Lagniappe Volume 5 : simplebooklet.com

*Trigger warning: eating disorders, self harmLittle Pudgy Sausages*..............................21Cassio FoxMy Gallbladder Had Enough....................22Shephaly SoniI'm Not Bitter About Any of It Anymore...........................................................25Colleen HugoTime....................................................................26Maya DavidOn Prayers.......................................................27KSBKeep Going ......................................................28Rachel Cooleyperson paradox...................................................29 The Interminable T3I can't sit with this .......................................30Shephaly SoniT A B L E o f C O N T E N T SA P R I L 2 0 2 2 V O L . 5 L A G N I A P P E M A G A Z I N EICD-10-CM Code F32.2 ................................10Shephaly SoniGalaxy Blues...................................................11Ally NoyesShock.................................................................12 Emma NewtonSleep/Wake.....................................................13AnonymousNever Knows Best........................................14Rex YunA Bird Now.......................................................15David Long(H1N1)pdm09..................................................16Shephaly SoniInvolvement....................................................17Blair EastonAnnie & I*.........................................................20AnonymousI can sit with this ....................................31Shephaly SoniHow Time Flies............................................32Julien BourgeoisYou Are Worthy..........................................34Timothy GressettWhisp..............................................................35Daniella ReimannFringe..............................................................35Daniella ReimannSilly Cat..........................................................36Charles PeperFathead...............................................................36 Daniella ReimannTogether........................................................37Patrick McCartyAltera/vita....................................................38AnonymousCeramics........................................................39Nicole Salfi ( ).................40Soo Hyun Choi

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T A B L E o f C O N T E N T SS p e c i a l S e g m e n t sA P R I L 2 0 2 2 V O L . 5 L A G N I A P P E M A G A Z I N EMedia Perspectives: On Drive My Car..................................................................44Daniel DellalPodcast SPOTLIGHT.....................................................................................................46Dr. Rebekah Byrne and Erika Bennett (The Open Hearted MD)T4 Reflections............................................................................................................................49 CompilationMakin' Groceries...........................................................................................................51Regional Cuisine..................................................................................................................................51Charles PeperFish and Chips: a Recipe for Poison.............................................................................................52Marc GebaraThe Best Fall/Winter Soup Recipe: Butternut Squash Soup.............................................53Tyler Metz Patito: A mezcal cocktail (Illustrated).......................................................................................54Shephaly SoniRisgrynsgröt...........................................................................................................................................55Emma NewtonCreator Index...........................................................................................................58

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DEAR READERThis time each year reminds me of gold; gold dust and golden light. The last handful of monthshave been clumsily clasped together by the unknown. In the past, I’ve faced the unknown bywriting: about a series of masks, the thick peel of yellow wallpaper, the strangeness of beingalive and having words to say and the desperation of not being able to say them. This time theweight of it all terrified me to the core and I stayed still, frozen. And then mid-March unraveled into a strain of happiness that was almost unbearable. Freefrom the unbound nature of not knowing, my ribcage gave way to a forgotten magnitude ofspace that allowed my lungs to expand. Fully. Finally. This volume is centered around duality: specifically the duality of lightness and heaviness.Inspired by Milan Kundera’s famous novel The Unbearable Lightness of Being, in which he ponderssimilar themes. In the novel, Kundera asks us “is heaviness truly deplorable and lightness splendid?”He then goes on to say: “The heaviest of burdens crushes us, we sink beneath it, it pins us to the ground. But in the love poetry of every age, [one] longs to be weighed down by [their lover’s] body. The heaviest of burdens is therefore simultaneously an image of [one of] life’s most intense fulfillment. The heavier the burden, the closer our lives come to earth, the more real and truthful theybecome.”However, “conversely, the absolute absence of a burden causes man to be lighter than air, tosoar into the heights, take leave of the earth and his earthly being, and become only half real,his movements as free as they are insignificant.” “What then shall we choose? Weight or lightness?” “Parmenides posed this very question [seeing] the world divided into pairs of opposites: light/darkness, fineness/coarseness, warmth/cold, being/non-being. One half of the opposition hecalled positive (light, fineness, warmth, being), the other negative. We might find this divisioninto positive and negative poles childishly simple except for one difficulty: which one is positive, weight or lightness?” “Parmenides responded: lightness is positive, weight negative.” “The last movement of Beethoven’s last quartet is based on the following two motifs: Muss es sein? (Must it be?) Es muss sein! (It must be!) Es muss sein! (It must be!). To make meaning of thewords absolutely clear, Beethoven introduced the movement with a phrase ‘Der schwer gefassteEntschluss’, which is commonly translated as ‘the difficult resolution’.” *~*~*~*E D I T O R I A LA P R I L 2 0 2 2 L A G N I A P P E M A G A Z I N E0 6

