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Growth Goals by Zakery Dabbagh

It amazes me that after growing up hiking through the oak-hickory forests of central Massachusetts and seeing trees at every stage of development, I’ve never actually seen one grow. It’s truly a marvel of nature. I was certainly there while it grew. Outside of winter, I’m not sure I’ve been in the presence of a living tree in a moment it wasn’t growing, perpetually expanding from the inside out, reaching for the cosmos with a new branch or leaf at a pace only perceivable to time-lapse cameras and God. But I will never see it, and neither will you. Maybe that should trouble us more than it does.

The saying goes, “If a tree falls in a forest and no one is around to hear it, does it make a sound?” I say, “If a tree grows in a forest and someone is there to watch, will they ever see it grow?” Admittedly, I’ve never seriously tried. I’d imagine it’s not unlike “watching grass grow,” which people compare to activities that are boring and uneventful, but I think that’s silly. The growth of trees and grass is anything but uneventful. They’re growing the whole time. Or maybe not. Maybe they grow a lot, and then get winded and take a break, and then grow a little more, and repeat the process until sundown, like construction workers on a hot summer day. It’s a beautiful little thing to never think about.

Another saying goes, “A watched pot never boils.” It’s an expression about how anxiously waiting for something to happen makes it feel like it’s taking forever, but every time I put a pot of water on the stove to boil, it feels less like an idiom and more like a fact of life. Perhaps trees are the same. If I were a tree, and I knew I had to grow a lot today because it was one of the best growing days of the year, and a complete stranger came up to stare at me while I was trying to grow, I’d probably get overwhelmed and mess up. Just because I do it all the time doesn’t mean it’s easy. I’d probably become self-conscious that I was taking forever, like when I’m struggling to put on gloves in front of a patient because I didn’t dry my hands completely after washing them. Stop looking at me like that, stranger. Don’t you know a watched tree never grows?

I hope the trees are less neurotic than I am. Why wouldn’t they be? They only do one thing, and it’s what their predecessors did, and what their followers will do, and there’s no other choice in the matter. The trees bear the burden of growing at tectonic speed, and I bear the responsibility of being able to choose. I have to choose to grow because I can choose not to. I’m not convinced growing for its own sake is worthwhile, and I don’t think the trees are either. They just grow because that’s what they think they’re supposed to do. Sometimes I worry I’m doing the same thing.

Maybe I just need to touch grass.

The Day my Accountant Made Me Cry by Miriam Hoffman, M.D.

July 7, 2025


I was driving home. The end of a long, hot, successful first day of the new academic year. First year medical students beginning their journey to becoming physicians. Welcoming them to the profession and to our school.

They’re not your grandmother’s medical students, I like to say. And we are not your grandmother’s medical school.

We had a blank slate, we started with our vision. We worked our way backwards from there. And that is how we ended up in an airconditioned giant tent on a hot July afternoon. 168 new medical students figuring out how to build bicycles with kids from the local Boys and Girls Club.

And that is why a few news stations happened to be there – to see the spectacle and to learn about new approaches to medicine and medical education.

And so, I found myself driving home, after a long and exciting day. As I drove, my phone announced an incoming text from Marty, my accountant. Marty is a great person and just as you would expect him to be. But I rolled my eyes as I saw that he was sending me a text. It usually meant there was something I needed to do. One more thing to add to my list.

But no.
Instead, the text read:

Miriam
Just saw u on ABC
TV
Great story
Marty


And instantly I smiled. An unexpected message and a wonderful one to receive while driving home from 168 people’s first day.

But then my moment changed. I could not tell my mom or my grandmother about being on the news. I couldn’t tell them about another successful launch to the academic year. I would never be able to send them the link to evening news.

It is 8 months since I ran out of the back of our amphitheater, about to teach a different group of medical students at the start of their clinical clerkships. 8 months since I heard my dad say something about chest compressions and EMS. How could there be chest compressions? They had been hiking the day before. I had been texting with her literally 20 minutes earlier.

But there were in fact chest compressions and an ambulance and an emergency room, and my mother was gone. It’s a wonder I made the 2 hour drive there safely. But she was gone.

I never really understood permanence until now.

