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From The Ground Floor |

FROM THE GROUND FLOOR

A literary magazine from Bellevue’s Emergency Room volunteers

| From The Ground Floor Cover Art by Arianne Maya


FROM THE GROUND FLOOR

A Literary Magazine from Bellevue’s Emergency Room Volunteers

Volume 1Summer 2017

Committed to providing a forum for Bellevue’s E.R. volunteers to share their experiences, beliefs, and

stories based on or inspired by their experience at America’s oldest public hospital.

“Wherever the art of Medicine is loved, there is also a love of Humanity”

– Hippocrates

Cover Art by Arianne Maya

| From The Ground Floor

Letter from the Editor:There’s no place on earth quite like Bellevue Hospital. Walking through its doors, one sees a myriad of faces: those that smile, those that cry, and often those that scream. No one face looks the same at Bellevue: all of its patients, doctors, and visitors seem to be of different shades, hail from drastically different countries, or pray to wildly different gods. But for all of Bellevue’s diversity, one quality remains strikingly universal in every person who calls it home, even if just for a few hours. No matter what language a Bellevue pa-tient speaks—whether they use a Chinese dialect or click their way through a Khoisan language—behind those words invariably lies a story. One that can evoke laughter, tears, or reflection; one that can spark conversation, change ideologies, and bring once-foreign worlds together.

These are those stories. I can only hope that they inspire you as much as they inspired us volunteers throughout the ten short weeks we spent at Bellevue. Reflecting on a life-changing summer, I can’t help but remember the words of a resident on my first shift in the pediatric emergency room. After a teenage mother was violently restrained by hospital staff, the young physician turned to me and said, “The first thing you have to realize is that this hospital isn’t normal. It’s like nothing you’ve ever seen before.”

And he was right. Bellevue isn’t like anywhere else in the world. But that’s what has made this place, and the stories that lie within it, so special.

To the many editors who spent countless hours reviewing and editing these pieces: thank you. To the authors who took time out of their summers to chronicle their experiences: thank you. And to the patients who inspired this journal: we are forever in your debt.

Arman Azad, PHC ‘17


Poetry

Table of Contents

The OrchestraStill

AbusadoraMental

A Beautiful ViewCrimson Red Shirts

StrongerUntitled

67

111324274254

Saima RehnumaMaissa TrabilsyHasanna TaitMaissa TrabilsyRoshana BrownAnonymous AuthorHaley BarravecchiaAnonymous Author

Prose

10:34 pm, SaturdayA Humble Prayer

The BoxerA Patient’s Resilience

PerspectivesLife Lessons

The Patient, not the PrisonerAllow me to tell you about

Project HealthcareA Loved One

RewrittenUp ThereOdaijini

Grammar SchoolTo ProcessCode Blue

ThankfulWednesday

Held MomentarilyShagotom

6/21: A Streamof Conscioussness

810121417202122

2628323436404446 47484951

Libby HoDivya RoyCristian RamirezErika ZambranoAnjay BatraIqra TahirSaima RehnumaAustin McMeekin

Lenura ZiyadinovaAlexis NdukaSophia SongCaroline YaoKevin WangNathanael RehmeyerAnonymous AuthorAmira CohanRachel MarksKristen PerezPooja DuttaMaya Graves


The OrchestraSaima Rehnuma

I saw his fingers go blue, his toes coldWithin what seemed to be a secondI asked the doctor later and they said he had only so much time.

They compressed, injected, and shockedTo a naive child it would appear an orchestra seamlessly performedSmooth sailing, no bumps.

We had signed up for it allThe good and the badNo calling shotgun.

The monitor mirrored the crescendo of his heartBeating and racing to keep up until—Time of death 17:36.

The doctors debriefed and I stood asideTrying to be a part of what seemed the right way to copeThe right way to process it all.

It stuck to me, his body lifelessBut just as the orchestra finished and the curtains were drawn,I had no choice but to carry on as a volunteer.

"Hello, is there anything that I can do for you ma’am?"The old lady smiled warmly,"A glass of water would be nice."


StillMaissa Trabilsy

We are so lucky to have two armsto embrace our beloved, and push away all we fear, so lucky to have a heart, and a mind, to understand how we feel, and have our heart ignore it anyways. We are so lucky.

Yet we don’t always know our wealth, so we let our struggles and painsbecome Us, manifesting themselves in every breath, in every step. So after I met you, and learned that you will be losing a leg, I wished you well, and even said I hope one day, you will be happy, nothing else but happy, because that’s all I ever desire to be.

With such gleam in your eyes, you said you already are. Keep living,

you are so Lucky.


A man waved me over and asked me to give him some gloves and abdominal pads, gesturing rather calmly at an

open flesh wound in his left leg. I hesitated, wondering what in the world this patient was planning on doing, playing doctor with himself. He saw my look of bewilderment, chuckled, and assured me that he was just going to clean the wound. I watched as he expertly put on his gloves, sprayed the wound with saline solution, wiped it clean with some sterile gauze, and taped abdominal pads to dress the wound. It was almost as if he was a doctor himself, taking care of his wound dressings the same way I’d seen so many residents do over the summer. After finishing, he took off his gloves and asked me to help slide him into his diaper. Any other 29 year-old man wouldn’t have even dared contemplate the thought of wearing a diaper, much less ask a naïve little volunteer to help him into one. But he said it with the ease of someone who had just finished dinner and was simply fol-lowing his normal daily routine before going to bed. His girlfriend had once shot him four times (he showed me the scars on his stomach, back, and hip) at 9:23 AM with his own gun while he was sleeping. He ended up in a wheelchair, unable to move his legs. Even today, he still couldn’t figure out why his girlfriend did that to him. After that incident, he got really paranoid and sat on his gun all day, every day in his wheelchair until he realized he had an ulcer in his left hip. He actually didn’t even feel

it at first, and it was only until the ulcer reached Stage 4 and hit his spine that he suddenly couldn’t move. But somehow, “by the grace of God” (and he made the sign of the Cross when he said this), his cousin happened to come into his bedroom at 3 AM in the morning, drunk and looking for weed. She saw him paralyzed, mouth wide open and just gawking at her with terrified eyes, and she yelled at the top of her lungs, “Dude, whatever weed you’re smoking, I don’t think I want it no more!” That was enough to wake up his grandma, who came in, saw him, and immediately called 911. If it hadn’t been for that drunken cousin thinking he was smoking weed at 3 AM in the morning, he wouldn’t have stayed alive. The surgeons took a skin graft from his left leg to replace the rotten flesh from the ulcer in his left hip. But the surgical wounds in his leg didn’t heal very well and kept opening up. That was why he had come over to the ED today, to fix up the nasty open wound in his mangled left leg. He told me he was trying to find a nursing home or some facility that could help take care of him in his crippled state. But no nursing home would take him, because he was only 29 and no one wanted to take care of someone so young and still capable of do-ing many crazy things. Race and his low-in-come status, unfortunately, were deciding factors as well. So he’d been stuck trying to be his own doctor until he could find a care facility willing to take him in. He said he did find one that had potential; it provided just the right amount of care he needed but allowed some freedom for him to do the things he wanted to do. But that was only in the talks for now. He showed me pictures of his 4 year-old son. He was an adorable little kid peeking out

10:34 pm, SaturdayLibby Ho


from his dad’s phone wallpaper, and the man raved about how smart and good-looking his son already was. He wanted to start walking again soon to take care of his son and raise him up the right way. His doctors told him he would never be able to walk again, but he was going to prove them all wrong. “Look,” he said, and I watched as he slowly, gingerly, in an act of proud defiance, raised his legs just over an inch above the stretch-er. He looked me in the eyes and repeated what he said. He was going to prove them all wrong. He was going to prove them all wrong. Because even as bad as all this was (he gestured broadly at his wheelchair and legs), there was always someone out there who wished they could be in his situation. There’s always someone worse off. And looking at him, with two crippled legs and four gunshot scars and a nasty leg wound from a surgery done to treat a Stage 4 ulcer, and not being able to walk and being confined to a wheelchair and having to ask a young girl to help him into a diaper at his age, I felt the strongest urge to believe him. This man sure had some rotten luck, but despite it all, he still fully believed that he would one day be able to walk again and take care of his son. Even with all the hellish challenges life threw at him, he’s still alive for a reason, and he’s doing everything he can to keep trooping along. “What’s your name?” I asked him before leaving. “Larry.” “Larry, you’re a pretty cool guy.” He grinned. That was nothing. If I wanted to see something really cool…He showed me pictures of his pets, two enormous boa

constrictors that were the size of his legs and wrapped around his arm three times. “The big one is Bella, and the baby one is Bellarina,” and he pointed to a not-so-baby-like snake that still looked significantly larger than my whole arm. He gave me another toothy grin. Something to show just how cool he was.


A Humble PrayerDivya Roy

“Father God, you have led me today to this woman, to this beautiful soul. Let your spirit fill her as we pray, and let not your spirit leave her during these hard times in her life. Father God she has no one in this land; no husband, no daughter, no mother or father. I pray that you can fill in those empty spaces. Make her fearless and courageous so that she can fight her battles. Make her a vessel to fulfill your purpose and God I pray, take away her iniquities. For she needs you Father. In this room filled with many faces, many problems, I hope you can see hers too. In your name I pray, Amen.”

I opened my eyes and I saw tear drops down her soft cheeks. She held my hand tight, and eye to eye, we stood there silently for some time. She couldn’t speak and neither could I. We smiled at each other. Believe me, for a brief moment we were speaking without any words. I parted with her unwillingly hoping that I have left her safe in the hands of God.


Abusadora Hasanna Taitt

Sweet venom rushes through my veins

I revel in the poison

Here ends my reign.

One more drop and it all goes away

One more drop

It’s my turn to fade

One more drop

I’ll never look back. That which debilitates

Also liberates

And then for once I’m free

Free from the chains

Free from society

Won’t you just let me be?

I am the unwelcome tenant

In the city that’s my home

But this liquid euphoria

Quiets my fears.


The BoxerCristian Ramirez

You’re a fighter. You were then and you are now. The grime of the sooty ring coated your face when you’d get knocked down, but you’d refuse to just lie there. Your card read “0 KO” until the last fight, a bad one. “I want our

daughter to grow up with a father, Bill.” You hung your gloves up and let the years pass. Brain tumor, malignant, they said. Or no, a stroke. Maybe. Maybe an aneu-rysm, tough to tell. Another MRI, another biopsy, who knows what it is. You refuse to surrender, after 53 hard-fought years. Your body, swift, strong, statuesque, once. Now, atrophied and disobedient. Your left leg collapses under the weight of grav-ity and your smile droops. You cry as you look into the passing shiny orbs on the ceiling. You stare at your reflection, interrupted by the grit-spackled tiles lining the hallway leading to the CT room. You reach out to the side of the stretcher. Your arm is marble-heavy, it twitches and lifts off in a winding trajectory before crashing down onto the bed. Blind fury fills your gut and you want to hit the wall. You catch a glimpse of your wife’s auburn hair, you focus on her freckles, you ignore the worry lines around her mouth, the dark circles around her eyes. She’s beautiful. She holds your hand. You relax. A whimper comes from behind you. You wonder what they told your daughter; does she understand? She’s been afraid to speak to you. “Turtle,” you call her, because she loved to hide as a kid. You motion for her with your work-ing arm. She carefully positions herself at your feet. Your back aches worse than when you took 37 kidney punches in a single round, your head burns like it’s been doused in kerosene and set ablaze, your right toes tingle and feel like they’re being prickled by microscopic needles. You look up. A spiraling, concentric sun dome shines the morning into the hospital room. The stained-glass panels scatter bright, white light onto you, like the spotlights that surrounded the ring. The announcer would scream your name when you’d step under the lights, the crowd would go wild. You wonder if heaven sits on the other side of those windows. A tap on your foot interrupts your thoughts. “Don’t worry, dad,” says your turtledove. “You’re a fighter.”


MentalMaissa Trabilsy

Sedated.Why couldn’t you help me?Why couldn’t you save me?My mind was racing,I thought I was flying,I saw an “S” on my chest,a red cape around my neck,and I wanted to flee,so I tried and tried.But I couldn’t,with restraints around my arms,until I could.And I soared,“Security” is what they called for,You held me down,beat my head into the ground,until I bled.Why couldn’t you help me?Why couldn’t you save me?“Violence” is what they called for,not one person,not one human.What is wrong with me?I didn’t know,They didn’t know,But no one thought to know.Blood gushing out my head,until I was sedated,Illness.


