The Journal of Imaginary Diseases: The Blind Spot

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By Alex Pozdnyakov (c2020). Photograph by Stefano Pollio (@stefanopollio).

Mr… uhmmm? Sorry, can’t recall your name, yes you, sir…

Finally, he came out of his office and asked me to come in. For the past four hours, I’ve been waiting, seeing people coming in and coming out of the room at the end of the hallway. Dr. Wang — smooth white coat, stethoscope gently wrapping his neck, probably just fresh out residency, looks like a stock photo of a doctor on Google Images.

I apologize, you checked in at 9 and I was supposed to have an appointment with you at 9:30, however for some strange reason, it wasn’t logged in the system.

That’s fine.

After waiting for three hours, I went down to the receptionist and checked if anything was wrong. She didn’t recognize me at first though

Please take a seat, Mr… uhm…

While staring into the screen of a Macbook, Dr. Wang slowly began to approach the issue, hesitant like a chilly swimmer checking with his foot the cold chlorinated water of the pool:

So, according to the records here, we met a month ago and you came in with complaints about paleness of your skin and ache in the chest. After referring you to a cardiologist, I had a second thought that came to my mind, which was a suspicion of a very rare disease, something more than a trivial cardiovascular issue. Remember you mentioned that on that day someone nearly ran you over at the hospital parking lot?

In fact, it happened to me again this time, but I didn’t tell it to Dr. Wang. In fact, it happened to me nearly ten times during the past month.

…and then, someone knocked you over in the corridor, right in front of me? Isn’t it strange, right? People just don’t seem to notice you, Mr…?

Whatever. Mr. Whatever.

Right, right.

Dr. Wang’s eyes, protected from the outside world with thick glasses, didn’t look at me, their pupils just skimming through some notes on computer, swinging like a pendulum. He took a pause for a while:

Ah? What was I talking about? Oh, right… Collective agnosia, also commonly known as the invisible man syndrome. It’s a very curious condition that we still fail to fully understand and as you will see soon, there is a reason why the literature on this condition is very scarce. This disease starts out in advanced age and progresses slowly — your skin becomes paler and more translucent, your voice tones down; at the more advanced stages, you move less, up until the point where your lungs don’t want to take in any air anymore. But those symptoms aren’t the worst ones. The tricky part is that as you decay into emptiness, people also stop recognizing and noticing you, hence the name — collective agnosia, when society ceases to acknowledge your existence. I find this particular symptom very fascinating — something is wrong not with the patient, but with all other “normal” people. I can’t recall but I think there’s one study group in Germany that researched any deviations in the brains of people, who failed to recognize a patient but their fMRI activity was perfectly normal, except the time when they interacted with the affected patient — the temporal lobe of “normal people” simply did not react. In other words, the “normal people” just gazed but didn’t see the patient…

Sorry to interrupt, Dr. Wang, but is there anything I could do?

…there will be periods of remission, when you will be met with greater recognition but those periods are very transient. Different people will have different degrees of recognizing you, it mostly correlates with the depth of interpersonal relationship but,eventually, you will be met with absolute denial from everyone. You will be completely invisible and nobody is going to care what happened to you…

Sorry, but Dr. Wang! What kind of treatment is offered?

…in fact, it is suspected that a lot of patients with this disease die from being hit on the road or stamped to death but, as you realize, nobody knows what happens to their bodies. If you think about it, there could be dozens of dead bodies lying around, but nobody is able to detect them…

Uhm, Dr. Wang…

…It’s definitely somewhat amusing and curious. We don’t even know, how widespread is this disease? How many people die from it? Is it dozens? Thousands? Millions? Haha, that would be funny but of course not…

I’m sorry, Dr. Wang…

-…it’s just at the order of statistical error…

I just remained silent.

…so, I’m very sorry to deliver such news. You’re like 60, or 70 now? It will end soon, don’t worry. I would estimate you have one year left but we don’t know. We know nothing. Collective agnosia. Sorry.

Dr. Wang, do you hear me? Go screw yourself and enjoy it.

Thanks, you too. Have a nice day – bye.

I didn’t mean to be rude. Just wanted to test my hypothesis, which turned out to be correct.

I sat on the chair, while Dr. Wang continued browsing computer, without knowing that I was still there.

Incognito browse tab: “How long can you keep a baby in the freezer reddit thread

What a beautiful world…

****
I left Dr. Wang’s office after a massive college soccer team captain sat on me for 20 minutes, narrating how he contracted gonnorrhea — I didn’t realize that I had to get out of the chair as soon as he came into the office. It seemed like today was a particularly bad episode of collective agnosia.

I still had to digest all the news from Dr. Wang. I suspected this disease around a month ago — it came up as a random suggestion on WebMD, as I hesitantly confessed my unusual symptoms to Google. Well, good thing is that collective agnosia does not spread onto my car so at least I can drive somewhat safely without people hitting me. But then, is it so? What if it exacerbates? Anyway, as I’m standing in the empty hospital elevator, I’m struck by the realization that in few seconds, a wave of people will rush into the elevator and potentially walk over me, as I’m absolutely invisible to them.

Damn, I can’t get off at the main floor, I’ll be stamped to death. I quickly press the button of the second floor, just before the elevator passes it. After getting out on the relatively deserted second floor, I take the back stairs to get to the first floor.

What am I going to do now with my life? No more socialization. Not that I had much socialization at this senior age. No more meaningful conversations. No more human touch. No more going out at crowded places. No more getting lost in the living mass of humans. Solitude and seclusion. That’s it.

Crap, I still need to cross the crowded lobby to get outside.

On the other hand, there are some benefits. I can go and venture to all kind of different places without being noticed, without being heard or seen. Kinda sucks that at this old age I’m not into exploring anymore. But then, it’s a lifetime opportunity…

Don’t get distracted! Watch out! Someone just smashed into your shoulder and walked on by.

Okay, okay, Dr. Wang said there are going to be remissions, maybe it’s just a bad day today. Here’s the door…

Oh no, there’s a guy round the corner, he just keeps walking…

I get hit by the door and fall, losing control over my body. Horrible pain in the head and the guy just stepped on my leg, crushing the bone. I’m bleeding and I’m right at the middle of the entrance and it is guaranteed that nobody will notice me. This is it. Time to give up.

I crawl in panic away from the entrance and start yelling for help but it seems useless. The physical reality is just viscous and impermeable. I might just as well lose consciousness and…

Sneakers. Army boots in mud. Some hipster gym shoes. All the different legs, swinging like pendulums. Beautiful, thin, open legs, smooth skin, perfectly shaven, framed by high heels at the bottom. Is it going to be the last thing I see in my life?

I grab one of the legs by the ankle and pull it towards my face. I have no choice and pierce my scarce remaining teeth into her Achilles tendon. It’s excruciating pain but it is the only chance I can get noticed by this cold indifferent universe. I hear a scream, and I bite the muscle instead with all the force I have. My brittle teeth start cracking and I see them falling, carried away by streams of our blood.

Paramedics rushing, now they can step over my face, turn it into slush that nobody will bother to clean off the floor. At least I tried.

Last thing I hear is Dr. Wang’s voice:

Wait, wait, it’s that guy with collective agnosia…

***

I ended up locked inside some room in the geriatrics ward. There’s a sign on the door that is supposed to remind everyone that I’m still there and that I’m very hard to notice, due to collective agnosia, yet it doesn’t seem to help much — nobody opened the door for the last two days and, I guess, soon I will starve to death, which isn’t the worst thing that could happen

And here is our very special drama queen who got admitted in a very spectacular way. If you want to know the story, ask the nurse if she remembers it.

