Back in the fall, in biochemistry, we learned about Lesch-Nyhan disease. People with Lesch-Nyhan are deficient in an enzyme called HGPRT involved in purine salvage, which leads to uric acid buildup. I remember these details because the other thing about people with Lesch-Nyhan is that they for some reason also mutilate themselves. They bite their own lips and fingers. Completely helpless to stop themselves, people with this disease often bandage their hands to prevent inflicting hurt upon themselves. Our professor referred us to a New Yorker article about a man with Lesch-Nyhan, and how the lack of control in self-mutilation pervades his entire approach to life. Instead of telling someone he loves them, he swears at them. Seeing a sharp pencil induces an uncontrollable urge to take it and do harm. He uses his right hand to grab and restrain his left hand from grabbing a knife and hurting himself or someone else. His intentions and his actions are completely at odds, and they divide his body.
The author of the article framed the disease as the extreme end of a phenomenon of which we are all victim, what Edgar Allen Poe termed "the imp of the perverse." The idea that we all do things that we know are bad for ourselves, like eating too much junk food to the point it's not pleasurable anymore or contemplating swerving your car into oncoming traffic for no particular reason. I remember first learning about this strange, rare disease and thinking that I must have some emotional form of Lesch-Nyhan, where I perpetuate things that I know, in mind and in heart, are not good for me and will hurt me.
Doing it once made me none the wiser the second time around. In a recent lecture about the biological basis of pain, we learned that when you feel a certain kind of pain for the second time, you feel it more acutely because you know its character. I'm not sure about the implications about your recovery and resilience, because I would guess there is also a desensitization process, the idea that pain makes you stronger and more able the next time. But what was clear is that once you get to know pain through first encounter, you are more aware when it hits you again. You don't have to feel around in the dark to learn its edges and figure out how to hold it. You know its contours without exploration.
The professor who lectured on pain did make a mistake, though, when he alluded to Lesch-Nyhan and said that people with the disease don't feel pain when they self-mutilate. I distinctly remember that they do feel pain, but the awareness of it can't stop them from hurting themselves. For them there is no desensitization or increased strength, only a constant fight against recurring pain. But I admired the man in the article, because there was a deliberate fight, a will against what he did to himself even if he knew it would continue.
For all the mistakes that I make twice and three times, growth does lurk in the corners. Despite similar themes, and a similar trajectory of trying not to hurt anyone and in the process hurting everyone including myself--there are different circumstances, reasons, people, feelings, and most importantly, more things learned. It does make me wonder again if I'll ever feel the same as I did the first time around. That used to worry me, but now I know that each thing offers something else, and it's valuable. And if I experience that feeling again, it will still have newness and surprises and a sense of other. It makes me think that for the man with Lesch-Nyhan, each finger bitten is not quite the same, and that even though you know the shape of its pain, you still reach out to find something different.
When I told Guson I was going home before summer because I missed my parents, he said I was maturing. My immediate reaction was to reject that idea, because isn't growing up about not missing home, not needing your parents? But it turns out he was right. There's only been one other time when I made sudden plans to go home. That time was a result of wanting to be away from where I was, a push from there to home. This time, I don't feel a push away from anything--I absolutely love where I am, in all senses--instead, it's a pull from home. That time I felt a little weak and this time I feel stronger. This time around, it's different.
Tuesday, May 20, 2008
Friday, May 2, 2008
loss
To borrow a sentiment from Steph's blog...God, it fucking hurts again.
*
A couple of weeks ago a graduating medical student was killed by a car outside of our dorm building, at an intersection we've all crossed hundreds of times. She walked along a red light, following a truck that was doing the same, and the car going green didn't see her. I was struck ajar at how much it affected me, the people around me, and the Yale community as a whole. There are many factors, I think--her youth, an emanating sweetness that seemed to touch those to whom she was unknown, proximity and inclusiveness. I don't really have anything new or insightful to say about the tragedy, neither its obvious immensity nor its subtleties. I'm sorry for that, but I'm glad there are many people who will do her memory full justice.
A few days after it happened, I read a short story called Found Objects about a woman who compulsively stole personal items. She didn't steal from stores, just people. She didn't steal for monetary or other gain; she didn't use any of the items she took. She piled them onto a table in her home, separate from all else in her life. She took a screwdriver from the back pocket of a plumber, a wallet left by a woman in the bathroom, bath salts from her best friend. The climax of the story was when she rummaged through the wallet of a one-night-stand and found a scrap of paper, saved through time and place, on it scrawled: I believe in you. She took it and never returned it. You could tell she hated herself for it. And you could tell she didn't know how else to be. It wasn't about the addictive thrill of getting away with the crime. It was about collecting pieces of people, and hurting them and hurting because of it.
It caught my eye in the New Yorker while I was in the waiting room at the pharmacy, because the title made me think of a short column I read once in the magazine about a person who collected people's lost gloves, storing them away in the hopes that someday one would find its other half. Found Objects turned out to have a very different theme, and it wasn't so much about things being found as being lost.
On the same day that we mourned the world losing Mila, I lost something separate and large in my life. It felt selfish, yet fitting at the same time, to be consumed by this multifaceted pain. What I lost, I lost because I was a little stupid, a little careless and not brave enough. Natural things that afflict most, and things sewn into all of us, and things grown out of circumstances and other people's mistakes too. So I'm learning to not place too much blame on myself but that doesn't decrease responsibility or the quite awful realization of your own capacity to cause pain.
