Archive for the ‘Pre-Med Musings’ Category

From the Archives: “For Good”

March 3, 2010

I wrote this just before I left the University of Washington, after spending four years there as an undergraduate.  It was there that I began to kick around the idea that perhaps life isn’t always about seeking happiness.  That perhaps the fullness of your life and your experience is what is more important.

Written Saturday, June 9th, 2007

For Good

This looks like it will be the last post I make in Washington for a long time.  We all graduated today in the cold and the wet; a perfect Seattle send-off for the class of 2007.  I won’t deny that going home to San Francisco is making me a little sad.  I suppose that whenever any chapter of your life comes to a close, that is to be expected.  All the same, knowing that I’m never going to be a college undergraduate again is a sobering thought, conjuring up images of middle age and laugh lines.  Everyone looks forward to college (or back upon it), saying that these will be (or have been) the best four years of their life, that this is the time when you will have the greatest freedom with the least responsibility.

For me, to a certain degree I came to the University of Washington with the (albeit embryonic) purpose of making it into medical school.  There was a point when I decided that was what I wanted to do, and that would be my top priority.  Social life, extra curricular activities, heck, even leaving the U-district were all generally subordinated to that purpose.  Reflecting now on that decision, I’m not unhappy that I made it . . . but I do wonder whether or not that was the best choice.  After all, you only get one life, and so it behooves us to make the most of it before it passes us by.

But that is not to say that I haven’t had good social outings, made good friends or had amazing experiences.  I have done all these things, and I know that I am happier for them.  We’ve played hide and go seek in the dark in the common room on L2, we’ve gone to Discovery Park and Gasworks, we’ve gone sailing, played sports, went to parties together.  We’ve laughed, cried, studied, worked, played, lived and loved protected and supported by each other’s friendship.  One would think that these memories would be enough to make one happy, and believe me they do . . . but in characteristic [me]-fashion, I wonder if it’s been enough.

College has really changed me, and I don’t really know if it’s been for the better or for the worse.  I got to strike out on my own, arriving in Seattle knowing nearly no one, and now I know I will drive home with tears in my eyes for the people that I will be leaving behind.  All I need to do is walk around campus, and the memories of times both good and bad come rushing back; I remember cuddling on a warm night over here, or dispiritedly sitting with my head in my hands on the bench over there.  This place and these people have been my world for the last four years.  This place has seen me both as the happiest man alive, as well as so low I thought no one here would care if I simply fell off the earth. The times I have spent here certainly have been ambiguous, but one thing is to be certain though; in the years that I have been here, I have lived.

Maybe that is all I can really ask of a place or time in my existence.  These years have probably seen the single most happy moments, as well as the most sustained sad times of my life.  I cannot leave here and say in full honesty that I have loved my years here, but maybe that is not entirely a bad thing.  Life after all is made up of both good and bad, and perhaps living means experiencing both and everything in between.  I’ve gotten the feeling that life is more than climbing into an Orgasmitron of perpetual bliss, and that the real living happens just as much while you are riding a high as you are while slogging it through a low.

If this is the case then, then my time living and learning here in Seattle has been well spent.  I would like to take a moment to thank you, UW for your acquaintance; for the people you have introduced to me, and the challenges and emotional blows you have dealt me.  These years have not been wanting for it’s ups and downs, and for that I think I should be grateful.

And thank you too, all the amazing people that I have been able to meet here, even if I’ve only known you for four weeks or the entire four years.  You, perhaps even more than the University have changed me as a person; you have taught me many lessons, many of which I suspect I won’t know I have learned or won’t fully appreciate until many years from now.  I cannot say that these four years have been the best of my life, but I can promise you that that I have certainly lived during them, and for that I am grateful.  Take care all of you, good luck, and best wishes to you all on whatever path it is you choose to walk.  I am so happy and privileged to have been able to meet you, and it is without reservation that I say I will shed tears for our parting on the drive home.

Life, I think, is not just all about the good times, it is about the bad times as well.  I have seen my fair share of both here, and so it is with a heavy heart that I walk away from the life I have lead at the University of Washington.

