Issue 1 Draft 3

These days all my vacations happen when
I’m asleep. A beach in Aruba. A boat in
Vienna. Beautiful places I had never visited
but somehow could perfectly picture. More often
these vacations took me to locations in my past.
Memories that were as relaxing as any holiday. I
suppose it’s my own fault. I knew what I was signing
up for all those years ago, when I told my college
advisor I wanted to start on the premed track. And
I have loved medicine, from the day I first opened
a Netter’s textbook to finally becoming a doctor a
few months ago. Still...there are moments. Where
reality with all its work and repetition falls away.
When the dreams feel real.
“Medicine,” the distinguished man with the
bowtie bellowed, “is a revolutionary profession.
For millennia humans have pleaded with nature.
In the face of her unrelenting, unending march of
evolution, we asked that our sick be saved, that our
lives be long, and that our children be happy. Oh,
how we pleaded. We never heard a response. Instead,
we were punished for our genes, our lifespans were
limited to as long as we could bear children, and
we died.” The man searched the sea of white coats
seated on a green lawn in front of a school in the
Northeast. I too was seated, excitedly polishing
my glasses, staring at his usually kind face now
unnaturally taut into grave significance. “Medicine
is the hard-fought triumph of the individual. The
declaration that I matter. I deserve to be saved. That
my life has more value than my genes and that my
joy and sorrow has worth. Our pleading has finally
been answered. By each and everyone of you who
has earned this title: doctor. So go forth, Class of
2022! Go forth and triumph!”
My arm swung across the bedframe and
grasped at the nuisance rattling, buzzing on the
Reflection
By Aditya Jain
M2, Harvard Medical School
Illustrations courtesy of DALL-E
hardwood floor. Where was I? I put on and polished
my glasses so I could read the pager. Urgent. New
admit. I placed one arm in my coat, one arm on the
door as I quickly exited the on-call room.
“Our patient is an elderly John Doe who
presents with amnesia, confusion, and irritability.
He is unable to remember his own name, age,
identity, or information regarding family members
or medical history. He repeatedly asks to be let
go and does not remember how he arrived in the
emergency room. There are no visible signs of head
trauma or other injuries. He is oriented to person,
place, and time, however he is unable to remember
this information and must be frequently reminded
who has seen him and why he is in the hospital. No
other signs of any cognitive impairment.”
“Great. Let’s get an MRI scheduled as soon as
possible. Anything else I should know?” My hand
was already on the doorknob when Nurse Brown
spoke again,
“Yes Dr. Ikari, it may be a few hours before we
are able to get the MRI. But I wanted you to know
that the patient’s behavior seems a bit off? I don’t
know how to describe it but he just appears...sad.
Sorry, that wasn’t very helpful.”
“No no Arianna, that is helpful. Thank you.” I
entered the room.
Think about when you last saw a family
member you had not seen in a long time. A parent?
Grandparent? Cousin? Maybe it was Thanksgiving
at your mom’s house and a stranger who claimed
they used to change your diapers gave you a hug.
Then you took a closer look and it happened. There
was a spark somewhere deep inside in your mind.
Recognition.
John Doe sat quietly in the patient room. He
was dressed in a gown and he wore no shoes. His
bright white hair stuck out in all directions, and he
had a beard to match. His arms trembled with every
breath. He wore large spectacles which magnified
his dark circles and wrinkles. And in them, his eyes,
deep blue like the sea, shone sadly, devouring all
else.
“Good evening, I’m Dr. Ikari. May I ask what
your name is sir?” He did not answer. I tried again,
speaking louder this time. Still no response. Then,
slowly, he pulled out a small cloth from his breast
pocket and began polishing his glasses. He opened
his mouth to speak. Recognition.
I paced across the on-call room. Surely it
was impossible. I put the thought out of my mind
— I needed to focus on the medical issue at hand.
What was the differential for amnesia? Given that
there was retrograde loss as well, perhaps it was
post-traumatic? There was no evidence of physical
trauma, but this still did not rule out emotional
trauma. A transient global amnesia from ischemia
seemed unlikely with no lab or EKG abnormalities.
The timeline appeared acute, but we could not know
for sure. Maybe this was part of a longer process — an
odd presentation of Alzheimer’s? Or maybe drugs.
I remembered reading a case study of anterograde
amnesia after glufosinate ammonium intoxication.
We were still waiting on the tox screen. The weight
of the differential felt suffocating. I knew nothing
for sure. It could be anything or everything.
I checked the clock. We would be able to get
him an MRI soon; maybe I could make a decision
then. And if I still had concerns, I could always
wake up my attending. I willed myself to relax.
Deep breaths. In and out. I felt a little better. Yet in
this calmer state, that crazy thought crept back into
my mind. Recognition. Was John Doe...me? The
way he polished his glasses. His hair. His eyes. Even
in my own mind it sounded insane, yet I felt certain.
I had no doubt. I knew my shape. I knew myself.
If this was a science fiction novel by the
late great Isaac Asimov, there would only be three
possibilities when it came to a doppelganger: time
travel, clones, or robots. Luckily in medicine, a
thorough physical exam is a part of every character
introduction. No screams during his lab draws
meant John was decidedly not a robot. That left
time travel and cloning. I began pacing again; I
could check in on him while waiting for his MRI. In
fact I had to — there was doctoring to do.
Even in my own mind it sounded
insane, yet I felt certain. I had
no doubt.
As I entered his room I once again felt an air
of quiet sadness. John had hardly moved since I left.
Might as well do a neuro-motor exam. I walked
towards the drawer with the reflex hammer. “Hello
again. I’m your doctor, Dr. Ikari. Do you remember
when I came to visit you earlier?”
“Came to visit.”
“Yes! We had a brief talk about how you were
feeling and I asked you some questions about your
life. Do you remember that?”
“Do you remember?” John ran his left hand
back through his untamed mess of hair, bringing
his hand down his neck and under his chin, leaning
forward to occupy a thinking-man pose. I felt my
stomach drop. Recognition. Why? He seemed to be
repeating what I was saying. Why? Was it a safety
protocol for if a clone interacted with the original.
Of course, I must be the original, everyone knows
clones age faster. It all made sense. Unless! What if
I was younger than I thought. What if my lifetime
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