31 May 2007

rant: war

this isn't my particular rant, but i couldn't have chosen a better way of expressing these sentiments against the war in iraq myself. (warning: video contains explicit anti-war remarks, complete with some choice 4 letter words.)

thanks super_blaze, for bringing this to my attention.

29 May 2007

picking up the thread: is it worth it?

first i must note that my beloved mac is finally back in my possession. i might not let it out of my sight again--that was one long tough week without it! i must thank the mac geniuses--they replaced both my fans, gratis. now the only periodic odd noise i hear is the sound of my cat, biddle, growling at the fed-ups man. did i mention that my cat thinks she's a dog? ;-)


i've spent a considerable amount of time lately pondering my pursuit of higher education. i'm not questioning the thirst for knowledge itself, mind you, but the actual paying-of-tuition / sitting-in-classes / eventually-getting-degree part of this whole journey to become a physician. choosing to delay my education for another year has left me feeling a bit depressed. this year, when (if?) i start medical school again, i'll be 30. i know chronological age is essentially meaningless (unless you're an actuary), but for some reason, i feel odd about this fact of turning 30. it's a petty thing, really--i'm experiencing that "always on the outside looking in on other's lives" syndrome that accompanies one of those life moments when everyone i come into contact with seems to have something that i want, yet lack. you know these people: they have the mcjob or the mchouse or the mcpartner or the mcbaby or the mcdog or...the real clincher for me these days...the mchealth. some people i come into contact with even have all of these things, including the mchappiness. i guess they got all the mcluck, too, eh?

the envy i feel probably stems most from having too much time to think. but recently, i realized that i'm not the only one gnawing on these feelings and issues, particularly as they relate to medical school and the sacrifice it entails. this is where i catch onto the thread--dr_panda_bear asked the question first, as far as i can tell, and dr_urostream mentioned it next--and so i might as well audibly voice the question that ricochets through the head of every med student as they hit yet another bump in the road: is it worth it?

it's a heavy question. one might think, based upon my recent "toad list" post where i ranted about some of the worst physicians on record, that i have a negative view of the medical profession. the truth is the opposite: i tend (to a fault?) to see the positive first. i'm a bit of an idealist in this way...and a tad gullible, i suspect, too. it's been difficult for me to answer questions posed to me about medical school and whether it's worth all the time/effort/energy/money/sacrifice/stress/etc. the other bloggers do a great job of addressing the issues in their posts--i wish i could write so cogently and analytically in response to the question.

when i ponder the question as to whether or not it's worth it for me to continue medical school, a certain experience comes to mind--the one that confirmed my convictions about being called to this career path. the story, i believe, speaks for itself:

when i first became interested in a career in medicine, one of my physicians, fertile_doc, hired me to work as the slave in his office for the summer. i spent most of my first few weeks on the job culling the thirty years of medical records and journals that were beginning to eat up all the storage space in the office. toward the end of the summer, though, i began doing more clerical work and having some interaction with patients.

the office was chronically busy, particularly on mornings when the ultrasound technician was present, as the majority of fertile_doc's practice surrounded treating couples with infertility issues and ultrasound plays a key role in this process. on one such morning, we were running a tad late. the waiting room was crowded and the staff was bustling about, trying to get all the phones answered, labs drawn, and insurance forms organized. i'd been assigned to "man the window," checking in patients and making sure charts made it to the appropriate spots on the racks for triage. and i was at the point where i was beginning to feel truly frazzled....

in the midst of this, someone knocked on the window. i groaned silently to myself; i'd thought all the morning's patients had been checked in already. what now? i was prepared to give my memorized, automaton directions to the bathroom, insurance policies, etc. i feared i'd strangle a drug rep if they appeared in the midst of our busiest hours. but i opened the window and was quite puzzled by what i saw. an elderly woman sat in a wheelchair with her husband standing behind her. they were definitely not the sort of people who'd show up for infertility treatment and i wondered as to whether they'd wandered into the wrong office. this was a situation that was going to require me to think. carefully.

