• A true passion for service by Shaun-Pierre Hall
  Friday, November 6, 2009
• The passion to HEAL by Eron Manusov M.D .
  Saturday, October 31, 2009
• Listen by Angela Green
  Tuesday, October 6, 2009
• Selection by Michelle Miller
  Tuesday, October 6, 2009
• Journey 1: Lost by Jason A Boothe
  Tuesday, September 22, 2009

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A true passion for service by Shaun-Pierre Hall
Friday, November 6, 2009

Your perspective on the need for sleep
Has been quickly rearranged,
Your adaptation to multitasking
Resembles skillful or deranged?
Your kindergarten friendships
Where you daily shared all experiences,
Have somewhat dwindled & shriveled
To mere supermarket coincidences.
You long to sleep for hours
But it feels guilty if you do,
As you think that somewhere out there
Others are days ahead of you.
You never just see faces
You see expressions, you see alignment,
You see way past the nods & shakes
You glimpse the desire for contentment.
Each day is a pop quiz
Are you prepared? Are you ready?
The answer not only foretells your grades
It determines your very destiny.
What could possibly make you choose
To live your life with this upheaval?
Praying you’ll make it through the week
Knowing your character is on trial?
It is knowing that at the end
You can help to ease the pain,
Dry the tear, Remove the problem
Help restore the hope again.
No other joy like helping others
No other all-consuming practice,
How Divine is the gift
Of having A True Passion for Service.

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The passion to HEAL by Eron Manusov M.D.
Saturday, October 31, 2009

Life, art, music, and love HEAL.

Physicians, medical students, nurses, and health workers HEAL.
To touch is to HEAL.
To listen is to HEAL.
To share is to HEAL.
To love is to HEAL.

Are we special because we can invade and walk where others don’t?
No, but we can HEAL when we do we care with compassion.
To learn is to HEAL.
To teach is to HEAL.
To Listen is to HEAL.
To Love is to HEAL.

Medicine is human and to feel is human.
Can we forget that we are human? Certainly.
To care is to HEAL.
To think is to HEAL.
To listen is to HEAL.
To really hear, care, and act,
HEAL.

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Listen by Angela Green
Tuesday, October 6, 2009

Please…..
Silence these voices… shouting in my head
Thoughts about my people…
who are dying…
Struggling to breathe….in this economic disaster
So they plaster… themselves against the wall
Hoping
Begging
Pleading for relief…
Or death
Whichever comes first

Can you hear the cries of Zemora
As she lays at night
In pain from the hunger of yesterday
And the despair of tomorrow
Can you… feel her sorrow
As she prays for death

Little Akeel is crying from…
No father in sight…. and
Mommy always working
So he… sleeps alone at night
Gunshots outside his window
His innocence is robbed
Listen softly and you will hear Akeel
Praying for death

My people are suffering
As they… struggle to live
To survive is the key…
But the door remains locked
So they… pray in silence
Through tears
And sorrow
They have no concern for tomorrow
Because they… pray for death

So I beg of you right now
To listen
Be attentive
To the thousands
Of children
Who… pray for death
Show them life
So thereafter
They can resound in laughter
And then smile
As you hear them
Thank God for life

---

Selection by Michelle Miller
Tuesday, October 6, 2009

There’s the fishbowl
Filling, not with water and fliesBut, with numbers to decide
the next two years of our lives

Energy is cracking as people move in
There is no line,just a mesh of bodies,
people who have to vie

Yet no pushing
As though we’re all resigned to this fateWaiting to be the next to pick
Then sign our name and wait

There are a few that do not participate
Faces smug with grinsBut hidden is the grief
At possibly losing friends

We wait in our seats
Numbers are announcedNo one hovers
Some even pounced

Names are filling the slots
Did they turn up the heat?I go in for the last spot
And as I am returning to my seat

A friend makes a comment
That was their heart’s desireChoices are fluttering in my head
As my palms are getting drier

How this will affect me
How this will benefit hisIs there a right thing to do?
There is.

This is just a practice
For in two yearsThere will be the match
A much larger fishbowl, and much more tears

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Journey 1: Lost by Jason A Boothe
Tuesday, September 22, 2009

So much confusion,
my soul needs to rest.
Pain radiates from my chest
as I sit back and contemplate the fate
of the many men and women seen
suffering from a disease called
Unfulfilled Dreams.
A family torn apart by a stigma,
an apparently uncontrollable enigma.
A little girl with the world in her eyes
stares at me as if I were more,
I just wish I could whisper in her ear and tell
her I found the cure.
Children with outstretched arms reach for me,
not truly understanding that in a moment’s time
they won’t be able to see.

Every life lost in this place is a defeat,
not to an economy
but to a family,
just think of what that person was suppose to be.
Now he or she is just another example in
a never ending tragedy.

Although death and loneliness surrounds us
like a blanket on a frigid night around us
we can’t help but to notice the smiling faces,
relieved, happy even, to see us.
I think to myself why are we worth such a fuss
but it is because just maybe there is a savior among us.
Someone who can change their world
and remove the blinding clouds of dust.
In my heart I know they just need someone
they can trust.

In this place, Eastern culture and Western knowledge
engage in a boxing match where there will be no winner.
For accepting one, means truly abandoning another.
Leaving one more child without
a sister or brother
father or mother.
Left to roam the street
with no money
and no shoes on his feet.
Or sell your soul
and become cold and cultureless.
For a person without culture
is a person without skin
desperate to find a place in this world we live in.
All this while people pretend
to fight wars that are meaningless.
Unwilling to feed the desolate deserving masses of
human beings
Trapped; or so it seems
in the black holes of poverty and hypocrisy,
with blindfolds over their eyes so they can’t see.
This can’t be.

• Reflections on a Falling Man 9-11-2009 by Eva Bellon
  Tuesday, October 6, 2009
• Waning Moon by Jen Packing-Ebuen, MPH
  Thursday, September 10, 2009
• Am I listening? by Amanda Grondin
  Thursday, September 10, 2009
• Conversaciones con Abuela by José E Rodríguez M.D.
  Thursday, September 10, 2009
• The inner invisible by Mariana Dangiolo M.D.
  Thursday, September 10, 2009

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Reflections on a Falling Man 9-11-2009 by Eva Bellon
Tuesday, October 6, 2009

