Fall 2021: The Health Humanities Journal of UNC-CH by The Health Humanities Journal of UNC Chapel Hill

The Health Humanities Journal

The University of North Carolina at Chapel Hill FALL 2021 | exploring illness, caregiving, and medicine

MISSION STATEMENT The Health Humanities Journal of UNC-CH aims to inspire and facilitate interdisciplinary thinking and collaborative work while developing and embodying a variety of ideas that explore the interface between arts and healing. This publication allows for dialogue, meaning-making, and multiple representations of the human body, medicine, and illness. To learn more about the publication or to submit, visit the following website: https://hhj.web.unc.edu.

DISCL AIMER The Health Humanities Journal of UNC-CH adheres to legal and ethical guidelines set forth by the academic and health communities. All submitters maintain patient privacy and confidentially according to the Health Insurance Portability and Accountability Act (HIPAA). The University of North Carolina at Chapel Hill and The Health Humanities Journal of UNC-CH do not endorse or sponsor any of the viewpoints presented in this journal. The opinions presented in this journal are those of the corresponding authors.

SPONSORS

The Carolina Parents Council

The Health Humanities Journal

of The University of North Carolina at Chapel Hill Fall 2021

Editorial Team Iris Kang Editor-in-Chief Majors: Psychology, Neuroscience Class of 2023

Olivia Delborne Editor Major: Psychology Class of 2022

Maia Sichitiu Design and Layout Editor Major: English Class of 2022

Rhea Jayaswal Editor Major: Nutrition Class of 2023

Ellen Hu Art Director Majors: Biostatistics Class of 2023

Miranda Almy Editor Major: Medical Anthropology Class of 2023

Malik Tiedt Treasurer Editor Majors: Medical Anthropology, Nutrition Class of 2023 Kym Weed, Ph.D. Faculty Adviser Co-Director, HHIVE Lab Department of English and Comparative Literature Jesse Bossingham Graduate Editor Fourth Year Medical Student Literature, Medicine and Culture MA

Annette Varghese Editor Major: Neuroscience Class of 2023 Cathy Choi Podcast Editor Major: Psychology Class of 2022 Kamryn Mcdonald Marketing Director Major: Psychology, Indisciplinary Studies Class of 2023

Table of Contents

ART by Ellen Hu

Iris Kang

Editor’s Note

Angus Bennett

a promise to my cadaver on our last day’s dissection

Scott Giberson Jr.

Wishful Numbness

Tulsi Patel

Distrust, Transportation, and Home Remedies in Rural NC

Leda Espinoza

Teeth

Jared Pittman

Haunted by History

Claire Molloy

Touching Down

Michele L. Mekel

After

Emma Astrike-Davis

Anxiety and Isolation: The Disproportionate Burden of the COVID-19 Pandemic

Rahul Menon

Sunitha

Phalaen Chang

Recovery

Chinmayi Balusu

Caretaking in Different Spatial Settings: Empowering Traumatic Brain Injury (TBI) Patients By Centering Autonomy

Katy Waddell

Recompense

Halle Pearce

Secrets

Rachel Kirsch

Schrodinger’s Son

Alexa Holloway

disassociation

Scott Giberson Jr.

Open Late

Akshay Pendyal

See one, do one, teach one

Settle Monroe

Dust and Snow and the Intensive Care Nursery

Virginia Tanner

Stolen Power

Editor’s Note

Dear Reader, What do you do when the world you have so carefully built over the years crumbles in just a few seconds? This image hits home to many of us as we continue to live in the grips of the pandemic, but personally, it was an all-too familiar question I had grappled with two years ago during my first semester in college. It feels like only yesterday when I was lying in the dark of my dorm room, listening to two fellow freshmen walking past the hall as they chatted excitedly about their night out. All I could think of in that moment was how could they be so carefree when all of our lives will eventually fade into dark? As a result of the countless health scares and therapist visits that had spiraled the months before, I was left feeling utterly hopeless and alone, struggling with questions of uncertainty about what lay ahead. Standing on the other side of this story today as a woman of faith and having had the privilege of reading the works of our authors over these past few months, I am reminded again of why this journal means so much to me as I know it does to you. There were many times when their stories shook me to the core and left me with a sense of familiarity despite our vastly different experiences. Whether it be the pilot whose cancer diagnosis has stripped away his identity, a mother grieving the loss of her son on a day she didn’t know would be his last, or the medical student rehearsing a heavy-hearted conversation in front of the mirror, this semester’s pieces have all captivated our editors with their vulnerability and voice, reminding us once again of the frailty of life. It was our art director, Ellen, who put into words this common thread through this semester’s highway-themed cover. Her vision was to capture the hills and valleys of life, all the while evoking its fleeting nature—a theme that echoes strongly in the pieces you will soon read. Upon seeing it for the first time, however, I realized that it is also on these dark highways of life that we are often accompanied by an ostensible companion: the feeling of being alone. True to this issue’s metaphor, not only does the theme of life’s brevity run deep through the pages, but it is also the solitude marking our struggles

with mental and physical health that interweaves them. Whether it be the pilot, mother, medical student, or college freshman struggling with anorexia, we all have stories that are waiting to be written and that have the power to resonate with another. And it is when we give words to these journeys that we realize one is never truly alone. Before we embark on the roads these pages will guide us through, I would like to recognize those who have brought to fruition the journal held in your hand. A thousand heartfelt thanks to the staff for their dedication and all the work they have poured into this latest issue. In particular, its production would not have been possible without our returning staff—Maia, Malik, Olivia, Rhea, and Miranda—who have been so patient and supportive as I navigated my first semester onboard. To our new staff members—Ellen, Kamryn, Cathy, and Annette—I am beyond grateful for all of your fresh insights that brought so much perspective to this edition. To our graduate editor, Jesse, thank you for always going the extra mile and bringing an abundance of wisdom to our discussions. Additionally, I would like to give special thanks to our adviser, Dr. Weed, whose guidance has been a true blessing to our team and the publication journey this semester. Lastly, you, our dear reader, make this journal a reality and a gift for so many people to partake in. As such, the Fall 2021 issue of The Health Humanities Journal is dedicated to you. We hope you will find healing, resonance, and—most of all—a companion in these life-breathed pages that remind us of an essential truth: fellow traveler, we are far from alone. Warmly, Iris Kang Editor-in-Chief

a promise to my cadaver on our last day’s dissection Angus Bennett There is a stippled, bright wind about, Carolina in mid-May — a near-constant green motion that stall-fumbles as one looks, then holds, holds and awakens one back into sea-kelp drift. Students are pushed by in clumps, voices low into the brick and lost to the light traffic of four-thirty in the after-term. I know nothing about you having dissembled about you, other than the weight of your right knee, bent, shorn of tendon gleaming in the overhead light as Burk, proud as a new father, encouraged us to touch your meniscus. Still surprisingly hard to do. I’ll see you again in a week, a parody of the receiving line as we shuffle by, long strands of eyes and pencils, last expects, as in, I expect this will be the innominate, the inchoate; hot light above, still air in want of breath. Something hushed, tagged with a ring that grows more silver, more strained.

