Synapses Vol. 6 (2022)

SYNAPSES A Creative Journal of Chicago Medical School VOLUME 6, SPRING 2022



SYNAPSES A Creative Journal of Chicago Medical School EDITORIAL STAFF William Agbor Baiyee, PhD Editor-in-Chief Candice Kosanke Managing Editor EDITORIAL BOARD Karen Black, MD ’88 Alumna Jeffrey Bulger, PhD Faculty Barbara Hales, MD ’76 Alumna Julie Phelan, MD ’01 Alumna Liza Pilch, MD Faculty Hector Rasgado-Flores, PhD Faculty REVIEW BOARD Saira Ahmed Student Natalie Bodnar Student Allison Cassidy Staff Andrew Chapman Student Noemi Cocone Pantaleon Student Vanessa Fan Student Anna Gomez Student Charles Humes Student Julia Kelly Student Chiemeziem DePaul Ohiri Student Alvin Onyewuenyi Student Kieran Palumbo Student Jessica Shuster Student Barbara Vertel, PhD Faculty JOURNAL OVERSIGHT BOARD Archana Chatterjee, MD, PhD Dean, Chicago Medical School; Vice President for Medical Affairs, Rosalind Franklin University Nutan Vaidya, MD Vice Dean for Faculty Affairs and Equity Chicago Medical School Lee Concha, MA Senior Vice President for University Enhancement and Chief of Staff, Rosalind Franklin University Shelly Brzycki Associate Vice President for Student Affairs, Rosalind Franklin University Chad Ruback, MSEd, MBA Vice President for Institutional Advancement, Rosalind Franklin University CHICAGO MEDICAL SCHOOL 3

SYNAPSES Title Front cover: “Long-Distance Potentiation,” artwork by Andrew Trandai, CMS ’25 Artist’s Statement: Drawing upon the idea of long-term potentiation (LTP), this piece highlights not only the strengthening of synapses but also the persistence to connect with each other across physical barriers. The COVID-19 pandemic has challenged our ability to provide support to patients and loved ones alike. However, technology has supplied new avenues through which we can maintain and foster relationships (e.g., telehealth, Zoom, etc.). Just as fiber optic cables transmit messages through the dark ocean as pulses of light, our myelinated axons conduct currents to and from disparate neurons—lighting our way back to each other. Long-Distance Potentiation reflects the human desire to be understood—to be heard and perceived—but raises the question, to what degree? How does one communicate their experience to another across sociocultural gaps? How much information is lost as it is repeatedly translated (e.g., electrical to chemical, physical to digital)? What nuances of human expression are lost as artifacts as they pierce the pixel veil of your screen? I wanted to explore the ideas of intimacy and separation inherent in a chemical synapse, specifically surrounding the synaptic cleft. The synaptic cleft provides the proximity for the delivery of neurotransmitters to their receptors but also the distance which separates the post-synaptic and pre-synaptic neurons. Thus, these hands parallel the act of two neurons “struggling to connect” as they reach towards one another, conveying a desire for closeness, the urge to overcome otherness, and the promise to nurture the warmth that our bonds bring. Medium: Digital art, Clip Studio Paint. 4 ROSALIND FRANKLIN UNIVERSITY

SYNAPSES FROM THE EDITORIAL BOARD We are delighted to present our sixth volume of Synapses, the creative journal of the Chicago Medical School at Rosalind Franklin University. The works in this volume reflect the creativity, imagination and passion of our community. [Rest of letter TBD] In a year when many of us found ourselves in uncertain and unprecedented situations, members of the CMS community used words and art to express their emotions and reflect on the events the world has been facing. The ongoing global COVID-19 pandemic has subjected humanity to an unusual degree of isolation, uncertainty, anxiety and inspiration. The pandemic normalized human hesitancy for physical contact due to safety concerns. A number of contributions to this volume reflect concerns around this pandemic. We are glad and proud to be able to provide this journal as an outlet for reflection and creative expression. Our journal is named for the components in the nervous system that form the connections between neurons and allow information to pass from one neuron to another. Synapses’ purpose is rooted in these ideas of connections and the sharing of information. This journal celebrates the relationships between the sciences and humanities, physicians and their patients, and the readers of this journal and artists who have shared their works. Synapses is a method of sharing information about unique experiences and perspectives, through reflections on the medical profession and human experience. Within the pages of this volume, you can share the experiences of a medical student writing a haiku for each day of the government-imposed lockdown, a physician memorializing the frontline healthcare workers who have died while treating people during the COVID-19 pandemic, a medical student remembering his first interaction with a patient, and much more. Each year one submission of fine art or photography is chosen for the front cover of the journal. This year our board selected the painting “Synapses” by first-year medical student Natalie Kieruzel. Natalie used acrylic paint on canvas to explore the new connections and channels of communication we have all had to make during the past year of social distancing, working from home and remote learning. We acknowledge the dedication of our review, editorial and oversight boards to the development of another quality volume of Synapses. We appreciate all artists for sending their creative works and congratulate those whose submissions are published in this volume. CHICAGO MEDICAL SCHOOL 5

SYNAPSES ABOUT SYNAPSES Synapses is a creative journal of Chicago Medical School at Rosalind Franklin University. The journal provides a forum for the expression and dissemination of creative works demonstrating Chicago Medical School’s commitment to develop a community of reflective learners and practitioners. The journal seeks to publish on an annual basis quality works that focus on experiences in medicine and expressions of the human condition. Submissions of creative works of poetry, art, photography, fiction and non-fiction, including narrative and reflections, to Synapses are open to faculty, staff, students, residents, fellows and alumni of Chicago Medical School. Each submission is reviewed blindly at two levels, first by reviewers followed by editors. Authors will be notified of editorial decisions. Submissions will open in mid-October and close in mid-January. The journal is published annually in the spring. To view past volumes and information about the submission process, please visit http://rfu.ms/synapses. © 2022 Rosalind Franklin University of Medicine and Science. The University has obtained permission to use the literary and artistic works that appear in this journal. The authors reserve all other copyrights for their works. All ideas and opinions expressed belong to the authors. Credit for image on back cover: iStock. 6 ROSALIND FRANKLIN UNIVERSITY

