Song of My Cells: The Pathologist's Poem

This is part of the Medical Humanities Series on Op-Med, which showcases creative work by our members. Do you have a poem, short story, creative nonfiction or visual art piece related to medicine that you’d like to share with the community? Send it to us here.

For he is of the tribe of Tiger*
Stout as a horse, affectionate, haughty, electrical,
I and this mystery here we stand**

I sing the body dissected,
ovarian tumors I sing
half the size of a bathtub,
I hymn clean margins as well,
pseudotumors, paradoxical
emboli, I celebrate
the frozen section and paraffin section equally,
ICD-10 I abominate, I denominate
gastrointestinal, hemato-, neuro-, bone and soft tissue, dermato-, gynecologic, and renal
pathology and all other kinds ad nauseam
(pathology a mansion with many rooms).

I sit late at night with my slides and alone
know who will live and who will die.

The income of pathologists is a jubilee
in the low to mid six figures,
good pay for nudging small rectangles
of glass around at high power.

The histology department I laud,
their water baths, their microtomes,
coverslips and solvents,
of that wide xylene inescapable.

Vivas to those who have failed
to make the diagnosis, who have foundered
on the rocks of malpractice,
for they meant well,
mostly.

I valorize commercial pathologists with their towering stacks of slides and big bucks
and poorly paid but well-published academic pathologists equally.
Nor will I stigmatize
medical examiners and their decomps,
for they too (the decomps that is) once were human.
I give the autopsy its due with its stinks and foul sights.
(I amble into the morgue and watch
two residents manhandling a colon
they’ve let slip into a garbage disposal.)

I commend amended reports
for second thoughts
are often superior.

Massachusetts General Hospital,
the Clinics Mayo and Cleveland, Johns Hopkins,
Harvard Medical School the acme,
and MD Anderson o’erweeningly large:
names I roll about on my tongue. I savor their majesty. They taste good to me.

I venerate surgeons who give us each day our daily tissue
no matter it’s insufficient always and they are irascible.

(Hail to thee, blithe organ,
hale thou never wert!
A colon well-rinsed--
mucosal folds pink, puffy, and tender--
is like a Hallmark Valentine Greeting Card,
for I find shit is within me as well.)

Non-contributory studies arouse me--
their meaning is veiled. I make room
for laboratory error
that cannot be helped.

I find I incorporate biopsies, excisions, pelvic exenterations,
and harbor fine needle aspirations:
I am plastered with specimens and gore all over.

I cannot exclude the triple negative
breast cancer, the large cell
variant of small cell
carcinoma.
I marvel at the unknown primary; it intoxicates me.

I stand by and gaze affectionately
at immunostains, for they make the unknown brown.
Electron microscopy garners a hero’s welcome
for it makes the unknown huge.

I must not overlook
the humble binocular microscope
with its 5 objectives even unto high-dry and oil
for it glorifies the plasma cell
(once a girlfriend embroidered one
on a pillow case but before she finished
we broke up and now I’ve a throw pillow
with half a plasma cell).

I pay more than lip service to the Billing Department
that keeps us well funded at least
when they collect the charges
but fear bean-counters even when they bear gifts.

Let us endorse without check the CAP,
ASCP, USCAP, SH, ABP, and the entire kinship
of AP and CP diplomates
who keep us companioned,
whose protocols are minutely observed
in theory.

I rub elbows with residents
who make me feel well-informed
by comparison even when I’m foolish
and fellows also for they keep me honest
and groan at my puns.
Chairpersons I salute,
teachers of humility and forbearance.

The tripartite Ur-Poem of Pathology, possibly repellent:
Tissue’s the issue, tumor's the rumor, is cancer the answer?

I recommend clinical correlations and close follow-up by default.

Levey-Jennings charts 6 sigma quality control
root cause analysis Westgard rules
keep me neat about the mouth if not accurate. I defer
to multiplex analyzers
when they’re plugged in.

Come let us honor the virtual slide for it is spectral
and flow cytometry for it is fluid
and send-out tests for they break the piggy bank
and painstaking cytology
and all pathology in general everywhere for it is our joyous knowledge of suffering.
*quoted from Christopher Smart
**quoted from Walt Whitman

What inspired this piece?

This piece was inspired by my 20 years in pathology practice. My favorite writers that inform my writing are Walt Whitman and Kit Smart.

Why did you choose poetry as your form?

I had Walt Whitman in mind and took after his free and easy format of long-lined poetry.

How long have you been writing poetry? How do you incorporate it into your medical practice?

I've been writing poems since college, with little gaps of 20-30 years for medical education/practice. I've never written another poem drawing on my medical practice, so this one is a one-off. It's nice to write a poem about pathology in the manner of celebratory Walt, because the practice itself doesn't get celebrated sufficiently.

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