Spring 2017: The Health Humanities Journal of UNC Chapel Hill

the health humanities journal

of the university of north carolina at chapel hill spring 2017 exploring illness, caregiving, and medicine

The Health Humanities Journal

of the University of North Carolina at Chapel Hill 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 explores 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 http://hhj.web.unc.edu

disclaimer 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 Information and 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

hhj of unc-ch spring 2017

editorial team Manisha Mishra Editor-in-Chief Majors: Biology and Interdisciplinary Studies Minor: Chemistry Class of 2018

Turner Wibbelsman Editor Major: Biology Minors: Chemistry and Creative Writing Class of 2017

Katie Huber Editor; Web/Design Editor Majors: Anthropology and Interdisciplinary Studies Minor: Biology Class of 2018

Kaylyn Pogson Editor Majors: Biology and English Minor: Medicine, Literature, and Culture Class of 2017

Chandler Batchelor Editor M.A. in English: Literature, Medicine, and Culture

Meredith Dorminey Editor Major: Biology Minors: Chemistry and Neuroscience Class of 2018

Sophia Shwartz Treasurer Majors: Biology Minors: Chemistry and Russian Literature and Culture Class of 2018 Yakin Ouederni Marketing Director Majors: Global Studies and Journalism Minor: Arabic Class of 2019

Jessica Fletcher Art Editor Major: Exercise and Sport Science Minor: Biology Class of 2017 Jane F. Thrailkill, Ph.D. Faculty Advisor Co-Director, HHIVE Lab Department of English and Comparative Literature

table of contents Editor’s Note Manisha Mishra

6

Why Stories Are Good Medicine

Ray Barfield

8

Arts of Bodies, Bodies of Work

Rita Charon

10

First Experience with Loss

Jesse Kovacs

12

Side Effects Nyla Numan

13

Depression and Stigmatization

16

Clara Davison

Time Off Sara Peña

20

Words I Won’t Say Out Loud

Shelby Anderson

22

Usually I Root for the Green Bay Packers

Anne Feng

24

Haunted Houses, Haunted Memories

Hallie French

26

Phantom Pain Angel Legare

27

A Review of Waking Up Blind

Kiki Pare

29

The Alcoholic’s Haiku

Jacqueline Kenny

31

Logan Gin’s Journey to Advocacy

Emily Long

32

Till Death Do Us Part

Brenna Elmore

36

The Cure Chandler Albert

38

Care in the Context of Crisis

39

Izzy Pinheiro

Unmade Taylor Fie

43

You Are More Jacqueline Kenny

45

Roots Taylor Fie

49

Post-PTSD Kat Tan

50

cover: Shattering Stigma by Jessica Fletcher

6

editor's note

“There is no greater agony than bearing an untold story inside you.” - Maya Angelou Dear Readers, Most people are familiar with the daunting blank page. It’s full of potential, waiting to be filled with something – anything. For some people, it’s easy to fill the page.

They know what they want to say. For others, like me, it’s a bit of a struggle. What do I want to say? How do I want to begin my story?

But I always tell myself: just write.

There’s something unsaid about putting the pen to paper. Writing has allowed me to express myself in ways I didn’t know I was capable of, and the experience of writing has always been self-fulfilling. There is some sort of liberation, self-advocacy that I rediscover every time I write, and this feeling is something that I cannot seem to recreate through any other means. In a way, writing has never failed me.

Last year, I lost my grandmother to terminal cancer. Her sudden decline was something that I rarely talked about, something I did not really want to talk about, and something I could never find the “right” words for. I did not know what to make of my emotions, and the one person who usually helped me make sense of my feelings – my grandmother – was gone. Yes, I was undergoing the identifiable stages of “grief ”, but that generic label minimized my experience of loss. What was I feeling?

During this time, writing became my self-prescribed therapy. A sort of conversation stirred up between the words on the paper and me. It was¬ a raw yet comforting conversation that I was grateful for and a conversation that guided me to the closure I indirectly sought for. I ended up writing a letter to my grandmother in

7 which I recollected our fond memories, replayed our inside jokes, updated her on current affairs, shared my fears about the future, and said my final goodbye to her.

Ultimately, this letter became the story about my experience of loss that I shared with others.

I do realize that there is an amount of vulnerability that I am exposing myself to each time I tell a story. However, I have learned that it is a risk worth taking. The authors who are featured in the Spring 2017 edition of The Health Humanities Journal of UNC-CH have collectively taken up that risk to voice their stories. They were not afraid to conquer the blank page in order to tell about their experience of losing a parent, supporting a loved one, being diagnosed with an illness, advocating for mental illness, or learning about healthcare in another part of the world. The Editorial Team and I are thankful and honored that these writers have shared their stories with us.

We all have stories aching to be told and experiences that are worth sharing. So, how do you approach a blank page?

Sincerely, Manisha Mishra Editor-in-Chief

8

why stories are good medicine Ray Barfield

Words make things happen. They can make a life better or worse. They

can make the human heart feel courage, or sadness, or joy, or hope. They can make a person feel worthless, and they can rescue a person. The world of medicine is not built with shiny machines, knives, and bags of Latinate-named intravenous fluids.

Those things are part of medicine, but the world itself is made up of stories that situate the person, account for the past, impact the future, and offer a sense of what to do next.

William Osler said, “It’s much more important to know what sort of patient

has a disease than to know which disease a patient has.” I tell my residents to stay curious about the lives of their patients if they want to become great doctors. For patients, storytelling in the hospital is literally a matter of life and death. If their stories don’t get told well, all sorts of terrible things can happen. This is true for an individual, but it is also true in a larger, social way as we try to understand the mystery of showing up in the world as frail mortal bodies. Stories—whether in the form of prose, poetry, painting, or song—are the work of the imagination. And it is here, in this arena, that beauty and suffering meet in medicine, even though modern medicine often lacks the language to express this. This is perhaps most intensely true when death is at the door.

So much of life, though it is not about death, is nonetheless illuminated

by our vulnerability to death. Suffering pulls against the loose threads of beauty’s tapestry and awakens us to being in the world, just like beauty’s outlandish ‘ta-da’ in the middle of a world full of agony. This is no bland world where beauty thrusts shards through sheets of raw suffering, and suffering shows up on the doorstep of a nearly-grown beauty that needs only a little more time, time that will not be given, to be complete. It is no poetically or philosophically bland world in which suffering tempts us to call beauty’s terrible draw a tease toward fairyland. Beauty lends a ‘maybe so’ to suffering, and suffering a ‘maybe not’ to beauty. In this uncertain world of friend and foe we serve our patients and their families.

