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Poetry and Medicine
March 21, 2007

Sewage Treatment

JAMA. 2007;297(11):1166. doi:10.1001/jama.297.11.1166

I remember the afternoon we spent
visiting the sewage treatment plant
beside the Monongahela River
in Pittsburgh. I was sure that trip
was a waste of time, down the drain,
another of the million small betrayals
I suffered at the hands of teachers
who didn't understand anything
about medicine. I chalked it up
to their obsession with demanding
irrelevance. Those who can't do, teach.
And then they put sewage on the exam.
At the time I planned to become
a psychiatrist and later that summer
married my sweetheart, a definite sign
of growing up. I remember
the lush grass, the continuous thrum
of machinery, and the clatter
of catwalks. A uniformed flunky
took us to each step of purification,
from sludged to seraphic. Today
I’m thinking about memory,
imagining how its pipes and pools
are being continually refreshed
by filtering, aeration
and slime, enabling the past
to flow into us, more wholesome
and drinkable than when it happened.

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