Eight years ago at this moment I was unable to sleep. Like the rest of the country I was shell shocked by the events of the day that had unfolded in front of my eyes. I remember the moment, more vividly than almost any other in my high school career. I walked into Mrs. Hensel's 2nd period English Honors class and she was leaned against her desk, fear in her eyes, staring at the screen of the TV against the wall in the middle of the room. There were only a handful of people who had beat me to class from first period and I slide my bag into my seat and moved closer to my beloved teacher. Had the entire world gone mad? Was this some horrible joke? At this point only the top of the North tower was on fire. Words like terrorism were only carefully speculated at by the news anchors and my class and I sat there in silence as they argued about what was happening in monotone voices- they themselves to far in shock to form many other thoughts. "I want you to see this; this is going to change the rest of your lives. This is history and we have to see this." That is all that was said by my teacher. Moments later the plane hit the south tower. Some of us screamed, most of us cried, but we all continued to watch. The news anchors were now declaring the act one of terrorism and many of them had lost all composure. Panic had begun to creep into their voices and we sat there completely lost staring at the screen. Then it fell. It crumpled into itself and slide into the floor of the city. Safely in our 10th grade Florida classroom we watched and we knew that thousands had just died. Mothers, fathers, brothers, sisters, children, and friends. The bell rang and brought us to the reality that we were in high school, although we all felt like we were standing at the base of those buildings in the middle of New York City for the past hour. Nothing would ever be the same. We stumbled out into the crowded hallways and met other students who had been watching in their classrooms. The few classes that did not realize what had happened were quietly filled in as we made our way down the halls. Tears streamed down half of the faces that I met. My friend Britney approached me in hysterics, cell phone in hand. "My dad left on a plane for New York this morning" was all she could get out before collapsing in my arms. We sat down across from our next class that we had together and she composed herself and called her mother back who was franticly trying to find out what flight he had been on. It was only a few seconds before we had to walk into class that she found out the plane wasn't his, but she still didn't know where he was. We walked into Calculus together and the TV wasn't on. I walked to it and pushed the button just to have my teacher tell me to please turn it off. My mind flew into defensive mode and I spoke back to her. This is history, we have to see this. She felt it was only upsetting us more and we should try to do some Calculus instead. Half the class spent the entire time texting friends and family who were watching the images; I sat there in a furious shock, my brain numb. Someone told us when the second tower fell and our whispers flew around the room. Soon after this, my principal, in an attempt to calm our frantic school (much of a community that attended school with us were originally from New York), he proclaimed that all televisions must be turned off and any cell phone use would result in confiscation. Britney said she would like to see them try to pry it from her hands. The rest of the day became a blur in my memory. All that stands out was the intense anger we had at our educators for censoring our information. That is what this note is about. Much of that day soon became censored, by the government and by the media. By the time I reached my house from the school bus, images I had seen earlier that day were already being pulled from clips. The most haunting and emotional images were when I watched the dozens and dozens of people who jumped to their death from the blazing inferno. I thought of my fear of burning to death and my fear of heights and weighed them against each other. I put myself in their shoes. I do not know which path I would have taken if escape was not an option. But these images that had affected me so much more than even the massive collapse of the towers- were nowhere to be seen. It is not that I wanted to relive that private and horrifying moment, that last moment of these people’s lives, but it is that I felt it was the perfect image of just how horrible that day was for America and the despair of all those that did not escape the horrible event. To me it was disrespectful to those falling individuals, for us not to see what they had to endure. Every year on this day I go on YouTube and watch pictures and news clips from that day so that I will never forget how I felt that day. When I did so today I went on a journey that I did not expect. I came across a video that is a documentary of those jumpers. It is the single most beautiful thing I have seen to date about remembrance of this day. I am not tagging anyone in this note because this video has images that may be too emotional for anyone with close ties to those that lost their lives that day. I am writing this note for me- so that I will be able to find this video again- so that I will never forget how I felt that day. I hope that others will watch the movie though, no matter how emotional it may be. The video is more than an hour long. It is long and beautiful. I thank the creators of it for bringing such a truth and respect to this subject.

Here it is: http://www.youtube.com/watch?v=BXnA9FjvLSU

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Waning Moon by Jen Packing-Ebuen, MPH
Thursday, September 10, 2009

I thought we would all be together, always.  But change is something that an immortal must learn to deal with.

“Dr. Cullen?  Dr. Cullen?”

I shook myself out of my thick haze of memories and looked up.  “Yes, Dr. Johnson?”

“Your sister is on line two,” She smiled at my temporary loss of composure and winked at me.

“Thanks, Patricia,” I smiled back, and then tapped my earpiece.  “Hi, Alice.”

“Bella, another visitor will be arriving from Volterra tonight.”

My eyes narrowed slightly.  “Does Aro know?”

“Yes.  He’s a friend of Eleazar’s.”

I glanced at the clock.  Fortunately, Edward’s last surgery coincided with my rounds.  “We’ll be home in two hours.”

“I know,” Alice laughed and hung up.

Another visitor.  This was the fourth from Volterra.  The shift in the balance of power had begun.

After the confrontation with the Volturi we enjoyed a brief period of peace, but within a few months the visitors began arriving.  At first it was just a few here and there.  Then about two years afterward it increased to every other month.  Soon it was nearly ten a year.  When we returned from Dartmouth with Renesme and Jacob, Carlisle had built a guesthouse for up to six people.

Some were curious, some were seeking, some were desperate, but all of them were asking how to live without human blood.  Word was spreading faster than any of us could have predicted.  And then we started getting visitors from beyond Europe and the Americas.  When Carlisle got the first postcard from Kate, he quickly realized what was happening.

Their grief from the loss of Irina threatened to overwhelm them, so the Denali coven took on a new mission as members of the Cullen family: spread the word.  They had started with acquaintances of Garrett’s and those friends had sent them on to others.  Within about ninety years Tanya’s family covered nearly every corner of the globe.

In that time our family had left Forks a couple of years after Charlie died at 62 of an unexpected heart attack.  I was in shock but Renesme was devastated.  Within a year, however, Jacob proposed and the newlyweds moved onto the reservation.  Despite Carlisle’s gray hair dye we finally had to make our excuses and move on.  We began the cycle again, but this time Carlisle, Edward, Rosalie and Jasper all posed as siblings, and the rest of us had married into the family.  For eighty years we lived happily, moving to three other communities, but everywhere we went, the visitors found us.

“Vampires around the world know your story.  They should know they can have a better life.  We’re starting a revolution!” Garrett laughed.

I walked through the halls of the Cullen Memorial Hospital to my last rounds before my shift ended.  Carlisle had made a large donation to refurbish the hospital, which needed some renovations due to advances in the latter half of the 21st century.  The new wing opened when we returned from college again, just before Carlisle’s 470th birthday.

Tanya, Garrett, Kate, Carmen and Eleazar joined us for the party, and brought along a new friend from India called Timir.  Timir was agitated and Edward noticed his thoughts were somewhat disordered, markers of a vampire who was purposefully avoiding feeding, so the boys took him out the morning of Carlisle’s birthday because they also wanted to play hunting games with the old man.

The brothers enjoyed their usual game of who can gorge the fastest.  But after Edward put down his eighth deer, he noticed that Carlisle had only taken two.  Edward began to walk toward his father, and then he realized Carlisle was leaning against a tree as if he was… fatigued.

“Carlisle?”

Edward… Carlisle called to his son as he sagged and fell.  Edward was there in an instant and caught his father before he hit the ground.

