My Land

Ryan McAdams, MD
School of Medicine and Public Health, Department of Pediatrics, Division of Neonatology


they say doctors make the worst patients.
do patients make the best doctors?

horizontal in a head cage, slid
in the ceramic catacomb, the MRI magnet
preps a warning blast of phaser fire–
five seconds of silence.

sonic bursts pulsate, vibrate, rock
the skull base, zombie beats bounce
a dendritic drift, a synaptic trip,
a galactic whirl, flip, tilt, turn;

cosmic chirps and voltaic clippers,
the fervent squeak of rubbed glass,
rattle sockets, concha, and condyles,
shake fossa, ossicles, and foramen,
while the aphotic hammer pounds
staccato, slams astrocytic, bang bang,
hum knock, brain clang, clip clap,

you okay doc?
frantic thoughts grow like bindweed,
dark vibrations echo as the urge
to swallow peaks into a panicked gulp,
frenetic tick tock, the scanner jabber wanes
protons align as gigabytes
of pixels rise from magnetic mist,
to unveil the neuronal hieroglyphics

a walnut in a white shell, sliced
into hundreds of grayscale images,
viewed on a glowing monitor in a dark room,
annotated arrowheads scattered over blood spots

numerous microhemorrhages,
throughout the subcortical cerebral
white matter, cerebellum, pons, and medulla
small foci of enhancement at the left superior
temporal gyrus and left occipital lobe.

the neuroradiologist dictates her differential
multiple cavernous malformations,
hypertensive hemorrhages,
amyloid angiopathy,
sequela of a prior infection
we are not sure

which bites when it’s your own brain.

seated. not leading the discussion
but being discussed. staring at the black,
gray, and white slices of me.
a medical record number. a filed report.

blood draws, see-saws, check-ins, signed consent
lumbar puncture; we are still not sure,
you could have seizures and may bleed again
which can lead to paralysis or death

on night call in the neonatal ICU
i sit with a mom and dad
to talk about their baby girl’s head bleed.
as i point at the screen
i see my reflection
a ghost face flickering on blood puddles

awake at 3 a.m. my head flows volcanic
i stare at a screenshot of my MRI,
white and gray plots and patches
fed by black tributaries
like a map of Nunavut
a place that no one knows about,
like my injured brain, my land,

my secret Canadian Arctic Archipelago
filled with thick tundra, mountains crags
and speckled quilts of color like Eureka,
Oymyakon, and Alert; bright stories clustered
and layered like ice sheets and shelves–
but zero in, so close the snow tickles your nose,
then closer still, covalent bond-close,
angstroms away from the polarized light

reflecting off a single snowflake spike,
a prism plate illuminating eighty billion neurons
filled with forty seven years of me
electric green molecules that merge and glide harmonic,
free-flowing along one hundred trillion synaptic strings,
crystalized memories that melt fluidic;

bedtime stories in my mother’s lap, the gentle
safety of my father’s embrace, grandma’s
weathered hands rolling cookie dough,
memories bound in elements and ions

thunder claps in the distance
my son hugs me
my daughter kisses my cheek
will i last the summer?

tears fall on my midnight drive home.
knick-knacks neglected in a basement box,
awards, publications, and plaques
the hundred thousand emails in my inbox;
the cold trophies won’t keep my wife warm
if i’m dead

in Nunavut
the Vikings left yarn spun from hare and rats,
hidden tally sticks and carved masks
buried deep below the permafrost,
like the blood filled caverns in my brain
that leak the clotted whispers of Kubla Khan
beware! beware!
but who understands that they only speak

Inuktitut north of the tree line?
and that my calendar chokes on meetings,
who will hire the candidates? who will deal
with the issues before the ice shelf breaks?
my global thermostat leaks mercury
and another baby just died.

polarized in my nautical nightmare, i’m so tired.
i want to hibernate and heal
but the relentless drip of melting ice
torments me as my eyes strain to see the fading
glacial hue, melting blue to gray, tracing the slight
depression in the mattress beside my wife
who will help with homework and dinner?
who will help tuck in my kids at night?

the hollowed mines in Nunavut have left
black pits vacated of gold and iron ore,
dormant diamond, zinc, and copper graves
scattered over the white terrain like the
ambiguous holes that riddle my head.
i wait, caught in a crevasse wondering
if the trickle of blood will turn into
a massive torrent.            but then

my son smiles and my daughter laughs
as we play on the beach, skipping stones,
we run and splash in the salty waves
as the sky glows yellow orange red
the sun seems brightest just before it sets.
my grief
like the last bit of nickel in Nanavut
sinks out of sight, concealed in the mouth

of the Meliadine River, washed by
the subarctic waters, currents that cut
the dreck, carve and polish the bones below–
bowhead whale ribs and caribou skulls,
osseous treasures tapping beats on bedrock
as a pray for time and search the nebulous night
for astronomical twilight to shine
at the solar culmination

should i retreat to Nunavut where silence
and solitude cajole safety? a bleak surrender,
a pandemic escape to save a pocketful
of snowflakes

No. I choose the promise of warmth
the hope of recovery
over this ephemeral anxiety.
that’s my corona, my land to nurture

in Nunavut, my land, the dark of december
is followed by the light of june