SYNAPSES TABLE OF CONTENTS Still, I Prevail James Nardini, CMS ’23 10 POETRY Fifty-One Days of Knowing You Noemi Cocone Pantaleon, CMS ’23 15 Stricken Vessel Regina de Leon Gomez, MD 20 Amazement William Agbor Baiyee, PhD 25 Pandemic Poems Part II Edwin Korouri, CMS ’23 26 America Is Brandon Golant, CMS ’22 33 An Open Water Pandemic Ashni Patel, CMS ’23 38 A Gastronomic Holiday Meal W i l l i a m G r e e n f i e l d , M D 45 Budding William Agbor Baiyee, PhD 46 Ghost in My Arms Marie Nunez Duarte, CMS ’25 48 An Imperfect Human Noemi Cocone Pantaleon, CMS ’23 49 Northpoint L e o K e l l y , M D 50 Dying S h i r l y S a m u e l , M D , R ’ 2 3 55 Dusk on the Door L e o K e l l y , M D 57 Long-Distance Potentiation Andrew Trandai, CMS ’25 Cover FINE ART Synaptic Idealism Lucy Yao, CMS ’23 11 Sitting Skeleton Kaitlyn Alleman, CMS ’25 16 A Mother’s Worry Masumi Padhye, CMS ’23 21 Peaceful Landscape in Rural Ethiopia Kuhn Hong, MD 22 CHICAGO MEDICAL SCHOOL 7

SYNAPSES Trans Arterial Chemoembolization Kuhn Hong, MD 30 (TACE) for Hepatocellular Carcinoma (HCC) Patient 31 36 Celebrate the Small Victories Sabahat Raees, CMS ’25 39 47 Thinking of Blue Sophia Yang, CMS ’23 51 Synapses L a u r a L i , C M S ’ 2 5 54 56 Currents L u c y Y a o , C M S ’ 2 3 60 Mobile Clinic: Patient Care for a Kuhn Hong, MD Remote Village Desert Mountains L u c y Y a o , C M S ’ 2 3 Kikuchi Disease Ashna Yalamanchi, CMS ’23 Getting Water for Survival K u h n H o n g , M D Remote M i r e k D u n d r , P h D 12 14 PHOTOGRAPHY Maple Leaves M e l i s s a C h e n , M D 24 27 Lunar Eclipse M i r e k D u n d r , P h D 32 34 Surf M e l i s s a C h e n , M D 35 37 Perspective A i s h a A h m e d , C M S ’ 2 4 43 Surviving the Storm Mirek Dundr, PhD Night is Always Darkest Before Dawn Edwin Korouri, CMS ’23 Jellyfish C a n d i c e K o s a n k e Solo M e l i s s a C h e n , M D 8 ROSALIND FRANKLIN UNIVERSITY

SYNAPSES The Yellow Brick Road Connor Haszto, CMS ’23 44 49 Shelter A b d u l a z i z A h m e d , C M S ’ 2 4 52 53 Great Blue Heron C a n d i c e K o s a n k e 59 61 Please Do Not Feed the Ducks P a t r y k L a b e d z , C M S ’ 2 5 62 Des Plaines River Trail Melissa Chen, MD Havasu Creek G r a n t C h r i s t e n s e n , C M S ’ 2 3 Hope M i r e k D u n d r , P h D FICTION George and the Gummy Rat William Greenfield, MD 28 Anne P a a r u l S i n h a , C M S ’ 2 3 18 40 NON-FICTION Lessons From Medicine Hitting Home Andrew Zwijack, CMS ’25 58 Dr. Rubin and the Pathologist William Greenfield, MD CHICAGO MEDICAL SCHOOL 9

SYNAPSES JAMES NARDINI, CMS ’23 Still, I Prevail “It’s a hoax” “It’s a conspiracy” “It’s just a cold” “The experts don’t know either” What a time we are in… What a time to be earning our stripes. How do we deal with the pain? Who will listen? Still, I prevail. I never imagined it would feel this way. I never thought I would be this tired. I didn’t think it would hurt. Still, I prevail. I will never stop fighting for this. I will never regret this journey. I will keep doing my best… And I will prevail. ■ 10 ROSALIND FR ANKLIN UNIVERSITY

SYNAPSES LU C Y YAO, C M S ’ 2 3 Synaptic Idealism Artist’s Statement: I was inspired by the philosophy of idealism, which asserts that reality is indistinguishable and inseparable from human perception and interpretation, as it relates to the synapse. Our minds do not function without synaptic transmission. Thus, on a certain level, reality lies within the abundance of neurotransmitters, receptors, and enzymes that exist within the synapse. This is represented in this piece by the explosion of color and vesicle-like shapes between two pre- and post-synaptic terminals, with wisps of transmission emanating from the cleft. Acrylic on canvas. CHICAGO MEDICAL SCHOOL 11

SYNAPSES MIRE K DUNDR, Ph D, FACULTY Remote 12 ROSALIND FR ANKLIN UNIVERSITY

SYNAPSES Artist’s Statement: Will the coronavirus spare the world’s most remote places? As we know, COVID-19 has reached the last coronavirus-free nations on Earth. Many tiny South Pacific islands such as Rarotonga in the Cook Islands cannot cope with even a few cases of COVID-19. CHICAGO MEDICAL SCHOOL 13

SYNAPSES ME L ISSA CH E N, MD, FACULTY Maple Leaves Artist’s Statement: “Take time to ce le brate t h e qu ie t m ira c l e s th at s e e k n o atte n ti o n .” — J o h n O ’ Do n o h u e Anderson Japanese Gardens: Rockford, Illinois. 14 ROSALIND FR ANKLIN UNIVERSITY

SYNAPSES NOEMI COCONE PANTALEON, CMS ’23 Fifty-One Days of Knowing You And every day is made new because of you. I have never known a love like this. Abundant. Enough to fill every cell of my body. You are my life. You are my pu rpose. To have you , an d to h old you are my g re ate st p l e a s u re s . 51 days of knowing you. And 51 days of knowing maternal love. Unconditional. Eternal. And ethereal. ■ CHICAGO MEDICAL SCHOOL 15