Cheers.

“It well may be
That we will never meet again
In this lifetime,
So let me say before we part
So much of me
Is made of what I learned from you
You’ll be with me
Like a handprint on my heart.
And now whatever way our stories end
I know you have re-written mine
By being my friend . . .

Who can say if I’ve been changed for the better?
But because I knew you
I have been changed for good.”

-Wicked

On Giving and Gross Anatomy

December 25, 2007

Of late, school has gotten rather hectic, and it has cut down somewhat on my writing time.  And so, here are a few pertinent entries I’ve made on my old xanga that I thought I’d transplant here in the meantime.

On Giving and Gross Anatomy, Posted Dec 25th, 2007

It is Christmas Eve, a rare quiet night in the house, and the lights of southern San Francisco are particularly pretty this evening.  On top of just having finished my first block of medical school, I think now is as good a time as any to reflect in general, but tonight on giving in particular.

They always say it is better to give rather than receive; that there is more joy in making someone else happy than in simply being the recipient of some worldly item.  I had to make a run down to Stonestown today to pick up a last minute gift as an errand for my mother.  It was a quick in and out operation, but I lingered for a while, and basically just wandered about people watching.  I got to thinking as I meandered around the mall about all the gifts that these people are buying, and how tomorrow morning there will be droves of happy children, spouses, parents, friends and relatives gleefully tearing open an assortment of gaily wrapped presents as the purchasers look on.  But then Boxing Day rolls around, and the 27th and 28th and January and February and March, and people start taking those gifts for granted, plucking their gifted clothes from the wardrobe or cashing in their gift cards without a thought as to how it came to be in their possession in the first place.  I’m not trying to make a judgment (lord knows, I’m lucky if I can remember who gave me what long enough to fire off the thank you cards), but an observation of how these gifts that we receive soon blend into our other possessions, and thus lose the transient luster conferred upon an item carefully selected, gift wrapped, and given in love or friendship.

However, there are always exceptions, times when you get ready to put on that wrist watch your mother gave you two years ago at Christmas, or pull on the battered baseball glove from your 19th birthday (yes, I know that most normal people get baseball gloves when they are like seven, but I was a bit behind the curve).  You get these items out and you pause, and you remember and appreciate not just the gift, but the person who gave it.

Last week, on Tuesday the 18th, we took our Anatomy final and I saw my cadaver for the last time.  Unfortunately I missed my chance to pay my last respects to him before he was sent off to be cremated.  To be honest, I felt quite guilty about having missed my chance, which I attribute to not properly honoring the amazing gift that the body donor had made.  I imagine that it is not an easy thing to give up your body to science, to allow the remaining physical husk of the person that you once were to be picked at and prodded by medical students with good intentions but unpracticed hands.  Even so, it cannot be reiterated enough just how amazing a gift the donors give to us; through their donation they not only teach us anatomy in the most basic sense (the head bone is connected to the neck bone . . . ) but also a whole spectrum of valuable lessons that are generally not contained in textbooks.

They have given me the gift of wonder at holding a human brain in my hands, they’ve taught me how to work in a stressful situation with a team, why you insert a chest tube above a rib rather than below it, as well as that no matter how lifeless, mutilated and cold the body was on the table, that the instinct to hold his hand was always subtly present.  I bring all this up because I want to thank whomever it was who donated his body for that amazing gift, for allowing me the chance to learn these amazing lessons.  I sincerely hope that as I continue my medical carrer that, like a well-appreciated present, I will remember this gift and the person who gave it.  When I place a femoral catheter on the medial side of the femoral pulse, I hope I will not forget, and still be able to pause from time to time and remember the amazing gift that has taught me that and innumerable other lessons.

This is certainly the season for giving, but it is also the season for valuing the gifts that you have received, and recognizing the people who have given them to you.  It is thus in this spirit that I wish to say thank you to my cadaver for the use of his body, and to reassure him that his sacrifice will not be forgotten.

