ecchymosis

With my hands in the ocean
With my hands in the ocean
With my hands in the ocean, I pay
I pray, oh, I pray

"Tick Tock" by Joji

 

There's something about you that reminds me of him. You look as if you haven't slept in days, shadows under your eyes, scrunched like the pinched edges of a dumpling. There's something compellingly handsome there, in a way that makes me want to smear dirt across your face. Something about you recalls the heavy cloud of marijuana and cigarettes, back before I even knew what weed smelled like, back when bad boys were something we fantasized about in books and movies, instead of the ones with their reckless motorcycles and culturally misappropriated tattoos for whom we now have no more shits left to give. 

But I heard you before I ever saw you. I hear you sing to an ex-lover, entreating her to remember the taste of your lips, watching her from the shadows as she caresses another man. I listen to your baritone gloom unfurl in ballad after ballad, the ache pulsating like a fresh bruise, and I can only wonder who broke your heart so soundly. And that reminds me of him too, the way I should have run, I should have turned the other way, but instead the poems and the music pulled me captive, a siren dooming the sailor to drown.

Vacation Blues

Life update time.

There's about one and half months left until I graduate from residency. Doesn't time fly? I'm slightly dreading next week, where I'll be covering MICU night float for one week. But it's probably the last high-stress rotation of my residency until I enter fellowship. 

I've been on vacation for the past two weeks. Before that, I had two weeks of research. So in essence, I've essentially been just chilling for the past month. 

The first week of research was glorious. The Person was out of town visiting family, so I was alone with the cat for a week. I thrive in self-imposed structure. During that week, I was up before 7 AM every morning. I would do board exam prep questions and set a very specific daily goal for my research data collection. Usually I'd finish the first half of this goal by lunchtime. For an entire week I never broke my fast before lunchtime. For an entire week I cooked all my meals and didn't order take-out. After lunch was my "free-time" which I spent however I pleased. This included shopping, buying new houseplants and revamping my balcony garden, reading, and writing. Just before dinnertime, I would exercise with Ring Fit Adventure on my Nintendo Switch. Again, I cooked all my dinners. After, I would work on the second-half of my research daily goal until I finished, and then I would go to bed. 

This probably sounds fucking miserable to most people, but I was a happy camper during that week. I felt productive, I felt well-balanced and self-cared, I found joy in the company of my cat and plants. My favorite hours were in the morning when I would sit by the couch next to the window with my laptop and a pot of freshly brewed high-mountain loose leaf tea, and I would watch the light move, shining on my Maidenhair plant and two pots of cat-grass. 

The second week of research block was not nearly as productive, but it was still a happy one. I celebrated my 30th birthday. YY came to visit with her fiance, and we ate our way through southern California. There was a week of clinic in between that was truncated for scheduling reasons and relatively chill.

Then came my two weeks of vacation. 

I think there are several reasons for this, but when I think back to these past two weeks, I've been increasingly irritable and melancholy. I think the most obvious is the unavoidable knowledge that my "free time" is coming to an end. Other reasons likely include the social anxiety I battled with during my class retreat (which occurred during the first weekend of vacation). And I think the biggest thing is the pressure I've been putting on myself to write.

Writing is only sometimes fun. The majority of the time, it's like feeling constipated and trying to find an appropriate laxative. I've tried many techniques this past month. I bought an Alphasmart Neo2 (which actually worked pretty well when I needed to literally force shit out). I scribbled on a notepad. I messed with outlines, vignettes, free-writes. All of this was dedicated towards the still-untitled medicine rom-com.

Maybe it's not kosher to compare your own children, but my stories are not real children with feelings, so whatever. Med-Rom-Com has been a challenge because it hasn't occupied the enormous amount of headspace over time the way EP has. For one thing, because I stewed in EP for over a decade, most of the characters including secondary ones are full-fleshed people in my head. I know their motivations, can articulate their relationships with other characters. Meanwhile, I've been working on a scene between the hero/heroine, and I feel like I'm still trying to pin down their personalities and mannerisms. It gave me a newfound appreciation for what I'd managed to achieve with EP.

