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Poetry and Medicine |

Metamorphosis

Jack Coulehan, MD1
[+] Author Affiliations
1Department of Preventive Medicine, State University of New York at Stony Brook (jcoulehan@stonybrookmedicine.edu)
JAMA. 2013;310(1):100. doi:10.1001/jama.2013.1125.
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Extract

Knobs appear beneath his drab sweater.
He comes in wearing a dark skirt
and gypsy blouse. When he sits at a table
near me, I notice the scarlet nails.
In a short time, I switch to the pronoun
she prefers. Several mornings a week
we sit, our backs to the windows,
two tables apart. When a story appears
in the Times on a marvel of medicine,
she brings it to my attention,
addressing me as “Doctor.” I’m surprised
her voice hasn’t softened, her walk remains
masculine. Her breasts become larger,
but her face and bare arms, though smoother,
reveal the same sharp scaffolding
they used to. With regard to an article
that touts advances in gene therapy,
she becomes flustered at my lack of
enthusiasm. With regard to a piece
about a theatrical new cure
for depression—I suggest reserving
just a pocket of doubt. In the months
that follow, her salt-and-pepper hair
remains dull, her makeup impasto,
her posture graceless. Metamorphosis
has ground to a halt, though trinkets of change
continue to accumulate. Each morning
I look for a difference I can’t put my
finger on, but have faith will shine through
when it happens. I yearn to nudge her,
to tip her toward happiness. She’s not
like those miracles in the paper, she’s real.

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