Medical Care is like Car Maintenance

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Dream Weaver

I have been known to have strange dreams in the past.  I have had enough situations where I've woken up feeling dazed and confused.  Most of my dreams really make no sense (see this post).  In other words, I have come to terms with the way my mind works when I am sleeping, and I deal with it.  But last night's dream was really, really too logical for my normal dreams...

Apparently, some time in the next 3 years, I decide to go on a six month mission trip to some remote village in Africa (think Sudan/Ethiopia/Kenya area).  It was actually that realistic.  I knew I was south of Egypt, and in an area of great unrest.  I also apparently was traveling with "The Next Food Network Star" crew because we were filming an episode that involved cooking ribs in the style of the native village where we were living (so much for being realistic...).  We were supposed to be safe, but in the middle of the rib cooking event, gunfire breaks out.  We have a group of about 15 US citizens, including some rich woman and her four year old daughter Christina, and as far as I can tell, our camp only had one African woman and her two to three year old little girl.  Anyway, I scoop up the two little girls, and we hide in a pile of clothes in a closet (because that was clearly the safest option to running, right?...maybe I lied.  Maybe my dream wasn't logical at all).  I remember telling the girls to be quiet (which somehow they were...not in typical little girl style for sure, another discrepancy with reality).  Our camp gets searched, but somehow our pile of laundry hideout is spared, and the next day we walk out to the utter destruction of the surrounding village.

At this point, the dream turns into

1.  Must find the rest of the Americans because they clearly won't be able to survive without my expertise.  I come to find out that along with being, well, a doctor, I'm also apparently a master navigator, fisher-woman, rock climber, musician, and general team morale booster...oh the coats I wear!

2.  Must navigate from Kenya (which I'm pretty sure is where I was, come to think of it) to the US embassy in Egypt (not sure why I picked Egypt, guess it seemed like a good idea at the time)

So I collect the girls (the little African girl's mother was killed by the ambushers, so in fine American style, Christina and I name her Natalie); I collect all the medical supplies I need (which conveniently fit in a single backpack and is enough to take care of the 20 person crew for the entire trek to Egypt) and my guitar (because I now know how to play said instrument, and frankly, it kept the family together) and we head off in search of the rest of our pack.  Which we find and I proceed to keep everyone alive and get us to the US embassy in Egypt, and we all become great heroes in the US...yeah, I know, ridiculous ending.  But, in a nutshell, that's about how it went.  I teach everyone how to fish (and we somehow don't all get dysentery and die in good ol' "Oregon Trail" fashion); I know how to use a compass (just follow the needle pointing north, right??); and when we finally land in NY, I lead everyone off the plane in a resounding chorus of "After the Storm" (Mumford and Sons, my current musical obsession).  I also am told by the embassy that I can just take little Natalie to the US with me, no need to fill out any paperwork or go through the usual adoption hoops, she's just mine.  And I teach her our own version of sign language (the sign for "family" is rubbing your left chest in a circular pattern, "dad" is stroking your chin like you have a beard, and "mom" is stroking your hair...yeah, super creative).

Oh, and there's a documentary because the Food Network film crew wasn't going to just let us idly walk through the treacherous jungle without something to vouch for our efforts.  The dream ended with the entire Frends Crew (wearefrends.com ... yet another obsession of mine, gotta love my snowboarders) greets me at the airport with my family because they are just so pumped by the story of our epic journey through Africa (disregard the lack of pow to shred...or really me being at all cool enough for them, anyway).

So, I think this dream most likely stems from the fact that I feel inadequate and useless sitting around studying for eight hours of the day.  In other words, I apparently need to be having ridiculously memorable adventures somewhere that doesn't involve my living room!  I think I'll start with something a little closer to home than a war-torn country, though.  Can't get too adventurous too quickly, now can we?

Fail?