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L A G N I A P P E M A G A Z I N EV O L . 5 Unlike Parmenides, “Beethoven apparently viewed the weight as something positive. Since theGerman word schwer means both “difficult” and “heavy”, Beethoven’s ‘difficult resolution’ may beconstrued as a ‘heavy’ or ‘weighty resolution’. The weighty resolution is one with the voice ofFate (‘Es muss sein!’) Necessity, weight, and value are three concepts inextricably bound: onlynecessity is heavy, and only what is heavy has value. Who was correct and who was not? “That is the question. The only certainty is: the lightness/weight opposition is the most mysterious, most ambiguous of all.”Our cover photograph for this issue is a commission done by Shephaly Soni, titled “A PandemicStory”. She illustrates the duality of the last two years: a tightness in the chest, a feeling ofanxiety, intertwined alongside unexpected joy, relief, growth, and healing. Slowly, we leavespace for the duality to exist. Alongside both halves of this volume, we stay true to our name and bring you a little somethingextra: an interview with the founders behind The Open-Hearted MD Podcast, reflections fromgraduating fourth years, a brand-new Media Perspectives segment reviewing the film Drive MyCar, and a Makin’ Groceries section consisting of mouthwatering recipes. Following this release of Volume 5, the role of Managing Editor is passed onto the exceedinglycapable hands of our current Lead Designer- Emma Newton. With the rest of our design team,she has brought the magazine you are currently reading to life. I can’t wait to see the newheights that she and all of our talented new editorial board members will take lagniappe. Thespace this magazine created has been irreplaceable and in reflection at the close, I wonder ifI’m scared I’ll run out of words or if I’ve already done so. But the honest answer is, no. I’m scaredI’ll never find the right ones. But it is also, I hope I never do find the right ones. Because what happens then, what happens next, how do we stand and where do we go?I hope you hold space for the infinite dualities that may exist in your life. Thank you for thismoment in time that you are spending reading our magazine. WITH BOTH HEAVINESS & LIGHT, M i m i C h e nM A N A G I N G E D I T O R *~*~*~* *~*~*~*0 7

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when the sun's brightness accuses you of all that you have yet to do legs leaden, pinned to the bed you remember what you often forget: inhale on a count of four, exhale on four (do it, really) today your breath is an ineffective shield against the crushing weight ofall...thisthe cacophony of guiltthe tightening around your t h r o a th e a r tf o r e a r m sf i n g e r sthe heaviness of inabilitythe stinging of your tearducts. the blunting of your mindjust 15 minutes, you sayi'll do those damn flashcards for 15 minutes ok 5 minutes, you pleadi'll do flashcards for 5 minutes i'll write a poem, you sigh i'll put on eyeliner and write a poemyou swing on the porch (you made it out of bed), your arms clench against your shivering ribs your brow furrowed, every face muscle contracts against bone you feel the mass of the earth rotating on axis & atlas in relation to the sun, moon, mars, mercury, jupiter, venus, uranus, neptune, saturn, each exploding star, each infinite black hole you feel their unique gravity, their electromagnetism shaping the ellipses of your failures do you want some toast? she asks, stroking the lines from your foreheadI'll bring you some teaGalaxy Blues - Ally NoyesV O L . 5 L A G N I A P P E M A G A Z I N E1 1 Sometimes the depression I experience feels like the weight of the cosmos is bearing down onme and medical school has only deepened this feeling. My partner at the time of writing was(and continues to be) an incredible source of support in helping me come back to earth gently.

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Count the martins flying at the shore before you go.Each one looks the sameso maybe there were eighteen, not seventeen, but not more.(Purple martins spend a few months here in the springnear the Lake where there are lots of bugs and a lingering breeze.)They don’t tend to live at top of the small, manicured hill exactly five point zero milesdue south from the end of our driveway.But here, over cold, hard dirt on top of the hill I look forone among the golden field of straw, the cottonwood trees, and the slabs of granitestretching across the hill that’s exactly five point zero miles away from our home on the Lake.Your home.I don’t remember how long the martins stay,or where they leave to after the spring rain endsand I’ve never seen a dead martin before so I don’t know where they go to die (not here).Martins don’t visit this small hill,not today and not back when we were kids andused to run between the granite headstones while Mom planted flowers just over there.No birds today. Grey clouds. Still grass. Cold,hard dirt for you on top of the hill exactly five point zero miles due south from the end of our drivewaywhere we used to run and laugh while Mom planted flowers and cried.Take one more glance above (please be there),in the grey overhead—oh, Brother! now it’s raining on the hilland I was silly to think you could flyfrom the cold, hard, dirt on top of you, only five point zero miles away fromwhere you should be.Apparently this rain is good for the martins becauseit makes more bugs come out near the Lake. Counted the martins when I got back. Seventeen,eighteen...Nineteen!A Bird Now - David Long(for my brother)V O L . 5 1 5 A trip to the cemetery to visit the grave of my sibling. Some say ourloved ones that we've lost visit us as animals, commonly birds.

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Lactose OceanWicked waives rise way upTowering torturedly over meCrashing down in curdlesDrowning me in drudgeCurrents cutting like knifesBubbles bursting like bombs Overtaken by this overwhelming ocean of Languishing lactose locking me in a Lonesome lull The HandsTik-tock, Tik-tock, Tik-tockThe hands go ‘round the clock.Ever so slow they move,Dragging about a groove.Thump-thump, Thump-thump, Thump-thumpSlow heart struggles to pump.FASTER! FASTER! I scream,I wish it were a dream.The walls are closing in,I’m on a downward spin.But the hands are dragging on,God, why can’t this all be gone?This MonsterThis monster has no clawsIt doesn’t breathe fire or hide under the bedYou can look but you won’t find itIt’s stealthy like the wind: invisible but eerie,Raising hairs wherever it blows, like a shadow it never strays But its’ damage is undeniable, From the inside-out, this monster consumes its’ prey “How”, you ask? In the most barbarous of ways,Hijacking its host’s mindThis monster is here to stay. They Say, I SayGUILT, FEAR, FAILURE.They ask how I don’t eat,I ask how they eat so much.FAT, UGLY, DISGUSTING.They say my perceptions are distorted,I don’t know how they don’t see it.They say food is medicine,But they have no idea.They don’t understand the TORTURE, the STRUGGLE.I say food isn’t medicine but ratherA tormenting menace. Annie and IA P R I L 2 0 2 2 L A G N I A P P E M A G A Z I N E2 0

