stealing joy

Wow, it's been a while since I've posted anything here. The longest yet. I've been thinking a lot about writing lately - writing or reading poetry and short stories, writing as a means of understanding medicine and human interactions. I want to delve into the newly-discovered world of narrative medicine. I should have some time to do so in the coming months, so we will see how far that goes.

In the meantime summer ended. The farmer's market made it's transition from strawberries and asparagus, to every green thing imaginable and berries, to squash and apples, and now it's gone. A chilly August was followed by a warm September and October (relatively speaking), but November  was ushered in with a freeze and I harvested all our potted herbs. The rosebush remains, two buds debating whether or not to bloom. My cooking followed the market trend. Transitioning from salads and things like these noodles to roasted squash, bean stews and all kinds of things with miso. The leaves turned and have almost all fallen, sweaters have migrated to the front of the closet, and I've initiated a daily ten minutes of sitting beside my SAD lamp. Autumn is verging on winter and I am determined to enjoy it by relishing in coziness as much as possible. I'm talking double socks, fun hats and scarves, casseroles and cookies, bubble baths, steam room at the gym, hot tea, poems like "November Night" by Adelaide Crapsey:

Listen. . 
With faint dry sound,
Like steps of passing ghosts,
The leaves, frost-crisp'd, break from the trees
And fall.

We already had our first snowfall, just a few days ago, it collected and stayed on the ground the whole next day, despite the brightly shining sun, deceptively not warming things up.

Actually, the first snowfall I saw was in October, but most people were asleep and it barely touched the ground before melting. I saw this beautiful snow - barely a fall at all, really a light drifting down, like a feather or crepe paper confetti - because I was up in the middle of the night on the labor and delivery floor of a community hospital, helping/learning how to deliver babies. Delivering a baby is one of the most magical experience I've ever had, and I struggle to describe it adequately. One doctor said it was like "stealing joy". There is something accurate about this, as it indicates that the doctor is still somewhat removed from this new family being formed. An integral part of the experience but ready to transform into bystander as soon as the whole visceral process is over. If you think of joy as something that is not diminished by being shared, but rather increases, then it sounds even more fitting.

But it's more than just the joy of new life (what a presumptive thing to say, just). It's the entirety of this most ancient ritual, born of complete necessity, drenched in blood and vernix (lit. 'fragrant resin'). The hours of the mother contracting, dilating, effacing, breathing. Teaching your gloved fingers to feel blindly for cervix and station, like digging through a bag  of cotton balls trying to find the one that is slightly softer. The absolute miracle of a newborn maneuvering through the cardinal movements of birth, filling his water-clogged lungs with air, remodeling his entire vascular system. A fish becoming a bird. When things go perfectly smoothly, it's seems the baby would have slithered out whether your hands were there guiding him or not (which does occasionally happen even in a hospital!).

That night, minutes after the baby was born, the nurse looked out the window and remarked, we had a little snow angel on our hands. I've delivered four babies so far. And yes, I am most definitely keeping count.

looking at art

A few weeks ago I went to the Chicago Art Institute. I always feel rejuvenated after visiting an art museum. It pulls me out of my head and distracts me from all the mundane things I worry about unnecessarily on a daily basis. This trip seemed long over-do, and somehow reflecting on it now makes me realize how much this past month was recovering from the prior five.

I began by studying some photographs, comparing the differences between printing and developing methods, reading the name of each artist, title, and materials. Then I set out through the contemporary building and decided that I was not going to read anything. Instead I would just focus on the painting itself – I could only take in so many words and changing my focus constantly was becoming somewhat dizzying. Often though, I couldn’t help myself and I needed the curator’s enlightening descriptions. I made my way through a few connected rooms and, quite pleased with what I had seen, stepped back into the hallway. Suddenly overwhelmed by how much was housed in a single wing of this building, I considered calling it a day - until I thought of all the beautiful paintings that would be in the next room over, so many artists I love. I decided that I had to walk through a few more rooms, just to be in the presence of such beauty and wonder. I stood to look at a painting, but rather than study it I let the whole room flood over me, with such richness that it far surpassed any one masterpiece.

Somehow my few hours immersed in artwork mirrored my recent experiences as a third year medical student, at least in sentiment. I have many stories to tell, each of them great on their own, but all together they make up something greater. Something I don’t yet have the words for and maybe never will. But it is wonderful, this mixture of excitement and anxiety, sadness and relief, complete engagement and detachment. And there has been an overarching sense of being overwhelmed. Not in the way I felt overwhelmed by the massive amount I had to learn in anatomy, not a sense of something being unconquerable or time being too short, but such a flood of experience that I will need some time to pull myself up out of the water before I can reflect on it all.

In contrast to all that, my few days of Christmas vacation have been so beautifully simple. I’m back in Texas, and I think that adds to the feeling, both for its reminder of my youth as well as the basic kindness of strangers that goes hand in hand with southern hospitality. I’ve been relishing in walks through the neighborhood, blue skies, green leaves still hanging to trees, and lazy mornings with my family. I think it’s the perfect transition into the new semester, with a new confidence that I know what I want to do with my future, and a renewed connection with the idea of becoming not just a doctor but a healer.

