Spring 2021: The Health Humanities Journal of UNC-CH

The Health Humanities Journal The University of North Carolina at Chapel Hill SPRING 2021 | exploring illness, caregiving, and medicine

MISSION STATEMENT The Health Humanities Journal of UNC-CH aims to inspire and facilitate interdisciplinary thinking and collaborative work while developing and embodying a variety of ideas that explore the interface between arts and healing. This publication allows for dialogue, meaning-making, and multiple representations of the human body, medicine, and illness.

To learn more about the publication or to submit, visit the following website: http://hhj.web.unc.edu.

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

SPONSORS

The Carolina Parents Council

The Health Humanities Journal

of The University of North Carolina at Chapel Hill Spring 2021

Editorial Team Elizabeth Coletti Editor-in-Chief Majors: Chemistry; English Class of 2021 Maia Sichitiu Design and Layout Editor Major: English Minors: Creative Writing; Writing for the Screen and Stage Class of 2022 Alice Peng Art Director Majors: Economics; Math Minor: Chemistry Class of 2021 Malik Tiedt Treasurer Editor Majors: Medical Anthropology; Nutrition Minor: Chemistry Class of 2023 Jane F. Thrailkill, Ph.D. Faculty Adviser Co-Director, HHIVE Lab Department of English and Comparative Literature

Anna Covington Editor Major: Neuroscience Minors: Medicine, Literature, and Culture; Chemistry; Education Class of 2021 Olivia Delborne Editor Major: Psychology Minors: Chemistry; Spanish Translation and Interpretation Class of 2022 Rhea Jayaswal Editor Major: Nutrition Minors: Chemistry; Creative Writing Class of 2023 Noah Ashenafi Editor Major: Nutrition Minor: Medicine, Literature, and Culture Class of 2023 Miranda Almy Editor Major: Medical Anthropology Minor: Creative Writing Class of 2023

Table of Contents Jane F. Thrailkill

Adviser’s Note

6

Elizabeth Coletti

Editor’s Note

8

Hazel Milla

A Special Sort of Terrifying

11

Abigail Westmoreland

Rh Incompatibility

12

Grayson Sword

Healing

16

Amber Hammer

Sustainability in Nursing Education: The Future Advancement of Academic Nursing Act

17

Reuben Tacas

A Postpartum Night

22

Maggie Conner

Don’t Fist Bump Me. My Mom Is Dying.

24

Alejandro Ramirez

Pandemania

27

Allison Ruvidich

In Which I Make the Case I Am Not Stupid (the Cognitive Assessment)

32

Medha Rao

What Happens When We Grow Old? The Elderly and the COVID-19 Pandemic

34

Travis Jones

You Made Me Cry, But You’ll Never Know That

37

Jessica McGee

Our Bathtub Poems

38

Lang Duong

GRIEF 101

40

Neha Dronamraju

Rose

42

ART

by Alice Peng

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Adviser’s Note

As I sit down to write, my upper left arm aches from the second Pfizer vaccination that I received yesterday. In two short weeks, I will once again be able to hug (vaccinated) friends, attend my daughter’s college graduation in May, travel to New York to visit my 92-year-old mother-in-law. These are the marvels of human contact and connectedness that were interrupted just over a year ago, when the World Health Organization declared that the novel coronavirus SARS-CoV-2 had reached pandemic spread.

As I think backward, to all that has transpired to make a friendly hug a remarkable achievement, I am overwhelmed. So much human effort and expertise! And despite this Promethean feat, so much loss of life. As of today, 7 April 2021, the WHO reports that almost three million human beings have died across the globe from COVID-19 (surely an undercount). Despite the once-unthinkable rapidity of vaccination creation and distribution, thousands more continue to perish every day.

Accounting, as precisely as possible, for the sheer magnitude of lives lost has been an extraordinary achievement. When leaders in the United States failed to take the virus seriously and meddled with the federal agencies devoted to managing and monitoring the pandemic, Johns Hopkins University stepped in to do the essential work of counting on their COVID-19 Dashboard. We have followed the terrible loss of life around the world, with the reddest bubbles bleeding together to blur the familiar outline of the country with the most deaths: the United States. This grim exceptionalism is a national shame, painting in red the shocking disregard for the basic precepts of public health. In the face of presidential inaction and perfidy, one can’t but honor the knowledge, expertise, and exhaustive on-the-ground labor that makes this database possible.

In a pandemic, counting is essential. Counting has revealed who counts—and who does not. Dr. Shreya Kangovi, associate professor of medicine at the University of Pennsylvania, calls on the resources of metaphor to express this injustice: “COVID is a funhouse mirror that is amplifying issues that have existed forever. People are not dying of COVID. They are dying of racism, of economic inequality and it is not going to stop with COVID.”1 The work of scientists and researchers and healthcare workers provide the glaring numbers that show our collective failure to protect individuals who are elderly, impoverished, incarcerated, and those working poorly paid jobs— especially people of color.2

7 In quiet moments, many of us turn to the humanities and the expressive arts to find meaning in grief, to seek consolation, and to make vital connections across all that separates us. In this issue of the Health Humanities Journal, we read poems and essays that give voice to our fragility: individual experience expands, testifying to what so many have endured.

We cannot “unsee” what COVID times have revealed—nor should we. The past thirteen months have lit up the essential roles that science, research, medicine, and technology play in our lives; equally, the pandemic has affirmed our need for beauty, reflection, and memorialization. The health of our communities, and society as a whole, is bound up with the efforts of millions of people, from factory workers to artists to civil servants. With millions of shots delivered free of charge in a few short months, we see what good government can accomplish. There is more work to be done, in the fight for affordable healthcare, racial justice, and dignified living conditions for those in congregate care.

Perhaps we are changed as a people, ready to invest in the things that matter?

The lovely works collected in this issue of the HHJ, the stunning achievement of the Johns Hopkins database, a summer of powerful protests against racist violence, the vaccine priming my immune system to resist the coronavirus: I concentrate on these, as hopeful portents of what human beings are capable of.

Jane F. Thrailkill

1. David Raths, “For Vulnerable Populations, ‘COVID Is a Funhouse Mirror Amplifying Issues That Have Existed Forever,’” Healthcare Innovation, April 13, 2020, https://www.hcinnovationgroup.com/population-health-management/socialdeterminants-of-health/article/21133730/for-vulnerable-populations-covid-is-afunhouse-mirror-amplifying-issues-that-have-existed-forever.

