once upon a wrote


here and there, in fables and tales,
some in no guile and others
in chancier disguises,
some sine-known and some sign-unknown,
some dead in stillbirth,
some penned these words,
some a few decades old,
some of but a moment ago eyelash distant,
making me think that
someday I will scribe,
cobble some truths and
some falsehoods into one
leaping heaping melting scoop,
letting you decide,
which for better,
which for worse...

<•>

"No matter that plain words
are my ordinary tools,
With them I shall scribe the small,
Cherish the little, grab the middle,
Simplicity my golden rule,
Write they say,
about what you know best,
Surely in the diurnal motions,
The arc of daily commotion,
Do we not all excel?"

<•>

the reason we say so oft,
in whispers emboldened,

I love you

to our children
is not the utility of
its summarizing brevity

no, no.
it is because
the eloquence of simplicity
supersedes any other poem
any of us could ever write...

<•>

is this craft that chose you,
not defined by machine millimeters,
precision absolute,
curvatures, so eye-pleasing,
they demonstrate no tolerance
for tolerance of the ordinary?

the skill of words, too, cut so fine,
find the  extraordinary within,
refine, refine, refine,
shave away the trite,
the reused,
discard the instant recognition,
unusable

<•>

There are natural toxins in us all,
if you wish to understand the
whys, the reasons,
of the nearness of taking/giving away
what soully belongs to you,
do your own sums,
admit your own truths,
query not the lives of others,
approach the mirror...

<•>

The Truth Burden
is the accursed need obligatory,
the sacred sanctity requisitioned,
when the whenever,
chooses to drop in and upflag the mailbox,
an uninvited invitation,
announcing with precise bluntness,
that precisely now,
is the tool crafted moment
and you fool,
the selected tool

you must render unto Ceaser,
by your own hand,
render your own rendering,
do your own undoing,
go forth and in haste,
will thyself into the cauldron of the
Great Mystery of Creation

you cannot lie in poetry

<•>

come, sit for awhile, in poet's nook,
soft pillows for our hard Adirondack chairs,
situe hard by the bay, if too hot, we'll slow
drift to the sun room of
lace curtains and suicide poems,
still we'll observe the water, the rabbits, the cacophony low,
listening to all the noisier, nosier
creatures asking themselves,
and the trees and leaves,
where did all those poets come from?

<•>

to the interior delve,
via brush or limb,
pen or music,
the exposition, the exploration,
the reconstruction of composing
one's self, creation and destruction
of your own myths

movement of arms and legs,
sparseness of simplicity,
subsidiaries of centricity,
tributaries of complexity

<•>

how cold are the carpenter's hands,
the weather, but an added obstacle,
this heat, makes dying different difficult,
the wood bearing cross requires additional nails
and flesh, for the extra load he's bearing,
when it snows blood in Jerusalem

the whole world can transition
when one man dies and another is risen,
where oh where lies then, the juxtaposition?

there is none, for man is man,
his divine spark, embedded,
to his maker's mark, welded and wedded,
neither snow or sun,
can ever extinguish

<•>

now I ken better distance 'tween
artist and art,
I, a workingman's
daily dallying in simplistic machine craft,
my works deservedly lost in
the water-falling
of the endless also rans

non-nebulous distances.between skies of
Oregon country blue and
the worldy worn asphalt grayed words of
a graying man aging,
then let clarity speak, in plainest harmony,
know my deference’s soars to the high above,
one of us at birth, god gifted,
was not I,
it ain't me babe, but
one of us, his tongue,
like Moses-stung
with a hot coal
of language's divinity

<•>

when your child comes out stillborn, they give you 24 hours with him.
24 hours of bleeding lips, 24 hours of fragile skin, 24 hours of cold toes.
they bring you food every three hours with the knowledge that you won't eat it, but the comfort of it there is.. sort of nice.
things like this aren't supposed to happen this far along is what they will whisper while they think you are sleeping
24 hours of he's getting colder, 24 hours of a lifeless, still rib cage, 24 hours of come on baby, just open your eyes for mommy.
making your way to the hospital, you hoped to come home with a bouncing blue boy but instead you come home to a cribless room.
they say it's easiest if people get rid of the reminders for you but his empty things are the only way i will ever feel whole.
then they start asking you the hard questions as if you didn't just press the button enough times to tame an ocean with waves full of guilt that will swallow your lungs.
24 hours of limp limbs and unreturned breathing patterns, 24 hours of there's some more flowers here for you, 24 hours of please just leave us alone.
we have 1 more hour together and your unresponsive nerves are growing colder. they made molds of your hands for me like they didn't know i would hold them forever.
we have 1 more hour together and the nurses will never be more apologetic in their whole lives than they are the moment they have to take a sleeping child from a mourning mother.
we have a little under an hour and as you wail, people watch from afar wondering if they'll ever be able to understand that sort of pain, the pain that makes you feel god has ripped your body open and left you for dead, the pain that makes you feel that this life really isn't worth living, the pain that there is no or might not be any god at all.
hours, minutes, seconds, days, time can't even begin to describe how long these panicky flashbacks of the moment they told me they found no heartbeat go on for.

Who shall praise the sour wheat?
We shall praise the sour wheat.
Who shall praise the stillbirth?
We shall praise the stillbirth.

We shall be grateful, yea; even for emptiness
And vacancy
For there is still another opposite, even to the
fullness of nothing down here-

We should be grateful even that we realize
there can be a 'nothing' instead of a 'something';
We should be glad-
Even the void here contains worlds of universes
While the echo there just goes on
past the unraveling edge of forever

I wrote to you in broad bold letters.
I wrote it on a tree.

You know the one, remember
—it called to us from the middle of the garden.

Sassafras: our secret token.

Winter's stillbirth is soon upon us,
and our placement in the sun in peril.

But I have whispered it all to stones
now ****** into the sea.

Remember the tree, and pray I live long enough to dream in its hollow.

I’m lying in fetal position, the bed is the womb.
I am nothing.
I do not exist yet.
I practice breathing.
Sharp in and out breaths.
Growing calmer. More fluid.
I feel myself forming, taking shape.
I do not exist yet.
In out in out in out in out in out.
I move oxygen. I stir the air.

Impregnated with uncertainty
Long overdue

Waiting on opportunity
My patience is subdued

Attempted abortions
With 4th trimester distortions
Stillbirth ensues

Screams inside the sirens
Struck with hospitalization
Bedridden doormen
Realization…

The time arrives
With labor pains
And liberation pangs

I cut the umbilical chains
Only a piece of me remains

I feel the guarantee
The time is now
I feel parturiency…

the ones warring on the flag of defeat can't be called either troll or parasite... too noble such entitlements, they are the **** genus worthy of ignorance, that they are found roaring on the flag of defeat, when such publicity is allowed of public musing deeper than soft-spoken in one's own room, as transcript of thought made public, ironically without one's geographic coordinates... and what lack of honour to be warring with such circumstances being allowed.

i shouldn't have written my words among poets,
too many simplicities surrounded them,
with the poets came made surrogates,
a stillbirth, if nothing more
9 months of **** as the new economics
that gave us appreciative homosexuality,
a curbing of the expeditions of population
we didn't blame on Chinese or Blue Indians
due to having inherited masochistic Christianity,
the last greek mythology, THE, LAST!
and no more from the greek tongue! no more!
then the second feat of the suffragettes
that became the surrogates...
and yet, i stilled braved to sing
for the escapist tongue of
brotherhood that *the misty mountain's cold
encapsulated... in which i braved
the brotherhood, every, second, counter,
to marriage to a woman...
domestication is no adventure! it's no adventure!
there is no fear and sudden death in
domestication... it breeds cattle! readied for
death not ready! two dungeons deep and caverns old...
the pines were roaring on the hight!
   the winds were mourning in the night...
the fire was red it flamed and spread,
the trees like torches, blazed with light.
this... this is my ideal afterlife! take your Koran
and terrorism and take a **** in the desert with
the cats for worth of knowing such "exquisiteness"
as it might be worth mining in the dunes of sand!
while the thirst of metalloid and abstract horse-tow
gives your false timing...
and when you take this anger written on the flag
of defeat, and turn to warring with it on your own
flag of defeat... you will be conquered,
slain and tortured, as is my promise, always
honourable.

