It's been so long since I've written that I'd forgotten what my last entry was about. It was about the surf contest in New York. M and I are in California now, and in a funny turn of events, a similar contest is taking place here in San Francisco. Neither place was a likely venue for such an event (none had ever taken place in Long Island before and this is the first in SF in thirty years), and the timing worked out that we caught the last one as we were leaving the East Coast and are catching this one just we arrived to the West Coast. Having something bracket our road trip seems to confirm our sense that this decision, which outwardly seems random and spontaneous, is right. Not just in the way that things end up right, but that it was meant to be this way.
To tell people before we left that I was moving, seemed to be a little inaccurate. We spent a month and a half on the road before getting to the Bay Area, we'll be here for a month before I spend half of December on the East Coast going on interviews and he's back on the East then too for the holidays, and then I'll be abroad and back in New Haven for two months, and we haven't planned for much after that. Because we're moving around so much, the end of the move--what characterizes a move--isn't too tangible.
Among the things we share, this flexibility is one of the most valuable to me. Being on the road is special in how easy it is to go somewhere/anywhere. M is actively open and actively adventurous, which gives our experiences an added layer of newness and absorption, a layer that almost becomes the experience itself.
We've established a mini-life in San Francisco. Mini in the sense that we're just here for about a month, mini in the sense that our routine is dictated by our impulses and has the time-feel of a vacation. So even though this feels like settled-ness compared to essentially living in our car, it's not how we would "live" if we were settling down somewhere. Though it's not exactly vacation either, because we're not going out doing vacation things every day. We just do what sustains us on a daily basis: cook and clean, climb and swim(for me)/surf(for him), explore the city intermittently, bum around regularly, be silly with the cat and each other. So sometimes, even with the ability to move anywhere, the choice to stay still for a bit feels pretty liberating.
And so even though I can't really accurately describe to you what we're doing in a label--not quite moving, not quite traveling, not quite nothing--I can say that it's good, very good. And that feeling moves me most.
Sunday, November 13, 2011
Monday, September 12, 2011
riding elements
Last week M took me the Long Beach Surf Contest, the first big contest to be held on the East Coast. Not knowing anything about surfing except for his love for it, I didn't anticipate too much. But it turned out to give on all levels--sensation, emotion, thought. If watching surfing for an entire day can do that for a girl who can't swim in the ocean, there's a reason for openness to the unfamiliar.
The first day rainy, the second day sunny, both at times uncomfortably so but mostly just enough to be steadily present. On the hot day I was without hat or sunglasses, and I felt like toast. Even though I'm almost black now, I'm glad for warmth so intense I could feel it under my skin. Watching the water for hours made it seem like a natural movie, and it's interesting to think of a natural place as a venue for something like that, a scene or an event or a narrative. There's the scene of the sky and sand changing character over the course of a day, the interaction between each surfer and water. It was amazing to see shifts in the environment, in temperature, cloud forms, tide coming in; to feel it happening to you and without any regard to you. It was amazing to see how well these people knew the water--how they adjusted for its curves and shapes and speed. And how as a result, there was crazy connection between person and water. I admire the desire and capacity to know something as dynamic, turbulent and feisty as water, especially having recently discovered how different a fluid world is versus a solid one. It changes pretty much everything, and in a way I see an exploration of it as an exploration of elements outside of yourself, that can become so deep that it's more yourself than the ground you were on before.
There is always more to say, and better ways of saying them, than I have ability and energy to write. But I wanted to put it down. Because though I don't have the expertise and experience to know and master the elements of air, water, and so on, I would like to be carried by them. And so, M & I are leaving for a long leisurely drive across country for new adventures in California.
The first day rainy, the second day sunny, both at times uncomfortably so but mostly just enough to be steadily present. On the hot day I was without hat or sunglasses, and I felt like toast. Even though I'm almost black now, I'm glad for warmth so intense I could feel it under my skin. Watching the water for hours made it seem like a natural movie, and it's interesting to think of a natural place as a venue for something like that, a scene or an event or a narrative. There's the scene of the sky and sand changing character over the course of a day, the interaction between each surfer and water. It was amazing to see shifts in the environment, in temperature, cloud forms, tide coming in; to feel it happening to you and without any regard to you. It was amazing to see how well these people knew the water--how they adjusted for its curves and shapes and speed. And how as a result, there was crazy connection between person and water. I admire the desire and capacity to know something as dynamic, turbulent and feisty as water, especially having recently discovered how different a fluid world is versus a solid one. It changes pretty much everything, and in a way I see an exploration of it as an exploration of elements outside of yourself, that can become so deep that it's more yourself than the ground you were on before.
There is always more to say, and better ways of saying them, than I have ability and energy to write. But I wanted to put it down. Because though I don't have the expertise and experience to know and master the elements of air, water, and so on, I would like to be carried by them. And so, M & I are leaving for a long leisurely drive across country for new adventures in California.
Thursday, August 25, 2011
therapy
In the past week I've pursued both physical and mental therapy, with the thought that it's good to be active and mindful of what I want, of what grounds me, and of what pushes me in positive ways. In medical school we're taught how to fix things, and M pointed out that healthcare is often seen as interventions when things have gone wrong. He noted how people don't think about how to optimize their health, even when nothing is concretely wrong. Since I want to go into primary care, with preventative care more appealing than acute care, I was struck by the thought that this is true, that even for people interested in keeping people from being sick, that a lot of care is focused on intervention and even maintenance, instead of active improvement.
I went to physical therapy today for my hip issues. While this seems like, and is, an intervention for a problem I'm having, the problem arose because of poor maintenance. The therapist told me that I have an upslip, which means that my hip has moved up compared to the rest of my pelvis. This can be caused by falls and trauma, or in my case, long history of high-impact motion without proper optimization of the muscles supporting this movement. My therapy will focus on getting the hip back into place, and then keeping it there by strengthening core and thigh muscles.
The therapist asked me what my goal for therapy was, which was a nice and important question to ask. My immediate response was to go back to running and to feel normal again. But as I learned about the exercises and thought about the 6-8 months of weekly sessions that he says it will take for me to achieve this, I realized that I've been desperate for this therapy not just to re-attain my baseline, but to have the potential to be better. Not necessarily just to run faster and longer, but also to learn the nuances of my body better, to pay more attention to those neglected muscles, to more finely tune movements, to learn new things and not feel limited--not even to just my prior baseline.
Recognizing that baseline can always be better was also what made me think about talking to someone about some of the qualities I sometimes feel trapped by. I had a moment recently where I was thinking so strongly that I should do one thing, but was swallowed by feelings that wouldn't let me do what I wanted. It was frustrating in a way I can't articulate. While I've tolerated that frustration in myself for a long time, seeing it visibly affect someone else made me think, I can try to change this. While generally adjustable to my environment and more than satisfied with the state of things, I've always had this tendency to slip into intractable moods that make me less the person I want to be. Because I appreciate the strength of responses--because this contributes to things I like and dislike about myself--it's been hard to target the negative while keeping the positive in tact. As rational and healthy as it sounds, it's hard to selectively control the intensity of emotions.
So I decided to try therapy for that too, which I have never done for anything. It's not something I've talked in-depth with anyone about, in large part because I find it really difficult to express. I think part of what I'm seeking in this process is developing more clear verbal expression of the abstractions I feel. And another part is to understand what this can do for someone. In the same way that physical therapy comes back to my life in medicine, one of my first thoughts about this is that I've recommended therapy to so many patients for such a wide range of things. So wide, that it seems to me that it's not so much a medical prescription as much as it is a natural need.
In that sense, the word "therapy" becomes more nuanced. When talking about receiving talk therapy, a classmate of mine asked, what does it mean when an intervention is something that's good for everyone? It becomes less a solution to a problem. It's not intervention, it's sustenance.
Even though it felt kind of crappy at first to feel like I'm a little mixed up--to have at twenty-seven years old the joints and moodiness of a menopausal woman--it actually mostly feels good to pursue active change. I feel lucky to still be at a stage to feel potential to do things differently, to not be stuck. And as someone who will be recommending therapy, now loosely defined as means of improvement, for my career, it's useful to be on this end of things. It makes me think that care comes not so much from distance between providers and their patients (the distance created by difference in medical knowledge and training) and this idea that one can fix the other, as much from the shared desire to live as well as we can.
I went to physical therapy today for my hip issues. While this seems like, and is, an intervention for a problem I'm having, the problem arose because of poor maintenance. The therapist told me that I have an upslip, which means that my hip has moved up compared to the rest of my pelvis. This can be caused by falls and trauma, or in my case, long history of high-impact motion without proper optimization of the muscles supporting this movement. My therapy will focus on getting the hip back into place, and then keeping it there by strengthening core and thigh muscles.
The therapist asked me what my goal for therapy was, which was a nice and important question to ask. My immediate response was to go back to running and to feel normal again. But as I learned about the exercises and thought about the 6-8 months of weekly sessions that he says it will take for me to achieve this, I realized that I've been desperate for this therapy not just to re-attain my baseline, but to have the potential to be better. Not necessarily just to run faster and longer, but also to learn the nuances of my body better, to pay more attention to those neglected muscles, to more finely tune movements, to learn new things and not feel limited--not even to just my prior baseline.
Recognizing that baseline can always be better was also what made me think about talking to someone about some of the qualities I sometimes feel trapped by. I had a moment recently where I was thinking so strongly that I should do one thing, but was swallowed by feelings that wouldn't let me do what I wanted. It was frustrating in a way I can't articulate. While I've tolerated that frustration in myself for a long time, seeing it visibly affect someone else made me think, I can try to change this. While generally adjustable to my environment and more than satisfied with the state of things, I've always had this tendency to slip into intractable moods that make me less the person I want to be. Because I appreciate the strength of responses--because this contributes to things I like and dislike about myself--it's been hard to target the negative while keeping the positive in tact. As rational and healthy as it sounds, it's hard to selectively control the intensity of emotions.
So I decided to try therapy for that too, which I have never done for anything. It's not something I've talked in-depth with anyone about, in large part because I find it really difficult to express. I think part of what I'm seeking in this process is developing more clear verbal expression of the abstractions I feel. And another part is to understand what this can do for someone. In the same way that physical therapy comes back to my life in medicine, one of my first thoughts about this is that I've recommended therapy to so many patients for such a wide range of things. So wide, that it seems to me that it's not so much a medical prescription as much as it is a natural need.
In that sense, the word "therapy" becomes more nuanced. When talking about receiving talk therapy, a classmate of mine asked, what does it mean when an intervention is something that's good for everyone? It becomes less a solution to a problem. It's not intervention, it's sustenance.
Even though it felt kind of crappy at first to feel like I'm a little mixed up--to have at twenty-seven years old the joints and moodiness of a menopausal woman--it actually mostly feels good to pursue active change. I feel lucky to still be at a stage to feel potential to do things differently, to not be stuck. And as someone who will be recommending therapy, now loosely defined as means of improvement, for my career, it's useful to be on this end of things. It makes me think that care comes not so much from distance between providers and their patients (the distance created by difference in medical knowledge and training) and this idea that one can fix the other, as much from the shared desire to live as well as we can.
Monday, August 8, 2011
girlfriends
Picking up my college roommates from the train station, the first thing M says is: Look at A's boots! A is sporting a pair of resilient chunky ankle-high hiking boots, prepared for our hike at Sleeping Giant. She has small hands and feet for her size, and the combination of petite and hardcore in the shoes give immediate amusement (and continual throughout the day as we talk about how to maximize the use of her boots during our hike).
I haven't seen these girls for a few months, and there's no need for hello, only laughs.
On our hike, I naturally read the map wrong, but we do manage to reach our destination. Along the way we talk and talk, and I'm reminded of how different conversations are with different people. There's a certain silliness and inappropriateness and openness specific to my interactions with these girls, these girls with whom I went through such a defining period of growth--not just the confusion of college but the daze of post-college and the feigned maturity of post-post college.
And it's with them that a weekend of girlfriends began, a weekend where I'm deeply reminded that I am a girl, and that it is amazing to be one. With M & A, we run through the gamut of past and current boys and flings, past and current fashions; the quality of kisses (and so on), the quality of our own bodies and how to be self-accepting; the irrationality of moods and ups and downs, and how we cope. We share the insecurities that come with being female and a person, freely and honestly because we know it's common among us and because in the end they will be sweetly funny and not damaging.
It is nice to share the trees with them, and a part of my life with them, and they appreciate it too. It's a long hike that tires us, but we reach the tower I keep telling them is the destination--it's a short tower that is anticlimactic as we approach, but it holds the view with the breeze as they fit into the arches of the tower's windows. We reward ourselves with ice cream (two scoops, which proves to be too much), and some napping at home before dinner.
The bed is where we gather before their departure, in the cozy style of a sleepover. Which lends itself to sharing photographs, commenting on male facial hair and body odor, talking about people from college I haven't thought about in ages, wondering whether people notice when you wear the same outfit ("I don't judge, but I notice"), comparing our stretch marks. In between these there lies what's more conventionally considered substance--jobs, future plans, philosophies and approaches to day-to-day and to things broadly. But when they leave I'm aware that there is incredible weight to everything we share, the kind that makes me paradoxically, wonderfully feel full and light.
*
It's this lightness that carries me through the night, where three of my med school girlfriends and I go out to dance. During dinner with M, A, and the wife, we tell M & A about our dance plans.
M: You're going to dance, just the two of you?
Wife & me, simultaneous: *shrug* we do it all the time!
(This night there are four of us, but we have gone out with just two many a good time). It's an eclectic crowd, the four of us girls, but we share the strong desire to dance that precludes caring about being the only ones on the dance floor. At Barcelona, this means having the entire space to ourselves, and I'm again so happy to be a girl. At Black Bear there are more people and songs that bring out the inner excitable. Being with girls who move with distinct styles and without any thought other than to have fun, and whose fun is so apparent in their faces and bodies, is a constant source of energy, and the fun grows exponentially with every second.
It feels so good to go all out, to both be aware of our physical selves and to let go of self-consciousness.
*
On the next day, with these same girls we make dumplings and watch Shakespeare's As You Like It as the Cabaret. I get sleepy during the play, in which I pay more attention to the use of space and creation of atmosphere than plot. And I think, what range of experiences I can have with the girls in my life, and what depth I reach in each one.
These ladies make me feel that at baseline we're something to be grateful to be: people who are capable. Of having all sorts of negative and positive feelings, from silly and jealous and insecure, to confident and affirming and persistent. It's not any one thing but more the spectrum, that I love.