2. Daniel Young, “Black, Disabled, and Uncounted,” National Health Law Program, August 7, 2020, https://healthlaw.org/black-disabled-and-uncounted/.

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Editor’s Note

Dear Readers, It is impossible to begin this letter without context. Was it just a year ago that I was frantically rewriting the introduction to the last spring edition of the Health Humanities Journal as news changed daily, looking up the formal definitions of “epidemic” and “pandemic,” and thinking what a peculiar moment that issue would reside within? Did I really believe the naïve hope that we would be able to distribute physical copies on campus in the fall? I have since been disabused of that idea of a contained moment, and even with the vaccine I find it difficult to imagine a return to normal on any timescale that matters, stuck in the nonphysical here reading pandemic literature and wondering how I can begin to justify the pages my thoughts take up.

In this year of continual tragedy and loss, it is very difficult to avoid what seem like the two most available reactions: anger and exhaustion. We can see it in the pieces within this journal. There is justifiable frustration at the vast number of preventable deaths. One writer mourns his grandfather while despairing at simple measures of caution not taken. Another shares her outrage at doctors lacking empathy after a devastating cancer diagnosis.

There is an examination of a short story where young people, furious at all they feel cheated out of, turn their blame on the elderly, and an essay on the future of nursing education ends with a litany of questions confronting mounting challenges and inequalities. Alongside these, a patient faces feelings of failure after surgery, and a daughter chronicles descriptions of her mother’s grief after the loss of a loved one that I can’t help but see mirrored in our own experiences in quarantine over the last year: dwindling motivation, disrupted sleep, fragile emotions, avoidance of what is really going on.

And yet, these are not the only responses available to us. The fact that the world has not completely deconstructed over this last year is proof of the incredible ability to continue on, hunting for solutions and silver linings, painting our own if need be. In this journal, there is also hope for activism within nursing education. Alongside characters accepting only hate, others refuse to relinquish their optimism and sense of self. Honest attempts to understand the suffering of others—or if not then at least to offer sympathy

9 and support—show how even as we have been physically separated, there are innumerable ways in which we have come together.

My gratitude goes to all who have supported the journal this year, including our sponsors, who enable us to continue printing the journal and hosting it online. Thanks also to Dr. Jane Thrailkill and Dr. Kym Weed for their support and guidance, to the board of judges of the annual Walker Percy Prize, and to the authors who have contributed to this issue, sharing their vulnerability, insight, and essential perspectives. To the Editorial Staff: I will never quite get over the loss of not being able to work on the journal with you all in person this year, and in fact it feels odd that for several of you, we have only ever known each other through pixelated video calls. Nevertheless, we have done what at many times during the year I thought was impossible and put together another two issues of this journal to stand with those that came before. It would not have happened without your work and careful attention in understanding and refining these pieces, and I am grateful to all of you.

As I graduate, I am happy to leave the Health Humanities Journal in the hands of its next editor-in-chief, looking toward a hopeful future with lively debates and sprawling conversations that we have all been missing in this year of virtual life.

The Editorial Staff and I are proud to present the Spring 2021 issue of The Health Humanities Journal of UNC-Chapel Hill. The poems, narratives, and essays within are not all happy. That would be an unreasonable request even in the best of years. There is anger and sorrow and grief. But as you read these works, we hope that you will see their vulnerable honesty and be able to find in them inspiration to enact change, catharsis of the losses so many have shared, commonality to prove you are not alone, and above all, hope for healing, for care, and for another open tomorrow.

All my best, Elizabeth Coletti Editor-in-Chief

A Special Sort of Terrifying

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Hazel Milla I know you’re trying to communicate something when you say your red shirt hurts on the radiator, but I’m sorry, I’m still struggling to interpret that one and a host of other ’isms that only you could come up with and the scattered words of the semi-vocal and the gestures of those who don’t speak with their mouths.

I’m trying to interpret all I’ve learned like how ableist slurs shouldn’t feel as familiar on my ears as they do, like how seeing someone who’s terminally ill and seeing someone who’s actively dying are vastly different experiences and the latter is a special sort of terrifying and people close to the end who are on morphine might scratch themselves bloody and aren’t very aware of their surroundings but stay close anyway because no one should die alone.

-Hazel Milla is a senior from Chapel Hill, NC, pursuing a major in Neuroscience and a minor in Creative Writing.-

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Rh Incompatibility Abigail Westmoreland

A few years ago, I became unexpectedly pregnant. I was always careful, and I never expected that a child would be something that I would want. However, after a month or so of doctor’s visits and seeing the tiny mass of cells smaller than a chicken nugget, I started to warm up to the idea of being a mother.

A routine doctor visit at the beginning of my second trimester noticed a crucial element missing: the heartbeat.

While the doctor told me that it was indeed unusual to lose the baby post twelve week gestation, he assured me that there was nothing I did wrong. I was numb as he calmly explained to me the next steps, that the miscarriage and passing of the fetus should happen naturally on its own, and that I could experience “period-like” cramping. In actuality, the next twelve hours would be the most painful, both physically and emotionally, I had yet to experience.

Truthfully, I don’t remember much of the next few days following the miscarriage. I was expected back at my doctor’s office, to check-in and make sure that things had gone smoothly. Routine blood work had revealed (too late) that the reason for my miscarriage was due to something called the Rh factor.

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The Rh (rhesus blood type) factor is a protein that is found on the surface of red blood cells. A person with this particular protein would be classified as Rh positive, whereas a person without this protein would be Rh negative.

This protein is inherited through genetics and usually is only a problem in a case of Rh incompatibility. This occurs when the mother is Rh negative and the fetus is Rh positive, essentially resulting in the mother’s red blood cells attacking the fetal blood cells. An injection called RhoGAM, a sterilized solution from human blood invented in the late sixties, can and should be given to women who may want to become pregnant. This injection can prevent antibodies from forming and attacking the Rh positive proteins on the fetal blood cells.

I was already struggling so soon after the miscarriage to fully come to terms with understanding that it was not my fault. It was even more difficult to forgive myself after learning that my body had labeled my baby as a sickness, a foreign invader that was unwelcome in my body. The subsequent shame was tremendous. I felt helpless, and I felt guilty. There must have been something I could have done. How could my body not realize that such a natural process

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was not a threat? There must have been something wrong with me. Babies are simply not incompatible with their mothers.

However, without indulging too much in comparative suffering, we are oftentimes not given much in the way of closure. The reality of incompatibility was an unwanted explanation, but an explanation nonetheless. This realization was also the first step in forgiving and giving myself much needed empathy to heal.