His dead!

I suspect Nietzsche did it in morality with a book;

I suspect Platon did it in birth with stillbirth;

I suspect Machiavelli did it on Ruling with the ends to justify the means;

I suspect Darwin did it in Galápagos with birds;

I suspect Scientists did it in laboratories with stem cells;

I suspect Romans did it in Golgotha with a cross;

I suspect Jews did it in Gethsemane with Judas;

I suspect Christians did it in Spain with inquisition;

I suspect Muslims did in New York with a plane;

I suspect Adolf did it in Poland with gas;

I suspect Stalin did it in Siberia with gulags;

I suspect United states did it in Hiroshima with a bomb;

I suspect United nations did it in wars by looking away;

I suspect God did it in Heaven by suicide;

I suspect I did it here with a poem
I suspect You did it.

the middle life of hands

say poverty could possess a doll whose favorite and only outfit a schoolteacher mends while picturing

     two pieces of chalk which become the late life ******* of the ghost mother who cannot cradle the crucified yet travels to the many scenes of crucifixion to lade the Christ pale glove onto the hands men think they’ve touched.    



sibling talent

my sister rubs cigarette ash onto her palms.  her lips could kiss a mime and get away with it.  I can’t walk on my hands at night without having my father come home mid-day to find my mother on her knees scrubbing the kitchen floor with circus cloth.      




husk bearing*

the bath a baby pool for the barren.  I turn the knobs, hear nothing, and call to my mother.  call with *ma, and then ma again.  most made of one silence but she of two.  my right ear at the door and my other patient.  her knees sound like my father’s cheekbones.  the tears in them he says are shrapnel.  of course I don’t believe this.  when I wanted to paint my treehouse yellow mother straightened me and asked for stillbirth yellow.  then poverty yellow.  for another example you would have to believe my bout with chicken pox left a yellow basket stranded on the still river of my tongue.  

     listen.  the buzz on a delay

but bee
arrives.

She was gorgeous misery framed
in makeshift bandage corsets
cinched with fall from grace
sutured lace to save face
Her battered life rife with strife
covered in the mock elegance of
a broken wing dress as
the frenzies
in her enigmatic
mascara trail of tears glare
soften slow burn devotions  
hastening their hopeless necromantic
insurrection

He was a fatal attractive
midnight black feathered wraith
Modeling trouble need scar heart genes
and a bleedwork tainted warshirt
earned by tethering himself to a mistake on
countless battlefields
his enemies' rancorous fear resonates
in a crippled ripple
across stillbirth waters
With his outspoken outrage accented
by photographic violence
knowledge of immoral history charm and
disguised threat lodge wisdom
luring her into
their surprised allegory demise

In the here and now we find
uncaring torture chamber musicians
singing in the black ground
as these two scar-crossed lovers entangle  
in a shotgun wedding
and machine gun funeral
Knowing from the start
it would always be
the two of them
together as one
against the old world

Falling as recalcitrance of movement – seeks completion – yet the ground
   ballasts.
            There is no path that leads forward as I live backwards.
    There is poetry in the way
              a woman carrying a bilao moves away from the vicinity.
       Sound departs.
I took a deep drag and fell into a thick web
    of smoke, recoiled to fetal nature, into the womb of my unbecoming.

       What seems to contain endlessness: dark.
What punctuates this claim: moonlight.
      In a house that continuously aches,
I am grateful for windows.
                             Night-erased repeatedly, the dance of blades of grass.
       There is more stasis when words flay
                 themselves to pass as something more resolute than there is
     the kinesis of life’s steady abbreviations. We shorten like this,
                             when we curse the destinations upon movement’s mindless
                approval.

We collect ongoing afternoons
                         and cohere to trees. Say falling like you mean it,
     the way we commit to breaking though unwanted, feared.
                 Feel the hands accumulate warmth when propped
  into the sun’s permanent daze – face becomes glare,
                            a day becomes a scar.

This    is  where   I do  not know   what moves   to become fully   stationary.
     Days crumble like this.
   In a poem that is not a poem.
   In a sound that is only sound and not music.
     In a dance that is not life, but stillbirth.
   In notes that are purely rambling, not reportage.
     A voice that champions a fiasco.
                             This is where the   throbbing  afternoon becomes   a part
       of me    that falls   into   a chasm of   a fateful night,
                lassitude    of   debris in  tow,

                                       starting     measures  everywhere  we   left and   returned –

To watch with intent but not desire, his life passed
     him on as he tries to explain which one he
     would take to the afterlife if there is such,
like a convergence at the tip of the horizon or a
     humid evening in Pasay as pyrotechnics scrape
     sky fashioned like acrobats. The breeze he needs
     no longer. And then begins to disquiet the quiet
    with the heavy burden of which he will then forget
    when he starts to move all of a sudden in space,
       capitulating afterlife again if there is such,

 and if everything takes a sojourn into the bleakness, must I remind you that you are all
     variations of the same absence. Remember when
you had your name carved on wood as attendance
    but not for long. You have escaped, locked in the
       arms of a life that you thought was yours but
     still isn't, leashed under the Sun. Bodies pulse
  then fluctuate but not a sign of life. Words function
     more in stillbirth. Never forget, as a dandelion
     hovers and puts a smile on your dreary face,

and a question in search for all available and naked
    answers. Principles undermine caprice. Do not
 adhere. Must I remind you that you are
       someone else apart from who you think you are.
  You have yourself straightened, tucked safely
       like intent, not desire in all its voluminous and
     vehement speeches annotating something unknown
           to the behest of ourselves. If I were a house,
  I am gratified by windows -- your mirage there
       transfixed in a secluded spot, looking out
   brimming with life as curtains oscillate as the
      Earth breathes with you. If I were a house,
   you would ransack everything with a sly mouth
        packed with powerful narrative. How you
   have done over, leaving everything undone,
        moved off-tangent, under impossibly gray skies,
    brindled in prayer. If I were a house,
    
       doors slammed, speculative fabrications sleep
  through evenings and mornings until no difference
   is met -- you meant a word as if it had a lock
       and the key, somewhere cold in the air of
             sleuthing pains making me so, less than
     this and more of a fractured house.

As the night unfolds
its quietness,
and distance
is silenced,
and movement
is carpeted
into echoing
rumbles,

a sight unveils
all once blinded
by day light,
by the hazardous
ransom of rush,

and it appears
before me
what lays
within
a trap of sand,
breaking down
the bones of will,
grinding morrow
into the narrowness
of a held back
gesture,

it appears
before me,
naked
like a stillbirth,

my solitude.

Oh those bodies
on the museum walls
Tennessee Valley bodies and Los Alamos bodies
shining blackly like the stripe of a credit card.

The price of bread fixed at five cents
and we all eat it in slices.
Your name is your labour and
your labour your name.

I have disappeared into a country that doesn’t know me
and I am tearing it up with my teeth.

Oh those bodies
that were once slaves.
Were they pictured any other way
but in idyll or whipped dry?
The dusty Union regiments at Baton Rouge
have made a postcard of one scourged back;
they share it around and die for it.

I have a few postcards, too.
It is strange to see any man kneeling.

Oh those bodies
Cornbread bodies and bodies like a corn snake
crushed among the broad leaves of tobacco;
The ones in bone corsets and the ones
in reed baskets, floating downstream.
The ones in rosy marble and wrought bronze
the ones whose striped backs are coming out in wings
feathers pink and wet
like a new-hatched chick or a stillbirth.

Your body
is a tight machine of grief
packed into homespun like a fist
and relaxes in sepia as it never did in life,
a babe slung underarm and the food
only from cans; they keep the dust out.
Oh those bodies that tend the home, larder and ledger,
and reach for the high cabinets
and keep reaching.

The old voices are back at work.
I am not the one they are speaking to
but I hear them all the same.
They spread out a catalogue of wares
on a sisal blanket in the dark
and every price sounds fair, every garment lovely
unless you made it.

