December 12, 2011

Birthday blues

It's my birthday tomorrow.  I will be two dozen years old.

Exams have exhausted me so much and we've only had one so far.

I feel like bawling.

All I want is to go home.

December 2, 2011

Où est-ce ?

Je cherche quelque chose.  Ce que je cherche, je ne sais pas.  La douleur me pique au côté des yeux, un oiseau qui ne trouve pas le ver.  J’ai l’impression d’avoir perdu quelque chose éphémère.  Il s’agit d’un amour qui peut-être n’existait que dans mon esprit, qui peut-être n’existait que dans mon cœur.  Pourquoi nous ne parlons jamais des idées ?  Pourquoi nous ne parlons jamais de la vie réelle ?  Nos conversations ne font rien que s’encercler, s’occuper de bêtises ou d’autres bons mots.  Dois-je être condamnée pour la naïveté, pour le désire d’être aimée ? N’est-ce pas la raison d’être ? Aimer et soit aimée de son tour ?  Tu me manques.  T’es là mais tu me manques quand même.

Dois-je trouver un autre ?  Dois-je t’attendre ?  Est-ce que c’est toi qui me manque, ou est-ce que c’est la personne dans l’imagination ? 

November 30, 2011

Today is what day, again?

It's almost December.  Where does the time go?

It's been two years to the day that I've been a vegetarian who occasionally eats fish.

It's been slightly less than two years since I was accepted to medical school.

It's been almost six years since I was accepted to college.

It's been five and a half months since Gammy passed away.

It was my mother's birthday yesterday, which means that my birthday is in two weeks.

November was different from what I expected.  Somehow, the time went very quickly and I have no idea where it was spent.  I used a lot more of my time for studying, and what little extra time I had afterwards I let my brain relax with plenty of TV watching.  A few times I could literally feel my brain relax, the way a muscle you've held tight sort of melts away when you release the tension.

November just felt weird.

Here's to hoping December feels better, and to hoping that the new year brings all sorts of amazing things.

November 2, 2011

Crazy ideas

Here we go again.

All right, NaNoWriMo, I'll give it a whirl.  But this time, no literary dreams.  I'm going to write what I know best--a good ol' fashioned bodice-ripper.

October 14, 2011

Invincible summer

I had been feeling so awful lately. Truly crummy--down in the dumps, overwhelmed with school and family issues and social problems--to the point where I was starting to feel like every psych lecture was about me (not in an ideas of reference kind of way).

I went and spoke to someone about it on Tuesday, and I've been feeling light and airy ever since. It's as if a weight I didn't know was there had been lifted up and has been borne away, to the point where, though I was ready for bed half an hour ago, I found myself thinking, "I am ready to write again."

This quote by Camus has shown up in my life several times recently, serendipitously: in my friend's blog here and on pinterest (a dangerous time-sink of a website full of beautiful things and fun craft ideas and cool stuff) as a tattoo, and the more I repeat it, like a mantra it has grown to feel true.

Au milieu de l'hiver, j'ai découvert en moi un invincible été. {Camus, La Chute}

October 5, 2011

Warning shot

Today, we practiced delivering bad news.

We went through an example in class, saw a video of a woman telling her patient that he has cancer.  When we practiced in our small group sessions, the patient had died and our task was to tell the spouse.

It's odd, the way that we beginners practice.  We all worked from a script, a set formula, a conversational form letter involving "warning shots" and "plain, layman's terms" and silence.  We used the same phrases, each of us:

"I'm so sorry that this happened."
"We did everything we could."
"Is there someone else you would like to be here?"
"I'll give you some time, but I'll be back in a few minutes."
"Do you have any questions for me?"

In the evaluation, the woman I delivered the news to played her part well.  She was a newly-widowed mother of two, and of course her concern went immediately to her children.

I couldn't help but think of Dad.  This whole session, I kept remembering the day he died, the way I remember time as very nebulous, how I don't quite remember how long after I called 911 that my mom came back home, that I don't remember how long it took for the middle school principal to drive Ben home, that I only remember seeing him there in the front hallway, Mom kneeling at his head, surrounded by EMTs despite the DNR, despite his being at home on hospice; I only remember that I hadn't known what to do except do what they show on TV, which is call 911.  Looking back, I wonder who called the school?  How did the principal decide to bring Ben home?  What did they tell him on the car ride?

My evaluation session ended positively.  My actor/doctor said that she had "felt cared for," that I had shown that I was caring for her whole family.  I couldn't tell her that I had only tried to do what I think must have helped my mom get through this: someone to take the heavy and unthought-of tasks and manage them.

September 20, 2011

Avast!

It be talk like a pirate day, ye savvy?  The webs o' knowledge and book larnin' be tellin' me I were born to be called:



 

    My pirate name is:
   

 

    Mad Anne Flint    

 
 

    Every pirate is a little bit crazy. You, though, are more than just a little bit. Like the rock flint, you're hard and sharp. But, also like flint, you're easily chipped, and sparky.    Arr!
   

  Get your own pirate name from piratequiz.com.
part of the fidius.org network
 



Arrr.

September 15, 2011

Open letter to my classmates

Dear fellow med students,

Quit whining.

