Commencement

Commencement addresses are hard to give and often boring for the audience. But I can unequivocally say that this is the best address you have ever heard!

Welcome to the University of Utah Family Medicine Residency Graduation 2024.

https://youtube.com/watch?v=jcLCH-jwdBc%3Fsi%3DIBKIjBhwGYNywVgF

Trauma

This is the fifth installment discussing my experiences working with Ukrainian refugees in Poland. Go here to see the other entries. More pictures of my particular group can be found herehereherehere, and here.

Lithuania stands with Ukraine

While people respond to recent short-term trauma differently, there are many commonalities in people’s reactions. The United States, thankfully, is not familiar with such atrocities as Ukraine faces currently. During my brief time in Poland working with Ukrainian refugees, I saw how many people were handling their stress and grief: anger, denial, and always fear.

                My second week in Krakow included working in a clothing tent distributing donated clothes. A certain amount of people were allowed in for a short amount of time to control the crowd, and more evenly hand out the clothing. Many mothers with small kids were present, along with elderly grandparents. The mothers often rummaged quickly through the options as they needed to select clothes for all of the kids as well as themselves. One mother, who had two extremely cute kids under five, went through like a whirlwind during her allotted fifteen minutes, trying to get everything that her small family needed. She was obviously stressed with the recent events of her life, and showed a short temper with her children. She found some clothes for each of them, but then returned to the tent about five minutes later as she lost her phone. Given that the clothes were in multiple boxes on crates, there were numerous places where the phone could have ended up, and it would be a long search. Needless to say, no one had seen her phone. She began screaming while repeatedly hitting her head. As she crumpled to the floor crying, she screamed something about being unable to connect with her husband, and then used the word “shot.” I didn’t understand if he had already been shot, leading to her meltdown, or if there was concern that he would be shot and she wouldn’t find out without her one communication lifeline to her home. A volunteer in the tent knelt down with her until we found her phone. She quickly left the tent with her kids, no doubt embarrassed, somewhat relieved to have her phone, but no less worried about what the future held.

                During my first week in the clinic in Warsaw, I saw a woman in her forties who had symptoms of a cold. Given the close proximity of everyone in the center, upper respiratory infections were rampant and most people either were recently or currently sick. During the visit, I asked her about all of the healing cuts on her right forearm. It looked to me like cutting with a razor that people often do to feel a physiologic release from their psychologic stress. She looked at her arm and said nonchalantly “Oh, that’s just from shrapnel.” I didn’t realize that I knew the Russian word for shrapnel, but it is the same as in English. “Is there any left?” I asked as I more closely examined her arm. “I don’t think so.” She didn’t seem concerned at all about her arm, now or then. I don’t know if it was because she had already moved on, if it was a comparatively small concern given her other traumas, or whether it was denial that anything had actually occurred.

                One of the most profound moments I had in Poland was sitting in the shelter in Warsaw, just observing the people from Ukraine. They came and went from breakfast, waited in line for the washers and dryers, or emerged clean from the showers. I saw a mother sitting with her kids at a picnic table, trying to keep the children’s attention on their food instead of running away to play. An old man sat next to me, staring at nothing in particular for a long while. I didn’t want to disturb his reverie. But what I really saw was a combination of regular people going through the motions of normal, everyday activities, and a group of broken people accepting whatever circumstances they had. Many had looks on their face that spoke of focus on survival, without immediate thought of their unusual circumstances. Others showed many proverbial wrinkles of worry, the weight of war all over their countenance and body language, like clothing they were unable to change.

                At one point in Krakow, forty or fifty pleasant Ukrainians waited in line outside of the clothing tent. A small plane flew fairly low and loudly over the area. None of the Polish people even noticed, but every person in line flinched as though it was a war plane portending danger. No matter how each individual or family handled their trauma, even if they could move on for a time, it remained. The flinching doesn’t leave that quickly.

Ukraine and Poland, inextricably linked forevermore.

Human Compassion, Seamus Heaney, and George Floyd

One of my favorite poets is Seamus Heaney. While I enjoy his poetry, I even more love his Nobel Prize acceptance speech, “Crediting Poetry.” I encourage all of you to read it.

There is one section of the speech that applies to all moments of history, but particularly this one. This is one of the most profound stories I have ever encountered, and I believe that it articulates our steps forward amidst the importance of #blacklivesmatter, and how to honor George Floyd:

Seamus Heaney, Nobel Laureate of Literature, 1995

“One of the most harrowing moments in the whole history of the harrowing of the heart in Northern Ireland came when a minibus full of workers being driven home one January evening in 1976 was held up by armed and masked men and the occupants of the van ordered at gunpoint to line up at the side of the road. Then one of the masked executioners said to them, ‘Any Catholics among you, step out here.’ As it happened, this particular group, with one exception, were all Protestants, so the presumption must have been that the masked men were Protestant paramilitaries about to carry out a tit-for-tat sectarian killing of the Catholic as the odd man out, the one who would have been presumed to be in sympathy with the IRA and all its actions. It was a terrible moment for him, caught between dread and witness, but he did make a motion to step forward. Then, the story goes, in that split second of decision, and in the relative cover of the winter evening darkness, he felt the hand of the Protestant worker next to him take his hand and squeeze it in a signal that said no, don’t move, we’ll not betray you, nobody need know what faith or party you belong to. All in vain, however, for the man stepped out of the line; but instead of finding a gun at his temple, he was thrown backward and away as the gunmen opened fire on those remaining in the line, for these were not Protestant terrorists, but members, presumably, of the Provisional IRA…

The birth of the future we desire is surely in the contraction which that terrified Catholic felt on the roadside when another hand gripped his hand, not in the gunfire that followed, so absolute and so desolate, if also so much a part of the music of what happens

“[The poem] knows that the massacre will happen again on the roadside, that the workers in the minibus are going to be lined up and shot down just after quitting time; but it also credits as a reality the squeeze of the hand, the actuality of sympathy and protectiveness between living creatures. It satisfies the contradictory needs which consciousness experiences at times of extreme crisis, the need on the one hand for a truth telling that will be hard and retributive, and on the other hand, the need not to harden the mind to a point where it denies its own yearnings for sweetness and trust.”