Image source: Unsplash
by Shreyas Banerjee
Artist’s Statement:
This piece is a work of creative nonfiction drawn from experiences during my third-year clinical rotations in medical school. Rather than following a single patient encounter or chronological narrative, it unfolds as a series of interconnected vignettes linked by recurring moments of music, memory, and transition. Its form is informed by the stream-of-consciousness techniques of the early twentieth-century modernist writers I love such as James Joyce, Alfred Döblin, and Virginia Woolf, adapted here to reflect the fragmented rhythms of clinical education and the fleeting encounters that shape it.
Toddling down the vacant hallways, monitor screens reflecting off the quiet floors, an empty dread fills my stomach. The first week of rotations and already running late, the time ticking away on my watch. Badge in, walk through the automatic doors into the Pediatric ICU. They unlock for you; are you worthy of that? The 6 a.m. sky glows, morning blue diffuses through the intermittently open patient doors, little worlds dying behind the closed ones.
The night shift resident and the other medical student gossip and laugh together as I scramble to set my belongings down in the back room. Morning, I mutter. Chart dig like the good med student you wish to be. Was it a fish bone diagram you’re supposed to use for electrolytes or was that vitals? Patient status unchanged, no acute events overnight. Then why do I see three order changes? A six-month-old, born premature and on and off a ventilator since birth. Underdeveloped alveoli, arrested exchange. What sort of life does she know? My confusion over the mechanics of bronchopulmonary dysplasia is trifling. Softly sighing, I step out before stopping, retracing my steps, and grabbing my forgotten white coat. Already crinkled of course, can’t be helped. Check its pockets: stethoscope, pen, notebook, miniature eye chart. Probably don’t need that last one for pre-rounding in the PICU. When I was given that chart by my professor I was always told to “keep your eye on the patient.” A pun on their part. I suppose that’s my job right now.
A soft knock on the door and a tentative step in, orange flickers creep into the lapis horizon. In the moments between, before I look over at the bed, I hear a whispered croon.
“Blossom of snow, may you bloom and grow
Bloom and grow forever”
She stops and looks at me, sheep-faced, glasses drooping as she stands over the crib. The undulating hiss of the ventilator fills the room, inhaling and exhaling. For a moment she was transported, carried away on waves of sound and memory. Now she is back in a place where she must answer questions for a student who doesn’t know what to ask.
Scrolling weeks swiftly pass in the life of a student. Rotating through, ever-transient, rootless, adrift. Learn the routine of a place, move along. Many people I meet along the way but most of the time I’m just confronting myself, my knowledge, my plasticity. In the long hours of the evening, I return home. The computer screen stays ever bright as all other lights recede, practice questions blinking in the retina. Don’t complain about something you signed up to do,; just get it done. Sitting in bed, blanket over legs, I find this life isn’t so bad. Switch to YouTube, try to find something to stir your studying. Let the homepage algorithm think for you, lazy bee. Looking at a collage of videos and songs of times long past, I wince. No wonder your listening age on Spotify is 93. Every comment section is filled with remembrances, exclamations of being transported back into the homes and arms of their loved ones for just a moment, caressed by invisible vibrations. As I listen, I share worlds with those shades that have passed and those on their way. Helen Forrest inhabits mine as her voice rings around my room.
“Through the mist of a memory, you wander back to me
Breathing my name with a sigh”
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Knocking and introducing, ever-forking paths always seem to take me to the same place. Stomach pain? Yes. After you eat? Yes. Impedes your life? Yes. Palpate. Ow. Let’s take the sucker out. Risks and benefits roll off the dome, images of mass transfusions fill my mind but aren’t shared. How many gallbladders does it take to reach the end of a surgery clinic’s day? The world may never know. After rotating through many outpatient sites, the ones with good flow become apparent. Here we have pre-written histories taped to the door. Well-trained medical assistants make all the difference. Take mental notes for the future. Survive a pimp, dodge a lance, the steps to this cha-cha become smoother over time. Whether it’s hot or cold, the weather is always an easy start of conversation with people you’ve never met and will likely never meet again. Today the solipsistic sun crowds out the cloudless sky, beating down on us all. What else is new.
