2020
AN ARTS & LITERARY MAGAZINE GEISINGER COMMONWEALTH SCHOOL OF MEDICINE VOLUME 7 | 2020
Cover Image Weathered Veins Momoh Osilama | MBS ‘19 and MD Class of 2024
Black Diamonds is an arts and literary magazine of Geisinger Commonwealth School of Medicine. All content is the property of each respective author/artist. No part of this magazine may be reproduced without the permission of the author/artist of each submission. Geisinger Commonwealth School of Medicine is committed to non-discrimination in all employment and educational opportunities.
NEXT SPRING Momoh Osilama MBS ‘19 and MD Class 2024 Should I regret my hope
my sunlight-bound edge,
that this season pass soon?
rather than pulled up
Lament my fallen amber leaves?
by my roots.
Aggrieved and awaiting next spring
Should I regret my hope
for my flowers to bloom?
that this season pass soon? I’ll wait
I’ve found forgiveness
for next spring
for my florets
for my flowers to bloom.
for what it is they have not become; Stems like black fingers on gaunt and empty, black palms, dried up, untimely departed, when Summertime’s tenor has come. I’ve counted that which I cannot lose: shorn only at
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F
or thousands of people living in northeastern Pennsylvania (NEPA) during the 19th and 20th centuries, coal was precious. It was the black diamond they mined and the substance that supported their
lives. Formed in ancient times under the massive pressure of the sediment above it, coal became the foundation of an entire economy in NEPA. That economy has all but vanished from this part of the country, but today, NEPA is witnessing the formation of a new and valuable resource. Created under the pressure of a great need for future physicians, Geisinger Commonwealth School of Medicine now exists. New students are coming in to NEPA every year to begin the process of being transformed into physicians through the steady, constant pressures of medical school. And like the rich veins of coal that extended through the region, these future physicians are now stretched across counties in northeastern and central Pennsylvania. For many of these students and their teachers, the arts are an important part of life outside of medicine. Our hope is that this journal can serve as a showcase for their expression and be an inspiration to those who read it.
Zachary Wolfe, MD MD Class of 2015
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table of contents next spring 01 lackawanna state park 05 roots: staying groundeD IN times of uncertainty 06 kinderdijk 09 central park, NY 10 roots and Reminders: a reflection 10 “shadowed” 12 message from above 15 watkins glen, ny 16 nightfall 17 dissonance 18 heart 18 skull / brain 19 mount charleston 20 valley of fire 21 a day in the life: a patient’s persepctive 22 Heart and Soul 23
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24 UNTITLED 28 morning mist 29 cologne cathedral 30 my Roots 32 ravello, italy 32 the amalfi coast and the bay of naples 33 cliffs of moher 34 peace & quiet 35 offgrid 36 planets 37 anatomy lessons 38 morning flight 39 blarney castle 40 “hey camp spifida!” 43 keepING watch 44 do the hornets miss their queen? 44 gone fishing
Lackawanna State Park Justin Collins Manager of Student Engagement, Diversity & Inclusion
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ROOTS: STAYING
GROUNDED IN TIMES OF UNCERTAINTY Olapeju Simoyan, MD, MPH, BDS, FAAFP, FASAM Founding Editor-in-Chief
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the introduction to each issue. Having done this for several years now, one might have expected that it would be relatively effortless at this stage. However, this time, I really struggled as I tried to decide on an appropriate message and how to articulate it. When I was writing the essay about transitions and the “arrhythmias” of life for last year’s issue, I had no idea of the twists and turns that lay ahead, but the last several months have been full of real life “arrythmias.” The editorial team chose the theme of “roots” for this issue, long before these events. Recent happenings in my personal life, our nation and around the world have allowed me to examine the concept of “roots” from very different perspectives. On a personal note, it seemed somewhat ironic that I would be discussing roots at a time when I
This is the seventh issue of Black Diamonds,
was in the process of moving to another part of
the first having been published in 2013 when the
the state. Having lived in the Scranton area for a
Geisinger Commonwealth School of Medicine
decade (the longest period I had lived anywhere
(GCSOM) charter class graduated. The second
continuously my whole life), I definitely felt like
issue was published in 2015, and since then it
I had grown roots in northeastern Pennsylvania
has been published yearly. As editor, in addition
(NEPA). And while I enjoyed living and working
to reviewing and approving the content with the
in the area, it is the personal and professional
editorial team, I have had the privilege of writing
relationships that were formed during that time
that I will miss the most. My NEPA “roots” are
foundation of our world was being shaken. For
really based on the connections I developed with
others, staying home meant forming stronger
the people there.
relationships, growing deeper roots.
