The Culprit Life

For the first time, my mind was not filled with all the things I would do if I dropped out of med school while I was taking the test.
I think I had a sense of resolve about the whole thing.
The first third of the questions gave me confidence because I felt like I knew most of them but as the test progressed I became more and more frustrated with the questions’ demands for tiny details that I was told I wouldn’t need to bother memorizing. The funny thing was, when I took the group test, I found out that I got a lot of the questions in the first half wrong and hardly missed any on the back half. Also, many of the genetics questions were just phrased poorly. Someone needs to make these professors take some kind of English class to they can learn to communicate their ideas properly. In fact I think, overall, the test was very sloppily made. It seemed to be a large discard pile from a poker game being played in the basement of the Association of American Medical Colleges.

But one thing I’m taking away from this whole doing poorly in school business is that I can’t blame anyone. Not my professors, not my undergraduate education, not even myself. Which has brought to mind the question: What do human beings do when we fail at things? And not just failing tests in school. I’m talking about failing at love, at raising children, at finding a job, at staying sober, at losing weight, at being positive, at cooking, at acting selfless, etc.
I think, in general, we look for a logical next step to take. Most of the time this step includes blaming someone or something. Sometimes we dramatically change our approach, maybe circumventing the obstacles we found enough fault in to blame. Sometimes we continue to ram our head against the wall, hoping our persistence will bring it down. And then other times we just give up entirely and find new goals to pursue or simply settle into our seemingly unchangeable position.
I don’t know if there are any alternatives to these.
Over the past couple weeks, my frequently wavering response to failure has given way to an unexplainable resolve to continue my education at nearly all costs.
I don’t know if this is the thing they call hope, but if it is, it has disguised itself as massless entity shrouded in ambiguity.
I can’t put my finger on it.

All of my days are bleeding together.
The normal rotation of weekdays and weekends no longer applies to me.
There are only two kinds of days in my life now:
Days when I spend most of my time studying and days when I don’t study at all.
The latter are few and far between. In fact I haven’t had one of them since early august before this all started. I will have six of them starting on tuesday and won’t have anymore until December 19th.
At this point I have studied as much as I feel I can. I have no regrets.
If this ship burns, it will burn with it’s sails full and pointed west.

Mixing

Today, after the last of the student disease presentations and a less than interesting continuation of our LCE orientation, we were sent out on our own to wander through a wilderness of degradation pathways and genetic screening methods. It is at once a comforting and terrifying feeling to know that you have already seen and reviewed all of the information that will be on the test several times. It’s terrifying because you reach a point where you’re not sure what else to study, what to focus on. You find yourself lost on an interstate weaving back and forth between colossal mountains of hard scientific statements shaped over decades by obsessed and often nearsighted men and women in laboratory coats. And it all starts to look the same, familiar, like you’ve been here before, like you aren’t going anywhere at all, like you are moving in fragmented circles around some intangible mass of data that is at the same time vitally important and utterly irrelevant.

Welcome to medical school.

On a lighter note, in preparation for the marathon work myself and a few friends are about to put into wrapping up Outwatch the Bear once this block is over, I started mixing the first song today so we can start editing it’s video immediately after my final. I was happy to find the composition still rather interesting. I think these songs will hold up well over time.

The last lecture for molecular medicine was phenomenal.
Except, it wasn’t.
The pseudo ending for this nightmarish course, which has sucked two and a half months of my precious youth away from me, fell flat on the exciting scale. Of course, that’s to be expected from a subject that mixes biochemistry, genetics, and cell biology together.

The BQE

There is no question in my mind.
Sufjan Stevens is one of the most phenomenal artists in American history.
He is quite possibly our most talented living songwriter. Notice I did not say “best” or “most popular” or “most inspirational”. But if you are judging on raw talent and diverse ability alone, Stevens has no equal in this country.
With the BQE, Stevens has created perhaps the best multimedia art project of the past decade: a whimsical and profound menagerie of urban, industrial landscape imagery that proves the perfect compliment to his gorgeous, cinematic, swirling expanse of a musical composition.
Easily the best $17 dollars I have ever spent.

As far as medicine goes, today’s proper curriculum was filled with fours hours of lectures on chemical pathways in the morning and an hour’s worth of physical diagnosis in the afternoon which served as a sort of dirty prelude to the education we are about to receive on how to look at cut and dry symptoms and come up with the best diagnosis using nothing but our brains and the supposed knowledge hidden within.
After participating in a brief survey on empathy that will be followed up on throughout the next four years, our class was released into the brilliant mid-afternoon heat fest that is Florida weather only to scramble into 120 separate corners of the earth seeking shade and a fitting study environment.
For myself, that environment proved to be a small, quiet conference room in the communications building where behind the closed blinds that kept us cool, Sarah Wilson and I carved up a a lengthy assemblage of scientific facts, digested, and spit them out only to find they had metamorphosed into a triptych of short stories containing references to sheepdogs, broken families, lighting strikes and star crossed lovers who’s complete and combined narratives totaled an estimated 7 minutes.
Needless to say, I am sufficiently satisfied with this approach to studying science and once again am hopelessly indebted to the irreplaceable character of Miss Sarah Wilson: screenwriter, director, and friend to tired, struggling medical students world wide.