9

As clinicians we cannot ignore the suffering, and neither can we be undone

by suffering. We are asked to find a way to remain present, and to serve well, even when relief of suffering is all we have to offer. But if we listen to the stories our patients tell about themselves, in the cauldron of suffering and loss they will teach us what love is, and what matters in a life. We have been invited to listen in on their stories while they are in the middle of loss. These stories tell those of us who are in medicine how to serve better, because the stories show us who our patients are and what matters to them. But if medicine is going to learn to hear the stories, we have to encourage our patients to tell us their stories. We would be foolish to ignore this. Intensive care units all over the country are full of unhappy people who could not tell their story, and who let medicine tell their story instead. If we want a better medicine, we have to ask our patients to become courageous story tellers. And then, we have to learn to listen like the story is a matter of life and death, because so often it is.

Dr. Ray Barfield is a pediatric oncologist at Duke University whose first novel (The Book of Colors) got him in even more trouble than his preferences in basketball teams.

10

arts of bodies, bodies of work Rita Charon

Dancer Emily Coates has choreographed a piece with physicist Sarah

Demers, who has taught the dancer something about the trajectory of the spinning body in air. London surgeon Roger Kneebone has learned methods from a group of craftspeople working in wood, fabric, and metal that have helped him to solve problems in his surgical technique. Playwright and retired serviceman Stephan Wolfert brings Shakespeare to a group of middle-aged veterans who find, through the study and practice of drama, a means to enact the as-yet unsayable.

Perhaps I meant to write “unassailable.” Perhaps the things that are shown

and not told are the truest among those things in us awaiting breath. Even those of us addicted to words have to admit that beyond syntax, metaphor, and plot lay a land of the felt, a fen of briny grassy matter. When physical therapists work with stroke survivors, guiding them into new uses for old limbs, their words are of no moment. It is touch, hold, step, grip, and rhythm.

If bodies are our first language, then maybe they are what we dream in.

It is a commonplace that one’s body knows things that one does not know; socalled medically unexplained symptoms often get laid at the feet of past trauma.

Anesthesiologist and philosopher Mark Sullivan reminds us that chronic low back pain is frequently accompanied by depression; even if the pain “caused” the depression, treating the depression can ease the back pain. Kathryn Montgomery told me decades ago that you could complete a whole medical history with one request to your patient: “Tell me about your scars.” Kathryn, it works.

This strange frontier/bridge of ours of narrative medicine or, more generally,

medical humanities turns out to have been the stage, perhaps all along, for these intersections of dance and physics, weaving and surgery, word and flesh. They are instantiations of one of the the convictions that drive our disciplines: life animates matter to endow it with potential meaning, and meaning is made and made visible in what works. The George Washington Bridge works, Henry James’ Wings of the Dove works, Rothko’s “Blue, Green, Brown” works, Bach’s Partita #4 works, the

11 coagulation cascade works, the retina works. We dispense with the distinction between the arts and the sciences, having recognized that both are creative acts that discover what lies beyond doubt. If the fact of embodiment consigns us to time and space, it gifts us with the capacity to transcend them both—through relation, through movement, through beauty, through desire, perhaps even through goodness and mercy, and certainly through the freedom to act and to behold others and what they have made.

If you don’t know these words already by heart, memorize them. On his

deathbed, Henry James’s character Dencombe in the short story “The Middle Years” says: We work in the dark – we do what we can – we give what we have. Our doubt is our passion, and our passion is our task. The rest is the madness of art.

Dr. Rita Charon is a general internist, literary scholar, and writer who, with her team at Columbia University, founded the field of narrative medicine.

12

first experience with loss Jesse Kovacs

7th Grade, spring Recreational baseball team Teammates are twins Matthew and Andrew I befriend them Closer to Matt Midway through season Matt gets sick Then gets sicker Passes away, meningitis I find out Shocked, Devastated, Confused Attend the funeral Don’t stay long Finality is overwhelming Can’t quite understand I quit baseball Need new sport Running

Jesse Kovacs is a junior from Asheville, North Carolina who is majoring in Global Studies and minoring in Medical Anthropology and Spanish.

side effects

13

Nyla Numan I. Fact: Two in three Asian Americans with Hepatitis B live unaware of their infection.

Fact: The morning she turned forty, my mother was still a part of the two-thirds.

Fact: By afternoon, she learned she was a part of the one-third.

II. Fifteen years old: standing barefoot in the local grocery parking lot— thinking more of how my cheeks are flaming red at the thought of seeing a classmate, how quickly the blood rushes from my chest in this open grazing field.

Thinking less of why my mother screamed at me to get out of the house, why chairs were thrown across the room, how they sailed over the sofa, crashing into the coffee table, shattering glass.

Why my shoes still sit by the front door, half-laced.

III. Fact: If you have chronic Hepatitis B, you take certain medications that you cannot take if you have rheumatoid arthritis.

Fact: If you have rheumatoid arthritis, you take certain medications that you cannot take if you have chronic Hepatitis B.

14 Fact: My mother had both by the age of forty-five.

Fact: The doctor predicted six months to live.

IV. My seventeenth birthday: my mother presents me with a Willow Tree figurine, a gold painted heart cradled between two resin hands.

Thank you, I say. I tell her I’m cleaning my room before I leave for college, that I have already thrown away my Niagara Falls globe, my mini metal Eiffel Tower my glass Cape Cod whale, my stone Washington Monument.

That these trinkets do not have a place anymore.

My mother slams my cake upside down in the trash.

Why did the devil curse me with this child? she cries.

She falls to the cold tiles of our kitchen floor, then rises. She begins to pack her bags.

V. Fact: The doctors have another option.

Fact: The option is to experiment on my mother with a new medicine.

Fact: If it works, she will take a pill every day for the rest of her life. She will walk.

She will go to work. She will maintain a strict diet.

Fact: If it doesn’t work—

VI. My last year of high school: I drive early in the morning and stay for as long as I can.

I come home and sleep. I pick up knives.

15 Papers pile on my desk.

My mother is furious with me, furious with my father for never taking her side.

Threatens to leave us for good.

Screams that we would be happier without her.

Days pass in this angry house.

One night, as I sit self-swaddled in fleece in a living room corner, my father slams a plastic sandal against my head five times, five blows in support of my mother.

VII. Fact: The medication warned against runny noses, headaches, diarrhea.

Fact: The medication did not warn against smashed cakes, bare feet in parking lots, disappearing mothers on unknown flights away from home.

Nyla Numan is a junior from Indiana, Pennsylvania who is majoring in English and Chemistry.