Seriously.  I understand, you're stressed, second year is full of BS stuff they make us do like sit in lectures run by bad teachers, but come on.  We got through first year just fine, and it was more of the same.  If anything, you should be more excited about this year, because we're finally learning useful material.

Oh, wait.  What's that?  You don't think we'll ever use this in the clinical setting?  Puh-lease.  Why do you think they make us learn it, then?  There's enough medical knowledge in the world that they're not going to waste our time on trivial information.  If they say you'll need to know it, I believe them.  They've been coordinating these courses for a long time now. 

If you don't like the way the lectures are run, don't come to class.  I get it, not everybody learns well by being in class.  You probably think you already understand all of this stuff, so you don't feel like you're getting anything useful out of being in class.  Well, that's great.  I'm happy for you.  But quit coming to class and making snarky comments that make it hard for me to hear the lecturer.


And another thing.  Lay off Pathways.  I get it, you think they're a waste of time and you wish we could be learning things in class instead.  But you know you would only complain about those extra lectures and how the test is going to be so much harder.  The reason they have Pathways is to make sure you're able to pursue the parts of medicine that excite you.  Quit complaining, because they are GIVING YOU A GIFT: the chance to keep yourself sane and interested in medicine and protected time (and basically, a reward in the form of credit) for doing so.

I am generally a positive person, but the more I hear you whining about how hard you think this year is, about how stupid that test question was, or about how BS it is that we have to sit in a lecture about lung sounds--you're really bringing me down.  Like, you're seriously affecting my morale. 

So, I'll say it again.  Quit whining.

September 11, 2011

"The Laughing Heart" by Charles Bukowski

A friend of mine shared this youtube video on google reader: it's a short animation accompanying Tom Waits reading this awesome poem by Charles Bukowski.




"The Laughing Heart" by Charles Bukowski (poem found here)

your life is your life
don’t let it be clubbed into dank submission.
be on the watch.
there are ways out.
there is a light somewhere.
it may not be much light but
it beats the darkness.
be on the watch.
the gods will offer you chances.
know them.
take them.
you can’t beat death but
you can beat death in life, sometimes.
and the more often you learn to do it,
the more light there will be.
your life is your life.
know it while you have it.
you are marvelous
the gods wait to delight
in you.


***

I really like this, especially the last three lines. Such a nice mantra to remember when times are tough.

September 10, 2011

Library picnic

Somehow, the sky is inevitably perfectly blue, the grass and trees are impeccably green, and the sun is shining benevolently on Milwaukee whenever we have to study for exams.

PB&J, veggies and dip, grapes, chips & salsa...hooray for library picnics!  At least there are windows here (unlike the study rooms, which are dungeons on the second floor).  A little Amos Lee on Pandora and I'm ready to spend the afternoon here, only occasionally gazing wistfully out at a beautiful Saturday.

September 6, 2011

There's a briskness in the air

The past two nights, I've slept with all my covers pulled up to my chin.  With the window open, it's just cold enough to want to snuggle up into my comforter, which is just how I like to go to bed.  Somehow, July and August tricked me into thinking that Wisconsin could be warm forever...but this weekend proved me wrong.  There's a cool thrill in the air and the smells have switched from fecund summer to crisp autumn.

Fall is definitely my favorite season.  I can't wait for apples and cider and apple butter and warm pumpkin dishes and soups and stews and baking bread so the oven warms up the kitchen. I can't wait to wear a hoodie and jeans every day and I love showing off the beautiful scarves and mittens my mom has knitted me.

September 5, 2011

Ouch

Sometimes, the truth is a slap in the face.  When a friend tries to do you a favor and play the mirror, to reflect your blind spots back to your gaze--that's when your cheek stings with the salt of honesty in the wound.

Nothing like someone who's heard it all before to bring you crashing back down to reality.

August 27, 2011

We never talk anymore

I miss you
I miss you
I miss you
I miss you
I miss you
I miss you.

August 25, 2011

What day is it, again?

Is it only Thursday?

Second year is already jam-packed with things to do, pages to read, assignments to complete, and immunology to wade through.

I was ready for Friday by the end of Tuesday.

On the other hand, it does feel good to be applying myself--I think I just didn't work hard enough this summer during research.  (The proof being that I still have to finish my abstract and do my poster...ahhhh deadlines!)  School starts to feel a little bit like purely mental yoga: you have to stretch yourself every day and hold uncomfortable positions (take in lots of information) until the pose is easy (you've mastered the material).  Then you do a variation or an extension on the pose (go to more lectures) and keep practicing that.

The difference is that yoga is pretty restful and rejuvenating, and med school is generally fatiguing.

Oh well.  We start heart sounds on Monday--I'm so excited!  The family med conference in KC had a lecture on heart sounds, and I like listening for them.  It's a bit like listening for a particular musical rhythm--you could most notate it with eighth notes or triplets, depending on the arrhythmia.

Here we go

In a few short hours, I will begin my second year of medical school.  It's funny, I don't feel any more advanced than last year; I feel considerably less nervous because I already know my classmates and have an inkling of what to expect out of the day.

