A Physician’s Plea.

A message rekindled for the caregivers of today…


A medical student. A simple question.

“How am I supposed to go on caring?”

At the time, suggestions abound.
Work-life balance. Self-care. Hobbies.
Remembering our initial calling.
Remembering we still make a difference.
Remembering our love for medicine
and the privilege we have as caregivers.

But then the realization-
I don’t know the answer.

I only know that I have witnessed around me-
at every stage of training and practice-
evidence of emotional exhaustion.
Dissatisfaction.
Disillusionment.

Burnout.

So this is my plea…

Continue reading “A Physician’s Plea.”

You Are Appreciated

Tendered is this touch that
saves and soothes, comforts and mends–
strength sustained by the pulse of
a heart constrained by its own calling,
the candle within softened by flame,
its waxen tributary a remembrance to
the joys and sorrows, gains and losses
…moments treasured in the care for mankind.

A few lines from Healerin recognition of the efforts of all the nurses, techs, and everyday caregivers out there.
Thank you for being you.
💙

 

A Bitter Thanksgiving.

Many of you may recall having read these lines from past Thanksgivings; it is a retelling of a visit I had with one of my patients during this time of year—a woman whose life and struggles were unlike mine in many ways, but who nevertheless taught me many things about courage and integrity.

I hope you enjoy these words, and have a blessed Thanksgiving week.

•      •      •

Allow me to spin upon the spindle
a tale of an encounter true.
A patient once, a homeless mum,
her words now shared with you:

The hour of autumn arrives anew
when mirth and feasts abound.
But let me confess my days to you,
true gifts which have been found…

The steady cadence of my heart,
voice to praise when souls fall dark,
vision to behold each fresh day’s start-
For this, I am thankful.

The assured exhale of every breath,
joys gone by, its memories kept,
cloth to shield from winter’s death-
For this, I am thankful

Days when I can veil my cries,
days I look you in the eyes,

to know on night lies brighter skies-
For this, I am thankful.

So for this…I am thankful.

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

Healer.

Dedicated to all whose compassion serves as a light in this world…

 

Shattered
like a vessel of alabaster
rent for its salve
she is an ointment
poured forth
upon bleeding souls
and wounded flesh
a river of compassion
forged with an oath
fueled by a vision
those hands of clay
guided by light
skillfully molded
with a wisdom
paid with a price.

Tendered
is this touch that
saves and soothes
comforts and mends
strength sustained
by the pulse of
a heart constrained
by its own calling
the candle within
softened by flame
its waxen tributary
a remembrance to
the joys and sorrows
gains and losses
moments treasured
in the care for mankind.

A Caregiver’s Heart.

I cared for you even before we met.

As letters meandering the page
sketched the contours of a portrait,
I looked forward to meeting you.

As I enter the room,
I sense a fragrance of time past,
of struggles endured years before–
silent whispers of a mind’s unrest
reflected through misted eyes.

As we talk,
of a soul’s facade you steadily disrobe.
Words of suffering and pain, joy and pride-
each syllable a silvered twine
weaving your life’s story.

I examine you.
Your heart-
that fulcrum deeply hinged.
A bittersweet thrum
of a battery strong but worn.
Your lungs-
that which sing
their own melodious song,
a lulling carol
invigorated with each exhale.

From there a journey it becomes
to strengthen you, to make you whole.
A disease conquered, a valley bridged.
A hollow filled, a life restored.

We work together.
As ripples in a wake,
your life affects mine,
for the same heart that aches
when you suffer
rejoices with you
in your victories.

Because this is what I treasure–
the chance to care for you,
to walk with you.

It is a privilege.

So thank you for letting me.

The Waning.

You already knew.
Gaze unflinching, 

you told us to say the words.

Amyotrophic lateral sclerosis

A. L. S.

Despite sparse questions,
your eyes revealed
an understanding far deeper
than our answers-

that with one moment,
robbed were you

of the years ahead,
of memories awaiting,
of stories belonging to you.
Now lost.

Strength dissolving,
your conviction remains
unscathed.

You savor
each passing sunrise.

Each caress, each step.
For you know.
As your legs cease to support,
arms stop to comply,
you still feel
your child’s touch.

Absorbing her love.
Pretending
you don’t care the roles
have been reversed

as you yearn
to return her embrace.

As its hunger ascends,
You treasure
the remaining days.

