Isn't It Ironic

The patient, a writer of 27 novels, lies motionless in his VA hospital bed, unable to express a single full thought. Just shy of four score, he has the remnants of a handsome face--dimpled cheeks, the strong cut features of a cowboy. His right arm is contorted into the characteristic post-aneurysmic twist, right leg splayed rigid like a log. But it's not his days of skiing that Mr. H mourns. We ask our first question, and his eyes light up instantly with the answer in mind. But his left-sided stroke led to an expressive aphasia, so even though he understands us, and there's nothing physically the matter with his mouth or tongue, he cannot find the words to piece together his answer. A pen wouldn't help, either--he quite literally can no longer get his thoughts outside of his head. Through an unfortunate nerve block, Mr. H now suffers in silence with the ultimate writer's block.

A Word to the Wise

Yassir Arafat has a platelet disorder. Funny thing is, we're learning hematology now. Last month, Bill Clinton had unexpected bypass rugery smack in the middle o four cardio moedule! So apparently, if you're a current or former world learder, you should watch our for your lungs during the next few weeks.

(It's things like this that make me wonder if maybe the world actually *does* revolve around me?)

Memoryspeak

Memory. Memories. We exist because of memory.

Fifty-four years ago today, my grandmother Gertrude Weiner died. When her mother heard the news, she immediately suffered a stroke and died a week later. Gertrude was 38.

She left behind a husband, Ben, and two little girls: Toby, a precocious, bossy 7 yr old; and Susan, serious and shy at age 4.

Stories. In nine days we come to the anniversary of that Fateful Night, October 29, when my mother and father (1) met, (2) connected, (3) acted upon their desires, and (4) conceived me--long before they had ever conceived of me. For 18 years, my father existed for me purely as a remnant of my mother's memory o a single 12-hour period in the thousands of other hours in her life.

Every time I have a new insight about life, it instantly updates all of the old memories to reflect this new revelation. It's very Orwellian, in a way.

Recent revelations:

- Triangles. Love triangles. Connect two dots and you get a line. Connect three dots and a new space emerges. The human heart most resembles a triangle. The holy trio, triumvirates, the three musketeers—there’s something sacred about the number three. Put two people together and they can create the third; three is the number of creation, of love, of spring. Triangles are more stable than rods, three-legged stools more stable than stilts. I innately seek out threesomes when it comes to friendships. Interesting.
- I'm like Merlin the magician, living my life backwards. I feared death most when it was least likely (age 9, when I started having "that feeling" of imagining the world after human existence had ended), I grieved the loss of my father before I met him, and had a responsible adolescence before graduating into my wildly rebellious twentysomethings (woohoo!).

Inside My Brain

So many things
flood the space
between my ears
running relays along my sulci
bouncing off the elastic pleura of
my inner cranial surface
unrestrained, unorderly, like
schoolchildren playing at recess

Season's Greetings

Crisp apples arrive
ruggedly handsome
dusty scruffed cheeks and
unassuming ease

Pierce through their dura mater--ah!
explosion of autumn colors
in my mouth
sweet as the afternoon harvest sun
tangy with the bite of chilly mornings
better than Dunkin Donuts' pumpkin muffin
with cinammon spice coffee
stupid artificial flavorings of the season

Hospice

We visited the Branford Hospice today. Having spent so much of my childhood hanging out in nursing homes, and that summer in England at the Sir Michael Sobell House Hospice, I thought today would be boring. You know, "been there, done that". I've thought about death plenty. Too much, if you ask me.

But the truth is, I haven't been back to a hospice as a medical student. So I never *really* thought about what it would mean to be any of these patients' doctor. And, I never knew as much about the sometimes excruciating, senseless process of disease and dying as I know now after a year of medical school and the family illnesses that have since appeared.

We spent most of the time talking to a friendly, highly cultured lady who has been around the world and back many times over. Mrs. M was sitting up in a chair, chatting with us about the election. She's already filled out her absentee ballot, and is determined to stay alive to see Kerry elected. She looks no less healthy than your average 84-year-old, and she has an incredibly wide perspective on life, the sum of both her long life experience and her amazing life experiences in diplomacy and the FBI.

Saying goodbye to Mrs. M felt almost too cheery. Something was amiss. This is not what we came for--to continue to deny the reality of death. Doesn't she have esophageal cancer? But she seemed so...hopeful and positive. The reality, our preceptor conveyed to us with a "it's too bad, but..." expression as we pulled the curtain back around, is that she probably won't make it to election day.

As we turned to leave, I glanced at the woman lying in the bed across from Mrs. M. There was no curtain giving her privacy. She gave us That Look as we walked past. That Look of wheelchair and bedbound patients at hospitals and nursing homes everywhere. I've seen it hundreds of times, but usually I just feel guilty. This time, I was struck by something new: fear. The devastation of losing control.

I suddenly felt the impotence of lying frail in a bed wet with stale urine, mouth dry from thirst, wanting to die but frustratingly holding on. After a long, full life, that is could end like...like this. How awful. No one deserves that kind of farewell. Everyone deserves the going away party Ed had in "Big Fish."