Dreamy Eyes

The library is noisy, but only I can hear the sounds. The creak of a door handle, the squeak of a chair against polished tile, a cough, a sneeze, a blown nose. The symphony of students hard at work. Or hard at Facebook. Instagram. Snapchat and WhatsApp? Whatever they use these days. I lost track years ago.

I peak out into the open from the shadow of the textbook I’m hiding behind. Harrison’s Internal Medicine. 16th Edition. Outdated and battered. No one will come looking for it. It’s August, which means that a batch of newly-minted medical students will be joining these studious souls on their quest for knowledge and excellence. Ah, the very thought of it makes my wings tingle. Fresh, curious minds just waiting to be filled with knowledge. I retreat back behind Harrison’s and skip a few shelves to the left. Hurst’s The Heart. Possibly the largest book in this entire collection. I snuggle against it, inhaling the sweet, stale scent of a dusty textbook that hasn’t been touched for years. The technological explosion means that there is little need for books. Or for me. But that doesn’t bother me as much as I thought it would. An unused book has a certain smell, taste, feel. Fragile, yet strong.

The stuff a dreams.

“Wow.” An unwelcome intrusion. I curl up closer to Hurst’s The Heart and scowl. “That is one big book.” Before I can react, Hurst’s The Heart is dragged from its place of honour, leaving me exposed to the glaring fluorescent of the basement-level library. “Wow, so heavy, too. How many chapters are in this thing?!?!”

Big brown eyes, straightened hair, ironed shirt, and brand-new jeans. Must be a first-year. A keen one, by the look of her. Might have been her very first day on campus. By the time they’d been around for a while, both the novelty of studying and dressing to impress had worn off. The end-of-year OSCEs were always met by bloodshot eyes, stained scrubs, and pizza breath. That’s if you saw them at all, of course. Final-year students were rare specimens. Board exam studying was undertaken at more exotic locations, like the gym, the park, or the dinner table, over a bowl of tinned ravioli which expired two years ago.

The girl was still ooh-ing and ah-ing over the brightly coloured pictures and photographs, and I smirked, creeping closer for a better look. Her name tag read ‘Kennedy Park’. A good name for a physician. Doctor Park. Sounded strong, and uncompromising. I crept to the ledge of the shelf for a closer look, but ended up slipping on a rather large pile of dust left behind from the book, tumbling off my perch and landing right on page 37.

“Oh!” said the girl, oddly calm. “Hello!”

“Bah,” I said, dusting myself off before fluttering back to my shelf. “Give me back my book!”

“I’m sorry,” the girl said, closing the cover. “Were you reading it?”

“Silly girl!” I said. “Clearly I was sleeping! Do I look like I could pick up that giant book anymore?”

“I’m sorry,” the girl said again. “I’ve just never seen a library fairy before.”

A library fairy? Where did this girl think she was, Disney World? Where on earth would anyone find a library fairy? “Excuse me,” I said firmly, “but I am not a library fairy. I am the Spirit of Medicine. A-A guardian, if you will. Key to information. Ask, and you shall be told.”

The girl’s eyes filled with wonder. “So, you know everything there is to know? About medicine, I mean?”

How gullible and foolish first-year medical students are! So innocent, so eager to know, so happy to please. “I did, at one point. But I’ve become smaller as time passes. There is not much spirit left in the medical community. And, as the spirit shrinks, so do I?”

The girl’s eyes fell, and her forehead furrowed. “Spirit?”

I waved my hands impatiently. “Silly girl, you must know what spirit is!”

“I do, I do, I’m sorry!” Another thing about medical students. They apologise far too much. That might be part of the reason they are so often used as punching bags. “I just meant, I thought there was a lot of spirit in medicine. I’m happy to be here, for one.”

“It won’t last long,” I said, kicking at a rather large pile of dust. My, but these shelves did get dusty! “Give yourself a year or two, and you’ll be crying in the washrooms for your momma.” As if on queue, there was a crash in the ladies’ room behind us, followed by a loud wail. “Good lungs, that girl’s got.”

“That won’t happen to me.” The girl’s bright grin reflected borderline stupidity. “I want to be here. I really do. I’ve wanted to be a doctor since I was six years old. This is a dream come true!”

I shook my head sadly, stepping to the side as the girl replaced Hurst’s The Heart in its rightful spot. “That’s what they all say,” I whispered, more to myself than her. I’d seen hundreds of thousands of medical students grace these corridors over the years. I’d witnessed their eager curiosity, their joy, their pain, their sorrow, their falls. Bit by bit, as the joys dwindles and the sorrows grew, I myself shrunk until I was no larger than a few lines of text in the books they used to read. What happened to the joy of medicine? The delight of healing? Even the newest students these days were focused on grades and research and electives and residency spots. So competitive! No one paused to consider things, to leap for joy, to pursue knowledge for the sake of learning, to learn medicine to help others!

“Well,” the girl said, uncertain. “I guess I’ll see you around.”

