S.O.A.P.

To document the progress of patients today's intern uses the format Subjective, Objective, Assessment, Plan: S.O.A.P. Case in point: a long-haired, bespectacled man brought in at midnight to Emerg.

Subjective; “I'm the lowest of the low.” (Long pause.) “That's it. that's all you need to know.” Objective: Pale, disheveled middle-aged Caucasian male lacking I.D. Expressionless. Paucity of movement, speech. No evidence of vis./audit. hallucinations. Assessment: Major depression. Rule out head trauma, schizophrenia, dementia. Plan: Re-assess when more able to communicate. Suicide watch. Vitals Q2H. Blood work to rule out organicity. Attempt to locate family.

The method organizes thought – though at first I balked at making SOAP from the boiling pot of human woes. Profound depressions all look the same.

As I probe this man's good vein he holds his arm out like a branch that ends in his hand, gazing ahead, as in a dream.

“Next week,” I answer, “things will be different. Your sadness is confusing you.” But his expression remains the same. That's it. Nothing more, though much more I need to know.

Ron Charach took his medical degree at the University of Manitoba, Canada. He trained in psychiatry in Toronto and New York, and has lived in Toronto since 1980. Dr Charach is the author of nine books of poetry and the non-fiction book Cowboys and Bleeding Hearts: Essays on Violence, Health and Identity. This poem is from his new volume of poetry Forgetting the Holocaust, published in Calgary, Alberta, by the Frontenac House (2011). Ron Charach.

Chosen by Femi Oyebode.