Poetry by Richard M. Berlin from Practice
Playing God in the Hospital
A fly buzzes
black complaints
at the glass.
Drawn by sunlight
reflected off snow,
it is trapped
without design
to know another way.
My pager calls
code blue.
And for no reason
at all
I lift the window
and blow a little life
back into the world.
Between Reason and Panic
One minute she’s breathing room air
and the next you’re barking orders
at a team wheeling in a crash cart.
You review signs and symptoms you missed,
the rough rhythm of her heart before she coded.
You want to believe your reasoning
was as elegant as a glass filled with cabernet,
and you want to forget the bottle you imagine
rests on a tray table at forty thousand feet,
ready to tumble when the captain announces
the plane is diving for an unscheduled stop.
But I don’t need images of air disasters
to convince you doctors live
somewhere between reason and panic:
just flip open a laryngoscope, visualize
the vocal chords, and forget you have
fifteen seconds to thread in the tube before
the breathless body on the bed turns blue.
A Lobsterman Looks at the Sea
His new hip healed in, we’re working
on a bluff, talking doctors and health care
reform as we shove a new propane tank into place.
A shape on the surface catches his eye:
“Right whale,” he says, but I can only see
endless swells rolling in from the east.
He points out the gradations of gray
and green that mark deep ledge, the tide’s
shape along the islands and rocks,
the whale’s glistening back suddenly in focus.
I react with the same surprise
my patients feel when I observe
what they can’t see—
a sudden shift in gaze, or a crease in a cheek,
understanding how a doctor becomes
like a man who has spent sixty years
on a lobster boat, watching the world
swim fast and shining, right before his eyes.
“Spring and All,” Revisited
—after William Carlos Williams
By the road home from the general hospital
under the surge of the pink
towering clouds drifted from the
southwest—a warm wind. Beyond, the
edge of a mountain pond, redwings
on bulrush calling out their claims,
circle of black water
the veil of thin ice, receding
All along the road, the same reddish
purplish, forked, upstanding twiggy
stuff of bushes you saw years ago
Damp and buzzing, spirited
spring awakens—
Pickerel feed in the shallows,
skunk cabbage on the shore unfolds
brownish-purple and mottled-green,
shell-like and hot
around the knob of tiny flowers,
above them, a great blue
heron, sharply waiting
And I think of you, Doc Williams
stopping by the road to the contagious
hospital that morning, standing in a
cold Jersey wind
before the rush of nurses in starched
uniforms and white-winged
caps, your patients with diseases
I’ll never see, like the ferocious
little girl with diphtheria in “The Use of Force”
Right now I’m a hundred and fifty
miles from the waste of your broad
muddy fields, the end
of a day with dementia and AIDS,
headed home to re-define
the objects in my world—
raw knuckles of red
rhubarb breaking the earth’s clay crust,
sawed-off apple limbs expecting fire,
sticky-swollen horse chestnut buds,
tips sharpened to stingers aimed at the sky,
all around, the grass a rumor of green
Looking Like a God
“What do your patients see when they look at you? They see a God!”
—Robertson Davies
The trouble with looking like a God
becomes clear after we learn to wear
our mask of omnipotence, pretending
to know the answers to questions
as small as a milligram and as large
as death. Joan Osborne wrote a song
about meeting God on the subway,
just another rumpled, gray commuter
without a seat, grasping the overhead rail.
And I believe I met him today
at the general store, seated behind
the counter, sipping coffee, Mozart
on the radio, his expression like mine
when I shuffle papers piled on my desk.
I ask where to find a flyswatter,
but he doesn’t have a clue, and he can’t
tell me when the eggs will be in
or the price of the Times. At peace
with his ignorance, he smiles before he
lifts the paper cup to his lips, the light
in his eyes forgiving my questions,
like a God.
Lazy Birder
Dawn is at five, but I sleep past nine,
not caring if I miss a few warblers
flying home for summer. I was a lazy
med-student, too, hated to see sunrise
before surgery rounds, didn’t choose
to stay awake all night to learn
the differential diagnosis for belly pain.
But I was never lazy with my love
for patients and their stories,
the way they appeared at the ER
without warning, like the pair
of cedar waxwings in my apple trees
suddenly back from the tropics,
elegant black masks, stylish crests,
and that fiery red wing patch
even a lazy birder can’t help but notice.
The Page Turner
stands heron-still, flexed,
fully alert, focused on the music,
her hand a burst of wind
tossing a white sheet.
While the spotlight admires
the soloist’s passion, I love
the page turner even more,
remembering the thrill
of starting at the bottom—
tracking labs, holding retractors,
the lowest rung a badge of honor,
all the confidence earned when
we learn to accept our place.
The Intern’s Spot
We teach every intern how to find
the place where they can lay down
a silver stethoscope and listen
to everything that matters at once—
the heart hammering in its hollow,
air charging the lungs, the bowel’s
borborygmi, all the body’s music
in an instant, as if the intern
had flicked a radio’s power switch,
diagnosis nailed tight at 2 AM
when all anyone wants is the right
answer and a few hours sleep.
There is pleasure for us, too,
the teachers who pass down secrets
our professors shared long ago,
like advice from a loving parent,
like the translation of a sacred text,
or the last sun-bleached page
ripped from a lifeboat’s survival kit.
Takotsubo Cardiomyopathy
I’m reviewing a left ventriculography
from a man with chest pain, MI ruled out,
his wife dead for a post-crash hour.
The scan shows his cardiac apex
bulging with each beat, shaped
like a takotsubo, an octopus trap
a Japanese cardiologist recalled
from his childhood fishing village,
the scan just another broken heart’s
beaten down story of futility and resilience.
I will say, “I am sorry for your loss,”
explain the image, reassure him
his heart muscle will recover in a week,
all the time wishing I could hug him
with eight strong arms instead of two.
Empathy
One more mouth
rimmed in charcoal
after an OD
screams for release,
to let her search
for the man who left her.
No one fakes
an interest—at 4 AM,
it’s too late to care.
She bolts toward the ER door
and we herd her like a cat.
Without medicine
for this kind of pain,
I sit beside her
on the gurney
and we stare
at the first gray edge
of light that separates
mountain from sky.
In the collapse of time,
we breathe in silence,
rhythms synchronized
in twilight sleep.
Half-awake
I touch her arm
and hear myself say,
“It hurts so much
to lose someone you love.”
She pours out a story
sad and familiar
as a country song,
our shapes in the window
reflecting like hope in new light.
I start to pull back,
warm and distant
as the rising sun.