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Connective Tissueart and literature at UT Health Science Center San Antonio

2011 • Volume IV

http://www.texashumanities.org/connective_tissue.cfm

Connective Tissue2011 • Volume IV

Editor in ChiefStefani Hawbaker

Promotions EditorSusan Mauro

Faculty AdvisorsJerald Winakur, MD

Lee Robinson, JD

Visual Arts and Photography Editorial Committee

Rosalinda BarrientosSupriya Hattangadi

Michael HerzikClaude Jourdan-Le Saux, PhD

K. Ashok Kumar, MDStephanie Lynch

Katherine MackeyAdam Mankowski Rachel Mehendale

Alastair MooreJudy Phillip

Cyndy Purcell Jason Rocha

Amanda Schultz Elizabeth Spencer

Pon-pon Yeh Krista Young

Literature Editorial Committee

Daniel BarronKristin Budde

Amani Jambhekar

Angela KimMichelle Moller

Stephanie OpusunjuSheeja Thomas

Amy Yu

Literature EditorChristopher Wisely

Junior Literature EditorDavid Wilson

Layout DesignJulie Wibskov

Amanda Evrard

Visual Arts and Photography Editor

Amanda Lipsitt

Junior Visual Arts and Photography Editor

Angela Kim

Special thanks to the Center for Medical Humanities & Ethics for making this journal possible. The selection process was especially difficult this year, and we thank everyone who submitted a piece. Additional thanks to Amanda Evrard for her vital assistance, patience and flexibility; to Jerald Winakur and Lee Robinson for their inspiring ideas, moral support and financial con-tribution; to J’aime Jones for pioneering the project; and to Julie Wibskov and Catherine Reppa for passing on their knowledge and encouragement. Thank you all for adding your life and passion into Connective Tissue.

The works published in this magazine were selected based on their artistic and literary merit and do not reflect the personal views of UT Health Sci-ence Center San Antonio, the Center for Medical Humanities & Ethics or the editorial staff.

For more information about Connective Tissue, including past issues and details on how to submit your work, please see our web site at http://www.texashumanities.org/connective_tissue.cfm.

Front Cover:Barry BridgesPainting entitled See, Shore

Back Cover:Richard Rigby

Chini Raha Tiaha Sarangkot, Nepal

Contents

Tiffany Castellano, White Sands - Honorable Mention ...................................................... 1Douglas Cole, Eppur si muove ................................................................................................... 2Joanne Wright, Shadows ........................................................................................................... 3Craig Klugman, PhD, The Big Day - Honorable Mention ..................................................... 4Jessica Hollingsworth, Lazy Sunday ......................................................................................... 6Jason Rocha, Blossoming ............................................................................................................ 9Pranjali Gadgil, MD, The Laborer’s Wife ............................................................................. 10Stacy Sahcnez, Misc. ............................................................................................................... 11Melissa Vaconver, sketch entitled Palpation - Category Winner .................................... 12Shannon Laine Williams, Four Nerdy Anatomy and Physiology Love Poems .................. 13Richard Usatine, MD, Balloon Fiesta ..................................................................................... 15Mo H Saidi, Death Trap .......................................................................................................... 16Melissa Vanover, Fire Dancers ................................................................................................ 18Shih-Fan Yeh, Mission Concepcion ......................................................................................... 21Linda Porter-Wenzlaff, PhD, Requiem ................................................................................... 22Pamela Lenow, painting entitled Rainbow ........................................................................... 23Susan Seale Jarvis, The King Cake Crisis - Category Winner ......................................... 24Travis Reece, My Gambian Brother - Baaba Modou Sallah .............................................. 26Katy Zentner, Sewanee ............................................................................................................ 29Mo H Saidi, Curiosity ............................................................................................................... 30William Miller, Green Dragon ................................................................................................ 32Jennifer Schwantes, The High One ........................................................................................ 33Rebecca Ruth Wright, RN, Talk, Listen, Deep Breath, Repeat... ....................................... 34Smitha Tomy, painting Untitled ............................................................................................... 36Marvin Forland, MD, The Transition Generation ................................................................. 37Pamela Lenow, sketch entitled Hands ................................................................................... 39Patricia Wathen, MD, MRI - Honorable Mention ............................................................... 40Melissa Vanover, sculpture entitled (The) Flight ................................................................. 43Matt Mullane, Quiet As She Goes ......................................................................................... 44Richard Usatine, Donna Sillan and Annie Lu, Abraham of Ethiopia ................................ 45Travis Reece, Untitled ............................................................................................................... 49

Editor’s SectionStefani Hawbaker, Happily Ever After ...................................................................................51Amanda Lipsitt, painting entitled Roots .................................................................................52Christopher Wisely, No Greater Love .....................................................................................53

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Honorable Mention

Tiffany CastellanoWhite Sands

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Douglas Cole

Eppur si muove

Should there be one view to govern us,To bind all thinking things?Does Science or God hold the torch,Do we have academic or celestial kings?

If science shows itself to be the wayHow do we know we know at all?Is knowledge precision born of chaosReality’s sensorium-shaped spall?

The thread that ties my premises Is no thread at all I could protestSimply proof random perceptions and ideasCan seem threaded at reason’s request

And just what is reason then my friendIf all is due to random chanceA chance itself most unreasonableBased on uncertain facts you advance

Uncertain because I know quite wellTo know I must first buy into The tools and theories and methodsThat fodder what is “true”

For no fact ever stands aloneAll relies on knowledge pastWhether in measure or interpretationData fit the die that has been cast

And God who are you to speak so stronglyI stab questions through your booksIf to be saved men must think like youYou are naught but a crook

For your thoughts surely are many And legion the ways that you extolYou say all religions can’t all be rightIs all then but fool’s gold or coal?

Your faithful think they have found the prize And work to see your faceIn fervent desire they honor your wordThey proselyte, conquer, haze

Warring on your other followers With weapons of money, word and swordBecause these books you have given themEach describe a different Lord

And thus humanity’s cauldron simmersWith science and god to add spiceIn this myth pistou of personalitiesTruth seems judged by neuronal dice

For perhaps each idea is justifiedAs judged by each man’s mindPerhaps the profession of, “I believe.”Is all the truth that we can find

And concepts of the absoluteAre naught but man-made thingsBorn of a lust for certaintyThe natter of truth-mongering

Alas, where can a heart like mine turnTo make sense of this placeWhether religion of science or of godBoth are built on boundless faith

If freedom is found in belief’s pursuitThen I starve to be freeYet faith shan’t be freed from reason’s graspAnd my reason comes only from me.

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Joanne WrightShadows

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The Big Day

A shrill bell broke the silence of the approaching dawn. A white hand, covered in a network of blue highways shot out from under the thick, down blanket and turned off the brass alarm. Martha slid the covers down from over her head. She breathed deeply, smelling the scent of freshly cut grass. The dark red light coming from the window gradually lightened, turning a shade of orange, then pink, and finally the blazing yellow sun broke through the gray morning light of the little room. After Alfred’s death, Martha had con-verted her old sewing room into a bedroom. She didn’t sew anymore, her arthritis made the fine movements too painful and this was the only room in the house that got the morning light. Besides, she could never sleep in her marriage bed without her husband. She still hadn’t cleaned out his clothes or even used the room for the last ten years.

She turned towards the large brass clock and saw the little hand near the seven and the big hand near the six. Normally Martha didn’t rise until ten or eleven or whenever the whim hit her. But today was Wednes-day, her big day, and she needed all the time that she could get to prepare herself.

The light brightened and turned white. That sunbeam crept slowly up the bed, warming the lady be-neath. When the warmth reached her face Martha knew it was time to get up and start her day. She pulled the covers aside in an orderly fashion. Covers were never tossed aside, or thrown upon the floor, or discard-ed in a sloppy fashion. No, instead they were carefully folded aside.

She smiled at the large picture hanging on the wall. She stood there with her husband at their forty-fifth wedding anniversary. The cracked lines in the old black and white image matched the lines on her face now, Martha thought. They looked sad as would be expected so soon after young Donny had died from polio. Even now, Martha wouldn’t swim in a public pool, heeding the advice of yesteryear. She whispered good morning and wiped her eyes with the sleeve of her nightgown.

Her feet searched for the familiar confines of her pink slippers, remnants of another lifetime. Putting one hand on the bed and one on the nightstand, she managed to stand. Her complaining joints made some pops and groans, but nothing that seemed very serious. She envisioned her body as an old car -- it made a lot of noises but you learned to distinguish those that just came with age from those that meant something was seriously wrong.

