The Healing Muse is SUNY Upstate Medical University’s journal of literary and visual arts published annually by the Center for Bioethics and Humanities.

The Center for Bioethics and Humanities at SUNY Upstate, established through the generous support of the Medical Alumni Association, is committed to promoting health care which is patient-centered, compassionate, and just. We accomplish this through educational initiatives in bioethics and the medical humanities, clinical ethics consultation, multidisciplinary research and scholarly writing, and health policy analysis and advocacy.

Cover art: Fiume Arno, Italia by Yolanda Tooley

©2011 SUNY Upstate Medical University

ISSN 1539-6983

ISBN 978-0-9789605-5-1

The Healing Muse

A Journal of Literary and Visual Arts

Advisory Board

Table of Contents

Editor’s Note

This is a book about distance, a fitting concept for a journal devoted to notions and images of healing. The writers and artists in these pages have traveled and crossed wide and disparate distances to reach a place or a measure of acceptance.

We began The Healing Muse to encourage a dialogue among all those engaged in healing: clinicians, patients, caregivers, and friends. Each year we are humbled by the stories sent to us and delighted by the artistry used to convey them. While suffering is as old as humanity, its manifestation can be unique to each age. Our age knows the ravages of cancer, and indeed, in this issue many of our writers meet the challenge of telling the all too familiar tale of its arrival in new and affecting ways.

Illness doesn’t just alter the patient’s life; it causes shifts and upheavals in families and friends, in work routines and personal expectations. In this issue, we meet people struggling and coping with the after effects of electric shock treatments, amniocentesis results, drug dependency, and the death of a loved one. Sometimes they write about their own experiences; sometimes they describe another’s, but in every case they craft an indelible phrase, a unique image that brings the reader as close as possible to what it felt like to hear that diagnosis or live that prognosis. The courage, the wit, and the passion they record linger in the reader’s mind and heart linking us in ways social media can only envy.

I chose “Distance,” one of B.A. St. Andrews’s unpublished poems, to open this issue; eight years after her death, her words remind us that language allows the impossible: “I throw my heart / As if it were a hawk, / into the sky / and bid it fly to you.” Strong hearts beat throughout this issue bearing witness to love and faith, to people dedicated to shepherding loved ones through procedures and side effects, through altered bodies and weary minds. In the poem, the speaker’s heart lands “harmless as a rainbow, / a wish, an autumn leaf / on your outstretched hand.” This image we offer to our readers, in much the same fashion those engaged in healing offer their loved ones and patients.

With such love and confidence we bridge these distances between life as it was and life as it is now.

Deirdre Neilen

Vol. 11, No. 1 (Fall) 2011

Founding Editor

B.A. St. Andrews

(1945-2003)

Distance

B.A. St. Andrews

Across the mountains

your heart sleeps.

This love that tears

my breast can find

no rest inside the mews.

I throw my heart

As if it were a hawk,

into the sky

and bid it fly to you.

Fierce and fleet

its wings beat against

this separating air

to accomplish what it

cannot understand.

Believe that it will

land harmless as a rainbow,

a wish, an autumn leaf

on your outstretched hand.

Cover Artist

I embraced black & white film photography over twenty-five years ago and have never tired of its multifaceted and magical qualities. I sometimes hand color the prints to give them a different air, collage them to express complex ideas, solarize to intensify a dark mood and mood is what drew me in the first place— monochromatic images emanate powerful vibrations. Like a musical score, listen to my photographs, they will sing for you.

Yolanda Tooley 2011

Yolanda Tooley ∼ Street Music 2

Kathleen Gunton ∼ Beyond Obstacles

Poetry and Grace

Bruce Bennett

Poetry is not grace;

it can’t absolve

a sinner, or replace

lost faith, or solve

Conundrums by what’s learned

beyond the grave.

But it is swift, unearned,

and it can save.

Dark and Bright

Bruce Bennett

The dark side of a blessing.

The bright side of a curse.

The substance of what’s missing.

The best in what was worse

Through loss that keeps on giving

and light that gilds despair.

This life beyond that living.

That gift that’s always there.

