loveliness in presence

Happy New Year! I hope you are enjoying a bit of time to reflect on 2013 and dream about 2014. And staying warm. I think resolutions are a beautiful thing, especially when they go beyond the typical list of do's and don'ts. 2014 is going to be a very exciting year for me. But first, a bit of reflecting.

I happily have been able to read a lot more than usual over the past 6 weeks, especially during the 2 weeks around Christmas & New Year's.  Growing up, I almost always had 2 novels going at once, but it's been quite a while since I've had enough leisure to do that. It was a great joy to read through Marilynne Robinson's Gilead in just 3 days. This is undoubtedly one of the most beautiful books I've ever read. The entire book is a letter written by an elderly pastor in the small town of Gilead, Iowa to his young son. He tells of abolitionists and pacifists, devout friends, deviant sons, and the old man's attempt to find peace and reconciliation in his final days. The language is simple and cuts clean to the reader's heart. Pristine.

Here is a passage that immediately had me writing in the margin:

By “life” I mean something like “energy” (as the scientists use the word) or “vitality”, and also something very different. When people come to speak to me, whatever they say, I am struck by a kind of incandescence in them, the “I” whose predicate can be “love” or “fear” or “want,” and whose object can be “someone” or “nothing” and it won’t really matter, because the loveliness is just in that presence, shaped around “I’ like a flame on a wick, emanating itself in grief and guilt and joy and whatever else. But quick, and avid, and resourceful. To see this aspect of life is a privilege of the ministry which is seldom mentioned.

I think this describes the way I feel about having difficult discussions with patients in the medical setting. Conversations about death and dying, scary diagnoses, psychological turmoil. During my month-long rotation in the ICU this happened pretty regularly, and I found myself feeling better on those days compared to others. I hate to use the word "better" here. Perhaps what I mean is something like more fulfilled, more alive. It's something I tried to explain to my husband, cringing as I used such positive words to describe such a negative situation, failing to explain it even to myself and wondering fearfully if it were just some sort of morbid fascination. But reading these words cleared it up for me. Like a confession these conversations highlighted the presence, the I, of those patients and their families. And what I felt was privileged to be part of such a lovely thing.

book report: THE ROAD

Cormac McCarthy, author of No Country for Old Men and a few other books-turned-movie, has an impressively simple style that conveys so much more emotion than I could have imagined possible. His writing is intensely beautiful and impacting. I have only read one of his novels, The Road. I became so engrossed in it that I won't let myself read another until I have more time to spare. It's funny how I can fall asleep on the second sentence of a textbook, yet an hour can pass of reading a novel like this in which the existence of time seems irrelevant. Actually, I haven't been consumed by a book like that for years; I had forgotten what a delicious experience it can be.

The Road is about a young boy and his father attempting to survive in some sort of post-apocalyptic world. We hardly get any background or explanation for the way things are, but it's clear that that doesn't really matter. What matters is the present state of the world, the relationship between these two people, and each of their relationships with the desolate earth. McCarthy has said that he was inspired by his own son. Here is an excerpt:

He was a long time going to sleep. After a while he turned and looked at the man. His face in the small light streaked with black from the rain like some old world thespian. Can I ask you something? he said.
Yes. Of course.
Are we going to die?
Sometime. Not now...
What would you do if I died?
If you died I would want to die too.
So you could be with me?
Yes. So I could be with you.
Okay.

beautiful bookstore

We kind of have a thing for books. Along with our library, my appreciation of books themselves has grown. I began to notice how some books just feel better in your hands than others - they are just the right size, have just the right laxity to their binding, and the pages are just the right thickness. Others are admirable for the type-setting of the cover and the font of the text. Finding just the right combination of text, image, and color is certainly an art. Placing several books from the same publisher side-by-side adds a whole new dimension to book aesthetics. And of course, I never tire of finding a used book with some antique inscription on the front cover (an absolute must in my mind when gifting a book), or an old strip of newspaper stuck inside, a forgotten bookmark.

