Aenigma MedicorumThe Puzzle of Doctors

An Annual MUSOM Review of Literature, Photography, Art & Music

Pictured (from left to right): Scott Studeny, Hilary Hott, Ally Roy, Stephen Roy, Matt Christiansen, Joanie Garratt

Aenigma Medicorum

Founder.................................................................................................................................Bi Mo

Executive Editor.................................................................................................Matt Christiansen

Design Editor...........................................................................................................Joanie Garratt

Submissions Editor....................................................................................................Scott Studeny

Copy Editor...................................................................................................................Hilary Hott

Selection Committee..............................Ally Roy, Stephen Roy, Blake Epling, Gordon McLemore

Faculty Advisor.......................................................................................Thomas C Rushton, M.D.

Faculty Advisor............................................................................................Stephen Petrany, M.D.

Faculty Advisor.......................................................................................Guada Lopez Marti, M.D.

Our heartfelt appreciation for the funding provided by the Multicultural Advisory Council.

Letter from the Editors

We would like to welcome you to this inaugural edition of Aenigma

Medicorum, the annual literary and art review of the Joan C. Edwards School of

Medicine!

We know that medicine is as much an art as it is a science. Woven into the

day-to-day practice of medicine are stories of sickness and accidents, birth and

family, struggle and prosperity. These experiences inform health care providers as

much as their patients: while patients look to medical professionals to manage their

health issues, we learn from them as well, forming a partnership toward mutual

wellness. This physician-patient understanding is crucial in our quest to improve the

human condition through medicine and find a niche that best serves our community

and loved ones.

The practice of medicine is therefore a puzzle with many solutions leading

towards the same end; each experience is directed by our own unique encounters, life

stories, cultures, and backgrounds. The name Aenigma Medicorum translates

roughly to the Puzzle of Doctors, an acknowledgment that the most important

aspects of medicine go far beyond interpreting lab results, reading an image on a

screen, or a making a diagnosis.

With this publication we hope to contribute a piece of this puzzle by featuring

creative works that reflect the experiences of our community. Our submissions reflect

a broad spectrum of professional experience, from medical students just entering the

field to researchers and physicians who have practiced for years. This board is

honored to present Aenigma Medicorum and reaffirm our commitment to fostering a

culture that emphasizes humanism and clinical excellence in medical education at

the Joan C. Edwards Marshall University School of Medicine.

Contents

7 Sunflowers.......................................................................................Yasser Etman

7 Fall Colors.......................................................................................Yasser Etman

8 Old Tailor Shop...............................................................................Yasser Etman

9 A Dying Secret....................................................................Rezwan Ahmed, M.D.

10 Unlocking The Cell..............................................................Rezwan Ahmed, M.D.

11 Dislocated..................................................................................Warren C. Doyle

12 The Adventures of Mothman & Larva Boy............................................Ryan Clagg

13 Where the Heart Meets the Sky........................................................Joanie Garratt

13 The Sentinel...................................................................................Joanie Garratt

14 A Tranquil Stroll.............................................................................Joanie Garratt

15 A Young Woman.............................................................................Stephen Clark

15 Study of a Man..............................................................................Stephen Clark

16 Mug and Napkin............................................................................Stephen Clark

17 Tiger Swallowtail.........................................................Aaron M. McGuffin, M.D.

18 Remembering him on Vacation.......................................Aaron M. McGuffin, M.D.

18 Rhinorrhea...................................................................Aaron M. McGuffin, M.D.

19 Untitled..........................................................................................Scott Studeny

19 We Are...........................................................................................Scott Studeny

20 High Light.....................................................................................Scott Studeny

21 Untitled............................................................................Kimberly Becher, M.D.

23 Only true kingz do these thingz.....................................Thomas C. Rushton, M.D.

24 Civilization’s compass...................................................Thomas C. Rushton, M.D.

25 Hyacinth Batik...................................................................................Gina Guzzo

26 Ostrich Feather Skirt, Cowl Back Top...................................................Gina Guzzo

26 Wine Bottle Chandelier........................................................................Gina Guzzo

Contents [Continued]

27 Rhino Bug...........................................................................................Kate Steele

27 Dog, Honduras....................................................................................Kate Steele

28 Ignorance Gains Access........................................................................Kate Steele

29 Wink.............................................................................................Matthew Boyer

30 Bones............................................................................................Matthew Boyer

30 Untitled Desertscape......................................................................Matthew Boyer

31 Minions........................................................................................Dilip Nair, M.D.

33 Who Are You, Really?....................................................................Dilip Nair, M.D.

34 Stairway to Nowhere....................................................................Dilip Nair, M.D.

35 Man selling dates at a souk in Kuwait City, Kuwait..........................Shaun Stanley

36 On Shadowing a Case of Clostridium Difficile............................Michael Hardman

37 Portrait of Harris Hawk..............................................................Zachary Sanford

37 Portrait of Cheetah.....................................................................Zachary Sanford

38 A Matter of Perspective................................................................Zachary Sanford

39 Stained Glass................................................................................Sarah Johnson

40 Thinking Place..............................................................................Sarah Johnson

40 Clown Dash..................................................................................Sarah Johnson

41 Rose...........................................................................................Daniel Roberson

41 Mile 1........................................................................................Daniel Roberson

42 Sugarwood................................................................................Daniel Roberson

43 View from the Top: Rainstorm.....................................................Neha Goyal, M.D.

44 Elaborate Dining Room.............................................................Neha Goyal, M.D.

45 Where Dreams Come True..................................................................Kate Proffitt

46 Love Birds.........................................................................................Kate Proffitt

46 Somewhere Over the Rainbow............................................................Kate Proffitt

Contents [Continued]

47 Ohio River...................................................................................Mats Lemberger

47 Ode to Joy...................................................................................Mats Lemberger

48 L’Enfant Plaza Subway Station..........................................................Kyle Burner

49 Trees.........................................................................................Matt Christiansen

50 Animals....................................................................................Matt Christiansen

51 Men anpil, chay pa lou: Many hands make the load lighter...........Nafreeza Hussain

51 Ritchie.......................................................................................Nafreeza Hussain

52 Nan Lakou la: In the backyard...................................................Nafreeza Hussain

53 Dil to pagal hai......................................................................Meaghan Tranovich

53 Kabhi khushi kabhie gham.....................................................Meaghan Tranovich

54 Kuch kuch hota hai.................................................................Meaghan Tranovich

55 Wayfaring Stranger...........................................................................Shane Cook

55 Wagon Wheel....................................................................................Shane Cook

55 Carolina in the Pines..........................................................................Shane Cook

56 Dusk in Laguna Niguel.................................................Guada Lopez Marti, M.D.

58 Theatre..............................................................................................Shayne Gue

59 MAY...............................................................................................Sarah Slocum

59 Power Down...................................................................................Sarah Slocum

60 REX...............................................................................................Sarah Slocum

61 Untitled.............................................................................................Jason Locke

62 Cruiser 2......................................................................................Darlene Cordle

63 Indigent?..............................................................................Shirley Neitch, M.D.

Fall Colors

Sunflowers

Since I was a child I had a passion towards art. I

have always wanted to be a physician and thought I can do both in the same

time. After starting medical school I found

myself forced to sacrifice making art to be able to succeed in the medical

career. After I had completed my medical training I was able to rediscover my talent in making art and to self

educate myself to be able to satisfy my life long

desire to make good art.

⓪⑦

Old Tailor Shop

I am a pulmonary medicine fellow at Marshall University Joan C. Edwards School of Medicine and plan to pursue training in critical care medicine. I will continue to do my best to save lives and make art at the same time.

Yasser Etman

⓪⑧

A Dying Secret

9 minutes till expiration....

I stare into her eyes, unknowing that my words

Will be reverberated for all of time

 

However simple, however profound

They are my last, encapsulated

A mere montage in time

 

Hitherto, the script was evolving

Now an Ellipsis has been placed

Into the story - one that's never-ending

 

The zephyr from my breasts slowly

Seem to be overcast and alarmed

An urge takes a hold of my being

 

Almost exasperated, I tenderly utter

What my youthful lips

In much despondence shamefully compels

 

"Please forgive....

I am a first-year Internal

Medicine resident at Marshall

University, Joan C. Edwards

School of Medicine. The

unique interactions that

health care professionals have

with their patients gave me

the inspiration to write “A

Dying Secret” and “Unlocking

the Cell.” I have always

wondered how life would

seem if experienced as

someone else. If we could re-

experience our lives in

reverse, knowing that we had

less than 10 minutes left, what

would we tell to the one who is

by our side at that moment?

“A Dying Secret” poses that

question. “Unlocking the

Cell” is a poem about a

medical student who was

unexpectedly afflicted with a

stroke in her pons, leaving her

forever debilitated. Her story

is one of denial and anger,

emotions I have seen

expressed by many patients.

My sympathy goes out to those

afflicted with unforeseen

circumstances, hoping that

their hardships can one day

be provided with a greater

purpose and meaning.

Rezwan Ahmed, M.D.

⓪⑨

Unlocking The Cell

Urgently transported, awaiting bed

I stare at the victim, bewildered.

Frozen in time, our eyes collide...

As I take a leap inside her blinks

 

"Why, why me?"

Agony echoes through the cap,

Piercing my heart, yet I start blankly,

Unable to show my daggered outrage

 

One moment in time that forever

Paralyzes her goals, deafens her beauty.

An infarct within her pons that

Mutes her daily experience

 

I wonder how her patience is tested

Herself, a future medic.

Serving graciously,

Not reliant on the system in which she is now involved

 

It silences my thought during this brief exchange

Knowing that the expression of "help," a "blink,"

Will not provide assurance for

This eternal state of lifelessness

①⓪

Dislocated

I lie inside that ambulance, left arm mangled,

Head swirling, eyes blurring, choking and strangled,

By the tears and the fears and the shock and the pain,

And an anger that I hope I'll never feel again.

I was a senior in college, it was early in fall,

It was my last soccer season, and soccer meant it all.

I was fit, I was hungry to guide my teammates and team,

I had just been named captain, I was living in my dream.

I had worked hard to get there, trained and sprinted for weeks,

I'd run miles and miles, and come home sweating in streaks.

I wrote emails, made phone calls, to my teammates and coach,

To get them pumped for the season, so we'd be ready to go.

And then the first game came, I was starving to play,

It was warm and beautiful, it was a bright, cloudless day.

But then the brutal moment that I'll never forget,

My elbow snapped in a tackle that I'll always regret.

And then reality came, and then the pain came too,

And not the pain from my arm, the pain that soccer was through.

See this game was not a game, it was a part of my name,

It was a part of my heart. I'd never feel the same.

Soccer was my identity, it had always felt fated,

And now my arm and my spirits were dislocated.

I was broken, I was crushed, I felt lost and depressed,

I would cry in my room after games that I missed.

It was a really hard year, but during that year I grew,

And I'm a better person now, for that bad card I drew.

Because I had to learn lessons from those cards I was dealt,

And I had to learn strength from that pain that I felt.

And while I still sometimes grieve for that season long gone,

I learned to change, to adapt, and I learned to move on.

I wrote this poem originally as part of a

hip hop song I made with a friend in college.

It was written in 2007 after I suffered an

elbow dislocation that was really painful and difficult for me. I was

depressed that I couldn't play, and writing this poem/song helped me

put this unpleasant incident behind me. The care I received as I was

having my arm reset and the interactions I

had with my doctor as I was recovering have

long been a motivation for why I wanted to

pursue a career in medicine. My doctors

helped me deal with my pain and get my

strength back, and they did it with an empathy

and deftness of emotional intelligence

that continues to inspire me. I hope to be able to help others in the future

as I was helped by the physicians who fixed my

arm.

I am a first-year medical student at

Marshall University, Joan C. Edwards School

of Medicine. I love outdoor activities,

traveling and playing sports (especially

soccer!). I'm so thrilled to be here at Marshall

and on my way to a career in medicine.

Warren C. Doyle

①①

The Adventures of Mothman & Larva Boy

The Mothman Prophecies film came out when I was 13. My friends and I would joke about Mothman being a classic

superhero like in a comic book. Naturally he needed a sidekick, so I came up with Larva Boy, a physically inept but

highly intelligent partner. In describing this creature, I would push up my glasses, uncomfortably flick my tongue a

few times and shout “Larva Boy” in a Jerry Lewis-inspired squeal.

Cut to 10 years later. I was waiting for a response from Marshall but was convinced that I wouldn’t be accepted. Out

of desperation, I started looking for a job as an illustrator. I got the Adobe Illustrator program and a drawing tablet

to start building my portfolio. Striving to think of something original, I remembered my middle school joke and

imagined what it would be like if Mothman and Larva Boy had their own comic book. This drawing would be the

cover to the first issue. Hopefully in the future, I can pick up where I left off and make the rest of it.

I am a first-year medical student at Marshall University, Joan C. Edwards School of Medicine.