Turning around took some effort and then she began the ritual of making the bed. Today was Wednes-day which meant that tomorrow would be spent changing the sheets and cleaning her little room. Flexing her fingers to work the night’s stiffness out of them, Martha pulled back the cover in exactly the opposite manner in which she had just folded them aside. Making the bed, tucking in the sheets, and fluffing the pillows would occupy the next hour of her time.

Honorable Mention

Craig Klugman, PhD

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She slipped into her robe, a faded pink that had been Alfred’s last gift to her and walked to the front door. She slipped the chain, turned the bolt, and fiddled with the various locks that had been installed over the years. The door made a sucking sound when she opened it, swelling against its frame with the intensify-ing heat of the day. She poked her head out, being sure that her feet never moved off the carpeting of her entrance foyer and looked in both directions. No one was around, no one saw her wispy white hair flowing in all directions, carried by the wind like a broken spider web.

At her feet was a brown bag from Marco’s market down the street, the only local store that still deliv-ered. Yesterday the bag had contained milk and bread. Today’s would hold two dozen of the ripest, most perfect lemons ever seen in the state of Texas. With a smile on her face she took the bag into the kitchen and laid it down on the countertop. A slightly rusted, metal juicer hung on the rack above the sink. This she took down and ran her hand over the tongs at the end, the metal forks that prevented the seeds from falling into the glass. She then selected the proper knife from the top right drawer. A lemon knife should be short and sharp. If it was too long or sharp then you might nick one of the little pockets that held the fruit and that would mean throwing away the lemon.

Each lemon was taken from the bag one at a time. Martha would hold them in her hand and feel if they were the right hardness and color. She would squeeze to see if these were good juice lemons or some cheap ones that Marcos was trying to pass off onto her. Well, if they ever tried that, they would certainly hear from her. Then she smelled the lemon, making sure it was ripe and fresh, not sitting on some shelf for the last few days after having passed their prime. If Marcos ever tried to pull that on her, they would certainly hear about it too. The lemons smelled fine.

She took the first lemon and sliced it precisely in half across the narrower axis, never along the long axis or you might spill some of the juice. She grabbed the top half, placed it on top of the juicer and pushed down hard, lifting herself off the kitchen floor with the effort. Tomorrow her bones would hate her, but then again, she only had to clean the parlor tomorrow. When the juice ceased running she would twist the lemon piece to the left, then to the right, and back and forth, smiling as the juice trickled down the metal lump and settled into the base of the juicer. The doctor had once suggested that she get an electric juicer, one that would do all the hard turning and pushing for her. Martha explained how you can taste the effort that someone puts into making their lemonade and an electric contraption would never do. She never went to that doctor again.

One by one, each lemon was put through this ritual, this transubstantiation where the lemon was turned into the body of nature, the essence of life, an elixir that Martha swore was responsible for keeping her young and on her toes. When the juicer was filled, she poured the pale golden liquid into one of two glasses, until they were both full. After six hours, she had one lemon left which she put on the window sill. It wasn’t quite ripe enough anyway.

The grandfather clock in the living room chimed three o’clock. Martha jumped, worried that she wouldn’t be ready in time for her big day. She put the two glasses in the icebox. Back in her bedroom she opened her closet and looked at her assortment of dresses. Making her way through the six or seven that lined her closet she took her best Wednesday dress off the hangar -- a beige ruffled dress that covered her ankles and her

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Jessica HollingsworthLazy Sunday

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wrists as any proper dress should.

Martha sat at her makeup table in the hallway beneath her grandmother’s old mirror. With a practiced hand she applied the base, rouge, eyeliner, lipstick, mascara, and powder. A woman has to look her best at all times, especially if it was Wednesday. Martha glanced at the clock and saw that it was already 5:30 in the evening. She had to hurry or she would be late and she has never missed a special Wednesday yet.

Placing down her powder puff, Martha stared at herself in the mirror and admired her handiwork. After 80 years she was still a very attractive woman, a very desirable woman. At least, that’s what she told herself in the mirror before going to bed every night. She slipped into the bedroom and put on her silk slip -- the only one she owned. Martha hadn’t gained a single pound since her wedding day. She worked hard keeping her trim figure; every day she watched the Richard Simmons workout, the Health Channel workout, and the Golden Seniors workout. She didn’t believe in remote controls, the infrared rays could cause cancer after all. All that getting up and down to change the channel was enough to exhaust anyone.

She ran into the kitchen and grabbed the small paper bag that held two aluminum tuna fish cans and a number two plastic vitamin bottle. Martha walked out the door holding her crumpled paper bag. The bag was soft and well worn. It felt more like a fine piece of cotton than paper. The sunlight streamed onto the front porch, hitting the front of the house at this time of day. Martha smiled and glanced into the sun.

Clutching the bag to her chest, Martha stood at the edge of the driveway. She looked down the street and didn’t see the truck. They never came early, so as usual they must be late. Martha was never late and was annoyed by those who were. Actually, she believed that everyone should be five minutes early to every appointment, Alfred always was. That’s what she first fell in love with, his promptness.

Martha heard the grinding sound and saw the big truck coming down the street. It had the big recycling flower on its side. The big truck pulled up in front of her house and came to a stop. Two men stepped off the back of the truck and walked up to her.

“Good evening Charles,” Martha said to a man with graying hair and a full belly. No need to worry about food going to waste in that house, she thought.

“Hello Mrs. Markham,” Charlie responded in a deep bass.

“I told you to call me Martha, I haven’t been Mrs. Markham in a long time.”

“Yes, Martha.”

“And how are you today Manny,” Martha requested of a short, muscular man with a long, black pony-tail hanging halfway down his back.

“Can I take your bag Mrs., I mean Martha,” Manny said.

“Of course,” Martha replied. She handed the dog-eared bag to Manny. He opened it and pulled out the two cans and the bottle. These were dropped in barrels labeled cans and plastic. Martha smiled, watch-

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ing her efforts help save the environment. He handed her back the bag.

“Thank you Manny,” Martha said, folding the bag along the creased lines. A few holes had appeared in the bag and Martha realized that someday soon this bag would find its way to the barrel labeled “paper”. “Would you boys care to come in and have some lemonade?”

“That’s very kind of you Martha,” Manny said.

“But we still have half the city to finish and my daughter is in a dance recital tonight,” Charles added.

Every week Martha asked if they’d like to come in for some lemonade, and every week they said perhaps next week. But in the many years that Martha had been greeting them at the curb, they’ve never accepted her invitation.

“Have a good week Martha,” the men said in unison. They waved from the back of the truck as the large recycling beast drove away. The sun began to set.

Martha waved after them until the truck turned the corner and she couldn’t hear the sound of its power-ful engine anymore. She held the paper bag in her hands, creasing the folds over and over. Martha took a deep breath and turned to her house, walked down the driveway and opened the door. The sun disap-peared over the horizon. Closing the door, she spent several minutes turning the locks. Martha stifled a yawn and decided it was time to start getting ready for bed. After all, she only had a week to prepare for the next big day.

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Jason RochaBlossoming

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Pranjali Gadgil, MD

The Laborer’s Wife

His fingers on the piano work magic.

His music is mesmerizing.

When he plays, you forget about the world.

When he plays, he forgets about you.

You’re the pianist’s wife.

He’s a kind a man. He lives for the world.

He forgets his own when giving to another.

He‘ll give his own morsel to the hungry.

And unknowing, he’ll give away yours.

You’re the philanthropist’s wife.

He has big dreams and you are in every one of them.

You want to see what he sees and believe in him.

Yet life isn’t a dream and you wait for him to wake up

So that someday your own dreams come true.

You’re the dreamer’s wife.

He labors dawn to dusk

Comes home with some bread

You share it over a bowl of soup and then tidy up.

You both then sit back and watch the moon rise.

Yet you complain you’re only a laborer’s wife?

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Stacey SanchezMisc.