Chuckling, Dr. Stakanov entered into the room, escorted by two residents, 1 man and 1 woman:

Amir, Cathie, do you even see our patient? If you try looking into the right corner of the room, near the window, you might discern his contours.

In fact, I was standing at the opposite corner, but, hey, at least he acknowledged my existence.

Huh? — Dr. Amir Al-Boustan took out his iPhone and started browsing it.

It’s okay, at this point it is estimated that less than 1% of people can be consciously aware of the patient’s existence. What a spectacular clinical case, isn’t it? I once went to a conference on collective agnosia that took place in Baden Baden and there are so many different theories on the disease’s pathology. We are even confused about classification. The majority of experts place it into the category of either neurological or psychiatric disorders but there is a curious paper that claims that we ignore the patient because of some abnormal pheromones released due to metabolic disruptions…

Dr. Cathy Suarez is also on her iPhone, searching things up pubmed and interjecting from time to time:

You mean the article by Park Dae-Jung, Kunt Tim et al., 2015, published in Journal of Biochem…

Dr. Stakanov continues, staring into the beautiful sunset over the downtown skyline:

Oh my, you even cite in the APA format, take it easy, girl. Whatever, back to collective agnosia — I once even submitted a grant to study collective agnosia but never heard back regarding it. Anyway, I specialize mostly in Alzheimer’s so it’s kind of out of my field. Speaking of the lady with AD that used to be next door, Ms. Goldfarb… What  mayhem… They transferred her to ICU with pneumonia a week ago, intubation, all that jazz until she died yesterday. Gentle death, as expected, nothing you can do with late stage dementia like this. They declared her brain-dead, but then, her Jewish Hasidic family comes and refuses to accept her death… oh yeah, by the way, they have three lawyers in that family. Of course, brain-dead is legally dead, but her attending, Dr. Ramayana, just can’t make the final decisive step and walks around the hospital avoiding her…

All three of them are about to head out, and I will need to make sure they forget to lock the door. Dr. Amir Al-Boustan is completely consumed by his phone. I look over his shoulder and it turns out he is searching up a “where to buy burner phone canada”. Anyway, he reminds me of a tired boxer and I punch him hard in his nose, out of idleness and boredom.

Hey, Amir, you’ve got a nosebleed.

Oh, shoot!

I know the residency workload is crazy, but you’ll be done in two-three years, so keep it up, man. Go grab some tissues, we will wait for you outside.

I hold the door open, and the white-coated folks don’t offer much resistance. They leave and the door remains unlocked.

Now I can go steal some food from the cafeteria.

***

When I come back, I see that the sign on the door is removed and a large bodyied end-stage cirrhosis patient is lying on my bed, surrounded by unread magazines, unfinished pill bottles, and unfulfilled dreams.

No way I could do anything, it would be impossible to move this standing rock, it’s pointless as Sisyphus’ work. I am leaving, I am done.

It’s already late into the evening, and, fortunately, the hospital is quite empty. I don’t know whether I should go outside, just to be finally hit by a car or a cyclist.

I just sit there on the floor, at the far end of the hallway. No grudge against people who ignore my existence due to collective agnosia. No thoughts, no feelings, nothing whatsoever. Just pure emptiness, vanishing into the thin air, becoming a plastic bag, carried away by the chaotic winds.

As Dr. Wang said, it’s probably one of the late stages of my condition. Maybe the end is near. The whole life of perceptual fluctuations just mutes into tranquil equilibrium. Death is the final point of homeostasis.

In the final and brief remission, I get an idea.

I just need to make it to the floor below and find the brain dead lady, who indifferently keeps on sucking the air from tubes.

A Match

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By Nikki Reklitis (c2020). Photograph by Soroush Karimi (@soroushkarimi).

“Please be aware that most stem cell donors and patients never meet.”

     The Guide for Potential Unrelated Donors, OneMatch Stem Cell and Marrow Network. Canadian Blood Services.

     There’s a message on the machine when I get home from work. A red and flashing number 1. A rainy Thursday in May. I slide the balcony door open to cool, wet air. Still in my work clothes, hospital dress code. I take a deep breath. Across the apartment building’s parking lot, on the front lawn of Canterbury High School, the maples are wet and shining.

     The starburst of self-doubt explodes inside my chest. Again. Can I manage this new job? Do it well? Surely the Director doesn’t like me. The heat radiates to my throat. My stomach fills with churning, unfamiliar waters. A wave of awkward and then of clumsy and then of side-glances from strangers. Undertows of I don’t know what I’m talking about. I’m nauseous.

     In my galley kitchen, I poach an egg. A bowl of chick peas. Golden olive oil. Fresh parsley, chopped. I stand at the counter and eat. I imagine my two year old at Daddy’s for supper. Is she watching TV?  What did he cook for her? Did he help her wash her hands?

     We’ve lived in this apartment for a year. I like that she visits Daddy, but prefer her here. Where I can see her. Where I can pull her onto my lap, twirl her curly hair around a finger, kiss her neck. I lull myself with a song, a ballad, an old cantada about home. Here we are. There is no more pleading or wondering. The missed calls, the closed doors, the silence, the brick wall, the tension in his face: all behind us. I take a sip of Shiraz.

     The message. I listen to it twice, straining to hear. A young man speaks English from somewhere far away. Static. Dead air. The March of Dimes? Scotia Bank? I can’t make out the words. I try again. I jot down a 1-800 number and a question mark. I leave the note on the dining room table. I delete the message.

     I slip off my tweed pants, my pleated blouse. The sound of rushing bath water is like pulling curtains on a noonday sun. I’ve saved this jasmine blossom bath bomb since the weekend. Since dishes and laundry and swimming lessons and story time. I float and suspend in the soaker tub. I watch the green and pink tornado swirl above my breasts. It smells like honey, like mimosa.

     I close my eyes. I don’t know it yet but that blinking symbol, that distorted voice played back: this is the first sign of you. A far-away, barely audible bell sound. I don’t know it yet but there it is, your beating heart.

     I get the call that September, on a bright Saturday afternoon. I sit at the Wild Oat, a cafe in the Glebe. I watch people walking by: running strollers, re-usable shopping bags, light jackets. I shake cinnamon over my latte. I wait for a pedicure appointment at a spa nearby. I have time to take the call. I’m admiring the archway to The Fourth Avenue Baptist Church across the street when my mobile rings.

     A representative from the OneMatch Stem Cell and Marrow Network. A cheek swab I sealed in a Ziplock bag years ago is a match. The closest match among others. A possibly perfect match.

     You need a stem cell transplant. Likely bone marrow, maybe peripheral blood. More tests to be run. Tests for infectious diseases, confirmatory typing.

     I take a sip from my cup.

     A case manager from the Canadian Blood Services office in Ottawa will contact me for an information session, an interview, further assessment. She will coordinate a work-up, more blood work, a physical exam, and an ECG.

     Do I wish to proceed?

I read the sign across the street:
Sunday Service.
10:00 am.
Sermon: Give It Away!
All Are Welcome.

     I see a baby in a stroller with a string of brightly painted wood shapes strung around its neck. A rubber soother in its mouth.

     I hear the clink of forks on dishes, running water.

     I lick sugar off of my top lip.

     “Yes,” I manage. “I would like to proceed”

     I finish the call and for the first time, I come to know of you. You spring forward. I sit in the cafe and imagine you. There you are, hazy but materializing on the bench across the street, by the bus stop. Waiting. Waiting for me to finish the call. Waiting while I gather my bag. Waiting while I get my coat on.

