LASTING
IMPRESSIONS
University Hospitals’ Medical Humanities Journal
Volume I │ 2015
Lasting Impressions
University Hospitals’ Medical Humanities Journal
Volume I │2015
Lasting Impressions is an avenue for artistic expression for the Cleveland medical
community. It is an outlet for providers to share their reflections on anything from
patient interactions to work life balance. Unlike the many scientific journals available, this online journal hopes to allow medical professionals to share themselves in
a humanistic way. By sharing our lives through artwork or writing, our medical experience is elevated, and as a medical community we can relate to each other better.
We invite submissions of poetry, prose or artwork from medical students, trainees,
alumni, and healthcare workers in the Cleveland area.
For more information please visit:
http://medicine.case.edu/societies/the-gold-humanism-honor-society/lastingimpressions
Sharmeela Saha, MD
Editor-in-Chief
Lisa Arfons, MD
Managing Editor
Marty Tam, MD
Managing Editor
Front cover artwork by Dr. Donald Hricik
LASTING IMPRESSIONS │ VOLUME I │ 2015
TABLE OF CONTENTS
4
Untitled
Priyanka Bakhtiani
5
The Cry
Michelle Duke
6
Bacillus Affliction
Jessica Kumar
7
A New Year
Sharmeela Saha
8
Innocence
Mariam Diab
9
The Patient Experience
Hiloni Bhavsar and Sharmeela Saha
10
Untitled
Donald Hricik
11
Heart Bulb
Aditya Khetan
14
Still Life
Christine Koniaris
LASTING IMPRESSIONS │ VOLUME I │ 2015
Untitled
Priyanka Bakhtiani
Priyanka is a pediatric endocrinology fellow at
Rainbow Babies and Children's Hospital.
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The Cry
Michelle Duke
It's funny we never realize what we have until it's gone.
Then we think back to the things we've once done.
Pain yet is so very hard to understand at the time.
Remembering when we didn't even have a dime.
Through the bad times you were always here.
Why do we only remember the bad times through the year?
When I sit, and think of what I put you through the year.
I realize that I was such a fool.
No one on this earth can take the place of you.
Only if the lord would hear my cry, and send a miracle breakthrough.
Michelle Renee Duke is a medical assistant in
the University Hospitals Health System. She is a
single mother of eight children with the last
being natural triplets. Michelle has a deep
ambition to one day become a writer and share
her inner thoughts and life experiences.
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LASTING IMPRESSIONS │ VOLUME I │ 2015
Bacillus Affliction
Jessica Kumar
Jessica Kumar is an Adult and Pediatric Infectious Disease Fellow who studied painting and
chemistry as an undergraduate student at
Washington University. She completed internal
medicine-pediatrics residency at Albany Medical Center. Jessica continually strives to keep
art in her life during her busy academic pursuits in the sciences. Keeping a balance in life
and work is imperative and this integration
allows her to bring the art and science to the
medicine she practices.
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LASTING IMPRESSIONS │ VOLUME I │ 2015
A New Year
Sharmeela Saha
Both said they wanted 2015 to be a good year.
Both said they were ready for 2014 to be over.
Both managed their problems with grace.
Both were inspired by the fresh start that the new year would bring.
She was done with the highs and lows that 2014 brought.
She said in hindsight 2013 was fantastic but
She appreciates it more after the tsunami of 2014.
She ended relationships that she thought were going to be lifelong.
She hopes for 2015 to be steady and strong.
He was forced to slow down.
He hadn’t thought he was going to retire.
He started dialysis.
He survived another surgery and is ready to leave behind fear.
He hopes he might get a kidney transplant later this year.
The unexpected is frightening when its challenges we face.
The unexpected is welcome when its good fortune we embrace.
The struggle we encounter is surmountable if we learn how to cope.
She and he persevered with new beginnings of hope.
Sharmeela is an Assistant Professor of Medicine. She is from Columbus, Ohio
and completed her bachelor’s degree in Biology and International Studies at
Washington University in St. Louis. She went to medical school at the University of Cincinnati followed by internal medicine residency at University Hospitals Case Medical Center and nephrology fellowship at Vanderbilt University
Medical Center. She believes that the art of medicine incorporates the way
healthcare professionals relate to their patients and that the diverse opportunities for human interactions, whether experiencing disease remissions or managing therapeutic failures, produce a creative environment.
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LASTING IMPRESSIONS │ VOLUME I │ 2015
Innocence
Mariam Diab
Child innocence is the meaning of pure, simple, transparent
life. You wish it could stay forever.
