Poem: Dance

Dance

Medicine is dance: the hold and release,
the intuition, the half-light, illumination of
curve and angle. Before each song, each melody,
each figure, I follow the note to the end,
hear it vibrate in my mind.
It is dance before it starts:
impressions, donning gloves, taking a hand
and slipping in that IV.

Dance is the imperceptible nod,
the inflection of facial muscles that say
yes, I will carry you through
and we will awake together
that this waltz will transform me just as much.

It is a menage a trois; the music steps between us
and we move in concert. The monitors sing.
Each beep, buzz, tone, and chime guide my hands,
tell us how quickly to move, remind us
to move gracefully. The floor is crowded.
Each movement calculated and instinctual
as if I knew all along how to keep my partner safe.
The scrub and scalpel whirl by,
but only as close as I allow.

Poem: Song

Song

Words nestle into the cadence of the heart,
the body's metronome. Time and sustenance marked
in this alien landscape, its orbiting moons gathering light
in handfuls and dispersing it on the body,
a body alien, framed in blue, rubbed deep brown
awaiting the brave and foreign to part its skin.

The heart knows, accelerando!
the anesthetized body's tongue. Even in this state
the heart has reasons that reason knows not.
Even in this state, the body sings.
We are interpreters of language.
Anesthesia is, willingly,
a fascination with the surrender of the body,
muting before interrogation, a reversal
of things natural, a conscientious poisoning.

The more we inhale those fumes,
the more we realize it is as much a snare
for the recipient as the giver, that as we
tame more and more of the wild,
we become more ambitious
in some quest to cure human ailment.
Where is that border? Where is that limit
beyond which the body no longer sings
but cries out, beyond which we, with all
our draughts and devices and guilement
cannot rescue the body from
the enchanted sleep we devise
and the sleep it craves?

Poem: Perseids

Perseids

When you came, I left the hospital wearing scrubs onto the hill,
I tilted my head and listened for music. Droplets
flamed and retreated. How when I wished on a falling,
I was reminded of childhood, of the kind of succulent
that dwelt in my heart through teen years
and filled notebooks with poetry. I must be old now.
I don't recognize constellations. I don't write
in margins. I no longer perseverate for hours.
Last time you were here, I was not so practical,
I belted my passions and cared not who heard.

In one sun-tinged voyage, a Perseid year,
my maps unfurled, left me wanderlust.
I captain a ship that once fixated on a single point,
a pivot that deserved obsession, all dream and wish,
every one of those Swift-Tuttle rocks, and now
we flitter starlight to starlight, neither indecisive nor lost.
Everything seemed to shrink since you came last
but now, I look into the far edges of that canopy
and wonder where you came from, where you go next.

Image shown under Creative Commons Attribution Share-Alike License, from Wikipedia.

Poem: What's in a Name?

This is a rough poem I wrote during the last writing group. Right now, it's all one stanza and I'm playing with breaking it into parts.

-
What's in a Name?

Your identity haunts you forever.
The names you accrued through middle school
scribbled in yearbooks, sepia-colored,
rhymed alliteration of food-snorting incidents,
the ones that sent you to mother wishing that
identity fades in an instant.
When you close your eyes, engulfed in dreams
you see a new job, a new quest, new love, new ambition.
Eventually, you have enough dreams
to carve away self, discard old clothes,
move from home to the city where you find that
identity haunts you forever.
You can't dispense your accent, walk, mannerisms
and in a few months, a year, your skin doesn't feel right
and you beg parents to go home, to your bed,
to an old job, to a place where
identity fades in an instant.
The high school sweetheart is married,
the streets are different, your parents have changed.
Your friends no longer hang out at the coffee shop.
You exfoliate your skin every month and finally
you meet someone new and
your name changes
but your parents call you the same
for identity haunts you forever.
Now your parents are in your house.
You install shower safety bars,
find abandoned walkers a nuisance.
Jeopardy is always on
and the world outside seems foreign
fading like identity.
It's insidious; first an address, then a phone number,
then the year. You drive to the police station
where they've been picked up
and then it happens again.
Soon their eyes glaze
and they don't remember your name.
Your identity haunts you forever.
No, identity fades in an instant.

Scene from the ED

This is a couple paragraphs of creative nonfiction I jotted down during the last writing group based on an experience in the emergency department.

