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When God Speaks to Me

By Savanna Winsted

The Holy Spirit spoke to me as I sauntered past a hill of wildflowers along the pathway to my car.

Look at the flowers. View the beauty in the chaos. All the different flowers, grasses, and entanglements of green. See, the world looks at this from the human perspective as weeds and messiness that instead should be plucked and manicured for straight lines and perfection. You destroy the very creation I call beautiful. God placed that wild arrangement there with purpose and destiny. I feed my grass; I grow my flowers; I lay them exactly where they were meant to be. See the beauty in how I care for my creation when it follows my will.

Then He reminded me of the landscaped flowers and bushes I pass everyday on my way to work. He then tells me…

Something greater planted these flowers and bushes. Man places the plants yet the rain and wind destroy them in an instant. It was never their purpose to be in that place. Though they are beautiful and appealing to human standards, they cannot thrive outside the spiritual realm. Human condition and human ideas fail and fall every day because they do not follow my will. You can only thrive where you were meant to be planted; you can only grow when you are led by the Spirit. The world sees my creation as wild weeds and a nuisance, but I find joy as they flourish, grow and spread as designed to do. As they obey my voice, they prosper to no end. This is what love does. This is the desire I have for my people — my creations. For too long you have done things beyond my will. You have searched for external beauty and perfection in appearances and placement. People have plans for their lives, but my purpose prevails. I have longed for my people to return to glory, to search their hearts, and understand the beauty that is already within. That beauty is concealed by expectations, false truths, and lies from the enemy. This is the time for my creation to return to its proper place, to understand its purpose, to know the truth. Hear my voice, and obey my commands. As you draw near to me, I will draw near to you. This is where love is found, in my arms and in my will.

Savanna Winstead is a Patient Services Coordinator in the Care Management Department at UAMS.

My First Patient

by Frederick Guggenheim, M.D.

Do you remember your first patient in your chosen specialty, or what was to be your chosen specialty? My first such patient, new to a psychiatric diagnosis, was Eleanor. I was a Clinical Associate internist at National Institute of Mental Health at NIH, having finished three years of Internal Medicine residency. The year was 1965, and I was the On-Call physician for psychiatric emergencies every two weeks at the NIH Clinical Center, even though I had had no specific psychiatric training. I had, after all during my training years at Bellevue Hospital, pretty much seen “just about everything.”

Eleanor, referred to National Cancer Institute at NIH from a small town in California, was 22. When I first saw her, I noted that she was a blond, blue-eyed young woman with a round face, dressed in a hospital gown and lying on her back inside a formidable, clear plastic, oblong, plastic bubble — a so-called Life Island. I had never seen such an isolation device before: it was then on the cutting edge of American medicine, as was bone marrow suppression and transplantation.

The Life Island covered the entirety of Eleanor’s hospital bed. Talking was easy enough. But because of the drug-induced immunosuppression used to treat her acute leukemia, the only way that staff could give her medication, or food, was through two side-by-side, plastic-encased portals that gloved hands or sterilized food samples could be quickly passed in.

The psychiatric consultation for Eleanor was called in at just after the 8:00 p.m. close of visiting hours. Eleanor was upset, psychotically so. Her paranoia and shrieking were spreading histrionically. The precipitating event had been the visitation from a never-before-seen preacher from upstate Pennsylvania. He had traveled to the NIH Clinical Center specifically to see Eleanor. Somehow, he had heard that she was an identical twin being treated for acute leukemia who also happened to have congenital heart disease, while her healthy twin had neither condition.

The preacher was described as a tall, bearded man dressed all in black and wearing a broad-brimmed black hat. He felt impelled to see her — to tell her that she must have acquired these disorders because, somehow, she had displeased God. This freaked Eleanor out. She began yelling and screaming.

Enter, minutes later, me, in the unfamiliar role as the psychiatric consultant. It was very clear that I was having to work far above my pay grade. It was nighttime, and all my psychiatric solons had long gone home. A small dose of oral Thorazine settled down the room, to my relief. After close to half an hour, Eleanor and I finally were able to talk, commiserate, unwind, and get past our introductions.