I haven't seen these girls for a few months, and there's no need for hello, only laughs.
On our hike, I naturally read the map wrong, but we do manage to reach our destination. Along the way we talk and talk, and I'm reminded of how different conversations are with different people. There's a certain silliness and inappropriateness and openness specific to my interactions with these girls, these girls with whom I went through such a defining period of growth--not just the confusion of college but the daze of post-college and the feigned maturity of post-post college.
And it's with them that a weekend of girlfriends began, a weekend where I'm deeply reminded that I am a girl, and that it is amazing to be one. With M & A, we run through the gamut of past and current boys and flings, past and current fashions; the quality of kisses (and so on), the quality of our own bodies and how to be self-accepting; the irrationality of moods and ups and downs, and how we cope. We share the insecurities that come with being female and a person, freely and honestly because we know it's common among us and because in the end they will be sweetly funny and not damaging.
It is nice to share the trees with them, and a part of my life with them, and they appreciate it too. It's a long hike that tires us, but we reach the tower I keep telling them is the destination--it's a short tower that is anticlimactic as we approach, but it holds the view with the breeze as they fit into the arches of the tower's windows. We reward ourselves with ice cream (two scoops, which proves to be too much), and some napping at home before dinner.
The bed is where we gather before their departure, in the cozy style of a sleepover. Which lends itself to sharing photographs, commenting on male facial hair and body odor, talking about people from college I haven't thought about in ages, wondering whether people notice when you wear the same outfit ("I don't judge, but I notice"), comparing our stretch marks. In between these there lies what's more conventionally considered substance--jobs, future plans, philosophies and approaches to day-to-day and to things broadly. But when they leave I'm aware that there is incredible weight to everything we share, the kind that makes me paradoxically, wonderfully feel full and light.
*
It's this lightness that carries me through the night, where three of my med school girlfriends and I go out to dance. During dinner with M, A, and the wife, we tell M & A about our dance plans.
M: You're going to dance, just the two of you?
Wife & me, simultaneous: *shrug* we do it all the time!
(This night there are four of us, but we have gone out with just two many a good time). It's an eclectic crowd, the four of us girls, but we share the strong desire to dance that precludes caring about being the only ones on the dance floor. At Barcelona, this means having the entire space to ourselves, and I'm again so happy to be a girl. At Black Bear there are more people and songs that bring out the inner excitable. Being with girls who move with distinct styles and without any thought other than to have fun, and whose fun is so apparent in their faces and bodies, is a constant source of energy, and the fun grows exponentially with every second.
It feels so good to go all out, to both be aware of our physical selves and to let go of self-consciousness.
*
On the next day, with these same girls we make dumplings and watch Shakespeare's As You Like It as the Cabaret. I get sleepy during the play, in which I pay more attention to the use of space and creation of atmosphere than plot. And I think, what range of experiences I can have with the girls in my life, and what depth I reach in each one.
These ladies make me feel that at baseline we're something to be grateful to be: people who are capable. Of having all sorts of negative and positive feelings, from silly and jealous and insecure, to confident and affirming and persistent. It's not any one thing but more the spectrum, that I love.
Thursday, August 4, 2011
precognition
M told me awhile ago about a phenomenon called precognition, where people can process things that happen in the near future, without consciously knowing it. This unconscious absorption can then manifest itself in thinking about what will happen in the future, before it actually happens. In some experiments, subjects are shown images of two curtains and asked to predict under which curtain contained a picture. They were then shown which curtain was correct, and even though they had no idea before being shown, they predicted the curtain correctly more often than would be predicted by chance. The idea is that something outside the usual senses absorbs this future experience, or the experience "travels" back in time to you, so that your mind has glimpsed it before your senses do.
Since he told me about it, he's mentioned some examples that have happened to him. I am by nature like most people, resistant to ingrained, familiar processes of thought that make sense to me mainly because I haven't given them much thought. But that stubborn narrowness exists more in the immediate than long-term. The willingness to continue considering something, combined with M's natural way of pushing me to be more open, makes the world much bigger and wider, and richer.
The other day, I was telling M about a blog I read. A few days before that, I decided to finally comment on this person's blog that I've read over the past couple years. A little while ago she became sick and needed a bone marrow transplant. I was pretty jarred by this, the sudden change in a stranger's life; somehow those take on the regularity of those more familiar to you. Her blog moved to a different website and became focused on health updates. I'd read it only sporadically, but recently became invested in reading it more regularly. I like her way of taking things as they come, and how her qualities that were associated with her old life--being out and about, active, running--still seem present despite not being able to have that life anymore. I'm not sure why, after all this time, I decided to comment and tell her a little of my connection to her blog.
As I was telling M, I remembered that I was struck by how she mentioned doing "laps" around the hospital, walking with her IV down the hallway. One of the things I'd liked reading about was her running, and I was struck by the contrast. It also made me think of how sad I've been over my rusty hip, and not being able to move to the same degree as before. Compared to her change, it's not much of a difference, but with the effect this small change has had on me, I can imagine how much more difficult such loss would be. I think this is one of the things that prompted me to comment.
I'm not sure why, a couple days after posting the comment, I brought it up to M. I introduced it on my own and we had a long conversation about bone marrow transplants and donors. A few hours later, I am told that a friend has just received a letter about being a possible bone marrow match for a 51 year old man. Long story, I'm involved in communicating to this friend that she's received this letter, and I'm struck by the coincidence. M is the one to point out possible precognition.
Though experiments are centered around having precognition of something that happens just several seconds later (not several hours like my case), things like that make me feel that thoughts are in some way sent out to the universe. It's not so straightforward, like telepathy or the idea that thinking something will happen will make it happen. More that energy and thoughts exist in forms we might not feel or know directly. I don't know how much this changes anything other than maybe to consider and feel things with slightly different awareness. Which as far as measuring value of being open to the incomprehensible and unlikely, seems more than enough.
Since he told me about it, he's mentioned some examples that have happened to him. I am by nature like most people, resistant to ingrained, familiar processes of thought that make sense to me mainly because I haven't given them much thought. But that stubborn narrowness exists more in the immediate than long-term. The willingness to continue considering something, combined with M's natural way of pushing me to be more open, makes the world much bigger and wider, and richer.
The other day, I was telling M about a blog I read. A few days before that, I decided to finally comment on this person's blog that I've read over the past couple years. A little while ago she became sick and needed a bone marrow transplant. I was pretty jarred by this, the sudden change in a stranger's life; somehow those take on the regularity of those more familiar to you. Her blog moved to a different website and became focused on health updates. I'd read it only sporadically, but recently became invested in reading it more regularly. I like her way of taking things as they come, and how her qualities that were associated with her old life--being out and about, active, running--still seem present despite not being able to have that life anymore. I'm not sure why, after all this time, I decided to comment and tell her a little of my connection to her blog.
As I was telling M, I remembered that I was struck by how she mentioned doing "laps" around the hospital, walking with her IV down the hallway. One of the things I'd liked reading about was her running, and I was struck by the contrast. It also made me think of how sad I've been over my rusty hip, and not being able to move to the same degree as before. Compared to her change, it's not much of a difference, but with the effect this small change has had on me, I can imagine how much more difficult such loss would be. I think this is one of the things that prompted me to comment.
I'm not sure why, a couple days after posting the comment, I brought it up to M. I introduced it on my own and we had a long conversation about bone marrow transplants and donors. A few hours later, I am told that a friend has just received a letter about being a possible bone marrow match for a 51 year old man. Long story, I'm involved in communicating to this friend that she's received this letter, and I'm struck by the coincidence. M is the one to point out possible precognition.
Though experiments are centered around having precognition of something that happens just several seconds later (not several hours like my case), things like that make me feel that thoughts are in some way sent out to the universe. It's not so straightforward, like telepathy or the idea that thinking something will happen will make it happen. More that energy and thoughts exist in forms we might not feel or know directly. I don't know how much this changes anything other than maybe to consider and feel things with slightly different awareness. Which as far as measuring value of being open to the incomprehensible and unlikely, seems more than enough.
Monday, July 25, 2011
saturday & sunday
On Saturday M and I take a short road trip to Rhode Island, the one New England state we didn't visit on our early summer road trip. Our windows are down the whole time. The drive is mostly on 95, then for awhile along a smaller road with trees whose freshness we can smell. We drive over the bridge leading to Newport. We pass by the mansions, and look for a beach with waves. After some logistical hodgepodge of parking, coins, inquiries, beach-hopping, and so on--we make it to a warm beach with some waves where M can surf and I can be a bum. The water is chocolate brown, the brown coming not from chocolate but from massive amounts of algae. It feels good to be in it; it's been so hot. M catches one very long wave which makes him happy and a good amount of other ones too, and it's nice to see him happy in this way. After he gets out of the water he sits looking at the water while I fall asleep with his hat over my face, and when I wake up we walk out onto a cliff of boulders by the sea. There's a large one with three sides from which you can climb up, so we clamber over it for awhile and this is my favorite part--the confined yet endless exploration. Then we throw the Frisbee around, to warm up to get back into the water. He wants me to get comfortable going underwater in the ocean. So we jump into waves for awhile, one hand in his to keep from dying and my other hand over my swimsuit which slips too easily. After several of these, M looks at my back and tells me we have to get out. I follow, and seconds later feel the urgency of his return to shore--the algae living in the water is host to tiny crawling worm-like bugs that bite. We spend a good twenty minutes trying to wash them out in the same water where they swarm. We find a "shower"--a two-second stream of water giving about a fourth the volume of a faucet. There's only one, so we take turns, pressing the button for second and third streams before giving it up to someone else waiting and getting back in line for more. I can't do much about the algae now growing entwined in every strand of my hair, until we're at home and I shampoo it out half a dozen times. To get there, we drive home, in the dark now, still smelling the same trees through the windows.
On Sunday we do three loads of laundry and get groceries. M has completely run out of shirts, and I've eaten my last egg and piece of bread. And our things from the beach need much cleansing. I stock up on fruits and veggies, and he buys masala sauce and naan to make our own chicken tikka masala dish. I'm glad to have the basics in abundance, and eat two peaches, handfuls of grapes, an orange and an apple. Our attempt at Indian food is good but needs more cream added to the sauce, we decide. Next time we'll buy cream.
On Sunday we do three loads of laundry and get groceries. M has completely run out of shirts, and I've eaten my last egg and piece of bread. And our things from the beach need much cleansing. I stock up on fruits and veggies, and he buys masala sauce and naan to make our own chicken tikka masala dish. I'm glad to have the basics in abundance, and eat two peaches, handfuls of grapes, an orange and an apple. Our attempt at Indian food is good but needs more cream added to the sauce, we decide. Next time we'll buy cream.
Friday, July 22, 2011
adjustments
I've had hip pain for the past few months, which started after a run where I tried to increase speed, after months of steady running. I'd had this type of pain before and back then I went on a long running hiatus, and even after getting back to it after half a year or so, hadn't gotten back to where I was. So it was frustrating to have it happen again. This time around, I was able to get back to running sooner than last, but the pain stayed, happening during other stretching and exercising. So my classmate referred me to a friend of his who's completing the physical therapy program at USC. I talked to her, and one of her classmates, last night for an hour about my hip. They got my history, watched me do some squats, and diagnosed me with hip impingement. They told me that I need to work on strengthening the smaller muscles involved in dynamic movement like running, and that I need to stretch my hip flexors to open up the hip joint, especially since so much of my exercise entails hip flexion.
I tried the exercises today before p90x and already noticed a difference. And like with other chronic pain, the absence of pain is noticeable; normal becomes prominent. It will take longer to go away completely, but I'm very happy with the change made by this attention to small motions and interactions.
*
I had another interview with an ALS patient today. It was a full day venture, as his home is an hour drive from here, and our interview lasted two hours, and I stayed for lunch. He talked about how he notices sudden differences in his motion. One day he can stand on his tiptoes to hang home decor, three days later, he can't do it at all. He first suspected problems when he developed foot drop. When going down the stairs, he can't flex his feet and his heels come down hard on each step. The trick, he said, is to walk downstairs backwards.
I tried the exercises today before p90x and already noticed a difference. And like with other chronic pain, the absence of pain is noticeable; normal becomes prominent. It will take longer to go away completely, but I'm very happy with the change made by this attention to small motions and interactions.
*
I had another interview with an ALS patient today. It was a full day venture, as his home is an hour drive from here, and our interview lasted two hours, and I stayed for lunch. He talked about how he notices sudden differences in his motion. One day he can stand on his tiptoes to hang home decor, three days later, he can't do it at all. He first suspected problems when he developed foot drop. When going down the stairs, he can't flex his feet and his heels come down hard on each step. The trick, he said, is to walk downstairs backwards.
Monday, July 18, 2011
one-time meetings
Being a quiet person and someone that doesn't usually register on anyone's radar on first meeting, I believe in the need for time and multiple interactions to get any significant sense of someone. It goes without saying that you usually need more than a first impression to get to know someone, but I think that it's hard to base even small things on a first interaction, depending on circumstances. M thinks you can get more from this than I give credit, and I think it's true that I should give more credence to these things, even as staying open to what else might inform your perception and understanding of someone.
Two interactions today made me think of this even more. The first was meeting with the person who will be writing a letter for my residency application. Residencies require a letter from the chair of your department, and if you aren't so naturally inclined to networking like me, you might not have met this person before you need a letter from them. So they set up a meeting to speak with this person, so that they might get to know you enough to write a letter about you. The person reads your CV, personal statement, has a conversation with you, and writes the letter that same day. Going into this, it felt like a routine part of the process, something to elicit skepticism but something needed to be done. Afterwards, I was surprised at how much was exchanged and received, and how glad I was that this person would be writing about me. I don't know if he has always had this ability or has cultivated it over a lot of people interaction, but at the end of the forty minute meeting, he had picked up on different themes important to me and connected them in the same way I perceive and feel them. I was glad on the one hand that some of my thoughts had been conveyed in my personal statement, which at the time of writing felt a little distant. On the other hand I felt that a lot of this understanding came from him--what he noticed, what he listened to, what he asked. It was a pleasant surprise to feel that an important part of me had been shared, and it is something to aspire emulating.
