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 😉

A Blessed Christmas Tragedy.

A bustling hospital. An unexpected arrival. A frigid Christmas Eve.

I was saying goodbye to another patient when fate collided us.

“I’m sorry Father,” I heard your son say, “you can no longer live with us, but here is a nice doctor who will find you a home. Merry Christmas, Dad.”

Pretending not to notice your son’s exasperation as you pleaded for him to stay, I choked down the anguish of my own awareness and proceeded to examine you. 

Bound to the prison of your seat—scared, bewildered, frail—you looked so lost. You asked why, what you did wrong, where your son had gone, not fully comprehending the chaos surrounding. A deep sigh escaped pursed lips as I searched within for an answer that would never come. Taking your hands, contorted by disease, I gazed into eyes dulled by years gone by—their hope fading beneath a glimmer of fear of an iniquitous present and an unpromised future–and I made you a promise I wondered if I myself could keep. 

“It’s going to be okay…you’ll see.” 

But hours pass, and it was not okay—you couldn’t sleep, you wouldn’t eat, and the only sound I heard as I passed the door of your half-vacant room was the resonance of muffled tears.

Behind a mask, I also let myself weep.

*    *    *

Soon the day ended. I entered your room, prepared to make my final rounds. But instead of a bid goodbye, what escaped was an exclamation of the first words that came to my mind.

“Sir, I think we should have a party!”

And that was what we did.

A 90-year-old veteran. A 30-year-old internist. A 20-year-old nurse.

Gathered around your bed, over reconstituted cocoa, you shared with us your history, your joys, your life’s adventures. Over paper cups of chicken broth, I told you my story. As the muted treble of holiday cheer dripped through the bedside radio, together we heralded in, with bittersweetness, the arrival of Christmas Day.

You then took my hand.

As I started to apologize for the late hour, you stopped me. Eyes still glimmering, I hear you laugh, and I believe I finally catch a glimpse of what was the real you.

“Thank you for a blessed Christmas,” you said.

Yes.

A blessed one, indeed.

Meet Mayra.

mayra.jpg

• Vinto, Bolivia •

 One of our littler and bravest guests, I first met Mayra when she was admitted to the hospital with cerebral malaria (a severe form affecting the brain) a month prior. Few thought she was going to make it, but as one can see here…she absolutely did. 

From scared little girl to fearless survivor, she quickly became an inspiration to those caring for her. Bonding over children’s songs and Dum Dums (green apple was her favorite), our friendship grew, and she quickly became a ray of light in my day.

Here, she is pictured at one of her follow-up appointments with—what else—
—but a green apple Dum Dum. 

😀

Neighbor.

bolivia-cow.jpg
• Monteagudo, Bolivia •

Puppydoc, in her usual fashion, seems to befriend animals wherever she goes. This particular companion was one who lived adjacent to the hospital…and whom Puppydoc would visit whenever she just needed some time alone.

☺️

Isolation.

tb
• Monteagudo, Bolivia •

This is where tuberculosis patients, including little Luis’ father, were kept, quarantined away from other patients. It is quite different from the standard isolation facilities seen at most hospitals today, but this is all they had, and they made the most of it.

Outside is where little Luis played while visiting the hospital. 

And Puppydoc did end up getting latent TB after caring for the patients, but she took medicine and is now all better. 

☺️

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.

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

Some people call this a hospital.
I like to call this a place of my P’s.
A hidden treasure
in a downtown peach orchard

where all my P’s roam.
But don’t panic.
Let’s pause.

This is the place
where physicians palpate,
pain is palliated,
and papillae are poked.

Patients are pacified,
parking is pitiful,
penlights are peddled,
and parolees panto.

But me?
I just call this home.

 

Create a website or blog at WordPress.com

Up ↑

%d bloggers like this: