VoluMe iV, 2017 - Murmurs Magazine · 2017. 8. 20. · Layers Janet Green.....5 Ka Oshapatamihk...

t h e j o u r n a l of a r t a n d h e a l i n g

VoluMe iV, 2017

CeleBrationS

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E D I T O R I A L COMMITTEE

EDITORSAgata Dzwonek

Farriss BlaskovitsAiLi Wang

Andrea Zumrova

CREATIVE DIRECTORS

AiLi Wang 王艾莉Andrea ZumrovaAgata Dzwonek

Farriss Blaskovits

FACULTY ADVISORS

Dr. Pippa HallMs. Lynn Bloom

COVER ARTAndrea Zumrova (front cover)

Yang Yating (back cover)

CONTACTMurmurs MagazineUniversity of Ottawa Faculty of MedicineRoger Guindon Hall

451 Smyth Rd.Ottawa, Ontario

[email protected]

ISBN978-0-88927-494-5

EDITOR'S NOTE

ACKNOWLEDGEMENTSFaculté de médecine | Faculty of MedicineUniversité d'Ottawa |University of Ottawa

Programme de médecine et les humanités | Medicine and Humanities ProgramÉtudes médicales de premier cycle | Undergraduate Medical Education

and the support of Dr. Melissa Forgie

Dr. Pippa Hall, Ms. Lynn Bloom for their advice and supportTalia Chung and the UOttawa Library staff

Medical students across Canada and at Shanghai Jiao Tong University School of Medicine for their artistic contributions to

Murmurs as well as professor Zhou Dong and associated faculty members for their involvment.

The fourth edition of Murmurs: Celebrations is hon-oured to be promoting Canada’s 150th anniversary by showcasing impactful art from across this land. Our unique country is an international emblem for cultur-al diversity, friendship and harmony, cornerstone val-ues that are reflected in the art submitted by young Canadians in the health field and students from the Shanghai Jiao Tong University School of Medicine. By dedicating this edition of Murmurs to Canada’s 150th anniversary, we hope to recognize the arduous work of our predecessors that has permitted us to become who we are today. The literary and visual works of art offer a glimpse into the lives and experiences of our future physicians, shedding light on the humanity within us all. From dragons to stethoscopes, you will find a part of yourself reflected in this art. We hope that the talent and creativity in this edition will in-spire you, evoke empathy and healing, and that your right brain will tingle with adventure and imagination.

From far and wide, happy birthday Canada!

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TABLE of CONTENTSVISUALLois Anastasia McCarvill................................................................................ 4Layers Janet Green............................................................................................ 5Ka Oshapatamihk Miyooayaan Brendan Groat, Rebecca Whaley, Kate Elliott...................................... 6Sound Heart Amina Allalou......................................................................................... 7Medical Comics Daniel Turski.......................................................................................... 8Supporting Life Melissa Teixeira Maltez......................................................................... 9The Beat of Life Parinita Verma....................................................................................... 11You are Light Marie Jeong-Min Kim............................................................................ 12Thrive Vikhashni Nagesh.................................................................................. 13Two Pictures Yang Yating............................................................................................. 14So much more than just a Pump Kaitlyn Orton......................................................................................... 14Reality of Comorbidity Phoebe (Tsz Man) Cheng....................................................................... 15Tree of Life Xinyuan (Camilla) Hong......................................................................... 16-17A Beautiful Mind Harpreet Singh....................................................................................... 18Lost in Orbit Heather McDonald................................................................................ 19Dreamcatcher Tamara Pokrupa-Nahanni........................................................................ 20Beauty Within Serena Deketele..................................................................................... 21Outport Nicholas Tompkins................................................................................. 22Fire and Blossom Thuy Linh Do........................................................................................... 23A Silent Solicitude Samiyah Khan........................................................................................ 24Orange is the New Patient Lucy Smith............................................................................................. 25Both Sides Yipeng Ge.............................................................................................. 26Connected Waters Kevin Dueck.......................................................................................... 27Basic Structures Jonathan Ore......................................................................................... 27On Call of the Wild Carter Lim.............................................................................................. 28The Hand of Time Agata Dzwonek...................................................................................... 30Myocardial Infatuation Vivian Gu................................................................................................ 31

LITERARYLife Lines Farriss Blaskovits.................................................................................... 4Underneath the Surgeon's Knife Farriss Blaskovits.................................................................................... 5Sign the Dotted Line Kayla Simms............................................................................................ 6The Trainee's Interface Sarah Hanafi............................................................................................ 7 Colour me Purple Vaness DeMelo........................................................................................ 10-11Cinders Prasham Dave.......................................................................................... 12Tachycardia or Love Raphaël Nahar Rivière............................................................................ 13Pounding Giuliana Garna........................................................................................ 14Will Alexander Bahadur.................................................................................. 15The Dragon and the Page Anna York-Lyon........................................................................................ 18-20Bedside Musings Brittany Cameron.................................................................................... 21Doppler Matthew Lee............................................................................................ 22Haiku (English) Zehua Li, Ruoxi Lai................................................................................. 23Depression Mathew Lee............................................................................................ 24My First James De Santis...................................................................................... 25 In me, the Starlight of the Past Shouyan Deng......................................................................................... 26Crash Course Carol Dennison....................................................................................... 27Haiku (French) Shiwei Zhao, Yujie Lu.............................................................................. 28Dyssynchrony Jasmine (ZiJin) Cheng............................................................................. 29The Algorithm Nikhita Singhal........................................................................................ 30

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Lois “The Queen will see you now.”Anastasia McCarvillDalhousie University MD2019

The lines extend Not far enough.

