HEART MURMUR | Serena Choi Fernandopulle

The toxic smell of Purell fills my nose
as I walk into the patient’s room.
My hands are still slightly slick,
and my pen nearly slips out of my grasp as I ask, 
“What brings you in today?”

She is a woman in her 60s,
wearing white ankle socks that press into her skin,
and I write “lower limb edema” in my notebook as she talks about her grandchildren.
It was one of their birthdays last week.
I smile, proclaim how fun that must have been, and then ask about her medications. 

Minutes later I tell her I’ll be listening to her heart now.
She nods, and coughs as I press my chilling stethoscope into her chest.
This is an unnerving intimacy for strangers,
we are only inches apart,
but in this context we both pretend for each other that it doesn’t feel odd. 

The room is quiet now,
only the sound of her valves snapping fills my ears.
It is like I am underwater at the beach as a child again,
hearing only the motion of the waves cascading above me
as they crest, white-tipped, near the shore. 

As she shifts, 
crinkling the scratchy paper of the exam table,
I hear a blowing amid the waves,
like the sound of the pump my father would use
to blow up my bike tires in the summer. 

I think the murmur is systolic,
and I have to stop my fingers from tapping out the rhythm
as I awkwardly elongate the time we spend suspended like this. 
It surprises me how identical the sound is to the one I heard a month ago,
emanating from a limbless pale mannequin in class.

I look down at her,
an urge to tell her how this is the first real murmur I’ve heard.
Her eyes are angled away from mine though
and I see the dark brown sun spots on her face.
I stiffen and lean away from her.

I notice my own heart pulsing underneath my ribs,
and the unconscious contractions become unnerving.
My stethoscope hangs limp around my neck,
and I find the words I need to say,
and I try not to flinch.

Serena Choi Fernandopulle is a second-year medical student at Albany Medical College. Fernandopulle graduated from Harvard College in 2024 with a degree in human evolutionary biology with a minor in English. She went on to graduate from the University of Cambridge in 2025 with an MPhil in human evolutionary studies. She is interested in human social bonds in the context of literature, psychology, medicine and evolution.

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