David Anson Lee

STANDARD OF CARE

The denial arrives in a language
designed to resemble grammar
without ever becoming speech.

The patient waits.

Inside the body, time keeps working
like a clerk who never leaves his desk.

The physician submits records:
scans, codes, proofs of damage
translated into acceptable doubt.

The insurer replies:
additional documentation required.

Winter requests the same of trees.
The ocean, of drowning.

Weeks accumulate without permission.

The medication sits behind a digital gate
guarded by an algorithm
that has never held fevered skin
or counted breath in a dark room.

When approval arrives, it does not arrive as mercy:
only as delay that learned to sign its name.

Too late is still a category of coverage.

The ambulance appears
after the fire has finished speaking.


Gerald So's YouTube reading of "Standard of Care"


David confesses: This poem reflects on the quiet violence of procedural medicine: how adherence to protocol can sometimes blur the boundary between care and detachment. It considers the tension between clinical language and lived vulnerability.

DAVID ANSON LEE is a retired ophthalmologist, educator, and poet born on the Pine Ridge Indian Reservation in South Dakota. A former endowed chair and professor of ophthalmology, his poems explore medicine, ethics, identity, history, and the hidden costs of institutional life. His work has appeared in numerous literary journals and anthologies.