I studied with a few friends today.
You know that part where they tell you about how close you’ll get to all the people in your class?
I know what they mean now.

I just finished a short bit of prose that I wrote in a COMPLETELY different style than anything I’ve ever written, and I think that’s maybe why I decided to write it, because I felt like I could.
It’s similar to Miranda July’s stuff and somewhat stream of consciousness. Also, completely honest and vulnerable, so I’m pretty sure I wont release it for at least a few years. I figure it was brave enough of me to actually write it, so being too much of a coward to release it anytime soon doesn’t bother me a whole lot.

Study Study Study

Light Studying

My group had our presentation this morning on OTC deficiency and I think it went quite well. For some reason I was slightly nervous when I got up to close the presentation out with the social/ethical aspects but I feel like I generally got my points across.

The rest of the day was occupied with studying/story writing which included a brand new narrative on Phenylalanine and his Tyrosine robots.
Awesome.

In the morning, I had a kind of physical diagnosis practical workshop where I learned how to use the ophthalmoscope and otoscope. When I say, “I learned how to use” them I mean that I can turn them on, position them in the right places on the patient’s head, and see some kind of barely identifiable images through them. Oh and we also got to play around with our reflex hammers and tuning forks a bit more.
The afternoon’s TBL was down played due to the physical therapy students having their white coat ceremony that night. Dr. Eichler included some of the TBL material in his lecture but didn’t make us take a real quiz, much to my relief.
During the lecture, I started putting my story telling method into use and it really helped! I was able to understand everything (and even memorize a few things) during the actual lecture instead having to go home and figure half of it out. So far, so good.

Turning Science Into Stories

The body is a cinematographer. It tells us a story visually.
There’s a setting: the liver, the bloodstream, the brain…
There’s a conflict: excess ammonia, cancer, hypertension…
There are characters: enzymes, medications, leukocytes, hormones…
There are resolutions: disease symptoms, death…
There are director’s cuts and alternate endings: treatment, recovery, life

Doctors and patients are story telling teams. The patients usually provide the conflict and the setting. The doctors often identify the characters and cast new ones. Through treatment plans and surgeries they rewrite and edit in an attempt to bring about a desired resolution to the conflict.

This is how I have come to view medicine, and it may just save my life.

After the LCE orientation, two student presentations (that I found quite interesting), and a liaison meeting, I was finally able to meet with my course director about the trouble I’m having wrapping my brain around all the material in the class. Together, we discovered that my real problem is organizing the information in a way that makes studying practical and efficient. He told me the reason I’m not getting it is NOT because I’m not putting enough time or effort in but that I haven’t learned to use appropriate triggers for my brain. While explaining the use of triggers to me on a white board, he helped me realize something very profound about the way my mind works. It’s a concept I feel will prove to have unlimited potential in my life.
I view everything in a narrative way. I learn through stories.
I can memorize formulas and understand diagrams (I’m extremely visual) but I don’t retain them well. What I DO retain well and am able to keep with me consistently are stories.
Films, novels, folk songs. These are vehicles through which my mind develops and adopts systems of knowledge.
The problem is, the scientific information in this course is being delivered as a laundry list of dry, seemingly unrelated facts (maybe because they are). And most people in my class don’t have too much of an issue with that because their brains analyze and retain information in a compatible manner. But for me, this is an assault on my whole way of thinking. It’s overwhelming.
Now, I have a much clearer idea of what I need to do. It will require me to work a little harder than my classmates (at least in this type of course) because not only will I need to review and digest the information, but I’ll then need to rearrange it into a format that allows me to access it quickly from my mind.
So I am writing rough screenplays. I am listing “characters” and describing settings. I am dissecting plots and describing resolutions.
I am transforming science into art.
And if it’s true what they tell us, that medicine is an art based on science, than maybe I’m on the right track. A peculiar one, that is certain, but perhaps a logical one as well.
This is new and exciting and I’m very optimistic that it will work. The only question is:
Do I have enough time left to redeem the things I’ve lost?

Today’s weather was by far the most beautiful we have had all year.
The obesity capstone this morning went well and, in the afternoon, the clinical correlation patient discussion on Prader-willi syndrome was just as fantastic as all the other clinical correlations we’ve had.
Then, in the last two hours of lecture, it all fell apart. The optimism I had been carrying for the past week or so deserted me. Frustrated and with a slight headache, I later spoke to a trusted friend in the class of 2012 who so graciously listened to my grief and offered some practical suggestions and a well received dose of compassion that only gives me further assurance that this particular friend will turn out to be a spectacular doctor.