-Angus Bennett is a fourth year medical student in the UNC School of Medicine from Mocksville, NC.-

Wishful Numbness Scott Giberson Jr. Did you feel anything?

I never formally introduced myself — well to be frank neither did you. We met under harsh circumstances like a fresh bloom amongst the weeds; you were the flower, and I was simply a honeybee encountering you for a fleeting moment. The sterility in the air was gone the moment you entered the room. Shouting and moving like members of a marching band, they surrounded you, cutting off my view momentarily as I peered through the flurry of drugs and equipment. Yet there you were, motionless, in a state of chaotic peace. Did you feel anything? They moved you with quickness to the bed as they stripped you down with a mechanical precision only familiarity can bring. Bruised and vulnerable you lay with your chest rising only enough to keep you alive. You slipped away for a moment… you looked peaceful, like you didn’t have a worry in the world. Like you couldn’t feel them fighting a battle with eternity where you were both the prize and the battlefield. Then you moved, but not by choice as a foreign shock contorted you in a way that you wouldn’t have liked. You jumped, but not in the way that you would on the court. I could tell from your shoes that’s where you felt at home. No, this time you jumped like you were awoken from the precipice between being awake and asleep. You know that feeling of falling you get when you nod off without noticing? Have you ever gotten that feeling?

11 Your eyes remained hesitantly closed as if you wanted to peek out of the darkness you inhabited. A woman entered the room, She looked like you. We had to ask her to step out when she fell on the floor, screaming for her baby. I was someone’s baby once. I wonder if she wanted to hold you in her arms like she did when you couldn’t even dream of driving that car. People kept coming, you know. One by one they walked in hesitantly. Some stoic, some angry, most confused, with strained faces as they tried to hold back tears as tightly as they wanted to hold onto you. You weren’t alone I promise. When your chest began to sink you weren’t alone. When you were broken under the weight of a man willing your blood to move you weren’t alone. They never left you. Did you feel anything? As that woman was told that we tried our best, there was no consolation prize. No participation trophy. Only wailing. Only pain. John Doe early 30’s killed during a motor vehicle collision. Time of Death: 2235 Please tell me you didn’t feel anything. -Scott Giberson Jr. is a first year medical student in the UNC School of Medicine from Austin, TX.-

Distrust, Transportation, and Home Remedies in Rural NC Tulsi Patel Nefertiti Byrd, a resident of Warrenton, NC, said her physician wasn’t “somebody that you grew up with or somebody in your family that you knew” (Byrd, 2018). While she continued to trust the rural healthcare system, other Warrenton residents began choosing home remedies over allopathic treatment. This divide between allopathic healthcare and home remedies is exploding across rural North Carolina as a consequence of the lack of Medicaid expansion. Interviews obtained from the UNC Southern Oral History Program portray how the lack of Medicaid expansion has caused rural hospital closures, patient distrust, and a transportation burden, ultimately leading people to turn toward home remedies. Since Medicaid was not expanded in North Carolina, the increasing uninsured population gave rise to dwindling resources and hospital closures. Uninsured patients reduce compensation for hospitals, leading the US to have its “worst year for rural hospital closures” in 2019 (Heath, 2021). The COVID-19 pandemic has put 40% of rural NC hospitals in negative margins (Paschal, 2020). This financial strain prevents hospitals from buying updated equipment and having an adequate staff size (Paschal, 2020). This instability could potentially discourage clinicians from working in rural hospitals. In counties with hospital closures, the median number of clinicians per 100,000 patients dropped from 71.2 to 59.7 (Heath, 2021). Clinicians could possibly be avoiding working in rural hospitals, discouraging other rural clinicians and creating a vicious cycle. Hospital closures magnify the lack of medical facilities and professionals across rural NC and decrease healthcare access. The lack of resources and general unreliability surrounding rural healthcare generates distrust between clinicians and patients. Darlene Spencer-Harris, from Rocky Mount, NC, spoke about how she “will hear a lot of people say, ‘I don’t go to the doctor in Rocky Mount. I go to Raleigh or Greenville where I know I’m going to get the best of care’” (SpencerHarriss, 2019). This distrust is exacerbated by the dwindling number of rural physicians. Spencer-Harris demonstrates the importance of continuity of care to patients. Despite her physician not accepting her insurance, she

states that she “[doesn’t] want to start over” with a new physician because the established doctor-patient relationship compensates for the financial burden. Other rural residents do not receive this continuity of care “because every time [they] turn around, a doctor is leaving” (Spencer-Harris, 2019). Strong doctor-patient relationships cannot be built due to this instability, reducing quality of care. Rural hospital closures exacerbated by the lack of Medicaid expansion prevent people from trusting the remaining rural hospitals. Alongside increasing patient distrust, rural hospital closures decrease access to healthcare by increasing travel times. Areas with rural hospital closures saw an increase of 20 miles for the median travel distance between 2012 and 2018 (Heath, 2021). Compared to urban cities, rural areas do not readily provide modes of transportation, such as buses or ridesharing services like Uber. Stephanie Atkinson, a nurse in Dunn, NC, describes the latter by saying “nobody is sitting around waiting for somebody to need a ride because it’s such a rural setting”. While Medicaid does provide transportation, the lack of Medicaid expansion in NC prevents people from having that resource. As Atkinson mentions, “transportation is one of the biggest barriers [rural communities] face” (Atkinson, 2018). In Fairmont, West Virginia, a woman was forced to take a 25-minute-long ambulance ride to a hospital in a different county because the medical center in her town closed (Paschal, 2020). Transport burden is an indirect consequence of the lack of Medicaid expansion in rural NC. Travel burdens ultimately cause rural patients to turn toward home remedies and local herbalists. Ana Marie Deaver, a nurse in Dunn, NC, explains how her family relied strictly on home remedies because they weren’t “privileged enough to go to the doctor” (Deaver, 2018). Her mother would prepare a mixture of castor oil, honey, and garlic to treat colds (Deaver, 2018). Similarly, many other uninsured families cannot access allopathic care and opt to treat themselves with home remedies. These remedies are not typically harmful and many have served as reliable preventative measures for generations. Increasing people’s access to healthcare is not meant to demean herbal medicine but allow people the option of allopathic medicine that they otherwise would not have. Medicaid expansion would decrease travel times, increase patient trust, and provide the opportunity to receive allopathic treatments. This

14 increased access to care would allow rural hospitals to be compensated, preventing further closures, and opening new hospitals. A growing system would encourage clinicians to work in these hospitals, establishing continuity of care and increasing patient trust. Medicaid expansion would reduce the homeopathy-allopathy divide because North Carolinians would have sufficient access to both treatment types. Alongside diminishing the transportation burden and instilling patient trust, Medicaid expansion would allow rural communities to utilize both herbal and allopathic treatments to receive the best care possible.

