Kafka’s Medicine

Thin, without fever, not cold, not warm, with empty eyes, without a shirt, the young man under the stuffed quilt heaves himself up, hangs around my throat and whispers in my ear, “Doctor, let me die.”

Post-call days have become my sacred days alone with literature. After a long and sleepless night in the hospital, I love coming home, picking out a good story, and translocating myself into a different time and space. Today, wanting to read a story along the same themes as my last post (re: narrative medicine), I remembered a bookmarked chapter in my collection of Franz Kafka’s short stories called, “A Country Doctor”. Curious to compare it to the similarly named book I last wrote a blog post on (A Young Doctor’s Notebook by Bulgakov) I began reading.

The first page describes a scene I jokingly mentioned in my last post – a doctor in a rural area frantically looking for a horse-carriage to get to an ill patient … in the middle of a snow blizzard. The similarities between Kafka’s doctor, Bulgakov’s Bomgard, and even Boris Pasternak’s Doctor Zhivago – the heroic rural male doctors who must overcome great natural hurdles by carriage for their patients – were not lost and definitely made me laugh. But, despite the cliché imagery, the rest of Kafka’s story is anything but banal.

Unlike Bulgakov, Kafka was not a doctor, but the two writers share the special trait of being masters of the bizarre. I love surreal stories. Borges, Murakami, Marquez, Allende, talking cats, faceless men, devils who make pacts – the more bizarre a story, the better. In that regard, Kafka of course did not disappoint. This story tells the tale of a physician who must attend to the care of a “seriously ill” child, only to be faced with rogue horses, bite marks, a maggot-infested wound, an echoing children’s song, and a threatening family. Within only six pages, Kafka’s story is packed with creepy acts, charming quotes, and existential monologues. I really couldn’t do it justice by trying to review it; so I’ve attached a link to the story at the end of this post.

However, my escapade didn’t end there. Not long before I closed the book with the unnamed feeling one gets after reading a great story, I stumbled onto an online reference to Kōji Yamamura’s 2007 animated short film on this very story (see video below). Within a short 20 minute Japanese animation, Yamamura captures the very essence of Kafka’s peculiar characters and plot. The animation is so beautifully weird (and a little terrifying), and it leaves you feeling haunted and pensive. 

Kafka’s doctor says, “To write prescriptions is easy, but to come to an understanding with people is hard.” I hope that I have convinced you that a little Kafka in your day goes a long way. 

The Story: https://www.kafka-online.info/a-country-doctor.html

A Young Doctor’s Blog

15956705 2As I finished my first and dived into the second year of my pediatrics residency, I tried to find more ways to marry my two favorite interests: medicine and literature. (As Anton Chekhov, a Russian writer/doctor, says, “Medicine is my lawful wife and literature my mistress.”) Last year, I learned about the flourishing (but by no means novel) field of narrative medicine – the concept of using written or spoken narratives in clinical practice to promote healing, communication, understanding, and much more. As I read casual and academic articles on the topic, I ran into several quotes by none other than one of my favorite authors, the aforementioned Chekhov. Imagine my delight upon finding out that some of the biggest names in Russian literature were also physicians (see the many references to my love of Russian literature in previous posts…). Upset that I did not know this much about the private lives of my favorite authors, but intrigued by this new niche genre I had discovered, I began to do more research.

I soon learned that, along with Chekhov, Mikhail Bulgakov, most known for his beautifully absurd novel, The Master and Margarita (another one of my favorites), was also a physician. I quickly ordered his collection of short stories A Young Doctor’s Notebook, and after a long and busy 24-hour call, reading these stories were, in a sense, therapeutic. The collection, mirroring some of Bulgakov’s own experiences as a doctor, recounts the tales of the newly graduated Dr. Bomgard, who has just moved into a small rural town to practice at the Muryino Hospital. Filled with fear at the thought of encountering medical emergencies alone (strangulated hernias, purulent appendicitis, need for tracheostomies, or God forbid… a childbirth!) and distracted by his own self-doubting, inexperienced inner voice, Bomgard settles into the new hospital where he meets a loyal physician’s assistant and two experienced midwives, who remind him quite frequently of the big shoes he needs to fill.

Despite his desperate attempts to self-soothe his worries, Bomgard does, in fact, face the terrifying clinical scenarios that would make any resident in this age shake in his/her boots. Faced with transverse-laying pregnancies, diphtheria, and venereal disease outbreaks (treated with “black ointment”, I might add), our endearing hero shuffles for any and all breaks he can get. (In my favorite scene, Bomgard announces that he will step out for some cigarettes during an operation’s prep time – when in fact, he runs back to his office to shuffle the pages of medical books to remind himself how to perform the procedure… He also gets lost in a blizzard at night with his horse-carriage – a must have act in any Russian piece, but that’s a blog post for another time.) The final chapter of the book details the diary entries of one of Bomgard’s colleagues with a crippling morphine addiction (an autobiographical chapter for Bulgakov). Although the entries describe the physical and emotional features of addiction, they also hint at the taboo effects the medical field can have on physicians’ mental health.

Despite our protagonist’s signs and symptoms of “impostor syndrome” and his coworkers’ curiosity of the knowledge behind his young looks, Bomgard learns that carrying himself with confidence and persistently learning are key to his survival as a new doctor. He begins to see a hundred (yes, one hundred!) patients a day, manage inpatient and outpatient services, and even confidently perform the dreaded podalic versions, amputations, and tracheostomies. He even delivers a baby on a bridge in the woods. When he begins to reflect on and boast about his accomplishments, he encounters another puzzling and scary case that quickly snaps him out of his arrogance. Written almost a century ago, this whimsical collection is full of funny anecdotes and humbling lessons that could apply to all of the young physicians of the EMR-era. Aside from its relatable monologues, hilarious witticisms, and fascinating view into the early 1900s rural medical practices, it is written in a beautifully descriptive and colorful fashion fit for a Russian author.

And as I settle into my second year of training, Bomgard’s words strike a particularly familiar tune: “As one year has passed, so will another, and it will be just as rich in surprises as the first one… And so I have to go on dutifully learning.”