I'm excited.  I'm ready to put summer behind me and dive in, dedicate myself again to learning, put my nose to the grindstone, and so on and so forth.  But, I'm also nervous.  The specter of the Step 1 exam is looming over this year like a sullen rain cloud, promising a downpour but delayed on the horizon for a moment.  Also, classes this year threaten to be ferocious: pathology (in other words, learning all the diseases that happen to mankind), microbiology (tiny things that make you get sick, also immunology and other mysterious workings of the body), and pharmacology (all the drugs you would use to treat all the diseases and microorganisms from the other two classes) are the big three.  They're a bit scary, but they also feel more doctor-y than physiology or biochemistry.  

We also get to learn how to perform a complete physical exam, which will then qualify us to actually examine patients and learn something about their health status beyond what they can or will tell us.  We take a few other minor courses: advanced (abnormal) psychology, medical ethics, little bits and pieces here and there to soften the onslaught of path, pharm, and micro.

Bring it on...

August 15, 2011

Tomato, to-mah-to

Patience is so hard.

I traded a basil plant at the end of May for two baby tomato plants, each about two inches tall.  I carefully tended them, potted them first together in a pot on the balcony, then eventually separated them the way parents separate siblings who have grown too old to share a bedroom.

They grew up.  They grew leafy.  They had long tendrils of tomato vine with delicate foliage.  But they didn't have any tomatoes.

The past few weeks, I have checked every day (sometimes, I confess, I checked too optimistically and more often than that) for evidence that the vines would give up luscious, red fruits.  I checked the yellow flowers obsessively, looking for the telltale signs of plant pregnancy.  No dice.

Today, I decided to rearrange the myriad pots of basil, mint, and tomatoes on our tiny balcony so that they all get a little different sun patch.  I leaned in--my face about six inches from the flowers--and flicked my index finger just underneath.

Behold!  A tiny green globe, about a centimeter in diameter.
I will get tomatoes yet!

August 9, 2011

Dreaming, dreaming

And when do the dreams fade away?  When do we stop meeting here, in this unconscious space, so that I wake up missing something that I never had?

It would be so easy to continue as we were, to hold myself back, tied invisibly, imperceptibly to you.

The habits of mind, of thought are the hardest to break.

August 2, 2011

Gazing at the distance

One of my best friends once gave me some great advice.  I was freaking out on the phone with her and she said, "You know, when I feel that way, I write about it and it helps me get some perspective."

I went home last weekend to attend the national family medicine conference and to see my family.  I also went in order to hang out with a friend who goes to school in New Orleans, someone I rarely get to actually hang out with.

The conference was a blast.  It was interesting to see so many people interested in family medicine; the lectures were informative and a great introduction to some clinical skills we'll polish up this year but haven't been introduced to yet, and I even got to brush off my debate skills and write a resolution for the student congress to discuss.

I met lots of people, talked to lots of residency programs, and realized I probably am not going to do family medicine.

I hope I am actually keeping the open mind I tried to promise myself I would keep--to consider all specialties as I come across them.  But I definitely want to work in women's health.  And I definitely want to provide abortions.  And I definitely think that being an OB is the place for me.  All of this, sure, with a grain of salt and a knock on wood.

None of this really freaked me out, though.  What was bothering me was that I was at this conference for some pretty selfish reasons: as an FMSA board member, the family med department paid for me to fly out to KC; I got to visit my mom and hang out with my family; and I got to see my friend (disclosure: he's a boy. There's the rub).

My friend and I went around to lots of the residency exhibits to visit with people, pick up a farm's worth of animal-shaped stress relief squeezies, and just wander around.  However, something stood out to me.  I realized that while this friend was someone I cared about, and had contemplated having a long-distance relationship with, I became aware of the fact that there simply was no way that we were going in the same direction.  He's interested in primary rural care, which is awesome.  However, he also has to practice in Louisiana for five years after residency.  This would be cool--except that I like places with winter.  Let's not forget why I moved to Milwaukee in the first place--Missouri was just too stinkin' hot in the summer.  A lot of the time that I've been contemplating our relationship (friendship+ if you will), I kept thinking that, "You know, Louisiana is a cool place.  It'd be neat to live there," etc.

But, that's just not true.  I mean, it is true, I'm sure it's cool to live in Louisiana.  But I like snow.  I like winter and fall and spring and seasons in general.  And I shouldn't be thinking about giving up what I like just for a hypothetical relationship.

It's scary.  I don't want to give up the nice, backup-y feeling of "But I like him! and he likes me!"  And there is always the tiny voice that is whispering, "but what if no one else ever likes me?"

I have to take a stand for myself.  I have to put my foot down, so to speak, even though part of me is balking.  There are plenty of fish in the sea, and just because I snagged one once doesn't mean that I'll never snag another one.

I realized after I got home that one of my favorite quotes had been there, waiting for me to remember it: "Aimer, ce n'est pas se regarder l'un l'autre, c'est regarder ensemble dans la même direction."
"Love consists not of gazing at one another, but of gazing together in the same direction." ~Antoine de Saint-Exupery

The hard part is knowing when you have turned your gaze in the wrong direction.

July 26, 2011

Change and stay the same

This summer has been strange, transformative.  I have found myself being remade, changed, fashioned anew into a different version of me.

Part of it is because of Gammy: negotiating the space between my family and the medical system, acting as interpreter and liaison and physician by proxy--all of those experiences remind me of the distance that I have already traveled, diverging from the lay public toward the specialized knowledge of medicine.