One of Ian's most exciting finds before my arrival in Freiburg was a bookstore, and I joked that when he showed me around the city all I would see was bookstores. I have in fact been to at least 5. However, the Buchhandlung zum Wetzstein is certainly worth returning to again and again. Just being inside of this bookstore feels nice. The books are tastefully arranged amongst photographs of famous authors and various small sculptures, paintings, and beautiful quotes hand-written by somebody who works there. I love this wall of colorful books. All of the same height and width, all with a different beautiful pattern that somehow is associated with the title or the subject matter, many of them classics.

If you ever are in Freiburg, please visit this place. Even if you can't read German. When you walk in at least two people will say "Guten Tag" and ask if they can help you. Don't miss the case of  facsimiles and first editions, or the back room full of signed and rare books. It's one of the few places where I have heard people say "Aufwiedersehen". When we walked out today, we each received such a lovely farewell from each of the 3 people working there. That's 6 Aufwiedersehen's, which is 24 syllables. These people love books so much that they also love all other book-lovers.

Of course, Ian has found and purchased some really great books here, including a few that he couldn't find elsewhere and they kindly ordered for him. He is already trying to figure out how he is going to get everything home and still has 2 months left!

Reading in the Biergarten -- too good to wait!

bottle that feeling up

I recently read Cutting for Stone by Abraham Verghese. This novel did not receive very high reviews amongst the literary community, but it was strongly recommended to me by several medical students and physicians. Like them, I loved it. I suppose it stems from a love for the intertwining of medicine and art. Verghese is a physician who displays passion for pure, simple, hands-on medicine. He lauds the skilled physician who considers the whole of the patient and is able to diagnose with only his hands. Reference: "A doctor's touch" TED talk.

Throughout the novel he describes anatomy and disease processes in a clear and beautiful manner. Well, beautiful compared to a textbook. Apparently it's gibberish to the non-medical ear. Either way, I soaked it up and felt inspired to continue along this path to becoming a doctor. It made me want to really know my stuff - well enough to write about it without having to reference Netter's, well enough to feel minute but essential differences between radial pulses. (Shoot, I still get excited when I feel a liver edge.)What I'm about to say may sound crazy, but it was enough to make me think that studying for boards might not be that bad. Synthesizing all that I have learned the last 2 years, putting the pieces together and seeing the bigger picture of what all this time and discipline has really been about.

Wow. I wish I could bottle that feeling up and carry it around with me for the next 5 months.

Maybe a little Ethiopian food will help as a reminder. You see, most of the novel is set in Ethiopia and descriptions of the food sneak in every now and then. Of course, I became curious about sour injeera and garlicky wat. Finally, this weekend, we went to the Ethiopian Diamond with one of our favorite food-loving couples. To be honest, the experience itself was worth a lot more than the food. Don't get me wrong, it was tasty, but I don't think I would get excited about leftovers. The dinner itself was fabulous. The restaurant was filled with groups of people from every ethnic background imaginable, all eating with their hands, smiling. I love eating with my hands, like adding in that additional sense makes the food that much better. Ian had a bit of a cold, but medical students are pretty proud of their immune systems and nobody minded his hands in the mix. The sour injeera, salty meats, sweet honey wine, and friends to share it with all combined to make a beautiful evening.

sweet folk medicine

Back in Denton is this great natural foods store with an amazing salad bar and cafe. It is one of the places that makes me realize living in a small town like that was actually really cool. Occassionally they have sampling days, in which they lure customers in with many free samples and recipe cards, etc. On one of these days a woman gave me a taste of some raw honey and touted its health benefits, as stated by physician D.C. Jarvis. She even had her own worn copy of his book to show customers. If you have never had raw honey before, it is delicious. It is firmer than regular honey and has more of a bite to it. It's the perfect consistency for spreading onto toast. Sometimes when I feel a cold coming on, I dip a raw piece of garlic into the honey and eat it just like that. This woman convinced me to buy both the raw honey and some apple cider vinegar. I was a pretty easy sell because I had recently seen a recipe calling for apple cider vinegar and the honey was so tasty.

