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Pectoriloquy |

Elusive Diagnosis FREE TO VIEW

Alexander Levering Kern, MDiv
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Editor’s Note:The author writes, “‘Elusive Diagnosis’ took shape when I was struggling to understand the difficulty I had in breathing. Ultimately diagnosed as a case of post-viral illness, the experience taught me about the benefits of good healthcare and the importance of opening myself to the beauty and healing available in everyday sacred moments of our lives.” Alexander Levering Kern has worked in health care as a Quaker hospital chaplain at Brigham and Women’s Hospital and in clinics supporting Haitian earthquake survivors, Tolupane Indians and campesinos in Honduras, and homeless persons in Boston.

Editor’s note for authors of submissions to Pectoriloquy:Poems should not exceed 350 words, should not have been previously published, and should be related to concerns of physicians and medicine. First submissions to the Pectoriloquy Section should be submitted via e-mail to poetrychest@aol.com. Authors of accepted poems will be asked to submit the final version to CHEST Manuscript Central.

Michael Zack, MD, FCCP

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2014;146(3):872. doi:10.1378/chest.14-0228
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Published online

In the doctor’s shining enamel castle
the physician’s assistant taps your vein,
pushes your heart, listening deeply to the fog
flowing in & out of the darkened harbor
of your chest. She dresses you down
for an EKG, sensing your pale, naked fear.
She attaches you to an asthma tube
yet after all this, there’s still no answer.
It’s midday now after months of illness
and the tight net of winter has lifted its grip
yet still there creeps the familiar guilt:
the halting thought that you’ve abandoned
the grand duties of work for another fruitless trip.
On the long drive home, the busy policeman of your life
watches the faces of crossing guards
searching for signs of judgment.
Instead, you discover a carnival: the Haitian lady
in speckled eyeshadow twirls a long feather boa.
A Navy veteran shepherds lost children
through the sea of traffic. Pass by now, he says.
   Pass on by, little ones.
The oceans part, you breathe and contort,
tossing up curses at the cloud of unknowing
and the brutal thump-thump of the man upstairs,
until at last, in spite of yourself, you arrive home safely
and at the end of it all, you find words of comfort
traveling down the telephone line:
An old Quaker friend – her voice clear as light–
offers what truth this day demands:
  To find the reason for your illness,
  go deeper, she says, go down to the root.


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