16

depression and stigmatization Clara Davison

Stephen Hinshaw states that “stigma refers to the global devaluation of

certain individuals on the basis of some characteristics they possess, related to membership in a group that is disfavored, devalued, or disgraced by the general society.”1 Stigma is a combination of stereotyping, prejudice, and discrimination, resulting in people being lumped together in a group associated with generally negative perceptions. In his report on mental illness, former Surgeon General of the United States David Satcher stated, “Stigma was the main barrier to mental health funding and care across the nation.”2 Since stigma affects those suffering from mental illness to the extent that some will refuse to seek treatment out of fear, the world needs to consider what contributes to this widespread societal belief.

In 1996, the Glasgow Media Group conducted a research study on the

media’s portrayal of mental illness and its possible contribution to the stigmatization of mental distress. They emphatically stated that the mainstream media has contributed to the stigmatization of mental illness and that many people mask their illness with alcohol or drugs because they prefer to be thought of as “drunk” rather than “crazy”.3 The stereotypical mentally ill character in contemporary media is either violent or incapable of living a normal life. Films, television shows, and pop culture display a “tendency for mentally ill characters to be portrayed as unlike most real people…who have family and jobs that establish their identities as participating members of society.”4 Not only is this disrespectful to those who experience mental illness, but it also creates a negative connotation for the general public. Additionally, the widespread portrayal of mental illness as being responsible for nearly every act of violence, especially gun violence, has only added to the negative perception of the mentally ill.

This far-reaching stigma surrounding mental illness includes depression

1 2 3 4

Hinshaw, Stephen P. 2007, 23.

Hinshaw, Stephen P. 2007, 142.

Glasgow Media Group 1996, 112.

Wahl, Otto F. 1999, 42.

17 and those who suffer from it. A recent survey shows that “31-41% of respondents… indicated beliefs that weakness in personal character contributes to depression.”5 When people are considering telling friends and family about their depression, there is the constant worry that they will not be accepted and that disclosure will result in alienation from their loved ones. In her essay about living with mental illness, Madeline Diehl acknowledges that she wrote her narrative about mental illness nine years before she ever allowed it to be published. She stated, “I decided it would be a liability—the stigma might affect my professional or personal life.”6 For people struggling with depression, they are well aware that disclosure to friends and family will most likely result in social alienation, uncomfortable interactions, stereotyping, and total lack of support, therefore undermining the individual's quality of life.7 This fear prevents many from revealing their daily struggles to even the closest of family and friends.

Though families and friends may allow stigma to alienate them from

their loved ones, there remains hope that medical professionals will rise above this tendency and instead focus on treating the illness. However, this demographic is not immune to the reaches of stigma, and a lack of understanding of mental illness continues to permeate the field. Dr. Lewis Judd is entirely straightforward about the present state of professional medical opinions on mental illness. He states that “there is a stigma, even within the medical profession, against mental disorders…we have not done a great job in training physicians to recognize mental disorders and to be comfortable treating them.”8 Many doctors continue to lack the understanding of treating a mental illness with the same seriousness as a physical illness. Advocate Liz

Saycer states that studies have begun to uncover the alarming trend that

when seeking a safe space from social stigma, individuals struggling with depression often avoid seeking medical assistance because they have previously encountered discrimination within the medical field.9 When those who are charged with 5 6 7 8 9

Wahl, Otto F. 1999, 15.

Feinstein, Karen Wolk 2016, 149.

Goodwin, Stephanie A. 2012.

Cronkite, Kathy 1994, 80.

Saycer, Liz 2000, 24.

18 protecting and understanding human afflictions refuse to acknowledge the legitimacy of depression, to whom will people turn when seeking help for their daily torments?

As media, friends, family, and even medical professionals continue to

hold onto their stigma, this vicious cycle only creates havoc among the depression community. Those who suffer from depression are aware of the stigma that surrounds the illness; often, they were aware before they even recognized that they suffered from depression. Because of this, people with depression often believe that the benefits of disclosing are outweighed by the penalties. Not only does the constant stigma prevent many from sharing their struggles, but it can also “involve self-stigmatization, whereby members of stigmatized groups are prone to internalize the negative messages” and thus can result in even more negative effects.10

Saycer concludes by saying that if more spokespeople had already stepped

forward to represent the population of depression, then “everyone would have [already] learnt—at first reluctantly—that having a mental health problem does not have to stop people from contributing, as friends, colleagues, partners or parents.”11 Personal narrative is the greatest way that advocates of depression can humanize this illness and speak to the crippling effect that stigmatization can have on victims of this illness.

10 11

Hinshaw, Stephen P. 2007, 26.

Saycer, Liz 2000, 18.

19 references Cronkite, Kathy. On the Edge of Darkness: Conversations about Conquering

Depression. 1st Ed. New York: Doubleday, 1994. Print.

Feinstein, Karen Wolk. Show Me All Your Scars: True Stories of Living with Mental

Illness. Pittsburgh, PA: In Fact Books, 2016. Print.

Glasgow University Media Group. Media and Mental Distress. London; New York:

Longman, 1996. Print.

Goodwin, Stephanie A.; Morgan, Susanne. “Chronic Illness and the Academic

Career.� American Association of University Professors, 2012. Accessed 4

December 2016.

Hinshaw, Stephen P. The Mark of Shame: Stigma of Mental Illness and an Agenda

for Change. Oxford; New York: Oxford University Press, 2007. Print.

Karp, David Allen. Speaking of Sadness: Depression, Disconnection, and the

Meanings of Illness. New York: Oxford University Press, 1996. Print.

Saycer, Liz. From Psychiatric Patient to Citizen: Overcoming Discrimination and

Social Exclusion. Houndsmills, Basingstoke, Hampshire: Macmillan Press,

2000. Print.

Styron, William. Darkness Visible: a Memoir of Madness. 1st Vintage Books ed.

New York: Vintage Books, 1992. Print.

Wahl, Otto F. Telling is Risky Business: Mental Health Consumers Confront

Stigma. New Brunswick, N.J.: Rutgers University Press, 1999. Print.

Clara Davison is a junior from Cramerton, North Carolina who is majoring in English and Political Science.

20

time off Sara PeĂąa

Looking back, it should have been obvious not to count on the internet for comfort.

During Fall 2016, I created the following comics while I was tackling a foot/ankle injury that knocked down a chain of mysterious symptoms and illnesses. Until then, I was lucky that I had never been hurt as such before. Never in my academic career had I ever needed to take time off. However, I was in so much pain and experienced such strange symptoms that I decided to turn to the internet for a diagnosis - which proved to be nothing more than unnecessary stress. The search term "weird swelling" convinced me that I had a blood clot (I did not). The search term "bizarre ankle pain" convinced me I would likely need an amputation (I did not). The search term "sore neck" not only convinced me that I possibly had meningitis (I did not), but it also got me out of bed at 11:30 P.M. on a weeknight to buy a thermometer to make sure I did not have a fever.