My initial plan for this essay was to focus
Then came the senseless killing of George
on saying goodbye – a farewell from me and a
Floyd. Before that there was Ahmaud Arbery and
reflection on the loss my family experienced last
Breonna Taylor, not to mention several others.
fall when my 85-year-old-father unexpectedly
The sad reality of racial injustices and inequities
passed away. And then COVID-19 happened...
that have plagued this society for so long once
Moving to another city to start a new job during a pandemic certainly had its challenges. The COVID-19 pandemic changed our lives in ways we could never have imagined. Schools and businesses were closed. Large gatherings were suspended. Virtual meetings became the norm. Even the publication of Black Diamonds was delayed. “Social distancing.” “Flatten the curve.” “Lockdown.” “Shelter in place.” Previously unfamiliar phrases became part of our daily vocabulary as we adjusted to the “new normal.” The number of confirmed cases and deaths due to COVID -19 soared as conspiracy theories spread on social media. Our sense of connection to family, friends and community may have felt threatened. For some, it felt like the very
again came to the forefront. As I reflected on these events and the protests and riots that followed, it appeared that as a nation, we were back in the sixties. Martin Luther King Jr. gave his famous “I have a dream” speech in 1963, before I was born. In that speech, he articulated
T H E S E S O C I E TA L ILLS WILL NOT M A G I C A L LY DISAPPEAR O V E R N I G H T. . .
the hope that his children (who were then very young), would one day live in an America where they would be judged by the content of their character rather than the color of their skin.1 Here we were, almost six decades later, in a society where, despite our advances in other areas, people were still being judged by the color of their skin. These societal ills will not magically disappear overnight, as history as shown, but we cannot
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afford to be complacent. Racial and ethnic
our own way to a more equitable society. As
discrimination, whether overt or a result of
healthcare workers, we can advocate for equal
implicit bias need to be dismantled, and for this to
access to healthcare during the pandemic and
happen, the underlying – or “root” – causes must
beyond. Other responsibilities include exercising
be addressed. Superficial approaches to problem
our civic duties as citizens and advocating for
solving will not lead to lasting change.
equal rights and social justice.
Much as we need to examine the roots of societal ills in order to address them effectively, in times of difficulty and uncertainty, it is our own roots that help to keep us anchored.
... IT IS OUR OWN ROOTS THAT HELP TO KEEP US ANCHORED.
Such roots may come from our faith, family, community or a combination thereof. When we are firmly grounded, that foundation keeps us secure and provides a sense of hope for the future. On a personal note, my parents stood for faith, family and community and now that they are
no longer physically present with us, my siblings and I are empowered to continue their legacy as a result of the seeds they have sown into our lives and the lives of so many others, seeds that have flourished and are anchored by deep roots. While the challenges around us may seem insurmountable, we can each contribute in
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2020 has been a challenging year, but let’s look ahead with optimism as we continue to seek for justice, the elimination of health disparities and equality for all. I hope that our readers will share the hope expressed by our writers. Momoh Osilama speaks to the “hope that this season will pass soon” in “Next Spring,” a poem written prior to the pandemic. John Pacheco and Iris Johnston both wrote deeply personal essays about their roots and Liz Zygmunt shares a moving piece about navigating the healthcare system through the eyes of a patient. Finally, I am glad to say that my moving away does not mean the end of Black Diamonds. I would like to thank the many students and staff members who have worked diligently over the past several years to make this publication possible. Special thanks go to the Arnold Gold Foundation for Humanism in Medicine for providing funding for the first issue and the
Academy of Clinical Educators for funding the second issue. Special thanks also go to Scott Koerwer, EdD, Janet Townsend, MD, and Harmar Brereton, MD, for recognizing the importance of artistic expression and for providing the necessary institutional support over the years. I also thank those who have served on the editorial team, as well as the contributors for their efforts. Heather Davis deserves special appreciation for her tireless efforts in promoting Black Diamonds. It has been a pleasure working with you to provide an avenue for our students, staff and faculty to showcase their talents in such a meaningful way. I thank you all for the privilege of working with you to bring the arts to the community and look forward to staying connected with the Geisinger Commonwealth School of Medicine community through this transition period and beyond. Let’s keep faith alive as we hope and pray for better days ahead. To our readers, I say thank you for giving us an audience and a reason to continue with Black Diamonds, even when the odds were against us. I wish you and your loved ones peace, health and happiness. Reference 1. King, ML. I have a dream 1963. Available at archives.gov/files/press/ exhibits/dream-speech.pdf. Accessed June 10, 2020.
LET’S KEEP FAITH ALIVE AS WE HOPE AND PRAY FOR BETTER DAYS AHEAD.
Kinderdijk Miriam Eagleson MD Class of 2021 09
When I considered “roots,” the theme
MD Class of 2022
John Pacheco
of this year’s magazine, my mind immediately pictured the roots of a tree. For the tree, its roots provide an integral, immovable foundation of structural support, as well as a means of sustenance. Considering my own “roots,”
I went as far down as I could and worked my way upward. I noticed that each set of roots that I’ve planted so far has directly given rise to the next set: I grew up in Burrillville, RI, moved around in New England from Middletown, CT, to Boston, MA, during my pre-medical years, then moved to State College, PA, with my then-girlfriend-nowwife. At every level, I was taking a new step or doing something more specific to prepare myself
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Central Park, NY
for the pursuit of medicine. The roots I’m planting
Justin Collins Manager of Student Engagement, Diversity & Inclusion
here in NEPA as a medical student are no doubt a convergence of all of the ones below. Frankly, I’m not even sure that I could be considered a plant yet. Maybe I only recently sprouted as a little seedling student-doctor in 2018. Maybe I’m a
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ROOTS
R E M I N D E RA REFLECTION S: series of plants all connected at the base by the same
I had very little clinical experience at this point
interconnected network of roots, like a mangrove tree.