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My gallbladder had enough - Shephaly SoniThai-Inspired Chicken Meatball Soup has 5 starsand 8,700 reviews on New York Times cooking. Ithink I ate less that evening with the intention ofhaving leftovers for lunch the next day- the startof the endo-repro module, and the end of amuch needed break. My relationship to chicken,and many of the meals Brendyn enjoys cookingis complicated. I did not grow up eating chicken, or a lot of highfat meals. I’ve never had a burger in my life,unless you count the black bean burgers thatBrendyn makes at home, to which I never addmayo or cheese. Even then, I have come to lovecertain chicken dishes, and try my best toexpand the options for our mostly joint dinners.The chicken has to be in small pieces;this is key.Meatballs, as unappetizing as the term is to me,are good for this requirement of mine, becausethey can be smushed into smaller pieces anddistributed among the other elements of themeal. I did not have Thai-Inspired Chicken MeatballSoup for leftovers. In fact, it was 44 hours beforeI had anything else to eat or drink.The pain started at 1:30 am and lasted over 12hours. It never lasted this long before. I knewthis epigastric pain well, as it radiated throughmy belly, screaming to be let out. For the last tenyears I’ve had this pain. It wakes me from anotherwise uneventful, maybe even more restfulsleep. I learned a routine. While the pain getslouder, thumping under my costal margin, Igather the heating pad, heat up water withajwain seeds, maybe add lemon-honey- gingerand head to a future at the base of a toilet. I am lucky that this house we live in has twobathrooms. The guest bathroom is a perfectlayout for this painful episode. I lay a towel onthe floor to shield me from cold tiles. I try tohave a bowel movement, I sweat profusely, Irepeat to myself “this will pass, this will pass”and try to focus on something else. To say it isthe worst pain I have ever experienced in my lifeis not an exaggeration. This kind of pain does not stop with morphine.It is as if someone has seized my esophagus,pylorus, duodenum, and twisted them untilthey exploded. It is very sustained and severe,like pain you might get from severe cramps, butthey don’t come in waves, it just starts and theneventually stops abruptly. It is a pain thatmakes you want to stop breathing.Ten years ago these started off as very shortepisodes that were easily cured with a hot teaand bowel movement. I thought it was relatedto having rumination syndrome since the age of15, but many GI specialists convinced me thatthe problem was related to my depression andanxiety. No one ever suggested an ultrasound,and I struggled to comprehend a life wherethose illnesses didn’t impact me in every way,including my bowels. I am laying on the floor, I’ve taken all my clothesoff because I cannot stop sweating. I amsobbing in between violent jolts of my bodyheaving vomit into the toilet that now needs tobe cleaned. I am making involuntary soundsthat embarrass me. Goodbye Thai-inspiredchicken meatball soup, I think. I feel dizzy. I remember a clinic lead trainingshift that needs to happen in 4 hours, andthink, well this will surely end before 7:30 am. Itdoes not end. I find respite momentarily when Ifall asleep on the green towel, exhausted fromthe feeling of my entire body clenched like afist, from vomiting, from constipation. I do not go to clinic, because the pain did notend like it had in all the episodes of the last tenyears. This is not stress, I think. I spent theweekend painting arches in my kitchen, cookingmeals with my boyfriend, going hiking with thedogs. I am not stressed. I am not mentally ill. Iam managing it. A quick Telehealth appointment with a campushealth doctor cements the fear that somethingelse is wrong, and her urges to send me to theER are met by my ignorance and first yearmedical student diagnostic skills. A P R I L 2 0 2 2 L A G N I A P P E M A G A Z I N E2 2

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answer our questions. A nurse practitionercame in to explain what was happening, andwhen we probed for answers, she said “I’m justa navigator here.” When she left the room,taking her condescension with her, Brendynasked if I caught her role. She’s an NP. Shespoke to us like she was just passing by, noteven working on that unit. I make a note tomyself about how to talk to patients when theirexpectations aren’t being met, how to showempathy and compassion for their sufferingeven when I cannot fix it. I wake up from the ERCP, the person at thebedside gives me apple juice on ice, which I’mguessing I requested. I tell her it’s the bestapple juice I’ve ever had in my life. It’s the firstthing I’ve consumed in 44 hours. Theytransported me back to the hospital with the EDstaff who have probably seen so much at thispoint, empathy is running dry; except now I getadmitted to the medicine floor.My room has soothing lighting and windowsthat open to trees. The art on the wall isn’t toobad, and my nurse, Nancy, is the mostwonderful person I’ve met in a long time. Shefeels like family. We exchange stories aboutbowel movements and laugh. I get a lot ofmorphine between now and the surgery. Mysurgeon is someone I aspire to be. Sheimmediately acknowledges my anxiety and goesthrough all the imaging and reports with me.She treats me like a normal person, a personwho has not seen 1000 cases ofcholedocholithiasis, and she teaches me like amedical student. I am so grateful for her. Therewas a moment where I felt such fear after thesurgery. I was having more post op pain thanthe hospitalist expected, and again saw theresults of the imaging before they had time totalk to me about it. I was crumpled over in a bedside chair with myheating pad as Brendyn tried to console me. Iasked for the nurse repeatedly to quell the painI was having. Concern turned to panic whichturned to tears which turned to seizing anxietythat hit me like I was being stabbed every time Iheaved. Brendyn tried to show me videos of thedogs, and I am sure that the look in my eyeswas so helpless. A call with a friend empoweredme to ask for the medicine I needed, and theEventually I go. For the first time, the woman atthe registration desk asks me “honey, what’swrong?” And I burst out in tears. Simultaneouslyfeeling great pains and also relief that someonemight care enough to fix me. I am afraid of beingin the emergency department, I am afraid ofgetting COVID. Brendyn is there, and he isallowed to stay the whole time. Something I willnever be grateful enough for. I was quickly givena private room, fluids, and toradol. The roomwas silent, the window faced a concrete wall.Brendyn tried to cheer me up by trying to eat 5saltines without drinking water, and succeeded. Iwas scooped up into a wheelchair multiple timesfor imaging. The ultrasound technician was kindand gentle. She said that the doctors will alwaysgive a more thorough reading, but she could seegallstones. 24 hours before this moment I was in astandardized patient activity where myclassmate and I did an exam and history on apatient who had cholelithiasis. I thought back tothis as I tried to self diagnose every symptom Ihad in the last 10 years, wondering how it wasmissed. Ochsner uploads test results to the portalsometimes sooner than the physician on call canaddress it. This is an unfortunate benefit of theirsystem for patients like me, who have enoughknowledge to ask questions, but not enough tostop anxious thoughts from overflowing. It’sbeen 1 week, and I am still staring at images ofthis MRI. I zoom in and rotate the MRCP thatshows my tiny gallbladder filled with stones. Itrace the anatomy that I learned two blocks ago,cystic duct, common hepatic duct, common bileduct. Just before the sphincter of oddi I see atiny black spot. The on-call surgeon comes inand here begins a day of communicationblunders, tears, and waiting. She explained what was happening in the mostmatter of fact tone I’ve ever heard. More drugs,and I would have assumed she was telling methat tonight’s forecast was sub 40 and a coatwould be necessary. Sub 40 here being there isa stone in my common bile duct. A coat meaningI cannot leave the hospital. I have to get thestone removed, and then my gallbladder. Thenext day as I was hitting over 30 hours withouteating or drinking, not one person was able to V O L . 5 L A G N I A P P E M A G A Z I N E2 3

