April 2018

Sunlight drifted through the open window and crisp spring air breezed through the screen. A cardinal sat perched on a nearby tree branch, its radiant red feathers artistically contrasting the newborn spring greens, glowing in the April sun. It was the first cardinal spotting of the year. I marveled at the creature as it centrifugally hopped along the branch of the elderly sycamore. Speckled eggs nestled comfortably in a messy swarm of twigs, soon to break with the new life of hatchlings. It paused for a moment, providing me the perfect opportunity to capture the cherry of nature. I zoomed in on the majestic bird and snapped a photo. Too blurry. Stealthily creeping closer to the window for a better vantage point, I focused the camera for the perfect shot with the shallow breaths and the steady aim of a sniper. The bird was in perfect focus, surrounded by vibrant greenery with the sun’s light saturating every last feather and leaf.

My phone rang. 

It flew away. 

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In the black of the night, I was sitting in the driver’s seat, guiding a small sedan along a serpentine one-lane suburban road. A dense fog lingered above the ground. Headlights illuminated the path before me. There were no other vehicles on the road. There was no music playing. The steering wheel, dashboard, center console; all unfamiliar. This wasn’t my car. As I approached a bend, I slowed the vehicle and gazed to my left. There was a small ranch house. Tire marks ripped through the grass. The tracks leading up to a bare coniferous tree split in two. A bouquet of flowers at its base. My attention returned to the empty road as silence floated through the air. I drove further before looking to my left again. Two black horses were walking in the oncoming lane.

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November 2017

You woke up, eyes heavy. Vision blurred. Brain fuzzy. A soul full of laughter and joy.

Look at the clock: jesus christ it’s almost noon. How did you sleep this late, on a couch nonetheless. It’s medical school and you’re tired and on vacation visiting friends. You deserve this. You are at Shaliek’s apartment. Best friend from college. He’s in law school now. Cozied up on the couch with her on the eighth floor of this grungy building. This is exactly where you needed to be. Surrounded by friends and laughter. This is what you’ve been longing for.

You reach around for your phone – the coffee table, between the couch cushions, not there. Slip and wiggle your hand under her. Feel the rubber case and cold glass of the screen. Yank it from beneath her butt. Press that button on the side. So many notifications overlying a background of happy days. Who could want this much from you on a Saturday morning.

Mom: six missed calls, messages saying “call me, please”.

Missed calls from your brothers.

Dozens missed calls from various friends.

What gives.

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June 2022

I’m sorry I didn’t come to your birthday weekend. I’m sorry I bailed on your family’s party in the winter too. I really am sorry. I’d say I’m sorry about not acknowledging you birthday when we originally met, but your birthday is the first of July. An atrocious birthday — we were all just tepid little interns on our first day.

You were an intern doing a transitional year internship before fleeing to greener pastures in the world of anesthesia. Life was.., idk, predetermined. I was an unmatched lost boy trying to figure out what the hell I was going to do with my life. We started intern year in the ICU together. We did our first intubations, lines, etcetera as doctors together. You took a picture to commemorate this. We joked around and wrote our notes together. We’d go on long walks around the hospital on slow afternoons to just goof around and vent and bond. Funny thing is, I scored like fifty points higher than you on Step 1 yet you were the better intern, the better doctor. You made me want to be smarter. I still remember how torn up you were when your thirty-something patient was put on ECMO and eventually died. We did chest compressions and watched people die together.

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October 2017

The short hand rested peacefully over the number one while the long hand climactically crept closer to the twelve. Two laps remained. He watched intently. Before the long hand reached its destination, the doctor said, “good job today, everyone”. On this cue, the students folded their laptop computers and placed them in their bookbags.

It was a Friday. The group, consisting of eight medical students and one physician instructor, had just spent the previous two hours dissecting two clinical cases pertaining to pediatric pathology. One, acute lymphoblastic leukemia. The other, diarrhea. 

He, as always, strategically sat at the head of the table to ensure that no one could see his computer screen. While engaged in the discussion, he also liked to text her under the guise of researching the topic at hand. 

He often complained to her about these group activities. 

As the session was dismissed, everyone packed their bags and engaged in friendly banter – weekend plans, an upcoming quiz, board exams.  They would often stay in the room for five to ten minutes engaged in conversation before trickling out.  He, however, left immediately.  As he always did. 

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July 2022

It’s Friday evening and I’m on a flight to Philadelphia to visit my brother. Cheap Spirit flight for a weekend trip. Window seat and the sun is setting and the sky is so ethereally gorgeous I have to take a picture. Last night you texted me: don’t forget the good stuff if you ever write about me. And now that wifi and cell service are obsolete — well why not.

I called you “day-nuh” and you told me it was pronounced like “Donna”. Might be an Israeli thing. I don’t know. Anyways, it was a Friday night like two months ago. We got cocktails at the Speakeasy lounge I bring all my dates to. To enter you have to punch in a code at a back door of another bar. This gives me like 0.0001 cool points. It’s a charming place with good lighting. Overpriced drinks but what can you do. The lighting though – if someone doesn’t find you attractive in that lighting and setting, they never will.

Sure you were attractive in that lighting but you were also attractive at sunset on the beach, at the pho spot, in the morning, everywhere. You were kind and you made me laugh. Transparent and introspective. It never seemed like an act. You were hot but didn’t have the whole hot girl facade personality. You spoke with this sort of off-kilter cadence and you had these vocal inflections that I thought were so impossibly cute. You asked me questions and genuinely wanted to hear what I had to say. And I wanted to hear what you had to say. On most dates girls give me monologues, trying to be impressive or cool. I have to pinch myself to keep my attention. Not you though.