Lesson learned: no more internet, only doctors.

While the internet was not the proper outlet for information on my ailments, the number of health care professionals I visited before I got answers left me disappointed as well. Although my injury started as an ankle/foot problem, it spread like wildfire into unexplained pain, swelling, and body markings. I searched for answers only to be referred from doctor to doctor and saw a total of eight different health care providers within three months. While I was thankful that each professional was able to offer a new insight into what might be going on, I was frustrated to leave not knowing what was happening to me. I was referred until I could not be referred any more. Eventually, I found a specialist who gave me a diagnosis. Although I still cannot explain everything, I now feel - months later - that I am on the road to recovery.

21

Sara PeĂąa is a second-year student from Durham, North Carolina who is in the Division of Occupational Science and Occupational Therapy in the School of Medicine.

22

words I won't say out loud Shelby Anderson sometimes the night is too dark.

I have…I have…

I can’t say it.

I’m crumbling under the weight of life’s heavy burdens, just waiting to collapse. all I want to be isn’t me. in the mirror? is that me? a disease? a disorder? a defect? the pills. the promises. the possibilities. that it would stop. that it would be okay.

23 a meeting of five minutes let's up the dosage, just wait a couple weeks.

I’m fighting an invisible battle that leaves silent scars and offers no chance of surrender. but the stigma makes the words stuck in my mouth and their labels stick. they told me I could be anything, but it feels like I’m losing everything.

Dear DSM*, Please Don’t-Stigmatize-Me.

*Diagnostic and Statistical Manual of Mental Disorders

Shelby Anderson is a junior from Dallas, Texas who is majoring in Chemistry and Psychology.

24

usually I root for the green bay packers Anne Feng

I don't really care much for football. I don't know why points come in seemingly arbitrary packets of sixes, sevens, and threes. I have no idea where Green Bay is or what anyone who lives there has any business packing.

What I do know is that a year and a half ago, I volunteered on the Pulmonary/ Infectious Disease Unit of UNC Memorial Hospital. Theoretically, I was there to run errands and provide company for any adult cystic fibrosis (CF) patient. In practice, not much conversation actually happened. It was maybe my third visit to the inpatient unit, and already I was well-versed in the inevitable dialogue that would follow each time I knocked on a patient door.

"Hello, my name is Anne. I'm one of the student volunteers, and I was wondering if there was anything at all that I could bring for you or if you wanted any company."

"No thanks, I'm good."

"Okay, hope you have a nice day."

Barring the occasional request for juice or crackers or a Starbucks run, that was mostly the end of that. While I always hoped that someone would finally take me up on my offer to chat and end my endless laps around the west wing of the hospital, I could hardly blame them for their reticence. If I were in their shoes, the last thing I would want would be a not-quite-twenty-something bothering me about juice and crackers somewhere between the pokes and jabs and rounding physicians in training.

About half an hour into my shift, I made my way over to one of the largest rooms on the floor. The first sign was the banner of green pennants spanning the top of the doorframe. I knocked, received the obligatory "Come in" and was promptly bombarded with Packers paraphernalia as far as the eye could see. Somewhere amidst

25 the green and white and yellow was a young woman in bed against the far wall wearing a nasal cannula and a cheerful grin. After "No thanks, I'm good," I told her I loved her room because I did. She laughed and replied, "It's not easy rooting for an up and down kind of team, but I'm an up and down kind of girl."

She ended up staying for three more weeks. Throughout the remainder of my time rounding on the inpatient wards, I never found any other room that, despite its best efforts otherwise, looked something like home the way that hers did.

The following spring, after I had been transferred to a different floor, I was scrolling through my Facebook newsfeed when I came across a photo of that CF patient. It turned out that her mother had tagged a photo of one of the nursing assistants that I had added as a friend prior to leaving the unit. She sang praises of the nursing staff of the dear old sixth floor and thanked them for their tireless care of her recently departed daughter.

As I read that one little line, I remember just feeling like someone yanked hard somewhere inside my chest before abruptly letting go. I didn't know her. Honestly, by all measures, she was practically a complete stranger. I had no right to really mourn. But she seemed so alive in the few moments that I knew her, so much more alive than she ought to have been - than I ever would have been - considering how many times I nervously poked into the room to ask her if she was alright halfway through a seemingly endless wave of coughing and wheezing.

And now she wasn't.

So for a week, maybe two, I just could not get her out of my head.

And every time I see that telltale white G on a dark green sweatshirt or "Packers" on the scoreboard as the channels scroll by, I still sort of can't.

Anne Feng is a junior from Cary, North Carolina who is majoring in Biology and Interdisciplinary Studies and minoring in Chemistry.

26

haunted houses, haunted memories: embodiment, reproduction, and storytelling Hallie French

Bettina Judd, an African American poet, writes in her book Patient of her

harrowing experience of being ignored by her doctors and finally losing one of her ovaries as a result. In her poem “In 2006 I had an Ordeal with Medicine,” Judd writes, “I had an ordeal with medicine and was found innocent or guilty. It feels the same because I live in a haunted house. A house can be a dynasty, a bloodline, a body.” Her poetry is not just about her own experience, but is also an exploration of the ways in which African American women’s bodies have been exploited, ignored, and abused by the medical profession throughout American history.

Using Judd’s framework of body, bloodline, and dynasty, I launched a

yearlong thesis project on the relationship between African American women, stories, the past, and medicine in the works of late twentieth-century African American women writers. The texts that I focused on include: Toni Morrison’s Beloved, Gloria Naylor’s Mama Day, Gayl Jones’ Corregidora, Octavia E. Butler’s Kindred, Dessa Rose by Sherley Anne Williams, and Stigmata by Phyllis Alesia Perry. Many of those works endeavor to reclaim the past and remember the bodily experiences of the women that came before them. By thinking through that painful past, each author works to unravel the threads of history and explore the present.

I am interested in answering why these writers have chosen to brutally and

consistently write history on the backs of their female characters. I argue that this choice is one that reminds the reader of the past’s brutality and of the ways that the past can be passed down. The works that I examine embody activism while honoring African American women’s bodies, both past and present. My project converges over these two points and seeks to call attention to the ways in which the past can affect the present in real and damaging ways; to quote the South African writer Chimamanda Ngozi Adichie, “All of us, women and men, must do better.”

Hallie French is a senior from Aurora, North Carolina who is majoring in English and minoring in Medicine, Literature, and Culture.

phantom pain Angel Legare You think you know how much pain you can take How strong you are And then you lose a parent Sudden loss of your father You wonder why you ever thought these things Sorry for your loss Words spoken off the lips of those that strive to not Not ever have to say those words My loss, my mother’s loss, my brother’s loss, the world’s lost How are you?

