I don't use military metaphors in medicine lightly

"Barbed wire birds," stencilab, Flickr (2008)

CC BY-NC-SA 2.0

"In the Trenches"
A poem published in the Ad Libitum section of the Annals of Internal Medicine

Feel for the teenaged girl who cuts
herself so she can control some-
thing in a divided household
but cannot bear the dozen pricks
of the thin lidocaine needle
so she will not feel any of
the one hundred twenty stitches
needed to lace her wrists back up.
Sutures march like rows of barbed wire
across this no-man's land of skin.
Her mother whispers in her hair,
while her father stands guard, arms crossed,
watching from the foot of the bed.
My hand cramps around the forceps
as I bend down to sew again.


I don't use military metaphors in medicine lightly, despite their ubiquity: we talk constantly about "fighting cancer" and "beating the disease." In graduate school I did a research project on the use of contemporary geopolitical language in the earliest days of bacteriology (~1880s). Because non-white, non-Western bodies seemed to bring diseases with them (especially cholera), terms such as "invasion" and "colonization" reflected both fear and the vacuum of an entirely new field that needed a vocabulary. What this sometimes overwrought language did, however, was pretend like nineteenth-century European and North American cities weren't also already filthy places to live.

While military metaphors seem normal now due to their longevity, the anthropomorphization of unthinking malignant or infectious cells is not inevitable, as Susan Sontag wrote in Illness as Metaphor (1978). She described how being encouraged to "fight" her breast cancer made it seem like her clinical outcome depended more on her state of mind than on the biology of the cancer or the efficacy of the available therapies.

In this poem I invoke "the trenches"--of World War I, of a family at war with itself, of front-line healthcare workers threatened with burnout. I think it's important to point out that burnout can happen if a nurse or doctor becomes overwhelmed with all the tragedy around them--essentially if they feel too much for their patients--and it can also happen if the long hours and bureaucratic red tape prevent them from feeling anything for the vast majority patients who come seeking aid without ulterior motives like pain medications or a free turkey sandwich.

One last note: as I counted up the syllables to make them even in each line, I realized that 15 lines x 8 syllables = 120 beats/stitches.

N.B.--Other poetry you might enjoy include this little Ogden Nash ditty, and this more somber verse about the relationship between the Pacific Ocean and the coastline.

What Residency Looks Like CXV: Accomplishments

Monday: 

Graduated from Internal Medicine Residency (no more shifts!). I dressed up for the live-stream, although no one could see me except in the selfie I posted on Facebook. Even Dear Husband was on a different Zoom meeting.

Earned a Certificate in Medical Education. Was "voted" most likely to give a history of medicine lesson on rounds. Sore that the foodie award went to someone who isn't even a Yelp Elite.

Friday: 

Took a knee against white supremacy, racism, and police brutality. Medical professionals around the city gathered at noon to reflect and kneel for 8 minutes and 46 seconds, but I was not on campus due to graduation. So I had my own one-woman protest on the busy street corner in scrubs, a white coat, a refurbished version of the "White Coats 4 Black Lives" poster that has lived in my rear car window since medical school. I didn't do it for likes on social media, so I didn't have Dear Husband come take pictures or video or anything. I did it for the white man who started crossing the street, turned around, and came back to ask what I was doing. I did it for the black city bus driver who honked and waved. I did it for the black woman who asked to take my picture. I learned that 8 minutes and 46 seconds is a long time to support my weight on one thigh, and that the pavement is very hard when the soft neck of a Black person isn't underneath.

Graduated from Pediatrics Residency (1 Emergency Department shift, 12 more hours of jeopardy, and 3 weeks of out-patient elective to go!). DH, my parents, and I gathered at my colleague's house for a graduation party. Since Allegheny County had moved to Green that very day and there were still fewer than 10 of us, we figured it was safe. I confess that sitting on a friend's couch to watch a pre-recorded ceremony with an adult beverage in your hand is absolutely a superior way to experience a graduation. Big surprise: I was awarded the American Academy of Pediatrics Med-Peds Resident Recognition Award for my advocacy work, and the program director read my poem, "In the Trenches."

