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.
DISCLA IMER 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. This publication is funded at least in part by Student Fees which were appropriated and disbursed by the Undergraduate Student Government at UNC-Chapel Hill.
SP ONSOR S
Fall 2023
The Health Humanities Journal of The University of North Carolina at Chapel Hill exploring illness, caregiving, & medicine
Editorial Team Editor-in-Chief
Ryan Phillips (Class of 2024)
Managing Editor
Tara Hinton (Class of 2025)
Art Director
Anna Curtis (Class of 2026)
Secretary | Treasurer
Iris Chang (Class of 2025)
Layout Editor
Yan Zhu (Class of 2026)
Marketing Co-Director
Alicia Equan (Class of 2026) Sabrina Shaw (Class of 2026)
Undergraduate Editors
Penelope Alberdi (Class of 2024) Camilla Feeley (Class of 2024) Rotem Olsha (Class of 2025) Ash Chen (Class of 2025) Tiffanie Ann Lee (Class of 2025) Aliyaa Pathan (Class of 2025) Isabel Kakacek (Class of 2025) Boatemaa Agyeman-Mensah (Class of 2025) Heidi Segars (Class of 2025) Aaron Stepp (Class of 2026) Roshni Arun (Class of 2026) Halle Hunt (Class of 2026) Izabella Counts (Class of 2026)
Graduate Editors
Olivia Davis (UNC School of Medicine: Class of 2025) Jacqui Zanders (UNC School of Medicine: Class of 2025)
Faculty Advisers
Jane F. Thrailkill, Ph.D. (Co-Director, HHIVE Lab | Department of English and Comparative Literature) Kym Weed, Ph.D. (Co-Director, HHIVE Lab | Department of English and Comparative Literature)
Table of Contents Editor's Note
Ryan Phillips
6 8
Community Responses Last Week’s Chemo
Ray Zhang
9
Here’s to Writing About Better Days
Sarah Flora Chocron
10
The Known Foreigner
Megi Maci
12
Time of Death
Frances Neal Kincheloe
14
Between Motherhood and Medicine
Archer Race Schaeffer
17
Chronic Femininity
Elaje López
18
Another Question
Joanmarie Lewandowski
20
Summer Sickness
Ray Zhang
21
Doctors are Murdering Black Mothers: The Impact of Racial Bias on Maternal Mortality
Emmanuel Ifeanyichukwu Okeke
22
The Proper Evolutionary Conditions for an Isopod
Naomi Lytle
25
Survivor’s Guilt
Esha Raut
27
Brief Summary Patient Package Insert
Alexis Paige Turturici
28
Visualizing a Journey Through Alzheimer’s Disease
John Felix Arnold
32
At World’s End
Peighton Robison
35
The Chronicler
Hilary Nguyen
38
Corrections, Questions, Perceptions
Shreeya Yarlagadda
41
Art by Anna Curtis
6
Editor’s Note Dear Reader, The word “health” evokes a host of images. A cold hospital room with a chemical scent. A therapist’s office with a deep, enveloping couch. A website with recommended exercise routines. But in practice, health is so much more. It’s a trusted primary care doctor who answers your late-night call. A trusted friend who makes you dinner after a tough day. A mother who watches over her son while he practices with his soccer team. This edition shows that these two perspectives on health are just two sides of the same coin. As our collection of emotional, thoughtful pieces came together over the past few months, my own vision of what health can be expanded and evolved. Our authors’ stories range from high-stakes medical scenarios to introspective reflections on the everyday. Witnessing the breadth of these experiences reminded me not only of the pervasiveness of health in our daily lives, but of the deep, significant stories happening all around us, often without our notice. In my first semester as Editor-in-Chief of the Health Humanities Journal of UNC-CH, the process of working with our authors was symbiotic; while the staff and I provided feedback to the writers, their pieces opened our eyes to a wealth of unique yet universal experiences. As our collection of emotional, thoughtful pieces came together over the past few months, my own vision of what health can be expanded and evolved. I feel it necessary to acknowledge recent events that have affected staff members, authors, and the UNC community at large. The early weeks of this semester were filled with fear, uncertainty, and trauma. Following two active shooter incidents in short succession, the UNC community was left with few outlets for healing. The residual mental anguish and fear for our physical health was emotionally draining for our peers. In this process of recovery, students, staff, and faculty were required to lean on each other for support. When the pain and recovery made it hard to move forward, our peers were there to carry us. Witnessing in so many people the instinct for care and protection stabilized me. While it in no way delegitimizes the horror and injustice of these events, the mutual support from our peers was a testament to the power of love in the face of such incalculable loss. At the same time, it speaks to the human instinct for care in situations where our health is at risk. As the semester went on, I became increasingly attuned to the idea of protection and care, both in medical settings and beyond. I came to realize that the desire to protect is as fundamental to humanity as it is to health.
7 When I sat down with Tara, Anna, and Yan, our managing editor, art director, and layout director respectively, I was still thinking about the prevalence of care and protection. We looked at pieces that speak desperately out of concern for a loved one, powerful words of anger from people who did not receive the protection they needed, interior monologues from medical professionals unsure of how to contextualize their own role. Viewing all of these pieces in conjunction with each other, we found protection, care, and support to be the guiding threads that unite these pieces. As you read through this expressive, often heartbreaking, and ever-thoughtful collection of works, consider your own role (or roles) in care, protection, and support. No matter who you are, the part you play in your own network of support is complex and variable. The questions are manifold: When you need protection, to whom do you go? Who looks to you when they need support? What do you need when you need support? How do you care for your friends? Your family? The strangers around you? Do you feel the need to protect them? Do you feel that your peers care for you? How do you know? The list goes on and on, the questions increasingly difficult to answer. Protection, much like health itself, is a broad notion that means something different to everyone. But at the same time, it is universal. I would be remiss without closing this note with a series of thanks to all who made this journal possible. Thank you to all of the hardworking members of our staff for their tireless efforts and tremendous care throughout the semester in bringing the best out of our pieces while protecting their original intents. In addition, I want to thank our advisors and mentors, Dr. Thrailkill, Dr. Weed, and Dr. Kopp, who are always available to provide support to our publication. Thank you to our sponsors, who support our work and allow us to distribute the urgent voices of our authors. My last and greatest note of appreciation goes out to our authors, who have provoked engaging thought and moved me and my fellow editors alike with their perspectives. Thanks to them, my notion of protection, care, and support has been forever changed. And it is my sincere hope that your experience can be the same. -Ryan Phillips, Editor-in-Chief
8
On August 28th, 2023, tragedy struck the UNC community. A gunman opened fire on our campus, resulting in the death of Zijie Yan, a beloved professor in the Department of Applied Physical Sciences. The event left the community shaken and disturbed, unsure of how to move forward after such an act of violence. We spoke to students after the tragedy, giving them the space to reflect and share their feelings anonymously. Here are some of the responses we received: “I feel angry that something like this could happen and we act like it’s normal.” “I think the fact individuals are turning to violence, whether that be to themselves or to others, is something we should be concerned about.” “A new level of tragedy and revelation hits me every few days. It’s a horrible thing.” “I feel as though UNC does not support my safety as a student. Where does our money go?” “I have not processed it yet!” “No one’s first tour of our school should be spent in a 3-hour lockdown fearing for their lives” “Feeling crazy that I don’t feel anything” “I feel worried about how the campus will move forward” “How are we supposed to go back into the rooms where we hid for our lives?” “There’s so much shame – shame about feeling too much or too little, shame about loneliness. I hope we can learn to share these burdens.”