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Visual Arts and Photography Category Winner

Melissa VanoverSketch entitled Palpation

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Poem #1

InnervatedIntervasculatedRange of motion and subtle articulationShould I take the risk,Our intertwined handsWould work like intercalated discs

Poem #2

My CNS whispers to my PNSWhen you are aroundWhat they say, it makes me blushBut you shouldn’t hear itOver the sound of my heartKnocking on its thoracic wallRibs four, five, and six

Shannon Laine Williams

Four Nerdy Anatomy and Physiology Love Poems:

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Poem #3Past the surfaceBeyond the epi and the dermisLies the meat of sterner stuffBut that has layers tooEndo- peri- epi-mysiumAnd the same nutritious stuffThat causes me to blushRuns quickly through my veinsThen strong becomes weakThere go my knees

Poem #4 I must say,Rather attracted to your brachialisCant stop thinking about that pectoralisCaptivated by the extensorMotivated by the flexorBut i find it quite humerusAs i keep to your radialisAll i want to do is hold your palmaris longusTo touch your capitateAnd gaze at the lunateOrbital to orbitalEven though we are distal right nowI keep you medialAnd you are always on my cranial

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Poem #3Past the surfaceBeyond the epi and the dermisLies the meat of sterner stuffBut that has layers tooEndo- peri- epi-mysiumAnd the same nutritious stuffThat causes me to blushRuns quickly through my veinsThen strong becomes weakThere go my knees

Poem #4 I must say,Rather attracted to your brachialisCant stop thinking about that pectoralisCaptivated by the extensorMotivated by the flexorBut i find it quite humerusAs i keep to your radialisAll i want to do is hold your palmaris longusTo touch your capitateAnd gaze at the lunateOrbital to orbitalEven though we are distal right nowI keep you medialAnd you are always on my cranial

Richard Usatine, MDBalloon Fiesta

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Disregarding the pearls of sweat collecting under her white dress, the timorous bride looked around the room, worried about her eight-year-old brother David, her closest pal in the whole wide world. She had last seen him several hours ago when her mother had been preaching some final maxims about her upcoming uxorial duties. It was late evening now; the reception dinner had been served, consumed and cleaned up. The children were playing in the dimly lighted cobble-stone yard while the adults had gathered in the spacious living room to listen to a young female singer. Nervously holding hands, bride and groom were sitting on a wooden bench with their shoulders touching and their backs leaning against the white stucco wall of the room.

The singer paused to take a sip of water. She glanced at the very young bride on whose forehead streaks of sweat were glistening under the intense light — a child turned woman after first menses, even a very light one. The singer took a step towards the father of the bride and resumed her song:

May this marriage be wine with halvah, honey dissolving in milk

May this marriage be the leaves and fruit of a grape vine

May this marriage be the moon in a light-blue sky

. . . . . . . . . . . .

The father averted his face. Guilt for not stopping the proceedings washed over him; he felt an abyss yawning in his heart: the ache of losing a daughter, a child. I’m a weakling of a father in this matriarchal house.

The singer paused and acknowledged the enthusiastic applause of the audience with a graceful nod. The father quietly left the room.

Still looking for David, the bride peeked around the room, hoping in vain to locate his comforting face among the noisy crowd. David was not there. Concern for her adventurous sibling, her best friend, overrode the despair of her own situation; she turned her head until she identified her mother, a small figure squeezed between the new in-laws. Through eyes blinded with tears she stared at her mother, trying to signal her worries. Her mother noticed the quiet tears flowing from the bride’s eyes, got up immediately and made her way through the cheerful relatives to her daughter’s side.

“Where is David?” the bride whispered.

“Don’t worry, he’s playing outside in the yard.” her mother said.

“I want him here!” the bride stammered in a tremulous voice, “I want to hold his hand!”

The mother pushed her way through the crowded room and out into the yard where children were playing hide-and-seek in the dim light of torches tucked under the eaves. In a ringing voice, she called out David, again, and again; she crossed the garden and again shouted the name. The children stopped their

Mo H Saidi

Death Trap

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game and gathered around her.

“Has anybody seen David?” she asked them.

“I saw him earlier,” one little tyke piped up. “He was mean to me; he pushed me out of the way and then walked out and slammed the gate like he was in a bad mood.”

“How long ago was this?”

“I don’t know,” the kid said.

The mother opened the gate, stepped onto the flat, slippery steps in front of the threshold and again called out David’s name. She gazed into the stygian darkness of the narrow alley but could neither hear nor see a thing. After a few steps the cobble-stone alley became a covered passageway, a long tunnel under a stretch of ancient, moss-covered brick homes before it ended near a square. Into the other direction the alley declined steeply before it turned around a corner and abruptly ended at a bluff jotting over the river some hundred feet below. The mother stared into the obscurity of the dark tunnel but could distinguish neither the covered passageway nor the other end of the alley near the bluff. She didn’t see the turn and she never saw the old man farther away who would soon climb the alley and stride toward the bluff, a lantern in his hand.

Time and again she shouted David’s name and when she received no response she turned back into the courtyard, her heart fluttering uncontrollably, her mouth bitter and dry. Suddenly David’s disappearance alarmed her, and she became deeply worried.

David had walked away from the children, left the courtyard, climbed onto the portico in front of the long living room where the wedding celebration was going on and peered through the window. There was the face of his sister, his playmate, pale and childlike under the intense light. The sheer chiffon of the bridal veil had been pulled up and her naked white face reminded him of a full moon. “Mahe mani,” he mumbled.

The old Benedict’s gnarled hands were clutching the bride’s petite, smooth hands; he was lost in the singer’s soft voice. Young David and his sister were separated by only fifteen feet of royal-blue carpet, but this carpet was an impassably deep sea. David scrutinized the fleshy face of the bridegroom, his bushy, black eyebrows, his dark suit; he observed how the groom was leaning toward his new bride and whispering in her ear. David watched his sister as she tried to lean away from her groom’s thick breath and as she failed to hide the emotions visible on her face. David despised the man.

This superficially joyous scene with a cacophony of mixed music and garrulous conversations angered David; only a few days earlier, in their own home far away from here his sister had confided to him that she was scared, that she did not want to marry anyone at this time but finish middle and high school first. She was dreaming of becoming a teacher instead and wanted to go to college. Recalling these memories made David angry, he felt an urge to shout, to disrupt the wedding, to jump up on the bridal bench and punch the bridegroom in the face, to pull a carving knife from the kitchen and stab him, to nail a dagger into the man’s chest and push it in up to the hilt, to rip the groom’s heart apart, letting his blood flow on the blue carpet and inundate the wedding scene. Turn the carpet all red and then – stop the hideous event.

David tried but failed to make eye contact with his sister. Frustrated he turned away and climbed

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Melissa VanoverFire Dancers

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down from the portico and crossed the semi-dark garden and emerged through the gate into the blackness of the alley and crawled towards the bluff. Blinded by rage and the gloom of the night he followed the course of the winding path by feeling his way along the wall and touching the cool mossy bricks every few steps. He skidded a few times on the slippery cobbles but pressed on until he heard the roaring sounds of the fast moving river, the rush of water against the palisade of bluffs after the deep bend, the tumble of waves between the boulders and the thunder of the falls further down, beyond the cliffs. Once he slipped and cut his forehead on a jagged cornerstone; his blood ran down his cheek, staining his shirt and dripping onto his shoes. One hand touching the brick walls and columns, he advanced slowly towards the noise of the fast moving river.

David took off his blood-stained shoes and put them down; then he inched toward the edge of the bluff and stared into the dark space below, where the river rushed under a black mist, roaring like a pride of charging lions. Suddenly a gentle cool breeze stroked his face, chest and legs, and he felt something pulling on his loose shirt. He moved his torso forward and pushed his knees down towards his bare toes, which were his only remaining connection to solid ground. He bent his body, tilted his body forward, uncoiled his limbs, and leaped into perpetuity.

The courtyard was quiet now, the children asleep. The lights had grown dimmer in the hall, and the singer climbed back on the small, carpeted platform in the corner, heaved a deep sigh and readied herself to resume the empty ritual, the singing of love songs; observing the sleepy faces of the guests she was pleased that she would not have to continue her performance much longer. She glanced at the empty wooden bench where bride and groom had sat and held hands, and she imagined the two of them in the bridal suite consumating their marriage, the little girl squeezed under the pressing body of the groom. And she thought of the bride’s first-ever sexual experience at such a young age when her body was barely suited for intercourse, and imagined the bride’s moans, the streaks of blood running from her groins; and she remembered David’s face before he fled the scene in tears and she could not stop her own tears rolling down her cheeks. She overheard a murmuring among the guests that a mysterious old man with his lantern had been spotted near the bluff and she imagined again the cold basement where the bride’s muted cry would indicate her loss of virginity and the singer began to croon softly while all these thoughts marched through her mind.

The singer turned and smiled at the bride’s mother who looked sweaty and exhausted. The mother nodded in return but kept her arms tightly locked around her bent knees. The singer followed the melody issuing from the badly tuned instruments of two musicians beside her and then she intoned her last piece, a repeat of her earlier blessing song:

. . . . . . . . . . . .