Ryan Clagg

①②

Where the Heart Meets the Sky

A view of the Basilique du Sacré Cœur on the summit of Montmartre in Paris, France. Known as the “Basilica of the Sacred Heart of Paris,” this church is located at the highest point in Paris. As this photo captures the Basilica of the Sacred Heart against a beautiful sky in the highest point in Paris, it is only fitting to name the photo “Where the Heart Meets the Sky.”

The Sentinel

A photograph taken from the Chimera Gallery atop the Notre Dame in Paris, France. Enraptured by the power of the church, this chimera of Notre Dame, once considered a demon, has been converted. It is now believed to be a guardian that watches over and protects the parish. I tried to capture the chimera as a guardian overlooking the city of Paris.

①③

A Tranquil Stroll

A photograph of a quiet canal in the sestieri of Castello in Venice, Italy. In such a popular destination as Venice, it is difficult to find solace from crowds. I was surprised to encounter such a beautiful area of the city that had yet to be discovered by tourists. I hoped to capture the serenity of Venice that lies beyond the tourist attractions.

I am a fourth-year student at Marshall University Joan C. Edwards School of Medicine. With interests ranging from woodworking to drawing, I have always considered myself to be an artist. However, my true artistic passion remains with photography. I am particularly enthusiastic about travel photography. I enjoy capturing my unique perspective of all the world’s beauty and sharing it with others.

Joanie Garratt

①④

A Young Woman

Study of a Man

①⑤

I am a second-year medical student at Marshall University, Joan C. Edwards School of Medicine. Having taken

a year off from school due to health reasons, a former teacher and a family friend (a retired physician) both

suggested that I spend time learning to draw, paint and sculpt throughout the year. Having very little

background in art, it took some time to begin to learn the techniques and skills needed, but I found myself

enjoying the creativity of it. This creative process helped to take my mind off of my health and changed the way

I look at even ordinary objects in the world. As I have returned to my studies this year, I have continued to

pursue art when I have had time, and although I am still very much a beginner, I hope to continue to improve

upon my artistic ability. I highly recommend anyone who is interested in art of any form to try it. The pieces

pictured - Mug and Napkin, A Young Woman, and Study of a Man - are some of my early works.

Stephen Clark

Morning Tea

①⑥

Tiger Swallowtail

Poised upon the side of a dirt road is a butterfly whosearrival was announced by an exotic display of fittinggrace. The black and yellow wings signaling wildly inaerodynamic Morse code..--.. untranslatable beauty.

The stillness of its stance uncharacteristic, nearlymotionless upon the ground, save the slow mechanicalupbeat of its hind wings, mesmerizing and golden.

In its pause, there is the background of poverty. The

wingspan of debris stretched from a discarded crush of rusted can to soil soaked paper, refuse routed in a serpiginous flush by a trail of liquid feces. The froth andfoam forming a delta in the nearby ditch, where the

dogs lie, counting their ribs with parched tongues, licking themselves clean off the bone.

Such is the system of waste in Honduras.

From the doorway of an adobe a family is staged, a shirtless father and his shoeless sons, cocooned

within a roof of tropical leaves. Their browned skinmetamorphic with the beaten paths that lead up totheir beaten bodies. In one of their hands is a machete,humidly swinging, back and forth, hypnotizing another

generation of blackened pupils into overgrown fields.

They are neither eating nor drinking when the suncomes up. The cultural silk that binds them unbroken. And so they remain, at the doorway, unchanged,

as the fleeting path of a Papilio glaucas goes unseen,its wings lifting to the higher leaves of a nearby tuliptree. It is here where the yellow-green eggs are laid and the caterpillar emerges, free to spin itself into new life.

I have written poetry since my mother, Rosemary McGuffin, exposed me as a young child to monthly poetry meetings held by the Marshall University English Department. Mom was an English teacher and was a wonderful writer. My first publication was at age 12 in the “Laurel Review”. Since then I have written much, but submitted little. I have had three poems published in the “Pharos” and one in the “Archives of Pediatric and Adolescent Medicine”. My tendency is to write about what I know best, which is medicine, and how health and illness affect those around me. “Tiger Swallowtail” was written based on an experience in Honduras where I observed a butterfly in the middle of a destitute village. Its beauty in contrast to the surrounding scene prompted the poem. “Remembering Him on Vacation” is a poem that compares my experience hugging a dolphin during vacation with that of not hugging a patient with cancer. It speaks to a paradox for physicians that at times we hug things we normally wouldn’t and don’t hug when we probably should. “Rhinorrhea” is a shape poem, addressing a common symptom, that of a runny nose, from the perspective of the drainage winding its way down the face. The “drop” personifies, perhaps, a person contemplating suicide. Poetry for me is a form of expression that uniquely and safely helps me reflect on how I experience the world around me.

I am the Senior Associate Dean for Medical Education at Marshall University Joan C. Edwards School of Medicine.

Aaron M. McGuffin, M.D.

①⑦

①⑧

Remembering him on Vacation

I did not really know a dolphin

until I hugged one fully,

ventrally exposed and raised

above salted water on the playful

cue of a trainer’s whistle.

The weight and understanding

of his mammalian burden

fully captured, wet and firm

upon my overwhelmed chest.

Like I did not really know you

sufficiently touched, but unhugged,

ventrally exposed in hospital gown,

lying parallel with the grave,

and taking medicine, tasteless,

swallowed without benefit.

The serious and rueful silence

before an intercommed code blue

the weight and confusion of

your cancerous burden uncontrolled,

diaphoretic and wasted, hundreds

of miles separating our hearts.

Rhinorrhea

When

it is cold

on the inside

I want to run violently, downhill;

a flashflood, discharged unnoticed,

with movements too quick to be wiped away.

The emotional torrent takes me to the edge of

a cliff,

a quivered lip, where I prepare to jump, after

a final pause to remember why I do not care

anymore and confirm I am not worthy

of my salt. I wait for the last time

for a slow build-up of hydrostatic

courage to end it all as a drip

that drops to a pendant splatter

concentrically warming

the outside ground

below.

These three poems will be published in May 2013 in a

collection entitled “Common Illness: Poems Written For a

Love of Medicine”.

Untitled

I took this picture

on top of a West

Virginia hill in

Ona. I really just

couldn't pass up

the opportunity to

capture the colors

that had been

painted across the

sky on that

evening.

We Are...

This picture was taken at a family trip to the Greenbrier river. Growing up in Huntington, I have always been a

Marshall fan. This was just a fun way of showing our support to the Herd. It's amazing what you can do with

some sparklers and a slow shutter speed!