However, nothing seemed to be able to stop a slow and sleepy passive depression that worked it’s way into my subconscious throughout the evening at home. Finally, at a quarter till midnight, I picked up my guitar, sat on the top of my couch and, illuminated by a single light fixture, stared out into the physical and metaphorical darkness as I began to write the following song.
After an hour, it was done and I will not lie and say that I didn’t have tears steaming down my face nearly the entire time I wrote it. It is probably the most personal song to come out of this project yet. It is a form of grieving in a way.

I decided to record it in one take on a low quality voice recorder that I recently purchased. It’s dirty and raw but maybe that’s how it should be.


“Half the Man”

What would you say if I told you all I want to do is run?
What would you say if I gave you what I thought were good reasons?
What would you do with your hands lying inside that hospital bed?
What would you say if I told you I don’t know what else to do?

I don’t understand how you could take pride in a grandson who’s nothing but unique,
‘Cuz I don’t find comfort when I think of the fact that I don’t know anyone like me.
And I don’t understand how you could take pride in a boy who turned out to be this weak,
‘Cuz I gotta be honest, I don’t think I’m half the man you thought that I would be.

Would you tell me to turn and look at my mother crying at night through anxious prayers?
Or tell me to make a fist like my father and work 9 to 5 until I’m dead?
Or tell me to wipe the sweat from my forehead and ignore the blood just like you did?
Or whisper a song about how you love me and tell me I’m part of some big plan?
Tell me I’m part of some big plan.

In the morning, we had a fairly interesting set of lectures on blood histology and immunology. In the evening, I read, what seemed like, endless articles on obesity while eating a ginormous piece of red velvet cake with a large glass of whole milk.

There was one particularly long journal article on the cynical humor that exists between medical students, residents, and attendings. I have to say though, that, honestly, I see both sides of it. While I myself don’t need to use humor as a coping mechanism, I understand why many people would. Also, I don’t think it’s right or realistic to expect the same population who loves Scrubs and Will Ferrell movies to produce doctors who wouldn’t engage in that sort of humor when it is around them everyday in the workplace. We are human after all, and don’t patients want doctors who are human?

On the other hand, when I think of it in black and white logic, I know it’s not right for medical professionals to make jokes among ourselves about the patients who are in the hospital because of their own poor choices or lack of will power. We all make mistakes. We are human after all. And, from a purely Christian standpoint, one person’s life should never be valued above anyone else’s in the grand scheme of things because ALL life is sacred. That belief comes into jeopardy when we involve ourselves in this humor so much that we start to give a lesser quality of care to patients we deem at fault for their condition.

But the issue isn’t black and white; it’s gray, very gray in fact. Like an elephant.
So I wont be so quick to pass judgment on myself or my colleagues. We are human after all.

Personally, the thing that works as a trigger to instantly make me much more compassionate and empathetic toward these individuals is when I think about my family members or friends I’ve had throughout the years that have struggled with being overweight. While reading this article, I was very happy to discover that I can do this at any point when I find myself becoming cynical and produce an immediate change of attitude. I think it’s a mental and emotional tool that will come in handy when I’m working more in the hospital, and I think I will be a better doctor because of it.

Certificate of Life

This is some heavy crap.
The document above is what they give the parents of children who die in the NICU. Granted, they probably give this to all parents who have their babies at TGH, but I was given this as part of a packet that NICU staff delivers to the parents of children with lethal conditions. They also give them a certificate of baptism and other baby book like objects packaged in what’s called a bereavement box. Later this week I will give my presentation that includes what I learned from talking with the NICU workers.

Today was very productive. I studied with my mom for around four hours! Yes, that’s right, my MOM. In my new quest to find alternative ways to cram all of this test information into my brain, I though it might be a good idea if I could go through some lecture powerpoints with someone else and explain them as I go. The problem is, the only people interested in this stuff are other medical students who definitely don’t want to hear me, their peer, deliver the material to them. Enter my mother who, being a former medical professional herself, is insanely interested in anything slightly health related. We went through about 8 hours of lecture material in 4 plus she made me some meatballs for dinner! Can you say “Win Win”?
But seriously, I feel like I got a lot done and I solidified the material from those lectures in my brain.

And finally tonight, after reflecting on my own mental state, I once more concluded that I am excited about becoming a doctor! I seem to be on quite a little optimistic streak. Let’s see if I can keep it up.

Study Study Study

The Birth of Community

I’m studying late in the histo lab again. Another lovely friday night.
The last few days have been interesting. They have been peculiarly positive as far as med school goes for me. And I don’t mean that our lectures have been any better either. I don’t know where it’s coming from but I’m starting to have a more optimistic outlook on this whole medical thing.
I really want to be a doctor.
That’s for sure.
I wouldn’t have spent over 13 hours (and counting) in the histo lab studying today if I didn’t. Actually I’ve been at school since 8 because I had class this morning. Maybe I’m becoming adjusted. Maybe I’m settling in. Maybe I’m getting excited at the prospect of being in the hospital every week starting next month. I don’t know what it is but all of a sudden I’m really grateful to be here again, and in a different way than I was before. Maybe I’m becoming more mature. Maybe I’m growing up a little bit. I feel like I’m being reshaped and reformed by a new set of experiences, by a new group of people, and by the same God who’s plans for my life continue to be unfathomably beyond my own imagination. And that’s saying something because I have a very active imagination.

