poem

Vigil

Before putting in the arterial line

They check the pulse at her wrist

And document a negative Allen sign.

DNR, do not intubate, no surgery

Even if it would save her life.

But pressors were ok and antibiotics

And anything else to relieve her suffering.

The POA papers didn’t make any sense—

Keep her alive but do it kindly?

She was tach-ing away in the 130’s

Wide eyed and pale,

Positive Blumberg sign,

Cheyne-Stokes respirations,

Surrounded by a phalanx of providers.

This was the danger zone.

Everything here has a name

Except for what to call the gathering

Of family and friends clutched in vigil

In the small room next to the elevator

Waiting for the procedure to be done. 

We have murders of crows,

Coalitions of cheetahs,

Quivers of cobras,

Pledges of wasps,

But no word for small clusters

Of humans on the verge

Of a devastating loss.

2/22/24

poem

 Call Haiku

Morning after call

More than new names on a list

They belong to you

2/22/24

poem

 Incantation

Her name looked like a magical spell

When written out in her native tongue

All I had to do was whisper it 

And my heart was bewitched

For me it’s simple to comprehend 

Others see gibberish

The glyphs a child would draw 

If told to invent a new language 

My struggle is with proper pronunciation

A youth spent learning how to say new words

Based on how they sounded in my head

While silently reading 

I still recall the strange looks on faces the first time I said assuage

Out loud, not realizing it was supposed to rhyme with rage 

2/20/24

poem

 Sunset People

Sometimes I’m more of a sunset guy

Beach gatherings in the gloaming

Half buzzed, surrounded by friends 

Sipping ales and watching 

A clutch of clowns on stilts

Unicyclists in top hats and tuxedo tails

Sword swallowers performing 

In the middle of a drum circle 

Everyone vaguely satisfied

Swaying to a shared beat 

Distant horizon sails

At the end of the world

Commemorating the death

Of another half-lived day 

Other times I prefer the sunrise

Which is best received alone

Please respect my privacy 

Get the fuck out 

What I say when I blow

The embers of god back to life

Is none of your damn business.

Sunrise people tell sunset people:

It’s all phony nostalgia

You’re just drunk 

One day closer to the end

Is nothing to celebrate

You’re confusing the end of all this

With the beginning of raucous night 

Sunset people tell sunrise people:

Drink some damn coffee

Or just go back to sleep

The essence of man is melancholy 

Not an eager hopefulness 

Tomorrow is never better

Than what we had yesterday

Tragedy and comedy.

All this rising and setting   

Some can’t choose

Between one or the other 

So they sleep in and stay at the office late 

For them, what’s coming up only

Makes sense on the way down 

So I usually head north

To the land of perpetual darkness

Where the sun never rises, the sun never sets

The sun never rises, the sun never sets

It’s solace enough to know 

The light is thousands of miles away,

All at once 

2/20/24

poem

 PEG Tube

Demented and contracted

Cachectic stage before skeleton

Another stroke last week

Choking on her own saliva

Staring off to the right 

Imaginary windows or mirrors

Anybody’s guess

It won’t help her, I tried to say

But not with any conviction

The family insisted:

A feeding tube for nutrition

Mom needs it to get better 

The bite block framed 

Her swollen dry tongue

Her eyes watered.

Then glazed over 

I began to feed

The lighted black scope

Down her throat .

