Pre-aphasia counseling for the neurologist’s lover
how many words do we get before we go?
how many are we able to mean before it ends?
i denied amma of my first so i’ll repay her with
my last, but the rest? i’ll leave to you.
this is to say, if a stroke leaves me speaking
nothing but everything, know that i’ll be calling
for you in each and ev-ery-thing: hear your name
in apple, in skateboard, in both traffic and jam.
if i call the feather in my colleagues’ coloring-
book-pictures ‘confession’ and the cactus a ‘picnic’ -
if ‘I’ becomes ‘stranger’ and ‘love’ becomes ‘elegy’ and
‘you’ become ‘bereft’ whilst sat there still next to me,
i ask that you bear witness to me as candidly as you
did that october day on arthur’s seat, when we split
our lunch with the gulls and laughed as we plucked
away at those dried thistles stuck to us like fat ticks,
when you, fiddling with that fraying gorse spine
i’d one day frame, first confessed your love for me,
and i, robbed then too of all words but our truth,
professed it back over and over and over again.
Akshayaa K. Chittibabu, MD
Commentary
The Methodist DeBakey Cardiovascular Journal is proud to publish “pre-aphasia counseling for the neurologist’s lover” as the first-place winner of the 2024 Michael E. DeBakey Medical Student Poetry Awards. This annual contest is hosted by Baylor College of Medicine and is now in its 21st year, though this marks the first occasion upon which the winning piece is being published by the medical journal that bears DeBakey’s name. Dr. Chittibabu’s poem is a harrowing reminder of how thin the boundary is between physician and patient—and also showcases how the medical humanities can effectively personalize the medical conditions that providers devote their lifetimes to treating.
The award has been given annually since 2004, after Dr. William Fann invited DeBakey to read to his poetry elective course at Baylor College of Medicine.1 Though a nonagenarian, the storied surgeon read his favorite poem with vigor—which he was wont to do on more than one occasion,2 selecting Thomas Gray’s “Elegy Written in a Country Churchyard.” This reading inspired Fann to establish an annual contest in DeBakey’s honor and to serve on its inaugural panel of judges, joining other luminaries of the health humanities including physician-authors Dr. John Stone and Dr. Jack Coulehan. It is difficult to imagine a more worthy honoree than Michael E. DeBakey, just as it would be nigh impossible to find an area of cardiovascular surgery that did not benefit from his contributions. He not only performed the first carotid endarterectomy and was involved in the first multiorgan transplant but was also instrumental in the development of techniques for vascular bypass surgery, aortic aneurysm repair, and mechanical assist devices.3 He further developed a system for recognizing and repairing aortic dissections, establishing the DeBakey classification scale that is still widely used today.2 His service to the medical community, both across the country and throughout the world, influenced countless generations of physicians and solidified his legacy within the annals of medical history.
Through his busy schedule on hospital rounds, myriad innovations as a clinician, and consistent workload as a surgeon, DeBakey established himself as the “father of modern cardiovascular surgery.” He also strongly advocated for the importance of the humanities,2 thereby following in the footsteps of another giant in the halls of medicine, Sir William Osler. Dr. Osler has been labeled the “father of modern medicine” and showed a similar ability to pursue lasting advancements in administration, education, and patient care. He was also a great champion of the medical humanities, so much so that a group of physicians in the Houston area founded the American Osler Society (AOS) in 1970 to further his work in this arena. One of their first official acts was to host a Humanism in Medicine symposium in Galveston, Texas, featuring several presentations showcasing Osler’s important work in the field.4 DeBakey, who kept an active lecture schedule into his nineties,2 was later invited as a guest speaker to one of their annual meetings, providing yet another connection between these titans of medicine.
Since the inaugural AOS symposium, medical humanities programs have developed across the country—from the Medicine & the Muse program at Stanford to the Master of Science in Narrative Medicine now available at Columbia. The author of the poem featured here is no stranger to the humanities, having published previous writings and also co-chairing the narrative medicine collective while attending medical school at the University of California at Los Angeles (UCLA). She is also well acquainted with academic achievement, having won the Fulbright, Marshall, and Truman scholarships on her way to a career in medicine. Her poem provides touching insights that become ever more impactful upon subsequent readings, overall producing a memorable portrait of aphasia. These details are what make hers such an effective piece—such as the way she hyphenates each syllable of “ev-ery-thing” in the second stanza, recalling the pattern of speech familiar to those who have cared for victims of aphasic strokes. She effectively alters her cadence throughout, ultimately using her writing to showcase an in-depth understanding of aphasia and an alacrity with the poetic devices that make her work powerful. Chittibabu writes of her hypothetical future aphasia, a condition that she will come to diagnose while also possibly finding innovative solutions to aid in its treatment. In the same way, DeBakey, a pioneer in the management of aortic dissection, later suffered from and was treated for the same condition, cared for by a physician he personally trained using techniques he directly developed.3 Their stories, one hypothetical and one historical, remind readers of just how tenuous the divide is between physicians and the patients they dedicate their lives to treating.
Dr. Chittibabu completed her training at the David Geffen School of Medicine at UCLA and has since begun a residency in neurology at the University of Pennsylvania. She joins the ranks of 20 previous winners of the Michael E. DeBakey Student Poetry Awards, a contest that has been a flagship for the medical humanities and fostered countless creative efforts from future physicians. Readers who would like more information can visit the competition’s website through Baylor College of Medicine (https://www.bcm.edu/departments/surgery/education/debakey-poetry-contest).
Disclaimer
The views expressed are solely those of the authors and do not reflect the official policy or position of the US Army, US Navy, US Air Force, the Department of Defense, the US Government, or Houston Methodist Hospital.
Competing Interests
The authors have no competing interests to declare.