I hope that is not too morbid for you guys, especially now on Christmas Eve (well, Christmas Day now, but whatever).  At anyrate, merry Christmas everyone, and best wishes to all of you in the new year.

Why I Want To Be a Doctor

November 4, 2007

This is another one from the old vault.

Why I Want To Be a Doctor, Posted November 4, 2007

Perhaps this entry is coming about a year or so too late; after all, I am in medical school now.  But back in those pre-med days it was all about the hypothetical.  Now I’ve gotten to experience some of it, and I can finally speak to some of my motivations for becoming a doctor in a concrete sense, without being forced to extrapolate my reasons for making this effort.

The best way to explain this might be with a small scenario I watched play out at a clinic I volunteered at last weekend.  At this particular clinic, one often sees sex workers, drug users and the like, and this particular patient had gotten an enormous abscess from using a needle that was not sterile.  An abscess is basically a huge pimple under your skin; it is the result of some infection, and over time if it is not treated you find yourself with a compartment under your skin filled with pus, blood and general unpleasantness.  The way one deals with this is first to numb the area, lance (puncture) the abscess, and drain the fluid out.

Being about the most junior medical student at the clinic that day, I got to watch as the second year medical student, under the supervision of our preceptor, prepared to cut open the abscess with a scalpel.  I’ve sat here and tried to do my best to recreate the scene in prose, but I think the situation is best described by a small poem I wrote shortly after watching the scene (please forgive my sad, limping poetic abilities, but it was better than anything else I could come up with).  For want of a better title, I think “The Student” will suffice.

A sterile field, gloves and face shield on,
The student prepares to lance an abscess.
She’s never done this before and she’s nervous,
But this is medicine; you must learn some things by doing.
Her face is collected and composed,
But behind her eyes she is awash in trepidation.
The doctor yields to the student,
And she comes forward and looks to her task.
She takes the syringe and touches it to the patient’s skin,
But her hands betray her composed exterior;
They tremble.

Hopefully that communicates my thoughts better than plain writing.  I suppose that the real moral of the story is that this was an incredibly human moment that I got to observe.  They told us in one of our inspirational, “welcome to medical school” lectures that as physicians we will gain “a unique view into the human condition.”  I have gotten the impression that in some of my most memorable experiences with medicine, this has truly come to pass.

I want to be a doctor because it means that I will get to feel.  These feelings may not always be happy or sad, but the one thing I feel I can count on is that they will be intense.  As a doctor, I think you are privy to some of life’s greatest triumphs and tragedies.  And more than simply observe this drama, you get to participate.  Already, I feel like so much has happened.  I’d never seen a mastectomy before Tuesday, but after shadowing an oncologist that morning, I had seen and felt at least a dozen, and got to speak to the brave women who live with them.  I got to see the courage of these people who have sacrificed a very physical piece of themselves to cancer, while still living under the constant fear of a fresh relapse.  And on a much smaller, but perhaps more personal level, I got to see the strength of that second year medical student as she tried to master her apprehension and go forward with her task.

Here I have done pelvic exams, prostate exams, successfully drawn blood, and have spoken with people who knew they were going to die.  Not all of these things are happy things, but they have all been profound, and that is why I want to be a doctor.  This is all something of an adventure, where I get to learn about the world around me, as well as myself.  I don’t know how I will react when someday I will find myself standing over a real human being with a scalpel in my hand, or when I am trying to resuscitate a patient who may or may not die under my treatment, but I do know that I will get to do these things.  And that, I feel, really makes this line of work particularly interesting.

The Adventure

September 25, 2007

And my last of the ‘dug out of the archives’ series:

The Adventure, Posted September 25th, 2007

Well, it’s been about three or four months since my last post just before leaving Seattle.  Three months can be a long time . . . or it can feel like it’s whizzed by so fast.  June, July, August and now September have been ridiculous months filled with all manner of crazy stuff.  Since that post in June, I have worked at Camp Mather, broke my thumb, had my thumb rebroken/had surgery, slept under the stars, and learned to drive a stick.  I’ve matriculated into medical school, met 110 new amazing people and studied from sunrise to sunset with some of them.  I’ve improved my ping pong game and play a lot of ultimate frisbee.  I’ve volunteered in clinics, moved into my apartment, stabbed patients with needles and drew my first blood sample.  I’ve learned how to use a stethoscope, how to find a hernia and the proper technique for rectal examination (on a live person!!).  I’ve cut open a body and held a human heart in my hand.