Bend Sinister

kIt’s not really a secret that my favorite author is Vladimir Nabokov – I think I’ve (explicitly) implied it each time I’ve mentioned him on this blog. But how could it not be, when every sentence he writes is an intricate string of syntax describing the most minute details of his characters’ appearances, thoughts, and surroundings, in the most linguistically beautiful way possible? *insert schoolgirl googly eyes*

So of course, for my first vacation a few months in to my pediatric residency, I chose to read the first novel Nabokov wrote after moving to America. That in and of itself was not really the deciding factor; to be perfectly honest, I chose it because it was on my bookshelf, and I thought about how much I’d missed reading his novels. However, I was curious about what kind of ramifications this move would have on his writing. After all, as a writer whose familiarity with Russian, German, and even British cultures had clearly influenced his previous works, writing in a completely new environment (America) would surely also impact his future ones.

On that note, imagine my peaked interest when I found with each passing page of Bend Sinister that his first novel in the States was in fact a dystopian novel (jokes regarding our current political climate aside…). The story is that of a grieving philosophy professor who tries to maneuver his way through the new regime of a dictator while trying to protect his young son. The synopsis on the back of the novel warns that the book carries a political theme throughout; but I guess I was taken aback when I read Nabokov as a dystopian writer – someone I’d never thought of him as. This novel almost read Orwell-esque; it is eerily dark, has an infamous dictator, and has gruesome imagery that is unlike the Nabokov I know. That being said, I haven’t read all of Nabokov’s works (but I am working on it!), and I might find that he surprises me even more as I continue to read his other works.

Aside from the surprise in genre, the language he uses is still the one I fell in love with in college. It is obvious that he chooses each word with precision, tries them on within sentences, and replaces them with just as much care if they do not fit correctly the first time. However (and perhaps it’s because I’m on vacation and have a low threshold for overlooking philosophical ramblings), I found myself often getting lost on the long stream-of-consciousness thinking of our beloved author. Some of the passages are excruciatingly riddled with metaphors and imagery (I counted at least 10 in one sentence), including a lengthy analysis of Hamlet in a conversation between two characters. In those tiring passages, where I found myself getting a forehead-wrinkle headache from trying to decipher the author’s underlying messages, I reached an understanding with myself that I would read those sections for the sake of literature and not hang on to the details that did not necessarily change the plot. After all, I am still on vacation.

But of course, a few lengthy paragraphs can’t deter me from my favorite author’s (have I already mentioned that?) novels. Up next, I have Pnin, another Nabokov novel about another professor living in the US. It will be a nice chance to compare the two characters, and I know that I will be equally pleasantly surprised, whatever it may bring! 


A Clockwork Orange


Although I had several book suggestions from my friends up next on my “to read list”, I started this book until I could get the chance to acquire those. Having heard its name multiple times, I got this novel last year without knowing any more about it. I excitedly started it as soon as I brought it home, but right from the first page, I was faced with multiple odd words like “droogs, rassoodocks, mesto, vesch, mozg, peet, deng” and became frustrated with not being able to understand most of what I was reading. Although the novel is mainly in English, these strange words prevented me from understanding the entire meaning of the sentences, and unfortunately, being too eager to dive into a new fictional world, I moved on to a new book. Few months in and having forgotten why I stopped the first time, I thought I’d give A Clockwork Orange another try – nope!

Finally, I picked it up for the third time a few days ago – this time, expecting what was coming. So, I did some more intensive research beforehand. These “gibberish words” were none other than Anthony Burgess’s own made-up Nadsat language: a Russian-inspired, secret slang language used by the teenagers in this dystopian setting. For the first few pages, I tried to guess the meanings of the words based on the context. While it worked for some of the simpler ones, I couldn’t quite figure out all of the words and had trouble moving along. At that point, I started using an appendix of all of the Nadsat words I found online (Appendix). I read the first couple of chapters with my book in one hand and my phone with the glossary open in the other hand. There were instances where I did have to look up the same word several times as there were too many to remember in such a short time. But, with each page, I began to become familiar with more and more of the words, and by the last third of the book I was able to read 99% comfortably without needing to look up any. By the end of the novel, Burgess not only told me a story, but he also taught me a whole new language – one of the most amazing things I’ve ever seen an author do with his/her literature.

As for a quick recap of the plot: the story revolves around a group of teenagers who terrorize the public after dark with robberies, assaults, and even murder. The rest of the story focuses on the dystopian government’s unconventional methods of “curing” our antihero. That is the most I should say so as not to ruin the rest. However, the novel focuses on themes like good & evil, free will, and violence – a lot of violence. The book is very dark with many graphic scenes (the main reason for getting banned from multiple high schools). However, it does have a lot of dark humor that makes up for some of the more heavy themes.

I wanted to use the book’s own title as the name of the blog post since it is strange enough to begin with (its meaning is more fun to discover while reading the novel). Described online as a form of metafiction (“fictional writing which self-consciously and systematically draws attention to its status as an artifact in order to pose questions about the relationship between fiction and reality”), the title is actually the name of a book written by a character within the novel itself. Simply put, this book is filled with many dark twists and turns, including lots of secrets the author has hid along for us to find! For those who have read the book, I would love to hear your perspective and thoughts about it! What started as an infuriating piece of literature has definitely become one of my new favorite books.

Barrabás came to us by the sea


Surprise! This blog post is NOT about a Russian novel! Maybe I’ll start with how I came to put a hold on my quest to read all the Russian classic novels. I mentioned many, many moons ago that I was spending the 23rd year of my life exploring NYC by reading novels on the trains and teaching middle school science classes. Fast-forward nearly five years: I am finishing up my last few months of medical school (hence, why I’ve suddenly started updating my blog after so many years!). I spent the majority of my fourth year working on applications for residency programs, which meant not only a lot of traveling for interviews, but also having many opportunities to discuss books with people I met along the road – including my interviewers. When I mentioned to one of my interviewers that the last book I had read was by Gabriel Garcia Marquez, she asked whether I had ever read The House of The Spirits by Isabel Allende, an author who (like Marquez) uses predominantly magical realism themes in this novel. Although I immediately jotted down the name of the book in my black portfolio so as not to forget, the excitement/stress of the application process got the better of me, and I did end up forgetting it. However, a few months later, while running my fingers along used-book shelves at the bookstore, I coincidentally ran into the only copy of this book there. Without thinking twice, I grabbed it, excited to have woken up so lucky that morning.