That was almost exactly a year after my first real exposure to this kind of permanence, when we said goodbye to my mom’s mom, at almost 105 years old. My grandmother was the president of my fan club. Just ask her friends and neighbors, and the staff at her gym. She made it to my school’s first graduation. In the middle of COVID, masked up and spaced out. I know those 18 graduates had proud parents, but I am not sure they were as proud as my grandmother was on that day.

And here we were, a year after saying goodbye to my grandmother, losing my mother in such a sudden and unexplainable way. No one had that on their bingo card.

And then I came swirling back to my car ride home on this year’s first day.

I will never be able to send either of them the link to the evening news that I was on. They will never be able to see what I do next. I will never be able to get my mom’s feedback on a paper I am working on or a narrative that I write. They will go unedited.

And yet, I suppose, I will somehow go on. Milestones will occur. I will think of her, but she won’t be there. I will use all that she taught me, but I won’t be able to show her.

I will read things and listen to things and watch things and won’t be able to discuss them with her.

I don’t know how to end this narrative. So I will just leave it. Unedited.

The Fragments that Hold by Raymond Huang

Pottery. Really? The last thing I wanted to do on my Saturday evening was sit in a room fixing broken pottery with strangers. When my therapist suggested that I attend this class, I almost laughed—among the other silly things that they have had me try, such as journaling and meditation—fixing bowls was going to help with my mental health? Still, here I was, standing in front of an inconspicuous shop tucked away between a fragrant bakery and a bookstore. The window displays an assortment of plates, bowls, and cups, with sparkling veins of gold within each. The sign on the door read, “9 PM: Kintsugi Workshop: Mend, Reflect, Accept.” I could’ve just grabbed some powdered beignets at the bakery and crawled home to my isolated cocoon. Even though I lied about meditating and journaling, a part of me sighed and thought, Well, I’m already here.

I let out a long breath as I pushed open the door. A soft ring of the bell greeted me as I entered. For a moment, I stood still, taking in the surprising, tranquil hush that filled the room. The air smelled of a mixture of tea and sawdust, and the gentle glow of the paper lanterns painted the walls a soft amber. At the center is a long wooden table with ceramic fragments, brushes, and small pots of gold powder and lacquer. Around the table, a few sat quietly, their heads bowed down and deeply focused on putting together shattered pieces of pottery. An older woman walks around the corner and greets me with a smile. It was not the smile of someone paid to welcome visitors, but something gentler, more patient, as if she’d been expecting me.

I hesitated, unsure if I should wave or introduce myself. She guided me to an empty seat and said, “take your time.” I gave myself an internal facepalm when I responded, “you too.” I awkwardly slid into my chair, running my fingers along the cool, textured edges of the porcelain laid in front of me. The bowl, shattered in several pieces, each piece of the sunflower design guiding me. For a moment, I stared at it. What am I even doing here? But as I started putting the pieces together, I felt something I hadn’t expected: a faint loosening, as if the tension I carried had been noticed by the shards themselves and given me permission to soften.

My fingers trembled as I held the pieces together and steadily brushed a golden vein of lacquer between the jagged edges. I missed a couple of times, accidentally painting my thumb a streak of gold. Eh, I’m not interested in becoming a surgeon anyway. The faint, earthy scent of the lacquer mixed with the warmth of the room momentarily quieted the usual tormenting chatter in my mind. I leaned in closer, watching as the bowl slowly took shape, the painted sunflower at its center, blooming back to life. Broken, but not ruined. Fractured, but not irreparable.

The older woman walks over to me, seeing that I’ve completed the bowl. “Well done,” she says softly. “How do you feel about your work?” I hesitate. “It’s repaired, but it’s not perfect. It’s still scarred.”“The scars show healing,” she replied. “They will always be part of the bowl.” She gently places her hand against my arm, and smiling, “Some may even say it’s more beautiful that way — not despite what it’s been through, but because of it.”
I run my stained thumb lightly over the bright seams, now holding the bowl together like a mosaic. In the glimmering lines, I catch the reflection of my face, someone who grew up navigating an abusive home, who learned to weather the unpredictability of love, who carried the weight of other people’s storms. My invisible scars, carried even after leaving home behind for medical school, after crossing thousands of miles to escape the place where they were first etched. For the first time, I wonder if these cracks were never meant to disappear. If maybe, just maybe, they could hold their own kind of light, a sort of hidden gem.