The other was an interview with a patient, for my research on terminally ill patients. It was the first time I'd met anyone with amytrophic lateral sclerosis (AML, or Lou Gehrig's disease). This disease affects a person's muscles, such that there is progressive decline in the use of your arms, legs, throat, and lungs. Most people die from respiratory failure several years after diagnosis, after losing the ability to walk, eat, talk, and finally breathe. Knowing rationally how devastating this must be, I was a little unsure what to expect. In the hour of speaking with him and his wife, an incredible couple, they shared a part of their story not yet voiced to anyone else. He had never talked about dying before, and as he did, a lot seemed to pass between us--not just the sadness, but also the lighter moments, had weight. As hard as it was, I felt pretty lucky to receive so much from meeting a stranger. I suppose this is the nature of all interviews, when you expect to get some sense of someone from an interaction structured to do so, but always having been skeptical of this notion, I was surprised.
Maybe I wouldn't have trusted the second interaction in the same way if I hadn't had the first one; after all, who can say what we observe is true or what bulk it comprises. But so it often goes, that each meeting is isolated and connected.
Two interactions today made me think of this even more. The first was meeting with the person who will be writing a letter for my residency application. Residencies require a letter from the chair of your department, and if you aren't so naturally inclined to networking like me, you might not have met this person before you need a letter from them. So they set up a meeting to speak with this person, so that they might get to know you enough to write a letter about you. The person reads your CV, personal statement, has a conversation with you, and writes the letter that same day. Going into this, it felt like a routine part of the process, something to elicit skepticism but something needed to be done. Afterwards, I was surprised at how much was exchanged and received, and how glad I was that this person would be writing about me. I don't know if he has always had this ability or has cultivated it over a lot of people interaction, but at the end of the forty minute meeting, he had picked up on different themes important to me and connected them in the same way I perceive and feel them. I was glad on the one hand that some of my thoughts had been conveyed in my personal statement, which at the time of writing felt a little distant. On the other hand I felt that a lot of this understanding came from him--what he noticed, what he listened to, what he asked. It was a pleasant surprise to feel that an important part of me had been shared, and it is something to aspire emulating.
The other was an interview with a patient, for my research on terminally ill patients. It was the first time I'd met anyone with amytrophic lateral sclerosis (AML, or Lou Gehrig's disease). This disease affects a person's muscles, such that there is progressive decline in the use of your arms, legs, throat, and lungs. Most people die from respiratory failure several years after diagnosis, after losing the ability to walk, eat, talk, and finally breathe. Knowing rationally how devastating this must be, I was a little unsure what to expect. In the hour of speaking with him and his wife, an incredible couple, they shared a part of their story not yet voiced to anyone else. He had never talked about dying before, and as he did, a lot seemed to pass between us--not just the sadness, but also the lighter moments, had weight. As hard as it was, I felt pretty lucky to receive so much from meeting a stranger. I suppose this is the nature of all interviews, when you expect to get some sense of someone from an interaction structured to do so, but always having been skeptical of this notion, I was surprised.
Maybe I wouldn't have trusted the second interaction in the same way if I hadn't had the first one; after all, who can say what we observe is true or what bulk it comprises. But so it often goes, that each meeting is isolated and connected.
Tuesday, July 12, 2011
daily happiness
There's something about continued, sustained small reasons for gratitude. Currently, I'm happy for summer dress weather, the company of an ever-encouraging friend while I doggedly, slugglishly write my personal statement at the library, red cheeks so hot after a workout that a cold shower feels delicious, and having him at the end of the day for thoughtful conversations and silly brawls.
Monday, July 11, 2011
being back
I've been back in New Haven for little over a week now, and already feel full of things. This sensation is familiar, and I'm glad for familiarity of such a nice feeling. The sense that a lot has been done, a lot to be done. I'm writing a little rambly and frazzled right now, as warm-up for writing my personal statement for my application to residency. I have less than a year left at medical school, and part of that year will be invested in trying to get somewhere after that year is over.
But it's also a year to have on its own. Since being back, M has started teaching me how to swim, which has been an experience to rank among my top in life...it might seem silly that something so common becomes like that, but I think there's a lot to that, that I'm saving up somewhere to put down somewhere at some point. Continuing to p90x and to climb, and building stamina even as much of it is still hard. My right hip, which started acting up after a run a few months ago, still feels funny, makes me feel old, and presents a concrete reminder of effort and movement.
Hoping to see as much as possible this year, more road trips and more farther trips and also more local exploration, with a list of new places to run. There will also be trips to interview, and new hospitals to see, cities to see in new contexts. Through that, would like to keep the old growing and close.
But it's also a year to have on its own. Since being back, M has started teaching me how to swim, which has been an experience to rank among my top in life...it might seem silly that something so common becomes like that, but I think there's a lot to that, that I'm saving up somewhere to put down somewhere at some point. Continuing to p90x and to climb, and building stamina even as much of it is still hard. My right hip, which started acting up after a run a few months ago, still feels funny, makes me feel old, and presents a concrete reminder of effort and movement.
Hoping to see as much as possible this year, more road trips and more farther trips and also more local exploration, with a list of new places to run. There will also be trips to interview, and new hospitals to see, cities to see in new contexts. Through that, would like to keep the old growing and close.
Friday, June 10, 2011
while being away
I guess that I've been away, or really that New Haven has been away from me. In either context, things are happening, which is the nice thing about doing things in compact spaces of time/place. Like on trips, when so much seems to happen in a week, by nature of changing routine and scenery. While in California, there have been blocks of things contributing to an intense, fragile balance of being fulfilled and seeking out.
In the morning before work, I get up to do the p90x workout of the day. Before this I've never considered exercise to simply strengthen. I like activities, and liked them a lot when young, but early in life, learning overshadowed playing games, and so now, when I feel a bit too old to be learning anew, throwing myself into activities seems more of a priority than developing strength and flexibility and balance. But not only do those contribute to being active, they also feel good on their own. My brother said to me, why does a girl need to be strong? It was said with slight real sexism; and it's true in a way. A girl doesn't usually need to be strong to attract a guy, or to beat up another girl. I've discovered that I really like feeling strong, for no real reason other than to know you're capable. It is also a little odd to see your activities make concrete changes in your body, and like all physical things I enjoy, it strengthens a lot of mental processes and approaches.
I take the bus to my rotation at the San Francisco Free Clinic. Walking to the bus stop, riding it, and walking to clinic takes about an hour. It goes by pretty fast, and doesn't bother me in terms of time since clinic hours are usually 10-5. I like navigating the city this way; I also use the bus to meet up with friends, go to the rock gym, go shopping and run errands. I often don't know from which side of the street I should be waiting for the bus. But I have more time to figure it out than I would in a car. And I'm by myself so only I have to deal with my spectacularly awful sense of direction, and only I can feel how rarely this can feel less of a confusing burden and more of a freeing confusion. A lot of old people ride the bus, and there are so many Asians in this city; I alway forget this. I'm not sure yet how the difference in population has affected me, but it's something that made me take notice. On the bus I read books, and I've gotten into Agatha Christie, as there are several of her books at my brother's. I was never into genre novels--fantasy, sci-fi, mystery. But I've gotten into Christie because the books are fun and easy to read, and because over time I've organically gotten better at paying attention to details, which makes both the book and life outside of the book more enjoyable.
The patients at the clinic, which provides primary care to the uninsured, have made for an amazing experience. Each one has subtly strange qualities, strange in that they are rare, not always that they are extreme. Because of that, I have a much stronger sense of each one after a day of several patients, than I have in other primary care settings I've experienced. Each one makes me think, or cling onto a characteristic or word or facial expression, or share our conversation with someone else. More on this as it goes on, can't fully describe the gratitude for such exposure and absorption of things outside of how I am/what I know.
In the evening, I eat dinner with my brother in his beautiful apartment lined with floor-to-ceiling windows that open up to the ocean. The water can be blue, green, gray, or mixes of those, and colors the rest of the house with its lighting. During the ab exercises from p90x, we sit up from painful crunches to see the sun setting diamonds on the water. The dinner is often something my mom has packed up for us. I'm glad to be in easy comfort with my brother in the same apartment, my parents across a bridge, not a day-long flight away. If I have an early day or extra time, I take the bus to the rock gym to boulder, since I can't climb by myself...I miss the style afforded by being attached to a rope, but bouldering is pretty mentally challenging. It requires a lot of initial strength that I don't have, and also a lot of overcoming fear (since there is no rope), which I've found very hard, especially alone. But it feels really, really good when at one moment it happens, especially after a lot of stalemate and frustration. On some evenings I spend time with friends in the Bay Area; it is a place containing people from different phases of my life. I'm lucky to have so many people with whom I want to share the mixed-up self I bring back to home, a person away.
At night I share the bed with Mikey the cat, whose personality has been branded dog-like. He follows you everywhere, showers you with affection, licks and bites you lovingly, stares at you with huge green eyes of neediness. I've pretty much fallen in love with him, and his strangely perfect combination of cat and dog.
It's also at night that I think of being away. Immediately before coming here, M and I went on a fantastic week-long road trip through parts of the East Coast. Coming straight from that to another experience, I might find it easy to forget the smell of fires, fresh early summer mornings, new sun emerging from weeks of rain, long drives of lush green, five kinds of rain in five minutes, a beautiful rest stop and unassuming cove of space and lucky discovery on the search for a bathroom, a beach wrapped in fog, revisiting a home in perfect weather--but I haven't. The sensations resurge in small moments and strong waves, and I feel incredibly lucky to have so much here, and so much away.
In the morning before work, I get up to do the p90x workout of the day. Before this I've never considered exercise to simply strengthen. I like activities, and liked them a lot when young, but early in life, learning overshadowed playing games, and so now, when I feel a bit too old to be learning anew, throwing myself into activities seems more of a priority than developing strength and flexibility and balance. But not only do those contribute to being active, they also feel good on their own. My brother said to me, why does a girl need to be strong? It was said with slight real sexism; and it's true in a way. A girl doesn't usually need to be strong to attract a guy, or to beat up another girl. I've discovered that I really like feeling strong, for no real reason other than to know you're capable. It is also a little odd to see your activities make concrete changes in your body, and like all physical things I enjoy, it strengthens a lot of mental processes and approaches.
I take the bus to my rotation at the San Francisco Free Clinic. Walking to the bus stop, riding it, and walking to clinic takes about an hour. It goes by pretty fast, and doesn't bother me in terms of time since clinic hours are usually 10-5. I like navigating the city this way; I also use the bus to meet up with friends, go to the rock gym, go shopping and run errands. I often don't know from which side of the street I should be waiting for the bus. But I have more time to figure it out than I would in a car. And I'm by myself so only I have to deal with my spectacularly awful sense of direction, and only I can feel how rarely this can feel less of a confusing burden and more of a freeing confusion. A lot of old people ride the bus, and there are so many Asians in this city; I alway forget this. I'm not sure yet how the difference in population has affected me, but it's something that made me take notice. On the bus I read books, and I've gotten into Agatha Christie, as there are several of her books at my brother's. I was never into genre novels--fantasy, sci-fi, mystery. But I've gotten into Christie because the books are fun and easy to read, and because over time I've organically gotten better at paying attention to details, which makes both the book and life outside of the book more enjoyable.
The patients at the clinic, which provides primary care to the uninsured, have made for an amazing experience. Each one has subtly strange qualities, strange in that they are rare, not always that they are extreme. Because of that, I have a much stronger sense of each one after a day of several patients, than I have in other primary care settings I've experienced. Each one makes me think, or cling onto a characteristic or word or facial expression, or share our conversation with someone else. More on this as it goes on, can't fully describe the gratitude for such exposure and absorption of things outside of how I am/what I know.
In the evening, I eat dinner with my brother in his beautiful apartment lined with floor-to-ceiling windows that open up to the ocean. The water can be blue, green, gray, or mixes of those, and colors the rest of the house with its lighting. During the ab exercises from p90x, we sit up from painful crunches to see the sun setting diamonds on the water. The dinner is often something my mom has packed up for us. I'm glad to be in easy comfort with my brother in the same apartment, my parents across a bridge, not a day-long flight away. If I have an early day or extra time, I take the bus to the rock gym to boulder, since I can't climb by myself...I miss the style afforded by being attached to a rope, but bouldering is pretty mentally challenging. It requires a lot of initial strength that I don't have, and also a lot of overcoming fear (since there is no rope), which I've found very hard, especially alone. But it feels really, really good when at one moment it happens, especially after a lot of stalemate and frustration. On some evenings I spend time with friends in the Bay Area; it is a place containing people from different phases of my life. I'm lucky to have so many people with whom I want to share the mixed-up self I bring back to home, a person away.
At night I share the bed with Mikey the cat, whose personality has been branded dog-like. He follows you everywhere, showers you with affection, licks and bites you lovingly, stares at you with huge green eyes of neediness. I've pretty much fallen in love with him, and his strangely perfect combination of cat and dog.
It's also at night that I think of being away. Immediately before coming here, M and I went on a fantastic week-long road trip through parts of the East Coast. Coming straight from that to another experience, I might find it easy to forget the smell of fires, fresh early summer mornings, new sun emerging from weeks of rain, long drives of lush green, five kinds of rain in five minutes, a beautiful rest stop and unassuming cove of space and lucky discovery on the search for a bathroom, a beach wrapped in fog, revisiting a home in perfect weather--but I haven't. The sensations resurge in small moments and strong waves, and I feel incredibly lucky to have so much here, and so much away.
Monday, May 9, 2011
outdoors
Last Saturday, I went on a retreat organized by one of the professors here, an internist who teaches the patient-centered interviewing curriculum. He wears a long braid, glasses, and sandals, which makes him easy to parody in our Second Year Show, but also makes his warmth and openness sincere. Like the pastures of the abbey where the retreat took place, he shares with and accepts from anyone. To get there, I drove an hour through woods on both sides. The theme of the day is Ora et Labora, or prayer and work. The idea is to make one like the other, or an indistinct continuation. To work at prayer, to make work more mindful. I'm not at all religious, but medical school people and experiences have really made me value both mindfulness of the present and a sense of things outside of the immediate. Physical labor is beautiful when it's a choice. Clearing the landscape, in this case a grassy field freshly green and lush with smell and color, is pretty naturally therapeutic. Part of doing that required gathering branches lined with thorns, and I learned how damn annoying tenacity can be, when imbued in compactness. The thorns penetrate clothing, and cling to areas on, behind, around you as you try to maneuver them. It was frustrating work, tedious, forcefully thoughtful. That made it a good experience, to tuck away for future writings and perspectives, but honestly I liked loading heavy firewood onto trucks better. The nuns are hardy, of course, and on the assembly line of log holders, they would toss the logs to me. An older man would bend over, pick them up, and unable to hold them long enough for someone else to take them, set them back down, a bit closer to the next person in the assembly line. We took a break with the best hummus I've ever eaten (homemade; could have eaten it plain with a spoon). The evening prayers took place in a wooded church, that smelled and looked like fresh unpainted wood. The wood was interrupted by continuous glass panels, for effortless sunlight. The day was shared by a group of people in different phases of their careers, all still incredibly open with their points of view and their feelings, all still incredibly kind, welcoming, warm.
