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Poetry and Medicine
February 26, 2014

The Dust Bowl of My Elbow

Author Affiliations
  • 1Easton, Pennsylvania

Copyright 2014 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

JAMA. 2014;311(8):865. doi:10.1001/jama.2013.282512

Like the p’s in psoriasis and pneumonia,
    I was a silent child.
Like the exhausted Oklahoma topsoil,
    always under foot.
Like my smooth alabaster elbow,
    unnoticed till I came unhinged.
The unpronounced, the downtrodden, the ignored
    rise up eventually.
The p’s migrate to parched, pain, peril, and peace.
    A scorched earth catches the wind.
       A drought comes to a woman’s elbow.
“The surface of the earth crusted,”
    Steinbeck wrote, “a thin hard crust”;
        and the soil cried out for rain.
Once your skin becomes your enemy,
    it is like the dust you will return to,
        storming up from your bones
            to bury your breath.
A small patch of foe skin
    spreads everywhere.
        I scratched until I bled.
            It felt good to bleed,
to break through thirsty skin
    to the olecranon process,
        a half-moon of pain.
Forty years of scales and scabs,
    my dust bowl lasted.
        John Updike went to war with his skin.
I yearned to molt, to be a snake, to flay myself.
    The canvas I now inhabit is blank, healed.
        At your beautifully set table, on heirloom white linen,
            I lean my polished elbows, a perfect W,
                not to be rude or ungrateful,
                    not to take up more space
                        than I deserve,
                            but to ask why
                               I have suffered so.

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