"does fertile_doc work here?" the woman asked.
"uh...yes." i replied, still feeling puzzled.
"is fertile_doc here now?"
"yes" i replied. "do you have an appointment?"
"no" she said, "but i would like to speak to him."
"I'd be happy to schedule an appointment for you."
the woman looked at me--my confusion was no doubt clear by this point--and then struggled to pull herself up out of the wheelchair until she was standing. now eye-to-eye with me, she said:
"twenty-four years ago, fertile_doc detected my breast cancer during a routine exam. i survived because he discovered it early. i'm here because i would like to thank him."
she then carefully lowered herself back down into the wheelchair.

a few minutes later, i watched as this woman thanked fertile_doc for
what he'd done. most physicians i'd known treated breast exams as a perfunctory part of the physical examination. it's another one of those areas in which technology (in this case, mammography) often replaces good hands-on examination in medicine. but fertile_doc always took this portion of the exam seriously, taking time to really look and feel for lumps and changes in breast tissue. now i knew why he did so. it was a profound lesson.

as i watched this frail woman give fertile_doc a hug, i discovered something even more profound: fertile_doc had given this woman more time--time to be with her children, her husband, her loved ones...time to live. with one small, attentive act in the midst of an everyday job, fertile_doc made a huge difference in this woman's life.

it was in that moment, watching this interaction unfold, that i realized that there was nothing more meaningful i could do with my life than follow a career that had the potential to give even one person an extra minute, day, month, year, of quality life.

is anything worth more than that opportunity?


the answer for me, to the question "is it worth it?" is a simple resounding yes. in spite of all the bullsh!t that surrounds medicine these days, I believe it is a privilege to become a physician.

to all those physicians who have taken care of me, my loved ones, and even (especially?) the homeless jane & john does on the street: thank you for choosing to make the sacrifice, to dive in, & serve by example to show students that the pursuit of medicine is, indeed, worth it.

25 May 2007

formatting issues?

i had to leave my beloved laptop with the "geniuses" at the mac store a few days ago when i was in the nearest big city. poor thing's fan had started making funny whirring sounds (that were, of course, not reproducible in front of said geniuses). so my laptop is not with me, which leaves me not only with a good deal of separation anxiety, but means that i'm forced to use my old PC desktop.

the experience of using a PC again has proven to be very odd. I'd oh-so-joyously forgotten about the crashing, freezing, restart updates, and generalized slowness of windows. this is kind of funny, considering that i customized this desktop myself and spent a considerable amount of time tweaking it to my liking. i was annoyed last year when i learned i'd have to buy a laptop for school (no matter which direction you go, they're expensive). but i got my macbook pro and never looked back.

now that i'm having to spend a few days on the pc, though, i've noticed something that i'd forgotten to check about: web-page formatting. (i say forgotten, because when i use dreamweaver to work on a website, i'm always careful to check to see how the page will appear in the various different browsers.) i pulled up my blog on this pc in both firefox and ie and am seeing some egregious formatting errors. is my page appearing strange on anyone else's computer?

i had a moment today where my past-post widget appeared with the month names in spanish. how odd is that?!?!?

if anyone has thoughts on how to ensure that blogger behaves on all platforms, i'd love to know the secret. in the meantime, my apologies for missing pictures, strange languages, and other odd behaviors on the blog. never a dull moment, eh?

the ponderous patient: a panic attack

i swore when i began this whole medical school process that i wasn't going to be one of those medical students who thinks she has every disease or physical problem about which she reads. (i knew i'd be the student with 500 different colored pens and notecards, but that OCD behavior began long before I ever considered this path.) i actually have made a point *not* to read about any treatments I've needed or medications I've taken since beginning med school, because I've been certain that my subconscious will suck up the information like a heavy-duty paper towel sucks up blue liquid on a commercial and that I would, ergo, become one of *those* students....