beyond volunteering, as an undergraduate, in
Maybe I’ve already stretched the metaphor far enough.
an inpatient hospice unit. Hospice unit patients
Regardless, I’d like to share a story that describes
are typically there for no longer than a couple of
the foundational strength of some of my roots and
weeks and are therefore typically nonverbal. The
illustrates how those roots have been invaluable to my
one other person I’d worked with in the visiting
journey through medical school so far. I first met my good friend Ricky in winter of 2016. On weekends away from the research assistant job I held at the time, I volunteered for a visiting hospice and palliative care group. His nursing home was a quick walk from my apartment, so I visited him quite regularly for
capacity was quite near the end herself and was rather reserved
MAYBE I ONLY RECENTLY SPROUTED AS A LITTLE SEEDLING STUDENT-DOCTOR IN 2018.
almost a year and a half. Ricky was a 65-yearold gentleman who was living in a nursing home after suffering a traumatic brain injury due to a seizure. He had severe short-term memory loss and no use of his legs. He was bedbound and had severe pressure ulcers requiring near-constant attention.
about the end of her life. She just wanted a friend to sit and play cards with. That was easy enough — I love to play cards! Ricky, on the other hand, couldn’t really handle playing games. He just needed someone to talk to. As his sister told me in advance, “He’s kind of a chatterbox,
and he loves company.” Anybody who’s had significant time to get to know me knows that I can be slow-to-warm. I didn’t want to decline such an interesting
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opportunity to get to know someone and to improve my own communication skills, but at the same time I felt completely ill-suited for the task while I was on my way to meet Ricky for the first time. I remember having the thought to myself: “I can’t do this, I’m way over my head here.” As I quickly found out, that was silly of me. Ricky had a talent for articulating whatever thoughts happened to be passing through his head at the time, as well as his definitive opinion on them, to whoever would listen to him. As I sat by the foot of his bed, I listened and responded to everything Ricky had to say: he talked about politics (as he loved to watch CNN nearly 24/7, and the 2016 election was a hot topic at the time), he talked a little about what he was currently reading (he loved biographies and historical works), but most of all, he talked about the people in his life that he loved dearly. He told me all he could about his dear sister, her husband and their children. He had an entire scrapbook’s worth of pictures of them covering the walls of his tiny room. When it crossed his mind, he would talk about a man (A., for Anonymity) who used to fill a similar role to mine. Ricky would gush praise for A. and their relationship that he treasured, and then as if a switch was flipped, resentment would come out.
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“Shadowed” Alayna Craig-Lucas MD Class of 2021
He blamed A. for part of his current condition,
perhaps, sometimes vindictive) habit of ripping
telling me that when A. left his life, it triggered a
all of the pages out of his books and tearing them
“nervous breakdown” that made his condition far
to tiny pieces and throwing them on the floor for
worse and “put me here.” Then, as quickly as it
said folks to clean up. He expressed his fears
came, he would be distracted by another passing
about the upcoming election and for a good while,
thought. I found that the hour of our appointment
his persistent resentment and sadness for “what
flew by before either of us knew it. After I got the
happened” with A. I found that over time (right
word in edgewise that it was my time to leave,
around the time that he began remembering my
he was sad to see me go. He was, however, quite
name), he stopped talking about A. around me. As
pleased to hear that I’d be back again in a week.
the time went by, we spent summer afternoons outside in the sun and away from
The next time I saw him, Ricky didn’t quite recognize me. He was pretty sure he might have seen me before, but that’s as far as he got. And that’s how I learned how severe his memory loss really was.
the gloomy news cycle, until the
THE NEXT TIME I SAW HIM, RICKY DIDN’T QUITE RECOGNIZE ME.