Part of the transformation has been my work in the garden.  I have not yet written much about the garden on my own time because I keep regular notes of what happens for myself and for my research.  In a way, I am letting the garden teach me (remind me) about anthropology and field research.  I try to record not only what I do, but what others do.  I step back and try to see the bigger picture, pick out threads among the tapestry that weave a story of this place as it is to each person and to the community.

Along with the time I have spent in the garden, I have also taken up plenty of hobbies this summer.  I have found again my love for crocheting, for creating things with my hands; I have dived again into cooking, experimenting much more with growing food rather than simply preparing or cooking it.  (There is a definite thrill to watching seedlings pop out of the earth, to tending window boxes full of lettuce and pots of tomatoes and basil and other herbs on the porch, to rinsing beans or mustard seeds in water until they sprout.)  I started a food blog (shameless plug) with friends, though so far I'm the only one who's written anything for it.

I have struggled and struggled against myself, in the conflict of pragmatism and desire and possibility and plausibility, each time beating my will and doubts and fears between hammer and anvil and in so doing, have watched my self emerge, stronger and tempered and more defined.

For the most part, it is good.  Sometimes, I am less sure, but mostly I am.

Il faut cultiver notre jardin.

July 11, 2011

Flag Day

There have been many things I wanted to say but none of them deserved to be said until I had written something about Gammy.  The problem has been that I do not know what to say, which words are the most important to use.

She slipped away from us quietly on June 14th, at around 7pm.  She had not really been responsive since Saturday morning, when she was still making faces at the bitterness of the ativan and the morphine.  By Sunday, her breathing began to be labored and heavy, phlegmatic from the secretions which the hospice nurse assured us were a natural part of dying.  Though we were careful to keep her doses of morphine and ativan regular, it was difficult because in some ways, they didn't help.  Also, giving her this medicine when she was so out of it sometimes made me feel as if we were just drugging her for our own convenience.  Intellectually and according to the nurse, that was the best course of action--to alleviate any possible pain she might be having, and to help her rest easily in these last few days.

On Tuesday, we had all sat down to dinner around 6 maybe.  Gam's breathing had gotten slower all afternoon, and I kept looking over to where she lay by the window, every once in a while listening closely for the sound of her breathing.  After dinner, I went over to check on her, and the secretions from her throat had bubbled up as she breathed, foaming somewhat.  I took a paper towel to wipe it away, swabbing it until her mouth was free and clear.  All this time, I was watching her breathe.  It seemed to me that her breathing was slowing down, and she hardly made a sound anymore, quite a change from the past few days.  I pulled up a chair to sit by her, picking up her hand and holding it in mine even though it was like tepid rubber.  I wanted to take her respiratory rate, so I started watching the small clock on the table, but the second hand was broken. It twitched on the 1 for at least ten seconds before it moved on.

Mom brought me a mouth swab and a cup of water for me to clean her mouth, but by the time she brought it I already had realized that Gammy's breathing had gotten so slow as to be almost finished.  I put the glass of water on the table and turned to sit, watching Gammy breathe some more.  Mom stood at the foot of the bed and watched with me.  Her voice wavered as she said, "She's breathing really slowly, isn't she?"  My voice sounded strangled and weak as I replied, "I think-- I think this is the end..."  Her breath caught and hitched and she called my brother, my cousin Kirste, and GrandDad to come and see.  We stood around the bed, encircling Gammy one last time as we bore witness to her passing: for this was what I felt, that we were there to look upon her face in death and bear it up in our memories, to preserve the fact that she lived by remembering the moment when she died.

We were there motionless for a few minutes, then moved away as Mom and then each of us in turn took a moment to say our own personal goodbyes.  The sun was setting and the living room grew darker as the light faded from the sky.  We called the hospice center and they sent one of the head nurses, who formally declared the time of death when she arrived.

It was over and somehow, it was a terrible relief.  The burden of waiting and watching was lifted and replaced instead with an awful knowing that this was the end, that she was truly gone.

June 9, 2011

Grief for the living

Cancer means grieving while your loved one is still alive.

Hospice care only underlines this fact, the truth that while you are given this time to comfort them and ease their life to its close, at the same time you are brought face to face with the knowledge that goodbyes are near.

For the third weekend in a row, I will make the drive to my mother's hometown to visit Gammy.  She has been set up in a hospital bed at home, now, and while the hospital in St. Louis put in stints to help her liver function a little longer, they can no longer combat the ravages of cancer tearing through tissues like tornadoes leaving scars on the Missouri countryside.

This morning, my mother sent me a message saying to bring funeral clothes with me, just in case.

Just in case.

Even though with my mind, I knew that the end was near, I had divorced this knowledge from my emotional center.  Unlike the past few days, when I would roll over and hit the snooze on my alarm for another half-hour, today the text message came right before my alarm would go off.  I lay in bed, eyes wide open and staring myopically at the ceiling.

My breakfast tasted too sweet, clinging to my mouth and settling like lead in my stomach.

I have been at work for forty-five minutes and this was all I could think of, I could not bring myself to focus on reading journal articles or preparing for my meeting or contemplating the benefits of gardening on self-efficacy in urban populations.

We speak of how the heart aches and it is cliche.  But the cliche exists because it is true: my heart is heavy, pendulous, each beat weighing on my chest wall and pulsing in my throat.