SYNAPSES K A I T LY N A L L E M A N , C M S ’ 2 5 Sitting Skeleton 16 ROSALIND FR ANKLIN UNIVERSITY

SYNAPSES Artist’s Statement: Anatomy drawing has helped me better appreciate the beauty and complexity of the human body. The human form is my favorite subject to draw and after staring at this skeleton for hours, I have a newfound wonder for this structure within us all. Graphite (left) and charcoal (right). CHICAGO MEDICAL SCHOOL 17

SYNAPSES PAARUL SINHA, CMS ’23 Anne The following is a reflection on my first experience in a clinical setting as a medical student. It is a brief summary of my day shadowing in an assisted living facility as well as my reflection and thoughts about the experience. All names have been changed to maintain confidentiality. ***** I stepped into the lobby of an assisted-living facility in North Chicago. Soothing shades of aqua and turquoise bathed the walls, which were adorned with minimalist but chic paintings of watercolor florals. I shifted nervously in my white coat and stethoscope, feeling more like I was wearing a costume than a professional garment. It was, after all, my first time donning this uniform in a clinical setting. As I waited in the lobby, I took further notes of my surroundings: the swanky interior was peppered with furniture and art that made it feel more homey. Nurses’ stations and supply closets were shyly tucked from view and medical experts fielded questions from staff and patients 24/7. Though this was an assisted-living facility, it lacked the typical drab look and felt more akin to an upscale hotel. Soon, I was shadowing Dr. Smith, a physician at this facility. I followed him through the wide hallways with doors that were spaced out and decorated with names of patients whose compact homes were just on the other side. And the other side is where I met Anne, a 97-year-old resident who had stopped taking her medications over the weekend. I stood at a respectful distance from Anne while Dr. Smith sat on a small couch in her sparse living room. “Is there a reason you have stopped taking your medications, Anne?” he asked. Anne shrugged her shoulders with indifference. Her hands, which were clutched over her heavily breathing chest, betrayed her apathy. “I’m 97 years old, I’ve lived my life.” Dr. Smith noticed her labored breathing and asked how Anne was feeling. Anne admitted to shortness of breath. A wave of concern crept up Dr. Smith’s face, and quickly, his demeanor changed. “You know what I have to ask you next … would you like to go to the ER?” “Never, you know that.” Anne began telling us about a daughter, Kathleen. Kathleen lived in California but was on her way to see Anne. Anne shared this information with stoicism and peacefulness. Dr. Smith, sensing the urgency of Anne’s rapidly declining health, immediately phoned Kathleen for her ETA. But, it turns out, there had been a mistake. Kathleen did not have plans to come. Dr. Smith insisted she get on the next flight to the facility. Anne overheard and grimaced, “Oh …maybe tell her to not worry about it.” It was clear Anne wanted to minimize her burden on loved ones. My heart sank, and I felt my throat close up as I watched this frail yet poised woman be so deeply empathetic even at this stage of her life — the one she had decided would be her last. It was at this point that the mirage of this so-called five-star, amenity-filled facility shattered for me. I realized that the decisions residents had to inevitably contemplate here were grave. The fancy art and bright walls were only compensating for the weight of the decisions that were discussed in their confines. As these thoughts floated through my head, my hands fidgeted with all the items I had stashed into my pockets to prepare for today — stethoscope, a reflex hammer, pens. I came to the realization that they wouldn’t help in caring for Anne today. I let them go, clasped my hands together, and focused on being present in the gravity of this moment. 18 ROSALIND FR ANKLIN UNIVERSITY

SYNAPSES I followed Dr. Smith out of Anne’s unit as he went into a workstation room to put in an order of morphine for her, to keep her comfortable until her daughter could arrive. He quietly told me that he suspected Anne would not make it until the end of the day, given her labored breathing. Some moments later, I followed Dr. Smith into Anne’s home one last time with the morphine. “Oh dear, I’m not going to get hooked on this stuff, am I?” Anne quipped. We all broke into light laughter. Anne subtlety and knowingly smiled. The news was playing at a quiet volume on the TV, and the current president was giving a press conference. “So what do you think of this guy?” Dr. Smith jovially asked, checking Anne’s blood pressure. “Oh, don’t get me started. I’ve only voted Republican once my whole life, and that was for President Eisenhower,” Anne managed to get out between harsher breaths. “I’m with you there, Anne,” Dr. Smith chuckled. “Good boy.” Later that evening, as I took off my stiff white coat, so many thoughts crossed my mind. Thoughts of Anne. The glimpse I had into a pivotal day of her life. Thoughts of Kathleen. I hoped she made it in time. I hoped Anne was as comfortable as she could be. I felt a renewed sense of importance fall upon my white coat. No longer was it just a costume. I realized this coat will grant me permission to be privy to people’s most vulnerable moments. Moments from this day had brought a sense of significance to my own, and whatever I did, I knew I had to make it count. ■ CHICAGO MEDICAL SCHOOL 19

SYNAPSES MASUMI PADHYE, CMS ’23 Stricken Vessel She puts on a motherly face of understanding, a look of courage, when the reality is anguish. She cries when she hears “admission.” She has a pregnancy complication despite having sheltered so diligently. She’s done quite well, in my opinion. In the thick of the pandemic, without a vaccine, she’s not infected and she is full-term. The virus has nothing to do with what is happening now… except for a fragile psyche. The breaking news manages to shatter the idyllic leaving her disappointed. The virus has everything to do with what is happening now. waves wash over us stop. hands and mouths on deck brace foam effervesces ■ 20 ROSALIND FR ANKLIN UNIVERSITY

SYNAPSES REGINA de LEON GOMEZ, MD A Mother’s Worry Artist’s Statement: This piece depicts COVID-19 vaccine hesitancy among pregnant women. As many as two-thirds of pregnant women remain unvaccinated. The color division emphasizes a pregnant woman’s internal conflict on whether or not to get vaccinated, while the multicolored background reflects the various thoughts, concerns, and questions pregnant women may have about the vaccine. Watercolor, 5.5 by 8.5 inches. CHICAGO MEDICAL SCHOOL 21