①⑨

High Light

This is actually one of the first pictures I took with my camera. I knew once I took the photo that this picture was

going to really give direction to the type of photos I would take throughout my journey as a photographer. For

some reason, the close-up shot of the highlighters really caught my eye. The picture really captures my daily

routine at the time: studying and drinking coffee. I received the camera as a gift, a way to just help relieve stress

and escape the clutches of the textbooks.

I am a fourth-year student at Marshall

University Joan C. Edwards School of

Medicine. I am excited to pursue a career

in Pediatrics, and can't wait to see where

the medical career is going to take me.

Scott Studeny

②⓪

②①

I am a second-year Family Medicine resident at Marshall University Joan C. Edwards School of Medicine.

Kimberly Becher, M.D.

I am currently exploring gender issues and "Civilization's compass" is one image from the series.

How do gender roles influence and shape a culture and society? Is this an absolute? In other words,

does visual imagery find common ground, or are the symbols interpretable only within the

boundaries of a particular worldview? The image captured without a lens lends itself to helpful

ambiguity. Beauty is strength and strength is beauty. The second image, "Only true kingz do these

thingz," is part of the "beauty and the beast" series. The element of science fiction, one of my

favorite literary genres, suggests a future dystopia. There is masculine posturing and feminine

posing. Is the future that much different than the present after all? We perceive the strength of "true

kingz" and hear their plea to be noticed and respected, but it is not to be. She will enchant us. We

will gaze upon the beauty, after all, and not the beast. What about a subset of the world, medicine in

America? Medicine looks different today. This is not merely technological but rather a dramatic

shift in demographics. So the art and science of medicine, its practice and modes of delivery, are

palpably shifting. For example, I have found that I must adjust my teaching style depending on the

gender of the student to maximize effectiveness.

My ideas for exploring "gender" go back to my childhood in this way or that. Somewhat confusedly

and certainly ignorantly, I grew up with both a twin and younger sister. They will tell you that I was

the best brother they ever had (and the only one). They had friends. This was a potent soup of fear

and curiosity; and it was frequently scalding. It was like a bad Billy Joel song. But I couldn't resist.

I finally married one, Catherine, who is a forensic science faculty member here at Marshall. My

daughter, my oldest, explained to me one day how she was a woman and women know fashion. I

picked out my clothes that day. She is getting better at it as of late. Still, it seems that genders have

tendencies that suggest hard-wired proclivities. I see the desire and incomprehension in my son's

eyes. I suppose one could attempt to articulate them (Turgenev did: "beware the love of women, the

ecstasy, the slow poison"), but I prefer to use a camera in some form or fashion. Do I believe Stieglitz

and his "equivalents?" It would seem an important and timeless question worthy of further

exploration. I neither went to the Brooks Institute of Photography nor became an astronaut, but I

did go to medical school. I still shoot film and read books made out of paper. I could give up food to

have more books and film, but find it hard to do when there is a good bottle of wine at hand. Or

chocolate. I will work for chocolate except if the Dean is reading this; if so, I work for a paycheck;

Adam Smith and all.

Thomas C. Rushton, M.D.

②②

②③

Only true kingz do these thingz 4X5 inch format color slide, Epson flat bed scanner.

Model: A Wren (Blanton)

②④

Civilization’s compass

I am a Professor of Medicine and Chief Section of Infectious Diseases for the Department of Medicine at Marshall University Joan C. Edwards School of Medicine.

Thomas C. Rushton, M.D.

Lensless camera, 4X5 inch format, printed on Rives BFK paper using "new"

cyanotype process.

Model: Beth Funfstuck

②⑤

Hyacinth BatikI have many creative outlets.  Sewing, painting, cooking, gardening, and remodeling are just a few.  All these works represent different facets of my life.  Despite the different types of work, most stem from a general theme: I enjoy nice things, and I enjoy the sense of pride and accomplishment that comes from making them yourself.  The batik represents original artwork, which I made to decorate my home.  It was based off a lakeside photograph of hyacinths blooming and butterflies flying. The clothing and the chandelier were inspired from designer pieces, though I morphed each to fit my personal style.  

Ostrich Feather Skirt Cowl Back Top

Sewn by Artist.

Wine Bottle Chandelier

Made by Artist.

I am a fourth-year student at Marshall University Joan C. Edwards School of Medicine.

Gina Guzzo

②⑥

Rhino Bug

During a medical

mission trip in

Central America, this

insect created quite

the commotion with

its unique rhinoceros

features.

Dog, Honduras

This pup stole my heart as I stayed overnight in a

farmhouse on a coffee plantation in Copan, in the

western region of Honduras. She made her way into

the outdoor kitchen during each meal looking for

scraps and was promptly shoo'd away by the cook.

As we helped clean up, however, we found ways to

slyly pass her leftover empanadas and platanos.

I am a fourth-year medical student

at Marshall University, Joan C.

Edwards School of Medicine.

Kate Steele

②⑦

Ignorance Gains AccessPresident Guebuza was coming to town, so of course I wanted in on the action. This was about 2 months into my stint as a Peace Corps volunteer in Mozambique and I wanted to experience as much culture as I could possibly imagine. When my roommate and I arrived at the city center where he was to speak, there was such a massive crowd that we were overwhelmed by just exactly where the president was going to be. As we stood contemplating how to navigate the mass of people, we watched as a group of mostly children, with some adults, would run from something or someone, stop and regroup, then begin running again. Intrigued, we went closer to find out what was happening and as we approached, the crowd made way for the "mzungus" to see. I saw this group of men in such elaborate costume and was blown away by the amount of "African culture" I was seeing and immediately went to photograph. I was encouraged to go as close as possible to get the best angle, and I did not hesitate to step right up.

As my two years there went by, I learned quickly that that would be the one and only time I would get that close to the Nyau. I learned more about this secret society and its practices and the rumors that surround it. Even though this is a UNESCO World Heritage group and they are a great attraction during public festivals, they are also well known for their violent and possibly hallucinogenic-provoked raids on the community, terrorizing those who live in the area. When not in chicken feathers and large masks dancing to the rhythm of the hand drum, they are in the mountains having secret meetings and show up in the village, scantily clad, bodies covered in dried mud with their faces covered under burlap. When the Nyau are out, a hush quickly spreads over the village because no one dares to step foot outside.

Whether the rumors are folklore or truth, we may never know. However, from the instances I came in contact with this group, such as fleeing the dirt road from the market with a woman to hide on a neighbor’s front porch as a Nyau covered in mud came screaming out of the bush and somewhat after us, I developed quite a healthy fear. Unfortunately, I rarely had the chance again to get as close to this amazing piece of culture as I did the day the president came, before I became aware of who they were.

