Saturday, November 11, 2006

Now what...

Twenty four hours ago I asked myself what the hell I was thinking…medical school…I must be out of mind. All week I recited the same line over and over again from time to time. Examination time always makes a person reevaluate decisions. Today I completed an examination of the entire body. The rules were quite basic: 1) Anything regarding the HUMAN body goes and 2) Gray's Anatomy textbook is the bible. Needless to say, the conditions were ripe for people to fall into the grips of panic, anger, panic again, more anger, and ending with the final statement of 'Oh shit what is that test doing in front of me.' So far in life I've learned a few powerful lessons:

1) If you don't know where to start then just start.
2) Hard work pays off.
3) Don't be afraid to get dirty.
4) Believe in yourself.

These four lessons helped me tremendously during the 500 lb gorilla of medical school, Gross Anatomy. Something in me changed during the course of that class. I don't know when or where it happened, but something changed. Socrates' famous quote makes me smile. "All I know is that I know nothing" could never be more true than to the field of medicine. In a way, Gross Anatomy sobered me up more so than any other time in my life. I learned how impossible it is to learn everything about the human body much in the same way clinical cases relate to medicine as a whole. I now have in me a body of knowledge that could make me quite dangerous. Or should I say, the potential of this acquired body of knowledge makes me dangerous. The true irony of medicine is the more you know the more dangerous you become. It is the 'sober' physician and surgeon who make the best doctors, i.e, the ones who know they do not know everything and will not know everything. No wonder why Gross Anatomy remains the hallmark of a medical education...

I wonder what med school will be like now that I'm not elbow deep in a cadaver every Monday, Wednesday, and Friday afternoon (at least).

Saturday, September 9, 2006

I was pimped twice this last week.

Pimp (verb): to make use of often dishonorably for one's own gain or benefit. –Merriam-Webster OnLine

I was pimped twice this last week: once during lab and once during lecture. Pimping is an unwritten passage that ALL student physicians must come to terms with early on in their careers. Call it an initiation. But, also, understand, pimping makes physicians better physicians. Pimping is sort of a one-sided dialogue, a barrage of questions directed from the senior to the newbie or rookie or underclassman all the while putting the student on the spot under a floodlight in the stark of night. These questions are designed to find the edge of student's knowledge and then push the envelope a few notches. The effects are two-fold: 1) reminder of humility and 2) reinforcing continued education. Excellent physicians and surgeons keep true to both, i.e. humility and education. They go hand-in-hand. Medicine is a field of humility encompassed by in depth, continued education: those who can do for those who cannot with selfless actions built on years and years of training.

Sunday, September 3, 2006

Like Ducks...

Tuesday of this last week, I was told that Labor Day weekend was this coming weekend. To be honest, I was completely clueless of such a three-day weekend. Yesterday, the remnants of a hurricane / tropical storm paid us a visit...again, clueless of such a storm brewing off the eastern seaboard. Since starting, school has become my universe, and for the most part, I'm ok with that. I enjoy what I am learning. I pray that the information sticks in my head so that I can remain in this privileged profession. I'm so focused that when I learned it was a three-day weekend the first thought in my head was (as with most of the class): awesome another day to catch up. For most students, there are those freakish exceptions without any such gauntlet, the gauntlet of medical school does not reside in scientific theory. If one has a sound foundation in the basic sciences (biology, physics, and chemistry), then the theory, found throughout medicine, digests without much difficulty. The gauntlet pretty much comes down to the volume, the amount of information. I have tried to use the fire hose analogy a few times, but then I realized accuracy wasnt up to par. Better to compare medicine like this: take two or three fire hoses of information, turn them full throttle, and stick your mouth on the outlets. Comfort comes when one realizes that others past and present will or have walked the same bumpy road. Last week a fellow classmate and friend told me a good analogy she had once heard:

Liz: Med students are like ducks.
Me: Like ducks, Liz?
Liz: Yeah like ducks. We look completely calm and put together on the surface, but when you look below the water, we are frantically kicking and moving around just trying to stay afloat.

You work very hard. You play hard, and if there is still time left, then you sleep, or, in my case, you write.