SYNAPSES KU HN H O NG , MD, FACULTY Peaceful Landscape in Rural Ethiopia 22 ROSALIND FR ANKLIN UNIVERSITY

SYNAPSES Artist’s Statement: Whenever I have free time while doing a medical mission trip in Ethiopia, I love to visit the countryside to see the vast scenery. Yo u c a n s e e th e th atc h e d ro o f w i th m u d walls of rugged homes. This structure houses the entire household and their animals. There is no electricity nor running water. Many houses do not have an outhouse either. Families are friendly and hospitable and often have many children. They must travel long distances on foot to get to medical facilities for help in emergency situations. Oil on canvas. 48 by 60 inches, 2021. CHICAGO MEDICAL SCHOOL 23

SYNAPSES MIRE K DUNDR, Ph D, FACULTY Lunar Eclipse Artist’s Statement: The longest partial lunar eclipse of the 21st century occurred on November 19. A lunar eclipse happens when the sun, Earth, and a full moon form a near-perfect lineup in space. The moon gradually glides into Earth’s shadow until most of the lunar disk turns from silvery gray to an eerie dim orange or red. The world witnessed the longest partial lunar eclipse of the century on November 19. It lasted 3 hours and 28 minutes, making it the longest partial eclipse of this century and the longest in 580 years. 24 ROSALIND FR ANKLIN UNIVERSITY

SYNAPSES WIL L IA M AG BO R BAIYE E , Ph D, FACULTY Amazement This universe of boulders and rocks. A magical Place A unique natural phenomenon. Unpredictable. These Boulders daze us. Intriguing, gigantic, and heavy. They resist gravity. The stand-up. These rocks disperse around us. They embrace the elements. They pay their respects to the boulders. Here are some of them. These scenes are stunning. Some of them are attractions. They are wonders. A place to revere. These leaves are purple. Raindrops on them stay in place. They are impressed with their powers. They move the rock/leaves to this position. This is the garden. Diversity abounds here. There are trees growing sideways. They move to and fro. How does this boulder rock on its axis? Why does it not fall? Why does the rock stand that high? Why is the boulder stuck there in suspense? Amazing!. ■ CHICAGO MEDICAL SCHOOL 25

SYNAPSES EDWIN KOROURI, CMS ’23 Pandemic Poems Part II Each day since starting remote learning on March 13th, 2020, I wrote one haiku. As I did for last year’s edition of Synapses, I have chosen eight of my favorite haikus to share. #340 Yes! Vaccinated! Hope this pandemic ends soon Shout out to Pfizer #437 Step 1 tomorrow Dedicated was taxing No more Anki, great! #438 Took Step 1 today Tomorrow is the next step Start Step 2 Anki #479 First day of clerkship No “Good job” in medicine We say “Strong work” here #488 Doc told me “Strong work” Best day in medical school Huge dopamine rush #622 Oh no! Omicron! Uh oh, this does not look good More data needed… #643 Halfway done, third year Psych, OB, Peds, and IM Time for Winter Break #655 5 day quarantine Then pinky promise to mask “Everything is fine” ■ 26 ROSALIND FR ANKLIN UNIVERSITY

SYNAPSES ME L ISSA CH E N, MD, FACULTY Surf Artist’s Statement: “You can’ t stop t h e wave s, bu t you ca n l e a r n to s u r f.” — J o n Ka b at-Z i n n San Diego, California. CHICAGO MEDICAL SCHOOL 27

SYNAPSES WIL L IA M G RE E NFIE LD, MD, FACULTY George and the Gummy Rat If ever a man needed rescuing from himself, thought Louise Dalig, it would be poor George Schultz, and she was the woman to do it. Besides, she knew that since her divorce a few years before, she missed and craved male companionship. And as she slid — or maybe galloped — along and alone into her “Fabulous Fifties,” her pickins’ were slim to almost none as an elementary school teacher in a small suburban school. No divorced single dads in her classroom, no unmarried colleagues in the teachers’ lounge — nobody. So, when Margaret Schultz passed away of her lingering disease, after having been lovingly attended to for months by George, Louise joined the casserole brigade bringing prepared dishes to the house. She noted that while he had concentrated on her needs, he wasn’t much of a housekeeper, and hadn’t paid much attention to himself either. She snooped a little during her post-funereal visit. The house needed a good cleaning, the cupboard was empty of staples, and the fridge and freezer held just an assortment of TV dinners, soda pop, and beer. Pretzels and popcorn completed his larder. Being the good neighbor, she volunteered to come back in a few days after school, after he had mourned alone for a while, to help him clean up, maybe do a little shopping for him, you know. Being a man of a half generation older than her and used to not being concerned with such matters — Margaret had gotten her MRS degree in college and had dedicated her adulthood to housewifery — he was surprised but gratified by her offer. So, as they say, one thing led to another over the next several weeks, leading to her hinting that while she wouldn’t live in sin with him — what would the neighbors think? — she was agreeable to marrying him. For George, he was not so much her senior that it would not be a “nurse or purse” situation, and he knew she couldn’t displace his memories of almost 50 years with Margaret. But he had gotten used again to meals on the table when he got home from the office, and he did at least like her, and was beginning to like her very much. Louise had an agenda. First, she put the house back in order. She thought that the spirit of Margaret would be pleased with how the floors were polished, the sink was never full of dirty dishes, and the bed, formerly her connubial bed, was once again made with almost military corners on the mattress. And unmade, on some nights, with activity long gone from it. (Well, Maggie might not have appreciated that part, but George certainly did!) Then Louise paid attention to George’s physique and health. A beer and pretzel diet had added pounds to his already somewhat too heavy body, and when his partial denture had cracked he’d neglected to see the dentist for a new one. She proposed that they walk around the block after dinner. She admonished him not to graze on Dunkin’ and other high-sugar, calorie-rich goodies at the office, and sent him off every day with a small Ziploc box with chunks of cut-up pineapple (his favorite), halved apples and pears, and the like. All to his sweet tooth, but more nutritious than M&Ms, cookies, and glazed doughnuts. He did well under her regimen toward healthfulness, putting aside his occasional problem with a belly ache and a harder time than usual passing his stool. Until one dark and stormy night when he awoke with a terrible cramping in his gut. Louise dressed quickly, and took her suffering spouse to the Emergency Department. Examination showed him to be sweating profusely, in obvious severe pain, and with a distended abdomen. His doctor, who met them at the hospital, was concerned about possible bowel obstruction, ordered an abdominal series, and asked for a surgical consult. “The sun should never rise or set on an obstructed bowel,” he instructed the worried couple. The x-rays were confirmatory, suggesting a large mass blocking the lumen of the horizontal section of the large intestine. The surgeon concurred. They wheeled George off to the OR. Once the prep was done, and the sleepy anesthesiologist had put George under, the surgeon carefully opened the belly. Putting his hand in the breech he grasped the colon where the offending lump was, expecting to feel an immovable, firm mass, a “hugger”. However, the mass was not fixed to the inner wall — it slid away from his fingers! He grabbed it again, and again it slid gently 28 ROSALIND FR ANKLIN UNIVERSITY