②⑧

I am a first-year student

at Marshall University

Joan C. Edwards

School of Medicine.

Matthew Boyer

Wink

This little guy is a chameleon. His eyes move independently of each other. I was living and working in

Botswana before the start of medical school and got to see some fantastic wildlife in the region. Photo taken

June 2012 in South Africa.

②⑨

Bones

Untitled Desertscape

The Arabian Desert is a

mysterious place with many

spectacular views. I took these

photos while on a road trip

from Riyadh to Manama.

Pictured here are camel bones

and a sand formation in the

shape of a sine wave. Photos

taken December 2008 in Saudi

Arabia.

③⓪

Minions

Memorandum

To: Health Care Administrator, Novice

From: Health Care Administrator, Mentor

RE: Minions

My assignment as your mentor arrived via e-mail last week, hence this message to you. I had not been able to get to it earlier due to my responsibilities in the Department of Obfuscation. We have new Policies and Procedures that are to be released soon and I had to proofread them to eliminate any clear and straightforward language. Please note that I may be using such language in this memo, so treat it confidentially.

You need to know that you are embarking on a grand and promising career. You will hear some of our critics sneer that we are recent interlopers in a previously sacrosanct relationship between doctor and patient. Do not let this self-righteous mockery bother you, it comes from sheer envy. We have taken up a role for which no one anticipated the need but whose absence no one can now imagine: “Regulation of Physician Behavior.” In the weeks ahead, I will give you detailed tips regarding this task. (They will give you an advantage over the other administrators, especially if you do not share them with anyone.) For now it is sufficient to paint you the big picture.

The core secret to regulating physicians’ behavior is to keep them continually off-balance. As long as this is achieved, doctors’ behavior is like putty in our hands. The most successful strategy to this end has been to overwhelm them with an avalanche of detailed tasks that have nothing to do with what they thought being a physician was about. We have had three major allies in this endeavor:

1. Medicare (officially, CMS), the government payer for doctor’s services

2. The architects and vendors of the Electronic Health Record (EHR) and

3. The purveyors of Evidence-Based Clinical Practice Guidelines

A fourth is OSHA (Occupational Safety Health Administration), but it is the mere threat of their involvement that sends doctors’ organizations scurrying to put bridles on their members of their own accord. It is, of course, no surprise that these entities are so helpful; we have thoroughly infiltrated them already. In fact, we were involved in their establishment.

You may have heard that doctors are self-impressed, egotistical types who are accustomed to having their own way. All true, I assure you. How then have they been so successfully cowed? Well, first let me point out that just because their behavior has been regulated doesn’t mean that their hearts have been conquered. There is still a fair bit of whining and even snarling as they comply with our Rules and Regulations and follow our Policies and Procedures. Our job is not for the faint of heart or the thin-skinned. “How then,” you ask, “have our strategies worked?” Well, we have another, most important ally: the physicians themselves!

③①

Indeed, some physicians have joined our ranks as administrators, and so have some nurses. While these individuals have particular influence with doctors, bi-cultural as they are, they are not who I have in mind when I speak of our physician allies. No, it is the regular, rank-and-file doctor of whom I am speaking. This creature has two essential tendencies that play right into our laps: a craving for comfort and an expectation of entitlement. If these traits did not run so profoundly, so pervasively and so powerfully, we would not be half as successful as we have been.

To be sure, there are a few physicians out there who seem not to be as susceptible to our methods. They tend to be generalists (specialists are, on the whole, more intelligent and pragmatic). They are mavericks who insist on staying in solo or small group single-specialty practice clinging to their autonomy, running their practices as they wish. These sorts are also often willing to make less money and work longer hours than their more compliant counterparts. Some even tend to be skeptical about the universal applicability of evidence-based practice guidelines and seem to actually take seriously the guidelines’ disclaimers about the need to apply clinical judgment in the specific individual patient’s context! However disturbing these misguided troublemakers may be, there is every reason to be hopeful.

For one thing, these outliers are few in number and will get fewer still since we have successfully begun running medical education as well. For another, under our guiding hand, hospitals have become the dominant giants on the medical landscape. Patients need hospitals and even these miscreant doctors need patients, so we have them. They cannot simply use hospitals for the care of their patients as they were able to in the past. They must become servants of the hospital as it dispenses services to its customers. (Incidentally, this is why sub-specialists are our dream. They are able to perform rare, exorbitantly expensive tasks with highly sophisticated technology that we can easily convince the public they need. If a sub-specialist behaves like a temperamental prima-donna, humor him. It is worth it!) Finally, the government will soon put a stop to any foolish notions of individuality or independent practices among physicians.

So you see, you have chosen well by throwing your lot in with us. Live long and prosper!

P.S. You would be wise to destroy this memo after you have committed it to memory. Be prepared to deny any and all of its contents if the need should arise. Reacting with offended indignation would also be a good idea.

Dilip Nair, M.D.

③②

Who Are You, Really?

The words above the pocket of your white coat

Curl and loop in elegant flourish

Declaring who you are in most professional tones

You are a physician, so it would seem

But, who are you really...?

Are you a merchant plying your trade?

Selling goods and services most sophisticated and technical

To men, women and children most desperate and needy

For beneficence, commerce and at a fair price

Considering the demand, the labor and the third party payer

Or are you someone else?

A mentor, friend and confidante

A shrewd and skilled advisor

A tearful and tender neighbor

You are a physician, so it would seem

But, who are you, really...?

All three of these pieces - Minions, Stairway to Nowhere, and Who Are You, Really? - are born out of my

profound sadness and distress over the shape and trajectory of both the practice of medicine and medical

education. In these pieces I seek to awaken our consciousness and sensibilities to what is being lost and to

the detrimental and even pernicious aspects of modern-day trends in medicine and medical education. If my

work is biting it is not out of malice as much as an attempt to arouse us from self-perpetuating complacency.

I, a family physician, am

a professor in the

department of family

and community health. I

came to Marshall over

20 years ago to begin

residency training in

family medicine. I have

stayed ever since. I am

passionate about family

medicine and am eager

to cast a vision for its

reformation and

renewal. Laurie, my wife

and partner of almost 25

years, and I live in

Huntington. For the last

6 years we have been

deeply engaged in

educating our two

children at home.

Dilip Nair, M.D.

③③

Stairway to Nowhere

“A Center of Excellence we have become,” shrieks the billboard,

Parading ranks of stern-faced surgeons, physicians poised for action.