so. yesterday the cats woke me up at (i kid you not) 6am. i guess they decided it was play time. i disagreed, but couldn't go back to sleep, so i chose to drag myself out of bed and plop myself in front of my computer. i ended up chatting with j.p. (who never sleeps anymore) via gmail talk for quite some time. when the conversation was over, i decided to get myself a glass of chocolate soy milk. <--this has become my new favorite food. yes, i am that pathetic, being so unable to eat anything that tastes good that now fat-free soy chocolate milk is, to me, absolutely delicious. (have i mentioned recently that i'd like my gallbladder back?) so, as i was reaching into my near barren refrigerator for my yummy carton of chocolate soy milk, i noticed that i had a bright pinkred circle on my arm. i put down the carton, rubbed my eyes, and looked at my arm again. still pinkred. "hmm..." i thought, walking over to the ray of sun coming through livingroom window and looking at the spot again. still pinkred. uh-oh.

did i mention that the bright pinkred circle was precisely in the same location as where i had had a tb test done the day before?

so. i make my stupidest move ever and do what i've sworn not to do: i pull out my microbiology textbook. i flip to the index and look for tb and skin reaction. i turn to page 234. and i gasp. there, on the page, is a picture of someone's arm with--you guessed it--a big pinkred spot. "aaaggghhh!" i think. then i read a bit, realize that the circle's size matters, so i go find the handful of coins i keep in my backpack for those marathon lecture days when i cannot stay awake without making a mad-dash to grab a coke from the vending machine. "hmm... not as big as a quarter, but about the same size as a nickel. g-r-e-a-t." having had enough of my microbiology text, i toss it on the floor in disgust.

i then sit down at my computer and do a google image search for tb and skin reaction. up pops about 10 pages of images of arms with--you guessed it--round pinkred dots. it's about at this point that i believe i began cursing. audibly. i scanned a few pages and paragraphs--from places like nih.gov, not bigpinkspot.com--and see a few brilliant key words: weight loss, nausea, loss of appetite, yada, yada, yada; the sites list out about 60 % of the symptoms I've been experiencing lately. more cursing ensues.

my mind starts racing. i spent years working at a medical center that put me at high risk for tb, but i now comparatively live in the proverbial boonies. i had a tb test last year around this time (it's one of those annually "required" tests for medical school) and it was negative. "how the f*ck could i have gotten tb?" i wondered. in spite of the advertisements posted by medical schools, there really isn't any clinical contact during the first year of school. not unless you consider cpr to be a clinical contact experience, which i don't. so it's not like i've been around any patients. and, loathe as i am to admit it, i live in yuppie land. seriously. mcmansions, mcdogs, mcbabies, mchummers, mcgolfers--you mc it, we've got it. except for tb. tb is just not one of those things that gets mc'd. not in this day and age, anyway....

i start thinking about how crappy i've felt in the past year and all the medical problems i've been experiencing during my soon-to-be-over 20s. nobody my age should have this many medical problems. so, once again, up pops the hypothesis: what if all these things are not random individual events? could i have an immune disorder? it certainly would explain a lot...not to mention that one of the populations that most easily contracts tb involves those who are immunocompromised. hmm....

by this point, it's 10 till 9 am. just time for the doctor's office to open. i feel like a schmuck doing it, but i call at exactly 9 am. <--the emotionality about calling stems from having been on the other end of that phone on more than one occasion. medical staff are like any other mortals. talking to them first thing in the morning, just before or after lunch, or in the 5 minutes before closing--it's a bad idea. it gets you labeled as one of *those* patients. the kind of patients who copy down the phone number for the office's back line--since it appears on caller id when you call them to give them test results and such--and then proceed to call that number incessantly if they can't get through on the main number. as if there were enough hands to pick up another ringing phone! note to patients: just don't do it.