SYNAPSES up the tube. “Dunno,” he said to his colleague who was assisting him. “It feels like he’s swallowed a whole gummy rat. Feel it yourself before I open.” On inspection, the pliable object which had caused the obstruction was about six inches long, two to three inches in diameter, and shaped somewhat like a slimy miniature football. That morning the pathologist pronounced it nonmalignant, a benign extraneous obstruction called a bezoar. Unusual in the West, it was somewhat common in China during the persimmon festival, he explained, caused by people swallowing excessive amounts of not fully masticated pulpy fruit. In retrospect, George’s missing denture stopped him from properly chewing up the hunks of fruit Louise prepared for him daily, and some of what he bolted down hadn’t passed, coalescing into the semisolid gloopy mess the surgeon had extracted with a flick of a finger from the blocked tract. After his post-op recovery and before the dentist made him a new plate, George went back to work every day not with a box of cut-up fruit, but with a pureed slurpie of the same apples, pears, and pineapples, transformed into a safer delivery system. And George and Louise lived happily ever after. ■ CHICAGO MEDICAL SCHOOL 29

SYNAPSES KU HN H O NG , MD, FACULTY Trans Arterial Chemoembolization (TACE) for Hepatocellular Carcinoma (HCC) Patient Artist’s Statement: We offered a two-year fellowship program in Interventional Radiology (IR) at the mission hos pital in Et h iopia. We re cru ite d five yo u n g E th i o p i a n ra d i o l o g i sts fo r th i s p ro g ra m . Te n I R specialists from Korea spent one week at a time every month to instruct the fellows. They would start the procedure and the Ethiopian radiologists assisted and watched the procedure at the beginning. As time went on, the fellows started performing the procedures under the supervision of the visiting Korean IR specialists. Eventually, the Ethiopian fellows performed the procedure successfully by themselves and became the first pioneers of IR in Ethiopia. Whenever we did these procedures, all the trainees participated and watched the procedures. Medical students came to see the procedures as well. Oil on canvas, 2021. 48 by 60 inches. 30 ROSALIND FR ANKLIN UNIVERSITY

SYNAPSES SABAHAT RAEES, CMS ’25 Celebrate the Small Victories Artist’s Statement: This henna design was inspired by the unfolding events of COVID-19. Henna is often put on by Middle Eastern and South Asian populations during celebratory holidays and weddings. In its true essence, henna is used to celebrate special moments in life. This drawing reminds us to celebrate all moments in life and each step forward. While the fight against COVID-19 is not over, we must celebrate the advancements of research and the development of the vaccine, which are moving us in the right direction. Each victory, no matter how small, is a victory in itself. So, let ’s celebrate all of our personal and collective victories together. CHICAGO MEDICAL SCHOOL 31

SYNAPSES AISHA AHMED, CMS ’24 Perspective Artist’s Statement: This year has taught us a lot about how easily our perspectives can change on life. The pandemic forced us to change how we view, think, and interact with others. When looking at this photo it may not be immediately evident that it is the iconic Gateway Arch until you think about the perspective and angle at which it is taken. Location: Gateway Arch, St. Louis, Missouri. 32 ROSALIND FR ANKLIN UNIVERSITY

SYNAPSES B RANDO N G O LANT, CMS ’22 America Is This poem was written in response to the January 6, 2021 insurrection (but still is relevant). It’s not easy to say, most days, I don’t recognize her The broken glass shattered on the floor Cracks in the long, winding roads Chipped paint on the ceiling She’s always been that way, I’ve just never been brave enough to see it She is America, and she is beautiful America is great America is great because of those who see the broken glass Because of the man who picked up the trash, The people who recognize the concrete cracks They, and only they, see her true beauty They see her potential, The vision of who she was meant to be, even if that’s not who she is right now And now I’m brave Brave enough to be patient Brave enough to cut my feet on the broken glass, To trip over the concrete cracks and be hurt And as I lie there, Mending the wound on my knee I take the time to seal the crack And now I know That no one else will trip and fall No one else will get cut by the glass No one else will walk past the trash America is beautiful America is broken America is good America is a lie America is exceptional America is unacceptable America knows not all, but America is wise America is great America is all of this stitched up and sewn into 13 stripes and fifty stars, hung up and waving across a nation America is gone But America, is back ■ CHICAGO MEDICAL SCHOOL 33

SYNAPSES MIRE K DUNDR, Ph D, FACULTY Surviving the Storm Artist’s Statement: How long will the omicron storm last? 34 ROSALIND FR ANKLIN UNIVERSITY

SYNAPSES EDWIN KOROURI, CMS ’23 Night Is Always Darkest Before Dawn Artist’s Statement: On the date of this photo’s capture, I had a tough day at the hospital. My resident and I delivered difficult news to a patient, and it was the first gloomy, rainy day of the year. After I was dismissed for the day, I looked to the heavens while I processed my emotions. Suddenly, the sky began to clear. I felt some relief and hopeful for a brighter, better day tomorrow. I took a photo juxtaposing the hospital against the graceful sky to remind me of the emotions that can be felt in each setting, and as a reminder that even on the darkest days — wherever they may be — the sun can shine through at any moment. CHICAGO MEDICAL SCHOOL 35