Policies and Procedures, covering every contingency in every way,

Slice sharp edges that cleave the Excellent from the Mediocre,

Those pitiable competitors, plodding on, unaided by Protocols, Graphs and Charts

Oblivious of the beans left uncounted.

Professors of excellence fumble for the approval of chairs and deans,

Propitiating peer reviewers, grant-givers, guardians of PC,

Attacking exam room keyboards for offerings to gods of Productivity,

Warily negotiating with students eyeing their popularity ratings,

Yearning to hear an insatiable master proclaim,

“Well done, good and faithful servant. Come into the Halls of Excellence.”

Societies of Mutual Admiration bestow students with honors, one to another,

Fueling clamor to play the game, jumping hoops, talking the talk,

Painfully filling every point of Competency on every painstaking scale

For all the Right reasons, by all the Right metrics.

To be noticed as more Excellent than the next or the last.

“Come with me, my friend” said one Excellent to another,

Scales falling in the light of Epiphany,

“Let me show you the Stairway of Excellence¹;

It is a Stairway to Nowhere².”

¹ I am indebted to Charles McCormick, M.D. for this phrase. ² I am indebted to David Powlison, Ph.D. for this phrase, an adaptation of his “ladders to nowhere.”

③④

③⑤

Man selling dates at a souk in Kuwait City, Kuwait

I was fortunate enough to encounter this wonderful scene of hanging lights and dates while at the souk (market) in Kuwait City, Kuwait in 2003.

I am a fourth-year student at Marshall University Joan C. Edwards School of Medicine.

Shaun Stanley

On Shadowing a Case of Clostridium Difficile....

Upon opening the doors, the air smelled sour,

I had been shadowing the floor for nearly an hour.

But something was not right when we entered the hall,

The omen stung my olfactory like a bee set to maul.

We walked down the path; the smell grew stronger of course,

I knew in my heart we would be reaching the source.

As if my legs resisted movement, they produced a stumble to my gait

Masks, gowns, and gloves so we would not share the same fate.

“How are you feeling today?” the physician inquired.

“My bum hurts,” she said. “It is less than desired.”

She told us then of a most horrific story without any forewarning

One of copious blood, water and toilets “and that’s just since this morning.”

My head shook, eyes watered, and stomach turned and tossed

I feared for the party that my lunch would soon be lost.

“Well, we’ll get the colonoscopy soon,” and the patient grimaced in pain

“Don’t worry,” he said, “the procedure is rather mundane.”

As we left the room the fresh air felt like bliss

He said to me, “This is not a colonoscopy that you should be prone to miss.”

My body recovering from hypoxia, my nostrils felt singed in defeat,

“I think perhaps not; for my shadowing hours are complete.”

Dear Reader: In the time it took you to read this poem, 0.64 Americans were diagnosed with a case

of Clostridium difficile colitis. It is a serious condition that currently has many treatment options,

and I believe that it needs more awareness. I would like to challenge the reader to this responsibility:

Please tell three people about the serious epidemic that has spread like a mudslide across the United

States. It is my hope that someday these bacteria may never grow again. I am a fourth-year student

at Marshall University Joan C. Edwards School of Medicine.

Michael Hardman

③⑥

Portrait of

Cheetah

Philadelphia Zoo,

Philadelphia, PA

Portrait of

Harris Hawk

Academy of Natural Sciences,

Philadelphia, PA

③⑦

A Matter of Perspective Eastern State Penitentiary, Philadelphia, PA

Photography has always been a passion of mine since the very first time my aunt introduced me to her old

manual exposure camera. From the intricacies of dark room development to the meticulous nature of framing

the perfect shot to encompass an entire moment in one single image, the photographer is constantly challenged.

These works represent some of the sights of my adopted home of Philadelphia, where I was able to complete a

Masters in Medical Sciences at Drexel University College of Medicine. Since the completion of my degree I have

moved here to Huntington where I am currently completing my Medical Degree at the Joan C. Edwards School

of Medicine at Marshall University. Although my time is at a premium, I hope to continue finding opportunities

to place myself behind the camera and encapsulate future moments on film.

I am a first-year medical student at the Joan C. Edwards School of Medicine at Marshall University and plan

to pursue a career in surgery. I am an avid traveler and amateur wildlife photographer.

Zachary Sanford

③⑧

Stained Glass

I started painting in high school, following an assignment that I really enjoyed. It's not a frequent hobby; I do it when I feel something that needs to be put down in a concrete form. Most of my paintings are bold, brightly

colored, and abstract, like these. I believe that sticking with images that already have connotations would limit what the art can express, and art that elicits unique thoughts in each viewer often promotes a connection to the

piece, which is my goal.

③⑨

Thinking Place

I am a second-

year student at

Marshall

University Joan

C. Edwards

School of

Medicine.

Sarah Johnson

Clown Dash

④⓪

Rose

Mile 1

④①

I am a first-year student at Marshall University Joan C. Edwards School of Medicine. I like to look at life and the things in it from a different angle. So much of how people live is based on perception and it's always fun to change one's perception of things from time to time. I like to take pictures of everyday things that are fun to look at. The only piece that "means" something is the Mile 1 piece. John Heywood said, "A hard beginning maketh a good ending," and I believe he is correct. Medical school is difficult and is not an easy road on which to travel. I took the photo on the road to Huntington before officially starting my medical education, so it seemed appropriate. I am most passionate about people and I like to spend my time around others. I have a habit of noticing things that most normally wouldn't. For example, I might notice little things like why inhabitable and habitable are both words yet they mean the same thing. I have been given many blessings and I like to take time to be thankful and give back when I can. It's an honor to think other people might like the pictures I've taken.

Daniel Roberson

Sugarwood

④②

View from the Top: Rainstorm

④③

Elaborate Dining Room

The ever changing aspect of nature as well as human imagination is what I aim to depict in these pictures. I am a second-

year Internal Medicine resident at Marshall University Joan C. Edwards

School of Medicine.

Neha Goyal, M.D.

④④

Where Dreams Come True

④⑤

Love Birds

Somewhere Over the Rainbow

I am a fourth-year

student at Marshall

University Joan C.

Edwards School of

Medicine. The beauty of

nature has always

fascinated me. I enjoy

capturing the beauty of

a rainbow, a sunset, a

flower or an animal.

The rainbow photo was

serendipitous. It had

been pouring down rain

all day in Washington

DC. As our day came to

an end, we began to

walk to the Botanic

Gardens. Suddenly, out

of nowhere, the beautiful

rainbow appeared. It is

a memory that I will

never forget. The cross

stitch is a hobby that I

have enjoyed for many

years. I particularly like

the cross stitch of Mickey

Mouse walking along

with Walt Disney in

front of the Magic

Kingdom castle. It

shows Walt and the

realization of his dreams

with Mickey and the

backdrop of Cinderella's

castle.