I walked through reporting and giving orders at each bedside without needing much forethought.  The team following me took many notes.  If only vampire medicine was so comfortably routine.

Edward deposited Carlisle’s unmoving body in the upstairs office where there was a full set of equipment for emergencies.  But vampires have no heart beat, no respirations, and we had never seen an unconscious vampire before.

“He’s alive,” Jasper said with a clenched jaw.  “He would be hard as a rock if he were dead.”  He was the one among us who had seen enough death to know.

Four hours later Alice ran up the stairs and Edward followed her when he heard Carlisle’s first confused waking thoughts.

I arrived just as Esme sat on the bed and pulled his face to her.  “Carlisle!  Tell me what’s happening!”

Carlisle caressed her cheek tenderly, then turned toward the door.

“Would everyone, please, join us?” Carlisle called, and everyone gathered within seconds.  Renesme stood by the door but Carlisle and waved her closer.  He pulled her petite frame up onto the bed, and her anxious face buried in his shoulder broke my heart.

“What are you keeping from us?” Edward said with a slight edge in his voice as he listened to Carlisle’s thoughts.

Carlisle sighed.  “About a decade ago, I noticed very subtle changes.  My vision was not as acute.  My hearing was slightly less sensitive.  Then about six months ago, my energy dropped suddenly, and I stumbled at work.”

Esme’s grip tightened on his shirt. “Why Carlisle?  Why keep this from us?”

Carlisle squeezed her hands gently.  “I didn’t realize how much I was being affected, it was so subtle at first.  And then I was researching, I wanted answers before I spoke to everyone.  I had a few old notes from when I first learned how to clean venom wounds, and reassemble disembodied vampire limbs, but I’ve never seen what I am experiencing.”

“So you’ve found no explanation?”  Edward’s face was still tight.

Carlisle looked into Edward’s eyes and then dropped his gaze again.

“Carlisle…” Edward’s frustration mounted.

“I think I’m dying, Edward,” Carlisle said quickly.

Every vampire in the room was frozen.  Renesme pressed her face to Carlisle’s soft marble chest, and began to cry quietly.  I knew her fear of losing her other grandfather was coming true.  Carlisle wrapped both arms around his granddaughter.

“Carlisle, that’s… not possible!”  Rosalie gasped.

“Rose, I’m not saying that my logic is infallible, but I’ve excluded many, many other possibilities.”

“But Aro is older, still strong and…” I whispered.

"No, he isn’t,” Edward said with a hollow voice.  “They’ve all become more fragile in the past five centuries.  That’s why they have the guard, and Aro’s shield.”

“But you don’t look all thin like they do!” Emmett said angrily.

Carlisle turned to Emmett.  “What is the main different between Aro, Stephan, and me?”

“You’ve fed only on animals,” Edward said quietly.

Each person considered the implications of this news in their own thoughts.  Then Edward turned to Alice who was sliding down the wall, her face in her hands.

“ALICE!  STOP!” Edward knelt in front of her and pulled her hands away from her tear stained face.  “STOP!”

“I…I can’t see!  Anything!  ANYTHING!”  She sobbed.  Edward stared at her. They both knew what that meant.

Carlisle turned toward Alice.  “Alice, we don’t have to know.  I have lived an unnaturally long and fulfilling life.”  He gave her a calming smile.

Edward grimaced as he held Alice.

"Don’t you think we should at least try?” Esme protested.

“There is only one person you need to call now,” Carlisle said quietly.

“Aro,” Edward read the thought in his father’s mind.

Carlisle nodded.  “I believe he has seen this before in other animal feeders.  I need to know what he has seen.  He may confirm what I believe is happening.”

“Or he may try to kill you!” Rosalie shouted.

“Rose, please trust me.” Carlisle’s eyes pleaded.

“I’ll call Aro,” Edward said with authority.

“Thank you, Edward,” Esme’s pain was unmistakable.

Edward turned away to hide the hurt in his eyes.  Carlisle had never kept secrets like this from them.  Then Edward stared at Timir.

“How is this comforting to you?” Edward whispered incredulously.

Timir blinked.  “Mr. Edward, do you have any idea how many vampires would give anything to know that there is an end to their existence?”  He turned to Carlisle.  “I wish peace and prosperity to you and your family.  I will tell everyone.  You have changed me, for as long as I live.”

Timir nodded to each family member, and his words impacted us all.  He found hope where we were despairing.

I knew that Edward still felt ashamed for his anger with Carlisle.  It was a subject he avoided even with me.  I kept my thoughts to myself as he walked up to me smiling, his leather bag full of patient charts and paperwork.  He leaned down for a tender kiss, and then I smiled back.

“Time to meet another visitor.”

As he us drove home from the hospital I reminded myself again of the perspective of the vampires who came to us.  Some needed direction.  Some needed instruction.  Some needed hope.

Our hope was draining away when Edward called Volterra.  The human valet was not surprised to get Edward’s call, and just a short time later, she was giving Edward the private jet’s flight time.  Aro would arrive in the evening the following day.  Eleazar was visibly agitated at the thought of Aro in the house.  Tanya and Kate were quiet most of the time.  The loss of Irina was still so painful that losing Carlisle was almost too much.

When Jacob returned from patrolling that night for the party, the palpable change in the house alarmed him.  Renesme placed her hand on Jacob’s cheek and he watched her thoughts in silence.  Then we led him up to Carlisle.  Edward was standing by the bed with a hand on Esme’s back as she sat on Carlisle’s bed.

Jacob could see the agony in Edward’s eyes, and it so clearly reminded him of his own father’s death that he nearly lost control of his calm façade.

“Dr. Cullen, without you there would never have been any chance for peace.”

“Jacob, peace takes agreement and action on both sides.  You are the future of our alliance.” Carlisle looked at both Jacob and Edward.

Jacob felt the gravity of such a commission deep in his stomach.  Then, he put a hand on Edward’s shoulder.  Edward turned to him and nodded.

The next morning, Alice told Edward that Marcus and Caius had decided to come.  Edward was now concerned that Volterra was planning a second attack.  We went to talk to Carlisle and Esme.

“Carlisle, if you die, what is to stop them?” Edward wrung his hands as he sat next to Carlisle’s still body.

“Edward, they cannot.  Our family is too strong.”  Carlisle said quietly.

Edward shook his head, “I don’t trust them.   Why would they come here without hidden protectors?”

“Alice says they are alone,” Carlisle did not waver.

“They know how to mislead her,” I added.

Carlisle did not respond.

“Carlisle?” Esme sat up and my eyes widened.

Carlisle’s eyes were blank and half open. 

Edward leaned over his father and grasped his shoulders, “Carlisle!”

“I’m here, Edward.  My vision suddenly clouded.  I can’t see you clearly…” Carlisle’s voice faded.

Edward’s forehead creased as his brows came together.  “Father, I… cannot do this without you…” Edward’s voice cracked slightly.