Dr. Brené Brown defines shame as “the intensely painful feeling or experience of believing that we are flawed and therefore unworthy of love and belonging—something we’ve experienced, done, or failed to do makes us unworthy of connection.” Physically healing from a traumatic experience is often expected to facilitate the emotional healing from a traumatic experience. However, I believe that shame is best combated through genuine connection and empathy from others, as well as from yourself.

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-Abigail Westmoreland is a second-year graduate student from Wilmington, NC, pursuing an MA in Medical and Science Writing.-

16

Healing Grayson Sword

The breathing contraption is my enemy and my lifeline. The thin blue notches lie in wait, daring me to try to move the piston to the 2000 mark. I’m not ready, I plead with the respiratory therapist. She tells me to try anyway.

Smiling cartoon animals line the incentive spirometer at the 500, 1000, 1500, and 2000 marks, silently cheering for—or jeering at—me. My mom holds the device as I take a shallow breath in, the effort only enough to make the piston lazily glide to the 300 notch. My cheeks turn hot as my mom squeezes my IVpunctured hand in a wordless attempt to mend my broken pride. But I know I am a failure.

I glance down at the six-inch long jagged scar slicing my sternum in half.

Blood cakes the edges that peek through layers of gauze. White-hot heat floods my chest, and I crumple into the stale hospital sheets. youcantevenbreatherightyourenotstrongenoughyoucantdoityourenevergoingtobeokay As it turns out, you can’t expect perfection three hours after reentering the land of the living.

-Grayson Sword is a sophomore from Asheville, NC, pursuing a major in Public Policy and minors in Business Administration and Biology.-

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Sustainability in Nursing Education: The Future Advancement of Academic Nursing Act Amber Hammer The World Health Organization declared 2020 the “Year of the Nurse and Midwife” to acknowledge the essential and tireless work of devoted nurses around the world. The designation coincidentally aligned with the onslaught of the COVID-19 pandemic, which called nurses to action in unprecedented ways. Moreover, the pandemic highlighted the severity of racial and social inequities in healthcare, and public discourse centered on how to ameliorate the egregious disparities.1 COVID-19 exacerbated previous deficits in the nursing workforce, such as increasing clinical nurse and nurse faculty shortages, lack of representation in nursing academia and practice, and inadequate or outdated infrastructure in schools of nursing.2,3 In response, the Future Advancement of Academic Nursing (FAAN) Act (S.4396/H.R.7945) was introduced on August 4, 2020, by Representative Lauren Underwood (D-IL-14) and Representative Eddie Bernice Johnson (DTX-30), the only two nurses serving in Congress at the time of submission.4 The goal of FAAN was to improve access to high quality and equitable nursing care by allocating funding to nursing schools to address the critical workforce deficiencies, to promote social justice in nursing, and to increase preparedness for the growing demands of our nation’s health and wellbeing.3,4 Nurses constitute the largest sector of the US healthcare workforce, with three million nurses nationwide.5 A significant nursing shortage has been an enduring national issue since the late 1990s, and the current nursing shortage is projected to worsen over the next twenty years.6 With a large aging population, increased rates of chronic conditions, and an aging nursing workforce, the demand for nurses will continue to rise.7,6 COVID-19 has contributed to additional burnout, and it is currently unknown what long-term effects the pandemic will have on recruitment, retention, and

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engagement in the nursing workforce. To adequately respond to the workforce shortage, nursing schools will need to increase graduating RNs by 8% annually.3 A deficit in nursing faculty also persists. In 2019, nursing schools across the nation declined admittance to 80,407 qualified applicants due to a lack of faculty and infrastructure.8 A reported 7.2% nurse faculty vacancy rate plagues nursing schools nationwide, and the majority of vacancies require doctoral degrees.8 Contributing factors to the faculty shortage include an aging workforce, limited number of nurses with advanced degrees, and lack of competitive salaries.9 Race-based health disparities are well documented as a public health crisis in our country.10,11 Racial inequities in higher education are also widely acknowledged, and are even more profound in the field of nursing.10,11,12,13 In the United States, the dominant identity within nursing demographics is white, middle and working class women, revealing that whiteness shapes the values, practices, and cultural norms of nursing culture.13 As the US population becomes increasingly diverse, it is essential that the nursing workforce reflects the ethnicities and races of the population receiving care.2 In addition to ethnic and racial inequities, individuals from rural communities are also underrepresented in the nursing workforce and in desperate need of improved access to quality nursing care and education.

Rural regions are noted to have increased nursing shortages when compared to national averages.14 Rural communities have increasing morbidity and mortality rates, with an aging, less-educated, and more economically impoverished population.14 FAAN aimed to address these issues by bolstering funding for schools in medically underserved communities with a projected outcome that training nurses from rural communities will facilitate improved workforce retention in those regions.4 Key stakeholders of FAAN include leaders, populations, students, and faculty. Leaders with a vested interest in an improved nursing workforce via

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bolstered nursing education include local, national, and global government and nongovernment organizations; healthcare system administrators; and

university and nursing school administrators.3,6 Populations likely to benefit from improved nursing care include aging populations, individuals with chronic illness, and rural and underserved populations.3 FAAN would benefit nursing students by ensuring that financial, faculty, and infrastructure support is available to help them thrive in their educational pursuits.4 Lastly, a larger and more diverse nurse faculty pool will better support current faculty and address the growing needs of aspiring nurses and the populations for which they provide care.2 The enactment of FAAN into law would have addressed the nursing workforce shortage and lack of diverse representation in nursing. As such, the guiding goal was to improve access to care and ameliorate patient outcomes in minority populations. Furthermore, funding aimed to advance nursing education by creating resources to modernize nursing curriculum and academic technologies. Unfortunately, FAAN did not receive a vote and died in the 116th Congress.15 Current policies and funding are inadequate to support the advancement of nursing education.3 Additional research efforts are needed to evaluate deficits in local and federal funding available to nursing schools: How should federal funding for nursing education be distributed to achieve equity and sustainability? What tools are available and should be developed to analyze public policy from a critical nursing perspective? How can policy efforts gain traction and meaningfully influence the advancement of nursing education? Answering these questions through collaborative efforts can help establish a strategic plan built to meet the demands of a growing nursing workforce, establish sustainable nursing education, and provide quality care to diverse populations.

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References

1. Cato T. Laurencin and Aneesah McClinton, “The COVID-19 Pandemic: A Call to Action to Identify and Address Racial and Ethnic Disparities,” Journal of Racial and Ethnic Health Disparities 7, no. 3 (2020): 389–402. https://doi.org/10.1007/s40615020-00756-0.