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I wrote this because I cannot move on like Ithink I am expected to. It wasn’t an acute event,it was ten years of feeling this intense, horrifyingpain at random moments, getting in the way ofmy life, social activities, school, and work. It wasten years of laying on a bathroom floor andwondering why my depression and anxietycaused this; even now when I know it wasprobably biliary colic I cannot peel myself awayfrom the shame that I somehow did this tomyself. And because the pain is not gone, I needto see more specialists. I do not care if I cannoteat all the fat and dairy New Orleans has tooffer; I simply want to sleep through the nightwithout a quiet twisting sensation that growsinto a monster that steals my time and energyfrom me. I mostly want to hide from the demands of mylife. I don’t want to participate in the clubs I amresponsible for, I don’t want to walk the dogs, Idon’t want to cook dinner or wash the dishes. Iwant to crawl into a bed under a pile of fuzzyblankets and sob until everything stops feelingso intense. “Your emotions are tired”, my sistersaid. I wonder how tired my gallbladder musthave been, to hold onto the stones and thesludge. I tell myself that this will pass, and that I am herebecause I am resilient and that I must makeanother Anki card, I must draw another diagram,I must study in order to put this behind me. Ijust wish that resiliency was not required of me,not right now. presence of my surgeon soon after I receivedpain and anxiety medication calmed me. Sheexplained the pain I was feeling, what theimaging showed, what the labs showed, whatthe medicine would help with, what it would nothelp with.Now I am home. Recovery is different foreveryone, and I wonder why I am so depressed.Why I am allergic to the pain medicine, why I stillfeel waves of cramps every few minutes. It feelslike someone tied a string to the loops of myintestines and put small weights at the end ofthe strings. It doesn’t feel quite right. I amfatigued, I want to sleep for 15 hours. The brainfog is potent, and it feels like my thoughts arecovered in mayonnaise as I try to get through asingle lecture and Anki deck. I keep going backto look at my MRI. I keep thinking about thepain and being on the floor for ten yearswondering why I was so stressed out that mybody would react this way. I feel deeplydepressed in a way I haven’t felt in a long time. The idea that my body failed me in such a way,that when I brought it to the attention of severaldoctors over the years it was diagnosed as aresult of my depression and anxiety. It makesme feel tied to mental illness and to a timewhen it was impossible to study for hours onend because my mind and body were notworking as they should. Naively, I thought thatmy mind and body were done misbehaving. Ithought they would leave me to thrive inmedical school, because it had taken everythingto get here. My surgeon said that I didn’t cause this. Asidefrom a guilty pleasure of fries maybe once everycouple months, I eat mostly vegetarian, mostlyhome cooked meals that aren’t high in fat. I feelthe judgment of my medical school curriculum,looking back on the slide deck for the GImodule. They were surprised my labs were notmuch worse, and that I had lived with this for solong. A P R I L 2 0 2 2 L A G N I A P P E M A G A Z I N E2 4

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yesterday myneurologist asked about mymother’s health historyi told him she had MS and thenhe asked aboutmy fatheri told him we areestranged and he said“i’m sorry.”i know that it was a normal politecolloquial deferentiallyHUMANthing to say but i thought how lucky it is how luckyi amthat when he asked, “what about your father?”up-to-code nursing home where he will pay lewdbut excusable compliments to thefemale waitstaff and i will watchthe bipolarity cede todementia.” because then only then after hearing of myhealthy paternal relation my neurologistwould be forced tosay, “i’m sorry your mom hasMS.”i am not bitter about any of it anymoreColleen Hugoi did not have to say“we are joined at the hip and also we gotlunch lastweek. before my junior prom he made a shotgun joke andone day we will walk down the aisle in a symbolic act ofselling me forsome livestock. when he is older,when i have my own life and my marriage is tied up ininherited Gordian knots iwill put him in a niceexpensive V O L . 5 2 5

