Numbers Game

Med school finals, ten backpack pounds

of biochem hauled for months, my epiphany:

I would never know more about glucose

metabolism than that morning, another

“Pass” on my permanent record of forgotten

scores-SATs, MCATs, USMLEs-numbers

placed like bets in a bookie’s ledger.

Now I play for higher stakes, and today

I hit all my numbers, a trifecta of patients

treated, charted, and billed,

every intervention evidence-based,

delivered knowing I’d fail the exams

my med student daughter nailed this week,

though I can’t convince her no one will die

when she forgets a step in the Krebs cycle.

But I haven’t confessed I’m cozy

with the insurance mob, how they decided

to skim another percent off my take.

She doesn’t know they’re into me deep,

demanding records of patients’ private

confessions. They don’t buy betrayals

with smashed knees or cement shoes,

just audits rammed into my temple

like a Glock muzzle, sweat bullets

dripping relentless as a film noir faucet,

each drop hitting louder than the last,

heart pounding, no one to hear my scream.

Disclosures:

Dr. Berlin is Senior Affiliate in Psychiatry at the University of Massachusetts Medical School. E-mail: Richard.Berlin@gmail.com. His most recent collection of poetry, PRACTICE, is published by Brick Road Poetry Press.