2. Nalo Hamilton and Emily A. Haozous, “Retention of Faculty of Color in Academic Nursing,” Nursing Outlook 65, no. 2 (2017): 212–221. https://doi.org/10.1016/j. outlook.2016.11.003.

3. World Health Organization, “State of the World’s Nursing 2020: Investing in Education, Jobs, and Leadership,” 2020, https://www.who.int/publications/i/ item/9789240003279.

4. Future Advancement of Academic Nursing Act. H.R. 7945, 116th Congress, 2020, https://www.congress.gov/116/bills/hr7945/BILLS-116hr7945ih.pdf.

5. Bureau of Labor Statistics, U.S. Department of Labor, “Occupational Outlook Handbook: Registered Nurses,” 2020, https://www.bls.gov/ooh/healthcare/ registered-nurses.htm.

6. Stephen P. Juraschek et al., “United States Registered Nurse Workforce Report Card and Shortage Forecast,” American Journal of Medical Quality 34, no. 5 (2019): 473–481. doi.org/10.1177/1062860619873217.

7. American Association of Colleges of Nurses, “Nursing Fact Sheet,” 2019, https:// www.aacnnursing.org/News-Information/Fact-Sheets/Nursing-Fact-Sheet.

8. American Association of Colleges of Nurses, “Nursing Faculty Storage,” 2020, https://www.aacnnursing.org/News-Information/Fact-Sheets/Nursing-FacultyShortage.

9. Nancy P. Bittner and Cynthia F. Bechtel, “Identifying and Describing Nurse Faculty Workload Issues: A Looming Faculty Shortage,” Nursing Education Perspectives 38, no.

4 (2017): 171–176. https://doi.org/10.1097/01.NEP.0000000000000178.

10. Whitney A. Thurman, Karen E. Johnson, and Danica F. Sumpter, “Words Matter: An Integrative Review of Institutionalized Racism in Nursing Literature,” Advances in Nursing Science 42, no. 2 (2019): 89–108. https://doi.org/10.1097/ ANS.0000000000000265.

11. David R. Williams, Jourdyn A. Lawrence, and Brigette A. Davis, “Racism and Health: Evidence and Needed Research,” Annual Review of Public Health 40, (2019): 105–125. https://doi.org/10.1146/annurev-publhealth-040218-043750.

21 12. Jacqueline K. DeBrew, Lynne P. Lewallen, and Edna Chun, “Outsiders in Nursing Education: Cultural Sensitivity in Clinical Education,” Journal of Professional Nursing 30, no. 2 (2014): 149–154. https://doi.org/10.1016/j.profnurs.2013.08.005.

13. Roberta Waite and Deena Nardi, “Nursing Colonialism in America: Implications for Nursing Leadership,” Journal of Professional Nursing 35, no. 1 (2017): 18–25. https://doi.org/10.1016/j.profnurs.2017.12.013.

14. Sarah Smith, Jenny Sim, and Elizabeth Halcomb, “Nurses’ Experiences of Working in Rural Hospitals: An Integrative Review,” Journal of Nursing Management 27, no. 3 (2019): 482–490. https://doi-org.libproxy.lib.unc.edu/10.1111/jonm.12716.

15. “H.R. 7945 (116th): FAAN Act,” GovTrack, accessed March 24, 2021, www. govtrack.us/congress/bills/116/hr7945.

-Amber Hammer is a second-year MSN student in the UNC School of Nursing from San Diego, CA.-

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A Postpartum Night Reuben Tacas

Dear Baby, Do you cry like everyone else?

I hope you’re just hungry.

Yet, I still blame myself.

They say you are mine.

I can’t question the doctor, But deep down—How? Can I be your mother?

I want to forget it.

What they put me through— The cuts. The stabs. The bleeding.

For you! They just wanted you!

What am I saying?

My tears swell with regret.

I love you, okay?

Don’t you ever forget.

People say this is normal, But they don’t have a clue.

How. Much. I. Hate. To. Hear.

That it’s painful and true.

Dear Baby, I love you like no other.

This will be different than before—I swear.

You’re alive and well unlike your brother.

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The poem is written from the perspective of a mother who is struggling with postpartum depression. Her words show that there is more to her suffering than just a simple diagnosis of “PPD” on a clinical note. Clinicians sometimes fail to meet patients where they are in life, neglecting the full breadth of their patients’ realities and prolonging their suffering. As a male nursing student, I acknowledge that I will never be able to truly fathom this struggle of women, but I decided to write this piece to challenge my biases, my insecurities, and the stigma of being a male nurse.

Drawing inspiration from testimonies, autobiographies, and photographs, this poem represents my genuine and humble compassion toward the hurting women contending with postpartum depression, miscarriages, and other complications in pregnancy. Moreover, I hope this poem honors and validates the lives of the brave women who have shared their experiences with me.

-Reuben Tacas is a senior in the UNC School of Nursing from Durham, NC.-

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Don’t Fist Bump Me. My Mom Is Dying.

Maggie Conner Throughout medical school, I have watched many physicians deliver

poor prognoses to patients. Some do it very tactfully, with grace and compassion. Some stumble through it, making an awful situation even more unpleasant. The worst I have witnessed was not when I was watching, but receiving—when an oncologist told my mother she had terminal cancer.

My mom was a lovely, healthy 58 year old who had no medical problems and did Zumba regularly. One evening, she had chest pain and shortness of breath. A CT scan in the emergency room came back with shocking results. She had multiple blood clots in her lungs and a four-inch tumor on the tail of her pancreas, in addition to the numerous (i.e., too many to count) smaller tumors in her liver.

This prompted a slew of tests, but her doctors continued to reassure us that we wouldn’t have any definitive news about her prognosis until the results of her tumor biopsy came back.

After a week of painful anticipation and imagining the worst, we were called into the office to discuss the results.

My mother was the youngest patient in the dingy oncology waiting room by at least twenty years. Bland elevator music played in the background.

I caught a whiff of the distinct smell of vomit. I realized the trashcan next to me was the culprit and quietly transferred it to the other side of the room.

We waited in this purgatory for what seemed like hours.

Finally, we were taken to a room. More waiting. My mother perched on the exam table, the paper under her crinkling every so often when she shifted. I examined the wall of obscenely brightly colored pamphlets advertising cancer drugs.