9
Last Week’s Chemo Ray Zhang My fingernails grow a millimeter per week. Cells cluster, crafting a scaffold of dead skin only to be stained yellow from oily tangerine peels. I know this because of the anticipation to strip keratin with teeth, to greedily reveal soft valleys of red tissue, to ooze juice and regret. When I visit, another day goes by. The red river of chemo drips into your veins like meat left out too long. If there is an allegory in this, I’m still searching for it. Tangerine peels curl against your chest, hardening against the sun. I let you feel between jagged fingers and loose bits of hangnail waiting to fall, expose the fragility of our flesh, flesh decaying, flesh regrowing.
—Ray Zhang is a freshman majoring in Biology at Columbia University from Troy, MI.—
10
Here’s to Writing About Better Days Sarah Flora Chocron I’ve been thinking a lot about Oliver Sacks lately. In his lifetime, he was considered a renowned neurologist as well as a best-selling author of books and essays. There has been an Oliver Sacks essay for every big milestone and mundane moment in my lifetime. “My Periodic Table” is the essay that taught me to find the celestial joy in aging. I revisit this essay every year on my birthday, thinking of how Sacks celebrated his growing age by collecting the periodic element matching his age every year. “Sabbath” is an essay about the commitment to rest and is a piece of writing that found me at a time when I was restless. The famed neurologist and author wrote about his fondness for philosopher David Hume, the medical unknown, the gray area between symptom onset and post-diagnostic treatment, his complicated relationship with his sexuality, the strangeness of the human brain, and reflections about life and his own death in 2015. In June of this past year, I was diagnosed with Stage II thyroid cancer, a slow-spreading highly survivable form of cancer, a few months before I turned 21. It has been an experience that I, through writing this essay, hope to find the words to express. There is an immediate expectation upon cancer diagnosis to become a deeply profound and reflective vessel that lives with a heightened view of the landscape of life, spewing wisdoms like a fortune cookie. The truth of the matter is that I still don’t quite know how to be a cancer patient or how to make this difficult period in my life meaningful. However, I have once again returned to the essays of Dr. Sacks and specifically his essay entitled “My Own Life,” detailing his thoughts on dealing with his own terminal cancer diagnosis at the age of 81. While my own diagnosis is nowhere near terminal and I may very well live to turn 81, I was comforted by his words and the duality of his sentiments. Sacks writes that he is “among the unlucky ones” with the particulars of his ocular melanoma leading him to an unlucky 2 percent whose cancer metastasizes, in his case, throughout his liver (2015). In many regards, I too feel unluckily bound by the statistics of my circumstance. According to the American Cancer Society (ACS), I am a part of the 5 percent of the population whose thyroid nodules turn out to be malignant, part of the 2.7 percent of thyroid cancer cases which are diagnosed between the ages of 20 and 34 years old, part of the 30 percent whose cancer metastasizes, and part of the 0.5 percent of people who get diagnosed with thyroid cancer in the first place under the age of 49 (ACS, n.d.).
11 But in the immediate sentence in which Sacks states how unlucky he is, he follows by saying: “I feel grateful that I have been granted nine years of good health and productivity since the original diagnosis” to which he later elaborates that “I cannot pretend I am without fear. But my predominant feeling is one of gratitude” (Sacks 2015). Despite the statistical unluckiness of my fate, I, like Dr. Sacks, feel an immense sense of gratitude in the face of cancer. I find myself grateful for the words that have comforted me and the words that have distracted me. I am grateful to have had the summer, of all seasons, to face this disease and the battalions of loved ones and friends who have supported me. I have spent years within the medical unknown—with countless doctors not knowing what was wrong with me and although my case was probably not as intriguing as the cases of the late Dr. Sacks, I find myself thankful for a diagnosis and what feels like a concluding chapter to years within the medical system with questions unanswered. It is curious that among the misfortune that beheld Dr. Sacks in his last months, he felt gratitude so strongly. He held both sentiments in their entirety and in their contradiction. In his lifetime, he saw the human experience as being bound by the same “neural fate” that every human brain traverses in its beginning, individual path, and inevitable death (Sacks 2015). I can only hope to live my life as fully as Dr. Sacks did with a reverence for words and their innate capacity to convey the dualities and complexities of emotions. So, here’s to Oliver Sacks, the medical unknown and diagnoses alike, to beating cancer soon, to writing odes to better days, to finding joy in the words for this moment, but most importantly here’s to being “a sentient being, a thinking animal, on this beautiful planet” and finding gratitude within the unluckiness that beholds us” (Sacks 2015).
References “Key Statistics for Thyroid Cancer,” American Cancer Society. n.d., accessed August 24, 2023, https://www.cancer.org/cancer/types/thyroid-cancer/about/key-statistics. html. Sacks, Oliver, “My Own Life.” The New York Times, February 19, 2015, https://www.nytimes.com/2015/02/19/opinion/oliver-sacks-on-learning-he-has- terminal-cancer.html.
—Sarah Flora Chocron is a junior majoring in Information Science and History at UNC-Chapel Hill from Montreal, QC and Wichita, KS.—
12
The Known Foreigner Megi Maci On my way out of anatomy lab one day, I ran into a stranger. He stopped me and asked, “Doesn’t that bother you?” He was referring to the time I spent with the cadavers. “Don’t you feel...?” he started to say, waving his hands in front of himself as if to catch the right words. What was he going to say? Weird? Hurt? Disgusted? I didn’t know what he wanted to say, but based on his gestures and facial expression, he seemed disturbed and uncomfortable, as if the cadavers’ bodies were foreign creatures. Without hesitation, I knew how I wanted to respond. “No,” I told him. “That’s my body, too.” In this moment, I thought that the only thing we shared was anatomy—a physical and superficial connection—and that the only difference between us was life and death. Later, I found out that we shared much more. I loved anatomy lab. I was heartened by the generosity of people whom I’d never met donating their bodies for the sake of science and exploration. To my surprise, I was not squeamish or uncomfortable—and it was this apathy that frightened me most. Why was I unfazed? Why did I feel so emotionally disconnected from a body that mirrored my own? Was it because I had experience holding a scalpel? Was it because I was used to the gore and rawness from performing neurosurgeries on mice in my previous job? Strangely, it wasn’t until later when I started dissecting my own cadaver that I felt something. And it was strong. My lab was the last cohort to dissect. With my scalpel in one hand and confidence in the other, I made an incision in the gluteal region. Just then, my eyes landed just to the right of the cadaver’s prone body, and my sympathetic nervous system kicked into overdrive. My eyes widened. My heart started to race. My stomach dropped to the floor. My once-confident hand began trembling. The voices of those around me in the lab faded into oblivion. I froze. I had just seen the cadaver’s pale hand and fingernails curled inwards and completely intact. Almost lifelike. I had been in anatomy lab looking at cadavers every day for the past three months, and out of all moments, this one—looking at my cadaver’s hand and fingernails that had once loved, touched, cared, cleaned, cooked, hurt, worked— triggered me. Because any identifying and human-like features on the cadavers (face, hands, etc.) are usually covered or partially or completely dissected, seeing the untouched hand and fingernails on my cadaver added this visual component I had been missing during my time in the lab: the cadaver’s humanness and likeness to me.