The country workman in bronze now and forever
with his rolled shirtsleeves; his body
raises a hammer and his bicep, mid-shiver
is always striking something, always building
Heaven, and Manhattan, from the foundations.
Stained glass his union flag
and Union Army blood he forgot or never knew.
The thin white arms of Andersonville,
meeting two generations hence, in his arms,
the dark scarred shoulders of the South.

Who brought forth upon the continent this new nation,
and who brought forth the ironclad Monitor
and who put into song the Maple Leaf Rag or Swanee River
and who put that soil there from which the cotton still grows
and who made your dress?
Who owes the debt and who records it?

You and I.

Oh those bodies swathed in light.
Oh those bodies becoming angels.
Bodies bound blackly
and bodies forgetting
which is what bodies do with injury:
they absorb, and they forget.

HIGHLIGHTS OF PRESCRIBING INFORMATION
These highlights do not include all the information needed to us e
M-M-R II safely and effectively. See full prescribing information
for M-M-R II.
M-M-R® II (Measles, Mumps, and Rubella Virus Vaccine Live)
Suspension for subcutaneous injection
Initial U.S. Approv al: 1978
-------------------------------INDICATIONS AND USAGE-------------------------------
M-M-R II is a vaccine indicated for active immunization for the
prevention of measles, mumps, and rubella in individuals 12 months of
age and older. (1)
-------------------------- DOSAGE AND ADMINISTRATION--------------------------
Administer a 0.5-mL dose of M-M-R II subcutaneously. (2.1)
• The first dose is administered at 12 to 15 months of age. (2.1)
• The second dose is administered at 4 to 6 years of age. (2.1)
------------------------DOSAGE FORMS AND STRENGTHS -----------------------
Suspension for injection (0.5-mL dose) supplied as a lyophilized
vaccine to be reconstituted using accompanying sterile diluent. (3)
---------------------------------- CONTRAINDICATIONS ----------------------------------
• Hypersensitivity to any componentof the vaccine. (4.1)
• Immunosuppression. (4.2)
• Moderate or severe febrile illness. (4.3)
• Active untreated tuberculosis. (4.4)
• Pregnancy. (4.5, 8.1)
-------------------------- WARNINGS AND PRECAUTIONS --------------------------
• Use caution when administering M-M-R II to individuals with a
history of febrile seizures. (5.1)
• Use caution when administering M-M-R II to individuals with
anaphylaxis or immediate hypersensitivity following egg ingestion.
(5.2)
• Use caution when administering M-M-R II to individuals with a
history of thrombocytopenia. (5.3)
• Immune Globulins (IG) and other blood products should not be
given concurrently with M-M-R II. (5.4, 7.2)
----------------------------------ADVERSE REACTIONS----------------------------------
See full prescribing information for adverse reactions occurring duri ng
clinical trialsor the post-marketing period. (6)
To report SUSPECTED ADVERSE REACTIONS, contact Merck
Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., at 1-8 7 7 -
888-4231 or VAERS at 1-800-822-7967 or www.vaers.hhs.gov.
-----------------------------------DRUG INTERACTIONS----------------------------------
• Administration of immune globulins and other blood products
concurrently with M-M-R II vaccine may interfere with the
expected immune response. (7.2)
• M-M-R II vaccination may result in a temporary depression of
purified protein derivative (PPD) tuberculin skin sensitivity. (7.3)
-------------------------- USE IN SPECIFIC POPULATIONS--------------------------
• Pregnancy: Do not administer M-M-R II to females who are
pregnant. Pregnancy should be avoided for 1 month following
vaccination with M-M-R II. (4.5, 8.1, 17)
See 17 for PATIENT COUNSELING INFORMATION and FDA
approv ed patient labeling.
Rev ised: 06/2020
FULL PRESCRIBING INFORMATION: CONTENTS
1 INDICATIONS AND USAGE
2 DOSAGE AND ADMINISTRATION
2.1 Dose and Schedule
2.2 Preparation andAdministration
3 DOSAGE FORMS AND STRENGTHS
4 CONTRAINDICATIONS
4.1 Hypersensitivity
4.2 Immunosuppression
4.3 Moderate or Severe Febrile Illness
4.4 Active Untreated Tuberculosis
4.5 Pregnancy
5 WARNINGS AND PRECAUTIONS
5.1 Febrile Seizure
5.2 Hypersensitivity to Eggs
5.3 Thrombocytopenia
5.4 Immune Globulins and Transfusions
6 ADVERSE REACTIONS
7 DRUG INTERACTIONS
7.1 Corticosteroids and Immunosuppressive Drugs
7.2 Immune Globulinsand Transfusions
7.3 Tuberculin Skin Testing
7.4 Use with Other Live Viral Vaccines
8 USE IN SPECIFIC POPULATIONS
8.1 Pregnancy
8.2 Lactation
8.4 Pediatric Use
8.5 Geriatric Use
11 DESCRIPTION
12 CLINICAL PHARMACOLOGY
12.1 Mechanism of Action
12.6 Persistence of Antibody Responses After Vaccination
13 NONCLINICAL TOXICOLOGY
13.1 Carcinogenesis, Mutagenesis, Impairment of Fertility
14 CLINICAL STUDIES
14.1 Clinical Efficacy
14.2 Immunogenicity
15 REFERENCES
16 HOW SUPPLIED/STORAGE AND HANDLING
17 PATIENT COUNSELING INFORMATION
Sections or subsections omitted from the full prescribing info rma tion
are not listed.
2
FULL PRESCRIBING INFORMATION
1 INDICATIONS AND USAGE
M-M-R® II is a vaccine indicated for active immunization for the prevention of measles, mumps, and
rubella in individuals 12 months of age and older.
2 DOSAGE AND ADMINISTRATION
For subcutaneous use only.
2.1 Dose and Schedule
Each 0.5 mL dose is administered subcutaneously.
The first dose is administered at 12 to 15 months of age. A second dose is administered at 4 to 6
years of age.
The second dose may be administered prior to 4 years of age, provided that there is a minimum
interval of one month between the doses of measles, mumps and rubella virus vaccine, live {1-2}.
Children who received an initial dose of measles, mumps and rubella vaccine prior to their first
birthday should receive additional doses of vaccine at 12-15 months of age and at 4-6 years of age to
complete the vaccination series [see Clinical Studies (14.2)].
For post-exposure prophylaxis for measles, administer a dose of M-M-R II vaccine within 72 hours
after exposure.
2.2 Preparation and Administration
Use a sterile syringe free of preservatives, antiseptics, and detergents for each injection and/or
reconstitution of the vaccine because these substances may inactivate the live virus vaccine. To
reconstitute, use only the diluent supplied with the vaccine since it is free of preservatives or other
antiviral substances which might inactivate the vaccine.
Withdraw the entire volume of the supplied diluent from its vial and inject into lyophilized vaccine vial.
Agitate to dissolve completely. Discard if the lyophilized vaccine cannot be dissolved.
Withdraw the entire volume of the reconstituted vaccine and inject subcutaneously into the outer
aspect of the upper arm (deltoid region) or into the higher anterolateral area of the thigh.
Parenteral drug products should be inspected visually for particulate matter and discoloration prior to
administration, whenever solution and container permit. Visually inspect the vaccine before and after
reconstitution prior to administration. Before reconstitution, the lyophilized vaccine is a light yellow
compact crystalline plug, when reconstituted, is a clear yellow liquid. Discard if particulate matter or
discoloration are observed in the reconstituted vaccine.
To minimize loss of potency, administer M-M-R II as soon as possible after reconstitution. If not used
immediately, the reconstituted vaccine may be stored between 36°F to 46°F (2°C to 8°C), protected from
light, for up to 8 hours. Discard reconstituted vaccine if it is not used within 8 hours.
3 DOSAGE FORMS AND STRENGTHS
M-M-R II vaccine is a suspension for injection supplied as a single dose vial of lyophilized vaccine to
be reconstituted using the accompanying sterile diluent [see Dosage and Administration (2.2) and How
Supplied/Storage and Handling (16)]. A single dose after reconstitution is 0.5 mL.