     An hour later, on a leather throne high up, under soft lights, there are hushed voices. My feet are bare and soaking in a milky, oily bath. I talk to the woman sitting in front of me about new jobs, her dog, my daughter, break-ups, the weather.

     I read and re-read the same sentence in a novel, over again. I pick a polish the colour of Abrusco grapes, of a Cabernet franc, of blood. I close my eyes and invent you. My match. My best match. You’re a formation at this point. An outline. A frame. I can’t make out your details. You’re a smoky, opaque grey.

     I wonder:

               Where do you live?

               What part of the world?

               What do you do on a Saturday afternoon?

               What do you take in your coffee?

               Who are you?

               Person waiting.

     One month later, I move into my new home. When I first saw it with the realtor, empty and sparkling, it was like I’d been there before. I fell in love with the crab apple tree in the front yard, with the fireplace, the lush front garden, the bay window, the space on the hardwood floor for my daughter to fill.

     On a weekend that October, I pack up our belongings. Weeks have passed since the call in the cafe. As I lift boxes I wonder if there is a mistake, a mismatch, a complication. My family members help me unpack dishes, sweep floors, make food. My daughter tantrums. I fill out forms.

     The very next day, a busy Monday at work, the Ottawa office calls. The date of the donation is set. A bone marrow extraction. December 18, 2014. A Thursday. Day surgery.

     The end of this call is a careful review of a form that will be couriered to me in the next 24 hours. Once signed, a commitment to donate. I learn that it will trigger a series of procedures for you. That you will undergo high-dose chemotherapy and/or radiation in preparation to receive my stem cells. I understand that if I change my mind past this point, without a transplant, you will not survive.

     The call ends. I return to my work without hesitation. I don’t waver or pause. I’m focused, energized. I lock my office door and stop to think of you.

     I consider:

               What did your first home look like?

               Do you live there still?

               Who lives there with you?

               Who do you think about before you fall asleep at night?

On my drive home, the doubts in my mind are many: how I’m doing as a parent, can I write anything good, my job security, whether I’ll move on to love someone else. They are not about you or about this. Of this I’m certain. It’s the one thing I know I can do.

     On December 12th, in the early morning, I visit the Pre-Admission Unit at the General hospital for pre-operative teaching and an anesthesia assessment. The anesthesia resident is tall and thick and handsome with curly dark brown hair, sea-blue eyes and a Scottish accent.  I want to pet and curl up into his shawl cardigan sweater, an oatmeal-coloured wool with suede elbow patches. I want to fall back into the water of his warm voice, his gentle encouraging tones. I ask him if he’ll be attending my surgery, not only because he is beautiful but because he is funny and kind.

     After an exam he tells me that I have a “reassuring airway”. I’m flattered. As if he’s told me I’m ravishing, sexy, a fox.

     “Thank you,” I say.

     I’m happy he’s happy. For the first time in years I feel that dancer twirl and somersault on my chest. That familiar choreography, those footprints. The music in my ears turns up a tiny bit: a sultry tango, a funky bass, even some R & B.

     I tuck my hair behind an ear as he marvels at the amount of marrow that will be extracted: one litre. A Pepsi bottle. He asks me if I’m aware of this, if it’s something I’ve consented to.

     “Mmm, hmm,” I say.

     The dancer undulates down my belly and on to my lap. I fold my hands there and focus. I keep myself from smiling, relieved to be flush again, after all this time. I’m happy about this quickening, a desire still alive and crackling in my fingers, down my legs.

     The assessment is complete and I have an hour before work starts. I stop at the Second Cup cafe at the bottom of the escalators. I order a cappuccino and flirt with the young barista. I sit at a table and linger over the cloudy creaminess. The line-up around me grows: white coats, warm jackets, scrubs and suits. I wonder if you’re one of them, looking at your phone, ordering a drink, waiting for a friend. I project you into the chair across from mine: female with straight brown hair. Your blazer is draped over your shoulders. Your fingers are curled around your cup, nails shaped and coloured perfectly in a mulberry hue.  My imaginary friend.

In my mind’s eye, I ask you,

     Are you dating anyone?

     How do you meet new people?

     Ever go online?

     Do you prefer it when things move fast? or slow?

     Think you ever would again?

     It’s five minutes past eight in the morning on the day of the surgery. I’m wheeled on a gurney to the hallway outside the operating room. I’m shaky. The porter leaves me there. A nurse from the BMT team comes down the hall to greet me. She asks a few final questions. A repeat of the past assessments already conducted. Questions about risky behaviour and infectious disease. This time there is a new and unexpected query.

     “Have you ever had sex with someone from Africa?”

     I pause. “Yes.” My daughter’s father, although 22 years in Canada, is of Gabonese origin. Africa.

     She stops the interview, looks down at her clipboard. I swallow, worried that this is grounds to cancel the extraction. Worried that you won’t survive. We are both confused.

     “Have you not been asked this question before?”

     “No.”

     We continue. With her clipboard under an arm she pushes me through the theatre doors.

     Have you ever had sex with someone from Africa?

     I close my eyes against the bright overhead lights and there he is. There he still is. There are his eyes, large and round. His lips. The crease in his brow. His shapely arms. His muscular thighs in soccer shorts. His smile. There it is. It’s beautiful.

     I am on my back on the operating table. To my right is a nurse. His eyes are green and bright over his mask. He wears a colourful cap over his hair. He speaks to me directly, touches my arm, tells me about what’s next. Directly in front of me are three other nurses. They are silent, masked, far back. I don’t know why they are there. To my left, behind me, is the anesthesiologist and his resident. They introduce themselves. They set up an IV in my left arm and I start to sing Born To Run. To myself, silently. Bruce Springsteen. I know all the words.

     To my right, there are two surgeons that I recognize from past clinic appointments. I can tell them apart despite their gowns and masks. One has smiling eyes. One is taller. The taller one speaks. An introduction, an opening. He reviews the procedure about to take place. I take a deep breath. He is like a conductor, his orchestra behind him. He is like a football coach introducing an important play, a strategy. Everyone there pays careful attention. That’s when I zone him out.

     I take a deep breath and there is my daughter. I project her onto the ceiling above me. There she is in her navy blue bathing suit. A one-piece with white polka dots. Her lustrous hair has expanded, engorged into a wet crown of curls. She’s wearing a royal blue life jacket. Her thin and muscular legs. Barefoot. She’s standing on a mini diving board. Her swimming instructor Jeff is treading water in the pool beneath her, ready to catch her. She looks up at me in the stands and waves, smiling. “Hi Mommy! Look at me!” The oxygen mask is on my face. The nurse counts my breaths. I close my eyes. She jumps in the water.

     I open my eyes in the recovery room and hear a nurse to my left telling a story. Her daughter has a Christmas concert this afternoon, at school. She’s arranged with the clinical lead to end her shift early so that she can be there for it, hear her daughter sing, take pictures.

     I find it difficult to talk, to smile just a bit, to communicate with her. I try to use my eyes, my hands. Everything is heavy, frozen. Something the weight of a basket of pears is sitting on my chest. I don’t like it. It feels like I can’t breathe. But I can. I know I can. So I focus on that: my breath and her story about the Christmas concert. I ask her about her daughter and try to tell her about mine. This is the first time I’ve found it difficult to smile, to nod, to make eye contact, to connect with someone I want to connect with. It’s like I’m under water. A wall of thick water between her and I.

     It’s the most afraid I’ve been this day. The effects of the anesthesia have tricked me. I believe I can’t breath, can’t talk, won’t make it back out to my daughter. I want to push through. But instead I focus on my breath and think of you, waiting. Somewhere.