Having really enjoyed several of Marquez’s works in the past, I was excited to enter another magical realm with this book. What I did not expect was to be pulled into a page-turner. The general plot focuses on several generations of the del Valle family, their familial and romantic relationships, the turbid political environment they live in, and the unspeakable secrets they hide from one another (similar to those of the Buendia family of Marquez’s One Hundred Years of Solitude). However, Allende begins the story with magical elements right from the first page with an introduction to Clara, the family clairvoyant, and Rosa, the unearthly beautiful (mermaid-like) older sister. From there, she pulls in her readers with further mystical (or odd?) events such as an uncle with an exceptional adventurous spirit and an abnormally large pet dog, Barrabás. These are just a few of the initial oddities the readers face. The rest of the book addresses ghosts, mummies, and other paranormal activity, but the natural and effortless incorporation of these elements into the story (as if the abnormal is expected or easily accepted) distinguishes the story as belonging to the magical realism genre rather than horror or supernatural fiction.

As I mentioned, the story deals mainly with the familial dynamics of several generations. There are themes of love, loyalty, betrayal, justice, feminism, revenge, political resistance, punishment… I could list at least ten more. Because this is a longer novel, Allende explores all of these themes eloquently. Her writing is engaging, poetic, and flows effortlessly. In fact, it has helped me create such a vivid visual of the settings and characters that I am sure I will keep these mental snapshots for years to come (see my first post!!). In order to express these ideas effectively, she does use strong (and even a bit graphic) descriptions. Some of the treatments of her heroines were painful and upsetting to read, and I wondered how difficult it must have been for an author to put her leading characters in those situations. But I understood the importance and necessity of it in the end.

Before I wrap up, I will mention that the name of this post is the first half of the first sentence of the novel. Although it has contextual significance, I simply loved the way in which the words just seemed to complement each other so perfectly, and it is the first phrase to pop into my mind when I think of the prose itself. I realize I could keep talking about how much I enjoyed this book, but I’ll leave this post short(ish). I hope that it at least gives you an idea of what the book is about and has gotten you curious enough to jot its name down on a corner of the nearest sheet of paper.

Евгений Онегин


I planned out my Sunday as soon as I woke up this morning: After breakfast, I would go to Taylor Books (my favorite local bookstore in town), grab a coffee, find a comfy couch, finish reading my “novel in verse” –Eugene Onegin– and then head to a couple of stores to run some errands and buy some groceries. All of it played out as I planned, except for the last bit. After finishing this book, I had so many thoughts about the ending that I came straight back home, opened up my computer (after an avocado toast lunch, as I’m more of a millennial than I care to admit), and began to type. How can a man, who lived 180+ years ago, still change the course of my life today?

To rewind a little, I’ve been really drawn to poetry for the past couple of months. This was an interest that started with watching hours of spoken-word poets featured on the Button Poetry youtube page. The more I listened to upcoming poets, the more I was reminded of my love of words and syntax. I spent hours rummaging through multiple boxes in my parents’ basement a few months ago to find my poetry notebooks from my elementary/middle school years. My 3rd grade notebook had rhymes in Turkish about fruits, school, Leyla and Mecnun, and my mother; whereas my 6th grade journal had more developmentally appropriate verses about peace, love, and oddly enough, the Loch Ness monster. Although my family enjoyed teasing me about the contents of these poems, they did prove to me that this fascination with words was in fact rooted to my childhood. 

To fast-forward, I excitedly ordered Pushkin’s Eugene Onegin while reading Dante’s Inferno. Knowing that Onegin is considered to be one of the most famous works in Russian literature, I immediately began “previewing” it before finishing the other (reader’s sin, I know). Sure enough, I was hooked and had a hard time putting it down again. The story revolves around two men, Eugene Onegin and Vladimir Lensky, and their respective romantic interests, Tatyana and her younger sister, Olga. Although written in second person point of view (Pushkin loves to talk to his readers), his own autobiographical tales about his relationship with his Muse interestingly makes him the third protagonist.

The friendship between the two men is quite comical. Onegin is a socialite who enjoys the spotlight, parties, and company, although he gets bored very easily, very fast. Lensky is a younger, more sensitive poet, who strikes me as slightly depressed. The two men become best friends in the countryside while bonding over their mutual feelings of disinterest in life and society. I don’t want to give away too much of the story as it’s a classic, and I wouldn’t want to ruin it before anyone else has the chance to experience it for themselves. However, Pushkin tackles many themes, including revenge, societal expectations, naiveté, and regrets – not to mention a good old-fashioned duel! He also has a lot (A LOT) of references to other literary works, for which I gratefully referred to the “Explanatory Notes” in the back of the book.

Pushkin brilliantly finished the novel with all of the loose ends tying as deserved. So why was I left confused…? I think it was because nothing “good” (for lack of a better word) actually happened. By that I mean, none of the characters (save for Pushkin?) actually got a happy ending. I closed the book smiling at how frustrated I was – feeling as though I had just been led-on and pranked. As I mentioned in one of my first posts, “Great books should elicit physical responses.” Eugene Onegin did just that. Although I couldn’t quite pinpoint why, I could feel my heart rate rising, my forehead wrinkling, and slight upward curls forming of the edges of my lips. I realize now as I’m trying to verbalize my feelings that I will not be able to do this amazing classic justice. But I will do the next best thing and vehemently recommend it to everyone else.

A couple of logistical notes: As these verses were originally written in Russian, I did some research before committing to the James E. Falen translation (the Oxford World’s Classics edition). It seemed that this was the most well-liked, although considering how difficult it must be to not only translate a Russian poem into an English one, but also to preserve the rhyme, rhythm, and tone of the piece, every translator who has worked to do this masterpiece justice deserves credit. I also noticed that Nabokov, one of my favorite authors as you all know, also translated this work. I did hesitate to read his translation, though, because I associated him with his *own* work – kind of like watching any movie with Daniel Radcliffe but always subconsciously seeing Harry Potter. ¯\_(ツ)_/¯ However, I was pleasantly surprised to learn later that Falen’s translation was actually influenced by Nabokov’s anyway!