4 CONTRAINDICATIONS
4.1 Hypersensitivity
Do not administer M-M-R II vaccine to individuals with a history of hypersensitivity to any component
of the vaccine (including gelatin) {3} or who have experienced a hypersensitivity reaction following
administration of a previous dose of M-M-R II vaccine or any other measles, mumps and rubellacontaining vaccine. Do not administer M-M-R II vaccine to individuals with a history of anaphylaxis to
neomycin [see Description (11)].
4.2 Immunosuppression
Do not administer M-M-R II vaccine to individuals who are immunodeficient or immunosuppressed due
to disease or medical therapy. Measles inclusion body encephalitis {4} (MIBE), pneumonitis {5} and death
as a direct consequence of disseminated measles vaccine virus infection have been reported in
3
immunocompromised individuals inadvertently vaccinated with measles-containing vaccine. In this
population, disseminated mumps and rubella vaccine virus infection have also been reported.
Do not administer M-M-R II to individuals with a family history of congenital or hereditary
immunodeficiency, until the immune competence of the potential vaccine recipient is demonstrated.
4.3 Moderate or Severe Febrile Illness
Do not administer M-M-R II vaccine to individuals with an active febrile illness with fever >101.3F
(>38.5C).
4.4 Active Untreated Tuberculosis
Do not administer M-M-R II vaccine to individuals with active untreated tuberculosis (TB).
4.5 Pregnancy
Do not administer M-M-R II to individuals who are pregnant or who are planning on becoming
pregnant within the next month [see Use in Specific Populations (8.1) and Patient Counseling Information
(17)].
5 WARNINGS AND PRECAUTIONS
5.1 Febrile Seizure
There is a risk of fever and associated febrile seizure in the first 2 weeks following immunization with
M-M-R II vaccine. For children who have experienced a previous febrile seizure (from any cause) and
those with a family history of febrile seizures there is a small increase in risk of febrile seizure following
receipt of M-M-R II vaccine [see Adverse Reactions (6)].
5.2 Hypersensitivity to Eggs
Individuals with a history of anaphylactic, anaphylactoid, or other immediate reactions (e.g., hives,
swelling of the mouth and throat, difficulty breathing, hypotension, or shock) subsequent to egg ingestion
may be at an enhanced risk of immediate-type hypersensitivity reactions after receiving M-M-R II vaccine
.The potential risks and known benefits should be evaluated before considering vaccination in these
individuals.
5.3 Thrombocytopenia
Transient thrombocytopenia has been reported within 4-6 weeks following vaccination with measles,
mumps and rubella vaccine. Carefully evaluate the potential risk and benefit of vaccination in children
with thrombocytopenia or in those who experienced thrombocytopenia after vaccination with a previous
dose of measles, mumps, and rubella vaccine {6-8} [see Adverse Reactions (6)].
5.4 Immune Globulins and Transfusions
Immune Globulins (IG) and other blood products should not be given concurrently with M-M-R II [see
Drug Interactions (7.2)]. These products may contain antibodies that interfere with vaccine virus
replication and decrease the expected immune response.
The ACIP has specific recommendations for intervals between administration of antibody containing
products and live virus vaccines.
6 ADVERSE REACTIONS
The following adverse reactions include those identified during clinical trials or reported during postapproval use of M-M-R II vaccine or its individual components.
Body as a Whole
Panniculitis; atypical measles; fever; syncope; headache; dizziness; malaise; irritability.
Cardiovascular System
Vasculitis.
Digestive System
Pancreatitis; diarrhea; vomiting; parotitis; nausea.
Hematologic and Lymphatic Systems
Thrombocytopenia; purpura; regional lymphadenopathy; leukocytosis.
Immune System
Anaphylaxis, anaphylactoid reactions, angioedema (including peripheral or ****** edema) and
bronchial spasm.
Musculoskeletal System
Arthritis; arthralgia; myalgia.
4
Nervous System
Encephalitis; encephalopathy; measles inclusion body encephalitis (MIBE) subacute sclerosing
panencephalitis (SSPE); Guillain-Barré Syndrome (GBS); acute disseminated encephalomyelitis (ADEM);
transverse myelitis; febrile convulsions; afebrile convulsions or seizures; ataxia; polyneuritis;
polyneuropathy; ocular palsies; paresthesia.
Respiratory System
Pneumonia; pneumonitis; sore throat; cough; rhinitis.
Skin
Stevens-Johnson syndrome; acute hemorrhagic edema of infancy; Henoch-Schönlein purpura;
erythema multiforme; urticaria; rash; measles-like rash; pruritus; injection site reactions (pain, erythema,
swelling and vesiculation).
Special Senses — Ear
Nerve deafness; otitis media.
Special Senses — Eye
Retinitis; optic neuritis; papillitis; conjunctivitis.
Urogenital System
Epididymitis; orchitis.
7 DRUG INTERACTIONS
7.1 Corticosteroids and Immunosuppressive Drugs
M-M-R II vaccine should not be administered to individuals receiving immunosuppressive therapy,
including high dose corticosteroids. Vaccination with M-M-R II vaccine can result in disseminated disease
due to measles vaccine in individuals on immunosuppressive drugs [see Contraindications (4.2)].
7.2 Immune Globulinsand Transfusions
Administration of immune globulins and other blood products concurrently with M-M-R II vaccine may
interfere with the expected immune response {9-11} [see Warnings and Precautions (5.4)]. The ACIP has
specific recommendations for intervals between administration of antibody containing products and live
virus vaccines.
7.3 Tuberculin Skin Testing
It has been reported that live attenuated measles, mumps and rubella virus vaccines given individually
may result in a temporary depression of tuberculin skin sensitivity. Therefore, if a tuberculin skin test with
tuberculin purified protein derivative (PPD) is to be done, it should be administered before, simultaneously
with, or at least 4 to 6 weeks after vaccination with M-M-R II vaccine.
7.4 Use with Other Live Viral Vaccines
M-M-R II vaccine can be administered concurrently with other live viral vaccines. If not given
concurrently, M-M-R II vaccine should be given one month before or one month after administration of
other live viral vaccines to avoid potential for immune interference.
8 USE IN SPECIFIC POPULATIONS
8.1 Pregnancy
Risk Summary
M-M-R II vaccine is contraindicated for use in pregnant women because infection during pregnancy
with the wild-type viruses has been associated with maternal and fetal adverse outcomes.
Increased rates of spontaneous abortion, stillbirth, premature delivery and congenital defects have
been observed following infection with wild-type measles during pregnancy. {12,13} Wild-type mumps
infection during the first trimester of pregnancy may increase the rate of spontaneous abortion.
Infection with wild-type rubella during pregnancy can lead to miscarriage or stillbirth. If rubella infection
occurs during the first trimester of pregnancy, it can result in severe congenital defects, Congenital
Rubella Syndrome (CRS). Congenital rubella syndrome in the infant includes but is not limited to eye
manifestations (cataracts, glaucoma, retinitis), congenital heart defects, hearing loss, microcephaly, and
intellectual disabilities. M-M-R II vaccine contains live attenuated measles, mumps and rubella viruses. It
is not known whether M-M-R II vaccine can cause fetal harm when administered to pregnant woman.
There are no adequate and well-controlled studies of M-M-R II vaccine administration to pregnant
women.
5
All pregnancies have a risk of birth defect, loss or other adverse outcomes. In the US general
population, the estimated background risk of major birth defects and miscarriage in clinically recognized
pregnancies is 2% to 4% and 15% to 20%, respectively.
