I’m writing this aboard a ship cruising in the waters around Alaska. I’m on this trip with my parents, oldest brother, sister-in-law and nephew (almost two and already a terror, a beautiful one). It has been less traveling and more bumming around, which has been perfect for me. We sleep a lot, we eat a lot, we play a lot of Scrabble, we laugh a lot at the little one, we sit at window-side tables for hours and watch water that stretches on and on. The latter is my dad nad me; we alternately talk and sit in silence. I’m grateful for the quality quiet time I’ve had with my family. Usually our time is wrapped up in the bustle of the holidays, and while I always love that, this is a different kind of shared time. There is a sense of just living the basics together, and it has been good to live slowly.
This is also the longest time I’ve been able to spend with my nephew, enough so that he has formed an attachment to me. I know that will fade quickly enough after the trip, but it is nice while it lasts. His only words are mommy, daddy, and uh-oh. He uses mommy and daddy to refer to pretty much anything he likes, and sometimes he will chant the words over and over for no apparent reason. Because I call him baby, he has a new word now, “bobby,” or sometimes “bah-bee,” and that’s what he calls me. He still speaks in streams of baby babble, but can understand pretty much anything you tell him. He will also kiss you on command, and he loves holding hands and being held. When he gets excited he’ll holler repeatedly with some laughs in-between, and it is so funny. He’ll climb anything, and he’s at that age where he is so eager to use every sense he has. Being with him makes almost everything a sensory experience. Watching him chew with effort, I feel more strongly the stringy peel of orange slices; watching him fall back with delight after pushing himself forward to complete double high-five, I feel more strongly his little weight and how compactly he fits in my arms.
Outside of being with family, the cruise itself isn’t particularly my thing. It’s crowded, and cheesy, and centered around consumption. There is too much service; we’re constantly being asked how things are and if we need anything and what did we do today and what would we like to do tomorrow. Even though I have nothing to be private about, I miss my privacy. I have yet to find a reliably solitary place, especially on days we’re at sea and not landed anywhere, and everyone is inside. I’m not sure if I enjoy microcosms; as big as the ship is, I feel like I’m experiencing everything in miniature. But the wide-open of the seas does compensate for this. Spending long minutes watching the blue and white, with nothing but music for company, has been a welcome conduit for breathing. It has also been incredibly nice to run everyday in front of sea spilling through windows. I will miss that.
Mostly it has been nice to indulge in nothingness. I sleep without thinking about when to wake up, and that simple sensation makes me consciously happy when I get into bed at night. There is no need to do anything; we do things because of simple urges to do so. I would’ve liked to do more outdoorsy things, but my parents can’t do those things and also it has been raining quite a bit. After ending the most intense year of my life thus far, taking it easy has been welcome. This wasn’t something I planned or thought about; it just happened. The serendipitous gift of being able to do almost everything with a view of water is something to take back with me; I think even after the sight is gone the sort of stillness carried in perpetual movement stays.
Wednesday, June 30, 2010
Tuesday, June 15, 2010
a man / the questions
One man is waiting for his wife. She left him twenty years ago, with much love and little reserve left for a life plagued by fixed false beliefs. When asked where he will go from here, he tells us his wife will be picking him up. If your wife doesn't come, will you be willing to return to your apartment until she does? A loose shrug with eyebrows raised just as lightly, his body giving into his mind, and agreement. Yes, I'll go back, but she should be coming. He combs the gray strands of hair on the side of his head before he talks to you, and he shakes your hand after every meeting, something people normally reserve for a more permanent goodbye. When asked what he's looking forward to when he leaves, he says, nothing really. Just to be with my wife. You know how it is. What about your music? He has spent his life making music, but here he is distant from it; "it's different here, less free." What about your music? Yes, I'll go back to the piano and writing music, but really, just to be with my wife. Today he is told again that he will likely have to return to his apartment if she doesn't come; he nods: but she will come. At the end he says, I hope she comes. What is it like to be in a state of perpetual anticipation?
One man has a large tongue that moves with his words so that his speech flows as if through a thick wall. A meeting lasts for an hour and a half among a dozen different people, a meeting about where he will go from here. He is brought in for a few minutes at the end, and asked where he would like to go. He imagines himself in his own apartment somewhere, maybe West Haven, and the faces meeting his are sad, amused, and used to it all. They don't tell him what they have decided for him. Having given him his allotted time, they continue in their knowledge and let him continue in his. In the end when all control is taken from a person, only honesty is left, and when that becomes elusive, it suddenly becomes a mystery as to what we want to save. So many people taking so much time for this one man, but what do we give and what do we take away?