This summer I came across a copy of D.C. Jarvis' Folk Medicine at our annual library book sale, so I bought it and set it aside until recently. I only read about half of the book, but the main gist of it is that you should drink apple cider vinegar and eat honey. This is Jarvis' panacea - have insomnia? try a few spoonfuls of honey before bed; overweight? drink a glass of water with apple cider vinegar before each meal; is your livestock giving birth to underweight calves? pour some apple cider vinegar over their fodder every day.

Obviously I think that he goes a bit too far with these two, but there is some legitimate insight to be gained about Vermont folk medicine. One theme is looking to animals for an example of healthy living. This encourages physical activity and a reasonable diet, as well as things like sleeping with the windows shut in the winter to mimic hens tucking their heads under their wings.

Plus, there are some legitimate benefits to both of these foods. First of all, honey as been shown to reduce burn-healing time and ease symptoms of cough in children, and it may be of beneficial use along with standard treatments for high blood pressure. Early evidence suggests that it might help lower blood sugar levels in diabetic patients when compared to other sugar sources because of its effects on insulin release and glycogen storage. Raw honey has anti-viral, anti-fungal and anti-bacterial properties, so it might help you to ease a sore throat or relieve a canker sore. Some naturopathic doctors will prescribe patients with pollen allergies raw unfiltered honey that was made within 20 miles of their, the idea being that it exposes you to the antigen in a small amount, just like allergy shots. Apple cider vinegar might also have benefits for diabetics. It is thought to slow starch digestion, thereby decreasing the spike in blood sugar that carbohydrates will cause. It might also help you to feel full more quickly so that you are less likely to over-eat.

The Mayo Clinic website is a good, trustworthy starting place for learning more about the risks and benefits of nutritional supplements. If this is something you are really interested in, you might consider getting a subscription to the Natural Standard website. With the amount of knowledge I have right now, I'm not suggesting that anyone starts consuming either honey or apple cider vinegar by the spoonful on a daily basis, but you might consider incorporating them into your diet as alternatives for other sweeteners and vinegars. If nothing else, they really do taste good.

Here's a recipe for a salad dressing using both of them. Making your own salad dressing really does not take much time and it will greatly increase the nutritional value of your salad. It is so difficult to find a dressing that does not have vegetable oil or high fructose corn syrup or preservatives. Here is one with only six ingredients - and you might already have them all on hand.

Honey Mustard Vinaigrette Recipe:

1/2 c. olive oil
4 T. apple cider vinegar
1 heaping T. honey (raw or filtered)
1 heaping tsp. mustard
1 T. ground flax seeds
black pepper to taste

Pour all ingredients into a glass jar, screw the lid on tightly and give it a good shake. Pour over your salad and enjoy.

my nightstand

We all go through periods of time where something seems to consume our entire life - a heavy semester, a project at work, a difficult family situation. Some of us have just resigned ourselves to lives that will always be busy and filled with working and caring for others in some shape or form. I challenge you to think of one thing that brings you peace or joy or fulfillment and make that a priority, and then set aside ten minutes for it every day. It will be a daily gift to yourself. I bet you will be able to find the time, at least on most days, and that it will help you to remember there is a whole world outside of whatever it is you are usually caught up in.

For the past 3 weeks I have been caught up in anatomy. I have learned so much in that short amount of time that it feels as though I had been studying this for much longer. The price (aside from medical school tuition) is a world consumed by anatomy. My brain wakes me up in the middle of the night because it can't quite trace the path of the vagus nerve in my dream and needs some consciousness to figure it out. This blog is one attempt at remaining connected to the world outside the anatomy lab. Another one is keeping a book on my nightstand and reading something other than a textbook just before I fall asleep each night. I don't usually manage more than 2 paragraphs at a time, but it allows me to hold onto something that I have loved since I was a child.