Mariam Diab is a second year internal medicine
resident at Saint Vincent Charity Medical
Center in downtown Cleveland. She is of Palestinian origin. She enjoys drawing and sports.
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LASTING IMPRESSIONS │ VOLUME I │ 2015
The Patient Experience
Hiloni Bhavsar and Sharmeela Saha
Stripped of privacy
Extinct personal space
Quiet time annihilated
Asked to divulge
personal information
To a stranger
Poked for blood work
Woken up for testing
Sleep, meals and conversations
Interrupted
Bombarded with information
Confused and bewildered
Overwhelmed and numb
Fluorescent hallways
Pungent smells
Gurneys, hospital beds and wheelchairs
Tunnels inducing claustrophobia
We should never forget what we ask you to endure
Hiloni is an Assistant Professor of Medicine.
She attended Wright State University College
of Medicine and was a chief resident after
completing her internal medicine residency at
University Hospitals Case Medical Center.
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Untitled
Donald Hricik
Dr. Donald Hricik is a Professor of Medicine. He
attended the University of Notre Dame for his
undergraduate education, Georgetown University for medical school and Tufts Medical Center for Nephrology fellowship. He is the Division Chief of Nephrology and Hypertension at
UH Case Medical Center. In addition, he is the
author of two novels, Racing to Pittsburgh and
Nothing to Confess as well as numerous research publications. He enjoys both painting
and writing.
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Heart Bulb
Aditya Khetan
My first anatomy lesson was at the age of 5. We lived in a joint family in Dalkhola, a
small town in the eastern part of India. My father was the youngest of three brothers, and they all lived and worked together, as our family business was located on
the first floor of our house. One of my aunts had fallen sick, and I was told that she
had to have her heart ‘bulb’ replaced. I remember her as rarely stepping out of her
room, her absence in the common areas punctuated only by sporadic sounds of
retching and vomiting. I imagined that just like we needed bulbs to light our outside world, to find our way; our bodies too needed an internal source of illumination. An image of a light bulb deep within my chest, lighting up my whole body
from within and providing a path, was my first imagination of the mysteries of the
human body.
My aunt had rheumatic heart disease, and she needed to travel over one thousand
miles to Chennai to get a double valve replacement. We had no family or friends in
southern India, so as the date of her surgery approached, an entourage boarded the
Coromandel Express to go to Chennai and donate blood for the surgery. My aunt
returned nearly 2 months after she had first left home. The vomiting had stopped,
and now her diet was filled with coconuts. The doctors had told her that coconut
water was good for the heart. It seemed to our family that the absence of coconuts
explained my aunt’s condition, and our terrace was soon filled with them. It was a
mistake that my mother would ensure was never repeated, and I was fed coconut
water three times a day. Even today, we have more than ten coconut trees around our
house in Dalkhola.
When I was a bit older, I was sent to a residential school in Darjeeling, a hill station
6 hours away from our coconut trees. I only came home thrice a year, and consequently, grew apart from my extended family. My mother would ensure that I visited the houses of each of my local relatives every time I came home. The obligatory
familial visits were an arduous chore during my week long break as I had to pay my
respects to each of my paternal grandfather’s four brothers.
One holiday break for Durga Puja, in seventh grade, my parents somberly told me
that one of my granduncles, younger than my grandfather, had unexpectedly passed
away from a heart attack. As she delivered the news, my mother told me that I
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could cry if I wanted, and I remember feeling awkward at that suggestion. Just like
we feel ashamed of everything at that age, I felt ashamed of not being close enough
to him to cry at his death. He was a grandfather after all, weren’t people supposed to
die after they became grandfathers? Why was I supposed to cry at that, especially
because it had already happened a few days ago? In any case, there were to be no
puja celebrations in our house that year, and all my plans of visiting the puja pandals and taking part in the town’s annual “Fun Fiesta” were laid to rest. I spent the
rest of my holidays visiting my granduncle’s house daily for compulsory mourning
rituals. My grandaunt, usually friendly and outgoing, was nowhere to be seen during those visits, and my mother told me that she had secluded herself. It was years
before my grandaunt started attending marriages and celebrations and always
adorned in a white sari, signifying she was a widow. Even now, she rarely travels
for any celebrations.
Soon after starting medical school, my maternal grandmother passed away from
heart failure due to coronary artery disease, after suffering from diabetes for many
years. While driving to the hospital three hours away from our home, my mother
called. Quietly sad, she recounted how difficult my grandmother’s life had been; a
lifelong battle with severe bipolar disorder, physical health ailments, and vast financial hardships. My mother grieved at her death, but believed that my grandmother’s suffering had ultimately been relieved.