I did have to do some extra reading on this book to get the most out of it, but I got just as much out of my own Internet digging as I did with the piece itself. Having said that, I could not talk about Eugene Onegin without mentioning the famous “Onegin stanza” which was termed after the rhyming scheme Pushkin uses in this work. Although I had heard of it previously, I really enjoyed reading the original, as Falen stays true to this scheme, as well. 

Although I had a lot of feelings about Eugene Onegin, I’m secretly glad that I could not fully express all of my emotions and went off on several tangents, because I hope that that in itself will ignite enough curiosity in whoever is reading this post to pick up a copy, as well! 

Books & Cats & Goats, Oh My!

I recently discovered a really special place hidden in the small town of Niantic, Connecticut – The Book Barn. A huge used bookstore with four different locations, The Book Barn is exactly what it sounds like – barns with books! Each week, the owners receive thousands of books for a total of over 500,000 used books. Some of the copies are so old and fragile that they are kept within glass cases, and some have been used so gently that their pages are as pristine as when they were first printed. However, the books are all similar in their affordability and accessibility. The barns, each with their own themes and genres, are connected by paths lined with witty signs, seasonal decorations, potted plants, wooden benches, and smaller book stands. Of course, no barn would be complete without goats! Just a few steps away from the main barn is a small pen with a few goats. But, most importantly (ie my favorite find), the barns are homes to many cats that add a heart-warming component to the readers’ browsing experiences. Sleeping within the shelves and on couches spread out throughout the barns, the kittens accompany those who read within the stores. With countless gems and books scattered throughout The Book Barn, one can spend hours simply enjoying the warm environment and flipping through pages. What’s not to love? 


Upon nearing the location, one is welcomed by this beautiful building and Rapunzel in her castle



The mystery book barn holding novels of authors A-H



The Haunted Book Shop, holding the rest of the mystery books


Unexpected signs and decorations around every corner


The vampire fiction section


Fun captions line the shelves


Decorations within the main barn



One of the many cats inhabiting the main book barn!



This little girl followed me within the barns and outside in the gardens


Although a little far in this picture, the goats are only within a few steps away from the main path


The “outhouse”


Barn with books about gardening, cooking, traveling…



One of the many book stands on the grounds


‘Tis the season


The sign for Book Barn #4, just a block away from the main location



Entrance to The Book Barn grounds


The map of the grounds



The Rules of the Road


Can you find the kitten?

Hasta Mahremiyeti

“Doktor Hanım, Doktor Hanım!”

Doktor Hanım, asistanlar, ve Amerika’dan ziyaretçi bir tıp-öncesi öğrencisi olarak ben, endişeli bir annenin ağlayışını andıran sese doğru başımızı çevirdik. Orta yaşlarda, uzun kahverengi pardösülü bir kadın 10 yaşlarında küçük bir erkek çocuğunu (daha fazla utandırmamak için bundan böyle biz ona “Ahmet” diyelim) bileğinden tutmuş, gri hastane koridorları boyunca sürüklüyordu.

“Doktor Hanım, Ahmet’in kızarıklıklarına bakacaktınız. Her şeyi denedim, ama daha da kötüleştiler!”

Nefes nefese kalmış anne bir eliyle omzundan kayan, kendine fazla büyük çantasını yakalamaya çalışırken, diğeriyle mahcup bakışlı Ahmet’in elini sıkı sıkı kavramıştı.

Annesi, sanki geceden ezberlediği ve prova edip geldiği oğlunun sağlık hikayesini bir çırpıda sayıp dökerken, ben tam önümde dikelmiş Ahmet’i izliyordum. Dalgalı, kahverengi saçları yüzünün soluk tuvaline karşı parıldayan çillerine iltifatlar ediyordu. Yeni ve sınırlı tıbbi bilgilerime rağmen, onun yaşına göre küçük ve hasta göründüğünü görebiliyordum. Ama, onun mahallenin diğer erkek çocukları ile kan ter içinde bir telaş ve heyecanla nasıl futbol oynadığını, yokuşlardan aşağı nasıl bisiklet yarıştırdığını da gözümün önünde canlandırabiliyordum.

Kendisini seyrettiğimi fark edince, yıkana yıkana rengini atmış penyesinin lekeli kolu daha çok ilgisini çeker oldu ve mahcup bir şekilde gözlerini gözlerimden kaçırdı.

“Peki, bir bakalım. Çocuğun elbiselerini çıkarın,” diye buyurdu Doktor Hanım.

Başım aniden şaşkınlıkla silkelenirken, gözlerim kocaman açılmıştı. Bu halka açık muayenemizi seyretmek için etrafımıza toplanan kalabalık büyürken, “Burda mı?” diye geçirdim aklımdan. Her saniye, başka bir hastane çalışanı, yeni bir hemşire, farklı bir hasta bu endişeli anneyi dinlemek ve Ahmet’in tıbbi anomalisini teşhis etmek için bize doğru yaklaşıyordu.

Doktor’un artan ilgisiyle iyice heyecanlanan anne, omzundaki kocaman çantasını yere fırlattı ve Ahmet’in üstündekileri telaşla çıkarmaya başladı: Tişörtünü, atletini, ve en sonunda pantolonunu…

Bütün asistanlar Ahmet’in kabuk bağlamış 4-5 santimetrelik döküntülerini daha iyi görebilmek için sanki birer robotlarmışçasına Ahmet’in göğsüne, kollarına ve uyluklarına doğru eğilirken, Doktor Hanım eliyle her kızarıklığı yokluyor, derinin üstüne bastırıp renginin solup solmadığına bakıyor, deriden kabarık olup olmadıklarını ve sıcaklıklarını kontrol ediyordu.

