Sort of after “Dream A Little Dream of Me,” with the kick on the “of,” because the vowel scheme here seems to be reaching for something like that.

This phrase sounded self-important so I left it in (took out “guardians of the apostrophe,” an oblique reference to a supervisor’s digression on serial commas in diagnostic reports that caused me to go into a Seinfeld “Desperado” trance)

Pro-ject (other poem’s title) and PRAH-ject (this one’s title). Line breaks / enjambment really doesn’t interest me, and this one felt lazy.

The set-up here is meant to mimic invasive tumor growth, with interlacing motifs (recurring phrases) and intrusive thoughts.

Also really like the phrase “scare quotes.” Would use them in my poetry but the gimmick’s been taken away from those who do it well like Tao Lin and Carlos Perez.

“Theory of change” has been one of my favorite phrases dating back to this 2007 Slate article on Teach for America. Medical schools use “stages of change” to describe addiction counseling strategies and they struck me as thematically similar in an Infinite Jest kind of way. I can’t articulate why; that book, I guess, does (never finished it). It just sounds so empty and non-sensical. I mean, metaphysics and religion are theories of change, not organizational interventions.

This hook was inspired by me literally not seeing what other diagnosticians see on the slide. When I started out I used to start with the clinical history to infer a diagnosis, then write the slide description to match what I thought the diagnosis should be based on all available evidence. That is different from writing about what I actually saw, because I could not put what I saw into words that made sense. How would you describe the following image?

If you said “patches of glandular-appearing epithelial cells in a background of myxoid stroma, with some foci more suggestive of squamoid epithelial clusters,” you’re probably going to benefit from a second opinion, even though you’re mostly right! Far out. (Pleomorphic adenoma of salivary gland – benign.)

Such is training. And you begin to appreciate it only as you begin to improve. And then I tried to describe that as a life metaphor. Most pathologists are far more literal than I am, though we are similarly neurotic about language. We just speak different languages and I am still learning theirs.

Good tie in to the other poem here, “Building Insight,” which is also about feeling misunderstood. Both try to do clear, accessible language to describe the feeling of being misunderstood for one’s words.

One of my bosses hung a draft of this poem up on her door.

Boo like scared but also like romantic companion, so very patronizing, like “step up your game, babe.” It’s to clarify that the previous language described is passive-aggressive.

“Passion Project” imagines a conversation with a surgical pathologist, like a confession of sin over blood and flesh, hence “passion.” It is also a knock on the Steve Jobs “do what you love” Stanford commencement speech. I was on a surgery rotation the night Jobs died and was not lovin' it.

The vocabulary here comes from an extroverted and exuberant pathologist and uses the word “exuberant” often to describe proliferative inflammation or tumor growth. I thought that was so great: English is not the person’s first language, and the word itself adds such character to otherwise dry result reports.

The tumor here, though, is in the envious narrator: For much of my first year of training, I did not share that exuberance and kept finding I used descriptive language incorrectly. It is really hard to translate the explosion of activity one sees on a microscope slide of a cancer or fulminant infection into words. In anatomic pathology – I’m an aspiring clinical pathologist with anatomic training – that’s called “having an eye,” being able to see the salient diagnostic features in the first place. It is like trying to find a contact lens on a Persian rug, then being asked to describe all the patterns on the rug and the path you took to get the lens. Or, like, an Escher drawing. And you either have an eye or you don’t. People like that do, and people like me, who are word or number people…

As a kid I thought this “especially” construction was one of the funniest jokes I’d ever heard. Of note, it’s from the “Brother from Another Series” episode, a.k.a. the Frasier parody. I related a lot to Niles Crane at that age. That episode came out when I was a little older. Part of my love of the chocolate cake comes from my love of the brownies sequence in “Cape Feare.”
https://www.youtube.com/watch?v=WZsX6t5djd0