Available data suggest the rates of major birth defects and miscarriage in women who received
M-M-R II vaccine within 30 days prior to pregnancy or during pregnancy are consistent with estimated
background rates (see Data).
Data
Human Data
A cumulative assessment of post-marketing reports for M-M-R II vaccine from licensure 01 April 1978
through 31 December 2018, identified 796 reports of inadvertent administration of M-M-R II vaccine
occurring 30 days before or at any time during pregnancy with known pregnancy outcomes. Of the
prospectively followed pregnancies for whom the timing of M-M-R II vaccination was known, 425 women
received M-M-R II vaccine during the 30 days prior to conception through the second trimester. The
outcomes for these 425 prospectively followed pregnancies included 16 infants with major birth defects, 4
cases of fetal death and 50 cases of miscarriage. No abnormalities compatible with congenital rubella
syndrome have been identified in patients who received M-M-R II vaccine. Rubella vaccine viruses can
cross the placenta, leading to asymptomatic infection of the fetus. Mumps vaccine virus has also been
shown to infect the placenta {14}, but there is no evidence that it causes congenital malformations or
disease in the fetus or infant .
The CDC established the Vaccine in Pregnancy registry (1971-1989) of women who had received
rubella vaccines within 3 months before or after conception. Data on 1221 inadvertently vaccinated
pregnant women demonstrated no evidence of an increase in fetal abnormalities or cases of Congenital
Rubella Syndrome (CRS) in the enrolled women {15}.
8.2 Lactation
Risk Summary
It is not known whether measles or mumps vaccine virus is secreted in human milk. Studies have
shown that lactatingpostpartum women vaccinated with live attenuated rubella vaccine may secrete the
virus in breast milk and transmit it to breast-fed infants.{16,17} In the breast-fed infants with serological
evidence of rubella virus vaccine strain antibodies, none exhibited severe disease; however, one
exhibited mild clinical illness typical of acquired rubella.{18,19}
The developmental and health benefits of breastfeeding should be considered along with the mother’s
clinical need for M-M-R II, and any potential adverse effects on the breastfed child from M-M-R II or from
the underlying maternal condition. For preventive vaccines, the underlying maternal condition is
susceptibility to disease prevented by the vaccine.
8.4 Pediatric Use
M-M-R II vaccine is not approved for individuals less than 12 months of age. Safety and effectiveness
of measles vaccine in infants below the age of 6 months have not been established [see Clinical Studies
(14)]. Safety and effectiveness of mumps and rubella vaccine in infants less than 12 months of age have
not been established.
8.5 Geriatric Use
Clinical studies of M-M-R II did not include sufficient numbers of seronegative subjects aged 65 and
over to determine whether they respond differently from younger subjects.
11 Description
M-M-R II vaccine is a sterile lyophilized preparation of (1) Measles Virus Vaccine Live, an attenuated
line of measles virus, derived from Enders' attenuated Edmonston strain and propagated in chick embryo
cell culture; (2) Mumps Virus Vaccine Live, the Jeryl Lynn™ (B level) strain of mumps virus propagated in
chick embryo cell culture; and (3) Rubella Virus Vaccine Live, the Wistar RA 27/3 strain of live attenuated
rubella virus propagated in WI-38 human diploid lung fibroblasts. {20,21} The cells, virus pools,
recombinant human serum albumin and fetal bovine serum used in manufacturing are tested and
determined to be free of adventitious agents.
After reconstitution, each 0.5 mL dose contains not less than 3.0 log10 TCID50 (tissue culture infectious
doses) of measles virus; 4.1 log10 TCID50 of mumps virus; and 3.0 log10 TCID50 of rubella virus.
Each dose is calculated to contain sorbitol (14.5 mg), sucrose(1.9 mg), hydrolyzed gelatin (14.5 mg),
recombinant human albumin (≤0.3 mg), fetal bovine serum (<1 ppm), approximately 25 mcg of neomycin
and other buffer and media ingredients. The product contains no preservative.
6
12 CLINICAL PHARMACOLOGY
12.1 Mechanism of Action
M-M-R II vaccination induces antibodies to measles, mumps, and rubella associated with protection
which can be measured by neutralization assays, hemagglutination-inhibition (HI) assays, or enzyme
linked immunosorbent assay (ELISA) tests. Results from efficacy studies or effectivenes s studies that
were previously conducted for the component vaccines of M-M-R II were used to define levels of serum
antibodies that correlated with protection against measles, mumps, and rubella [see Clinical Studies (14)].
12.6 Persistence of Antibody Responses After Vaccination
Neutralizing and ELISA antibodies to measles, mumps, and rubella viruses are still detectable in 95-
100%, 74-91%, and 90-100% of individuals respectively, 11 to 13 years after primary vaccination. {22-28}
13 NONCLINICAL TOXICOLOGY
13.1 Carcinogenesis, Mutagenesis, Impairment of Fertility
M-M-R II vaccine has not been evaluated for carcinogenic or mutagenic potential or impairment of
fertility.
14 CLINICAL STUDIES
14.1 Clinical Efficacy
Efficacy of measles, mumps, and rubella vaccines was established in a series of double-blind
controlled trials. {29-34} These studies also established that seroconversion in response to vaccination
against measles, mumps and rubella paralleled protection. {35-38}
14.2 Immunogenicity
Clinical studies enrolling 284 triple seronegative children, 11 months to 7 years of age, demonstrated
that M-M-R II vaccine is immunogenic. In these studies, a single injection of the vaccine induced measles
HI antibodies in 95%, mumps neutralizing antibodies in 96%, and rubella HI antibodies in 99% of
susceptible individuals.
A study of 6-month-old and 15-month-old infants born to mothers vaccinated with a measles vaccine in
childhood, demonstrated that, following infant and toddler vaccination with Measles Virus Vaccine, Live
(previously US-licensed, manufactured by Merck), 74% of the 6-month-old infants developed detectable
neutralizing antibody titers while 100% of the 15-month-old infants vaccinated with Measles Virus
Vaccine, Live or M-M-R II vaccine developed neutralizing antibodies {39}. When the 6-month-old infants
of immunized mothers were revaccinated at 15 months with M-M-R II vaccine, they developed antibody
titers similar to those of toddlers who were vaccinated previously at 15-months of age.
15 REFERENCES
1. General Recommendations on Immunization, Recommendations of the Advisory Committee on Immunization Practices, MMWR
43(RR-1): 1-38, January 28, 1994.
2. Measles, Mumps, and Rubella — Vaccine Use and Strategies for Elimination of Measles, Rubella, a n d Co n g e nita l Ru b e lla
Syndrome and Control of Mumps: Recommendations of the Advisory Committee on Immunization Practice s (ACIP), M M WR
47(RR-8): May 22, 1998.
3. Kelso, J.M.; Jones, R.T.; Yunginger, J.W.: Anaphylaxis to measles, mumps, and rubella vaccine mediated by IgE to gel atin , J.
Allergy Clin. Immunol. 91: 867-872, 1993.
4. Bitnum, A.; et al: Measles Inclusion Body Encephalitis Caused by the Vaccine Strain of Measles Virus. Cl i n . In fect. Di s. 2 9 :
855-861, 1999.
5. Angel, J.B.; et al: Vaccine Associated Measles Pneumonitis in an Adult with AIDS. Annals of Internal Medicine, 129: 1 0 4 -1 06 ,
1998.
6. Cecinati V, et al. Vaccine administration and the development of immune thrombocyto pe ni c p urp u ra i n ch i ld re n. Hu m an
Vaccines & Immunotherapeutics 9:5, 2013.
7. Mantadakis E, Farmaki E, Buchanan GR. Thrombocytopenic Purpura after Measles-Mumps-Rubella Vaccination: A Systematic
Review of the Literature and Guidance for Management. J Ped 156(4): 2010.
8. Andrews N, Stowe J, Miller E, Svanstrom H, Johansen K, Bonhoeffer J, et al. A collaborative approach to investigating th e ri sk
