Mother Tongue

John have you got your umbrella
I think it’s going to rain. Can you
come play with me? If I told you
once I told you a hundred times.

Things here just aren’t the same without
Mother, I will now sign your
affectionate brother James. Oh
what am I going to do? So

I said to her I said if he
thinks she’s going to stand for that but
then there’s his arthritis poor thing
and no work. I love you. I hate

you. I hate liver. Joan dear did
you feed the sheep, don’t just stand around
mooning. Tell me what they said, tell
me what you did. Oh how my feet

do hurt. My heart is breaking. Touch
me here, touch me again. Once bit
twice shy. You look like what the cat
dragged in. What a beautiful night.

Good morning, hello, goodbye, have
a nice day, thanks. God damn you to
hell you lying cheat. Pass the soy
sauce please. Oh shit. Is it grandma’s

own sweet pretty dear? What am I
going to tell her? There there don’t
cry. Go to sleep now, go to sleep….
Don’t go to sleep!

Taken from a commencement address given by Ursula le Guin at Bryn Mawr College, 1986. Submitted by Jim.

Case History 5.1

The paramedics will be arriving
In four minutes
With a 34 year old patient who has
A blood pressure
Of 80 millimetre of mercury
And a stab wound to the back,
between the shoulder blades.

What form of shock might this patient be
suffering from:

Haemorrhagic shock?
Pump failure due to pericardial tamponade?
Pump failure due to tension pneumothorax?
Neurogenic shock due to spinal cord transection?

All are possible.

What action may be necessary?

Case history taken from CCrISP (Care of the Critically Ill Surgical Patient), 2003, submitted by Jim.


And then you’re in an operating room,
Staring deep
Into a stellate smash of livid liver.

It oozes discontinuous destruction.
Fragments of hepatic mush are strewn
And coddled among clots of blood,
Stained with bile and mixed with stool.
The beauty of the enzyme pathways is nowhere to be seen;

Dr. Krebs is not in the building.
Weak indeed is the capsule holding it all in,
split apart like broiled bratwurst.
How little it takes!

(From Dr Schwab’s Brittle Beauty. Submitted by Jim)

A silent fall of immense snow

He moved

forward a few

fine chattering gems.

He knew exactly who would

now sneeze calmly through an open
door. Had there been another year

of peace the battalion would have made
a floating system of perpetual drainage.

A silent fall of immense snow came near oily
remains of the purple-blue supper on the table.

We drove on in our old sunless walnut. Presently
classical eggs ticked in the new afternoon shadows.

We were instructed by my cousin Jasper not to exercise by country
house visiting unless accompanied by thirteen geese or gangsters.

The modern American did not prevail over the pair of redundant bronze puppies.
The worn-out principle is a bad omen which I am never glad to ransom on purpose.

By Jim. This is a Snellen chart (used to test eyesight) taken from the Oxford Handbook of Clinical Specialties, 2007.