13 As I pulled myself together and proceeded to shakily finish that first incision, I felt like a traveler traversing the territory of another’s body whom I had never known and yet one that also felt familiar. Despite minor differences, our anatomical territory was basically the same. After this encounter, I found myself apologizing to and thanking the cadaver frequently. I used non-binary pronouns out of respect for the cadaver’s identity because I never had the chance to ask how they identify. I wanted to learn so much more about this person who once breathed the same air and walked the same Earth as me; who loved and lost, cared and hurt, laughed and cried, was happy and sad—who once knew what it was like to be human in all its simplicity and complexity. We were one body, connected through similar anatomical and physiological function, but further united through our ability to connect via our shared humanness—our soul. As humans, we traverse a fine line between the body we physically inhabit and the soul that inhabits us. We spend our lives dissecting the soul to uncover its depth and meaning only to find that it doesn’t just lie within us but through us as it reaches out to connect with and be fulfilled by others. Through empathy, shared identities, interests, passions, and selfless acts of service, we learn more about each other. Human connection nourishes the soul. As I gently stripped away layer after layer, muscle after muscle, I delved deeper into our shared humanity. As I paused to reflect on each step, to reflect on each muscle, bone, and ligament that we shared, I thought about what other life experiences the cadaver and I might have shared and how the universe serendipitously drew us together in this very moment. With each layer, I felt a deeper connection between the human whom I had never met before lying in front of me, but whom I felt I had come to know better since the first incision.
—Megi Maci is a second year medical student at Loyola University Chicago Stritch School of Medicine from Boston, MA.—
14
Time of Death Frances Neal Kincheloe “Time of Death: 6:32 am.” I turn to the young couple and open my mouth, then close it again. I move across the room to the windows, where I begin busying myself with the blinds, doing anything I can not to impede the couple’s space of grieving. Somewhere, I imagine baby birds have begun chirping in their nests, where mothers and fathers will feed them and raise them until they are ready to fly. They will never get to see their baby leave the nest. The thought brings me back to my surroundings. I spin around softly to see the couple. The mother lays in the bed. I remember how excited she looked when she had arrived the night before, how I watched her husband help her pull back her braid as she labored, hunched over with every contraction. Her face, once cheerful, now holds a silent look of indescribable pain. Tears roll fast down her cheeks, but she cries silently as she holds her baby in her arms. Her husband, cheeks also stained with silent tears, has his arm around her shoulders. night?
How can someone look like they have aged ten years in the span of one
As a labor and delivery nurse, there are many things I could say to the parents to try and comfort them, but the thing they need most right now is time to just be with their baby. The mother has already been checked for possible postpartum complications by the other delivery nurse, and now it is my responsibility to take care of my patient properly as they work through the grieving process. I look the husband straight in his eyes, and begin to speak as steadily as I can. “I’m going to give you both some time to say goodbye. Please let me know if there is anything you need. Anything at all.” The mother has still not looked up when I softly close the door behind me. Though the room I am leaving is filled with loss, in the hallway, the hospital is alive. That’s the thing about working in a hospital. It is a place filled with loss, but it is also a place filled with life. Time doesn’t stop when someone dies, because there is so little time to save the lives of so many others. The hospital is a place of liminality, the hallway between two doors, and it’s my job to make sure that as many parents walk out of the right one with a healthy baby ready to live a fantastic life. It’s a terribly tragic but also beautiful thing, and it’s why I am able to pick
15 myself up after losses like this. As I turn to go down the hallway toward the supply closet, I see the doctor from earlier leaning against the nurse’s station. His head rests on the wall behind him, eyes closed. I approach him softly, and he opens his eyes. “You did wonderfully,” I tell him. His eyes are shining with tears. “I lost her,” he says. “There was nothing you could do,” I say. “Go rest up. Collect yourself. We have a full day ahead of us.” I give a brief hello to my colleagues, then head into the supply room. I move fast, because time is everything in this situation. I grab a cuddle cot and flip the switch so the bed can begin cooling before the baby is placed in it. This special bassinet will give the family the time they need to grieve their child before it is to be taken to the morgue. From the cabinet, I grab what we L&D nurses call a keepsake box, a box filled with items to both care for the lost infant and to commemorate them, so the parents have something to look back on later. The boxes are arranged by size according to the gestation period. 39 weeks. These parents should have been walking out of the hospital tomorrow with a healthy, full term baby. Now they will have to leave the hospital with their baby inside. How could someone handle that pain? From another cabinet, I pick out a pink dress with lace detailing from the handmade baby clothes we keep in case parents don’t bring a “going home outfit”. Only this baby isn’t going home. It’s extremely important to treat our bereaved families with the same care and compassion we would a family with a healthy baby, if not more. These kinds of practices weren’t taught to us in nursing school, rather we learn them from the guidance of the older L&D nurses who have experience with infant loss. I will never forget my first loss.These kinds of patients are the ones you carry with you. I wheel the bassinet back down the hall to the room. Someone, probably the other delivery nurse who was assigned to my patient, has put a small teardrop sign on the door next to the patient’s name, signaling to other nurses on the floor that the family inside was grieving. I open the door to find the room now brighter than before. Sunlight streams across the floor and onto the bed where the mother is unmoved from her earlier position, just holding and rocking her baby, only her crying has stopped. Her husband is across the room, gazing out the same window I was at only a few minutes before. I wonder if he’s thinking the same thing I was, wondering how it could be fair that his child will never get to see the world outside this hospital. I hand them the keepsake box, telling them how truly sorry I am, just as something begins to vibrate in my scrub pocket. I pull out my pager. I am being
16 called elsewhere for another delivery. Another nurse opens the door and slips inside the room, and I take the opportunity to slip out quietly. Now, I will have to move on to the next room and pretend like I didn’t just experience what was surely one of the worst days of this couple’s life. I move down the hall towards the room where I can hear a mother yelling as she labors. Before my hand has even touched the door handle, I hear the familiar song fill the hallway loudspeaker, and through the door, a baby’s first cry.