I Killed a Man with My Own Two Hands

Amy L. Friedman

Dearing Writing Award, Prose

Faculty/Employee Division

I killed a man with my two hands. I didn’t mean to. It was an error—an error made by a human being. I am the human who made that error. This error—my error, cost him his life. When his life ended, mine changed forever. I am trying to survive.

I had given this man my oath to honor his trust in me and in my judgment, in my ability to make the system work on his behalf, in my guarantee to be transparent about the known and unknown as it transpired in his care, and in my promise to skillfully repair his broken anatomy. We had peered into each other’s unclothed souls while he held the hand I purposefully offered in confident closure of my pledge. Today, I still desperately need to believe my long ago promise was offered out of conviction, not arrogance. But this only matters to me, since nothing can change the outcome. I had been wrong. My hands were not good enough on that day. My promise was broken because I broke it.

The moment his vein slipped from my fingers I knew he had died, though we worked for another sixty-eight minutes. The problem I had created simply had no solution. Even now, so many years later, as I once again feel the diaphanous, blue tissue escape, my heart is suddenly racing, my breaths are rapid and shallow, and I can only clearly see these words on the page while everything else has become blurred and sounds have become far away, much like those first seconds when his blood began welling up. Flashbacks don’t come as often these days, but are no less awful when they do. We have probably all wondered how horrible it must have been for the Titanic victims to have foreseen their own drowning deaths in the freezing ocean waters, or for the Challenger astronauts to have known they were falling impossible miles to earth within their intact, yet doomed, capsule. At least the pain and suffering did end for those poor souls. When my fingers failed to control this man’s vessel, I knew instantly that death would happen with that same certainty. And it did. But it was his death, not my own. Fortunately, he did not suffer or have pain because he was appropriately prepared. But others did. And I am one of them. How might one measure whether it is more awful to bear the knowledge of imminent death if it is your own, or it is a death you have caused and must continue trying to personally survive, or why? Regrettably, this was such a moment of inevitability, and it was terrible. But for me it did not stop with his death, because I replay it over and over again. Can I ever give it back? Please? Such knowledge simply escapes description. For a long time, perishing with this man was very inviting. Continued existence did not seem possible.

When time slowed, the faces and voices around me blurred and my team watched every move as I reached deep into the virtual bag of tricks that I already knew to be empty, in contrast to Mary Poppins’ magic carpetbag. Would my colleagues immediately accept that there was no answer in my bag and that we could simply stop our efforts right then? Such a judgment would have seemed so brash, and inappropriate, and ultimately have led to such severe consequences from those unable to grasp the key surgical issues that I chose to continue what I knew to be a charade, even though expensive and valuable resources were expended in doing so. To save face and to avoid answering difficult questions, I stood there hopelessly prolonging the bloodbath. Was my choice wrong or weak or simply practical? To this day, it still seems like the best one to have made, because it allowed my teammates to feel as if they had personally tried desperately to save his life. I cared about them, and do not regret having done so. If I was cowardly in choosing the more traveled road, and being self-protective, forgive me. On this charge, just this one, I have fully forgiven myself.

After thanking everyone for their help, I dragged myself to the scrub sink outside the bloody operating room and saw the stool and clean scrubs my circulating nurse had prepared for me. She knew just how drained I was, how much paperwork and other responsibilities still awaited my attention, and how hard it would be for me to face his family. She gifted me with those two simple acts of kindness and caring at a very tough time. To this day they remain the only words or actions acknowledging that death’s impact on me that I have ever received from any member of a healthcare system. I will always be grateful for her thoughtfulness.

I had to tell his wife. She was devastated, as one would expect. I had to tell my husband. He was supportive, as one would hope. I continue to find solace from my spouse. The man’s spouse cannot say the same. On that night I was inconsolable. I remember the warm bath water my husband used to soothe my shaking limbs, the calming words he spoke, the softness of the cloth on my face, and the way he cradled me to his chest. I could never bear to think about how she made it through that night.

But at work no one ever said a personal word about his death. Most would not look directly at me—or maybe that was just my perception. Without pause, I resumed operating. The case was reviewed through the usual processes. In today’s terminology, it resulted from a human error, not a system error. No checklist or timeout could have prevented the death. At the time, I could not speak about the details of the case with anyone else, because our conversation would have been discoverable. No grief counselor was offered. I could not share my grief. I worried about being sued yet no legal advice was offered. Ultimately, I survived the statute of limitations. That provided a certain type of relief.