I felt a bit like the woman who steals, and it makes me think of the driver of the car in Mila's accident. Granted that no one will ever suffer like those close to her--but the driver must suffer too, knowing what his mistake (and it was no one's clear or full fault) did to a life and having to live with that always. I feel a sort of immense sorrow for him, and I worry this is a little unfair and not right, but it seems to me that pain can't be too relative. It hurts very much to be hurt, and it hurts very much to inflict the hurt upon someone else. The driver on Frontage Street, the woman in Found Objects, and me, different beads on the same string.
Nowadays when I see people crossing that intersection against traffic when the light's red, I get a little sad because they don't know any better. And nowadays, when I do the same, I get a little sad because I do.
*
A couple of weeks ago a graduating medical student was killed by a car outside of our dorm building, at an intersection we've all crossed hundreds of times. She walked along a red light, following a truck that was doing the same, and the car going green didn't see her. I was struck ajar at how much it affected me, the people around me, and the Yale community as a whole. There are many factors, I think--her youth, an emanating sweetness that seemed to touch those to whom she was unknown, proximity and inclusiveness. I don't really have anything new or insightful to say about the tragedy, neither its obvious immensity nor its subtleties. I'm sorry for that, but I'm glad there are many people who will do her memory full justice.
A few days after it happened, I read a short story called Found Objects about a woman who compulsively stole personal items. She didn't steal from stores, just people. She didn't steal for monetary or other gain; she didn't use any of the items she took. She piled them onto a table in her home, separate from all else in her life. She took a screwdriver from the back pocket of a plumber, a wallet left by a woman in the bathroom, bath salts from her best friend. The climax of the story was when she rummaged through the wallet of a one-night-stand and found a scrap of paper, saved through time and place, on it scrawled: I believe in you. She took it and never returned it. You could tell she hated herself for it. And you could tell she didn't know how else to be. It wasn't about the addictive thrill of getting away with the crime. It was about collecting pieces of people, and hurting them and hurting because of it.
It caught my eye in the New Yorker while I was in the waiting room at the pharmacy, because the title made me think of a short column I read once in the magazine about a person who collected people's lost gloves, storing them away in the hopes that someday one would find its other half. Found Objects turned out to have a very different theme, and it wasn't so much about things being found as being lost.
On the same day that we mourned the world losing Mila, I lost something separate and large in my life. It felt selfish, yet fitting at the same time, to be consumed by this multifaceted pain. What I lost, I lost because I was a little stupid, a little careless and not brave enough. Natural things that afflict most, and things sewn into all of us, and things grown out of circumstances and other people's mistakes too. So I'm learning to not place too much blame on myself but that doesn't decrease responsibility or the quite awful realization of your own capacity to cause pain.
I felt a bit like the woman who steals, and it makes me think of the driver of the car in Mila's accident. Granted that no one will ever suffer like those close to her--but the driver must suffer too, knowing what his mistake (and it was no one's clear or full fault) did to a life and having to live with that always. I feel a sort of immense sorrow for him, and I worry this is a little unfair and not right, but it seems to me that pain can't be too relative. It hurts very much to be hurt, and it hurts very much to inflict the hurt upon someone else. The driver on Frontage Street, the woman in Found Objects, and me, different beads on the same string.
Nowadays when I see people crossing that intersection against traffic when the light's red, I get a little sad because they don't know any better. And nowadays, when I do the same, I get a little sad because I do.
Friday, April 4, 2008
backwards
Yesterday I met a baby two days old, and realized that's the closest I've ever come to the concrete very beginning of life. Then we saw another newborn born without a small intestine who, the nurse told us, wasn't going to make it. And that was the closest I've ever come to the concrete very end of life.
Last weekend, I left the rain in New Haven for rain in Fremont. The hills had turned green since I last saw them. There is nothing I love more in my hometown than the green hills on gray days. The greenery is so fresh against the rain. We drove through Niles, a part of Fremont I rarely see; the last time might've been the summer before high school, with the same friends. We drove for two and a half hours to get to Sutter Creek, and drove through numerous new-to-me and lush highways and narrow roads along the way. We passed hills sprinkled with churning windmills, hills strewn with cows, flattened hills that stretched to remote ranch houses. I saw a whole new part of California, with two of my oldest friends as passengers, going to the wedding of a friend whose closeness I still miss. The tears at the ceremony were for him growing together with his one, but selfishly, the feeling that lingered afterwards was our growing apart.
I missed home and family something awful while I was at home, most when they were right there for me. I sometimes get the impression people here don't think I'm attached to them or value these values as much as they do because I don't miss California and my family when I'm away. It's hard to explain that these things are so sewn in me that I rarely feel disconnected from them. Yet for whatever reason this past weekend, the physicality of my parents made me feel there are some things I can't carry as well as they can give me in their presence. When I was leaving, my mom exclaimed, I miss you so much! She often forgets to insert the right tense in her English phrases but her mistake made my nonsensical ache for home while I was there right. I miss missing home.
Last month, Henry visited me at Yale and I talked to him in person for the first time since June 2006 when we graduated, and we had similar conversations as we did then. Or at least similar topics of conversation. He mentioned the people we respectively let go. He called them the birds we let fly...willingly, purposefully. He talked about how hard it was, how he hasn't loved anyone that intensely since then, but focused on how much he's grown since then, and how he didn't think he could've grown in the same way if he hadn't. I agreed but will never make up my mind about a concrete rationale for any of that, no longer want to make sense of my senses. I miss the bird I let go, the one who nodded yes you are a difficult person but I don't find it difficult and want to be there as you figure it out because I love all of you. All of you. I grew with him and I've grown a lot without. I've been incredibly happy in both. Like Henry, I know that I've lived distinctly differently because of that willful, purposeful choice.