—Frances Neal Kincheloe is a sophomore majoring in Biology and minoring in Chemistry and Medicine, Literature, and Culture at UNC-Chapel Hill from Atlanta, GA.—
17
Between Motherhood and Medicine Archer Race Schaeffer
For my mother, it was never a decision between motherhood and medicine. Now, that’s not to say I never felt jealous when her patients got more attention than me. When they called, she answered, and I felt like that moment—a moment meant to be shared by only the two of us—was stolen. But then I reminded myself of what these conversations meant to her patients: a course of antibiotics for a painful UTI, counseling a patient for postoperative bleeding, or offering words of comfort in a moment of need. I learned that my mother’s dedication to her patients was a reflection of the way she loved us, her family. She mothered the way she practiced medicine. Today, I cherish time with my mother even more. I hug her and hold her laughter so closely to my heart that I can hear it at the thought of her smile. These photos capture that moment, her smile, and that sound, her laugh, as I told her how much I love her. —Archer Race Schaeffer is a second year student at the Baylor College of Medicine from Amarillo, TX.—
18
Chronic Femininity Elaje López When I was 19 years old, something that I now know was an inevitable event came to pass. At the base of my spine sits my L5-S1 vertebral disc, which unbeknownst to me had been quietly ravaged by degenerative disc disease for years. A dull lower back pain had become a hum in the background of the biological hubbub my body maintained to keep me alive, and I had written it off for years. But then 19 came, and so did the day that I volunteered for my local food bank, which required the lifting and distributing of heavy cans again and again and again for hours. By the next morning, the hum of my lower spine had increased in pitch to something more urgent, and I knew something had gone terribly wrong. From that January commenced the most excruciatingly difficult and painful year of my life. Six months after an initial round of painkillers and physical therapy failed to rectify the throbbing pain that radiated from my lower back into my legs, an MRI confirmed that I had an enormous herniated disc. “Significant compression of the S1 nerve,” my physician’s notes said, calling it “compromised.” And that’s how it felt: a section of my body, compromised, down for the count, no longer accessible to me. I lost the ability to bend forward farther than 15 degrees. I couldn’t extend my right leg in front of me. I couldn’t flex my right foot. Pushing myself to do so resulted in a peculiar sensation like being struck by lightning, or getting hit by a train. The pain was blinding and paralyzing–my body, trying to save me from myself, would not let me push past a certain point, and the nerve running down my right leg screamed in agony as it was crushed every time I tried. I wondered sometimes if I was going to go insane from the incessant shriek of the pain like a siren in my head. The pursuit of feminine beauty was suddenly something that sapped me of all energy. Wearing cute but uncomfortable shoes, sitting to apply makeup and don jewelry, removing body hair–all of these things suddenly manifested in so much physical pain that I started to wonder at their capacity to create a sense of conformity. Was femininity always something that took so much from me, from my body? How had I not noticed its parasitic nature as I moved through girlhood into womanhood? Like my lower back pain, it had been a diegetic hum constantly in the background of my psyche, now forced into the spotlight. Like the transition from adolescence to adulthood had facilitated the slow decay of my spine, it had also increased my feelings of discomfort with the manipulations I learned to perform on my body to make sure I fit the standards of femininity and attractiveness. After a year of continually worsening pain, I returned to the doctor, undergoing more exams and a spinal consult and eventually being told I would need an urgent microdiscectomy to relieve the pressure being placed on my sciatic
19 nerve. The moment I awoke after the operation, I felt more free than I had been in months. All of a sudden, the world had gone quiet. I stretched my right leg, wiggled my toes, flexed my foot—and nothing. The scream had disappeared. I felt like I had been given a key to finally unlock the door. Tentatively, I re-entered my body, feeling like I had finally returned home and that I was venturing into a place completely unfamiliar to me. Throughout the healing process, I realized that some aspects of my femininity tasted bitter upon return. I could now tolerate the discomfort of tight dresses and skirts, and squeeze my feet into pointy high heels, and reach down to shave my legs, but did I really want to? The constant hum of male surveillance had been drowned out by my own scream of pain. It was a violent reclamation, but it was a reclamation nonetheless. Being freed from the desire to present my body for anyone else’s subjection but my own made me realize just how light I felt when I set down the weight of beauty, palatability, and sex. I grew impatient rather than embarrassed hearing criticisms of my physical appearance, because in the face of how much effort it took just to get up out of bed and get through my day, why should it matter? Why would I induce more pain by attempting to mask my own true sentiments and feelings for the sake of a feminine standard requiring me to be quiet and digestible? The first time after surgery when I squeezed myself back into a breast-baring top and tight jeans, I felt a sense of rejection emanating from every fiber of my being. No, no, NO, came the scream again. I am not an object to be viewed. I could feel the thought pounding through my body like the beat of a drum when I walked by men smirking and catcalling and telling me what they wanted from my tits and my ass. Alone at home again, I stared at myself in the mirror in those clothes. I suddenly felt the heaviness of how very wrong they felt on me, a facade creating the illusion of a woman that I wasn’t sure felt like me anymore. And the drum continued to beat in my head, a deafening pound. Slowly, I peeled the clothing off of my body, piece by piece, until it was just me, gazing at myself. I ran my hands down my sides. I squeezed my breasts. I grazed my hips. I tiptoed my fingers down past my knees, over my shins, down to the floor. I raised myself back up, running a finger down the scar on my lower back. Slowly, the drum slowed to a halt. And finally, it was me, just me, again and again and again, in the silence.
—Elaje López is a senior majoring in English and on the premedical track at Columbia University from Davis, CA.—
20
Another Question Joanmarie Lewandowski I flip through the pages of my medicine board review textbook, numb to the flow of information filling my brain. Section after section, I flip through until a familiar word catches my eye. I grip the page taut. “Neuroblastoma.” “A pediatric cancer that often begins in early nerve tissue.” I think about skipping it. I know nothing at all, yet I already know too much. It’s the neighbor down the street that you always see but never speak to. I know where you live; I know what you do – but who are you? To be so intimately intertwined with a stranger is disturbing. The section is no more than 300 words. 300 words! I am insulted, for the first time, as the book taunts me with its ability to simplify. I read on. It starts with statistics about ages and demographics—none of which you fit. The book slaps me across the face with the use of “common.” Common?! Tell that to literally anyone I have ever met, ever. If the 13-letter word escapes my mouth, it’s as if I am speaking in tongues. I read the clinical presentation. “A firm mass. Can cross the midline.” Not to be confused with this or that. I can see the physicians prodding your small belly. Did they know when they first laid their hands on you? Or were their minds fluttering with the weight of a thousand diagnoses? Next, the diagnostics. The urinalysis will show these markers, and that’s how you know you’ve got it. I feel hollow. I see the moment when the doctors reviewed your results. I ache knowing there was a moment they knew what would come before we, your family, did. Were they relieved when they finally identified what was going on? Possibly even celebrated that it was so clear what was happening? Were we just another question they got right?