-
When I entered the room I could tell something was wrong by the way the husband stood. There was an air of aggression, the kind that made me want to send him out and pry the poor woman for domestic violence. He hovered, leaning forward, arms across the chest. But when I looked at her, I could see that she was seeing down a row of mirrors. She was afraid, but not of him. He was picking up on some unspoken sense between husband and wife; he raised his haunches to protect her.

She had been crying. She struck me as the type of patient who puts on make-up before showing up at the emergency department, and tonight, she looked a mess. The skin of her hands were white and taut with worry. Her gown was strewn across her shoulders. There was blood on the sheets, in splotches.

I got a translator. Oh, there are times when my Spanish would suffice, even for those in distress, heaving in chest pain, speaking in one-word sentences. But here, I already knew I needed help. It was not a question of diagnosis; I already had a gut feeling, and later I would learn that she did as well. But this was the kind of thing you have to do correctly, the kind of thing where a misstep would ruin everything. The interpreter was curt, dressed in a white coat, looking more formal than I did in my scrubs. When she herself realized the diagnosis, she started shifting weight on her legs. But I anchored her down, forced the conversation down meandering paths.

We talked, and over talk, we bonded; her husband softened, the interpreter clicked in the background. I learned of her life in Mexico, her two children, her faith, and her job. Then I probed a little deeper, and I learned of her prior and her fear that this was a repeat miscarriage. I held the timber of my voice. I had to ease her in, I did not want to couch ambiguity, and yet I did not want to lay things bare.

The attending did the exam, and I was disappointed in him. Two traumas had arrived; there was a stroke code, a STEMI, a waiting room full of patients. He had to go, without even a parting word. But I knew my part. I sat on a stool, kept my gaze on the patient and her husband, and chose my words carefully. I could not tell whether the diction carried through the interpreter. But to this day, in these situations, I focus on the tone and arc of my voice, the lilt of the phrases, the gestures, the facial expressions. I hope these cross cultures - over not only race and ethnicity, but the vastness of experience, gender, age, hope and fear into some common ground where cold medical dogma and the emotion of loss coincide.

Poem: The Act of Writing

The Act of Writing
Craig Chen

Writing exhumes.
It unearths, resurrects--
and not from tombstones
(except on days we write of zombies)
no--writing is tilled earth;
stillness ingrained, deeply planted;
it is sweat and callous,
work-song.
Writing draws out seedlings
and occasionally it floods.
We work fields
and writing scrubs off layers of skin
and finds a different word than raw
to describe beneath.
Writing buoys.
It floats, bubbles out, a splash inverted,
expands larger than you or I could have said,
levitates away.

Poem: The Map and the Territory

The Map and the Territory
Craig Chen

here, wildebeest of colors crowd

sense & conflagration, in burst

& sway over torrent of wind aloud

& the rustle reply of leaf coerced

drifts among cloud, swift & hope

in somnolent grasp through plea:

run with me, color & elope

over freedom and thrice we see

for it is the opening of sun

after exhaustion of slumber

& our cells cry run run run

lest we get hit by thunder

in map of mind and dream

we in recollection dance

until even twilight's gaze seems

to rivverrun this trance

we fall together hand-in-hand
dream swim & wave abound
over reason and tight lip demand
and drift resounding sound

Story: Dialogue

One of the exercises in the last writing group involved creating voices and characters out of objects and incorporating them into a dialogue. Dialogue is one of my weakest points. Here's what came out of the exercise:

-Is she asleep?
-I think so; after 3 days of insomnia, she's succumbed.
-Ah well, it was fun while it lasted. That was some car we crushed, wasn't it?
-Some car you crashed. She had no part in it. You had me locked in some backwater part of the brain, near the cerebellum.
-Sorry about that; you know you wouldn't have allowed her to frolic like that. She had more fun in the last few days than she's had in your entire dominion.
-And now she's going to have the biggest hangover.
-Yeah, well, you're going about it all wrong. You're treating it with lithium when ritalin would do the trick.
-You'd fry her brain. I should shove some lithium down your throat.
-Why not? Let's break into a pharmacy tomorrow, it'll be fun.
-We are not shoplifting. I've finally turned her around.
-But if you give me a chance, a whisper, she'll listen to me.
-How do you manage that, to poke your head in every few months?
-I build my house in the heart. I palpitate, I throb, I skip beats, I swoon her.
-You swoon her?
-It's a verb, trust me. I pressure her speech. I goad and plead. I masquerade as you for a bit. It's fun, you know, she believes me. She likes me much better than your cold-fisted government.
-You're talking rubbish. How could you usurp my throne? I sit upon the Turkish saddle, keep reins on the neurons tentacling. She calls herself by me. I wade through her mind and she sleeps and wakes in comfort that I linger. I cling. I define her.
-You define one side of her, the side that bores and languishes. The other side, the true self, starts a small revolt in your cerebral empire. She forgets her meds. I take over.
-Until I can put her back to sleep again.