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I am heavy, I am floating,I am absent,I am present. Weeks after I lost the person who felt like mysoulmate, I found myself walking alonethrough a field in rural Louisiana, listening toAmy Winehouse, mosquitoes devouring mysweaty skin. After I lost my mind, I buriedmyself in my sheets, hospital sheets,stranger’s sheets—silent, starving, nauseous,filthy, vile. I drew on walls, and I cried my eyesshut. I screamed and cursed into my pillowwhen I woke up. I still do.My grandma said, “I don’t like to watch or doanything on Sundays that messes with myspirit. I try to respect the Sabbath. Nodancing, no blues records, and stuff like that.”I commended her dedication though Icouldn’t understand it. I stopped believing inGod when I stopped believing in my parents,yet I still pray out of desperation when I’mespecially lost.I don’t believe in prayer, but I believe insunsets, wildflowers, cocktails with heavypours, cigarettes, and decadent meals. Ibelieve in sex, hugs, reality tv, and a goodbook. I believe in rock n roll records playedtoo loud. I believe in the universe and that ifGod exists, she is a misunderstood womanlike Lilith. Who sins and has wings, and herspirit flows through the wind.Nothing makes it go away. Yousimply wake up and keep going; inhale and exhale until the moonmakes way for the sun.On Prayers - KSBV O L . 5 L A G N I A P P E M A G A Z I N E2 7 It is a meditation on what prayers mean to me and how they appear.

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Physical appearance is manifest as loveLack of love is grotesque appearance Environment, time, love…This shows who you are physically Overweight, disproportionate limbs;Is it your fault? is it lack of love?What would your body look like with love?Without love? Reservoirs of love, of physical creditThey live within your bodyYou can go many generations off this creditThe credit of love lasts many generations Eventually it starts to show on your bodyEventually love sculpts your bodyThe disfigurement, the cancer, the deathThe attraction, the health, the longevity Love, or lack of love from others, controls all We are attracted to those who persist Persistence is love, and it makes manifestLove physically manifestsI love you even if you are disfiguredI love you even if you feel grotesqueMy love for you is eternal There was never a time when we didn’t exist Yet, we are mortal in this bodyWe sail through life changing our body Changing our idea of loveBut eternal love is unchanging You maintain your body to align with loveAnd persist in an idea of loveBut listen to meYou are worthy of loveYou are worthy of love You Are WorthyTimothy GressettA P R I L 2 0 2 2 V O L . 5 L A G N I A P P E M A G A Z I N E3 4

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Amber is made from the sap of prehistorictrees, which, millions of years ago, would trapinsects and small animals within it. Aftersome time, the amber is turned to stone bychemical processes beyond myunderstanding, and the animals trappedwithin the amber become preserved for thereaches of time. Grief, in some ways, isamber. It traps our memories of a person lostinto golden stone, leaving them unchanging.All their flaws, complexities, their personhood,is sacrificed for the sake of memory andpreservation. We don’t dare break the stone,because to question who a lost loved onewas is to lose our memory of them. The amber of grief is one of the central ideasin Ryusuke Hamaguchi’s Drive My Car, basedon the Haruki Murakami short story of thesame name. While I haven’t read the originalshort story, I’ve been told that it differssignificantly from the movie at severalpoints. In the film, Yasuke is a theaterdirector and actor who is staging amultilingual performance of Chekov’s UncleVanya during an arts festival in Hiroshima.Two years before this, his wife Oto died of acerebral hemorrhage. Yasuke and Oto hadwhat seemed like a happy marriage, butYusuke knew that Oto was also seeing othermen. One of them, Koji, is a young actor he’schosen to be part of his production of UncleVanya. Much of the story revolves aroundYasuke’s attempts to reconcile hisproduction with his grief, however the heart of the film is the relationship betweenYasuke and Misaki, a young driver fromHokkaido who’s assigned to drive his redSaab 900 for him while he’s in Hiroshima.Yasuke and Misaki have both experiencedloss; her mother was killed in a mudslide whenshe was younger. Their shared expressions ofgrief are quiet, often taking place standingfar from each other, or from the front to backseat of the Saab. Yasuke always sits in thepassenger seat until he has a conversationwith Koji, where he’s told that while Oto didlove him, both Koji and Yasuke could nevertruly know her. Koji shatters Yasuke’shardened amber image of his wife, his fear ofcoming to terms with the depth of herpersonhood. Koji too, sees this, and tells himthe end of a story that Oto would used to tellYasuke while they were together. Yasukewould only hear the beginning, Koji the end.Both of them trapped in amber, unable to seeOto as herself. Misaki too, struggles with the amber of grief,in her memories of her mother. Her childhoodwas hard, growing up in an abusive householdwhere she learned how to stay quiet tosurvive. Her mother, too, is encased in amberas a memory, almost as a mirror image to Oto.While Yasuke and Oto’s relationship wasloving, but yet filled with a depth of negativemystery, Misaki’s relationship with her motherwas fraught, rough, but yet there was atenderness that she admits she misses. Media Perspectives On Drive My Car: Daniel DellalA P R I L 2 0 2 2 L A G N I A P P E M A G A Z I N E4 4

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Drive My Car doesn’t pretend to provideanswers to the questions of grief. It doesn’tattempt break the amber of memory, toshatter Yasuke’s perception of his wife, orMisaki’s feelings about her mother, only toshow the aftermath of loss. People may copewith loss and grief with memories, they mayseek out answers, they may retreat intothemselves. But what all loss inflicts is thestruggle to keep living, which is what Yasukeand Misaki resolve to do. They live their livesto the final lines of Uncle Vanya; “You havenever known what it is to be happy, but wait,Uncle Vanya, wait! We shall rest. We shallrest. We shall rest.”Misaki and Yasuke bond over their sharedloss, and move to confront themselves andtheir memories. They drive to Hokkaido, andvisit Misaki’s ruined house, buried under bedsof snow. There, they shed the memories ofthe people they’ve lost, and remove thedistance between themselves as theyembrace. They are the ones left behind,moving and fluid, and they must leave thestones they burden themselves with. Hamaguchi’s camera often lingers on wideshots without focus on faces, emphasizingthe distance between characters. His choiceto make the production of Uncle Vanyamultilingual emphasizes this as well, as noneof the characters understand each other, butinteract nonetheless. Each of the actorsresponds to lines on timing alone, unable totruly hear what’s being said to them. Did Otofeel this way about Yasuke, or Misaki abouther mother? Perhaps he’s trying to show usthat the distance between the living is oftenas far as the distance between the living andthe dead, and our understanding of thosearound us, our isolation, doesn’t stop whenwe pass, but instead lives on in the memoriesof those around us. Koji and Yasuke know thesame woman, intimately in some ways, butyet they know nothing about her, or eachother at the same time. Misaki knows hermother, knows the damage she’s done to her,but still she misses her in some way despite itall. V O L . 5 L A G N I A P P E M A G A Z I N E4 5