His death was shocking, though I am very comfortable with deaths from patient disease, even those occurring intra-operatively. But, this was death caused by me making a technical error that another surgeon might not have made. On that day, I was not a good enough surgeon—a mighty big thorn. Had I been wrong in believing I could safely perform such a procedure? Before his case, I had done so for other patients. After his death, I always feared that very step in each of the cases that unfolded exactly as planned, even with subsequent patients doing well. I always thought of him as my fingers held their tissues tight. But in his case, it was an irretrievable error. I can never forgive myself for that error. Somehow, completely on my own, I needed to understand how to tolerate being imperfect.

We surgeons do not offer each other much comfort or compassion. No department, or hospital or legal group has ever openly arranged for team support that has been apparent to me. Neither have I have ever known another surgeon to candidly seek such solace. Perhaps they do, and I don’t know it. But, why should I not know? Is that appropriate? If I have suffered so greatly in carrying this load, can I truly be alone in such personal sorrow? Surely I am not the only imperfect surgeon, or the only human one. Am I unusually sensitive or insufficiently inured to my own shortcomings? At last, now, I find relief in sharing with you that I still care about a man whom I killed so long ago. It has been an awful secret. Not his death, because that was never hidden. But my response and grief that were so tightly contained, and the disappointment I have in myself. I was provided no outlet for my tears. Surgeons are expected to appear strong and poised. The reality is that I still cry for him. I am crying now.

I killed a man with my two hands. I am only a human being. Part of me died on that day too.

From the Motel Window

Amy Haddad

Brake lights bleed on the gray snow

as cars and buses move in and out

of the teeming parking lot. Healthy and young,

students and coaches trudge to the stadium entrance,

a swim meet, the sign says. Their breath hangs

in misty clouds over their heads.

She stares down from the motel window,

while the tiny phone delivers crushing news.

Every detail of the scene below is burned

in her mind. She hears the words, all bad,

“tests inconclusive,” “multi-system failure,”

“may not survive the night,” but her attention

is on the dirty snow, the cold she cannot feel,

and the silence in the room. She pulls

the curtains behind her and leans closer

to the window looking down, trying to listen.

The grave voice on the phone

asks about next steps. She knows there are none

merely laying the groundwork for death.

She is trapped here, not where she should be.

Forever she will think this is what grief

looks like, frozen on the other side of a transparent

wall where you can see others move and breathe

but you cannot hear what they say or feel

the cold on your face and in your throat.

February Second

Barbara Crooker

The lines in italics are from An Exact Replica of a Figment of my Imagination

by Elizabeth McCracken

A child dies in this book….a baby is stillborn.

The snow is coming down again, the ground pale as Snow White’s skin, and a blood-red cardinal lands on the black lid of the barbecue, where I’ve scattered some seeds. In the book I’m reading, a sentence flies off the page, flaps between my eyes: It’s a happy life, but someone is missing. Someone is always missing. Time stopped forty years ago in the delivery room in those last moments before the nurse couldn’t find the heartbeat. I became a watch that no longer ticks. You cannot change time, but I wish I could be innocent again, believing all stories have happy endings. Closure is bullshit. You never forget, though everyone else does. Here is a birthday unmarked on a calendar, where no cake is baked, no icing piles up in drifts, no candles are wished on. Forever after, I am the bad fairy, the one you don’t want to invite to the christening. This story is so sad that no one remembers it, and I have to tell it again and again. Just like this snow, which keeps stuttering down, trying to write its little white lies, but the black facts refuse to be swaddled; their harsh calls rise up, crows on the snow.

Etiquette for the Very Ill

Johanna Shapiro

Let’s say you get cancer

or have a heart attack

or get hit by a bus

You may think you need a doctor

or a hospital

But what you really need

is a lesson in etiquette

Otherwise you will end up

making a very bad impression

on friends, family,

doctors, nurses,

and complete strangers

so that

while struggling to live

or struggling to die

you will also be universally perceived

as completely lacking

in decorum

Etiquette

That’s right

By getting so sick

you’ve just committed

a serious social faux pas

That’s French for

a fucking bad mistake

from which you will probably

never recover

Ha-ha

(Generally speaking,