Expansing the surface, Almost.

Having reached the end Fingers trace it back.

Across the palm Across the mesh of skin.

Covering flesh, Tensed muscles,

Connecting fibres, Vasculature, Fat, Life.

Back and forth, In and out,

Smooth and rough, Dense and thin.

Like hay Worn out in the sun. Crisping over time, Give me more time.

LIFE LINESFarriss Blaskovits

University of Ottawa MD2020

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LAYERSJanet GreenDalhousie University MD2019

Your spine is unnerved

You stare, swallow, palm the scalpel.

Feel tentatively along ridges –

See the body like hills from the air.

A sense of awe and uncertainty –

And cold.

You learn about yourself

Through his sacrifice, skin, stubble.

He taught you technique, calmness –

Self-mastery and silence.

You stood over and feared him –

And he still made you better.

You came of age through death

To command breath, bone, body.

Now touching warmth –

A glove of pulsating muscle.

The fear is different –

And you breathe exaltation.

Step and steel –

Remembering notch, name, nail.

Step and slice –

Remembering him, hum, humble.

Step and stroke.

UNDERNEATH THE SURGEON’S KNIFEFarriss Blaskovits


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I know it’s been awhileI don’t come here all the timeI’m here to ask a favourWill you sign the dotted line?

You don’t quite understand, DocAnd I know that’s hard to hearYou think you know it all sometimesBut I know you don’t know fear

Not the way that I’ve seen itThrough the pain in my daughter’s eyesWith no food on the tableHer smile, a disguise

I know you’ve made tough choicesLike which specialty to pursueAnd where you’d want to studyShould your stethoscope be blue

Our choices have just been differentIt’s not that I haven’t triedI dropped out of school at 16 yearsAfter our grandma died

I robbed a couple stores you seeTo pay my sibling’s wayMy sister was an athleteA star runner in her day

I sold drugs to my neighboursTo keep the heat on in our homeI’m not proud of these choicesBut I’ve made it on my own

I know you’ve had it tough, DocLike when you almost quitYour take-home fees were getting cutYou were tired of the grit

I’ve had it tough too, you seeI spent a month in jailI never slept a wink those nightsKept praying I’d make bail

Now I’m in your officeAnd my choices have come and goneI’m faced with tough ones every dayI can’t say if I’ve made them wrong

And as you stare down at this formI know the look you showYou’re not asking if I’ll abuse these drugsBecause the answer you think you knowThere’s nothing I can say to youTo ease the choice you faceMy pain, I carry every dayLife’s Karma in this race

The empty stare you shoot meAs blank as the spot to signAnother choice I’ll have to makeWith this empty dot-ted line

SIGN THE DOTTED LINEKayla Simms


KA OSHAPATAMIHK MIYOOAYAAN (Envisioning Wellness)Brendan Groat, Rebecca Whaley, Kate ElliottUniversity of Saskatchewan MD2019

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Today I was a shoulder for many to cry on,an undeserving confidante,relegated authority without concomitant merit,a responsibility that I’d have rather be shared.

Today I was a double agent in the war between the doctor and the patient,privy to the judgmental attitudes of my seniors,as the team moved on to round I remained sole witness to the ailing’s darkest fears,yet felt hopelessly powerless as my advocacy for the vulnerable fell on deaf ears.

This is the in-between, the dilemma, the inter-face of the student:not doctor enough to be consumed by orders that numb them to the human,but too layperson to be preserved from the emo-tional hazards of the occupation.

Yet I fear the day when I will no longer have the “time” to be exposed to these tears,for it is in these moments of sacred vulnerability that I find Meaning:

When Mrs. S reached for my hand as her eyes welled with the arduousness of spending sleep-less nights without her spouse,when the cancerous meaning of Mrs. C’s abnor-mal cortical activity metastasized to her daugh-ter,

when Miss M. revealed that she was one failing pain medication away from taking her own life,and when Mr. L rallied enough of his meager myotomes to croak out ‘help me’ while his lungs continued to fill with water.

And although challenging to brace this interface,I am already mourning the day when my white coat will reach my knees,as something tells me that both time and experi-ence will continue to eat awayat the very thing that drew me to this profession - that is, “heart” disease.

