nebulous beast

When we speak
of you on rounds:
a nebulous beast
awakens
without warning
without cause
and we recoil in fear.

Many try to alleviate
this master of symptoms,
fumbling with the tools
handed down in biologic alchemy
of the poppy.

Yet, so few of us
know its power,
respect its toxicity
and can wield
the axe of analgesia
towards this
emperor of all maladies.

Though as we palliate,
and lay the beast
to a somber rest
we walk that morbid line
between control
and death.

awakening in darkness

We hear your cries,
the wailing
of dependence and hunger
pulling us from the lightest
forms of slumber.

My bride
called for sustenance;
the maternal keeper
of life and thirst.

I hear her footsteps fall
quietly slipping
out in the dark hall,
hushing your breaths
while trying to not awaken
my thoughts.

I slip into the night
to catch a glimpse
through a cracked door,
of you looking down
holding her close
rocking, nursing and loving her
with all your tired might.

I lay knowing,
of your strength
love and devotion,
allowing me to slip
back into the solace
of darkness.

on learning of your death

For Galway Kinnell

Sitting at a red light
in the darkness
of the early morning;
the slow lifting
of daybreak
as the awkward light
tries to awaken 
my senses.

My brain still throbbing
from the migraine
which rudely greeted me
upon my cessation of slumber,
a harbinger of the turmoil
my soul had been wrestling
the day before with a patients
premature demise. 

Preparing for another day
on the oncology wards:
healing few
and attempting
to return a few more
to health.

I hear your name
spoken on NPR
and my breath catches,
as I learn
that you have taken your final breath;
thankfully, at home,
nestled in that place
of wholeness
and family.

Your voice streams
in tribute
as you read
your enigmatic
words
with a syntax
and cadence
that takes me back
to Portland, Oregon
where we met just once
over blackberries and Nightmares.

Your death
though not unexpected
yea' as an octogenarian,
still comes
as a gut-blow -
to a young poet,
who found your work
to be at the heart
of life, love, and growth.

Your words
are eternal,
a legacy
for those of us
who lived them
and breathed them
in youth,
and return to them
to comfort
our hearts
and push us
to put pen to paper
and fingers to keyboards.

nothing

The mechanical hum
and the cacophony of chaos
surrounds you,
in this place;
a supposed cocoon
of healing.

Yet for me,
on this eve
baring the burden
of the night's watch,
I find no solice
in this space.

For a father,
cannot rest
cannot think
cannot move
knowing that his baby
girl
lies ill.

Nothing,
no one,
no tincture
no potion
no words
can ease the terror
lying in the depths
of a father's mind.

You lie still
swaddled in cotton
the infusion
of health
coursing through you
synchronous with the beat.

A father can try
to be objective
to be protective
to be anything
for her;
because until the bitter
end
you
must always be
nothing more,
and
nothing less,
than perfect.

agony

A father,
standing in darkness,
can hear his child,
produce
a cry of cold
a wail of hunger
or a bronchitic wheeze,
from miles away.

Biologic sounds
which are etched
in permanence,
deep within the cortex
and tattooed upon
the reptilian stem
for eternity.

So now
halfway across the world
standing in the medical wards
speaking broken Kiswahili
I hear her --
a cry,
a scream,
a gutteral cacophony
of pain.

My blood recoils
as a previously senescent
reflex arc
now activated -
springs
into action.

My feet
must find this child
must understand
who
what
can cause
such a sound.

Yet, as I am compelled
to seek and find,
I am horrified -
at the sight
the shear agony
tearing a place,
a new home
in my memory.

Action
becomes reaction
with feet again
racing
towards an elixir
an antidote
to this agony
to my anger and horror.

the countdown

I am here again,
at the bedside
holding vigil
with wives, sons, and daughters,
as time drifts
with each breath.

We spoke for
days,
hoping and praying,
swearing and screaming,
raging
at this passage
beyond;
life.

The question:
at each stage,
in every encounter
asked-
in a myriad
of permutations;
remains
eternally
the same.

You knew
the countdown
had begun -
the moment
you oozed and slipped
your way
into that first
sucking-screaming inhalation
of life.

Yet
we all yearn
grasp-claw-scratch-fight
to know,
to have an iota
of an incling
of when
of where
of how.

I have the sad
wisdom
of knowing
when the final
countdown
has begun;
and yet,
am powerless
to know
anything more
to soothe
the wounds
of that vacuous
space
between-here-now
and expiration.

knowing you

We sit again,
the way two married people sit,
the comfortable, knowing closeness,
the sort of sitting,
that is pure and familiar.

The sitting now,
is changed,
as now I can feel,
something next to me;
what,
I am not sure.

An arm, a leg,
a foot, a hand,
gliding, pushing, reaching,
forth
from the fantastical
roundness of your womb,
gracing me,
in this sitting.

We look at each other,
the knowing look,
of the long married
that requires no words;
a knowing that we have created,
you.