This past Sunday, we had our first rock-climbing venture outdoors, in a little park off the side of the road, 40 minutes east of here. It was very different from indoor climbing, to not have a route to follow, but indoor climbing has given us an intuitive sense of where to place our hands and feet. I also felt something similar to what I felt hiking on glaciers in New Zealand--a feeling of how dynamic, organic the environment is. It sprinkled and showered on and off while we were climbing, and the wet changed the rocks, made the same climbs different. When I was up on one particular climb that we all tried, and failed with extreme frustration, the sun came out and warmed the rope, the face of the rock, and my own face. Elements evolve with seconds, and nothing can be experienced the same outside those slivers. The woods were lightly greened with trees, which made for bright contrast to gray clouds, with jarring breaks of sun.
M and I talk a lot about sacrifices made for medicine, how the intellectual can take away from the environment. I understand and have felt the danger and consequences of that. But I also feel strongly about how medicine, and the people to whom I've connected through it, make stronger, more poignant, more full, the tie between outside and internal. I think the openness medicine pushes you to give, if you want to enjoy it and value it, begins to apply to everything. And this opening can create a path between all that you do, so that things meld, the strength in one supporting vulnerabilities in the other, much like working on land to connect labor with prayer, or climbing a rock to connect routes with freedom.
This past Sunday, we had our first rock-climbing venture outdoors, in a little park off the side of the road, 40 minutes east of here. It was very different from indoor climbing, to not have a route to follow, but indoor climbing has given us an intuitive sense of where to place our hands and feet. I also felt something similar to what I felt hiking on glaciers in New Zealand--a feeling of how dynamic, organic the environment is. It sprinkled and showered on and off while we were climbing, and the wet changed the rocks, made the same climbs different. When I was up on one particular climb that we all tried, and failed with extreme frustration, the sun came out and warmed the rope, the face of the rock, and my own face. Elements evolve with seconds, and nothing can be experienced the same outside those slivers. The woods were lightly greened with trees, which made for bright contrast to gray clouds, with jarring breaks of sun.
M and I talk a lot about sacrifices made for medicine, how the intellectual can take away from the environment. I understand and have felt the danger and consequences of that. But I also feel strongly about how medicine, and the people to whom I've connected through it, make stronger, more poignant, more full, the tie between outside and internal. I think the openness medicine pushes you to give, if you want to enjoy it and value it, begins to apply to everything. And this opening can create a path between all that you do, so that things meld, the strength in one supporting vulnerabilities in the other, much like working on land to connect labor with prayer, or climbing a rock to connect routes with freedom.
Thursday, April 28, 2011
belief
One of the recurring themes in Power's "Problem From Hell" is how response to genocide is often hindered by an inability to believe. This is distinct from an accusation of lying. It's not that, when confronted with the notion that people are being tortured, raped, killed, humiliated, on massive massive scales, that people say--I don't believe you because you're lying. It's that they say, I don't believe you because I can't believe you. It's so awful, people can't imagine that it would actually happen. Even the victims themselves would hold out hope, make up for themselves excuses, that what was happening wasn't really, that it wouldn't reach them eventually, that they would be different. In many ways, this is an instrument of survival, but in other ways it keeps us in a damaging narrowness.
On Park and Crown, there is a building whose brick wall has recently, for some reason, been covered by a black and white mural of Anne Frank's face. In the corner it tells us, as she did: "Believe in people." I remember reading as a young girl, her diary of a young girl, and being struck by the same sentence that made her famous--"in spite of it all, I still believe that people are really good at heart."
My own sense of disbelief arises more in response the inability to believe in bad, than in response to the bad itself. I've always thought of myself who believes in people too, but lately I find myself thinking more that it's not a belief in goodness or the opposite, but an openness to the full spectrum in between. I believe in capacity. People are capable of incredible good, and that is incredible; they're also capable of incredible bad, and that is also incredible. I don't think recognizing one negates the other. Regardless of which way you think people tend to lean, the most human thing is that they can lean any which way, depending on what is supporting or not supporting them.
I think one of the nicest things about doctoring is the opportunity to know people, not kind friendly grateful people, but all people in whatever it is that they have become. This isn't to say that there aren't things to dislike; I dislike a million things about a million different people. But if we marvel at our own humanity and wonder at how it is that we can accomplish so much, I think it's important to recognize that the root of it all is the same range of possibility that gives rise to inhumanity and how it is that we can destroy so much.
On Park and Crown, there is a building whose brick wall has recently, for some reason, been covered by a black and white mural of Anne Frank's face. In the corner it tells us, as she did: "Believe in people." I remember reading as a young girl, her diary of a young girl, and being struck by the same sentence that made her famous--"in spite of it all, I still believe that people are really good at heart."
My own sense of disbelief arises more in response the inability to believe in bad, than in response to the bad itself. I've always thought of myself who believes in people too, but lately I find myself thinking more that it's not a belief in goodness or the opposite, but an openness to the full spectrum in between. I believe in capacity. People are capable of incredible good, and that is incredible; they're also capable of incredible bad, and that is also incredible. I don't think recognizing one negates the other. Regardless of which way you think people tend to lean, the most human thing is that they can lean any which way, depending on what is supporting or not supporting them.
I think one of the nicest things about doctoring is the opportunity to know people, not kind friendly grateful people, but all people in whatever it is that they have become. This isn't to say that there aren't things to dislike; I dislike a million things about a million different people. But if we marvel at our own humanity and wonder at how it is that we can accomplish so much, I think it's important to recognize that the root of it all is the same range of possibility that gives rise to inhumanity and how it is that we can destroy so much.
Wednesday, April 27, 2011
history
Yesterday I spent an hour of my day sitting quietly and asking about things around the room--paintings on the wall, books and photographs on the coffee table. My company was a quiet woman whom I found to be really lovely on first meeting, and more so on subsequent visits. We talked about travels--she's been to Siberia, the only person I've met to take the Trans-Siberian railroad, and she was in her seventies when she went. Nowadays she finds most fit nestled in a chair, reading. She worked as a librarian for most of her life, and now spends most of her days with a book. She likes history.
I've never been half as interested in history as in literature. It's one of the main reasons I abandoned thoughts of journalism freshman year of college, after spending the latter half of high school toying with the idea. For me, fiction over fact. But one general life goal is to seek stories in real life, and not just real life in stories. To be less in my head and more engaged with the outside. And, while I associate literature with more nuance than other areas, sometimes it's not so good to be immersed in detail.
Have been reading Samantha Power's book on genocide, Problem from Hell. One thing that strikes me in her portrayal of America's inaction in regard to all major 20th century genocides, is how much we evaluate things based on what's around it and often falsely call this considering context and learning from history. She brings attention to how our experiences affect our responses: how we didn't want to intervene in Cambodia because we'd just failed in the Vietnam War, how we didn't want to stop Iraq because we were scared of Iran. And we hear it in the news all the time now: we can't help Libya because look at how badly all of our other Middle Eastern ventures have gone. And we link everything together: why not help Syria too then; we can't help everyone.
The irony in calling this taking lessons from the past is so suffocating, it's hard to first read about in history and secondly consider how perpetual it is. Of course there is always context we need to consider, but if you really want to give credence to context, consider the individual situation and present time. Cambodia isn't Vietnam, Libya isn't Syria, or Iraq. And if you want to look at patterns, why not focus on what actually is similar--that Cambodia's Khmer Rouge was as deadly as Hitler's Nazis, that Libya's Qaddafi is as brutal as Iraq's Hussein. The politics and convenience of choosing what to take from history's patterns and what to dismiss from them, and the inability to evaluate the nuances of a particular situation, makes for such mess and incompleteness. That's a little of what I get from the bigger picture.
This perspective, and many miles from my own doorstep, helps to bring the narrow of my life into better focus. I've taken on one of the harder endeavors I've devised for myself, with a little push from M whose point of view I trust and respect, who believes that persistence really does overcome even natural incapacities. Which is considering my own patterns that aren't so useful or pleasant. Instead of imposing these often illogical patterns on my life, I want to more rationally approach situations as they arise. To consider the context that matters, to discard misapplied context, to leave room for what's new and different, to learn from what's old and recurring. This is pretty damn hard when you are both the evaluator and the object of evaluation, but probably one of the worthier goals to pursue.
From the woman and her books, I admire that someone at the end of her life can seek more to be learned from the past. From Samantha Power, I admire the ability to learn about facts as distinct components and part of a larger whole. From M, I admire the drive to try at whatever you want, the belief that you never have to feel trapped by your own self. And so for me, and for every person really, lies the process of taking what you value and living it.
I've never been half as interested in history as in literature. It's one of the main reasons I abandoned thoughts of journalism freshman year of college, after spending the latter half of high school toying with the idea. For me, fiction over fact. But one general life goal is to seek stories in real life, and not just real life in stories. To be less in my head and more engaged with the outside. And, while I associate literature with more nuance than other areas, sometimes it's not so good to be immersed in detail.
Have been reading Samantha Power's book on genocide, Problem from Hell. One thing that strikes me in her portrayal of America's inaction in regard to all major 20th century genocides, is how much we evaluate things based on what's around it and often falsely call this considering context and learning from history. She brings attention to how our experiences affect our responses: how we didn't want to intervene in Cambodia because we'd just failed in the Vietnam War, how we didn't want to stop Iraq because we were scared of Iran. And we hear it in the news all the time now: we can't help Libya because look at how badly all of our other Middle Eastern ventures have gone. And we link everything together: why not help Syria too then; we can't help everyone.
The irony in calling this taking lessons from the past is so suffocating, it's hard to first read about in history and secondly consider how perpetual it is. Of course there is always context we need to consider, but if you really want to give credence to context, consider the individual situation and present time. Cambodia isn't Vietnam, Libya isn't Syria, or Iraq. And if you want to look at patterns, why not focus on what actually is similar--that Cambodia's Khmer Rouge was as deadly as Hitler's Nazis, that Libya's Qaddafi is as brutal as Iraq's Hussein. The politics and convenience of choosing what to take from history's patterns and what to dismiss from them, and the inability to evaluate the nuances of a particular situation, makes for such mess and incompleteness. That's a little of what I get from the bigger picture.
This perspective, and many miles from my own doorstep, helps to bring the narrow of my life into better focus. I've taken on one of the harder endeavors I've devised for myself, with a little push from M whose point of view I trust and respect, who believes that persistence really does overcome even natural incapacities. Which is considering my own patterns that aren't so useful or pleasant. Instead of imposing these often illogical patterns on my life, I want to more rationally approach situations as they arise. To consider the context that matters, to discard misapplied context, to leave room for what's new and different, to learn from what's old and recurring. This is pretty damn hard when you are both the evaluator and the object of evaluation, but probably one of the worthier goals to pursue.
From the woman and her books, I admire that someone at the end of her life can seek more to be learned from the past. From Samantha Power, I admire the ability to learn about facts as distinct components and part of a larger whole. From M, I admire the drive to try at whatever you want, the belief that you never have to feel trapped by your own self. And so for me, and for every person really, lies the process of taking what you value and living it.
Monday, April 18, 2011
only girl
My advisor, who I love meeting each week for the pure reason of being with the type of doctor I'd like to someday be, once said that one thing she loves about being a physician is being what people need, which changes for each person. Some people need her to be stern, others need her to be lenient. Some people need affection, others need distance. It's not just personal preference, but about what's best for personal character. At first this might seem like playing a part to cater to someone, but I think that after awhile, if you train yourself to remain open to whatever someone brings to you, you naturally adopt different parts of them and different corresponding parts of them.
This might sound like advocating against being your own person--to be malleable and different depending on who's around you. But I don't think that necessarily has to be the case. I think being open to how another person can change and shape you, can mean drawing on resources within you that you aren't used to reaching for, haven't had to assume in the circumstances you've been in, aren't part of the general personality you've developed. Doing things, saying things, feeling things outside of your usual self aren't always less you than what you do everyday. You own all of it, including what you accept from others.
I thought of this today when Rihanna's "Only Girl" came on the radio. I'm a big fan of that song, and of Rihanna whose voice I love for its slight twang and high power. I thought of it because my friend C and I blasted this song throughout our cross country drive from Connecticut to Arizona, and back. And C is a person who makes me think of how different people bring out different things in me that I wouldn't always offer on my own. She's extremely expressive, while I find it pretty difficult to show when I'm really excited or happy about something. We've grown up in different environments, we respond to our current environments differently. I love in her all of these things that make us different, and she's open to me despite them, and I think that's the one and only thing I require in a friend, a certain openness to how I am and to how people are in general, that makes it easy to connect even if you're very different.
C and I both love this song, and other fun pop songs, and any time we heard one of our favorites, she'd go crazy in the car, and it would make me go kind of crazy too. This one song being iconic, whenever I hear it, I remember those free-for-all moments: all the windows down on a dark road in the desert of New Mexico, with flat-topped mountains fading into the black of night so that you can't see any shapes but think how beautiful it must be during the day; singing over the words over a straight road flanked by cotton fields in the middle of Arkansas which is full of deep reds and pale greens; dancing in the seats of the car through the wide therapeutic nothing of Texas with its surprising pink-tinged wheat and beauty.
And when she blasted the radio on full volume, put the car in park at a stop sign, jumped outside and danced barefoot on asphalt, in some residential southwest neighborhood already asleep. How I didn't hop out after her, but hopped out at the same time, as though I'd already absorbed the energy to fulfill a previously dormant whim. To feel something in you slip out of its cover is almost like to create something new, and there's so much in people to make you feel new.
This might sound like advocating against being your own person--to be malleable and different depending on who's around you. But I don't think that necessarily has to be the case. I think being open to how another person can change and shape you, can mean drawing on resources within you that you aren't used to reaching for, haven't had to assume in the circumstances you've been in, aren't part of the general personality you've developed. Doing things, saying things, feeling things outside of your usual self aren't always less you than what you do everyday. You own all of it, including what you accept from others.