     My father drives me home from the hospital. He is 79 and strong, tenacious, a bull. He stays and waits for me that day; he doesn’t eat lunch, he pushes me out to the car in a wheelchair.

     I recover in my parent’s home for longer than I expect to. Twenty-four hours turns into three days. My daughter stays with Daddy.

     My mother prepares yourvalakia, a traditional Greek meatball soup in a white lemon-egg broth. It’s hearty and fragrant. The iron-rich ground meat is held together with puffy white rice. There are flakes of parsley. I dip a hunk of baguette. I eat two bowls.

     I watch Greek satellite TV: black and white movies filled with music, Christmas cooking specials, bright and loud game shows, the news.

     There’s blood on the beige and brown velour couch I’m lying on. The one that has sat in the family room since I was in high school. I’m surprised to find the incisions on my lower back are bleeding. I’m embarrassed.

     I lie down on my front in a bedroom upstairs. My father removes my bandages, cleans the incisions, and applies fresh dressings. My father, almost 80, with a bottle of rubbing alcohol and cotton batten. My mother stands behind him with a towel, looking over his shoulder. I put my head down onto my arms and close my eyes. I think to myself: this is the last time that I’ll need them in this way. The last time I’ll be in their care recovering, dependent.

     I take my pain medication. Before I fall asleep in the twin bed, a small pull-string lamp to my side, I wonder about you: who is caring for you, who your parents are, if they are with you, standing over your bed, watching you sleep.

     On Christmas Day I spend four hours with my family. We eat around two rectangular tables covered in red and green cloth poinsettias. There are green salads with dried cranberries, lemon-roasted potatoes with oregano, a turkey. There is a large tray of moussaka, a bowl of rice pilau and platters of spanakopita and tiropita made by hand.

     We drink white wine and Dr Seuss’ How The Grinch Stole Christmas plays on the widescreen TV. My daughter runs around from chair to chair and lands on my brother-in-law Rocco’s lap. Her favourite, her crush. My father is jealous. There is Stella, my sister’s miniature schnauzer. My daughter eats feta cheese and Kalamata olives and bread rolls and nothing more.

     My nephew, visiting from BC, gets up for seconds and there is an empty chair. I imagine you there with us, sitting, listening to my brother talk about work, watching my sister make espresso at the stove in a Bialetti, meeting my niece’s teacup poodle.

     Later, you would join in on our Secret Santa gift exchange. You might sit beside my father and listen to stories about his doctor appointments. You would surely enjoy the dessert table. Maybe you wouldn’t like the noise, the children, the dogs, the loud voices, the Christmas movies in the backdrop. Or maybe you would.

     I dream. You and I sit across from each other at a walnut-brown harvest table. Everything around us is covered in snow, except the water. The Ottawa River flows beside us. We sit under a weeping willow tree near Mooney’s Bay beach. It’s winter but we are not cold. There are platters and plates of food. A feast. There is a mulberry coloured wine in a voluptuous crystal decanter. Two full and fat wine goblets. White linen napkins.

     The dream version of you is radiant, resplendent. You have thick, dark brown hair, a deep maroon pea coat. You use your hands when you speak, gesturing. You tell me stories about home, your family, the sea. We eat roasted eggplant and dip chunks of homemade bread into saucers of olive oil, hummus, baba ganoush.

     You pour us sparkling water and ask me about love, art, music. The dream-you has dark brown almond-shaped eyes, skin the colour of toffee. You are taller than I am, with long elegant fingers. Your legs are crossed under the table.

     We stab heavy silver forks into large bowls of green salad: mesclun, arugula, parsley, red cabbage, slices of leek and raspberries. We share a platter of cheeses, fat purple grapes and walnut halves. We lick our fingers and watch the ducks glide by on the still un-frozen water. The snow falls off the willow onto the table from time to time.

     I tell you stories about work, a crush, my ex. You suck on the pit of an olive and tell me about your mother, the neighbour you admire secretly, your dog.

     We watch kayaks glide along the river behind you. There is no one in them.

     We raise our glasses for a toast:

               To our health!

               Stin ygeia mas!

               Sante!

               To life.

     We pass between us a bowl of strawberries and wild blueberries and spoon clouds of whip cream from a frosted glass bowl. We eat the berries with our fingers. We look up at the Canada geese flying overhead and I ask you:

     “Was it painful? The transplant.”

     “No,” you reassure me.

     You pick a blueberry off of my plate.

     “Did it hurt?” you ask me. “The extraction.”

     “No!” I wipe a crumb off the table. “That was nothing.”

     The harder part was knowing but not knowing. The grey spot. The black hole. The soundproof wall of anonymity. The shapeless shape you took.

     “I wondered if you were OK,” I tell you in this dream. “If you were cold, alone, comforted or sad.”

     You smile and squeeze my hand near the end of this dream. You pour me another glass of wine. We sit and drink in silence as night falls on the water.

     At my parent’s home on New Year’s Day we cut into a vasilopita. A traditional New Year’s cake commemorating St Basil, the shape of a full moon. It’s a buttery, sweet white cake, orange-scented and dusted with powdered sugar.

     A slice is cut for every member of the family with a long serrated knife. There is a coin somewhere inside, a shiny piece of good fortune, ready to surprise us. To fill someone’s new year with luck and brightness.

     I pour myself a cup of coffee and break my slice in two. There it is. A silver coin wrapped in wax paper. It’s mine. I’m the lucky one. I smile and call out to my daughter.

Later at home, I wrap up the coin and my piece of vasilopita in layers of cellophane and foil. I put it in the freezer and we head upstairs for bath time.

     Two months later, on a cold and grey morning in March, a reminder pops up on the computer at work. I close my office door and call the Case Manager at Canadian Blood Services. I’m permitted to inquire about your well being. She answers the call on the third ring and I take a deep breath. You lived. The transplant itself was successful, she said.You lived for three months post-transplant, until recently, when your disease took you. You didn’t survive. I end the call and there is numbness. A tingling in my hands and feet. A stillness.

     That evening at home, at supper time, before I pick up my daughter, I pull out the piece of vasilopita and warm it in the oven. I set the table with some butter, a silver knife with a ceramic blue handle, two of my favourite dessert plates and mugs for tea. Two napkins.

     The piece is already in two. I eat my half of the sweet slice and wish you luck. I sip my black tea and toast the year ahead, grateful. For you, for the day, for my daughter. I drop a golden cube of sugar into the cup and imagine you, in the airy space. On the other side of the thin wall. I’m sorry. As I finish my slice, I’m sorry. As I sip the last sip I imagine you in the chair beside me: clear, defined, solid. There you are: you are you, you are me, you are anyone, you are everyone.

Dr.

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Written by Marina Wang (c2018). Photo by Terry Thach (c2019).

He called me “Dr.” I am no doctor. Did he not hear me introduce myself as just a medical student? I open his chart full of tabs and labels but to me it is an angry mess of half-filled forms. Drowning under drug names, I barely have the sense to register that his medication list is empty. In his EMR I am confronted by bricks of consult notes and attacked by numbers that jest at my incomprehension. I get lost within wards in the east that are labelled “South” and lock myself into a wandering-patient hallway.

He called me “Dr.” I am the furthest thing from being a doctor. Awkward silence fills the room as I struggle to remember my history questions. OPQRST. Options, plan, quarantine, reflux, steroids, treatment? “Is there pain?” I ask him as he wilts away hyperventilating and near tears. No shit: there’s pain. Good. No actually: Bad. I run out of questions, certain that I’ve forgotten all the important ones. Clumsy and sweaty, I pull out my stethoscope to save myself. I hear his heartbeat… or is it my own?