I look up at her, a faint smile tugging at the corners of my mouth. “Yeah,” I say quietly. “Maybe it is.”
I pause, then add softly, “Thank you.”

“Go home and get some sleep,” she says with a gentle smile. “You’re welcome to come back anytime.”

I step outside, the bowl carefully in my hands. The cool night air greets me, carrying the distant hum of traffic and the soft murmur of voices, the familiar, restless heartbeat of New York City. Lights shimmer on wet pavement, a city that bends, cracks, and somehow keeps shining. I breathe in, the bowl cradled in my arms, my mind a little quieter. I step into the night, into a city that gave me a second chance, into a life I’m still learning to mend, and into the work of helping heal others, one fractured piece at a time.

The Prior Auth* by Raymond Huang

HiGoodMorningNiceToMeetYouIAmAStudentDoctorABCFromHackensackMeridianSchoolOfMedicineWorkingWithDr.XYZTodayCanIPleaseConfirmYourNameAndDateOfBirth? I announce in one seamless, single-breath exhale. Exactly as the OSCEs trained me to do.

“Uh… November 45th, 2678?” he says with confidence. I nod. No need to ruin the rapport.

“Okay Mr. November, before your liver runs away again, Dr. XYZ wants to start you on dihydrogen monoxide.”

“Sounds dangerous,” he says, concerned. “It’s actually water,” I reply. “Oh, like vodka?”
“Not exactly. Unfortunately, it does require prior authorization. And our great medical student will help us with that,” said Dr. XYZ with a wide ear-to-ear grin.
“For water?” Mr. November asks.
She shrugs. “It’s a formulary exception request. The hospital only covers trihydrogen dioxide. That’s the sparkling kind.”

It’s 7:03 AM, and the sun has already set. I walk over to a kyphotic hospital computer on wheels, greeted by 240p resolution, a small dying-walrus wheeze, and a flickering screen that either forgot its lamotrigine or was trying to communicate in Morse code.
.----….-..-.-….----.-..-.-.
Translation: “help me.”
I type my login. Password expired. “Passwords expire every 10 minutes instead of 5 for your convenience,” says the prompt.

New password must include:
- Exactly 1 uppercase
- Exactly 1 lowercase
- One special character
- No numbers
- 3 ancient Egyptian hieroglyphics
- One haiku

I type @𓆣𓆣𓆣𓆣𓆣𓆣

DENIED.
A cockroach with a miniature leather briefcase stood patiently in the elevator. It adjusted its tie and pressed “3.”

The door closed before I could join.

I took the stairs because the other elevator had filed for PTO. A mistake. Each badge reader at the exits gagged at my ID and went silent. I was trapped in a bottomless staircase, with nowhere to go but down.

Each door had tallies etched into the concrete with what looked like a pen cap or those flimsy cafeteria spoons. The floor below had 42, the next 97, and with deeper grooves, like someone had grown impatient.

One door was blank except for a mangled stethoscope used as a failed lockpick. I kept going.


Floor signs stopped appearing after “ß2.” The air smelled like a humid safari and forgotten discharge paperwork.

At some point, a deep-sea anglerfish with legs hissed at me and ran off, “I’m kidding, I’m vegetarian,” it muttered.
I counted 83 flights. The hospital has 5 floors.

At subbasement level “I-lost-count,” I met the Radiologist.
A pale, translucent being floated toward me — sunglasses the size of dinner plates, helping them see in the blinding darkness of the submarine environment. They held a CT of a kidney in one hand and a croissant soaked in contrast in the other. I froze.

“NEED CLINICAL CORRELATION,” they screamed. I flee.
The hospital mice pointed me toward their maintenance tunnel, which finally led to the insurance department. I offered them my half-eaten granola bar, and one of them politely declined. Another handed me the sacred cafeteria meal card meant only for staff and gave me a salute.

“YOU WILL NEED A PRIOR AUTH FOR YOUR PRIOR AUTH,” read a neon-lit sign. “Use one of our premier carrier pigeons to mail your authorization slip. Please allow 40-50 business years to deny your request.”

