I have always wanted to perform spoken word, and this week at our first-year talent show I was able to try it for the first time. I was very nervous (and wish I had made time to memorize it) but my classmates were so supportive and attentive that it was one of the best experiences I’ve had this year. I wrote this poem to express some of the feelings I and my medical school classmates have shared over the last year, especially over the last week, and relate it to this new language of medicine we’ve been learning. The attack on LGBTQ peers in Orlando was devastating and it has made us all ruminate on what it takes to overcome rejection and hate.

Transplant Rejection

The anti-rejection medication list is long

I know because he has to sit, on Sundays, and fill in little boxes for the week—

Morning, noon, evening, bedtime—

Like an off-season advent calendar—filled with

Not chocolates but

Pills

of all shapes and sizes –

Like pez and smarties and stale mike and ike

Rattling around—

He is rattled by it, but still, he takes them—

 

The anti-rejection medication list is long—

I know because when my parents came to this country they bought a Christmas tree

The day after Christmas

Black Friday

So that it would be cheaper

But so that we would have it

I know because we all balled our fists in anger at our mothers

For packing our favorite meals to school

Because we wanted Lunchables, not spice that stained our fingers and our breaths—

Because those foods were off-limits until they became trendy–

Because the fear that we would be singled out

Was palpable

 

The anti-rejection medication list is long—

I know because he says when he takes them,

Sometimes, his hands tremor

Uncontrollably

Sometimes his voice shakes

And his eyes wring out tears

And he finds himself wondering

Whether it’s the medication

Or him

And that distinction—does it matter?

 

The anti-rejection medication list is long—

I know because we insert “sorry” and “maybe” and “I was just wondering”

Between our words

Because hesitance becomes a reflex

And we find ourselves wondering if it’s the way we like to talk

Or the way other people prefer us to talk—

I know because random strangers have told us to smile more

Have commented on our bodies like

Commenting on the weather—

Have told us which bathrooms to use—

I know because “I can’t breathe” was somehow not enough

Because youth and innocence were not enough

Because centuries of pain were not potent enough

 

The anti-rejection medication list is long—

I know because he feels obligation to take them

As a thank you to the person, a much younger person,

Whose lung now resides in his chest—

When it rains outside

Or when it snows

The large scars hum and throb

And make themselves heard—

I wonder what it’s like, to carry someone else inside your body—

Then I realize that perhaps one day I will know, in a different sense—

 

The anti-rejection medication list is long—

I know because men stand on podiums and proclaim

That certain people who come to this country, or who are born in this country

Do not belong—

They activate a cascade that forms a clot in the heart of America—

 

Have any of us ever belonged?

We were all transplants

We all should have been rejected

But still we grew, we became a part of the tissue

Useful, indispensable in our new host—

We created the medications they would take from us

So that they would not reject us—

 

Though it is hard to compound and bottle and dole out love

That is what we try to do with words

And silence

And hugs

And light

And prayer

And reason

And peace

Even in the face of unspeakable rejection

When antibodies take bodies

Simply for loving other bodies

We continue our vaccination campaign of love

 

We say there are natural killers

But is it unscientific of me to refuse to believe it?

 

We immunosuppress

We try to stop the parts of the body that recognize

The new tissue as foreign

We try to stop the parts of our body that recognize

Ourselves as foreign

With each new pill we think we’ve moved on,

We hope that rejection is a thing of the past

Until it happens

And we are devastated

 

The immune system is trigger-happy when it turns on them, when it turns on us

An insistence on hygiene becomes a loaded gun—

Taking a good history could have told us this would happen—

This failure of tolerance,

The danger of focusing too much on self vs. non-self

 

So what is our plan? I find no ICD code for this pain—

If nothing else, we have learned this year that

the best laid plans of doctor and patient

Often go awry

 

But if you ask your patient, they’d say it’s simple

if you ask me as I sit naked, vulnerable, covered by a patterned paper sheet,

ready to be poked by a stranger,

I would say it’s simple.

The foolproof difference,

the most validated tool, to go from stasis to progress is

love

 

Love is not friable, it is not well-circumscribed but like a trophoblast invasion it is not malignant,

it sustains life.

 

My medical school classmates, you stood and you wept and you sang and you smiled and you cared

 

We present with intractable idealism and they tell us it will wane,

And maybe it will

But maybe it will wax again, like the moon,

revolving around our patients, around each other—

 

To care for a transplant as you do your own tissue

Is beautiful

Is possible

Is everything

 

And I want to thank you for reminding me.

 

 

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