Mr. W

We ask you to name someone you trust to speak for you when you no longer can-
pleading that we cannot be the ones to decide. 
How dare you have no one, we think.
How dare you work the night shift –
come home as the sun peeks through the skyscrapers,
to cook chicken and rice alone in the warm dusk of your fourth-floor apartment.
Laugh to yourself watching the re-runs, crawl into bed,
unfurl limbs, stretching from one side to the other.

You ask us to get you on your feet,
but your spine has failed you. 
Cancer erodes a life of weekends ambling down your block to the movie theater.
Large popcorn, extra butter,
Settling into your regular seat in the back, content with solitary peace.

We ask how you want to live the rest of your life. 
Feigning choice, but it will be here in this hospital bed, us standing watch 
as sick crawls its way around your neck, nestles into your belly.

You ask us what is next,
and we cower under the weight of all that we cannot cure. 
We tell you circular stories—
about if, then, if, then, if, then.  
Our palms are empty upward to the sky,
heaving ourselves across an unbridgeable fracture. 

We bring shame, you guard yourself.

In your dreams, you are a boy chasing your brothers down a muddy river in Haiti, wondrous, feather-light, drowning in sunlight and shadows. Your mom sits quietly on the bank scrubbing play out of your clothes, infusing care into each thread. As you trot home, dust swirls around your feet and the warm earth steadies you and everything is simultaneously expansive and familiar. 

In your dreams, you are a young man landing at JFK alone thinking- 
America dirty beautiful loud hopeful.
One step forward, the axes rebalance, and you are brave and wondrous, and it is all yours. 

In the hospital, you are a question mark when everyone wants something to fit in the confines of a disposition line. 

In the hospital, when we finally intubate, we fasten your arms to the bed—
for safety everyone says. 
We walk out of your room and into the next,
pretending it is simple, that we are satisfied.  

In your dreams,
you fly up and up and up, 
over cramped city apartments, 
over ocean,
over the spirits of your mother, your brothers under village earth, 
over it all. 

Time sweeps along – an undulating unstoppable tide.  
And Death sighs, weeps, and welcomes you in as messy and strong and free as you arrive.

From the author: This poem is a reflection on the limitations of our US healthcare system when it comes to creating space and capacity for meaningful conversations about illness and dying. It speaks to the ways in which we, as medical providers, often (unintentionally) flatten patients into one-dimensional individuals in their hospital bed with problems we believe we must overcome and solve efficiently, whilst forgetting all of the moments, contexts, and identities that infuse patients' lives before they arrive to us.

Mikayla Gordon Wexler is a fourth year medical student and recently applied into Internal Medicine Residency. She is interested in family caregiving, narrative medicine, and reducing barriers to equitable health care and social needs.