When Love Gives Way to Lies
By Janie Cao
Edited by Shaun Webb
One evening on my way back from a hospital shift, I saw a woman staggering along the street. Half walking… half falling… It looked like she was trying to get back home after spending some time at the nearby bar.
I didn’t know how I was supposed to respond as an almost-doctor. But it didn’t feel quite right to just leave her be, especially when she was drunk and in the dark, all alone.
By the time I drove to her, she was already in the parking lot of her apartment complex. I got out anyways, just to say “Hi.”
I remember when she turned and looked at me. She paused. And in those moments of silence, I saw heartache. There was also sadness, anger, and a pain that would leave marks. It didn’t matter that she didn’t know me enough to trust me. There was too much hurt to hide. As I watched her eyes, I remember wanting so much to stop her from feeling that night.
Finally, she chuckled and smiled bitterly. “My husband…” she said. Then she gave me a kiss goodbye.
She never finished her sentence, but I wonder if it had something to do with this: that when a husband hurts his wife, and love gives way to lies, it can simply be called life. I went home after, and cried.
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based on a true story
Smiling Rust
By Janie Cao
Edited by Mary Abramczuk
My grandpa used to be a particular quirky smile.
He was once a certain amused sigh.
But nowadays, at visits I pay
He’s a bag of dust— hidden behind marble and rust.
On those days, I am truly glad
That I believe in more than what passes the eye.
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Photo credit:lavagirl66
The Dying Man
Written by Janie Cao
Edited by Mary Abramczuk
A few years ago, I spent half my day with a dying man. I remember these things about him: his name, his past profession, and that he was dying alone.
I never saw his résumé, the size of his house, or how much money was left in his bank account. I was not curious to know, either. But I bet they seemed significant once upon a time, at a dinner party, maybe. He worked as an engineer.
On that day—the day he died—no one who had cared about those things was there.
I was a stranger, yet I saw his last breaths. It was a curious day.
This world teaches us to do many things. To set goals (S.M.A.R.T ones, in fact) and to meet them. To maximize profit and minimize loss, and to use other people, to our advantage. We learn to build storage houses and efficiently fill them with glorified trash; to talk like we matter, and live like it, too.
Someday, we will all be that dying man. Not fully here, and not quite there; mere wisps of breath. When that day comes, will this world be at your bedside?
Sometimes, I wonder.
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Dedicated to a friend: May you find what you are searching for.
Photo credit: Jörg Lange
With our white coats on we feel the aura of pressure.
Pressure to be professional, to act accordingly.
We walk through the hospital with our heads held high, knowing we have a duty.
Tossing our white coats aside, true personalities shine through.
Most are gleaming of kindness and enthusiasm to learn,
Others are tainted.
These souls strive to reach a level of professionalism behind their white cloak,
but fail to reach expectations while unhidden.
What I see frightens me,
because these individuals will one day be responsible for the lives of others.
They lie to professors to get what they want.
They come to mandatory sessions, only to depart minutes later.
They cheat.
They sell prescription drugs.
They abuse prescription drugs.
They get intimate in the study spaces.
They do it all with a cheerful face.
What I see frightens me,
because I never want to be like them.
What can be done?
I’ve tried to approach them,
it ended friendships.
Administration knows,
yet I see no change.
Perhaps most terrifying,
these individuals exist at all medical schools.
They hide amongst the rest of us,
polluting the image of our profession.
So here I stand, turning a blind eye,
but what can I do?
I can’t change the mindset of others.
I can’t change their actions.
I find a glimmer of light.
It is the shape of a keyhole
and wavers. I crawl
blindly in a sudden desperate desire
to find the lock
and the source of light that is behind it.
The keys in my pocket jangle.
When I am in the hospital I am a stranger
amongst other strangers. Only
because I am wearing a white coat
I am supposed to know where
to go. The hallways bustle with white noise.
I hug myself and move quickly so no one
can see me shaking.
There are several keys in my pocket.
Keys made to open to secure
to keep safe to rescue.
Keys that are purposeful and always always
come with a lock. But there
one key is still being formed
is new and raw
is lockless.
The streets are full of ice
and wherever I step
the dark glimmer cracks.
I feel that if I am not careful
I may miscalculate a step and then
the crystal surface of my confidence
hair-thin
will collapse, will bring me ankle-deep
in barely frozen water rushing unintuitively upwards
rising into my socks past my white coat
soaking my barely used scrubs
ice-water surging towards my knees
femur gasping in its acetabulum
thoracic spine shaking
like a suffocating fish.
I am drowning in the thought that
I am not enough.
The snowbanks drip in the sunlight
and sparkle.
I sit amidst all my past and present identities
and begin to make out a new one ahead.
It is mirrored in the M4s: knowledgeable mature
scruffy in a responsible doctor-like way.
Will I too become like them?
I am not afraid of how I might change but rather
what I will lose after a year in the hospital.
The lock to my growing key remains unknown.
And yet, I sense its existence—
a path of light filtering through the darkness
towards me…
…and you too. Your light
your key
your lock
our journey.
Med17: thank you
for the past two years
and for the years to come.
I have my key in one hand
and your hands in the other
as we search for our hidden locks together. We walk
and look and celebrate when one of us finds a lock that fits
that opens up a bright new world of excitement.
Where will you be?
Where will I? Only time and walking and sharing together will tell.
And the doors one day will open
leading to new rooms and new doors
and our keys will jangle
like the sound of clapping hands
like the sound of many smiles
breaking ice.