of thrombocytopenic purpura after measles-mumps-rubella vaccination in England and Denmark. Vaccine. 2012;30:3042‐6.
9. Rubella Prevention: Recommendation of the Immunization Practices Advisory Committee (ACIP), MM WR 3 9 (RR-1 5 ): 1 -1 8 ,
November 23, 1990.
7
10. Peter, G.; et al (eds): Report of the Committee on Infectious Diseases, Twenty-fourth Edition, American Academy of Pediatri cs,
344-357, 1997.
11. Measles Prevention: Recommendations of the Immunization Practices Advisory Committee (ACIP), MMWR 38(S-9): 5-22,
December 29, 1989.
12. Eberhart-Phillips, J.E.; et al: Measles in pregnancy: a descriptive study of 58 cases. Obstetrics and Gynecology, 82(5): 797-801,
November 1993.
13. Jespersen, C.S.; et al: Measles as a cause of fetal defects: A retrospective study of ten measles epidemics in Greenland. Acta
Paediatr Scand. 66: 367-372, May 1977.
14. Yamauchi T, Wilson C, Geme JW Jr. Transmission of live, attenuated mumps virus to the hu m a n p l ace n ta . N En g l J M e d .
1974;290(13):710‐712.
15. Rubella Vaccination during Pregnancy —United States, 1971-1988. JAMA. 1989;261(23):3374–3383.
16. Losonsky, G.A.; Fishaut, J.M.; Strussenber, J.; Ogra, P.L.: Effect of immunization against rubella on lactation products. II.
Maternal-neonatal interactions, J. Infect. Dis. 145: 661-666,1982.
17. Losonsky, G.A.; Fishaut, J.M.; Strussenber, J.; Ogra, P.L.: Effect of immunization against rubella on lactation products. I.
Development and characterization of specific immunologic reactivity in breast milk, J. Infect. Dis. 145: 654-660, 1982.
18. Landes, R.D.; Bass, J.W.; Millunchick, E.W.; Oetgen, W.J.: Neonatal rubella following postpartum maternal i mm un izatio n , J.
Pediatr. 97: 465-467, 1980.
19. Lerman, S.J.: Neonatal rubella following postpartum maternal immunization, J. Pediatr. 98: 668, 1981. (Letter)
20. Plotkin, S.A.; Cornfeld, D.; Ingalls, T.H.: Studiesof immunization with living rubella virus: Trialsin children with a strain culture d
from an aborted fetus, Am. J. Dis. Child. 110: 381-389, 1965.
21. Plotkin, S.A.; Farquhar, J.; Katz, M.; Ingalls, T.H.: A new attenuated rubella virus grown in human fi bro b la sts: Evi d e n ce fo r
reduced nasopharyngeal excretion, Am. J. Epidemiol. 86: 468-477, 1967.
22. Weibel, R.E.; Carlson, A.J.; Villarejos, V.M.; Buynak, E.B.; McLean, A.A.; Hilleman, M.R.: Clinical and Labo ra tory Stu d ie s o f
Combined Live Measles, Mumps, and Rubella Vaccines Using the RA 27/3 Rubella Virus, Proc. So c. Exp . Bi ol. M e d. 1 6 5 :
323-326, 1980.
23. Watson, J.C.; Pearson, J.S.; Erdman, D.D.; et al: An Evaluation of Measles RevaccinationAmong School-Entry Age Ch i ld re n,
31st Interscience Conference on Antimicrobial Agents and Chemotherapy, Abstract #268, 143, 1991.
24. Unpublished data from the files of Merck Research Laboratories.
25. Davidkin, I.; Jokinen, S.; Broman, M. et al.: Persistence of Measles, Mumps, and Rubella Antibodies in a n M M R -Va ccina ted
Cohort: A 20-Year Follow-up, JID 197:950–6, April 2008.
26. LeBaron, W.; Beeler J.; Sullivan, B.; et al.: Persistence of Measles Antibodies After 2 Doses of Measles Vaccine in a
Postelimination Environment, Arch Pediatr Adolesc Med. 161:294-301, March 2007.
27. LeBaron, C.; Forghani, B.; Beck, C. et al.: Persistence of Mumps Antibodies after 2 Doses of Measles-Mumps-Rubella Vaccine,
JID 199:552– 60 , February 2009.
28. LeBaron, W.; Forghani, B.; Matter, L. et al.: Persistence of Rubella Antibodies after 2 Doses of Measles-Mumps-Rubella
Vaccine, JID 200:888–99, September 2009.
29. Hilleman, M.R.; Buynak, E.B.; Weibel, R.E.; et al: Development and Evaluation of the Moraten MeaslesVirusVa cci n e , JAM A
206(3): 587-590, 1968.
30. Weibel, R.E.; Stokes, J.; Buynak, E.B.; et al: Live, Attenuated Mumps Virus Vaccine 3. Clinical and Serologic Aspects in a Fiel d
Evaluation,N. Engl. J. Med. 276: 245-251, 1967.
31. Hilleman, M.R.; Weibel, R.E.; Buynak, E.B.; et al:Live, Attenuated Mumps VirusVaccine 4. ProtectiveEfficacy as Measure d i n
a Field Evaluation, N. Engl. J. Med. 276: 252-258, 1967.
32. Cutts, F.T.; Henderson, R.H.; Clements, C.J.; et al: Principles of measles control, Bull WHO 69(1): 1-7, 1991.
33. Weibel, R.E.; Buynak, E.B.; Stokes, J.; et al: Evaluation Of Live Attenuated Mumps Virus Vaccine, Strain Jeryl Lynn, First
International Conference on VaccinesAgainst Viral and Rickettsial Diseases of Man, World Health Organization, No. 147, M a y
1967.
34. Leibhaber, H.; Ingalls, T.H.; LeBouvier, G.L.; et al: Vaccination With RA 27/3 Rubella Vaccine, Am. J. Dis. Child. 123: 133-1 3 6,
February 1972.
35. Rosen, L.: Hemagglutination and Hemagglutination-Inhibition with Measles Virus, Virology 13: 139-141, January 1961.
36. Brown, G.C.; et al: Fluorescent-Antibody Marker for Vaccine-Induced Rubella Antibodies, Infection and Immunity 2(4): 360-363,
1970.
8
37. Buynak, E.B.; et al: Live Attenuated Mumps Virus Vaccine 1. Vaccine Development, Proceedings of the Society for
Experimental Biology and Medicine, 123: 768-775, 1966.
38. Hilleman M.R., Studies of Live Attenuated Measles Virus Vaccine in Man: II. Appraisal of Efficacy. Amer. J. o f Pu b l ic He a lth ,
52(2):44-56, 1962.
39. Johnson, C.E.; et al: Measles Vaccine Immunogenicity in 6- Versus 15-Month-Old Infants Born to Mothers in the Measles
Vaccine Era, Pediatrics, 93(6): 939-943, 1994.
16 HOW SUPPLIED/STORAGE AND HANDLING
No. 4681 ⎯ M-M-R II vaccine is supplied as follows:
(1) a box of 10 single-dose vials of lyophilized vaccine (package A), NDC 0006-4681-00
(2) a box of 10 vials of diluent (package B)
Exposure to light may inactivate the vaccine viruses.
Before reconstitution, refrigerate the lyophilized vaccine at 36°F to 46°F, (2°C to 8°C).
Store accompanying diluent in the refrigerator with the lyophilized vaccine or separately at room
temperature (68° to 77°F, 20° to 25°C). Do not freeze the diluent.
Administer M-M-R II vaccine as soon as possible after reconstitution. If not administered immediately,
reconstituted vaccine may be stored between 36°F to 46°F (2°C to 8°C), protected from light, for up to 8
hours. Discard reconstituted vaccine if it is not used within 8 hours.
For information regarding the product or questions regarding storage conditions, call 1-800-
MERCK-90 (1-800-637-2590).
17 PATIENT COUNSELING INFORMATION
Advise the patient to read the FDA-approved patient labeling (Patient Package Insert).
Discuss the following with the patient:
• Provide the required vaccine information to the patient, parent, or guardian.
• Inform the patient, parent, or guardian of the benefits and risks associated with vaccination.
• Question the patient, parent, or guardian about reactions to a previous dose of M-M-R II vaccine
or other measles-, mumps-, or rubella-containing vaccines.
• Question females of reproductive potential regarding the possibility of pregnancy. Inform female
patients to avoid pregnancy for 1 month following vaccination [see Contraindications (4.5) and
Use in Specific Populations (8.1)].
• Inform the patient, parent, or guardian that vaccination with M-M-R II may not offer 100%
protection from measles, mumps, and rubella infection.
• Instruct patients, parents, or guardians to report any adverse reactions to their health-care
provider. The U.S. Department of Health and Human Services has established a Vaccine
Adverse Event Reporting System (VAERS) to accept all reports of suspected adverse events
after the administration of any vaccine, including but not limited to the reporting of events required
by the National Childhood Vaccine Injury Act of 1986. For information or a copy of the vaccine
reporting form, call the VAERS toll-free number at 1-800-822-7967, or report online at
https://www.vaers.hhs.gov.
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as linking clouds and earth
as still life on canvas
born of stillbirth
is still us