Carlisle moved his head, searching for Edward’s pale face in the blur before his eyes.

“Edward, you have known for a long time that you would take over leading this family.  You have the strength.  You have a loving partner who will support you.  Your mother will be at your side.”

Edward nodded, and long denied tears finally fell.

“And son, I will always be with you.”

Edward released his hold on Carlisle’s shoulders, and took both of Carlisle’s hands in his.  “I will take care of them.  I will defend our family, as you would have.”

“Thank you, son, but I never doubted that you would,” Carlisle said, and then he smiled.

Edward looked intently at his father.  I knew Carlisle was talking to him without speaking.  Edward’s eyes softened and the corners of his mouth turned up slightly.  But then I saw Edward tense, and grip Carlisle’s hands tighter.

“Not yet,” he whispered so quietly no human would have heard him.

Edward prepared his brave face for our visitor as we pulled into the large garage that held fourteen of the family vehicles.  I could see he felt the weight of his responsibility as he stared straight ahead.

The evening Jasper ushered Aro, Marcus and Caius into the house Edward stopped them at the top of the staircase.  Aro bowed low, completely submitting to Edward’s authority in the Cullen household.  Edward turned and led them into the office.

Carlisle was laid against a stack of pillows so that he was sitting up, but his head was tipped slightly back because he could not hold it up.

“He cannot see or speak.  He wants you to approach, Aro,” Edward said quietly.

Esme was still sitting on the bed, her head laid on Carlisle’s right shoulder, holding his hand.  Aro sat in the chair on Carlisle’s left next to the bed and nodded to Esme who looked sadly back at him as a fresh tear rolled down her cheek and landed on Carlisle’s shirt.

Marcus and Caius stayed respectfully silent near the door.

Aro leaned forward slightly.  “Hello, my old friend.  I am utterly grieved to see you this way.”  Then he lifted his right hand and placed it on Carlisle’s cold cheek.

Aro remained motionless, his eyes trained on Carlisle, and the two unmoving figures locked in that moment resembled a timeless Michelangelo sculpture.  When Aro finally lowered his hand, I could see sadness in his eyes that echoed with ancient desolation.

“He is declining quickly,” Aro said quietly and turned toward everyone present.  “It is true that human blood has fed my body better and more efficiently than animal blood is feeding yours.  I am a product of uncounted millennia of evolution.  But even I am NOT immortal.  Our beloved Carlisle, believes that there is hope for animal feeders.” Aro smiled slightly at the entire family.  “Carlisle is the strongest animal feeder I have ever known of, and I believe his hope is justified.  As you who were transformed by him carry on his line, your future progeny will only grow stronger.” Aro looked at me.

“But,” Esme breathed, “You… cannot help him?”

Aro dropped his eyes.  “It is not within my power.”

“But there is something that can be done?” Emmett said angrily.

Aro frowned at Emmett.  “Your father would cease to exist if I fed him human blood.  I will never force that upon him.”

Edward looked over at Carlisle, who gazed in his direction reassuringly with unseeing eyes.  “He wants to talk to all of the Volturi.”

Marcus and Caius were already drifting toward the bed, and Aro lifted up Carlisle’s left hand in his.  Marcus and Caius each laid their right hands on top of Carlisle’s, their fingers intertwining with Aro’s as he served as the conduit between the minds of all four vampires.  I watched with fascination at the re-enactment of a ritual that the four had performed only once before in Voltura two centuries ago.

Within a few seconds Aro turned and raised a hand to Edward.

“Edward, your father has named you as head of your family.  And we will honor how you govern yourselves among the humans as long as it does not conflict with our own safety.”

We all exchanged glances.  Edward’s position as family leader was not a surprise, but Aro’s graciousness was.  Caius seemed displeased, but resigned.  A diminutive smile passed over Marcus’s face.  Their ancient fight for domination that killed his wife was over.  There would be two primary covens from this point in history forward.

“Aro,” Edward held out his palm, and Aro lowered his hand to it.

Aro smiled.  “Thank you, Edward.  I hope the Cullen Family will accept the Volturi’s deepest sympathies. I look forward to our next meeting.”

Aro turned to me and bowed.  Then he, Marcus and Caius all floated down the stairs and disappeared into the limousine and into the night.

We all took positions on and around the bed, each one laying a hand on Carlisle.  Edward spoke aloud from Carlisle’s thoughts.

Carlisle remembered his origins, his transformation, and learning his new way of life.  He spoke of our alliances and friends, and about his wish that we would extend our family. He remembered finding each of us, of his joy at seeing all of us happy, and of his love for his only grandchild.

His final thoughts were for Esme.

“He says, My love, my love… forever…” and then Edward abruptly stopped speaking for the first time in over thirteen hours.

Edward tightened his grip slightly on Carlisle’s leg, and found that his once soft marble flesh was now rock solid under his fingers.  Edward’s face twisted with grief, and his cry of anguish echoed in the house, but soon faded to silent sobs.  Esme threw her arms around Edward’s shaking shoulders.

“He would be proud of you,” I said laying a hand on Edward’s forearm as he continued to stare ahead, making no move to leave the car.

Edward turned toward me.  “He told me in his thoughts, he had come to believe that this was the reason he was changed.  He found peace as a healer for humans; but God’s purpose for him was… to bring hope to vampires.”  Edward looked at me as tears pooled in his liquid gold eyes.  “And I believe him.”

I smiled at Edward as a tear rolled down my white cheek, and then I squeezed his hand.  I thought we’d all be together, always.  And he was still with us.

“Let’s go meet our visitor,” I smiled.

---

Am I listening? by Amanda Grondin
Thursday, September 10, 2009

Amanda originally wrote this essay as a part of an application to a scholarship, but as she reflected on what it said, she modified it and sent it to HEAL.  Her experience can help all of us as we move forward.  This is her story:

During an international service learning trip to Ecuador in the summer of 2008, six other medical students, a faculty member, and I toured several medical clinics and hospitals.  Dr. Bradley Quist, an American family physician who had been volunteering there for eleven years, was kind enough to show us his missionary clinic outside of Quito.  He explained that his journey to Ecuador began at the age of ten.  He knew that his purpose in life was to become a physician and volunteer internationally.  He listened obediently to his calling from God.  Upon reflection that night, I began thinking about my journey to medical school.  Unlike Dr. Quist, I did not know I would be attending medical school until the age of twenty-one.  I had considered several options before finding “my fit” in the medical profession, but my ability to excel in medical school and enjoy patient encounters assures me that I am in the right place.  I couldn’t help but wonder, “Am I listening?”