SYNAPSES S O P H I A YA N G , C M S ’ 2 3 Thinking of Blue Artist’s Statement: This is an abstract depiction of how a thought is formed in our brain. When neurons fire, it is like a domino effect, quickly spreading to neighboring neurons. And with each impulse, the thought takes over more and more of the “canvas” of our mind until our whole mind is aglow. Acrylic on canvas, 8 by 10 inches. 36 ROSALIND FR ANKLIN UNIVERSITY

SYNAPSES CANDICE KOSANKE, STAFF Jellyfish Artist’s Statement: I saw this jellyfish in San Francisco’s Aquarium of the Bay. The jellyfish in the tanks were mesmerizing in their beauty! CHICAGO MEDICAL SCHOOL 37

SYNAPSES ASHNI PATEL, CMS ’23 An Open Water Pandemic Have you ever been swimming in the ocean? Where the waves keep on coming and coming? Some are bigger than your head Some, you can duck under But the surges keep on coming Many are scared of the open water Afraid of swallowing water, of losing their breath But the surges keep on coming We train lifeguards to keep us afloat Some of us using floaties to stay above the surface But we still feel something looming beneath And still the water rises The surges keep on coming But finally The waves die down The water stills We can all breathe again The surges stop.. ■ 38 ROSALIND FR ANKLIN UNIVERSITY

SYNAPSES LAURA LI, CMS ’25 Synapses Artist’s Statement: With the world currently still in the midst of the COVID-19 pandemic, the question of “When will things be normal again?” comes up often. We experience wave after wave of variants, which spread fear, exhaustion, and distrust with each one. There may even be times when we think that things will never be the same, and we feel hopeless. I reflected upon this when creating my piece. Upon viewing it from left to right, we see a flourishing of ‘synapses’. This then tapers into a thin strand, almost breaking, in the center. However, due to the resilience witnessed in our communities and across the globe, we carry on. New synapses are born, although this time they are different from before. Somber blues and greens have replaced the previously bright yellows and pinks, and gold has replaced silver, but these changes represent the possibility of a new normal that hopefully isn’t too far away. Mixed media on paper. CHICAGO MEDICAL SCHOOL 39

SYNAPSES ANDREW ZWIJACK, CMS ’25 Lessons from Medicine Hitting Home I. Separation When I entered medical school, I was instructed to not let the science of medicine overcome the philanthropy of the practice. As much as I would learn about disease, anatomy, and pathophysiology, reminding myself that a person — not a disease process — sits across from me in the examination room would come to serve me well. Despite taking into account this precaution, I began to feel the natural tendency to separate myself from my work: envisioning the cadaver below me in my first anatomy lab not as the former body of an elderly gentleman, but a mechanism of learning. This allowed me to perform necessary dissections efficiently and effectively. I think this tendency is inevitable but influenceable by both one’s internal and external environment. A major event in my external environment (in this case, my family) leads me to the former thought. As the September breeze and leaves cascaded across campus, one hour south, back in my hometown, my mother’s COVID-like symptoms became aggressive bouts of nausea, dizziness, myalgia, and lethargy. One Sunday morning, a temperature of 104 degrees Farenheit prompted a frantic call to me and 911. What had been discounted by my mother, family, and I as the Delta variant or a fever was diagnosed as Acute Myelogenous Leukemia (AML) one week later. Due to hospital restrictions during the pandemic, I could confront this reality as most first-years conceptualize the things we learn about: from a distance and through virtual resources to pick apart and further expound upon in search of most relevant and testable information. How else are we to survive and thrive when we are told that half of what we are taught in medical school will be wrong in ten years? II. Filtration As my mother’s diagnosis was digested by my family, my class and I began learning about cancer in a course entitled Scientific Foundations of Medicine. An introduction to chemotherapeutics thrust me into the stark reality of some of the medications my mother could and eventually would encounter. The ultimate solution to her condition — a bone marrow transplant — was compacted into a one-hour lecture that I have re-watched at least four times. In my head, I took a step back, and surveyed this lecture in comparison to the ten others I learned that week: each was similar in length, but the ten lectures in comparison to the one I found most applicable were sped up, skipped through, and made into flashcards vigorously. I realized how conditioned I am to approach lectures with a finely- sharpened scalpel, deciphering only “high-yield” information, and carefully trimming certain sections and whole lectures I felt would be irrelevant on test day. I know I am not alone. The few questions I received on my exams pertaining to chemotherapeutics and bone marrow transplants were straight-forward and fact-based (facts I either knew or did not). All other information that I had ingrained in my brain — of immense relevance to me and my family and of vital importance to my mother — was perceived by professors, peers, and Boards as low-yield in that exam period. Returning to my usual process of information gathering and reviewing was vital to maintaining my passing grade in the course and future courses, but an overwhelming awareness of how applicable all lecture information is in certain circumstances continues to reside within me. This has resulted in an increased respect of the content, but additionally feelings of uncertainty. Information relevance is situationally-dependent; but how do I control the situations I encounter? What if skipping a lecture on rare genetic diseases comes back to bite me in the form of said illness in one of my patients, or one of my family members, or even myself? III. Selection As my mother began chemotherapy treatment number two, I began learning about white blood cell disorders in a course entitled Infection, Immunology and Hematology. Over the next few days and weeks, I learned what chromosomal translocation occurred to cause her condition. I learned what blood smear findings and lab values must have clued doctors to her diagnosis. I learned what havoc my mother’s own body was wreaking on itself and did my best to communicate this information to her at her request. But this was not my mother’s foremost 40 ROSALIND FR ANKLIN UNIVERSITY

