skin

the largest organ...the barrier...it breathes...it protects...it blushes...it gets cut and heals...it sweats...it glows...it toughens under the sun's rays...and wrinkles in water

the skin of my patients shows they've been to hell and back.

there are scars. thanks to biopsies, catheters, needle sticks, vaccines, rashes, iv's, skin grafts, feeding tubes, trachs. vivid, wordless legacies that recall suffering and fear...and healing.

there are colors. if you've never seen them, i'm glad for you. few things rattle me as much as running into a patient after a few months and seeing a sick complexion. their eyes and their smile and their hug tell one story, but their skin tells another. it's a yellowish, grayish, non-humanish hue that can bring tears to my eyes in an instant. a color that makes me want to know if they've been down or if they're going down. that makes me want to ask, 'what the hell have we done to you?"

there are messages. it turns yellow when the liver has been insulted. it gets bumpy and itchy when the immune system doesn't approve of a certain drug. it gets baggy in strange places to show weight loss. it goes numb when a nerve has been injured. it gets rather ornate when the blood is not clotting well. it lets go of heat to inform us of a fever. it's a good communicator.

to hell and back. back being the key. they are back every week. and friday nights they flip throug my mind like a slideshow. a show that i have often tried to cancel or unplug or drown out with red wine. i'm letting it play tonight - it's healthier, i know. not that there's not wine involved - which i hear is healthy also.