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Q: Can you talk about the inspiration for the podcast?Erika: Tulane medical students went with Dr. Byrne to northern India for an elective called TheTibetan Refugee Elective and as a part of that elective we did health screenings with Tibetanmonks and nuns. We also received so much from them in the way of learning about the Tibetanapproach to medicine, meeting Tibetan medical students, and Ayurvedic medicine. In the finalchunk of the trip we found out we were set to have an audience with His Holiness the DalaiLama. He spoke with us for over an hour and the first question we asked him was “What does itmean to be a good doctor?” and he laughed – he doesn’t take himself too seriously – and in anutshell he explained kindness is at the heart of it. Beyond that, he spoke about emotionalhygiene. Because of Covid, we couldn’t send another group of students the following year, and webrainstormed ideas to continue the learning and share the lessons we received from HisHoliness and share the interactions with the refugees. So the podcast is our way of continuingthe discussion and sharing the lessons. Dr. Byrne: Our wheels started turning in June when we knew for sure that we wouldn’t besending a group that year. We bounced ideas around for about four or five months, and itwasn’t until January of 2021 that we came together as a group and decided to put together apodcast – it’s a consumable way for receiving information for medical students and otherlearners – and we batted around names and all felt that Open Hearted MD was what we reallywanted to embody in our podcast.2.25.2022, Dr. Rebekah Byrne and T4 Erika Bennett, founders of"Open Hearted MD", sat down with Lagniappe to provideexclusive details on the "Open Hearted MD" project. This initiativepromotes dialogue that "explores the opening of our hearts tofurther strengthen the doctor-patient relationship." One successfulavenue that the project uses is their eponymous podcast.Fascinating expert guests make for easy, engaging listening abouttopics "integral to the healing practice." Open Hearted MDSpotlight: PodcastL A G N I A P P E M A G A Z I N EA P R I L 2 0 2 2 4 6

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Q: How did the connection with Dr. Epstein happen?Dr. Byrne: Dr Ronald Epstein is the first guest as you know. He wrote a book called Attending:Medicine, Mindfulness and Humanity. And I felt that ‘Wow, this book really hits on what itmeans to be a mindful, compassionate doctor and it’s what I want to personally embody andwhat I want my students to embody. We have all been pleasantly surprised by the people we’vereached out to and found out how interested they are!Q: If you had to define your audience, how would you define it?Dr. Byrne: America! Erika: I think our audience spans from medical students, learners at the beginning of theirexperience in the medical community through to people working as residents all the way topeople working as physicians. Also, beyond folks with MDs to broader members of the medicalcommunity and patients as well. At the end of the day, anyone who wants to hear about thehealing interaction. Q: What’s going on in medicine that can make it difficult to be open hearted?Erika: I think the healthcare system is set up in a way that makes it hard to flourish as a healthyhuman. As a medical community we have work to do to talk more explicitly about compassion,to own our own flaws and ways to grow. But truly, the most meaningful patient interactions I’vehad are the ones where we connected on a human level. Patients really respond to taking amoment to show genuine empathy and kindness. Dr. Byrne really models this in her clinic andhelped show me that it’s possible. Q: Can you talk about your role with the podcast, Erika?Erika: I would call my role “producer”. Although I was a student host for an episode, really I dobehind the scenes recruiting to student interviewers, finding out what topics make sense forthem. Also, I’ve taken a deep dive into the world of internet tech and figuring out how topublish the podcast online. Dr. Byrne: I’d also add, Erika, that you’ve done great curating for the website. Creating reading,goals, reflections on the website. Q: How has being involved in Open Hearted MD affected how you approach your training?Erika: I’ve found myself incorporating the tips our guests have shared which has been reallycool to be able to practice as we are working on the podcast. Also, working on the podcast hasgiven me an opportunity to reflect along the way, and think about ways I can be more mindfulin my work. L A G N I A P P E M A G A Z I N EV O L . 5 4 7

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Scan here to access "MD in Progress"Q: Do y’all have Mardi Gras plans?Dr. Byrne: I went to Muses last nightwhich has been a long time favoriteparade of mine, and on Sunday I’m gonnawatch Thoth with neighbors, and ofcourse St. Anne’s on Tuesday. Erika: I love muses I also went last night.One thing I love about Mardi Gras is thatit captures the spirit of doing things forthe sake of fun! Q: Any last thoughts?Dr. Byrne: If there are students who areinterested in being involved, they canreach out to Erika!“In response to the pandemic and the feeling of isolation we were experiencing, JonathanAllotey had an idea for a podcast to create a space to capture reflections of life in medicalschool during a pandemic. He approached Bridget Bunda and Tina Reddy with the idea andwe were all very excited about it. Using our different skillsets, we collaborated with ourtalented classmates including Michael Chen and Charley Wallach to bring it to life.” - from TinaReddy Scan here to access "Open Hearted MD"Contact Erika Bennett at ebennett2@tulane.edu for more information about Open Hearted MD, or to get involved.MD in ProgressL A G N I A P P E M A G A Z I N EA P R I L 2 0 2 2 4 8