SYNAPSES concern. Instead, she wanted to know why AML had chosen her. She had lived her whole life up to this point as a non-drinking non-smoker, who walks 5-10 miles a day, eats healthfully, believes in God, and spends plenty of time outdoors and in nature. She could not understand how one aberrant mutation just happened to occur in her. Two simple words flashed in her mind: “Why me?” As I listened to my mother further, I began realizing that her questions were extending beyond what mechanisms were occurring correctly and incorrectly in her body. Instead, my mother wanted to know why this severe illness was happening to her — questions that perhaps the degree in Philosophy I was contemplating on working towards back in college could have helped me answer, but questions even the most esteemed doctor would not be able to answer to her satisfaction. Confronting mortality and the true uncertainty underlying life became a very apparent part of facilitating her health and wellbeing. Giving her the courage and motivation to face chemotherapy every day is as vital as regular intake of her medications and flushing of her PICC line. While she certainly had never taken the importance of these thoughts into account before, I argue that neither had I when I first thought of becoming a doctor, nor most medical doctors until fairly recently in the history of medicine. Her treatment could not be simply biological; it needed to be biological, psychological, and sociological as well. It is one thing to read and hear about this view of medicine, but an entirely separate experience to watch the need for it manifest in a person across time. IV. Adaptation I moved back home to help my family with responsibilities when my mother was diagnosed. Doing so meant retracting the time I had put aside for leisure activities and social events to care for and spend time with the people I love. And I did just that, adjusting to a mostly-virtual medical school education and only traveling to campus for necessary labs and interesting lectures. I have immense gratitude for the incredible efforts of peers, professors, and faculty of Rosalind Franklin University for making this transition possible. Adjusting was not easy, and brought back the same manner of coping I drew from to help myself with cadaver lab in anatomy. But it was not enough to simply block out certain aspects of an experience (like not thinking about the former life my cadaver once had as I cut into him). Instead, I had to selectively open up and shut out aspects of my life across time. When my mother was receiving blood transfusions and chemotherapy, I had to block out the lectures on adverse effects of chemotherapy and transfusions that I had learned. I did this at times and in a way that did not prevent my education but did allow me to sleep, work out, and take care of myself while remaining optimistic with my family. I had to keep motivated and hopeful while speaking to my mother about her prognosis whilst professors and second-year medical students in review sessions constantly reminded me of the fairly poor prognosis and severity of AML. I had to estimate whether the personal wellness and benefit of a flight to see my girlfriend in Montana, or an hour drive to campus for a lab, or even a drive to the grocery store was worth it when my mother could deteriorate at any moment during a dangerous treatment cycle. I needed to shift my thinking from medical student to son to boyfriend to brother to any other role I needed to fill; and I needed to do so very carefully, otherwise my efficacy at each could be compromised. V. Validation I wish I could say that I adjusted to my mother’s cancer and its impact on her, my family, and myself effortlessly. I wish I could say that I took care of my family; was there for my mother when she needed someone to talk to; took care of myself physically, mentally, and spiritually; performed consistently well in medical school; and remained a good boyfriend and friend in the process. After all, doctors are often considered unbreakable in the face of suffering; as a medical student, shouldn’t I be as well? The truth of the matter is far from the former. My actions did amount quite positively and I did a lot of things right, but there were also times when I upset my family and significant other, inefficiently attempted to increase my medical education, and did not treat myself as someone I care about. At the moment my mother’s diagnosis was confirmed, and I confronted the extent of her situation, I thought that if I failed even the slightest at my responsibilities, everything would come crashing down. But by taking ownership of my entire life situation — my right and wrongdoings, the wellbeing of the people I love, and my own health — I CHICAGO MEDICAL SCHOOL 41

SYNAPSES was able to find my ability to persevere despite the odds stacked against me. I did not ace my courses; I did well enough. I did not prevent every tragic family argument; but at least I helped prevent most situations from becoming hell (tragedy and hell are different; trust me). These experiences strengthened my mind in the same way endurance running has callused my feet and toned my muscles. I was given a new outlook on medicine from the bedside of my mother and the potential to understand what it is like to respond to another’s health concerns while simultaneously increasing my education and keeping my personal life together. I was and am still astounded by these realizations: even in the seemingly darkest of moments, the capacity to turn chaos into order exists. VI. Conclusion When I think about the roles ahead of me – such as resident, doctor, husband, and father – I wonder how I will fill them. I wonder if I will avoid burnout. I wonder if I will achieve “work-life balance.” My mother’s experiences took the ever present truth of death and the limited time we all have on this planet and placed it front and center in my mind. Now more than ever do I catch myself from attending too much to a nonexistent future and a distant past. All that there is is the present and what lessons the present provides, and an awareness of death encourages focus on what is truly important. It is much like the filter I place on the content in my studies, and it manifests in instances when I realize watching another YouTube Short could instead be a moment I take to tell my mother I love her. Being present and coordinating my life as such seems the only answer to make the meaningful parts of life meaningful and the mundane or recreational parts enjoyable. I encourage everyone who reads this to regularly contemplate the brevity of life. None of us know how much time we have left, and acknowledging this helps to prevent suffering over stupid things and allows your next interaction with another human being and yourself to be much more meaningful, even in times of uncertainty and pain. With this way of thinking, I suspect that external triggers like serious life circumstances may not be required to elicit the same effect; perhaps the capacity to positively conduct oneself can instead be brought out solely by pure will. Your own will. ■ 42 ROSALIND FR ANKLIN UNIVERSITY

SYNAPSES ME L ISSA CH E N, MD, FACULTY Solo Artist’s Statement: Solitude as guide Shadows stretch across the path Winter is coming. Greenbelt Forest Preserve, North Chicago, IL. CHICAGO MEDICAL SCHOOL 43

SYNAPSES CONNOR HASZTO, CMS ’23 The Yellow Brick Road Artist’s Statement: This photo was taken in Pittsburgh. Specifically it was taken in South Oakland. This is an area that surrounds the University of Pittsburgh’s main campus. South Oakland is historically an older area with some buildings dating back to 1889. South Oakland currently is mainly populated by students. The environment is surreal due to the stark juxtaposition between the classical antiquated architecture of South Oakland compared to the new, postmodern architecture of some of the campus facilities. In the middle of the photo is the Cathedral of Learning which symbolizes knowledge. The view of the cathedral from South Oakland inspires one to think of the enormous progress that comes with the attainment of knowledge. 44 ROSALIND FR ANKLIN UNIVERSITY