A Patient’s ResilienceErika Zambrano

To me, the most gratifying and beauti-ful sight at Bellevue Hospital’s Emer-gency Department was a patient’s

resilience and positivity. By saying this, I do not mean to romanticize or generalize patient pain and suffering. I refer to the patients who, despite enduring life’s great-est hardships, remain resolute in fighting for their survival. I deeply value each of the patients I interacted with this summer. As I gained their trust, they shared a painful moment of their lives with me, a complete stranger. An Emergency Department is full of a vari-ety of medical cases, but Bellevue cares for New York’s most marginalized populations. Many patients come from underserved communities that have suffered systemic violence and state neglect. They are some of the most broken but most resilient people I have met in my life. Because I am one of the few Spanish-speak-ing volunteers in the program and Bellevue caters to a large Spanish-speaking patient population, I had a special connection with many immigrant patients. Immigrating to a new country and not speaking its main lan-guage is an intimidating and difficult experi-ence. When many patients saw me walking through the ER, I introduced myself or they called out to me hoping I could speak Span-ish. As soon as I confirmed their suspicion, they became more relaxed and friendlier. I felt so happy and privileged to be able to provide some comfort just by communicat-ing in our shared language. They happily engaged as we conversed about each other’s

lives and common experiences. I felt helpful at being able to communicate between them and the healthcare providers. Often, individ-uals would reserve questions from doctors and ask me because they felt uncomfortable “bothering” the doctor. I often reassured them or asked the doctor or nurse myself if they were simple, non-medical questions. During one of my social work shifts, I was able to talk to two Spanish-speaking patients who had suffered from assault and helped mediate the communication between the English-speaking social worker and the patients. The first was an older woman in an abusive relationship who had moved from Spain, following her husband. The second, a man who had suffered an assault at gun-point in his friend’s car. After moving to the States with her hus-band, Olga suffered domestic abuse for four years. That day, she arrived at the hospital with multiple bruises and a red eye. Holding back tears, she recounted how her husband constantly belittled her and threatened her that the police would never believe her and that they would deport her due to her undocumented immigration status. The social worker and I told her that police could help her with a restraining order so that she could leave her aggressor. However, we could not assure her that she would not be vulnerable to possible deportation by engaging with law enforcement (NYPD), especially in this current presidency that has repeatedly demonized immigrant commu-nities. Even though I couldn’t do more than serve as an interpreter and offer compas-sionate support, Olga tearfully thanked me for helping her. I felt a mixture of gratitude for this kind woman and guilt at not being able to assure the possibility of her safety and of her living situation. Although I am aware that the social realities that drove her


into this abusive situation and cause her fear are out of my control, I couldn’t help but feel powerless and disappointed. As she entered her taxi, she gave me a hug and graciously thanked us for the resources we provided and suggested. After Luis was stabilized, we talked to him. Luis told us of his fear for his life at being held at gunpoint and how he took away the car keys and refused to relinquish them. The aggressor hit Luis is the nose with the gun and Luis took advantage of the opportunity to run away with the keys. Thankfully, the aggressor fled the scene. As we took pictures of his wounds, he asked, “Should I smile?” Even though he had just gotten attacked, he was so grateful that he was alive. He told me that life is awful so one must be happy to numb the pain of reality. He was not just re-ferring to his assault from this day but his life in general. We took one serious picture and another of him smiling so sincerely. Frankly, I was amazed that he radiated happiness and tranquility and admired him so much at this moment. These two interactions reinforced my hope in people’s humanity and their faith in living. At Bellevue, I lived through so many similar interactions with dissimilar patients. The seemingly little actions that I carried out for patients proved to be the most helpful. I was humbled by their grateful attitude. An incarcerated patient came in in a stretch-er and had a C-collar on. After introducing myself and asking if he needed anything from me, he voiced his extreme thirst. As I noticed he had not yet been seen by a nurse or doctor, I told him that I couldn’t bring him anything to drink until he had seen a healthcare provider. Exhausted, he under-stood and I reassured him that as soon as the doctor cleared it, I would give him some-

thing to drink. I checked back periodically and as soon as the doctor said he could drink water through a straw (because he couldn’t move his neck in the C-collar), I hurriedly left to find a drink. Once I found the juice, I desperately tried to find a straw. The AES pantry had not straws left and I looked in the stockroom. I went to all the stations looking for one and asked the nurses where they could be found. No one knew where the straws were and I felt frustration at not being able to help this patient immediately. After ten to fifteen minutes of looking for straws I went to another department and looked for them. I finally found them and came back to the patient and helped him drink the juice while he could not move. He thanked me with so much sincerity and I felt that I had truly helped this man. People were so hopeful and proud of my possible future as a physician. I didn’t want these conversations centered around me, but I learned that patient trust is earned through sharing experiences and commonalities. I improved on carrying on difficult conversa-tions with patients I related through shared or unshared experiences. I provided compas-sion and actively listening to a patient’s story of suffering. Many patients who arrive at Bellevue are scared, frustrated and tired of their life’s un-fair treatment. If they come to the ER, they have most likely exhausted other alternatives or more than likely have no other alterna-tive. They are scared and worried about their physical mental health, a roof to sleep under for the night, some food to quench some of their hunger, financial ability to pay etc... I’ve learned from life experience to never belittle an individual’s story life experienc-es or pretend to understand them, because I cannot. I can only imagine the pain, the


hurt, the frustration, the hopelessness, the emptiness, and the cynicism. Most patients deemed “uncooperative” sometimes needed validation of their experiences, not someone who supposedly “understands” or minimizes the emotional impact of trauma. I never pre-tended to understand experiences I have not lived myself; I only listened and responded with compassion and hope. There are so many indescribable experiences. I could never understand a homeless patient who has confronted starvation, frigid nights, intoxicating summers and hopeless thoughts. I don’t presume to. I can never understand the trauma suffered inside a prison cell and the abuse at the hands of police. I’ve suffered a lot in life due to personal experience and can relate my own trauma that manifests in panic and hopelessness. I relate to the frus-tration of many and hopelessness in a system that fails many. I admired their optimism after facing com-parable and more extreme hardships than my own. I admired their positive attitude and smiling faces. We agreed that life forces us to suffer and fight through the pain. We must be resilient and find the happiness into the little moments of joy we are afforded. I only hoped to be able to do that for the patients: to be able to share some joy and hope. My only regret this summer is that I couldn’t do more for patients. So many patients had social issues that exacerbated their health conditions and these same social realities often led to illnesses. I cried for them and their situations. I cry frustrated tears as I am writing this reflection because our healthcare system and other services are so flawed and fail so many. Denying healthcare to patients is dehumanizing; deeming a person’s life as less deserving because of their identity or their inability to pay is ludicrous and cruel. I

cry at life’s inequity and how I see it manifest-ed: its ability to ruin people’s lives, take away their peace of mind, separate families, take away loved ones and cause so much suffering. I was frustrated at how powerless I felt in many situations. There is no doubt in my mind that I want to go into healthcare to alleviate pain, but also to provide comfort and inspire hope that manifests into action and tenacity needed to fight for their health and some control over their lives. Hope for a better tomorrow keeps me and resilient patients going. My goal has always been to help those who suffer the most and I hope to follow the right track through Emergency Medicine. I want to go into this field to fight for equity-centered, compassionate, humanistic care. I want to engage in collective action with future fel-low healthcare providers to improve local communities and also fight for federal policy change. In this way, I could provide care but also minimize inequity in communities and directly impact social problems that exacer-bate health.


PerspectivesAnjay Batra

On June 12th, I left my dorm on 14th Street for my 6pm shift at Bellevue Hospital at roughly 5:15pm. Thank-

fully, it wasn’t raining, but a downpour was clearly imminent. Dark gray clouds hung over the familiar Manhattan skyline, en-shrouding the beautiful top of the Chrysler Building. It was summer, so the sun was working overtime, diffusing its light through the clouds. Occasionally, it would find its way through a small gap, reminding me that it was still there.

I made it to the hospital by 5:45pm, and to the Emergency Ward, where I was as-signed that day, by about 5:55pm. The EW is where patients go after being stabilized after a trauma, and they stay there either until they can be admitted to a bed upstairs or they’re discharged. Therefore, patients who are in the EW are typically very sick. The ward is a V-shaped room, with two rows of patients intersecting at the apex of the V and the nurses’ station in between. As I walked down one row of patients toward the nurses’ station, I heard slightly raised, tense voices snapping back and forth, as though in an argument. I began to eavesdrop, when I heard a deep, low groan come from the patient room to my left. The sound was one of a pure, piercing, pervading pain, the kind that would evoke sympathy and sadness in even the most cold-hearted person. I tried to shake it off and walked to the nurses’ station to introduce myself. Although some tension still hung in the air from whatever had hap-pened earlier, the nurses introduced them-selves. The charge nurse, M, smiled as soon as she saw my bright, fire engine-red polo. “You guys are finally here for the summer!

We’ll need you, believe me,” she said. As I looked around the room, I noticed that most of the patients appeared to be asleep, their rooms dim. One of the patient care techni-cians (PCTs) walked me to an empty patient room and showed me how to properly fold some oversized paper towels. She asked me to fold thirty of them. It was raining hard on the windows above me as I folded.

After I finished, I spent the next fifteen min-utes or so walking around the room, work-ing up the confidence to introduce myself to patients and family members. I thought of what to say. “Hi, my name is Anjay and I’m a volunteer. Please let me know if you need anything.” That would work, right? The first person I spoke to was a middle-aged woman, presumably the wife of the simi-larly-aged man in the patient bed. The man seemed to be asleep, with several plastic tubes connecting a wall of machinery to his insides. A quick glance at his vitals moni-tor indicated that his heartbeat was wildly irregular. An elderly woman, presumably a relative, sat next to him, praying. I turned to his wife and tried my line. “Hi, my name is Anjay and I’m a volunteer. Please let me know if you need anything,” I said, awk-wardly trying to balance friendliness with solemnity. What could she possibly need from me, though? This lady’s greatest pri-ority at the moment was probably to have her husband feel better and get out of the hospital. Regardless, she smiled, nodded and thanked me. After introducing myself to the patients, I went back to the nurses and asked why the unconscious patient’s vitals were so irregu-lar. M lowered her voice and said, “He had a hemorrhage on his brainstem,” the part of the brain that controls vital functions like heartbeat and breathing. “There’s no hope for him, but the family has waited a week to


pull the plug. Most people do it within three days. I don’t know what they’re waiting for.” Upon hearing this, I was most taken aback by how well put-together the family seemed. His wife had smiled at me.After hanging around and watching the nurses for a few minutes, I awkwardly left the nurses’ station and walked around the EW, looking for a patient I could have a conversation with. Everyone was either unconscious or unresponsive. As I walked past the nurses’ station after making a full round of the room, L, another nurse, looked up and said, “You really need something to do,” with a touch of impatience. She was tall, with a serious face and a matter-of-fact tone. I shrugged and said, “Do you have anything in mind for me to do?” “Where are you from?” She asked. “Houston, Texas.” She typed on her computer for a few seconds. “You want to be a doctor?” “Yep,” I responded. “That’s the plan.” She smirked. “Good luck.” “Any advice for a pre-med?” I asked, expecting to be told to live a balanced life or something along those lines. “Don’t do it.” There was an awkward pause. “Why?” I asked. “Don’t do it unless you can’t think of anything else to do. That’s what I tell my son. There is no more glory, the country doc-tor is dead, the pay isn’t as much as it was, and you could randomly get stuck with an HIV needle, or hepatitis, or something. The patients don’t even appreciate you anymore. It isn’t worth it. There are other ways to make money if that’s what you want. What do you think?” she said, turning to the other nurses. They nodded in general agreement, and one nurse said, “Yeah, this is a pretty screwed up place.”

This was not what I was expecting on my

first shift. Was medicine really the way L painted it to be? After years of being con-vinced that my future would be in medicine, I was questioning myself. What’s the point if no one feels any better at the end of the day? In that moment, with the sound of the rain pouring on the windows, the dying man in a coma a few feet to my left, the memory of the painful groan from the patient I still hadn’t met, in the dim nighttime lighting of the EW, I wasn’t sure about medicine anymore.

It’s mid-July now, and we’re more than half-way through the summer program. Since my first shift, I have encountered several nurses, attending physicians, residents, and other care providers who enjoy their lives and have a generally positive outlook on medi-cine. I’ve had patients thank me and call me “mijo” simply for bringing them a glass of water or some juice. I’ve seen residents put a smile on pediatric patients’ faces by blowing up a glove into a balloon. I’ve met PCT’s who greet me with a “What up brother!” and a fist bump.

A few shifts ago, I met a senior resident, T, in the Adult Emergency Services depart-ment. What struck me initially was how genuinely he smiled when I introduced myself. Further, he said he’d come get me “if anything cool is going on.” He kept his word. Later, when a patient with a developmental disorder needed an ultrasound of the heart, he pulled me into the room to show me how a heart looks through an ultrasound. When we walked into the room, the patient was very nervous, as her chest felt tight and she was concerned it was something serious. She anxiously listed a series of issues that bothered her, even though she thought some might be unrelated, but she just wanted to be sure. From the way she was insistently tell-ing us of her problems, I got the sense that she wasn’t used to being listened to. But T


listened with patience, sometimes giving her a gentle smile. Over the course of the patient interview, she calmed down. Not only did she visibly become less nervous, but I watched as her blood pressure and heart rate decreased on the monitor. I was amazed.

I’m convinced now that medicine is still a rewarding field, filled with good people who enjoy their lives. In a high-stress environment like the emergency department at a pub-lic safety-net hospital, people are bound to become frustrated in difficult circumstances. However, as long as people like T continue to smile at patients and listen to their stories, and to teach the next generation to physicians to do the same, I’m certain that medicine will remain effective and rewarding for both patients and providers. We must understand the pressures faced by providers in such fields and provide adequate support for them to maintain such a positive outlook and stay healthy. I look forward to each of my remain-ing shifts at Bellevue, and I hope to find time between sightseeing and volunteering to tell more stories. “The soul becomes dyed with the color of its thoughts.” – Marcus Aurelius


Life LessonsIqra Tahir

The communication, interaction, and thinking that occurred in the background of Bellevue Hospital were truly life-changing. Besides clinical competencies and medical terminology, the most important thing that I learned during Project Healthcare was the humanistic side of medicine and patient advocacy. I devel-oped skills in observing my environment and the body language of patients, in addition to conversing with individuals from diverse backgrounds. I would not have learned these if I stood still. As a Project Healthcare volunteer, you see a recurring theme: the necessity to be proactive and to foster your own knowl-edge and growth. You have to reach out eagerly and without fear for richer knowledge and I developed the confidence to do just that.

