CONFLUENCE | Megan Mensinger

My white gloved hand is anchored in the abdominal cavity. I am holding the smooth purple parenchyma of the liver in place. The perfect job for a medical student.

This is just my second time in an operating room, and my wide eyes are glued to the patient’s gaping abdomen. Blood shines like red acrylic paint under the OR lights. As surgeons whirl their glinting metal, I am fearful to move an inch. My mind keeps catching on the surrealness of the liver transplant before me.

I watch as they splay open the patient’s artery and the donor’s artery. So many hands setting the tissue up with sutures, like snags of fishing hooks and line. It’s time to anastomose, to connect the donor liver to the recipient. But I can’t stop looking at the arteries splayed open. I’m reminded of anemones and their soft pink flesh. Hundreds of tentacles reaching in the current. Phylum Cnidaria, jellyfish cousins.

Suddenly, the surgeon knicks a bleeder and the tide rushes in. Blood collects in the abdomen, and I think what a strange beating tide pool this is. No moon, no celestial fingers pulling the strings here. Just the ebb and flow of suction and coagulopathy.

***

The rope is waterlogged and laden with life as I haul it in. A few seasons underwater was ample time for an ecosystem to take root. I gaze at the tangle of orange, green and brown piled on the weathered planks of a dock that has been here longer than I’ve been alive. Not much gets updated in this town.

I’m on holiday break during my first year of medical school, and my biologist dad has recruited my help at the marine lab. Long before realizing I wanted to be a doctor, I spent my childhood summers here. Most of my time was at the beach, exploring the underwater world of the Atlantic. I would watch the slow trek of periwinkle snails along the sandy bottom, hold slippery ctenophores (comb jellies) in my palms, and chase the silver glint of minnows moving as one. An effortless grin forms as I take in the familiar surroundings.

This patch of murky water against an impossibly blue sky is Eel Pond. It floats countless vessels from no-nonsense Boston whalers waiting to go out fishing to larger sailboats, their port holes peeking at us. The emerald hull of the Gemma, the lab’s rusty collecting boat, takes a well-earned rest nearby. In the distance, a drawbridge leads out to sea. To a place called the Hole, a swirling of currents greeting each other. Halfway through my childhood, the drawbridge got replaced. Corrugated green metal to sleek paved top. No one liked it. Didn’t fit the character of this salt-worn place. In protest, anonymous fingers redid a favorite piece of graffiti from the old bridge. So, the underside still reads:

Summer people, Summer not.

The proclamation rises in the air every hour as ships pass underneath.

At the end of the rope is a scientific instrument known as a hydrophone. For months, its submerged chrysalis shape eavesdropped on fish. Specifically, toadfish, with their rotund bodies and mottled brown camouflage. Creatures known for an elaborate communication of boat whistles and grunts. Adding their noise to the ocean’s rich soundscape. While my dad secures the hydrophone, my task is to clean the rope and return much of its ecosystem back to Eel Pond. My hands find a litany of textures from spongy to coarse to gelatinous squish. I hold the rope close to my nose excitedly as my peering eyes try to parse the different organisms. I quickly identify the white chitinous crust of barnacles, the flitting segmented bodies of marine isopods (cousins of the roly-poly), and so much seaweed.

But it’s not long before I hold up a squishy brown orb and lob a question that I’ve asked my dad thousands of times:

“What’s this?”

“Sea squirt,” he says without hesitation.

Phylum Chordata. Just like us.

And the rhythm of our work continues this way. My countless queries about marine organisms and my dad’s happy answers. And in the background, riding the tide, is relief. That as I fill my mind with medical knowledge, there is still room for the curious girl captured by the ocean.

***

The screen displays the pink cavern of the bladder in real time. Hysterectomy concluded, we wait, watching the orifices where the ureter and bladder connect. When the jet of urine bursts into the bladder, I can’t help but think of hydrothermal vents on the ocean floor. I shake my head, marveling.

I didn’t expect to find a tide pool in an open abdomen in the OR, or be reminded of marine biology at all. To be engulfed by wonder in such an unfamiliar and stressful environment. And that awe is the girl, hair still damp and feet caked in sand, pointing excitedly. Saying look what we found.

***

Wrapping up my first clinical rotations of medical school, I can already feel the drift. Days that are impossible to explain to those outside of medicine. My hand holding a liver that hours ago belonged to another life. An almost unbelievable one-way rental. Or a surgeon putting me in charge of measuring more than a foot of a man’s resected bowel. I exhale when a flick of my apartment light reveals only my own company. There is peace in a microwaved meal-prepped concoction and no talk about my day. In a group meeting during my first year, my faculty advisor asked us to share what scares us most about becoming a doctor. I scrawled losing myself in blue marker on a thin strip of paper. On the wards, it is so easy to slip right past yourself.

So, I gather the wonders in my cupped hands. The body and its depths.

And I grin as I unspool them into small puddles of sea. That way, when the tide goes out, I won’t be left gasping.

Megan Mensinger is a third-year medical student at the University of Minnesota who is passionate about narrative medicine. Her work has been published in the Journal of General Internal Medicine. She is a founding editor of Trabeculae, an arts and literary magazine showcasing the creative work of University of Minnesota medical students.