They call it
A woman's coin purse
Buried away like an afterthought
In the folds of her body.

But hers is a feral little thing
Throwing away angry outbursts
With the tide of each moon.

It scoffs at being
Belittled and unused
Writing her opinion in bloody letters.

I paced in the hallway outside of the patient's room, going over my mental checklist of items to do during the history and physical examination. Bringing in a paper list was discouraged; we were meant to "flow" through the exam "naturally."

I stuffed my hands into the pockets of the white coat I'd received three weeks earlier, during the White Coat Ceremony for first-year medical students. Feeling around the deep pockets to make sure that I had everything I needed, I felt my left hand graze a cold metal reflex hammer with a sharp tip, used to test for nerve damage in the feet of diabetic patients. (Alternatively, it could be used as "a medieval torture device," my mother had said the previous weekend, as I'd practiced my exam on her.) In my right pocket, I felt my tuning fork, blood-pressure cuff and ophthalmoscope.

In my third year of medical school, I started a rotation at the nearby VA hospital. Walking toward the polished glass doors that morning, I saw my reflection--clean white coat, assured expression to cover up how lost I felt. It was my second clinical rotation ever, and my first time at the VA.

I found my team and soon met a patient I'd be seeing for the next month. His name was Jim. He'd already been hospitalized for a week--and he wasn't leaving any time soon.

At seventy, Jim had no muscle or fat on his body. His gray skin hung like a sheet over the ridges of his skeleton, and his bony arms were covered with tiny puncture holes from years of injectable drugs.

Despite Jim's weakness, he clearly didn't want to be hospitalized. Each morning, he'd frown at me through bloodshot eyes and snarl, "When the hell are you gonna let me leave?"