The curve of your spine

The first time I learned you had scoliosis was on the day of your funeral.

You had a partial spinal fusion and a rod placed in your back your junior year of high school,

And you wore a full body cast for at least a semester.

When you could no longer play baseball because of your surgery,

You asked the coach if you could be his assistant so you could still be a part of the team.

And you did.

 

How did I never bother to ask?

From the number of piggy back rides

To the number of times you hoisted me on your shoulders,

How did I never notice a scar or a bar supporting your spine?

There are so many things I would ask you if I had a little more time.

 

If I had five more minutes, I would ask if your body cast itched and how you bathed.

I would ask the name of your first grade teacher

And what street the school bus picked you up on.

I would ask the name of the boy your age who lived next door

And what your favorite game was to play together.

I would ask what you dreamed about when you were a boy,

and giggle with you about how my first dream job was to be a princess.

I would ask you the name of your first kiss, (but not in front of mom)

and if you got butterflies when you’d see her in the hallway.

I would ask about your first car,

and if it was as well loved as your old dodge ram truck you drove me to school in.

I would ask if you danced on your mom’s toes in the kitchen when you were little,

just like I danced on yours.

Daddy, I would ask you all the “nothing” questions.

The ones that don’t seem to matter at first glance.

But when you string them together, it makes a life.

 

I’m sorry I didn’t take the time to ask you those questions.

I’m sorry that the picture of how I knew you was mainly contained in the 20 years of you being my dad,

And hardly in the former years and experiences that made you the man in front of me.

I’m sorry that your role as a dad overshadowed in my mind all of your other important roles.

You were a chemist and a diver,

A golfer and a writer,

A teacher and a learner,

A rock enthusiast and cross word puzzle solver.

You were a boy, and a teen, and a twenty something.

You were so much more than I ever knew.

 

I’ll spend the rest of my days filling in the pieces.

 

If I could grab your hand one last time,

I would tell you to start from the beginning.

Please just give me five more minutes.

I’m not finished.

Advertisements

Shade & Sunshine

It was pouring that morning when I got the phone call.

Low on sleep, skidding through the rain.

Yellow rain jacket trailing behind me,

The only light in the world that day.

I ran into a hospital room that had been my second home the past two months.

I got down on my knees and held your hand,

Praying the angels would take you gently.

 

That day I watched a life fade away.

The life of the most impactful man I have ever known.

When I could no longer feel your pulse, I lied across your bed and cried.

I’m sure it was poetic.

The striking difference between a tear-coated yellow rain jacket in a dark room

And the dim light of the world crying outside.

No matter what, I always tried to be your sunshine.

Do you think the Morton salt girl ever cried?

 

The most heart-wrenching part is how our house is exactly the same.

I look back on your anxiety of going to the hospital for a minor procedure,

Thinking you would come back to live out your days in the comfort of your own home.

Part of you must have known you would never come home.

Did you know that pneumonia would riddle your body, rendering you unable to breathe on your own?

Did you know you would transition from walking down the hospital hallway with a walker,

To sitting on the side of the bed,

To not moving at all?

I’ll never forget the day you were transferred to Louisville, just so you could be close to me.

The way you cried, the second time I’ve ever seen tears in your eyes.

You knew you were dying.

You knew these four walls were the last you’d ever see.

And I vowed to hold your hand on the good days and bad days.

While you gave me the sanctuary of a shaded room, where we were the only 2 people who mattered.

I vowed to tell you stories and give you smiles.

To be your sunshine on the rainy days

And to hold the umbrella for both of us when the sun just couldn’t quite shine.

I vowed to let you rest when you needed it.

To show you that I knew your body would be whole again.

I vowed to meet you on the golf course when the end came.

 

I pray I was everything you needed to ease your journey from this one to the next.

I pray the tears we cried together were healing for both of us.

I pray, in some sense, I was able to ease your pain.

I pray the way with which I held your hand gave your soul the strength to burst through in all its glory.

I pray you know the tenderness with which I removed your copper wedding band.

And know the vows and promises it holds are ones I will continue to uphold for you.

 

The seasons keep changing and the world keeps turning without you.

Much to my surprise.

My wounds have been licked.

I am trying to heal.

When I finally allow myself to feel: hurt, anger, disappointment, hope.

Mostly, I look for you in everything around me.