One man spent sixty-four years in silence before speaking about the experiences that make him talk without pause, take your hand with tight warmth, and change the glint in his eyes from a reflection of lamplight to something fighting inside. He speaks now for all those who were with him, for those he ordered to die, for those he watched die, for those who died on the other side of the ditch. He held the hand of a prisoner of war, a man on the other side who had no one but him to look at as he passed away, a man who makes it so that any mention of nationality makes this man so angry. Who CARES, it's just human beings. "Do you know what that did to me?" and that glint becomes something else. I don't know. An infantry ranger during World War II, he carries the Normandy invasion in the ridges that set his eyes apart and uphold his blunted nose. When depressed he goes down to his basement and writes, writes about these things. Later he reads them, "just to check for spelling," and when he reads them again, he hates the words and rips up the papers. He says, it's hard, it's hard to speak about this, but I want to do something good; there's so much guilt. On a scale of 1 to 10, with 10 being the most good you could do, I hope, I just hope this is a 2 or 3. When asked what gives life meaning for him, with the evident hope that he sees his sharing as purpose and a means to turn pain into worth, he says, I like living but I don't like life. And later--I don't like myself, I hate myself. And then later--I do this because maybe, maybe, I say MAYBE and not that this will be, maybe this will make things better for people. How does someone whose sense of worth has been so damaged, ever come to feel and believe what seems so true to those who receive his good, that his capacity to live for maybe is a tremendous thing?
One man is still a child, in the literal sense. He is small, guarded but polite and sweet in his non-effusive openness, and spends most of the day hunched over a table with a book, or playing games with staff. At little over twenty years old, his home has suffocated him with the accumulation of things collected by a mother who can't throw away, with the carelessness of a father who can only consume. It's like a museum, he says; you can look but you can't touch. Dust is forced to layer on objects. He articulates his thoughts of jumping off a cliff (one that sits in his backyard) as a way to escape his current state, as a sort of fantasy, a way to place himself somewhere other than where he is. He doesn't step on the cliff, nor does he imagine himself on the other end of it, but there is a freedom in that jump that doesn't exist elsewhere. He knows the trajectory of the questions posed to him: I'm not manic. I'm not schizophrenic. Yes, I'm depressed. He came here because he wanted people to talk to, to have some sort of connection, and to go somewhere else from here. When a life is so crowded that space is defined only by crevices in between, how do you begin to make room?
One man has a large tongue that moves with his words so that his speech flows as if through a thick wall. A meeting lasts for an hour and a half among a dozen different people, a meeting about where he will go from here. He is brought in for a few minutes at the end, and asked where he would like to go. He imagines himself in his own apartment somewhere, maybe West Haven, and the faces meeting his are sad, amused, and used to it all. They don't tell him what they have decided for him. Having given him his allotted time, they continue in their knowledge and let him continue in his. In the end when all control is taken from a person, only honesty is left, and when that becomes elusive, it suddenly becomes a mystery as to what we want to save. So many people taking so much time for this one man, but what do we give and what do we take away?
One man spent sixty-four years in silence before speaking about the experiences that make him talk without pause, take your hand with tight warmth, and change the glint in his eyes from a reflection of lamplight to something fighting inside. He speaks now for all those who were with him, for those he ordered to die, for those he watched die, for those who died on the other side of the ditch. He held the hand of a prisoner of war, a man on the other side who had no one but him to look at as he passed away, a man who makes it so that any mention of nationality makes this man so angry. Who CARES, it's just human beings. "Do you know what that did to me?" and that glint becomes something else. I don't know. An infantry ranger during World War II, he carries the Normandy invasion in the ridges that set his eyes apart and uphold his blunted nose. When depressed he goes down to his basement and writes, writes about these things. Later he reads them, "just to check for spelling," and when he reads them again, he hates the words and rips up the papers. He says, it's hard, it's hard to speak about this, but I want to do something good; there's so much guilt. On a scale of 1 to 10, with 10 being the most good you could do, I hope, I just hope this is a 2 or 3. When asked what gives life meaning for him, with the evident hope that he sees his sharing as purpose and a means to turn pain into worth, he says, I like living but I don't like life. And later--I don't like myself, I hate myself. And then later--I do this because maybe, maybe, I say MAYBE and not that this will be, maybe this will make things better for people. How does someone whose sense of worth has been so damaged, ever come to feel and believe what seems so true to those who receive his good, that his capacity to live for maybe is a tremendous thing?