References Byrd, N. (2018). Interview with Anna Freeman. 14 (Y-0012). Southern Oral History Program Collection (#4007), Southern History Collection, Wilson Library, University of North Carolina at Chapel Hill. Malone, T., Kirk, D., Randolph, R., & Reiter, K. (2020). Association of CMS‐HCC Risk Scores with Health Care Utilization among Rural and Urban Medicare Beneficiaries. Rural Health Research Gateway. https://www.ruralhealthresearch.org/publications/1395 Heath, S. (2021). Rural Hospital Closures a Hit to Patient Care Access, Outcomes. xtelligent Healthcare Media. http://www.louisianaweekly.com/experts-are-warning-that-the-sky-is-falling-forrural-health-care-in-the-south/ Paschal, O. (2020). Experts Are Warning That the “Sky Is Falling” for Rural Healthcare in the South. The Louisiana Weekly. http://www.louisianaweekly.com/experts-are-warning-that-the-sky-is-falling-forrural-health-care-in-the-south/ Spencer-Harris, D. (2019). Interview with Lauren Frey. (Y-0129). Southern Oral History Program Collection (#4007), Southern History Collection, Wilson Library, University of North Carolina at Chapel Hill. Atkinson, S. (2018). Interview with Maddy Kameny. (Y-0003). Southern Oral History Program Collection (#4007), Southern History Collection, Wilson Library, University of North Carolina at Chapel Hill. Deaver, Ana M. (2018). Interview with Maddy Kamey. (Y-0020). Southern Oral History Program Collection (#4007), Southern History Collection, Wilson Library, University of North Carolina at Chapel Hill

-Tulsi Patel is a sophomore from Whiteville, NC pursuing a major in Neuroscience and in Medical Anthropology.-

Teeth Leda Espinoza Teeth, his not-so-pearly whites, Stained by coffee and twenty-some years of living, Concealed beneath a thin swath of hospital blue for safe-keeping. Teeth, a once forgotten serrated kitchen knife, Unforgiving and irrevocably precise, Patiently waiting to carve any fleshy form. Teeth, our universal end, Accompanied by that fabled, terminal light, Eager to swallow anything and everything whole. A single Tooth, my needle, A different kind of sharp, This one sterile and serene, A physical, curved link between A boy, not yet a man, And a novice, not yet an expert, Who now sit, Together, In the piercing numbness that all began with those tired, lonely Teeth, Wondering: do we put each other back together again?

-Leda Espinoza is third year medical student in the UNC School of Medicine from Emerald Hills, CA.-

Haunted by History Jared Pittman

“The labs for your liver levels are extremely elevated.” I try to stammer out a response, but it is incoherent. I grip the sides of the cold metal chair and clumsily shift my body into a tense position, in which every joint feels slightly contorted by the demands of my now rigid muscles. “Have you used drugs or alcohol in the past?” Why was he asking that again? I told him when we first met that I hadn’t. Had he just forgotten? I weakly mutter “N-no,” while carefully controlling my throat muscles so that I do not sound as shaky as I feel. “Are you sure that you’ve not used any drugs or alcohol in the past? I won’t get you in trouble, but I need to know the truth.” His accusatory tone makes it clear that he has not forgotten my answers; he just does not believe me. I take a deep breath in an attempt to cool the irritation that I feel seeping out of my tensed muscles and burning my skin. I can’t quite make out what I say next, but the look on his face indicates that my comment came off a little harsher than intended. I feel the heat of anger fade into the uncomfortable warmth of embarrassment. I loosen my grip on the chair and shift around in an attempt to cool off. “Okay then… does anyone in your family have any genetic liver diseases?” I have to brace myself before I answer. As I rush through my family history, my mind is being bombarded with horrors that I had almost convinced myself I had forgotten. I see my grandmother’s yellowed arm raised above the railing of the hospital bed as she limply pulls at the tube of her ventilator. I hear her gasping for a little more time. I see the terror in my aunt’s eyes when she coughs and a trickle of blood lands on the wall next to her. I hear the splatters that follow. I see her collapse in a pool of blood as my Mom drags me out of the room. “So just to double-check, you said they both died of Alpha-1 complications, right?” While I had been speaking the rusty, decaying smells of dried blood and death had filled the room. I know that if I open my mouth right now I am going to vomit, so I simply nod my head in agreement. “Well… based on that and your lab results it’s likely that you could have

Alpha-1, but we’ll have to draw more labs to make sure. With that being said, I think it’s best that you move back home for the time being, just in case any complications arise.” Complications were such a polite, gentle way to describe what likely awaits me: the vomiting, the swelling, the wrinkling, the yellowing, the weakening, the wasting, the crying, the begging, the bleeding, the gasping, the dying. As my mind is filled with these images of my own suffering, I try my best to hold it together. Despite my efforts, a few stray tears escape my eyes and run down my cheeks. As I reach to swat them away, I finally allow myself to notice that my hand is yellow.

-Jared Pittman is a sophomore from Green Mountain, NC pursuing a major in Biology and a minor in Chemistry.-

Touching Down Claire Molloy

my husband used to play remote controlled airplane toys with his boys flying-site chit-chat with wife-packed bagged lunch stomped home mad when it crashed – snapped propeller he used to fly real planes tooAir force chief; I recall him pretend catholic and coquettish popped collar and coke-bottle glasses didn’t see red. no late-night workshop painting plastic wings and doll pilots to fit in pint-sized cockpits and screwing in wheels to make sure it lands right and now, no more putzing with planes. pancreatic cancer – he lays on our living room couch spoon fed, bird-bath bathed barely-there, waitin’ on deathbed landing his flying site friends visit frequently and he gives away his handmade planes I know they’ll just crash them he doesn’t say much these days but he still manages to flirt with the hospice nurse she never listens when I talk about my nursing days he touches my hand when he can and I feel sick thinkin’ about the time when he can’t how’d we touch down so quick? I sit, watching him wondering what he remembers and wishing I knew how to fly too. -Claire Molloy is a senior from Goldsboro, NC majoring in Biology as well as Women and Gender Studies.-

After Michele L. Mekel Will the demand for mediums and séances rise when COVID ends? How else will we say goodbye to those we loved and lost without warning — in isolation, wearing ventilator masks and dying alone.