The trees have all but burst into their fall colors

And with my car window down, one tiny leaf falls perfectly onto my knee.

I know that it’s you.

Reminding me that you will always give me shade

As long as I keep being your little ray of sunshine.

Not your typical love poem

For 24 years I’ve derived my self-worth from other people.

I’ve waited for boys to bring me flowers and tell me I’m beautiful.

I have held out for teachers to tell me I’m competent.

To have friends show me I’m worthy of the love and affection I receive.

But today, I face the real issue:

Loving myself.

 

For years it seems I’ve been buying time.

I have been waiting for a stranger to fall in love with my smile as he passes me on the street.

I have held out for someone to hear my laugh and the effortless joy that reverberates across the room,

And realize he couldn’t live without that sound the rest of his life.

Most of all, I have been waiting for someone to fall in love with my heart.

All of its intricacies and complexities,

The love that pours out as steadily as the Ohio River on a calm Sunday afternoon.

 

I think my biggest misconception is that I am not already whole.

I don’t need someone to complete me.

I have enough love in this frame for two already.

And I don’t need a partner to go on adventures and experience life.

I backpacked across South America by myself.

I slept under the Chilean stars and hiked Machu Picchu.

I mountain biked down Death Road in La Paz, Bolivia,

And walked along the widest avenue in the world in Buenos Aires.

I held conversations with locals, met lifelong friends,

And had experiences I could have never had were I not alone.

I’m already whole.

It isn’t any less beautiful to do life on your own for a while.

It makes you strong.

 

I’m sure one day I’ll meet someone – but not someone who completes me.

It will be someone who accentuates my attributes,

And falls in love with everything I hate about myself.

He’ll love the scars on my face, and the extra bit of padding on my thighs.

He’ll love the overpowering vulnerability I feel sometimes,

The way tears can well up suddenly in a crowded library simply because I wish I could hug my dad.

He’ll love my permanent coffee breath and coffee stained teeth,

But he definitely won’t be able to match me cup for cup.

It’s going to take a special person to keep up with me for the rest of my life.

 

Until then, I will keep dressing up for myself.

And when people ask me why I look nice, I’ll continue responding:

“It’s a Tuesday.”

I will keep doing all things with love, but I’ll stop romanticizing life, like I cannot survive without it.

I’ll keep falling in love with being alive,

And remember that living is so much more than a boy liking me.

I will keep my boisterous laugh that escapes the depths of my soul

And try not to take it personally when others tell me to calm down when I get excited.

I will have to keep reminding myself that not everything can be fixed with a smile.

But I’m for damn sure going to keep trying.

And I will keep loving in one volume:

Loud.

The Universal Language

A little boy no more than 2 stands in the rain in the middle of an amazon village.

I watch him closely for several minutes and he doesn’t move.

I don’t know his native language of saterè, or even if he’s old enough to speak it.

I approach him with a minature beach ball and a smile.

I kneel down to his level and tap the brightly colored ball gently with my hand.

At first, his timid eyes watch me questioningly.

But with a bright smile, I persist.

I gently toss the ball to him and his eyes light up with joy.

His tiny fingers tap the ball with force as he sends it back to me.

I will never forget his giggles or the way his eyes smiled.

 

To help medically, I need a translator.

But play is a universal language

Kicking a soccer ball or jumping rope don’t need translations

Smiles and giggles are the same in every language

The persistence to continue a fun activity doesn’t need words.

And we’d all be healthier if we played a little bit more.

 

The sky opens up, drenching this tiny Amazon village perched on a hill.

The kids don’t notice, not bothering to pause the intense fútbol match.

Water drips down their faces,

Dust turns to mud.

Squeals ring out into the distance.

The two year old boy toddles around with his ball and proudly and shows it off to his neighbors.

I find that he can’t yet speak sateré, but he doesn’t have to.

He tosses the ball to a girl his age, and I see her brown eyes light up with the same joy that filled his.

Their eyes and giggles say more than most words ever could.

Jungle Medicine

The hardest thing about my journey in medicine so far is knowing that I can’t save everyone.

We spend years of our lives as medical students and physicians,

Thousands upon thousands of hours

Learning about various illnesses and diseases, causes and cures.

We dedicate a huge portion of our lives to understanding physiology and anatomy

The biochemistry of the body and ways to treat illness with medicine, therapy, or surgery.

