Poetry
Diagnosing
I did not need to think
I knew, as soon as
I saw Mr. X’s presentation
I put together the pieces
No labs were needed
No imaging to order
No further tests
Mr. X had fasciculations,
His tongue wriggling around
Mr. X had atrophy,
His hands withering down
Mr. X had hyperreflexia,
His legs jumping off the bed
Mr. X had ALS, there was
No doubt
I was a student,
Always referring back to my notes,
Confirming the next best step that NBME was always asking about
Mr. X’s broken motor neurons screamed the answer out loud
I now understood the feeling of knowing
And knowing
No words
Would be good enough to say
Author: Shannon Clare
Bio: Shannon Clare is an M4 at University of Michigan Medical School, applying into Internal Medicine residency.
Commentary: This poem reflects on diagnosing a patient with a motor neuron disorder. Fundamentally, the disease does not allow this patient to maintain full control over his movements, starting in overt ways such as affecting his gait, but ultimately will progress to affect even his ability to move air in and out of his lungs.