Sometime between 1am and 3am last night, I came to a completely shocking and profound revelation: I am part of a new community, a community that I can breathe love and hope and creativity into.
I am going to anchor myself here. I am going to plant seeds in all of the walls and watch pure, organic beauty grow out of the cracks like vines until it becomes so thick that it entangles all 120 of us in a web so profound that it will be impossible to remain unaffected.

You know you’re a med school student when:
You complete a thorough review of a 57 slide powerpoint on genetic screening methods while attending the first three quarters of your college’s nationally televised football game.

In physical diagnosis this afternoon we started reviewing the physical exam. It’s pretty exciting because we’re doing actual doctory stuff like palpating organs and such. Some of the techniques were a bit odd though, like tapping with your middle finger to hear what an organ sounds like. Does that really work??? Answer: No. Not for me yet anyway. Oh and then there’s the putting your hands on someones chest and having them say “99” which is supposed to give you all the information you need to diagnose them with pneumonia. Right. If all these little tricks really work, I’m thinkin’ the doctor-god-complex thing is actually slightly explainable. Next they’ll have us diagnose cancer through a handshake.

And then, in the midst of an afternoon of studying I finished off a verse for a fairly dark song.
Here is one reason why I know I’m a decent songwriter (and yes I realize how narcissistic that sounds): I can exploit whatever transient emotion I am currently experiencing for the purpose of writing a song that has nothing to do with that specific emotion or the experience attached to it. I can harness the pure intensity of that feeling and use it in a way that is constructive. I am very proud of what I wrote today, even though it was relatively short. I may never show it to anyone else but I still feel it has helped me grow a bit. There is actually a good number of songs that I write that I never openly share. Probably for every four that I write (or at least start to write) there is one that I “release”. I do hope to finish a few more and post them on this blog soon though. I think it’s getting kinda stale with all these words and a few sparse photos here and there. However, my inner scale that measures quality versus quantity, along with my obnoxious amount of science to study will most likely result in offsetting the previous stated hope so that anyone reading this should probably disregard that statement altogether.

The Return of One of Indie Rock’s Finest

David Bazan is, without a doubt, one of the best songwriters of the last ten years.
He’s legendary really. The most depressing man in music today is also the most honest and that’s what is so loved about him. He’s a songwriter’s songwriter if that makes any sense. Most of us dream about having the guts to be half as brutally truthful as he is in his songs.
Bazan played bass throughout his whole set and only grabbed a guitar to play two songs by himself for an encore. The band that backed him up was surprisingly tight and suited him well. This was the first full band tour he has played since his Pedro the Lion days and I must say, he is in top shape. During his set, he paused literally 7 or 8 times to ask the audience if they had any questions. And they did except they were mostly shallow inquiries about his current preferred alcoholic beverages. It was like an AA meeting in reverse. It was almost a celebration of alcoholism. But despite this one unforeseen qualm, the set was incredible enjoyable to me. He played some Pedro of course and even a Headphones tune. Afterward, I rock, paper, scissored a fellow audience member for a set list that was left upon the stage. Ahhh, a rare rock show souvenir! I can’t remember the last time I got one of these. I can’t remember the last time I cared enough to try to get one. But that’s the thing about David Bazan for a songwriter, you get a bit starstruck I guess because you know when you go home, pick up your guitar and write your next 3:45 masterpiece, it wont be a tenth as genuine and sincere as one line from an old Pedro the Lion tune.

Two histo lectures were given on neurology this morning. One of which was taught by the chief researcher of the new Byrd Alzheimer Institute. Afterward, a few classmates and I pondered why someone so seemingly important would want to teach 1st year med students a the very basics of neurology. Our answer? An outrageous sum of money. But maybe we’re just cynical. And who knows, maybe he really likes teaching. Nothing wrong with that. Besides, what do we care? We’re getting taught by some of the most prominent members of the medical community every week. That’s what I call a “win win”.