But for some illnesses, there is no Hail Mary.

My own father is suffering from a terrible disease for which there is currently no cure.

One skill we have to learn as physicians is how to handle these situations.

The ones where you can’t write a quick fix on a prescription pad,

Nor give good news in terms of a prognosis.

What do we do for these patients as physicians?

What do we do when we can’t save?

 

The most important distinction I’ve learned is there is a big difference between healing and saving.

I might not be able to save or cure every patient I meet,

But medicine is more than physically fixing a patient’s problems.

People want their concerns validated,

They want to know you are listening and that you care.

They want to feel the love and compassion that led us physicians into medicine in the first place.

Medicine requires intelligence, dedication and hard work, but even moreso

It requires love.

The power of love is healing.

 

I met a family on my journey along the Amazon.

They were unable to come to our clinic, saying that their 16 year old daughter was unable to walk.

We visited their house

Nothing more than a dirt floor and a few hammocks.

I helped to examine the girl named Valina.

She had the saddest eyes, but the brightest smile.

She said her muscles stopped working when she was 8.

Her calf muscles were as slender as my forearms

And her hands were turned outwards like a waiter with a tray.

The way that she crawled to greet us, a 16 year old on her hands and knees,

Left a pit in my stomach.

We determined that she had a progressive neuromuscular disorder, not all that dissimilar to the one my dad suffers from thousands of miles away in a Kentucky suburb.

His possibly caused by a sporadic mutation,

Hers probably a source of a genetic disorder due to inbreeding and a small gene pool in their sateré tribe.

 

Valina’s brother, 9 years old, also has the disorder.

His legs are just beginning to be affected and he has a club foot, with his ankle completely inverted so that he actually walks on the top of his foot.

We examine him in his bright green shirt while lying in a dark blue hammock.

His smile is bright, and his eyes don’t yet have the sadness his sister’s contain.

We know enough about their condition to know there is no cure or save we can provide.

 

In laziness, a physician would say, “I’m sorry, there’s nothing we can do.”

But we do more.

We talk to them about their concerns & their lives.

We ask about their favorite subjects in school

And we brainstorm about ways their lives could be more comfortable.

We give them iron for anemia

Vitamins for malnutrition

Hydrocortisone for eczema.

In those aspects we are able to provide help.

But the real healing comes in the hours long conversations

The love and compassion that we are able to show

The camaraderie we are able to share by sitting cross legged on a dirt floor.

 

In love, there is healing.

Knowledge will come to an end.

Love never ends.

Where one’s physical needs cannot be met with medicine,

Love can heal.

 

Note: names have been modified slightly to protect patient privacy

Sunrise to Southern Cross

The breeze off the river rocks the hammocks silently right to left.

Some hang low with the weight of a snoring inhabitant

Others tousle, vacant, with their inhabitants up to watch the sun rise.

The light breaks, showing off the dense forest on each side of the wide river.

A dentist sits with a cup of coffee and stares out into the distance.

He contemplates his day, but also the number of fish he could catch if given the opportunity.

A medical student adjusts the position on her hammock with a yawn.

A Brazilian missionary softly strums his guitar while preparing for the day.

The Amazon river twists and turns its way as the backdrop.

So wide at points, all you can see is river ahead of you.

So narrow at points, tree limbs scratch the boat.

 
We all have different hometowns and stories,

Different lives, occupations and families,

But one thread ties us all together.

Our hearts for adventure and spreading love.

We each have different talents that help us accomplish our goals.

Some, years of wisdom in medicine and dentistry.

Others, a joyful heart & a healing touch.

The ability to communicate in the native tongue.

A way with kids.

A desire to learn and serve others.

Me: average to the world, not the smartest – but sturdy, willing and possessing a bright smile.

Individually, we are limited.

But by pooling together our unique talents,

We see how much a group of people with a common purpose can accomplish.

 
I sit on the front of the boat with the dentist.

He asks about my dad and I ask about his wife.

ALS and ALZ

Each affecting the body in completely opposite ways

One, the body atrophies and the brain remains completely intact.

The other, the body completely functional with the brain being the one to form plaques and decay.

I share my story and he shares his.

The pain and heartache, but also the joy and uplifting moments.

The appreciation of the every day and consideration of all time to be precious.

In sharing our stories and scars, we are able to remind each other that we are not alone.