Trembling…
the burning coal has gone to sleep,
before igniting the dry grass.

Eye to eye colliding
turning you into ophelian mess.
Light had gone back to black matter.

It was a frisk season―
in sick society. The hidden plaques
have come out in the blood stream.

You are now backtracking
on the uphill, ready to fall
from the green heights to connect with ground.

For keepsake I will
again unwrite the book
not mentioning the stillbirth of freedom.

A king withdraws into his castle
his eyes drawn out while sitting on the throne
now I'm not a king I'm just an *******
but I do know what it's like to sit at home
not knowing what's going on
a court jester growing con
shows I don't belong
to the awaiting bombs
so I move along.

I need time
and space
I'll wait in line
there's no race
just a loss of grace
that needs to be replaced
this isn't ideal
but I need to heal
from the hamster wheel
of ample feels
like despair over what went wrong
shame which is my only law
pain is there and is raw
so I withdraw
like a sick fawn
without its skinned mom.

The doors to my eyes are shut
as long as I'm stuck
in this lousy rut
building walls of muck
as blinders for a buck
who isn't racing
only running
from those chasing
and gunning
but there's no way to dispel
Satan himself
a turtle withdraws into its shell
laying precariously on the freeway
it knows what awaits is hell
but it can't peel away
because it sees a way
it can be in play.

Seasons slink
I need to think
while on the brink
of an overcast downfall
I put up a sound wall
to ignore the ground's call
asking me to withdraw
into its halls
where I'd switch all
the things I've acquired in life
for eternal night
an infernal fight
to do what's right
and keep the damage inner
temptation says come hither
that wily wyvern
always gives burns
but I never will learn
that my plans of stillbirth
cause a fiery chill hurt.

I'm in a delicate state
and need to deflate
no need to debate
please for my sake
give me a break
I need to escape
the chaos
in which I'm way lost
like the sky that is grey glossed
and the ground made of clay frost
we all have the same boss
whose favorite move is a flame toss.

The withdraw gets worse
turning into a curse
I'm living in a hearse
willing to see the dirt
I feel it flirt
beckoning me to my reckoning
everyone else is seconding
that motion
so I withdraw into an ocean
made entirely of land
the soil I scan
only to find desert sand
passing through my hands
to show I'm ******.

Time goes by
as withdrawn I
had delusions I could fly
they were just withdrawn lies
to make me try
despite belonging on the ground
completely covered by the color brown
with a scent that could gag a hound
so when I finally look around
no one is there
they've withdrawn into pairs
making me stop and stare
yearning for tender care
so I shoot a flare
into the air
but it withdraws back into my gun
like the blacked out sun
telling me I'm done
and the withdraw won.

[notes from life under bell]

(i)

on video my cousin is singing a song she’s learned by heart. she’s maybe four. I don’t know where to begin. this pond behind her, perhaps? that in my memory is the size of a fire pit. or maybe, here, in the darkening sameness of those sentences strung together by cows. or years from now, even, with the word no and her sister’s lookalike being assaulted by an only child in a library of fragile non-fiction. my cousin is singing a song she’s learned by heart. she’s five. a careful six. sound’s fossil. no city half-imagined. no insect obsessed with privacy. time matters to the frog we catch.

~

(ii)

there are days he is the son of muscle memory and funny bone. days his hands are gloves from a small god. poor god, he says, and grows. days he can carry a circle to any clock in the town of hours. days his past can be heard by his siblings- you’re beautiful the way you are. days his blood pushes a bread crumb through his thigh. days his scar is a raft for ear number three. nights his brain / the separation of church and church.

~

(iii)

violence is a dreamer. a boy on a stopped bus is dared to eat a worm. it feels authentic. alas, there is no worm. the devil knows to stay pregnant. word spreads about the girl without a tongue. cricket lover. and then, bulimic, when she won’t sneeze.

~

(iv)

the mother of your hand is smashing spiders with her wrist. we have a high-chair for every creature that eats its own hair. the twins in the attic have switched diapers. skeptics. voices heard by the ghost of my stomach.

~

(v)

it is snowing the first time my daughter drives alone. Ohio is cruel. stillbirth, old four-eyes. you want them to like you. the insects you save.

~

(vi)

a lawnmower starts then dies then is pushed by a noisemaker past fog’s dark church.  an unprepared prophet drinks the milk meant for baby eyesore.  my sister loses most of her hair putting together a puzzle of her mouth.  a bomb is dropped on a bomb.                

~

(vii)

the man his shadow and the woman her dream.  

their child
its track
of time

~

(viii)

onstage a dog barks at an empty stroller.  the mosh pit is weak.  last count had three pregnant, three resembling the man who unplugged my father, and two praying for the inner life of a hole.  onstage a boy is holding up a kite for another boy to punch.  dog’s been tased.

~

(ix)

we put a museum on the moon. I had all my dreams at once. a mouse was wrapped in a washcloth then crushed with the songbook of baby hairless. fire treats grass like fire.

~

(x)

outside the bathroom’s designer absence, our melancholy impressed by symbolism, we form

a line

~

(xi)

tree: the unbathed statue of your screaming

shade: the folder of my clothes

~

(xii)

praying he’ll see again them cows of lake suicide, the handcuffed frog shepherd

prays he’ll see again them cows of lake suicide    

~

(xiii)

a body to dry my blood.  some god

seeing me
as a person…  

how quickly birth gets old.  

~

(xiv)

lonelier than creation, I have nothing on trauma.  genetically speaking, I don’t think anybody expected us to spend so much time on one idea.  this open umbrella.  ghost at the keyboard.

~

(xv)

and in the spacecraft where a mother diapers the doll that makes her fat there plays the voice of god asking for a film crew none will miss

~

(xvi)

we wore clothes as an apology for being nearby.  a door was a door.  a ghost was a ghost and a door.  the house was possible.  its rooms were not.  baby was a body spat from the mouth of any creature dreaming of a bathtub.  I got this lifejacket from a scarecrow.  said the redheaded tooth fairy.

~

(xvii)

his baby is wailing in its crib for its mother and he mans you up for a cigarette and blows on the baby’s face and somewhere you yourself have stopped crying as you are pulled from a pile of leaves by two people made of smoke

~

(xviii)

for a spine, doll prays to fork.    

all kinds
of shapes
miscarry.

~

(xix)

one day my son is dying, the next he is not, and the next he is.  day four:  prayer is dismissive, but welcome.  whose past is how we left it?  body is delivered twice.  beginning and end.  nostalgia and wardrobe.  middle eats everything.  it snowed and I thought my blood was melting.  could be the way you reason that happens for a reason.  I was a kid when mouse was a kid.  there’s no hope and I hope.  

-

my son’s weight is a cricket on a piano key.  it’s more than I can handle that god gave us god.      

-

aside:  we don’t come out faking our death, but are born because birth can’t sleep

-

aside:

I study lullaby
and lullaby
bruise    

-

it takes four juveniles to recruit his thumb.  his fist has been called:  hitchhiker practicing yoga in a junkyard.  I cannot visit the instant ruin that forgiveness creates.

-

sickness in the young is god’s way of preventing nostalgia from becoming the god I remember

-

I was beautiful but now I’m ugly. (now) being the most recognizable symbol of the present. this is the silence I speak of. my son says (more ball) and you hear (moon bone). he is very sick. his moon has bones.

-

the disappearance surrounding said event.  a horse belly-up in water’s blood.  see telescope.  also, cane of the blind ghost. magician, maybe, on a rabbitless moon- oh cure.  

oh silence afraid to start a sentence.  

-

in the photograph a fist is cut from, a kneeling family of five is putting to bed

the unremembered
present.  

-

traced, perhaps, for a terrible circle-

today was mostly your hand.

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~



NOTES FROM LIFE UNDER BELL

(i)

on video my cousin is singing a song she’s learned by heart. she’s maybe four. I don’t know where to begin. this pond behind her, perhaps? that in my memory is the size of a fire pit. or maybe, here, in the darkening sameness of those sentences strung together by cows. or years from now, even, with the word no and her sister’s lookalike being assaulted by an only child in a library of fragile non-fiction. my cousin is singing a song she’s learned by heart. she’s five. a careful six. sound’s fossil. no city half-imagined. no insect obsessed with privacy. time matters to the frog we catch.