I don’t remember ever being asked those three words Those simple three words as often as that first month As a child you believe wholeheartedly that these two Two very important beings Will be with you forever in this earthly place To have a connection to someone This innate connection To feel cut from the same cloth To have that one person who shares so many So many unspoken understandings And now No more How are you?

You are lost So lost

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28 How are you?

I’m drowning, I can’t take a breath A constant dull pain in my side At times the burning of a knife Twisting As a reminder that all is not well How are you?

You grip your sides and squeeze tight So tight to make it stop Consuming A part of you missing And a pain lingers there Time not measurable by clocks or calendars How are you?

Time passes Quickly and slowly all at once You start to again feel a part of this world To have more good days than bad But still some days you have this pain A pain for a part of you that is no longer there This phantom pain Invisible to everyone but you The occasional burning to remind you That the love between child and parent is such a gift How lucky we are

Angel Legare is a second-year student from Fairfax, South Carolina who is in the UNC Physician Assistant Program.

a review of waking up blind

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Kiki Paré

In the early 1980’s, Emory Eye Center in Atlanta was growing rapidly:

accumulating a multitude of new partners, seeing a growing number of patients from around the state, raising funds, and moving into a brand new building.

A majority of the increasing success was attributed to Dr. Dwight Cavanagh, the former chairman of Emory University School of Medicine’s Department of Ophthalmology. Unfortunately, he followed an immoral and unethical path to achieve his acclaim, making many intentional medical and legal errors. His mistakes, and the grave repercussions that followed them, triggered Ophthalmologist Dr. Tom Harbin to write an account of the happenings, entitled Waking Up Blind.

Harbin became a glaucoma specialist in private practice at Eye Consultants

of Atlanta in 1975, around the same time that Cavanagh started working at Emory.

Harbin became partly involved in the destruction caused by Cavanagh, when one of the patients that Cavanagh had wronged came to Harbin’s practice in need of medical help. Harbin also witnessed the downfall of two doctors’ careers who stood up against the immorality of Cavanagh. Harbin felt that their stories needed to be told and their reputations absolved. Therefore, he published Waking Up Blind in 2009, about ten years after the last of the multiple lawsuits against Cavanagh were finally settled. Through court documents,, letters, and interviews, Harbin recounts the disturbing events that took place during Cavanagh’s career at Emory.

Harbin moves from Cavanagh’s rapid career acceleration to his specific ethical misbehavior, which include fraudulent billing, unnecessary surgery, and alteration of charts to cover up wrongdoing. Many doctors had private issues with Cavanagh’s practice, however many unwittingly supported Cavanagh due to the revenue he generated. Two ophthalmologists who constantly challenged Cavanagh are Dr. David Campbell and Dr. Allen Gammon.

Harbin carefully narrates the process of Cavanagh’s investigation that was

largely instigated by Campbell and Gammon. He describes in detail the activity of the seven lawsuits filed against Cavanagh and the Emory Medical Clinic. In the end,

30 Campbell was forced to resign with a tainted academic reputation and a reprimand by the Emory Ethics Committee for showing “moral superiority” towards his peers.

Cavanagh took a plea bargain from the American Academy of Ophthalmology and went on to be the University of Texas Southwestern Medical Center’s Vice Chairman of Ophthalmology.

The hierarchy in the Emory administration and physician greed are what

struck me the most. Campbell and Gammon consulted every source they had access to and found little to no support. There were department meetings, committee investigations, and an ethics investigation focused on Cavanagh, which all resulted in the scolding of Campbell and Gammon for not being supportive of their colleague.

It is astonishing that this level of corruption and dangerous practice could slide by. As I read about Campbell and Gammon’s struggle, I felt frustrated by various authority figures’ lack of accountability and their prioritization of income. I was also disappointed with the subordinate, unnamed doctors, technicians, and nurses that should have made a larger effort to speak up. Nevertheless, I recognize their limited ability to voice their opinion due to fear of losing their jobs.

Cavanagh’s approach to his career is a prime example of how arrogance and

ego can present a consequential problem in the doctor-patient relationship. His actions, such as spending only two minutes with patients and scheduling patients of lower socioeconomic status last, unveil his lack of empathy. He was not troubled by the health problems of his patients, but rather he was only interested in increasing his wealth. It is shocking to me that a doctor as such was allowed to be in practice.

This book demonstrates the tragic outcome of placing financial gains in front of ethical patient care.

Kiki Paré is a first-year from Atlanta, Georgia who is minoring in Medicine, Literature, and Culture.

the alcoholic's haiku Jacqueline Kenny

memory is like fingerprints on a wineglass circles of dissolution

Jacqueline Kenny is a junior from Centennial, Colorado who is majoring in English and minoring in Creative Writing and Comparative Literature.

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logan gin's journey to advocacy Emily Long

Students at The University of North Carolina at Chapel Hill (UNC) all

sport Carolina blue for 2016 Homecoming Halftime Show. The air in the stadium is full of anticipation over who will become the next Mr. and Miss UNC. The homecoming court stroll onto the field. The crowd’s attention is immediately drawn to a member of the court who is shorter in stature and uses crutches as he takes his position. After each candidate is announced, the stadium is filled with applause and shouts of approval when this candidate, Logan Gin, is crowned as Mr. UNC 2016.

When I learned of Logan’s Mr. UNC campaign in late October 2016, I

was interested in learning more about his story. Although I did not know Logan personally, I had seen him whizzing across campus on his scooter or hanging out in the Pit with his friends, so I emailed him and asked if he would consider allowing me to interview him. Even though he was in the heat of his campaign at this time, he responded enthusiastically, typical of kind-hearted manner.

Logan was born with diastrophic dysplasia dwarfism, a condition that

affects the development of cartilage and bone, which leads to short stature, joint pain, and deformities that make mobility difficult. He describes the time after his birth as being one of “uncertainty” because his parents were not previously aware that he would have dwarfism. “I had difficulty with cartilage forming in my bones and joints… I have still some joint and muscle issues and pains,” he said. The thick callouses on Logan’s palms from years of using his crutches are the evidence that mobility is not easy for him, but he always manages to get to where he needs to be, even stopping along the way to greet friendly faces, exchange a quick smile, and quick a “Hey, how’s it going?”

Logan had several surgeries throughout his childhood to aid in bone

alignment and to correct his spinal scoliosis. When I asked about his experiences with hospitals and physicians, I was expecting tales of doctor-patient conflicts.