In some ways I have already changed greatly. In others, I'm the same. As a student doctor, I met my first living patient this last week on Tuesday. Sounds early, doesnt it? But, this was exactly what I wanted from a medical school. Although Irma (my groups cadaver, we assigned the body a name as a sign of respect) will teach my fellow lab partners and me very much, she cannot communicate back to us. Medicine is as much about science as it is about human relationships, a balance of science and art. This first living patient really left an impression on me. I will not speak of our communications, just of big picture stuff. His condition was congenital, meaning from birth, and very debilitating in the eyes of the healthy, non-deformed population. He however looked at life very differently, in the most pleasant and refreshing of ways. To him, life embraced a blessing. He does not see debilitation; he sees a challenge. During the visit, he smiled the entire time; his undertone spoke of running downhill on a nice fall day in lieu of running uphill and against the wind in the snow. His love of life, his outlook just completely amazed me. I hope when I am infirmed and/or injured, as I will be...we all will be, that I can take life by the balls and hang tight like this patient, this fellow human being.

Sunday, August 27, 2006

A New Life...

Monday, 14 of August, 1330 hours, in the bowels of the medical school, we stood among our first patients. The pungency of formalin righteously inflamed our nostrils. I sat there and thought about the next few minutes. The potential whirlwind of emotion, touching the dead, cold, yet moist body, nobody knows how they will react under such circumstances. I remember looking up and around before we started. Everyone, and I mean everyone, stood dead serious. Upon completion of prayer, our instructors asked us to commence, starting with removal of the denim, plastic, and white cloth. While looking up at each other, my lab partners and I stepped into almost robotic procedure of pulling back the cadavers covers. She was old, her skin no longer soft. Her head and arms were still wrapped and contained. Some of us placed our hands on her body in an attempt to reach out and thank her as she would reveal some of her deepest secrets. She knowingly gave up her body to allow us to learn in the name of science, of humanity, of humility. Our scalpels in hand, we questioned how much pressure to avoid causing harm to our first patient. Although I had dissected many animals, this would be my first human. The first cut came easily as did the second and third. We became more engrossed in making sure we didnt damage the body in a way to lessen our learning experience and less in the fact the person before us was living at one point. As the week rolled on, our cadaver revealed more and more secrets. It took little time amidst a human dissection to realize the complexity of the body. So to keep this experience personal and not remove ourselves from the fact the cadaver was once living and breathing, we decided to name our cadaver, as is the case with many lab groups at this school and most others around the world. A few of us started to brainstorm as we worked our way through the muscles and vasculature of the back. Irma, Irma was the perfect name. Irma spoke of a grandmother; a grandmother who taught her grandchildren about life and that is exactly what she is in the process of doing. The students of Irma use her name with the utmost respect and in some ways she lives with us everyday.

Saturday, August 5, 2006

NASA NO LONGER

I am NASA no longer. A divorce` of our manned space program, I have no privilege to know the inside scope, mission detail, etc. Sadly, the papers and TV news generally get the truth all screwed up, which has always rubbed me the wrong way. Ratings, ratings, ratings.

But, what did I learn along the way? Does NASA have it all wrong? Is space exploration not right for us right now? What of this shuttle? What of this space station? What of our future?