“I doubt you will,” I said, curling back into my spot of refuge behind Hurst’s The Heart. “You’ll forget about books and learning soon enough. Good luck with your residency applications.”

“I’ll come back and visit! Promise!” said the girl. “Just you wait and see.”

“Of course,” I said, my tongue heavy as I drifted off to sleep. “Just another empty promise from a dreamy-eyed first-year student…”

lilac’s blooms

i’d hold your hands through wind and rain

if love could shield me from this pain

but i know life won’t be the same

for you’re long gone, and i’m to blame
you faded faster than a lilac’s blooms

like a spark of hope, you died too soon

i reach for you, but there’s nothing there

i hold your hand, but i’m holding air

your face is a blur from a midnight past

too flighty to stay, too perfect to last

we once were forever, but now i’m alone

i’ll forever be lost, for you were my home

Timid

They tell me I’m timid, and call me “too shy”

But they do not know me, nor how loud I can cry

My voice is on pages, in words, black-and-white

And my words throw a punch worse than any fist-fight

It’s a quick party trick, standing still, taking hits

Grit your teeth, curl your hands into tiny little fists,

Look away, run away, let them laugh at your back

But with words you stand up, turn around, and hit back.

They’ll never see it coming. I swear they never do.

To see a story where the villain screams his insults like they do.

And I can bring tears to any hardened-heart’s eyes

With a few simple words, carefully crafted in my mind

See, I’m not really “timid”. I just speak a different way.

I shout with words unspoken, but they’re forever here to stay

I hit you back far harder than you ever could hit me

Your hits may make me sting, but my words will make you bleed.

Circling the Drain

It is twenty past five on a Thursday afternoon. Dr Wong and I are rounding on my last patient, ninety-year-old Mr Patel.

 

“Hello, Mister Patel,” says Dr Wong, the fake cheer in her voice too pathetic to fool even a small child. It is her first day on our ward, an emergency locum called in, and she is tired. She is ready to go home, ready to be done with these patients.  She was speaking with the surgeon on call about a pool and margaritas only a few minutes ago. “How are you today? How’s your pain?”

 

“I’m terrible, thanks for asking,” says Mr Patel, folding the newspaper he was reading neatly in his lap. “I’m sick of this place. Takes forever to get anything done. And you doctors come around here at your own convenience. I ask and ask, but no one comes. I want to know what’s going on. I’ve been in here long enough. I want some answers. I’m like a goddam prisoner here, and I’m real sick of you doctors not telling me anything.” Mr Patel is using the same rant he’s used for the past week, even though I’ve addressed everything twice today alone. Perhaps he thinks that Dr Wong might give him more answers, an idea not completely unfounded. She is the doctor, after all. But Dr Wong stiffens, as if Mr Patel’s words are personally insulting. “I’m sorry, sir,” she says. I can hear her teeth gritting from across the room, where I stand. “But doctors are very busy people, and I’m sorry if you don’t realise that you’re not the only patient on this floor. Or this hospital.”

 

I don’t know who is more taken aback by this outburst, Mr Patel or me. Mr Patel has been here for over one month without diagnosis or treatment with any curative intent. His CT scan alone was delayed four times over the past twelve days. To me, Mr Patel has every right to be upset. His situation is a mixture of bad luck, failed communication, and, yes, blatant incompetence on several staff members’ parts. But, as upset as he is, Mr Patel’s family is even angrier. I have met all four of his sons, two of his three daughters, two daughter-in-laws, five grandchildren, a brother, a neighbour, and, of course, his ever-present wife, with her elaborate embroidery she works on by the window.

 

But Dr Wong doesn’t know this. All she sees is a wrinkly old man who reeks of faeces and stale urine standing between her and her pool and margaritas. Dr Wong is tired. She is worn-down. Her empathy metre has run out years ago. I make excuses for her as her mouth opens, spilling words out. “Your CT scan results came back,” she says, her voice devoid of emotion, her eyes bored. “They show that you’ve got lung cancer, spread to the liver, brain, and most of the bones. There’s some thick parts around the bladder, too. Not sure what that is, but no use in looking, really. You’ll be dead before we can get the test results back. Nothing we can do. You’d better call in any family from out of town,” Dr Wong nods to the corner, acknowledging Mr Patel’s wife for the first time. “Won’t be long, now.”

 

With those words, Dr Wong turned on her heels, and left the room. “Hey, kid, consult palliative care,” she calls to me. “There’s probably no point in a hospice referral, but we’d better put it in to make the admin happy. Palliative closes at three-thirty, so get to it.”

 

Mr Patel’s wife is crying. Her eyes are big, red, and puffy, and her embroidery has been discarded on the floor. I place a hand on her shoulder, searching for words of comfort, kindness, anything to ease the blow they have just been given. But Dr Wong’s screeching voice is calling me outside the room, a pulsing distraction, and I can only squeeze her shoulder before running outside, grabbing the ringing telephone from the outstretched hand to speak with the palliative care nurse. Dr Wong interrupts every few seconds before grabbing the phone back. “Stupid girl,” she says. “Can’t you even do a simple consult? Brad,” she says to the phone. “The man’s dying. Room 32. Scopolamine, hydromorph, do what you have to do. Sure, the kid’ll do a hospice referral, but he’s circling the drain. Yep. Yep, he’s not leaving this place.”