Poem: Hands

Hands

Hands fought an axe once.
Best friends, it was a cordial tussle but
well, the odds were against the hands anyway,
and now there's a trickle of blood
and the axe feels sorry.
Swathed in beeswax and oats
the hands still heft the blade,
it arcs over the shoulder
whistling a tune in the cold winter,
the kind of winter that gnaws joints,
numbs hangnails -- it was one of those
brisk and golden winters
the hands and axe stood vigilant
under a canopy of branches
while I slept safely
and owls swept the distance.

Poem: Delusions of Grandeur

I'm doing the evening monthly writing workshop at Stanford again and it's really fun. One of the prompts was to take a poem (shown below), cross out every other line, and then rewrite the poem filling in the alternate lines. (The next step is to cross out every other line - those of the original poem - and fill in the rest, thus creating a completely original poem). I'd never done this exercise before and it was quite fun. Here's the original poem:

Psychology Today
Darnell Arnoult

Have you ever had
delusions of grandeur?
I read all about it
in a magazine
on the coffee table
at Dr. Broadwell's office.

Have you ever thought
you were meant for
something special?
But you were afraid,
Afraid if you tried
you'd fail?
People
would think you
a fool?

You might risk
everything
only for
delusions of grandeur?

I have.
Thought that, I mean.

-
Delusions of Grandeur

It was one of those news stations, called
Delusions of Grandeur,
hounding and cannabilizing fear, horror.

In a magazine
there were six bullets. There were six bodies
at Dr. Broadwell's office.

Your heart stops at such headlines.
You were meant for
worrying -- her name isn't even Broadwell

but you were afraid
and opened the webpage anyway, because someday
you'd fail,

ignore and
would think you
caused it, did it, pulled triggers in outrage.

You might risk
a heart's wayward beat, a run of anxiety
only for

a moment to check the article.
I have.
Thought that, I mean.

Poem: Questions for the Doctor

Questions for the Doctor

Writer's block, pen hovering over
notepad and its small red font:
Questions for the Doctor.
Where do I start?
Was it the glass of wine my mother drank,
the one that committed her to AA
or was it my father with his alcoholic hands
or first grade, when I punched the teacher
or the time I left home?
Did it start with that first beer, age 14
or that first smoke, the first high,
the first drop out or the first pregnancy --
that first divorce?

Did it begin with the last time I believed
in social work, in welfare, in health and well being?
The last time I took my medications
or ate a warm meal
or remembered a day from start to finish?
Did it begin with the anorexia
or the skin popping
or the suicide attempts,
the broken jaw or the rash?

I erase everything I've written;
doctors write in pen, but I in pencil
for how could one live life without erasure?
This is the question I want to ask
and yet I don't know what to say
when she comes into the room
white coat, hair all business,
looks down at my wallowing face
flips through the chart for the number
I already know - less than 200 -
and tries to align resistances.
Oh, this will be the last time I get asked
that question, Questions for the Doctor
yet I am resigned to silence.

W;t

I recently reread the play W;t by Margaret Edson. I had initially read this as a freshman in college for one of my introduction to the humanities courses (I had taken a course called "visions of mortality" - which probably lead to my current fascination with death and dying). I was really struck by this 1999 Pulitzer Prize winner and the film version starring Emma Thompson. I do not read a lot of plays, and I'm not sure I even know how to read a play, but I can say that this short, easy read works a number on the emotions and strikes at the core of end-of-life care and oncology. It describes a professor of English with terminal cancer and her interactions with the oncologists and nurses as she undergoes chemotherapy. The play ties in the Holy Sonnets of John Donne, including Holy Sonnet X (below) which addresses death directly. The language of the play reflects the clinical encounters patients often have, and the self-reflection of the main character reveals the rich internal dialogue that presumably patients have as well. Overall, it is one of the best reads for understanding the patient perspective of cancer and I recommend it to everyone in medicine.