This afternoon I met with a neonatologist and a NICU nurse down at TGH who kindly agreed to help me with my portion of my groups disease presentation next week. For about an hour, I sat in a small conference room in the NICU as these two incredibly strong women educated me on the social and ethical issues involved in a disease that causes the death of a significant amount of the infants who are born with it. But to be honest, a lot of the time, it felt more like I was giving them something: a chance to open up about all of the terrible and sometimes wonderful experiences they’ve had while working to save the lives of these newborns. I can’t begin to describe all of the wisdom and compassion that filled the air over those 60 or so minutes but walking away from it all I felt like I had just met two of the absolute best people in the entire world. Is there a more noble job than the one they carry out everyday? Probably not. Do they get thanked? Not nearly as much as they should. But, as was clearly related through their own words, the reward comes in knowing that they are able to make one of the most horrible experiences in a family’s life, at least a tiny bit better.
Even though the bulk of our conversations involved death and sickness, in a strange way, it gave me great joy. Looking back, I think it’s something I can point to as being a moment when I was most genuinely proud of joining this profession. It will be an honor to one day stand across from people like these and call them my colleagues.

On a side note, I wrote four more stanzas of what is so far a six stanza musical response to my penpal Tiffany’s letter to me. I’m sure it will get somewhat longer and be included in a kind of art project we are creating together. There will be more to report on that later. Much later.

I don’t know how much more I can study for this past week’s lecture material. I understand everything, but I know I will still screw something up on the test. At least I know I did my best this week.

I am currently writing two new songs that are completely different. It’s so weird; this has never happened to me before. And I use the phrasing “happened to me” intentionally because I really didn’t choose to start writing these, they almost just started writing themselves. I’m sure every artist feels this way at some point (or maybe all the time). For me, this is what results from having very little time to play music and a sporadic amount of inspiration.
But it’s strange because they are such different songs musically and also they come from completely different emotional places. It’s like they are at war with each other. Which translates into there being a war inside of me right now. I don’t intend to delve into my personal emotions here as, like I’ve said before, this is not a journal, it exists only to document my artistic and medical journeys throughout these four years. But this is about the method of creating art and hence I deem it appropriate to speak about in a vague manner.
I process almost everything through songwriting. There are very few significant events/relationships/epiphanies that I have had throughout my 22 years that I have not written a song (or two, or three, or ten…) about. Now, in the summer I wrote and recorded a collection of very melancholy, somewhat folky songs for Outwatch the Bear which emotionally function to process pieces of the past three or so years of my life. The Culprit Life is a brand new, wide open format for me that will hopefully carry me in a new direction on a variety of levels. It is arranged so as to allow me to process all of the new things in my life over these next four years (and trust me, there are and will be a lot of new things). But for some reason I seem to be in this prolonged transitioning period where some of the style and emotional content of my last project have hung on a bit longer than I expected (or wanted) them to. And while I definitely see myself progressing into places I haven’t been to, there still remains this undeniable beckoning back to everything that embodied Outwatch the Bear. Just when I thought I had resolved these emotional issues and creative tendencies, I find out that my heart and mind are not so quick to move on. Now it is like having one foot in Milton’s Ill Penseroso and one foot in his L’Allegro. I wish there was an alternative poem and path, on an entirely different plane than those two. They both seem so polarizing to me at this point and time. Must I choose between this deep melancholy or this shallow happiness? I hope not. I think, subconsciously, I have been working towards a deep happiness, something I feel I have never quite produced before. At least not to my satisfaction. And personally, I posses the raw materials for such an endeavor. But until I can fully redevelop myself, I have a feeling these ghosts will still come back to haunt me, my lyrics, and my music from time to time and with that, crack open the doors I had tried so hard to bolt shut.
This is life. This is art. And I am failing to see the difference between the two.

Study Study Study

This afternoon, my partner for the On Doctoring take home exam, Hinda, and I finished our test in about 3 and 1/2 hours. I thought it should have taken two but it was a good deal more time consuming than I thought. Still it would have taken even longer if it hadn’t of been for Hinda’s awesome act of going through the exam before hand and answering a few of the questions on her own. She was a pleasure to work with. And to think, she told me people were jealous of her when they found out I was her partner! That’s pretty ridiculous. She was a way better partner than I was. Just because I’m the On Doctoring liaison doesn’t mean I’m necessarily better at this stuff than everyone else. It just means I tend to like it a little more and people voted me in for that or some other reason.

Before this, there was an awesome student presentation on cystic fibrosis. I say it was awesome because a few of my friends were doing it, they did a good job, and it is a disease that has been close to my heart for the last few months ever since I became fast friends with a wonderful person with CF named Rosie.

And finally: you know that feeling when you’re in a plane and you’re way up high, above the clouds, I mean really high, you can’t even see land and you’re looking out the window at the infinite blue and suddenly in the distance you see a small white speck dart across the sky and you realize, it’s another plane with other people in it who are just as high up as you are? It’s a very odd feeling. Comforting in a way.
Well this evening I was the recipient of that feeling when a random message from someone in my class threw me for a bit a of a loop. And to think, my feet were on the ground the whole time.
Below is my response to her. And although I wrote these words for her and her alone, I just decided to post them because they capture a specific emotional point in my life that I don’t ever want to forget.