He called me “Dr.” I cannot be his doctor. I look on helplessly as he laments his story of the frightening anguish he feels. Why does it hurt so? I don’t know. I am useless- wishing I can just hold this poor soul and bless away this undiagnosed monster. But I have to listen to his lungs now. It’s part of the exam.. My eyes water as I help lift him up from the bed, trying not to let his wince bother me. No crackles or wheeze, normal bilateral lung sounds. He is so heavy. He is so weak.

He called me “Dr.” I wish I knew how to be his doctor. He looks at me and I look at him. Is he really the one feeling pain or is he just mirroring my own face full of misery and despair? I am full of guilt. Guilt for not remembering which opioid is dilaudid. Guilt for not being able to do something more for the pain. Guilt for not being able to even offer an explanation. But mostly, guilt for not being the doctor he deserves.

And yet, he called me “Dr.”  he needs me to be his doctor. There is no one else right now. No one but me. So I tell him what I know, even though what I know is nothing. In fact no one on the ward has figured out what is wrong with him yet. And at that he laughs, boasting that he’s given us a real good problem to solve. I smile. And then I laugh. And then I start to remember how to be a functioning human being again. The silence is gone, replaced by small-talk in the middle of the ER. We speak of his family, of his hobbies, of the strange circumstance that brought him to the bed in front of me.

Because he called me “Dr.” so let me be his doctor. Though I can’t write orders or sign scripts, I am certain that I have some responsibility to him now. I search his charts and reveal information previously hidden in a forest of paperclips. I start to paint the art of medicine and hum the tune of consult notes. And from somewhere I have mustered up the courage to acknowledge the unknowns and the sympathy to know when he cannot tolerate more testing. And I look to him and vow to us both that we’ll smile and laugh again soon.

He still calls me “Dr.”. He shakes my hand vigorously for the last time. Nonchalantly, he asks how my studies are going and I realize that he knew all along I was a medical student. But of course it didn’t matter to him. It occurs to me that this ought to make me nervous, but it doesn’t anymore. He jokes again about how much trouble he’s been and we laugh, real uninhibited laughter. Then he jumps off the bed, out the door, and into the car back home. And me, I return to the wards ready to face a new challenge, understanding that the learning will never stop.

And one day, I will be the Dr.

Time Doesn’t Stop

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Photo by Darwin Chan (c2018); Anonymous writer

My ear is tuned to the music around me, sounds an untrained ear might never notice. A man coughing as his wife pats his back, a baby gasping for breath after a crying spell, a woman by the window slurring her speech after one cocktail too many. All of these have the potential for disaster, but, while that stage is latent, I wait in the shadows, taking another spoonful of soup.

It is but another side effect of growing up in a medically-minded family. Medicine appears everywhere: in the grocery store, the park, the highway, even the elegant cruise ship dining room where we now sit. Thanks to countless hours on call in the hospital, I have now perfected the art of semi-relaxing, always ready to jump to the call of duty when it sounds. Disaster isn’t heralded with flashy neon signs. It’s subtle. It’s quiet.

Then it explodes.

So I listen, ready to act if need be. The baby is drinking from its bottle. The man is back to his dinner. Everything is quiet, at least for now. I turn my head, bringing my focus back to the table in front of me. I am wearing a special dress, a pink-and-white flowery thing with box pleats and a thin belt. It took thirty minutes to iron, but I didn’t mind. I’m a girly-girl. I like dressing up, when I get the chance.

The soup is tangy, green tomatoes and lemon and something else I can’t pinpoint. Cayenne? Perhaps. There is a strange sound to my left. The baby’s mother is making cooing noises. Behind them, the intoxicated woman is being helped outside by a friend. I relax, slightly, scolding myself for being so uptight on a holiday. Free time is scarce in medical school, and I know I should be relishing every moment I have off. But I know how easy it is for the compass to turn. The images are raw and, even in the middle of the ocean, far away from hospitals and pagers, old habits die hard. I take two more mouthfuls of soup, hoping to wash down the feeling, the memory, of how little time it takes for a patient to code…or a child to arrest…

Or a doctor to become a patient.

It starts in my throat. The spoon clunks noisily against the side of the bowl, and I try to steady my breathing. It’s a familiar feeling: burning and stabbing and pins and needles, all at the same time. I take a breath in to try and clear the feeling. It doesn’t go away.

I glance at my mother. She has finished her soup, too, and is laughing at something, a joke that isn’t funny. She is happy, happier than I have seen her in a long time. I don’t want to burden her with undue concern. I know I often overreact; medical school has joined years of bullying to teach me anxiety and paranoia. Perhaps this is just nerves.  I’ve had a sore throat for the last few days. Perhaps the acidity was too much. Perhaps it will pass. Perhaps I can…

And then it strikes. The hallmark of any allergic reaction: feelings of impending doom. It’s a strange sensation, difficult to describe if you’ve never felt it, but unforgettable once you have. It starts in your stomach, small, bubbling its way up, then explodes, paralysing your heart and mind in an inexplicable, terrifying horror. As if you’ve woken up to find a murderer in your bedroom. And a knife in your chest.

The fear surges, and the hum of the dining room disappears. The feeling in my throat is growing larger, now the size of a quarter. I grab my mother’s hand. She looks at me. With one gesture, I have relinquished all control. My mother is a nurse. She is used to emergencies. We are both used to emergencies.

I’m just not used to being one.

We stand up, and the room tilts sideways. I am vaguely aware of my mother pulling my arm, guiding me through tables to the nearest exit, but I can’t focus. I’m helpless. I’m scared. I think some people stare. I’m not sure. I hate staring. Everything is shaking. I’m swimming through a fog. I trip on something, and my mother’s grip tightens. The feeling in my throat is spreading. Backwards. Up my tongue and towards my lips. I hear voices. Everything is blurry. My mother says something. I can’t speak. My tongue is too thick, like a dumbbell in my mouth.

I am helpless. I am scared. We reach the lift. It’s empty. We’re going up. Back up to our room. The lift jerks upwards, and my stomach jerks, too. My lips feel funny. Burning, shooting, pins and needles. I lick my lips. They feel too big. My tongue is too big. This isn’t right. I’ve had anaphylactic reactions before, but not like this. It’s supposed to go down, to my stomach. I get cramps. I feel sick. And then it goes away. But this isn’t going away. It’s getting worse. It’s going backwards. The wrong way. The feeling in my throat is now the size of a tangerine. A lump. It’s growing. It’s not supposed to grow like this.

I turn to my mother. “My lippppsh shfeeeel sffunny,” I say. Everything is tilted. Why is the boat rocking this much? A woman passes us, walking on the walls. Or is that just my head? My mother starts moving faster. My lips are swollen. She pushes me into the room, onto the bed. Why is everything spinning so much? I can’t think straight. I can’t see well. Where are my glasses? Am I wearing my glasses? There’s an orange in my throat. It’s heavy. It hurts. My father is squeezing my hand. Where did he come from? I don’t remember.

Everything is dark and blurry. My mother gives me a bottle of water to drink. I can’t swallow. It hurts. It’s swollen. It’s blurry. I start to think it’s not the boat that’s shaking. Eventually the water goes down. It hurts and squeezes and gets stuck inside the orange, somewhere. I swallow once more. Twice. Thrice. It squeezes down eventually. Painfully. My eyes water. My tongue is too big.

My mother is doing something. I can’t see what. I can’t do anything. I can’t say anything. I’m used to being in charge, in control. But here I have no control. There are hands around my throat, squeezing. Who is squeezing me? Why isn’t anyone stopping them? Why are they squeezing? What do they want?