-

Holy Sonnet X
John Donne

Death, be not proud, though some have called thee

Mighty and dreadful, for thou art not so;

For those, whom thou think'st thou dost overthrow,

Die not, poor Death, nor yet canst thou kill me.

From rest and sleep, which but thy picture[s] be,

Much pleasure, then from thee much more must flow,

And soonest our best men with thee do go,

Rest of their bones, and soul's delivery.

Thou'rt slave to Fate, chance, kings, and desperate men,

And dost with poison, war, and sickness dwell,

And poppy, or charms can make us sleep as well,

And better than thy stroke; why swell'st thou then?

One short sleep past, we wake eternally,

And Death shall be no more, Death, thou shalt die.

Image from Wikipedia, shown under Fair Use.

Poem: The Delivery of Modern Medicine

This poem is incredibly early and rough; I didn't really want to post it, but time's up and a blog must be entered.
-

The Delivery of Modern Medicine

starts with a number, eight digits and a band,
a looping, a manacle, a room and a curtain
budding into a nurse, a cuff, another looping,
numbers, more numbers, numbers divided by
other numbers, into a poke and whisper
of the arm, into poles and bags and foot-manacles
to stop the clots that bloom from being bound.

The Delivery of Modern Medicine
echoes with the repetition of story, and again
to each wayward passenger on this medical train
the same prodding fingers, bounding stethoscopes
reverberating into routine alarms,
the voice of the phlebotomist, and then the intern
and then the resident, and then the attending.

Oh, the Delivery of Modern Medicine
quakes with the steps of social work
the power behind the throne, the one
who moves patients, rocks, mountains.

The Delivery of Modern Medicine
trades in pills, tablets, capsules, caplets,
barters in knives and lasers
a commerce in drugs of Janus,
two faces, two names, a dozen colors.

The Delivery of Modern Medicine
ought to start with a touch, with a warmth
with a hand on a shoulder, a grasping
of the willows and oaks, a burgeoning
of sense, a blossoming of age, recapitulation
of that we know, deep within us.

Poem: Childhood Dreams

Childhood Dreams

Sometimes I wish I could be evil,
black as flint and glass-sleek,
my hair chopped off and heinous-looking.
You would have been a good henchman
and I, a connoisseur of evil.
I wish we didn't have to be so good all day,
what's in it for me anyway?
Other people will save lives in my absence
and even if they didn't, it'd be fine--
we're being bad today, remember?
We would make true our promises,
get crayons the size of lampposts and terrorize Atherton,
sing sea shanties waving cider
and plop our feet on the arms of couches
without removing our shoes.
We hold peculiarity hostage,
build a fort of pillows, our sanctuary of villainy,
communicating in code,
making our rapscallion reputations
and staying up much, much later than we should.

Poem: Aging

Again, a poem I wrote in a writer's workshop. The prompt was "write about aging."

-
Aging

A pot ages on the stove, effervesces in a film of brine.
A tap with a spoon on its crust, as if creme brulee
and a flame coaxing the soup from its stupor
into a welling of lemongrass and coconut
steaming my glasses as I stir.
Each circle of the ladle draws in new colors,
the fire of a carrot, the silk of tofu,
the lucency of onions, the curry spice.

Do you think it's still good, she asks.
We made it on her birthday, and ever since, she's resented time,
that winged chariot, that muse of poetry.
It rumbles past outside, in the cold.
What is it for our pasts to slough off,
why are we so recalcitrant,
why must we dig in our heels to slow the earth's revolution
or else hide in an hourglass' wake?
What could we want or imagine or have
if we could leash time to our bending, if we cage it
or well it into dams? Unleash it during boredom,
savor it in joy, curl it as a madman or sorceror?

If I could bottle time, I would cork it, hide it,
keep it in the cabinet next to the cinnamon and nutmeg.
I'd add a dash or two every time I make lemongrass soup.