—Joanmarie Lewandowski is a third year student in the School of Medicine at UNCChapel Hill from Hendersonville, TN.—
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Summer Sickness Ray Zhang Raw sunflower seeds roasted over fire— bitter for tastes of comfort like a baby begging to wean. 355 degrees, the temperature each endosperm begins to falter, agitated by the heat. All summer long, mother refused to see a doctor, placing herbal patches to soothe her hips. One finger etching around the piriformis, nails following riverbeds of wrinkles and stretch marks. All the while taking sips of tea and comforted by overcooked sunflower seeds. It became our waltz—suggestions of urgent care side-stepped by blaming one too many sips of wine. Watching her sway around the kitchen, I look into her irises, a shade lighter with age, and try to see what hasn’t changed: dimples where I used to rest my pinkie, freckles dotting smooth braille. Even as I sit before my plate, the smell of tiger balm has begun to claim the air, calling me to concede. Soon, I’ll leave these suburbs knowing these aromas will linger. But before that, before it all dissipates I’ll bake sunflower seeds.
—Ray Zhang is a freshman majoring in Biology at Columbia University from Troy, MI.—
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Doctors are Murdering Black Mothers: The Impact of Racial Bias on Maternal Mortality Emmanuel Ifeanyichukwu Okeke
Whenever she gets the chance to talk about her kids, my Black mother always recalls her experience of giving birth to four children within the U.S. healthcare system. For my older sisters and me, she noted that her labor process went fairly smoothly. However, it wasn’t until she had my youngest sister that problems arose during her labor. As she was going through intense labor, despite voicing her concerns about the unbearable pain, the doctor simply suggested that she push through it. It wasn’t until a nurse finally came to investigate her condition, that her current state of excruciating pain had finally begun to subside. Luckily for my mom, she made it out of the labor room with no underlying health complications and a healthy baby girl. However, for many other Black women in America, they are often met with a different fate. According to the Centers for Disease Control and Prevention (2023), “Black women are three times more likely to die from pregnancy-related causes than white women” and “have the highest infant mortality rate of any racial or ethnic group in the United States” (Taylor et al. 2022). While many attribute this racial disparity to socioeconomic factors or the prevalence of health inequities, “Black women, regardless of social or economic status, are [still] more likely to die of pregnancy-related causes” (Martin and Montagne 2017). What further complicates this statistic is that “approximately three in five pregnancy-related deaths could have been prevented,” which suggests a de-emphasis on pre-existing conditions of pregnant mothers and rather a greater emphasis on the responses of healthcare workers in navigating these factors (Centers for Disease Control and Prevention 2023). In the case of my mom, although she was a low-income Nigerian immigrant and already 35, these factors did not overwhelmingly contribute to her near-death experience. Instead, it was the decision of a doctor, who believed she could bear more pain, that may have led to her death. The stories of epidemiologists Shalon Irving and Kira Johnson also serve as examples of how even highly-educated and financially stable Black women can fall victim to maternal health crises. “They had well-paying jobs and lived in safe
23 neighborhoods. They had health insurance coverage and access to care. [Yet], none of those factors could protect them from maternal death” (Taylor 2020). In the case of Shalon, the lack of immediate action from surrounding healthcare workers, even after her evident fluctuating blood pressure and postpartum swelling, ultimately resulted in her untimely death. Likewise for Kira, after her husband’s concerns of her postpartum hemorrhage came to no avail at the hospital, it was too late to save her even once she received the medical attention he had pleaded for so long. These dismal outcomes hint at a more complex issue that goes beyond individual socio-economic factors. “Social determinants are not protective factors for Black women—not when they are deemed invisible to the health care system and their cries for help or expressions of pain are ignored” (Taylor 2020). This is because the real issue is rooted in doctor-patient interactions. In a shocking study by Dr. Lisa Cooper, a leading researcher on racial health disparities at Johns Hopkins University, it was found that “nearly all 40 participating Baltimore-area primary care doctors said they regarded their white and their Black patients the same.” However, testing on their unconscious attitudes revealed an entirely different story. The test revealed that “two-thirds of the physicians preferred white patients to those who were Black. About the same percentage perceived white patients as more cooperative, while they perceived Black patients as more mistrustful and reluctant to comply with medical guidance” (Cooper et al. 2012). By failing to acknowledge the effects of their own personal implicit bias, doctors continue to uphold a racial structure that disproportionately contributes to Black patients’ deaths. There must be radical change in the medical field to counteract the effects of doctors’ implicit racial biases. Doctors themselves must be willing to make a more effortful attempt to curb their racial bias. The first step for change starts by recognizing the implicit racism and bias within their own work as doctors and implementing ways to account for it. However, the accountability doesn’t stop here. Implicit bias training needs to be implemented across all health professional schools to ensure that healthcare providers are equipped with the tools and mindset to actively combat their unchecked bias before their actions potentially cause real-world harm. Only then can we begin to dismantle the structures that perpetuate the mistreatment and neglect of Black mothers in the healthcare system.
24 References Cooper, Lisa A., et al. “The Associations of Clinicians’ Implicit Attitudes about Race with Medical Visit Communication and Patient Ratings of Interpersonal Care.” American Journal of Public Health, vol. 102, no. 5, 2012, pp. 979–987., https://doi.org/10.2105/aj ph.2011.300558. Nina Martin and Renee Montagne. “Black Mothers Keep Dying after Giving Birth. Shalon Irving’s Story Explains Why.” NPR, NPR, 8 Dec. 2017, https://www.npr.org/2017/12/07/568948782/black-mothers-keep-dyingafter-giving-birth-shalon-irvings-story-explains-why. Taylor, Jamila K. “Structural Racism and Maternal Health Among Black Women.” Journal of Law, Medicine & Ethics, vol. 48, no. 3, 2020, pp. 506– 517., doi:10.1177/1073110520958875. Taylor, Jamila, et al. “Eliminating Racial Disparities in Maternal and Infant Mortality.” Center for American Progress, 5 May 2022, https://www.americanprogress. org/article/ eliminating-racial-disparities-maternal-infant-mortality/ “Working Together to Reduce Black Maternal Mortality.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 3 Apr. 2023, https://www.cdc.gov/healthequity/features/maternal-mortality/index.html.