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September 2021

There’s a quote from 13th century Persian poet, Rumi, that says “respond to every call that excites your spirit”.

Once I was 18 years old. And I was with my friends on a beach off the Gulf of Mexico. The water was calm so we decided to swim out to sand bar a few hundred feet out. Seemed like a fun thing to do and we were able-bodied, athletic kids. We waded through the waves until we could no longer touch the ocean floor then we picked up our feet and started swimming. We swam and we swam. The shore grew further and further. I started to tire. We surmised that we must be close, we just had to swim a little further. I was exhausted. I was struggling. But we were so close. Once we reached that sand bar we could stop treading water and sink our feet into the sand below and stand and have fun and laugh until we were reenergized enough to swim back. But there came a point when we realized we’d gone too far. It was high tide. There was no sandbar. We were so deep into the ocean that the people laying on towels and sitting on beach chairs looked so small. You couldn’t hear them speak or yell or hear their music. I was gasping for air, panting, treading water. There was no moment of rest. All I felt was electric fear. You have to push and swim all the way back. You don’t have a choice. So I stopped thinking about how out of breath I was. About how exhausted I was. Rhythmically with each arm I tore into the water kicking my legs with as much force as they could generate. I saw the shore and kept rowing my arms until it got closer.

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November 2021

You need to budget better. Stop eating out. You need to cook for yourself more. Have you ever tried meal prepping.

Listen, I’m a fantastic cook. And I’m not talking your run-of-mill ‘dude who knows how to cook chicken and rice and boil noodles’. I can cook. This winter on separate occasions I made a seafood and chorizo paella (absolutely splurged on the saffron) and I also cooked a batch of my Italian grandmother’s sauce from scratch. Took me an entire Sunday. I was really proud of that. And I deserved to be — they were damn good. They were both fantastic. I can cook.

And I love cooking. But. Try waking up in complete darkness and being the first car to leave the apartment parking garage in the morning. Getting home from the hospital anywhere between 6 and 9 pm. And only in my wildest fantasy do I get home at 6 pm every day. When I do get home, I am mentally and physically exhausted. Brain feels like applesauce. Hips feel like a twelve year old Labrador. I want to sit and involute on my couch. I don’t want to speak to anyone. I don’t want to text anyone. I want to do something mindless because I spent the entire day thinking and stressing and pacing around under bright fluorescent lights. I want to dissolve. I do not want another task. Another chore. I don’t want to spend any effort preparing a halfway decent meal, cooking it, eating, cleaning the dishes, and so on. Can you imagine. Twelve plus hour day, you cook a good meal, then, my lord – the dishes. Hang me.

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April 2021

The number was typed into my phone, thumb hovering over iPhone call button icon. For at least a minute I was frozen. It was my patient’s daughter. Three in the morning. This is a total DSP, I thought. Parlance for “day shift problem”. Calling families is a total DSP but if someone dies or is actively trying to die you have to do it. Hell. But there was little optimism he’d make it through the night, so. I inhaled deeply and exhaled slowly. Pressed the button. I hoped she wouldn’t answer. Rang a few times and I had that thank god feeling until someone said hello. Shit. I told her I was doctor so and so, a resident at the hospital, working in the intensive care unit. She asked about her father. I had to tell her with muted emotion that he wasn’t going to make it much longer. Do you want us to continue complete resuscitation measures, i asked.

I just, I just need a minute, she said. 

She came back. Explained to me how they thought he was doing better, his kidneys were improving and the numbers indicated his infection was clearing up. He was doing better, she said, voice choked up from the burst of emotion one feels when they hear that someone they’ve known their whole life, someone who made them who they are, is for all measures, gone. And will never come back. 

I got angry. How the hell did anyone paint a picture that he was doing better. Why give this woman and her family that hope. I professionally sucked all of that hope of out them. All I could think to say was I’m sorry. What can you say: I’m sorry. 

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April 2022

When does it get better, she asks. 

I don’t know. I mean, a switch doesn’t flip one day. When someone you love dies you don’t hear a eulogy and think to yourself, gosh, it all makes sense now. You don’t say a prayer and find some sort of divine comfort. Nothing helps. It sucks. Nothing is going to happen for you. Life isn’t a Disney movie. Shitty things happen. And nothing will ever convince you it doesn’t suck. You are doomed. Doomed to carry it with you until other things and people start occupying your heart. A tree dies and a new one doesn’t spring up from the ashes in the morning.

Still, you can be sad and angry all you want. You deserve to be. You should be. This whole thing sucks. So. Obsessively ruminate over why and what you could have done differently until your brain breaks. Mentally rehearse conversations you’ll never have with people who don’t care you exist. Scream into the void. Drive yourself insane. Go crazy.  For as long as you want. For as long as you need. 

But you have realize. You’ll get off work one day mad about something innate to residency while someone in your dream program is feeling the exact same. You’ll despair over some program that didn’t want you. After two years you’d be counting down the days until you could leave anyways. No matter what you’ll be physically exhausted from long hours in a gloomy hospital. 

You can shake your fist at the sky but it’s still blue and there isn’t a damn thing you can do about it. You can scream and curse but beautiful songs and melodies will forever drown you out. One day you decide to go for a walk with good music in your ears and the sun is shining and a wide-eyed puppy scampers at your feet and jumps on your knee, its tail wagging all joyous and such. I promise you, that dog doesn’t give a damn about the match or your residency. The sun sets and it looks like bob ross himself painted the sky and it’s still picturesque, despite you. Go ahead and try. But you can’t escape the small pleasures. The beauty of it all. The watermelon on a summer day; it’s still sweet. Your mom is still excited to hear your voice on the phone. A baby smiles at you in line at the grocery store. You laugh with new friends. Life is still happening.

All is not lost.

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