Reflections

What’s lost in the translation from writer to physician? My life as an undergraduate was very different — as a Creative Writing major at the University of Chicago, I read anywhere from Toni Morrison to Rachel Cuskin, pieces on miscarriage masked in metaphor and viscerally vengeful angels. I wrote about ginkgo trees in ancient China, friends going through heartbreak, a baggie of cashews dropped on the job.

Part of the writing process was letting everything give me pause and catch my breath. There’s a story by James Baldwin: in conversation, when a painter told him to look down at a span of water, all he saw at first was water. The painter told him to look again, and suddenly he saw “oil on the water and the city reflected in the puddle.” 

According to Baldwin, this painter “taught [him] how to see, and how to trust what [he] saw. Painters have often taught writers how to see.” Per Baldwin, the crux of writing is not translation but rather apprehension. To skillfully capture the marvel of things, whether by word or color, one must first know to appreciate what they see. 

So I took strongly to the minutiae of the day-to-day; describing small details felt like one of those delightful secret languages from girlhood. Perseverating on the tiny wonderful elements, propping up their likeness in text — it all held a wondrous quality.

Yet I went on to doubt this practice when I first stepped into the anatomy lab. Incoming first-year medical students were given a tour of the lab with donors, and from a cursory glance, it looked like others were managing the walkthrough competently. 

On the other hand, I found myself frozen by the sight of a dissected hand peeking through an unzippered slip. Like a rotor, questions came to mind: what did that hand hold, the morning its owner passed? Did it like to be warmed around a cup of coffee, or in the clasp of a loved one? What dreams had it helped accomplish, and what still lay out of grasp? 

There was no sublimation of apprehension. Seeing death in the flesh for the first time, I could not come to terms with what I was seeing, much less trust and translate. 

Since then, my perspective regarding donors has matured into one of gratitude at the choice they made to support our medical education. This approach brought me peace, allowing me to focus on learning in service to my future patients. 

Now a fourth year medical student, I’ve seen death, centrally and peripherally, far more times. The mother of a son with brain cancer tearfully asked me how she was to lift her son onto his hospice bed; he was so tall and she was not. 

A quiet man at the Emergency Department had liver enzymes higher than any I’d ever seen. He dropped his bright-colored beanie on the way to the bathroom, he chuckled when I handed it to him, and months later he passed away before he could gain admission to a rehabilitation facility. 

Months ago, I broke the news to a patient that she would likely have less than a year left to live, struggling to explain to her in our shared native language that the cancer was not her fault. Each time, I try harder not to focus on the details of what is lost, directing my energy toward what I can do for the patient. 

In skirting those smaller elements, what happens to that reflex of looking intentionally? How does one remember or justify seeking the city’s reflection when their gaze pins the treacherous, uneven street? 

So much of my mind is occupied making sure I’m doing everything possible for the patient from a provider perspective. When I let too many wondrous human details give me pause, it moves me from the state of placidity honed to best support the patient. In that state, I may shed regretful tears after rounds over the kind lilt of the patient’s voice, time that could be spent querying novel palliative treatments from recent literature. 

We all know that the real estate of our schedule and mentation is limited, not to be squandered on things outside the patient’s health. But perhaps the human detail that demands recognition is sometimes oneself. 

There’s a quote by the artist Yoko Ono in her book “Grapefruit,” where she says “when you leave things, you leave your spirit behind too. But if you don’t leave them, you age.” What is to be done when leaving things ages you? 

Writing and reading helps me appreciate the little things in life and foster compassion for its people. And yet so much of medicine, functionally, is stalling death. Life unadulterated is precious but rarely lingered upon. Health for many exists only in the context of illness. 

Indeed, the physician’s task is not to prolongedly marvel at the calluses on your palms; they pinpoint the distributions of your weaknesses and paresthesia, so as to offer the right treatments. And that, to be fair, has always been my life’s calling — the joy of helping a patient in discomfort, in bringing peace of mind or supporting a health goal, is the utmost privilege. But by the end of this journey, I still hope to seek the rainbow sheen in the water, the bridge mirrored on the bay.