A nurse walked in. “What have you been told?” she asked. “Nothing!” we almost yelled, our tone clipped with frustration. She pulled up my mother’s chart on the computer and clicked around for what felt like an eternity. She turned to us, avoiding eye contact, her voice flat.

“It says here that you have Stage 4 Exocrine Pancreatic cancer.”

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We slumped deep into our seats. I stared at the scuffed linoleum floor, tears blurring my eyes, wondering how this could possibly be our reality. I pulled out my phone and googled “exocrine pancreatic cancer” just to triplecheck what this meant. I had extensively researched the difference between exocrine and endocrine pancreatic cancer in the days prior, so I already knew exocrine was a death sentence. But I was so confused upon actually hearing the words out loud. Google confirmed that this was, in fact, the worst news we could get.

“What does this mean?” my father asked. The woman was already walking toward the door. “The doctor will explain,” she said as she slipped out.

Another period of waiting. My mom looked so small and pale. My heart ached for her. I brushed my tears away periodically. The clock on the wall ticked. I remember thinking to myself, “If hell exists, this must be what it’s like.”

None of us spoke until the oncologist entered fifteen minutes later.

“Hello!” He greeted us with a jarring cheerfulness. Could he not read the room? Didn’t he know our world was on fire?

My father stood to shake his hand. “I don’t shake hands, I fist bump!” the doctor chirped. My dad, still in shock from the biopsy results, awkwardly patted his fist. The man then had the audacity to fist bump my mother. I felt nauseous.

He uttered a quick, insincere apology for my mother’s diagnosis.

“How long does she have to live? Should we do chemotherapy?”

I asked. The oncologist held up his hands as if these were outrageous questions. “Woah hold on now, I don’t even have her scans, we don’t know if the cancer is in her lungs or not.”

I stared at him in disbelief. I had spent hours on the phone coordinating the transfer of my mom’s medical records and scans so that we would have all the information for this appointment. I confirmed their receipt multiple times.

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Anger boiled up from the pit of my stomach into my chest. “The scans

are in her chart and the radiologist didn’t see any pulmonary metastases!”

My mother had come to this appointment just to receive the news she was dying, and this man hadn’t even bothered to read her chart?

He scrolled through my mother’s scans and turned back to us. “Yes, there are no metastases in her lungs.” He then went on to tell us that without treatment, my mom would live only six to eight months. If we decided on treatment, it could “maybe” add a few months. He told us he was sorry about my mom’s diagnosis and wished us luck as he stood up and walked out of the room.

Where was he going? He had spent all of seven minutes with us. The door closed behind him, and the nurse entered and began her wrap-up spiel.

I realized the oncologist did not intend to come back.

My rage erupted. “Please tell him to come back here!” The nurse stopped, widened her eyes, and nodded.

The oncologist skulked back into the room. We asked about treatment regimens and the pros and cons of chemotherapy. With every question, he huffed slightly, as if it were a monumental waste of his time to be here discussing this with us. I finally extracted all the information I could from him, and the visit was over.

We shuffled out of the clinic in a daze. In the elevator, my mom began to cry. My father pulled her into his arms. I looked away, wanting desperately for this to all be a mistake.

Years later, I still get unwelcome flashbacks of the oncologist’s behavior. My family needed his undivided time and attention to understand my mother’s diagnosis, rather than a few minutes of desensitized treatment.

We needed to be cared for. We needed empathy. We did not need a fist bump.

-Maggie Conner is a fourth-year medical student in the UNC School of Medicine from Columbus, NC.-

Pandemania

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Alejandro Ramirez “I hope to pass away in my sleep so I don’t have to worry about it, so no one else has to worry about it, y’know?”

Papa ended the healthcare interview rather eerily. However, it was brushed off as a remark typical of an older adult who has contemplated and understood death to a greater extent than younger individuals, a typical topic of conversation in the college course that assigned this interview.

This also came as no surprise given that Papa’s rather calm demeanor was ordinary behavior that I understood well, for he was a significant figure in my and my sister’s upbringing. That was the last time I talked to my grandfather.

Four days after I interviewed my grandfather for a class assignment, he began feeling minor symptoms of illness. Papa was a tough cookie. He served in the Air Force and had a career of erecting scaffolding. After retirement, he remodeled homes for fellow independent-living community members to “age in place,” so feelings of fatigue were ordinary for him. But things took a turn for the worst shortly after, when he started to realize he may be yet another case of the universal virus, a fear that the aging population can perceive as even worse than a more natural, inevitable death.

“What does health mean to you?” I asked to commence the interview.

“Well, it means a lot. I want to move around as long as I am mobile and able to talk,” Papa answered. “I don’t think I’m in great shape, but I’m not in the fetal position, so I think my health is fair.”

Papa celebrated reaching the age of 81 just a few days before this conversation. Many of his health issues stemmed from diabetes, but these ailments only slowed him down, while his mind remained healthy and lucid. His worsening symptoms bore down on his body within days of his initial onset of fatigue, to the point where even he had doubts about his ability to stick it out at home for the remainder of what he was beginning to understand as his battle with COVID-19.

28

Let me remind you, Papa was the polar opposite of the melodramatic

type. This is the same man that accidentally shot a nail straight through his hand while carpentering a wooden chest, then proceeded to tell my grandmother, “Just get me a Band-Aid.” The doctors he had contacted voiced concern about his health status when he called, but upon reflection, they had underplayed his need for hospital care. Maybe they needed additional proof of how severe his ailments were, or maybe they were hiding the fact that all local COVID units were nearing maximum occupancy. Luckily, a helpful neighbor let Papa borrow their pulse oximeter, which is when he understood his oxygen levels were dangerously low—his ticket into the hospital.

Shortly after hospital admittance, Papa was attached to a ventilator in the ICU. He was in critical enough condition that my family began planning for his death. My grandmother called every evening after receiving the news of his likeliest fate. She was awaiting an update on how and when the moment of his passing would occur, but could not get a hold of the doctor, resulting in a nail-biting wait. The emotional battles stemming from uncertainty relentlessly plagued her mind for that duration, and her sleep pended for as long as she remained unanswered. Sure enough, that cot ended up being his death bed. When his final moments were eventually arranged, Granny witnessed Papa pass through her computer screen.

