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.

bad news

Holding your hand,
resting my grip on your shoulder,
looking into your anticipating eyes,
speaking in soft tones,
only minimally alleviates
my inner suffering
as I convey the diagnosis
you have been dreading to hear.

You always ask
about time,
as if by some measure
of temporal information
will make what I have just said
any more painful and agonizing.

Nothing I say, can prepare you
for the desolation that lays ahead,
but I promise that as much as I can
I will be your guide,
your pilot down this river,
of your disease.

I will attempt
to steer this vessel
through the calm shallows now,
and the treacherous swells
to come,
yet I can only be a guide
I am afraid,
for only you can bear
the weight of your disease,
as mortality stares down
from above your bed,
cloaked in a tired white coat.

libido

The feeling has returned
that stench in the depths,
the lower cortical function
that drives yearning and lust.

A mind soaked
in feral desire.
A pestilence
has infested
every synaptic transmission.

I have regressed
to reflexes of suckle and root,
perseverating on the return
to the aromatic origin,
of my limbic poison.

odd couple

I walked with you again today
hand in hand
down the sterile hallway,
as you slowly shuffle
your way through this maze.

You squeeze my hand
a signal I slowly learned
was how I could gauge your mood,
since it had been years since
you have said a coherent word.

The nurses watch this odd couple,
the frail and the young
the patient and the physician
pace these hallways
day after day.

I learn with time
the subtle reality
that no medicine
in my vast armamentarium
will quell your agitation
as much as the subtle act
of holding out my hand
and taking a walk
down these hallways
once again.

east and west

for W.H. Auden

A fallen comrade
passes into the dark night,
one moment standing at your bedside
holding your hand
as our digits intertwine
the warmth passing between
our skin.

The next:
your skin growing pale
the ashen fetor slips between your
dermis and subcutaneous tissues,
the funeral blues,
as you pass
ever so quietly
into eternal sleep.

You are taken
from your love;
their are no planes passing overhead
painting messages unto the sky,
for the only sound
is the respirator
switching to the off position.

Their are no stars
to extinguish in the night,
only cardiac monitors
and pulse oximeters
to disconnect
allowing silence,
in finality,
in your time of death.

the rose city

Seeing you again,
slinking through your streets,
sun soaked
and under the cover of summers darkness.

You are my lady covered in sweat,
the funk, the stench of my years
between these hallowed shores.

How dare you change around me,
without me.

Forcing me to explore you again,
to trace the path
of the evolution of my youth
under your new skin.

I want to embed these streets,
into my soul.
Roll in your grime and grit,
and tattoo this earth,
permanently,
deep into my dermis.

family meeting

Down the hall
in room fifteen
she lays in the darkness;
the tentacles of polyvinyl tubing
infusing sustenance
and filtering toxins.

I stand in your doorway
this morning making my rounds
as dawn breaks in the distance.
You know not of the new day
birthing force
as it seems your belly
would hope to do with its roundness
of the sun basking light
into this glass chamber.

Viral wrath has claimed your heart
as its own possession
and has stolen your intricate
defenses
against the dark art of microbes and
infectious agents; harbingers of your end.

Yet we will not let that pass,
as a mother agonizes over the
passing of another child into the night.

We speak yet again
of "multi-system organ failure"
the words passing as discourse
and conversation,
when in reality they are merely
cloaks with which we wrap ourselves
to shield our souls from speaking truth:
"I am sorry ma'am,
your granddaughter is dying,
their is nothing more that we can do."

The nurses pace about bearing
the weight of this burden daily,
some shield it beneath their loving care
and others project their disgust at dying
upon the young doctors
weighing the balance
and attempting to stem the tide.

lillie

Looking to the floor
the bleakness in your eyes
as you speak of a life
in your dreams.

A family, a husband
a house to clean
and a dinner to cook;
a man to wait on hand and foot.

You speak in rapid religious outbursts
shifting from one rapid thought
to the next
as reality fluctuates.

Tears now as you
spill the pain of the life
you never had the chance of living
because of your mental illness.

Your mind broken,
damaged by the torrent of thoughts
years of untreated illness
and moments of chemical bliss.

A verdict handed down from on high
as if despite your unwavering faith
the spirit was taken
from you child.

shaking hands

My back to the door
as I exhale the heartache;
the words of childhood beatings,
a drunken fathers pain continues into today.

I cannot help but stare
as you speak of sadness, the hollow in your soul,
at the fresh wounds on your wrists
the dried blood still clinging as a foreign reminder
of your attempt to escape into the night.