May this marriage be the lambent glow of the moon

Softly reveal the bride’s beauty and the groom’s happiness

May this marriage be bliss mixed with peace and joy.

Below the hall in the dank, starkly decorated basement which served as the bridal suite, the groom stood near the bed, wiping himself with a white sheet, and watched his wan bride, streaks of sweat rolling from her ashen forehead to her cheeks and into her disheveled hair---the dim candlelight barely illuminated

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her naked feet, her tiny thighs and bloody groin. The young bride was slowly recovering from her ordeal.

The hall was fully deserted when the mother returned from an unsuccessful second search around the alley. The bride with her blood-stained, white gown had left the bed and the groom who was now deeply asleep producing loud snores and stinky breaths. The bride had climbed up to the living room and now stood by the open window and stared into the garden hoping to identify David next to her mother who was wondering in the garden and still looking around. She ran towards her in the courtyard and asked for David. Her mother hugged the panicky bride and whispered that she had not yet found David.

With a loud moan the bride tore loose from the embrace and rushed through the courtyard, her mother following behind. Racing along, the bride pulled one of the flaming torches from the garden, took off her shoes and darted through the gate into the alley. Not pausing even an instant, she dashed toward the bluff, the mild breeze waving her sheer chiffon veil above the white dress. Near the precipice the breeze suddenly turned into a strong gust that pushed the flames of the torch toward her face. The chiffon caught on fire and the flames rapidly ignited the rest of the feathery layer. In one instant, she was engulfed by fire, heat and smoke. She screeched violently, stumbled towards the edge of the bluff, and jumped into the deep darkness and into the river, never noticing the dimly lit lantern beside which stood a pair of bloody shoes belonging to David.

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Shih-Fan YehMission Concepción

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The sky tonight was raw Hong Kong silk.The western horizon pure, clear pink becoming increasingly vibrant as night

approached; overlaid with clouds reflecting ripples of purple and magenta against the encroaching darkness.

The eastern breakpoint deep cobalt; with a full soft moon quietly illuminating the darkshadows of the trees, changing their character and their presence.

The kind of evening when all of life’s burdens transcend to a place of perspective reality;when even the heaviest heart smiles lightly in the breeze.

The kind of evening when one is fully alive with the collective energy of the universe and all potential is tangible.

Pure magic …… I wish you could have seen it.

Linda Porter-Wenzlaff, PhD

Requiem

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Pamela LenowPainting entitled Rainbow

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Clarence discretely pulled the object out of his jacket pocket. In his rush to the airport, he had forgotten to remove the minuscule plastic baby doll. He often wondered why he had never had a patient rush into his clinic choking on the toy. There were hundreds of them around town every year. Just another quirky aspect of his life for the past two years. But those days would soon be behind him. He had paid his dues and would soon be where he belonged—a big city private practice with a big city private income.

“Dr. Robinson, don’t you agree?” The abrupt voice brought him back to the present. The use of his surname alerted Clarence that the speaker expected his full attention.

Clarence quickly replaced the toy in his pocket, focusing on the Armani suit sitting at the conference table across from him. Bradford Paige, III, M.D., was head of the prestigious private practice and looked the part. Clarence would have to rehabilitate his own wardrobe. Shopping at Godchaux’s Dry Goods definitely had its limits. But then, living in the small Louisiana Cajun town had lots of limits.

Dr. Paige abruptly turned to three other physicians at the table. “I’ve been telling Dr. Robinson here that the idea of farming young physicians like him out to the boonies for two years is a waste of time and talent. They should do their service in a city practice and still get their student loans forgiven. They’ll see hundreds more patients in a big city and a greater variety of medical problems.

“What’s the most exciting case you’ve seen, Clarence, one of those Cajuns who got drunk and fall off his pirouette or whatever they call those ridiculous boats?”

“They’re pirogues, sir, and I’ve seen some interesting cases.”

The older doctor ignored the response.

Clarence wondered how many of the men at the table ever treated a tularemia patient. Gaston Arceneaux, the burly trapper who lived in the Atchafalaya Basin, was his first. Gaston’s English was slow and broken, his laugh quick and boisterous.

Gaston had presented at the office with a fever of 104, swollen lymph nodes and a nasty sore on his right hand. Through careful questioning, Clarence learned he had been rabbit hunting the previous week and cut his hand cleaning one of the animals. Clarence’s challenge was convincing the patient to take the whole round of streptomycin.

The day Gaston appeared for his final checkup, Alice Bordelon, the office manager, came into Clarence’s private office. “Excuse me Doctor, but Gaston wants to know how you would like to be paid.”

Clarence was surprised Alice even bothered him with such a question. “The usual way, Alice. If he doesn’t have insurance, he can pay by cash, check or credit card. We can work out a payment plan for him if necessary. I’m surprised you bothered me with this.”

Alice smiled. “Well, you see, Doctor, Gaston pays folks around here with a different sort of

The King Cake Crisis

Literature Category Winner

Susan Seale Jarvis

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currency. He wants to know if you prefer your payment in armadillos, squirrels, venison or rabbits. He asked me to tell you the rabbits make a fine pot of stew in the winter. I think he’s not real fond of his rabbits right now if you know what I mean.”

Clarence knew what she meant. One of the furry four-legged animals had caused Gaston a lot of discomfort and cost him three weeks of hunting time.

“Please tell the patient I’ll take the rabbits, Alice.”

The same day Clarence went to the local appliance store and bought the largest freezer he could find. Within a few months, it was full of fish and various mammals.

Gaston was not Clarence’s only unique case. He recalled the day a mother brought her young daughter in for the first time. He was still treating the child with the small head, triangular face and anteverted ears. She was his first patient with autosomal dominant mirocephaly. Clarence soon learned the condition was more prevalent in Cajun country than elsewhere.

A sudden rise in Dr. Paige’s voice brought Clarence back to the present. Surely Dr. Paige recognized the reason for “farming out” as he called it was to service rural areas with limited access to medical care. No need to elaborate on the issue; Clarence had already recognized the older doctor was not the listening type.

“Well, enough about your backwater experiences. You’re in the real world now, my son. Where you’ll get what you’re worth. First of all, we’ll make sure you get a membership in the best country club in town. Rubbing elbows with the right people is good for the practice. We’ll use you in pulling in more of the younger folks, Gen Z, or whatever they’re called these days. A good-looking young bachelor like you can really draw them in, especially the young women. We want you out and about, Clarence, being seen with the right people.”

While the older voice droned on, Clarence reached back into his pocket. He deftly pulled the plastic object out, remembering his first King Cake embedded with a similar doll. The pastry reminded him of a brioche, coated with green, gold and purple sugar, traditional Mardi Gras colors. King Cake parties started on Twelfth Night and continued until Ash Wednesday. The weekly rituals were held in gatherings throughout southern Louisiana. In Clarence’s clinic, the party was each Friday afternoon. A small bean or doll was traditionally placed somewhere in the dough. The unlucky person getting the slice of cake with the bean or doll had to host the next party. When he first arrived, Clarence was the loser each week. He suspected his staff had somehow located the doll prior to the cutting and made sure which slice he received. As the weeks progressed, his luck was more in line with the others. At that point, he felt he had been accepted.

Yesterday was the first time this season he had found the doll. If events went as Dr. Paige predicted, he would not be hosting the next party; he would be busy packing and moving by then. He’d ask Alice to pick up a cake at Landry’s bakery and take it to the party for him.

Dr. Paige loudly pushed his chair back from the table. “Well, Clarence, enough of this gabbing. Time for a tour of our facility here. It’s truly one-stop shopping, if you know what I mean. Everything from Botox to bariatric surgery. Patients that look good feel good I always say.”

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Travis ReeceMy Gambian Brother- Baaba Modou Sallah

27

“I’m still not sure exactly where I fit in to this picture, sir. I’m a family practice doctor.” Clarence could not understand his role in this facility of expensive procedures.

“Don’t worry, young man. Your main job will be to keep the mamas happy. Every time they read about a new medication or procedure on the Internet they’re in here wanting it for their kids. Our requests for antibiotics go up every time a new drug is placed on the market. Your busiest time will be right before special events-- graduations, debutante parties, that sort of thing. Their daughters come down with a cold or sore throat the day before the big event and the mamas call for a prescription. Your job is easy—just call in the script for what they want and everyone is happy.

“Oh, your other main request will be weight loss meds for brides-to-be. They find after all those wedding showers they’ve gained a few pounds right before the big day. You better read up on the quickest fixes—diuretics, that sort of thing. Now let me give you that tour of the clinic.”

