I once believed
what mattered most
was the knowledge I’d secured—
not the pleasantries of weather,
nor the gentle “How are you?”
I clung to decisions
etched in stone,
a great tree fed by facts
and logic alone,
its roots crowding out
the soil of empathy.
Ninety percent answered correctly I read,
I roll my eyes, inhale, and count to three.
One…
Two…
Unheard but felt— nails on the board,
Hands cup my face to play the chord.
Continue reading “In Your Head”
I knock on the door,
clipboard in hand, heartbeat racing.
The cold, hard plastic chair remains—
but I no longer sit in it.
The path. The path. Oh, the path. I am inexorably bound by the path as I travel through the Garden. The path was conceived and constructed, ordained and blessed, by Them. Continue reading “The Path”
During college, I decided to teach myself how to play piano. It began with a timidly, with my eyes glued downward, trying to coordinate my hand eye movements. After a while, I began to get more confident, slowly walking through song after song. A milestone for my journey learning piano was the first time I got lost in the music, closing my eyes and trusting my hands would find the right keys.
Fast forward to an ordinary night at the JayDoc health clinic. It was the summer after my first year in medical school, and the familiarity of the ophthalmology clinic welcomed me once again. I eagerly anticipated the first patient of the night.
I walked down to the hall towards the waiting room. As Isla’s primary language is Spanish, I grabbed one of the interpreters before starting the visit. I called over Isla and introduced myself. Together, we walked down the halls until we reached the visual acuity chart, where I guided Isla through the examination. This was not my first rodeo, but Isla’s difficulty with the large letters hinted at a more complex story. We documented the results and proceeded to the exam room.
Running through the typical questions and exams, I sensed that Isla’s condition was more severe than those I had encountered before. Anticipating a quick fix for what seemed like cataracts, I dilated Isla’s pupils, informing her that it would take about 20 minutes for the medicine to take full effect. At that point, we would go across the hall and the ophthalmology resident would take a better look at her eyes. She smiled and said thank you. I left the room right behind the interpreter.
I began working on my post-encounter note. It’s easier for me to prepare my case presentation if I transcribe my chicken scratch into the EHR. Once the resident was ready, I presented Isla’s case. Since the 20 minutes had elapsed, we decided the best next step was the slit-lamp room. All the interpreters were occupied, so I dialed a language line on my phone. Isla smiled when I entered the room and joined me as we walked into the slit-lamp room. I handed her my phone so she could hear the interpreter the best. The resident began his exam. Typically, the residents call out elements of the exam so that I can note them down in the chart. This time he was very quiet. I assumed the words were just to complex for me to know how to spell (a common occurrence).
As the resident concluded the exam, he asked a series of weighted questions. I am no medical veteran, but I do know how to spot doctor talk – especially when it’s a doctor about to break bad news. The resident said he really wanted to attending physician to take a look at her eyes before giving a final diagnosis. I escorted Isla back to exam room and then had a debrief with the resident.
To spare the patients privacy, we will keep her diagnosis vague. But in simplest terms, her vision was terminal. It would not get better, and unfortunately, there was no operation or medication we could provide to improve her symptoms. I could tell that the resident had seen this presentation a few times, but it was still hard for him to state the treatment plan, or lack there of.
The attending saw Isla and confirmed the diagnosis. We had to relay everything through the virtual interpreter. And while the attending and resident had the utmost compassion, there is a level of empathetic sterility that happens when you communicate through a phone. Isla was justifiably shocked. I brought her back to the exam room to give her time to process. She was holding it together, but the moment she sat down in the room, she sobbed. The intense emotion compelled me to sit beside her. We just sat there. No interpreter. No words. Just an instinctual emotional experience that transcended language.
After what felt like an eternity, I contacted the interpreting service to address any lingering questions Isla might have. A brief conversation ensued, culminating in her request to leave. Ensuring she had the necessary information for the next steps, I escorted her out of the clinic.