Allison,
Thank you so much for your kind words and for you openness about how your feeling. You’re random message is just the kind of hope I desperately seek day after day. I think my favorite part about what you wrote (or the part that touched me the most at least) is when you said we are sacrificing our youth for these people. It’s so true. I will be 25 when I get out (if I don’t have to repeat anything) and I’m lucky because I’m one of the youngest. It seems like such a strange place that we’re in, you and I. It’s like one of those photographs where there’s a ton of people moving around but only one of them is in focus. We are the person that is in focus. Thanks for sharing your thoughts about the girl in the shop. I day dream like that all the time, especially during the tests. I can think of a hundred things I would rather be doing during those moments. And I hate when people who are not in med school give me all those inspirational pep talks like “It’s all gonna be okay” and stuff. They have no idea. And the truth is it may not be okay, it may really not be okay. We could screw this up really bad and then I’m not sure what I would do. I like when people just agree with me and say “yeah, it sucks”. Because it does and in some strange way it makes it feel so much better when someone says that to me. Maybe it’s some sort of emotional validation. Some intrinsic aspect of human nature that relief is found in an affirmation of misery.
I will tell you the thing that makes me feel better though. The clinical correlations when a patient comes and speaks to us directly. It’s so surreal for me because it makes me remember why I wanted to be a doctor in the first place (a thing I have been prone to forgetting lately). Maybe that’s not the thing that does it for you, or maybe it is; I don’t know. I just can’t stand the basic science stuff. I flat out hate it. I’m a bit like Poe in that regard; I think science can make you insane and illogical and completely disconnect you from the rest of humanity. And right now, thousands of notecards filled with cold depressing facts are standing in between me and the warm bodies of patients who I hope to help in some way. And now can you see the paradox? I so badly want to be doing them some service, saving them, when in the end, the fact of the matter is they will be saving me. From boredom. From misery. From the ever swelling ocean of science. From the feeling that I didn’t live up to my potential as a human being. Of course you can never say that aloud when you’re talking to them. But I will, quietly. I’ll look into their eyes: the old man with rough hands, the pregnant woman, the 3rd grader with the heart murmur, the barista with cervical cancer. I’ll look into their eyes and say it as loud as I possibly can:

“Thank you for saving me.”

Monovision

Photo by Polley Pantcheva

Today was a good day. I woke up and worked on my physical diagnosis patient write up. That involves watching a dvd of myself which isn’t my favorite but I’m definitely learning how I can be better next time. Then, class included an awesome clinical correlation with a mother of a child with Congenital Adrenal Hyperplasia. This mother is nothing short of phenomenal. She does research on her child’s disease, wakes up at all hours of the night to give him his medication when it is best for him to take it, and keeps up with a network of other parents who have children with the same disease. I learned so much about the disease and how to interact with patients and parents of patients. I absolutely love when we have clinical correlation days.

Then tonight we had a small pancake party at my place. The theme was visual art and mustaches apparently. Dan made mustache templates and felt/posterboard material for us to make them with. A few people ran slide shows of their photographs and drawings on computers set up around the living room and I ran one of my Who Painted the Lion? photography project on the tv. Surprisingly, for a good portion of the night, everyone worked on the tree! There are a lot more branches and probably around 50 leaves hanging down from it now. It’s such a nice thing to walk into my house and see after a long day of studying. It reminds me of all the friends who have worked on it, mostly Dan and Joyce, but others too. Oh and because we all had mustaches on, Dan decided to make a giant one for the tree and place it on the trunk so he wouldn’t feel left out. I think it looks very becoming of him. I can tell he’s getting older and wiser already. Mustaches have that effect.

Undone

These are the strings that I used to record all of the songs for Outwatch the Bear during the summer. I finally decided/had the time to change them.
Changing the strings on my own guitar is somewhat like operating I think. And while I recognize that the latter is something I have never done, the former is something I have done a hundred times. In a way it’s routine in that I’ve performed this same act over and over again for years but there’s also this bit of anxiousness and uncertainty that comes with it. Will the strings come into tune quickly for me? Will I stretch one out too much and have it pop under the sudden tension? I know exactly what to do, in fact I’ve taught numerous people how to do this, but still I get slightly nervous, in a good way. I’m careful. And now I see it as almost a spiritual act, changing the strings. It’s about renewal. It’s death and birth. It’s vulnerability. The guitar is naked on my bedroom floor. It’s mute and I am responsible. But I am also responsible for bringing it back, for resurrecting this beautiful thing. It’s a bit tricky, but if I do it right, the guitar comes out sounding 10 times better than it did before. And playing with new strings on a finely tuned guitar is one of the best feelings in the world. For me anyway.

What I thought would be a fairly boring On Doctoring session on professionalism turned out to be not so bad thanks to the quantity of responses by the other people in my class. Later we had an information session on the nine different scholarly concentrations we can choose to do. They are all elective but you can only choose one of them (anymore than that and your grades would most likely take a proverbial jump off a proverbial cliff). I found most to be interesting, a few to be interesting enough to make me want to do them but only one that will be practical for me to engage myself in: medical humanities. The structure is much more loose than the other concentrations and the first year just involves watching some films at a faculty member’s house mostly. The project is also very ambiguous which leaves a lot of room for imagination.
In short:
I’m gonna be doing art in my free time for the next four years anyway so I might as well get scholarly recognition for it.