In sharing our stories and scars, we are able to remind others they are not alone.

In sharing our stories and scars, we are better able to serve & love.

 
I’m thankful for the sweet moments along my journey across the Amazon.

The all encompassing sunrises and sunsets,

The numerous cups of coffee while admiring beauty from the light of dawn to the twinkling lights of the southern cross.

The cooling rain in the middle of a hot day and the overarching rainbows.

An area of biodiversity and richness,

Holding the most diverse array of creatures and life the world possesses,

Was able to enrich my life in the most fulfilling of ways.

From the songs and prayers, to the laughs and tears

To the lives we changed and the lives that changed us.

Obrigado, Brasil.

Dream Team

You’re the male version of me.
You laugh a little too loudly but you’re never ashamed.
You proudly wear your wide smile.
You light up so others can shine, too.
In the US, they call me “sunshine”
But in Brazil they call you brilho de sol: “ray of sun”
We each light up our own little corner,
But together – our separate lights accentuate the other
Morphing into more than they could ever be alone.

Brown eyes as soulful as dark bay colored Kentucky colts,
Sweet Portuguese melodies roll off your tongue while you effortlessly strum your guitar.
On the steps off the side of a concrete fútbol field
The sole street light flickers,
Drowning the scene in periodic flickers of light and darkness
Singing in another tongue of love that has no end.
I concentrate on the feeling of the music instead of the lyrics.
I watch your smile and the way your lips move with the melody.
I feel the accentuated word in each verse,
And the love in the words is palpable.

I know people come into our lives for a reason.
I can’t quite place my finger on the reason our paths crossed just yet.
Maybe it’s the way you make me want to be spontaneous with my love.
Uproot the routine and leave my comfort zone.
Maybe it’s to remind me that there are other people like me out there.
It may take a trip to Brazil thousands of miles away.
But I found someone else who gets so excited people tell him to calm down.
I found someone else with a joyful heart who shows it at all costs.
I found someone else who is loud with his love of life.

God only knows if our paths will cross again,
But I leave here encouraged.
I don’t know where I’ll end up in life, but I’ll always know you’re out there somewhere.
Spreading love
smile by smile,
laugh by laugh,
and melody by melody.

There’ll be days like this my momma said

There will be days you wake up with a headache no amount of coffee or ibuprofen can fix.

But just remember, baby girl, that means blood is still pumpin’ to your brain.

Sweetheart, there’ll be days when all the answers you think are right are dead wrong.

You just remember that gives you the opportunity to learn more.

There will be days when no one talks to you.

And when someone finally does, rude & hateful words are the only thing to leave his mouth.

But you’ll remember this as a chance to show your kind heart.

There’ll be days when frustration rules.

And when those days happen, you just turn on “Take it Easy” by the Eagles as loud as you can.

There’ll be days when someone tells you that your dreams will never become a reality.

Sweet girl, you give that person your best smile and thank her for the extra motivation before you leave the room.

Baby girl, there will be people who tell you the way you tiptoe the stars makes you upside down.

And you’ll have to remind them that “right side up” is all a matter of perspective.

And there will be those days when you’re on top of the world.

I want you to enjoy the view, but remember the climb.

There will be days when you’re the jerk,

And when you realize it, remember how I told you to always leave places and people better than you found them,

And strive to be better.

There will be days when the world falls at your feet.

And I want you to remember how I told you life is only a small portion of what happens to you, but mainly how you respond to it.

When you have your first heartbreak and you break your first heart,

I’ll remind you that a heart that’s been broke is a heart that’s been loved.

And on those rare days when everything just falls into place and looks like it fits,

Just remember your momma told you there’d be days like this.

Pavement Reflections

The feeling of pavement underneath a head of wild curls

Goosebumps rippling their way across sun kissed skin as the sun sets.

Blue-green eyes staring into the expanse of the cloudless blue sky until it hurts her eyes.

The sound of children playing in the glow of the last of the evening light echoes around her,

Only momentarily drowned out by the airplanes landing and jetting off that captivate a portion of the blue expanse.

 

The arch of water sprayed from a dollar tree water gun captures her attention.

She reminisces back to days spent in a backyard.

Chasing her older brother around,

water being sent in every direction, except at her target.

The innocence of those days is no longer lost on her.