I wonder how your wife
would have heard the news of your
suicide
had you not stopped at the superficial dermis
and allowed the scissors to work true to fashion
into those pulsating vessels beneath your weathered hands.

The air now acrid
an admixture of tears and days old scotch
breathed into the daylight
of a hospital morning.

Your hands tell the depth of your story
not the wounds on the surface
but the grime worn into the keratinous layers
wringing with each word of "manhood" and "death."

Your hand-shake a firm grasp
conveys respect, anger, frustration
and your pain buried in the torments of youth
at the hands of a father,
and the resilience of time.

wounded

Gleaming metal in hand
chills course through each nerve ending
as a Christmas eve birth unfolds;
sanguine sadness with each contraction.

She lays silent in the glow
of hospital sheets and fluorescent lights,
slow tears in the dark corners of her olive eyes
where whimpers replace words.

A drop of blood falls to the floor
a sparkling contrast on the sterile linoleum-
'deck the halls with bows of holly'
plays on from the nurses station .

Peering into the birth canal
the life blood ends
in dark clots, as the miscarriage continues
into the holiday eve.

We do not speak the same language
our origins far from similar
yet I reach forward and stroke the sweat soaked
wisps of hair from your face
and whisper "bless you child"
into the night.

wrathful

Assume the fetal position
sullen under the starched sheets
hiding from your mind
as it betrays your sight.

Blood pours forth
spilling urine
discarded to the porcelain
goddesses of these hallways.

You speak only of death today
perseverating on time;
driving home the point
in incoherent diatribes.

Beads of sweat accumulate
on your brow
the only sign of the fever
boiling within your mind.

Lucidity comes in small blasts
verbal ejaculations
of coherent thought
only momentary and without context
making the diagnosis difficult.

The surgeons and psychiatrists
now at odds and wits ends
about the future
of a malignant diagnosis.

Slowly the tincture
crawls into the recesses
of a diseased brain
giving freedom to speech.

I now hold the fluid
of your backbone
sealed in sterile plastic
and bless holy
the waters of your mind.

Pray with me now
over a cup of warm
chocolate milk
on the strength
and resolve of your
cellular interdigitations
keeping viral wrath at bay.

the dictum of duty

I was once told
that my mind was a "gift"
not to be wasted
on the banalities of modernity.

I was honored
as a young man
to soar to new sights
an eagle above boys;
an enigma in this age.

I dreamed of a day
when cast in a cloak
of white cloth
healing powers
would transcend
through my touch.

Yet, now as a son
of the alpha and the omega
a foot soldier
amidst marines,
I toil in hallways
under the shadow of "time."

I once calculated the anion gaps,
the alveolar-arterial gradients,
and corrected calciums,
of patients and people,
with a hope to heal.

Now my elementary arithmetic,
is spent adding 24 + 6,
subtracting one day in 7
equaling a total of hours (80);
in the hopes of not violating
the dictum of "duty."

Merely a distraction,
from the true reality
of the broken system
of fractured care,
within the sanitary wards
coined "modern medicine."

suffering

May I ask you brother,
soldier of foreign wars:
a battle now raging
in the catacombs of your marrow,
if you suffer,
as you lay at my feet
cloaked in white linens?

I inquire
about your pain
as a measure in digits
of your suffering,
as if that integer
can convey your daily agony.

I attempt not to stare
at the sinew of your tendons
tearing forth through your forearms,
to peel my eyes from the image
of your emaciated breast,
as ribs thrust forth
asking heaven to grab hold
like the handle of a bucket
and carry you home.

Thankfully today
the must of falling rain cloaks
my nasal passages
from the odor of dying;
because yes doctor,
their are things in this hell on earth
that are far worse than death.

Behold the agony before me,
the cognoscente dying man!

In the past I could take solace,
in seeing the dying escape into delirium
that wondrous somnolent confusion
as death marches near,
yet today my friend,
as you speak,
it is painfully evident that your mind,
has fought away the waxing and waining sleep,
of peaceful passage.

Take a tincture of relief,
so that I may be relieved of my own suffering,
as you lay dying under my care;
drink of this cup and sleep,
if for a moment beyond the horror of nausea,
and a step ahead of suffering,
for I know this will not last.

As I leave your living tomb,
and break into the sterile hall
once again,
I breath again of that rain scented air
and thank the Lord,
as I scrub and scour
your suffering
from my hands.

four-thousand souls

Piece by piece my brother,
the children have fallen
to the ground;
searing the earth with their blood and bile.

Does your nose grasp that odor?
The fetid chemical aroma
of cutaneous cautery
at the hands of a suicidal man.