The orange in my throat hurts. It’s growing. I’m choking. My mother turns around. In her hands is anorange-and-blue tube. I know it. I’ve counselled countless patients on its use. I’ve demonstrated it and discussed it, know it better than my own stethoscope. But why is it here? Why here? Why now?

And then I realise that those are not hands, that no one is squeezing me. My throat is closing up, all by itself. In a few minutes, I won’t be able to breathe at all. My vision will turn dark, completely black. Fade into nothingness. Already I can’t sit up by myself. I’m leaning against something. My father? The wall?

It’s cold. It’s cold and hot, at the same time. My mother lifts up my beautiful box pleat dress, marking the skin with her fingers. “I’m sorry,” she says. At least, that’s what I think she says. There are tears streaming down my face. I’m crying. Why am I crying? When did I start crying?

There is a pause. A click. And then pain. I’m not a screamer. My throat is too tight to scream. So I say, “Ouch!” Quietly. Very quietly. But the pain stays. It grows. One, two, three, four, five…each second is an hour. I’ve been like this at least five hours. Ten hours. The pressure is released, but the pain lingers. “Ouch,” I say again, louder this time. “Owaaaaaaaa…” My tongue is too heavy. They’re something on my tongue. It tastes like grape medicine and chalk. Chalk. Where did we get chalk? My tongue is too heavy. Everything is spinning. A telephone is ringing. RIIIIING! RIIIIIING!

My heart starts to race. Slowly at first, then faster. Louder. I close my eyes, pressing a hand against my chest. B-B-Beat, b-b-beat, b-b-beat. I crack open and eyelid. Everything is dizzy; I close it again. My mother is next to me. Something about a doctor, someone coming up. I’m confused. My leg is bleeding. I bleed too easily. Too much. I ask for a tissue, noticing my tongue isn’t as heavy. My words aren’t as blurry. The medicine must be working. My hands are shaking. I reach for the tissue, and I’m shaking. I’m freezing. I’m burning. I’m so cold I’m burning up. That doesn’t make sense. None of this makes sense. My leg is still bleeding, but I can’t put pressure. My mother puts pressure. My hands are shaking. My legs are shaking. My heart is racing. There’s a knock at the door.

Someone is at the door. My mother stands me up. We are walking somewhere. My legs can’t walk. They’re shaking too hard. There’s pain — pain! My bleeding leg hurts. “Can we slow down?” I ask. My leg is seizing up. I can’t walk. I can’t stand. A man says sorry. Who is this man? I can’t see his face. It’s blurry. It’s dizzy. Everything is shaking. The orange in my throat has stopped growing. It still hurts. My lips are huge. I can feel it. We get into a lift again. All the buttons on the lift are lit up. Now I know I’m seeing things. I stare a bit harder.

“The boys,” someone says. That man. He is apologising. A game, he says. How are they playing games, I wonder. My world has stopped. It has shattered. Time is standing still.

But it doesn’t stand still for anyone else.

At every floor, there is activity. People get on the lift. People get off. Two women in bikinis. A man with a cocktail. Teenagers with ice cream. Some of them stare, stare at the shaking girl with the swollen, tear-stained face and bleeding leg. I stand against the wall. I don’t like their stares. I try to close my eyes, but the shaking seems worse, somehow. A woman laughs. Time hasn’t stopped for them. They are on holidays. They are living. I am dying.

Am I dying?

We’re down in the bottom of the ship. The lowest level. They put me on a chair. A bed. They wire me to the monitors. I smile. Everything is dizzy, but I know these monitors. They’re my friends. I hear the beep. Beep, beep, beep. I’m alive, beep, beep. People speak. Ask what happened. They think I’m diabetic. I’m not diabetic. My mother tells them I’m not diabetic. They’re timing things on clocks. Beep, beep, beep, says the monitor. Every beep is good. I’m still breathing. My heart is still beating. My mother takes off my glasses. I was still wearing my glasses?

The orange in my throat is back to a tangerine. It’s sore, raw, like strep throat. I can’t stop shaking. There’s a feeling in my stomach. Cramps. It aches. It’s sore. Someone asks me about my periods. A doctor. I want to yell at him, to scream, to call him names. I’m not pregnant. I’m not diabetic. My stomach hurts. My leg hurts. I focus on the monitor. The beeping. It’s familiar. It’s normal.

Eventually, my mother grows tired of the questions. They are asking the wrong questions. We’ve been here long enough anyway, she says. She disconnects the monitors, taking me upstairs. I’m still shaking, but I’m hyper. Extremely. The adrenaline has gone to my head. My stomach is cramping and my throat is sore and my leg is in spasms but I want sugar. I. Need. Sugar. I start speaking fast. Random things. Everything. That girl in my ninth grade dance class and the recipe for chocolate sushi and the reason barracudas should have ten legs and golly how my legs ache can I please have something to eat I need sugar is there any sugar? My stomach is churning. I lay down. The spinning has stopped. My lips are still swollen, but I suspect they will be for a while.

When I wake up, the sun is high in the sky. My stomach is sore and my lips are still swollen, but I can speak. My mother says I have had a restless night. I say it was dreamless. I am exhausted. Drained. I have no appetite. After last night, I think I’ll never want to eat again. Certainly not soup, with green tomatoes and lemon and something else. I was sick before this, and I get even sicker afterwards. Asthma. Gastro. I lose six pounds before I get home.

And yet, time didn’t stop while I was gone. I have messages to send, work to be done. It’s CaRMS season. I have to get my letters out. It’s back to school. Back to work. The patients are waiting. I am out of shape. I gasp going up the stairs. I walk with a limp. I ache all over. But now I’m back in charge. I answer questions. And time works in its own strange ways. Two close family members (one in my own house) are diagnosed with cancer, five days apart. The phone rings nonstop. I am answering questions. I am a counsellor, a library, a “rock”.

But I don’t feel like a rock. I feel helpless, vulnerable, open and soft and squishy. I was a patient. My world stopped. Time stopped.

But only for me.

Is that how these people feel, lying on stretchers, eyes closed, hands shaking? Vulnerable? Afraid? Alone? I am lucky. I had help. I knew what was happening. But many of these people don’t. They lie in purgatory, waiting for the gavel to fall. The dice to roll. What will happen to them? Will they walk out of here, limping up stairs, but grateful for the chance to recover? Or will they be taken out the back door, a white sheet covering their faces?

Either way, their lives are frozen. They are here, but not here, suspended in an alternate limbo while they wait for their fates to catch up. I know the feeling, of time standing still. But, whether on a ship in the middle of the ocean or in a hospital on the edge of a lake, one truth lingers: time stops for no one, least of all me.

It is hard to understand something if you have not lived through it. I might go as far as to say you cannot understand it, not fully, until you have seen it from both sides. As the doctor, and as the patient. Many people don’t understand allergies. It’s just a little butter, they say. You can’t even see it. It’s so tiny. Just scrape it off. I scraped the nuts off the top, they say. They scraped the nuts off the soup. They even changed the bowl. But it didn’t matter. It wasn’t enough.

At first, I was a patient. Then I started to become a doctor, and forgot about being a patient. But, sometimes, a reminder is all we need to shock us back into reality, to remind us that we aren’t invincible, that we can still fail, that we can still fall. We are all human.

And time doesn’t stop for anyone.

Clocks

old-clock-1426318Written by Angela Hu, c2018

====== Begin scene ======

I walk into the room, along with another medical student and our preceptor for the day, a home care nurse.

The patient’s wife greets us cheerfully, welcoming us in and treating us like old friends. Outside the hallway of the retirement home is musty and old, but inside the apartment is bright and clean – a refreshing change.

