Brandon Ko CWA 2009

Brandon W. Ko ‘10 received a Bachelor of Science in Neurobiology, Physiology and Behavior from University of California, Davis. A former boxer, bartender, and backpacker, Brandon is currently in his second year at YSN, studying to become a Pediatric Nurse Practitioner.

Listen to Brandon Ko’s Masks as a netcast on Yale’s iTunesU

Transcript of the Reading:

Untitled (Masks)

“Definitely wear a mask in there.” 

So ends the morning report on my patient. Mr. C is a 72 year old Jamaican man, and I am expecting him to have dreads. My last Jamaican patient was a swollen bear of a man, with a fountain of dreadlocks cascading about his edematous cheeks. His heart stopped the day after I met him, and the sight of his gnarled hair writhing with his chest compressions sticks in my mind. 

I am surprised when I enter the darkened room; there is no mane of ropey hair. Sprawling beneath the wrinkled linens is a wasted figure, hairless and leathery, more creased than the sheets about him. Immediately my gaze is drawn to his face. Small bright eyes and a toothless smile frame the gaping, ragged pink crater that has replaced his nose, cheeks, and upper lip. A gauze bandage feebly seeks to hide this horrendous disfigurement, but has slipped away, revealing peeks of glistening raw-beef granulation. Poking through the gauze, like paired moray eels, are two blood-streaked nasal trumpets, greedily sucking in the stale room air. 

His are injuries of abuse, neglect, and depravity. They are dog-bites. Mauled by two pit-bulls, he now lays before me missing a third of his face, with severe wounds on both arms and legs. A dog needs to be trained to perpetrate such crimes, and anger flashes in my thoughts as my own pit-bull waits patiently for my return home. 

“Are you in any pain?” I ask reflexively. 

“No, no,” he rasps and shakes his head wearily, smiling despite his mangled body. Which is why I am wearing the mask that has been so strongly recommended. Mr. C has leprosy. There are no open sores, or rashes to warn me of its presence, but another sign of leprosy is a deadening of the nerves in the skin and extremities. Closer inspection reveals Mr. C’s hands are not only swollen and rheumatic, but missing several digits as well. His feet, too, are lacking toes. I later find stories for these in his chart, accounts of landscaping and lawnmower accidents in which Mr. C obliviously lost pieces of himself to the world. 

Hastily conducted research informs me that there are two types of leprosy; one spread by contact with open sores; the other by coughing, in a fine rain of droplets. The hospital’s Infectious Disease Team was “pretty sure” Mr. C had the first kind; that gloves and hand-washing were enough to prevent infection. But I decide to keep my mask.

My largest triumph of the morning involves vanilla pudding. Specifically, spoon-feeding an entire cup of it to Mr. C for breakfast. He is cachectic, wasting away from malnutrition, and Kozy Shack is as nutritionally ambitious as Mr. C is willing to be today.

Pudding is a challenge when there is no upper lip. I find myself hovering inches from Mr. C’s pulpy complexion, maneuvering spoonfuls of quivering pudding between his gaping lip and maxilla. The smell of his fetid, pudding sweetened breath assails my nose as my eyes absorb the sight of him: his smacking mouth, with crust and ooze caked into the sides, and above, the nasal trumpets, yellowed tunnels rattling as he coughs invisible leperotic spores onto my flimsy mask. My bandage covering the quarry of his nose is no more than a thin tent, staked down and barely concealing the meaty swamp below. 

Hanging above this ravaged terrain are his eyes. They are the stars over a battlefield. A red tinge of conjunctivitis has crept into them, but that doesn’t keep them from shining with delight at the pudding. Though small, they glitter, and are surrounded by a thicket of wrinkles that grow deeper with every smile, and every vanilla bite. Halfway through the cup, his eyes stop and grow wide, then fix on me, imploring. 

“Now you,” he rasps. “You have some.”

Such is their power that for half a second I pause, considering. 

“No, no thank you,” I decline, but I smile behind my mask. “This is all for you.”