I am in a windowless room with nothing but countless rotary phones, each with a single button labeled “HOLD,” and a picture of the sun is taped on the wall for vitamin D… presumably. A laminated sign reads: “You can now select which hold song the patient listens to while they wait! #patientcare.

“Mr. November does not exist. See your patient to reconfirm their name and date of birth,” states a muscled-out pigeon with “Cryptococcus” on its name tag. “When you’re done, just fill out the neo-form-man,” it added proudly. “I made that one up. Funny, right?”
Sigh…
I retrace my journey back to Mr. November’s room.

“HiGoodMorningNiceToMeetYouIAmAStudentDoctorABC…”

*Disclaimer: This work is purely fictional. Any resemblance to real hospitals, EMRs, faculty, prior authorization protocols, cafeteria meal cards, or muscled-out pigeons is entirely coincidental.

 

Improvising by Kenzo Lacuarta

The cable that connects my phone to my car is on its way out. The wire, exposed, has more bad days than good ones. Because of this, my ten-minute commute to school has been filled with silence and the hum of my AC.

Two weeks ago, I turned on the radio before I started my drive.

83.7, 87.6, 98.7, 101.5. Jazz, Easy Listening, R&B, Pop.

The stations in-between opted to play the infamous radio static noise, which kids today might only know as a sound effect. What I discovered that day was a hidden gem. I shuffled through the stations, each one in its own world with its own set of rules.

The radio has quietly become a lost art, as big iPad screens with CarPlay come standard in today's cars. When did this happen? My brother and I used to share a room when I was younger, and on the nightstand in between our beds was an M&M branded FM alarm clock. It was only set to one station, but I forget which exactly because it’s been more than 15 years since I’ve seen that clock. On that station, the host would take calls from listeners every night around seven PM. Some shared their worries, while others shared their joys and excitement. A young guy calling in about his new crush, a new mother and her worries about motherhood; people unknowingly opening up to the world and to my M&M radio. Delilah, the host, would then find a song to be played for the subject of the listener’s story.

The songs played back then are now littered in today’s 2010’s Classics playlists (read Hey There Delilah by the Plain White T’s, How to Save a Life by the Fray, etc.) but it was Delilah’s genius that brought those songs meaning and life. I spent years listening to Delilah, and thinking about it now, I don’t remember the moment I stopped listening. One day, I just didn’t think to turn on the radio.

While I don’t know if her show is still on air, I do know that we can’t let radio die just yet. In what scenario do you get the chance to interact, in real time, with the host, in front of an unknown audience? No huge production crew, no script, no invisible wall between the makers and the takers. A dance between the listener and host, a hidden form of improv hiding in every car.

Anatomy of a Hand by Karen Liu

It was easy, at first, to divide dissections of the body into systems.
To name, to label, to move on.

Until week three. Until the hand.

Our donor’s hand lay cold and gray in mine, fingers curled tightly inward, as if still holding something unseen, reluctant to let go. The lines across the skin of her palm were deep and familiar, more tangible than any diagram. At that moment I was no longer just studying anatomy; I was confronted with the memory of a person who once was.

I eased her fingers open, pressing them flat against the table; keeping the hand stable with my scalpel poised to cut. Our hands interlocked— mine gloved, hers still. But the gesture felt startlingly alive.

The blade met the surface. Skin yielded, then the layer of fat– padding the fleshy parts of the palm– peeled back before us.

Beneath the bright overhead light we continued; exposing a web of translucent fascia stretched across pale pink muscle, arteries dyed a bright red, and fluorescent ivory white cords of tendon.
The checklist of required structures faded from my mind. What stayed was the thought of all the lives these hands had touched.

Hand


What had these hands once done?
A hand pressed to a fevered brow.
A hand preparing a comforting meal.
A hand lifted in greeting, waving in a crowd.
Hands clasped around a loved one’s, calming, comforting.

Hand2


Hands reveal so much of who we are. They console, protect, and communicate. In medicine, we are attuned to body language, to notice the unspoken things our patients convey. I wondered what she would have expressed, her words animated by her hands.