Bense gürültülü yabancıların doldurduğu bir koridorda, boyasız ayakkabıları ve eskimiş külotu ile cildindeki kızarıklıklarının ardında gizlenmeye çalışan Ahmet’in utançtan yüzü al al kızaran yüzünden gözlerimi alamıyordum. Üstünden çıkarılan her bir kıyafet tabakası ile, vücudunun rengi kırmızının gölgeleri arasında değişiyordu. Çıplak bedenini delen yabancı bakışların en derinlerinde onu ne çok acıttığını ve gözlerini yansıtıcı zemine dikerek elinden geldiğince bu bakışları nasıl savuşturmaya çalıştığını yüzünde okuyabiliyordum.

Ahmet’in o sabah yaşadığı utancın Türkiye’de olağan dışı bir hasta deneyimi olduğunu düşündüm. Çoğu zaman, hastalar doktorlara karşı sevecen ve saygılıydılar, ve doktorlar hastalara yardımcı olmak için çok yoğun bir tempo ile çalışıyorlardı. Fakat bir sonraki gün, benzer bir siluet asistan odasının kapısında yinelendi. Yine kahverengi pardösülü, yine orta yaşlarda, fakat farklı bir anne, ve hatta sol koluna tutunmuş Ahmet’ten daha da küçük bir erkek çocuk ve utangaç bir gülümseme ile, sanki bizlere yaklaşmaya korkar gibi kapının bir adım dışında duran gövdesiyle içeri doğru eğildi:

“Kusura bakmayın, doktor hanım. Çocuğu nerde tarttırabilirim?”

Ben annenin masum ve basit sorusuyla gülümseyerek bakarken, arkamdan öfkeli bir “Off!” sesi geldi. Arkamda duran bir hayli uzun boylu, 26 yaşından henüz gün almamış bir bayan asistan, hasta dosyalarının tepelemesine yığıldığı bir masaya doğru bir de elindeki hasta dosyasını savurarak söylendi:

“Teyze! Koridorun tam köşesinde! Bunu da mı bizim söylememiz gerekiyor yaa?!”

Saniyeler içinde annenin utangaç tebessümü soldu. Ürkek bakışları ve önüne düşen başı bana bir önceki günden Ahmet’i hatırlatıyordu. Kadın buruk bir minnettarlıkla bize teşekkür etti ve bizimle göz teması kurmamaya gayret ederek, kolundaki şaşkın ve allak bullak olmuş görünen çocukla kapıdan uzaklaştı.

Ahmet’i, annesini, ve kapının ardından çocuğunu nerde tarttırabileceğini soran anneyi ilk ve son defa o koridorun floresan ışıkları altında gördüğümde aylardan Ekim’di. Şikago Üniversitesi’nden henüz mezun olmuştum ve İstanbul’da bir hastanede ziyaretçi/gözlemciydim; ve Amerika’da bir üniversitede tıp okumak için başvurularımı yapmış, cevap bekliyordum.

Takip eden Ağustos ayında Amerika’da bir tıp fakültesine başladım. Hemen ilk gün, ben de bütün yeni öğrencilerle birlikte bir oryantasyon programına alınmıştım. Götürüldüğümüz büyük salonda yakalarımızda gururla taktığımız yaka kartlarımız ve takım elbiselerimiz içinde oturuyorduk hepimiz de.

Merhaba”lar, “isminiz ne”ler, ve “nerelisiniz”lerden sonra, kısa boylu, keçi sakallı, hafif göbekli bir adam bu hevesli kalabalığın huzuruna çıktı. Bütün sabah duyduğumuz merhabalar ile aynı çabuklukta bir merhabadan sonra, salonda aniden “Hasta mahremiyeti” kelimeleri yankılanarak gürledi. Gözlerimizdeki ışık sönüvermişti birdenbire. Bizler kendimizi göz kamaştıran kahramanlar olarak hayal etmekle meşgulken, Dekan Bey dikkatlerimizi henüz hiç düşünmediğimiz birilerine çekti: Hastalar.

Yeni başlayan tıp öğrencileri olarak oturduğumuz koltuklara yerleşmeden önce hepimiz de “Hasta mahremiyeti”ne dair oldukça kapsamlı bir on-line eğitim sürecini tamamlamakla yükümlüydük. Hastaların bütün bilgilerini, isimlerini, iletişim numaralarını, teşhislerini, laboratuvar sonuçlarını, ve resimlerini saklı tutacağımıza dair sayfalarca form doldurup, kağıtlar imzalayıp, sayısını bilmediğimiz yeminler ettik.

O kadar önemli miydi ki biz bu konuyu tekrar tekrar konuşmak zorundaydık?

“Müsadenizle, ne yap-ma-ma-nız üzerine bir kaç örnek vereyim şimdi,” diyerek devam etti Dekan Bey, her bir öğrenci ile birebir göz teması içinde.

Sonraki bir saat boyunca hasta mahremiyetini ihlale giren çarpıcı örnekler anlattı. Mesela, asansörde kanser hastalarının –isimleri zikredilmese bile- tanıları hakkında konuşan tıp öğrencilerinin hikayesi (çünkü hastanın öyküsünden kimliğini teşhis edebilecek birileri olabilirdi etrafta); hastaların isim listesini arabasının yan koltuğunda bırakan bir tıp öğrencisinin hikayesi (arabanın yanından geçen biri arabanın koltuğunda duran dosyayı kazara görebilir, görünen kısımlarda kazara hastanın ismi ve bilgileri okunabilir, hatta daha da kötüsü Allah muhafaza araba çalınabilir ve hastanın dosyası araba hırsızlarının veya başka yabancıların eline geçebilirdi); hasta, parlak ışıklar altında ışıldayan bağırsaklarının ve iç organlarının resminin sosyal medyada yayıldığından ve bir gün hiç tanımadığı birinin sosyal medyada kapak resmi olacağından habersiz ameliyat masasında yatarken selfie çekilen gösteriş budalası cerrahların hikayesi; veya hastasına tedavisi ve ilaçları hakkında kalabalık bir koridorda uluorta bilgi veren ve Allah bilir kimlerin kulak misafiri olduğu tıp öğrencilerinin hikayesi…

Her ne kadar tıp fakültesinin ilk iki yılını bitmek bilmeyen Latince kelimeler ezberleyerek, slaytlar izleyerek, soru çözerek geçirmiş olsam da, şu ana kadar edindiğim tıbbi eğitim ve tecrübe yoğun bir şekilde hasta memnuniyetinin altını çiziyordu. Dahası, fakültenin ikinci senesinde ders programımızda hasta hakları üzerinde yoğunlaşan “Ahlaki Değerler” dersi dahi mevcuttu.