We do not know
you,
we do not even know,
if you are a he or a she,
but we know,
that in this sitting,
that you know,
we are
a family.

the calling of listening

The feeling today,
a dreary summer shower,
tickling my window
with drops from Jupiter.

I ponder in the morning haze,
how things can go awry
become broken
beyond repair,
a permanent schizm.

So in hearing your words
of heart break - sorrow,
and now shear sickness
in the loss
of sense and purpose.

Knowing that I sit,
in this seat
to listen once again,
to sit with the pain
and empathize with agony,
brings a pure solace;
of knowing my place
in this hierarchy
and of the calling
of listening and healing.

impotence of illness

A chapter of life closes,
the rite of passage
thousands have endured
in frightening sleepless nights
among the houses of Gods.

A bittersweet finale
as my mind and heart
continue to try and comprehend
the last five years of suffering.

Oh' the anxiety of a virginal clinician,
and the struggle of an artist
of the healing arts,
to accept the defeat of death
and the impotence of illness.

fixed and dilated

We gather today
for a teachable moment:
a bedside skill rehearsal,
the "cold calorics"
a demon-ic-strated tool
for a final decision.

One could never sense
the pain and suffering
that would be cast over
this moment:
the making of another
diagnosis.

Holding back your lids
I watch intently
as the cold slurry
is sent awash
deep into the canal
an attempt to tickle
the most basic of
human
reflexes-spinal-carnal.

And in a moment,
I see the students,
in pairs:
the one's intent on the
'skill'
watching the master
hoping for an ounce of "see one" -
and the others
disgusted
at another therapeutic maneuver
of human indignity.

My mind
now tormented
sitting idle,
for all I can see
are your pupils,
fixed and dilated
staring towards the heavens,
reaching forth beyond words
screaming for a somber
release
from the captivity
of a broken body.

My horror
now magnified
as we "elicit"
the necessary stimulation,
to define
death
as it howls
in banal clarity.

'L" Taravell

The beast shutters in the darkness,
as we course outbound
away from the salt licked shores
of the bay.

You slip into position
the seat providing solace
I suppose,
from the concrete
and the cold.

I view you now
through my trained lens:
diagnosing the seborrhea
and the burgeoning alopecia
for in my other speak -
"appears older than stated age."

The stains grow deep
into your weathered surface
yet what draws me closer
are the blackness,
the decay
of the finger tips.

Digits the tinge of midnight,
in the heart of a March eve,
for my mind runs the differential
of your sadness
and your madness.

I wager the stain
grew in the cold nights
when numbers #1-3
crept out of an encased sleeve
into the numbing crisp air.

I wonder of these digits
black from an acrid burning
an escape into a moment
of synthetic bliss.

Yet, the diagnostic lens
worries of organic poisons coursing
through your veins;
a heart and its chambers
a permanent home to your
impending death.

Your eyes close now
in a moment of rest
or escape
or transcendence;
allow me to sit and worry
for a moment
about the differential
of your demise
on an outbound train.

livedo

Here again,
in these halls,
the putrescence
is horrific this morning,
yet I push on
past the fungating wounds,
and the emesis basins.

I see you
from the moment I turn the corner,
and I know,
in a single glance,
that death is at hand.

Your palms cold and pale,
a sign of the catastrophic hemorrhage,
that is suffocating
your mind;
a heart screaming
to keep up with
the brains demands.

You have passed beyond
pain,
and for a moment I take solace,
and sit;
filling the void
to prevent another soul
in this hell of a place
from dying alone.

Your hands limp,
and peaceful in mine;
my hands
full of anger and sadness
as I had held these hands
just days before,
when life was vibrant
and hopeful.

Now sitting
with my hand in yours
watching the slow
decline
in breaths
and heart beats;
I see you escape
from this mortal prison.

I pray now
that you sit
in peace,
in love,
and with hope
for a better day.

rage against

I am here again
in the darkness
screaming for you,
raging against
your pulseless arrest.

My hands now gripping
a final salvo
the squeal of the charge
growing in the morning
light;
you jump then,
at my touch,
a final
burst
of energy-artificial-iatrogenic.

I pace around your bed
a general at battle,
loosing yet again,
to the war in you heart.

Five weeks now
I have watched you
die;
some quietly overnight,
slipping away from this earthly grasp,
other though, died,
with a warrior by your side,
raging against
your premature escape.

I want you to know
that despite our different origins,
the barriers of culture and language
I have loved you
I have ached for you,
and my heart has
broken
for you.

Standing now
yet again,
as the battle
comes to a quiet close.
I watch you take
your final breath
agonal and deep,
your last effort
to consume this world
one final time,
until you expire-
my hands still
on your empty chest.

Touching you now,
your raging heart quiet,
at last
their is a moment of peace;
until I walk to the next bed,
and my rage consumes me
stoking the fires of war
once again.

Into Africa

I left you today,
flew away in the darkness
of morning.
The rain falling
like tears
in anticipatory anguish,
of the loneliness to come.