Poem: Masquerade

I wrote this poem at the last creative writing workshop. It was inspired by Mary Karr's "Viper Rum." The prompt was: masks are a prominent party of Halloween. Write a poem about a mask or masks.

-
Masquerade

For nineteen years I danced.
I danced to forget, unknowing, ill-caring.
There were no faces, eyes sanded away
leaving only the frame of things, the rock and sway
of blues, the kiss and linger of waltz.
Masks of glitter, masks of gold,
masks of clay and wood.
The sprung floor ached rhythms
and we wrung tears from the paneling.
A face painted black and white lead me blindly.
Eyes were painted over eyelids,
they fixed me upon my axis,
I could only spot on white pupils with each turn.
A woman with feathers leapt with pas de basque,
skirmishing the others until hearts subsided.
I found a mask on the ground, trampled, formless,
and yet we need not heed the warning.
We danced month after month, year after year
until drumming and fire flickered in ritual,
our madness conjuring motion from dust.

He came for us in the end, how could he not,
and he sent us awry, ascatter.
His mask was white, bloodless, rent and bloodrung.
I knew then he came for me.
The stamping became more furious,
the drums would not hush. I fled.
The mask I wear is the one I destroyed nineteen years ago,
the one my wife, my daughter, my family knew.
The cult-summons gleaned confession from me,
sweat escaped the sides of my face's tomb.
I tore it off, stripped a layer of skin,
recoiled in apprehension. The webs and spiders of the room
flooded me, harnessing, and when in years past,
I would let the rebound catch, this time, I pushed through.
The room was humming in ghosts and macabre.
Out in the river, I emptied my pockets,
the rope, the gun, the razors.
The water caught my glance, then hurled it back.
I touched my face; unconcealed, wet,
the first time I had touched it
since I had last seen myself.

Poem: Crisp

Crisp

Sun-baked cinnamon, mulled senses and flame,
November's whisper dances circles across the floor.
We cannot be but horizontal,
eating to the sky, our tongues lavishing
stewed tart apple, our cheeks brushed with brown sugar
ice cream droplets scatter the pillows framing our heads.
We lap up cider, aroma like tea, lemons bobbing,
the flicker of shadows as a draft caresses candle.
Amber, woody, auburn, fall,
basking in the luxury of sense, texture of smell.

Revision: Mythology, and Other Lies

Mythology, and Other Lies

And when I smother myself in poison,
find clumps, hills in the shower,
negotiate nausea, pain, itch
I wonder how Prometheus did it,
letting vulture consume that which he did not want
hoping to regenerate the purveyor of iron --
oh, I know of the Prometheus support groups
pre-transplant, post-transplant kumbayas --
but I defy absolution! I bathe in your
widowed, your winowed -- I roar
against cages, cells, cancers --
I am not so sure we are not Titans,
that we aren’t chained some precipice
to have our organs devoured.
Burn me, hold me, let scars radiant
beam down that valley, shadow, light.

Poem: Window

I signed up for a writing workshop associated with the medical school. It is a three-session evening class with 15 writers, all members of the Stanford medical community. Somehow it fit in my call schedule and I am very excited about this. We focused on creating new work. Here is one of those poems.

-
Window

Each morning, I wake to a new window.
Today it is the window of an officer's glasses
eyes magnified, serpent-like
in an expression encountering halitosis alighting
that breath of rum and vodka,
and the next window is the torch:
look at my nose, the prodding voice commands
and I dodge into the next room
the images swim up, portals of access and descent
until another window consumes, a window
with a blackberry vine, a meander across
the splintered barn, my shoulders aching
from the beat and welt of days.

You are too serious, I tell the bars
and like you, their insistence is silent.
Oh, the windows say the same thing every day
shelter among shelter, and believe me,
if I could climb through, I would have long ago.

Poem: The Beginnings of Things

The Beginnings of Things

(as such may be)
flitter me away
to that edge, sky to sea where
cloud burns to seaspray
and scientists goggle
at The Beginnings of Things
and I simply want to leave
to bury my head
where I love it so much
and I give it all away
to The Beginnings of Things
(that refrain we sing)
as if we were not always here
as if becoming safe in our skin
makes us statuesque
and rumbling tide turns
rock into sand all the way until
(you know where we return)