Kate Proffitt

④⑥

④⑦

I am a first-year medical student at Marshall University's School of Medicine. I was inspired to pursue a career in medicine after

volunteering in McDowell County, West Virginia as an undergraduate.

Over the years music has been an irrepressible source of hope and wonder for me. I came up with this arrangement of Beethoven's

"Ode To Joy" in 2010 during my postbac premed year while I was living in Haverford, Pennsylvania. 

Walking beside the Ohio River last year, I was struck by the expansiveness and the composition of the scene. I snapped a

photo;"Ohio River" is the result.

Mats Lemberger

Ode to JoyPlease visit the

Aenigma Medicorum

website at

http://musom.marshall.edu/students/aenigmamedicorum

to listen to the audio

file of Mats’

composition.

Ohio River

L’Enfant Plaza Subway Station

This photograph, for me, captures one of those moments when you open your eyes to the beauty that exists all around, be it in nature or man made. Taking this picture was a matter of luck for me. I was just fortunate to have a camera on

me as I was waiting for the subway. I have very little experience when it comes to art, but the way the train was blocking the light and how this affected the ceiling struck me as truly amazing.

I am a Huntington native. I received my undergraduate degree in Biotechnology from Marshall where I was a Yeager Scholar. I am a first-year student at Marshall University Joan C. Edwards School of Medicine. I am also a 2nd

Lieutenant in the Army and have an interest in anesthesia.

Kyle Burner

④⑧

Thinly sawed firewood, stained and shellacked. Trees

I have always been fascinated with the natural world and the interactions between humans and the outdoor environment. After receiving a BS in Conservation Biology in college, I spread my wings (or fins) and worked as a

Fisheries Biologist in Yellowstone National Park and then in the Bering Sea, Alaska. I found that the fish weren't as grateful as I had hoped and I turned to human medicine to satiate my curiosity. During my transition to human

medicine, I became even more fascinated by the effects of our environment on our health. With the increasing prevalence of lifestyle diseases that affect Appalachia so profoundly, we see that our mastery of the world around us is

not quite so thorough as we thought. How well we are able to mediate these interactions with our environment, whether it is tobacco smoking or pollutants or choosing what to eat for dinner, will determine the success of the health care field in the years to come. I hope these pieces serve as a commentary on the effects we have on our surrounding

environment and, conversely, the effects that it has on us.

④⑨

Animals Sheep hide, Deer hide, Alum tanned, stretched and lightly bleached.

I am a fourth-year student at Marshall University Joan C. Edwards School of Medicine.

Matt Christiansen

⑤⓪

Men anpil, chay pa lou: Many hands make the load lighter

Ritchie

Photography and public health have

been separate passions of mine. In my

travels not only to Haiti, but other

countries, I realized I can bring my

two passions together. In the future, I

hope any of my international

medicine endeavors will further allow

me to combine public health and

photography.

I am a first-year student at Marshall

University Joan C. Edwards School of

Medicine.

Nafeeza Hussain

⑤①

Nan Lakou la: In the backyard

⑤②

Dil to pagal

hai

the heart is crazy

Kabhi khushi kabhie gham

sometimes happiness, sometimes sadness

⑤③

Kuch kuch hota hai something something happens

I am a second-year student at Marshall University Joan C. Edwards School of Medicine. I am considering a career in

Physical Medicine and Rehabilitation.

Meaghan Tranovich

Since a young age, I have loved dance and been fascinated by movement of the human body. Although I am most

familiar with classical ballet, I am always interested in learning about new forms of dance. My classmate Madhvi

Shah is trained in Raas, a traditional Indian folk dance. She was generous enough to teach me about it and I enjoyed

the challenge of trying to capture the motion in a photograph.

⑤④

Wayfaring Stranger

Bert Wood: Lead vocal, rhythm guitar, dobro

Wendle Cook: Bass

Shane Cook: Harmony vocal, mandolin, banjo

Wagon Wheel

Shane Cook: Lead vocal, rhythm guitar

Bert Wood: Tenor vocal, dobro

Wendle Cook: Bass

Carolina in the Pines

Bert Wood: Lead vocal, tenor vocal, rhythm guitar, dobro

Wendle Cook: Bass

Shane Cook: Harmony vocal, banjo

Growing up in a small town in southern WV, I was fortunate to have excellent role models and an amazing family that helped me to establish good morals and values, as well as my faith in God. I come from a talented musical family on both my mother and father’s side and was privileged to have an excellent music teacher and family friend, Bert Wood.  My mother’s father, Meredith Kirk, opened a recording studio (Gearl’s Recording) in 2000 in Hewett, a small town in southern WV.  The musicians that came though and produced records inspired me. With the help of my grandfather’s best friend, Bert Wood, I began playing the banjo at age 14.  As I progressed from the banjo to the mandolin, dobro, and later the guitar, I started playing in church and at funeral services with my grandfather and Bert Wood’s bluegrass gospel band, the Hewett Gospel Boys.  After the loss of our bass player, my father, Wendle Cook, quickly picked up the bass and joined us.  Our group spent a lot of time playing in churches and funeral services in our town and the surrounding communities.  However, after the very unfortunate and devastating loss of my grandfather in 2005, the number of services we played drastically decreased and the album we were working on at the time was never completed.   

About a year ago, Bert Wood, my father and I decided to finish our old album and make a new bluegrass gospel and traditional bluegrass album.  The songs submitted here are our unmastered takes on songs from the two albums. Wayfaring Stranger is a gospel hymn that I first heard A’capella style by my great grandmother, Nina Barker.  The song has since become a favorite of my father and I.  It was also one of the first songs I learned and recorded with my grandfather.  Wayfaring Stranger really captures the great aspects of bluegrass gospel music—the high, lonesome, mountain sound with the good message.

Please visit the Aenigma Medicorum website at

http://musom.marshall.edu/students/aenigmamedicorum

to listen to the audio files of Shane’s compositions.

I am a second-year student at

Marshall University Joan C.

Edwards School of Medicine.

Shane Cook

⑤⑤

Dusk in Laguna Niguel

I am originally from Argentina and love to travel the world. This past summer we spent some time in

California, driving the nearby Los Angeles seaside towns. Laguna Niguel caught my eye, with its colors at

sundown and the wide blue Pacific Ocean waving good bye. I joined the Pediatric faculty at Marshall in 2010,

specializing in Pediatric Infectious Diseases. I love the family-centered community of Huntington and enjoy

swimming at the YMCA, practicing yoga, traveling and taking pictures of my surroundings. My other passions

include my 3 year-old daughter, Mia, and my husband, Damian.