Her hafta Ahlaki Değerler dersinde, bir daire şeklinde oturuyor ve nelerin bir hastanın haklarını ihlale girdiğine dair farklı bir vaka okuyorduk. Moderatörümüz, “Bu vakada yanlış olan nedir?” diye bize soruyordu ve biz vakanın detaylarını, kimin hatalı olduğunu ve muhtemel yasal sonuçlarını bütün detaylarıyla tartışıyorduk ki gelecekte bizler de aynı hataları tekrarlamayalım. Bu vaka tartışmaları Down sendromlu bebeklerden, boşanmış ailelerin çocuklarının sağlık meselelerine; Yehova Şahitleri’nin kan nakillerine, ve yaşlı hastaların karar verebilme kapasitelerine kadar pek çok konuyu içeriyordu.

Ayrıca, günlük iletişimlerimizde hastalarla sağlık problemlerini tartışırken bu konuların nasıl bir çerçeve içinde konuşulması gerektiği ve hangi doğru kelimelerin hangi kriterlere göre seçilmesi gerektiği üzerinde de tartışıyorduk. Dönem boyunca bu meselelerin tıbbi bilgi ağırlıklı derslerde öğrendiğimiz bilimsel bilgiler kadar önemli olduğu, hatta bir ihmal durumunda hekimlik hayatımızın tamamen bitebileceği dahi bize defaatle bizlere hatırlatıldı.

Okulun üçüncü senesinde başlayan klinik stajlar ve rotasyonlarda Türkiye’deki ve Amerika’daki sağlık hizmetleri arasındaki farklılıkları çok daha açık bir şekilde mukayese edebilme şansım oldu.

Bir sabah, elimde bir klasör ile, yaşlı bir hastanın odasının dışında asistan ve hastanın kocasıyla birlikte hastanın uyanmasını bekliyorduk. Hastanın test sonuçları özenli bir şekilde klasördeki dosyada işlenmişti. Asistan, nazikçe ve yumuşakça hastamızın endişeli kocasının omzuna elini koyarak , “Üzgünüm, ama hastanızın sonuçları çok iç açıcı değil,” diyerek söze başladı. Asistan, takip eden dakikalarda hastanın yakınına karşı oldukça hassas, saygılı ve şefkatliydi; Böyle Bir Durumda Nasıl Davranmak Gerek dersinin temel kitabıydı adeta. Bütün bu hassas ve kısa bilgilendirmesine rağmen, daha sonra bundan haberdar edilen klinik şefimiz, hastanın test sonuçlarını hastanın bilgisi ve izni olmaksızın hastanın kocasıyla (çok masumca bir niyetle de olsa) paylaştığı için asistanı bütün öğrencilerin ve diğer asistanların önünde azarlamıştı.

O an, hastaların durumuna dair hiç bir bilgiyi onlara danışmadan en yakınları ile dahi olsa paylaşmaya hakkımız olmadığını öğrendik. Onu çok seven kocası onun için ne kadar endişelenirse endişelensin, hastanın yaklaşan ölümünü kocasından saklamak istemesi en doğal hakkıydı ve bizim hastamız, kocası değil, o yaşlı hanımdı.

Sonraki haftalarda, şahit olduğum pek çok diğer vaka ile birlikte doktor-hasta ilişkisine dair düşüncelerim şekillenmeye devam etti. Etrafımdaki doktorların hassas kelimeleri ve mütevazi davranışları, hastaların kimlikleri, geçmişleri, hikayeleri, ve yaşları ne olursa olsun her bir hastanın bize güvenmeye ve bizden saygı görmeye hakkı olduğuna olan inancımı pekiştirdi.

İlk hastalarımdan biri uyuşturucu bağımlısı, bir evsizdi. Pek çok defa hastaneye yatırılmış ve her seferinde doktorların müsaade etmemesine rağmen hastaneden kaçmış ve çok daha ciddi bir sonraki enfeksiyonuna kadar da hastaneye dönmemişti. Buna rağmen, saygı ve ilgi bağlamında hastanedeki hiç bir hastadan farklı muamele görmüyordu. Kendisinden her zaman “X Bey” olarak bahsediliyor, üşüdüğünde yedek battaniyeler tedarik ediliyor, yatmaktan yorulduğunda pozisyonunu değiştirmesine yardım ediliyor, çağırdığında hemen odasına koşuluyordu. Doktorlar durumunun ciddiyetini ve hastaneden ayrılması durumunda hayatının tehlikeye gireceğini kendisine anlatmak için odasında bir araya geldiklerinde, X Bey’in mahremiyetinin sağlanması için kapılar kapatılıyor, hatta tıp öğrencilerinin dahi odadan çıkmaları rica ediliyordu. Çünkü X Bey, bizim hastamızdı ve bu saygı onun en tabii hakkıydı. Her sabah onu ziyaret ettiğimde, odasından ayrılmadan önce “X Bey, başka bir ihtiyacınız var mı?” diye sorarken, Ahmet’i ve çocuğunu nerde tarttıracağını öğrenmek isteyen anneyi düşünür, bu saygı ve mahremiyete onların niçin layık görülmediklerini merak ederdim.

Asistanlardan duyduğum farklı bir hikaye ise hamilelik sürecinde gizlice uyuşturucu kullanan ve bunu kocasından ve kocasının ailesinden saklamak isteyen bir annenin dünyaya uyuşturucu bağımlısı bir bebek getirmesiyle ilgiliydi. Yeni doğan bebeğin uyuşturucu krizlerini gözlem altında tutabilmek için, bebeği yeni doğan bakım odasına yatırmışlardı. Ama eşinin uyuşturucu kullandığından habersiz olan genç baba neden kendi bebeğini eve götüremeyeceklerini sorduğunda, sorusu hep cevapsız bırakılmıştı. Asistanlar onu, “Bizim görevimiz annenin sırrını paylaşmak değil” diyen hocanın direktifi nedeniyle, “Bazı nedenlerden dolayı bebeği bir süre daha burada alıkoymamız gerekiyor” diyerek avutmaya çalışmışlardı. Annenin haklarını çiğnememek için çok çaba verilmişti, ama bu nedenle yeni babanın ilk çocuk sevinci ve heyecanının yerini korku ve şaşkınlık almıştı.