I saw some art again today. This time it was the Menil Collection, a much more manageable, focused collection of art. I walked through the naturally lit rooms, surrounded by beauty, and felt like I was able to take it all in and process it to some degree. My last stop was the Rothko Chapel, and left with a profound feeling of peace.

I hope you have all had a wonderful Christmas and are filled with love and joy as we begin to look towards the new year.

one year later

Last year, I often ended up parking on the top of a six-level parking garage, which was fantastic really. Six flights of stairs was sometimes the only exercise I got in a day, and I had a great view of the Chicago skyline. One night I happened to have my camera and decided to snap a photo. From then on I tried to get a picture every so often. Now, one year later, I have a nice progression of the seasons.

9/22/2010

9/24/2010

10/12/2010

10/22/2010

11/8/2010

12/4/2010

12/9/2010

1/26/2011

Are you getting tired of bare trees and gray skies yet? The play of light in different times of day might help to make it more interesting. Here's one in the morning... 

2/4/2011

...and in the evening

2/9/2011

2/17/2011

 It can be pretty windy up there.

2/18/2011

3/30/2011

4/6/2011

 Finally! some color!

4/11/2011

4/28/2011

5/6/2011

5/18/2011

5/20/2011

Today: 8/16/11

 

 

an intention for the new year

As we begin a new year, instead of a goal or a resolution, I am setting an intention. This is an idea that comes from yoga. At the beginning of every session we set an intention for the next bit of time on the mat. Not a goal to stretch farther nor a demand not to become distracted, but a feeling or an idea that will keep one grounded throughout the practice. Perhaps that intention will carry over to the rest of the day. My friend and favorite yoga instructor used to conclude each session with the words, "may the blessings and benefits you have cultivated today be taken off of your mat and into your world." I often think of that when I practice at home.

I don't think I can really give a clear explanation of what my intention is. It's more of a feeling because if I put it into words I'm afraid it will become a goal. Over the past year I've learned that finding this feeling can really help to calm or cheer me. For example, when I feel uncertain or stressed it helps to think about the peaceful ashram where I used to do yoga in Denton, or moments when I was surrounded by friends and my spirit danced. Sometimes it helps to focus on my physical core. An anatomy professor suggested we imagine tracing our finger all around our head, even into the respiratory tract, as a technique for learning the cutaneous innervation of the cranial nerves. In a similar manner, I find that I can refocus myself by looking inside and thinking of energy flowing through each chakra. Or it's like making life a constant prayer. I know, I'm using a lot of jargon that doesn't really make sense in our western rational minds, but if you let yourself just go I think you'll know what I mean.

Okay, how about this one: my intention is my new kitten.

We just got him from a shelter downtown and named him Zenith. He lives a simple life and is always true to himself. He is playful yet peaceful and always seems to hit the right balance between high and low energy. He purrs frequently, like a yogi's mantra. Because he has a loving home and is well taken care of he is full of love and can share that with the world, even if does have a very small world.

What is your intention for the new year?

Namaste.

and so it begins

What do you get when you combine 150 new first-year medical students, beer, and one last week of freedom? A very strange social situation. That's because there is no common mold for student doctors. We are quite the diverse group, ranging from the East coast frat boy to the shy first-generation American. Also, none of us knows exactly what we are getting into, but we do know our lives are about to change.

The week of orientation began rather anticlimactically, with lines and paperwork. The second day included fun pep-talks and boring safety speeches. On the third day, however, the tone changed. We heard from the top guys at the medical center. Students no longer let their eyes close heavily, nor whispered plans for the evening to their new-found potential soul mates. We sat up straight and at attention as we were told that we are on our way to becoming doctors. This means making sacrifices, we were told. One must be willing to work long hours and give up the idea of going home early for a birthday party. One should participate in many admirable organizations, become involved in research, sit on important boards, etc., even if it means one's spouse may threaten divorce. One should expect one's liver enzyme function to decrease, as there will be little time for drinking. Fortunately, we were also told that medical school will not only teach us science, but also how to function while fatigued, because we will almost always be fatigued.

But there is one more presentation, and I must tell you about it because it explains why we are all here. The doctor in charge of our curriculum walks to the podium and kindly asks, "How many of you woke this morning and thought, 'Wow! I'm a medical student.'?" He then begins what is known as the "First Patient" lecture. One of his patients, Mr. A., has agreed to come speak to us. The doctor asks him questions, as though he were a new patient of his, regarding a previous injury. Then we are called upon to ask questions. I am impressed by some of my classmates' questions. Mr. A. answers them all kindly, clearly and honestly. I am even more impressed by his knowledge of his condition.

You see, Mr. A. speaks simply, with imperfect grammar, but thoughtfully. He tells us that he has to use the dictionary when he goes home from the doctor's office in order to understand everything. That's a fine quality to find in a patient. He also tells us that his doctor really listens to him and discusses treatment options. He tells us that this is what we should learn from this doctor, because it will allow our patients to trust us. The doctor blushes. Mr. A. is a proud man, in the most positive sense of the word. I would guess that he has always worked blue-collar jobs and that his family is grateful for the life he has allowed them to realize. He is proud to have a wife and sons, who help him when his pain is most severe. Although he has not been able to work for over a year, he has not signed up for disability privileges because he is proud of what he was able to contribute to his community in the past and he is hopeful that he will regain those abilities. I find that to be quite respectable.

I hope that someday I will work with a patient like Mr. A.