The tour showed the facility was just as Dr. Paige had described—one-stop shopping. In many ways it reminded Clarence more of a plush spa than a health care facility. He observed the patients in the various waiting rooms. Plenty of Gucci bags on the floor beside the loudly tapping stiletto heels. Several women smiled at Clarence, displaying their perfect, snow white teeth. Maybe the facility had a dental office somewhere on the premises. Truly “tip to toe” one stop shopping.

After the carefully orchestrated tour, Dr. Paige turned to Clarence. “Well, young man, enough of this dilly-dallying around. You’ve met some of the other partners and toured the facility. Time to get your name on the dotted line. Let’s go over to H.R. and get you on board.”

It never occurred to Dr. Paige that his offer might be turned down. In the director’s opinion, anyone in Clarence’s current work situation would naturally be thrilled, even honored, to be associated with the prestigious clinic.

“If you’ll excuse me for a few minutes, sir, I really need to check back with my office to make sure everything is under control. I’m the only doctor within forty miles you know.”

“Go ahead, just make it snappy. We have a luncheon reservation at the club at noon. I’m sure if there’s a crisis, those Cajuns can get into the next town. They do know how to drive don’t they? Some folks that don’t speak English don’t understand the traffic signs. Shouldn’t even get a driver’s license.”

Clarence was silent. No need to try to explain that maneuvering the narrow back roads to the closest town with a doctor could take up to an hour. If the roads were flooded, the trip was impossible.

He walked out of the building and dialed Alice’s number. “Any problems on the home front, Alice?” Funny he had never referred to the clinic in that manner before.

“Nothing too major, Doctor. Oh, we did have one crisis but everything is taken care of now. Odd thing is it’s never happened before. The teachers over at the high school were having their King Cake party. Meredith Marchant, the math teacher, started choking on the baby. She was in real trouble until someone came up behind her and did the Heimlich on her. That baby doll popped right out of her mouth.

“Coach Barker was the one that helped her. He said he’d attended one of your life-saving lectures a while back. Seems your idea of putting on those lectures was a good one after all. As I said, it’s mighty funny. This sort of thing never happened before even with all those King Cake parties year after year. It’s

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kinda like an omen—like that doll was mad about something.”

Clarence could swear his own doll was kicking inside his pocket.

He looked up at the imposing glass façade of the clinic. Dr. Paige assured him he would have an office on the top floor with a panoramic view of the city. Between ordering the antibiotics and diet meds he’d plenty of time for window-gazing.

The doll kicked again. Alice was right. Meredith’s doll had been mad about something. Just like his. Finally he got the message.

He called Alice back. “Do me a favor. Get me reservations on the first plane back to New Orleans. I’ll pick up my car at the airport and be back in the clinic tomorrow afternoon.”

Dr. Paige was walking toward him. “You know, Clarence. I don’t like to be kept waiting. Better to learn that from the start. Now get back in and sign those papers.”

Clarence looked into the steely eyes. “I’m sorry, Dr. Paige, but you’ll have to find someone else for that top floor office. You see, I’m hosting a party next week. A very important party back home.”

He knew the kicking in his pocket was over. For good.

29

Katy ZentnerSewanee

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IIn the clear summer night you lie on a thin mattress, up on the flat roof you gaze into the deep skies an enormous universe, myriads of stars

you climb the ladder of imaginationsearch for a blue planet like Earthfor the trail of the prophet, the spacewalker who dragged his son along the Milky Way

the floating dagger that slipped awaythe sacrificial lamb, the meteorites the booming voice that shook the desert jolted the triumvirate, the mirage of sand.

You open your eyes to the abating glowof the stars, breathe the cool morning airthe sun shines, warms up the world you feel the breeze brushing your face.

IIYou walk to the nearby mosque where fourteen teenagers are being flogged for watching the World Cup; the mullah shouts some verses denouncing the infidels

Neda still bleeds from neck, ears, and mouththe sniper climbs down from the roof murmuring Allah-o-Akbar. He dreamshe’s going to Behesht to sleep with virgins

he will drink wine mixed with milkhe will visit the prophet who slaughtered the lamb raped the king’s daughters.

Mo H Saidi

Curiosity

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IIIA hummingbird soars in the airits heart beats fast; its bloodhurries to its minute brain

its eyes espy bright colors from afarit hovers above a band of day liliessucking nectar; its wings invisible.

IVIs it all designed for us to traverse a predetermined, circuitous path, to wander the world, to dance to nature’s chaotic tunesto rise and settle on an isolated planet?

Are we fettered by thin air, bound to slippery ground? Or we are the creature that fills only a dash in the book of nature?It took millennia for the ferocious river

to carve the Grand Canyon---do not despairfor you need miles of DNA strandsto decipher the riddles of the universeto absorb and digest all the morsels of truth.

You are born with a blank mindyou walk and see, and fill the dark vaults.You think, sleep, and awake, and youconsume your life---the sun rises

and sets and warms up the aging planet.Nature is not curious about your fateyou are an anonymous speck; you risewander awhile and think, you live and sleep.

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William MillerGreen Dragon

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Jennifer SchwantesThe High One

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She calls me several times a day. She forgets she has already talked to me and that she has asked me the same questions and that she has told me the same comments. Still I listen to her voice over and over again with the same enthusiasm. She gets so happy to hear my voice. It’s as if she is hearing it for the first time today. To me, this is the 7th, or perhaps the 8th, or 9th time I am hearing her voice. This is what it is like to be the daughter of a mother with Alzheimer’s. There are days that I can keep up my upbeat tone in my voice with her. When I know I cannot. I do not answer the phone, and let my “upbeat” recorded voice in my voice mail take over. It reassures her that I love her and that at the moment I may not be able to come to the phone, but I assure her to leave a message and that I will call her back very soon. So how is it to be a mother with Alzheimers? Somehow, I know that she listens to the recording and feels the love, feels the connection to her child, the one thing she does remember. The one thing she really does remember and feels she can still trust and knows that I am very near to her, even if it is just a voice next to her ear. It is her connection with what she knows makes sense in her world. She holds on to this. She leaves a message. Tells me she loves me and to call her back. She hangs up because she knows the mechanics of putting down the phone. She really doesn’t know why she puts the phone on the base, but she does. She’s done that all of her life. It’s a motor skill not forgotten. I imagine she sits in her chair, looks around and sees strange people passing by in front of her room. She’s probably not sure why so many strange people keep passing by, but she knows that she somehow must be in a safe place because she turns to look at the wall and sees pictures of her parents. This must be my room, is what she might be thinking. There’s even a picture of my “Lupita”. This is my first daughter. I think she is dead. I think she died as a young child. Pictures of my parents and my first daughter, yes this must be a safe place. Then she looks back at her table. She sees a phone. She somehow remembers that she should call Becky. She looks at the wall again. She sees Becky’s phone # 9-219-1234. She tries to push the buttons. I don’t know how many times she tries and finally succeeds. She calls me. I answer. The conversation starts all over again. The conversation for her is new to her. For me, it’s the 10th time we talk about the same things.

Rebecca Ruth Wright, RN

Talk, Listen, Deep Breath, Repeat…

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So who has it tougher? The daughter of a mother with Alzheimer’s or the mother who has the Alzheimer’s? Perhaps I have an advantage because I know what is happening, or at least I think I do. My mother on the other hand does not know and is dependent on me and trusting me to keep her safe. But honestly, I don’t think it’s a question of who needs to be the martyr here, it’s more of a question of how well did my mother teach me to “mother”? This is exactly what I am doing. I am now the mother of my “mom”. We have now reversed roles and now we will see if I can pass the test. Personally, I think she did a great job in teaching me to love a child, to be protective of a child, and to be there for a child for when I am needed. It’s been three years on this journey together and we are still bound together like mother and child. It is a sacred duty. I am just praying that I can continue to have the strength to make the right “motherly” decisions my mother made when I was a child. Her purpose in her old age is to somehow be happy, be spiritually fulfilled, and become ready for the next world. Her purpose is to have dignity in her old age, to have respect from her caregivers, just as a child is to be given the God given respect that is deserved. So for now, I talk to her, listen to her, take a deep breath, and repeat. And for her… she talks to me, listens to me, takes a deep breath, and repeats.

My mother has been in a nursing home for three years. Her nursing home is only three blocks away from UT Health Science Center San Antonio and only five miles from my home. She is in good physical health for a 79 year old. Her major problem is her cognitive impairment, Alzheimer’s.