No words can express
the pain and sorrow,
as you wear it freely
etched in your amber eyes.

I know not to where
I will tread,
but this I know;
without you by my side,
I would wander, lost.
You have given me
this life,
of boundless possibility
of maddening love,
of bliss.

The color of your eyes,
the taste of your lips
lingers with me now;
a memory I thrust
into permanent storage
as to draw upon you
for my ongoing strength.

For into Africa
I fly,
with an ounce of abandon
and a gallon of
anxious anticipation.

I know not what
this world holds in store,
but I promise to
drink it to the fullest;
to challenge my soul,
my convictions,
my knowledge and beliefs.

I promise you my love,
that your sacrifice
will not be in vain,
for I will take
the love and trust
you have blessed upon me
to serve the suffering
and heal their wounds
with you at my side.

Sleep tonight in solace
that I travel
as your vessel of hope,
and with your fortitude
will strive to bring
pride to your heart.

the violins

I did not order the violins
singing down these sterile hallways,
in the florescent glow
of ward eight.

I did not order the sadness
streaming in glistening tears
down the faces
of your seven sisters.

I did not order the agitated delirium
that has plagued your mind
switching your days to nights;
a circadian beast.

I did not order the carcinoma
diagnosed on hospital day six,
which has answered the wrenching question,
of your rapid decline towards death.

Yet, I did order the comfort
of your family at your bedside,
holding vigil
in your honor.

I did order the tincture's
to relieve pain and the disquieting confusion,
in a final salvo
against an unnatural death.

sitting

They say that as you go along,
you learn to sit with it:
with the sadness,
with the hopelessness,
with the trauma,
with the terror and the horror,
with the nightmares and flashbacks,
with the memories.

I have been told,
that the sitting gets easier,
that you can listen to the story,
within the story,
like some sort of Jedi mind trick.
That you can sniff out,
the trail head towards redemption;
a bloodhound in the darkness,
bounding through the fog of memories.

The sitting continues,
day in and day out,
yet the sitting is never the same,
the themes, the plot lines, though,
seem to repeat,
sparkling around the room,
a mirrored disco ball,
of dysfunction.

The sitting today,
fresh and plump,
of excruciating pain and shear agony,
of torture,
of madness growing in the depths,
of anger in the bowels,
retching forth with each syllable,
and sitting,
I reach out,
and attempt to pluck,
the words out of thin air,
in a feeble attempt,
to make the bleeding stop.

escape

Return to me,
my lady,
as my somnolence
has been an evil
holding my thoughts
beneath the surface.

The sanguine ink
in my glass
makes these words
escape with far more ease.

You lay in candlelight,
my olive princess
with the sweet smell
of jasmine and mint,
penetrating my limbic recesses.

I have yearned for this moment,
for far longer than I could bare;
we make for the sheets,
one more time
in an attempt
to make me whole
once again.

silence

I will keep asking myself,
if their was something else
I could have done
for you.

The days that turned to weeks
standing at the foot of your bed
on morning rounds,
and during the rapid response.

We seemed to have
quelled the fire
in your bowels
and the arrhythmia in your heart.

Or so it seemed,
on the day of discharge;
yet now as you lay
silent...

I will keep asking myself,
if their was something else
I could have done
for you.

what I know

What I know,
about you,
is renal cell carcinoma,
metastasis,
hemorrhage,
ischemic bowel
renal failure,
continuous veno-venous hemodialysis,
norepinephrine and vasopressin,
anuria,
pressure ulcers,
anasarca,
liver failure and jaundice,
and finally,
digital necrosis.

What I know,
is a loving wife,
devoted and vociferous,
three daughters,
one with child,
(your grandchild)
full of fear and hesitation,
a faith in God,
and a favorite dog.

A Sunday paper,
an obituary,
and what I learned.
A Vietnam veteran,
a Marine,
a soldier and survivor,
a Purple Heart,
a hero.
A businessman,
a Miller brewing man,
and a husband of 43 years.

What I did not know,
could be kept in volumes,
of that I am sure,
but what I do know,
and what I learned,
will live in me forever.

a toast to better days

Your mind has calmed,
the raging paranoia
the tirade of fear and persecution
has escaped
as the serotonin was silenced.

You smile this morning,
shake my hand
and swallow hard.
The agony of each word
visible
on you sullen face.

Swallowing, that simple masticatory endpoint,
now an experiment in razor sharp pain,
testing a man's tolerance for anguish.

We discuss Labrador retrievers
and laugh when you mention your wife's
love of animals and your love of Nascar.
Yet as the humor subsides,
the chuckle turns to tears,
as you speak of family
and "helplessness,"
as the disease and its treatments
have ravaged your body
and stolen your mind.

Holding onto each moment,
it seems is all you can bare.

We sit silent
my head nodding in agreement
"that this sickness sucks."

Those words hang above
for minutes it seems.

You speak of hope
as I leave the room,
to continue the rounds,
and I hope too,
that I will see you again
tomorrow.