The patients I interacted with became my teachers. I witnessed many patients bed bound and dependent on the individuals around them. Nurses were con-stantly changing adult diapers, providing food, and cleaning patients in the Emergency Ward, Adult Emergency Department and in several other depart-ments. While observing vulnerable adults, I was also able to see infants in the Pediatric Emergency Department clinging onto their parents in the waiting room or when the physicians examined them. So it could be said that vulnera-bility is a cycle. You are born into the world frail and delicate, but leave it just as helpless. This vulnerability requires a healthcare worker to become a supportive friend physically and emotionally. The patients are in their most critical stage and they lay their lives in the doctors and nurses that become their only lifeline.

The people that come to Bellevue don’t need pity, they need love and respect. As a volunteer, I became a supportive friend with one of the greatest responsi-bilities in the hospital: to provide that love and respect. I also had the opportu-nity to listen to diverse stories while caring for these patients. They taught me about respect, empathy, happiness, and hardships. I realized then that a person does not learn from a textbook or short story, you are inspired by the people you meet, who unknowingly teach us life lessons and guide us to the right path.


The Patient, not the PrisonerSaima Rehnuma

It was another one of my emergency room shifts. I was tired from having shifts consecutively and had a fever from the night before. I couldn’t imagine staying on my feet for 5 hours, but as I thought of this, I laughed to myself. This was only the start of a career I have dreamt of and the hours were only going to get longer.

I remembered the patient from Rikers Island, the one I refused to call prisoner, who held my hand so tightly as he went in and out of seizures. His tired pale body was curled up into a ball, his left arm hanging limply on the side of the bed extended through the bars of the bed rail. His right arm, with veins that yearned for hydration, appeared thin and pruned. Silver cuffs hung loosely grazing the wrinkled skin of his ankles. With hardly any energy to muster, I cradled his hand as we waited for the medicine to kick in, and to be taken to CT.

“It gets lonely, thank you for being here with me,” he whispered and smiled bleakly. I wanted to say “I understand” but I didn’t. I didn’t know how it felt to be in prison for 37 years, to be kept isolated from the world, and only to interact with people when brought to the hospital. Could it be that this was as good as it could get for him? I didn’t want to think that. I wanted to tell him it would be alright and that he would be alright, but every thought I had seemed futile. And all I could do, at that moment, was squeeze his hand.

The officer that came with him told me to stay away, dismissing the patient. It was an interesting relationship; we were both players of the same team trying to help the public, but we had such different approaches. I was a volunteer of the hospital, and like the staff here, I worked to help anyone who walked in. But he? He was quick to dismiss and push aside, but I learned quickly to give everyone the benefit of the doubt.

The patient thanked me countless times. He was so appreciative of my being there. I didn’t care that he was a prisoner, that he had committed a crime to have led him to this position. I only cared about what was right now. To a large extent that is the beauty of medicine- we are solely here to help anyone and everyone, and with that in mind I headed to my shift in the emergency room.


Allow me to tell you about Project HealthcareAustin McMeekin

Allow me to tell you about Project Healthcare. Unfortunately, Project Healthcare is a one-of-a-kind 30+

year old summer program for young adults to volunteer in Bellevue’s Emergency De-partment. I say “unfortunately” because sadly a program like this has yet to become a staple in emergency departments across the country. Its beauty and power lie in the expanded roles us volunteers have the privilege of undertaking, which surpasses most medical volunteering positions in this nation – or at least the ones I’ve seen as a veteran pre-medical student. At first, I was a bit puzzled by the continuous remarks from the emergency department staff – doctors, nurses, patient care technicians, social work-ers, and administrative staff – regarding how happy and appreciative they were that we, as volunteers, were here. And it made me wonder: why are we so helpful? We’re only volunteers. We have little power and our absence would not vitally impact the normal functions of the ED, or so I thought. After weeks of sitting on this idea, I realized our power lies in our expansive roles as patient advocates. We were informed of this title at the beginning of the program, but its meaning had little substance in my mind. However, volunteering in the adult and pediatric emergency rooms, the urgent care unit, the emergency ward, social work office, and so much more has shown me a side of medicine that I began to see was severely lacking in the regular emergency department operations. Within this ED, everyone has their responsibilities. Doctors attend to the medical needs of the patient,

nurses tirelessly ensure that this process and the functions of the ED operate smoothly, patient care technicians assist with some of the more non-pressing needs of the patient, social workers connect the patient with the outside world, and the administrative staff keeps everything afloat. Everyone is a cog in a healthcare machinery that makes up the emergency department. But what are we as volunteers? What does it mean to be a patient advocate? Simply put, we attend to the needs of John Smith. John Smith, while a patient, also has a name, a family, a mental well-being, and a brain that is trying to process what is happening in the emergency room. And sometimes while each cog in our ED machine is turning with one another, one might be a little off centered, or not well-lu-bricated, or a bit cracked. In the end, our patient John Smith is the one that is affect-ed. So what are we as volunteers? We are the adjusters, the lubricators, and the repairmen that have the privilege of not having our own cog but the oversight to see all of these moving pieces. In doing so, we can catch those little moments that affect our health-care machinery and work to make them better for the sake of Mr. Smith. When I saw a female patient lurch-ing in pain on her stretcher one day, I approached her with the intention of under-standing the situation. Through her visible discomfort, she informed me that the doctor said he would get her pain medication a half hour ago. A red flag immediately went off in my head; a cog had potentially become out of place. With the freedom bestowed to us volunteers, I drifted to the whiteboard, found the patient’s provider, and sought him down to ask for clarification. In my wander-ing I came across a 4th year medical student wearing an I.D. badge with the name I was looking for. I stepped closer as he relayed information of this particular woman to the


attending physician. His voice was oddly devoid of emotion and I briefly wondered if he was aware of how much pain she was in. But then again, this was a medical student on rotation. I had never seen him before and it was equally possible that this was his first few times caring for a patient in an emergen-cy setting. I asked myself If I would be any different. Well, of course I would, but I’m not in his shoes yet to understand their medical logic. Or there was the equally likely chance that the medication order was already in and they were waiting on one lab, scan, or anoth-er result before administering it. Whatever the case may be, I was determined to ease her suffering, even if it was only with the knowledge that the pain medication was on its way. I sat by the medical student and the attending doctor listening to their conver-sation while trying to discern what might be the issue. The medical student continued listing off details about this woman while the attending physician critiqued him on his assessment. An inner struggle raged in my mind: do I interrupt this critical teach-ing moment, which might come off as rude and ignorant if I wasn’t careful, to ascertain whether or not this woman’s pain had been forgotten? I was caught in a second of hesita-tion until I decided that in the end, I was not volunteering for the doctors. After assessing the conversation before me, I interjected with my limited knowledge of the E.D. oper-ations and braced myself to bear the reper-cussions. “Excuse me.” Two pair of eyes land-ed on me. “You’re talking about Ms. Carlson in room 18, yes? I just wanted to check on the status of her pain medication because it seems like she’s in a lot of discomfort.” The attending physician slightly widened her eyes and glanced around at her computer. No medication was currently listed and she quickly put in the order while calling over a nurse. “Let’s go check on Ms. Carlson,” she

said. They stood up and left me behind to my own thoughts. Was that it? Had I fixed her pain? Well, yes. I watched as the nurse gave her the prom-ised pain medication intravenously and saw her body visibly relax. I did it. I momen-tarily ended her suffering. I was able to do something that I thought was critically and necessarily needed. Her cog fell between the cracks of communication and I was fortu-nate enough to bring it back to its proper place. I learned what it truly meant to advo-cate for patients. My fellow volunteers and I could give you countless stories of similar form. The truth is that in the emergency room, like any working machinery with multiple parts, small lags sometime accumulate and lead to a serious problem down the road. And who is tasked with catching these lags? Well nobody, except us volunteers. We can be patient advocates. We do have a criti-cal purpose within Bellevue’s Emergency Department. One that is not met in many other hospitals. While they may benefit from such immersive volunteer programs as well, Bellevue remains the original prototype that has proven its efficacy. And perhaps one day Project Healthcare will inspire these hospi-tals to start their own volunteering programs within the emergency departments. But for now, we volunteers will continue our roles to the best of our ability, and in doing so, help those that have momentarily fallen through the cracks.


A Beautiful ViewRoshana Brown

What you doing at that crazy house? I don’t need to be at Bellevue! I promise I’m not crazy. No one wants anything to do with me.

I’m not a monster! I don’t have schizophrenia.

That’s Bellevue for you.

I was a Vietnam war sniper! I escaped my abusive husband. I am illegal.

Can you find me a detox bed?I don’t think I can live any longer.I’ve been homeless for 9 years. The streets are my bed.

I don’t have any money for food.Can I have a sandwich?

I don’t have any family. I want to get better, but life is too hard.You’re going to be somebody one day.Thank you for talking to me-I needed that.

I just need a shower, can I have some soap? He’s a regular.

Doctor, you’re so smart, no one else could find out what’s wrong. You made my day a little brighter.

The following are statements and questions made by Bellevue Hospital patients, nurses and doctors.


These are the best doctors.

I know you’re not allowed to, but can I have a hug? Why are you so nice to me, do you want something from me?Thank you for talking to that patient.

Can you make some stretchers?Volunteer needed for transport! You make my job so much easier.

Why are you wearing a red coat?

Don’t talk to me like a child, doctor. Can you sing, Little Monkeys again? My children make me proud.

Tell my husband, ‘I love you, I miss you and I can’t wait till I see you again.’ It’s my birthday, a volunteer made me this card!

Bellevue is my home.

Thank you for being so helpful.I am going to miss you.

It has it’s ups and downs, but I wouldn’t stay if I didn’t enjoy my job. You can’t make this stuff up.

I love Bellevue.


A Loved OneLenura Ziyadinova

It was a busy afternoon in Bellevue’s Emergency Room when a new trauma case was brought in by EMS. Having had

an early notice, doctors huddled up to discuss the course of action. The patient was found unresponsive at his work place. As he was wheeled into the trauma slot, his gaze was fixed. He did not move, nor did he talk. Was it a stroke or a brain bleed? The possibilities seemed endless. Curiosity and anxiousness filled me as I stood on the side observing the team examining the patient, inserting IVs and prepping him to go for a CT scan. I was fas-cinated by the abilities of doctors and nurses to think and act so rapidly under pressure: one doctor intubated the patient, another was ventilating, while nurses administered medicine for what was now confirmed to be a stroke. Every minute was important, every minute was crucial to saving this man’s life.

As a student interested in medicine, any new case brought into the emergency room is seen as an opportunity learn more about anatomy, pathology, and medicine. Yet, we are often re-minded that medicine is not about treating a disease but about saving a human being. This trauma case was just another reminder. As soon as the patient was stabilized, I followed two of the doctors to the family waiting room. As we walked inside, we saw a middle-aged woman sitting in the corner, staring blankly into a wall. She quickly stood up the moment we came in, and fearfully looked at the doc-tors. She was mortified as her husband, her loved one, was lying on a stretcher hooked up to monitors, unable to breathe. Perhaps she simply couldn’t believe that the same man, who just earlier that day kissed her on the forehead as he left for his job at the local

sweatshop, was now admitted to the hospital in a critical condition. This middle-aged man was no longer just a patient who needed to be saved. In my eyes, he was now the son, husband, and grand-father who meant the world to his family. Despite the severity of the news delivered to her, his wife stood strong and held back the tears. Was she in shock? I kept wondering. She approached her husband, held his hand and whispered something into his ear. It seemed like nothing around them mattered at this point. The environment around them was hectic: nurses passing by ensuring IVs are in place, doctors overlooking the patient’s breathing, medical students calling an elevator for him to be transferred upstairs. But for the couple, time stood still. Her simple touch and loving words were the only thing needed for her husband in this scary situation. I stood and watched them next to one another, as she affectionately stroked his hair and rubbed his hand to make them just a bit warmer. I waited by her side until her husband was taken into the operating room. She wanted to be strong for her husband and only when he was no longer in her sight did she let her emotions take over. She sobbed as I hugged her. She asked me to help her dial a number on her cell phone. Her hands were too weak.

Weeks after the incident I came to know that this man has fallen into a coma. Palliative care has been advised for his family and hopes re-main low. At times, I wonder about his grand-kids who can no longer play with their grand-father, about his children who come to see their loving father in such a helpless situation. Lastly, I wonder about his wife who is most surely fighting and hoping for his recovery. I try to hold back the tears remembering that hectic day. I realize that a clear and concen-trated mind is key for any medical profession-al, but emotions are the true humanity that elevates a patient from a body to a loved one.


Crimson Red ShirtsAnonymous Author

I wanted to leave, to run away and never look back.But I stayed.I stayed because everyone else left;The nurse with the warmest smile,All three of your doctors, your father and then your mama.

When you told me of how an angel had wrongfully taken your father away,Flashbacks of my father’s death flooded my mind.I looked down at my crimson red shirt, and said ‘look, you’re doing well’

But I knew damn well, that you never forget.There are five stages of grief,but I’ve discovered a sixth;Bearing tainted memories everyday.

