Unsterile

“Unsterile”

I've practiced the ritual of clean hands—
scrubbed thought from touch,
masked the face that feels.
Emotion, too, must be gloved
in the ER.

But today,
she arrived–
frail, fractured language and
a physiology of poverty:
tachypneic with shame,
skin perfused with neglect,
erosion of agency.

She bore the scent of collapse–
not sepsis but the slow rot
of the systems that failed her.
Not just of the body–
structures: housing, food, mercy.

Beside her,
her sister—her caretaker—
counting costs in units of guilt,
hands pressed by the same weight,
recounting the silent echo of meals.
They were both
in deficit.

I examined her with textbook hands–
but it was useless.
There is no differential
for despair.
No dose of Zofran
for the nausea of inequity.

My gaze caught where the margins blurred—
where her history smudged past the ink.
Not a symptom,
but something more peripheral:
the quiet violence of luck—
how I move within systems that hold,
while she
had long been slipping through.

I found myself unsterile.
Contaminated by
what I've learned to suppress,
colonized by truth.
I remember why,
I step into this space.
Something vital, 
penetrating the numbness.
Then I foam out,
and wash it from my hands.

The Post Shift Poet is written by an emergency physician practicing in the United States. After each shift, they write one poem. 

The project began as a personal ritual—an attempt to process what lingers after the notes are written and the rooms are empty. What started as an exercise in survival became something more: a practice in attention, in meaning-making, in remembering that this work is human work.

Each poem is anchored in a specific moment—often a patient encounter, sometimes a hallway conversation, or the silence of a long drive home. It’s not meant to be comprehensive, or even cathartic. It’s just a small act of witness.

The writing is anonymous. That’s intentional. The focus is on the encounter, not the storyteller. These are fragments, not pronouncements. An attempt to honor what is often invisible: the absurdity, grief, grace, and quiet resilience that live beneath the surface of emergency medicine.