—Emmanuel Ifeanyichukwu Okeke is a sophomore majoring in Neuroscience and Behavior at Columbia University from Fontana, CA.—
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The Proper Evolutionary Conditions for an Isopod Naomi Lytle “I can’t sleep anymore.” We are 15 years old. The future ahead is supposed to be bright, but the circles under her eyes are only becoming darker. “How long?” I ask. “Only got a couple of hours this week, I think.” A primal exhaustion pours from her blue eyes. They are deep waters. And in deep waters there’s not much to do other than to become lost. This becomes a pattern for the next couple of months. Although I walk beside her during the day, I fear she walks a different road every night. The glimpse of the deep ocean within her eyes becomes a tsunami. As I drive her back to her house, the waters fill up my car. We are both struggling to breathe. Her thoughts are drowning. They spin like a whirlpool, moving everywhere, going nowhere. However, I can adapt. I can grow gills, perhaps a fan-like tail to keep us afloat. But can a human heart withstand the water pressure? “Did you know that sedatives could stop the floods?” That’s what I imagine the pharmacist saying while they hand her an orange bottle. Pharmacists are not well versed in flood prevention. I don’t think they’ve ever had their dearest friend ask them if they were real. And I doubt they’ve had to scare off the shadowy figure supposedly following us on our walk. The whirlpool still spins, and we struggle to stay above the water. To my annoyance, I see a couple of those orange pill bottles floating around us. In my eyes, they serve more as a desperate companion rather than a savior. I’ve had a lot of time to think while I tread the water with her. Perhaps my consciousness, too, is like a current, although far less powerful and violent. Maybe it’s duller, flatter, animalistic— nevertheless I will adapt. We’re probably 18. I’ve grown used to the temperature of the water, and I like to think I’m a good swimmer. There’s life here: schools of ideologies and pods of
26 new ideas. It’s a shame they like to keep adding chemicals to it... for the sake of a calmer sea. The idea of forcing the Pacific Ocean to be an “efficient” or “proper” member within society is foreign to me. Yet she still struggles and my heart aches. Her anger rushes over my head and I feel the ripples of her fears. Her sadness pierces me like a hidden iceberg, and her anxiety has the sharp taste of salt on my tongue. She’s now learned every type of stroke to stay afloat. The pill bottles are a sad excuse for flotation devices. Not me though, I think I sank to the bottom once I woke up to a voicemail. It was the final step to my evolution, my call to the depths. A true reflection of what I have become. “I did something bad. I’m sorry. I’m sorry. I’m sorry. I’m-” Oh! I’ve hit the sand. The pharmacists’ sedative was merciful to me that day. She woke up “safe” in the morning. She still swims—now with a lithium taste to the hard water. I, however, have morphed into something more grotesque. My spindly legs burrow into the sand and my hard outer shell faces the rest of the world. I watch her quietly. The ripples of her strokes are a reminder of the persisting peril that paralyzes. The waters of my own mind are growing colder, less habitable. She swims and I wait to be fossilized.
—Naomi Lytle is a sophomore majoring in Psychology and Linguistics and minoring Conflict Management at UNC-Chapel Hill from Winston-Salem, NC.—
Survivor’s Guilt Esha Raut I only see you in the in-betweens now, waking moments, drinks, inhales, and there you are. My gaze is glassy but you’ve never been so clear. Sometimes I suffer you quietly, a figure in my periphery, watching. When you clutch at me the quaking comes from your bones the longer I hold you. Fold me into your arms hearth, home, hurt. Slowly boiling in rotation twice cooked over, feverish and confused. You’re fading away, and what is the price of this perception? It’s not a taunt, never so deliberate a reckoning never felt, I hope you never feel. Fault lines forming in your presence as guilt gives up. You take my tremors. To my visiting rights I force an end. Closure beckons me closer waiting for my final move arms out in an embrace. I’ll be there one day, as will you.
—Esha Raut is a junior majoring in Psychological Science at the Illinois Institute of Technology from Buffalo Grove, IL.—
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Brief Summary Patient Package Insert Alexis Paige Turturici INTRODUCTION Oral contraceptives, also known as “birth control pills,” are medical solutions to the now-preventable problem of unwanted or unplanned pregnancy. When taken correctly to prevent this condition, oral contraceptives have a very low failure rate. In my personal experience, they also have a high rate of changing your sleeping patterns, intensifying your acne, rerouting your period schedule, and escalating daily emotional changes into full-on mood swings. Your gynecologist will smile broadly at you, explain that the pill is very safe, and send you on your way with a prescription in your fifteen-year-old hands—problem solved. The pharmacist will hand you a document with your first three-month supply: sixteen pages thick if you’re given the short version, folded into a neat little square nestled by the pills in the paper bag from CVS. When you get home, you’ll stretch the giant piece of paper across your wingspan, and laugh, wondering where you may fall in the absurdly long list of side effects and symptoms. For the majority of women, oral contraceptives can be taken safely. For the small minority of women (in a world of billions of women, what constitutes a minority anyways?), these pills are unsafe, or even fatal. These risks associated with oral contraceptives increase dramatically with the following lifestyle choices (Planned Parenthood, 2000): 1. Drinking 2. Smoking 3. Eating poorly 4. Not exercising enough 5. Exercising too much 6. Being stressed 7. Having other comorbidities (unspecified) You should not take the pill if you are pregnant, plan to become pregnant, or have unexplained vaginal bleeding. Unexplained vaginal bleeding and spotting is also a symptom of side effects from the pill. We will cover this soon, but not in enough detail for your side effects to be differentiable from your existing symptoms. Most side effects of the pill are not serious. This does not mean they are pleasant. SIDE EFFECTS OF TAKING ORAL CONTRACEPTIVES
29 This is not an exhaustive list, and we recommend asking your aunt about her experience on contraceptives since she will probably have more to say than the internet, which prides itself on being inconclusive. Here is a brief synopsis (Brief summary patient package insert—food and drug administration): 1. Severe headaches and vomiting 2. Change in appetite 3. Depression 4. Loss of hair 5. Difficulty sleeping, weakness, and lack of energy 6. Irregular vaginal bleeding 7. Weight gain from fluid retention 8. Melasma 9. Blood clots in the legs 10. Pulmonary embolism 11. Stoppage or rupture of brain vessels 12. Heart attack 13. Angina pectoris 14. Dangerous liver tumors 15. Severe internal bleeding caused by tumor rupture 16. High blood pressure 17. Increased risk of breast cancer 18. Increased risk of cervical cancer 19. Gallbladder disease
30 WARNING SIGNALS Your best friend is going in to get her IUD today. With no insurance, she hasn’t been able to afford the monthly cost of oral contraceptives. The doctors don’t give her any pain management medications when she undergoes the procedure, and she will complain for months afterwards of random bleeding. No worries, she tells you, the doctors told me this would be normal. At least I won’t get pregnant, she says. Your mother needed an emergency hysterectomy a few years ago. She developed ovarian cysts that grew into the size of softballs without her knowledge, which eventually burst. Your stoic mother, who never complained of anything, later told you it was the worst pain she had ever experienced. Your grandmother needed a double mastectomy during her bout with breast cancer. She is one of the strongest women you know, and took the disease on with a resolve unlike anything you’d ever seen. Sometimes, you watch her in the mirror, noticing the furrow in her brow as she looks at herself. She mentions, almost offhandedly, that she is no longer the same woman that she was before the cancer. Women you follow on social media hold signs in the streets, screaming silently in the stillness of a photograph. “Bans off our bodies!” they shout to the world, to society, to the United State Supreme Court. A sense of lingering fear stays with you long after you close the social media app: is it too late to fix this? WHEN TO SEEK MEDICAL ASSISTANCE You will see red when the online contraceptive provider opts not to refill the contraceptive you’ve been taking since you were fifteen. The nurse practitioner, who does not specialize in ophthalmology, will tell you that elevated ocular pressures are a side effect of the contraceptive you have been taking for six years. 6 years. 72 months. 2,232 days. 2,232 pills. How many times have you popped that little pill into your mouth, and swallowed without a second thought? Glaucoma interactions are not listed as a side effect of the pill, but you have glaucoma. No one told you this when you were handed your first prescription. You seek out your specialist immediately. Maybe this explains your randomly high eye pressures, your headaches. Maybe this explains nothing. Maybe it explains everything. She does not know if oral contraceptives create adverse reactions in glaucoma
31 patients. No one has ever asked. You used to be a child patient of hers, grown into a young woman now at twenty-one years old. She doesn’t know what to tell you. You don’t know either. But that’s the thing about the pill: if you stop taking it now, years of taking it will have all been for nothing. The catch-22 of your life, your mother’s, and her mother before her: balancing the beautiful curse of being born with a uterus, and bringing it into compliance with the rest of your life. Start the pill just after puberty so it doesn’t hurt as much, so you don’t bleed as much, so you don’t get pregnant, so you become easier to deal with. Now each time you swallow the pill, it sticks in your throat like an unspoken thought. Like so many before you, you play the game, but never stop wondering when you’ll be told you can finally just be yourself, no pill required.