THE TRAINEE’S INTERFACESarah Hanafi

University of Alberta MD2018

SOUND HEARTAmina Allalou


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MEDICAL COMICS

Daniel TurskiMcMaster University MD2019

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SUPPORTING LIFE

Melissa Teixeira MaltezUniversity of Ottawa MD2018

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Vanessa DeMeloWestern University MD2017

“People can’t help but loving Western. I mean, every-one looks good in purple!”This thought ran through my head and made loop-de-loops as I stood in the Intensive Care Unit, watching the resuscitation of a teenage MVC victim. One year younger than my little brother.She was a Western student. An orientation week lead-er like me, I later learned. We had friends in common. Her oxygen sats were swinging around the forties, fif-ties, making occasional dips like the music playing in my head. I had never seen numbers that low(Except on the SimMan during anaesthesia training. Don’t intubate the esophagus)You could say this call shift had gone in a slightly dif-ferent direction than expected.

Med students become excited when they talk about trauma. “I love trauma!” they exclaim. I watched as her oxygen saturation hung around hip-level, and the trauma team leader set his phone. Every five min-utes, an alarm sounded and a new shift began on bag-ventilation duty, with her pulmonary resistance too high for machine ventilation. “Vanessa, you’re next”Okay. I’m ready for this. I’m pumped. It’s a trauma and I’m getting involved! Me, a mere medical student, to whom, one year ago, the most dramatic thing to happen was filling in Scantron bubbles. (I am being facetious for literary’s sake. Stay with me.)Being involved in this trauma did excite me. It also made me feel off, epigastrium unsettled. Was it nau-sea, from lack of sleep? Perhaps hypoglycemia, the ticking seconds counting far too many since my requi-site clerk Clif bar?No. This was someone’s daughter. Someone whose parents were currently racing in from far away, her family physically rallying to the Notable Tertiary Care Centre in London, Ontario. She was actively dying and doing an exceptionally good job at it. My mom, my biggest supporter and idol, always talks about how her heart instantaneously clenches when-ever the phone rings in the middle of the night. She says being a mother means always being nervous

that something could be wrong. I can barely stand the thought of these parents receiving one of the worst phone calls possible. So I keep my eyes wide open to prevent my brain from fully processing it. And here I stand requisitely enthused; I’m the lucky clerk who was on call tonight, to whom goes the honour and opportunity of physically forcing air into this girl, young woman, student’s lungs.This isn’t something to be excited about. This is a tragedy.

I still have difficulty reconciling the ideas of simulta-neously being excited about trauma-induced oppor-tunities and being able to fully appreciating the na-ture of the tragedy. Adrenaline seems to help with compartmentalization at the time, but post-event, the event is sitting on a shelf in my brain. I occa-sionally take it down, roll it around in my hands and examine it. I haven’t come to any conclusions, but I’m still glad that I was there.

Then arrives the Gracious Opportunity to perform CPR for my Very First Time. Our girl was doing exceptionally well in her attempt to die. Her oxygen saturations frolicked beneath our toes, her myocardium gasping. And once more, “Vanessa, you’re next.”Did you know that purple isn’t even a real colour? It’s a combination of blue and red; the blue made twice as bright as the red. My favourite thing that is blue is the Tyrrhenian Sea along the five coastal villages of Cinque Terre, Italy. It’s one of the most beautiful places in the world to hike, makes wine that will knock your socks off, and feels like joy. Red reminds me of Christmas, and the twenty-four stockings I received in the mail as the most thought-fully gifted Advent calendar of all time. I lean over her, and her face is fully purple.

CPR is physically gruelling. The one-minute mark comes after a lifetime of “staying alive, staying alive”, and the two-minute mark and my end of turn are greeted by a notable amount of lactic acid ca-

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THE BEAT OF LIFEParinita Verma

Memorial University MD2019

vorting around my triceps et al. Deep Purple sang a song called Smoke on the Wa-ter. I don’t know how that song goes, but the re-nowned Eiffel 45 played in my head as I kept my eyes continuously moving over the situation. I could be brown, I could be blue, I could be violet skyI could be hurtful, I could be purple, I could be any-thing you like. “This patient is going to die. Is everyone aware of that? Does anyone have any further suggestions?”We don’t. We are on a boat all by ourselves, and nobody is coming to rescue us.

But then. If this was a cinematic production, it would be ac-companied by dramatic music, foggy montage

scenes, and repetitive phrasing voice-overs.

She didn’t.She didn’t die.She lived.

Violet is a real colour. Like lavenders, and amethysts, and ecchymoses. A wavelength of 380-450 nm. Was her face violet, or purple? Does that matter? Does that make it any less real?I searched for Deep Purple, and Wikipedia told me that the band was named after a like-named piano compo-sition. Mitchell Parish added lyrics to Peter DeRose’s creation, and these included,“And as long as my heart will beat, lover, we’ll always meet, here in my deep purple dreams”.

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YOU ARE LIGHTMarie Jeong-Min Kim


Sunken eyes my burden and a blazing smile my shield,

My patient burned under baleful fluorescence, purified en blanc.

My breaths were shallow. His shallower still.I was haggard and he was in shambles,

I was shuffling and he was frozen,I was ash and he was a husk.