But that's a given for anything you choose or anything that happens to you, that it has shaped your life in a certain way that's never quite the same as if you had chosen something else or if something else had happened to you, but you can't judge which is more worthy, and in the end you can only be grateful for having had something and later, something else.
Last weekend, I left the rain in New Haven for rain in Fremont. The hills had turned green since I last saw them. There is nothing I love more in my hometown than the green hills on gray days. The greenery is so fresh against the rain. We drove through Niles, a part of Fremont I rarely see; the last time might've been the summer before high school, with the same friends. We drove for two and a half hours to get to Sutter Creek, and drove through numerous new-to-me and lush highways and narrow roads along the way. We passed hills sprinkled with churning windmills, hills strewn with cows, flattened hills that stretched to remote ranch houses. I saw a whole new part of California, with two of my oldest friends as passengers, going to the wedding of a friend whose closeness I still miss. The tears at the ceremony were for him growing together with his one, but selfishly, the feeling that lingered afterwards was our growing apart.
I missed home and family something awful while I was at home, most when they were right there for me. I sometimes get the impression people here don't think I'm attached to them or value these values as much as they do because I don't miss California and my family when I'm away. It's hard to explain that these things are so sewn in me that I rarely feel disconnected from them. Yet for whatever reason this past weekend, the physicality of my parents made me feel there are some things I can't carry as well as they can give me in their presence. When I was leaving, my mom exclaimed, I miss you so much! She often forgets to insert the right tense in her English phrases but her mistake made my nonsensical ache for home while I was there right. I miss missing home.
Last month, Henry visited me at Yale and I talked to him in person for the first time since June 2006 when we graduated, and we had similar conversations as we did then. Or at least similar topics of conversation. He mentioned the people we respectively let go. He called them the birds we let fly...willingly, purposefully. He talked about how hard it was, how he hasn't loved anyone that intensely since then, but focused on how much he's grown since then, and how he didn't think he could've grown in the same way if he hadn't. I agreed but will never make up my mind about a concrete rationale for any of that, no longer want to make sense of my senses. I miss the bird I let go, the one who nodded yes you are a difficult person but I don't find it difficult and want to be there as you figure it out because I love all of you. All of you. I grew with him and I've grown a lot without. I've been incredibly happy in both. Like Henry, I know that I've lived distinctly differently because of that willful, purposeful choice.
But that's a given for anything you choose or anything that happens to you, that it has shaped your life in a certain way that's never quite the same as if you had chosen something else or if something else had happened to you, but you can't judge which is more worthy, and in the end you can only be grateful for having had something and later, something else.
Friday, March 21, 2008
time
To get to the photo lab on Willow Street to develop my film, I take the Green Shuttle from Phelps Gate to Orange and Willow streets. Having gone three times before, I have the timing down. The Green Shuttle comes every thirty minutes, on 5 and 35 of the hour. It takes exactly ten minutes to walk from York Street to Phelps Gate to pick up the shuttle. This route begins at 12:46 PM. In the morning prior to this time, the shuttle comes on 8 and 38 of the hour.
After I found the morning schedule at 11:26 AM today, I scrambled to get ready in 2 minutes so that I could start walking by 11:28 and make the 11:38 shuttle. I made it there at 11:37, and had to wait a couple minutes because the shuttles are always slightly off. I saw the Green coming my way at 11:39...then the driver waved his hand and passed me right by. Thinking that perhaps the morning schedule didn't quite work the way I thought, I waited for awhile longer. Fifteen minutes longer. So when a Blue Shuttle came by, I decided to just take it instead of waiting another 15 for the next Green. Because I can take the Blue Shuttle to Whitney and Canner, which is right near Willow Street. The walk is about twice as long as from the Green Shuttle stop, but I estimated it'd be less time than waiting for another Green.
I got on the Blue, which took me right back to the Med School because the Shuttles don't go back and forth; they travel in loops. When I get there, the driver tells me that he's taking a break and that I have to wait for the next shuttle to get there in 10 minutes. It's near noon by this time, and I figure that if I have to wait another 10 minutes, I might as well walk the 10 minutes from the med school to Phelps Gate, to catch that next Green Shuttle that I didn't want to wait for in the first place. And try to catch the 12:08 Green. Since the 11:38 was on time but just didn't stop for whatever reason; maybe it was a transitional shuttle, I thought.
So I walked back to exactly where I was 20 minutes earlier, having expounded twice as much effort to get there than the first time around. I waited a little bit and saw the Green coming; it always stalls at the red light. I thought I'd made a good choice, even for having wasted a half hour..and then it passes by me again. I swore audibly.
It was another 15 minutes before a Blue Shuttle came by. I took it, again. It brought me back to the med school, again. I waited there for 10 minutes before it took off on its route, again. This time I rode it all the way to the stop and walked the 10 minutes to the photo lab. I finally got there at 1 PM.
When I got there the woman told me that she wouldn't be done developing my photographs until 3 PM, so I sat there and read while I waited. It turned out that I could only develop 2 prints out of 2 rolls (about 24 prints) because something went awry in my camera winder and the prints overlapped, making it impossible to print them. The fact that the Puerto Rico photographs I'd been so looking forward to are now forever encased in negative was bad enough, because I get upset like that. But atop it all my entire morning and early afternoon was taken up with this fruitless commute.