It took him a few months, but he did eventually learn my name. Over the same period, I learned more about Ricky. In the cyclical fashion that his mind would allow for, he told me all about the things he’d said plenty of times before and more: his prior job as a librarian, his love for classical music (I ended up getting him some good CDs and bringing in my keyboard once or twice), his disdain for the nursing home and the folks working there, his nervous (and
seasons eventually brought us back in to listen to Chopin and talk about CNN. We had a good routine going, every Saturday at 1 p.m. until late July 2017. I’d known for a while that my
wife and I would be moving out of Boston that summer, and I did my best to prepare Ricky for it. I knew, given the way he talked about A., that he would not respond positively to me exiting his life abruptly. When the fateful day came, I had brought a card for him with a lengthy note written in it that he could keep on his wall to remember me. If he ever wondered where I went, he could
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read it and know that he’d always have a place in my mind too. With all this, Ricky seemed pretty
a happy ending to this story — that’s the final
okay. I felt like I’d done my job well, and I was truly
interaction I had with Ricky and his family. Did I
a little heartbroken myself. In retrospect, I should
kill him by leaving? Of course not. But I don’t know
never have been worried about meeting a guy like
that I’ll ever know how he really died. Truthfully,
Ricky. All he needed from me was to simply be an
reflecting on the end of this story has been an
attentive, affirmative and consistent presence in
exercise in accepting that some questions have
his life, and I believe this did make
no answers, and that there will be
a positive difference for him over
questions like this for the rest of
that year and a half. What I was
my career. What I do know is that
not prepared for, was a phone call from his sister just about 10 days later: Ricky had passed away. I had dealt with the loss of many patients before in the hospice unit. None of them, not even the 35-year-old mall Santa whose bed I sat by, alone, during his very final hours, hit me as
THE MEMORIES HE GAVE ME HAVE SERVED AND WILL CONTINUE TO SERVE AS A NIDUS FOR MY OWN PROFESSIONAL DEVELOPMENT.
I’ll never forget him as a result of all this. In the same way that he found comfort and remained grounded in his own core memories (his family, the people he grew close to — roots, again!), the memories he gave me have served and will continue to serve as a nidus for my
hard as this. Without a moment’s
own professional development. The
hesitation, my mind kept repeating
irony isn’t lost on me that a guy with
the questions, “Could I have been
limited memory and a penchant
helping to keep him alive? Did I kill him by leaving?”
for hyperbole lives on in my mind as a rather
He seemed to be in the same state of health on
hyperbolic reminder: an attentive, affirmative and
the day I met him as on the day I left! In my mind,
consistent presence might hold the line between
the parallel between his “nervous breakdown”
life and death for a patient.
when A. left him and now this, just after I left him, was stark and painful.
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And, that’s pretty much it. There isn’t much of
I hope that this story illustrates a fact that the
Message From Above Janis Williams Administrative Assistant for the Office of Student Affairs 15
curriculum at GCSOM emphasizes exceptionally well: Patient-centered medicine really does matter. Prior to meeting Ricky, I’d never had the opportunity to develop a meaningful relationship with a patient. After having such an impactful personal experience with him, I knew that I could find genuine personal fulfillment as an in-home caregiver for a year in State College, and I did. Beyond the admittedly selfish motivation, I continued to witness how the little things I could do to make my clients’ days better sometimes had dramatic ripple effects on their well-being and that of their families. When I was choosing a medical school, I knew that I needed to be educated in a way that preserved my commitment to making the world
I FIND THE STRENGTH TO DO THIS IN MY ROOTS.
a better place, one person – one interaction – at a time. GCSOM’s commitment to community-focused, patient-centered education reflected my values in this regard. There it is again: each root providing support for the next.
Watkins Glen, NY Justin Collins Manager of Student Engagement, Diversity & Inclusion 16
So here I am, along with all my peers, working harder than we have ever worked, gaining the privilege of providing patient-centered care in one of the highest capacities that our health
system currently allows. Personally, I find the strength to do this in my roots. Each of my roots is an integral part of the foundation of all that I am, and all that I strive to be. They give me the support and fuel I need to keep growing against the ever-increasing, ever-expanding demands of our training. For his part, Ricky reminds me every day I’m better suited for this than I sometimes think I am. I can do this. I will earn the privilege to be called “doctor” someday, and I sincerely believe that each of my peers will as well. We just have to remember how we got here.
Nightfall Alex Mettler MD Class of 2022 17
DISSONANCE Andrew Denisenko MD Class of 2022
There’s some dissonance that comes when a stranger’s heart is thrumming in your ears A beat to a rhythmic flow of breath I try to read and to connect countless lifeless facts So much more than sheets of cells arrayed like modern art in rose and violet shades Irreducible complexity in a chorus which sounds through small talks in cold, fluorescent rooms Bright digits shine as clumsy analogues for something sacred, vaster than this space All this Awe that’s better off redirected while I’m still figuring out How to percuss
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Heart (WaterColor) Leana Pande MBS Class of 2020
Skull / Brain (Mixed Media) Leana Pande MBS Class of 2020 19
Mount Charleston Kristina Lake Borham MD Class of 2020 20
Valley of Fire Kristina Lake Borham MD Class of 2020
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A DAY IN THE LIFE A PATIENT’S PERSPECTIVE Elizabeth Zygmunt Director of Media and Public Relations I work in public relations at GCSOM. On Saturday, Oct. 5, 2019, I was at the school around 10 a.m. to wait for the reporter I had invited to cover our Hacking Health competition. It was an ordinary day. My plan was to wait for the reporter who was coming between 10 a.m. and noon and then go do regular Saturday things, like shop for groceries. Here is what happened instead: It’s 11:55 a.m. and the reporter has not shown
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12:15 p.m. I’m in Mom’s house. She was diagnosed with aortic stenosis about three years ago but refused a valve replacement and since then she’s been slowing down. Congestive heart failure is a series of steps down. It’s a source of constant surprise and sadness to Mom to experience how a faulty heart shrinks her world. A year ago she was still driving to the store and to the doctor. One day, she gave the car to my brother. Six months ago she would clutch the cart for support while I helped her to shop. One
up. My sister, who is a certified registered nurse
day she handed me a list with some coupons
practitioner (CRNP) calls me. She lives in the
attached. Three months ago she cooked and I
Philadelphia area and has traveled to Dunmore to
set the table. Today she doesn’t even supervise.
watch the Penn State versus Purdue game with
I cook and my husband sets the table when we
my mother, age 88, an ardent Nittany Lions fan.
visit. I don’t think she knew it would be like this.