Lessons learned (Cliff Note version):
1) Public enemy number one unfortunately has buried itself deep in every mind on this Earth. Public enemy number one is we. When we choose death over saving life, when assets of war take shape as human life or a lack thereof, and when protecting our way of life necessitates pulling a trigger we have become our own worst enemy. Homo sapien has walked the Earth for over five hundred millennia. Ingenuity has brought us from smacking stones together with hopes of fire to channeling fire to propel human beings onto the Moon and beyond. Yet, we still to this day wage war. We still take life away as if it was ours to take away. In America, we debate the death of serial killers, rapists, etc, but what of innocent lives lost at the hands of those who exist almost solely to take it away. This deep-rooted evil festers amidst us. As a species, we have these wonderful abilities and awesome responsibilities. So when will we stop? Will we ever stop? Will we ever stop being our own worst enemy.
2) Where are we? Why are we here? Such are age ole questions. Mothership Earth. We are on a spaceship traveling at 18.5 miles/sec, 30 km/sec (or 66,000 mph) through the heavens. Mysteriously, we exist here on this ship. Why are we here? I dont know nor do I really ask this question with the same ferocity I once did. I have chosen to focus more on my purpose.
3) Go for it. If you have a dream, then go for it. How do you know unless you try? Study up on your dream, understand it, then so be it. Let it roll. Not necessarily caution into the wind but rather rid yourself of regret. Life is a journey of the body, mind, and spirit. Challenge yourself, because who knows...who truly knows. Live a happy fulfilling life.
4) Find what makes you truly happy and cherish it.
5) Try to do everything without arguing or complaining. (yelling, screaming, losing your cool type of arguing, not to be confused with the intellectual argument)
6) Nothing wrong with stating your opinion, but try to understand the whole perspective.
7) Keep your morals. Morality is a fiber. The more you wear it out, the less there is of it.
8) One of my favorite topics, space exploration. Why do we go? Do we need to go? The long answer is a book, but such a book would end with the following: we must go, because our very existence depends upon it. The future of our children and our childrens children rests in how we spend our lives whether it is in the name of peace and survival or in the name of war. To some degree, we can decide our own future. Ultimately, our very ability to move life from this rock, this mothership, will decide whether or not we Earthlings survive, and this realization may be sooner than we think.
9) What of the space shuttle. Often called the most complicated machine ever built by human hands, the space shuttle is something marvelous and special. But, Space Shuttle is not our future. It is our past. A design of compromises, the vehicle does not fit our needs. We must be bold. We must progress and not digress.
10) Space Station. Space station holds many secrets, not of the treasure chest type but rather of the fulfilling awesome type. The public misunderstands Space Station. For instances, the press likes to get the public bent out of shape over scientific research on board Space Station. They speak of the Space Station budget, making sure to broadcast budgets at every chance. They demand answers to myopic questions. The International Space Station stands for so much. Please allow me to divulge a little. Fundamentally, a bridge to our future, an analog to voyages beyond LEO (Low Earth Orbit), we use Space Station as a dry run to solve problems of long duration spaceflight. An exploration mission to Mars involves so many challenges. Once you leave Mothership Earth, the opportunity for coming back outside of the mission plan in the event of a contingency becomes more and more remote with each second. A broken screw, a stuck hatch, compromised seal, debunked water system, bacterial or fungal growth on equipment could all become huge problems. Crewmembers for such a mission must be Supermans in their own regard: handyman, EMT/nurse/physician, spacewalkers, martianwalkers, friends, scientists, explorers, etc. For most of these roles, Space Station remains the primary means of perfecting or growing in these roles as zero-g complicates the daily course of life roughly 2 fold. E.g., completing a task in zero-g when compared to on Earth requires double the time in space. As weird as it sounds space exploration still resides in its infancy; therefore, Space Station must be if we want to continue in space.

Sunday, May 7, 2006

In The Details

In The Details

Silhouettes whisper in dance
Enticing subtleties
She bites her lip
I pull her close
Hearts out of control
Souls spinning as one
Driving me wild,
I resist no more
Lovingly tender
One breath, two bodies
Just right here
Just stay right here
This perfect moment
In the details

Thursday, April 27, 2006

The Event Horizon

The Event Horizon

Empowered by cat eyes and a deep stare
Dangerous, beyond reach
A living enigma of beauty
Her presence overcomes me
Warm, soft, confident
With a powerful, sexy prowl
The dress fades into perfection
Worshipping her body
And hinting at pure ecstasy
Amongst the night whispers beckon
Enticing my soul
Complete intoxication
She pulls me close
Enkindled by an amorous breath
Lips of subtlety unite our bodies
Without words, I meet her eyes
Lost in her being
Time moves no more.