Handmade trinkets adorn the shelves and walls. A lace handkerchief has been artfully made into a serene-looking angel. Embroidered flowers and scriptures are tastefully hung.

We reach the living room, and sit down on the floral loveseat. Across from us is who we’ve come to see: a man grasping the edge of the sofa, quietly wheezing. He is cachexic, dressed in his pyjamas, with his thin strands of hair matted to his scalp. His voice is raspy as he tells us of his worsening efforts with breathing. Visibly tar-stained nails with clubbing peek out from below his sleeves. We discuss his medical issues, and his palliative care. He tells us he is tired, and that he cannot hold on anymore until his grandchild is born. I look at the ground in discomfort.

The clock chimes, and I jump. Eleven strikes, the penultimate hour. The chimes seem never-ending, and I look around and count at least three more clocks. Their ringing is cacophonous, and the ticking ceaseless. Constantly ticking and ticking, with the same rhythm and autogenicity of our heartbeats.

I look back to the patient. He is clearly in much discomfort, and the nurse suggests going to the hospital to receive oxygen. He solemnly agrees. His wife gets up and starts getting his things ready. One last trip. She fusses around the house, making sure nothing is forgotten. She gets his health card, and he shows it to us. The picture was taken three years ago, showing an altogether different man with plump cheeks and a healthy complexion. We see his DNR form, signed, dated and stamped.

At last his wife has finished gathering everything. We place the 911 call for an ambulance. The dispatcher is calm and business-like, telling us the ambulance will be here any minute. We sit, and wait. The clocks continue ticking.

We hear the sirens coming down the lane. A crew of burly firefighters walk in, filling up the small space. Next come the paramedics, with their purposeful stride and immediate delegation of tasks. The patient is fitted with an oxygen mask and eased ever so carefully onto the stretcher. The clocks chime again – twelve strikes. The wife hurriedly tells us to lock the door with the keys when we finish. I accompany her to the door. I wish to embrace her, but awkwardness overcomes me. Instead I grasp her hand as she leaves. ‘Pray for us,’ she says, and I smile weakly. ‘I will,’ I say, closing the door.

====== End Scene ======

Student Spotlight: Sabrina Lue Tam

The Student Spotlight is a glimpse into the lives of McMaster medical students through portraits and storytelling. The goal is to highlight the wonderful diversity of our student body.

Meet Sabrina, a 23-year-old Canadian Jamaican-Chinese (Hakka) from Markham, Ontario.

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Photographer: Darwin Chan; Editor: Selina Zeng

Here are some of Sabrina’s favourite things…

Hobby: Trying to guess babies’ ages based on their developmental milestones. Can get kinda awkward in public. I also enjoy dancing and reading.

Book/Piece of Literature: The Lord of the Rings trilogy

Movie: All Disney all the time! (I also really love “How to Train Your Dragon”)

Song/album/artist: The Japanese Philharmonic Orchestra’s “Super Smash Brothers Grand Medley”

Character/superhero: Nightwing

 

Shocking Secrets

I wrote an embarrassing amount of fan fiction before and during high school. My boyfriend is now offering a reward to anyone who manages to find the skeletons in my closet. In our “spare time”, we also like to play League of Legends and yell loudly and creatively at our screens while we sit in the same room (it is one of my main means of communication with my sister nowadays…). I talk to other cars on the road as if I am having a conversation with them. My best character impressions are of Ke$ha, Janice from “Friends”, and Fluttershy from “My Little Pony: Friendship is Magic”. My sister and I like to bake at 2AM when I visit home.

Not so shocking: I get asked, “Are you old enough to be a doctor?” or some variation thereof at least three times every rotation. I was once asked if it was my preceptor’s Take-Your-Kid-to-Work Day while doing a horizontal elective…

Inspiration to Medicine

I had a teacher in high school that often said, “You’re going to get into medical school, I know it”. It seemed like it was just flattery at the time, but she always said it with such conviction that I started to hope for it once I began to consider post-secondary programs. One day we had an alumnus come speak to us while I was in Grade 11, and he talked about his experience as a second year medical student at U of T. Everything he experienced and described made me feel like medicine was the only thing I could ever want to do with my life, and he made it seem feasible. The research opportunities and the idea of learning something new every day—that really appealed to me. He told us a story about a patient encounter he had with an elderly lady. He talked to us about taking a sexual history as part of his full assessment (even though he felt awkward about it). The patient (well into her 70’s) laughed when he asked if she was sexually active, and replied, “Not as much as I would like!” He said they had a really good laugh together and I thought that was beautiful. I wanted to make those kinds of connections. At the time, I wondered if that really could be me someday! My philosophy about trying to achieve my goals has been to at least try.

Once I was in Grade 12, I was still willing to try but not as optimistic about the outcome. In retrospect, I think I was just starting to react to stress — I was juggling several extracurricular commitments with my schoolwork and felt like I was starting to drop the ball. In a moment of panic, I submitted a couple extra university program applications thinking I wouldn’t be accepted to my top three choices. In the end, I was very fortunate to get accepted to my top choice of undergraduate program.

By second year of undergrad, I thought I would “at least try” to prep for and write my MCAT, and “at least try” to apply to medical school. When I received an offer to interview for Mac Med, I was both extremely excited and anxious. The dance team competed the weekend I was interviewing — the night before the MMI, I was celebrating the completion of the competitive season with my teammates. I couldn’t sleep that night from a mixture of apprehension and happiness. One of my biggest fears was not waking up in time to get to the interview!

Looking back, I’m so grateful that I never let my moments of doubt prevent me from trying, because that is how I ended up here. There were many points along the way where I was so close to thinking, “maybe I’ll just try next time”, but whenever my faith in myself wavered, I thought about all the people in my support network who believed in me and that was what kept me on track. There will always be a next time, but “this time” only comes once. I think it’s definitely worthwhile to take as many “this times” as you possibly can!

Sabrina in Alternate Dimension

As you might know, I spent some time as the Saffron City Pokemon Gym Leader, which was somewhat exhausting and I resigned once I heard about all the recent emergency room visits associated with catching Drowzees. Otherwise, I might still be there, ordering Marsh Badges by the crateful to battle all the hopeful young trainers out and about. Hogwarts never actually got back to those owls I sent throughout my teenagehood. I wasn’t tall enough to sit at the Sailor Scout table, and joining the Power Rangers was considered social suicide (although I still thought they could use a Teal Ranger…). I was working really hard on harnessing the magic to transform into a bunch of different mythical creatures, like a dragon, unicorn, phoenix, or mermaid, but then there was this man who kept trying to hunt me for my heartstrings and hair and feathers and scales and it was just creepy. Ms. Frizzle offered me a job as her assistant but she forgot to un-shrink me once and I spent all day stuck in her bloodstream. She nearly flushed me down the toilet at the end of the day and I gotta say, I was a little traumatized. My eyes weren’t quite gigantic enough to be Disney princess material, and I couldn’t keep up with the physical comedy well enough to be cast as an anime character (they also require that you are fluent in Japanese and subtitles). I applied to Winchester Bros. Demon Hunters Inc., but I jump at loud noises so I wasn’t offered an interview.

I’ve always wanted to be a writer, or an actor like the dude from “The Hangover” and “Community” who is actually a cardiologist. His parents told him that he could be an actor after becoming a doctor. Maybe I should give him a call…

Thankful Words

I would never be able to adequately express my gratitude to everyone that has been a part of my life thus far. Every person who has encouraged me and supported me in any capacity has played a vital role in my journey.