Although what you have read may be perceived as a negative impression on physicians, I assure you that is not my intention. Moments of poor management were admittedly at play throughout my grandfather’s final receival of healthcare, but the clinicians involved undoubtedly exerted their best efforts in saving his life. The social behavior of those in our nation is the true problem, a feeding ground for the selfishly oriented, tainted in ignorance. These traits do not comprise us all, but the result of contrasting political views and personal beliefs leave far too many downplaying the preventative measures needed to halt the pandemic’s pandemonium as promptly as possible. Papa presumably contracted COVID in his workplace,

from a person who did not honor masks, nor social distancing. It would be

29

one thing if lessons were learned, but the same person was seen at the same workplace continuing his foolish unmasked behaviors, just days after Papa passed. This person even dropped off a condolence gift to my grandmother, showing awareness of the incident, and hopefully at least some cognizance of his actions’ alleged consequence.

The pain is not only excruciating for those who fall deathly ill to the virus, but also for their emotionally devastated loved ones. Family and friends are victims, faced with puzzling grief, enduring obstacles in coping that cause stagnation in the bereavement process. My grandmother was unable to offer my grandfather bedside support in the hospital for the greater good of public health, but these events would have never unfolded if public health precautions had been taken seriously in the first place by all.

No matter one’s beliefs regarding the importance of practicing preventative measures, the sad reality we are presented with shows that more and more of the personally unaffected will need to face traumatic exposure to the virus before everyone follows public health guidelines as strictly as they should. COVID’s wrath will hit closer to home for thousands more families, and only then will these precautionary requirements be met. Personally, I do not see that happening anytime soon, even given the current vaccine rollouts nationwide. You might see optimism along the horizon, but what lies in the foreground is a fog that masks it, deeming optimism an illogical belief to currently uphold here in America. This haze will rise out of view one day, well into the atmosphere—just not yet. The current state of our nation is too far from being unified for that possibility.

30

The following image was color-corrected to epitomize the factors described above, highlighting how the vibrancy of days well before the global pandemic can reflect the future. Even then, some of us contained hateful beliefs that hindered society’s progression towards the greater good, but that was a time when morally unjust perspectives were not emphasized as brightly in the light, so they remained in the shade. Take note of those shadows; they lie behind me and Papa. We are photographed walking away from them, but they follow us into the background foliage, which hosts plenty more. The forest you see represents the present day, where those shadows loom large.

There are moments where we will be consumed by those shadows, to the point that we can no longer see light. But do you see that slender horizontal beam past the forest? You will know when you see it, it is glistening! That is the lake we long for; there is a reason we brought our fishing poles. It might still be in the distance, even now, but we caught a glimpse of it. Papa may have passed, so his presence may no longer remain next to us physically, but it has since been converted to spirit. It is up to us to eventually reach that lake, knowing that he will be with us every step of the way.

31

-Alejandro Ramirez is a second-year graduate school student from Nashville, TN, pursuing an MS in Gerontology.-

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In Which I Make the Case I Am Not Stupid (the Cognitive Assessment) Allison Ruvidich

One

lamb

secret

kitten

secret

seven

shame

secret

seven

shame

seven

secret

shame

What a titan of shame, what a colossus to speak before this court of one and make the case that I am not stupid.

On a better day I will argue the very idea, take apart the concept, whip its etymology up in the course of my argument, blunt it with its own historic blade, but today, I will only fight.

One

lamb

seven

kitten

It was a summer night, and we were eating dinner on the porch when they realized I could not tell them what number added to eight made ten.

Four, or six, and shouting, and the dinner guests embarrassed.

One

lion

septum

kitten

That was the secret I kept, that words barely mean anything, but numbers are nothing; they are marks and drips and blots on the page.

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And that is a secret we have all kept together, right?

When we whisper to Siri, what is sixteen minus seven?

Because the lines are water running out.

And so this case is no more than a legal exercise, an impossible thought experiment, a brief suspension of our infinite reason for a moment of whimsy, because I cannot be the only one who sees the nothing all the way down.

Nothing and nothing make nothing, no difference, no sum of an act equally impossible for us all.

Five

Seven

Thirthrenty

But say that it isn’t as impossible for you.

Tell me that I’m still not stupid.

Say that these lines mean something.

Please, let me finally rest my case.

Maybe there is a world where eight and four make ten, where I wrote this poem in one sitting in a clean apartment, where stupid is a swear word on late night TV. Let’s believe it, you and me, for a few words longer, and as long as we say it together Our stupid words have meaning.

-Allison Ruvidich is a first-year graduate student from Chatham County, NC, pursuing a master’s degree in Information Science.-

34

What Happens When We Grow Old? The Elderly and the COVID-19 Pandemic Medha Rao

As readers, we tend to immerse ourselves in a story while maintaining a clear line between reality and fiction. While it may have been a wonderful read, we rest assured that our everyday lives look nothing like the bound pages we just put down. However, what do we do when that line starts to thin? The COVID-19 pandemic puts many works of speculative fiction into perspective. As resources dwindle and stockpiles empty, decisions are being made regarding who gets to live and who needs to die. Such is the current climate of the modern world, in which the world in Margaret Atwood’s “Torching the Dusties” has become the unfortunate reality for many.

In her short story, Atwood paints a gruesome picture for the members of Ambrosia Mansion, a retirement home of financially well-off members.

We follow Wilma and Tobias as they experience the brutal “Our Turn” movement. The our-turners are a group of young individuals who feel that the elderly are a burden, having ruined the economy and environment for future generations. Because of this, they blockade supplies from reaching the retirement home. While local law enforcement does not support this movement, they are complacent. The protestors manage to stop the supply of fresh linens and force the employees to leave the building before ultimately setting fire to the retirement home. This fiery ending leaves the reader with a bitter taste as we realize that the members of Ambrosia Mansion died helplessly.1 The fate of the Ambrosia Mansion retirees parallels the fate of elder generations around the world. Ventilators have become a hot commodity as ICU wards overflow, and the elderly often do not make the cut. While we see many medical perspectives, there is one voice that is absent: the elderly. However, a possible response lies in “Torching the Dusties.” The running theme of “us versus them,” which lends itself to the idea of the elderly in hospitals as “burdens,” is starkly contrasted by the sentiments of Tobias, a character in Atwood’s story. It is quickly apparent that Tobias is an unabashedly opinionated member of Ambrosia Mansion who holds a disdain toward society’s youth while making the most of his old age. As the pandemic continues to take more lives, governments are forced to decide which lives are worth saving as resources dwindle.