What do you do to stay balanced? What's on your nightstand?

soda and cigarettes

In the Seven Year Itch the main character, Mr. Sherman, sends his wife and son away to Maine for the summer. He is initially determined to obey the doctor's orders to quit drinking and smoking and to eat healthily. He locks away his cigarettes and eats dinner at an outrageous vegetarian restaurant. He goes home and removes a bottle of soda from the fridge. He reads the back of the label: "Carbonated water, citric acid, corn syrup, artificial raspberry flavoring, vegetable colors and preservative." Then he asks himself, "Why is this stuff better for you than a little scotch and a twist of lemon? I'd really like to know." Of course, it's obvious to us that it is in fact much worse to drink the soda. What I find interesting is that this must have been obvious to the 1955 audience as well.

There is a lie that I have been telling myself for some time now as a means of explaining how our tolerance of preservatives and artificial flavorings developed. It is the same story that we often hear regarding cigarettes. They didn't know any better. I reasoned that we must excuse ignorance, and that the food industry was out of control before we realized that these things could be so bad for us. But clearly that is not the case. In 1955, although he still got milk delivered to his apartment door every morning,  simple Mr. Sherman knew that drinking corn syrup and preservatives was unhealthy and his doctor told him to quit smoking.

Then how did we get to where we are today? Well, clearly health is not the biggest concern in these matters. I think it is reasonable to argue that media plays a huge role*. Although Mr. Sherman was the protagonist, he was just a nice guy, a bit of a schlump. The real star in this film is clearly Marilyn Monroe. She is oblivious to any reason that one should quit smoking. And she eats potato chips with champagne. Today we don't see the glamorous cigarette adds that were common in the 1950s, fewer Americans smoke, and fewer Americans die from diseases associated with smoking, like stroke and heart attack. But it certainly took a while to get to this point, and it is still a problem. How long will it take for better eating habits to become the norm?

I'm actually very optimistic about this. I think change will come sooner rather than later because it is necessary. I certainly see it in my peers (okay, so maybe they are all medical students, but still). I also see how many people are drawn to farmer's markets and  and preparing their own meals. There is even a movement for specialty ingredient foods - chocolates, wines, gelato. Even if these are not the healthiest items, the call for natural whole ingredients is promising, and it proves that Americans are willing to pay for quality, not just quantity.

I recently began reading In Defense of Food: An Eater's Manifesto by Michael Pollan. He argues that America's nutritional problems have been complicated by the rise of what has been called Nutritionism. Nutritionism is the idea that we can calculate what we should eat and follow those numbers in our diet and be perfectly healthy. But that has lead to catastrophes like Liebig's Extractum Carnis, the idea that multi-vitamins would solve all our problems, or that simply cutting back on fats or carbs would solve all our problems. This idea forced me to think a bit more, because I am very interested in understanding more about nutrition - what different foods can offer us, how different nutrients work together as our body attempts to metabolize them, etc. But the more I thought about it the more I came to understand that when we try to apply a formula to each meal we can no longer enjoy our food. It becomes like a pill we have to take or a temptation we must resist.

When I was in high school I paid no attention to the nutrition information on packages and I definitely could not tell you what percentage of my calories came from fats or if there was too much sodium in my diet. First, I want to clarify that understanding these things are essential for people that are already overweight or have Diabetes or Hypertension or are at risk for heart disease. Second, I do think that for most of the population we can totally forget about these numbers and follow our instincts when it comes to eating well. Michael Pollan's manifesto is this: "Eat Food. Not too much. Mostly plants." So, basically, avoid artificial anything, be mindful and don't eat past the point that you are full, and listen to your mother - eat all your vegetables.

It is likely that I will have more to say about nutrition in the coming months, as I read more of this book, but I'm curious to hear what you think. Should we rely on our gut to tell us what to eat? Or do we need science to guide us?

*So does the government - according to Pollan, as recently as 2004 the Bush State Department was enlisted in a campaign to recommend that Congress threaten to cut WHO funding unless they agreed to raise their daily recommendation of calories from added sugars from 10% to 25%, the official U.S. recommendation at the time. I believe that has been changed, adding to my optimism.

bebelplatz

This plaque is laid in the ground at  Bebelplatz in Berlin, the historic site of the Nazi book burning. Nearby is a small glass-covered chamber that descends into the ground, like an up-right coffin. All that is inside are empty bookshelves.