Low Lights/High Lights

My internal medicine core was really difficult for me. It was definitely a hard rotation for everyone because there is a lot of work to be done and expectations are high. The learning was phenomenal, but the clinical encounters, for me, were extremely depressing. There were some patients I truly dreaded seeing, because nothing I said or did would make anything less painful for them. Nothing would change. Some of those patients came in from nursing homes with advanced dementia, and would return to those nursing homes without any change in their quality of life. Most of them never had any visitors for the weeks they spent in hospital. It felt like a cycle of futility and it was hard to get out of bed in the morning feeling like there was no difference to be made. People would be just as sick and sad and lonely today as they were yesterday, and the day before that. They would be just as sick and sad and lonely tomorrow, or maybe worse. I think the constant feeling of uselessness and hopelessness made me feel almost numb. I spent forty minutes administering CPR in a code blue before we pronounced death, and I realized that I wasn’t shaken in the least. A patient died under my hands and I didn’t feel the devastation I thought I would, that I thought I should have. I was intellectually sad — it was very sad to see the patient’s spouse later that day, and to observe my SMR breaking the bad news – but I didn’t feel anything. During my first week of the rotation, I felt my throat progressively tighten with every chest compression I gave, feeling bones and flesh shift under my weight. My fingers continued to shake for hours after we regained a pulse that night. Only a few weeks later, that pulse didn’t return, yet my voice was steady when we debriefed. I was somehow unfeeling, and I was more unnerved at my lack of emotion toward the event than the event itself. I wondered if I had lost my sense of empathy, and I questioned whether or not I was really fit to become a physician. It wasn’t until my very last day of my rotation when I talked to some friends about it that I felt like I could breathe again. I hadn’t lost myself after all—I wasn’t the only one feeling some effects of burnout, and my empathy hadn’t been completely incinerated as a result. I teared up thinking about my patient’s spouse asking, “Is he gone?”, and then the experience caught up with me.

I think it’s important for us to talk about these low points, because everyone will hit them. Everyone goes through struggles, and pretending they don’t exist will not make them go away and we won’t be any stronger for it. I’m really grateful that I had so much support and that my friends were open about talking about their own difficulties, since we forget sometimes that we’re allowed to be human and we will have moments of weakness that do not define us as weak people. We’re just people, and we will only be miserable and exhausted if we don’t allow ourselves to be just that. We will fail, we will be defeated, and we will be overwhelmed, but there must be something driving us to get through and that is what makes the journey worth every stumble. Find your something and don’t settle for anything less.

Conversely, I’ve had many highlights during my time in medical school. One of my favourite stories to tell is about a toddler I met during an elective: he came in with persistent fevers over the last three or four days, and as soon as I walked into the room he slid off his father’s lap and asked me to pick him up. I gathered the history with him hugging me around the neck. My preceptor and I completed the physical exam together, and in true toddler fashion, he was crying and screaming once my preceptor lay him down on the examination table. Once the exam was finished, he reached out for me and settled as soon as I picked him up. It was such a cute, heartwarming moment I didn’t even mind when he wiped his teary, snotty face in my sweater while I held him. (I still didn’t mind even when I got sick a few days later…)

Future Goals

I love children, and I want to go into pediatrics so I can make children smile. As a doctor, I want to help nurture healthy, happy kids. Above all, I want to develop strong lifelong relationships with my patients and their families. I want to see my patients grow up and do things they enjoy. It would be great to see some of them get married and have kids of their own.

STUDENT SPOTLIGHT: Gayathri Naganathan (C2018)

The Student Spotlight is a glimpse into the lives of McMaster medical students through portraits and storytelling. The goal is to highlight the wonderful diversity of our student body.

Meet Gayathri Naganathan, 28 year old from Vavuniya, Sri Lanka

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Photographer: Darwin Chan; Editor: Selina Zeng

Some of her favourite things…

Hobby: Bharathanatyam, though I don’t get to practice it as often as I would like

Book/piece of literature: When breath becomes air by Paul Kalanithi

Movie: Alaipayuthey (Tamil film)

Song/album/artist: A.R. Rahman

Character/superhero: Elizabeth Bennet from Pride and Prejudice (my 12 year-old brain connected so strongly with her the first time that I read the book)

Shocking Secret:

I was inspired to start learning American Sign Language after watching a tv show called “Switched at Birth”. So I found some guides and videos online and forced all my friends to practice with me for a while. I am exceptionally bad at ASL though and can barely sign “My name is G-A-Y-A-T-H-R-I”.

Journey and Inspiration to Medicine

I was a classic premed keener. I volunteered in hospitals and nursing homes as a teenager, enrolled in a life sciences degree at a big box university, and got involved with some really interesting medical research throughout undergrad. But by the end of my undergraduate degree, I became a bit disillusioned with the whole idea of medicine, largely because the path to medicine seemed more about getting the formula right and less about compassion and genuine interest in serving people. Instead, I fell in love with research and ran off to grad school where I engaged in work that was the polar opposite of the research I’d been doing throughout undergrad. As an eager pre-med, I worked in the area of pediatric brain tumour research, spending endless hours alone in the lab, performing the same protocols again and again. In grad school, I learned and explored qualitative methodology, which was an entirely foreign language for my staunchly quantitative brain. I struggled significantly along the way, often asking myself uninformed questions like, “If the data isn’t generalizable, why am I even doing this?!”. But as I started to delve further into the complexity and richness of qualitative and mixed methods research and became involved with various research projects, the pieces started to fit together. I worked with amazing academics and clinicians in diverse fields, and contributed to various projects including examining the lived experiences of racialized homeless individuals with mental illness and understanding the perceptions of first and second generation Tamil Canadians and their experiences of war, migration and multiculturalism. Throughout this time, I also volunteered with smaller community organizations like the Council of Agencies Serving South Asians and gained a grassroots understanding of Health Equity and community advocacy. I even spent a brief stint as a public servant, working as a policy analyst in the Ministry of Health and Long-Term Care. Throughout this time, I learned a lot and gained greater insight into myself and my interests and passions. But most importantly, throughout this long journey studded with missteps, self-doubt, victories and defeats, I learned how to fail and to pick myself up and try again. Though there were multiple paths that I could have taken, in the end the siren call of medicine won out. It won out mostly because I found myself repeatedly hitting a wall in my research life. As I conducted research interviews with very complex patients, I had the privilege of hearing their stories and gaining a deep appreciation for and insight into their lived experience. But, at the end of each interview, I was only able to say “thank you for sharing your experiences. Hopefully this will help patients coping with similar issues in the future.” For the patient sitting in front of me, however, there was very little I could do. Having hit this wall again and again, I realized that it was important for me to gain hands on skills to be able to help vulnerable individuals in a direct and meaningful way. So in my final summer of grad school and with just 2 weeks before my thesis defense, I wrote the MCAT (for the third time) and took one last shot at my med school pipe dreams.

Gaya in Alternate Dimension

I would be a starving writer. Starving mostly because I’m not very good at writing, but I find it so powerful when done well and cathartic even when done poorly. I’ve written short stories and poetry since I was a kid and had aspirations of one day writing a novel, so in an alternative universe, this is probably what I would be doing.

People to Thank For

My parents are my “how to guide” for living a life of generosity, courage, hard work, and happiness. Everything I have ever achieved and everything I will ever achieve is because of them.

Highlights

The people have been the highlight. I’ve met incredibly interesting, accomplished and inspiring people in this program that I would otherwise have never crossed paths with.

Goals as a Future Physician

Too many things. I want to make medicine, as a career, more accessible, particularly for communities who have historically and systemically been barred from the opportunity to pursue medicine. As a physician, I’d like to bring together my passions for health research, health equity, policy, and patient care into some harmonious whole (but this may be my new pipe dream).