03 July 2012

Day One

Day One
Year Four, Part Two.

It’s relearning this particular kind of efficiency, impatience with the IT guy on the phone when he doesn’t actually know what I’m talking about, taking the stairs not really for exercise but for time, and rushing, rushing everywhere. What a pager feels like. How many notes, papers, pens I might end up carrying and how to organize them. That I still remember where the stairs are, just carried there naturally,without thinking. After all, I used to write while walking, here, email while walking, where everything becomes rote, in a finite space. Only seven floors.

Remembering only with the third patient visit that, yes, appended to my name is supposed to be “medical student.” or “student doctor..." partly forgotten because any introduction with "poet" or "writer," while in writing school, felt self-important and uncertain. We used to discuss that - what it felt like to attach those names to ourselves. At what point. For what.
Impatience with the white coat. Impatience with the white coat.

So many things the same – nurses the same, wards the same (and why wouldn’t they be?) but a face recalls the patient we both had, a room, another one I wonder about. It’s a year ago. It isn’t. And every mistake (all. day) I make when trying to read paper or computer records recalls one I’ve made before. Once I figure out the answer. Second time around.

Some kinds of authority are still there. Walking in. Sitting down. Asking the questions that aren’t easy, asking and not being asked back. Though, today, “have you ever experienced anything like this?” (tuberculosis, isolation). Through my N95 particulate mask. Leaning forward. “No.” Another comparison she makes: “it’s like when you’re just waking up, between asleep and awake…that’s what the headaches feel like. That’s when the nightmares are.” I take human experience, my human experience, as evidence and descriptor. We are our patients are us are our patients.

I managed to hit most of the necessary points in the story. It’s a story, after all; any reader knows what she wants and needs to know. For the most part. “Felt like the house was moving.” Another line in my note. This part, I’ve done. This part, the listening, is poetry too.

The part slower to come back. Causing pain (“discomfort”), the importance of my exam, findings that I can actually report if they haven’t been reported before. Maybe. First day back. Full neuro exam. And putting the reflex hammer in the coat had felt superfluous, over-eager med student-like. But later I almost wished I had the needle points. The tuning fork. Pain, cold, pain. Vibration. I didn’t test proprioception – where are you in space, what is this room where people wander in so covered that no air escaping you, nothing of you into that air, could enter them.

Causing discomfort. My half-thought out, presented rationale “well, the patient was already doubled over in pain…so I didn’t do that part of the exam…”. Now I realize that that is the question – that pain (I didn’t cause it, I can call it “pain”) – the why. Why. And so tomorrow morning I have to go in and cause discomfort on top of the pain. My prerogative, our prerogative, the “greater good.” Of her, us, whomever else.
Poets? Pain, anything acute or acute-on-chronic or chronic-on-acute is a medium. The medium of poetry is image, the medium of fiction/literature/prose is the word (Ezra Pound, highly paraphrased/oversimplified).

There’s one thing the same. Poetry and medicine, with bodies as interlocutors. The use of poetry – fiction can’t describe simultaneity in the same way, conflation, distortion and ambivalence and reality within irreality within reality of an internal and external universe. Medicine is…the art of figuring out what the body is actually saying, and all we have are words, numbers, and some pictures (intrusions. inner) to describe. For poetry…it’s images, and we have words and space and placing (proprioception – where is this word, this phrase, this articulation, this sound. How is it related to anything else. How does it find itself).

Returning from a field that treats nebulousness with particularity and infinite variation with rigorous category and study. To another field that calls nebulousness particularity in word and in acronym, and organizes infinite variation into bell curves.
To the Venn diagram, scatter plot, Punnett square*, and any other shape used to cull entropic humans into a visible form.


*poetry prof actually used that to describe one of my poems, the other day…

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