Following this emergency meeting came months of daily semi-scheduled conversations. She did the talking, and I the listening. Eleanor’s twin, after the initial bone marrow donation, had since returned to California. Eleanor stated that she wanted to go back home, and preferably not in a plain wooden box. Fortunately, she didn’t want to bolt out of the Life Island, which she felt kept her safe, after a series of bone marrow suppressions.

Eleanor was a help to me in my learning to be a psychotherapist. As my first case of supportive psychotherapy, she wanted to talk and she related warmly. We quickly developed a therapeutic alliance. I helped her deal with her emotional distress by being a constant person during a time when her NCI Clinical Associates kept rotating in and out of her life. Mostly what I did was just listen attentively and sympathetically. Psychoactive medications did help. My role as her therapist was to focus on her issues, her voice, and her needs while not raising issues that she was not grappling with. Her mood improved and she became realistically hopeful about her potential for meaningful gains.

Eleanor did talk about her twin, but not about how she was the unlucky one to have several disorders. She accepted what had been dealt her in a very mature way. We never heard anything more from that malevolent preacher. Eleanor did achieve a temporary remission at NIH. She was pleased to achieve her main goal — to fly back home in a temporary remission.

Our work together was good for me, too. Having enjoyed the process with Eleanor, I decided to apply for yet another residency, this one in psychiatry. After all, what was wrong with adding a sixth, seventh and eighth year to my training if I felt it was meaningful!

Frederick Guggenheim, M.D., is Professor Emeritus in the Department of Psychiatry, College of Medicine.

White Coat Anonymity

Do you notice me?
Do you see my soul?
Or does attire blind you?
And is all I am a role?

We all have a part to play
And I play mine well
So I keep on performing
In this living Hell

Do you know what it costs me?
Do you see the price I pay?
You may see a coat of white
But I see a world of gray

I make a great impression
But you don’t know the real me
I am hidden in plain sight
White coat anonymity

Tyler Estes is a M.D./M.P.H. student at UAMS.

To the Front-Line Healthcare Providers in the Time of COVID-19

In ancient times the knights rode out to cheers and loud applause,
To fight our foes, those armed heroes, took up our common cause,
And now a gentler sort suits up to face our fears and ills,
They wear clear shields and masks and gloves to fight this one who kills.

God bless and keep you, fearless ones, who face this threat for all,
And keep us mindful of our debt to you who took this call.

Lee Archer, M.D., is the chair of the Department of Neurology.

The Laundry Cycle

Do you ever feel like a shirt,
With wooden clips pinning your shoulders to the line,
Left blowing in the wind to dry,
With your colors bleaching under blue sky?
Do you ever feel like a sock,
Bought extra in a pack of three,
Left in the crease of a washing machine,
Each cycle bringing swirls of new dirt and clean?

Do you ever feel like a blazer,
Complementing a blue button up,
With fitting cuffs level with the first thumb,
And a flower-pinned lapel smelling sweet as plum?
Do you ever feel like fresh underwear,
Sought out like the last clean pair,
Slipping on with ease with only a folding crease,
And fitting the form of hips with fleeting Tide whiffs?

I feel everything,
I am a shirt that is both clean and dirty,
Cycling through the laundry each week,
Tidying myself for a new day,
Getting dirty the same day.

Mason Belue is a medical student at UAMS.

Phased Out?

Princess bedside and stand-up telephones.
Landlines. Ma Bell.
Telephone booths.
Victrolas. 78 and 45 rpm records.

Ash trays. Analog photography.
Alarm clocks. Walkman. Transistor radios.
Beta and VHS. Tape cassettes.
Vacuum tubes. IBM desktop typewriters.

Blockbuster stores. Telegrams.
News reels at the movies.
Air mail and Special Delivery.
Three cent stamps. Fountain pens.

Oldsmobile. Pontiac.
Nash Rambler. Plymouth.
Spark plugs. Packard. Edsel.
Rumble seats. Leaded gasoline.

Rhodesia. Belgian Congo.
Washington Star. New York Herald Tribune
Hotel lobby toilets, some with dime stalls.
Motel vibrating beds for a quarter.

Elevator operators. Hotel page boys.
Top hats. Hamburg hats.
Girdles. Stockings with seams up the back
Women wearing hats in Catholic church.

Chocolate malted milk shakes.
Banana splits. Royal Crown Cola.
Crudities on the table at restaurants.
White Castle’s dime hamburgers.