Swarming into our sterile room, steel eager and arrogant,This was his broken olive branch, rosary bead chance.

We undid his bindings, taut and distended,Spilling humours putrid and vile with no origin to be found.

We sealed him shut, inferno unabated, Spent, he burnt out.

A whispered condolence, a thoughtless prayer, My pager beeped.

How would the next fare?

CINDERSPrasham Dave


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The lights turned on. He turned his head suddenly and our eyes locked.

My pupils dilated. Mydriasis unabated. My breath stopped. No expiration. Bronchoconstriction. Even palpitations. My heart thundered. Disbelief and

wonder.

He broke a slight grin with lips grooving up slightly more to the left.

I felt pre-syncopic. Qu’est-ce qui se passe? It couldn’t be love, it couldn’t be lust. Step back. List the differen-tial. It’s probably phys-iological, or maybe psychological? No chest pain, No cough, Sounds named after Korotkoff, heard upon ausculta-tion, No thrills felt on

palpation

He blinked. I breathed out. My heart wanted to come out. The blood in my

veins, saturated with doubt.

Heart flatlined. Need a sign. Atrial Systole. P wave on the ECG. My atria contracted, could I be

attracted?

His lips parted slightly. What would he say? Would I be kept

or be casted to the fray?

Isovolumetric contraction. In a fraction, of a second, a QRS wave happened Depolariza-tion preceding an Ejection of

oxygen-rich blood gushing out like a flood His lips sealed. Nothing to reveal.

Diastole started Love’s not for the fainthearted. Isovolumic relaxation A new sensation Aortic valve

closes blood redder than all roses, out the aorta quick, blood heavy and thick PCO2 high I let out a sigh as Hemo-globin becomes taut Unloading O2 can’t be stopped

Tissue perfusion What’s his decision? Capillary diffusion My head’s in confusion

Up against gravity Through the chest cavity the inferior vena cava with the superior

vena cava brings it all back still no heart attack

Mitral valve opens as its rapid inflow time Feeling like a victim

in an uncommitted crime Dias-tasis keeps on A chance long

gone.

Its been a whole beat, Still standing on my feet. Pulse

above 100 Couldn’t help but won-der Is it an arrhythmia? A sudden

tachycardia.

No it couldn’t, it shouldn’t, it wouldn’t Its the only explanation A rhythm de-

viation No ST-elevation A faster wave propagation

As I continue to debate. He retracts his gaze. I couldn’t see his face. It

was too late. What cruel fate.

Our eyes no longer locked. Lights turned off.

TACHYCARDIA OR LOVERaphaël Nahar Rivière


THR I VE Vikhashni Nagesh University of Calgary MD2018

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SO MUCH MORE THAN JUST A PUMPKaitlyn OrtonUniversity of Ottawa MD2020

my handswith their fingers interlaced

pressed onto your chest pounding and pounding

ah ah ah ah stayin’ alive, stayin’ alive

pounding and pounding good pace, keep going

my glasses slipping off of my face

and onto your chestpounding and pounding

under my handsyou began to change

first your skinturning gray

POUNDINGGiuliana Guarna

McMaster University MD2019

as the life left you and then came purple pounding and pounding

and then there it was --

hope

your heartalive on the monitor ah ah ah ah, stayin’ alive, stayin’ alivepounding and pounding

it’s been four months yet me heart leaps each time I thinkof you

pounding and pounding

TWO PICTURESYang YatingJiao Tong University

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REALITY OF COMORBITIDYPhoebe (Tsz Man) Cheng

University of British Columbia MD2018

WILLAlexander Bahadur


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T R E E O F L I F E

Xinyuan (Camilla) Hong University of McGill MD2019

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T R E E O F L I F E

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Let me tell you a story. It’s a true story, or mostly true. The people and the feelings are all real. There’s just a little extra magic this time around, because all the best stories have magic. And we all listen a little bet-ter to the stories that have magic, because it gives us hope for impossible dreams.

Once upon a time, in a hospital not too far away from where you are sitting now, there was an old man who was lived high up in a tower. Now, the man wasn’t born in this tower. He was born on the ground and he loved to walk in the rain and catch taxis from the airport and run after his grand-children down the laneway. But it just so happened that the man became sick, very sick. He was tired and frail and so he went to go stay in the tower. His wife sat with him and watched him carefully. She fretted, seeing him so pale and weary. Sometimes she would touch his brow softly, with just the pads of her fingers as so not to wake him. Sometimes she would pace the room or stare out the window with her fingers tight in the sash. Hour after hour, day after day, she walked and waited and he slept and breathed, high, high up in the tower.