June 2, 2011

Hours and hours and hours

Time spent in a hospital is oddly vacant.

It stretches out, blank and empty, tucked neatly into hours like the cotton blankets on the patient beds.  Like a vortex, like the Bermuda triangle, the hours spent in a hospital swirl and cycle and somehow never move forward to truly pass.

Gammy's face looks like a crayon, the color of dandelion petals faded by the hot July sun.  Her hair, soft and fine and shockingly white, is brushed back and also flattened so that it stands out like a tiara, a halo of daisy petals around her face.

The doctors give us words to learn: cholangiocarcinoma, adenocarcinoma, lymphoma.  I already know the parts of the words and it is up to me to explain them.  Chol- from cholesterol, meaning bile.  Angio- meaning blood vessel or duct, like angiogenesis or angiotensin.

Carcinoma, meaning cancer.

It is days before they are able to do the biopsies and endoscopes and procedures that confirm what my gut already knew was true: inoperable, untreatable cancer.  Tomorrow she goes home with arrangements for hospice care and a fool's timeline, anywhere from a month to a year to live.  The lack of precision is astonishing and disheartening, and while I would normally consider myself an optimist my experience with Dad tells me to count only on the low end, if that.

I am already mentally packing my bag to leave tomorrow to go and help my mother settle Gam back into her home, or possibly to help her pack up to move to Kansas City.  It will be a long summer, but will it be long enough?

May 17, 2011

Mmmm, smells like Spring!

Is there anything that smells as glorious as fresh-mown grass?

It takes twice as long to walk home as it does to walk to class when it's this beautiful outside.

Other things I love about spring right now: the way dandelions have taken over my neighbors' lawns, the tiny white and violet flowers that peep out from around the grass on slender ballerina-necks, the fact that the tree by our sidewalk has enough leaves to cast a shadow on our yard, the perfect counterpoint between cool breeze and warm sun, the way the air actually feels different from any other season, the giddy energy that wells up in everyone, the clean-washed blue of the sky, the way the light looks at four o'clock, both warm and gentle at the same time.

May 16, 2011

Five years

Dad

We shared
mountains of popcorn
crusted with salt,
coated in butter—
the too-rich concoction,
Mom called it
A heart attack waiting to happen

Summer sausage,
cheese on crackers;
pigs in a blanket—
always accompanied by
a painter’s palette:
ketchup, mustard—

Saltines in soup—
under chili then finished
with melting cheddar,
stringing from the spoon to the bowl
and caught in your beard,
your mustache.

Oatmeal crème pies,
Swiss rolls, sugar babies,
terribly seductive:
a death sentence
for a diabetic, driving
your pancreas into perpetual production

Missing you is a famine,
a stomach too long empty to growl.

-----

I wrote this in Spring 2007 for an intro to poetry class.  It's been five years today that he passed away from pancreatic cancer, which sometimes feels like an eternity and sometimes feels like it just happened.

I think the Anne Sexton quote says it best, though: "It doesn't matter who my father was, it matters who I remember he was."  He was loyal, hard-working, trustworthy, a man of his word, selfless, and determined to do anything to help someone else.  He was an Eagle Scout who truly lived the Scout law (A scout is trustworthy, loyal, helpful, friendly, courteous, kind, obedient, cheerful, thrifty, brave, clean, and reverent).  In fact, I can think of no better words to describe him; I can actually remember him being each of those things in turn on more than one occasion.

When I was younger--when he was still alive--it would infuriate me to be compared to him, because I only saw his flaws.  He was tempestuous when angered; he was stubborn; he wanted to do things the hard way; he saved everything for some future purpose.  Now, I take any comparison, slight though it might be, with pride. I hope to be as good a person as my father was.

May 14, 2011

Slowly, sweetly

Daydreams are always better when your eyes are closed.  When you let your mind spin off in an imaginative road not taken and curl up sideways under a soft blanket as you succumb to the fuzzy warmth of perfection created in your mind, time slips away like air through an open window.

Somehow, I have let myself get caught in a never-ending daydream, where I can see future and past spread around me like a field of flowers in a painting.  And in this imaginary space, with this imaginary future, I see everything as it could be, years and years down the road.

I was baking bread yesterday, and as I mixed the biga into the dough, I could hear myself teaching my future daughter to do the same thing.  "We make this little bit of dough ahead of time, so that it has better flavor.  Then we let it sit in the fridge so it develops slowly, because the slower we take it, the better it tastes and the sweeter the bread in the end."  And it seems that I am telling her, this daughter of mine that does not exist yet, about bread but also about life, about good things that grow slowly with time, that develop and mature and start from bare ingredients but transform into something substantive and nourishing.

May 2, 2011

Perfect Weekend

Last weekend was perfect.

Despite plane cancellations and flight delays, I made it into New Orleans late Friday night.  We dropped my bags off at his apartment, and went out for a drink.  We talked late and came back and crashed.