My sister wants to know if I will join them.
She counted on being independent till the end.
Today she looks particularly gray and isn’t showing any enthusiasm for the game, even though she has her Penn State regalia on from head to toe. 12:30 p.m. Mom’s silence and disinterest in our gossip demands notice. We both want to ask her what’s wrong, but know you have to be careful. If you push too hard, she snaps at you and won’t engage any further. Then you can’t get her to call a doctor, take medicine, do whatever. So, we proceed with caution. 12:40 p.m. I still don’t know how it happened. Thirty minutes ago, I was thinking of what to buy at the supermarket but now I am gathering Mom’s things and frantically searching for her insurance cards. Somehow my sister has persuaded her to go to the emergency room. Her feet are swollen to the point where she wears bedroom slippers instead of shoes, but she’s ready to go. 12:50 p.m. The emergency room is jam packed and the wrong football game is on in the waiting room. I know Mom is anxious because
Heart and Soul Becca Lees MD Class of 2023
that doesn’t even register. She sits staring at Oklahoma playing Kansas. My sister and I search for words that will cheer her, but she clutches her
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insurance cards and stares as two teams she doesn’t care about tussle over a football. What is she thinking? Maybe coming to terms with old mortality. Our talk seems trivial, so we stop. 2 p.m. Finally, someone comes to take vital signs. We think we are making progress. 3 p.m. We have not made progress. 4 p.m. Someone comes into the waiting room to draw some blood. 4:10 p.m. We go with Mom for X-rays. 4:30 p.m. We finally are invited to “go into the back.” By now, “being taken back” seems like the pinnacle of human achievement. We made it! There are patients everywhere, including on gurneys in the hallways. We are lucky. Because Mom is most likely going to be admitted (she begins to plot her rebellion, she hates the hospital), we get an actual room. 5:45 p.m. The emergency room doctor arrives. He listens to Mom’s heart. “I don’t appreciate the murmur,” he said... or something like that. My nurse practitioner sister suddenly sits up straighter.
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Untitled Becca Lees MD Class of 2023
6 p.m. By now my other siblings (two brothers
beside a gurney occupied by his own mother.
and another sister) have filled the room. The
Despite these distractions, we focus on our plan:
doctor tells us about transcatheter aortic valve
Talk to the cardiologist. Start the TAVR ball rolling.
replacement (TAVR). This is the surgery Mom refused three years earlier. Now, because she feels so sick, she’s listening. Although she clearly understood that her congestive heart failure would progress without valve replacement, she planned to “go in her sleep” without any suffering and debility or causing anyone any fuss. Of course, the universe laughed. 6-10 p.m. Nurses and other staff are in and out. All we talk about is TAVR. Suddenly, Mom’s shrinking world has expanded. My brother points out all the wonderful things that are suddenly back on the table: going to her granddaughter’s wedding in a few weeks, holding the first great grandchild due in a month, maybe even another trip to Hilton Head Island, the place she considers paradise. She is happier and more engaged than she’s been in months. We still don’t have a room on the telemetry unit and are often ordered to leave Mom’s bedside when she wants privacy. When we are dismissed, we are obliged to join a chatty man standing
10:30 p.m. Mom finally gets a room on the telemetry unit. Saturday is over. Sunday: Mom goes for an echocardiogram and we all hang out and make plans for her postTAVR life. She’s like a condemned prisoner in sudden receipt of a good letter from the governor. Reprieved! Monday: I call the office to let them know I will be late because I would like to be with Mom when she talks to the cardiologist. My nurse practitioner sister will also be there. The crisis seemingly averted, everyone else has gone home. 8 a.m. My sister and I are bedside with our coffee. The wait for the cardiologist is on! 9:30 a.m. A resident physician who says she is from hospice/palliative care appears at the bedside. What are my mother’s goals? We are bewildered. We protest. There’s been a mistake. We didn’t ask for hospice. We are waiting for the cardiologist. The resident seems momentarily confused. After a brief internal debate, she
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decides on a course of action. She says let’s just go through the talk and we’ll see about
view of the city. There is a building on the
the cardiologist... and I am going to go get my
University of Scranton campus that used to house
attending.