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"Go to therapy, talk to your friends andfamily, reach out when you need help.Sometimes when things (that rotation,that test, that recurring thought) feeloverwhelming, we freeze or just continueon. We try to enjoy the music we oncedid or snap ourselves out of it with atired cup of tea. In those moments, talkto someone, friend or therapist or familymember. Doing so can allow you toreflect on what is actually happening andwhat needs to change. I remember atthe end of third year, I was extremelyburnt out and was having tremendoustrouble with brain fog and motivation. Ifinally made a therapy appointment andcried the whole appointment. Doing sowas a huge wake up call for me that thiswas not normal and I was not taking careof myself. Also would highly recommendlexapro for anyone who needs help withmotivation/depression. :) " -Nicole Salfi "You can do it. Each step adds a newchallenge, but remember how faryou’ve come from sitting with yourTLC group on the first day oforientation. It’s ok to stumble. Ask forhelp if you need it. Life and medicineare team sports, and we all do betterif we help each other out." -anonymousT4 Reflectionsfind people who will cheer for yoursuccesses (not matter how minor)and won't judge you when you fall.these are the people you wantaround you for these four years. Foranyone or anything that isn't bringingyou joy anymore, don't be afraid togive your energy elsewhere, you'll besurprised what you can do with extratime without extra stress -anonymousL A G N I A P P E M A G A Z I N EV O L . 5 "Fuck. FUCK! Fuck, dude…. Man. What a time." -Meredith Freeman4 9

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"Don’t describe patients asinteresting. I was always troubled bythis. For better or worse, oureducation strives to jam us with asmuch discrete and out of contextinformation as possible - and withthat overload comes a lack ofperspective. The pathology that westudied incessantly during 1st and2nd year without ever facing a realperson dealing with an illness, tothen trying to impress attendingsand residents during 3rd and 4thyear by expressing our excitementin that field by claiming “interest” ordescribing patients as “interesting”seems to continue to dehumanizethe very real struggles that ourpatients are living with, dealing with,and dying from. Learn to separateacademic interest in themechanisms behind pathology anddisease, and how you express yourpassions in medicine. The motherwith metastatic breast cancer doesnot feel like her condition is“interesting” - she is scared. Theparents of a son who is in the midstof his first psychotic episode arelikely frightened. The father, who youare walking beside as he is beingwheeled into the OR for his valvereplacement, is looking back at youon what is likely the worst day of hislife. He doesn’t care about the selfiein your scrubs you are about to poston Instagram stating that being inthe OR is your “calling”. Don’t everlose that perspective and yourhumanity, even if it comes at thecost of not impressing an attending.After all, you became a physician tohelp people, not to satisfy yourinterests or your own ego."-anonymousL A G N I A P P E M A G A Z I N EA P R I L 2 0 2 2 Call your mom more "if I could have told you at the beginning..." (to your younger selves)1. -Nicole5 0

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Half the day had passed and I was ready togo home. The highlight of elementaryschool had arrived: lunch hour. I rippedopen my lunch bag to find the standard kit:a sandwich, a bag of chips, and my waterbottle. I chomped away starting with thechips- I was happy… for about five minutes.When I was done I tossed the plastic bagaside and found it had been labeled“poisson.” I couldn’t believe my eyes, theday had finally come;: my mom decided shehad enough of me and was ready to takeme out.I ran out of the cafeteria screaming. I foundmy teacher and showed her the plasticbag,: “MY MOM TRIED TO KILL ME, DOESN’TTHIS SAY POISON?!” She seemed unusuallychilled out about the whole situation andshrugged her shoulders. I was furious, howwas my teacher unable to confirm the waypoison is spelled? I knew it had to be true:my mom understands how fast I eat so Iwouldn’t check the labels of anything shepreserved. Poison was the perfect method:quiet, untraceable, out of sight out of mind.The more I thought about it the more itmade sense.: I was more trouble than I wasworth. I was young enough to not pose anydanger to her; she could get rid of me nowand replace me with another son before Igot stronger. But I wasn’t going downwithout a fight. I ran off to the nurse’s officewhere I knew they had poison antidotesbecause I remember Steve Irwin talkingabout them on T.V. I could feel it in mychest–- the poison was circulating mybloodstream and I didn’t have long. I sworeto myself once the nurse fixed me up Iwould exact revenge on my mother, hersupplier, and all those who wanted medead. Fish and Chips: a Recipe for PoisonI found the nurse’s office and barged in,:“I’M SORRY FOR NOT KNOCKING BUT MYMOM TRIED TO POISON ME AND I NEEDANTI-POISON MEDICATION RIGHT NOW!”The nurse was completely taken aback, andinsisted I recount the story despite the factthat I only had several minutes left to live. Itold her in less than a minute andreminded her that if I didn’t get help ASAPshe could be held accountable for mydeath. She explained that the schoolmedication cabinets don’t have anti-poisonkits and that Steve Irwin probably hasaccess to supplies that public elementaryschools don’t. I collapsed into a nearbychair in fright. Of course it had to end thisway–- my mom had masterfully plannedeverything such that I never stood achance. As I was starting to accept myinevitable doom, the nurse handed me thephone and asked if I wanted to call home. Isaid yes, because if I couldn’t exact actualrevenge maybe my final words hauntingher for the rest of her life would bepunishment enough. I waited patiently asthe phone rang.When my mom picked up I instantly wentoff. Screaming at her through my tears, Itold her how I knew she tried to poison meand I hoped she would never forgiveherself for snuffing out my potential. At theend she just laughed and asked me how tosay fish in French. Of course, “poisson”double s is fish in French, single s is Englishfor something entirely different. Sheexplained to me that she reuses plasticbags to store food, and she had originallystored fish in the plastic bag she put mychips in. My mom still sends me food fromtime to time and I learned my lesson:always check the labels beforeadministering medication… and consumingfood. Marc GebaraA P R I L 2 0 2 2 5 2

