The coronavirus pandemic is again burning through our hospitals, disrupting our living and dying. Patients depart in austere circumstances without hugs from their loved ones, isolated and stripped of the basic dignity of touch. The virus ricochets in congregate living facilities; the horror spirals, devastating families; and frontline health care workers bear witness to accumulating loss.
“Self-Portrait as Exit Wounds,” a poem by Ocean Vuong from his acclaimed 2016 collection Night Sky With Exit Wounds, is a tribute to the legacy of war, a torrent of images that “traces the path of a bullet, depicting the ruptures it creates not as endings, but as points of remembering.”1 Health care is not war, but the excess mortality count in the US attributable to the pandemic now exceeds that of our most lethal armed conflicts.2,3 As a hospitalist I’ve witnessed the deaths and created this “self-portrait” in tribute to Vuong’s poem and my patients and their families. The sharpened silence in these images speaks of my hospital’s experience, our palpable grief and collective despair. To find our way out of this crisis, vaccines will not be enough. We need reason, kindness, empathy, and compassion as our guide. And throughout, a reckoning, a feral howl.