As I walked back, I saw the Green Shuttle pass right by me again and walked on forward to the Blue Shuttle stop, which I did catch. Because there's only one of each colored shuttle for each shift (morning and afternoon), the same driver who dropped me off picked me up. He was a gruff man in his late fifties with scraggly hair who looked through me when he talked to me, but not unkind. In the seat behind him was a boy maybe ten years old, who rode with him. I'm guessing his grandson. His grandson was there on the shuttle I took to the lab, and the shuttle back. He didn't have a book, or a gameboy. He didn't really talk to his alleged grandpa or to anyone else. He just sat in the same seat, looked out the same window, sometimes got up and stood by the driver and sat back down. He didn't look bored or restless. He rode that same route all afternoon.
More than wasting hours on the shuttle and being disappointed with my memories and subsequently my whole day because I get so easily consumed by moments, the image of that boy riding on the shuttle made me hurt. I miss that. I can't even remember when exactly I lost that. The ability to while away, nothingness, without thought to time. Spring break was a slight hint of that, and just this morning I talked for an hour with Dr. Fenn about what I love, and that included writing and stories and traveling, all things that make me distort my sense of time, give me more than what I have concretely, make me think outside those bounds while still feeling their weight.
But from day to day and for the past who-knows but too many years of my life I have been too often obsessed with time. What I could've done instead, whether I was "productive," whether even fun time was spent well. One of my top ten things in the world is commuting. Being a passenger or driving alone, with no real purpose but to arrive. And even that is not quite comparable to this boy on the shuttle. People say it's not the end, it's the journey, but that's assuming there is an end. For the boy, there was no end even. Just the same route.
I'd like to have days I can ride on the same shuttle, even more than twice or three times like I did today, and not be frustrated or think that something has gone to waste or forget to be glad for time itself and not just for what I do with it. I'd like to do absolutely nothing and feel more something because of it, to remove the brackets from time and just go around for a bit.
After I found the morning schedule at 11:26 AM today, I scrambled to get ready in 2 minutes so that I could start walking by 11:28 and make the 11:38 shuttle. I made it there at 11:37, and had to wait a couple minutes because the shuttles are always slightly off. I saw the Green coming my way at 11:39...then the driver waved his hand and passed me right by. Thinking that perhaps the morning schedule didn't quite work the way I thought, I waited for awhile longer. Fifteen minutes longer. So when a Blue Shuttle came by, I decided to just take it instead of waiting another 15 for the next Green. Because I can take the Blue Shuttle to Whitney and Canner, which is right near Willow Street. The walk is about twice as long as from the Green Shuttle stop, but I estimated it'd be less time than waiting for another Green.
I got on the Blue, which took me right back to the Med School because the Shuttles don't go back and forth; they travel in loops. When I get there, the driver tells me that he's taking a break and that I have to wait for the next shuttle to get there in 10 minutes. It's near noon by this time, and I figure that if I have to wait another 10 minutes, I might as well walk the 10 minutes from the med school to Phelps Gate, to catch that next Green Shuttle that I didn't want to wait for in the first place. And try to catch the 12:08 Green. Since the 11:38 was on time but just didn't stop for whatever reason; maybe it was a transitional shuttle, I thought.
So I walked back to exactly where I was 20 minutes earlier, having expounded twice as much effort to get there than the first time around. I waited a little bit and saw the Green coming; it always stalls at the red light. I thought I'd made a good choice, even for having wasted a half hour..and then it passes by me again. I swore audibly.
It was another 15 minutes before a Blue Shuttle came by. I took it, again. It brought me back to the med school, again. I waited there for 10 minutes before it took off on its route, again. This time I rode it all the way to the stop and walked the 10 minutes to the photo lab. I finally got there at 1 PM.
When I got there the woman told me that she wouldn't be done developing my photographs until 3 PM, so I sat there and read while I waited. It turned out that I could only develop 2 prints out of 2 rolls (about 24 prints) because something went awry in my camera winder and the prints overlapped, making it impossible to print them. The fact that the Puerto Rico photographs I'd been so looking forward to are now forever encased in negative was bad enough, because I get upset like that. But atop it all my entire morning and early afternoon was taken up with this fruitless commute.
As I walked back, I saw the Green Shuttle pass right by me again and walked on forward to the Blue Shuttle stop, which I did catch. Because there's only one of each colored shuttle for each shift (morning and afternoon), the same driver who dropped me off picked me up. He was a gruff man in his late fifties with scraggly hair who looked through me when he talked to me, but not unkind. In the seat behind him was a boy maybe ten years old, who rode with him. I'm guessing his grandson. His grandson was there on the shuttle I took to the lab, and the shuttle back. He didn't have a book, or a gameboy. He didn't really talk to his alleged grandpa or to anyone else. He just sat in the same seat, looked out the same window, sometimes got up and stood by the driver and sat back down. He didn't look bored or restless. He rode that same route all afternoon.
More than wasting hours on the shuttle and being disappointed with my memories and subsequently my whole day because I get so easily consumed by moments, the image of that boy riding on the shuttle made me hurt. I miss that. I can't even remember when exactly I lost that. The ability to while away, nothingness, without thought to time. Spring break was a slight hint of that, and just this morning I talked for an hour with Dr. Fenn about what I love, and that included writing and stories and traveling, all things that make me distort my sense of time, give me more than what I have concretely, make me think outside those bounds while still feeling their weight.
But from day to day and for the past who-knows but too many years of my life I have been too often obsessed with time. What I could've done instead, whether I was "productive," whether even fun time was spent well. One of my top ten things in the world is commuting. Being a passenger or driving alone, with no real purpose but to arrive. And even that is not quite comparable to this boy on the shuttle. People say it's not the end, it's the journey, but that's assuming there is an end. For the boy, there was no end even. Just the same route.
I'd like to have days I can ride on the same shuttle, even more than twice or three times like I did today, and not be frustrated or think that something has gone to waste or forget to be glad for time itself and not just for what I do with it. I'd like to do absolutely nothing and feel more something because of it, to remove the brackets from time and just go around for a bit.