Provided by-stander aid to an older gentleman who fell off his motorcycle due to a near-miss with a car. Good thing there was a house full of doctors on the corner, and good thing he didn't really need us!

The ambulance driver who came to pick up the biker was definitely
laughing at us as she drove down the street after the accident...

Saturday:

Repaired a closet shelf that had collapsed when we moved in and I tried to store too many boxes of books on it. (Credit: Father Man)

Acquired a blister from a lovely walk in Frick Park in inappropriate footwear.

BBQ shish-kabobs (Credit: Father Man, who wore his new "My Favorite Doctor Calls Me DAD" tshirt)

Games after dinner included the tallest-ever Tier auf Tier tower (Credit: DH). We also made up rules for Gluecksferkel, because the instructions were missing from the box (I acquired 3 German children's games for free back in grad school).

Sunday:

Adult Forum finished talking about Barbara Brown Taylor's Holy Envy: Finding God in the Faith of Others; Zoom church went off more or less without a hitch; and DH had very thoughtfully picked up Klondike bars with which to mark the start of "summer church" (we're still meeting at the same time, however, since we don't have to move to the cooler worship area at an earlier time due to the lack of AC).

Re-upholstering my rocking chair. It was 10 years old when we got it with the dining room table and chairs from another history graduate student; at that time I replaced the stained blue-and-white coverings with green-and-brown stripes. 10 years and 2 cats later, however, it was time to replace the fabric. Mother brought a beautiful dark blue cotton with light blue flowers that remind me of blueberries and Maine for the front and ottoman, which we paired with a sturdy light blue polyester for the back.

45-minute hike in North Park (Mother and I are wearing matching face masks that she sewed)

Successfully ordered burgers to go (it only took two tries in three days, as the first time we accidentally landed on the site for a burger joint 30 minutes out of town!); watched Top Gun; chilled

Monday:

Had second breakfast together and said our good-byes until...mid-August for family vacation?

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National World War I Memorial & Museum in Kansas City, Part I of II

With the annual history of medicine conference happening at the Westin Crown Center Hotel (named for the world Hallmark headquarters next door) and literally across the street from the National World War Memorial and Museum, how could I not go? I found a hole in my panel schedule one morning and navigated through a construction site to reach Penn Valley Park.

On one side was Union Station, one-time railroad gateway to The City of Fountains and The City of Champions.

On the other side of the street, a grassy lawn gently slopes upward toward the memorial that had opened in 1926 as the Liberty Memorial. The museum followed in 2006 and has been expanded since then.

There's a bas relief below the stele that I didn't get very good photographs of.

If there is not yet more construction, apparently you can approach the museum from this direction, but I had to walk the long way around to the south to find the sunken entrance.

Above: The parking lot is behind me from this perspective.

Below: After buying my ticket and dropping my bag and jacket off at Guest Services, I entered the museum via this glass bridge over a field of poppies.

For a small museum, there is a LOT of stuff and information, and I don't think anyone could look at all of it. There are big things like posters and artillery as well as small things like postcards and personal objects. There are large panels with general information about the war as well as smaller panels with specific details. There's a comprehensive timeline in the center of the space as well as many glass cases of clothing, weapons, implements of various kinds, etc.

Hardtack!

There are life-sized dioramas of British, German, and French trenches,

as well as a one toward the back about the trench as "one long grave."

The photo below is part of a quotation about the experience of being shelled.

(Maybe from Ernst Junger? I forget.)

There are three well-done films about the beginning the war, the middle of the war with an emphasis on the American perspective (uniforms below), and the aftermath.

I was interested of course in the medical side, which had a lot of details on the American side, with several cases of women's experiences. I didn't see anything about the influenza epidemic until I got to the gift shop, however.

I buzzed by the gift shop to pick up a book on the history of food and the war that I somehow hadn't already read, as well as a poppy pin and a "food as ammunition" magnet before hurrying back to the conference hotel. Luckily, I was able to come back after the conference ended to see some of the special exhibits. (See Part II.)