Medball - UBC Medicine 2013 (James Bond Skyfall Parody)

It’s my honour to announce the following top winners of UBC Medicine’s 1st ever celebration of the written word – the Art As Adjuvant Writing Competition 2014:

1. The Hidden Cost of Medicine by Patricia (“Trish”) Caddy; SMP 2016 – Prose
2. Blood by Daniel Essau; SMP 2016 – Prose
3. Untitled by Arsalan Hassan; VFMP 2016 – Poetry

Thank you for all those that submitted original, inspiring, sad, funny, hopeful and incredibly creative pieces. It made judging quite difficult, but ultimately demonstrated what talented artists we have amongst us.

Here’s Daniel’s runner-up submission: “Blood”

“Have you ever had sex with someone who may have HIV/AIDS or who was born in Africa after 1977?”
I raise my eyes from studying the carpeted floor to look at the friendly but serious eyes of my interrogator.
“Nope.”
I’m in a blood donation clinic, sitting in a tiny cell. Room. The elderly woman scribbles my answer into the bubble sheet, and proceeds with the next:
“Have you had sex with a man, even one time since 1977?”
“Nope.”
1977 is apparently an important date here at the blood clinic. I anticipate the next question.
“Have you exchanged money or drugs for sex in the past six months?”
Ok, maybe I didn’t see that coming. Why six months? Random number.
“Nope.”
——————————————————————————————————————————————
Eventually, the volunteers have nothing left to fill out, and allow me to enter my third waiting room of the night. I glance at my watch. Four forty one. I left my house at two. Not so bad. I might get home by six.
The volunteer comes back and places a large container on the chair next to me. Contained are the forms we just filled out, my driver’s licence, and a sinister tangle of tubes and needles that I assume will soon be poked into my arm. She grabs my shoulder. I jump.
“Thank you.”
She sounds sincere. In the cell, we had discussed how it is her first time ‘screening’ as they call it; it is my first time donating. I got a sticker for my troubles; she got a red volunteer vest. I nod weakly, she walks away. I look to my left and see a young girl in a beige dentist style chair, wet bandages circling her wrists and forehead. The chair is set up so that her feet are higher than her head – she has sandals on. That’s not how you give blood… Is it? Then I notice the nurse circling her bed, checking bandages and fiddling with needles. He is using his wheeled chair to deftly scoot around the medical equipment strewn around the foot of the girl’s chair. I am staring, and he notices. He gives me a strange look that tells me to get some manners, and I realize that the girl must have fainted during the blood donation process. Oh. I look away. Sorry.
I absent mindedly watch the blood bag of the patients slowly fill up. They have the blood bags on these little machines that go back and forth, rocking the blood. I think I see one patient’s blood form little waves. I imagine the Nile with Moses on the bank, crooked staff in a calloused hand. Does the Nile get waves? Time passes. It’s been fifteen minutes sitting here. Is that normal? I swear that I was here before that bald man who is being helped into his dentist’s chair.
“Are you still here?”
It is the nurse again. Does he want me to leave?
“Yes.”
He starts searching through a stack of cards with patients names on them. I filled out one before I went into processing. The old lady, the new volunteer, must have forgotten to put mine in the stack. The stack holds the whole bureaucracy of this place together. A patient’s name goes on a card, which is then placed in this stack. When a patient is taken to donate, their card is removed and the next card is ready for the next available space. Above the stack is a sign that reads: “We Care About Your Time”.
“Never mind,” he says “I’ll take you to chair five.”
——————————————————————————————————————————————
“Slight pinch”
I feel more than a slight pinch. What gauge is that needle?
“Worst of the torture is over.”
Cool. The needle man leaves to torture someone else, and my mind wanders. Where did six months come from? They never asked me if I had had sex in Africa after 1977, only if I had stayed there for more than six months. Seems like a possible loophole to me.
I look at my right arm. A needle. Unsurprisingly. I pull away the bandage they have covering it. Metal blends with flesh around a strangely perfect red circle of blood. How long is that thing? If there was a fire or an earthquake, or a terrorist attack, and I bend my arm to protect my head, will the needle punch through my arm? The mass of tubes attached to the needled are straight red. It doesn’t look like anything is flowing through them. They look like solid red plastic.
“It doesn’t bother you?”
It’s the nurse again. I like him. Even though he stabbed me with a long, sharp object, he seems like the decent sort. I shake my head.
“Most people look away.” I nod. “Look,” he says, pointing to a nearby machine “green light, means that your flow rate is good. Yellow means your flow rate is slowing down, and red means flow rate has stopped.”
“Cool.”
I am green. It has been several minutes now. How much blood do they take again? I look back at my needle. I feel a little tipsy now, like after a handstand when the blood is beginning to rush back into your head. I look away, but the solid red plastic tubes are stuck in my mind. I try to think about other things. I haven’t seen my family in a while. I wonder what my twin brother is doing right now. Across the room, a patient gets up and walks towards the refreshments table. That’s our reward: cookies and juice.
I turn my head to the television on the far wall. The world seems to have trouble keeping up; it blurs and shifts before finally focusing on the television. Strange how much humans have changed, as a species I mean. I doubt my ancestors would have sit still and let some guy stab them with needles. The television is playing the Simpsons, which reminds me of my brother. We watch it together sometimes back home.
——————————————————————————————————————————————
I’m in the backyard, a garbage can lid clutched in my left hand. Shield. My thumb traces the grooves in the chestnut held in my right. A young face pokes out from the large chestnut tree in front of me. I overhand hurl my chestnut and miss terribly, the chestnut flying far off course. The owner of the face, my brother, charges out from the tree and tackles me, all rules of a fair ranged combat bout ignored. I laugh and try to raise my shield, but he ducks under it. The autumn leaves rush up to meet me, and clouds converge in the blue sky above me.
——————————————————————————————————————————————
Back awake. People rush around me. Nurse grabs my arm and pulls the needle lose. Ah shit. Can’t even give blood right. A face forms above me.
“You’re in the blood clinic.”
I know. She is trying to help. I could be disoriented or scared. I am fine. They place cold bandages around my forehead and wrists, and raise my dentists chair so that my legs are above my body. I am wearing shoes. I am fine. A small nurse approaches me.
“You ok?”
“I’m fine. Sorry.”
I feel terrible. I come in here, try to donate blood, and just end up causing trouble. Should have just stayed home. Everyone in the clinic is looking at me, sitting in their dentist chairs just staring. How rude.
——————————————————————————————————————————————
Eventually, I do get the cookies and the juice. They are hard to digest. Everything makes me dizzy. The small nurse is my favourite person today. She tells me that I have given the same amount of blood as a woman loses when she gives birth. Maybe my blood will help deliver a baby, she says. There are other patients sitting around the refreshments table, and all are staring at me.
“If it helps, I fainted my first time too.”
It doesn’t. It just makes me think about it again. They try to give me a little pin as a prize for donating blood but I refuse. The look in the volunteer’s eyes is one of complete and honest hurt. Shit. I seem to be making things worse here. I still don’t want to take her pin, I will just throw it out. Who wears those things around? Just take it. Too late now, she has already walked away.
“It’s not a big deal, happens to lots of people.”
Another patient. They are trying to help.
“Thanks. I feel fine now so I’ll head out soon.”
I don’t feel fine, but I do leave. The bus ride home is long, and the bus shakes and bumps with every acceleration. Not helping my nausea. I try to look out the window at rainy Vancouver, but it is too dark to see anything. I look at my watch. Seven. I have no choice but to confront the thought that is foremost in my mind. You can’t be a doctor if you faint.