One day, the man began to moan softly. He gritted his teeth and tried not to make more than a whisper, but his wife heard. She came over to him, pressed her fin-gertips against his face and pressed her face to his own. “I’ll get some help,” she whispered. “Hold tight my love. I’ll find someone to help.” This she promised, but she didn’t want to leave him. What if she came back to ghost or a memory? She loved him too much to have him die alone. So, from time to time, the wife would cry out the tow-er window, “Someone, please come. Anyone. He is in pain!” She cried out for hours and hours. No one came. At long last, out in the distance, a procession of rid-ers on horseback was seen. The wife screamed her sorrow and her worry and her hope, “Please, help. Help!” The group of riders pulled closer, many people of all races and genders in long white robes and blue scrubs. They pulled up beneath her tower and called

out to her, asking what the issue was that had her shouting so. “Please help.” Her voice was hoarse from all the shout-ing. “My husband. He is sick. He is in pain.”One of the riders called up from the procession. “We know. We’re giving him the best care possible.” The wife wanted to cry, to weep. Her throat was raw, her voice just a whisper. “Please.” The rider smiled a confident smile and said “We’re keep-ing a close eye on him. Don’t worry ma’am. We’ll be back soon.”

The procession rode on. Hours passed, or maybe days. Time is strange in fairy tales and in hospitals, with each minute blurring into the next and never enough time in the end to do everything.The procession had not returned. The wife hardened her heart and wiped her tears and curled herself around her husband’s bed.

Let us go now to a very different character. Far away in that long procession of riders, sitting on a pony slightly too big for them, was a page. Now, if you are not familiar with medieval rankings, let me give a quick summary of what it means to be a page: a page is someone with very little experience and very little power, who does a lot of running around doing their best and not being very useful to anybody. It is a bit of a miser-

THE DRAGON AND THE PAGEAnna York-Lyon

University of Ottawa MD2018(1st Place Literary Category Prize)

A BEAUTIFUL MINDHarpreet SinghUniversity of British Columbia MD2018

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able life at times.

The page was trying to get their pony under control (and not doing a very good job of it) when they heard a whisper coming down the procession. The whisper said that there had been a bit of commotion around one of the towers. It was the tower with the old man and his wife, said the whis-pers. Someone had heard shouting. The white-coated riders around the page sighed when they heard the news. They were busy. There were so many tow-ers, so many patients, so many people in pain. The young page looked around – people shifted their horses awk-wardly, stepping left and right but no one stepping up. Was no one going to go to the old man’s tower?

The page squared their shoulders and took a deep breath. “Uh – I’ll go. I can go see them.” Their voice quavered as it spilled into the air above the procession and the riders turned to look at which small, weak thing had spoken out. The page choked up a bit with nervousness but they fin-ished, “To be honest, I’m not much use here anyways. I might as well help someone.”The riders looked at each other and nodded. Good. The patient would be seen to and they could keep on with their busy schedules. “Excellent initiative, page. Go see the pa-tient.” The page nodded. They turned their pony around and raced towards the old man’s tower.

When the page arrived at the towers’ base, the wife was nowhere to be seen. Where had she gone? She had been forever hanging out of the tower window, calling out for help. Had she abandoned her husband? The tower had changed too – the turret broken off, walls covered with

vines where there had been no vines before. How long had the procession been gone from here? It seemed like a hundred years.

The page shook their head to clear it; there was no point in faltering now. They jumped off their pony and started up the tower stairs. The tower was tall – much taller than it had seemed from the ground. By the time the page had reached even halfway to the top, the ground seemed miles below, cut off and distant from the world in the tower. It was cold up here, forgotten by heat currents and people alike, and the page began to shiver.

When the page entered the old man’s room, the wife was not to be seen. The man lay under his covers, moaning softly. The page rushed over to the bed. They reach out, almost brushing a hand across the man’s shoulder when – THUMP. Pain. Force. A giant scaled hand reached out and tossed the page against the stone wall, like a child might throw a doll into the sky on a spring day. A giant dragon stalked out from around the bed. It was as large as a storm cloud and just as angry. Its tail curled around the old man’s pillow. “How dare you touch him!” The dragon’s voice was tear-choked and hoarse with worry. “You are so late. You have left him for so long. What kind of people make a patient wait for so long?”

The page wanted to cry, to leave, to beg lack of expe-rience, to run back down the many stairs of the tower and grab their pony and ride away. They cried in their head, this wasn’t my fault, I don’t know anything, it wasn’t my fault. And yet, crying and running wouldn’t help anyone. The man would stay sick, the white-coat-ed riders would stay distant, the dragon-wife would stay eaten by anger.

So, the page carefully got to their feet. They wiped some blood off their palm, looked the dragon right in her golden eyes, and stuck out a hand. “Hello. I’m very sorry that you have been left so long. I hear your worry. I would like to assure you that I will do everything in my power to help your husband.” A breath in, a breath out. The page’s hand was hanging out in mid-air still, shaking slightly, waiting. “Again, I am sorry that you have been waiting so long. I will try to find out why your husband is hurting and help him, or, if it beyond my capabilities, find someone who can

LOST IN ORBITHeather McDonald


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help him better. Does this sound alright to you?” The dragon blinked once, then twice. She lifted her head up to the ceiling of the room and roared. When she lowered her head, her golden eyes were filled with tears, spilling over like a tidal wave of liquid worry. And then, somehow, the wife was in front of the page and her hand shaking the page’s hand tightly. Her eyes still shone liquid, and the tears ran in tracks down her cheeks. But her voice was calm and steady as she said “I don’t really trust you yet, to be honest. But thank you for apologizing and thank you for com-ing. I’ve felt so worried alone.” The page nodded weakly, trying to stop their own tears from spilling out. “I’ll do my best.”