A callous on her hand caught my attention. Did she write with fervor, grip her pen tightly, pressing her thoughts into paper? Did she work long hours with her hands?

When pulling the flexor tendons, her fingers curled again, mimicking motion, mimicking life. It seemed she was reaching out, offering a hand. For a brief second, I imagined she was.

So I squeezed her hand in return.
Not to study, not to steady—
but to answer with a quiet offering of thanks.

 

 

HANDS by Sarah Mohideen

My very last EM shift of the rotation. So far, the evening had been a steady, unceasing churn of patients, full of phone tag and unreachable consultants and a backed-up line for CT; in other words, much the same as any other busy night.

Until midnight, when the special phone on the wall dedicated to EMS calls squawked to life with a sad story. A middle-aged female who’d been complaining of chest pain to the correctional officers at her facility had refused further treatment and was found down forty-five minutes later, probably hopeless, but no physicians were around to pronounce her deceased and they didn’t feel right doing it themselves. The possibility of pronouncing her over the phone was raised but quickly and firmly dismissed. She’d come in as a resus.

“Two rounds, then we’ll call it,” said my attending, with a degree of confidence that suggested clairvoyance. (We ended up doing four.)

ETA ten minutes; just enough time for me to quickly review cardiac arrest. As I did, I became aware of a nagging anxiety in the back of my mind. It had been almost a year since I’d seen a real code, and this one seemed almost certain to be unsuccessful. Even the circumstances themselves were hard for me to swallow: found down by correctional officers forty-five minutes after refusing treatment. So many things had to have gone wrong for this situation to arise, and they had to have been going wrong for a long time. I was about to witness the end of what had no doubt been a difficult, lonely life. Was I ready for that?

I’d soon find out. She arrived already receiving mechanical chest compressions from the LUCAS. I can’t remember her arrest rhythm anymore, but I’ll remember her hands, strapped into place near the motor that was propelling the piston-like central rod into her chest with such brutal force that it would have been torture if she could feel it. They were stiff, gray, curled inwards. My heart sank. Those were not the hands of a living person.

The last code I’d seen had been beautiful: a calm, tightly choreographed affair where we diagnosed the problem and achieved ROSC within twenty minutes. Tonight was different. For some reason the room was stuffed full of what seemed like every kind of healthcare worker in the emergency department that night: EMS, students, nurses, techs, residents, phlebotomists, pharmacists, all in a flurry of simultaneous activity that made it impossible to follow what was going on. I squeezed in between a nursing student and another medical student and felt briefly useful when I passed along a tourniquet from the crash cart. Someone shouted above the chaos for an ultrasound machine and I volunteered to find it, partially because I’d seen it in a room just a few minutes ago and partially to get some air. All our warm bodies crammed together were raising the ambient temperature.

The hallway was cooler, but the machine wasn’t where I thought it was. Before I could look elsewhere a familiar voice called out from the room next door.

“In here!” I was surprised to see an off-service resident I’d worked with before who had apparently also ducked out of the code in search of the ultrasound.

“Thanks, I got it,” I said, grabbing the machine by its handle. I’d last worked with him, very briefly, nine months ago. At the time the other students and I had found him slightly intimidating but basically helpful. I was sure he didn’t remember me. In fact, this was already the longest conversation we’d ever had one-on-one.

“Have you ever seen a code before?” he asked, trailing behind me.
Anything with wheels, I’ve learned, becomes exponentially harder to maneuver in proportion to the stress level of the person pushing it. I ran over my own foot and cursed.
“Sorry. Um, just once,” I said.

In the instant before I turned the corner towards the room something very unexpected happened. He stopped me, put his hand on my shoulder, and looked me in the eye.

“Codes can be rough, sometimes,” he said, gently. His tone was frank, without a trace of condescension. He could have been stating a fact as basic as the difference between v-tach and v-fib. Still, I had the strange sense that there was something implicit in his expression that I was unable to parse in that half-second. Now, with the benefit of hindsight and experience, I think it might have been: for everyone, not just you.

I’m sure he couldn’t possibly have known how much that small gesture meant to me. There was no time to speak, so I tried to say it all with a look—thank you, yes they can, I don’t think this one is going to make it, I don’t know what to do with this feeling—but then someone opened the door, pulled aside the curtain, and I was swallowed up again.