These memories welcomed new alliances;Alcoholism, depression, anxiety.I saw you fighting, but in some battles even ninjas need love.

I told a nurse about you.She reached to phone the CPEP consult, she swiftly asked‘Is he suicidal?’‘No, not at the moment, he’s been to CPEP once before.’‘Oh, then there is nothing we can do’

There is nothing we can do.

I wanted to leave, run away and to never look back.I couldn’t dare tell you, I couldn’t become another bearer of failed promises.But I stayed.Sometimes all we can give are crimson red shirts.


RewrittenAlexis Nduka

“VOLUNTEER TO TEAM 2. VOLUNTEER TO TEAM 2,” the voice echoed overhead.

I walked up to the nurse who was putting the speakerphone down.

“Hi, I’m a volunteer. Did you call for a volunteer?” I asked her even though I knew the answer. “Yes, take the patient in room 4 to the 17th floor west,” she replied. “Ok, thanks!” I said with a smile. The nurse handed me a large mustard yellow envelope and turned towards her computer.

I walked into the isolated cube-shaped room and saw a thin, frail woman. She stared blankly at me as I opened the door. I looked at the yellow envelope to see the patient’s name. “Betty?” I asked. She nodded her head. “Hi, I’m Alexis. I’m a volunteer of Bel-levue,” I said as I elevated her stretcher to accommodate for my 5’10 height. “You’re being admitted upstairs. I’m going to be tak-ing you to your room now. Is that ok?” “Yes,” she responded. I released the stretch-er from its brake and started to wheel her down the aisle. This was my first time seeing Betty. When I previously passed her room, the doors were closed and the curtains were drawn. I did, however, notice that there used to be a young woman standing outside the room.

“Was that your daughter before?” I asked. “Yes, it was.” “I can tell! She looks just like you. She’s a carbon copy of you.”

“She does look like me, yes,” She said with a smile. Her cheeks rose and pushed up against her eyes. Despite her thin frame, she seemed full. The gray strands in her hair and dark bags revealed a fifty-year-old woman, but her bright brown eyes and eager smile reminded me of a twenty-year-old. “Is she your only daughter?” “Yes, she is. My only child.” “Did she leave?” “Yes, she has to go to work.” “Where does she work?”

The conversation continued as I wheeled her into the patient elevator. Betty spoke quietly but confidently. Whatever made her sick wasn’t getting the better of her when she was telling me about her daughter being a teacher.

“How old are you?” she asked as I wheeled her stretcher out of the elevator and down the halls of 17 west. Questions about my age were common. The most common questions, however, were “Why are you volunteering?” and “Can I get food?” “I’m 21,” I replied. “Oh, you’re young!” “Yeah, haha. I am.” I locked the stretcher in place as I passed the yellow envelope to the nurse at the main desk. “She’s in room 1735,” the nurse said as she took the envelope from me. “Ok, no problem. Thanks!”

I rolled Betty down the hall. The room was not too far from the main desk. The other patient in the room could have been my age, or younger. The patient’s family had circled her and pleasantly smiled as I wheeled Betty into the room. I smiled back as I headed towards Betty’s section by the window. The window had a beautiful view of not just a cascade of buildings and bricks but parks,


grass, and trees.

“Ok, this is your room! Isn’t it nice? You’re by the window.” I managed to put the stretcher parallel to the bed so she could slide over. “Yeah, it is. I thank God.” “Ok, do you think you can scoot over to the other bed?” “Yeah, I can.”

As I watched her slowly and painfully slide over, I couldn’t help but want to stay with her. She was weak yet determined, in pain yet strong, and seemingly in a hopeless situa-tion yet so hopeful. “Is your daughter coming back to see you?” I desperately needed to know that she would be tended to before I left. “No, she will be at work.” “Oh, right.” “She needs to make more money.” “Yes, money is definitely needed to do anything in this world,” I chuckled. She adjusted herself on the bed as I removed her property bag from underneath her stretcher. “Where do you want me to place this?” I asked. “Put it in there,” she said pointing to the drawers by her bed, “I need to use the re-stroom.”

As she lifted herself off the bed, the odor of the room changed. The muted or neutral smell that filled the room was now replaced by a smell I could only describe as violent. I could nearly taste the odor. My thoughts changed from Alexis, take your time to Alex-is, leave as soon as she is stable. I maneuvered the stretcher out of her section and took some deep breaths before returning to the room. “Can you ask the nurse for another napkin? The one under my armpit fell,” Betty asked as she walked out of

the room’s private restroom. I nodded and speed walked to the nurse. As I led the nurse to Betty’s section, I convinced myself that I would leave once the nurse started clean-ing the wound. But as I got a glimpse of the source of the odor, I couldn’t turn away. A hole, the circumference of a volleyball, was under her armpit. The hole was deep enough to see her flesh but not deep enough to see her bones. Bumps and lumps varying from the size of a fist to the size of a lychee fruit decorated the hole. The nurse quickly closed the curtains around Betty’s section. “I’ll be right back,” the nurse said as she dashed out the room. I couldn’t resist want-ing to know more about her condition.

“What did the doctors tell you that you have?” I asked. “Stage three breast cancer,” she said as she looked at my eyes. Her tone was sure but distant. “When did you start seeing the symptoms for this?” “I went to the doctor in November. He gave me an envelope with the information in it. And I showed it to my daughter, I sent her a picture of the paper. And I didn’t really understand what the paper said, so I started looking up the words. And I found out it was cancer. And she called me, and she told me she was looking up the words, that she thinks it says cancer, but I already knew. I already knew.” “Did you start receiving treatment then?” “No, no money. No money. I don’t have insurance and it’s expensive to get the sur-gery done.”

She stared at me. I could not tell if she could see my eyes getting red or beginning to water. It felt as though she was staring at me, looking past me, seeing through me, seeing my thoughts and ignoring them all at once.


“So what did you do from November until now?” I asked. “I changed my diet. I stopped eating meat. I hear it helps.” “Are you sure you don’t want your daugh-ter to come?” “Yeah, I am sure, by God’s grace I am fine.” “Amen,” I responded. I don’t know which one of us found more peace at the mention of God, her or me.

The nurse came back with a mask, gloves, gauzes, and tape. I tore the package from the gauze and passed it to the nurse. The nurse stuffed the large asymmetrical hole with gauze and then covered the hole with more. She then wrapped the tape from around Bet-ty’s armpit to her back. Temporary fix.

“Can you fill my water container, please? I’m thirsty.” “Of course.” I grabbed the gray container from the top of her desk. The nurse pointed me towards the supply closet and gave me the code to open it. I went in the room and calmed myself down as the water filled the container. I closed my eyes and told myself not to cry, not to tear up, and not to feel for a couple of minutes until I left her presence. Although I wanted to stay with her all day, I couldn’t. I didn’t want her to hear the crack in my voice as I talked. I came back with a full jar of water. “ Is there anything else?” I asked. I prayed she would say no. “ No, that’s it darling.” She held her cup up as I filled it with water from the container. “ I have to go downstairs now, but I hope you feel better soon.” “ By the grace of God, I will.” “ Amen, you will.” I smiled and walked away. Away from her, away from room 1735, away from the nurse, away from 17 West, away from everything and every emotion that was attached to her, and that, and it.

Later, I realized why Betty’s condition made me so emotional. Although cancer itself is an emotional topic, her circumstance reminded me of my late Aunt Grace’s cir-cumstance. Aunt Grace was really a family friend but I called her aunt out of respect. Like Betty, Aunt Grace disregarded the signs of breast cancer because she didn’t have the money. Aunt Grace was also diagnosed with stage three-breast cancer. Aunt Grace had no daughter, no sister, no mother, no brother, just my family and some other friends. And there in room 1735 laid Betty, no daughter, no son, no husband to stay by her side, just me, a volunteer. The last time I saw Aunt Grace was on a bed, at a hospital upstate. Her appearance and personality was completely altered. She was usually loud and vibrant but on that day she laid on her bed, quiet and weak. She was usually a tall, large woman but the illness made her thin and frail. The doctors told my mom that Aunt Grace was in her last stages of life. A part of me wishes I hadn’t seen her in her last weeks. She wasn’t herself on that bed. Now all I could remember was someone who was not her in her hospital bed, answering to her name. Aunt Grace passed away in 2013 due to breast cancer. I wanted the story to end differently with Betty. In place of fearing for the worst with her condition, I decided to make my own ending for her:

The hospital received a large dona-tion for which they put part of the money to pay for her surgery, and rent for the next year. She recovered faster than expected. Betty lived a long life after the treatment. Her daughter, to whom she still bears a striking resemblance to, got a promotion, and was now the principal. Her daugh-ter also received a tremendous bonus and married the love of her life, Sam. Betty went back to work, due to sheer boredom of be-ing home 24/7. Betty still does not eat meat;


she hears it works to keep illnesses away. She sings in the choir at church and frequently dances. She’s happy and after recent news of having a granddaughter on the way, first wanted to name her Peace, after her own mother, but now hopes to name her Grace… for reasons she cannot explain.

I wish this fix was not as temporary as the gauzes stuffed in her wound. I wish this fix were not just words on a paper. I pray God rewrites her story better than I have.


Up ThereSophia Song

“Chest hurts,” the patient responded, face twisting in despair. The two residents looked at each other. This was about the tenth time that the man used that answer in response to their questions. “Yes, but what about your head? Is there pain there?” they tried ask-ing again. “No. Chest.” the patient empha-sized. This time, the residents paused and discussed with each other how to proceed. They turned back to the patient and gently inquired, “Have you ever thought of hurting yourself?” It had only been a couple days working in the Bellevue Emergency Department be-fore this event occurred. Even within the short timeframe, I noticed the impact of staff being able to communicate in another language. Not only did it save valuable time by bypassing the phone interpreter, but also the patients were more responsive in their language of choice. They were visibly more relaxed and described their symptoms in greater detail. When another volunteer approached me and asked, “You speak Mandarin right?” my heart leapt in joy. I thought to myself, “I’m finally able to use my second language to assist a patient to communicate with the providers, thank God.” I rushed over to AES Team 1, eager to help. Upon entering, I saw most of the doctors and nurses seated at the team station, with one nurse placing an IV into a patient. There were six patients there that morning, so I easily identified the man who needed help on my left. My eyes imme-diately fixated on a frail, elderly man with wide eyes and sunken cheeks. I saw him ly-ing on a stretcher with a Neurology resident

standing beside him. His skin showed telltale signs of extensive sun exposure and his slen-der frame that of malnourishment. As I approached, he glanced over before quickly returning his attention to the resident. The resident quickly explained to me that the man did not have a comprehensive medical history. Usually with these types of cases, the hospital would call the patient’s family and friends to collect the missing information, but he had no one. She was called as a consult because the records suggested that he had a stroke over two years ago. She was there to access the patient’s neurovascular condition and discover the reason for his visit to the ED. To the best of my ability, I translated the provider’s questions. However, the patient’s terse answers seemed to always steer towards his immense chest pain. He could not elabo-rate on the pain, just that it was agonizing. It seemed as though he understood what I was asking, but couldn’t communicate a complete answer other than the immediate source of his distress. The neurologist finished her exam and only had enough information to confirm a past stroke. I left with the resident, feeling somewhat underwhelmed with the use of my second language. I thought that I would be able to help uncover the problem, the phy-sician would come up with a treatment plan, and it would be a case well done. Periodically, I popped my head back into AES team 1 to check on the man, only to see him balled up underneath the white sheets. He was so slim that had I not been there earlier, I would have assumed that the patient had de-parted and left behind a mountain of sheets. Near the end of my shift, I checked in again to see two medicine residents by his bedside. Once again, I ventured over in hopes that I could help. I was too late this time; they had already called the phone interpreter.


The residents conducted a similar interview to the Neurology resident, with similar responses from the patient. Although he was incapable of fully explaining his symptoms, his eyes told of desperation, seeking relief from the pain. In a way, he was trapped in his body, with only his eyes relaying his desire for freedom. The residents realized that they could not get far with the standard interview questions they were asking, so they switched gears. They started asking if he had ever thought about ending his life. This question made the man pause and contem-plate his answer. After a little more prod-ding, he finally confided that yes, he often did. He attempted to jump off a building two days ago. He wanted to go “up there” and be in peace. He didn’t want to feel this pain anymore, didn’t want to be alone anymore. Standing by, I felt an overwhelming amount of heartbreak for this man. He had no one to share his pain with, and thought death preferable to his lonely existence. This could have happened to anyone who lost his or her memory due to a stroke. It easily could have been my brother, my grandfather. One of the residents took the man’s hand firmly and reassuringly stated, “We will help you.” They repeated their promise until the man’s shoulders slightly relaxed. He nodded his head in understanding and gratitude. He still may have been experiencing chest pain, but his eyes became more tranquil in nature. The comforting touch of another human changed the patient’s demeanor from one of agitation to trusting. It was in this instance that I understood that practicing medicine encompassed more than just addressing a patient’s physical concerns. The resident eased the man’s pain by simply assuring him of their support in his journey to a happier life. Whether the chest pain could be re-solved or not, the residents still alleviated his suffering during this visit.