a ballroom. My grandfather, an immigrant from
10 a.m. The resident returns with her attending physician, a tall woman with an authoritative presence that is still somehow kind. She is going to tell it like it is but hold your hand while she’s doing it. We repeat what is by now our mantra: We are waiting to see the cardiologist. “Let’s look at your echo,” the hospice physician says. She turns the computer screen at the foot of Mom’s bed a bit so she can look at both it and Mom simultaneously. All the light and air leave the room as she begins to read a litany of findings consistent with heart failure. It’s not just one
a Polish town called Sierpc, used to go dancing there. I can also see the slope where he once descended a coal shaft and the steeple of my parents’ church. The building where my late father went to work for 40 years is also visible... across from it, the office in which my mother worked for far fewer years, having spent most of her young adulthood at home raising six kids. Hospice is making me see ghosts. I know Mom is seeing them too because she stares fixedly out the window as the attending physician no one asked for continues to talk. I think again of the emergency room doctor
valve now, it’s another (tricuspid?). Left side isn’t
who didn’t “appreciate” some sound with his
pumping. Right side isn’t pumping. Pulmonary
stethoscope and told us about TAVR. Perhaps he
hypertension. Ejection fraction less than 20
should have waited for the cardiologist, as we had
percent.
all planned to do.
10:30 a.m. Seventy-two hours ago I was thinking
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My mother’s window has a beautiful, panoramic
Despite the news she is delivering, we warm
about a grocery list. Yesterday, we were talking
up to the attending. She is brisk and no-
about taking shifts to help Mom as she recovered
nonsense, but her compassion for my mother
from TAVR. Now, we are actually talking about
is unmistakable. Her message is that hospice
hospice — hospice — as if it’s a real thing.
will make Mom’s life better, so dry your eyes
and listen up, people. I suspect she’s read Atul Gawande’s Being Mortal. 11 a.m. The cardiologist finally arrives and rules out TAVR. By now that’s old news and where we once had a thousand questions, we now have none. We are still reeling, silent. In shock and denial, grief experts would say.
POST SCRIPT A hospice doctor first spoke to my mother at the beginning of October 2019. Mom died at home at the beginning of July 2020. What did nine months of receiving hospice care in her home do for Mom? It gave her one more huge family Thanksgiving at my sister’s
Mom can go home tomorrow on hospice. The
house in New Jersey. One more huge, traditional Polish Christmas
attending’s only discharge order: Do what makes
Eve at my home. One more huge birthday party for her in January.
you happy.
Mom had five children, five in-laws and 12 grandchildren – so huge
For about a week after her discharge, Mom doesn’t do anything that makes her happy. She stays in bed waiting for the end. Yet life goes on. The hospice nurse and the nurse aid are bright and cheerful. One sibling or another goes every day to check on her. Her grandchildren come from great distances to visit her. Gradually Mom realizes she’s still alive. She continues to be tired and short of breath and needs plenty of help, but she’s welcomed her first great grandchild and is determined to travel to my sister’s house in New Jersey for the holidays. Her most important prescription — do what makes you happy — has begun to take effect.
means in excess of 20 people around a table. When the pandemic hit, she wasn’t in a nursing home, meaning that as soon as it was safe, her whole family could come visit her again. During her final two weeks, it meant that her children could be with her constantly and various grandchildren could travel to see her. No one close to her was denied the opportunity to say good-bye, which in the age of COVID was priceless. She also got to distribute precious belongings that would be deemed worthless in probate — her falling-apart prayer book stuffed with treasures like the little notes my father wrote to her, a battered blue McCall’s cookbook she consulted almost daily throughout my childhood and the crucifix necklace she never removed. Hospice at home made Mom’s final months time lived instead of time waiting to die. In an age where too many of our elderly spend years in a kind of half-lived institutionalized twilight, I am grateful to the doctor who decided to deliver the tough talk that was, in fact, an act of enduring compassion.
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Morning Mist Alex Mettler MD Class of 2022 28
Cologne Cathedral Miriam Eagleson MD Class of 2021 29
Iris Johnston Library Specialist At first I wanted to tell you the story of how my
MY ROOTS
ancestors came to America. My maternal relative Edward Doty was an indentured servant on the Mayflower. For real. I wanted to write about the contrast between the pride of saying “we came over on the Mayflower” and the truth of his lowly, even embarrassing, origins. He was a horse thief and a drunkard, and he’s remembered mostly for starting the first duel in Plymouth. Not a great story. Maybe my paternal side is better? You can imagine the family coming over from Ireland, a 5-year-old boy holding the hand of his father, watching Lady Liberty rise before them. But the boy, my great-great grandfather, reached the shore alone. His father disappeared before landfall, either thrown (more thievery) or fallen (more drunkenness) overboard. That’s all I know about him, too. These anecdotes are a little too vague to feel like a real anchor to the past. If they were radically different, or if I didn’t know them, it might not change who I am at all. Then suddenly I remembered our pediatrics faculty member, Dr. Dawgert. He teaches that experiences in childhood shape how we move through
30
adulthood. In medicine, this usually refers to
aqua. Her beak is violet. Her feet are striped red
things like trauma and illness. But I’m not a
and silver. Frankly, she looks a mess. I wasn’t
physician, I’m an artist. Art, both making it and
necessarily trying to be different. I just wanted to
loving it, influences everything from my career to
see if there was a better way to color a duck.
my manicure. My discovery of art is both more
I’m 12 years old. It’s not awesome. It’s so very
immediate and more graphic in expressing who I
not awesome that I am being homeschooled this
am than a story about my ancestors. Here we go.
year. For cultural outings, my parents take me to
I’m three years old and we’re learning how to
see independent films at the F.M. Kirby Center in
wash our hands at Little People Day Care School
Wilkes-Barre. The film playing this early October is
in Dallas, PA. I’m standing next to my best friend
Basquiat, about the painter Jean-Michel Basquiat.
