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Pectoriloquy |

Orkambi FREE TO VIEW

Eliza Callard
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Editor’s Note:The author writes, “I am a 41-year-old cystic fibrosis patient recently put on the new drug, Orkambi (lumacaftor/ivacaftor). I wrote this poem to document my first two weeks on the drug. Orkambi has, clearly, had its ups and downs, but I feel lucky to have lived long enough to have met this drug.”

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


Copyright 2016, American College of Chest Physicians. All Rights Reserved.


Chest. 2016;149(6):1573-1574. doi:10.1016/j.chest.2015.12.006
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July 2, 2015: The U.S. Food and Drug Administration today approved the first drug for cystic fibrosis directed at treating the cause of the disease in people who have two copies of a specific mutation.

    Prologue
    Tilt my head up and to the right,
    catch the eye of the moon and beg.
    For one day without it. One school day
    with no pain, no worry, no wheezing
    or crackling or coughing. Wish the moon
    would reach in with his moony fingers
    and pull out all the mucus like half-
    dried rubber cement, peel it away.

    My nurse asks where the congestion
    lurks. I dip into my chest, send
    a little mind-speck of light from
    the back of my eyes down the inside
    of my face, down my throat, let it sweep
    through my upper chest before dropping
    like a plumb bob to the cellar
    of my lungs. I point and she listens
    with the stethoscope. Her faraway
    look becomes a smile; she high-fives
    me. Or she shakes her head and says
    “An inch to the left.” I learn.

    Week One
    I.
    Fifteen minutes after commencement,
    a thin, clear film of saliva slips across
    my tongue, back to front. Spit. I have
    not had spit in fifteen years. Moisture
    layers my eyes--not tears, just the normal
    wetness of normal eyes. When the fan
    is on, my lids close over the cool.

    II.
    It is not the sensation I expected. The moon
    has not ravaged my body. Instead, a French
    Revolution has risen up. Creeks and rivulets
    are flooding the alveoli streets with pickaxes
    and battering rams. The rioters push
    against the old stone battlements that have
    been getting thicker and more impenetrable
    for four decades. Pain climbs until they bring
    the walls down and rebels and stones
    are coughed down the channels, up, and out.

    III.
    Sick, my chest once held a baby sock
    of air, but now the shapes change hourly.
    At first, a finger on the left. Above
    it, a playing card teaser that soon fleshes
    out to the fullness of a stretching hand.
    Then, a clementine-sized shock. A thin,
    grey veil of headrush every time
    I breathe in. I should be Julie Andrews,
    my arms flung out on top
    of the mountain. Instead I am Boo
    Radley behind a door.

    Week Two
    I.
    Two a.m., seized awake. A thousand
    steel balls on strings pulled
    through my left lung toward the center.
    A thousand knives. A thousand intruders.
    The front line ignites. Its contour edges
    to my midline, the pain a sharp angel,
    bringing ruin, bringing salvation.

    II.
    I gain a cannonball of lung in one day.
    The controlled explosion brings up
    years of my life. A breath,
    and my favorite red shirt in middle school,
    news stories long forgotten, an election
    I wore a badge for flash
    into mind. The memories were hiding,
    barricaded by dark green milestones. I am
    breathing as well as when I was thirteen.

    III.
    99.9 degrees. Skin sore, as if my back is
    some kind of spiny animal. I want
    to pull out the invisible hairs on my
    sacrum. A cleaner lung smell makes
    the sinus infection stand out
    as a lone, sad trumpet.

    IV.
    Energy level steadily increasing. Dizzy
    every afternoon to bedtime. Constant
    confusion like a camera changing focus.
    Sputum color and consistency, thin
    and light green. Fighting cautious optimism.

    Epilogue
    We go for a walk which turns to a bike
    ride when we see the rentals. Indian summer,
    and the crowds are out. A hundred
    pedal-turns in and I am waiting for the pain,
    the usual moment when my thighs,
    hamstrings, and calves fill with sand and glue.
    Instead, the clear, deep breaths reach my toes
    and the rubber-band muscles push without effort.
    The sun has found me.


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