Every word, every smile.
For you know.
Soon it
consumes your voice,

drains your visage,
until all that is left is
the silence
of a vacant mask.

Unable to reflect
your thought’s grin,

your heart’s laugh,
your soul tears
as you blink away the moisture.

As your breaths
increasingly betray you,

you are not defeated,
for the flames
of your bruised spirit
are not quenched,

and you give thanks
for the time you had,

even as your body dims
and you fade away.

A Search Within.

How do I know
the pill won’t seem
bitter to your tongue
through your teeth?

How do I wear
a once white coat
stained with tears
of memories?

How do I compel
my pen to write
scripts to fight
a dimming light?

How do I know
 which waters will flow
to unearth the strength
within me?

How do I persuade
a heart to let go
when it’s my hand
that sets you free?

How do I ensure
my smile won’t be
one of the last
that you’ll see?

How do I force
my ears to hear
a song I fear
of dusk so near?

How do I know
which waters will come
to enshroud the doubts
within me?


The Hug.

Bitterness.
Each word, a slap.
Each consonant, piercing.
Bursting in like a winter’s storm,
you permeated into our lives.

We wanted to help you,
but we only came to fear you.
Many shook their heads in pity.
Some avoided you.
Others talked about you.

Contempt.
Each gesture, scornful.
Each insult, stinging.
My attempts to talk to you
only seemed to anger you more.

You terrified me. Yet I yearned.
To see. To know. To understand.

I knew you were frustrated.
Your disease, unforgiving.
Slowly devouring. 
I knew you were discouraged.
Your body, powerless.
Slowly succumbing.

But why wouldn’t you let us care for you?

Desperation.
Each day, the same.
Each encounter, fruitless.
You turned us away again and again. 
Until one day I confronted you. 
I asked you why.
And you told me.

I know you don’t really care. This is only your job. 

My job.

It all made sense.
The bitterness. The coldness. The distancing.
I understood.

Stepping forward,
leaving behind the pride, the decorum, 

my arms enclosed around you.
The fear escaping my racing heart
only after you made a move to wipe your eyes.

You then collapsed into me.
My shoulder, an insulation
to the sound of choked sobs.

You never said a word.
But in your cry I heard your anguish.
I heard desolation.
I heard relief.

Things were never the same after that.

Your bitterness was gone.
Your words, softer.
Your eyes, warmer.
You allowed us to care for you, 
remaining strong even
as your disease progressed.

Until one day, like winter’s snow, 
the seasons beckoned for you to leave.
But even then, as you faded away,
you reminded me of the day everything changed–

The day I gave you the hug. 

What the Stethoscope Hears.

What do I hear when I bring you to my ears?

What story does your body unveil?

I hear your heart,
the clap of each valve,
sloshes of vigor from lumen

to chamber to reveal
resilience and strength.

I hear your lungs,
the whisper of bronchi,
each crackle, each wheeze
unearthed with your breaths
to expose a hundred secrets.

I hear your bowels,
the timbre of that song,
divulging their activity
to massage a burden

through labyrinthine depths.

I hear your thyroid,
the swoosh of velocity,
fluid chased through vessels
to evoke visions of an
overzealous organ.

I hear your liver,
a resounding echo
against my fingers,

betraying your history
by disclosure of its girth.

So what do I hear when I bring you to my ears?

I hear the story that is your life.

To Let the Heart Speak.

Dear Diary,

What do I write about when I have nothing to write about?

When my lips have nothing to say?

Do I paint for you portraits
of hollow chimes adrift
in dew whose songs
mesmerize with
each sway of
the wind’s
caress?

Do I liken you to a single rose
who has but endured a
winter’s wrath to
weave a quilt
of fragrant
hues?

Or do I reflect upon my life as it is,
to tell you how much I treasure
the privilege of being able to
help you, to care for
you, whenever
you are
ill?

Do I try to express how tremendous my
heart feels when I tell you that it is
going to be alright, or when we

know that it may not, that
we will 
conquer it

together?

Do I admit to you that whenever you
smile, my day is brightened,
my heart is warmed,
and that when you
weep, my soul
tears with
you?

And do I tell you how much I appreciate you-
your presence, your courage- as you
battle through your illnesses,
uncertainties, and fears-
while reminding you
that you are an
inspiration
to me?