Furthermore, I have not accomplished the plans I had laid out for myself as a medical student.  Rather, I have accomplished more than I could have expected.  Without a doubt, Florida State College of Medicine is where I am meant to be.  It is here that I have expanded my knowledge of global health and medicine and became involved with the Students Interested in Global Health (SIGH) interest group.  I was fortunate enough to meet Dr. José Rodríguez, who not only agreed to be the faculty mentor for a summer international service learning trip to Ecuador, but also encouraged me to be an active student leader and trip coordinator.  He is who I have to thank for helping in my personal development.  A number of wonderful experiences and memories have come from the trip to Ecuador, including cultural sensitivity and a new dedication to improving my Spanish skills.  I was even able to conquer my fear of heights by going on a zip line.  Most importantly, it has helped me begin to see my purpose, and the potential for me to serve poor communities domestically and abroad. 

While I continue on this journey and am unable to always see where I am going, I can see that my past educational experiences were a strong foundation to strengthen my medical education.  My women’s studies courses focusing on race, class, and gender have made me more aware of the difficulties that many patients face in finding medical care.  While learning with faculty members at the Neighborhood Health Service, I witnessed the suffering that I learned about in those courses.  I interviewed one patient who suffered from depression and had contemplated suicide, but every doctor had refused treatment due to lack of health insurance.  I can now see that regardless of my poor “listening skills,” each experience has shaped my past, and will contribute to my future.  I hope to always remember that listening to that inner voice will help me develop into the caring, compassionate physician I hope to become.

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Conversaciones con Abuela by José E Rodríguez M.D.
Thursday, September 10, 2009

This is the first one of a series of conversations with grandmothers and grandfathers.  This project began in an effort to connect students with the elderly in their community.  This particular conversation was with Dr Rodríguez’ grandmother, who is the matriarch of his family.  It is presented in Spanish because that is the only language that grandma speaks.

Hace muchos años atrás, mis tías Elvia y Doris le hicieron una semblanza a Abuela Orpa.  De esa semblanza decidí juntar las historias de su vida para mis hijos, mis sobrinos y mas que nada, para mi Abuela Orpa.  Me hubiera gustado hacer esto para mis otros abuelos, pero en ese entonces, yo ni tenia la habilidad ni sentía la necesidad de hacerlo.  Aunque se que Abuela Orpa vivirá por muchos años mas, siento que ahora debo de dedicar un tiempo a juntar los hechos de su vida.  Y si me toca volver a Puerto Rico solo para hacerlo, lo haré porque siento que este trabajo es muy importante.  Todos somos familia, y todos los nombres de nuestro árbol genealógico tienen una historia.  Esta es la historia de ella.

Abuela Orpa nació el 18 de febrero, 1916 en la finca de sus padres en Barrio Robles de San Sebastian de las vegas del pepino, Puerto Rico.  Ella nació en la casa de sus padres que queda cerca de la casa de su hermano menor, Pibe (Marcial).  Ella hoy día tiene 93 años y estas son algunas cosas que compartió con migo en el ultimo viaje a Puerto Rico. 

Abuela Orpa no se llama Orpa, sino Olga Eladia Velazquez.  Orpa era una de las concuñadas de Rut, en el antiguo testamento, y Abuela Orpa tiene una hermana que se llama Rut.  Cuando nació Abuela Orpa,  Abuela María (su mama) le mando a Abuelo Marcial (su padre) a inscribirle al registro demográfico con el nombre Orpa.  Abuelo Marcial se fue con un amigo, y se distrajeron, comiendo y bebiendo.   Cuando llegaron al registro demográfico, ya se les había extraviado la hoja donde Abuela María había escrito el  nombre que ella quiso ponerle a su segunda hija.  Seguro que Abuelo Marcial y sus amigos estuvieron allí juntos y mi bis abuelo le decía a sus amigos “Contra, María me va matar.  Creo que el nombre empezaba con la O.”  El le puso Olga Eladia Velazquez del Río, pero ese no era el nombre que Abuela María quería.  Aunque Abuelo Marcial no le puso ese nombre, Abuela Orpa nunca lo supo.  Ella se crío como Orpa Velazquez y no fue hasta después que murió Abuela María que Abuela Orpa se enteró que se llamaba Olga.

Abuela María era una mujer fenomenal.  Ella nació en el año 1889 y ella fue a la universidad y trabajo todos los días de su matrimonio fuera del hogar.  Y esto fue machismos años antes de que las mujeres en Estados Unidos hicieron lo mismo.  Por 36 años ella trabajó en el Barrio de Robles en San Sebastian de las vegas del pepino.  Por eso, Abuela Orpa pasó los primeros años de su vida con los abuelos Mama Senda y Papa Tití del Río, que vivan en Ponce.  Allí ella asistía la misa con sus abuelos, y allí ella se hizo católica.

Abuela María, sin embargo, no fue católica.  Ella era evangélica, de la secta de Lutero, pero sus hijos se criaron católicos porque se criaron con los abuelos, y porque abuelo Marcial era católico.  Eso me sorprendió mucho, porque siempre pensé que la primera persona en mi familia por parte de mi mama en salir de la iglesia católica fue mi madre—Nilda Mireya Maury Velazquez.  Abuela Orpa me contó que Abuela María no fue evangélica toda la vida.  Cuando Abuela María tenia 4 años, el huracán San Ciriaco ataco la isla de Puerto Rico de una forma increíble.  Abuela María vivía con sus padres en Añasco, y  el huracán destruyo el pueblo.  Su familia perdió todo, y hubo un tiempo que las aguas subieron tanto que casi todo el pueblo estaban juntos encima en una loma.  Entonces Abuela María, siendo niña pidió a la virgen de Monserrate que preservara a todos los que estaban en esa loma.  Ella repetía todo lo que le decian los mayores.  Ella también hizo una promesa con esa oración, de repartirle 10 peso a las personas mas pobres de los vecinos. Ella nunca pudo pagar su promesa, pero Abuelo Marcial y Tia Adel, Tio Casto, Tio David, Tia Tuti, Abuela Orpa, Tia Rut, y los demás hermanos fueron y pagaron la promesa después del dia de su muerte.  Aún con pocos años Abuela María tenia fe, y esa fe esta muy fuerte en las venas de Abuela Orpa, de Mami y de todos sus nietos y bisnietos.

Abuela me contó que ella vivió al lado de Abuelo Jacinto, y ellos se conocían toda la vida cuando se casaron.   Ella se caso cuando tenia 21 años, y abuelo Jacinto 23. 

Cuando Abuela Orpa era niña, ella estudiaba en San Sebastian, pero esa escuela solo llegaba hasta el octavo grado.  Como mucha gente no podían ir a otros pueblos para estudia, allí terminaban.  Pero Abuela Orpa no fue así.  Había un lugar en Añasco donde ella podía terminar su escuela superior, y le permitieron ir a estudiar.  Ella estuvo allí hasta casi ganarse el diploma, pero ella necesitaba ir a Mayagüez para el ultimo semestre.  Abuelo Marcial, no quiso que se fuera a estudiar en Mayagüez porque era muy lejos, así que nunca termino la escuela superior.  Ella volvió a Robles (el barrio de San Sebastian donde se crió), y estuvo allí hasta casarse unos cuatro años después.