Drops Like Stars

Photo by Dan Nguyen

Hit the ground running. That’s the idea apparently. Walking into the histo lab in the morning after the test, my friend Nancy excitedly informed me that the attending doctor for my LCE (longitudinal clinical experience) that starts in November will be her husband! Apparently he’s some rock star pulmonary doc down at TGH where he’s involved with lung transplants and cystic fibrosis patients which happens to be right up my alley. Then Nancy warned me that her husband is a “tell it like it is”, straight shooter type who curses like a sailor and proceeded to ask me if I was able to handle that! Hilarious. She was worried because I’m such a “nice kid”. I assured her that I have spent a lot of time around doctors and I’ll be okay. Oh Nancy, gotta love her. Actually I’m not too surprised because Nancy is somewhat of a straight shooter, rock star type herself and I get along well with her. Although I get along well with almost everybody.

On Doctoring was about research ethics today and how we are supposed to reconcile “do no harm” with “well, you may get hurt during this experiment”. Actually they didn’t really tell us how we are supposed to reconcile these, they just kind of said “uh… yeah… it’s a problem…”.
Great.
It was good to learn more about the Nazi experiments and the Tuskegee syphilis study though.

Later we had a series of surprisingly good lectures by a new guy called Bennett, who I think is quite good despite his boring subject matter (membrane communication and potential), and a final lecture by Dr. Williams. It was sad because I didn’t know it was his last one until he told us what a good time he has had with our class. Oh well. At least this Bennett guy gives me hope for some decent lectures, though he is no where near as hilarious.
Dr. Williams, you and your extensive vocabulary and unparalleled comic timing will be missed. Greatly.

And finally, my day ended with an astounding lecture by Rob Bell at the Tampa Bay Performing Arts Center downtown. Rob Bell’s books along with Donald Miller’s convey the majority of what I believe spiritually. In a pseudo-sermon/interactive lecture/ multimedia presentation, Bell presented the very generic topic of tragedy shaping and connecting us in an ultra-unique way that somehow made everything I already knew on the subject substantially more profound. I am writing this here because everything was displayed in such an artful manner and in fact the conversation greatly revolved around art itself. At one point, Bell spoke about a get together he had at his house with a bunch of sculptors. He gave them each a bar of soap and they spent the next hour carving it into something. He showed us the photos of all the interesting things they produced that night, including a tiny replications of Duchamp’s urinal! Awesome. Of course his point was we all have these spectacular things inside of us, we just need to eliminate all of these other things to produce it, just like an artist does. Then he gave us all our own bars of soap. I’m not gonna lie, I will probably never do anything with it. But I did think it was a really cool way to make his point.

So, Exam 2. I don’t really feel like expounding on the myriad of emotional upheaval this test has brought to my life recently. Here is a fact: I guessed on 75% of the questions today. Here is another fact: I don’t have the test results back. So any fuss and debating about what I’m gonna do with the rest of my life is just superfluous at this point. Contrary to all logic and despite having the memory of a horrendous past 24 hours fresh in my head, I feel happy and content right now. It’s the strangest thing. It’s as if I have experienced every emotion in the past 24 hours except for these two and so my head and body are saying collectively “well, we might as well check these off the list too”.

Maybe this will all be a book someday that a bunch of people will read. Or maybe my grandchildren will get as far as entry 23 and say “Geez, does abuelo ever stop being so emotional all the time? Is this really abuela’s diary? I’m gonna go play on my hoverboard now…”

Study Study Study

The Histology Lab at 2:06am

They lied to me. They said that the hardest part of the path to becoming a doctor was getting into medical school. But they lied. All of those doctors and admissions staff members and university faculty, they lied. Because the hardest part is NOT getting into medical school; the hardest part is medical school.

This is how it was explained to me by some friends in the histo lab:
If you fall below a 70% average (something I’m dangerously close to) at the end of any class, you fail that class and have to make it up in the summer. If this happens in two classes, you fail that year and have to make up the year. And I’m pretty sure if you fail something else you just get kicked out of the program.
So right now, besides all of the metabolism pathways running through my head, my uninhibited thoughts have been centered around how one might possibly pay back $40,000 in loans while at the same time putting food in their stomach and redirecting their course of life completely.

So I watched presentations from the overflow room in the morning for the first time and I must say it’s just like being in a cave with a giant TV.
From 12 to 1 I went through critical skills “boot camp” to learn how to give flu shots, check glucose levels, blood pressure, and vitals. I learned the last few things in POM but it was a good refresher. The whole thing was pretty fun because not only were we doing hands on medical stuff but we were joking around with each other the whole time. Did I mention I love my class?