The carefree attitude,

the butterfly nets and firefly catchers.

The sidewalk chalk and jump rope.

 

She is brought out of her reverie by a question asked by the person lying beside her.

“What was your favorite childhood recess game?”

Thinking back on games of red rover and kickball,

foursquare and tag,

“I think hide and seek or red rover.”

She adjusts her position on the pavement and sits up.

The squeals of children being soaked with water,

the sun setting on the days of school and the summer fun just beginning.

She wishes there was a way to know you were in the good old days while you were in the middle of them.

 

The blue skies turn darker as the light of the sun fades,

the clear images of children turn into silhouettes.

The goosebumps on her skin urge her to get up,

but she stops to take in the scene and appreciate it for a moment longer.

These are the little moments of life that make the every day worthwhile.

If you don’t stop to appreciate the little moments, what good are the big ones?

“Life is not the mountain tops, but the walking in between.”

A L S

From the viewpoint of a second year medical student and most importantly, a daughter:

 

I spent my first year of medical school learning every muscle in the body.

I traced my fingers over nerves that carry pain sensation to the tips of your toes.

I carefully followed the arteries and veins that encircle the heart,

I outlined the various gyri and sulci of the brain.

I learned the functions of these arteries and veins, nerves and muscles

and how they work in a healthy body.

 

I didn’t know I would see the real life ramifications of how anatomy goes awry in disease so soon.

How the muscles I so carefully examined can atrophy

How the nerves I vigilantly traced and the pathways I meticulously studied allowing coordination between the brain and voluntary movement could decay.

 

When I heard a neurologist speak the term “dysphagia” a year ago,

I had no idea the beauty and coordination involved in an act as commonplace as swallowing.

It was not until I visualized the muscles of mastication

Personally examined the skeletal muscle of the tongue

Solidified the importance and its role in propelling food to the back of the oral cavity

Saw animations of how the soft palate elevates and closes the entrance to the nasopharynx

And how the pharyngeal constrictor muscles contract sequentially to squeeze food downwards, that I could appreciate the beauty of this ordinary, yet extraordinary act.

I was overwhelmed by the coordination of over 30 muscles

And how the inability to coordinate this act could be contained in so few letters.

 

Now I watch with sad, but interested eyes.

The way you barely hold your head up as your neck muscles weaken

Your sternocleidomastoid and trapezius wasting

No longer able to support your head as it begins to droop to one side.

Your levator scapulae no longer lifting

Your obicularis oris no longer allowing the showering kisses on my forehead,

The branches of your facial nerve no longer enabling the beautiful smile I’ve grown accustomed to love.

But your thenar muscles still allow for the thumbs up that has become the new signal of content.

 

Your biceps and triceps may have atrophied,

But I’ll always remember the tension as I held onto them like monkey bars.

Your splenius capitus may sag,

Yet I choose to remember how I held onto your neck like a monkey in a barrel.

Your gastrocs and adductor muscles waste away,

But I remember how I pretended to be a leech on your leg

And the way you scooted me across the kitchen floor.

Your hypoglossal nerve no longer lets you move your tongue

But the silly faces and na-na na-na boo-boos will always be my favorite.

 

Your condition may cause hand weakness and difficulty manipulating small objects,

However, your happiness can still be measured in the simplest of things.

Like the number of buttons you’re able to button on your shirt or the number of steps you make in the driveway.

While your lack of movement makes your muscles stiffer,

I watch your slow steps

And see the determination that emanates from all you do.

The way you still put one foot in front of the other every day.

 

Your left deltoid and supraspinatus have decayed, and you are no longer able to extend your left arm

I watch as you pick it up with your right and lie it carefully on the table.

The complex array of muscles and nerves allowing production of speech have long since degenerated,

So you write me a note with your dry erase board instead.

You remind me of all the muscles required to frown,

But only a few are needed to show my bright smile.

You tell me that your life has been everything you could have imagined and more.

 

The one thing that hasn’t changed in size is your heart.

No matter what happens to you, daddy, I know it won’t decay.

And while I hope there is no physiologic hypertrophy,

I know my heart swells with pride every time I’m around you.

The lessons you have taught me will stay in mine forever.

Especially the one you have shown so bravely over the past two years:

 

“Because of the challenges I face, I am less than half the man I used to be on the outside, but more than twice the man on the inside.”