-Michele L. Mekel, JD, MHA, MBA, is from State College, PA and is currently the interim director of the Bioethics Program at Penn State.-

Anxiety and Isolation: The Disproportionate Burden of the COVID-19 Pandemic Emma Astrike-Davis

The COVID-19 pandemic created a sense of shared sorrow and sacrifice for many Americans. How we attend school, interact with family and friends, shop, and even worship have been impacted by the pandemic. While these experiences have been shared across the country, they have not affected everyone to the same degree. Age has defined the impact of this pandemic on many individuals, especially for older adults living in long-term care facilities. Nearly one third of the overall COVID-related deaths have occurred in long-term care facilities and nursing homes (Times, 2020). These figures represent over 186,000 individuals in long-term care facilities that have died from COVID-related complications as of September 2021 (AARP, 2020). For me, the story behind these statistics is captured by the experience of my 92-year-old grandfather. A socially engaged and physically stable senior, his initial level of risk seemed controlled and manageable within the walls of his assisted living facility. However, as our understanding of COVID-19 continued to develop, it became clear that none of us were prepared for the full impact of the pandemic. During the spring and those first months of uncertainty, my classmates and I found solace in the purpose of assisting others. While my routine with medical school was fundamentally altered, there were still ways to maintain a sense of direction, contribution, and, most importantly, connection. At the same time, my grandfather’s long-term care facility began their first of several increasingly strict lockdowns, keeping families apart and residents isolated to their rooms. My grandfather was doing well physically, but his feelings of loneliness, despair and fear quickly took root. Our interactions shifted to FaceTime and porch visits separated by masks and lines of tape. All our interactions were clipped and distant. Additionally, he had no physical activity and no opportunities to talk with other residents in his facility. He became weaker by the day. His sense of isolation and despair grew to a dangerous level of anxiety and despondency. Despite the restrictions and careful diligence of staff members, by September 2020, most assisted living facilities in North Carolina had experienced outbreaks, and 6 facilities were already reporting more than 100 cases (NC DHHS, 2020). By the end of October, my grandfather was

diagnosed with COVID-19 along with nearly every other resident in his hall. His section of the facility became a designated COVID-19 unit, and staff members further reduced their interactions with him to the most basic necessities. His worst concerns about the impact of COVID-19 began to slowly play out. Even the mystery novels that had become his sanctuary for the past several months now eluded him. He lost the strength to move from his bed to his reading chair, and it would have required additional staff exposure to help him sit upright and hold a book. He became disoriented and spent days without his hearing aids, making phone conversations nearly impossible. He gradually lost his connection to the outside world, and we lost meaningful contact with him. Despite the physical challenges presented by COVID, it was the continually occurring isolation that began to dictate his recovery prognosis. For six months, he had not seen another person smile at him. For four months, he had not been touched by a hand that was not gloved. Scientists have long reported on the impact of touch on human growth and development. Deprivation of tactile stimulation increases the risk of psychological disorders, immune dysfunction, and cognitive impairment (Ardiel & Rankin, 2010). Just as lack of human touch can hinder a developing life, it can also obviate peace and dignity in death. My grandfather faced the choice to seek further medical care at the hospital or stay at the assisted living facility. He asked aloud, “what’s the point?” and decided to withdraw all treatment and remain at the facility. For a man dedicated to the service of others through his career as an educator, pastor, and entrepreneur, his disconnect with others had diminished his will to survive. Ironically, the day after he died, my grandfather’s assisted living community was approved to receive the vaccine. Currently, the CDC has endorsed the use of booster shots for individuals in long-term care, and visitation restrictions have been lifted in most facilities. These measures are critical to the health and well-being of this vulnerable population, but the toll exacted by the pandemic remains ever-present. While the COVID-19 death rate among nursing home residents has dropped significantly with vaccinations, the anxiety and fear of residents and their families have not abated. Staff shortages in nursing homes and long-term care facilities persist even as occupancy rates drop (Abelson, 2021). It is time to critically assess how we care for people who need assistance in the acts of daily living. Many families now choose to care for elderly

22 relatives at home rather than admit them to assisted living facilities or nursing homes. However, this is not possible in all situations, and many older adults thrive in the community of a long-term care setting. As a nation, we must provide for older adults based on their individual needs. By prioritizing care for our senior citizens, we may prevent such devastating outcomes in future health crises like the COVID-19 pandemic.

October 2020: A window visit with my aunt and my grandfather. We spoke on the phone while sitting on opposite sides of the glass.

23 References: Abelson, R. (2021, May 6). Covid Forces Families to Rethink Nursing Home Care. The New York Times. https://www.nytimes.com/2021/05/06/health/ covid-nursing-homes.html Ardiel, E. L., & Rankin, C. H. (2010). The importance of touch in development. Paediatrics & Child Health, 15(3), 153–156. COVID-19 Nursing Home Resident and Staff Deaths: AARP Nursing Home Dashboard. (n.d.). Retrieved September 24, 2021, from https://www.aarp. org/ppi/issues/caregiving/info-2020/nursing-home-covid-dashboard.html COVID-19 Ongoing Outbreaks in Congregate Living Settings. (n.d.). NC Department of Health and Human Services. https://files.nc.gov/covid/ documents/dashboard/Weekly-COVID 19-Ongoing-Outbreaks.pdf Times, T. N. Y. (2020, June 27). Nearly One-Third of U.S. Coronavirus Deaths Are Linked to Nursing Homes. The New York Times. https://www.nytimes. com/interactive/2020/us/coronavirus-nursing-homes.html

-Emma Astrike-Davis is a fourth year medical student in the UNC School of Medicine from Durham, NC.-

Sunitha

Rahul Menon Just yesterday my aunt whispered through the face-time from thousands of miles away tucked in a hospital bed, “I’m fine.” With hair gone, eyes red, and skin covered in neurofibromas. We played along. Prayed for her. Ended phone calls. What could We do from here? What could we do from Here? Just today a stroke left her in a coma. The doctors say her blood grew thicker and thicker and thicker, like suffocating sludge, calcified against her squirming arteries leaving an impenetrable wall, slowing all motion until everything just stopped. Eyes shut, seeing vacuous darkness. We saw her through the phone but she didn’t whisper back this time. Still fast asleep. Hopefully dreaming. Maybe about her husband, who hasn’t eaten a full meal since her admittance. Or maybe her son, who has the first stages of the same condition that afflicts her.

