© Alexandra Adams
MS3 MD/MPH Candidate
“There must be a better way to make a living than this!”
Silence, except for the persistent heartbeat.
The beat of the ticking time bomb, the dying heart.
It beat uselessly, against flapping intima, seeping vessels
Blood oozing and clotting and weeping everywhere.
An aortic dissection – a dissected body
Laying open, uselessly repaired.
Hand over hand squeezed dripping laps into the cell saver
Warm blood water falling over my student hands while
Seasoned surgeons grafted against a ripping aorta
A stranger, wandering and confused, memory meandering.
Surgeons thought it was hopeless,
Left no other choice.
Intimal flaps flipping across valves, blood pressure bottoming
To the operating room they went
Middle of the night
Sutured in a bright new aorta, came off bypass
Every needle puncture gushed. Coagulating, bleeding.
Defeated, surgeon threw down instruments, stomped from the room, exclaiming.
Resident crossed to other side of the table, handed me the needle.
Fresh flesh, best practice.
Heart still beating, close the chest.
Blood still oozing
First time suturing
First patient dying
Under my hands, must approximate edges
Not too big of a bite now
Family waiting, don’t butcher him
Nurses impatient, huffing and cleaning
Hands shaking, not breathing, patient still dying, patient still bleeding
Don’t breathe; don’t let them see you cry.
First patient dies
While you piece them back together
You feel the heart stop beating.
I held my breath the firt time I read through this poem, and I was unaware of the passage of time. The short lines and short sentences fit the poem so very well. Two stories (maybe more) are woven together. The story of a life that ended too soon and the story of a life of medicine that is just starting. Life and death and the range of raw emotions that go with them, the triumphs and the failures of medicine. This observant young
doctor-in-training has given us an unforgettable glimpse into the making of a physician.