DREAMCATCHERTamara Pokrupa-Nahanni


And that’s the end. Yes, the end. What – more? What more from the story do you want? What did the man have, you ask? Why was he sick? But see – that’s not the important bit of the story. This isn’t a story about sickness. It’s a story about dragons, the dragons that people turn into when they are left alone with their worries and fears. If you want a lesson to learn, perhaps take this one: There is no such thing as a difficult patient or difficult families, there are only people stuck in difficult places. The hospital is big and patient rooms are as isolating as towers, but even the smallest page can make a difference. So, stand tall, page, and keep trying to make that difference.

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BEAUTY WITHINSerena Deketele

Northern Ontario School of Medicine MD2017

i’m feeling weak, dizzy and a bit squamish today.

a little less energy now.

that’s all.

beautiful cemetery across the street.

but I believe in cremation.

i’m braless at 95 years old.

can you imagine that?

rubbish food.

thankfully i have my biscuits of course.

and i’ll have lots of friends there.

well some now.

that’s the thing when you’re old.

everyone dies.

it’s okay.

this tea was cold anyway.

celebrate the successes.

my dear.

i’m still going to live though.

that’s the plan.

BEDSIDE MUSINGSBrittany Cameron

Dalhousie University MD2017

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OUTPORTNicholas Tompkins

Memorial University MD2020

I remember my high school physics class, the plastic green chairs with tennis balls on the feet

Question: an ambulance is driving toward you, then away

Can feel the pencil gripped in my fingers

Then: the Doppler effect, where I feel the pulse quicken

Now: concerned about who is in the ambulance, and what is their story

I feel the probe gripped in my fingers and glide over where 206 says you should be

Of course, you are there, beating like the Doppler says

Whoosh whoosh whoosh, not unlike a siren

Although dad’s face lights up without the red and blue

DOPPLERMatthew Lee


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FIRE and BLOSSOMThuy Linh Do


Physicists have physical timePsychologists have psychological timeMedical students have no time

-Zehua Li Jiao Tong University

Don’t wanna study, wanna take a showerI’ll take my shower after this study hourAnd wash away all that I’ve learnt

-Ruoxi Lai Jiao Tong University

Sun and shines are two lightsDark and starry are two nightsMyself and I are two lives

-Ruoxi Lai Jiao Tong University

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A SILENT SOLICITUDESamiyah Khan

University of Ottawa B.Sc. in Medical Research

I can only describe myself sitting on a stoolAnd when you speak of song your eyes drip notes

As well, the rhythm of pills that shake in their plastic vialEach day lighter by milligrams as they did for me

I can only describe myself filling out a questionnaireEven the moment where the pen dies

And something about the betrayal of that ink came flowing outPouring and gushing out as a scribbled hurricane rips dry

and rough through the page

I can only describe myself nodding in agreementOf course, of course, yes, yes, of course

Every night, faithfullyBut instead of kneeling at my bed I look in the mirror,

swallow, and turn out the light

DEPRESSIONMatthew Lee


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It was my very first “real” rotation – I just started work-ing on the CTU during my internal medicine core. That first week I was assigned my very own patients. He was one of them. Room 28.

Over the next three weeks, I got better at what I was do-ing. I became more efficient at dictating, I could come up with a differential diagnosis for chest pain, I could manage a COPD exacerbation. As I was getting better, he was getting worse. Many of my patients went home to their families and their friends. He did not. His family and friends came to him.

He was an older gentleman. He had a loving wife of 50 years. She was in every morning at 8:00 am and left every night at 8:00 pm. She would always ask me the questions she came up with from the night before. I did my best to answer them all. Their daughter-in-law was also a healthcare professional. She did her own research and would bring me new ideas every day to help her dad. I have yet to see a family so involved in the care of a patient as this one. Many of their friends came to visit also. They all geared up in the gowns and masks, doing whatever was necessary to visit their friend. Everyday someone new visited.

As family and friends visited, he continued to fluc-tuate. Throughout the course of his hospital stay, there were three differ-ent times where we almost sent him home. Every time he developed a new complication. And he and his family handled the compli-cations as best they could. The family was always strong in front of him, but

to me, they confided that they knew something unfor-tunate would happen. About one week later it did. I came into work and the nursing staff told me I should visit him right away. I asked him how he was doing. And like every day be-fore, he said, “ohh fine”. Except this time the state-ment was made through laboured breathing. After or-dering bloodwork with my attending, I stayed back in the room. A nurse and I then noticed that he started agonal breathing. A moment later his carotid pulse was no more.

Code blue.

Doctors. Nurses. RTs. Me.

ECG. Ultrasound. Chest X-Ray. Fluids. Epinephrine. Blood

Me: CPR. Start. Stop. Continue. Switch. Start. Stop. Continue. Switch.