Saturday, April 8, 2006

A Religious Experience

I had what I call a 'religious' experience yesterday evening and this morning. I pushed my body to a place where it has never been before. I completed an 11-hr Relay For Life (cancer fundraiser) by myself. I'm not sharing this, because I want people to perceive me as some macho man or b.s. like that. I'm sharing this, because I learned something about myself. For perspective, I cleared well over a marathon distance, closer to 2 marathons. Funny, thing is before this run the longest run I did was more like 10 miles. At times during the relay I had to walk so that I could eat and drink water/gatorade, but in all my time in sports, running, surfing, soccer, etc, I have never experienced what I experienced last night and this morning. When I started, the end goal seemed impossible. I remember at one point thinking "10 more hours of this...can I really do this for 10 more hours?" 3 hours later, I had no doubt left. Something last night changed in me...something changed forever. Although there are physical limitations imposed on the body, the mind, it is so wonderful, so incredible, so capable of overcoming incredible obstacles. "Mind over matter" are no longer just words strung together; they have meaning to me. I can now look somebody dead in the eyes and say such words with true and honest conviction. Today, I have paid for being on my feet for 11 hours. It has been difficult to move around all day but not impossible. My minor injuries will heal. The lessons, however, will stay much, much longer.

Thursday, March 23, 2006

Surfing In The Rain

I love to surf in the rain. I love to close my eyes, turn my head up, and feel the drops kiss my face. The salt washes away, leaving my body refreshed. Life slows down, stretching each second to feel more like a minute. I don't want to leave this moment. A roller breaks the horizon. The shower has smoothed out the swell. The gentle beast grows and grows and grows. My shoulders drop with my hands resting on my thighs, totally relaxed, waiting to engage. Its teeth start to show. Reflexive action turns my body now mended to the board. Two, three, four strong strokes, then I'm flying. The rain strengthens almost totally washing out my vision. No matter, this engagement does not require much vision; my body can feel almost every square inch of this untamed monster. Time has stopped all together. Reality is no more than this wonder of nature and myself. I want to be there right now!

Tuesday, February 21, 2006

...could you come sit next to me tonight...

God could you come sit down next to me tonight? Just for a few moments. Sometimes I wonder if I am doing my best…if I am doing what is asked of me…if I am worthy. I woke up this morning, left a few messages for those who have given me their friendship, went to work, and, damn it, I fought hard. I came home, jumped into a long sleeve shirt and some running shorts, pounded pavement, and, yet, I feel I accomplished nothing today. Strongly, I know, deep down in my gut, life is what we make of it. But today, today, I don't know…I just don't know. Everything from leaving my career and going back to school, to prospect of letting my heart loose into her arms, to making those I love know I love them dearly, I guess tonight in this room with the fan spinning and the faint light of Houston coming through the sliding glass door I just feel a little lost. I hate admitting it, but I cannot hide from the truth. Moreover, I believe we all should embrace the truth no matter how painful, no matter how frightening. So right now, I will hold my fears, loneliness, and apprehension close to my soul. I will own them. I will reflect upon them, because they are all part of me, part of my life, part of my choices. God, when it is my time, please come and sit next to me. You don't have to say anything…just come and sit next to me for a while.

Monday, February 6, 2006

Glimpse of Napkin Diaries

-01 Feb 06-
Welcome to D.C. The Pentagon was incredible this evening. Funny, I just realized I've spent my who life surrounded by man-made marvels...the Panama Canal, Kennedy Space Center, Disney World, Mission Control - Houston but nothing was so inpsiring as D.C. on the flight in. I strangely felt at home in this new alien world. Foreign but at the same time I have always belonged. Is this destiny or just another travel trip in my life? Since the beginning of this journey last Thursday, I have spent a fair amount of time traveling, mostly via airplane. I close my eyes in Houston, open them in Chicago or Philly or Orlando, etc. In the blind of an eye, my known universe transforms into something new and fresh. On this trip, strangely the most constant of all the variables is people. I will take quite a few lessons away from this expedition across the eastern seaboard. Primarily, my influence on people can have drastic and awesomely remarkable effects. Simple smiles or brief, friendly southern conversation, goes a lot further in this world than I ever imagined. From interesting conversation with the 'competition' during med school interviews to James the parking shuttle guy at George Bush airport, to the mom of a future nursing student, I have just had a profound experience. An experience I wouldn't trade for the world. I am on the eve of a life long dream. Tomorrow, I will see the Mall, the memorials, the Smithsonian, the Capitol, the White House...tomorrow I will see Washington. This will be a very personal experience, so I am quite thankful I will do it alone. Not that I am necessarily a private person but rather that somethings in life should be walked alone. My life is about to change. A journey to becoming a physician. A journey close to my heart. Right now, however, I sit here in the lobby / student center and watch and listen. The room is still quite alive although midnight has just struck. I am endowed in the memories of undergrad life. The intensity of youth, the random conversations, text books, and research material. I am the Sargassum fish among the Sargassum...invisible yet watching.* Cheers.*Sargassum grass is a seaweed in which one of nature's wonders find refuge. I used to find the fish while surfing by lifting the free floating plant out of the water...unfortunately and fortunately for the fish...it stays behind. I know, I know it is a little cruel, but I always make sure the fish finds it way back to the plant before I paddle off.