Alone in a back stairwell, I concluded my notes with a growing pit in my stomach. The desire to contemplate this moment clashed with the reality of more patients awaiting my attention. I had to keep moving forward. The undeniable truth is, moving on seems both impossible and, more importantly, inappropriate. Isla’s impact resonates in every patient encounter. She wasn’t just a case; she was a reminder that we, physicians, have the power to transform routine moments into life-altering ones. She instilled in me the invaluable skill of slowing down and illuminated the humanity within the realm of medicine.
Now, as I lose myself in the melody of the piano, entrusting my instincts to guide me, I feel Isla’s presence. Eyes closed, instincts trusted. It’s a visceral reminder, a tribute to her enduring influence. Isla, may life grant you moments of profound immersion, where, despite your limited sight, self-trust, and peace envelop you.
“The Patience (read downward)
Patience.
A student holding a pen in an exam, a resident with a scalpel in hand, and now an attending holding their
patient’s hand waiting for the results with…
Hope, because this doctor was once…
A bit afraid, to be honest. But now I looked in her eyes and felt comfort and felt
It will be okay. She fought as hard as she could and I was
Looking at the clock, before looking into her eyes and whispering
“I will be here for you, no matter what happens.”
“Breathe, please breathe”…I prayed for each breath as she said
Doctor…Will I be okay?
Anxiously, hopefully, patiently wait with the
Patients.
The Patients (read upward)”
Do you hear crying?
Demanded to move, she
Swallows belongings
And cradles her womb.
”This property is private, or didn’t you see?
You don’t belong near people like me.”
Without help, she scrambles alone
Packing the items that make up her home.
An ache finds her spine like the ache in her heart
For a place to exist and create a new start
But the feet in her womb push her on
Down this path.
Two miles pass and she drops to her knees, crying
In pain as she falls on the street.
Without any medicine, what can you do for a pain so engulfing it hurts just to move?
And yet, in the stillness, the baby won’t rest.
Do you hear crying?
As she’s helped from the ground, the pain overcomes her
But, also, this sound is the cadence and chorus of
Something so sweet—the sound of a battered soul
Finding relief.
I enter her room, my notebook in hand, noting the
Name on her hospital band.
She shares how painful recounting can be, and as
She details her past miseries
I remember we all are just human.
Blood tests and images unfold the truth:
Infections are sprouting in scars from her youth.
Bacteria runs from her heart to her bones and, just
As she does, continues to roam
In search of someplace a new life can survive.
A child smiles softly, toy reflex hammer released
a plastic stethoscope still donned
as pudgy fingers fight to apply a Little Mermaid bandaid
over thick, black fur
where Mr. Snuggles’ heart would lie.
A girl counts silently, bag-valve-mask squeezed
a plastic stethoscope no longer sufficient
her hammering heart unwilling to still
as breathing for two people
leads her to wonder
how the woman became so ill.
Older now, naivety removed
like fallen autumn leaves
she knew the burden of illness
and the cruelty of disease,
reflected in patients’ eyes and
mirrored in those who held them dear.
The fragility, unpredictability of time
that causes a loved one’s screams
to overshadow outside noise and etch
a permanent mark in memory
as compressions neglect to replenish
ink into a pen–
unwritten chapters forever blank.
Yet, older now she knew that snowdrops bloomed
despite winter’s unforgiving chill
and knowledge mixed with compassion
achieves incredible feats
and gratitude in patients’ eyes
leaves her feeling unable to speak.
For medicine is most complex
and indescribable at best
to be entrusted with patient care
is an honor above all the rest.
8 o’clock in the morning watching a red moon
blossom on a woman’s neck, holding open the
edges for the carpenters to saw and scrape, to
heal the way they know how—tiny blades, tinier
forges. the small, hurried movements of their
wrists a dance i cannot mimic with any grace,
and there is no room to stumble, not here.
10 o’clock in the morning, my own gloves stained
with blood from my little blunt efforts, retracting
that little moon into fullness, then snipping it into
an eternal crescent. the case is not yet over, even
when the deft hands still and away. still, there are
my bloody gloves, a woman under blue drapes,
wet and dry cloths on her sweet, slumbering face.
10:07, and i find my own deftness in the gentlest
touch, cloth wiping away orange iodine stains
around even the nares. good morning, ma’am—
you were here, and i, too, took care of you.
Med Intima 