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Smitha TomyPainting Untitled

37

A referral call from Dr. Winter was rare. I was puzzled as the patient he briefly described had no major problems in my area of specialty. Perhaps a clue was the mention of a distant family relationship, sometimes a source of patient or physician discomfort. However a new patient always provides the possibility of disclosing a new window on the world and an appointment was promptly made.

On her first visit Mrs. Glazer was accompanied into the examining room by her two 60ish, businessmen sons. A still handsome early octogenarian, squatty framed, with her long grey hair coiled in a low-set bun, I immediately thought of Golda Meir – and my late grandmother who, as an intrepid widow, had shepherded her three young children from a Ukrainian shetl to New York’s Lower East Side. Mrs. Glazer’s assertive speech gave hints of her Eastern European origin, New York City upbringing, and a long Texas residence. As we chatted I observed that her relationship to her hovering sons was one of independence, protesting their clarifying comments regarding her medical history, while also commanding their mindfulness of her needs and desires. Mom remained a family force. My initial examination and studies revealed only some minor problems necessitating ongoing medications and periodic follow-up. I admired Mrs. Glazer and was pleased to find an archetypic Jewish grandmother here in my South Texas practice.

Mrs. Glazer’s apartment was directly on the path of my drive home and, given the warmth of our relationship, I occasionally would choose to stop-by in response to her telephone message with a minor question or request. We would sit in her cumbrously furnished but cheery living room, surrounded by family photographs, and I would enjoy brief reminiscences of her long-departed, loyal, hard-working husband, and learn the latest achievements of her gifted grandchildren. A large bowl of assorted candy miniatures always rested on her coffee table, maintained to capacity for the grandchildren’s visits. I was invited to sample and a number of times she retreated to the pantry to deliver from the mother lode a bag for me to take home for my children.

Several years into our relationship a persistent winter cold progressed to pneumonia and Mrs. Glazer spent several days in our University Hospital. As I stopped by one late afternoon to check on her progress, her room door was ajar and I heard this aggrieved exchanged.

Older son: “But Mom, I’m 65 years old.”

Mrs. Glazer: “Does that make me any less your mother?”

I was eventually rewarded for my attentions to Mrs. Glazer with the referral of her daughter-in-law’s mother to my care. Also an early octogenarian, she had been an admired beauty and legendary ballroom dance laureate in the border town where she had long resided. Preservation of her appearance

Marvin Forland, MD

The Transition Generation

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was a primary concern and lovingly encouraged by her two middle-aged daughters. She reported that she remained an eagerly sought-after dance partner during her annual Miami Beach sojourns. I now had two contrasting, but lively grandmother surrogates.

In early December, some three years later, I had a call from Mrs. Glazer to stop-by her apartment on my way home. She warmly greeted my arrival and presented me with a large package festively wrapped in menorah and dreidel decorated gift paper. She urged me to open my Chanukah gift. There was a plaid sports shirt and handsome matching sweater. They clearly reflected the fine tastes of her two now grown businessmen grandsons. I was appropriately effusive in expressing my gratitude. Patient gifts were an exception for me. My medical school practice was primarily at our public hospital clinics were mainly home grown. Here we greatly appreciated sampling homemade tamales brought by our patients residing near-by and the fresh grapefruits from those living further south, both meaningful holiday expressions of their gratitude.

Several months later I had an urgent call from Mrs. Glazer’s daytime caregiver. Mrs. Gazer had fallen in her bedroom and was in great pain and unable to get up. I drove over immediately and my first look revealed the asymmetry of her resting feet, with the left turned markedly outward. The Emergency Medical Service responded promptly and x-ray studies in the University Hospital Emergency Room revealed the expected left hip fracture. After appropriate consultation, the decision was made to recommend surgical pinning of the fracture in the morning. Following thorough, three generational Glazer family discussions, permission was granted.

I left home early in the morning for a pre-surgery visit. It was chilly and I was proud of myself in remembering to wear my new sweater under my sports jacket. When I arrived Mrs. Glazer was already on a gurney in the dimly lit pre-operative area, resting with both eyes closed. I pulled a chair near the head of the gurney and softly greeted her:

“Good morning Mrs. Glazer. Look what I’m wearing this chilly morning.”

She groggily opened one eye, inspected the white shirt, tie and sweater under my coat: “So where’s the shirt,” she responded, and closed her eye.

The anesthesiologist was soon there and the operation and recovery period went smoothly. Some two years later Mrs. Glazer retired routinely one evening and failed to awaken in the morning.

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Pamela LenowSketch entitled Hands

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“So where’s the shirt” continues to be a refrain parlayed within our family when troubled by a sense of incompleteness. For me it is an echo of my father’s oft heard comment, “What happened to the other four points?” when my sister or I brought home a school grade on a test or assignment which was less than top notch. As children of the transition generation, we sought for completion, indeed perfection. We frequently fell short of the mark, but we strove for and cherished their commitments to excellence and their utopian aspirations for us.

I shook my head with disdain, and my heart ached as I held the thick legal-size parcel, a citation for a medical malpractice law suit, in my lap. I sat in front of the fireplace of my two-bedroom apartment and opened the envelope and glanced at the thick stack of legal papers. There were over eighty pages of double-spaced typed script; and the list of defendants in the case was a “Who’s Who” of the New Jersey College of Medicine and Martland City Hospital’s officials. The citation was issued on behalf of a burned patient, William, against anybody who had any contact whatsoever with him during his six months of hospitalization. All together, forty-nine people were named as defendants: three departmental Chairmen, twelve faculty members, nine residents, the director of the hospital and several employees, a nurse supervisor and me. My name, number forty-nine, was at the bottom of the list.

I felt the weight of the package and despised it. The cold wind was pattering the window; and the fire in the fireplace was beginning to wane and begging for more fuel. My eyes stopped at the last word of the last line of the package, William. The package was cold and heavy and unpleasant and dangerous as it was contaminated with lethal venom. I intuitively decided to make good use of the voluminous material.

Deliberately and with a bitter sarcasm I began to dismember the package: delicately and one page at a time, I dropped the entire citation into the flames. Like floating leaves of fall, lost kites on a deserted playground, the wilted pages would glide in the hot air above the fire change color from white to yellow and bright gold and then shrink and come to rest on top of the burning wood. With my eyes gazing at the burning law suit, I would lift the goblet and take a sip of the warm wine.

By the time I dropped the last page in the fireplace, I felt pleasant heat in my chest, my initial anger had subsided and an ephemeral sense of relief spread through my tired muscles. I stared into the vanishing flames and the image of William, the burn patient whose ordeal was the crux of the law suit, emerged. I recalled that infamous late night when I was on call in the hospital ward, trying to relax by reading medical journal articles, when a sudden call from the emergency room made me hurry down; I vividly recalled William’s half-burnt body lying in a pool of slimy ooze on a stretcher in the corner of the emergency room moaning.

Earlier that night, there had been an earth-shaking explosion at Newark Chemical Company where William was working the night shift and where he and several other workers had been hit by flying debris

Honorable Mention

Patricia Wathen, MD

MRI

41

and flaming liquid and gas. All together five of them had been pulled from the inferno, but William had the worst injuries by far. Three ambulances had brought the victims to the emergency room of the main hospital of New Jersey College of Medicine. William was in the first one and unconscious, near death. He had no skin on his cheeks and forehead, and no eyelashes. He was in a state of hypovolemic shock.

As a rotating intern in the division of plastic surgery and on duty that night, I was assigned to admit William to the ICU, then to call the plastic surgeon on call and request his involvement in the case. Two general surgery interns and two medical students took the four other patients, leaving me in sole responsibility to care for William. An RN at my side, I began cleansing the wounds. The fire had vaporized his clothes, burned his hair and grilled his chest. Almost seventy percent of his body surface including face, neck, head, chest, abdomen, hands, and the front of his thighs had incurred first, second or third degree burns. But the worst damage was on his face, neck, and chest. William’s face had lost most of its skin and was covered with puffy layer of a frothy red slime. His lips were bleeding, eyebrows were gone, and his swollen eye-lids were like pieces of sausage that totally concealed his eyes.

The fire was dying. What was left of the citation package and burnt woods were embers of the dying fire. The document I read and disposed of stated, “The abovementioned defendants failed to deliver the necessary care to safeguard the well-being of my client and left him with numerous deformities as a result of which he became totally disabled, disfigured, and deeply depressed and miserable,” It put the responsibility of all of William’s misfortunes squarely on the shoulders of those forty-nine medical and hospital administrative people. And I was at the bottom of the list, the intern who “. . . failed to attend to his medical care promptly, efficiently, and accurately.”