References Planned Parenthood. 2000. “Planned Parenthood.” Plannedparenthood.org. 2000. https://www.plannedparenthood.org/learn/birth-control/birth-control-pill/how- safe-is-the-birth-control-pill. Review of BRIEF SUMMARY PATIENT PACKAGE INSERT. 2005. Food and Drug Administration. July 20, 2005. https://www.accessdata.fda.gov/drugsatfda_docs/ label/2005/021690ppi.pdf.
—Alexis Paige Turturici is a junior majoring in Radiologic Science in the School of Medicine Division of Allied Health Sciences at UNC-Chapel Hill from Southport, NC.—
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Visualizing a Journey Through Alzheimer’s Disease John Felix Arnold In 2020, after years of battling Alzehimer’s disease, my stepfather and I placed my mother into a memory care home in Durham, NC. This event, the finality of her being locked away, opened up a cataclysmic shockwave within me. The act of placing her into this center and the previous years of madness and confusion which had resulted in such final action created a deep psychic tear. Alzheimer’s runs throughout my family on both sides. I watched my paternal grandfather die of it in 1995. Now I watch as my mother slowly embraces a different dimension of being, where her physical and mental self dissolve into the great unknown one day at a time. Her disease began to reveal itself in 2016. By 2018, her care had become an anxious full-time struggle which threatened her safety, ours, and others who came into contact with her. My mother is a dancer; a former New York City Ballet student, a member of multiple dance companies across the country, and one of the founders of the Ballet School of Chapel Hill. Upon her admittance to the memory care home, I began artworks channeling the experience of her disease into a multi-disciplinary series of visualized forms. As time went on, and once she had found a sense of peace and place, and once the insanity of existing with a parent with Alzheimer’s had finally reached a calm (coincidentally as the pandemic started to show a sign of receding), I came back to describing the experience of her disease from my point of view within our connection through this ongoing series of artworks. Some became portraits of my mother simply living with the disease of Alzheimer’s. Others became psychic landscapes and abstract contemplations on hers and our journey through it all. The work presented here is from my ongoing series of portraits conveying some semblance of her physical reality, an engagement of cathartic conceptual object, and the interior shared journey of “us” into the non linear spaces it traverses. It is meant to humbly and lovingly pay homage to my mother, and to the baffling powerful reality of Alzheimer’s (and Dementia-based diseases) in its different appendages within the human experience. I choose not to forget or remove myself from her lived experience, not to retreat from the sense of connection that exists in the fading of memory itself. I choose to engage her and the space we share, so as to offer a realm of consideration and love across the multiple dimensions that life can be and become. While the idea of tragedy is inescapable, the
33 idea of awakening, of a growing connection with the beautiful unknown, has become an ever-present piece of our puzzle. I continue to share an ever-morphing sense of time with her in her journey.
Geras Reimagined, 33”x24”x3”, acrylic, house paint, glitter on linen, on bricks, 2023
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Grateful Mortality, 20”x16”x1.5”, burnt branch charcoal wash and collage on wood panel, 2021
—John Felix Arnold is an MFA Candidate with the Department of Art and Art History at UNC-Chapel Hill from Durham, NC.—
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At World’s End Peighton Robison Year Six: 2:00 am The TV is blaring. That means he’s gotten ahold of the remote again; next time we’ll have to hide it better. I have school tomorrow. I could wake mom, but she looked so tired when she tucked me in. So, instead, I creep into the living room. He’s sitting on the couch, blankly staring at the screen. It’s Pirates of the Caribbean: At World’s End, playing for the third time in the last 24 hours. “Dad, could you turn it down, please?” No response. Just a blank stare. I sigh, return to the hall, and wrap myself in a blanket. I sit next to him on the couch and wrap him up too. I watch Jack Sparrow run around with a bottle of rum for the millionth time. Eventually, my exhaustion overcomes the raucous pirates, and my mom finds me the next morning curled on the couch; he is still staring at the screen. Year Seven: 1:15 pm As they call my name over the loudspeaker, I feel the eyes of my classmates on me. I feel the bile rise in my throat, it’s never good news when they call me down. I slowly trudge to the front office to delay whatever news awaits me. They tell me my mom called and asked me to skip soccer practice and ride the bus home, she has to go to work, and someone has to watch him. I force myself onto the bus when school lets out at 3:00. 6:00 pm He’s looking for the car keys again. He does this sometimes; just distract and divert. Turn on the TV, offer him his favorite foods; distract and divert. This time, it doesn’t work. He gets in the car, demanding the keys. “Just give me the keys, I’m going to be late for work and they’ll fire me! Please, I’ll bring you back a present if you just hand them over.” He isn’t going to be late for work—he retired years ago. “Dad, please, please just come inside. They’ll understand. Tell them I’m sick and you have to stay with me.” It’s 40 degrees and we’ve been out here for an hour. I’m freezing. By now the tears of frustration and desperation have started to leak out, and I can’t
36 seem to stop them; patience has betrayed me. “Please? If you come inside, I can make us dinner—grilled cheese, extra crispy.” “Do we have tomato soup?” “I think so.” “Fine. You’ll tell them why I’m not coming in? So I won’t get fired?” “Of course I will.” Year Eight: 11:30 am Mom says she needs to mow the lawn and weed-eat by the creek before it gets any hotter. She asks if I can feed Dad lunch. I make him a sandwich: ham, cheese, lettuce, tomato, mayonnaise, and mustard. I put it on the plate with some chips and grab a glass of water. I sit down on a barstool by his hydraulic lift and start feeding him. Something is wrong. He is choking. I’m administering the Heimlich maneuver, but I barely know how; Jessica, the CNA, only showed me once. He coughs up a bit of crust and begins to breathe normally; I do too. I throw away the rest of his sandwich and make him a protein milkshake for dessert. He always loved ice cream. Year Nine: 7:00 pm I’m removing the foam wedge from his left hip, turning him from his right, and replacing the wedge. Mom is cooking dinner. He gets bed sores, so you have to turn him every few hours to ensure there isn’t too much pressure on one part of his body for too long. My hair is traitorously dangling in my face. He reaches up, with a shaky hand, tucks it behind my ear, and his hand lingers near the side of my head. I softly pat his hand, cover him up, and walk away. I cry tears that are embarrassingly hot until Mom calls for dinner. Year 10: 9:00 pm I’m hunkered down beside the bed. He has a catheter now. That means the bag has to be emptied. I turn the switch, the bag’s contents pour into the bedpan, and I flush it.