I thought of this today when Rihanna's "Only Girl" came on the radio. I'm a big fan of that song, and of Rihanna whose voice I love for its slight twang and high power. I thought of it because my friend C and I blasted this song throughout our cross country drive from Connecticut to Arizona, and back. And C is a person who makes me think of how different people bring out different things in me that I wouldn't always offer on my own. She's extremely expressive, while I find it pretty difficult to show when I'm really excited or happy about something. We've grown up in different environments, we respond to our current environments differently. I love in her all of these things that make us different, and she's open to me despite them, and I think that's the one and only thing I require in a friend, a certain openness to how I am and to how people are in general, that makes it easy to connect even if you're very different.
C and I both love this song, and other fun pop songs, and any time we heard one of our favorites, she'd go crazy in the car, and it would make me go kind of crazy too. This one song being iconic, whenever I hear it, I remember those free-for-all moments: all the windows down on a dark road in the desert of New Mexico, with flat-topped mountains fading into the black of night so that you can't see any shapes but think how beautiful it must be during the day; singing over the words over a straight road flanked by cotton fields in the middle of Arkansas which is full of deep reds and pale greens; dancing in the seats of the car through the wide therapeutic nothing of Texas with its surprising pink-tinged wheat and beauty.
And when she blasted the radio on full volume, put the car in park at a stop sign, jumped outside and danced barefoot on asphalt, in some residential southwest neighborhood already asleep. How I didn't hop out after her, but hopped out at the same time, as though I'd already absorbed the energy to fulfill a previously dormant whim. To feel something in you slip out of its cover is almost like to create something new, and there's so much in people to make you feel new.
Sunday, April 17, 2011
moth
In our house the kitchen is in the center. It's adjacent to the living room, where my roommate dwells most of the time along with a handful of her many friends, and with our regular visitors, our neighbor across the street and our neighbor down the street. It shares a door with my bedroom, and it provides a door to the outside as well as to my other roommate's room. I get a phone call while making dinner, so I take it in the kitchen. While listening to a friend's new findings on an old romance, I get a phone call on the other line--the neighbor across the street wants to eat his rice krispies at our place. He starts a conversation in the living room about how things have been the same over and over, each day, calling out to me sporadically for input. The kitchen door to outside swings open, and it's a friend who's been watching a movie in my other roommate's room. Pulp Fiction. My roommate says, oh I need to watch the ending of that. My friend says, oh it's at the end now. My roommate says, but I've forgotten the middle. We laugh, and my friend watching the movie goes to the bathroom, and returns, and asks everyone if they've eaten. Let's go to dinner. It's late, but we haven't eaten. I've already made food, I say. I'm still on the phone, listening to how a story we thought went one way went some other way, but at least now we know and we can leave it be. My neighbor with his rice krispies shouts about how we've been separated from our mothers, and that's all that really mattered. My hungry classmate says, let's eat. The person on the line says, What's going on, and I try to think of a description. And then I see a white flutter--a moth--fluttering outside my bedroom door--the source of the mysterious bug smell in our kitchen, which I'd discovered to be moths, but I hadn't seen one in the kitchen until now. Motion with no noise, unnoticed by anyone. And I think, that's nice.
Saturday, April 16, 2011
dancing
My stomach's hurt all day, have spent most of the day in bed. As often when I have a physical ache or pain, I feel old. I'm getting older, of course. I'm almost 27, and this means a lot of things, like slowing metabolism and decrease in agility. I often feel I need to catch up on a lot that's physical (learning to bike, swim), and I also worry I won't be able to keep up at the things I feel semi-able to do. These worries will all come to fruition, of course. That's age.
A hip hop song on the radio made me consider, when will I no longer be able to dance? Not even just physically, but socially. Those older folk getting down, even as they must be having fun, aren't seen as belonging there. And maybe that shouldn't bother me, but of course part of the fun of dancing in a crowd is being a part of the crowd. Most girls love to dance, and I'm not exception to many things girly. I've loved to dance since we were taught in the sixth grade to dance the Macarena, and though we learned that dancing is just moving, some of the boys at our first dance would dance that choreographed move to every song whether it resembled the Macarena or not. I love the inherent desire to move, the work you build up, and the freedom. When will it no longer be okay, when will we no longer look like we're dancing, when will we be just, too old? It feels kind of, sadly, soon.
As M would say, good thing I still look seventeen! Or less.
A hip hop song on the radio made me consider, when will I no longer be able to dance? Not even just physically, but socially. Those older folk getting down, even as they must be having fun, aren't seen as belonging there. And maybe that shouldn't bother me, but of course part of the fun of dancing in a crowd is being a part of the crowd. Most girls love to dance, and I'm not exception to many things girly. I've loved to dance since we were taught in the sixth grade to dance the Macarena, and though we learned that dancing is just moving, some of the boys at our first dance would dance that choreographed move to every song whether it resembled the Macarena or not. I love the inherent desire to move, the work you build up, and the freedom. When will it no longer be okay, when will we no longer look like we're dancing, when will we be just, too old? It feels kind of, sadly, soon.
As M would say, good thing I still look seventeen! Or less.
remnants
Oop, haven't been jotting down for the past couple days.
The other day, at Jojo's Coffeeshop, I recognized the yellow cup from which I'd drunk chai the day before in the hands of another man. I love chai more than any other coffeeshop drink. I don't know what he was drinking. The path from cup to mouth was obscured by an off-white beard with full, light volume. This drew attention to his strings of hair, separated into distinct threads held together by the oils and moistures of time. He drank from the cup standing, looking out the window, a window I'd moved away from because the warmth was overpowering. Then he went outside with the cup, with its patterns of different suns, printed on it two by three.
Yesterday we went to see Twelth Night, at a funny time of day, which would be four o'clock. I've seen many more plays during med school than in college, due to the proximity and affordability of the Yale Rep. This one was put on the Drama School in a venue right down our street. The most prominent thing I've noticed is that I'm not usually affected by the story/feel the same way I do with books, that what overpowers that is the stage and atmosphere. I'm always surprised by what people can create, concretely; how they use space, color, elements; by how different that all feels depending on the position of space you occupy while observing.
K, onto another day.
The other day, at Jojo's Coffeeshop, I recognized the yellow cup from which I'd drunk chai the day before in the hands of another man. I love chai more than any other coffeeshop drink. I don't know what he was drinking. The path from cup to mouth was obscured by an off-white beard with full, light volume. This drew attention to his strings of hair, separated into distinct threads held together by the oils and moistures of time. He drank from the cup standing, looking out the window, a window I'd moved away from because the warmth was overpowering. Then he went outside with the cup, with its patterns of different suns, printed on it two by three.
Yesterday we went to see Twelth Night, at a funny time of day, which would be four o'clock. I've seen many more plays during med school than in college, due to the proximity and affordability of the Yale Rep. This one was put on the Drama School in a venue right down our street. The most prominent thing I've noticed is that I'm not usually affected by the story/feel the same way I do with books, that what overpowers that is the stage and atmosphere. I'm always surprised by what people can create, concretely; how they use space, color, elements; by how different that all feels depending on the position of space you occupy while observing.
K, onto another day.
Wednesday, April 13, 2011
hurt
Found myself spending snips and chunks of today considering moments where I've felt extreme emotional pain. Don't worry (that's to you wife, who is the first and probably only person to read this), I'm not currently hurt. Only, I woke up this morning with a vague precursor of what it might feel like in the future, and it made me think of the past. If I had to narrow it down to the most excruciating, there would be six moments I'd put on my list of god-awful emotion, and mixed in with those are moments I'd pile in the same section of a fabric store, the kinds with similar threads even if they aren't the intense shades you immediately return to when perusing shelves of memory [a well meaning, pretentious person taught me that "peruse" is commonly mistaken to mean skim when it actually means to deeply delve. Since then, I debate how to use it, because if language is to communicate and that's how people interpret it, why not use it in the way people will take it? In this case, you can take it whichever way].
As a friend and a med student and other-relations-to-others, I've been privy to other people experiencing pain, just as most of us have. I could describe the expressions of those things, but when it comes down to the inside, we can only draw from ourselves. So from myself I draw the periods of time, short and long, where I was in sharp conscious unwavering pain. There was that time I ate nothing but cereal for weeks, and watched a lot of movies with sensory overload in the hopes of crushing inner workings to no avail. This was the most drawn-out, recurring pain. There was that other time I didn't eat anything for several days, didn't sleep either. I thought it'd be drawn-out and recurring too, but it wasn't, but it was damn intense in its compactness. There was that time I sobbed in a stranger's kitchen, for someone I knew and didn't really know, and then spent days in beautiful new places and felt tangibly less touched by the beauty, the pain coloring all else. This one comes suddenly into focus at moments that make sense and ones that don't, and fades. Then when I sobbed against my car in a cold snowless winter, for someone I kind of knew but didn't really know. This doesn't come back too often. Then when I felt shelter crumbling while wearing kid pajamas, when I sat holding the hand for someone older and in more pain than me. Then when I was the wielder of such pain, different than other cases because the person who bore it didn't choose it; this happened in a place away from home, and I came home and put the wrong on bare display for two people who love me and it hurt like all hell. All of these come back in the form of sadness more than pain, and in some ways you can't say that you'll never forget; there's always forgotten. Strangely it's not so bad to remember what parts of it I do.
As a friend and a med student and other-relations-to-others, I've been privy to other people experiencing pain, just as most of us have. I could describe the expressions of those things, but when it comes down to the inside, we can only draw from ourselves. So from myself I draw the periods of time, short and long, where I was in sharp conscious unwavering pain. There was that time I ate nothing but cereal for weeks, and watched a lot of movies with sensory overload in the hopes of crushing inner workings to no avail. This was the most drawn-out, recurring pain. There was that other time I didn't eat anything for several days, didn't sleep either. I thought it'd be drawn-out and recurring too, but it wasn't, but it was damn intense in its compactness. There was that time I sobbed in a stranger's kitchen, for someone I knew and didn't really know, and then spent days in beautiful new places and felt tangibly less touched by the beauty, the pain coloring all else. This one comes suddenly into focus at moments that make sense and ones that don't, and fades. Then when I sobbed against my car in a cold snowless winter, for someone I kind of knew but didn't really know. This doesn't come back too often. Then when I felt shelter crumbling while wearing kid pajamas, when I sat holding the hand for someone older and in more pain than me. Then when I was the wielder of such pain, different than other cases because the person who bore it didn't choose it; this happened in a place away from home, and I came home and put the wrong on bare display for two people who love me and it hurt like all hell. All of these come back in the form of sadness more than pain, and in some ways you can't say that you'll never forget; there's always forgotten. Strangely it's not so bad to remember what parts of it I do.
Tuesday, April 12, 2011
daily
The author of Bird by Bird talks about keeping index cards with her at all times, to jot down anything she wants to remember: an image, a memory, a sentence. This seems useful for creating worlds based on substance of real thoughts/feelings, but I'm not too good at creating. I do like the idea of conscious recording, and in that vein I'm going to try to blog for half an hour every day. I used to save, but saving pushes things back and back until they're no longer retrievable. And really, it's the daily stuff I may never record in any other form. I never wanted to write a blog about what-I-did-today, but a detail stowed in the corner of what-I-did-today isn't so lackluster. Or, even if it is (because honestly my life is pretty boring) the beauty of an index card is that it's not snobby about its content.
When I was in Vietnam, I wrote an email to M describing my uncle's house, and the strong senses associated with it that I'd forgotten. One was how the bathroom smelled like bugs, and he asked how could that be, what do bugs smell like. I said that he'd have to smell it to understand, mostly because I wasn't really sure what the smell was or how I knew it was the smell of bugs, but I was sure. Yesterday the wife says to me, why do we have moths in our kitchen (well, at first I thought she said "mops")? I hadn't seen any moths, but when I got closer to the sink, I smelled my uncle's bathroom. This tiny rectangle of space, smaller than a closet, that I frequented often at night because for some reason Vietnam gives me nocturia. And also, the smell of lots of rooms in Japan I'd been in. Moths! They're moths! How come I never actually see the moths? Is it because they have such short life-spans (this I learned from Virginia Woolf's Death of a Moth), or is it because they hide? I don't know, but I know their smell now.
Well, that took all of ten minutes.
When I was in Vietnam, I wrote an email to M describing my uncle's house, and the strong senses associated with it that I'd forgotten. One was how the bathroom smelled like bugs, and he asked how could that be, what do bugs smell like. I said that he'd have to smell it to understand, mostly because I wasn't really sure what the smell was or how I knew it was the smell of bugs, but I was sure. Yesterday the wife says to me, why do we have moths in our kitchen (well, at first I thought she said "mops")? I hadn't seen any moths, but when I got closer to the sink, I smelled my uncle's bathroom. This tiny rectangle of space, smaller than a closet, that I frequented often at night because for some reason Vietnam gives me nocturia. And also, the smell of lots of rooms in Japan I'd been in. Moths! They're moths! How come I never actually see the moths? Is it because they have such short life-spans (this I learned from Virginia Woolf's Death of a Moth), or is it because they hide? I don't know, but I know their smell now.
Well, that took all of ten minutes.
Monday, April 11, 2011
bike riding
I've been in a moody rut since coming back from Vietnam, conceptual anchors loosening into the framework of physical disorientation. Things that normally ground me feel heavy. My knee throbbed after a run yesterday, climbs that used to come easily feel frustrating. Instead of being excited by the recent experiences that compel me to write, I'm paralyzed by the stack. I get even more easily upset than usual, wallowing in trivial petty things, and staying irrationally there. M tells me to give it time; I trust him and the sentiment, so I am letting things happen. This doesn't mean I overcome the moodiness, I let that happen too, but I trust that the stifling character will break, leaving a baseline moodiness which I can handle, and appreciate.
On Saturday, after a morning of moping in moodiness, we entered a a sunny crisp not-yet-spring day, and he said, let's get you on a bike for lesson #2. Lesson #1 entailed sitting on a bike for the first time and having him hold the bike and me up, running alongside as I got a feel for pedaling. It served several purposes. I learned that it's scary, and hard, to be on a bike for the first time. I fell, the scruff of my pants opening to scrape my skin; having been holding me, he fell too. We expected lesson #2 to proceed in similar increments of progress. I know he wanted me to move, to try something new, to make me feel better, and the thought was enough to slightly jar the heavy air fogging me. He said, even if you're just on it for five minutes, it'll make next time easier.
