My attending
looked at me
and asked,
What is killing your patient?
This collection of acute angles
and spidered limbs
folded up
like a shirt left in the wash too long.
Skin flaking like old paper mache
and eyes that cracked and seeped to follow suit
embedded in a ledge of fine china
above swollen tongue and cracked lips.
Thirty one is so old
for a cystic fibrosis patient.
What’s killing her if not the feeling of being at sea
with only brief interludes of
breath?
Salted in stridor,
agonizing in affect.
No.
My attending announced a word we didn’t
think to hear.
And we shifted uncomfortably
in our rose-tinted world of
tried and true medicine.
A comfortable series of steps,
an algorithm trusted to save her
as well as to preserve our wonder and
awe of medicine.
She’s dying from something far more mundane
than her splintered and failing genetic code.
She’s dying because she’s hungry.
She’s dying because she can’t buy enough food
to support her defeated body.
She’s dying because she’s poor.