25 Did she see herself as a curse or a burden? Being left out on a hospital bed like a piece of rubbish? No. Just a butterfly with broken wings, but no one could fix them. And all I can do is watch my aunt die from Thousands of miles away through a phone. In her comatose state, her brain was like a candle struggling to stay alight in a strong wind. The candle flickers and everything is working against it to eventually blow out the light. After fighting for forty-six years, that candle went dark. And I think about all the diapers changed. The cooked food. The ice cream escapades. The movie marathons. The well wishes. The hugs and kisses. All the missed calls. And unread texts. Texting her more when she’s gone. The cremation is on Friday She will return to Mother Earth while my grandmother watches. I am. She was. We were. -Rahul Menon is a senior from Montville, NJ pursuing a major in Biology and a minor in Chemistry.-

Recovery Phalaen Chang

When my grandma first came home from her open heart surgery, she couldn’t remember anything. It was as if the sterile white of the hospitals and bright lights of the nursing home had blinded everything in her mind into a hazy slate—empty, save for the chalkdust fog of words smeared by an eraser. The nurse asks her, “Do you remember who she is?” pointing at me. My grandma smiles bashfully, eyes sparkling with a hint of mischief as she looks at me. “My brain isn’t so good anymore these days.” But it is clear she remembers, somewhere; she calls out my name whenever she needs me to help her with something. “That shirt over there, it needs to be washed,” she says. And then it isn’t so clear how much she remembers. “The doctors already took my heart, haven’t they?” My mom and I laugh and remind her again that her heart is still in her chest, and that it is still hers. “The nurses and doctors all said you did very well,” we tell her as we help her bathe. She would smile then. “They told me I was very pretty. You see, I have such good skin unlike your mom.” But she wouldn’t sleep through the night. Like a restless spirit, she drags her walker through the halls of our home, wandering in and out of the bathroom, the kitchen, and around her room as the sun sets and rises, just looking and looking. “Ah, how unlucky I am,” she would sigh, looking longingly off into the distance. “How unlucky I am to have gotten heart problems at this age! I used to be so strong and so smart. I taught myself how to read, you know! I taught myself how to make clothes! I could lift the heaviest things. But now, I don’t have any strength. When you go back to school...what will I do?” “You’ll be able to do things independently by then,” I had said, but leaving for school felt like leaving her behind. These days, over 2,000 miles away from home, I get great nostalgia whenever I’m on the train, looking out the windows to the stations, lights, and darkness whizzing by. The forward motion rocks us back and forth like the lull of ocean water, and it seems as though I am sailing through time and memories

in a flip book with the pages turned too fast. I wonder if this is what my grandma sees when she tries to remember who she used to be—peering into the walls of a tunnel separate from time. Today, in the orange seats across from me, there is a newly married couple with a baby. The father smiles tenderly at his sleeping daughter and scoots closer to his wife for a family selfie. Next to him, a grandma pores over photographs inserted between the pages of a thick book. When the next station approaches, she pulls one out of the bundle. As she hobbles out of the train, I catch a glimpse of a young girl on the photo she had pulled out glaring petulantly somewhere off camera as though to spite the photographer. I watch her leave until the doors slide closed and the train pulls away from the station, on our way elsewhere. I imagine my grandma in another universe, one where she would be a character in a story wandering the city looking for a past version of herself surrounded by scenes and snapshots of things she had already experienced. My grandma remembers all of us these days, but isn’t sure she remembers who she was. When we FaceTime, she is reading books upside down, without her glasses. She smiles brightly and says that if I’m spending all this time calling, I must not be studying very hard. My parents let me know that she is eating well, but still spends the nights walking and walking, looking, dragging her walker loudly on the wooden floors. I want to ask what she is looking for, but she simply stares at me and sighs, but almost more out of habit than resignation. “I’m so old now, and I don’t remember anything.” “But what do you think you’re forgetting?” In the background, VCR tapes of our home videos play on our TV. My grandma, eighteen years younger then, carries a giant handbag in one arm and holds my hand in another. In this VCR tape, I am two, and she is young. Her hair is done just how she likes it, permed into neat, full curls. Although we are just at the park, she is dressed in pearl earrings, a blazer jacket, and leather shoes—she always dresses her best when going out, face done up with full makeup. She looks at this moment of her from a time past and says, almost in admiration, “I used to be so strong and so smart.” Then there is a pause. She looks down at the old faded pajamas she is now wearing and runs a hand through her uncombed hair. “Now I can’t remember anything. The doctors took my heart, didn’t they?” -Phalaen Chang is a junior at Columbia University from Los Angeles, CA and is pursuing a major in Neuroscience and Behavior as well as Public Health.-

Caregiving in Different Spatial Settings: Empowering Traumatic Brain Injury (TBI) Patients By Centering Autonomy Chinmayi Balusu

Open, empathetic communication is essential when engaging patients, medical teams, and family members to chart out the best possible outcomes. However, shifting autonomy dynamics can cause these decision-making conversations to become convoluted. Illness severity, socioeconomic status, and care provided by family members versus professional clinical staff as well as differences between inpatient and home caregiving are several factors that can contribute to complications. Therefore, it is important to empower patients during their recovery journey by exploring the role of autonomy within intersecting spatial and caregiving contexts. Specifically, autonomy signifies the ability to “identify one’s own needs and goals and [...], plan one’s own life, [...] and participate with others in the construction of society” (Arcuri et al., 2013). While many assume that patients have autonomy over long-term clinical choices, that is not always the case for those with neurological impairments who struggle with concentration difficulties, personality changes, memory lapses, and loss of consciousness. Specifically, this paper will focus on autonomy dynamics for patients with a widespread neurological condition known as traumatic brain injury (TBI) that affects approximately 5.3 million Americans. TBI occurs when the brain is suddenly damaged due to “motor vehicle accidents, sports injuries, domestic violence, [and] military-related injuries” (Thurman et al., 2016). Patients with severe TBI who require dedicated long-term care are often admitted to inpatient rehabilitation centers or return to home-based support (Johns Hopkins Medicine). TBI patients residing in inpatient rehabilitation centers gain access to skilled medical care around the clock. However, since staff must care for a set quota of individuals each day, they are limited in the time they can spend with each patient, which can lead to patients feeling that their needs are not being understood at a deeper level. Scholars such as Havi Carel, professor of philosophy at the University of Bristol, believe that since “chronic illness is perceived as a physiological problem, [...] the loss of agency, productive function, social participation and financial status are not recognized as part of the illness and are not addressed by the medical care team” (2007).