Instead, Logan told of a close relationship with one of his favorite doctors. His orthopedic surgeon “...has dwarfism as well. So we kind of have a special connection

33 with that. He kind of knows some of the things that I go through or have gone through…We are able to connect in a special way.” His doctor helps him by giving him personal advice and keeping his own experiences in mind when deciding treatment options.

Although it would be easy to have a negative outlook on life while living

with a disease that causes pain and difficulty walking, Logan is optimistic. He described his condition as “the circumstances that I was dealt [with].” He added, “I’m in a pretty good place now. It certainly impacted my childhood with being in and out of the hospital and things like that, but most of the surgeries have been with a purpose, to make me more independent and to function in everyday society… I do about 99% of what anyone else does. I just do it a little bit differently.” Logan’s childhood was more difficult than most, but he chose to make the best of it, striving for the independence that would eventually allow him to come to UNC.

When he began college, Logan faced some challenges; however, he quickly

gave UNC credit for doing its best to make the campus accessible. Logan described the overall campus accessibility to be “pretty decent” as a result of university staff going out of their way to try to make the campus as accessible as possible. One of the main challenges that Logan faced is the inaccessibility of lab benches, which are hard for him to reach to conduct experiments. While some challenges do still arise for Logan, he does most of the same things that any other student does. He said, “I can get to all my classes. I can get to the places that I need to be… I can get the accommodations that I need with Accessibility Resources.” Logan acknowledged that “the university does the best they can, given the infrastructure, to be able to make it as easy as possible.”

A major challenge that Logan faced when coming to the UNC was living

on campus. He said he has “had a pretty positive experience with housing,” but his first-year was a bit difficult because he was on the fourth floor of his dorm on North Campus, so he was forced to always take the elevator. Logan cited the lack of accessible rooms on the first floors of dormitories as being “a little bit shocking” and as something that “housing didn’t really have a solution for.” The vast majority of first-year students at UNC live on South Campus, a 15-minute walk from classroom

34 buildings - a distance inconvenient for Logan. Though his dorm had a first-year floor, he said that he had some difficulty making friends. He attributed this to being separated from the majority of the first-year population. Logan’s problem with his physical condition interfering with his social life is not uncommon among people with dwarfism.

Despite this, Logan has lived on campus for all four years. He has grown to

love the on campus community so much that he now serves as a Resident Advisor.

To him, this position has been “symbolic” because “there have been a lot of people who have helped me transition into college and the different accommodations that I’ve had around the residence halls, and things like that. Now I can kind of be a resource for other students through that, which I really enjoy.” His Community Director has been very accommodating and has worked to ensure that the residence halls are accessible for him. He mentioned that when he began his job, the box in which spare keys to residents’ rooms were stored was mounted above his reach on the wall, so he enlisted his Community Director’s help. Logan said, “We were able to talk to facilities, and they were able to come and lower it to a place where I would be able to easily get in and out if a resident were locked out of his room.”

Additionally, Logan is a co-chairman for Advocates for Carolina, a UNC

club that focuses on disability awareness through events such as speakers with disabilities, wheelchair basketball in the Pit, and other socials. One of his projects is to implement a new accessibility icon in which handicapped spaces, such as parking places and accessible bathrooms, will be marked with a symbol of a person actively leaning forward while maneuvering their wheelchair instead of passively sitting.

Logan explained the icon as “a new and improved symbol for different places around campus because it is a symbol that shows empowerment, independence, and more accurately represents a college student with a disability here on campus.”

Outside of Advocates for Carolina, Logan also has his own goals to improve

the lives of those with disabilities at UNC. His Mr. UNC campaign was based on an issue that is very close to his heart - bringing wheelchair basketball to UNC. He said that it is “a project that kind of came out of all of this work around disability.”

Throughout his time at UNC, Logan has noticed that “there hasn’t necessarily been

35 options for students with disabilities to have access to recreation, leisure, sports, activities…but that’s not to say that students with disabilities don’t need these things, and they certainly do.” Logan hopes to bring wheelchair basketball and other adaptive sports to UNC as a way to unite people with and without disabilities to play together.

Additionally, he is working with the campus transportation service to

provide better ways for students and faculty with disabilities to get from place to place on campus. Currently, those with disabilities can access either a 24-hour van service or a golf cart shuttle. Logan believes that the system could be improved because it operates via an “outdated” walkie-talkie and telephone system, so the people who use these services often have no way of determining how far away their ride is or when they will be picked up. Thanks to Logan’s advocacy, the transportation system will soon unveil a new app that will resemble popular ride request apps. Always modest, Logan cited this major improvement in disability access as “a small example of how things have changed” on campus since his arrival.

My final question for Logan was, “If given the choice, would you remain

a person with diastrophic dysplasia or magically transform into a body without dwarfism?” This caused him to pause to contemplate his answer. He concluded that in an ideal world, he would love to play college basketball since he is a huge sports fan. However, he would not change his life by relinquishing his disability. He said, “Disability kind of is part of my identity now. It means so much to me, and it’s the work that I do. It’s the work that I’m passionate about. It’s stuff that I’m going to make a career out of…taking that away from me would change my life and my trajectory, my childhood, my growing up…I just can’t imagine life without it.”

Throughout his time at UNC, Logan has endeavored to spread the positive message that people with disabilities are people first and that their abilities far outweigh any disabilities.

Emily Long is a sophomore from Jefferson, North Carolina who is majoring in Biology and English and minoring in Medicine, Literature, and Culture.

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till death do us part Brenna Elmore

It started two years ago, Suffocating in the shadow — Breathing through ruptured lungs, Chest collapsing under a thousand tons.

Fear. Fear. Irrational fear.

Never ceases. Crumbles into pieces.

Fear. Fear. Irrational fear — “I’m here, I’m here, I can help my dear…”

No. No. You see the shaking, The gagging, The weeping, But you don’t feel it.

You tell me to conceal it.

“This too shall pass,” But I call bullshit.

Covers choke me, Take my breath away.

Was once carefree, Now happiness is all just hearsay.

37 My name becomes anxiety, I will never know sobriety.

Hugging becomes a squeeze, An inoperable terminal disease.

Society tells me to move on, That it’s a temporary phenomenon.

They give me pills, pills, and more pills — One to make the pain disappear, One that’s illegal to sell in this hemisphere, One that kills me, One that ends me, One that takes it all away.

One day.

It started two years ago, I drowned in the shadow — Wheezed through mangled lungs, Heart riddled by five blazing guns.

Till death do us part, I’m here for the ride Paralyzed in a seeping puddle of formaldehyde.

It’s too late now — wedding bells amplified, Panic is my groom, and I his bride.

Brenna Elmore is a junior from Chapel Hill, North Carolina who is majoring in Journalism and minoring in Creative Writing.