When it occurred to me

To wonder if anyone had asked 

If she was even hungry

2/20/24

poem

 February

No it isn’t sunny

It’s just day

Not too cold

Barely a winter

Not a Monday

One of the others

Not what we envisioned

But what we have

Not who you thought

Only as I am

2/19/24

poem

 Consultation

The patient came to see me for a consultation. He said his doctor had referred him. But he didn’t know why. Just that it was critical that he see me as soon as possible. He wasn’t experiencing any pain. His weight had been steady. He denied fevers, sweats, rashes or catarrh. He hadn’t noticed any bulges, lesions, lumps or viscous secretions. He ate well and trimmed his nails. Drank only occasionally. Most mornings he woke at dawn and worked out. He seemed a paragon of robust middle age health. I had a busy day, many more patients to see and then a couple add-on cases after clinic, but I didn’t want to seem rude. Let’s go back to the beginning, I said. Do you remember the look your father gave you the first time you realized he wasn’t your hero? Do you remember when your mother was young and pretty? Did you ever get your revenge on the neighborhood bullies? Did you peel back all the layers and get into the pulp? Do you think of the life imagined with regret or a sense of relief? Did you get so good at pretending that you forgot what your masks were supposed to hide? Is love, for you, a question of faith or hope? Is hope the remainder when love is taken from faith? Is faith just hope when it falls in love? We made some progress but again I was running out of time. We agreed to end the initial consultation and have him return in a couple weeks.  This became our routine. Every visit advanced the agenda a little further. We worked our way through his life. I knew everything about him. He held nothing back. The closest we could come to an articulation of our common purpose was the heavy silence that hung in the air just before I said well, that’s enough for today, I’ll see your next week and stood to shake his hand. We began to veer into areas that were outside my realm of expertise. I told him as such. I didn’t need to get sued or anything. I even had him sign a waiver. What did I know about how collapsing wave functions, properly shared, represent the utter totality of reality? Who was I to assert that each of us is simply the perfectly vibrating tone the universe has been desperately waiting to hear, all along? How was I to know whether believing it matters or just pretending it did made all the difference? Where did I get off trying to sell him a copy of the self help book I had originally written on a roll of cheap toilet paper? I auscultated, percussed, palpated and looked. I knew every square inch of skin. Every mole and imperfection. I scanned him over and over. We drew lots of blood. No splenomegaly. Pedal pulses palpable. Negative Murphy Sign. He was thoroughly examined. After all, he was still a body. Like me. Somehow a briefly coherent medley of transient loose notes that gave rise to the symphony happening right now. (Next time you look in a mirror you ought to pause. It’s really quite unmooring.) But a body is always changing. The next time I saw him he had shaved his head. He had gotten divorced. Was living in a commune with vegan dwarves. One time he tried to change his name. I told him it would mess up all the insurance forms. He got tattoos and binded his own feet. Had become a shaman for a small Amazonian village.  He began to seem almost astral. Not quite non-human. But different from me. The years passed and I began to feel a sense of shame. I hadn’t helped him at all. We were no closer to the answer than when we first started. But what was the question doctor? he asked. The question, I bellowed, with unequivocal frustration, is: Why are we here? And he laughed and laughed and they brought in coffee and we took a moment to review our respective notes. The last time I saw him he was an old man dressed like a tuna dressed as a man. I brought him some water and gave my old sheepish grin and told him I was out of ideas. I’d retired, in fact, years ago and could barely hear what he was saying. I hadn’t read a surgical journal in decades. I might have been 90 or 99. It’s ok, he said. He was kneeling before me and trying to feed me some lukewarm broth. My tongue felt heavy and numb. I was cold, despite the blankets.  I think it’s time for that operation, I said. He nodded and put down the spoon. I don’t want to go to sleep for it, I said. Just some local. 

2/13/24

poem

 Poetry Is Making A Comeback

All the things we decided not to talk about 

Now get written about

In the only way

That can't be said.

It’s progress

But it can’t last

Some asshole will ruin it

Pretty soon our lives will be metered

And broken into stanzas.

Schools will arise to tell us

Why certain poems are good

And all these others are bad. 

Schisms inevitably ensue

Between rival schools 

Over the true definition of a sonnet.

There will be a heraldry

Of pompous inanity

A cacophony of competing reveilles

Platoons of Shakespeare cosplayers

Wielding iron quills.

A king declares : poem, poem, not a poem, poem, not a poem

At special gatherings of his small council.

The official poems will make all the money

While the rest return to lives of squalor

A few of these survive as samizdat

Slips of paper passed under tables

My fingertips brushing your hand

You’ll feel me every time you read it

You will think: poetry is making a comeback

2/7/24

poem

 The Surgical Subspecialties

Bones

Vessels 

Tears

Blood

Inside

Outside

Tumor

Putrefaction

Soft

Hard

Indurated

Crepitus 

Pain

A different kind of pain 

Marrow

Bleeding 

When all bleeding stops 

Things that swell

Things that contract

Fixing

Fulgurating 

War

Relative value units 

Gowns 

Masks

Laying on of hands

Knife please

Looking away

Falling in 

Amped up 

Half dead

With care

With love

Heart

Head

Touch

Gloved

Addition

Subtraction

2/7/24

poem

 Blue

The truth is what we make of it

Power doesn't make the sky seem blue

It simply is, take it or leave it.

Oceans have nothing to do with it

And the physicist's insistence on

Sunlight scatterings is largely irrelevant

The color blind see another kind of blue

Which is just as true

As the one we perceive

But deceivers 

Never look up.

They sit in rooms 

Hunched over desks

Yellowed by candlelight

Writing blue, blue, blue, blue

In massive tomes 

That get translated

Into dozens of languages

Because once the truth

Is reduced to a word

The rest of the world

Demands a foreign equivalent

2/5/24

poem

 Groundhog Day

I’m not exactly the easiest person

To connect with. Not that I don’t

Want to. I have the desired information 

And the necessary tools of communication.

I just lack one or two critical components. 

I’m like Punxsutawney Phil

From Groundhog Day. 

Every blue moon I appear, 

Do the one thing or the other

That everyone seems to get

And then retreat to my burrow

For exactly one year

2/5/24

poem

 Weekend Rounds

On Sundays the hospital 

Is quiet as a weekday church

The high-ceilinged atrium 

Like an empty nave.

Linoleum floors, empty waiting area chairs

And long halls that take you anywhere.

The silent OR is a dull gray catacomb

While the chaplain is down the street 

At the nursing home.

The patients are all upstairs

Swaddled in beds 

Behind doors in private rooms

Like sins hidden in the heart

Hollowing out bones

Festering in a stye,

Waiting to be tended to

By doctors making rounds.

Everyone gets seen—

Broken hip, productive cough

Post-op colon, rule out MI

No one takes a day off.

2/5/24