During this pandemic, I discovered the romance genre and have read a bucket-load of romance books. This includes a series called Immortals After Dark, courtesy of a podcast I randomly discovered called Fated Mates. Paranormal romance is not normally my cup of tea, but because I enjoy the episodes where the podcast hosts deep dive and analyze books on their show, I decided I would read the namesake series that the podcast is named after.

It's been an interesting experience. The podcast was created in 2018, so their discussions and analyses are from a current perspective. However, the early books in the IAD series were written in the mid-late 2000s. To give context, this is about the same time I first started writing EP as a high-schooler. It is actually quite fascinating to analyze how our attitudes towards relationships, whether heterosexual romantic or female-female rivals, has changed. The alpha-holes whose "protectiveness" of the heroines now come across as intolerably domineering. Slut-shaming other girls or women is no longer so acceptable or prevalent. 

Anyhoo. Today was the first time in over a year that I consciously returned to EP. I took a notepad and literally scribbled down the problem areas, any out-of-the-box changes that could be made, and what the domino effects of these changes would lead to. Vacation's almost over, but I think if anything, my struggles with Med-Rom-Com have helped me realize that it still needs to stew in daydreams a bit longer. In a reversal, I might just end up taking another crack at EP. Now that I've been emotionally distanced from it for over a year, I'll probably be much less precious about hacking away the parts that don't work anymore.

Mimicry Redux

I can't sleep no more
In my head, we belong
And I can't be without you
Why can't I find no one like you? 

--"Streets" by Doja Cat

 

Mimicry. A defense mechanism. A mantis hidden among the gnarled twigs. A milk snake masquerading with the colored bands of a venomous coral snake.   

The dress was backless, save two minimalist lines crisscrossing mid-thoracic spine. Inside the nightclub was dark, but the flashes from the stage that briefly illuminated the room revealed the fabric in different hues of yellow---saffron, canary, butter, marigold. His hand ran over his mouth, dumbstruck at the vision.

As she turned around, the colored lights shifted across her face like a kaleidoscope. He had never seen her hair undone from its ponytail or topknot. Black waves tumbled down from a slicked side part, veiling her right eye. She looked up at him, peeking through the luminous hair. He felt a thrill burrow in his chest as she bloomed towards him like a sunflower towards the sun.

Everything he had ever felt for her, tamped down and suppressed under the weight of duty and responsibility, bubbled up like a hot spring.

Mimicry. A predation tactic. The nectar-guide web of a Silver Argiope spider. Female Photuris fireflies luring male Photinus fireflies to their demise. 

Even amidst the dense haze of body heat and sweat in the nightclub, she felt too cold, too aware of every sensation grazing her exposed skin. Her roommates had collectively inhaled when she'd stepped out of the dressing room like the goddess spirit of a yellow ginkgo tree. They'd somehow talked her into buying this dress, so unlike any other clothing she'd ever owned: airy flowing fabric, vibrant color, daringly open back.  Then, back in the hotel room, Nina had convinced her to let her hair down, using her curling iron to give her vintage Hollywood waves. She and Nina ended up skipping dinner as a result, which was a mistake. Two shots and one cranberry vodka later, Elise realized how shite her tolerance had gotten one and a half years into residency.

She felt someone's gaze upon her. When she turned and saw him, the corners of her mouth lifted reflexively in weightless joy, untethered in her tipsy state. 

Mimicry. A reproductive tactic. The Copper Beard orchid, enticing male wasps with the scent of a female to pollinate from orchid to orchid. 

He was buzzed, but nowhere as far gone as her. She spoke slowly, phrases broken into fragments that she fumblingly strung together. He was hyperaware of the negative space between them, as if electricity charged from his fingertips into the dark.

"Can I kiss you?"

He nearly fell over. Head flooded into his face, body thrumming with energy, as he struggled to remember why he shouldn't do this. She was his co-resident. She was sloshed.

Before he could answer, she grabbed the back of his neck and pulled him into a kiss.

Fragment 0.03

So what, so what, we all were all afraid.
So this I swear I know, it's not the chemicals.
You are off my mind I finally got away.
You said it's such a life to remember,
So come on, and we'll sleep away December.

 

It was you, bringing your white company.
Bringing the night so it seemed.
And we will never sleep again.
So as you walk through the door,
And yell I'm never coming back here.
It's over we are still nothing.