the nurse calls me back a while later and asks if the area is raised. nope, just redpink. round. and starting to get kinda itchy. she tells me not to put anything on it--no lotions, creams, soaps, etc--and to come in at my scheduled time on friday to have it checked. "some people have an allergic reaction," she says. so. i realize that there's nothing i can do about this bright redpink spot on my arm except wait.

this means that i now have to focus on my emotions, which have suddenly gone haywire. why did this freak me out so much? i really can't say. my only guess is that, at a certain point, we all hit our limits for the quantity and quality of physical ailments that we can take in any given period of time. for whatever reason (lack of sleep?), this damn redpink spot scares me.

i do the only thing i can think to do: i take a xanax and crawl back into bed.

needless to say, the redpink spot faded over the course of the day and gave rise to a purplegreen bruise. today, there is nothing on my arm save the remnants of said bruise, which is now about the size of a pencil eraser. definitely not tb material. not even in the least.
so. with my tail between my legs, i went into the doctor's office this afternoon to have the spot "read." "where's this pink spot you were worried about?" asks the receptionist, the nurse, and the doctor...although not all at the same time. it's a pity that we're not having hoodie weather, because i could have really used something to hide under. *blush*

so. it's official then: i'm as paranoid as the next medical student, if not more. i was hoping not to catch the disease bug, but like the highlighters, the notecards, the supplemental textbooks, and the 1,001 questions, all fingers point at me. even as a patient, i'm the penultimate med school nerd. penultimate because there are still a few worse than i am--they're the ones still sitting in the doctor's waiting room. ;-)

23 May 2007

the ponderous patient: the list

in the midst of my appointment with mr_dr_do today, he wondered aloud as to where he was on my "list." for some reason, he thinks i have a list of physicians in some sort of order--like my own personal rankings. lol. i've been a patient for a long time, but i don't make a habit of going back to "repeat offenders." nevertheless, i've since been pondering this list notion and have decided it would be pretty funny to give out some "awards," particularly to a few choice physicians whom i sincerely hope are no longer in practice anymore or that i hope have since learned not to do what they did to me and/or to my friends/relatives/etc. i certainly can't and won't mention names...but there may prove to be some great healing humor in this. feel free to add your own favorites! :-)

toad awards:

  • worst doctor ever award: dr_suicide. dr_suicide was my friend's psychiatrist. he wins the worst doctor ever award for telling my friend, during a suicidal episode, that life would never get better and that it would always be bad. needless to say, my friend attempted suicide after that appointment. that's a hell of a way to lighten a case load!
  • worst pelvic exam award: dr_3_fingers. this particular er doc performed a bimanual exam that nearly made me jump off the examining table. his response to my distress: "sorry, i'll only use two fingers next time."
  • worst rectal exam award: dr_gi_partner. this gi doc was a partner of a gi doc i had during one of my surgeries. put it this way: he must have learned in anatomy that you can palpate the brain through the rectum. enough said.
  • needs to remediate english award: dr_doogie. dr_doogie was a very young o.b./g.y.n. assigned to me at a small town hospital when i was in college. i discovered, upon obtaining my medical records, that he did not know the difference between an adjective and a noun. it's "virgin," you idiot, not "virginal." at least, not unless the patient's name happens to be mary and the year is 33 b.c.e.!
  • worst bedside manner: dr_old_gyn_surgeon. i heard the doctor i was seeing for an acute surgical problem talk to this guy in the hallway while i was still in the exam room (where the partner, who gets the worst bedside manner runner-up award, had left me in stirrups!). he'd never met me--didn't know anything about me except my age--and managed to blurt out: "well, if we go in there now, we'll have to take 1/2 her ovary. then in two years, we'll have to take the other 1/2. two years after that, we'll have to take the other, and, by the time she's 30 and wants to have kids, there will be nothing left!" he then flies into the room and proceeds to probe me with the ultrasound machine. (note to future doctors: don't assume that (a) every woman wants to reproduce, (b) every woman is straight, and (c) if you're a gyn, that every adenexal mass in a 20-something is ovarian--it was my *appendix* they were seeing on the scan, *not* my ovary. i'd have *died* if they hadn't done surgery. can't have kids if i'm dead, you know?)
  • most outrageous solicitation award: dr_repro_endo, in new England. no, i will not buy the cholesterol supplements that your husband has left medical practice to sell. i will not buy them even if you say you won't treat me unless i take them. if you want to sell stuff, join Amway.
  • sexist award: dr_teeth. i hate to break it to this guy, but having a statue of a "lady in distress" being saved by an oral surgeon does *not* earn him a vote of confidence from a woman, even if he was born before 1920.
  • w "family values" award: dr_teen_ob. my friend, who had a baby when she was in her teens and living in a small town, delivered her baby in the presence of this doctor, who gave her a completely unnecessary grade 4 episiotomy. i'm usually not the type to promote revenge, but i hope this guy ends up as my friend's patient...with a very embarrassing problem. have issues with teen pregnancy? then don't go into obstetrics!
those are just the ones that i can think of off the top of my head. there have been more, many more...i'll add more later....