Amerikan sağlık sistemi bu ve benzeri hikayelerdeki gibi insani değerlerle şekillenmiş olmakla birlikte, oyuncular perde arkasında aslında işin içinde kapitalist sistemin en kıymetlisi olan paranın ciddi bir rolü olduğu gerçeğini de göz ardı etmemek gerektiğine dair hikayeler anlatırlar. Hastalar çoğunlukla samimi bir saygı ile muamele edilirken, sahte bir gülümsenin tamamen bir satranç hamlesi olarak kullanıldığı vakalar da vardır; tıpkı Türkiye’de hastalarla çoğu zaman yakından ilgilenildiği halde, hastaların en tabii hakları olan mahremiyetlerinin aynı derecede inkar ve ihmal edildiği durumların da var olması gibi.

Hastanede daha fazla zaman geçirdikçe, bir hastanede değil de bir şirkette çalışıyormuşum hissi edinmeye başlamıştım. Her hasta bir müşteri idi. Haliyle, bizim işimiz hastaların memnuniyetidir ve müşteri her zaman haklıdır. Taburcu olduktan sonra tüm hastaların evlerine gönderilen anketler, doktorlar ve diğer hastane çalışanlarının performanslarının değerlendirilmesinde önemli bir etken olduğu için, tüm hastane personeli hastalara karşı zaten saygılı, sabırlı, sevecen ve şefkatli olmak zorundadırlar. Hatta kimi zaman, memnun kalmayan bir müşteriden kaynaklanan meseleler ancak mahkemede çözülebilir. Fırsat bekleyen uyanık bir hasta için kaba bir doktor, dikkatsiz bir hemşire, saygısız bir sekreter, hatta bir bilgisayar hatası dahi yüklü bir tazminat için yasal bir süreç başlatmaya yeterli nedenler olabilir.

Evet, oldukça bariz bir şekilde sürekli vurgulanan “Hastalar insandır” düşüncesi Amerikan sağlık kurumlarında kesinlikle uygulanıyor; fakat bunun hayal kırıklığına uğratan bir yanı da var ki o da bu düşüncenin hata yaparsak neler olabileceği hususunda sık sık bizi uyarıyor olmasıdır.

Kabul etmek gerekir ki, Amerika’da hastaların yasal şikayetlerinin sonuçları çok daha ağırken; Türkiye’de hasta yükü çok daha fazladır ve doktora şiddet oldukça korkutucu bir olasılıktır. Fakat bütün bu faktörlere rağmen, hastalara kaliteli bir sağlık hizmeti sunarken doktorların da güvenirliğini ve saygınlığını koruyabilmek için evrensel bir denge gereklidir. Yolun yarısını geçmiş bir tıp öğrencisi olarak henüz bu dengenin nasıl sağlanacağına dair bir cevabım yok; ve belki de bu cevabı hiç bir zaman bulamayacağım. Fakat doktor-hasta ilişkisinin çift yönlü bir yol olduğuna inanıyorum: Bu oyunda yer alan her iki oyuncunun da hakları eşit derecede önemlidir, çünkü oyuncuların her ikisi de eşit derecede insandır.


Sevde Felek

Nihayet, February 2017



The perfect soil was under the old mulberry bush behind the neighborhood kindergarten. This soil was different than the one feeding the sour plum tree or the one hosting Aunt Aisha’s rose garden. Our soil always smelled like it had just been sprinkled with a spring shower, no matter the season. It was gentle, yet convincing; light, but resilient. Before using it, of course, one had to sift out the contaminants – the dried up berries we forgot to pick last summer, the inhabiting ants we weren’t afraid to hold (but never disturbed), and the sharp-edged pebbles that would scrape our small hands and leave scars. We were brave. But we took our job seriously and performed it meticulously. Sifting soil with our bare hands would not yield a pure sample as months of experience (as our short lives allowed) taught us, so we used old pieces of tulle our grandmothers used to make cheese with. Sifting through two, sometimes three times gave us the cleanest soil we needed. The hard work, however, was worth it as this was the only soil in the neighborhood that was consistently reliable and forgiving.

We were also young, but we were smart. The earth naturally only gave us a brown foundation. To add color, we used our resources. By sifting the crushed bricks left over from the construction at the old park, we could collect red dust and use as a dusky-colored paint. We cautiously approached the brick piles, and with our delicate fingers, picked out pieces of green, broken glass we were too small to identify, cigarette stubs of different worries, and rusty nails that were carelessly left behind by the construction workers. After gathering enough dust, we tiptoed out of the troubled site and back into our childhoods.

Collecting the materials was just as important as the craftsmanship itself. We carefully carried the supplies for our work’s foundation in old ice cream cups back to our workshop (the sidewalk outside of our apartment building #14), balancing cups of soil and water, our pockets filled with twigs and pebbles we would use for embellishment. The sun, synchronously with the blaring ezan of the noon prayer, would overcome the building’s shade soon. Time was short; we had to work quickly.

Two handfuls of soil to three bottle caps of tap water.

Knead until soft but firm – “like playdoh.”

Two-three pinches of red brick dust if needed for color.

Shape into desired sculpture.

Leave out to dry under the sun for two hours or until solidified.

The mud was our childhood. We poked, shaped, flipped, and squeezed the small balls of dough in our hands methodically without stopping once to clean our fingernails. We splashed the dirt on our bright tights and our thick hair held back with butterfly clips. The tshirts our mothers bought us were adorned with inkblots from the earth, but we did not inspect nor analyze.