Jamie. I’m staring at her hands as she washes
Because it was directed by a painter, Julian
them. White sink, yellow sunshine. Brown Jamie
Schnabel, the photography is achingly beautiful.
hands, pink Jamie palms. Clear still
The nuances of the storytelling will
water, white frothy water. It’s so
take me longer to appreciate. As
beautiful and I’m full of a happiness I don’t have words for. For the rest of my life I will get a little frisson of
“BUT I’M NOT A PHYSICIAN, I’M AN ARTIST.”
an adult I will see the heartbreak of systemic racism, homophobia and addiction. At twelve I see an
delight putting colors next to one
irreverent boy making gorgeous,
another and seeing what they do.
wild, strange art. Laying the wrong
I’m six years old and we’re coloring ducks. Each duck has a student’s name printed on it. We all line up with our ducks and take turns
colors beside one another. Trying to find a new way to express classic ideas. I am in love. I am more than a painter. I work in the library,
tacking them to a bulletin board that reads, “April
for example! I am a linguist, and an activist, and
Showers!” All the ducks are yellow with orange
a daughter. But if all that went away, if I just lived
beaks and orange feet. Maybe Brock, who already
in a cave, I would still be drawing pictures on the
goes hunting, has colored his duck dark mallard-y
walls. Putting shapes to the experiences that
green with a white band on the neck. My duck is
make me who I am.
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Ravello, Italy Jane A. Kanyock Director of Major Gifts
The Amalfi Coast and the Bay of Naples Jane A. Kanyock Director oF Major Gifts 32
Cliffs of Moher Dougan McGrath MD Class of 2022 33
Peace & Quiet Janis Williams Administrative Assistant for the Office of Student Affairs
34
OFFGRID
Offgrid in the North Johanna Dungca MD Class of 2022
Offgrid in Palawan II Johanna Dungca MD Class of 2022
Offgrid in Palawan I Johanna Dungca MD Class of 2022 35
Planets Miriam Eagleson MD Class of 2021
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ANATOMY LESSONS
Unmistakably a small rose
Caroline Bandurska
tattoo on a cadaver’s ankle
MD Class of 2023
Suddenly the list of
We hold hands before the first day of
anatomical structures I’ve
lab
been agonizing over
All 119 of us, slightly cramped,
doesn’t seem so important
Encircling the area where our first patients rest
What an unusual, ethereal
Anatomy lab, they tell us, is where you
experience
first learn to be a doctor Starting the dissection, I don’t feel like I’m learning to be a doctor I feel like I’m back in kindergarten, learning to draw shapes Or, if I’m bold, trying to draw a flower — So familiar by sight, yet stubbornly difficult to replicate on paper It’s in week 2 that I see it Faint line of stem, small projections for thorns
Being permitted to see the inner
f
sanctum of one’s body Skin, muscle, and bone — things a patient never sees Yet we see less than the whole We miss the stories and connections and loved ones What made them laugh on a Saturday afternoon In that 2nd week I learn the first lesson of being a doctor: How, beyond the corporeal form, humanity blooms
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Morning Flight Ed Lahart Registrar 38
Blarney Castle Dougan McGrath MD Class of 2022 39
“HEY CAMP SPIFIDA!”
Vanessa Thiel MD Class of 2021 It’s hard to explain the feeling after leaving a week of Camp Spifida. Exhaustion, joy, relief, happiness and sadness are just a few emotions I felt as I walked along the camp grounds, back to my car. It truly was an amazing week and despite the several information packets and the orientation I received, nothing could have prepared me for the impact it was going to have. Camp Spifida takes place during one week in July in Millville, PA, just around the corner from Geisinger Medical Center in Danville. As you could probably guess, Camp Spifida is a summer camp for kids with spina bifida. More than that, I’ve learned, it’s a home away from home and a place of acceptance and empowerment for all those involved. Camp Spifida is indeed a special place, close to many hearts. If it’s any indication, when you head to their website (campspifida.org), the first thing you will see is a giant countdown — right down to the very second camp will start. No doubt, campers (and counselors/staff!) will check the countdown from time to time, excited for the next week of camp in about...194 days, 15 hours, 6
40
minutes and 46 seconds.