Tears shed by mothers and fathers
to absolve their son's
of their heavenly wickedness.

Do you realize that one day
everyone you know will die?
Memories of your time
on this swirling ball of gas
and organic existence
will for eternity be erased.

isolation

Missing you again
tonight
counting the minutes to midnight
that transition of days
when our bodies can meet again
between the warmth of cotton sheets.

You do not know
that most of my nights,
during fits of insomnia
I breath you in,
slowly,
in an attempt to intoxicate myself
back into the forbidden realm of sleep.

abbreviation

I stand in front of your door,
once again,
in the sterile hallway
burdened by the knowledge
of your disease.

I hold in my mind
the malignant meaning of your mortality;
the very thought of which rots my soul,
quickens my pulse, and sours my bowels.

Sleeping there, oblivious
to the verbal damage I will convey
of the inanimate death
cursing through your veins.

The three letters that I utter
at your bedside:
a word once a whisper in darkness
now an atomic blast articulated in loquacious detail.

I am the minion of the reaper
cloaked in white
a facsimile of a healer
for I bring disease to your heart
with my forked tongue of diagnosis.

I speak the alphabetic characters
mortal men have assigned to Beelzebub
in a Biblical attempt
to obliterate the trinity.

My visage in this moment
seared
into your hippocampal files:
a horrid image
napalmed into your myocardium
for eternity.

Please forgive me brother,
in name and spirit,
for bequeathing unto you
the scarlet letters of my generation.

memoriam

So much to say

my friend…

Of what you have taught me,

in this life,

and what I will carry beyond your days.

You will always be B-I-G, BIG,

larger then life,

my friend,

in heart, in family, and especially in friendship.

You raised two fine sons

brothers to the end.

Men now in life

and now a grand-father to be!

You garnered my respect

not because of your size,

But because every man who met you

felt in your presence a warmth and love

which you emanated.

You took a couple of skinny white boys

taught them to be better fishermen;

Skilled them with a rifle and a square-knot,

led them into the wild

by foot and by sea.

Please know

that you inspired me to be a stronger man

pushed me beyond myself

and were a model of what it meant to be a father, husband, and friend.

I will think of you always,

when I set foot on a trailhead,

when I cast my line into the depths of lakes and seas,

when I fix my gaze on a target in the distance,

and when I attempt to heal one of your brethren of war;

You will be with me.

Thank you for

being BIG,

for helping this tenderfoot, this cub,

become an Eagle,

for helping this boy

become a man, a husband,

and a healer.

God now knows your warmth.

Knows your smile and the comfort

drawn from your spoken word.

And, for this, I am thankful.

It was my honor to have known you!

To carry you on in my heart and mind,

to have learned from your wisdom and experience.

For this, I am blessed!

the harvest

In the darkness I lay
as I try to allow my mind
to escape into sleep
if just for a moment
as the chaos of disease unfolds.

The girl child rings;
my pager just another
squealing and vibrating apparatus
breaking the silence of the night
in this cathedral of suffering.

A harvest has occurred:
organs plucked like ripe fruit
from the human vine
as one life extinguishes in the night
another hopes for a few more breathes
of this acrid hospital air.

The ability to expire
has once again been decreed;
an irony as life
has already passed his last breath
through those verdant trees.

A question lingers on my mind
far from my tongue
as those with this healing power
appear to deny the reality
that death lives on in each
resurrected soul.

I ponder now
that when this structure falls,
when technology fails us,
and future civilizations examine
what transpires in these halls of healing,
will my life be
an abomination?

hail mary

The baby pictures
hanging in black and white
at your bedside,
seemingly miles away
as the symphonies of infusions
and respirations keep death at bay.

The sanguine seeping has stopped
if for a moment.
The sirens of the monitors have ceased,
giving your healers
some peace, and some time to contemplate,
the march of pulseless arrest.

Yet all I can feel,
is the continuous pounding
in the silence of my mind,
and the sensation of your body
beneath the weight of my hands.

I looked into your eyes
as I forced your breast
in reverse
to move the stagnant blood
once again.

I felt your arm brush my thigh
as it weightlessly fell towards earth
under the cantor of the compressions,
as I counted the beats in my head
hoping for a moment
that you were going to sit up
and ask me to stop.

Yet as I peered once again
into the vacant hollow of those orbs
I knew the beat must go on
and the code must continue.

Laying in the darkness now,
prayer comes, with sore muscles
and swollen joints,
Hail Mary,
that my hands
resting over your heart
moved mountains.

For as I peer
into the newborn face
in black and white,
I hope God heard my cries
and the beat of my hands
knocking on your heart
to say hello.