Under such conditions, TBI patients may feel that the medical caregiver’s autonomy and decision-making dominate over their own. To combat this, medical professionals have attempted to supplement such conversations with questionnaires such as the Progression of Autonomies Scale (PAS). PAS aims to understand several dimensions of autonomy, including the personal level (e.g. individual’s ability to wash and dress oneself), domestic level (e.g. using a telephone and household appliances), and extra-domestic level (e.g. using public transport and doing shopping), among others (Arcuri et al., 2013). While the intention is to foster detailed reflection beyond bodily health, the downside is that autonomy is difficult to grasp through quantitative rating scales, especially since the health status of TBI patients can greatly shift over time. Furthermore, although the scale may assist the medical team’s judgment, it cannot entirely bridge the conversation gap. On the other hand, the transition from the hospital to outpatient home care can be a confusing, unsupportive time period (Abrahamson, 2017). A study found that only twenty percent of TBI patients who had previously lived alone were able to live independently once more after discharge, with eighty percent of patients relying on caregivers, a large proportion of whom are family members (Penna, 2010). Setting boundaries for the patient’s expectations can cause strains in social relationships with family, especially since family members are unfairly expected to fulfill the roles that trained inpatient rehabilitation professionals are experienced with. Patients can feel more entitled to receive dedicated care from family caregivers since they have deep emotional and personal bonds, but other patients can repeatedly refuse to accept care. Professor Eva Feder Kittay addresses this issue of dependency as a feeling of vulnerability for patients at their lower points. But dependency can also be a sign of deep trust as the patient is sharing autonomy of their needs with family. For the family caregivers, however, this back-and-forth dynamic can be a “frustration of their duty and obligation,” and they may struggle with ambiguity, distress, and changes in psychological wellbeing on top of the added stress of providing care (2013). Compared to the relatively static asymmetry of the medical caregiver and patient (who is forced to give up autonomy in the inpatient setting), the family caregiver and patient relationship causes more tug-and-pull autonomy struggles. Besides the personal burden of caregiving, TBI-related financial costs are also detrimental. The overall economic burden for TBI patients across the United States is tens of billions of dollars (Thurman et al., 2016). Since

30 the defining characteristic of TBI is that they are sudden, it is not possible to predict the jarring associated healthcare costs, putting emotional strain on patients. Motor and cognitive deficits can prevent patients from returning to work in full capacity, and limited salary can cause these individuals to think twice about affording expensive procedures or hired caregivers. Patients may also increasingly rely on family members to substitute financially. Overall, the amount and significance of care that TBI patients receive are unequal between inpatient and home care, which contributes to patients’ varying autonomy struggles. Following their illness onset, the patient’s sense of “self” can differ greatly based on the spatial setting. Involved medical and family caregivers must emphasize centering the patient in discussions about their care plan and wellbeing, as this can help develop positive selfattributes that adapt to new experiences and challenges associated with long-term disability (Knox, 2016). At the end of the day, understanding autonomy’s varied yet intertwined aspects can catalyze more understanding conversations for everyone involved without compromising autonomy.

31 References Abrahamson, V., Jensen, J., Springett, K., & Sakel, M. (2017). Experiences of patients with traumatic brain injury and their carers during transition from in-patient rehabilitation to the community: A qualitative study. Disability and Rehabilitation, 39(17), 1683–1694. https://doi.org/10.1080/09638288.2016.1211755. Arcuri, F., Lucca, L. F., Lagani, V., Rosadini, V., Mercurio, G., & Mazzucchi, A. (2013). Evaluation of autonomies in the severely brain injured: the Progression of Autonomies Scale. Functional Neurology, 28(1), 29–38. Carel, H. (2007). Can I be Ill and Happy? Philosophia, 35(2), 95–110. https://doi.org/10.1007/s11406-007-9085-5. Kittay, Eva Feder. “Caring for the Long Haul: Long-Term Care Needs and the (Moral) Failure to Acknowledge Them.” International Journal of Feminist Approaches to Bioethics, vol. 6, no. 2, University of Toronto Press, 2013, pp. 66–88, https://doi.org/10.2979/ intjfemappbio.6.2.66. Knox, L., Douglas, J. M., & Bigby, C. (2016). “I’ve never been a yes person”: Decisionmaking participation and self-conceptualization after severe traumatic brain injury. Disability and Rehabilitation, 39(22), 2250–2260. https://doi.org/10.1080/09638288. 2016.1219925. Penna, S., Novack, T. A., Carlson, N., Grote, M., Corrigan, J. D., & Hart, T. (2010). Residence following traumatic brain injury: a longitudinal study. The Journal of Head Trauma Rehabilitation, 25(1), 52–60. https://doi.org/10.1097/ HTR.0b013e3181c29952 Rehabilitation After Traumatic Brain Injury. Johns Hopkins Medicine. (n.d.). Retrieved October 18, 2021, from http://www.hopkinsmedicine.org/health/treatment-testsand-therapies/rehabilitation-after-traumatic-brain-injury. Thurman, D. J., Alverson, C., Browne, D., Dunn, K. A., Guerrero, J., Johnson, R., Johnson, V., Langlois, J., Mallonee, S., Crutcher, M., Archer, P., Feck, G., Thoburn, K., Santili, L., van Tuinen, M., Land, G., Roesler, J., Kinde, M., Whiteneck, G., … Pilkey, D. (2016, January 22). Report to Congress: Traumatic Brain Injury in the United States. Centers for Disease Control and Prevention. Retrieved October 18, 2021, from https://www.cdc.gov/traumaticbraininjury/pubs/tbi_report_to_congress.html.

-Chinmayi Balusu is a junior at Columbia University from Folsom, CA pursuing a major in Medical Humanities.-

Recompense Katy Waddell

Recompense is a drawing representing the long-term effects of concussion and other mild-traumatic brain injuries. This piece is inspired by the physical process of whiplash, which is one of the common mechanisms through which one can sustain a mild-traumatic brain injury. This drawing illustrates the physical and emotional processes that one may endure during the recovery process. The skeleton figure represents the physical side of the injury while the male figure in the center represents the invisible nature of these types of ailments. Finally, the shaded figure illustrates the emotional toll of mildtraumatic brain injury and the feelings of being trapped in one’s own mind and condition.