[oh, and mr_dr_do, if you happen to have found my blog and are reading this, you no doubt now realize that you're nowhere near to getting on this particular list! don't worry!]

configurations of the past

this is not a post about medicine. it is not a post about medical school. or patients. or being a patient. it is a story about the past. about configurations of the past. about love....

most girls would scream. most would run. but she doesn't. she stands, transfixed, as she watches the tiny egg in his hand shiver ever so slightly. it shivers; then it breaks. a crack clean down the center and then the sudden appearance of a slimy greenbrown creature, complete with tail. most girls would squeal. most would at least say "eww..." but she doesn't. she watches. she watches as a baby lizard unfurls in his palm. she watches it look at him, at them, and then she watches it disappear--almost instantly--as the little creature leaps onto the nearest bush.

most girls would never have noticed him. most would vanish. but she remains....

twenty years later, the girl--now a woman--sits cross-legged in her overalls, back pressed against a locked hotel room door, as she waits in the hallway, reading intently. the girl--the woman--she is intense. transfixed, she can sit for hours, reading, looking, watching...but never quite taking part fully in the world around her. she is still a bit shy. tentative. but she stays....

she sees them first, striding down the hallway. it's been nearly ten years since she last saw them. she feels her breath catch in her chest. they were boys...they were still boys when they all last parted. but these guys she sees now, these aren't boys. these are men. and she--a woman.

the sparks between she and he are instantaneous. he has the body of a man--lean, fit, inviting--yet retains the grin of the boy. that grin, that twinkle in the eyes, his laugh...the same she'd seen when the mama lizard bit him and hung from his finger--her punishment for his disturbance of her nest--juxtaposed against the joy of his curiosity and the surprise at her wonder. the curiosity, the wonder...it remains....

she learns this two days later when, after having spent the night together engaged deep in conversation, he kisses her, just before dawn. electricity. she feels electricity. she feels the heat from his lips, from his chest, and from the raw undeniable presence of his lust for her as he presses against her. she sees the curiosity, the wonder, the hunger in his eyes. when they leap, together, half-blindly like the baby lizard into the new relationship, she cries. she's waited for this, distracted mind wound up in her studies, observed the world from a distance, and longed for something real. something true. and this is, she thinks, this is true--and it remains....

it remains through the early days, from the first moments, when, breaking out of shyness, she discovers the power of her body. being with him is not an intrusion. it is not like one of the several dozen medical exams she's submitted to over the past few years in an attempt to find healing. it is not like being half-covered, she thinks, in a degrading paper gown. it does not hurt...it does not hurt like so much of her life has. this--this relationship--this is new. this is beautiful. in her interaction with him she feels, possibly for the first time, whole.

she puzzles over this new way of being with another person. perplexed by the complexity and depth of her feelings, she wonders at how non-intellectual life can be with him. he lives in the moment.

or so she thought.

