Auxocardia Spring 2024: Arrival and Departure

Letter from the Editor

Devon Gingrich

I was reading Ways of Being by the philosopher, scientist, and writer James Bridle on a plane ride home for the first time in too long. I felt the weight of my body pressed in the seat pushed high above the towns below and finally had the space to think. Between sub-internships, research projects, meetings, and marathon training it can feel like every pocket of time is gobbled right up. These two quiet hours of darkness in the sky were suddenly brought to a luxury of new heights.

In Ways of Being James Bridle pushes for a wider world in which we as humans acknowledge, honor, and collaborate with the many forms of intelligence all around us - plant, animal, and machine. With an expanding world view may we take in a more whole and less selfish way of seeing things to better ourselves and the planet in the process. As we continue to learn of the many ways in which living species of all kinds hold an interconnected intelligence, how can we alter our way of examining the world around us to approach it with more understanding and empathy? How can the constant cycling of new knowledge with old bring with it humility and compassion rather than frustration or adversity?

In many ways this shift in thinking applies to healthcare as well - how many times have diagnostic criteria, treatment plans, and underlying pathophysiology been turned over with the arrival of new discoveries? And how have the practices of old retained their importance or taken on new value in a constantly shifting system? Furthermore, how can we view this process not as finalities or end destinations, whether it be graduations or degrees, but instead as a cycle - of learning, of healing, and discovering our purpose along the way?

In this issue we were taken by the wide array of interpretations on our theme Arrivals and Departures and delighted in the ways in which this resonates with discovery of self through training, with the impacts and interactions with patients and families, and the larger changes occurring within the field at large. Let this be the space where the flurry can quiet, where we are allowed to explore the changes, the murkiness, and the challenges along the way. 

In Darwiche’s Burning the Past, Embracing the Future we are reminded of the influence of past selves and our contemporary preconceptions of them in our training. In Darwiche’s poemWearing the Jacket we see the weight of those we love and hold dear carried with us in an environment that can often feel increasingly foreign from our sense of home. Amid training there is a constant process of self-reinvention and discovery, a daily practice of integrating new information and conceptions of self with the old. In Adeyemi’s For You we reflect on this process of self-discovery and identity and in Asfew’s Stand Still we feel the tugging of this process acutely on developing into a future provider. And while we contemplate the influence of training on our own identities, Desai’s Flesh and Steel pushes us farther into the future of medical technology, allowing us to envision new forms of intelligence alongside us in providing care.

Just as we feel this push and pull of training in developing ourselves as future clinicians, so too is this gravity and privilege of this work ever-present. Our featured narrative piece in this issue, Heinonen’s Dear Anne reminds us of the ephemeral nature of our training, our memories, and our moments with patients, not as ways of losing faith, but of a reminder of the privilege that comes with these great intimacies.

In our featured poem this issue, Onadipe’s Left, Right, in the Middle, captures the beauty and heartbreak witnessed by every trainee. In a role that can feel both overwhelming and miniscule at times, as those with feet planted on both sides, may we bring the insight of this duality into our role to see the perspectives of both patients and providers, having not yet departed one nor become the other.

In Albdewi’s Morning Rounds we saw the contrast of high emotions with efficiency often seen in opposition, showing the sharp changes in time and breath we bear witness to daily. In Lapite’s Doses and Limitations we are confronted with the boundaries of ourselves, our training, and our hearts and the delicate balance of compassionate care with self-preservation. In this balance, Zhao’s The Fall exquisitely captures the tensions between the selves we are building in this training and those which are nourished outside of clinical spaces. Wang’s Morsels further remind us of the fragility of memories gained and our ever-growing selves, even when the pace of training can often obscure these changes from ourselves. 

Though with the loss and tumult of this process, so too comes forth new life, discovery, and with it - hope and mystery to buoy us once more. Our featured visual artistic work this month, Skibniewska’s AAAAAAHHhhhh, jumps off the page, bursting with arrival, holding fear, hope, and a new reckoning in its wake. Jackson’s 7lbs 8oz provides us with a new take on arrival and departure (or descent) and the world of unknown unknowns that lay ahead. So too with Aulakh’s I Emerge, I Fly are we reminded of the hope that spawns in the wake of new beginnings and shifts from our pasts.

In the smaller moments, particularly those transitional times often found in a commute - a walk home after an endless shift or early morning drive to clinic, the space between departure and arrival opens an expanse for reflection. In the frenzy of training and academics it can be easy, almost by default, to submit to the tumult, deadlines, and pressures of a system while losing yourself in the process. But these little moments of liminal space create new pockets for reflection. I hope we can all find more of these corners, no transit required. Can we make a mental space, even a physical corner of the house, that can be made for reflection? What new types of intelligence and acceptance and futures may be created if we allow ourselves to rest in this in-between space?

So as the days stretch longer, may I urge you to consider your own arrivals and departures in the context of your training. What will you hold tightly and what do you let free to make space for so much more? Find your corner, your pocket of time, to read, to write, and to reflect on how far you’ve come just to be right here. We are so amazed.

Thanks for letting us come along.

Your Editor,

Dev