"December" by Lydia

 

Every so often, the compulsion bubbles to the surface without warning. As time passes, so do the intervals in between. It remains unclear whether there are exacting conditions or settings that must be met, like the night-blooming cereus that unfurls only a single night in the year. Sometimes, it creeps up in the early hours before sunrise, when the only sound is the stereo within muted car windows. Other times, it strikes like a lightning bolt, violent and blinding, leaving you reeling and unkeeled.

Time has been kind to Freya. The faintest edges of fibrosis betray her scars, traceable only with a discerning touch. But this tranquility that comes with age owes much to the callused layer that cocoons the amber of her former self. Where she used to feel the crests and troughs, now there is stillwater. Where there were once bursts of crimson and vermilion and violet and every vibrant hue in between, the color palette has faded to shades of gray.

 

There is the obsession. The intrusive thought. The only way to break is the compulsion.

 

And so, Freya picks up the metaphorical razor. She has her set of blades. You will have your own personal collection. The songs that transport you to that exact memory, that particular moment. For Freya, the purpose of the incision is not to hurt, but to feel. just for an hour, just for a night... slice the cocoon, shatter the amber, let me bleed, hurtle me back to the rustling green leaves, the yellow frisbee on the white beach, back when my highs and lows moved like the tides following your gravitational pull, when my emotions burned like a supernova and collapsed like a dying star, when i told you i wanted to never feel like this again but maybe this was the most alive i ever was and will ever be.

 

When it's over, Freya holds compression until the blood coagulates. The skin will close, the tissue will granulate, and in time, the cocoon and the callus will smooth over once more.

 

Second/Third Wave

You grow an exoskeleton, because it's the only thing you can do to protect yourself. 

Yesterday was the last day of my three-week MICU block. My first day was on December 15. I barely noticed Christmas and New Year's pass by, as if the holiday lights had simply flickered on and off. On Christmas Eve, I took a new admission that was intubated almost immediately when he arrived to the unit. We tell our COVID patients to lie prone, because it's one of the things that can help in ARDS to improve gas exchange. He was breathing so fast while lying on his belly, I remember thinking he was like an upside-down V or U bowing in and out. There are some patients I see and cannot help but imagine, if we all had a timer hovering over our heads in red glowing digits, how many days or even hours must be left ticking down. 

In these times, I have seen this one story play out too many times. It does not matter if it is a 34 year old man with no prior medical history or an 81 year old abuela with a slew of chronic conditions. Most of the ones who take their chances with the ventilator will never speak to their loved ones again. It feels like watching a slow spiral moving closer and closer to a monstrous whirlpool. Sometimes, we can power the boat with enough force to evade its grasp. Other times, it feels futile and inevitable as the boat is dragged under the depths.

Medicine stands on the muscled legs of science, but its arms require the dexterity and touch of an artist. I ask a patient hanging by a thread on high flow NC if he would want to be intubated. He asks me if I think he will live through this. I have seen too many like him who did not make it. But I am not cruel enough to snuff out hope. I tell him it is too early to say. This man is convinced by his wife and daughter to be intubated, and to our delight, he is successfully extubated a week later. He is one of the few lucky ones.

 I call the families each afternoon to give them daily updates. At what point do you tell these families that they should not expect their loved ones to make it out of the hospital alive? Early, to give them time to process and prepare for the worst? Later, to give them hope to cling to until the patient is about to careen over the edge? The shades of gray in between are innumerable. 

Do you know what self-care involves these days? Muting and deleting people on social media. The girl who was on your high school tennis team who writes "Scam-demic" under an article about the stay-at-home orders in California. The cousin of a cousin who praises Amy Coney Barett's Supreme Court confirmation and writes of how Biden will ruin the country. I never thought I was capable of such constant simmering rage. I am angry nearly every day of my life.

You grow an exoskeleton, because if you dwell too much on what is happening, it will rip your psyche into pieces. A woman in her 40s who leaves behind a set of 11 year old twins. A family tragedy that began at the father's funeral, then leading to the death of his 30-year old son. A 91-year old woman with dementia whose family chose not to intubate and to let her go peacefully, mouth open in a dark O and gasping alone as her daughter wails on the other side of the glass.