All clear. Shocking.

Crying wife. Start. Stop. Continue. Switch.

Let’s go to ICU.

He’s stable for now.

Two hours later… New Lab Results: Expiration Note.

They say you will never forget your first.

Later that day, there was a new man in room 28.

MY FIRSTJames De Santis


ORANGE IS THE NEW PATIENTLucy SmithMemorial University MD2019

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The time slips away, and it all ends up here.When we are involved in an event or a trifle, we are so stuck with the current situations, that we unconsciously neglect the true beauty of the time, but turn out com-plete appreciation of it afterwards— this, probably, ap-plies to everything and everyone in the world.And it is time, for farewell, for goodbye, and for depar-ture.The forever magnificent aqua-blue sky, the continuously piling-up rosy clouds; the mild and soft breeze, the ten-der and gentle drizzle— all branded on my memory, my fragrant memories, that in those sparkling days, I have danced with the brilliant sunshine.And the leisure of the journey, the pleasure of the cook-ing; the hilarity of the video, the mania of the shopping— all the same.I’m still not aware, that whether we would yearn for the extremely clean air in the fog and haze, delightedly com-plain about eating pizzas daily when glut ourselves with delicacies, or recall the biochemistry and cell biology when we have switched gear to pathology and patho-physiology.

The West, so shiny.

This kind of feeling highly resembles sinking into a com-fortable sofa, bathed in the warm and unrestrained sun-shine, silently reading a tiny book with an elegant and gorgeous cover beside a giant and elaborate French win-dow, that with time passing by, the sun sets with a fin-ished book, making us slightly unsatisfied with the void

IN ME, THE STARLIGHT OF THE PASTShouyan Deng

Jiao Tong University

and emptiness, but full of ever-lasting recollections simultaneously.

We can always keep it, just as we wish— and it merely depends on our wishes.

We can always remember the special facilities de-signed for the disabled (e.g. the slop plate on the bus), the exceptionally expensive tips in the restaurants, the time-consuming student card (for it takes ages to be brought out), and the endless variety of creatures in the museums.The dissection room for systematic anatomy, the labo-ratories of biochemistry, the two BBQ parties, and the national holiday.Even when it comes to the HST, the costly public trans-portation, the varied and graceful culture, the unfor-gettable Outlets (even just prior to the final examina-tions), the splendid glories of the fireworks, and the quietly running Ottawa river.It seems that we are so likely to ignore our present life, so many, so many wonderful moments, that we can only pick them up in a certain period of memory after failing and wasting them, brushing down the ashes on them, cherishing them with our heart and claiming that “present” is the best.

Old friends, soft wind, gentle rain, the starlight of the past kept in my mind.Stretched mists, setting sun, grand scene, the sun-light of the future chased in my heart.

BOTH SIDESYipeng Ge


BOTH SIDESYipeng Ge


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This is intrusive and irrelevantThey could easily make me more comfortable and let me stand

Is this really necessary? Yes. You have to or you won’t be admitted This is irrational and inefficient She could easily just lie down so we can get on with it

Don’t panic. Just try to breatheCan I please just sit up?

These questions are idiotic and redundantWhy didn’t she just read the file before she came in the room?

Do you feel fetal movement?

I can’t really tell right now

I sound like an idiot. This form is so confusing. Hours of fake histories with fake patients and I’m still not ready.

She is meI am her

We are the same character from different realitiesWe hurl our words back and forth across crevasses of timeWith every wave of contraction and questions with drift fur-ther apartEach of us feels increasingly alone, but the gap between us is narrowingThe more we talk the less we listenWe are always thinking about each otherCreatures of habitThe harder we dig in our heels the more sand slides between our toesCollision is inevitableChecklists and rhythmic agony won’t save usNot even from ourselves

CONNECTED WATERSKevin DueckMcMaster University PGY1 Family Medicine

CRASH COURSECarol Dennison

University of Alberta MD2019

BASIC STRUCTURESJonathan OreDalhousie University MD2019

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ON CALL OF THE WILDCarter Lim


Livres déroulés sur la tableExamens soulignés sur l’agenda

Rien retenu par cœur

-Shiwei Zhao Jiao Tong University

«Chacun son goût.»Egale

«Chacun sa maladie.»

-Shiwei Zhao Jiao Tong University

On dit que la tachycardie peut aboutir à la fuite de palpitation,C’est à cause de l’excitation du nerf sympathique et de l’extrasystole.

Pour nous, c’est l’amour.

-Yujie Lu Jiao Tong University

Est-ce qu’il existe une signalisation dans la pensée?Et est-ce que l’inhibiteur du récepteur va fonctionner

Pour que tu ne me manques plus? -Shiwei Zhao Jiao Tong University

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One cold morning as I make my way

to case based learning in the middle of heart failure week, I find myself struggling with autocorrect dyslexia. Countless idiotic

texts later, I finally realize Siri hadn’t gone HAL on me only that my fingers had lost all semblance of fingers and turned into alarmingly bloodless gray sausages. Is it Raynauld’s or frostbite? Or.. it is too early in the morning and in heightened state of paranoia my mind begins to muddle fact and fiction. How ironic it would be if our fictional patient survives but his real life young mockter dies at the hands of the same terrible beast.. It is not long before I am freaking out because this was COLD and WET. And Cold + Wet = Death.