Looking down on my notebook to remember the patient’s name, I enter. Familiar words pierce my consciousness from the grilles of a phone.
“And I discovered that my castles stand
Upon pillars of salt and pillars of sand”
The sounds of stadium rock bounce slightly up and down with the rhythmic contractions of his right gastrocnemius. Really? Coldplay of all things? We all have weary tunes we lay down on to steady the nerves I suppose. In the split second between my looking at him and his looking at me, he’s gone far, far away, the king of a forgotten castle, tapping away. Who am I to judge the ways we cut our tethers to this realm? He looks up, the pause button pressed, the phone shakily stowed. Time for my routine and his reality. Now how about this heat wave?
Freezing, squirming in my scrubs, I spin my gown. I’ve passed into the city of woe. This is an aseptic place, all considerations of life driven away for the one we’re trying to save. No light enters this domain of steel and blue. Time does not exist; the clock is frozen. Emanations of bilious aura fill the room. You want to scratch your face, don’t you with that nose of yours writhing under that mask? Fingers flexing, back aching, leaning against the open human body. Getting by with a little help from my friend. At least I’m not the one being operated on. Too long or too short: the eternal dilemma. I’ve abandoned hope of figuring it out long ago. Just cut. Finally, the nurse has chosen a song.
“Are you reelin' in the years?
Stowin' away the time”
My soul soars high out of my chest. It transmogrifies into a bird, flapping away in the clear guitar sizzle over rivers of running piano. It glides radiant, sublime, above the suffering of all others, away from the crying exudations of this world. It flies in concordance with prisms of perfect harmony, refracting a gleaming light around all else. It communes with every soul who ever has and ever will find solace through the song.
The case ends. I scrub out.
Logging in over and over on clinic computers, my passphrase has become imprinted on my hippocampus. “Who cares for you?” What started as a remembrance to Lewis Carroll—I would think of the rest of the quote “You're nothing but a pack of cards!” while typing—has now become bored into my being as just the solitary question. Perhaps not the best thing to have ringing in your head repeatedly through the bitter winter months. Longitudinal care.; I’m just a flash. Still, to get a glimpse of a life is no small privilege, I remind myself. So many faces, so many stories, so many labs. How they keep track of it all I’ll never know. Happens naturally once in the groove I suppose. Backbones of medicine should get paid like it. Overwhelming gray pervades all. Not all winters are like this. Then again, we all rewrite the pains of yesterday to fit today’s fleeting quibbles. The momentary present is always a passage to a shifting past and ever-infinite futures. Another door, another door, always another door with more to remember behind each one.
I walk through this one. Trodden, droop-shouldered son sits alongside ancient mother. She stares vacantly into the empty air, seemingly at peace. Her son, not so. He perks up, lion-chested, and greets me. She can’t speak anymore. Apple, table, penny, no use. The world is backwards. Does she even recognize me? I have no answer. Tears gathered thickly in the not-so-young man’s eyes. Putting on a reassuring voice, as if for my benefit, he tells me one thing she still can do.
He sings.
“Never thought my heart could be so yearny
Why did I decide to roam?”
Her eyes brighten; lips crease up into a smile. She replies.
“I’m gonna take that sentimental journey
Sentimental journey home”
The sounds of their creaky duet filled the room. It flitted out, went through the clinic, and expanded to the curtained sky. It went out and was bound together with the songs of all others across Toledo, across the world. Together they carry all our memories, comforts, escapes, and plights as they stream above us in incandescent warmth. They embrace us all as we gently pass through this life and as we pass beyond it.
Shreyas Banerjee is a fourth-year medical student at the UTCOMLS.