~

(ii)

there are days he is the son of muscle memory and funny bone. days his hands are gloves from a small god. poor god, he says, and grows. days he can carry a circle to any clock in the town of hours. days his past can be heard by his siblings- you’re beautiful the way you are. days his blood pushes a bread crumb through his thigh. days his scar is a raft for ear number three. nights his brain / the separation of church and church.

~

(iii)

violence is a dreamer. a boy on a stopped bus is dared to eat a worm. it feels authentic. alas, there is no worm. the devil knows to stay pregnant. word spreads about the girl without a tongue. cricket lover. and then, bulimic, when she won’t sneeze.

~

(iv)

the mother of your hand is smashing spiders with her wrist. we have a high-chair for every creature that eats its own hair. the twins in the attic have switched diapers. skeptics. voices heard by the ghost of my stomach.

~

(v)

it is snowing the first time my daughter drives alone. Ohio is cruel. stillbirth, old four-eyes. you want them to like you. the insects you save.

~

(vi)

a lawnmower starts then dies then is pushed by a noisemaker past fog’s dark church. an unprepared prophet drinks the milk meant for baby eyesore. my sister loses most of her hair putting together a puzzle of her mouth. a bomb is dropped on a bomb.

~

(vii)

the man his shadow and the woman her dream.

their child
its track
of time

~

(viii)

onstage a dog barks at an empty stroller. the mosh pit is weak. last count had three pregnant, three resembling the man who unplugged my father, and two praying for the inner life of a hole. onstage a boy is holding up a kite for another boy to punch. dog’s been tased.

~

(ix)

we put a museum on the moon. I had all my dreams at once. a mouse was wrapped in a washcloth then crushed with the songbook of baby hairless. fire treats grass like fire.

~

(x)

outside the bathroom’s designer absence, our melancholy impressed by symbolism, we form

a line

~

(xi)

tree: the unbathed statue of your screaming

shade: the folder of my clothes

~

(xii)

praying he’ll see again them cows of lake suicide, the handcuffed frog shepherd

prays he’ll see again them cows of lake suicide

~

(xiii)

a body to dry my blood. some god

seeing me
as a person…

how quickly birth gets old.

~

(xiv)

lonelier than creation, I have nothing on trauma. genetically speaking, I don’t think anybody expected us to spend so much time on one idea. this open umbrella. ghost at the keyboard.

~

(xv)

and in the spacecraft where a mother diapers the doll that makes her fat there plays the voice of god asking for a film crew none will miss

~

(xvi)

we wore clothes as an apology for being nearby. a door was a door. a ghost was a ghost and a door. the house was possible. its rooms were not. baby was a body spat from the mouth of any creature dreaming of a bathtub. I got this lifejacket from a scarecrow. said the redheaded tooth fairy.

~

(xvii)

his baby is wailing in its crib for its mother and he mans you up for a cigarette and blows on the baby’s face and somewhere you yourself have stopped crying as you are pulled from a pile of leaves by two people made of smoke

~

(xviii)

for a spine, doll prays to fork.

all kinds
of shapes
miscarry.

~

(xix)

one day my son is dying, the next he is not, and the next he is. day four: prayer is dismissive, but welcome. whose past is how we left it? body is delivered twice. beginning and end. nostalgia and wardrobe. middle eats everything. it snowed and I thought my blood was melting. could be the way you reason that happens for a reason. I was a kid when mouse was a kid. there’s no hope and I hope.

–

my son’s weight is a cricket on a piano key. it’s more than I can handle that god gave us god.

–

aside: we don’t come out faking our death, but are born because birth can’t sleep

–

aside:

I study lullaby
and lullaby
bruise

–

it takes four juveniles to recruit his thumb. his fist has been called: hitchhiker practicing yoga in a junkyard. I cannot visit the instant ruin that forgiveness creates.

–

sickness in the young is god’s way of preventing nostalgia from becoming the god I remember

–

I was beautiful but now I’m ugly. (now) being the most recognizable symbol of the present. this is the silence I speak of. my son says (more ball) and you hear (moon bone). he is very sick. his moon has bones.

–

the disappearance surrounding said event. a horse belly-up in water’s blood. see telescope. also, cane of the blind ghost. magician, maybe, on a rabbitless moon- oh cure.

oh silence afraid to start a sentence.

–

in the photograph a fist is cut from, a kneeling family of five is putting to bed

the unremembered
present.

–

traced, perhaps, for a terrible circle-

today was mostly your hand.





WE BROUGHT HOME THE WRONG DYING BABY



I ain’t been talked to in so long my wife’s kid thinks I have amnesia. ain’t been touched since Ohio’s ramshackle symbolism swallowed up some ***** donor’s shadow. I went yesterday to a funeral for a woman’s ear. told people what I was wearing was a bedsheet belonged to the man in the moon. told myself I had this microscope could see a ghost and that I’ve only ever lost an empty house. I don’t know how old I am but I know what year I want it to be. before dying I saw it flash how I should have died. low creature. tugboat.

~~~

father an optometrist inspecting a replica of a totem pole and mother an eel collapsing at the thought of a play performed in a stone.

and there, at the bottom of grief, a cup of dirt with nothing to bury.

~~~

mother is chewing gum like something fell asleep in my mouth. I say dog for both dog and puppy. pray for things I know will happen. a rooster through a windshield. a dried-up toad in a deep footprint.

~~~

mother and father give their word that all narrators are orphans. that blood is a short leash. sometimes, a fence. be, they say, the symbol your god remembers you by. tell your brother to act like a chicken. your stickmen to share a toothache.

~~~

I saw a cigarette with its mouth open. today was hard. hate is amazing.

god will die with his ear on my stomach.

~~~

the darkness has many stomachs and we’ve no one to tell my son he’s lonely.

seller of the disappearing stone, the mouth names everything and is born after eating a blindfold.

~~~

for desperation, boy puts a bird in a hand puppet. here a finger and there a worm, sadness has no family. oh fetus my moth of many colors. oh mosquito that bit an angel. time with my son

in scenario’s territory.

~~~

atavism
(god is someone’s calendar

–

valley
(a girl with a marble who answers to overdose

–

pulpit
(rooster ghosted by elevator

–

subculture
(in my years with the poor, I wrote nothing down

–

alpenglow
(the scalp will baby its grief

~~~

on muscle detail, the clapping boy from the cult of thunder brings a wheelchair to the last rocking horse known to model swimwear for the few dolls that remain married to the same mask. the boy is weak but maybe he puts two words together. like ghost

and exodus. for the second coming of the handcuffed animal.

~~~

the boy picking flowers for my shadow loves no one. everything I touch remembers being my hand. the world has ended, or started early. god’s heartbeat. sound’s watermark.

~~~

because her son can see the future, she is not yet born. god matters to the discovered.

~~~

overtook no cigarette. surprised no sleep. keyed the car

of a minor
toymaker.

radar is getting possessive.

~~~

for the gone and for the nearly, brother has the same stick.

I call belly
what he calls
eye
what answers
to limb

~~~

to speak
it needs gum
from the invisible
purse.

comes with everything. cries like me.

~~~

she says
three times
the word
brain
to her stomach’s
blue
mirror
and scores
sight’s wardrobe
of rags
in earworm’s
dream

~~~

there’s a comb
in my narrative, a goldfish

coming to
in a beheaded
angel

it is snowing the first time my daughter drives alone. Ohio is cruel. stillbirth, old four-eyes. you want them to like you. the insects you save.

A dynamic ****,
when you start crystal―
gazing.

Were you a participant
of an organized
**** of the planet?

Your roots drop,
as you gamble with the
change of coins. It would
become a stillbirth,
of a seaisle.

Telling lies has become
a lucrative job.
Are you going to buy immortality,
in the bazaar of bazookas?

The blast cells were
rising. There was intense
pain in my thighs. Blood
was turning white.

one day the sovereign self
will dissolve away,
iron clockwork oxidized already.

all is heavy when there's a song to play
that'll annoy the **** out
of everyone in the room,
but you love it as it is.
you love that pregnant awkwardness,
the thoughts on the moment,
the contractions,
the stillbirth,
the flowers in nice vases by the bedside.

I always go there.
it all always goes there.