And now for a big announcement pertaining to art:
The remarkably talented and ever delightful Sarah Wilson will be the director of the first music video for The Culprit Life!

As of yet, I have no idea what song it will be for (I still have about 6 months of demos ahead of me), but it will be shot at the very end of the school year.
Just for clarification about how music videos will work for this project: One EP will be made each year. From that EP, one song will be chosen to be made into a music video each year. Each music video will be shot by a different director.

In a meeting where I asked and received help with my disease presentation, Dr. Stevenson told me that he didn’t find anything that genuinely interested him in medical school until his third year!!!
But I think he told me that to let me know that other people feel the same way I do and also to make me feel better because at our medical school the clinical, hands on stuff starts a lot sooner than at most schools (in november of 1st year). It did make me feel a little better but I was still extremely stressed about the team based learning (TBL) quiz in the afternoon. But to my surprise, my team and I actually did quite well! It helps that it was hosted by Dr. Williams (the best lecturer ever) and I’m sure there was some mediation by the divine because me doing well on any really scientific based stuff in this place is nothing short of a miracle. Oh and I would be a total fraud if I didn’t mention that a few of my fellow first years really helped me out today with understanding the TBL material on Cushings disease. All that stuff in POM about them being each other’s support group was really the truth, and I couldn’t be more grateful.

There is no question about it.
The Decemberists put on one of the best live shows in the country.
Maybe the world.
And the evidence for this lies not only in their expert musicianship or hilarious on stage shenanigans but also in their somewhat unique focus on songwriting in a live show. What I mean by this is that they create an atmosphere that really draws you into the songs themselves, not just the performance. Many people have had the experience of going to a live show, seeing a band they’ve never heard before impress them with their performance, and then going home and being anything but impressed by their actual album work. By contrast, The Decemberists show is something like a football game that not only excites you about what’s happening on the field but excites you about football in general. It makes you want to go home and learn more about football, the rules, the regulations, the history. And then it makes you want to go out in your yard, in your middle class American, deed-restricted community and play some football yourself. The strongest facet of this band is their songwriting and that is exactly what their live performance showcases. For this reason, they are a favorite of mine as well as, I’m sure, many of my fellow songwriters.
Here is the The Decemberists show in bullet point:
- full performance on their newest album The Hazards of Love from begining to end, hitting every transition and with no breaks (a little over an hour long)
- half hour break
- a full set of their older songs (a few of which I didn’t even recognize even though I have all four of their main albums and some EPs) and a cover or two (a little over an hour long)
- an encore featuring a new song and a couple others (about 15 minutes)

Needless to say, they gave us our money’s worth.
While the first set was a note by note, serious recreation of their latest album, the second set was more of a hilarious late night variety show starring Colin Meloy as your wildly witty, well read host. There was a dueling guitar segment between Meloy and guitarist Chris Funk where Meloy went into the crowd and let a fan play his guitar. After multiple handstands, the drummer went crowd surfing. Meloy played “the worst song” he’s ever written and followed with a story about it’s cosmic implications that launched directly into one of their best songs. Meloy comically “conducted” the audience with the left half of the room, the right half of the room, and the balcony all singing different parts.
I think one of the things I liked the most about the show is that the band gave is their relationship with the audience. They respected us. They were flashy but not arrogant, fun but not sloppy. They not only acknowledged us but they included us in their antics while still wooing us with their beautiful melodies and dedication to their art. In all my years of going to shows, I would have to say that this was the best example of how a band and audience should interact (excluding the loud, obnoxious remarks by the drunk people beside me who seemed to be a part of some secret organization of annoying drunk people determined to stand beside me at every show I attend nowadays).

Oh yeah, and in case there was any question, medical school is still rocketing along on it’s usual nightmarish journey through repulsive academia. However, there was a good trajectory to this day! I had my first physical diagnosis assessment and it went pretty well. It was just on history taking but I was surprisingly slightly nervous when I entered the room. My standardized patient was one I had gotten before which made me worried because last time he was a complete jerk but this time he was quite pleasant and had pretty respectful feedback to give. His “character” was a patient with bad stomach pain. He was supposed to be from London but had a terribly inaccurate accent. My assessment was done by none other than Dr. Schrot himself! He was extremely nice and tactful with his feedback, providing areas of improvement but building my confidence at the same time. I think he even missed a few areas that I knew I could have done better in. Then a communications grad student came out from behind a one way glass window and also gave me some constructive feedback. The whole experience was very informative and exceptionally professional. I was impressed with education I received from it. I actually felt like I was learning something important and relevant for a change!

Well, The Decemberists show was my last artistic “meal” before retiring to my suburban study cave for a weekend long hibernation. One last deep breath before diving under the giant metabolic surface of this treacherous sea. But who knows, I may come out alive. If it’s anything like a Colin Meloy song, I’ll die in a beautifully dramatic way and become a doctor posthumously.