Chief complaint: fever. History of present illness: 49-year-old HIV-positive African-American woman, tested HIV-positive five years previously to admission, currently undomiciled. Presented to the psychiatric emergency department at admission with delirium and fevers and was then transferred to Adult Emergency Services. Physical findings on arrival on the Medicine service: fever to 102F, tachycardia, tachypnea, hypotension, crackles about halfway up the lungs bilaterally, and oxygen saturation of 89%. Blood cultures and arterial blood gases were drawn.
When you finally got blood from the hard stick
You spotted the backflash of red
And said Thank God. The woman's legs and arms
Were everywhere, and you were in the middle
Holding her down with one hand while wielding
A butterfly in the other. You stuck her and she bled.
You thank the Rock of Moses that she bled
And not you. Moses took a stick
To strike the rock, unwilling
To try his luck with more persuasion. God read
This as rebellion. Here the test of mettle
Is not getting stuck. Fuck! you cry, and hold her arms
Again. Can she please quit moving her arms?
She's used and used. Most of her life she's bled
High, or been sick, or in the middle
Of other people's lives. Now she's screaming. Stick
It out or shut up, you could say. It's for your own good. Red
Is what you want from her. Would you help us? Are you willing?
You promise her a Snickers and she's willing.
Her drugs are stamped on her arms.
Her lips and nails are painted careful red.
Her AIDS showed on a blot of what she bled.
Moses lashed out with his stick
When he wasn't out front, but in the middle.
But that wasn't what you were thinking in the middle
Of multiple stabbings and wheedlings.
You'll send the labs. You'll treat. Will it stick?
Is Bellevue just another scar on her arm?
I'm sorry if you want suspense: you stuck, she bled,
She shrieked and thrashed, the gauze turned red.
Moses, stick in hand, didn't know he erred
Till God denied him. Force: it feels like meddling
To those on divine peaks away from blood.
But we down here see in the scars and whealing
Proof indirect that what we teach our arms
Is strength, not just intention. A stick
Read as a resting staff is idle; wielded
With strong arms is a try at mettle.
We bled her to cure. She was a hard stick.
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