Drum roll please…

It’s my honour to announce the following top winners of UBC Medicine’s 1st ever celebration of the written word – the Art As Adjuvant Writing Competition 2014:

1. The Hidden Cost of Medicine by Patricia (“Trish”) Caddy; SMP 2016 – Prose
2. Blood by Daniel Essau; SMP 2016 – Prose
3. Untitled by Arsalan Hassan; VFMP 2016 – Poetry

Thank you for all those that submitted original, inspiring, sad, funny, hopeful and incredibly creative pieces. It made judging quite difficult, but ultimately demonstrated what talented artists we have amongst us.

Here’s Trish’s winning submission: “The Hidden Cost of Medicine”

Students of medicine trust that their lives as physicians will be revealed gradually, like a photograph coming to light. We hope that time and exposure will develop our clinical acumen, sharpen our focus, and help us maintain our composure. We’ve seen the wounds our mentors have rent and reunited. We’ve watched pains ease with remedies and rhetoric. We wonder at them, the ones who came before us, and ask ourselves which pearls they’ve sifted out, and kept, and which they’ve cast aside. Naturally, we believe that the art and the science of healing elevates and liberates our patients and ourselves. Surely, we think, the fruit of our labour is hanging somewhere in the sun, down a challenging road, and our struggle to learn (and learn, and learn) is how we’ll eventually pluck it. This is the truth, but it’s not the whole truth. The shadows of a photograph, the grit of an oyster, the bruise of a fruit, are all a part of our medicinal education that I never might have appreciated had my grandfather not fallen ill, and died.