###

The Secret She Carried by Gun Ho Moon

We were deep in anatomy lab when I saw it: tan and solid, nestled deep inside the kidney. A smooth, well-circumscribed calcified deposit protruding on the cut face of my bisection, like a pearl in its shell.

Pressing into the folds of the outer edges, the deposit slipped free with ease. Like the pit of a ripe avocado, it left behind a neatly round gap. In its place sat a lustrous sphere, resting innocently on its yielding bed. I lifted it toward my eyes. I had never actually seen a pearl before, yet, this felt like one— cupped perfectly in the two halves of its shell, gleaming with serene grace.

It was beautiful.

I found myself grinning, unable to contain myself. This was the product of our curiosity, our careful exploration, our willingness to bear through uncertainty and confusion—and now, success. With the half hour we had left, it felt like cause for celebration. After confirming with my teammates and fourth-year teaching assistant that it was indeed a kidney stone, we called over our peers. Soon, we were crowded from all sides, sharing enthusiasm, laughter, and awe—eyes widening as we held in our hands something we had only known in theory, until this very moment. That day, we realized that medicine is real life.

I say real life, yet that wasn't how I had known kidney stones. When my ninth-grade biology teacher had them, he was gone for nearly six months, and when he returned, he was a different person—thinner, quieter. Worn. Kidney stones are supposed to be a source of distress, formed over months, maybe years, lingering backstage as they irritate, injure, and tear. That tiny, innocent stone had the potential to do so much harm.

How long had the stone been inside her? Years? Decades? Did she bear through the pain? She couldn't have—she was half the size of my teacher. Did she even notice? She had more concerning problems, like her cavity-riddled lungs fused to her posterior chest.

Did she have anyone to support her? The truth is I knew nothing about her life, except for what I could guess from what I found inside of her. What I did know was that she carried the stone with her to death, and it remained with her here. As a curious being, it pained me to know her story was destined to remain a mystery for the rest of my life.

Once the excitement had passed, I tucked the pearl back into its pocket, closed the shell, and carefully returned the kidney to its place at the left flank. It felt almost silly—technically, it didn't matter. The body would soon be returned to its family, cremated, and the stone gone. Yet, it felt important to restore things to the way they were, as if never moved, never seen. "Leave it as you found it," I thought. Like a child. That day, I was a child. And when anatomy lab concluded, I moved on, grateful for what I had gained, a little more grown than before.

A secret. Medicine has its mysteries, and with them come many secrets—some you keep to yourself, and some you cannot help but share, because some secrets are meant to be seen: to invite discovery, inspire wonder, or stir the heart. It is an honor to learn such secrets, and they deserve respect.

And they excite us. This little secret between me and her is one I will carry for a long time. A reminder that pearls appear in the most surprising places— probably because they are everywhere.

confetti by Swathi Sowmitran

Confetti flutters around me in a foggy haze, and I reach out with grasping hands to catch a piece. I hold the colorful bit close to my chest, carry it home, and place it in a safe little box in a safe little corner of my bookshelf. The lid stays tightly shut to keep my memories from escaping.

As I get older, I find myself hoarding more and more fragments of my memories in that box to keep myself from forgetting. When life tumbles on with no reprieve, on nights where the ice seeps into my skin and the numbness sets into my bones, I crack open that lid to feel a flicker of warmth again. I look through pieces of confetti and letters from loved ones and polaroid pics and I can feel everything again. I’m taken back to the scenes of my happiest memories, tightly holding my friend’s hands, singing loudly off-key to my favorite song, savoring a meal cooked just for me, and giggling in the back row of a horror movie.

When times get especially hard, I get stuck in those moments, desperately digging through the box for any remaining warmth, just to get me through the night. But living in the past has kept me from enjoying my present. And as the warmth from my recollections starts to fade, the realization hits me: I can’t collect new happy moments while hiding in the shadows of my past. We need to live through the cold and numb parts of life, so the warmth of better times feels even sweeter.