I liked William; and I became accustomed to his slimy face and stench odor. For thirty days until the very last day of my plastic surgery rotation, it was my daily routine to start my morning very early with a visit to William; to change his bloody dressing, and prepare him for his trips to the operating room for debridement of neck, chest, and face wounds, and for the skin transplants. The ordeal of cleansing his wounds, caring for his face, separating his eye-lids, and opening his mouth would fill half of my early morning hours. Unfortunately despite all available medical efforts, he developed infection in the chest and thighs and developed high fever. By the next morning, half of his body surface was covered by yellow thin pus that required extensive cleansing and debridement. He was a large and a strong fellow who resisted death, responded to antibiotics, and eventually survived the infection but his body bore many scars.

On the ninth day of admission he was able to open his eyes. I was the first person who appeared in his new world, and the first person who passed a straw between his wounded lips into his mouth and fed him milk and apple juice. I was the first person who answered his first queries: “Where am I?” and “What happened to me in the factory?”

I slowly began to communicate with William and actually began to like him. He was thirty-eight years old and had a mother and a sister. He had graduated from high school, but had to drop out of Newark Community College because of his diabetic mother and mentally-ill sister. He began to murmur words and one day asked me to read him highlights from the newspaper, and a few days later he asked for The Newark Ledger’s account of the explosion at the factory. His mother who had kept the paper brought it to me. As I was reading the details of the accident, streaks of tears flowed from his puffy eyes. When I bade farewell to him at the end of my rotation, he struggled to speak and said a few heartfelt words like “Thanks for saving

42

my life,” and “I’ll miss you, Cyrus.” Two months later, I started my internship rotation to straight obstetrics and gynecology, but I would still go and visit William occasionally, until one day when I found his bed empty.

Several years later during my fellowship at the University of Texas Health Science Center, I had totally forgotten about William’s case. I was now busy in a new specialty of medicine caring for female patients with gynecology cancers unaware that he and his fiery accident would not go away from my life. During my fourth month at the University Hospital in Texas I was returning from the operating room to my office in the department, when I received a surprise visit by the chief of the gynecology division, Dr. Paul Weinberg. He sat in the chair and said, “Why aren’t you responding to the registered mail from New Jersey? The lawyer retained by New Jersey Medical School has called me and asked if you would kindly respond to his correspondence.” Out of the blue I remembered William’s face, the face of a man at death’s door, and the numerous yellow packages that I had received in the last four months, and the fire, the flames and the bitter sips of warm wine. I tried unsuccessfully to stop sudden tears. “I liked that patient. I’m certain he liked me too,” I said, “We really became buddies.” He nodded and patted my shoulders and left my office.

The fire that had begun in the factory and engulfed and burnt William’s body was spreading. A trial lawyer looking for a case to earn a living had visited the victims’ relatives and had become their legal representative to initiate a law suit. He felt William’s damaged face and contracted body represented the most persuasive subject for his case. So he filed a law suit and embarked upon legal procedures which have lasted several years. I was in Texas, five years after the date of explosion, when I received my share of the citation.

I took the fourth parcel to my apartment and late at night when the rest of my family had retired and the living room was calm and quiet, I poured wine in a glass, feeling like someone in a Gothic novel, turned on the fireplace and opened the parcel. This time I didn’t even peruse the pages; but I simply ripped the package apart and delivered page after page as fuel to the needy flames of the young fire. I did the same for the fifth and the sixth parcel. And then I received nothing more, from either William’s lawyer or the medical school’s legal team.

It was near the end of my fellowship that I realized through a comment from Dr. Weinberg why there was an absence of further communications about William’s case, and why I was not getting any more yellow parcels from New Jersey. “They settled the case and the medical school’s liability insurance paid William one million dollars.”

“Are you sure, Paul?” I asked.

“The dean of the medical school told me. They had to drop your name from the law suit in order to settle and close the case. By then they had received the signatures of all other defendants.”

Dr. Weinberg smiled and I smiled, too, but soon we both became quiet. “There must be a better way to help these victims,” I said.

“Well, you are off the hook.” He said

I went home that night and looked at my cold, black, and gloomy fireplace. I heard my wife’s steps, “I got you some firewood,” she said. “It is in the garage.” She brought a bottle of Pinot Grigio, two glasses and a tray of cheese. I went out to carry in the wood for the fire.

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Melissa VanoverSculpture entitled (The) Flight

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For what serves love,But to mend a wounded worldAnd heal a troubled soul.And in that soul,Love gathered up the sticks and stonesAnd built itself a home.

Quiet as she goes,“Be quick when you leave,” he said,“I’ve got a home in my heart where your love resides,And that’s where I’m gonna hold you ‘til the day I die.”Quiet as she goes home.

And on that day,A thousand other men and women Bowed their heads and prayedThat God would give them poise, and a good reason to stay.For their loss was the same, Their loved ones had been taken away.

Quiet as they go.“Be quick when you leave,” we said,“We’ve got a home in our hearts where your love residesAnd that’s where we’re gonna hold you ‘til the day we die.”Quiet as they go home.

Your dust is gone,And we, the leftover pieces of broken stone...We, the leftover pieces must live on.

For what serves loss,But to strengthen your heart, And awake your sleeping soul.And in that soul,Love gathers up the sticks and stonesAnd builds itself a home.

Matt Mullane

Quiet As She Goes

45

For what serves love,But to mend a wounded worldAnd heal a troubled soul.And in that soul,Love gathered up the sticks and stonesAnd built itself a home.

Quiet as she goes,“Be quick when you leave,” he said,“I’ve got a home in my heart where your love resides,And that’s where I’m gonna hold you ‘til the day I die.”Quiet as she goes home.

And on that day,A thousand other men and women Bowed their heads and prayedThat God would give them poise, and a good reason to stay.For their loss was the same, Their loved ones had been taken away.

Quiet as they go.“Be quick when you leave,” we said,“We’ve got a home in our hearts where your love residesAnd that’s where we’re gonna hold you ‘til the day we die.”Quiet as they go home.

Your dust is gone,And we, the leftover pieces of broken stone...We, the leftover pieces must live on.

For what serves loss,But to strengthen your heart, And awake your sleeping soul.And in that soul,Love gathers up the sticks and stonesAnd builds itself a home.

Ethiopia, July 2010

Matt and Annie (2 UTHSCSA medical students) spotted a young boy lying still in the tall grass just inside the metal gates of the government health clinic in rural Aleta Wondo, Ethiopia. He was alone and not moving. Annie touched his skin and it was burning hot. Matt (with EMT experience) leapt into action and scooped the boy up from the grass running with him into our makeshift clinic. Matt yelled for Dr. Usatine as he placed the boy on the only examination table. The boy was barely conscious but was able to cooperate with an oral thermometer which read a surprising 106.7°. The medical team brought over bottles of water as Matt began to rip off the tattered clothing of this young boy burning up in fever. Water was poured over the boy and a dose of ibuprofen was given to bring his high temperature down. Red ants were crawling all over the child and his clothes.

No obvious source of his fever was visible as thoughts of malaria and typhoid fever were entertained. The well-trained Aleta Wondo nursing staff ran to get intravenous fluid and an IV catheter. A nurse easily placed the IV and fluid was allowed to run in wide open to treat the dehydration that accompanied this high fever. Laboratory tests were negative for malaria, typhoid and HIV. While his neck was not stiff we decided to treat him with a broad-spectrum antibiotic to cover meningitis. Scabies burrows were found on his hands and waist. As the fever came down the boy began to awaken and we started to learn his story.

The boy’s name is Abraham and he is10 years-old. When he was 6-years-old his mother died and his father re-married. His new stepmother rejected him and his 3 younger siblings and kicked them out onto the street. Abraham walked over the mountains from Hagar Salam making his way to the nearest town, Aleta Wondo, around 30 kilometers away. He found a job as a tea boy at a local tea house. He prepared tea, served customers, collected money and closed up the shop seven days a week in exchange for a place to stay, one loaf of bread and one cup of tea per day. He slept in the dark shop by himself at night. Afraid of hyenas that howled each night, Abraham put chairs together to sleep on, just to get off the floor. The shop owner abused him. If he broke a glass he was beaten. If he spilled tea he was beaten. If he made a math error he was beaten. His head bears the scars of many beatings over the past 4 years.