We split the responsibilities eloquently. One of us sculpted the large couch, coffee table, and fridge. Another molded a television box, using a toothpick to carve out its details and thin twigs to represent the antennae. The last member of our brigade made tiny figures of a mother, father, and child – the model protagonists of any imagination. Their faces were always indiscernible, but their physiques identified them easily. Indeed, we were artists.

Our work was frequently interrupted with the children of the neighborhood passing by – the cute boy who rode by on his bicycle (and we pushed back our falling hair away from our faces with the backs of our dirty hands, pretending not to see him); the older girls who marched by to play dodgeball against the wall we worked next to, but we kindly held our territory; the neighbor’s daughter who wanted to jump rope with us, but we were “too busy right now – maybe later.”

With the first crackle of the noon ezan from the minaret down the street, the last few inches of the shade protecting our sprouting bodies disappeared as we had learned to anticipate every Sunday. We placed the final adorning touches, after using two wet fingers to smooth out the bumps and crooks on our sculptures. Then, we gently arranged the make-believe houses we had built on an old piece of cardboard we had found outside of the market and positioned the actors we had scripted into place. We slid our stage against the corner wall where the production would be safe from the crooked tires of hand-me-down bicycles and the whipping blows of homemade jump ropes. As our model dried under the scorching sun, we ran home to seek shelter from its waves – but not before washing the visible mud tracks off of our bodies with the garden hose, enough to be able to defend ourselves to our mothers.

As we allowed the sun to bake our creations, we spent the afternoon in the calm of our homes (after we were bathed, of course). We practiced dotting our Is and crossing our Ts on photocopied worksheets our teachers secretly slipped into our backpacks at school; repeatedly braided our dolls’ nylon hairs to master the technique, for we may one day be expected to prove ourselves at school; fought with our siblings over plastic toys we did not even want to play with; snuck the last Eid’s candies our parents thought they hid; and watched reruns of old cartoons we would surely discuss during recess the next day.

With the imam’s voice filling up our homes for the third time of the day as their cue, the neighborhood children began to trickle back into the streets. Though never planned, my fellow sculptors and I knew to meet back at our sidewalk workshop, where we stood and admired our finished craft.

We did not play with, announce, edit, nor move our work.

Indeed, we were artists.


-Sevde Felek,  11/6/17


ImageFellow literature lovers,

After an unacceptably long break (after such a short experience with blogging), I write again to continue my online literary journal. I know I haven’t posted anything in many weeks; I recently started teaching 8th grade science for the NYC Department of Education. Between the work, the exhaustion, and the general chaos of change, I haven’t had a chance to keep up with the blog. This is the first free day I’ve had in a really long time; I sat down, put my feet up, got my coffee and books, and I’m going to seize the opportunity to write.

Although I’ve been pretty busy, I use most of the free time I can find to read (especially on the trains!). I recently found an interesting book on my bookshelf, assigned in one of my old college classes. The class was called, Imaginary Worlds: The Fantastic and Magic Realism in Russia and Southeastern Europe, for which the title is quite self-explanatory; we read Russian and Southeast European literature encompassing magical and fantastical themes. Our reading list consisted of many short stories, Aleksandr Pushkin’s Queen of Spades, Mikhail Bulgakov’s Master and Margarita, Abram Tertz’s Little Jinx (which we actually didn’t get to in class), Orhan Pamuk’s The White Castle, and finally, the book I found several weeks ago, Milorad Pavic’s Dictionary of The Khazars, A Lexicon Novel.

The Dictionary is a complicated and beautifully bizarre novel recounting the tale of a lost tribe called The Khazars and its conversion to a different religion. However, unlike normal novels, it is a collection of encyclopedias from three different sources (each representing a different Abrahamic religion) that addresses the mystery behind these lost people. Strangely, the book also comes in a male and female edition. The two editions are exactly the same except for a single short passage (I’ll let you explore that yourselves).

I have actually only read the Christian source so far; but Pavic is immensely entertaining and creative. The book is filled with bizarre occurrences, such as the creation of a human from the limbs of other humans, or the tattooing of The Khazars’ entire history on a man’s body (on every single limb and in tiny print!), or the deadly inscription of letters on a princess’s eyelids that immediately kill those who read them. Although it’s a fun and weird experience, Pavic also has many Serbian political and historical references in these accounts. Pavic commented that “each reader will put together the book for himself, as in a game of dominoes or cards, and, as with a mirror, he will get out of this dictionary as much as he puts into it, for you […] cannot get more out of the truth than what you put into it.”

Even though I haven’t read the Islamic and Judaic sources, I’m still really confident about recommending the book (and determined to finish it myself). The reason I didn’t read all sources was because I found a book of Leo Tolstoy’s early stories at the bookstore, simply couldn’t help myself, and started reading it. I didn’t feel too guilty (as I normally might) since The Dictionary is not one continuous prose piece, and I had been searching for Tolstoy’s stories for a while anyway. As for the Tolstoy, I was slightly disappointed in the first couple of pages of the first story in the book, Family Happiness. It seemed to be moving too slowly; yet, for some reason, I couldn’t stop reading it either. After 10 pages, it turned into a real page-turner even though there still wasn’t a lot of action. But the more I read, the quicker I came to realize that I was actually really attracted to the interactions between the characters.

Following up with another one of his stories, The Cossacks, it became clear that Tolstoy is exceptionally phenomenal with simple human emotions, desires, and reasoning. While I enjoyed Dostoevsky’s exploration of the deep, dark corners of the human mind in Crime and Punishment, Tolstoy’s portrayal of universal thoughts made it more relatable. (Although I should mention that I have not read any of Tolstoy’s novels and shouldn’t be making such generalizations just yet.) But I guess what I’m trying to say is that I was excited about the fact that an author who lived on the opposite side of the world 100 years ago expressed feelings and ideas that I experience here, today. I guess it just goes to show that we are all more alike than we think; we’re all human.

Finally, yesterday I found an old copy of Guy de Maupassant’s short stories at home and ventured to the fictional French settings. I have only read two short stories, The Necklace and The Piece of String, and I’ve enjoyed both very much. But I think I might have to save those for another post. That’s my (what was supposed to be short) update. I will try to drop by as much as I can.

Leave me a message about what you’re reading or suggest for me. :)