-02 Feb 06-
The Mall. On this bench next to the Vietnam Memorial to my back the Lincoln Memorial, through the naked trees rests Washington's Monument and behind it sits the Capitol building, my eyes have struggled to not tear on so many occasions today...I have lost count. Patriotism is prevalent, not in action but rather in a lack there of. People seem to step softer, talk quieter, because on this swamp, rests the ideals and freedom of not one person, not one people, not one country, but more, mankind. We, Americans have been blessed with a gift to protect not only ourselves but also those who struggle under tryanny, repression, and slavery.

-05 Feb 06-
This morning I packed my two bags and stepped downstairs. Looking to depart on a walk to the train, I found myself greeting by my friend Jennifer, a 3rd year med student and new friend. She would take me to Arlington in lieu of me taking the train. I was gracious and finished a quick note to the occupants of the house I stayed at (a 5 minute walk to Georgetown). At my request, Jen dropped me off at Arlington Cemetery. The day was overcast, average temperature for a Washington, D.C. morning, and teh air was fighting back the humidity of a late night rain and morning dew. After cross-strapping the two carry-on bags over my shoulder. I walked to the cemetery. My field jacket came in quite useful on this walk and for most of my trip to D.C.; its presence was a the result of Boy Scout training and experience...ok, ok mostly just common sense. Without the jacket, my trip would have been quite cold and maybe shorter. The graves were impressive. I looked upon them as I would a starfield...so many questions, so much hope, so much respect. On my way to the Tomb of the Unknown Solder, my prime objective, I visited JFK's grave site. His famous speech engraved across from the grave caught my eye. I was reminded yet again of politics even amongst these soldiers, men of men. I continued my quiet meander. Alas, the structure was right ahead, which was a good thing considering the weight of the packs and time / distance devoted to this endeavor. Foot clicks have never shook my soul so vigorously s they did during the next hour. These men were amazing. Few times have I felt so proud and honored as I did watching those men guard that tomb. Perfect does not begin to touch the surface of what I witnessed this morning. Every American should see what I saw this morning in the manner I saw it (if physical ability presents). Every singleone of us should walk here, no tram or tour, just the breeze, the trees, a few birds, foot-clicks, the presentation of arms, and a guard's voice upon due diligence. For Christ's sake, I befriended to older french ladies on the walk back...every American...every American.

Monday, January 30, 2006

Somewhere between there and here

I am definitely somewhere between there and here. I don't exactly know where I am, just where I am going. These words are the summary of my thoughts that have occupied me for the last 8 years. Tonight, I drove around after taking care of the purpose of my trip to Virginia. It was drizzling, about 40 degrees F. I just needed to drive. I just needed to drive. My thoughts have been quite heavy as of late. Many big decisions lay in front of me. Decisions I was put on this Earth to answer...decisions I have waited many years to make. A beginning and an end. The yin and yang are upon me. Fortunate are those who recognize such freedoms. I am fortunate in so many ways...my family, my friends, my health, my ability to change the world around. With such decisions, of which do not always need to be discussed in specifics, come consequences or should I say potential consequences. To paraphrase a favorite philosophical quote: it is not always what we should expect out of life but sometimes what life expects out of us...