Monday, February 4, 2008
lub-dub
Last Thursday, on the last day of this year's first month, thirty and some of us sat in a lecture hall with stethophones on our laps and in our ears, listening to heart sounds that a stout doctor committed to principles of the physical exam played for us on a mysterious machine that used infrared waves to contact some rectangular box attached to our devices. His words are clear and serious. You've all been listening to normal hearts. It's important to know what abnormalities sound like. Know murmurs. Here's what mitral regurgitation sounds like. Once you hear it, you'll never forget it. First I'll start out with the normal heartbeat, and then I'll add the murmur.
We listen and wait. Here it comes. Lub-dub. Lub-dub. So soothing and constant and rhythmic and after such a long day, more than a bit sleep-inducing. I see him turn a knob and then whooosh. There's the murmur. Lub-d--whooosh--ub. Lub-d-whooosh-ub. I thought, suddenly--wow. That's it. My life is this lub-dub and I'm that whooosh that's just passing it by.
*
Thursday began with a 9 AM lecture on renal physiology. In college I hated studying the kidney because there are so many parts and each one functions intricately differently. But it's true that repetition helps, because after a very cursory look in college, the first overview lecture here, and the histology lab, I wasn't as intimidated by having to hear someone talk about how the kidney reabsorbs salt and water for an hour. It turned out to be an hour lecture on the proximal tubule (1/6 of the kidney's tubules). Just the proximal tubule. It was surprisingly good. The proximal tubule is a hard worker and very smart.
From 10 AM-1 PM we had our last anatomy lab. It was the most brutal we've had, and yet anticlimatic. I haven't been too bothered by the physicality of anatomy; it's been more beautiful than disturbing. Removing the chest wall, dislocating the shoulder, uncovering the hand muscle by muscle--it's all been for something, even at times we spend more time with dissection than actual visualization. It never seemed disrespectful, and we are reminded so often of what our donor should mean to us, to respect their gift.
This time, the sounds and movements and my own inability to distinguish anything in the nasal and oral pharynxes made the procedure seem unnecessary and made me feel sorry for doing it. It involved sawing the head--skull and all--in half. Through the nasal septum, if you managed to be exact. The sound was in one word, awful. We used a manual saw, and it was worse than the loud grinding of the mechanical one we've had in the past. Because the exertion was so obvious and physical, the back-and-forth and the amount of time was palpable.
Perhaps I should have prepared more, but the fact that I didn't know anything about the nose and mouth and gained very little from the lab made me feel infinitely more guilty for doing this to our donor. I don't attach too much significance to the body after death; I'd like to be cremated and I have some sense of some sort of soul. So it's not like I prioritize bodily preservation, but the sacred the body holds when alive can't help but remain.
I will remember where I saw my donor's ligamentum arteriosum because it made sense based on what I knew about it--I remember Rizzolo forcing us to reason out why it would be there and how satisfying it was to confirm it both anatomically and intellectually. I will remember the long tendons of his arm and hand and moving them to move his fingers, my favorite lab. I will remember the subdural hematoma that engulfed his brain and how that both fascinated and hurt me. But how much anatomy will I remember? Likely little. Are those memories enough to justify everything else? I'm not sure. I'm not sure if it would be enough for me to give myself up, even as a person who thinks little of what will happen to my body after this is all over.
And so, it ended. Not quite with a whimper, but definitely no bang. Allison and I were talking afterwards about whether we'd have strong visual memories of our donors. I said I didn't think so, because we never looked at the body in its entirety. We always covered parts we weren't working on, including the face, which would be easiest to remember. It's hard to really retain vivid images of things in isolation.
Yet--though I don't feel I've solidified an image of his body or even his face, I do know I've acquired, in slow and fast gulps, an entirely new perspective of body. They say anatomy is a rite of passage, and it is. It is, not for all the arteries and nerves and muscles, but for the new and complex and strange and wordless.
After lunch (and no, it's not really strange at all to eat after anatomy lab), I made a quick run to the post-office to drop off my ballot for Super Tuesday; the fresh air was nice. Then I had a meeting from 2-2:30 PM with a professor at the Public Health school. It was one of two required meetings for my application to go to Vietnam this summer. I'm hoping to do a social health project to evaluate the effects of the healthcare system on low-income patients, in terms of their living conditions, employment and education. The professor was helpful in telling me what I needed to do to make the study design tighter--which is the most difficult part of the whole thing. If it pans out, I'd be based in Hanoi, but also live with a family in a rural commune while doing fieldwork. Talking about the finer details made some anxiety about getting it all done re-surge, but I'm hoping very hard it works out.
From 3-5 PM we had Pre-Clinical Clerkship. Since the new semester started, it's been all physical exam. I honestly hadn't given much thought to doing the physical exam prior to this; despite it being a core experience, it wasn't something I associated with medical school like I did with anatomy. I guess I couldn't really see myself doing it. It's been fairly incredible. I feel as inept as ever, but small improvements like actually knowing the names of my instruments and how to hold them makes me feel disproportionately good. The fulfillment of DOING stuff gets so lost in academics, and it's been refreshing to feel things very concretely.
The hardest thing thus far has been using the opthalmoscope to look into people's eyes. You have to get uncomfortably close to a person's face to do so, and keep one eye closed. I discovered what a struggle it is to keep my left eye open when my right's closed. Then seeing the person's blood vessels is surprisingly difficult--finding the optic disc near-impossible. After many, many tries on different weeks I finally saw one, and again the excitement was too large for such a tiny thing.