they talked for hours, separated by thousands of miles, about the past, about the present, and about their dreams for the future. he lost some of his boyish spontaneity when he became a man, but had replaced it with a certain solidness and assurance that she felt she could wrap herself in, a warm blanket to protect her from the cold. one day, when they are together, riding on a bus, he leans over and kisses her on the cheek. a spontaneous act. loving. she imagines life between them could remain like this. she has no hope, no desire, no wish for anything more than just this: this spontaneous, tender love.

if she'd known...if she'd only known something about men, about what happens to boys when they become men, she might have seen it coming....

what she did not know was that her words would betray her. she'd spent years with words: learning how to put them together to weave a poem; discovering how to use them to persuade an audience in an argument; rolling the newness of foreign words from her tongue for the first time. some of her friends would say she was a word. she breathed language. she thought in streams of water, a constant flow of ideas flooding her brain.

it was her downfall.

the words, to him, to his man-self, were unquestionable. they were not spontaneous or flowing: they were bricks. they were to be stacked neatly in piles, here, and here, and there. once placed, they did not move. words were stone. sentences were walls. paragraphs became houses. there was no room for movement. this was how life was "supposed" to be.

she'd never known the true strength and immobility of the word "should" until he decided. he decided, without her, that her dreams were built on clouds. he convinced himself that a woman could not become both a doctor and a mother. he chose, instead, a concept, configured in the past, to guide his life. and no matter what remained of his curiosity, his spontaneity, his care, his love for her--it did not matter. her dreams were built on clouds--clouds he couldn't imagine being reached, not even as she lay, brick by brick, her own foundation....

he chose not to love her anymore. it wasn't a discussion. there was no discussion. one day they were together; the next, they were not. he decided. and he vanished.

a year and a half goes by.

the girl--the woman--continues reaching for her clouds. her foundation is not perfect. she does not always build upon it in order. it has holes. her walls are cracked and sometimes wobbly, but she persists. even when she has to go backwards--take a wall apart and build it again--she continues. she persists.

word comes to her, not from him--he has no time for her, for someone crooked, cracked, and sometimes kooky--word comes from afar. he has married. he has given himself to another woman, promised to love her, and has never looked back. his bricks are straight. his dreams are fulfilled, built on a solid foundation, for he has the new woman's word: her commitment, to place bricks on the ground, to make certain life is laid out perfectly, and to ensure that she reaches only for him, their future children, and never a dream upon a cloud in the sky.

the girl--the woman--knows she will never hear from him again. she knows the boy, the man, her lover, has vanished. she holds the fragile, fractured eggshell of a new world in her hand. she weeps. and she remains. these are her words.

the sound & the fury

my apologies, dear readers, for the silence on this end of the blogosphere as of late. the past two weeks have been odd. i'm attempting to find a way to write about some of it without revealing too much about my characters. it's one thing when i "let it all hang out" about myself--it's an entirely other matter when i write about people i know.

i tend to be quite WYSIWYG (for those non-geeks, the translation: what you see is what you get) about my own thoughts and feelings, but i know most people are not like me in this respect. hence my dilemma: how do i write about my experiences without uncloaking others? i don't have a good answer to this yet. sometimes i wonder if i've already said too much. :-}

so...since i'm still in the process of tweaking my latest entries before posting, i'll offer a parting thought, straight from Macbeth, that aims at a certain peculiar truth of this time.

life's but a walking shadow, a poor player
that struts and frets his hour upon the stage
and then is heard no more: it is a tale
told by an idiot, full of sound and fury,
signifying nothing.

now if only i could get some help from Faulkner's muse....

a little disclaimer...

i'm a medical student. just a student. so please, don't take anything i say too seriously. remember that i was an english literature major as an undergrad, so there is much fiction to be found in these pages. do you think i'm telling a story about you or your illness? more likely, you're tapping into my sense of "everyman"--that is, your story resonates with what i write here because it's not so uncommon after all. need help? please, please go see your physician. <--i'm not her. yet. ;-)