India is in the midst of an emerging epidemic of cardiovascular disease, we are told.
My own family experiences mirror the changing epidemiology of cardiovascular
disease, and indeed disease, in the country. While still a toddler, my younger
brother contracted tuberculosis of the lymph nodes and my father got pulmonary
tuberculosis a couple of years after that. My father’s sister had suffered from tuberculosis of the spine a few years before my brother. However, my father was the last
person in my extended family to contract tuberculosis, and that was twenty years
ago. Since then, the mortality and incidence of tuberculosis have both been halved
throughout the country. It seems that the disease burden has shifted to cardiovascular disease in my family.
When I think of my grandaunt, wearing her white sari and refusing to participate in
family celebrations, I understand the meaning of premature mortality. My younger
self was puzzled about why we should be so sad at the passing away of a grandfather. A few years later, I learnt from my books that my granduncle died prematurely, having passed away at the age of 62 years. But from my grandaunt I learnt
that the diagnosis of premature death is based not so much on a number, but by the
suffering that’s left behind. In that sense, my grandmother had a more “natural”
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death at the age of 64 years, a relief of her suffering. A finale that is the natural result of life. The idea though that she died in a hospital, away from her loved ones
continues to rankle me as a perverse destination for a natural death. In contrast, my
granduncle, who suffered from long standing uncontrolled hypertension and frequently complained of chest pain, failed to utilize the advances of modern cardiovascular medicine. The challenge that my grandmother and granduncle have left for
me, and us, is to ensure that people have access to the care they need and that simultaneously, we can help people understand what levels of care are appropriate and
within their goals and wishes.
Aditya is an internal medicine resident at
UHCMC. He grew up in India, studying in a
residential school near the Himalayas since the
age of 6. He went to medical school in Nagpur,
and tired of the 100 Degree temperatures
there, he decided that extreme cold was preferable to extreme heat. He's interested in
figuring out how to decrease suffering from
cardiovascular diseases in developing countries
like India.
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Still Life
Christine Koniaris
Oil on canvas panel.
Dr. Christine Koniaris is the Medical Director for Palliative Care and is an Assistant Professor of
Medicine at University Hospitals Case Medical Center and Case Western Reserve University
School of Medicine. She grew up in upstate NY and studied both at the State University of NY at
Albany and Albany Medical College. She completed residency training in Internal Medicine
training at Albany Medical Hospital and Long Island Jewish Medical Center before completing
her Hospice and Palliative Care Fellowship at Montefiore Medical Center in New York. She believes that we are all artists and all practice the art of medicine in one form or another. From a
mother's kiss on a bruised knee to a surgeon skillfully excising a tumor it is all encompassed in
the art and magic of our lives. She believes that having an artistic outlet of any kind helps process through the comedy and tragedy that encompasses the life that surrounds us.
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Share your work and thoughts with us!
Lasting Impressions Submission Guidelines
Editorial decisions are based on the content and quality of the submitted work.
Please email all submissions to [email protected].
Submission Guidelines:
 All work must be accompanied by contact information including your name and
e-mail address as well as the title of each piece.
 We invite submissions of poetry, prose or artwork from medical students, trainees, alumni, and healthcare workers in the Cleveland area.
 Please attach your written piece as a Word document.
 All prose submissions should be double-spaced with one inch margins.
 Prose submissions should be no more than 3,000 words.
 Please attach visual art as jpg files.
 Please do not exceed 1 MB in a single email.
 In order to maintain patient confidentiality, if a submission reasonably identifies an individual, a consent for publication signed by that individual, must be
provided as a prerequisite for publication. Download Patient Permission form.
 Literary submissions should preferably concern the subject of health care; however, any submissions will be considered for publication.
Copyright: By submitting your work, you affirm that you are the sole author or artist, and maintain all rights for your work. If
your work is accepted for publication, University Hospitals Department of Medicine retains an exclusive use of Electronic
Rights (the right to publish and reproduce your material online) for two years. University Hospitals Department of Medicine
also retains Electronic Archival Rights (the entire issue in which your work appears will be continue to be stored in electronic
form after original publication), and the non-exclusive right to reprint the piece, should we produce an anthology. We retain
the right to edit images or text to allow for formatting consistencies. While available as the current issue online, no original
work may appear in another publication, either electronic or print, to maintain accordance with the exclusive use of Electronic
Rights for the current issue. By submitting material to University Hospitals you affirm that you have read and agree to all of
our submission guidelines. Guidelines and rights are subject to change without notice.
These guidelines and rights were created with the help of review of other medical humanities journals specifications, including but not limited to "Hospital Drive" and "Abaton."