I love the way your quadriceps twitch beneath the table,
awakening your patella
and asking your damaged collateral ligaments if they are feeling any stronger today.
And I love how the curvature of your corneas focuses light just before it reaches your retina,
weakening your long-distance sight
and giving me another excuse to come closer.
I love the thickened areas of stratum corneum on your palms,
summoned from layers below each time you reach for a wrench,
and how they grip onto my epidermis each time you reach for my hand.
I love the way you manipulate your vocal cords and adjust the curve of your tongue
to effortlessly transform the air in your lungs into the sweetest “Good morning,”
and how your right lateral incisor proudly stands just a slight bit forward from the rest of your smile,
and how the collection of melanocytic nevi on your skin connects to form a crescent moon,
or an elephant, or train tracks,
depending on how the neurons in my brain direct my imagination that day.
I love the way your closed fist is pressed against the angle of your mandible,
supporting your head and all the vessels that travel through the delicate tunnels within your neck
that converge as they greet the heart I loved from day one.
My sophomore year of college, I had the incredible fortune of taking a course entitled “Literature and Medicine,” taught by a professor who inspired me in more ways than she ever will know. Professor Karen Thornber introduced me to the language of medicine and illness, and her course even now deeply affects the way I perceive the dialogue around, about, and in the clinic.
In particular, after reading Susan Sontag’s Illness as Metaphor and Elaine Scarry’s The Body in Pain as part of the course (both of which I highly recommend—especially Scarry’s work), I was intrigued by the notion of the resistance of physical pain to language. Even when describing the pain of a paper cut, we resort to using metaphors and adjectives, comparing it to other sensations in an effort to fully encompass the experience. Is the paper cut actually “stinging” as a bee would? How would you differentiate describing the pain of a paper cut to a more severe pain? In fact, the adjectives we use to describe pain directly are quite limited. And unlike other sensations that can be carried from one person to another with words, pain is perhaps too heavy, too dense to be transformed into language. Rather, we use cries, moans, and tears to transmit the experience of pain.
Now, more than ever, I find Elaine Scarry’s perspective to be enlightening. For if she is correct in saying that pain is one of the few feelings too big to be molded into language, we can never truly express our pain to others through words. We can never fully describe pain or share it. Pain is therefore deeply isolating.
Three years ago, at the end of my Literature and Medicine course, I decided to delve into the relationship between language and pain by interviewing eleven individuals of different genders, ethnicities, and stages of life. I created a survey for them composed of a total of ten questions that included prompts such as: “Can you describe a physically painful experience?” and “Use one or two words to describe pain.” From these interviews, I produced a poem that attempted to convey the complexity of people’s reactions to and views of pain and illness.
Now, as I read this poem, I think about all the times I’ve asked patients to describe their pain, to rate it in severity from 1 to 10, to talk about its onset and relieving factors. How easy it was for me to write that information down and jump from one differential diagnosis to another without truly understanding their experience. And yet, even if I can’t truly know their pain, at least I can play a role in providing hope for healing and for relief. At least, I can listen and acknowledge the experience of their hurt. That is, to me, one of the greatest honors of being part of the medical profession.
Below is the product of my investigation of the “unsharability” of physical pain and an attempt to better understand how difficult it is to give it a voice (Scarry, The Body in Pain). What is your experience with listening to others try to express their pain in words? Have you found any insight into making it easier for others to talk about their pain? Or do you find that your experiences differ from mine? Feel free to comment or email me at stephanie.wang@jhmi.edu. I would love to hear more!
*Note: Italics indicate quotes taken directly from interviewees. The majority of the content of this poem is based upon the interviews.
Here and There
We alternate between here
and there. You see,
there is a line, crooked and cracked,
an emaciated demarcation,
a highlight in air, breathlessly coughing
and smelling of phlegm.
It would be very painful
to cross it, this line.
Unable to be broken,
we wax in and out.
How to describe such a thing?
Mind-numbing and distracting,
distasteful, unpleasant, depressing and miserable.
Regret, helplessness, extreme
sadness. Sick, like you’re sick.
What pulls us along is an anti-happiness,
it drags us past the line,
it is an anger and an envy, a struggle for God knows how long.
It nests in suicidal thoughts,
family problems, rolled-up eyes, severe
shock, pain.
Pain, it’s like, it’s a…
A scar, a feeling I couldn’t recognize,
a breaking of the arm, a finger cut off,
a scrape of the knee,
a ball to the head, hurt jaw, appendicitis, unbearable
distress, tears, a scream, almost
dying. Well, I don’t like pain.
You can’t think, can’t do anything. Panic,
confusion. There is a leaving behind,
a change of identity—
you lend a hand
because you have to. You are supposed to do that. To help. The pity, the obligatory sad eyes. I wanted to stay away, I was really annoyed at the hack of her cough,
her eyes, feverish. I actually wanted to avoid her, avoid
crossing the line.
The millionth tripping from one side
to another sounds like fish scales,
feels like rain, the starting
and stopping, the forgetting and remembering
of hoarse throat, runny nose, seasonal allergies, itchy and flushed.
Forget about it, concentrate on something else, calm down, try to ignore it for telling people won’t change anything,
screaming and shouting won’t do anything, It’s like no one understands, I deal with it myself, I can kinda block it out.
Everyone does things to alleviate it. I’ll pray, but the only thing that really makes it go away is time.
Halos of stars plaster the sky
and the constellations only appear
when a story is made for them. Let us figure then
a way to line everything up against this thin mark
between two vast caverns. The body flung
from here to there
is yours and mine. As it will always be
your body, our pain.
Our pain, my body.