38

the cure Chandler Albert

Chandler Albert is a senior from Hickory, North Carolina who is majoring in Biology and Studio Art.

39

care in the context of crisis:

avenues toward holistic healing in jordan for syrian refugees and jordanian citizens Izzy Pinheiro

In the summer of 2016, I went to Amman, Jordan, intending to explore

how Syrian refugees with terminal illness or chronic disease navigated the interplay of the various facets of the experience of illness and displacement. While I was interested in highlighting the barriers facing refugees in securing their care they needed, my true investment lay in elucidating how these barriers structured the very nature of illness itself and that nature of care that individuals were forced to forage for in an unfamiliar land.

To accomplish answering this question, Arabic translators and I led semi-

structured interviews in government hospitals, private clinics, the Za’atari refugee camp, and in participants’ homes. I learned from clinicians and policymakers in Jordan that palliative services were minimally available for the general population because of the medical discipline’s recent nascent in the Arab world. Consequently, even most Jordanians are not able to access holistic care that is standardized, institutionalized, or free from stigma. The interviews exposed the institutions, actors, and policies affecting the variability and viability of the means through which the participants could cope with illness and related adversities.

Refugees relied on charities and live-in care facilities in order to get care and

were significantly distressed by the financial toll of the illness. Nearly all individuals said the financial detriments of their disease were the only feature of illness that impacted them, but this may be due to an unwillingness to publicly address the wounds of the soul and spirit inflicted by the traumas they underwent. Moreover, not being able to pay for rent and food exacerbated the individual’s disease, as this stress eroded their mental wellbeing and also meant that they could not nutritionally sustain themselves at the most fundamental level. In these conditions, typically manageable conditions such as diabetes become life threatening. In one instance, a Syrian mother with diabetes was on the verge of losing both her feet because she

40 could only get one generic medication courtesy of a charity of medical students in the area.

However, refugees who lived in camps or in live-in care facilities had direct,

sustained, and reliable care with providers that they often spoke of with affectionate or reverent tones, often regarding these providers as family. Displaced individuals in these particular settings also existed in isolated communities comprised nearly entirely of Syrian refugees, allowing them to form pseudo-filial relations with each other. Many Syrians attributed their ability to cope with difficulty to having received the support of their displaced peers. Moreover, these refugees encountered a vast and ever-changing array of individuals who were invariably impacted by the crisis. As a result, many people dismissed the gravity of their own suffering in comparing it to the more extreme cases that they witnessed.

In Jordan, as in many countries in the Middle East, doctors share the

diagnosis with families of patients rather than with the patients themselves. This practice underpins the a prevailing cultural belief that knowledge of an illness can exacerbate a patient’s condition and undermine their chances of recovery. This complicates central tenets of palliative care, as the “patient-centered approach” is compromised in accordance with the Western understanding of this concept, yet aligns with that of the Arab world. Many patients I interviewed expressed that they wish they had known the serious nature of their condition earlier, demonstrating that a larger cultural change must occur that would abdicate the provider of the responsibility of informing the patient about their disease.

In the Middle East, disability and mental illness both are loaded with

stigma of weakness and obscured by the shadows of silence. Mental health services were relatively sparse. Accessing these limited spaces is impeded by one’s own sense of embarrassment or fear of ostracization for being “weak.” Having disabilities also incited the violence stigma. This particular social malignancy affected refugees more than Jordanian citizens because many of them had been dismembered or maimed by blasts. These individuals would avoid going out in public and preferred to conglomerate with individuals who shared similar conditions, cultivating their own havens in which they could seek refuge from the pity of others that was ubiquitous

41 and shook their self-concept. In the spaces, such as a live-in care facility for Syrian children and adolescents who had been disabled by explosions and missile strikes, they were able to fortify their sense of self-worth and forage a family in having a closely integrated community that was enabled by living in close quarters that were removed from the unforgiving and unblinking public eye.

The stigma of disability and of mental illness also shaped the ways that

individuals talked about their illness. Many of the Jordanian citizens I interviewed were more willing to transparently address issues such as depression and anxiety.

However, even these terms were cloaked and spoken around rather than directly addressed with these more damning diagnostic labels. Jordanians and Syrians would often say their illness made them “nervous” or “more easily agitated.” In speaking with Syrians, the cultural reluctance to disclose about trauma or expand upon the erosion of one’s stability was evident through my encounters with people who often circumvented having to disclose through emphasizing financial distress.

While many interviewees explicitly asserted that their illness had not

made them weak, nearly every Jordanian and Syrian identified that illness had impacted their worldview and made them more aware of the primacy of health and/or faith. Some individuals denoted that illness had changed their identity.

Usually people became more reverent, reifying the strength of religious conviction ostensibly ubiquitous in countries in the region. Illness was dictated as a character disfigurement for individuals who confessed they became more angry people. This often emerged when the illness impeded someone’s ability to fulfill a role that was central to their identity.

In nearly every interview, death was spoken about in a depersonalized and

almost ritualized manner. Individuals did not address their own terminal status if they had a condition like late-stage cancer, possibly because their families had not informed them of the gravity of their situation. However, Jordanians and Syrians often expressed a comfortable and courageous attitude when invoking death. Many people said that disease does not kill man, only God does. Others viewed their illness as a test and would often use religious rites, such as participating in Ramadan or hajj, to ensure that they would get a better position in the afterlife. A few individuals

42 believed that they had become ill because of sins they had committed, and as such were using their recovery period to become a better Muslim. Having a strong relationship with God and having dedicated medical providers were of increased importance to Syrian refugees, likely because they did not have a network of family and friends in Jordan that could assist them in their time of need.

The demographics in Jordan are heavily marked by refugees of descendants

of refugees from prior crises. I was concerned to see a growing level of frustration among Jordanian citizens who felt that the needs of impoverished and vulnerable citizens were continually overlooked or compromised because of the country’s tradition of hosting refugees. Refugees also were generally more emotionally affected by the loss of their homes than by illness, often expressing a desire for peace in Syria rather than improved health. Suffering was a communal phenomenon that percolated to imprison even those who had found refuge. Returning to Syria was a dominant ambition amongst refugees, fueled by dissatisfaction in Jordan and discomfort with hostility. This dynamic was complicated by the gratitude and sense of debt many Syrians expressed towards Jordanians, as well as by the development of close ties between refugees and compassionate community members.

The ongoing violence and instability driving millions out of Syria and

displacing far more within it necessitates that we begin to consider how to develop services that most effectively address the needs of those with life-limiting illness.

Consequently, it is not only feasible but also morally obligatory to take steps to dismantle the machinery exacerbating or enabling the kinds of struggles that individuals here, and millions of others, face on a daily basis.