Saturday, I got a glimpse into life in New Orleans--not the touristy spots, which we skirted with all the aplomb of a native, but rather his favorite places: the park where he goes to run, a nice street full of shops and excellent restaurants and locals, the "fly," a riverside park where we basked in the sun, the zoo...I didn't realize how much we had been outside until we went back to change for dinner and I discovered a perfect V-shaped shadow around my neck where my t-shirt's negative was imprinted in sunburn.  We went to see Lake Pontchartrain as the sun set and then it was dinner at a cute creperie followed by ice cream.  The night finished with a long conversation over a mint julep (me) and a sazerac (him) at a beautiful hotel that looked like it belonged in Gone with the Wind and had a flowery garden terrace for loitering.

Sunday, we woke early and met up with his classmates to go tubing and camping.  I put on sunscreen but neglected my legs, and the end of the day saw that my anterior legs were tomato-colored (even the backs of my feet and hands).  That evening we cooked out, the whole group together, and sat around the campfire telling stories and saying things we were thankful for and listening.

I saw two shooting stars.  We found constellations using smartphone apps and tried to remember misty myths about heroes and hunters and gorgons.  When we went to bed, there were five of us in our tent and I really didn't sleep at all, listening to bullfrogs and four different breathing rhythms and fidgeting sleepers.

Monday we took time breaking camp.  When we got back to New Orleans it was shower and nap time, the perfect way to spend the afternoon.

We had dinner with his roommate and his roommate's girlfriend, then wandered a little more in the air heavy with summer temperatures and southern flowers.  We met up with some of his friends at an Irish bar and racked our brains about trivial knowledge.

Tuesday, we were up early and he dropped me off at the airport.  We hugged goodbye and I could hardly believe that three and a half days were over already.  The miles to home stretched before me like a lament, a heaviness that sank into the pit of my stomach and stayed there despite the defiance of gravity by the plane.  In my seat, I closed my eyes and could remember every sun-kissed moment, could feel it in the tender sunburn on my legs.  In remembering I dozed off, pleasantly deluded that I was still there.

April 17, 2011

Burning joy

"I'm so glad things are going well for you!  You seem so happy!" Carly exclaimed.


I smiled back at her hesitantly.  Until then, I hadn't realized how content I was.  Things are going well and life is good.


La vie est belle.


Comme disait Camus, "La joie est un brûlure qui ne savoure pas.“ Je me sens le chaleur du bonheur, mais je me promets à la même temps de savourer la joie aujourd’hui et la joie de la vie.  Jour par jour.  Un à la fois.

April 6, 2011

Procedures

I shadowed at PP last week.  It was different from what I expected, in mostly good ways.

What do I say about it?  It was more nonchalant that I was expecting.  More welcoming.  More like normal day-to-day business.  The women running the show were funny, lively, no-nonsense.  The patients were a mixed bag, some subdued, some at ease, some a little scared.  Afterward, almost all of them were relieved.  I say almost only because one woman was in considerable pain for her time in the recovery room, but when she left she seemed much better.  It was not regret that made her uncomfortable but simply the cramping.  There was a vast range in ages: from the very young (all the staff were checking with one another--did the authorities need to be called? had the proper counseling steps been taken? was this girl all right? could her grandmother come up to the recovery room?) and others who were older.  Women who were engaged, seeing someone new, single, mothers, nulliparous.  Some had never been there before; others had been at least once or more.  They all left with some sort of birth control plan and they all left with a little more control over their lives.

What was missing?  Somehow I had envisioned it to be a cold, forbidding place, with disapproval seeping out of every pore.  The lyrics of a song occur to me as maybe the basis for this: "and she heads for the clinic and she gets some static walkin' through the door/ they call her a killer, and they call her a sinner, and they call her a whore."  The staff at the clinic, though, are not the "they" from the song lyrics.  Somehow those words always made me imagine a male doctor, with dark-framed glasses, frowning paternally at a young woman with a bulging belly who's come in to have her nth procedure.  Instead, the clinic was full of women: women at the check-in, women at the front desk, women nurses and assistants in the exam rooms, and even the doctor was a woman.

There is more to be said, but in some ways it does not need to be said.  Like other experiences in medical school, some things should not be shared on the internet.  We have a very privileged place in terms of information--people's lives and secrets and vulnerabilities are given to us for safekeeping and it would be in poor taste and poor repayment for those gifts to be scattered to the wind.  Having signed a confidentiality agreement--and being firmly committed to advocacy for this cause--I also am very aware that this post could turn up in a google search.  Thus, the avoidance of certain terms.  I think this is the first time where I've actively edited something out of a post as I wrote it.

March 30, 2011

A personal Hippocratic Oath

Today was the last day of the Healer's Art course at school--as a closing exercise, they asked us to think of four clauses of an oath that we envisioned as an embodiment of ourselves as physicians.  Here's mine:

This I ask of all that is holy, now as I look to my future in medicine:
May I see my patients as beings endowed with a spark of the divine, each with their own story to tell.
Help me to honor the autonomy of my patients, so that their treatment is their will and not mine.
Grant me the ability to care for myself as much as my patients, so that my spirit is renewed daily.
May I do all I can to lessen suffering in this world, no matter how small the affliction or how deep the pain.
This do I ask and this do I pledge to do, with solemnity of purpose and strength of will, so that I extend by one more link the chain of physicians from before history into the future.


I'm not sure where the second clause came from.  I wrote it and it felt right, but I don't remember a time when it felt like the doctor was infringing on a patient's autonomy.  Maybe I'm afraid I will take too from my own world view and impose it on my patients?  I'm just not sure.  I like that it's in there, though.