-Katy Waddell is a sophomore from Canton, Georgia pursuing majors in Psychology and English as well as a minor in Exercise and Sport Science.-

Secrets Halle Pearce Can you keep a secret? Or, rather, can I tell a secret? Because every time I want to, my jaw locks up And every time I open my mouth, my voice dies Because here’s the thing: I’m too afraid to trust you But don’t worry; it’s not you It’s me It’s not just healthy skepticism Or normal caution It’s fear, raw fear A fear that eats me alive It’s feeling physically sick at the thought of revealing anything It’s remembering all the times when trusting failed It’s worrying constantly that I’ll be betrayed once more It’s preferring to remain in deadly silence than to ever be vulnerable again But maybe I can let you in on just one secret: Depression isn’t just sadness But something so much deeper, so much stronger Something that’s ever more rapidly killing me It’s wanting to fall into the vast, fathomless chasm in my chest It’s feeling as if the empty void in my heart is crushing me It’s being impossibly ensnared in a web of all-consuming hopelessness It’s failing to remember what joy ever felt like But shhh! don’t tell anyone Because I’m trusting you with this secret And if you keep this one, maybe I’ll you tell more secrets And maybe one day I can ask for help -Halle Pearce is a freshman from Durham, NC pursuing majors in Biology and Computer Science and a Spanish minor for the Professions.-

Schrodinger’s Son Rachel Kirsch

We stand shivering in the biting wind, freezing rain raking our faces whenever we feel even a fleeting ounce of comfort. We are deafened by gusts of wind that force our faces to bury deeper into scarves and masks that provide absolutely no shelter from the elements, only from that half-alive nigh-invisible fearsome phantom. Fearsome? Can I still feel fear? The worst has already come. Deaths that follow surely cannot compare. Still, I am afraid to hold anyone. Imagine carrying this burden and being afraid to hug what family remains. My grandmother, sharp-witted and active in her ninth decade; my nephew, his half-heart already overwhelmed by the task of sustaining his body. I have known them and loved them, all my life, all their lives. Their deaths must be worse. I don’t even know how to grieve for a stranger. And yet I do, and will forever. Over the last nine months death has become a childhood companion, the one where we look back thinking, “Why did I ever hang out with him?” We know him too well now, and we wish we never had. Coronavirus infects us all with fear, we are afraid even to breathe. It hijacks the cells, the body, the mind and spirit. It steals our oxygen to grow inside us. We sacrifice our bodies to bring forth its progeny. The rabbi, a living stranger, gestures, and we obediently turn towards a van. Blinking through the rain does not dull the details of this image: a tiny pine box emerges from the van. If my eyes are open only half the time, shouldn’t this be only half a memory? Yet somehow it fills every corner of my mind. I don’t realize I’m screaming. I turn away. I don’t want to look. I can’t look. That box looks real, but I know it’s not really there. I leave. Others will laud my stamina if this visage I can uphold, and the only way to hold up is this: I simply leave, now only eyes, watching from afar. I cannot feel the winter winds, but I see them. I see the tent, pulling against its earthbound coils, hoping to fly and deny reality, if only for a moment before gravity brings it crashing down. I see the heaped soil, somehow untouched by

35 the wind. Did it freeze? Is its core more solid than one would expect? It looks unnatural like that, holding together against the wind while the tent reaches futilely for the sky. I see Alan, carrying the box, alone. Weighted with the hopes and possibilities of an entire lifetime, yet he marches towards the tent as if his hands held a tiny bird. How is he so strong? Has he left, too? I look around. I don’t see him, at least not the second him. But I see me – the first me, holding Alan’s arm as we walk. Why do we walk so slowly? I scream through the interminable time! We drag it out, pretending at strength. So they worry less. If we run, if we hurl the box to the ground and flee the scene, they will send people after us. For our own safety. Because they worry about us. After the meters-long march, we reach that tenacious tent and find one chair too few. It’s easy to count during the pandemic. They have put out ten, the maximum number allowed for any gathering during the pandemic. We have eleven. Everyone knows. I don’t know if I sit to rest after the meterslong march, or if I stay standing to avoid showing weakness? I think I sit – but I’ll never know. You have to understand, I’m not trying to be dense. I’m not trying to be elusive or enigmatic. It’s just – if I name this, it becomes real. It cannot be real, so I cannot tell you. But I know you see it. The living stranger says some words, some in English that I understand, some in Hebrew that I don’t, and then I see me stand, facing the nine who remain seated, or near seats. Beside me, though we’ve never planned this act, Alan performs his part perfectly. In the role of silent supporter, his only duty is to take my place should I become incapacitated. I remove my gloves to retrieve the eulogy. I imagine my fingers must be freezing as I unfold it on the lectern. Every time I speak, my scarf pushes my mask up over my eyes – my other eyes. So, I remove the mask, too, shoving it in my pocket beside my gloves. I look naked now, vulnerable, should the phantom virus choose to take over my body and replicate inside my cells.

36 I see myself summoning strength. Strength? Guilt, shame, rage, pain, pride, grit, fault, farce, fear – I draw upon these, and then I see my lips deliver each word. Sniffling – crying? cold? covid? – punctuates my sentences. I inhale, imagining the horror of suffocation: you had the strength to fight back, every time. Until the last time. Will this be my fate, too? Staccato sentences turned silent, choked by tears and guilt? Every word I speak – every time I fight – will this be my last breath? Will I be able to fight for another, once this air is gone? I am so weak, so envious of your little box. Does it keep at bay the slicing wind? Are you warm in there? If I climb in, will you climb out? No, you couldn’t even walk. But if you cry out, they will hear you. So I’ll climb in, and you’ll cry instead of me. I never see myself deliver that final word: I am transfixed by the pine box. If there are two of me, can I die with you? This incorporeal form can offer no carbon to the soil. Not like you and your box. But when I am buried beside you, I hope the earth accepts the offer of my blood.

-Rachel Kirsch is a fourth year medical student in the UNC School of Medicine from Chicago, IL.-

disassociation Alexa Holloway

“he presents with…” “They.” “it’s too complicated.” dismiss diminish deny how can we hope to treat the body if we discard the identity which brings that anatomy to life?

