I. Arnie

His newly married son opens the door
and ushers me into the living room.
Orange and blue plastic flowers
catch dust motes that float on sunbeams
and drift towards the coffee table.
His father arises from the plaid armchair to greet me
freshly showered, clean shaven.
His mother sits immobile, stiff, mute
in her wheelchair.
Father and son have laid out a spread
of oreos and tea.
I must join them.
I glimpse a cot behind the sofa
Bedding neatly folded.
Is someone staying here to help?
The son nods.
The door bursts open and the wind
blows in his older brother.
Disheveled, stained coat askew
He snatches up a handful of cookies
and sprints out the front door.

Akinetic mutism

It’s been difficult the son says.
My wife may leave me,
but I must be here.
His father turns so I cannot see his face
and sits slowly down in his armchair.

II. Mary

She brings her chest pain to me
and Armenian Nazook for my children
and I admit her again.
Not a candidate for surgery
I tweak her meds this way
and that
like an ill-fitting dress that
I cannot force flat.
I go to her home thinking
perhaps I’ll find the answer
in too many stairs
and ask her to show me
how she takes her pills
that lie ajumble on her kitchen table.
What color is the sugar pill, she asks,
and I understand.
She cannot read.

III. Amelia

She sits forward for me to listen
to the rising tide of fluid
engulfing the lattice of her lungs.
Folding down her blue bedspread
I notice the tiny balls at its hem
dancing merrily
like the rim of a sombrero.
Stethoscope to wrinkled skin
I listen intently trying
to assess the depth of her suffering.
Over her shoulder
I see on her bureau
a village of ghosts
figurines and photos from years past.
May I ask you something? she half-whispers
All these years I’ve been seeing you
I’ve wanted to…
Yes of course.
Is my back dirty? I have no one to ask.
I’ve worried you’d think me unclean.

It’s fine, I reply,
but if you like,
I’d be happy
to wash it for you.


Beth Lown is Chief Medical Officer of the Schwartz Center for Compassionate Healthcare, Boston MA, Associate Professor of Medicine, Harvard Medical School and Director of Faculty Development and the Fellowship in Health Professional Education at Mount Auburn Hospital, Cambridge MA. As an intern, she began writing poems as a way to remember and honor her patients, to try to understand their experiences and to make meaning of her own. Now retired from clinical practice, she finds joy in supporting the empathy and compassion of those who touch the care of patients and families. She continues developing and spreading programs, and teaching and researching the impact of these essential foundations of caring.