His story is not an uncommon one. A war vet, and gorgeous, he saw more than his fair share of guts and God-knows-what in the strife between foreign nations. He was the son that came home, somehow. He married, and they had five children who grew up as bold as their father. Those kids left their third-world beaches, their titles, their cooks and their cleaners, to enjoy the promise of first-world welfare and isolation. All hopes were cast onto us, the next generation. The kids, our parents, would not leave ‘Ma and ‘Pa in the sweltering tropics. So, when fortune (though modest) afforded the flights, my grandparents came to Canada.

Here, they had a little house so blessedly close to mine in the shabby district. “Lola” cooked “adobo” and rice, crocheted and cared for cacti. Grandpa gave us little ones lessons in cursive and tree house construction. He gave us the honor of Scorekeeper, always, and taught us to carry our 1s.

As the years ticked by we all grew taller (he penciled the doorframe with all of our heights- “keep still, keep still…”). By the time we stopped growing, Lola had left, and the tender tendrils of creeping dementia had already started what couldn’t be stopped. Some days he would tell me to take his watch, his cane, his ring, in exchange for the rice without poison. Some days he would bellow and fly out the door, fall, bleed, and then tell the police we had pushed him. He told his children bawdy stories that did not concern their mother, God rest her. He dreamed, while waking, of foxholes and trains, the booming bombings, the march to Oblivion. Worst of all were his moments of lucid clarity… glimpses of my beloved teacher, flickering for an instant or more, then shuddering and going out, leaving us all more alone than alive.

At the end we all gathered, three generations of love and commitment. We kept vigil in that fluorescent room. I thought forward to all the times I would see this scene in the years to come. But this is the first, I thought. This was the only time that I would be that grieving grandchild, whispering into his maybe-deaf ears, whispering whispering, just in case. The care aides swept in and out like stagehands in a play, arranging and rearranging him like a prop between our mournful scenes, then rushing away. My parents, aunts and uncles were left with mouths agape, aborted questions catching in their throats. There were no pamphlets, no “What To Expect When Your Father is Dying”. No “How To Prepare Your Youngest For How Grandpa Looks”. The nurse seemed annoyed at our numbers, our accents, our questions, our fears. There was nobody else, so I set to work, interpreting the bland, quiet, brutal action.

“The drug is called morphine.”
“‘Vitals’ are vital signs: heart rate, breathing rate, temperature, blood pressure…”
“I’m sorry, they have to move him again. To keep away bedsores.”
“They’re trying to keep him comfortable— yes, they’re keeping him… sleeping.”

We nibbled cookies and sipped weak tea from the cart they rolled in with the folding chairs, and we waited for something to happen. The steady rhythm of his breathing was precious, and awful. We strained our ears between sentences, and clipped our answers short for fear of missing a change in the pattern or depth. The only thing my family knew was that the sound of him wouldn’t, and couldn’t, last.

But I knew what the cookie-cart meant when I entered that dank little room. I saw what the patch on his chest, the one with the ragged-edges and blue-black shading, for what it truly was. The lump in the hollow of his clavicle, the mole-hills in his groin when the care aide turned him… I understood, in a rudimentary way, how a stroke could leave him unable to swallow, unable to wake, and how his history of “staring spells” had meant that this end was a long time coming. I wondered what was worse: the fog of uncertainty that clung to my family, or the bracing insight that clung to me? Neither could change what would happen, and narrating the fine details of an old man’s death would have been no more help to them than hearing “forget it” would have been to me. His strong heart and able lungs still clung to life, despite the crumbling mind, the sickly brain, and the cancer running rampant. I recalled lectures on dehydration, sepsis, hepatic encephalitis, Palliative Care… I couldn’t help it. I couldn’t help them, not really, and I couldn’t help him. The pain of that is crushing.

The shadow in this picture, the grit that maybe begets the pearl, and the bruise that threatens to swallow the fruit, is the terrible insight that medical knowledge gave me, but not my family. The things that we, as students, will learn and have learned, will give us the power to help and to heal. In return, those things will reveal, without pardon, the times we are truly, utterly helpless. We worry day to day about the things we don’t know, but rarely consider the pain of knowing. When we accept our new careers we sacrifice our ignorance, and any bliss it might have brought as life hurtles on and on. It’s the fine-print of this contract we’ve already signed. The truth is that we will see the stigmata of death and disease in shopping malls, lecture halls, on the hands of strangers and the faces of people we love most dearly. There will be no unseeing. To practice medicine is not only to understand the minutiae of life and death, but also to learn how to balance the weight, to carry the terrible burden, of that understanding. And then, even still, when those lessons are mastered, we must go a step further; we must become deft at unloading, unpacking. We must arrange that knowledge somehow, some way, so that families sitting or pacing or weeping can pick up the pieces, carry them, and carry on, as we do. If we understand that as the true cost of medicine, all that remains is the question of whether we’re ready, and willing, to take on the price.