissonant harmony.

Glazed are your eyes
as they pulsate
with the cadence of their dance.
She looks at you.
Pleads for you to return.
Prays to the god she plays.
But your eyes plead for something more.

You leave her.

The story ends.

And the orchestra leaves.

•      •      •

◊ The Cardiac Arrest From a Patient’s Perspective ◊

•      •      •

The arrest

The Sleep.

Rivulets of sorrow meandering
down tear-stained skin.

“Keep her comfortable
until it’s time.”   

Simple words-
echoes
of eternal reminder within.
You rise.

Guiding her
through the threshold
into the chill,

shudders
of realization emerge.

You survey
the molting trees,

their arid leaves
embellishing her hair
like fragments of
woven rhinestones.
As if they weep for her.
As if even the ambiances
of ages past are beseeching
her not to leave.

Soon arrives the Foehn,
holding you within
its warm embrace.
Its breaths,
whispering lines of truth,
sculpt a bittersweet tune
as they herald
the evening’s arrival.
You understand.

Cloaked
by lyrics of singing ivy,
her expression calms,
your fears dissolve.
Consoled by a draft possessive,
you cradle her
through the darkness
and follow her
toward the seraph’s call
into the fold of
midnight slumber.

A New Day.


What do we do, come that day,

when walk we must through vacant streets,
when frore and tremulous become the nights,
and windowpanes with autumn’s dew weep?

What do we do, come that day,
when summertide flees from bitter air’s chase,
when even the trees forsake their leaves,
And swallows depart to a fitter place?

For that day has come,

and now we weep,

as the earth reclaims another,

their souls now sleep.

But come winter’s call new snow will fall,
then
autumn’s death will be entombed.

And as morning rays gleam through curtain seams,
New seedlings in our hearts will bloom.

Then we will know that a new day has come. 

This Poem is Dedicated to the Memory of Rhonda Elkins and her daughter, Kaitlyn.

To Rhonda.

 

Almost a year ago, I wrote something for your daughter.

 •

I never thought at that time that soon I would be writing similar lines for you.

So as I try to find ways to make sense of the pain of finding out that you left us, just as Kaitlyn had left us, I can only come out with these words…

…That through your daughter’s passing,
you had come into our lives.

Through your pain,
the world was moved.

Through your words,
 eyes were opened.

Through your tears,
hearts were touched, lives changed.

And through your perseverance,
Kaitlyn lived on.

But even as you worked unceasingly,
Your soul continued to break, your heart grieved.

And now you are again with your daughter, your bright shining star.

Goodbye, Rhonda. Now you can finally rest.

◊ A Poem Dedicated to the Memory of Rhonda ◊

Sky

 Though nothing can bring back the hour of splendor in the grass, of glory in the flower, we will find… rather… strength in what remains behind…

•      •      •

.For those who may not have known Rhonda, here are the links to her writing.

My Bright Shining Star: A Mother’s True Story of Brilliance, Love, and Suicide

My Bright Shining Star, a blog

To Say Goodbye.

Moisture burning her vision.
In the dark, it hides her eyes.
Teardrops.
Clinging onto her, one falls onto her lap
and stains her skirt.
She mourns.

Comfort her.
Tell her it will be okay.
That the shadow of a moment
may not stretch into tomorrow’s light.
That the ocean,
at its blackest
is still a reflection of the sky,
and she will not drown.

But the tide has come to take you home.
To her smile and her strength
she bids farewell.
Her heart, a piece borrowed and now returned,
departs with you.
She says goodbye.

phoebe-chi-grandpa

 

The Tragedy Behind a Poem.

We did it. We took it out.

Slowly, the oxygen saturation dropped.
Gradually, the alarms sounded.
Insisting. Imploring us to do something.
We turned them off.
Made him comfortable.
But we knew we couldn’t hide the truth.

We were letting him suffocate.

~     ~     ~

A lucid man.
A failing lung. A decision made.
A breathing tube placed—just temporarily—
until the lungs healed.
Until they got stronger. Until he got stronger.
But I saw the regret the moment it was inserted.
Nevertheless. We agreed to give it a chance.

But days passed. Then weeks.
No improvement.
Being alert, he communicated with us well.
Through his writing, I got to know him well.
His adventures. His best memory. His regrets in life.
He was a good man.

But a man who never desired to live like this.

While the family disputed on what course of action to take next,
he remained calm and unwavering.

“Please let me go.” was what he would say.

Then finally the moment came.

The time to say goodbye.

~     ~     ~

That day, I let myself weep during rounds.
In front of a crowd of stoic faces.
To weep over a friend.
To weep over a human being.
Over his courage.
An impossible decision.
The loss of a life.
Everything.

Because I didn’t want to do it. But I did.

I let go.

•      •      •

“To Let Go” – the poem

To Kaitlyn, a Girl I Will Never Know.

I’ve been wanting to write this to you for a while. I go to work, and though I’ve never met you, I think about you. I talk to a patient, and while I’m standing there, there you are again, tugging at my heart. Maybe it’s because I know of your mom, and I know of her heartbreak. Maybe it’s because I know you will never be able to do what you were meant to do.

This is what I know about you. You were a medical student. You went to school in North Carolina. You cared for people. And you wanted to care for them at the greatest capacity possible. You wanted to help people during their times of sickness, strengthen them in their weakness. But your life was robbed from beneath you. So this will never happen. And the world has lost another great physician.

I hear you were a loving person, one who illuminated the day of all whom you came across. Of course you did. You were your mother’s shining star. But what no one knew, and what you didn’t reveal until your departure, was that you were also suffering. Deeply. But you were good at hiding it with your smile. And because it was a genuine smile, we were beguiled. Especially those closest to you.

bench

When I think of you, my heart aches. Maybe it’s because I feel that I understand you better than I have a right to. Maybe it is because I once smiled a similar smile. I weep because of what you did, and because I think I understand why.

When I think of you, my soul is anguished. You were going to be a remarkable physician. You would have touched others with your empathy, changed lives with your care. They would have remembered you, not simply because you were the one who eased their suffering and comforted their souls, but because your spirit would have brightened their lives. No one had the right to take that away from you.

I’m sorry I never got to know you.

But even now, you will not be forgotten.

◊ A Tribute to her Mother: Rhonda Elkins ◊

◊ A Poem Dedicated to Kaitlyn and her Mother ◊

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