I suppose where I am going with all of this is a lot has happened in the last few months, and some of it not trivial, lightweight things.  It’s no lie when I say this medical school stuff has been a bit of a mind trip.  I mean, I’ve poked people, REAL people (patients!) with a needle and they let me do it!  No one jumped up and said, “Hey, what the heck are you doing?  Weren’t you just an average Joe-off-the-street four weeks ago?”  Instead, I’ve gotten to sit down with patients and ask them questions, and bring my meager clinical knowledge to bear on these people’s back aches and toe fungi (under the supervision of a real doctor of course), draw blood tests and recommend drug treatments.  If this isn’t the craziest crap in the world, I don’t know what is.

This whole thing is one huge blend of terror, excitement, self-doubt, self-confidence and overall amazement.  Today we learned how to do rectal exams.  How does one learn to do rectal exams you might ask?  Well, I read about it this morning (only this morning because I had been studying for a quiz last night), attended the lecture, and showed up in the exam room.  Once there, we review the technique for the genital and rectal exam with my Doctoring Group teammates, met the models we would be practicing on, and off we go to putting lube on your finger and sticking it up someone else’s butt.  Everyone (except the model, who was probably more amused than anything else) was terrified, but we did it, and now we know what a prostate feels like.

The same with my first successful blood draw.  My first week at the clinic I got blood out of a courageous second year medical student,  and went off to try my hand on two patients, from whom I failed miserably to extract a single drop of blood.  So then the second year medical student helping me stepped in and got blood on the first try.  (The fact in and of itself that because of me and my fumbling these patients left the clinic with more holes in their arms than was strictly necessary is a somewhat troubling thought that bears more consideration in a later post).  But one must learn how to draw blood, so in my next clinic visit I tried again, this time under the simultaneous instruction of a third year medical student and the patient via interpereter(who herself had been a pleobotomist in Mexico).  But this time low and behold, I actually got blood out of the patient!  And that is how things seem to go in medical school.

Right now we are studying our butts off learning physiology, anatomy and the like.  But all the same, we’re “student doctors” and with that title a plethora of doors open up.  People in the clinics let you poke them with needles and ask them awkward questions, while models are paid so we can learn how to do rectal exams.  I suppose really where I am going with all of this is that medical school so far has been everything I’d dreamed it might be.  I get to do stuff here that I would never ever had the chance to do anywhere else.  And I’m learning so much; at random moments, the stuff they say in ER actually makes some mild sense!

I dunno guys; I don’t want to sound conceited or braggy.  It’s just that I’ve wanted this for so long, it’s so amazing now that I can be here and live the dream.  During a particularly nasty period of studying, I was complaining about our work load.  One of my classmates looked up and said to me,”But really, is there anything else you would rather be doing right now?” and the fact of the matter is, the answer is no.  Things at [school] might get scary or difficult, but there is nowhere else I would rather be, and nothing else I would rather be doing.  Maybe things will change with time and routine, but for now, this is exactly where I want to be.

“I wanna have the same last dream again
The one where I wake up and I’m alive,
Just as the four walls close me within
My eyes are opened up with pure sunlight
I’m the first to know
My dearest friends,
Even if you hope has burned with time
Anything that is dead shall be re-grown
And your viscious pain, your warning sign,
You will be fine . . .”
-Angels and Airwaves

The Midnight Train to Georgia (another from the archives)

April 5, 2007

Thursday, April 05, 2007

The Midnight Train to Georgia

After I got wait listed at BU a few weeks ago, I had a phone conversation with my father, in which a rather interesting aspect of life in general came to light.  Namely, I came to realize that doing hard stuff is actually kinda hard.  Perhaps more concisely, it has been the increased recognition of what exactly “hard” looks like.  I freely acknowledge that I am young, and simply by virtue of living in the United States, just about anything that I might regard as a hard or difficult pales in comparison to the struggles of others.  That said, I don’t think think that I’ve bumped into anything quite so difficult in my life as my ongoing attempts to gain admission to medical school.