Izzy Pinheiro is a senior from Albany, New York who is majoring in Interdisciplinary Studies and minoring in Composition, Rhetoric, and Digital Literacy.

unmade

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Taylor Fie 4:14 am on a Tuesday I grew up on a regimen of bed-making. Even as a moody, pseudo-exhausted teen, I made my bed every morning before heading to school. Now, I barely glance at the pool of twisted covers, only realizing their untidiness as I yank them back to the top of the bed at night.

The fridge is stark white and contains a quarter gallon of milk, three water bottles, and a growler. The occasional hospital cafeteria box ghosts its way across the top shelf. I consider unplugging the fridge and saving on the electric bill before trudging out the door.

Waynesville, NC on a Saturday in early October I visit my papaw and count out his medications for the week, sometimes sticking around to watch the race. “Keep studying COPD,” he tells me, his eyes following the train of cars snaking around the track. “I need you to find a cure.” He says the same thing every weekend, turning to me with a hard smile, both of us acknowledging the desperation, the frustration in a moment’s glance before turning back to the TV. In the physicians’ lounge a few days ago A surgeon lets his frustrations loose, cursing the innards of a patient who tripped him up and turned a two-hour case into a seven-hour-long haul through hell. Next day on rounds, the patient exhaustedly pushes against a colostomy bag that shouldn’t be there as he tells us no, last night he did not experience the following symptoms: fever, chills, nausea, vomiting, chest pain...

44 Room 30 in the emergency department A surgical consult for bowel obstruction. Two sisters tearfully relay their mother’s state to the doctor. “She was perfectly fine until a month ago when she had that valve replaced in her heart. Apparently, she was in the five percent of people who have a stroke afterwards. And now she’s like this.” We were only consulted to emphasize to the family that the patient in question was not a good surgical candidate. This previously healthy, stubborn, sassy woman is declared inoperable.

9:48 P.M. on a Tuesday Once again, I glance at a cold bed before sinking into its wrinkled arms, pulling up the covers messily discarded near the bottom. It’s messy. It’s messy like a lot of things, and imperfect, but in the vast universe of imperfections, it’s comforting. In the dead of night, I gather in place the ends unraveling at the seams.

In the morning, I decide to keep the fridge plugged in one more day.

Taylor Fie is a fourth-year student from Clyde, North Carolina who is in the UNC School of Medicine and UNC Gillings School of Public Health.

you are more Jacqueline Kenny doctors are the worst ones it’s been five years and every time she walks into a different hospital the new doctor frowns and says it looks like she just needs to eat they whisper to her mother, anorexia I eat more than my dad, she tells me scraping the last of her avocado with a silver spoon she brings along two stocked blue and white wheeled-coolers when she leaves her house so that she can always have food on hand she hates the word skinny people—classmates, grocery-store ladies, the boys that walk past – they ask her if she is trying to become a ballerina they ask her if she has ever considered gaining weight they tell her, to her face in class that she is too— well, too thin, quite frankly I want to offer myself to walk around behind her, to glare at anyone who even thinks the word but I don’t

45

46

on the weekends, she goes to Disney World her mom takes her, they make the rounds Epcot, MGM, Animal and Magic Kingdom— her favorite thing is to stand in line to meet and talk with the princesses they all know her name by now she shows me a picture of her hugging Belle Belle is smiling down at her she is dressed in Tigger pajamas, beaming now, I kiss her on the cheek when she cries in front of me when she says that it hurts her to shower to stand to sit to sleep and if she walks she can manage the pain she can almost walk it away but the pain is there to consume her when she stops because she cannot walk forever because it hurts and she is scared that it has been five years

47 that she is twenty-one and why can she not— have a job? live at school? drive a car? why must her life revolve so much around eating? why must the exhaustion remain? in my mind, she says, I am well. in my mind, she says, I can do anything. it is hard, she says, to admit that I cannot.

I am a clumsy comforter my arm draped around her shoulder is heavy— God, I am aware of the healthy heaviness of my body and the amount of nothing that I am doing for her in the middle of our conversation about Moana do I look sick, she asks earnest and waits like she knows the answer I could fold her into my arms big eyes big heart big smile no, I say, no, your cheeks, your face— it is so much fuller than the last time I saw you and she squeals a little bit, and bounces in happiness pinches her own cheeks

48 my friend, you are more than the sick girl tell me you aren’t magical tell me you aren’t beautiful you are my friend you are your own Disney Princess swept in yellow swept in gold swept in the curly hair around your own big brown eyes you are the largest life and when you leave my house is empty of you and I keep on going to school, work, the bookstore, movie dates, rowing practice and restaurants where I can eat without my body curling agony into itself and it isn’t fair it isn’t

Jacqueline Kenny is a junior from Centennial, Colorado who is majoring in English and minoring in Creative Writing and Comparative Literature.

roots

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Taylor Fie It was the quietest birth I ever witnessed.

She arrives with her husband in the stillness of night, winter air released in puffs as they remove sweaters and scarves; She bares down to near nothing as a nurse ties a hospital gown around her neck.

Adjusting on her back to find a more comfortable position, she lays stoic as sweat trickles down her brow and into the thick dark hair swept behind her ears.

Her husband relays her predicament in broken English and we somehow gather that she had started laboring much earlier in the day, pacing their home with gritted teeth and groans until she couldn’t stand it any longer. She’s accustomed to the pain, her silent suffering almost routine as this is her fourth, her other three at home with a cousin.

She is quickly wheeled away to a private room, deemed ready for delivery with the tip of a baby’s head visible between her legs, an interpreter steps up to ask: “Why did you wait so long to come in?”

“I hate the smell of hospitals.”

She giggles sheepishly before the door closes behind her. Thirty minutes later, a baby is born.

Quiet like her mother, it takes a few rubdowns to coax a cry from her pursed mouth.

Moments pass and the placenta is delivered, roots to her existence, un árbol de vida with splayed vessels twining inwards to become a cord. Uprooted, she draws in unfamiliar air through muffled cries and eventually settles, planting her face against her mother’s neck, damp with sweat, dark hair swept behind her ears.

Taylor Fie is a fourth-year student from Clyde, North Carolina who is in the UNC School of Medicine and UNC Gillings School of Public Health.

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post-PTSD Kat Tan

We’ll laugh about this one day Find humor not in the ways my whole frame shakes and crumbles but in the way it doesn’t anymore; not in the ways your hands smooth the knots in my back as I’m attacked by the specters of times past We’ll laugh because we have finally beaten it

Kat Tan is a sophomore from Great Neck, New York who is majoring in Bioethics and minoring Creative Writing.