So we drove to get a bike pump, which didn't really work, but I got on the bike anyway. I pedaled in the parking lot of the mall, him again holding onto the handlebars and running alongside. The first thing he emphasized was to steer into my leans, because I'd lean to one side and would've fallen over and over if he hadn't been there to correct for me. It was too much for me to think about, to correct my leans and pedal at the same time (two things, too much). So because I couldn't, he steered for me as I pedaled. This let me focus on the motion of pedaling, and it also let me subconsciously absorb the hand motion of steering, to feel the handlebars under my fingers. Then he made me try to push off on my own, to start pedaling without him holding. I'd push off with my right foot, but wouldn't trust the bike enough to push hard enough to make it work. Each time I tried, I had to consciously breathe in and suck it up; sometimes the fake courage worked enough to push hard enough to bring the left pedal up quickly enough so that I would actually move forward. To our surprise, after some struggle with this, I could keep pedaling for a few seconds, before I leaned too much or pedaled too slow, and stopped myself.
We returned the faulty bike pump, drove to Wal-Mart to get another; he pumped the tires with success this time, and we started again in the parking lot of Wal-Mart. Realizing that I could continue after starting, he helped give me a push to start, and shouted to me from our starting point to keep going. Back and forth down the length of the parking lot, I stopped as I got scared or worried that this strange capacity to steer that I unconsciously acquired would slip. He made me keep going until I'd gone down the length of the lot, each way, without stopping, and I think we were both pretty surprised. I was surprised not just by the concrete happenings but by what it did for me.
The surprise, a childhood moment given to me as a near-27 year old, the dislodging of things in their proper place, facing loss of balance during a period of inward shakiness, the doing of something new--did me a whole lot of good. Being pushed to let go of ground, we find new holds, and that seems like good reason to keep traversing across moodiness.
On Saturday, after a morning of moping in moodiness, we entered a a sunny crisp not-yet-spring day, and he said, let's get you on a bike for lesson #2. Lesson #1 entailed sitting on a bike for the first time and having him hold the bike and me up, running alongside as I got a feel for pedaling. It served several purposes. I learned that it's scary, and hard, to be on a bike for the first time. I fell, the scruff of my pants opening to scrape my skin; having been holding me, he fell too. We expected lesson #2 to proceed in similar increments of progress. I know he wanted me to move, to try something new, to make me feel better, and the thought was enough to slightly jar the heavy air fogging me. He said, even if you're just on it for five minutes, it'll make next time easier.
So we drove to get a bike pump, which didn't really work, but I got on the bike anyway. I pedaled in the parking lot of the mall, him again holding onto the handlebars and running alongside. The first thing he emphasized was to steer into my leans, because I'd lean to one side and would've fallen over and over if he hadn't been there to correct for me. It was too much for me to think about, to correct my leans and pedal at the same time (two things, too much). So because I couldn't, he steered for me as I pedaled. This let me focus on the motion of pedaling, and it also let me subconsciously absorb the hand motion of steering, to feel the handlebars under my fingers. Then he made me try to push off on my own, to start pedaling without him holding. I'd push off with my right foot, but wouldn't trust the bike enough to push hard enough to make it work. Each time I tried, I had to consciously breathe in and suck it up; sometimes the fake courage worked enough to push hard enough to bring the left pedal up quickly enough so that I would actually move forward. To our surprise, after some struggle with this, I could keep pedaling for a few seconds, before I leaned too much or pedaled too slow, and stopped myself.
We returned the faulty bike pump, drove to Wal-Mart to get another; he pumped the tires with success this time, and we started again in the parking lot of Wal-Mart. Realizing that I could continue after starting, he helped give me a push to start, and shouted to me from our starting point to keep going. Back and forth down the length of the parking lot, I stopped as I got scared or worried that this strange capacity to steer that I unconsciously acquired would slip. He made me keep going until I'd gone down the length of the lot, each way, without stopping, and I think we were both pretty surprised. I was surprised not just by the concrete happenings but by what it did for me.
The surprise, a childhood moment given to me as a near-27 year old, the dislodging of things in their proper place, facing loss of balance during a period of inward shakiness, the doing of something new--did me a whole lot of good. Being pushed to let go of ground, we find new holds, and that seems like good reason to keep traversing across moodiness.
Wednesday, April 6, 2011
bird by bird
Back from a near three weeks in Vietnam, where the first half sped by and made me feel I'd been there forever and where the second half slowed to normality and felt too short, and where both halves exhausted me with experience. I went to Vietnam to translate for a medical mission, a group of plastic surgeons repairing the lips, eyes, and ears of children and a few adults. Afterwards I was able to spend some time with family and family friends.
Coming back I've returned to a disorientation that almost feels familiar at this point, coupled to the overwhelming sense of too many things-to-write that also feels familiar and would be friendly if it weren't for the fact that many times I'd rather it be a stranger. I have a couple months before I go to California for a primary care rotation, and in those couple of months, I'd like to:
-complete patient interviews for my research project
-start sorting through the lit review & begin introduction for my project
-write on translation & pros/cons of medical missions
-work with my co-translator to write about particular aspects of our mission, namely--how much do we know about our patient population when entering this foreign place?
-work on several projects for atrium magazine
-finish loose ends on the public health research project from years ago
-compile information re: family & relation to Vietnam
-plan trip to Bar Harbor with Allison, possible end-of-May trip with M somewhere?
-plan things-to-do in my month in California
Most everything is writing-oriented, and most everything is vague and nebulous; I'm working in the realm of broad goals, not yet to the point of concrete tasks. I've been re-learning chemistry as M bravely marches through his post-bac classes, and it's strangely been a deceiving escape to a contained world of facts and answers. But I think back to when I was contained in that, and how I saw it as a gateway to where I am now.
My advisor recommended a book on writing to me this morning, called Bird by Bird. The title comes from a story about the author's brother, who had a year-long term paper to write on birds. Near the very end, he'd attained encyclopedic information on a large number of birds, and sat unable to write anything about him. His dad told him to take it bird by bird, and somehow the image of birds on a wire turned a rational -ism into something real and felt to me. It's always been hard for me to multi-task, as the significance of each thing is so present to me, but as I chug piece by piece I feel it's not about finishing but about continuing; I remember that I'll never want to run out.
Coming back I've returned to a disorientation that almost feels familiar at this point, coupled to the overwhelming sense of too many things-to-write that also feels familiar and would be friendly if it weren't for the fact that many times I'd rather it be a stranger. I have a couple months before I go to California for a primary care rotation, and in those couple of months, I'd like to:
-complete patient interviews for my research project
-start sorting through the lit review & begin introduction for my project
-write on translation & pros/cons of medical missions
-work with my co-translator to write about particular aspects of our mission, namely--how much do we know about our patient population when entering this foreign place?
-work on several projects for atrium magazine
-finish loose ends on the public health research project from years ago
-compile information re: family & relation to Vietnam
-plan trip to Bar Harbor with Allison, possible end-of-May trip with M somewhere?
-plan things-to-do in my month in California
Most everything is writing-oriented, and most everything is vague and nebulous; I'm working in the realm of broad goals, not yet to the point of concrete tasks. I've been re-learning chemistry as M bravely marches through his post-bac classes, and it's strangely been a deceiving escape to a contained world of facts and answers. But I think back to when I was contained in that, and how I saw it as a gateway to where I am now.
My advisor recommended a book on writing to me this morning, called Bird by Bird. The title comes from a story about the author's brother, who had a year-long term paper to write on birds. Near the very end, he'd attained encyclopedic information on a large number of birds, and sat unable to write anything about him. His dad told him to take it bird by bird, and somehow the image of birds on a wire turned a rational -ism into something real and felt to me. It's always been hard for me to multi-task, as the significance of each thing is so present to me, but as I chug piece by piece I feel it's not about finishing but about continuing; I remember that I'll never want to run out.
Thursday, March 10, 2011
recharging
In the past week, I've had to replace my phone charger, my iPod charger, and my computer adapter (though my computer just died altogether, so it may not have been the adapter that was the issue). My phone charger has been acting up in the past few months. I have to wiggle and bend and contort its attachment to the phone, to reach a precarious position where it will charge the phone. For awhile it only took a few seconds and a book for pressure, to get it working. And per usual this is an inconvenience I can willingly put up with indefinitely. But it got to the point where ten minutes of adjustment didn't do the trick, and even if it worked eventually, there was no standard way of adjusting; it'd be a different trick each time. I've been content charging my iPod via my iPod stereo or my computer, since the charger that came with the iPod broke a long time ago. This was back when Apple still gave a charger with the iPod (that's right, first generation iPod packaging). This also gives you an idea of how old everything technological I own is. Anyway, I would've been fine without a wall charger, except now my computer is dead and I can't go without charging my iPod for three weeks while abroad in Vietnam. And my computer has been having issues with its adapter, where none would charge it up anymore; I'd found a new one at home that worked for several months, then wasn't working; so I got another last week. But looks like the computer needs more than that, because it won't start up.
So as many have told me, it seems that I probably need new things, rather than continually trying to recharge old ones. But even if I replace everything, I'm left with my old sometimes worn self, and I'll always have to find ways to recharge. Thank goodness for running into people at exactly the moment I need cheer, for stubborn climbs, for him in the evenings and how he makes me value not just his presence but my own, and for new travel to old places.
So as many have told me, it seems that I probably need new things, rather than continually trying to recharge old ones. But even if I replace everything, I'm left with my old sometimes worn self, and I'll always have to find ways to recharge. Thank goodness for running into people at exactly the moment I need cheer, for stubborn climbs, for him in the evenings and how he makes me value not just his presence but my own, and for new travel to old places.
Tuesday, March 8, 2011
friends
In a period of low where I felt both made to feel, and self-induced to feel, a bit mediocre, I sought love, and found it. No matter what else I accomplish or am trying to accomplish, knowing that I can be something to someone, makes me feel purpose more than anything else. When our home is a place to ring the doorbell at any hour, when our couch and kitchen is open to someone who wants company, quiet company while sleeping exhausted or raucous accompaniment to the guitar, when there is a knock at the back door just cause--I'm incredibly grateful to be a person to come to. And to be able to go to them. Though generally uncomfortable with positive reinforcement, I admit there are times when it's needed, and nice. To have a friend you respect so well tell you you're one of the best, to have a boyfriend who calls you at work when you're feeling inferior and makes you feel chosen instead, to have a group of wonderful people want to be with you, to have emails end with love that's genuine and felt across distance. To be deserving of it all, is the best goal to have, and when other things aren't going so well, this alone is reason to keep trying to be better.
Tuesday, February 22, 2011
schedule
As I'm apt to do when confronted with large blocks of free time, I've developed a semi-schedule for my weekdays. It's very broad in its division of time, and loose in obligations, and makes me pretty content every day.
Morning: Run or climb. Running makes for good alone time that gives energy for the rest of the day. Climbing in the morning means quality time with my classmate/friend Caitlin, who also gives energy for the rest of the day, and it means a mostly empty gym with lots of room.
Afternoon: Write and/or research. On some days I have interviews for research. Most days I spend long afternoons at coffeeshops, sometimes with other friends doing work. I have long stretches to write; I don't spend much of the time actually writing, but it feels like a process.
Evening: Spend time with M. We divide active activities between squash and climbing. He usually makes food, and now that he's taking classes, we spend some time studying. During that time I also do stray work that I don't like to do during the day, and that I find more bearable in his company. If there's not much work to do we watch movies, and regardless of what else there is to do, we talk.
Meals are often spent with friends, and evenings mixed up with friends too, and as I've been thankful for the past several years, I continue to feel lucky for the balance and perspective they give. And I feel lucky for the balance of these times of day, and how much they give me, so that in the future I can share. In the meantime, it's nice to just absorb.
Morning: Run or climb. Running makes for good alone time that gives energy for the rest of the day. Climbing in the morning means quality time with my classmate/friend Caitlin, who also gives energy for the rest of the day, and it means a mostly empty gym with lots of room.
Afternoon: Write and/or research. On some days I have interviews for research. Most days I spend long afternoons at coffeeshops, sometimes with other friends doing work. I have long stretches to write; I don't spend much of the time actually writing, but it feels like a process.
Evening: Spend time with M. We divide active activities between squash and climbing. He usually makes food, and now that he's taking classes, we spend some time studying. During that time I also do stray work that I don't like to do during the day, and that I find more bearable in his company. If there's not much work to do we watch movies, and regardless of what else there is to do, we talk.
Meals are often spent with friends, and evenings mixed up with friends too, and as I've been thankful for the past several years, I continue to feel lucky for the balance and perspective they give. And I feel lucky for the balance of these times of day, and how much they give me, so that in the future I can share. In the meantime, it's nice to just absorb.
Thursday, February 17, 2011
patience
Hemingway, who was my favorite writer in college and will always remain significant to me, said he would stop writing when he knew where to go next. This could be mid-sentence or mid-idea. This way, when he started again, it would be easy to start, and starting is always the hardest part. It’s advice that many aspiring writers quote, because it’s good advice. It works, by leaving something in anticipation and coming back to it in anticipation. It works not just in writing but also in living, I think.
But it’s hard to leave something with the feeling that there’s more. It takes discipline, willpower, and foresight to consider the benefits of delay. I’m not too good at it. Probably because in one sense I have a lot of patience for both good and bad. I don’t get tired of continuous good too easily, and I don’t mind trudging through some or a lot of bad to get back to the good. I’m not too particular about the ease of things, and I don’t give much thought to efficiency when it comes to abstractions in my life (or concrete things either, but that’s a different topic). While I think this is useful in some areas, I wonder if it’s the best way to go about things. Instead of having patience for inconvenience and difficulties, maybe I should have more patience for trying to cut down the inconvenience and difficulties, in my writing, in my life.
But it’s hard to leave something with the feeling that there’s more. It takes discipline, willpower, and foresight to consider the benefits of delay. I’m not too good at it. Probably because in one sense I have a lot of patience for both good and bad. I don’t get tired of continuous good too easily, and I don’t mind trudging through some or a lot of bad to get back to the good. I’m not too particular about the ease of things, and I don’t give much thought to efficiency when it comes to abstractions in my life (or concrete things either, but that’s a different topic). While I think this is useful in some areas, I wonder if it’s the best way to go about things. Instead of having patience for inconvenience and difficulties, maybe I should have more patience for trying to cut down the inconvenience and difficulties, in my writing, in my life.
Wednesday, February 16, 2011
recording
This morning, I met with my research advisor to go over a transcript of my first interview, which I conducted back in September. My project is qualitative research, speaking with hospice or near-hospice patients about their main concerns during this transitional period that we term end-of-life. My first interview was with a lovely woman from the South, with a subtly sharp sense of humor and generous spirit, who died a couple months after I met her. She's the one who I wrote about previously, who had written a story she'd wanted to publish in her nursing home newspaper. We'd worked on it together, and she died before it could get published; it will be printed in April.