They say that it doesn’t matter whether or not you get knocked down, but whether or not you get back up again.  Quite easy to say or to write, but I’ve started to find myself on the receiving end of a few knock-downs, and it has been interesting watching myself deal with it.  I’m sure you are all familiar with my sob story of working hard to build my pre-med hopes (if not, suffice it to say I worked hard on it and whined about it a lot).  Complaining aside, I’ve worked hard to get myself this close.  And I am close.  Five interviews, two waitlists, two pending decision, and one still to come.  Either of those two wait lists could have been the end of the game; a fat envelope and no worries until matriculation.  But they didn’t break either for me or against me; the damned coin landed on its side and so I wait.

They told us in Psych 101 that the real risk takers are the ones that pick the moderately hard tasks.  The others choose tasks that are too easy, because they know they will succeed, or tasks that are too hard because they know that they will fail.  The moderately hard tasks are the ones that might just be in reach; failure here means you can’t blame the task anymore.  This time it’s a very real possibility that the fault is your own.

I’ve never really taken the time to step back and look at how massive this task truly is; it’s taxing not only on your mental faculties, but on your emotions as well.  It’s hard to scrape the guts together to make that jump, to stretch for that thing which might just be in reach.  It’s hard to work so hard to get yourself to a point where the best you can say is “Well, at least now I’ve got a chance.”  This shit is hard, and the lumps along the way hurt like mad-crazy.  It’s hard because wanting it isn’t enough.  It’s a big part, and often it’s what decides in the end who will make it and who will not.  But when push comes to shove, you reach a point where you can’t try anymore, and you’ve got to let your fragile, hard-wrought aspirations go out there all alone to do battle with the adcoms.  Maybe it’ll come back in a fat envelope, but maybe all you’ll get is a form letter wishing you, Dear Applicant, the best of luck “in your future endeavors.”

Having your hopes returned to you piece by piece in thin little envelopes is hard.  But then, as my Dad reminded me, nobody ever said this was supposed to be easy either.  If you want it, you cobble it all back together and you try again, sending your hopes and dreams out again and again to get buffeted and beaten by those who have seen so many dreams laid waste one more doesn’t really matter.  If you want it, you get up again and that is hard.  They call it hard because not everyone can do it.  They’re not messing around anymore when they say this is going to be difficult.  They mean it when they say some of you are going to fail in this endeavor, and by implication, that means it could be me to whom they are referring.  That is hard, knowing that it could all have been for nothing.  It’s hard to keep working on something that may be a lost cause anyway.  The instinct is to cut your losses and walk away, to make it stop sucking.  It’s hard to fight that instinct and come back for more.

I don’t really know why I’ve decided to write this now.  For that matter, I don’t even know if this makes any sense or if it does, if it is even relevant.  We’ve all got problems, and we’ve all got hard stuff we’ve got to do.  So for those of you that have suffered through all this self-centered, whiny, needy text, thank you.  *shrugs*  This has been a big thing for me, and writing where I know people might read it helps a little.

All that heavy melodramatic emotional crap aside, things are not so bad.  I’m playing more sports than I know what to do with, my classes are easy and interesting, and the weather is finally getting warmer.  The quad is beautiful, I’ve got a great summer job lined up, and a bed waiting for me in San Francisco if I strike out in medical school.  It’s just hard sometimes to come home and check your phone and email for good news that might not be coming.

“He kept dreaming that someday he’d be the star,
But he sure found out the hard way that dreams don’t always come true.
So he pawned all his hopes, and even sold his old car,
Bought a one way ticket back to the life he once knew.
He’s leaving on the midnight train to Georgia . . . ”

As a bit of an editorial note, I got into medical school about three weeks after this post.