Even further indication of the camp’s impact is
problems, including lack of bladder/bowel control,
the first day. Not only are campers on time, but
learning disabilities and specific allergies. They
several are early, and will wait with their families
also may have a range of physical limitations.
in the car, eager to unpack their bags in their
With the help and training of staff and counselors
assigned cabin. Newcomers may be nervous,
at Camp Spifida, children are able to participate
even tearful as they leave the comforts of home
in a week-long camp, with activities such as
but most will soon discover great joy in this
rock climbing, ziplining, swimming and more!
week. Camp counselors and staff will also await
Camp Spifida shows that there are actually
eagerly, ready to welcome
no limitations, just
the campers with open
modifications for certain
arms and reassure tearful
things.
parents who may be
The camp also focuses
leaving their child out of
on positive self-image
their sight, for the first
and self-esteem for the
time ever.
campers. Through this
But what makes Camp
camp, a community is
Spifida so special?
created where everyone
“Camp Spifida is an
is accepted, no matter
incredibly unique opportunity for kids with spina
their abilities. Campers support each other, root
bifida,” says Christine Klingaman, DO, a resident at
for each other and empower each other. For me,
Geisinger Medical Center. “Camp creates a space
this was most evident during the camp’s annual
and environment that focuses on the campers’
talent show. All campers are invited on stage to
abilities and provides them with experiences
showcase their talents and passions, and they
that they may not have otherwise been able to
have the entire camp’s support while doing so.
participate in.” Indeed, Camp Spifida’s mission is
From comedy acts to moving renditions of “This
to “provide a typical camping experience while
Is Me” from The Greatest Showman, the talent
allowing for health and physical limitations.”
show is sure to move its audience and elicit a roar
Individuals with spina bifida face several health
of applause.
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On the last day of camp, there is a graduation
JOY
ceremony for those who have aged out of camp.
for Camp Spifida. In fact, it was my first time
These graduating campers have likely been
as a camp counselor, ever! Just like other new
coming for years and have formed a second
counselors and campers, I was nervous, scared
family in Camp Spifida. Their tears and emotional
and very unsure of what I had gotten myself
goodbyes really emphasize the impact this camp
into. Day by day, as I watched the campers get
has had on its participants. Following these
more comfortable and reveal their wonderful
goodbyes there is a slideshow presentation
personalities, I found myself following their
and all are able to reflect on another week gone
example. Although I am older, I found myself
by. At this point, many campers are tearful and
being taught valuable lessons of acceptance (of
saddened by another week come to an end.
oneself and of others) by the campers. I found
Those newcomers who were initially afraid to
myself receiving and exuding the strength of the
begin the week are now unwilling for it to end.
campers. Indeed, their spirit is contagious.
Surely as the campers leave, they are already counting down the days until next year, much like when children begin the countdown to next Christmas as soon as the presents are open. When spending a week at Camp Spifida, you
As I walked back to my car upon ending my week at Camp Spifida, I had a mixture of emotions. I was exhausted, for the week involved hard work, a busy schedule and long nights. I was relieved and happy to be heading home, to
see transformation and growth. “One of the most
my own bed and everyday life. I was however,
rewarding things as a counselor is to watch
sad to say goodbye to such a special place. Most
these children grow in so many ways throughout
prominently however, I was grateful — grateful
the week and from year to year. Their strength,
to be a participant and witness of the amazing
perseverance and energy are contagious,” says
impact of this camp. Even after just one week,
Dr. Klingaman. Indeed, watching the growth of the
Camp Spifida will no doubt have a special place in
campers is so contagious, you are bound to grow
my heart for a very long time.
yourself.
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2019 was my first time as a camp counselor
KeepING WatcH Janis Williams Administrative Assistant for the Office of Student Affairs
43
DO THE HORNETS MISS THEIR QUEEN?
SEED.
Jasmine N. Richards
&scarred.
do The Hornets miss their Queen? The buzzing never leaves; Can anything quell this incessant drone that fills from thorax to wingtip? rhizomes, nodules, &roots; crushed, grounded,
Curriculum Education Assistant
A vision of a warped future. Part flora and fauna. Waning more than waxing. Will She know anything outside of stagnancy? BLOOM. the Queen embraces those Loss. The buzz only unfurls on the Queen of The Night’s time where relief releases in sighs smaller than Baby’s Breath. petals, pollen, &windowpanes; spirited, rekindled &healed. Black-Eyed Susans attracts feather light moth smiles; Remember that blush, that fragrant smile for those inevitable new moons. And with Face to the Sun (full bloom.)
44
Gone Fishing
and Roots to the South (sacred alter.),
Janis Williams Administrative Assistant for the Office of Student Affairs
she remembers that stagnancy only bothers those afraid to grow.
COMMITTEE Olapeju Simoyan, MD, MPH, BDS, FAAFP Editor in chief Vanessa Thiel Managing Editor Katherine Mullen Layout Designer Heather M. Davis, MFA Production Manager
Miriam Eagleson Student Editorial Assistant Amelia Mackarey Student Editorial Assistant Iris Johnston Staff Editorial Assistant Alysha Nicholls Staff Editorial Assistant
Photo by Guy Cali