I think the best part was at the end, everyone read their oaths or a portion of them aloud.  Each person's little bits and pieces made me think, "Oh! I should have put that in mine!"

March 29, 2011

Hypothetical

I'm up to my elbows in a difficult cesarean section, the woman's abdomen retracted on both sides and about to slice into her womb to retrieve her baby.  The lights overhead sizzle and with a pop we are plunged into darkness.

I freeze.

"No one move.  Does anyone have a cell phone on them?"  A few murmurs go around the room as the anesthesiologist and the one nurse that isn't scrubbed in pull out phones, mashing buttons until their iridescent glow illuminates their owners' chins.

"You, go and find out what's going on.  I need power back in this room and I need a flashlight, now!"  The nurse hurries out of the OR.  The anesthesiologist looks at me, and I look back and wonder what we're going to do for this woman.

"We need to monitor her vital signs, and I don't have any monitors."  His face is tense, his mouth narrowed into a thin line.  His fingers come to rest on the woman's pulse.  The woman is fine, for now, but the surgery needs to continue; she can't remain open on the table for long.

"What's going on?  Why is it all dark?  I'm blind, I'm blind!  I can't see!  What's happening?"  One of the pediatric nurses steps next to the patient and begins to speak in a low, soothing voice.  The patient's shrill cries die out as she grabs tightly onto the nurse's hand.

The nurse I sent out of the room returns with a flashlight.  She brings it to the table and puts it in a sterile bag, like they use for other reusable equipment.  "I need your hands," I tell her.  "Is there any way you can hang that above us from the lamp?"  She looks at the lamp and decides it's doable.  We use suture thread to snag the top of the bag and then loop it over the handle of the OR lamp.  The light is dangling a couple feet from the sterile field, and I pray that it won't fall and that I'll be able to see enough to finish what I'm here to do.

I take a few deep breaths before I pick up the scalpel again.  I make the incision into the uterus and even though the rest of the OR is in pitch blackness, the table feels almost like any other c-section.  At the same time, I feel linked to the surgeon who first performed this act, hundreds of years ago, with no more light than an oil lamp or a candle.  The baby emerges from the womb and gets handed over to the pediatric nurses immediately, who cradle him in towels and wipe his face, and suddenly he cries out.  It is a miracle, and he is alive, and now the only task I have is to save his mother here, in the dark.

I peer closely at her abdomen.  I take up the suture needle and thread and begin to stitch her organs back together, repairing her uterus and weaving her flesh back into a whole piece as I work my way toward the surface.  I am securing the subcutaneous fat when I hear an electric hum in my ears.  It is followed quickly by the blinking on of bright fluorescent lights, and now the OR is bathed in light.  I finish stapling the woman closed and once her bandage is on, we lower the sterile curtain.  The nurses bring the baby over to the new mother and she has tears in her eyes as she looks at him, her baby from the darkness brought here into the light.

March 25, 2011

Song and Dance

I am a toe-tapper.
I wait for the music to swing
and I sing the words under my breath
as the melody is sweeping up
into chords
vibrant and triumphant and
shining into the dark like a
night light.  I hum harmonies
and pick out thirds above
or below and add
my own notes despite groans
when I miss the mark
just a bit.

I am a clapper-along.
I wait for the rhythm to tell me
that I belong in the middle,
bouncing a strong down-beat
with my feet on the ground
or my palms on my thighs
and the sound of my stride
makes music as I walk.
Even if I'm wrong and the
tempo trips me up--long
instead of short or I have to
clap on quarter notes instead,
my body picks the time
and I climb stairs with a lilt
so that the music in my head has percussion.

March 10, 2011

Dirty Heathen

An old friend and I were chatting on Facebook the other day. After the usual life updates, the fact that it was Mardi Gras surfaced.

"So, what are you giving up for Lent?" he asked.

"...Pffft. Nothing. I'm a dirty heathen. And dirty heathens get to be hedonists."

That got me thinking about the whole practice of giving something up for Lent in the spirit of the Lenten fast that Christians used to observe during the holy period. It's not that I think a little self-restraint is bad (far from it). And from a spiritual perspective, I think depriving the self of certain excesses for a period of time is a healthy way of clearing the mind and the body and preparing it for other tasks.

But I think another important aspect of this is that after the "fasting" period is over, you celebrate some sort of rebirth by allowing yourself to partake in whatever it is you've given up again. And since for Lent, that involves celebrating the resurrection of Christ and thus the salvation of mankind, as someone who doesn't really believe in that I don't feel the need to pick this season specifically as a time of fasting and spiritual preuve.


On the other hand, I have no problem with people who give things up for Lent.  If anything, I admire their resolve.  I just hope they're getting something spiritual out of it as the practice was intended.  Otherwise, it's just like a bet you make with yourself: "Can I make it 40 days without x or y?" And even if you lose the bet, the only one who knows is you (and the big Guy "upstairs").

Oh well.  This dirty heathen will continue to enjoy her chocolate up to and including Easter.

March 5, 2011

Endurance

I woke up on time to my alarm this morning and as I swung my feet out of bed, it occurred to me that it was only Saturday. As in, there are still five more days of intense, all-day studying before being able to enjoy the empty freedom of spring break. I almost pulled the covers over my head.