As the winds shift, I’ve learned to embrace every chill in my bones, every papercut, every shadowed feeling, as a reminder of being alive. I can weather even the coldest of days, and still seek out the warmth among the storm. There's still confetti all around me, waiting to be collected and added to my box. And I'll do exactly that, I just won't need to open the lid as often anymore.

The Gift of Pemphigus Vulgaris by Staci T. White

One morning after finishing my workout, I began to strategize on the case I was going to make to my doctor to convince her that 2 years into remission was the perfect time for me to get the butterfly tattoo I wanted. Butterflies now have a special place in my heart as a simple yet extraordinary symbol of renewal; of the necessary challenges in life that mold you into the person you should become. My plan was to place it on the inside of my left wrist as a reminder of what I had overcome and the beauty that awaited me on the other side which continues to unfold. As I tried to determine the angle I would use to secure my doctor’s blessing for this tattoo (to know my doctor is to understand why I needed to be prepared), the first thing that came to mind was that the tattoo was an opportunity to take something back that Pemphigus Vulgaris (PV) stole from me. That is the nature of chronic illness, isn’t it? It took my perceived control of my body, months from my life as I recovered and so much more. The madness was that as soon as I let those thoughts enter my mind, the next thought was how much PV actually gave me. The seeming ridiculousness of the idea startled me a bit. But as I let it linger I realized that PV gave much more than it took from me. Damn! Who saw that coming? I know, I know it’s counterintuitive when we think of all the challenges it brings, the pain, the twisted road to diagnosis and oh yeah, the fact that no one actually knows what the heck it is. My mother kept calling it Lupus for the first two years. My mind understood that she was just trying to find a reference point to understand it, but my heart was bruised each time I had to explain it to her.

I recognize that it is much easier for me to think about the gifts I received from PV two years into remission, but the voice you hear today is over 7 years old. My journey began in 2011 at the severe end of this illness with wounds/blisters over 85% of my body. On Memorial Day weekend in 2011 I landed in the ER in so much pain that I could not stand up straight without assistance. Specialists were called in from their long weekends because my care required it. Months after being discharged from the hospital where I was finally diagnosed, one of my specialists, Dr. S., told me he was afraid when he saw me in the hospital because my skin was gray. I’m sure this makes the idea of PV being a gift to me seem even stranger. However, I maintain my life is richer and more complete because PV changed my life in the best possible way.

It forced me to be still, something I had no idea how to do and no desire to learn. Stillness allows you to listen to your mind, soul and body. It gives you the opportunity to move on those quiet discoveries that come when you listen to your inner voice. Stillness creates a clear channel for God (or your higher power) to speak to you with such power and clarity that you have no choice but to move with certainty into your purpose. PV forced me to learn that real strength comes from vulnerability. When you move from being ferociously independent to depending on friends and family to do the simplest tasks for you like opening a bottle of Gatorade because you have blisters on your hands, you get humble and vulnerable quickly. The surprise is that as your walls crumble because you have no choice, you discover the rawest part of your strength and how to harness it in magical ways.

PV uncovered the creativity that lay dormant in my spirit. This piece would not be possible without it. I write poetry now. There are moments when words come to my mind with such intensity that they are pouring out of my spirit. I’ve learned to use words to breathe life into emotions. The clouds, sunsets and nature in general are more beautiful to me because I slow down long enough to savor them. PV pushed me to take pictures of these scenes as I stand awestruck by the beauty that surrounds me each day.

PV reordered my values. I always believed that my family and friends were the most important thing in my life. But if I was being honest I’d have to say that my actions said that my career was my priority with those I love coming a very close second. Now I seek quality time with my family and friends often. My goddaughter laughs at me because I always talk about making memories. If I have to choose between work and spending time with those I love, there is no choice and there is no hesitation.

Finally PV made me fearless. I feel in some ways like a superhero which is fitting considering my childhood idol was Wonder Woman. I approach life with a peaceful certainty that I can’t be broken and that difficulties arise to light the pathway for growth. If I can survive PV, I can get through anything and so can anyone in my village (my friends and family). That’s not optimism, it’s clarity based on fact and immovable faith. Everyone’s journey is uniquely their own, but I encourage you to consider this one thing. Is it possible that even though you didn’t ask for PV, it came to enhance your life in unexpected ways?