With those strings in mind, I read the transcript with my advisor, who said, isn't it funny to hear her voice coming back? I agreed, and I thought how nice it was that I had the interview on tape, and also how nice it was to see it transcribed on paper. I've been so trained to close-read that when conversation becomes written, I pay attention differently. Words take on much more contextual meaning. And as fresh eyes to the interview, my advisor noticed motifs and word choices and turns of phrases that I hadn't, while speaking to the patient. She also loves telling any story that comes to her mind when something reminds her of it; they're always funny, or touching, or interesting.
Reading the transcript made me excited anew about the project, realizing that there was more than I realized in those conversations. I'd worried that without structure, and with such different people in different situations, it'd be hard to glean anything from the interviews. But even if each transcript turns out to be very different, there are plenty of individual insights into a person's thought process and expression of them, and that's worthwhile.
Much of the reading I've been doing on qualitative research and narrative analysis emphasizes what's lost when conversations are transcribed into script. You lose tone, pauses, faces, and so on; it's true that much nuance is sacrificed. And so I was surprised to see that simultaneously true is that something's gained in this translation. There's something about the act of recording, which inherently must be in a different medium than actual experience, that gives a perspective outside of the experience itself.
*
This afternoon the wife and I continued to labor over our class slideshow, to be shown at our school's annual second-year-show this weekend. Each year the graduating class puts together a slideshow of pictures. Ever since I saw the fourth year class slideshow during my first year here, I've wanted to work on ours.
We downloaded all the pictures sent from our classmates, and because I wanted to give the show a theme and not just be a conglomeration of pictures, we went through them and organized them. Then we laid them out into slides, keeping in mind order and cohesiveness and variety. Then wife and another friend/classmate of ours chose music to correspond to different parts of the slideshow, and had to learn how to splice music to put together a mix. Then we had to sync, sync, sync, and sync again the music to the pictures; there were a lot of transitions in the pictures that we wanted to line up with transitions in the music. Then we embedded a short video to conclude the show.
We probably spent the equivalent of 24 hours over different days in order to piece together this 6-minute slideshow. We had to choose which parts of songs we wanted, decide which pictures to cluster together, find pictures of everyone in our class, learn how to have certain pictures come into view, figure out how to time slides. All of this required learning details, looking up programs, pulling hair, and intermittent/continuous swearing.
It also meant watching the show over 20 times to see whether our piecemeal efforts congealed into solid form. As frustrating as the process could be, watching the product always made me nostalgic. Four years of people and experiences, compressed in two-second segments placed side by side like pages pressed in a book. Each time we would notice new nuances, the way a lyric coincided with an item on the slide or how, small moments of self-pride and love for the images--that won't be noticed by anyone else, but are known to us and after all that work, gives a lot.
It's a representation, but not only a representation--not in the sense that it's something else other than a representation, but that "representation" encompasses more than we give it credit for. It's not a replica of the experiences that give rise to the memories or even the memories themselves, but it's an experience on its own. The process of making this out of things already made, surprises in the way that in how new it is, how much there is still to learn and feel.
There's the personal satisfaction from creating something with your own hands, and also the sense that something's happening to you. This dynamic way of connecting yourself with things outside of you that are also kind of part of you, and of connecting the outside with parts of yourself that are also kind of already part of your environment, is obviously too poignant for me to describe with any sort of clarity. But for all the curses and furrowed brows, it feels damn good (so long as it goes well for the show, too).
*
I'm really grateful for small experiences like these, things no one would pinpoint as reasons to be a medical student. And of course it's more than medicine that led me to having these moments, and of course if I'd done something else I would've been led to others, but I don't think I've been exposed to quite as much compact variety at any other phase in my life. M and I talk a lot about reasons for and against a career in medicine, with the long stressful process being a drawback. But there are also a lot of opportunities to meet things you may never have felt. I'm lucky that Yale is particularly suited to exploring these things, often without much idea of concrete goal. I also feel lucky for being a part of a small community of students for four/five years; for me it's combined aspects of high school and college I liked most (with some of the bad of each thrown in there, too). I don't think I'll ever experience anything like it again, and in remembering and living it, I miss it too. So for that too I want to record.
With those strings in mind, I read the transcript with my advisor, who said, isn't it funny to hear her voice coming back? I agreed, and I thought how nice it was that I had the interview on tape, and also how nice it was to see it transcribed on paper. I've been so trained to close-read that when conversation becomes written, I pay attention differently. Words take on much more contextual meaning. And as fresh eyes to the interview, my advisor noticed motifs and word choices and turns of phrases that I hadn't, while speaking to the patient. She also loves telling any story that comes to her mind when something reminds her of it; they're always funny, or touching, or interesting.
Reading the transcript made me excited anew about the project, realizing that there was more than I realized in those conversations. I'd worried that without structure, and with such different people in different situations, it'd be hard to glean anything from the interviews. But even if each transcript turns out to be very different, there are plenty of individual insights into a person's thought process and expression of them, and that's worthwhile.
Much of the reading I've been doing on qualitative research and narrative analysis emphasizes what's lost when conversations are transcribed into script. You lose tone, pauses, faces, and so on; it's true that much nuance is sacrificed. And so I was surprised to see that simultaneously true is that something's gained in this translation. There's something about the act of recording, which inherently must be in a different medium than actual experience, that gives a perspective outside of the experience itself.
*
This afternoon the wife and I continued to labor over our class slideshow, to be shown at our school's annual second-year-show this weekend. Each year the graduating class puts together a slideshow of pictures. Ever since I saw the fourth year class slideshow during my first year here, I've wanted to work on ours.
We downloaded all the pictures sent from our classmates, and because I wanted to give the show a theme and not just be a conglomeration of pictures, we went through them and organized them. Then we laid them out into slides, keeping in mind order and cohesiveness and variety. Then wife and another friend/classmate of ours chose music to correspond to different parts of the slideshow, and had to learn how to splice music to put together a mix. Then we had to sync, sync, sync, and sync again the music to the pictures; there were a lot of transitions in the pictures that we wanted to line up with transitions in the music. Then we embedded a short video to conclude the show.
We probably spent the equivalent of 24 hours over different days in order to piece together this 6-minute slideshow. We had to choose which parts of songs we wanted, decide which pictures to cluster together, find pictures of everyone in our class, learn how to have certain pictures come into view, figure out how to time slides. All of this required learning details, looking up programs, pulling hair, and intermittent/continuous swearing.
It also meant watching the show over 20 times to see whether our piecemeal efforts congealed into solid form. As frustrating as the process could be, watching the product always made me nostalgic. Four years of people and experiences, compressed in two-second segments placed side by side like pages pressed in a book. Each time we would notice new nuances, the way a lyric coincided with an item on the slide or how, small moments of self-pride and love for the images--that won't be noticed by anyone else, but are known to us and after all that work, gives a lot.
It's a representation, but not only a representation--not in the sense that it's something else other than a representation, but that "representation" encompasses more than we give it credit for. It's not a replica of the experiences that give rise to the memories or even the memories themselves, but it's an experience on its own. The process of making this out of things already made, surprises in the way that in how new it is, how much there is still to learn and feel.
There's the personal satisfaction from creating something with your own hands, and also the sense that something's happening to you. This dynamic way of connecting yourself with things outside of you that are also kind of part of you, and of connecting the outside with parts of yourself that are also kind of already part of your environment, is obviously too poignant for me to describe with any sort of clarity. But for all the curses and furrowed brows, it feels damn good (so long as it goes well for the show, too).
*
I'm really grateful for small experiences like these, things no one would pinpoint as reasons to be a medical student. And of course it's more than medicine that led me to having these moments, and of course if I'd done something else I would've been led to others, but I don't think I've been exposed to quite as much compact variety at any other phase in my life. M and I talk a lot about reasons for and against a career in medicine, with the long stressful process being a drawback. But there are also a lot of opportunities to meet things you may never have felt. I'm lucky that Yale is particularly suited to exploring these things, often without much idea of concrete goal. I also feel lucky for being a part of a small community of students for four/five years; for me it's combined aspects of high school and college I liked most (with some of the bad of each thrown in there, too). I don't think I'll ever experience anything like it again, and in remembering and living it, I miss it too. So for that too I want to record.
Tuesday, February 15, 2011
free time
We've been so ingrained to work for things, work so hard that we long for free time and freedom, that when there's no immediate goal to work for we feel a little lost. Writing is difficult because the hours don't add up to results; what is put in doesn't correlate to what is put on paper. I don't think I've had anything else in my life that's so painful and so fulfilling at the same time, except for maybe relationships, and it's funny to think of something so solitary to be most like something so connected to people.
I find it difficult to focus, turning to multiple writings to override the block in one (hence the blogging, the emailing). When trying to write things with clearer details and points to the details, it can be relieving to ramble with whatever comes to mind. I go back and forth between the endeavor of writing and the typing of thought, in almost a frenzy.
And I place things in the background; there is always always music and often there's a book. Currently I'm reading about qualitative research--how to analyze narratives, interpret stories. Which is interesting and informative, but also occupies a lot of the same space allotted for writing, and crowds things a bit.
I doubt that there will another time in my life quite like this one, where I can give so much attention to the space and crowding in my mind. It's ungrateful and honest to complain about the difficulty of free time and uncertain pursuits, and it's also necessary to fully portray how lucky I feel to be both so wound-up and unwinding.
I find it difficult to focus, turning to multiple writings to override the block in one (hence the blogging, the emailing). When trying to write things with clearer details and points to the details, it can be relieving to ramble with whatever comes to mind. I go back and forth between the endeavor of writing and the typing of thought, in almost a frenzy.
And I place things in the background; there is always always music and often there's a book. Currently I'm reading about qualitative research--how to analyze narratives, interpret stories. Which is interesting and informative, but also occupies a lot of the same space allotted for writing, and crowds things a bit.
I doubt that there will another time in my life quite like this one, where I can give so much attention to the space and crowding in my mind. It's ungrateful and honest to complain about the difficulty of free time and uncertain pursuits, and it's also necessary to fully portray how lucky I feel to be both so wound-up and unwinding.
Wednesday, February 9, 2011
anniversary
I like anniversaries for the thought of remembering and reflecting, all that's happened between two points in time. Which is a lot, and considering how many days go by without significance--to feel that one year with someone has given you this much to feel and consider and grow, is nice. We went through a long phase of uncertainty, intermittent phases of awkwardness, a phase of closeness through distance, a phase of travel, and are in something good at the moment. I've always thought it was valuable and important to experience different stages, as we're different in different contexts. Through these with him, we've tried to be honest and open, and more than ease or sap, this is what I've loved best.
Saturday, February 5, 2011
hospice (ending)
I just finished my month-long hospice rotation at the Connecticut Hospice in Branford, which both gave more and took more than I anticipated. Perhaps because after a slew of clinical rotations, I've lost a bit of the expectant newness that used to come before each new venture, and so there wasn't much anticipation to begin with. I didn't think much about what hospice would be like before I started. Having had a strong experience that led me to being interested in the rotation in the first place, I think I unconsciously felt that I'd reached a certain level of intensity that would prevent me from being taken by surprise here, even as I approached this rotation as an opportunity for broadening experience, concrete and emotional. I'm glad to have been wrong.
I haven't felt this motivated to write about a medical school experience for a long time, but before doing it in a structured and comprehensive form, it feels nice to sit in bed and ramble about all the things that made it filling, and hard.
On my last day, an APRN asked me what was the most memorable event during the rotation. It would be hard, and probably not accurate, to choose one event or interaction or experience. Instead it was more generalities absorbed that most affected me. I told her that I'd take with me the calmness of the place, the simplicity of the medicine, and the kindness of the people.
Connecticut had the most snow in January on record since years and years ago. We had two two-feet snowstorms, a couple ice storms, and record below freezing temperatures. While I was used to this in Boston where the winter is more harsh than here, I'd never had to deal with the visceral challenges of snow and ice. For the first time in my life, I had to shovel my car out of the snow, had to try to drive it through the narrowly plowed driveway, had to shovel myself out of the driveway that wasn't plowed widely enough, had to shovel piles of snow off the entrance to the street where the tires would just spin in place, had to chip away at inches of ice off every window and off the roof of the car, had to see why getting ice off the roof is important as a I saw sheets of ice slip off cars on the highway, had to steer my car as it slid on unsalted iced roads, had to walk strategically to avoid puddles of slush and piles of iced snow. It was uncomfortable, and tiring to have to work so hard and think so hard about how to simply get somewhere.
There were also incredible vignettes of how pretty harshness can be, in the snowflakes that would freeze on my car windows to create a printed pattern I'd have to scrape away, in the ice that dressed bare tree branches making the forests on my drive looks like crops of glistening gray hair, and in the sheen of clean soft snow hardened on top like creme brulee, by the ice. There were incredible views from the windows, of big flakes falling against warm yellows and cold grays. There were the first falls, untouched, and the old snows, dirtied.
After the trek through all of that, I arrive at a workplace with windows in tandem, bookshelves, and fireplaces. Laid on the beds are crocheted blankets and patchwork quilts. Hand-painted signs of patient's names are hung in their respective spaces. Guitars strum, and every other day there are sweets from families or employees. It seemed to me I was lucky to have done this rotation during the onslaught of winter, to have to confront bitter elements with reason to escape to this cove. It's not often that you think of a workplace as soothing, especially not hospitals.
It's true that this atmosphere is partly due to the way that the rough edges of medicine are worn away a bit by the different goals and mindset of hospice. There is more thought to necessity, and the removal of what's not. In that sense, things feel simpler. There are no fancy tests to order; people often get sicker and instead of embarking on a diagnostic quest for etiology, we acknowledge the worsening condition and continue. There's still a lot of room for creativity in catering to individual needs. My attending pushed us to consider the best options for care, to not get stuck in status quo. But grounding all of that movement is a framework of simple stability. Not to say that dying is simple, but in the face its possible complexities, people's wants and needs become basic and streamlined to the core, without the excess that can often distort. After awhile the pharmacological treatments become routine, leaving more room to focus on non-pharmacological care, and hospice focuses on that much more than other areas of medicine. Its wholistic perception of people is reflected in its interdisciplinary approach to care; doctors aren't at the center, are instead an arm, of the scheme. There is constant, continual communication with the nurses, social workers, pastors, and family. And while there are many factors to consider, the way in which all these people work together to focus on each person's care, gives a simple sense of value.