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Ingredients:1 tablespoon butter1 tablespoon olive oil1 large onion, diced3 cloves garlic, diced1 stalk celery, chopped1 carrot, chopped1 sweet potato, peeled and cubed1 medium to large butternut squash, peeled seeded and cubed 1 chicken stock container (I use low sodium but whatever works)Combine butter and oil in large potAdd in onion, garlic, celery, carrot, sweet potato, butternut squash andseasonings Cook for 5 minutes or until lightly brownedAdd in chicken stockCover and bring to boilReduce heat and simmer for 40 minutes or until larger pieces are forktenderBlend up soup (I use an immersion blender but you can ladle theveggies and broth into a stand up blender as well)Directions:1.2.3.4.5.6.7.Butternut Squash SoupV O L . 5 This recipe is my most heavilyrequested dish from my fiancéand a staple in my houseduring the colder months. It iseasy to make, healthy, andmost importantly delicious. Tyler Metz5 3

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1 cup rice1 tablespoon butter1 cup water5 cups whole milk1 teaspoon salt1 tablespoon sugarhalf and half/cinnamon to tasteIngredients: Instructions:Scald rice with boiling water. Melt half of the butter, add rice and water and boil for 10-15 minutes or until waterdisappears. Add milk and cook slowly for 45 minutes or until rice is tender. Add the salt, sugar and the rest of the butter.Pour into a bowl and drizzle with cold milk or half-and-half and some cinnamon.This is a Swedish rice pudding recipe that has beenpassed down in my family for generations.Traditionally, whoever makes the dish puts analmond either in the big pot or in one of the bowlsonce it has been distributed. Whoever gets the bowlwith the almond receives a marzipan pig, and willhave good luck for the rest of the year! Risgrynsgröt (pronounced Reese-en-grit)V O L . 5 4 9 Emma Newton5 5

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Creator IndexAlly Noyes - Galaxy Blues. Ally is a queer trans dreamer and schemer studying traditional and allopathic medicine. Theylove playing outside and making food for their friends. Blair Easton - Involvement. MD candidate from Charlotte NC.Cassio Fox - Little Pudgy Sausages.Charles Peper - Silly Cat. Charles Peper is a Tulane student from Chaska, Minnesota. He has slept in an igloo. Colleen Hugo - I'm Not Bitter About Any of It Anymore. Colleen (they/them) is a senior at Tulane studying French and studio art. They love NewEngland, coffee at night, and their mom. Daniella Reimann - Fathead; Fringe; Whisp. Danie is graduating from TUSOM this May. She loves people, pictures, pooches and pimples.Daniel Dellal - Drive My Car Review. Daniel Dellal is a first-year student from New York, New York. He enjoys rummaging throughyard sales looking for trinkets like a goblinDavid Long - A Bird Now. David Long is a third year student at Tulane from Geneseo, NY. He enjoys drinking coffee,spending time with his dog, Scooter, and watching The Office.Emma Newton - Shock, Risgrynsgröt. Emma Newton is a third year at Tulane from a tiny farm town called Hollis, NH. She lovestalking (a little too much), running (a little too much), snuggling with her (perfect) dog.The Interminable T3 - Person Paradox. The Interminable T3 identifies as forever learner, and is constantly trying to discover how to bea better human.Julien Bourgeois - How Time Flies. Raised in Louisiana, Julien Bourgeois is a third year medical student keeping his passion forart alive in between board exams.KSB - On PrayersMarc Gebara - Fish and Chips. Marc Gebara is a first year at Tulane from Houston, Texas, he enjoys working with computersand exerciseA P R I L 2 0 2 2 5 8

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Maya David - Time. Maya is a first-year Tulane med student from Hollywood, Florida. She enjoys cooking,traveling, and searching for the best chai latte in New Orleans.Nicole Salfi - Ceramics. Nicole Salfi is a fourth year medical student from Philadelphia PA. In addition to ceramics,she enjoys spending time with friends and walking around her neighborhood. Patrick McCarty - Together. Patrick is a first-year medical student from Phoenix, Arizona. He enjoys reading, creatingart, and exploring all that New Orleans has to offer. Rachel Cooley - Keep Going.Rex Yun - Never Knows Best. Rex Yun is a 24 year old artist that has always envisioned pushing the meaning of what itmeans to struggle. He creates sporadically to process negative emotions but ultimately todocument and remind himself of where he comes from. Shephaly Soni - I can sit with this; (H1N1)pdm01; ICD-10-CM COde F32 2; I can't sit withthis; My Gallbladder Had Enough. Shephaly Soni is a first year medical student at Tulane University SOM who uses art toprocess her experiences with mental health and medicine. Her work explores concepts throughvarious organ systems and uses plant imagery to symbolize transformation and growth aftertrauma.Soo Hyun Choi - ( ). Soo Hyun (Sue) Choi is a third-year medical student at Tulane University School ofMedicine. Born in South Korea, she has called Mongolia, California, Germany, and now, NewOrleans, her home. She earned a Bachelor of Arts in Studio Art and French at TulaneUniversity prior to joining their MD program. Her experiments in art and writing often considerthemes of heritage, upbringing, and historyTimothy Gressett - You Are Worthy. Timothy E. Gressett is a 5th year MD/PhD candidate in Neuroscience from Irvington, NY. Heis interested in studying the molecular basis of consciousness.Tyler Metz - Butternut Squash Soup. Tyler Metz is a 2nd year from Philadelphia who made New Orleans his home since 2014.His love for food and New Orleans inspired his recipe.V O L . 5 Creator Index(continued)5 9

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