 

Fifty-two years ago, Mr Patel quit his job as a mechanic to open the first of a successful chain of daycares, of which he was still the honorary president. He had spent a good half-hour this morning describing the details to me, noting that many of his former charges had gone on to become politicians, teachers, lawyers, doctors, artists. His eyes glimmered with hope and energy when he spoke about the children. “Every child is a new world,” he told me. “It only takes one person to change the world. For better or for worse, well, that remains to be seen. But when you’re in a room full of thirty children…think of all the things that those thirty could do to make this world a better place!”

 

But, the next morning, when I go to see Mr Patel, he is Cheynes-Stoking on the bed. His breaths are ragged, uneven and laboured. His eyes are wide, but unseeing. There is family gathered around the bed: his wife, two sons, two daughter-in-laws, and a little girl. I take Mr Patel’s hand, and squeeze it. There is a feeble response, but it is so weak I am not sure if I have imagined it.

 

I want to ask what happened, what’s happening, but I’m not sure how. The words have died in my throat, and my tongue is useless. But Mrs Patel spares me the agony of standing in silence. “He went down overnight,” she says, the ever-present embroidery now strangely missing. “Didn’t eat supper, didn’t sleep, just…this.”

 

“Oh,” I say. I need to say something. I have to say something. Some word of comfort, some solace, some support. But years and years of training fly out the window, and I squeeze Mr Patel’s hand, only to get no response this time.

 

“So,” says Mrs Patel, “I guess we just wait? For the hospice bed?” Mr Patel is circling the drain, medical lingo for ‘actively dying’. But there is no need to reiterate what we both know, so I just say, “Yes. Yes, I think that’s the plan. I put the request in yesterday.”

 

Mrs Patel nods, her expression as blank as I feel.  “We’ll be around all day,” I say, citing Dr Wong’s presence as if she might be some sort of assistance or comfort. “Just call if you need anything.”

 

Mr Patel dies several hours later. I’m in the room when Dr Wong pronounces him, not bothering to listen to his heart or check reflexes. There’s really no need to; Mr Patel’s mouth is open, eyes wide, body stiff and still, even in this early hour. The death certificate says ‘metastatic lung cancer’, but I know better. Mr Patel declined more quickly in twelve hours than in the past four weeks I had known him. He died of a broken heart, of lost hope, of crushed dreams. I want to blame Dr Wong. I am furious that she was so matter-of-fact, so unkind.

 

But she is human. How many patients has she seen die? You can’t feel for everyone. If you do, you’ll get worn out. Either way, you’ll end up like Dr Wong, a bright-eyed medical student hidden beneath the stony, cold-edged, uncaring exterior. I wonder if she realises that anyone could take offense to her behaviour.

 

There is a complaint filed against Dr Wong, but it is brushed off as the last resort of a grieving family to make some sense of their loved one’s passing. I receive a new patient, a Mrs Rebecca O’Leary in with pancreatitis. She has two children and five dogs. She is sent home after five days, and I move on. I see more patients. Some of them go home. Some of them don’t. A kinder, younger physician calls them ‘celestial discharges’. But I’m not used to it. Not here, not yet. Will I ever be? I’m not sure. I hope not, because, if I do, I will have become just like Dr Wong herself.

 

And still, with every dying patient I see, my tongue still freezes, and I feel my heart freeze still. But, really, what can you say, when a patient of yours is circling the drain?

Hand

I held the hand of a dying man

As he whispered words I couldn’t understand

His voice was harsh, and his throat was raw

But his eyes were the only thing I saw

They were lifeless, while he lay still

Clinging to life, for he hadn’t his fill

But, as with all things, life, too, must end

His hand went limp, and, like that, he was dead

Roller Coaster

Your love’s a roller coaster

It has its ups and downs

You build me to the highest peak

But then I plummet down

You twirl me through the loop-de-loops

So I can’t catch my breath

And when you freeze us upside down

I’m falling to my death

I never know what’s happening

Until we’re at the end

But when you say it’s over I find

I want to go again

And so I strap myself inside

And promise to be brave

But when I’m miles above the ground

I know nothing’s ever safe

To the One, who Lives with Death

I fell in love once, just a little too late,

For she was too restless, and she couldn’t wait

It wasn’t the love between women and men

No, this was much purer — the love of best friends

But she disappeared inside Death’s steely grasp

And that’s when I learnt that love never lasts

She leapt inside so willingly that I’d no time to fear the end

She leapt inside, and thus she died, my one and only friend

I watched the flames consume her there, helpless and afraid

I tried my best, did what I could, but she couldn’t be saved

And that was how I came to be all alone, in the end

My heart got torn to pieces when all I wanted was a friend

And I will never know her love at all, for she’s too far away

Just when I learnt what friends were for, she stole herself away