I imagine that the comforts and simplicity help the staff as much as the patients, because as calming and welcoming a place it is, it is a hard place to be. Because of that, I think it attracts and seeks certain qualities in the people who work there, making for an incredible community. I've never met such a cluster of genuinely warm, kind, and strong people. The nurses, who are the heart of hospice care, made the biggest impression on me, but the kindness is palpable in every person encountered, from the person at the front desk to the person manning the cafeteria.
In the morning, the nurses and physicians round together, going over the care for each patient. The nurses are the ones giving report, which has never been the case for any other rounds I've seen. They make me remember why I want to be good at whatever it is that I do. They take care in the most whole way possible: delicate where people are fragile, tough and honest when needed. They advocate for their patients, they know their stuff, and they all have voice. It's this combination of warmth and strength that I admire most in women who give care, and every day it reinforced goals to work for.
On my last day I told a slightly demented patient of mine that it had been really nice to take care of her. She replied, "It was really nice to take care of you too." Even as her response was a rote one, I appreciate the truth in that. I think that at their worst these patients and their loved ones have given me more than I could give at my best. Each person copes differently, experiences different pains and discomforts. It would be misguided to say that all of them gave the same thing, but as a whole, it was valuable to witness their capacity to give when so much is being taken from them. There is a woman whose body has been distorted and disfigured by tumors, and as she struggles with grace and patience, she makes me think of how deep our reserves run, how much we can face without being torn. There is a man who has accepted that it will be difficult for him to breathe until he no longer has to, and his first thought in conversation is to answer all the questions he knows you'll ask before you ask them, without pause and without rest, with the creases in his face working with effort to give you all he can. There is a man actively dying before the eyes of his wife, who comforts me with stories of him before he was sick--redheaded, singing silly songs in the morning.
In conversation about this, it was pointed out that perhaps it is something about this stage in life, and not something intrinsic to these specific people, that make us that way. It doesn't matter to me too much from where the source stems. To see people in pain, so close to something unknown, be gracious and generous and sensitive gives me faith in the endurance of these qualities and makes me try harder for the patience to endure. And it's not to say that these people weren't struggling, weren't falling back in some ways, but that there seems to be a pull to hang onto the good when things are slipping away.
I can't say that I endured the past month of this rotation with the same kind of grace that I observed in my patients and their families. The rotation was hard for me. I was surprised by how quickly people transitioned from alert to unresponsive, how I could never get used to someone changing so much over hours or days from the way I first met them even for the ones I rationally knew had come to hospice to die. I missed the people they were as they were still breathing, and I wondered how it was for people who had been their lives. While the pace was unhurried and I was never overworked, and I loved most days there, at the end of them I felt tired.
And I was mean when tired, and the emotional stress of seeing and taking in this weighty process manifested in a lot of physical breakdown. Getting sick, breaking out with a cold sore, a couple allergic reactions, and developing various muscle strains, I was told that I was pushing myself too hard, that I needed to listen to my body. I think it is true that we should take care of ourselves, but I also find value in digging for the resilience that lies in vulnerability, and believe that this first means knowing what makes us weak. I didn't plan this of course, and it could be argued that I'm rationalizing the discomforts of the experience. But somehow, an intuitive, inexplicable part of me feels that there is good reason the weather was so harsh, the people so fragile.
I haven't felt this motivated to write about a medical school experience for a long time, but before doing it in a structured and comprehensive form, it feels nice to sit in bed and ramble about all the things that made it filling, and hard.
On my last day, an APRN asked me what was the most memorable event during the rotation. It would be hard, and probably not accurate, to choose one event or interaction or experience. Instead it was more generalities absorbed that most affected me. I told her that I'd take with me the calmness of the place, the simplicity of the medicine, and the kindness of the people.
Connecticut had the most snow in January on record since years and years ago. We had two two-feet snowstorms, a couple ice storms, and record below freezing temperatures. While I was used to this in Boston where the winter is more harsh than here, I'd never had to deal with the visceral challenges of snow and ice. For the first time in my life, I had to shovel my car out of the snow, had to try to drive it through the narrowly plowed driveway, had to shovel myself out of the driveway that wasn't plowed widely enough, had to shovel piles of snow off the entrance to the street where the tires would just spin in place, had to chip away at inches of ice off every window and off the roof of the car, had to see why getting ice off the roof is important as a I saw sheets of ice slip off cars on the highway, had to steer my car as it slid on unsalted iced roads, had to walk strategically to avoid puddles of slush and piles of iced snow. It was uncomfortable, and tiring to have to work so hard and think so hard about how to simply get somewhere.
There were also incredible vignettes of how pretty harshness can be, in the snowflakes that would freeze on my car windows to create a printed pattern I'd have to scrape away, in the ice that dressed bare tree branches making the forests on my drive looks like crops of glistening gray hair, and in the sheen of clean soft snow hardened on top like creme brulee, by the ice. There were incredible views from the windows, of big flakes falling against warm yellows and cold grays. There were the first falls, untouched, and the old snows, dirtied.
After the trek through all of that, I arrive at a workplace with windows in tandem, bookshelves, and fireplaces. Laid on the beds are crocheted blankets and patchwork quilts. Hand-painted signs of patient's names are hung in their respective spaces. Guitars strum, and every other day there are sweets from families or employees. It seemed to me I was lucky to have done this rotation during the onslaught of winter, to have to confront bitter elements with reason to escape to this cove. It's not often that you think of a workplace as soothing, especially not hospitals.
It's true that this atmosphere is partly due to the way that the rough edges of medicine are worn away a bit by the different goals and mindset of hospice. There is more thought to necessity, and the removal of what's not. In that sense, things feel simpler. There are no fancy tests to order; people often get sicker and instead of embarking on a diagnostic quest for etiology, we acknowledge the worsening condition and continue. There's still a lot of room for creativity in catering to individual needs. My attending pushed us to consider the best options for care, to not get stuck in status quo. But grounding all of that movement is a framework of simple stability. Not to say that dying is simple, but in the face its possible complexities, people's wants and needs become basic and streamlined to the core, without the excess that can often distort. After awhile the pharmacological treatments become routine, leaving more room to focus on non-pharmacological care, and hospice focuses on that much more than other areas of medicine. Its wholistic perception of people is reflected in its interdisciplinary approach to care; doctors aren't at the center, are instead an arm, of the scheme. There is constant, continual communication with the nurses, social workers, pastors, and family. And while there are many factors to consider, the way in which all these people work together to focus on each person's care, gives a simple sense of value.
I imagine that the comforts and simplicity help the staff as much as the patients, because as calming and welcoming a place it is, it is a hard place to be. Because of that, I think it attracts and seeks certain qualities in the people who work there, making for an incredible community. I've never met such a cluster of genuinely warm, kind, and strong people. The nurses, who are the heart of hospice care, made the biggest impression on me, but the kindness is palpable in every person encountered, from the person at the front desk to the person manning the cafeteria.
In the morning, the nurses and physicians round together, going over the care for each patient. The nurses are the ones giving report, which has never been the case for any other rounds I've seen. They make me remember why I want to be good at whatever it is that I do. They take care in the most whole way possible: delicate where people are fragile, tough and honest when needed. They advocate for their patients, they know their stuff, and they all have voice. It's this combination of warmth and strength that I admire most in women who give care, and every day it reinforced goals to work for.
On my last day I told a slightly demented patient of mine that it had been really nice to take care of her. She replied, "It was really nice to take care of you too." Even as her response was a rote one, I appreciate the truth in that. I think that at their worst these patients and their loved ones have given me more than I could give at my best. Each person copes differently, experiences different pains and discomforts. It would be misguided to say that all of them gave the same thing, but as a whole, it was valuable to witness their capacity to give when so much is being taken from them. There is a woman whose body has been distorted and disfigured by tumors, and as she struggles with grace and patience, she makes me think of how deep our reserves run, how much we can face without being torn. There is a man who has accepted that it will be difficult for him to breathe until he no longer has to, and his first thought in conversation is to answer all the questions he knows you'll ask before you ask them, without pause and without rest, with the creases in his face working with effort to give you all he can. There is a man actively dying before the eyes of his wife, who comforts me with stories of him before he was sick--redheaded, singing silly songs in the morning.
In conversation about this, it was pointed out that perhaps it is something about this stage in life, and not something intrinsic to these specific people, that make us that way. It doesn't matter to me too much from where the source stems. To see people in pain, so close to something unknown, be gracious and generous and sensitive gives me faith in the endurance of these qualities and makes me try harder for the patience to endure. And it's not to say that these people weren't struggling, weren't falling back in some ways, but that there seems to be a pull to hang onto the good when things are slipping away.
I can't say that I endured the past month of this rotation with the same kind of grace that I observed in my patients and their families. The rotation was hard for me. I was surprised by how quickly people transitioned from alert to unresponsive, how I could never get used to someone changing so much over hours or days from the way I first met them even for the ones I rationally knew had come to hospice to die. I missed the people they were as they were still breathing, and I wondered how it was for people who had been their lives. While the pace was unhurried and I was never overworked, and I loved most days there, at the end of them I felt tired.
And I was mean when tired, and the emotional stress of seeing and taking in this weighty process manifested in a lot of physical breakdown. Getting sick, breaking out with a cold sore, a couple allergic reactions, and developing various muscle strains, I was told that I was pushing myself too hard, that I needed to listen to my body. I think it is true that we should take care of ourselves, but I also find value in digging for the resilience that lies in vulnerability, and believe that this first means knowing what makes us weak. I didn't plan this of course, and it could be argued that I'm rationalizing the discomforts of the experience. But somehow, an intuitive, inexplicable part of me feels that there is good reason the weather was so harsh, the people so fragile.
Tuesday, January 18, 2011
hospice (beginning)
I'm a week into my rotation at Connecticut Hospice, the first hospice established in the States. It's located in Branford, about twenty minutes north of New Haven, and overlooks the Long Island Sound. The water is a wide expanse, with a wide expanse of ground from the building to the water, and every room has this view. Currently the ground is piled upon with snow, and unlike the snow of city and of routine living, this snow has remained white since its fall one week ago. There's little to disturb it other than the few who walk out from the building to the black fence outlining the beginnings of the water, and these steps add not color but a faceless depth. The sun rising and setting seeps into crevices of the water and clouds, in increments of half seconds, such that you get a sense of change without any motion.
With that backdrop, we have morning rounds, where the nurses (the heart of hospice) report on their patients and their daily plans are discussed. With that backdrop, we visit the patients and write notes on those visits. With that backdrop, we watch people die.
I hesitate with that line, hesitate to dramatize, but when thinking of the actual fact of things, that's just what it is. And some of it is as heavy as it sounds, and some of it floats away without much notice. As not just newbies seeing things for the first time, but as students whose role is to absorb as much as possible, the experience as a whole is quite a bit to take in.
In this short time, I've been struck by a number of things. For example, of how scared I was to see someone physically transition from life to death. Not out of empathy for the person who had not much life before that transition than after, but out of an instinctual aversion to seeing it happen and an awkward, sad sense of trivializing something by being there for the last breath of a person I didn't know.
I've been struck too by resilience, by how people give more at their most difficult times than I can at my best. At a time when I imagine people might feel compelled to turn inwards, they are instead touchingly sensitive to others. They continue on as the people they were--they want to take care of the families they've raised, they are insecure about how others perceive them in hospital beds,
And I've been struck by the variety of burdens, in quality and quantity. There's a lot to consider, besides the sufficient issue of absence. There's a man whose wife donated her kidney to him, there's an unresponsive woman whose 14 year old son reads her stories she'd read him, there's a man whose son and wife don't know how to speak to each other about the same thing, there's a 98 year old woman who says she feels full of emptiness like a room where sound echoes on and on, there's a woman whose understanding of her husband's pain is a more meaningful transition than his from life to death, there's an artist whose wife never let him draw her portrait until now and he draws a black and white picture of her face with her eyes closed. There is a 46 year old man who without telling his wife bought a sports car, who then crashed it while speeding, who then dies after months of his family tracking the movements of his left eye.
And I've been struck by the humor, and conventional routes to warmth paved in a place one might imagine as cold. I wrote my first prescription for a daily beer, frailty quickly turns into feist when a woman wants her nails polished and thinks you're the one who promised them to her, and you find that innocence doesn't need to be young, that the sweetness of wanderings renews itself with dementia. And it's things like all of these that bring awareness from knowing logic to feeling realness, like the sense that maybe death is an emptiness but one that's full.
With that backdrop, we have morning rounds, where the nurses (the heart of hospice) report on their patients and their daily plans are discussed. With that backdrop, we visit the patients and write notes on those visits. With that backdrop, we watch people die.
I hesitate with that line, hesitate to dramatize, but when thinking of the actual fact of things, that's just what it is. And some of it is as heavy as it sounds, and some of it floats away without much notice. As not just newbies seeing things for the first time, but as students whose role is to absorb as much as possible, the experience as a whole is quite a bit to take in.
In this short time, I've been struck by a number of things. For example, of how scared I was to see someone physically transition from life to death. Not out of empathy for the person who had not much life before that transition than after, but out of an instinctual aversion to seeing it happen and an awkward, sad sense of trivializing something by being there for the last breath of a person I didn't know.
I've been struck too by resilience, by how people give more at their most difficult times than I can at my best. At a time when I imagine people might feel compelled to turn inwards, they are instead touchingly sensitive to others. They continue on as the people they were--they want to take care of the families they've raised, they are insecure about how others perceive them in hospital beds,
And I've been struck by the variety of burdens, in quality and quantity. There's a lot to consider, besides the sufficient issue of absence. There's a man whose wife donated her kidney to him, there's an unresponsive woman whose 14 year old son reads her stories she'd read him, there's a man whose son and wife don't know how to speak to each other about the same thing, there's a 98 year old woman who says she feels full of emptiness like a room where sound echoes on and on, there's a woman whose understanding of her husband's pain is a more meaningful transition than his from life to death, there's an artist whose wife never let him draw her portrait until now and he draws a black and white picture of her face with her eyes closed. There is a 46 year old man who without telling his wife bought a sports car, who then crashed it while speeding, who then dies after months of his family tracking the movements of his left eye.
And I've been struck by the humor, and conventional routes to warmth paved in a place one might imagine as cold. I wrote my first prescription for a daily beer, frailty quickly turns into feist when a woman wants her nails polished and thinks you're the one who promised them to her, and you find that innocence doesn't need to be young, that the sweetness of wanderings renews itself with dementia. And it's things like all of these that bring awareness from knowing logic to feeling realness, like the sense that maybe death is an emptiness but one that's full.
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