35 When the “Our Turn” movement is introduced in Atwood’s piece, we immediately get a sense of their central message. The our-turners are filled with vengeance and a sense of bereavement as the economy and environment lay in shambles. The very name of their movement creates two sides to the issue: young versus old. They feel that the older generation “[killed] the planet with [their] own greed.”2 These sentiments are not merely fiction, but are prevalent in modern society. The ill will between baby boomers and millennials has penetrated social media platforms, news outlets, campaigns, and dinner table discussions-turned-arguments. However, it was not done with mal-intent. Our elders did not scheme ways to obliterate the environment and economy. Why, then, are the elderly being denied access to life-saving equipment?

Ageism in healthcare is nothing new, although the COVID-19 pandemic has brought the issue to light. For decades, hospitals have had to decide which patients receive a second chance. Organ transplant lists often consider age and preexisting conditions that make an older patient’s second chance at life seem less valuable than a younger patient.3 Yet this in itself is a paradox as preexisting conditions increase with age.4 However, in this era of backordered ventilators and overflowing hospital beds, governments are creating plans for rationing patients admitted to ICUs.5 One criterion is age, with another being how high their Charlson Comorbidity Index score is (a system that takes into account preexisting conditions).

A phenomenon getting more attention is the doctor-patient-family relationship.6 Many times, doctors do not think about what the elderly patient wants. Instead, they listen to the family’s wishes and their pleas to save their loved one. Meanwhile, the patient would rather live comfortably (for however long that may be) instead of going through painful treatments to gain a couple more years to suffer through. Unfortunately, the elderly’s wishes are often overlooked.

Atwood’s portrayal of the elderly contrasts the beliefs that the ourturners and many younger members of our society hold in regard to elder generations. This gives way for questioning the morality of current policies during this pandemic. Is it right to treat the elderly with such antipathy that their medical needs are dehumanized? “Torching the Dusties” provides contextualization for the experience of the elderly that is relevant during the pandemic. It allows us the opportunity to understand what people at that

36

age would be going through when their deaths are considered inevitable.

Tobias is humanized through his optimism in the face of death, and the reader is empathetic to the experiences of the Ambrosia Mansion members.

We see him deal with the fear of death by sticking to everyday routines and maintaining a semblance of his unique personality. This is very common advice in the coronavirus pandemic to promote a positive state of mind during a time that is causing immense amounts of stress.7 Given that this is the way many people in the retirement home structure their days, it is important to notice the similarities in our lives under quarantine and the lives of retirees.

The pandemic has changed everyone’s lives in unforeseen ways. As we continue to navigate these uncharted waters, Atwood’s short story can serve as a reminder to hold compassion in our hearts for those tossed aside by our healthcare systems. With the fate of the world unknown, we can only hope for an ending much cooler than the flames that engulfed Ambrosia Manor.

References 1. Margaret Atwood, “Torching the Dusties” (McClellan & Stewart), 225–268.

2. Atwood, “Torching the Dusties,” 233.

3. Ethics Committee, “Ethical Principles in the Allocation of Human Organs,” U.S. Department of Health and Human Services, June 2015, https://optn.transplant. hrsa.gov/resources/ethics/ethical-principles-in-the-allocation-of-human-organs/.

4. “At Risk: Pre-Existing Conditions Could Affect 1 in 2 Americans,” Centers for Medicare & Medicaid Services, 2020, https://www.cms.gov/CCIIO/Resources/ Forms-Reports-and-Other-Resources/preexisting.

5. Adrienne Dunn, “Fact Check: Were Elderly Italians Left to Die? And Is Socialized Health Care to Blame?” USA Today, March 20, 2020, https://www.usatoday.com/ story/news/factcheck/2020/03/20/fact-check-were-italians-left-die-socializedmedicine-blame-coronavirus/2887743001/.

6. George Spaeth, “Treat the Patient—Not Just the Disease,” Review of Ophthalmology, 2015.

7. “How to Organize Time in Home Quarantine,” UNICEF, 2020, https://www. unicef.org/serbia/en/how-organize-time-home-quarantine.

-Medha Rao is a sophomore from Cary, NC, pursuing a major in Biostatistics as well as minors in Spanish and Chemistry.-

37

You Made Me Cry, But You’ll Never Know That Travis Jones You made me cry when You told me about how You couldn’t get out of bed This morning How every step is but a memory Of a life without pain Of a life without the Big C Of a life that no longer feels yours You didn’t see the tears Welling in the corners of my eyes You didn’t feel my heart shatter You only saw my somber face I stood there, still, watching as You stared at the white sterilized floor I cried but I quickly wiped the tears So you wouldn’t see when you looked up I cried as I looked at your x-ray Because your cancer-riddled bones Looked young again, but I knew They didn’t feel that way

-Travis Jones is a senior in the UNC School of Nursing from Raleigh, NC.-

38

Our Bathtub Poems Jessica McGee Water droplets make friends, Multiply amongst themselves.

Gather on the tile and puddles at my feet when the story begins.

A water droplet transforms into a stream, As I scream In my head because I don’t want to distract you from your daydream.

How kind of me. ~ Can I tell you a secret?

I do not know how to organize my thoughts.

When I pay attention to the little whispers in my head, I lose sense of time, Sense of self, Sense of sense.

Take a trip with my best friend, Dissociation.

Tear myself apart before I blindly piece my being together. ~ On second thought, I do not want to think about it anymore . . .

Forcing the hinges shut.

Water droplets turning my skin red I adore.

The tingling sensation reminds me of a cigarette butt.

Something to ease the disease that is my mind.

Add it to the bill and tip the waiter.

Another destructive hobby outlined.

Makes me question my creator.

39

~ Am I who I thought I would be?

Looking at the boxes of personality characteristics.

All I see is what I am not.

Remembering that we are all boiled down to statistics.

I matched my goals and followed my passions.

Strangers pass by without compassion, Spare a glance and I’m barely a portrait.

For I lost what was important.

Do I even notice? ~ Do I even notice . . .

My daydream does not have the decency to ask for my consideration.

Reflective rumination.

To be honest, It is kind of atrocious.

When I pay attention to the little whispers in my head, I lose myself and I can’t find myself unless I am out of focus. ~ I thank the plumbers for their hard work, Their effort frozen in time.

Meanwhile, I’m stuck with the jerk That I’m.

You might think it is silly . . .

You.

-Jessica McGee is a junior from Ridgewood, NJ, pursuing a major in Psychology and minors in Medical Anthropology as well as Health and Society.-

40

GRIEF 101 Lang Duong

Two years ago, I lost my grandmother and my mom lost her last parent.

Symptom 1: Sadness1

“Why don’t Mẹ (mom) open this book?”

“Too many pictures of Bà Ngoại (grandma), it make Mẹ sad. Mẹ can’t look at them.”