Not getting home until 7pm today means that I took a two hour dinner-TV break. Now I think I have to go study some more.

ARRRGH!

February 23, 2011

Proof that my cat is trying to kill me*

1. He knocks heavy water glasses off of my desk onto the floor, so that they shatter into a million razor-sharp shards right by my bed.

2. He infiltrates the bathroom while I'm taking a shower, lying in wait on the rug.  He knows that when I step out of the shower, I will not be looking for him and will step on him and hit my head on the many ceramic things in my tiny bathroom.

3. When he sleeps on my bed at night, he sleeps on my chest (the better to suffocate me) or next to my face (an even quicker modality); barring that, he curls up against me so that I can't move, effectively trapping me in a helpless position.

4.  He's always watching.

5. He employs psychological warfare by meowing constantly, keeping me awake at night and wearing down my will to survive.




*Inspired by the oatmeal, which featured this comic.  Unfortunately, the cat-crimes against humanity alleged herein are reflective of my cat's true nature.

February 18, 2011

Romance novels are a bad influence

Oh, how quickly the mind jumps miles ahead of the present, to years in the future, summing up the perfect sequence of events for an ultimate happy ending, a fantasy replete with history and romance and darlings and cheries and whispered sentiments.  The fall is simple, swift, and the chordae tendinae are pulled taut, the heart is full to the brim and overflowing.

February 2, 2011

Thundersnow

The physiology test has been postponed a day.  As early as Sunday evening, there was a buzz in the air about the upcoming storm: "What?  Weather.com is predicting blizzard conditions?"  The snow started yesterday with big, poofy cotton balls drifting determinedly toward the ground.  Last night, it changed and today the same snow continued: small, tiny particulates, thin and brittle ice-crystals that sting the cheek yet melt instantly on contact.  After dinner, I was going to sit inside and curl up on my bed, surrounded by textbooks and papers (but perusing facebook instead) and listen to the wind howl, but I decided to take a walk anyway.

Out into the cold, and I was alone.  I live on a busy street, and it was deserted at 8 p.m.  The whole scene was faintly orange from the streetlights, but the gusting wind turned gravity on its side and it was as if my glasses were made of frosted glass.  I walked and walked and saw only a handful of cars go by, each practically in the middle of the road.

Back inside, I found the crenelations of my scarf crusted with flakes, remnants of the wind tucked away among the threads.

Later, studying physiology with half-hearted attention, a flash of light slid around the edges of the window shade.  A second later, a pane-rattling boom echoed percussively around the air.  The wind was howling around the corner of our building.  It mocked gravity and hurled snow both new and fallen up and around and back again.

All I want to do is sit and listen to the wind and watch the fantastic spirals of snow in the air.  At times I cannot even see the house across the street.  My cat is curled up against my crossed legs (a perfect armrest as I type) and I sit, watching, wishing I did not still have to study for two exams this week.

January 29, 2011

An evening constitutional

My arms swing as if
I were a soldier.  As
I pick up the pace, feeling
the nice stretch of legs
used to sitting cross-legged,
sartorius contracted, a heavy
textbook across the knees,
the dark stain of evaporated snow
is now turned to ice
and down I go
knees and hands hitting first.

January 23, 2011

Idea!

When we learned about seasonal affective disorder (yes, SAD) in our introductory psych class last semester, our instructor mentioned the use of light therapy as a method of counteracting the effects of minimal sunlight exposure on the pineal gland.  There are special lights that have been made that you sit in front of for 15-20 minutes every day to get your dose of light that is equivalent to sunlight, thereby elevating your mood and satisfying your body's need for the proper amount of light.

Fast forward a month or so: I get a catalog [why does the spell-check refuse to recognize "catalogue"? "Catalog" looks naked, or incomplete.] that has, as one of its items, a full-spectrum lamp to treat SAD!  How exciting.  But unfortunately, it's $200 for a giant rectangle that sits on your desk or something.

Anyway, $200 is a lot of money.  So here's my idea: wouldn't it make more sense if they invented a fluorescent (or even incandescent) light bulb that could screw into your regular lamp so that you could just buy the light bulb?  Then you wouldn't have this weird rectangle o' light on your table, you could have the benefits of light therapy anywhere, and you could even get companies or hospitals to install them and keep their workers happy and healthy.

---
I just went and looked at light boxes.  I can't really tell why you would need the boxy-thing, and some websites will at least sell replacement bulbs for that...but it looks like there's a certain distance you have to sit in order for the intensity to be the appropriate magnitude and thus have therapeutic effect.  Darn.  Well, either way, it seems like it would be nice if there would be some sort of public place you could go (or maybe, like a tanning salon!) that would have light therapy-beds or booths instead of tanning booths.

Needless to say, I don't think I'm getting enough outside/sun time.

January 20, 2011

How do you say it?

"My dad had pancreatic cancer but he died when I was a senior in high school."

Revealing your story still
makes my breath catch,
tightens my chest,
I even now have trouble
finding the words to speak.

Somehow I feel unworthy
to say what happened
as if I were too happy now
to bear, submerged, this burden.

I feel my life being
reexamined, reconsidered,
interpreted anew with
this death-grey lens.