Luckily Emergency is a stone skip away from our classroom. So I skip away over, and am promptly triaged with a sentence of AHA stage D, NYHA class III. Like slam poetry to the beat of V-‐fib.. I hear whispers of poor prognosis,

transplant qualifications, concomitant palliative care, urgent surgery amidst the Zamboni-‐grade-‐certainly-‐not-‐bowel-‐sounds-‐but-‐I’m-‐no-‐ jedi-‐cardiologist murmur resonating from my sternum. Not good. The stretcher speeds towards OR. I catch a glimpse of the surgeon of the day blackboard –

Bill. Buffalo Bill? Or the Bill from Kill Bill? The doors open into a dimly lit room where Force and Sully, decked in their signature albeit blood splattered green spandex, were in the midst of evacuating their previous patient – a small white dog. Precious?? They hoist its limp body off the operating table and onto a stretcher. Sully shrugs at me before wheeling off stage right, as if to say, what did you expect kid, this is experimental open heart surgery in 1950. ….What the frak? Isn’t this taking artistic license and suspension of disbelief too far? But then again, Freud would argue it would be highly illogical for the daydream of a chronically psychologically stressed medical student to be logical.. … Once upon a time I used to open heart surgery was so cool. Now, lying here awaiting my final fate, I realize it was kind of cool. Freezing, actually. Surely someone has invented central heating by now. Couldn’t they turn the heat way up? “No, that’s the point. We’re inducing hypothermia to reduce your cardiac oxygen demand so we can get this pacemaker here into you and you out of here and back to class a jiffy.” I can’t see his face clearly because in 1950, looking at a surgical lamp is like staring into the sun. But the halo of light around the guy’s head illuminates his nametag. A feeling of awe and respect And anaesthesia washes over me. And then I go under -‐-‐ “JC! Wake up! Are you daydreaming again?” “So that’s why the dog was there.” I wriggle my fingers for emphasis. My CBL groupmates don’t get it. There’s no time to explain the Canadian relevance of the hypothermic dog in the history of open-‐heart surgery because our tutor has pointed at me.

“Okay JC, what’s next for this patient?” Today, it doesn’t take me a QRS interval to answer. “We should think about mechanical support eg. pacemaker and possible transplant in the case of advanced heart failure.” I feel slightly more confident about our patient. Thank you Dr. Wilfred G Bigelow. DYSSYNCHRONY

Jasmine (ZiJin) ChengUniversity of British Columbia MD2019

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Do not sleep. Do not waste time. Do not allow your-self to be distracted by anything that will not propel you further along the path to becoming a passingly competent physician.

Prove yourself. Do everything you can to gain expo-sure to a variety of clinical settings and specialties. What are you doing? You’re wasting time. I know

you’re tired, but look around you. You cannot possibly keep up. Your classmates are suturing lacerations, suctioning in-fants from ripe uteri, and you cannot even chart a proper history.

Acknowledge your stu-pidity. What made you think you could do this? How arrogant were you to presume you could endure this unscathed? How dare you even be surprised that it’s over-whelming?

Straighten up.

Smile.

Be open. Honest. Genu-ine.

When the inevitable question surfaces, al-

ways offer the proper response. An enthusiastic nod: “I love it here.”

Reflect on how fortunate you are to have this oppor-tunity.

Do not forget proper hand hygiene; lather, rinse, and repeat.

Do no harm.

Enjoy your time here. You have three years to build the foundation upon which your career shall rest; make the most of this experience.

Divide your time wisely between academic endeav-ours, clinical experiences, leisure activities, and stimulating social engagements.

Sleep for at least six hours each night. You cannot expect to pro-vide adequate care to patients if you are not functioning at an optimal cognitive level.

Accept that you will nev-er be able to grasp the intricate physiological mechanisms underlying each disease you study. This journey you have embarked upon is a life-long one, and you cannot expect to learn every-thing at once.

Read as many textbooks chapters, primary jour-nal articles, and system-atic reviews as you can find on each topic until you are certain you can teach those concepts to a group of your peers.

Understand that although it does not exist, perfection is the goal you strive toward—the standard against which all else is measured.

Do not show your weakness. Better yet, do not have weakness. Weakness is a luxury you can no longer afford.

THE ALGORITHMNikhita Singhal


THE HAND OF TIMEAgata DzwonekUniversity of Ottawa MD2017

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MYOCARDIAL INFATUATIONVivian Gu

University of British Columbia MD2020(1st Place Visual Category Prize)

O Canada! Our home and native land!

VoluMe iV, 2017 - Murmurs Magazine · 2017. 8. 20. · Layers Janet Green.....5 Ka Oshapatamihk...

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