Coming into Project Healthcare, I assumed that this would be similar to my other hospi-tal volunteer experiences. What I didn’t take into account was the patient population. It’s the underserved community that taught me that perhaps a physician’s greatest gift to pa-tients is empathy. This experience broadened my understanding of healthcare. Not every case is solvable, and not every patient’s di-lemma stems from a physical origin. Some-times the best we can do as caregivers is to listen and try to ease their sadness. Walking away from the man’s stretcher, I knew that he did more for me than I could ever for him. He changed my perspective of what a phy-sician should be and taught me the signifi-cance of compassion.


OdaijiniCaroline Yao

The minute Pak was rushed in from triage, he was surrounded by a bevy of residents, medical students, and

nurses. Pak thought he had the common cold before taking some cough medicine and experiencing worsening abdominal pain. A layer of sweat covered his tanned face. He clutched his front as he violently shivered under a thin sheet. “He’s febrile, diaphoretic, and guarding his abdomen. He might be septic...” “His blood pressure is 80 over 40, we need to give him fluids now...” Under the fluorescent lights, behind the blood-splattered, baby blue curtains of Bel-levue’s emergency room, residents hooked Pak up to a monitor, and attempted to take blood samples. Pak was so dehydrated that the nurses struggled to find a suitable vein to start the IV. Eventually, they succeeded and he was put on a four-liter saline drip and some painkillers. Bewildered and mar-veled, I gripped some blue nitrile gloves as I watched the flurry of action. “Thank you, you guys are amazing...” Pak forced out the words amidst his groans. The attending physician kindly smiled back at him, “No, you’re amazing. I love my job because I get to meet people like you.” Pak laughed weakly. As another volunteer and I stayed to assist Pak with drinking sterile water for his CAT scan, I learned he had taken some medica-tion that his friends recommended. I joking-

ly chastised him for not knowing what he was ingesting and bringing the torture upon himself as he laughed good-humoredly. I also learned he was Korean, but grew up in Japan. He had resided in New York with his pet dog for some time. His face lit up when I revealed my upbringing in Japan. “Do you speak Japanese?” He seemed aston-ished as I nodded. Suddenly animated, he started recounting the origins of his Japa-nese nickname as if his pain had stopped bothering him. I enthusiastically nodded at Pak’s references, feeling triumphant that I was able to provide a sense of familiarity and comfort for him 6,000 miles away from home. Fortunately, Pak’s CAT scan revealed no abnormalities, but his blood pressure was still dangerously low even after four liters of fluid. The resident relayed the need for a central line and expressed his sympathy. Pak quickly agreed; yet, his eyes darted fearfully to me as the risks were listed: pneumotho-rax, thrombosis, infection. I smiled sympa-thetically and touched his hand, which was dotted with marks of failed IV insertions. He smiled back bravely. The team of residents and medical students swept in again to prepare for the line. Before Pak was covered under the sterile drapes, he asked me to remove his flip flops, and place them underneath the bed for fear he would catch an infection from the bacteria. How silly is that request, I initially thought as I slipped the shoes off his feet. Instantly, I felt a pang of guilt. Given the risks, I would have done the same. Soon after, all I could see of Pak was the site of insertion on his neck. The whole

Editor’s Note: “Odaijini” is Japanese for “Please take care of yourself.” It is usually said as a familiar parting phrase

by the caretaker to every patient when he or she leaves the hospital.


procedure was understandably detached. Lidocaine, ultrasound, needle. The resident painstakingly inched the needle forward un-til dark blood aspirated. The atmosphere was tense and the half-dozen staff were quiet, save for an occasional groan and squirm that reminded me Pak was underneath the blue sheets. Like an anxious, invested fan from the sideline of a game, I worriedly peered at the ultrasound--- a jumble of black and white pixels I could not comprehend. After straining my neck for some time, I finally breathed a sigh of relief as the resident suc-cessfully inserted the guideline and the cen-tral line into the vein, then placed a couple of sutures. The attending came by to congratu-late Pak on his good work. Eventually, Pak’s blood pressure rose, and he felt much better. As our shifts came to a close, the other volunteer and I said our goodbyes to Pak. Looking at both of us with sincerity, he heartwarmingly remarked, “You are like angels sent from heaven.” The other volun-teer and I grinned embarrassingly at each other. Inevitably, a tinge of regret crept into my mind: it was too bad that I could not stay and confirm his recovery with my own eyes. I gave Pak’s hand one last lingering squeeze, then left him to video chat with his pet-sitter and dog. Pak is forever etched into my memory not because of the severity of his condition or the complexity of his case, but because of his strength and positive attitude in the face of life-threatening disease and a painful medi-cal procedure. He arrived at the emergency room in excruciating agony, yet he made his appreciation for the doctors known, expend-ed his energy engaging with the volunteers, and even remembered his dog. Despite his fear towards the procedure’s uncertain outcome and being stuck by needles more times than I could count, Pak courageously

faced the central line that would cause more discomfort. Through his openness, he gave me an invaluable lesson on how to confront adversity. He showed me, as a volunteer, the significant difference I could make for a patient, no matter how dismissive my role seemed.

Pak’s case also gives me hope. Too many times, I have witnessed frustrated residents call for beds upstairs for patients who need-ed to be admitted, and disgruntled patients trapped and hungry in the emergency room because of delayed test results. Too many times, I also have seen residents shake their heads at the homeless patient that had walked in for the third time that week, and nurses running short of patience with the patient who repeatedly demanded to eat or leave. As those instances chipped away at my idealistic vision of healthcare, Pak’s case renewed my belief in the efficiency, sensitiv-ity, and compassion of Bellevue’s emergency staff. His care showed how quickly Bellevue’s staff could come together to resolve a critical situation, and how much the staff not only cared for their patients’ physical health, but their mental and emotional well-being as well. I wish you well, Mr. Pak, and I would like to see you sometime again to see how you are doing. But in the likely chance that we never meet again, I just wanted to say: “Odaijini and arigato, Pak-san.” to make up for our premature farewell.


Grammar SchoolKevin Wang

Once again, the world’s spinning around me. My head is throbbing. It’s a dull ache that persists, suffi-

ciently pulsating through my head to set itself apart from the usual, one I’ve learned all too well to live with. It’s almost as if I’m pulsing with it, drifting in and out of sleep as it breathes poison through my bloodstream, gnawing at whatever’s left inside of me. But it really is most tranquil, me in my state of God-knows-where, knowing that there’s enough of me left to feel what a drink or two of refreshing booze can do to bring you back to life. The usual ache feels different though, deeper and darker. Much like the unknown creatures lurking in the perpetual night of the ocean depths. It’s too deep for me to reach and grasp, for me to do something about it. I didn’t ask for them to hop aboard my ship, only to sink me into suffocation. Many times I’ve tried, more than anyone here would care to believe, to wrestle my way out of their looming presence. It’s like swimming underwater towards the sunlight

shining through the water surface, only to find that it’s no more than a mirage. One you imagine ahead of you. One you can keep swimming towards, but will never seem to reach. I’ve lived too many years plagued by their low, rumbling sounds that never cease to remind me of their unsolic-ited company alongside me. It’s a different kind of ache than the one that’s in charge for the moment, but they’re both just as tangi-ble. But did I say it was a drink or two I downed? Jokes on whoever—because that pathetic amount wouldn’t have sufficed in the slightest. Not enough to bring me to where I am mentally, not enough to bring me to where I am physically. So whatever it was I put in me, it did what I needed it to do. Back to the hospital. Of course. The officers probably saw me slumped over on the edge of the streets, looking my best as always. And then they’d roll their eyes, even farther back than they did the last time they saw me, and make no effort to conceal their groans as they haul me into an ambulance. My money’s also on them making a joke out of me; heck, I’m probably still the laughing stock on the tip of their tongues. Here he goes again, they would say, laughing on as if I don’t hear them mocking me. Not like they’d give a shit if they knew I’d heard. But not like I really give a shit myself, anyway. It really isn’t much different from the looks I get from passersby on a daily basis, if I even get one in the first place. An odd amalga-mation of pity, disgust, repulsion, conde-scension, and, every once in a blue moon, a sparing dash of sympathy. Bottom line: I’m used to it. The only difference is that the officers wear it on their sleeves, fitting right there along with their badges and fancy stripes, serving the glamorous City of New York. Minus me, of course, the patron they all could do without. But on the flipside, it’s perhaps quite the honor, frankly, to be a fervent topic of conversation. I almost forgot

Author’s Note: This short story is largely a fictitious interpretation of an interaction I had with a patient living with homelessness. I garnered what I could of him through our conversations, but his character and backstory are based on fictitious narratives of my own. That said, I would like to make transparent my incapacity in truly writing from the patient’s perspec-tive, who is in a situation far less privileged and far more precarious than my own. I have no intention of projecting a self-righteous understanding of his plights and circumstances onto him, nor of supporting any negative stereotypes associated with homelessness. On the contrary, I wish to build a full character and inner voice as a testament to his humanity—one that ex-tends far beyond his struggles. Our interactions were simple, but they struck me powerfully and evocatively, and thus motivated me to harness fiction to convey my reflections, but presented through the patient’s perspective.


what that felt like. I open my eyes for the first time in a while to see the regular hustle of the emergency room in full force. I know what ‘regular’ is, just as well as anyone who works here. After all these visits, I can afford to call myself an expert too. It seems that I’m in the hallway this time, under the close compa-ny of figures dressed in all colors, moving briskly with such purpose in all directions around me. There are lots of blues (blues of all shades, in fact), as well as greens, blacks and reds. But it’s all really a blur at the mo-ment, and my headache soon takes over to seal my eyelids shut again. Let’s put that head back onto the bed, it demands. It’s somewhat comfortable. Suddenly, the senses of my body, probably worn out from the alcohol, finally catch up to my fleeting awareness, shaking me into lucidity. Its urgent message: I des-perately need to take a shit. I am also fam-ished, my appetite escalating with my hang-over. I sit up clumsily and lay eyes on the first uniformed person ahead of me. Proba-bly a nurse, but I really don’t care. “I need the bathroom,” I croak. “What do you want?” she says with a look of annoyed confusion laying bare across her face. She probably didn’t under-stand what I said, and I wouldn’t blame her. I struggle to understand myself most of the time as well. “I need the bathroom,” I repeat, with more success. She lets out an unrelenting sigh and looks beyond me, seemingly at someone else. “Volunteer, I need you to take him to the bathroom.” Moments later, a young man in an oversized, bright-red shirt shows up in front of me. He looks younger than most people I see here, but who knows. I repeat my request to him, pointing at my legs to indicate my difficulty walking. Partly actual difficulty, partly my own laziness, but who needs to

know? He nods with a faint smile, and dis-appears behind me to wheel my bed towards what hopefully is the bathroom. I fade out briefly, drifting back into my comfort.We stop in front of a door and he appears again. “This is the bathroom, sir,” he smiles, offering a hand, “do you need help walking to the toilet seat?” I nod without a sound and start shuf-fling down to the edge of the bed, stripping myself from the precious comfort of my sheets. It’s tiring and sore to move myself across the seemingly endless bed, especially with weak legs that barely support my sober self. After what seems like eternity, and pos-sibly even longer for the volunteer waiting with his hand outstretched, I land with my feet onto the floor. He grabs me by the arm, with his hand concealed in the typical blue hospital glove, and paces into the toilet with me. I reach the toilet seat (at last) and down I sit. He stands back quietly and stays with me, lest I fall, I guess. As I pull down my sweatpants, I notice streaks of my excrement smothered across my legs, again. It doesn’t feel particularly great at all, but I can’t say it’s the first time I’ve found myself laced with a foul smell and sight that repels others. Per-haps that’s why he’s so quiet, discreetly trying to avoid inhaling the noxious fumes I reek of. Personally for me, however, nothing new. Its surely nauseating odor escapes detection from my nose entirely. Not even the slight-est slips through, after all these years on the streets of New York. I mean, if you can still smell your own home, you probably haven’t lived there long enough. As I wrap up and stand myself back up again, pressuring the legs that threaten to give way any second I stay upright, he comes to my assistance. We wobble back to the stretcher, taking each step generously. What’s the rush, anyway? Where have I to go? What have I to do? Beats me. But I ask myself that everyday. “How are you feeling, sir?” he sud-


denly asks. The word “sir” always confuses me, because it conveys an empty and decep-tive sense of respect devoid of actual feeling. But I haven’t seen him before. He’s smiling, or at least trying to, which I guess is effort enough. “I want food.” I retort. My hollow stomach kicks me again, aggressively de-manding sustenance. It knows we’re at Bellevue again, and that the food cart is just around the corner. “We’ll get you some food as soon as I bring you back to where you were,” he reas-sures me. “My name is Kevin, by the way. I’m one of the volunteers here today.”Not everyone introduces themselves to me anymore. Not the doctors, not the nurses, and most definitely not the officers who approach me on the street. But, really, it’s the least you could do sometimes. “I know a Kevin,” I reply. “Really? How do you know him?” And with that, distant memories I forgot I still had began washing over me, as I’m briefly sent back decades through my life. All of a sudden, I am my innocent, prepubescent self again, barely independent, but somehow far more functional than I am today. It was the grammar school recess area, the one I’d rush to with my friends whenever we got the chance to. Nothing like the stuff they have these days, but definitely enough to house many episodes of pleasant memories that are all coming back to me now, after years of isolation in the unknown caverns of my head. There had been a rusty hoop poorly nailed into a wall, but somehow sturdier than it appeared. It was most surely the center of action each day, when we’d run in dribbling an old basketball we found on the streets, like typical kids filled to the brim with constant energy. Kevin was one of my first friends entering grammar school, and we stuck through many years as close friends and (sometimes more importantly) as bas-