Me contó que su mamá, Abuela María, era maestra, y trabajó 35 años en la escuela.  Eso me sorprendió, porque en ese entonces las mujeres no trabajaban fuera del hogar.  Ella también se crío en Robles, y hay una escuela que lleva su nombre allí.  Abuela María enseñaba de todo, porque enseño primero, segundo, y tercer grado.  Por eso, Abuela Orpa pasó mucho tiempo de su niñez en la casa de sus abuelos en Ponce, que era muy lejos de San Sebastian.  Después de enseñar todos los días, Abuela María volvía a la casa para hacer las cosas del hogar.  Muchísima gente le conocían, y algunos creían que ella era doctora.  Esta historia me intereso mucho, porque yo soy medico, y pensé que era el primero en la familia.  Trabajadores, vecinos, y otros venían a la casa de Abuela María para curarse. 

Abuela María curaba culebrón, y no estoy completamente seguro como se llama esa enfermedad en ingles hoy día.  Lo importante es que esa enfermedad causa ampollas en forma de una culebra, y se decía que si la cabeza de la culebra tocaba el rabo, la gente ya se morían.  Pero Abuela María los curaba con una ruda hinojo y con tinta.  Cuando la gente volvían agradecidos a Abuela María, ella nunca pidió plata, y lo rechazaba cuando se le ofrecía.  Abuela María simplemente les decía que por favor oraran por ella y su familia.  Esas oraciones se fueron contestadas, porque en la casa de Abuela Orpa, nunca había escasez ni hambre.  Tal vez es por eso que yo, en mi trabajo como medico, solo atiendo a los que son tan pobres que no tienen seguro medico.  Una herencia de mi Abuela María, por medio de mi abuela Orpa.

Hoy en día (Mayo 2009) la economía de Puerto Rico y de Estados Unidos esta en una crisis que tiene a todo el mundo asustado.  Hay muchas personas que están hablando del pasado, especialmente la “gran depresión” donde no había trabajo ni comida para muchísimas familias en Puerto Rico y en EU.  Le pregunte a Abuela Orpa como era la vida durante la gran depresión, y su respuesta fue muy agradable.  “Aquí no sufrimos mucho….”  Mi familia tenia tierra y ellos sabían trabajar.  Producían café, caña de azúcar, y maíz.  También tenían muchas personas que trabajaban con ellos.  “Eran personas honradas.”  Como muchas personas se vieron afectados por la depresión, muchos fueron donde abuelo Marcial, para ver si podían arrimarse, o vivir en sus terrenos si trabajaran por el.  Abuelo Marcial les dejo vivir en su propiedad, y estos “arrimados” cumplieron al pie de la letra con su patrón. Así que los Velázquez no sufrieron y aliviaron el sufrimiento de otros.  Tal vez es por eso que nosotros tenemos una conciencia social tan fuerte que muchos de mis primos y yo trabajamos en nuestra vida profesional para aliviar el sufrimiento de los pobres.

Abuela Orpa, después de casada trabajo fuertemente por el bien de los demás.  Ella se caso con mi Abuelo Jacinto Maury Ruiz cuando ella tenia 21 años.  Con el tuvieron cuarto hijos: Junior, Mami, Rigoberto y Godofredo.  Abuelo Jacinto fue muy trabajador, y con las tierras de abuela Orpa, las tierras que el compro, y las tierras que el heredó, tuvieron mucho éxito y mandaron a los cuatro hijos a la Universidad.  En ese tiempo, no había luz ni teléfono en el barrio de Robles, pero si lo había en otras partes de la isla.  Abuela Orpa lucho para que trajeran luz a su casa en la ruta PR 446.  Esta lucha le llevo a hacer demostraciones y peticiones en la plaza central de San Sebastian, frente a la alcaldía.  El alcalde los escucho, y por fin llego la luz en el año 1957.  Habían tantas curvas que tenían que poner los postes de la luz con helicópteros—una cosa que jamás se vería hoy día.  Poco tiempo después, el teléfono llegó al pueblo, pero no al barrio.  En ese entonces Abuela Orpa se hizo amiga de la primera dama de Puerto Rico, Doña Kate de Ferrer.  Ella correspondió mucho con Abuela Orpa, y el otro día Abuela Orpa tuvo que botar unas 45 cartas de ella.  En una de esas cartas, Doña Kate le había prometido $5000.00 para que Abuela Orpa pudiera traer una línea telefónica privada desde la fabrica de jugo en el pueblo hasta su casa en Robles.  Incluso, Doña Kate deposito el dinero en el banco para que Abuela Orpa lo hiciera. “A mi no me gusta comer cuando los demás no pueden” me dijo Abuela Orpa.  Ella busco firmas de todos sus vecinos y por su obra pusieron líneas de teléfono en todas las casa del barrio.  No se lo que pasó con los $5000.00.  Otro ejemplo de las cosas que heredamos de Abuela Orpa—consciencia social.

Abuela Orpa siempre fue una mujer bien fuerte, que luchaba sin fin por los derechos de su familia.   Ella tuvo esos cuatro hijos, y 3 nacieron en la finca donde ella actualmente reside.   El ultimo, mi tío Godofredo (Freddie), nació en el hospital en Arecibo, pero esa es otra historia.  Una vez me contó como nacieron.  Abuela María estuvo presente por los cuatro partos, pero ella estuvo como madre, no como medica.  Habían tres parteras en el barrio, y una de ellas la atendió durante cada parto.  Y después del parto, ellas visitaban la cada de Abuela Orpa por quince días.  Lo interesante es que ninguna de estas parteras sabían leer ni escribir.  Sin embargo, ellas tenían que certificar cada parto para recibir el pago.  Por alguna razón, ellas no registraban los niños que nacían—eso era responsabilidad de los padres, como abuelo Marcial.  Los certificados y los documentos de las parteras solo se hicieron porque Abuela María les ayudaba con la preparación de los documentos.  No se si Abuela Orpa recibía un descuento por ese servicio, pero me imagino que no.