So what do I do when my lips can find no words?

I suppose I let the heart speak.

The Flawed Physician.

She stands facing a closed door.

Your door.

As her gaze converges onto
enameled surface, she notes its
texture- the evenness a comfort to
a moment of hesitation within.

Smooth and finished–flowing
imprints mapping the course of
fine fibers swept over timber.

Flawless.

She makes a move to knock,
but her hand pauses,
and for a moment she wonders
whether you will find her pleasant.

Whether she will be worthy of your trust.
Whether you will believe in her.

Because she is flawed.

Like veneer upon wooden door, she
is but a polished version of herself.

As she again surveys its exterior,
she is let in upon a different truth–
that from underneath the surface
the grain peeks through, coarse
and jagged, its valleys exposed,
blemish revealed, age betrayed.
It is but fresh lacquer upon a
damaged interior, eroded and
frayed by the stress of time.

Like a white coat to the skin,
it cloaks the imperfection
and vulnerability of that
which lies beneath.

A coat enshrouding
scars of personal defeats–
An awareness
of critical introspection while
striving to exhibit confidence and certainty.
A struggle
to remain objective while
craving to empathize with you.
A hunger
to continue feeling through perpetual
immersion into death and suffering,
while self-preservation casts increasingly

impenetrable layers of emotional shield.
And a fear
of not doing enough, while similarly
recognizing the peril of doing too much.

But as her knuckles meet the door,
she is reminded of an oath–taken
at the dawn of this journey–
an oath of compassion, of
integrity, of humility–

an oath to do no harm.

So as she enters
your room,

she smiles–
for she never forgot its
concluding admonition:

That one would never lose the joy of helping others.

Therefore as an imperfect human being,
she will do her best to ease your suffering,
treat your illness, be your advocate–
Not because it is her obligation,
but because this is her love–

To help her fellow man.

To care for you.

•      •      •

“…may I long experience the joy of healing those who seek my help.”

-Oath of Hippocrates

•      •      •

caduceus

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 ◊

•      •      •

 

I.C.U.

Lines, tubes, wires, chains.
Dignity stripped, cavities drained.
The metronome of your pulse above
the beeping orchestra, dissonant buzz.
Each gesture tracked, beat recorded,
breathing measured, life distorted.
Do you still feel free?

The body, its function a masterpiece to muse,
altered by poison, fluid infused.
Vesicles, vessels, organs affixed,
shrouded in blood, lymph intermixed.
Adhered in oneness by tendon and skin,
scarcely quickened by a pump grown dim.
Do you still feel strong?

Risen before the dawning sun,
a swarm of stoic white has come
to declare the status of your issues–
Liver, kidney, heart, lung, tissue.
To examine and prod, inspect then move
a person, a soul, or a number to improve?
I hope you still feel human.

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

Malady.

Desperation.
Driven by disease
more clever than our hands,
you elude our grasp.

Come back.

Poison,
fighting for the soul

courses through your veins,
while the dusk

consumes the mind
of your decay.

Do you hear me calling?

Forsaken by a beast deceiving,
your breaths remains unmarred.
Spared by fiendish mercy,
your heart beats
undisturbed beneath the curtain
of a vacant shell.

I know you hear me calling.
I know you’re still there.
Perhaps our love will bring you back.

Come back to us.

The Big Heart.

Fluid.
Limbs flooded,
lungs immersed,
skin engorged-
you chase it off.
Pill
after pill.

Nights.
Twilight wheezes 

upon three pillows.
Four.
Five.

Bare
are your breaths
as you gasp,
fight-
hunger unquenched.

Stairs
unconquerable,
indomitable,
fatigue intractable.
Slowly you ascend.

Still
you conquer,
embrace
love,

life,
strength.

Your heart full.

Your dilated cardiomyopathy.

 

Cadaver.

Tendons, vessels, muscle, bone-
little more than its sum, alone.
Without life, alone.

A heart upon your fingers,
fibers smooth, firmness lingers.
A pump sleeps, alone.

Nerves, severed and denuded,
shimmering, taut, function diluted.
Pain without feeling, alone.

A lung, delicate sponge, blackened,
absorbs an essence, greyed, maddened.
Vacant sacs, stale breaths, alone.

The cerebrum, split, its valleys and mounds,
embodies a soul, full, without bounds.
My lifeless being is nothing alone.

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.

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