ketball partners, always on the same team. We weren’t incredibly athletic, but we were damned fantastic at a unique sense of syner-gy and teamwork that rivalled the biggest and fastest of players. And that specific moment I was taken back to was the first three-point shot I made at that old, rusty hoop. Being rather short as a kid, I compensated for my physical disadvantages with tenacity, along-side Kevin. But that day, he shot me a pass and I, without a second thought, went for it. Not a swish, but it hit the wall above the hoop squarely and firmly, producing the most bril-liant thud, and then landing smoothly into the hoop. Kevin jumped up to me in cheer and elation, hand raised as I prepared for the painful high-fives he’d give me in sheer excitement. But the pain was a beautiful one: one of accomplishment, one of pride. And it was but one of the many moments we’d shared together in our grammar school years, before we parted ways. This was the first real lesson of how things don’t always end up the way you expect them to, which is a conclu-sion I’ve come to experience time and time again, in all shapes and forms. The typical warm, fuzzy feeling fills me as I step out of that memory. It’s a feeling with which I’d lost familiarity over the years. But it’s one reserved exclusively for memories like these. A warm, fuzzy feeling that alcohol couldn’t even begin to rival, I must grudg-ingly admit. Because sometimes memories are all you have left. And they bring you back to different times, better times, and keep a dwindling flame inside you burning on. “I knew him from grammar school,” I respond, as I shuffle back onto the bed. I take my time as my limbs grow even wearier, but I don’t quite feel it as much anymore.It was a brilliant memory, but I stopped myself from saying more. I’ve since learned to keep these memories to myself. Not that anyone would care about some stupid, cliché childhood story from me anyway, when they have all these other people they could be fas-


cinated by. People who’ve been places, seen the greats of the world, and changed lives for the better. With people caring less and less about me, I’ve learned to offer likewise.But more importantly, they’re what I have to myself and myself only. And even in the absence of everything else, it’s what won’t tarnish with time, even in the most unfor-tunate of imaginable circumstances. No one can take it from me, and no one can under-stand it the way I do. In this insurmountable mess I’ve been a part of for too much of my life now, I deserve to have this of my own. Of course, the other reason is having no desire to bear the emotional weight of dwelling on these memories any further. What al-ways ensues is the psychological turmoil of self-questioning, asking myself about what could have been. Would I have done some-thing differently back then, had I known my fate? What did I do wrong? Is this even my fault? Like so many others, including the innocent-looking volunteer standing before me, I began life with a decent child-hood, playing, laughing, crying, living. What changed for me, and not for anyone else? And do those people I shared paths with, the Kevins I once had, still remember me? I don’t want to know the answer. I don’t care, or perhaps I don’t want to care, if he still remembers me or not. I have no feelings nor capacity left to handle the empty answers to these questions. I’m long past that. So for now, this Kevin in front of me seems like he cares a little more than the others, so he’ll have to do. He responds enthusiastically as I take refuge again in the comfort of Bellevue’s hospital bed, but frankly I am losing track of his words. My lethargy and the traces of al-cohol still running through me are taking me back into tranquility. I’ve grown sick of them telling me about how alcohol is dangerous and toxic. It can ruin and kill lives, they say, reading from some overused script, standing on their self-righteous pedestals. What the hell do they know about ruined lives? It’s the

only damn thing keeping me alive for all I care, and it clearly works much better than some fancy, mumbo-jumbo medical proce-dure. As if I could even afford it in the first place anyway. But I’m back behind my eyelids, drifting through the limbo that offers an elusive island of peace unavailable to me anywhere else. It’s almost if I’m back in my grammar school days, before the diver-gence of different lives took hold of mine. I vaguely remember returning to my original hallway position, and being handed some much-needed food in the usual paper bag. I probably finished it all and asked for more, knowing me. For once, though, my stom-ach is at peace, so I guess I wolfed down the food so quickly it escaped my notice. I sink back into my bed, and nothing else matters for now. Not the soreness of my feet, not the offensive stench I carry, and most definitely not what happens next once they discharge me again. And for these brief moments in the uncertainty that is my life, I feel some sense of calm, as the world continues spinning––around me, with me, or without me.


To ProcessNathanael Rehmeyer

I entered Bellevue at 5:50 pm, knowing I had just enough time to get changed and sign in, to start my 6 to 11 PM

shift in the Adult Emergency Department. I felt tired but was looking forward to the normal shift and the additional one from 11:30 pm to 2:30 am afterwards to shadow my resident mentor. But I was not nervous. By week eight I knew how the Emergency Department functioned and my role in it. I was prepared to talk to patients and poten-tially bother some residents as they worked. The volunteer I was replacing pointed out a young man on a stretcher in the hallway and said, “Go talk to him; he has an interesting story.” Seeing that nothing needed to be ur-gently done on the rest of my side, I headed over and started a conversation. It was a great interaction as he opened up about his life. His story is powerful but not the point of this piece and I do not think I have a right to share it anyways. However, it was the family in the room behind his stretcher that compels me to write now as I continue to process. I first noticed an older woman walk into the Emergency Department with two children at the beginning of my shift. I rarely saw children here. They really did not belong in the fast-moving and sometimes aggressive environment of the Emergency Department. It caught my eye and I watched as they en-tered the room next to where the man and I were conversing. The isolation room, as it’s called—typically reserved for infectious patients is separated from the rest of the de-partment. However, it was being used today as overflow and held an elderly gentleman in obvious pain. I was already with a patient, but I observed other volunteers bring the

family chairs. The girls seemed bored, so I made a note to go get them some books and activities, when they finally discharged the man I was with. After about an hour when the man left, I went to search for the books in the Pediatric Emergency Department. There was an awkward moment when scrambling through the books, I wondered what pre-ad-olescent girls looked for in a book. I played it safe, grabbing a Guinness World Records book from 2014, a word puzzle, and an Ar-chie comic. The girls were elated and quickly turned their focus to flipping through the records and finding words. Congratulating myself on a job well done, I gave them space to read and headed out to do other good deeds. I returned soon after, excited to see how they were doing. I love working with children and my favorite shifts are in pediatrics, so I was ecstatic to be able to interact with some in the Adult Emergency Department. They started sharing about the records they had found and ones they would like to beat, as well as words they had cir-cled. The girls seemed excited to have some-one to talk to and in a rush I learned they were vacationing in the USA from Ecuador. I got detailed information on the drama at school and when it was starting again, much to the girls’ disgust. In addition, I learned that the girls were cousins, the woman was their grandmother, and the patient was their grandfather who had fallen that morning. The grandmother injected bits of infor-mation here and there but otherwise just laughed at the interactions between myself and her grandchildren. The grandfather returned from a test and I left again with an enormous smile on my face, fueled by their energy. Later on, a friend in the city came to pick up the girls for the night and I walked them out. We said goodbye and on the way


back I remarked to the grandmother that she had wonderful grandchildren. I finished up the normal shift and started the shadowing shift without any further interaction with the grandmother or her husband and put my attention to watching my mentor put in a central line. It was near 2 am, the end of my second shift after eight hours in the Emer-gency Department, and I was thinking about heading home. Suddenly, there was a lot of movement in the department. Nurses and physicians were rushing in one direction and one called for my mentor to follow. We head-ed towards the isolation room as alarms rang out across the floor. It seemed like an endless stream of doctors and nurses were cramming into the tiny space. I prepared myself to follow my mentor in and shadow whatever procedure they were doing. That was when I saw the pumping motion, the visible sign that CPR was in full swing, and the flat line on the monitor. My heart sank as I saw her, the grandmother, slumped against the wall outside the room, trembling, and ignored by the rush of people trying to do their jobs and save her husband’s life. My mentor ran in and motioned for me to follow but as I nod-ded, I knew I had to stay with her. I went up and put an arm around her, whispering, “It is going to be alright.” I ran and got a chair for her to fall into and she thanked me. I put a hand on her shoulder, unable to say any-thing else. I knew we were too close and she should not be there, but I was frozen. Help-less in the noise and flow of people. I peeked into the room, unable to see the man behind the swarm of physicians, and held back tears. Someone eventually noticed her and asked us to move down the hall. I found her a chair and heard he had a pulse was intubated. I excitedly shared the news. After that it seemed like an eternity of me standing in stunned silence and her slouched in a chair, eyes downcast. I wracked

my brain for something to say. Something to take the pain away, distract her from this terrible situation. I was screaming at my-self to do something, but continued to just stand there. She eventually pulled out her phone and started showing me pictures of her grandchildren. We talked about Ecuador and her family. She spoke about her husband going to college in the USA and that he still worked in Ecuador because he loves his job. She invited me to come visit anytime. and I mostly listened as she shared. They stabilized her husband and pre-pared to take him to ICU. The grandmother received a call from her daughters so I went over and helped change him. I went up with the transport team and carried the family’s bags. Upstairs, I said goodbye and wished her a goodnight. I wanted to say something helpful and profound. Something to lift her spirit as she stood there alone by her husband’s side and let her know I would be praying. But I froze up again and the mo-ment passed. When we returned downstairs, I looked at my watch and saw that it was 4:30 AM. I thanked my mentor for the experience and he mentioned to take time to process as these things can be really hard. As I slowly trudged home, feet throbbing after standing for ten and a half hours, I felt emotionally numb. Unable to grasp the events that just occurred. In the pre-sunrise darkness I passed by quiet buildings and empty streets. The city that never sleeps, seemed to be tak-ing a moment of silence with me. I entered my building, collapsed into bed, knowing eight hours later I would be back at it, ready to go again.


StrongerHaley Barravecchia

I see youCovered in bruises, blood, iodine stainsBundled up, under thick white sheets I smell youThe alcohol swabs and packages of candyAll opened, all tasted, as if you were looking for somethingBut were never quite satisfied They say you have lupus,I lost my best friend to that. I hear youBetween beeps of monitors,Dreaming of what you would do ifyou were ever healthy again. A beach. Crystal blue waters, and peach colored toe nailsPlaying in the white crunchy sand.That is where you long to be.

But you will never lay in the sun They say you have lupus,I lost my best friend to that. You show me photosOf who you areof who you werebefore you had lupus I cannot recognize youBut I know you are not this diseaseNor should this disease be you.


I meet your mom,and your best friend.I was there when she called to say she was pregnant.

They know who you are outside of the white gown,away from the tubesand lullabies of the monitors. They say you have lupus,I lost my best friend to that. When you are finally sent homeA few days laterI paint my toes peachAnd go to the beach

Maybe I will see you there one day. They say you have lupus,But I know you are stronger than that.


Code BlueAnonymous Author

I entered AES (Adult Emergency Services) and immediately noticed how busy it was, which I’ve heard can be rather

normal for a Monday. With seventeen to twenty-two patients per team, it took a while to navigate in search of the person on the previous clinical aide shift, a shift designated to shadowing physicians in the Emergency Department. I soon learned that I would find the outgoing clinical aide volunteer in the trauma slot. Given past lectures about volunteers overcrowding the trauma slot, I questioned whether or not I should go in. I decided to enter, though with little idea of what I was walking into. When I walked into the room, one trauma case was in the process of dispersing. The other was just the opposite. There was a huddle of twenty or so people around the stretcher, many of whom were involved in some way or another with the performance of CPR. There were pulse checks, rounds of epi, and deliverance of shocks. All things I had either learned in CPR certification or heard of elsewhere but had never seen in front of me. This was all in an effort to save an 83-year-old man with dementia who was in cardiac arrest. Technically speaking, though not something I processed in the moment, this man was already deceased the whole time I had been present. Watching this resuscitation effort, I noticed and felt things I would not have expected. There were sounds and creaks, maybe from the cracking ribs or movement of the body on the backboard. There were unpleasant odors. In the moments when compressions were halted or exchanged, I noticed the

concavity of the chest that may have been caused by broken ribs due to CPR. It was difficult to observe so many people taking turns pressing hard and fast on the fragile chest of a lifeless body. There was one resident directing the chaos: which probably was not chaos at all, but it seemed like that to me, having no other benchmarks to compare it to. There were two attendings amidst the slew of people, asking for updates along the way. One attending reminded the resident that after this much time—about 60 minutes after onset of cardiac arrest—even if a heartbeat was restored, brain activity would not be regained. The other attending brought in the family, who were rather calm despite the circumstances. This gesture was done mostly to show the family that all efforts had been made to resuscitate their loved one. Though calm, they asked many questions that could not be answered at the time. When the family walked in, this patient, though lifeless, became more human to me. Throughout the code, I stood very still, gripping my hands together as if to hold my own hands. I had been nervous about this moment or type of situation for a long time coming, probably about seven years, with varying intensities. Anxiety about death is not necessarily common for a twenty one year old, especially when it sets in at the age of thirteen. Though for children who face the trauma of childhood disease and/or serious surgeries, like me, this may not be the case. In my case, the likely trigger was open-heart surgery at thirteen. Thoughts surrounding the transition from life to death—of myself, my family and friends, and strangers—pop into my head more frequently than I would like. They can


be momentary considerations or can span minutes that feel more like hours. They can occur at the strangest of times or times that seem more relevant. Back in the trauma slot, it is no surprise that these thoughts started to resurface. But I stood gripping my hands to help myself be as present as possible. I did my best to put aside the fear and instead focus on the realities that were occurring in front of me. Once the family had left the room, it was time to call time of death. Only v-tach had been detected. All other life signs pointed towards death. Time of death was called at 13:21 and all measures at resuscitation ceased. The commotion quelled and quiet lingered in the area. One attending stepped out to tell the family the news, though they had seen the dire situation only a few min-utes prior. It seemed that members of the team were still processing this event, yet there was immediacy towards getting back to busi-ness. In other words, there was a quick shift from providing life-saving measures towards a debrief in which the team discussed the medical situation of the officially deceased man and how to improve the leading of a future code. Though this transition was rather sudden—so sudden that the patient was still lying lifeless only a few feet from the conversation—I appreciated and under-stood the movement towards practicality. The discussion centered on concepts that I may not medically or scientifically know but could conceptually understand, unlike death, which to me is incomprehensible. Before long, all of the doctors headed back out to AES, likely to be bombarded with thirty more tasks and requests from patients and staff. Practicality and getting back to

business was at play once again. Not much time left to process the emotional aspects of the situation. For the remainder of my shift, I tried to get into the mindset that many of the residents seemed to. To package or suppress my feelings for now, until I was in a place and time where I would be ready to reflect on the situation. Even a week later, I have yet to fully examine or sort out this experience and my lingering emotions surrounding it, yet I know that I am appreciative of it. I am grateful that the first person I saw pass away was not a loved one, though that does not mean I don’t feel sadness for the nameless man whom I saw die. I am relieved that I got to experience my first code as a passive observer, with no responsibilities towards saving or providing care for the patient. However, in the future, being educated and experienced may help me make sense of the harsh realities of cardi-ac arrest and other fatal conditions. My hope is that this experience has, in part, prepared me to manage the emotions and fear that will no doubt be present when it comes time for me to actually participate in life-saving measures and have responsibilities towards my own patients.