La historia del nacimiento de Tío Freddie me sorprendió, no solo porque no nació en casa, sino porque el parto fue atendido por un medico partero, Dr. Bernal del Río, un familiar de Abuela Orpa—mami me contó que él era primo hermano de mi abuela.  El atendía partos en Arecibo, que en ese entonces quedaba muy lejos de San Sebastian, porque no había buenas carreteras ni autopistas.  Ellos se fueron el día anterior al parto.  El medico les había dicho que el niño iba nacer el 20 de enero, y que estuvieran en Arecibo el 19.  Yo no tengo idea como es que ese medico lo sabia, porque yo cuido mujeres embarazadas y yo soy el medico que les dice que día van a nacer, y con la ayuda de ultrasonido casi nunca adivino el día exacto.   Abuela Orpa dice que así fue el Dr. Bernal con todas sus pacientes.  El Dr. Bernal también le dijo a Abuela Orpa que ella debía de hacerse la esterilización.  En ese tiempo ese procedimiento era muy nuevo, y no se cual fue la razón que el doctor le dio a Abuela Orpa.  Ella lo consulto con Abuelo Jacinto, y con sus padres.  Abuelo Marcial estaba muy en contra, pero Abuela Orpa decidió hacérselo.  Ella ha de ser una de las primeras mujeres en Estados Unidos en hacerse ese procedimiento.  Estoy asombrado y orgulloso del valor que ella tuvo en hacer esa decisión.  Hoy día no hay ningún hospital católico en los estados unidos que hace esterilización de mujeres, y hay mucha evidencia que la esterilización que hicieron en Puerto Rico fue un programa oficial de los estados unidos para que no nacieran mas puertorriqueños, porque decían que la isla estaba sobrepoblados y tenia demasiada gente pobre.

Hoy día, Puerto Rico es el país que tiene mas mujeres esterilizadas de todo el mundo.  Hay mas que una tercera parte de las mujeres de las edades donde pueden parir que tienen ese procedimiento.  Y es el único lugar en los Estados Unidos donde una mujer con menos de 20 años puede pedir esa operación, sin importar el numero de hijos que las mujeres tienen.  Nunca me imaginé que había empezado en los años 40.  Aunque Abuela Orpa sabía que iba recibir “la operación,” muchísimas mujeres de su generación recibieron esa operación sin dar  permiso a los médicos.

A Abuela Orpa le gusta contar historias.  Y ella tiene muchísimas en su mente y en su corazón.  En los próximos meses trabajaré para escribir todas las historias tal como ella los  recuerda. 

Abuela Orpa, como muchas personas, tiene una consciencia social bien fuerte.  Ella me dijo que las mujeres de hoy día mandan demasiado a sus maridos.  Y que eso también causa problemas en los matrimonios.   Entre las mujeres que mandan mucho me imagino que se encuentran mis tías y mi madre—pero todas ellas están casadas por mas que 40 años.  Ella me contó una historia de un veterinario que vino a atender a los animales de casa que vio a mi tía Doris por la ventana.  El veterinario empezó a preguntarle a Abuela Orpa quien era, y cuando el supo que ella estaba casada con mi tío Freddie, el quiso saber mas.  Abuela Orpa le dijo “Eso no te importa” pero el siguió indagando.  “Preséntemela, por favor” le rogaba.  “No señor,” dijo Abuela Orpa, “mi marido no esta y usted no entra en esta casa.  Usted tiene suerte que yo lo estoy atendiendo afuera mientras viene mi esposo.”  Y asi Abuela Orpa lo puso en su lugar.  Pero había otra cosa que sucedía a la vez.  Tío Freddie estaba en Vietnam en la guerra.  Abuela Orpa y Titi Doris lo sabían, pero el veterinario no sabia.  Aunque tío Freddie hubiera estado en la casa de al lado, siento que Abuela Orpa hubiera dicho y hecho lo mismo.

La guerra de Vietnam fue una cosa terrible para mi familia, y cambio a Abuela Orpa y a Abuelo Jacinto para siempre.  Abuela me contó que ella el acreditaba al ejercito de los estados unidos por la angina de pecho de Abuelo Jacinto y por muchos años de sufrimiento.  Ella dice, “No podemos escoger el presidente de los Estados Unidos, pero el puede mandar nuestros hijos a la guerra.”  Es una política completamente absurda.  En la época de la guerra de Vietnam, era hasta mas absurda porque había conscripción mandataria.  Y mis tíos Rigoberto y Godofredo sirvieron en esa guerra.  Mi propio padre fue llamado, pero el nunca sirvió.  Esa historia lo escribiré en otra ocasión. 

Uno podía evitar la guerra en Vietnam de 4 maneras: 

1. Estudiar en la universidad
2. Mudarse a Canadá
3. Unirse a la guardia nacional
4. Enseñar

Cuando tío Rigo estaba en la línea para registrarse para las clases, el sargento del ejercito se fue donde ellos, señaló a 5 o 6 de ellos y les dijo que no se registraran para las clases porque sus números eran los próximos, y si se registraban iban a perder el dinero.  Esos eran embustes, porque si mi tío estuviera registrado para las clases, el ejercito no podía cogerlo ni mandarlo a la guerra.  Rigoberto hizo lo que el sargento dijo y dentro de semanas estuvo en Georgia en el ejercito.  Semanas después, llamaron a mi tío Godofredo, y Abuela Orpa se encontró en un grupo exclusivo de madres con 2 hijos en la guerra.  Esos años fueron de agonía para Abuela Orpa.  Ella oraba día y noche para que Dios le cuidara a sus hijos.  Uno de ellos se fue a Alemania de retaguardia, pero el otro vivió el infierno que era Saigon. Abuela Orpa decidió hacer una promesa al Señor, que si El le devolviera sus hijos sanos y salvos, ella se vestiría de blanco todo el resto de su vida.  El Señor escucho sus oraciones, y Rigoberto y Godofredo volvieron de la guerra.  Ellos todavía están vivos, aquí en Puerto Rico.  Han pasado mas que cuarenta años desde el día de su promesa, y yo no se de ninguna ocasión en toda mi vida donde ella haya usado un vestido que no fuera blanco.  Otro legado de Abuela Orpa—somos fieles y hombres de palabras.  No importa los años que le quedan, pero se que Abuela Orpa jamás va romper esa promesa.

Abuela Orpa siempre va odiar al ejercito de los estados unidos por la miseria que le causó.  Ella sabe que algunas cosas buenas vinieron del servicio de mis tíos.  Ellos jamás se encontraran sin seguro medico por sus servicio, y ellos aprendieron a puñetazo limpio a hablar ingles en el ejército.  Pero también, uno de ellos aprendió a fumar en el ejercito, y hasta hoy día no lo puede dejar.   La otra cosa que me dijo fue que el ejercito estaba sacando a hombres de la universidad al principio de la guerra de Vietnam.  Eso me sorprendió mucho, porque en Estados Unidos era prohibido sacar a hombres de la universidad para ir al ejercito.  Abuela Orpa me contaba que le parecía ridículo que nuestros hijos pueden ir a morir en la guerra pero que nosotros no podemos escoger el presidente de los Estados Unidos. 