Dean Angoff introduced our introduction to the physical exam by saying how important it is to feel the discomfort, anxiety, vulnerability of the patient. That by being patients for our partners to practice on, we have some sense of what it's like to have to bare yourself for inspection. I love Dean Angoff, and I love that after so many years in medicine she is still so in tune with people. I have definitely felt anxiety being the patient, and she makes me remember to be thankful to have that feeling to draw upon in the future. I'm not going to lie. Taking my shirt off for the lung and heart exams was uncomfortable. Actually, even having a light shone in my nostrils was discomfiting. And that's with an awesome partner who couldn't be more considerate. I imagine it's worse for a patient, who doesn't even know why we're doing things, whereas we understand why someone's poking us in this place and that.
The physical exam has also added yet another thing to draw our class into a cult, of people who torture each other with bright lights in our eyes and amateur percussing and hesitantly sticking otoscopes in our ears without damaging something in there. I try to step back and look at that from the outside, and it amuses me and find that as awkward as it can be to do this on people you know, it's another aspect of the med student bond. However, I welcome any of you to be my patients for practice.
This week's physical exam practice was supplemented with the heart sounds session I mentioned before. It is amazing to hear something buried in you beating in your ears. It is extremely hard for me to distinguish sounds, which beat is louder at certain places, the timing of a beat and an underlying/overlying murmur. It's such an art.
The day finally officially ended, and I spent my hour before dinner ordering books--Let's Go for PUERTO RICO, and yet more Murakami to read while in PUERTO RICO. After a five-hour planning party wherein ten or so people were in and out of my room on three computers searching for travel deals and spilling tea and yogurt on my sheets, we booked TWO rooms for FOURTEEN people in San Juan. Six nights, six-and-a-half days with packed, co-ed rooms. I am so excited, and so glad that all my good friends here will be together in another country with no med school frenzy.
After a nice dinner (our dorm food is always bad, but company is always good), I thought about doing work, but ended up g-chatting with Allison for a couple hours about boys, school, motivation, friends. Even though we're so busy, I think we all give a lot of thought to our experience here--why and how. It's necessary to stop to consider what we're doing, because it's so easy to get swept up in the rhythm of things.
I did manage to review the kidney lecture from the morning, but that was about it before we headed to PubMed. PubMed is a free party with open-bar on the first floor of our dorm. Its convenience cannot be beat. We got pretty tipsy. Some of our classmates who have formed a band performed several songs. Events like this make me want to grow super arms to hug my entire class at once. They are so goofy and amusing and supportive of one another. I like how, since the first day we went out, we can all dance with each other in complete innocence and fun. He and I had a tiff and a moment, which consumed most of the night but ended with me glad for how people surprise you.
*
I don't write much about daily happenings, because for me they don't give a good impression of how things are. But giving a sense of what medical school is like is difficult. Thoughts and responses clamor for space and it's hard to fully revisit any one of them. Thursday, January 31 was a long day with a smattering of almost every thing that comprises my life here, and one I'd like to remember in detail. I'd like to calm that murmur and listen to the beat of things.
Tuesday, January 22, 2008
my brother's wedding
My oldest brother got married. The event drove several very obvious things home: marriage is a big deal, life's hard, I've gained a sister and I am still a kid.
Back when they thought they'd have more time to plan the wedding, they took me to look at dresses and rings, and I couldn't really get into that. Flying to New Mexico, I felt little anticipation; I had a sense of going through the motions because of the practicality of the ceremony and its haste. This lasted until the moment I saw my brother and his bride, dressed--he in something other than his normal sweats and she with a winter coat covering the white but still instantly beautiful. He was so happy to see us, kept thanking us for coming; it's been a long time since someone has been that happy for my presence and I felt so lucky to be able to give it to him.
The mass was in Vietnamese, and I couldn't quite get into those formalities either but somehow I found myself near tears anyway. I almost felt like the older sibling--the one who's proud and weepy. Things that are of value are continual; they don't happen in a moment, but there are moments where these things concentrate and come to a point and make you hyperaware of them. You always wish for the happiness of those you care about, but during certain parts of the mass I could feel the strain of me physically asking for it. I'm not going to pretend that I feel that as often as I should, and the tug was like the loving ache a muscle makes after a long time in disuse.
The circumstances of the event weren't ideal, and I so wish that it had been better for the both of them. His wife is balancing school, of which she's missed much lately, their new life together coming into being and something in her old life passing away. I honestly don't know how she finds the strength to do it, and I wonder at how I get overwhelmed with my own life when it is so much easier. The happiness that day should be will always be overshadowed by the sorrow that it was. For me, so invested in memory and story, that would be so hard to accept. Without having any tangible evidence, I sense that she will and gracefully so. She and I get along, but we don't have too much in common and haven't really talked at length about many things. But it's easy to see there is much to look up to and learn from in her, and it hit me for the first time that it will be very different to finally have a sister in the family, and one who isn't actively trying to take care of me but is just showing me by being.
So it happened that marriage, birth, and death--the events of a lifetime--were crowded into the space of one day. I thought about how none of my days in twenty-three years has been quite like that day for her, and I can clearly recall being fazed by the sudden realization that I am a child. And that all the experience I hope for, the majority of it lies ahead and that I shouldn't want to hurry it. It comes hard and fast, and you need all the time before it to brace yourself (uselessly, probably) against the parts that don't fit.
