coming back

Since I returned to New Haven about exactly a week ago, I've been feeling out of sorts. The out-of-sorts feeling is out-of-sorts itself, as it's a fluid thing whose quality changes with the seconds, the temperature, the walls or windows, and with nothing at all. Its source and its course is never quite one thing for very long. A lot of things are happening or at least going on, and in the midst of it I feel messy and moody. Messy is status quo, but what's changed is that with it there is unease instead of easy acceptance, and moody is unusual. Writing about it will probably feel the same.

Leaving my family was difficult, even as I'll be returning to them in a few weeks. Even though my parents don't change much at all in the intervals between my seeing them, time always claims more weight when I see them. When I'm with them, I find myself wanting not vacation time but daily time, the kind that lends itself to stray stories and details of their lives that fall here and there. My mom is constantly losing her jewelry because she isn't careful with where she places her earrings and watches and rings after taking them off; I'm constantly telling her to simply put them back in the same place. As I help her search underneath the bed and by the sink, I miss her. When I come back to lose my own earrings, I miss her.

For some reason I wrestle with small decisions like spending the month of July at home or here. I had ultimately decided to study for Step 2 of the boards here in New Haven, instead of going home as I did for Step 1. Having to hop from place to place to study and with all the places closing early in the night for summer, I've missed my corner by the window with a steady view of Fremont hills and passersby. Leaving my family after our trip, and having it really hit me that I have two more years here, makes me wish I'd taken the opportunity to be home for a full month. At the same time, I appreciate having other things going on here for escape and a sense that I still function as a person outside of books. I know that I wouldn't have been completely satisfied at home either; still, this knowledge that I wouldn't have had a perfect decision in any case doesn't move the sense that this was an imperfect one.

A big reason for my staying was to spend time with a friend who will soon be leaving for most of the rest of the year, and in that sense I feel I'm in the right place. On my first real night back, we had an impromptu dinner at his place, as we've had sporadically over the past couple of years; a couple nights later we planned a potluck, as we've had sporadically over the past couple of years. This time it took place on the roof of the apartment building, with shadows a light black against the deep yellow that the sun becomes when it's retiring. The food was a hodgepodge, the cups included small bowls, and the girls wore oversized coats supplied by our favorite nature-lover who always has plenty of coats and who threw chicken bones over the side and who wanted to fly. The directions of New Haven sprawled as we ate and laughed, and I feel so lucky to have people who have so defined my time here.

How sharp that definition has been, surprised me a bit. A lot of my close friends are currently scattered about the world, and I can feel their absence. I also feel the absence of parallel doings; I'm the only one studying for my boards right now, and that has felt strangely strange. As I'll be spending most of my year off being the only of us to be doing whatever I'll be doing (an unstructured mix of writing, processing, and talking), it bothers me a little that I'm bothered by being alone in my endeavors. I had thought this solitude would be welcome. I'm finding that as much as I hate crowds sometimes, I really love individuals, and I've missed many of them upon my return to a place where they've been for so long. Of course they will come back, but they will come and go, as we are all forming our own structure right now.

And the challenge of that, for myself, is one that I hadn't fully recognized as such. I never acknowledged the change that is going from third year (the introduction to/immersion in clinical medicine, and our toughest year) to fifth year (a gap year where we choose pretty much what we want to do). I hadn't given much thought to what this freedom and self-guidance means, and more specifically, that it can be difficult. I completely set my own goals this year, and completely set my own ways to go about them, which is wonderful, and daunting. More than that, or more purely than that, it's different. The simple fact of change happened as I blinked, and the unawareness is another rarity, something that has made me feel not myself.

Not that I didn't think about this year's approach--when third year ended, I looked forward to time and space to digest all that's happened. I forgot that I first have to get through the harder parts of the year first, my board exam and my medicine subinternship, both intense endeavors that leave little room for the little things. I resent being restricted, when I feel flooded with things that want for my attention. Again I'm conflicted, as I'd looked forward to really getting down to it and consolidating all we've learned in the past few years that has accumulated in the clinical knowledge that'll be tested. And to be honest, it has felt good to study. I'm surprised by things I remember from studying for the boards last year, things like how the fungus malassezia furfur causes tinea versicolor and looks like spaghetti and meatballs under a microscope, and how rhizopus causes mucormycosis in diabetics (I think I just like the words). I like reading the questions, which are written as cases with symptoms and findings and test results, and I'm aware of each acronym and number I didn't understand just a year ago. Concentrating on the science for hours has also let me put other things, things that aren't so rational and organized, at rest for awhile.

There are a lot of those things. My hives, along with lip swelling, recurred intermittently over the past few weeks, and after several trips to the doctor I'm following a regimen of daily claritin for a month, to break the cycle of histamine outburst in my body. Other than the physical inconvenience, I don't like thinking about what internal happenings my body is reacting to. This past weekend emotional impulses and ruminating responses usurped my abilities to sleep and eat correctly. The fatigue and dizziness that followed was annoying less for the actual senses and more for the knowledge it was my own doing.

In less physical and equally consuming areas, I'm scared and excited about the prospect of spending this year writing. I have a pile of one-line stories, of experiences and things I want to record. I'm annoyed that currently, I can't get to them, and a small part of me is glad for some more delay as I struggle with fears of not-good-enough and not-sure-enough, and doubts about purpose and product.

In terms of life outside of lined paper and blank computer screens, I'm pretty sure it's impossible for me to have simple interactions, and while I know that misunderstandings and bumps in communication and nonlinear connections are always part of the space between people, I really do wish that sometimes I could find myself in something simple. And with that, I miss innocence. I miss when certain moments don't have to lead anywhere else, and when an accumulation of moments take you honestly and naturally to a place where pride and perceptions give way to vulnerability. I've found myself feeling deeply and strongly on one end of the spectrum to the other, in the course of days and nights, and in that yet another conflict, I've grown tired.

Immersed in this push and shove, and mix of so many components alternately distinct and connected, I've decided, both rationally and emotionally, to simplify for the time being. It's not how I approach things as a principle; I want to learn to face multiple complications and find balance. But right now, it's a bit too much.

For July I want to do the things that give good--and give it simply. As integral as they are to me, I'm going to avoid sources of complicated or layered good. I'm going to concentrate on learning as much medicine as I can, to do well on the exam and to prepare for my subinternship and to be a competent doctor. I'm going to go grocery shopping for what I'll need for the next few weeks, to cook and to eat well and to save money. I'll run most days and climb on the days I don't, to stay healthy and to have breaks in the day when I'm moving and to feel good. I'm going to be with friends, to laugh a lot and to have conversation and to have company. For all the rest, I'm letting it rest.