-Alexa Holloway is a third year medical student in the UNC School of Medicine from Chapel Hill, NC.-

Open Late Scott Giberson Jr.

OPEN You know this place is a window into humanity A drive-thru window maybe… we stand in the frame as flickers of humanity whisk by hoping we heard their order right 1st Order This teenager walked up to the window I don’t think she’s old enough for her driver’s license yet Please don’t tell me I’m pregnant I know what the doctor is going to say But let’s work on your algebra homework That’s at least something we can solve 2nd Order We say our window always stays open But I saw someone try to close it when his tattered jacket sleeve appeared I just need a place to sleep for the night I’m so sorry It looks like your blood work might be delayed I’ll get you a warm blanket while you wait

3rd Order A black car drove up to the window The woman inside tried to wipe away the mascara streaking down her cheeks Can I get something for my head Your wristband says FALL RISK But I’ve never seen stairs Leave such a palm shaped mark 4th Order He could barely talk through the blood when we first tried to take his order Now he can finally tell us what he wants Tell my dad that I love him No You’re going to tell him yourself This is one order we don’t need to fill CLOSED A window into humanity Sounds a little too clean too put together too sterile For the drive-thru -Scott Giberson Jr. is a first year medical student in the UNC School of Medicine from Austin, TX.-

See one, do one, teach one Akshay Pendyal

Pay close attention to how the doctor on TV says he’s sorry, they did all they could. The corners of his mouth will flicker just so & you’ll have to practice in front of the mirror until you get it right; a simulacrum of equanimity. There won’t be any violins or soaring strings the first time, only the ventilator’s lonely dies irae as you stumble over jargon & sweat blossoms on your forehead like it’s gym class all over again. The argot of tragedy is woefully incomplete, imparted piecemeal— something that even Halsted, sequestered in his darkened study with Gilead’s balm, must have known.

-Akshay Pendyal is a UNC School of Medicine alum from Chapel Hill, NC who is now working as a cardiologist.-

Dust, Snow, and the Intensive Care Nursery Settle Monroe Entering the Intensive Care Nursery feels a little like getting through TSA at the airport. Two forms of ID. Are you registered and approved? Scan your bracelet here. Any cough, fever, or sickness in the past 48 hours? Remove all jewelry. Remove your coat, scarf, and hat. Place them in a locker. Sign here. Scrub your hands and forearms for 30 seconds. Work up a thick lather. Slip on the blue, tissue-paper gown. Leave the opening in the back. Strap on the facemask. Make sure your mouth and nose are completely covered. Wait for the nurse to press the button to swing open the steel, double doors. Follow the nurse to your baby. The ICN lights are dim, and the rooms are still and quiet. This is the hospital’s clinical attempt to recreate a womb-like experience for sick and premature newborns. The rooms are partitioned with light green curtains, separating the infants and providing privacy for the visiting families. I am pushed in the wheelchair, still too weak and nauseous from anesthesia to stand. I see my son immediately in the far corner of the room. I know where I am going, but I follow the nurse to his incubator, no bigger than a shoebox. The nurse whispers that he is still too small to be touched. The low buzz of the machines, the whispers of doctors, and the shuffles of nurses, the wires, the tags, the monitors on my son - they are white, noiseless snow falling around a still center. That still center is a tiny, newborn mammal-like being. That center is my son. But there are other faces I will remember - the faces of the other mothers in that Intensive Care Nursery. With confidentiality a high priority, we never speak a word to each other, at most we share a smile or a shy nod. But there is a knowing among us, a silent welcoming into a club of women in crisis. None of us want to be a member, and yet none of us want to be alone. Long drapes of fabric insulate the precious time with our little ones. As we close our eyes behind those drapes, open our shirts to press our babies’ skin to our own, each of us in our own orbits, the gravity of life on the brink, our shared anchor.

42 I whisper Psalms and sing Joni Mitchell. I hum Neil Young’s “Harvest Moon” and read passages from Prince Caspian. Next to me, I can hear the low, scratchy voice of my neighbor-mother muttering monotone chants in a language I do not recognize. I listen as her voice cracks just like mine when I sing here. I imagine her baby pressed against her chest. I have heard that misery loves company. I don’t think that I believe that. But maybe there is something to knowing that another mother is chanting in unknown but understood words. Maybe there is something to knowing that we are in this together, clutching our loved ones, begging that all will be well. For ten weeks I scrub up and slip on the gown while the hospital hums around my growing boy. One morning a nurse pulls back the green curtain, and says through a smile, “You ready to go home buddy?” The first whip of fresh air brushes across my baby’s face. I tuck his blanket tighter. The edges of the fall leaves are curling, their last wave of surrender to winter. “Goodbye hospital,” I say, nuzzling my face against my boy’s. One, brown leaf floats to the ground ahead. Snow around us. I don’t think of the time I spent with my son in the ICN as particularly spiritual. But it sure did anchor me to the fragile ground. I wonder if there is anything more spiritual than knowing that we aren’t the only ones lying low with our cheeks pressed into the very dust from which we came.

-Settle Monroe is a student from Raleigh, NC pursuing an MA in English from NC State.-

Stolen Power

Virginia Tanner I sit in the bathtub, naked and alone. My few minutes of solitude for the week are spent in lukewarm water, its level not rising above the 13-inch scar that wraps around my thigh and knee. The bath is timed down to the minute when I have to be hooked back up to the ball and chain that is my IV pole. The clotted blood and black stitches cover my hairless leg like ivy, barely holding together the skin that was mangled by physician’s scalpels. This is the skin that hid for too long the tumor growing inside my bones. I sit and stare at the metal lined mirror, the bleached toilet, and the tile floor. It is a bathroom that is as less my own as my body is beginning to feel. I hear my mother in the next room, flipping through channels, looking for something other than bad news that seems to surround our life currently. Foreign, yet familiar, I feel my skin begin to chill as goosebumps appear, signaling I’ve been in the bath a minute too long. I try to reach the body wash to begin washing myself. I lean an inch too far and pain washes over my legs. At this moment, I realize how helpless and degraded I have become and I begin to cry. My mother enters and attempts to console me, rubbing my head as if she wished it contained hair. Feeling like a child in my 17-year-old body, my mother wipes my tears away and bathes me, giving me peace I haven’t felt during my treatment journey. My mother then helps me to the edge of the tub. I feel the scratchy hospital towel against my skin. Using my wheelchair, I enter my small hospital room smelling of cucumber scented body wash.

-Virginia Tanner is a senior from Hickory, NC pursuing a major in Biology and minors in Philosophy and Chemistry.-