Though he didn't show it, I know it was hard for him too, to have things done this way, having to cut so many corners for something he's wanted for a long time. Yet he adjusted so well, and found happiness in it all. And it made me very glad to have had the opportunity to speak about his selflessness in the speech he asked me to write. Sometimes I forget how much my oldest brother cares about me (much more than I actively deserve), because we only see each other once or twice a year, and neither of us have time to have the frequent conversations we used to have. When he first asked me to make a speech for the wedding, I was a little overwhelmed, because things have been so incredibly busy. In my semi-exploded state, to write something meaningful in a few days about an event we only knew was coming a week in advance seemed like too much to ask, when of course it wasn't and I was just being self-absorbed. As short as it is, it took a long time to write but like with most words that take time, I learned a lot about how I felt in the process of writing. After, I was really thankful and honored that he'd asked me to do it. He so rarely asks me to do anything and it was nice to contribute something concrete to his moment.
So here's what I said.
*
This is the first wedding speech I've ever made, and at first I thought it would be really difficult to write. And well, it was. When I asked Hoang what I was supposed to say, he said to me, "What else is there to talk about? Me and Vy!"...And while that seems obvious, it was helpful to hear.
Because as much as a marriage is about the union between two people, it's about the two individuals themselves. So in thinking about this, I thought about these individuals. One who has always been family, and one who has become family.
While I was growing up, Hoang always felt like a parent to me. Not just because he set my bedtime and wouldn't let me eat too much candy, but because he gave without expecting anything in return. As a child I found this to be natural. But when I got older I realized how rare it is for a person to give more than they take.
So when I met Vy and saw the same generous spirit in her, I knew it was something special. She extended her full self towards our crazy family, and with Hoang, she was unquestionably selfless. And so Vy reminded me as an adult of what Hoang taught me as a child: that a true connection between people is not about, like they say, give and take, but about give and give.
With their marriage, Hoang and Vy give not only to each other. They also give all of us faith that two such caring people do exist, and can find each other. For that and much more, we wish you many blessings, happiness, and much more.
*
The actual speech went about 82% the way I had practiced it--had to give some pause for laughs (I was struck slightly ajar by actual laughter), for having to talk louder because there was no microphone, for a couple slight misphrasings, and for how people started clapping and making noise at "many blessings," leaving the "happiness and much more" drowned in chopsticks against glass. I'm glad that part went 82%. For all the quiet steadiness of life thus far, it's the noise you often remember and you often look forward to.
Back when they thought they'd have more time to plan the wedding, they took me to look at dresses and rings, and I couldn't really get into that. Flying to New Mexico, I felt little anticipation; I had a sense of going through the motions because of the practicality of the ceremony and its haste. This lasted until the moment I saw my brother and his bride, dressed--he in something other than his normal sweats and she with a winter coat covering the white but still instantly beautiful. He was so happy to see us, kept thanking us for coming; it's been a long time since someone has been that happy for my presence and I felt so lucky to be able to give it to him.
The mass was in Vietnamese, and I couldn't quite get into those formalities either but somehow I found myself near tears anyway. I almost felt like the older sibling--the one who's proud and weepy. Things that are of value are continual; they don't happen in a moment, but there are moments where these things concentrate and come to a point and make you hyperaware of them. You always wish for the happiness of those you care about, but during certain parts of the mass I could feel the strain of me physically asking for it. I'm not going to pretend that I feel that as often as I should, and the tug was like the loving ache a muscle makes after a long time in disuse.
The circumstances of the event weren't ideal, and I so wish that it had been better for the both of them. His wife is balancing school, of which she's missed much lately, their new life together coming into being and something in her old life passing away. I honestly don't know how she finds the strength to do it, and I wonder at how I get overwhelmed with my own life when it is so much easier. The happiness that day should be will always be overshadowed by the sorrow that it was. For me, so invested in memory and story, that would be so hard to accept. Without having any tangible evidence, I sense that she will and gracefully so. She and I get along, but we don't have too much in common and haven't really talked at length about many things. But it's easy to see there is much to look up to and learn from in her, and it hit me for the first time that it will be very different to finally have a sister in the family, and one who isn't actively trying to take care of me but is just showing me by being.
So it happened that marriage, birth, and death--the events of a lifetime--were crowded into the space of one day. I thought about how none of my days in twenty-three years has been quite like that day for her, and I can clearly recall being fazed by the sudden realization that I am a child. And that all the experience I hope for, the majority of it lies ahead and that I shouldn't want to hurry it. It comes hard and fast, and you need all the time before it to brace yourself (uselessly, probably) against the parts that don't fit.
Though he didn't show it, I know it was hard for him too, to have things done this way, having to cut so many corners for something he's wanted for a long time. Yet he adjusted so well, and found happiness in it all. And it made me very glad to have had the opportunity to speak about his selflessness in the speech he asked me to write. Sometimes I forget how much my oldest brother cares about me (much more than I actively deserve), because we only see each other once or twice a year, and neither of us have time to have the frequent conversations we used to have. When he first asked me to make a speech for the wedding, I was a little overwhelmed, because things have been so incredibly busy. In my semi-exploded state, to write something meaningful in a few days about an event we only knew was coming a week in advance seemed like too much to ask, when of course it wasn't and I was just being self-absorbed. As short as it is, it took a long time to write but like with most words that take time, I learned a lot about how I felt in the process of writing. After, I was really thankful and honored that he'd asked me to do it. He so rarely asks me to do anything and it was nice to contribute something concrete to his moment.
So here's what I said.
*
This is the first wedding speech I've ever made, and at first I thought it would be really difficult to write. And well, it was. When I asked Hoang what I was supposed to say, he said to me, "What else is there to talk about? Me and Vy!"...And while that seems obvious, it was helpful to hear.
Because as much as a marriage is about the union between two people, it's about the two individuals themselves. So in thinking about this, I thought about these individuals. One who has always been family, and one who has become family.
