“Layers”
by Andrew Albert

Layers of dirt, rock and bone,
dark, damp, days of carefully peeling off one by one with a fine-tooth comb.
Focus, hope, patience, needed to defend against anticipation.
The agitation can become overwhelming in the mine, I’ve seen it happen ore’ again.

When digging too deep without repose
this awakens the earth, protecting what is trying to be exposed.
One can put their whole being into this purpose, scars and ache to tell.
Know well that under dirt, rock and bone there may be gold.

Folding layers of hardship and worn nerve can hide a soul.
Life like gold.
Just as the treasures of the earth are hidden.

Let then, the miner and physician know,
that below the surface there is true color to show.
For how much more precious is a life than metal?
We must persist in uncovering the layers.

Poem Commentary

The central theme of this poem was to describe the persistence required of physicians when working with patients that may be difficult to understand, and how that could connect to the process of gold mining. They both share a persistence in the act of uncovering, whether uncovering a precious metal in mining, or removing individual barriers to get to know a patient (alternative: person). Structurally the poem includes two lines of true rhyming followed by two lines of dissidence to build tension. Every new paragraph begins with an early connecting rhyme to attempt to bring relief to the previous paragraph’s tension. This echoes the fact that the physician’s process of uncovering is an ebb and flow of tension and resolve. The poem was designed to end without a resolve with a reference to the title. This was meant to prompt the reader to look inward, contemplate the theme as a whole and connect the weight of how much time and effort should be invested in people. It may be difficult to appreciate the complete meaning throughout the lines, so this next section is meant to address some of those nuances.

Lines 1-4: The poem begins with a vague reference to mining that may be unfamiliar to most. In placer mining, many days are spent in machinery peeling back the earth, slowly descending towards the layers in which gold can be found. This mystery to which the poem is initially referring, was meant to draw the reader in and promote a moment of wonder. The type of wonder that is defined as “a moment of admiration, caused by something unexpected, unfamiliar, or inexplicable.” This wonder and curiosity can be the same way students and physicians may feel initiating a connection with a new patient. Line 3 describes how gold mining can feel like an endless process. You may find yourself asking, “Will this be worth it; are we going to find gold? What does it even look like”? The anticipation is unbearable, and one needs a strong sense of hope and vision to keep going. The same concept must be applied to patients. It may be easy to give up on someone, and believe there is nothing worth digging for. Sometimes all you want to do is give up, and the anticipation and waiting can seem overwhelming, but hope helps you persist.

Lines 5-8: Mining can be a dangerous process. If you are not careful with maintaining the angle of repose (defined as, “the steepest angle at which a sloping surface formed of a particular loose material is stable.”) when excavating the earth, the walls can cave in. Mistakes like this happen when the miner gets impatient or greedy. Just like the earth can protect its precious metals, so too patients cover themselves and hide if “rubbed” the wrong way. The process requires great care and patience, but if done in a careful manner there may be a reward at the end.

Lines 9-11: The next section reveals and confirms the connection between gold mining and humanity, with layers of hardship being the experiences that may need to be uncovered to find what is beneath. The gold in humanity is not meant to be a specific human trait, but rather the unique good in each individual. Also, a fascinating characteristic about gold is that every piece is highly unique in color and shape, and you do not need to be an expert to find a piece of it in an inconceivably large mess of dirt. You always know when you see it.

Lines 12-15: The last section alludes to “true colors.” This makes an important distinction of neutrality because what is revealed may in fact not be beautiful or precious, but they are true colors none the less. Sometimes, even after the long hours, days, and years of trying to uncover this treasure, there may not be any gold at the end of your pursuit. It is a sad truth, but both the miner and the physician must continue on in hope regardless. In regard to the line “life more precious than metal,” one must consider how vigorously we seek and sacrifice for our worldly desires, and question whether we ought to give an even more significant effort in caring for our patients.

“What I hope the reader takes from this poem is that people and situations can be complex and difficult to work with, but one must persist in hope of finding the value in a person. Physicians, after all, are just like miners, and despite major setbacks, wall cave ins, bankruptcy, or hardship, they will be back to continue digging with a renewed vigor and hope for treasure.”

The author is currently in his fourth year of medical school. Prior to committing to a career in medicine he worked for six summer seasons, gold mining in the Alaska Range.

Publication DOI: 10.15404/msrj/10.2018.0159
Corresponding author: Andrew Albert
Contact: drewalbert7@gmail.com
College of Human Medicine, Michigan State University, East Lansing, MI, USA