37 6:00 am Mom isn’t in the kitchen. She always packs my lunch, so she’s usually in there by now. I walk into the living room. My mom is in the hospital bed trying to wrestle the catheter tube out of his hands. There’s blood on it, on him, on her—it feels like it’s on me. He ripped it out, inflated balloon and all. I turn and go back into the kitchen. The bus will be here in twenty minutes. I make myself a peanut butter and jelly sandwich. Year 11: 12:30 pm I tell my friends that my mom said I could have a sleepover next weekend. They all share looks around the lunch table. They tell me they’ll ask their parents. One by one, they tell me they’re sorry but they can’t make it. I know they’re lying. Someone told me they didn’t want to go over to my house because my dad looks like a zombie. He freaks them out. I don’t cry, I don’t even flinch, and I never ever tell my mom. Year Twelve: It’s over now.
—Peighton Robison is a sophomore on the premedical track at UNC-Chapel Hill from Green Mountain, NC.—
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The Chronicler Hilary Nguyen
I don’t label myself a photographer, yet, I indulge myself in the privileges of one. Through my photographs, I found control in capturing a fleeting moment in the margins of a mere 4 x 5 image. I felt a control against Time. It was fallacious for me to believe I could be so strong to turn the hands of a clock the way I desired. When the passage of Time occurs in small increments—a minute, an hour, a day even—our eyes are able to perceive its passing. Yet, with long stretches of it, a year or years, the formation of a wrinkle or a white hair goes unnoticed. Its passing goes unnoticed until we can directly juxtapose the past
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to the present—a juxtaposition we achieve through photographs. It is in these very photographs that I am cruelly reminded of my parents’ mortality. Since they are still images—each a sharp moment in Time—I’m given the Time to study every aspect of their face. It is unwittingly a game of spot the difference. I am prompted to compare the picture I’ve taken to the picture of them residing in my memory. I’m enabled to notice the growing crow’s feet on their eyes, the thinning of their hair, the slimming of their cheeks, the lightening of the brown in their eyes. They are aging and my Time with them is shortening. As I age myself, my Time left with them is all I think about, and I fear the moment when I can no longer take pictures of them.
40 By attempting to control Time through my photography, I inadvertently become its pawn. With each photograph I take, I become a documenter of its passage. Regardless of my ability to freeze moments with my parents within a frame, Time still ruthlessly surges forward and I become one of its chroniclers. Yet, what I dread most is how I ultimately become the constructor of my own fear. I watch my mother and father fight it too. My mother attempts to hide all of aging’s physical evidence on her body with a myriad of skin creams and hair dyes. My father attempts to push his mortality through constant exercise. Just as I tried through photography, they also try to control Time. However, the passage of Time is not a punishment. It can be a beautiful thing. Time defines us: who we were, who we are, and who we strive to be. It places us into context. In its boundless dimension, we create boundaries through seconds, minutes, days, years, and then a lifetime. We understand our extremities and realize our mortality; thus, we place value on our Time. It is as Lucretius says: movement cannot exist without void. With Time as the boundless void and our lives and meaning as movement, without Time, meaning cannot exist. I can wish for forever, but forever is valueless.
—Hilary Nguyen is a senior majoring in Medical Anthropology and English and Comparative Literature at UNC-Chapel Hill from Greenville, NC.—
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Corrections, Questions, Perceptions Shreeya Yarlagadda Her hair was cast in a net. Her wrists were chained together. Tied to her bed, to her mistakes, to her past. Was I wrong to empathize with her? Was it wrong that the woman who lay before me had taken a human life and was receiving care that others did not have access to? As a caregiver, should her story matter? Narrative medicine suggests seeing the patient as a whole and dismantles the separation of body and mind. I could hear and see her pain so vividly. Every time she seized, the electric shocks flooded her body and soul. What if this was her penance? The pain she felt for the pain she caused? I tried to understand her. But “for my safety,” my time with her was limited. Enter quickly, take vitals, and step out of the room. The mechanical approach to her care felt cruel. I was never told her name. Instead, I was told her title: “DOC.” Department of Corrections. But how was it correct that the officers in the room only spoke of the food they were getting after their shift, calling their families, and cursing about their issues? She was given bread and water while those around her spoke of home-cooked meals. Her seizures were seen as separate from her mental illness. The dichotomy between the mind and body may have prevented us from understanding what led her to take the life of another. Was I wrong to wonder what her motive was? She was villainized by those surrounding her, but to me, she started every sentence with “please.” What did I know of her? What could I know of her in a system that reduced her to her crimes? Nearly every bit of information that I used to understand her was from the lens of others. It was a story placed upon her. Aligning what I heard from others with what I saw in front of me, there was a constant ringing of dissonance in my ears. I found no harmony in the disjointed narrative that lay before me. I felt a palpable angst growing inside me, questioning what I was to think of this woman. If I think of her as the villain she is said to be, would I begin to question the reality of her pain? If I think of her as a victim of the system, was the life she took meaningless? This piece is not one of the answers but one of the brewing questions about
42 what I should use to perceive my patients. If I remove her story from her care, would I become another caregiver lost to the culture of dehumanizing modern medicine? Removing the story from the woman who sat in front of me would only provide temporary solace for my constant apprehension. When, how, and where am I to find my answers? Like her, I find myself tied to a broken system, and its grip is much stronger than my naive self could have presumed.
—Shreeya Yarlagadda is a freshman majoring in Neuroscience and minoring in Medicine, Literature, and Culture at UNC-Chapel Hill from Waxhaw, NC.—