ThankfulAmira Cohan

It has been a while since I have written about my past weeks at Bellevue. The summer is flying by, and the weeks run

together especially when I have weekend shifts. However, aside from the whirlwind of a schedule, my time here is only improving. I have adjusted to the hospital and its staff and from them I have learned such a great amount. I have met great people: both pa-tients and providers. When I think back on the past six or seven weeks I feel extremely lucky to have been chosen to be part of Proj-ect Healthcare. I feel extremely privileged to be allowed in all the areas of the hospital and to lend a hand, whether it’s assisting with a task, bringing a patient food, or simply extending my ears as a listener. I no longer worry about making sure the conversation flows or continues because I am confident that it will go on naturally. Which, is proof that my interpersonal skills have improved greatly. I now am able to talk to anyone and have found myself more willing to engage with people on the street or those around me, even when I am not at the hospital. It is hard to think about how only three more weeks remain, and I am reluctant to see my role here this summer come to a close. I will try to engage with the community in Boston when I return to school but it will not be the same. Bellevue is an extremely special place – and I don’t know of any other hospitals like it.

I consider myself very observant. When I am not talking or occupied with a task I

am watching. I consider this a skill because I notice little occurrences and if some-thing I see is concerning I will vocalize my thoughts. I believe attention to detail is very important, especially when working with

a puzzle that has so many pieces. When a patient enters the emergency room it is very important to do a well rounded work up to make sure no medical issue or root problem goes unnoticed. I am fascinated by just observing AES, watching how the patients sit or lay in their beds, watching how the staff interacts, and watching people come and go. One afternoon in AES around four o’clock an older woman came into the center of Team 1. She was brought in by an ambulance because she had fallen on the street. As she lay in the bed bleeding pro-fusely from the cut on her forehead doctors and nurses filled in around her. She had no family with her and I could tell she was not comfortable. I noticed that she was reaching her hand out toward me even though I was far from her at the foot of her stretcher. I looked around to see if any of the providers or medical students that were beside her would take her hand. No one seemed to notice it. Immediately I wedged myself in between the medical student and the bed and grabbed her hand. She took my hand and held it tightly. I held her hand until the end of my shift that afternoon and when it was time for me to go I passed her onto the next volunteer to make sure she did not have to be alone. After, I could not help but think about how nobody noticed or thought to grab her hand. I vowed to myself to never forget how something so simple can help a patient so much. More recently, I have left my shifts feeling like I really made a difference. I feel like my role is so important. I do not need the pa-tient to thank me or let me know I was help-ful, I can tell on my own, by the tone in their voice or if their body language changed, that my presence was appreciated and made their time in AES more tolerable. I am thankful. Thankful that I have always had good access to healthcare. Thankful for


my family members who support me. I am thankful. Thankful to be able to be a part of Project Healthcare. Thankful for my coordi-nators and supervisor who work so hard. I am thankful. Thankful to be given the ability to work in Bellevue. Thankful to have met so many people from so many places. I am thankful. Thankful to have learned. Thankful for the ability to make a difference, no matter how small. Thankful that the help I offer is so willingly taken. I am thankful. I am thankful. I am thankful.

WednesdayRachel Marks

It was on a Wednesday when I saw my first death. I walked into the emergency room at 8am, my drowsiness quickly

falling away as the now-familiar smell of an-tiseptic wipes and hospital food washed over me. People claim that hospitals smell like illness and death, but over the course of the summer, it had become one of my favorite smells. Team 1 had only a few patients on it when I arrived, two of whom were still deep in sleep. The only awake patient was a wom-an who looked to be in her early thirties, and was clearly not too thrilled with being in our ED. I went over and started talking to her, trying my best to distract her from her pain. I discovered that she was twelve weeks pregnant, and that she was on a business trip to New York when she started feeling sharp pain in her abdomen and decided to come to Bellevue. After a few minutes of chatting and even a few smiles from my patient, the overhead speaker interrupted us with a loud and clear “cardiac arrest, Team 1”. My heart jumped, as it does every time my team is called to the trauma slot, even though as a volunteer I have no real responsibility laying on my shoulders.

I followed the doctors into the trauma slot, which was already crowded with nurses and paramedics and an unresponsive woman laying in the middle of it all. It seemed as though half of the hospital was in the slot at that moment, yet everyone was totally calm. I grabbed a pile of warm sheets and stood in the corner, gripping them close to my body as I watched the doctors take over chest compressions. They pushed down on her body harder and faster than I imagined they would. This was no practice dummy. The doctors compressed relentlessly for ten min-utes, while they shot epinephrine and Nar-can into her, in the hope that drugs would induce some sign of life. Eventually they paused to check the pulse. No pulse. And just like that, it was over. “Time of death, 8:24.” I waited, expecting a wave of emotion to pass over me. But there was nothing. No sadness, no anger, only a bit dazed at how fast it was all over. I never even saw her face. As I was standing there watching the staff wrap up the body, another trauma came into the slot, with the usual slew of doctors behind it. No one looked twice at the body. Instead, they surrounded the patient that was still alive, the heart that was still beating. Because as a doctor, as a human, that’s all you can do. Keep moving forward.It was on a Wednesday when I saw my first life. The pregnant woman from Team 1 was brought into the GYN room and a resident grabbed me on his way in to chaperone. It was always a privilege to observe a pelvic exam, because it’s such a vulnerable moment in a woman’s life. The patient was clearly frightened, nervous about the status of her baby. Although this was her third child, she had never felt abdominal pain like this before, which is why she was so worried. As the doctor conducted the exam, she winced and screamed in pain, and it broke my heart to see her so in distress. Thankfully, the exam did not reveal anything of concern. I wheeled her back to her room and layered


sheets on top of her to help her feel warm and safe again. A while later, I was chatting with her when the resident returned with an ultrasound in tow. I watched, holding my breath as the probe focused on the little being inside of her uterus. Even at twelve weeks old, it resembled a developed baby, with a round little head and a heart that fluttered rapidly in its chest. I looked over at the mother and she was grinning, her eyes shining. “Can we listen to it?” she asked. And so with me standing right next to her, she heard her baby’s heartbeat for the first time. It was a rapid collection of clicks that sound-ed nothing like the heartbeat we all have, yet it was absolutely breathtaking.In school, Wednesdays are the worst day of the week, already dragged down by assign-ments but too far away from the weekend to feel any sense of relief. During Project Healthcare, Wednesdays don’t really exist. With the unconventionally scheduled shifts, it is easy to lose track of little things like the days of the week. But for doctors, Wednes-days could amount to anything. A trauma case, a surgery. A life, a death. And that’s what intrigues me so much about this pro-fession. This is no office job where the daily agenda is sitting on your desk, waiting to be checked off. Every day is something new. Everyday has the potential to leave you with a wondrous, humbling experience.

Held MomentarilyKristen Perez

I stood on the train platform, slowly suffocating from the summer humidity and the stench of stale vomit and urine.

My phone told me that it was only 7:00 in the morning, but I still felt anxious. My first volunteer shift in the Bellevue Emergency

Ward was to start in one hour; lateness would not be tolerated. Furious at the MTA’s inability to follow a schedule, I silently chided myself for not learning how to drive sooner. After what felt like an eternity, the train finally screeched into the station. As I eagerly leapt into the metal car to be pressed against the window like a sardine, I practically wept tears of joy because reaching my destination was a possibility at that moment.

I strolled through the EW exactly one hour later, proud of myself for making it on time to my shift. However, the pat on my back was imme-diately interrupted by the commotion from the trauma slot. As I peeked through the tiny red window looking directly into that room, a team of nurses and doctors had already begun to wheel out the body of a man who was lost in a sea of blankets, blood, and medical equipment. Poor soul, I thought to myself as I walked to the nurse’s station. Curiosity infected my mind. Who was the man? What happened to him? Did he have any family? I wasn’t ready to hear the answers. I couldn’t bear the thought of being invested in the life of a dying man. Instead, I distracted myself by keeping busy with my shifts. This plan was successful up until the EW nurses received John Doe’s belongings. As they rummaged through his personal items, I could no longer contain my desire to know how the mystery man landed in the hospital. “Do you know what happened to the last person in the trauma slot?” I asked. “He tried to kill himself. Jumped in front of a train,” said one of the nurses nonchalantly. “Come again? He must have been pushed in front of the train, right? That happens all the time around here,” I stammored. There was no way that anyone could be so casual about self-harm. “No sweetie, this was intentional. Unfor-tunately, this sort of thing is not uncommon at Bellevue,” said the other nurse somberly. The temperature of the room dropped ten degrees. Even though I was wearing a thick


sweater, I felt goosebumps rise on my arm. That’s why my train was so late, I thought. The thought of someone intentionally jump-ing to their death as I impatiently waited for the D line to show up sickened me. But, he was surrounded by a team of doctors and nurses after all. Perhaps he was still alive. “It’s a shame that he died. He had such beautiful children.”

The nurses popped my bubble of optimism faster than the thought could leave my head. Shivering, I looked over the counter to see them sadly examining several photos of John Doe’s family that they retrieved from his wallet. They also discovered an NYU card amidst his other items, suggesting that Doe was either an alumnus or professor at the college.

Sensing my distress, one of the patient care technicians decided to have a long conver-sation with me about the varying degrees of injury that are often seen in the EW , the most common being suicide. I sat there and listened to her speak, unable to move. She asked what I thought about the man sleeping peacefully on the bed across from us. “He has a giant bandage around his throat,” I said. “What else? Look closely,” she said patiently.

My heart sank. His thin arms were tightly strapped to both sides of the bed, inhibiting any upper-body movement. “He tried to kill himself too?” I asked desperately. “Many times,” she sighed. “But as long as he is here, we will not allow him to do that.”When my shift ended, I walked past the bandaged man who was now struggling to maintain consciousness. “Just kill me,” he pleaded. “I want to die,” he said louder. I kept moving forward. No matter how fast I walked, however, I could not escape the chill that had permanently settled within me.

ShagotomPooja Dutta

Growing up as a South Asian-Ameri-can in New York City is both excit-ing and enlightening. My hyphenat-

ed identity offers the chance to experience the vibrancy and grandeur of both cultures, as well as its fusion through concerts by underground rappers like Anik Khan and savoring pork belly paratha tacos at Smor-gasburg’s Goa Taco. However, I have also grown aware of a concerning generational gap amongst South Asian, especially Bengali, immigrants who were unable to assimilate as well as our younger generation and as a result, were frequently misled, confused, and separated from integrating into the Western majority culture. Consequently, I have been consumed with responsibility to address these cultural and deeply-rooted develop-mental issues. Working at Bellevue Hospital has given me the opportunity to not only serve a large underserved population, but also cultivate this personal mission. I was walking around the adult emergency room one morning, peeking over at each patient’s bed to find an inviting face to talk to. I came across a middle-aged South Asian woman lying with her eyes closed, twisting and turning in bed, writhing in pain. I went up to her and introduced myself.

No response.

I mentioned that I was a volunteer and here to help her with anything she needed.

No response.

She seemed very confused and I had an-ticipated that she had many unanswered questions from this ER visit. Despite being


rejected by her a few times, I mustered the courage to ask her in Bengali if she was also from Bangladesh. Immediately, the tense-ness on her face gradually subsided and her eyes were filled with some interest. “Yes, yes! Are you from Bangladesh?” All it took were a few words in Bengali to trigger many more hours of conversation. I learned that she was here with a severe viral infection and despite experiencing serious throat pain, she seemed to earnestly power through it to continue our conversation. I learned about her long journey to this country and the great deal of effort it took to establish a foothold to sup-port her family. Her story was similar to that of many other Bengali immigrants in that it demonstrated a unique resilient spirit. She lived with her husband in a tiny one bed-room apartment in Brooklyn with two kids and they labored away several hours of their lives to send their children to college, sac-rificing many of their personal aspirations. She shared her struggles with being accept-ed in the local Bengali community and the pressures she faced from her husband’s fam-ily to be the best housewife and mother. Her eyes glistened as she described her passion for cooking Italian, Chinese, Thai, Mexican and other cuisines in addition to traditional Bengali food.