Guada Lopez Marti, M.D.

⑤⑥

I am a Magna Cum Laude graduate of the Biomedical Sciences program and Honors College at Marshall University, and am now a second-year medical student at Marshall University’s Joan C. Edwards School of Medicine.

My stage credits include over 50 productions, including such roles as Amahl in Amahl and the Night Visitors, Scarecrow in The Wizard of Oz, Orin Scrivello, DDS in Little Shop of Horrors, The Rum Tum Tugger in CATS and many, many more. My professional performance work began in the summer of 2010 as an Entertainer and Diver at The Mayan Adventure in Sandy, Utah. I most recently starred as Princeton and Rod in the regional premier of Avenue Q produced by CUP.

I also has an extensive Show Choir background serving as the founder and director for the ARTS All-Star Show Choir, where I served as director from 2007-2010. Under my direction, the All-Stars received numerous awards, including the Fame Award, Best Male Soloist, Best Show Concept, Best Costumes, Best Instrumental Ensemble, Best Vocal Sound, Best Choreography, Divisional Grand Champions, and Overall Grand Champions.

I currently serve as the President of Curtains Up Players, Huntington’s premier theatre company. I will be actively involved in 6 full-scale productions over the next 12 months (all while studying for Step 1 at some point). Additionally, I serve as the choreographer for the 8-time State Champion Hurricane High School Red Hot Show Choir.

Throughout my life, I have been afforded countless opportunities to share my God-given talents with others. From coast to coast, I have had numerous “gigs” working with hundreds of the most talented professionals in the business today. Moreover, through Curtains Up Players, we are committed to a mission of spreading art education and theatre for social change to students throughout the Mountain State and the surrounding Tri-State area. I have never been so passionate about a cause as I am about this, and I’m committed to doing whatever is necessary to make it successful. I have been called “crazy” on at least a thousand occasions, mainly concerning my decision to take on such a large role in CUP and pursuing a medical degree at the same time – and maybe I am – but I wouldn’t have it any other way. I keep busy, but I’ve enjoyed much success with each and I have the best support system anyone can ask for.

There may not seem to be a clear correlation between Theatre and Medicine in the foreground, but theatre has had a tremendous impact on my life and, most certainly, on my future career as a physician. Because of theatre, I have confidence. I possess the skills to effectively communicate with others and work as part of a team. I possess creativity and good judgment. I can think abstractly. But perhaps most importantly, the arts have made me a better, more empathetic person – a trait I plan to utilize in caring for each of my patients.

Shayne Gue

⑤⑦

⑤⑧

MAY

I bought a carton of raspberries

at the market. Every time

I drop one in my mouth

I can’t resist rolling it around

my tongue. The fuzziness -

sparse, exquisite roughness, your stubbled

cheek against mine while you

hug my worries away.

The way they crunch when chewed.

Reminder - they’ve seen days of

sun and won’t give up so easy.

There’s a stain on my favorite

old sweatshirt to prove it.

West Virginia’s starting to smell

of honeysuckle. Delicious.

I roll down all the windows,

stick my head out like the coonhound

in that battered pickup. Inhale until

lightheaded I’m delirious with smiles.

I was one of those kids that loved hanging out in libraries so I could smell the old pages of books. I

began writing poetry when I was eleven while living on 250 acres of West Virginia wilderness, and started taking pictures soon afterward. "Power Down" was

taken on an Engineer's Tour of NASA's Vehicle Assembly Building, where I was fascinated by the

stories of the men and women who made America's shuttle program a success. We often forget how many

behind-the-scenes actions go into such a program, and I found the testaments to their work

mesmerizing. Everyone who has spent time in West Virginia should recognize "MAY". Those first, early

days of summer when heat radiates from the ground, carrying whiffs of wildflowers and cricket songs. They are second in my book only to the first morning when I can smell autumn. In late June, 2012, we adopted our first dog, albeit while my husband was out of town. Later that day, I was

walking him when the wind picked up out of nowhere and trees started sighing and cracking. We rushed home to hide from the storm and lost power for three days. I had promised Rex air conditioning

when I adopted him. My bad.

I am a second-year medical student at Marshall University School of Medicine, who grew up in Charleston, WV. Someday, I plan to have my

husband build us a house with a library, and adopt a lot more puppies.

Sarah Slocum

Power Down

⑤⑨

⑥⓪

I am a fourth-year student at Marshall University Joan C. Edwards School of Medicine.

Jason Locke

⑥①

Cruiser 2

Darlene Cordle

⑥②

Indigent?

Indignant taxpayers, we

Glancing at the early morning waiting room

Spot three.

Two Medicaids, say the murmurers, and one good one.

Don't get me started on Medicaid, they say.

That one's a frequent flyer. That new woman...just look at her- dressed to the nines and coming in here on Medicaid.

They oughta have to get jobs, buy insurance like we have to instead of buying Xanax and beer and tattoos and clothes like that.

You're new here doc, so let me tell you, the murmurers say.

That first one, he gets his Xanax every month right on schedule, never a day late.

H-hello d-doctor. I'm d-doing OK I guess. I'm st-still t-taking care of my Grandpa, and I th-think I'm good at it. I th-thought I might g-get a job at the nursing home, even with st-st-stuttering like I do b-but with my skin, this s-s-psoriasis. He rolls up his sleeves...

On to the next room. New patient. "Found a lump in her neck," it says.

Lovely young lady, scared to death. Squeaky clean, no make-up. I'm behind her to check her neck, the tag of that dress to the nines sticks out, brand name obliterated and "second" stamped there. Thrift store stuff, that fancy dress -threadbare at the collar and fading. I hope and pray I don't have cancer, doctor. We can't get any insurance since my husband had his cancer when he was a teenager. My kids....

Praying these patients didn't hear the murmurers. Praying I wasn't murmuring too.

Dignified patients, they.

Never having written poetry before, I was driven to this topic by the increasingly ugly talk of this political season. I used this as a way to express my feeling that in the labeling of people as “not taking personal responsibility for their lives”, when in fact one knows nothing of the lives of the labeled ones, these persons’ humanity is forgotten and their struggles are reduced to scorn. As I have always had a certain fascination with words themselves, I started with the “indignant taxpayers” idea, and the interrelationships of Indignant/dignified/indigent soon followed, and thus this piece.

Shirley Neitch, M.D.

⑥③