While I was growing up, Hoang always felt like a parent to me. Not just because he set my bedtime and wouldn't let me eat too much candy, but because he gave without expecting anything in return. As a child I found this to be natural. But when I got older I realized how rare it is for a person to give more than they take.
So when I met Vy and saw the same generous spirit in her, I knew it was something special. She extended her full self towards our crazy family, and with Hoang, she was unquestionably selfless. And so Vy reminded me as an adult of what Hoang taught me as a child: that a true connection between people is not about, like they say, give and take, but about give and give.
With their marriage, Hoang and Vy give not only to each other. They also give all of us faith that two such caring people do exist, and can find each other. For that and much more, we wish you many blessings, happiness, and much more.
*
The actual speech went about 82% the way I had practiced it--had to give some pause for laughs (I was struck slightly ajar by actual laughter), for having to talk louder because there was no microphone, for a couple slight misphrasings, and for how people started clapping and making noise at "many blessings," leaving the "happiness and much more" drowned in chopsticks against glass. I'm glad that part went 82%. For all the quiet steadiness of life thus far, it's the noise you often remember and you often look forward to.
Wednesday, January 2, 2008
home
Since we started college, no visit to home has been unaccompanied by conversations about how it feels to be back home and what it means. As more time goes by, the visits become fewer and more far between, and the conversations about them longer. I don't see Fremont being a place that I will be again, outside of the holidays. It won't likely ever again be my home again in the sense of living here for any extended period of time, not even summers. I may end up in the Bay Area again, but that could be anywhere--not this street, not this place.
They say home is where your heart is, but I'm not sure my heart is here either. Not because I don't love Fremont. It always surprises me when I come home, how beautiful Fremont is. This small town with few claims to fame, with little to do, with little to see. One of the first things I did here was run around my neighborhood in the morning. The love I felt for this home was so immediately palpable; it breathed as I breathed. So much of it came from familiarity, because if you know me you know it takes forever for my surroundings to become familiar to me. Even now, I'm little aware of the street names and how they relate to each other. But I recognize things and it doesn't take much to re-feel them. The route to my piano teacher's house and the church where we played our recitals, the steps where my first boyfriend and I used to kiss, my old junior high. It has been gorgeously bright and warm enough to run comfortably in a T-shirt. December is a nice month here, where the hills are just transitioning from brown to green, so you see them in all their shades. Seeing Christmas lights on houses and decorations in the yard, during the day instead of night as intended, gives this small cove of the town an endearing charm. Instead of magic, it's real, and sweet. Fremont's not hip or urban or quirky or worldly or especially quaint, and it doesn't keep anything hidden that makes you want to seek out its corners. It just is what it is, a place where people live.
Maybe for that reason, home has become a place where I fix things. I've written earlier about how I hang onto broken things as long as possible, but when I come home I'm more amenable to changing them. I finally switched from rain-worn phone to my old phone so that it won't die on me after a few hours anymore. My family gave me a new laptop for Christmas to replace my only somewhat functional computer of the past few years. Home is where my mom sews buttons back onto my coat, where I finally get clothes dry-cleaned, where I cut my hair and go to the dentist, where I finally get a pair of dress pants so I can stop wearing the ones from high school. Home is where I began running, and where I returned to it during difficult times. It's clear that much of this is about convenience and familiarity, but convenience is not easy to come by and familiarity inherently doesn't happen instantly. Some things aren't so easily mended, but what comes first is the desire to mend, to maintain or move forward. I might carry my heart wherever I go, but this will always be a place to move around the pieces, to put them back in place or make them anew.
They say home is where your heart is, but I'm not sure my heart is here either. Not because I don't love Fremont. It always surprises me when I come home, how beautiful Fremont is. This small town with few claims to fame, with little to do, with little to see. One of the first things I did here was run around my neighborhood in the morning. The love I felt for this home was so immediately palpable; it breathed as I breathed. So much of it came from familiarity, because if you know me you know it takes forever for my surroundings to become familiar to me. Even now, I'm little aware of the street names and how they relate to each other. But I recognize things and it doesn't take much to re-feel them. The route to my piano teacher's house and the church where we played our recitals, the steps where my first boyfriend and I used to kiss, my old junior high. It has been gorgeously bright and warm enough to run comfortably in a T-shirt. December is a nice month here, where the hills are just transitioning from brown to green, so you see them in all their shades. Seeing Christmas lights on houses and decorations in the yard, during the day instead of night as intended, gives this small cove of the town an endearing charm. Instead of magic, it's real, and sweet. Fremont's not hip or urban or quirky or worldly or especially quaint, and it doesn't keep anything hidden that makes you want to seek out its corners. It just is what it is, a place where people live.
Maybe for that reason, home has become a place where I fix things. I've written earlier about how I hang onto broken things as long as possible, but when I come home I'm more amenable to changing them. I finally switched from rain-worn phone to my old phone so that it won't die on me after a few hours anymore. My family gave me a new laptop for Christmas to replace my only somewhat functional computer of the past few years. Home is where my mom sews buttons back onto my coat, where I finally get clothes dry-cleaned, where I cut my hair and go to the dentist, where I finally get a pair of dress pants so I can stop wearing the ones from high school. Home is where I began running, and where I returned to it during difficult times. It's clear that much of this is about convenience and familiarity, but convenience is not easy to come by and familiarity inherently doesn't happen instantly. Some things aren't so easily mended, but what comes first is the desire to mend, to maintain or move forward. I might carry my heart wherever I go, but this will always be a place to move around the pieces, to put them back in place or make them anew.
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