The Harvest.

Ambaro, Madagascar

Our village specialized in ‘bageda’…sweet potatoes.
After harvesting, we would bring them to the market and trade them for maize.
Although only Hanitra and Puppydoc are pictured above…

Phoebe Chi Madagascar

…the entire family worked very hard.

◊ A poem about this family ◊

Conclusion.

orphanage

Quillacollo, Bolivia

Now that Gabriel, Juan, Angelica, and Alejandra
have been properly introduced,
it’s time to say goodbye. 

But I hope you won’t forget us,
nor the other kids at the children’s homes,

but that you will keep us in your thoughts and prayers
as we continue on this journey called life.

🙂

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.

The Patient.

I met you my intern year. I remember the first thing you said to me.

“I don’t care to be here.”

With a countenance creased from decades of hardship, a gait staggered from illness, eyes steeled by sufferings, your restrained presence betrayed a sheath impervious. I believed you previously had poor experiences in similar settings, because you told me so. I knew you didn’t trust me, because you told me so.

Our first few visits were stippled with formality. I posed questions; you answered. But they weren’t your answers, but perhaps words you knew I wanted to hear. I half expected you to stop coming. But you never did. Instead, you continued to sit there, guarded, a portrait of cordiality and cautiousness. 

And then one day it happened.

Your hard gaze glimmering with moisture, I saw your shell break. I then got to know you. Little by little, visit by visit. I learned of the pain you endure. I learned of your frustrations, your desperation…your despair. I learned of your deep heart. I learned many things. But most importantly, I learned who you were.

Months went by. Gradually a smile seeped through. Your eyes now shined as you shared with me the latest on your life. A life that I was lucky enough to now be a part of. But suddenly three years pass, and as my time with the clinic comes to an end, we now must part. On your last visit, I sense your frustration and anguish again, and I think I understand why. As you cry I reassure you that everything will be okay. But as I comfort you I am struck by a sudden surge of emotion, and I also struggle to keep my composure.

You see, through this experience, I have started to recognize what it is you were talking about. An understanding. A connection. Some may even say a friendship. Because even though you may not know this, I am now happier because you are happier. Because you are now healthier, more satisfied. Full of life. 

Now as we part I feel the tearing of a piece of my soul. As we hug one last time the goodbye is silent and understood. But then you pull back, look me in the eyes, and say simply, “Thank you for helping me live.”

As I hold back my own tears, I realize I am thinking the same thing.

Thank you for helping me live.

When We Simply Stop Caring.

I see it all around me.

Burnout. To be burnt.

When we simply stop caring.

Most of the time we don’t even need
to say anything.
But you know.
You hear it in our voice.
You see it in our eyes.
And you feel it too.
You know what
is going through our
mind with each wayward glance.

Is this what I signed up for?
Is this all this profession has to offer? 

Because I have seen the articles.
To prevent physician burnout.
The A-B-C’s.
Changes we must make.
Limiting expectations. 
Self-empowerment.
Decreased hours. 
Putting us first.

I too used to be desperate.

What is happening to me?
What is happening to my colleagues?

What is happening to medicine?

But then one day, I saw you.

You.

Not you the patient.
You the person.
You’re just
a person.
You are me.
And you are hurting.
And maybe I am too, although
you may never know.

So I thank you for being here.

Not only do I want you to know that
I honor the privilege of being able to
help you, but you should know that
you have in your own way
taken care of me.

And I do care for you.

◊ A Physician’s Plea ◊

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.

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.

Poetry & Medicine, part II.

“I could prescribe any of a dozen antibiotics to cure
endocarditis, 
or even a thrombolytic agent
to stave off a heart attack; 
but what I
yearned for was the elixir of poetry,

which could heal the otherwise
untreatable 
condition of
my broken heart.”

This quote, by poet and physician Rafael Campo*,
beautifully captures the essence of the union
between the arts…and the art of medicine.

Therefore, today I will let him speak for me. 
This is from his poem What the Body Told:

“To somewhere distant in my heart, they cry.
I look inside their other-person’s mouths
And see the wet interior of souls.
It’s warm and red in there–like love, with teeth.
I’ve studied medicine until I cried.”

*Rafael Campo is an internal medicine physician and poet currently on faculty at Harvard.

 •      •      •
 
A few bloggers I would like to ask to share a quote or two:

Rules of the Quote Challenge:

1-Post on three consecutive days.
2-You can pick one or three quotes per day.
3-Challenge three different bloggers per day.

 
With love,
PuppyDoc

Poetry & Medicine, part I.

Tidbits about William Carlos Williams (1883-1963):

♦ A renowned writer, he was said to be a “doctor by day, poet by night.”

♦ He attended medical school at the University of Pennsylvania, was trained in family medicine and pediatrics, and served as the chief of pediatrics for 40 years at what is now St. Mary’s General Hospital in New Jersey.

♦ He painted during his early years, similar to his mother, who was a Paris-trained artist.

♦ As one closely associated with modernest poetry and imagism, he also had marked influence on the American literary movements of the 1950’s including the San Francisco Renaissance, the Beat movement, and the New York School. 

♦ He is an inspiration to PuppyDoc. 

Thank you, Mysterious Mind of Mine, for challenging me. 

🙂

Now I would like to ask these ones to share a quote or two:

Annie at Gentle Kindness

Chris at The Brown Bag Special

Claudette at To Search and to Find

•      •      •

Rules of the Quote Challenge:

1-Post on three consecutive days.
2-You can pick one or three quotes per day.
3-Challenge three different bloggers per day.

 

With love, 

PuppyDoc

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

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