One man is still a child, in the literal sense. He is small, guarded but polite and sweet in his non-effusive openness, and spends most of the day hunched over a table with a book, or playing games with staff. At little over twenty years old, his home has suffocated him with the accumulation of things collected by a mother who can't throw away, with the carelessness of a father who can only consume. It's like a museum, he says; you can look but you can't touch. Dust is forced to layer on objects. He articulates his thoughts of jumping off a cliff (one that sits in his backyard) as a way to escape his current state, as a sort of fantasy, a way to place himself somewhere other than where he is. He doesn't step on the cliff, nor does he imagine himself on the other end of it, but there is a freedom in that jump that doesn't exist elsewhere. He knows the trajectory of the questions posed to him: I'm not manic. I'm not schizophrenic. Yes, I'm depressed. He came here because he wanted people to talk to, to have some sort of connection, and to go somewhere else from here. When a life is so crowded that space is defined only by crevices in between, how do you begin to make room?
Thursday, June 10, 2010
somatoform
I've broken out in hives, in response to nothing in particular. There are gross clusters of swollen, red blanching splotches on my hands, wrists, neck, waist, lower back, and feet; even my scalp itches. There is no defined distribution that would give a clue to an allergen; it's not from jewelry or lotion or clothing. The intensity is intermittent; in the morning they were pretty uncomfortable but I got a little used to them until they flared in the early afternoon. They calmed a bit after a shower. I had started itching a couple days ago but I attributed it to mosquito bites, to which I'm prone, but they got acutely worse last night and upon waking this morning I was pretty confused. After another morning of psychotherapy, in which I've never been more grateful for a cell phone interruption that kept me from bursting into tears in front of the psychiatrist, and then going to a class on somatoform disorders (real physical symptoms that have no physical cause, that instead stem from psychological/emotional roots), I remembered that this has happened a couple times before when I've been anxious, stressed or emotional. Not necessarily sad, but an emotion with a sense of strain.
I have really loved psychiatry for the patients, for how much depth of feeling and experience they show and share and that you explore with them. Much of this comes from the fact that I'm now working on a locked unit, such that the patients live their lives in a limited place, and it's not just hospital beds, it's their bed beds. In this way, living becomes dense and in some ways artificial, except that it's what they experience and so it's real. Being on the outside, students have the privilege of taking it all in. At some point, I think absorbing so much must make the skin break, the inside wanting an out. I really hope I can work towards giving it a worthy one.
I have really loved psychiatry for the patients, for how much depth of feeling and experience they show and share and that you explore with them. Much of this comes from the fact that I'm now working on a locked unit, such that the patients live their lives in a limited place, and it's not just hospital beds, it's their bed beds. In this way, living becomes dense and in some ways artificial, except that it's what they experience and so it's real. Being on the outside, students have the privilege of taking it all in. At some point, I think absorbing so much must make the skin break, the inside wanting an out. I really hope I can work towards giving it a worthy one.
Tuesday, June 8, 2010
patient-centered
After conducting clinical histories and physicals on seven standardized patients in a row for our third year exam, I came back to work to talk to my patient with schizophrenia. He turned to me and said, "Are you doing okay? Did you sleep last night?" It is nice, at the end of it all, to feel yourself again.
Monday, June 7, 2010
neuroticisms
In some ways my neuroticism has worn with age, the way my quick temper has been somewhat tamed by years, but in other ways it's intensified and my awareness of it has intensified in step. I would like to check my email less, write fewer impulsive emails, write less in general, remember little things less, be able to walk away more, be less sensitive, think less at night. Ideally I'd want to keep the good in all of that and leave the bad, but whatever it is that makes me this way doesn't let me choose. Or else I haven't tried hard enough.
Saturday, June 5, 2010
summer
Ran home umbrella-less in a summer thunderstorm tonight. Getting warmly soaked was lovely. I have to say that I love summer on the east coast more than on the west. I love the humidity and the fullness of tangible air. I love how the moisture builds up and comes back down in cool rain, complete with loud thunder and bright lightning. The rain comes and goes suddenly, and the day is interspersed with sun and gray, and the changes and textures make the day so real.
Spent the late afternoon at Lighthouse Point. Took photographs. Water and rocks give an incredible amount of texture. Drove with windows fully open, on highway too. With a friend whose friendship lost was a lot of pain, and whose friendship renewed is, simply put, nice.
Coming home, warm night outside with the sounds of car passing on wet pavement through open windows, listening to my favorite song (Runaway) on The National's latest album on the record player, I'm struck by how good everything feels. Summer is a strong season, I think.
Spent the late afternoon at Lighthouse Point. Took photographs. Water and rocks give an incredible amount of texture. Drove with windows fully open, on highway too. With a friend whose friendship lost was a lot of pain, and whose friendship renewed is, simply put, nice.
Coming home, warm night outside with the sounds of car passing on wet pavement through open windows, listening to my favorite song (Runaway) on The National's latest album on the record player, I'm struck by how good everything feels. Summer is a strong season, I think.
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