Suddenly, I was taken aback as she reached for my hand and clasped it in hers. She sounded helpless saying she had no hope and encouraged me to continue my studies and serving others. I imagined my mother and her similar obstacles when adjusting to this country. It was this same resilience that sparked her interest in entrepreneurship and led her to establish her business. I gave her ideas on how to transform her passion for cooking into a profitable source of income and encouraged her to seek resources to em-bark on this journey. Although she seemed skeptical, she was receptive and appreciative

to the help. Our conversation was interrupt-ed by doctors and nurses asking for infor-mation and drawing blood and I watched her grow more comfortable and reveal even more information as I reassured her that she was going to get the best care. At the conclu-sion of our meeting, a smile crept over her face as she said, “If you weren’t here I’d have so much trouble. You are like my daughter. You’ll be very successful.”It is often responses like these from patients that make volunteering an extremely grat-ifying experience. I was not only able to be an advocate for a lady who knew minimal English, but I worked on my personal mis-sion by trying to offer opportunities and services to her. In that moment in the ER, I lessened the gap and helped her feel safer in an unfamiliar setting. Although I could not treat her medically, it was thoroughly reassuring to know that I was able to heal her by hearing her story and trying to make her believe that her life was not yet over. She had given up half of her life for her family and I wanted her to believe that now it was time to live hers, and she was in the right place to do it. Working at Bellevue, a hospital whose mission to treat everyone and focus on promoting long-term healthy living in the underserved by providing resources and sup-port is aligned with my own. It inspires me to continue helping Bengali immigrants by helping to make their time at the hospital a more enjoyable stay and eliminating barriers to treatment such as language.


6/21Maya Graves

Today is my sixth shift, and I final-ly get it. I finally understand what the coordinators were talking about

during the entire orientation week. I finally understand how a patient—someone with no agenda to change someone’s perspective or impact someone’s day—can make you feel emotion that you had never felt until today. I think today I was consciously empathetic for the first time in my life.

The Emergency Ward is a very quiet place, which is an anomaly in Bellevue’s Emergen-cy Department. Rarely do you have anyone yelling behind a blue curtain because they want food, juice, sweatpants, or simply the attention of any part of the staff as they would like their IV to be removed. Con-versely, in the EW are some of the sickest patients in the ED that have been brought in by transport (typically a trauma) or walk in. Sickness is interesting, though. Aside from physical trauma, one can often not gauge the level of illness from which one is suffering. In my case, today, among the three patients that I spoke with, only one of them appeared “sick” as he had a gauze 4x4 taped on his neck spanning from below his left to right ear.

I came into my Emergency Ward shift mentally preparing for this to be one of the more “uneventful” or “lonely” shifts as there are no other red shirts (volunteers) on the shift with you. However, right from the get-go, Anu, another volunteer, introduced me to her “favorite patients” of the day. One of Anu’s favorites, a man named Mr. Young would soon be one of mine as well, impact-ing me more than he knew that afternoon.

A Stream of Consciousness

Although awkward at first, I attempted to build upon the conversation, and ultimately the relationship that Anu had created with Mr. Young once Anu had said her good-byes. Medically, I didn’t know the reason for Mr. Young’s stay at first as he had no visible debilitations, but after reading his chart I learned that he had fallen at home and the providers were worried about his heart function due to how out of breath he became from the smallest tasks.

If there’s anything I’ve learned thus far, it’s that you have to connect with people in your own individual way, at your own unique level, for the conversation to be both lasting and meaningful. Mr. Young and I connected through his reminiscing early life stories. I found out that he had been a part of a circus for most of his life (which I found fascinating! Who do you know that grew up as part of a circus?), and he also acted at La Mama, a theater run by a revolutionary African American woman in the ‘50s. La Mama to my surprise is just a couple blocks from where I live. I mentally noted to make it there one day and see it. A little while after chatting, I was asked to transport Mr. Young to receive an echocar-diogram. The nurse had given us the wrong location, so I was thankful that Mr. Young was so kind, understanding, and did not become frustrated when I took a couple wrong turns while wheeling him around the Hospital. After I dropped Mr. Young off a couple floors up, I attempted to spend time with other patients. One thing I have found is that, being a young African American woman, it is sometimes hard to approach men that are not quite old and also not quite young, but “father” age, as I like to see it. I don’t know why I feel this bias against them, or feel like they will not want to talk to me or will feel awkward talking to me, but I do and I am trying one day at a time to conquer it.


In order to uphold my promise to myself this summer that I would step outside of every comfort zone I have ever created and defeat all unconscious biases, I walked up to Robert. Robert was a 43 year old white male that did not look interested in speak-ing at all. But he was awake, I had nothing else to do, and I don’t regret my decision one bit. Robert was a Polish man who had been in New York City for the past 6 years. He and I initially related through his En-glish (which he considered broken but I perceived as conversationally competent), discussing first his diet habits and exercise and then moving into traveling and expe-riences. Once he understood that I wasn’t going anywhere, and that I actually wanted to talk about any and everything, he began to share with me why he was in the hospital in the first place. I still don’t know if Robert is an alcoholic or not. He was in the EW for vomiting blood over the past day. He shared that he drinks one day and then when he doesn’t feel good from drinking the pre-vious day he has another beer or two and then he wakes up the next day and does the same cycle over and over and over. This vi-cious cycle of self proclaimed therapy with more and more alcohol led to a tear in his esophagus. After speaking with the doctor, he understands that he has to change the way he thinks and handles his drinking. The doctor was worried about his liver function declining in the near future if he didn’t quit drinking. From our time speaking, which amounted to about two hours, I know Rob-ert is a smart man with a good background and I really hope he finds the strength to manage his drinking habit. I’ve never really wanted to feel hope for a stranger like this in my life before.

Empathy.

A close friend of his died 4 years ago from drinking. I hope that the memory of that and the doctor’s advice is enough for him to stop. He is lucky that he eats so healthily and is in such good shape otherwise, or his drinking may have taken a bigger toll on his body. After talking about his illness and after I made a couple of other transports with other patients, Robert talked to me about his latest girlfriend that didn’t work out because he thought she was was too controlling. From the way he portrayed the situation, he did the right thing by ending that relationship. What really upset me though was when he shared about his ex-wife and daughter that live back in Poland. He shared how he had tried to contact his daughter over Facebook and she has never responded to him. I don’t know why, but that made me distraught—I fought back tears in that moment.

Empathy?

To lighten the mood we talked about the next adventure he set his eyes upon after he divorced his now-ex-wife and left Poland. That conversation made it easy for me to control my tears as he described his new life in Barcelona as paradise. He shared how people told him that the US was paradise, but that he doesn’t necessarily agree any longer. Here in the U.S., it’s all about capi-talism and money, and from an immigrant’s standpoint, Robert painted that picture for me to understand quite well. It was weird to listen to an “outsider” describe the Ameri-can class system that he voluntarily became a part of six years ago. He stated first and foremost that it is so incredibly difficult for someone that does not speak perfect English to get much of a well-paying job. And on top of that, it is hard for someone of a different line of work to find a husband, wife or any type of partner with serious in-terest who holds a line of work with greater A Stream of Consciousness


prestige than the other. He specifically said, “a doctor doesn’t want interest in a cleaning lady and that is because of the class system.” In that moment, not only could I full wrap my mind around what he was referring to, but that analogy resonated with me in a manner that opened my eyes to the type of society we live in. I wish I would have asked Robert what type of work he did, but I did not want him to feel any lesser of a being af-ter he shared that he was nervous as he knew I wanted to go onto being a doctor. Now, after typing that, I realize how backwards of a thought that was, but at the time it felt like the right thing to do. I am not sure. I am never sure what is right or wrong in the realm of Bellevue human interactions.

Empathy?

With only about an hour and half remaining on my shift, a nurse was moving a patient from the stretcher to an admissions bed and asked me for a hand. Respectfully, I told Robert that I had duties to attend to and I allowed him to rest his “broken English” for a while. As I was finishing up that duty, the PCT next door asked me to help readjust a patient’s bed and help her put down sheets while he was in the bed. 1) Did I not only think it was impossible, but 2) I was mildly nervous to be around this patient as I had heard about him from my fellow redshirts the day prior. He, who I would come to know was named Justin, had gotten violent while attempting to hurt himself again and I didn’t want to be the next victim of pa-tient abuse. However, today, Justin was very relaxed and calm. He called me a couple names that I wasn’t keen to responding to, but nevertheless, after continuing our conversation while casually ignoring the things I chose not to hear, he proved him-self to be a kind but heavily agitated and confused patient. Justin had a huge bandage around his neck, spanning basically from

ear to ear. I soon came to find out that Justin had attempted to kill himself by slitting his throat. His mother, Julie, was also there. She was a 77 year old woman who didn’t look a year over 60. I was impressed by her strength in seeing her son in not only this state of being but also state of mind. Justin was sedated, which made his speech a little slower than normal, but he was able to hold a conversation. He shared how he knew that he had some sort of psychotic break, and that this was not the normal him. I don’t know if I was being naive to believe him, but I genuinely did. I think just accepting what patients say and not over analyzing as we are not providers is part of process in under-standing these patients. The more he shared, Justin seemed to be scared of the manner in which he was said to be acting upon his transport to Bellevue. He claims to have no memory. The PCT even agreed that what he did did not line up to what she had observed during her one-on-one observation. I think that observation was to determine whether Robert should be transported to the emer-gency psychiatric ward, but once again I am not sure. Am I ever sure about anything? Anyhow, that was that, and my five hour shift alone in the Emergency Ward was coming to an end quicker than an extremely hectic shift in the Adult Emergency Room. The next volunteer, Maissa, showed up, and I said goodbye to what I thought was a sleep-ing Justin, who in fact was not and whis-pered “Goodbye Maya” back.

When I said goodbye to Robert, he shook my hand and asked if I would be back tomorrow. Regretfully, I told him that although I would not be back tomorrow in the Emergency Ward, I would be back in the Adult Emergency Service and before my shift I would come say hello and check in on

A Stream of Consciousness


him. This was the first moment that I knew that breaking down barriers that I had created throughout my twenty one years of life was re-ally worth it. Because of the overtly simple re-quest Robert had posed, I knew that my words and my open ears had not only left footprints on my heart, but his as well. It was much harder than it should’ve been to say goodbye to Justin and now Robert, but time was ticking and I had to move onto Mr. Young.

Much like Robert, Mr. Young too asked me if I was going to be back tomorrow and if I would mind stopping by to say “Hello” and whole heartedly I said I would. Three patients that I thought would perceive me as nothing more than “the current volunteer who was doing her job” had asked me, me personally, to come back to check on them and I don’t think I’ve never felt as warm or needed as I did at Bel-levue as a volunteer anywhere else in my life. To know that these perfect strangers who I had only met five hours previously appreciated my presence and allowed me to contribute to their care in the simplest way meant more to me than I know they will ever even be aware. Although it is only my sixth day, there is one thing about emergency medicine that I know for sure—it is not for me. I do not think that I can spend time with a patient treating, caring for, getting to know and empathizing with and then just send them on their way to never see again. I kid you not, I came home and tried to find Robert on Facebook, but I didn’t catch his last name when I was in the EW and I failed to pay enough attention to the whiteboard to remember now. It saddens me to know that if these patients are discharged tomorrow before my shift at 1 pm, I may never see them again. But it also warms me to know that while I’ll never forget them, hopefully they will not forget me, either. And I hope that I changed their days in a way that made their Bellevue experience that much better. I hope I see them tomorrow—I really hope I do.

UntitledAnonymous Author

I hope God treats you well. You don’t know me but I cared for you.You, after all, were a man, just like my brother,or father.

I’m sure you have done some noble things, and some awful, whoever you were, you became a part of me, when I heard “cardiac arrest, team 3”. You were dying and I was watching. They did everything they could they said.I hope they did. I will never know you, but you will forever be entrenched in my mind.

I also cried for you. I didn’t even know your name, and I still cried.Maybe that was a sign of weakness, or strength, but whatever it was, I hope you felt my love for you. Because nobody deserves to die, as another patient, lesson, or a spectator’s show.

I was there with you. I hope you felt it too. I hope God welcomes you, and treats you well.


COLOPHONEditor-in-Chief

Arman Azad

Managing EditorsHaley Barravecchia

Anjay Batra

Literary EditorsAlexander Chong

Maya GravesAlangoya Tezel

Julia DokkoCristian Ramirez

Sarah Wishloff

Copy EditorsCaroline YaoKevin Wang

Recruitement and Publicity OfficersAlexis Nduka

Maissa Trabilsy

From The Ground Floor was founded by volunteers from Project Healthcare, an immersive clinical internship at

Bellevue Hospital in the Kips Bay neighborhood of New York City.

Project Healthcare is a partnership between the NYU School of Medicine and NYC Health + Hospitals/Bellevue. The Summer 2017

program was headed by Anthony Orneta, and this year’s coordinators were Julia Romano, Katie Nerlino, and Chris Laugier.

Cover Art by Arianne Maya

from the ground floor · committed to providing a forum for bellevue’s e.r. volunteers to share...

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