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Mindful Practice

Before each curtain, I must repair myself, I must adapt

Halvorson, Sonja Jamaica

Author Information
Journal of the American Academy of Physician Assistants: October 2018 - Volume 31 - Issue 10 - p 1-2
doi: 10.1097/01.JAA.0000545073.86472.1a
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Who knows what forest of trouble he knelt in,

Blue pines and dog tags,

Before I met him (if you can call it an introduction)

With a bullet clean through his wax-soft skull.

His body, now a slender sheath of warm organs

Prepares for the electric hum of an elevator ride upstairs,

To be parceled out, gifted and scattered.

Living ashes.

After, we give ourselves 4 minutes,

To wash our hands,

To wash our minds of his starburst laceration,

His cheek stippled brown with carbon,

Blue with fresh bruise.

This is exercise of a new kind:

Two more minutes to move the heart back into place,

Two more minutes to loosen the grip, reset the thermostat,

And remember

That there are others, in the lobby, awaiting you.

Our next patient,

Naive to the wardened silence next door,

Only looks up from her phone once, to

Swear at us for the delay.

She has a neck sprain and

I feel I have no poise in this.

I long to be nimble of heart,

To be decent through the throb of disappointment,

The imprints of sadness still palpable as we move on to

The less dying, but still scared among us.

She is not the patient that I wanted, but she is the one

I needed right then, a reminder

To give clemency where I can,

To see each patient partitioned,

Each room a sovereignty, set apart.

Often our suffering is not relative to the

Despair of others—

And there is a reason that pain scales mean nothing,

each of us calibrated by different and imperfect hands.

It's 4 p.m. in the ED and I am rearranged with a small sadness

I don't know what made me think

that life is always less painful

than death as I've seen it be, for the dying.

Sometimes they seem so quiet

surrendered to us, clothes cut off, placid.

Your flooded face, waterlogged and white, they dredged you from the edge of the river

a whisper of activity still left in your chest.

You came to us bleached, waxen, wet.

Mouth a sickening summer popsicle blue.

Your fluvial fingers, wrinkled just so, to tell us a story

of how you dove somewhere on the other side of the sky.

I don't know what made me think

anyone could be old enough, worn enough to not hold their breath through this.

The way we pressed down upon you, hard, over and over, before

the electric beeps announced your departure.

A declaration of your drowning through the small digital mouth

of a cardiac monitor gone loud, turned silent.

From these things I must learn to turn away,

to reemerge into the world sane, unhindered.

Able to sit on the couch, microwave a golden pizza,

to still feel sorry for myself like people do.

Your death must become nothing more than

a small interruption, a phone call, spilled milk.

I want to apologize for this but know I cannot.

How else can we resume?

We wash our hands, we drink diet soda, our lungs are dry.

We use the interstate to get home but sometimes it feels

Like I need a passport to leave that place

The customs so different, the locals keep dying.

In 10 days I will get $12.50 for watching you leave your life behind.

I arrive home late, I toast to the breakers and rollers of your hair, the aquatic blueing

in your eyes, now closed. Rivulets of veins across

such a narrow canyon of neck, what delicate bones.

You are a torrent, a deluge to me, a winding lesson in

tributaries and modifiers, in straddling two places with weak knees.

I am not good at this yet, at removing your rapids from my evening wine,

at taking a shower without some small panic,

at moving between this double life.

The next morning some sidewalk chalk says:

spirit lead me to where faith knows no bounds.

And I don't know what spirit that refers to but ma'am yesterday you fell into a river and inhaled.

Copyright © 2018 American Academy of Physician Assistants