Hektoen International

A Journal of Medical Humanities

Guillain–Barré – Vanishing Twin

John A. Vanek, MD
St. Petersburg, Florida, USA

Poet’s statement: Poetry provides a vehicle that takes me to places that logic won’t go, a way of understanding the incomprehensible, both in life and in medicine. I now prescribe poetry PRN, but warn that it may hurt a little. My poems are peopled with my family, friends, and patients.


for Mr. S.We spent a month together.
I cared for you,
you loathed me.I knew every inch of your body,
spent time with your wife
and daughter, sharedyour most intimate secrets,
blood counts, lung capacity,
saw the hatred in your eyes.You wanted me to leave
you alone, let your motionless
lips, body, diaphragmcarry you soundlessly away
from your flesh-covered cage
to a hushed death—yet you

underestimated me,
my determination
to care for you.

I wasn’t there the day
of your discharge
when your wife drove you home

to the rest of your life,
don’t know what you told your daughter
about me—

but today in the park
I saw you laughing
with your family

and I remembered you,
your angry eyes,
and I smiled.

DeterminationPhotography by Palo



Rock paper scissorsPhotography by Metamerist Vanishing twin2

From the very beginning, we were
intensely competitive for mother’s love,
nourishment, space.
I grew strong, but you
were helpless, trapped
against the wall of her womb.

On our birthday, conflicting tides
of grief and relief
tossed Mom like a derelict ship,
swept her in and out of my life for years.
She never quite got over you,
still keeps your photo
hidden in her dresser drawer.
You look just fine next to me
on the ultrasound snapshot, before
you starved or smothered by sixteen weeks,
began to reabsorb, became a part of her,
then mummified to papyrus, became
mother’s timeless paper doll, perfect
in her imaginary memory.

They say that twins can feel
each other’s pain, share everything, yet
I don’t—don’t have to.
Would I feel the same
if you had lived?

Let’s play a game
of rock-paper-scissors
for mother’s love.
You can’t hold a rock, but I
can hold the scissors,
slice away at your first
and only photo,
make you vanish forever.



  1. Guillain–Barré is an autoimmune disease that paralyzes the legs and arms first, then the diaphragms preventing breathing, but leaves the patient completely alert and aware. These patients can recover nearly all function if they survive.
  2. In 15 percent of twin pregnancies, one fetus dies in the womb (Vanishing Twin Syndrome).


JOHN A. VANEK, MD, is a physician and poet with works published in numerous literary journals and university press anthologies, such as Red, White and Blues: Poets on the Promise of America, as well as such diverse publications as the Journal of the American Medical Association and Biker Ally—The Motorcycle Magazine Geared For Women. He has read his poetry at the George Bush Presidential Library, the Akron Art Museum, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, and Eckerd College. His first full-length book of poetry, entitled Heart Murmurs: Poems, is available in print and on Kindle from Amazon.com. He has now retired from his private practice in diagnostic radiology. Both of these poems were originally published in The Examined Life Journal, a publication of the University of Iowa Carver College of Medicine.


Highlighted in Frontispiece Winter 2013 – Volume 5, Issue 1

Winter 2013  |  Sections  |  Poetry

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