Expectant
The orthopedic resident was quiet, as we practiced triage,
read histories of injury, decided where each soldier went:
minor patches—Xrays and a splint, a burn small enough
to wrap– or sent immediately for surgery, to fish out bullets
and shrapnel, sew the punctures, amputate the mangled leg.
A group of novice doctors, we argued most over “expectant” –
the soldiers so broken that they would likely die
and would tie up hours and personnel—best left
in a quiet corner, given morphine if they moaned.
After we marked off the last imagined wounded,
the orthopedic resident spoke: “In Vietnam, I was shot
through the neck, assigned expectant but stayed alive.
Fourteen hours later, a surgeon looked again and tried.
I don’t remember air-evac, the early days state-side.
A blur of hospitals and surgeries, recovery was slow.
They said I was too old for medical school, to be a doctor
and maybe so, but here I am.”
The PTSD Clinic
Once at an Army hospital, with a panoramic view of a city
named Baghdad by the Bay, a booming pass by Blue Angels jets
practicing formations for a show to delight the Fleet Week crowds
had half a dozen men dive to the floor, belly-crawling under beds
hands over ears or screaming while nurses ran for tranquilizers.
Shell shock, combat fatigue, flashback, combat psychosis, PTSD:
There is no cure in labels.
The past, like sucking sand pulls a human back to a moment
of inhumanity, settles them in to stay forever, an amber-trapped
fly, whose frantic buzzing slows and stills,
as the body moves through whatever is required,
finding reasons to survive, until the count of reason dwindles
into zero and the wounded animal of the body is put down.
The pills I give seldom work to still anxiety, and pain
is only dulled, sleep eludes and there are no pills for nightmares
that bleed into a sleep-starved day and dreams don’t run
from guns and knives no matter how strong the need for arms
to face the grocery store, trips for gas and liquor,
the mandatory anger management class.
How does a doctor heal fear-memory: the click of the mine
stepped on, the bloodied rags of flesh, once a child,
seen through the sniper scope, the revved engine
of a suicide bomber aimed at the guarded gate, the smell
of diesel, gunpowder and singed flesh, the muzzle flash
from a broken window overhead, the grit of sand in every crease,
days old sweat salt crust and stink, the night sky lighted red
by flares to call the missiles in, the acid taste of an arid mouth?
How do I bring the thousand-yard stare, the scanning gaze
of trigger-edge alert back, back to focus on my face? On any face?
Ambassador For Conscience
Poetry is an independent ambassador for conscience: it answers to no
one, it crosses borders without a passport, and it speaks the truth.
~Ellen Hinsey
It is always the children, blameless
but suffered to lose, no matter the victor
in war. Children, turned feral
as the world explodes in jagged lessons:
how to cower and slink, how to sleep
without sleep, alert always for disaster
and nightmare, how to cry without sound,
how to see without seeing, the flavors of pain–
tastes of tears and blood, the acids of grief,
how to seal it away like grit in the heart
of a pearl– black-nacred, lumpy, that grows
through the years, and is passed on
through generations, until some descendant
dissolves it all into words: makes a bitter drink,
distills a poem, a plea to the world, a plea
to conscience for peace.
Catharine Clark-Sayles was raised in a military family. An Army scholarship sent her to medical school and she was sworn in by her father as a reserve 2nd LT at noon on July 4, 1976. She graduated and completed training at Letterman Hospital in San Francisco (internal medicine and geriatrics). In 1990 she joined a civilian medical group and practiced in Marin County near San Francisco until retiring in 2019. She completed an MFA at Dominican University in poetry and narrative medicine. Her two books, One Breath and Lifeboat, were published by Tebot Bach and a chapbook, Brats, by Finishing Line Press.
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