I opened the book and flipped to the first page.

The first picture brought her to tears.

I closed the book.

Symptom 2: Loss of Interest2 “Hi Mẹ, Mẹ at work?”

“Mẹ không đi làm hôm nay.” (I’m not going to work today.)

“Tại sao?” (Why?)

“Mẹ don’t want to.”

“Okay. Did Mẹ talk to Mẹ sisters?”

“No.”

“Tại sao?”

“Mẹ too tired.”

“Okay. Did Mẹ eat today?”

“Yes, don’t worry about Mẹ. Con (you) should go study.”

“Mẹ sure?”

“Yes con.”

“Okay. Love you.”

“Okay.”

Symptom 3: Guilt1

“Why con not call Mẹ?”

“Con (I’m) very busy with school and work.”

“Con lucky Mẹ is alive. If Bà Ngoại is alive, Mẹ talk to Bà Ngoại every day.”

Symptom 4: Insomnia2

“Why Mẹ up at 6 a.m.?”

“Mẹ don’t sleep much now. Mẹ think it’s menopause.”

“Mẹ should sleep more.”

41 “Mẹ not sleepy.”

I knew she was lying.

She took a four-hour nap that afternoon.

“Mẹ don’t know why Mẹ feel weak.”

“When Mẹ see picture of Bà Ngoại, Mẹ cry.”

“When Mẹ look at things Bà Ngoại like, Mẹ cry.”

“Mẹ don’t want to eat, sleep, or go to work.”

I do.

Should I tell her?

Would she see it as disrespect?

Maybe I should just nod.

“Mẹ can’t stop thinking about holding Bà Ngoại hand in the hospital.”

“But Mẹ don’t want to think about it, con.”

“Mẹ, that’s called grief.”

Don’t cry.

I have to say it.

“Grief?”

Asian Americans hold a lifetime prevalence rate of 17.3% for any mental health

illness; however, they are the ethnic/racial group least likely to seek mental health treatment. While there are many cultural and social barriers in place, researchers have identified lack of knowledge about mental health services and issues as a main contestant.3

It took nearly two years for my mom to identify her feelings as grief.

She still hasn’t sought help.

1. Melinda Smith, Jeanne Segal, and Lawrence Robinson, “Coping with Grief and Loss,” HelpGuide.org, September 2020, https://www.helpguide.org/articles/grief/copingwith grief-and-loss.htm.

2. “Grief,” Psychology Today, Sussex Publishers, accessed February 4, 2021, https:// www.psychologytoday.com/us/basics/grief.

3. Raissa Tanqueco and Sejal Patel, “Mental Health Facts For Asian Americans/Pacific Islanders,” American Psychiatric Association, 2020.

-Lang Duong is a senior from Greenville, NC, pursuing a major in Psychology.-

42

Rose Neha Dronamraju Walt calls for his wife every day. During our reading sessions, smoke

breaks, garden walks, and dinners. It’s an ugly call—knotted, withered, soaked with sorrow. I remember a single magpie I saw years ago. I tried to lead her to my home, but she refused and waited for a mother who would not return.

One for sorrow, two for joy.

Souls imbue the turpentine walls and bright white tiles (I convince myself to ease the seclusion). When I’m not watching Him, I drive my ears into the gridwalls and strain to seek refuge in their whispers. To no avail— they never bear comfort. And when I tire of monsters under the sheetrock, I pine for open air.

On July nights the ladybugs come out to play. Their scarlet backs line up in rows—marching band style—and they flutter their wings and kick their legs to the tune of “Giant Steps.” Beat the oppressive heat by virtue of a slight frame. Beat summertime tragedy with jazz and soul. July is a rare month of lucidity for Walt. He’s daydreaming in the courtyard and I’m flitting from wire to wire, adjusting mask, monitor, gown. We’re supposed to be reading books, but every time I suggest one, he shuts me down. Mystery?

“Too predictable.” Science fiction? “That shit’s for teenagers.” Let’s try Beat poetry. “Affluenza boys. Never read a noble Cassady, a sober Ginsberg . . .”

What about horror? “Do I have children?”

So we sit through early summer picking our thumbs and watching birds. In three months’ time, I’m going to disintegrate from sweltering Texas heat.

Break. In the middle he asks to leave.

An outrageous request, but I am as eager to live as my derisive companion. And when I oblige, I light a fire behind his ancient eyes; it is enough fuel for my conscience. Enough to justify a breach in protocol, losing a job. We don’t speak, but we lock a gaze that holds midnight plans: three sharp knocks on the door, unhook, swing from window to grass, feel young for the first time.

At 2:15 in the morning there is so much pull and riot and elation in my chest that breath is elusive. I look down in front of me and see bliss, catch a

43 glimpse of heaven. Only street lamps light our path and we are tied to each other’s company. He sings as I propel his wheels forward, pacing according to the intensity of his tune. He sings her name and it doesn’t sound so ugly anymore. The cracks in his voice are more pronounced as they bounce from mural to alley to motel brick back to throat.

If I freeze, I can block out the wheels, the wind, occasional cars, and sparse nighttime chatter. I can reify the love in his voice. If I shut my eyes so tight that I see red dots, those dots will morph into a young couple slow dancing down an empty street on a July evening. Morning. Her silk skirt laps around her ankles as she spins in and out of devoted arms. The joy in his face is boundless. At this moment, it feels enough to spin the earth.

If I were a doctor, I would wipe Walt’s memory entirely. A painful affliction of existence is: existing in the grounds between life and death.

Where satisfaction is elusive so you trickle in and out of reality to keep yourself sane.

I hear my name, gnarled and ugly, and I turn to face Him. “What are you thinking about?”

“Whatever you’re thinking about.”

This is the truth. I’ve known Walt for two months, but that’s long enough to understand that he often contemplates his own fragility and dependence. What used to be and what is no longer.

A rare month of understanding for me.

As July melts into August, I part ways with Walt. Without tears or heartache and with the promise of reunification. When fall turns into winter and winter into spring, the constellations shift west. In July, the East Sky may present a sluggish jumble of stars—dull, purposeless, and soaked with sorrow.

But in early March, the West Sky celebrates. Its stars dance and glimmer and float in the shape of newlyweds. West Sky sings songs of redemption and afterlife, songs of love and longing, songs for Walt and Rose.

In the spring, West Sky calls “Rose, Rose, Rose” and I realize—that’s how it was meant to sound.

-Neha Dronamraju is a third-year undergraduate from Dallas, TX, pursuing a major in Public Health.-