[Poetry] Mada

"Our ultimate goal, after all, is not a good death but a good life to the very end." - Dr. Atul Gawande, Being Mortal: Medicine and What Matters in the End
--

[Poetry] 2 Abril 2016

For RC
---

All travel this journey - even you -
Yes, you. Although the isolation surrounds you
As you stand in the middle of that intersection
   Lost.
                                                                Disoriented.
                            Paused.
Your tearful contemplation worsens the agony
As passerbys salsa to the left
                                   or tango to the right
But they move forward
                                                                           while
                                                                    you
                                                           look
                                                  back
                                          and
                              simply
                   stand
        there.

Your heart, she beats a rhythm as beautiful as you are.
She is unique to you - only you -

So:
Follow her
     as if
          your life
               needs her - because it does.
Whether you salsa or tango
At this crossroad in your life
Just remember to dance
In step with your heart.

[poetry] Hail Mary, Full of Grace

"Don't change for no one, do you understand me? You are the only person on the team I trusted, and I knew when you said something would be done, I had faith it would be done. Don't let them change you." 
- Patient's parting words of wisdom.
--

You are not your
disease.

You are a woman:
Strong. Courageous. Determined.
Your beautiful womanhood comes from within,
but not from your cervix
    which steals your identity.     

It radiates from:
the Mother Mary amulet
with love you adorned
on the side of the hospital bed
to which you turn
when your pain is unbearable.
    And from your words
    said between your searing outcries:
    Your dignity makes me
    bow my head in humility
    as you apologize for the odor
    from your gas.

You are not your
disease.

You say you lost your beauty
and the bags and tubes make you feel
like an alien.

All that flows from you:
    Urine from your kidney tubes,
    Feces from the failed poop bag,
    The gas occasionally released, 
        even the blood pouring from your vagina,
        a reminder of that demonic thief,
Is beautiful:
Because it is you.

You are not your
disease.

In fact, they…they are the ugly ones -
for they pray not for your comfort
but for a date of discharge.

Forgive them for seeing only
your past dance with the needle
and denying a dying woman relief:
    Please know that I tried
    and only viewed you with grace
    as you once saw yourself-
        because, through our morning pleasantries,
        I could see you so clearly:
        How radiant you are.

You are not your
disease.

[poetry] Your loyal mashed potato plumber sidekick

« La reconnaissance est la mémoire du cœur. » -Jean Massieu

("Gratitude is the memory of the heart")

--

i see You:

in the recesses of Your mind:

dust in the corner; forgotten.

but someone is there –

Your eyes illuminate Your mental residence.

look! i can see into Your home – how beautiful and cozy!

they extend Your sincerest invitation for company

when Your words cannot,

and i am delighted to accept 

and stay for tea.

Your wife, how she raves about You:

a Husband to one, Father to two, and Friend to all,

a Peacenik, Educator, Lover, and Dreamer...

Your dog misses You, she told me to say,

as he is always curled up on Your side of the bed.

a foreign language You speak;

i am told it is untranslatable –

“neological, slurred, and broken,” they say.

but they ignore Your smile – a universal code

which expresses Your childlike excitement

as You exclaim Your greatest revelation:

“two thimbles might fix the pipe leak

inside the cloudy mashed potatoes!”

let’s find the sewing kit, Sir,

and rejoice in today’s adventure.

time summons my presence. but such a pleasure to meet You!

and may i happily meet You again

for the first time tomorrow, as

i will inevitably disappear

among the lost firings of

neurons when You rest

Your head tonight.

sleep well,

my Dear

Friend.

maybe one day i will be remembered

as Your loyal mashed potato plumber sidekick…

but so long as Your home shines bright

and the company tea simmers quietly on the stove top
even when Your light dims

i vow to care for You, always.

[Poetry] start the kettle

On my family medicine clerkship, some of my most cherished (and deeply moving) moments came from leading end-of-life care conversations with patients including designation of medical power of attorney and solidifying advance directives. Such dialogue continues to kindle my passion for geriatric care. However, the American medical system must do better to empower patients to understand the many medical services we can provide, including the demystification of hospice care and palliative care. No longer can we, in medicine and in society-at-large, continue to ignore death and dying as a natural part of life. This poem, "start the kettle," was written in reflection of such issues dear to my heart.

--

bolt the doors! lock them twice!
perhaps She will not come!
in such ignorance we find joy so temporary,
shaming and belittling Her
in our foolish feints to dodge Her.

we synonymize and mislabel Her,
costumed and ill-depicted.
Her presence is removed from our minds.
we cry that Her name will not pass our lips;
the Ostracized Outcast is unabashedly unwelcome

wake up! wake up unto new life! wake up, i beg!
you - who perceive this Woman as a Thief most vile
who will steal your finest jewels
tell me:
what thief makes Herself known to all?
what thief knocks and rings the doorbell?
are you so blind? open your eyes!
She is no source of fear!
mistreat Her no more!

She is a mere constant - like gravity.
She greets us, one and all:
our shared Mistress
in the end of the big chase
sheer surprise
or sobering self-retreat into Her arms.

She will be terribly apathetic
so long as you are of Her existence.
of course She shows up unexpected and uninvited!
we provide Her no directions to our house -
which way do you prefer? how should She find you?
it is easier to take the highway or the side roads?

These thoughts might molest the mind,
strip the soul, and harrow the heart -
but they need not.

if She must come,
plan ahead.
start the kettle.
invite Her into your home when She arrives,
whenever that might be. She is busy, remember.
offer Her tea, and be a good host.
for, yes, She comes for you,
but may you go in peace with Her.

[Poetry] Perspective

I wrote this poem entitled "Perspective" in honor of one of my patients on my neurology clerkship service. Señora, gracias por todas las lecciones de vida que compartió conmigo. Me encantó nuestras conversaciones y las aprecio.

"You are stupid. Don't think for a single second You know your disease! To be there for your family And To be strong for your children, What you say is closest to your heart -  What is most important is To succumb to your illness. You must learn not, If you want to find happiness, To find hope amid the darkness Surrender to the battle! After all, acceptance is the Solution to the chronic state. Don't you see? This is not a  Proper way to grieve! There is no Pause. Counting your blessings Won't stop the disease. You should be Wallowing in sadness. My dear, don't you get it yet? Yes, you have multiple sclerosis!"

"Yes, you have multiple sclerosis." "My dear, don't you get it yet? Wallowing in sadness Won't stop the disease. You should be  Counting your blessings. Pause. There is no Proper way to grieve. "Don't you see? This is not a  Solution to the chronic state. After all, acceptance is the  Surrender to the battle. To find hope amid the darkness, If you want to find happiness, You must learn not To succumb to your illness." "'What is most important is What you say is closest to your heart -  To be there for your family And To be strong for your children. You know your disease. Don't think for a single second You are stupid."

[Poetry] The Kiln

Enter the fire!
Ye children of the world -
The forever-marks you sustain
Give strength through the pain.
The roads we travel
Paint us beautifully in colour unique
But converge here -
The grey, ashen kiln

Enter the fire!
Ye children of the world - 
Emerge you shall
Colours not as they once were
But glazen, brilliant!
The imperfections
Bring character
To your art.