On the plaque is a quote from 1820 by the German Jewish poet, Heinrich Heine. It reads, "That was only a preview, where man burns books, in the end he also burns men." (my translation)

Something to keep in mind, in these days filled with anger.

travel reading

It took me a few months - okay, 10 - but I finally finished reading Moby Dick. Actually, if you count the fact that I started reading it in high school but never got past meeting the noble savage, it's been years! But this book is just so epic that I really had to be ready for it. There are people who have made careers analyzing this novel, so I don't even know where to begin, but I certainly did enjoy it. I can't imagine a more honest depiction of insane obsession.

Aside from the legendary plot and the remarkable character development, Melville includes so many thought-provoking one-liners. The fact that he was basically self-educated just makes it that much more impressive. Here's an example, spoken by Starbuck:

"'Here some one thrusts these cards into these old hands of mine; swears that I must play them and no others.' And damn me, Ahab, but thou actest right; live in the game, and die it!"

Wow, right? Here's another one. I think it might be the most beautiful of the book:

"Bethink thee of the albatross, whence come those clouds of spiritual wonderment and pale dread, in which that white phantom sails in all imaginations? Not Coleridge first threw that spell; but God's great, unflattering laureate, Nature."

 I read a good chunk of the novel while I was in Cape Cod this summer. One of my absolute favorite things to do when I travel is to read a book somehow related to the place I am in. For example, last summer I read Don Quixote in Spain and Berlin Alexanderplatz in Germany. I discovered what a pleasure this is when I read Milan Kundera's Unbearable Lightness of Being  (which I highly recommend) while in the Czech Republic. His description of the cemeteries gave me a whole new outlook on the cemetery we visited; suddenly it was a place full of beauty and life, by way of faded flowers and flickering candles.

Let me know if you know of any good books that take place in Chicago, and give it a try the next time you take a trip.

books

This past weekend our local library had their annual book sale. My husband and I saw a flier and decided we would go. We already have a lot of books, in fact we tend to buy them wherever we go, but this was for a good cause and certain to hold some good deals. When we got there we found it to be a much larger event than expected. It turns out they had over 100,000 books to sell, ranging in price from a mere 50 cents to $2.00 at the most expensive. People probably began lining up an hour prior to the opening, with bags and boxes and suitcases in hand. We felt thoroughly unprepared, but willing to fight the crowd for the love of books.

The sale was held in an old Volvo dealership, no bookshelves included. Instead, there was row after row of tables stacked with books above and below. And many hands grabbing for those books.

I was charmed to see children amazed by the sheer quantity of books and enjoyed observing the few people who studied each book with anticipation before placing it in their bags. Unfortunately the hasty, greedy, book-selling, book-grabbing people seemed to make up the majority. They rushed in with their boxes and their fancy smart phone attachments, scanning each bar code to see how much they could sell it for online. Some people carelessly shoveled whole stacks into their boxes. They did not look around to appreciate the enormity of the event nor to nod at their fellow bibliophiles.

This upset me a little bit more than necessary perhaps, and I had to sit outside and read for a while before Ian finished his search. All the money they spent still supported the library and somebody will be reading those books, but still... it almost seemed sacrilegious. Nonetheless, I did love the feeling of being completely surrounded by books.

I always have loved that feeling. When my sister moved to her own bedroom and I got our bunk beds all to myself I took out the bottom mattress, put in my inflatable chair and a bookshelf, and felt like I was encapsulated by my own little library. I suppose I've created a similar environment in my new apartment.

If you are ever in the need of bookshelves I would highly recommend this method. Although the cost of materials can add up,it's definitely cheaper than IKEA and you can completely tailor it to your desires. It's also very easy. All you have to do is stack the 1/2-size cinder blocks and wooden boards; you don't even need nails or glue. I decided to paint the boards gray to match the concrete, and used smaller bricks as well to add height to each shelf and to create this pattern on the side.