A week before the team of 8 first year medical students arrived in Ethiopia, Abraham fell ill and could not work. He was thrown out to fend for himself. Abraham eventually heard about a free clinic at the health center run by American medical volunteers and decided to go there. He made it into the gates in front of the clinic, where he collapsed in the grass. However, he made it far enough for his life to be saved.

Abraham stayed overnight in a hospital room. He shared a room with another child whose family was by his side. Abraham had no one. The following morning, the medical students gathered food from their breakfast

Richard Usatine, Donna Sillan, Annie Lu

Abraham of Ethiopia

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to take it to Abraham. Abraham was awake and his fever was gone. The rural hospital attached to the clinic served no meals so Abraham was hungry. The students were delighted to see Abraham sitting on the side of his bed looking well. He gave them a big smile in greeting. The students gathered around Abraham as he devoured the food, barely taking a moment to breathe between bites. They offered him water but he shook his head and continued eating ravenously. In Ethiopia it is a sign of love to feed someone. When Abraham slowed his eating for a moment, Annie took up a fork and fed him. Dr. Usatine snapped a photograph (see photo). The students could not speak to Abraham in his native language but our translator was a young man whose own story was similar to Abraham’s. He translated with compassion as he had once been on the streets as a child after leaving his own home to escape an abusive stepmother.

Our students asked the question “what will happen to Abraham now?” The medical students took this question to Tsegaye (co-founder of Common River - our host in Aleta Wondo). Tsegaye said that Common River would adopt him as their own. Abraham would be accepted in their school and they would find him a place to live. The next day Abraham was discharged from the hospital to the care of Common River. Everyone was so happy for his new life surrounded by loving and caring people. Abraham and our students cried as we left Common River the following day to return to San Antonio.

We continue to hear reports of Abraham and his new life. He stayed with Tsegaye in a guest hut for two weeks. There he was fed, clothed and enrolled in the Common River School. One of the cooks at Common River noticed how well he bonded with her children. She wanted him to have a family life so she took him

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into her home. He loved having a family again. Common River supplied the family with a bed, so that Abraham and his new “brothers and sisters” could sleep together in a bed off the mud floor.

When Abraham is asked if he wants to find his younger siblings he falls silent. He fears what he may find. He is also afraid that he will be brought back to his previous life or that his father may take him away. There is not a trace of paperwork to document his existence, so it is difficult to legally process an adoption or foster care.

He is thriving as a 1st grader and excels at math, given his 4 years experience collecting money and giving change at the teahouse. He loves school, sports and playing with the other children. He never attended school or had time to study or play before. He is incredibly helpful with the Common River staff and guests. He is a master at starting the fires each night in the guest huts. Voluntarily he sweeps the hut floors, hauls water, collects firewood, helps in the kitchen, serves food and picks fresh flowers for the guests. He conducts a full coffee ceremony on his own, from roasting the coffee beans, to pounding them, to boiling the coffee water, to serving it and to cleaning the cups. He is also aware of medicinal herbs and plants, which he says he learned from his father. He has started planting herbs in Common River’s traditional medicinal garden.

We are all grateful to have helped such a resilient boy who demonstrates the power of the human survival instinct. He is also the most loving and happy child. Even though deprived of motherly love since the age of six, and abused by a boss for four years, he is not hardened, bitter or afraid. His dream is to become a doctor because he wants to save lives just like the medical students and doctor who saved his life. The medical students continue to care for Abraham by sending him packages of clothing and items that demonstrate their love for the boy that touched all our lives.

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Travis ReeceUntitled

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by Stefani Hawbaker, Amanda Lipsitt and Christopher Wisely

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Stefani Hawbaker, Editor in Chief

Happily Ever After

Editors’ Sectionby Stefani Hawbaker, Amanda Lipsitt and Christopher Wisely

What is happily ever after but a premature clipOn the inner workings of the beautiful lightOverflowing our orchestrated cup. Please, take a sipOf the incomparable, unbreakable, powerful mightAnd soothe your soul to the surprising sensationOf belief, of hope, of destiny, of purpose.“I do” begins a trek nearing toward the sun.Unknown, yet safe; comforting, yet curious-We live for finality, one solution, one endThat will fulfill our wants, needs, utmost desires.The golden rule prevails; we do not offend;Yet why oh why are we so tired?Scientific theories and empiric formulasDo not cure. Oh! Isn’t ignorance bliss?Drudging, slacking, continuing on becauseOur one special day we do reminisce.One truth remains. We cannot go back.One path continues. Many roads diverge.Happily ever after, why do we lackWhen the promises uplift even the solemnest dirge?Anger and hatred; brokenness and contempt.Infidelity and religiosity; confusion and doubt.With no mechanism of action, all we have is lamentFor our puffed breast who receives no more clout.But wait. Look there. I see. On him. On her.The light. The sun. They still draw near.Ah, the beauty of a replenishing happily ever afterTo that, a sigh. The love. I can’t hold back a tear.

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Amanda Lipsitt, Visual Arts and Photography EditorPainting entitled Roots

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Christopher J. Wisely, Literature Editor

No Greater Love

“There is no greater love than to lay down one’s life for one’s friends.” – John 15:13

Dedicated in honor of all the people that have shown me [and others] love and who have been such great support and inspiration, walking with me through all the ups and downs…

Love. It is not an original thought of Christianity of Islam, nor any other religion, but is a common theme across numerous cultures and generations. Since the dawn of history it has been written about and experienced by many, while others have never experienced its warm embrace at all. However, in the city of the former Mission Chapel, just north of its center, is a unique, multicultural population that exhibits the greatest love I have yet witnessed. Here, they do much more than “make lives better.” They go above and beyond in order to breathe new life into their community and into the world.

Physicians, nurses, dentists, PA’s and other healthcare providers show their love for the hurt and the wounded, the acutely sick and the chronically ill. They carefully and compassionately work with trained minds and skilled hands earned through many years sacrificed to textbooks, lectures and practice. Researchers strive to make lives better through basic, translational and clinical research, surrendering endless days and nights at the laboratory bench. Together, these teams aim to be better servants at the bedside and put aside their own lives to mend others’ broken bodies and wounded spirits, making lives higher-quality.

It has been said, “A good teacher is like a candle; it consumes itself to light the way for others.” Likewise, this community’s teachers have dedicated their lives to kindling the minds of students, to lighting a fire in their hearts and to passing on the torch of knowledge and the fiery passion to care for fragile, human lives. Anatomy faculty, who invite you into their office at all hours, patiently draw out every muscle, artery and neuronal pathway until at last, it suddenly makes sense! Histology professors stay by your side until seven in the evening, even when you have suggested they go home to their families for Thanksgiving break, to help you complete your study. Other faculty members go out of their way to personally call you and answer questions or invite you into their homes simply to share stories, laughs and advice, and make you no longer a student, but family. Countless hours, spent sitting with students and doing everything in their power to help them succeed, testify to their sacrifice in the name of making lives brighter.

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Moreover, within this community many leaders exist with a love for venturing out into lesser-known and less-comfortable frontiers, reaching out, touching human lives and inspiring others to follow in their footsteps. These leaders choose to put aside their free weekends and vacations to serve those who often call out but are rarely heard, and to restore hope and the quality of life when both are fading fast. They remember those less fortunate than themselves, often forgotten or ignored, who suffer, bleed and feel lost and alone in their small corners around the globe. Although it seems sometimes that the rest of the world is pitted against them, they take the initiative, fight the odds and overcome all hurdles thrown in their way to bring medical care to places like Haiti, the Dominican Republic, Ethiopia and Nicaragua. Giving themselves unto others and refusing to abandon those in need, they make lives overflow with renewed hope.

Among all of these – physicians, teachers, leaders, and students – are those I admire most of all. Friends. Daily, they put aside their own desires and troubles to focus on soothing souls and restoring faith and determination in you and in all others around them. When the world begins to crash down on you, they rush in and help to ease the burden. They are your partners in the three-legged marathon of medical school that carry you across the finish line when you can no longer stand on your own, celebrate your victory as fervently as if it is theirs, and rejoice in your success. Understanding the dreams that you have but cannot quite reach, they reach out for you, make them attainable, and then share in your happiness. Incredibly, they find time between their own school and work to organize and volunteer in medical missions, care for their patients, teach others to do the same, and still manage to make every successive day seem like the best day of your life. Through all of this, they make lives motivated and inspired!

It is here in San Antonio that you find so many willing to lay down their own lives to make others’ lives better. It is here at UTHSCSA where you can experience unbelievable camaraderie between students, staff and faculty, where you feel such overwhelming inspiration to serve others and where there truly is no greater love.