Children born to married parents.
People saying “You’re welcome.”
Walking straight to the airport gate.
Mincemeat pie at Thanksgiving.

Black rhinoceros. White rhinoceros.
Grevy’s zebras. Addax.
Pangolins. Mountain gorillas.
Smallpox. Chernobyl.

Are we next?

Frederick Guggenheim, M.D., is Professor Emeritus in the Department of Psychiatry, College of Medicine.

The Healer

There are days I am disillusioned,
When I am bereft of my purpose,
Alone in my office,
Peering out my window
While the rain is pouring down.

Then I read their words,
Hear their voices,
Remember their faces,
And relish their smiles.
Then I remember. . .

I am a champion for the learners,
A guide on their journey.
Their passion inspires me,
And though I am their teacher,
They are teaching me.

I am not a healer,
Nor have I held a life in my hands.
Yet I peered into the eyes of those
Who will one day be healers
And hold my life in theirs.

Though I profess the intricacies
Of the body,
The art of the human form,
They convey a more noble cause
To restore it when broken.

They are my students.
I am but their teacher.
Since they give my life meaning,
Though they are not yet healers,
They are already healing me.

Edgar Meyer, Ph.D., is an assistant professor in the Department of Neurobiology and Developmental Sciences.

My Patient

“Can you please let me go?”
She pleaded with tears in her eyes
Her daughter was turning 16
And she needed to be there

Her body was completely swollen
Barely able to stand let alone walk
Her cheeks were sunken
Her eyes jaundiced

She was dying and knew as much
But she wanted to savor the last moments
With her daughter and family
Not in a hospital room surrounded by strangers

She did leave
And never came back
I hope she made it for her daughter’s birthday
And I hope that she’s finally at peace

Latha Achanta M.D., M.P.H., FACP, is a Professor of Medicine in the Department of Internal Medicine.

The Crowd.

On a lazy Sunday,
I sit in the sun,
reading a book by the swing.
Some shadows watch over
the unturned page,
and me,
if I fall asleep.

There is this crowd that walks with me
when I walk alone.
Some dear ones sit around the table,
When I sit alone.

On a tired day, I sit by the fire.
In my head are some forgotten words
of a harvest song.
I hum that tune.
Off tune.
A chorus sings along.
When I sing alone.

This crowd is not of strangers.
They have names and I know them.
Warm breath, and warm hands.
So close I held them.

My first dog.
Then the other one.
A bird, a mouse,
some dear patients, a mentor,
a friend or two.
A dear uncle and an aunt,
a sister, a brother,
a grandma, a dad,
and yes, some children too.

As I smell a flower and look at the sky full of rain,
as I read a book or cook a meal,
they walk around me-
loving, chatting noiselessly.

They didn’t pass, and I didn’t move on.
Moving with me is the crowd.

At the stove, there is a familiar smell:
a recipe I know so well.
Grandma.

On another day,
the floor has my cut hair
falling to the ground.
It’s a shade of black and brown.
I have seen these colors and felt that exact hair run through my fingers.
I combed it back and kissed a head, to which I said
‘now go play’.
My child.

I laugh at a joke in the Reader’s Digest
and a dad seems to lean back on his chair,
trying to catch his breath,
laughing just like that.
My father.

I tease a friend and know those words
those that I said before.
Retold stories,
shared memories.
Old friends.

They don’t move on, neither do I.
Moving with me is this crowd.

It could be painful
if I try to let them go,
like a part of me.
It’s crazy but comfortable
when I let them stay.
They are a part of me.

This crowd around me

The crowd helps me stand straighter,
hold my head higher,
extend my hand to a firm handshake
or to wipe a tear.

I don’t hold the memory
neither do I cry anymore.
I live and laugh loudly
quite like before.

They wait around,
Just in case I need a story,
Just in case I need a laugh
Or flavors of sips of tea.
They live with me,
the posthumous crowd.

Manisha Singh, M.D., is an Associate Professor in the Department of Internal Medicine in the College of Medicine at UAMS.

Haikus

1

high tech and high touch
treatment scans and MRI’s
where is the high touch

2

covid-19 lands,
people suffer, gasp and die.
Life goes on somehow.

3

when a patient dies
people mourn; still the daisies
bloom again in spring.

Paulette Mehta, M.D., is a professor in the Department of Internal Medicine.