En este ultimo viaje nosotros nos fuimos a comer helados 2 veces con Abuela Orpa.  Y la primera vez que estuvimos en la plaza, ella y yo vimos un mural que contaba la historia del “grito de Lares.”  El grito de Lares fue el único movimiento en Puerto Rico para independencia de España—pero fracasó.  Lo interesante fue que las personas que estaban buscando independencia realmente se quejaban de los abusos de los hacendados.  Parte de la batalla de Lares se peleo en “el pepino” y esta una lista de personas que murieron en la muralla de la plaza.  Cuando estuve hablando con Abuela Orpa, me di cuenta que los hacendados eran los españoles que tenían tierra en Puerto Rico.  Los bisabuelos de Abuela Orpa y los abuelos de Abuelo Jacinto eran dueños de mucha tierra en Puerto Rico.  También eran españoles.  Me fascinó saber que si yo fuera revolucionario en el tiempo del grito de Lares, yo hubiera peleado en contra de mi familia.

En la muralla de la plaza de San Sebastian, hay un mural donde figura Dr. Ramón Emeterio Betances.  Allí se escribieron muchos principios que se conocen como los diez mandamientos de los hombres libres.  El primer mandamiento fue: Abolición de la esclavitud.  Cuando leí eso, me di cuenta que había otra razón para que la gente se levantara en contra de mi familia:  Ellos eran dueños de esclavos.

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The Inner Invisible by Mariana Dangiolo M.D.
Thursday, September 10, 2009

This story happened to Dr Dangiolo when she was an intern in family medicine.  Here, Dr Dangiolo explores her relationship with a patient with whom she shared alot in common.  Here is her story.  All names have been fictionalized.

“Dr  Rene Favaloro comenzó a interesarse por cada uno de sus pacientes, en los que procuraba ver su alma. De esa forma pudo llegar a conocer la causa profunda de sus padecimientos."      copyright Fundacion Favaloro, Buenos Aires, Argentina.

“Dr René Favaloro started to feel sincerely interested in each of his patients, in whom he tried to see their souls.  In that way, he could successfully uncover the deepest cause of their sufferings. “ copyright Favaloro Foundation, Buenos Aires, Argentina.

I was very young and a brand new medical graduate from the University of Buenos Aires, Medical School. I was full of life and carrying a back pack filled with hopes and dreams.

It was summer of 1993 and I was a first year resident in the Family Medicine Program. As part of my internal medicine rotation I was sent to the Hospital Ramos Mejia, an academic hospital where uninsured citizens regularly receive medical care.

The HIV wave was striking hard in the world and Argentina was certainly not spared. In our hospital rounds I would frequently see end stage AIDS, flourishing Kaposi and other opportunistic infections. We did not know much about HIV other than “if you get it you will die”.  This death sentence was terrifying for most of us, junior medical residents, especially while performing blood tests on our patients during sleepless nights.

I met Alejandra one Saturday evening while on call. She had AIDS and this time was being admitted with weight loss and diarrhea. As I was walking down the hallway towards her room I felt chills, palpitations and a paralyzing fear.

Alejandra was a pale, very thin young woman with curly ash blond hair. I realized she was my age… Her eyes were light green, sunken, and covered by an almost imperceptible layer of tears.  In her face there was a mixed expression of suffering and resignation. Hector, her husband and loving caregiver was standing by her side.

Through a thin soft-spoken voice, Alejandra told me that she was diagnosed with HIV three years prior and had been admitted to the hospital with numerous infections since then. Her face lit up as she related to me her life’s dream of becoming a nurse. Despite her disease she had taken nurse aid classes and was close to graduation. 

Alejandra was very ill on this admission.  Her white blood cell count was almost imperceptible.  This time an intractable diarrhea was consuming her despite our efforts.

I soon became emotionally attached to my new patient and more concerned for her as she got sicker. In some way Alejandra’s misfortune was a clear demonstration to me that life and health are not to be taken for granted.   Every morning before rounds I would rush first into her room.  As I desperately tried to help Alejandra I searched for answers at the Medical library and consulted every expert I knew.  Witnessing my distress, my family continuously encouraged me with words of comfort and strength.

My experience with Alejandra would teach me the most important lesson of my medical career: In the medical profession even when we cannot cure, we can still heal.

One morning, as I entered her room, I found Alejandra dressed in a beautiful pink gown, Despite her intractable nausea her look was more vibrant: It was her 23 rd birthday. I sat by her side and asked her if she had a special wish. Alejandra didn’t answer instead she asked me about the necklace I was wearing.  It was an image of Virgin Mary as a child, my parent’s medical graduation gift.  Alejandra then told me that her faith was her main support in these challenging moments. She asked me if I could join her in a prayer, and suddenly I was part of a very special spiritual moment.  Alejandra, like me, was baptized Catholic; she dreamed of one day taking the Sacrament of the Holy Communion and Confirmation—which are among the most important rituals in our faith. 

With this conversation in resounding in my mind, an idea suddenly inspired me: “Could I make her dream come true?”

I knew time was essential due to Alejandra’s delicate health status.  I rushed to speak with the hospital chaplain, and the hospital director. Alejandra was transferred to an individual room and we made the necessary arrangements for the ceremony.

When I told Alejandra about it, she broke into tears of happiness and with a hug she asked me if I could be her Godmother.  I was shocked, honored and delighted. On the same day, my sister accompanied me to our spiritual gift shop and I ordered the souvenir religious cards. In the front, I chose a delicate print of Virgin Mary similar to the one on my necklace, on the back; I printed the names of every participant and the date of the ceremony.

I did not know at that time that the celebration of Alejandra’s Holy Communion was going to be one of the most memorable moments of my medical career. Everything was beautiful and special, the gospel readings, the priest’s reflections and the accompanying melodies of acoustic guitars played by the music therapy team. My heart was exploding with an immense feeling of love and appreciation.

Few days after, Hector, her husband, requested to transfer Alejandra back to their home. She was suffering pneumonia and getting progressively shorter of breath. Alejandra knew that her end was near and wanted to be home among her family. I promised to visit her as soon as I could.

The following Sunday, I went to her house. Hector received me; he was looking exhausted and scared. “She is not doing well”, he said with tears in his eyes. Alejandra was lying down in her bed. Her thin body was almost invisible under the covers and her eyes were slightly open. She smiled when she heard my voice. I left my stethoscope aside and I put my hand on her forehead. She stretched her hand and I hold it. I recited out the prayer that she liked. Her lips were lightly moving to the rhythm of my verses and her face was radiating peace.

I cannot remember how much time I spent with her that afternoon but I do know for sure that it was our last goodbye. That evening at home, I closed the door of my room and I cried.  I still can feel the heartache of the moment as I write this story.

Later in my career I encountered many similar experiences that left me sad and wondering but at the end I realized that this is what medicine is about: we frequently face challenges, pain and sorrow but instead of mourning for a long time we can see them as opportunities to grow and mature not only professionally but what is more important as persons.

Medicine cannot provide miraculous cures to everybody but we all possess very effective healing powers that can deeply comfort our patients in difficult times. Alejandra passed through my life to teach me a meaningful lesson: in medicine even when we cannot cure, we can still heal. I truly believe there will be moments when we may not have a way to repair the broken body but with an infusion of compassion, love and kindness we can reach our patients’ soul; the inner invisible that lies beneath.