SYNAPSES WIL L IAM G RE E NFIE LD, MD, FACULTY A Gastronomic Holiday Meal or, Festival Feast Food Foibles and Follies Alas, for meals of a much simpler time When cooking was easier: rosemary and thyme, Turkey, a roast, cherries in Jello A nice claret wine, all would be mellow Rockwell’s Post cover pictured it best Bountiful table, with food to be blest Peaceful participants, all ready to dine No trauma, no angst, all acting just fine But now...Wow! ‘Twas easier then, sans all this schism, But now I’m a scullion to multiculturalism I try to oblige, I try not to panic But Pedro insists I try cooking Hispanic! And Meghan’s a vegan, so no turkey for her Cindy’s lacto-ovarian (and ever so contrarian) Gary keeps kosher, now that he’s frum, So no dairy with meat (this drives me just numb) And Ali, née Al, eats only Halal And Sharon, of course, wants only “lo-cal” Nadine is a nut, with her “I’ll only eat white”, And Jenny’s nut allergy gives me a true fright Gerald hates garlic, no cilantro for him And it’s GMO’s a no-no for eco-green Jim And the gluten-free people — I wish them all treacle! Ah, was easier then, when the only big worry Was timing the prep, so as not have to hurry With a last minute dish, too hot or too cold But now — surprise — plain fare implies you’re just old What, then, will be my solution So all may dine with no fear of pollution? I give up, I do surrender Each guest can bring their own provender! That’s what I’ll say, I know what I oughta Bring your own grub; I’ll serve bottled water! ■ CHICAGO MEDICAL SCHOOL 45

SYNAPSES WIL L IAM AGBO R BAIYE E , Ph D, FACULTY Budding You are the promise of spring beginning a new project. You are the winter breeze. Just starting to incubate a company. You are the light of summer Starting the flight of a lifetime. You are the wind of fall shedding your old habits. You take a timeout to recharge. You take a deep breath with relief. Your sigh was prolonged As if you wanted to describe the promise. You hold your light for all to see. You are bursting at the seams. The sky is your limit. Your confidence is inspiring. You explain your theory. You apply your method. You see the results. You dance to the rhythm. You reach for the moon. You are creativity in motion. ■ 46 ROSALIND FR ANKLIN UNIVERSITY

SYNAPSES LU C Y YAO, C M S ’ 2 3 Currents Artist’s Statement: This piece was created using an acrylic pouring technique. I had just started experimenting with this technique this year and was surprised at how uncomfortable I felt initially. There was something unsettling about not having complete control over how the painting would turn out. No matter how much you may plan the colors or the composition, there is always an inherent unpredictable element present. After the first pour of paint, there is only so much you can do to try to steer the direction of the painting. This experience revealed to me how much discomfort I harbored within myself towards spontaneity. Sometimes, however – as is the case in many aspects of life – rewarding things can come from letting go and embracing the unknown. Acrylic on canvas. CHICAGO MEDICAL SCHOOL 47

SYNAPSES MARIE NUNEZ DUARTE, CMS ’25 Ghost in My Arms I have a memory, I promise. So faint, so faint, see it there. Even as you think it, already, it escapes. Take this darkness, veil off my eyes, for I cannot see And all I see is in my dreams Even as I sit here in front of you, whisper: I fade. I long to rest within my inner atmosphere, bury me here. line the sepulcher with gold and silver, sealed, so that I may not escape and though my fingers dig till every crevice has been filled by my blood, leave me. The passing of time: One of life’s many curses, that even as the thing happens it already starts to fade, in our memory. Still, that is not what I speak of, what I cannot shake is this veiled black web — I lived, married, and died in it. And forgetting is my deepest torment, that in thunder, I now hear. Open your eyes, see as slowly the smoke starts to rise, like a curtain. It is nighttime, your lover’s face is encased in shadow from the rosy armchair on which she sits. Her hat is lined with feathers, light and strange as if winged creatures had, by mistake, lost them when for a second, before flying away again, they came to rest just above her beautiful face. Unrecognizable, she is. As is the laugh of your friends then, when they were joyful together in the large, warm, wooden rooms of those legendary feasts, on those endless nights, before the gallows. The final sentencing of fate, my sword knows judgment, whole centuries, knows all, but cannot tell it to me now. And, almost too heavy for my handling, the ground touches it, as I see thousands of men fall from their feet. Ink is embedded deep beneath my fingernails, you see black as my eyes they’d be when I’d write till my skin turned to bone, turned to ashes, of our history. You are not me, but you are inside me. Hundreds, millions, you, those to whom I owe my weight, in spirit. Ghost in my arms, I cannot hold you And even as I do, from me, you spill. ■ 48 ROSALIND FR ANKLIN UNIVERSITY

SYNAPSES NOEMI COCONE PANTALEON, CMS ’23 An Imperfect Human You may have fo rg o tte n w h at i t fe e l s l i ke to feel loved. I’m here to remind you that love feels like a thousand sun rays kissing your face. It feels like an ocean breeze. It feels like kindness to yourself when you forgive your transgressions. Love feels like breathing without resistance. Put simply it feels like loving yourself completely as you are — an imperfect human. ■ ABDULAZIZ AHMED, CMS ’24 Shelter Artist’s Statement: The umbrellas at the Prophet’s Mosque provide cover from the blistering Arabian desert sun. I find it symbolic of the human condition to seek shade from nature’s harshest elements. Location: Al-Masjid an-Nabawi (The Prophet’s Mosque), Medina, Saudi Arabia. Taken on a N ikon D 3 2 0 0 C am e ra. CHICAGO MEDICAL SCHOOL 49

SYNAPSES L E O K E L LY, M D, FAC U LT Y Northpoint A poem of Door County I walked along the windy shore North from the ferry along Death’s Door. Driftwood and seaweed strewn about the sand As I walked and reached the end of land. I gazed out from the point at two waters, one black and one green; With only the wind and waves between. I thought of all the ships below Schooners, freighters and ore boats too many to know. And of all the brave crews who knew the cold danger of the Door, Yet bravely sailed through and were heard no more. As I turn away from the wind to go I wish for them the peace I now know. ■ 50 ROSALIND FR ANKLIN UNIVERSITY