I'm not one to do movie reviews, and frankly, this isn't really a movie review at all. It's more like a reflection in the sense that "A Complete History of my Sexual Failures" got me thinking about my past relationships. I found it interesting that at the end of the movie, the narrator/failure/guy behind and sometimes in front of the camera found someone that he enjoyed spending time with. That, without making this movie, he would never had been running around in the street with high doses of Viagra coursing through his...well, let's just not go there...and he would have never met his newest girlfriend. Without rehashing his past failed relationships (and those numbers were astronomical) he would not have met someone so compatible. He's an independent filmmaker, and she's a journalist. I didn't expect this movie to get me thinking...in all honesty, I just imagined it would be an awkward 1.5 hrs of me on the couch embarrassed for the poor guy.

In reality, it had its super awkward moments (like the S&M part...so not into that). And it had its moments where I wanted to run and hide for the poor girls that had to sit in front of the camera and tell this guy about what was wrong with him. But it also got me thinking about what my past relationships would say about me. I suppose the entire purpose of dating other people is selecting potential long-term partners. But as we progress through the process, do we evolve in some way? By the looks of this movie, it seems quite easy to get stuck in a rut. Yet, it was a self-induced rut. Instead of taking the time to process why his longest relationship with someone he truly loved ended, he just threw himself into many relationships that were meaningless to him. He continued to try to move on without really moving on.

I think if there's anything that I have walked away with, it's an understanding that in order to move on to a better relationship, you have to find some way to come to terms with your past. I'm not sure I can say the best way to do this, and I'm not saying that we need to all go out and make movies of awkward interviews with people we've broken up with. I'm also not saying that I'm going to air my own, personal, dirty laundry here for the world to see. But, I think, perhaps, in the sanctity of my own private journal, I might actually take the time to figure out just what it is that I have been stuck on the past couple years. I think that was ultimately what "A Complete History of my Sexual Failures" amounted to. This movie was a public display of this guy's personal coming to terms with why he seemed to be dating the same person over and over with the same outcome of being dumped. It wasn't until he realized that he was still in love with his longest girlfriend that he could process why no other girl seemed to work for him. And thanks to his mother, he realized that this girl would never have been compatible with him. She wanted different things than he did (ie. kids and a family), and at the time when they were dating, they weren't on the same page.

I'm not entirely sure where I'm going with this. It's most likely the fact that I haven't really watched a movie in a while that made me think quite as much as this one. Maybe I'm reaching a point right now where I can take the time to rehash my own life. Maybe it's because I can feel how close I am to the edge of something new. Perhaps it's the fact that sometimes I feel like I've been sliding backwards down a slippery slope, and I'm not entirely sure my feet will catch hold and allow me to move forward again. Perhaps it's more that I wish I were at the end of my movie, sometimes, and that I had the ability to look back and see how all my past failures have made it possible for one true beautiful, loving friendship to form. Or perhaps even to see that friendship has already started, and that right now, I can't see it for what it is. If only I had the ability to look into the future and see what it holds in the partner department. All I can do is sit back and enjoy the leg of the journey I'm on right now, and hope that I will one day know what it's like to be with someone who truly understands me and I him.

Foreign Country

I was walking down the hallway in the hospital today on my way to clinic. As I passed by several empty rooms with their beds made and ready for their new occupants, I thought about what it must be like for a new patient coming into the hospital. I don't mean a patient with any sort of medical background or even a patient with a friend or relative with medical background; I'm talking about any patient off the street with little to no medical knowledge other than what his or her family doctor has told him or her. I imagined how overwhelming it would be. Forget the ED right now, the patient is brought to their new cubicle of a room that probably overlooks the wall of the adjacent building. They are swooped in upon by a couple people in scrubs that they assume are nurses. These people strip them bare, attach multiple cords to them that then make all sorts of loud beeping noises, they get stuck with needles that are then attached to more tubing. Another machine is squawking at them now. Then, when all this is done, the nurses leave. Just leave, and the patient is now alone in this tiny room, attached to multiple machines, with only a TV for company. At some point, the patient is descended upon by an army of people in white coats, the doctors, and are told a bunch of things that sound really scary. Are these things explained? Probably not. Does the patient ask for enlightenment? No. Why? Because he or she doesn't want the doctors to think he or she is ignorant or stupid. 

It was disheartening for me to think about how I walk into the hospital each day of my own free will. How I have some semblance of an idea of how everything is connected together. I understand the language to some degree. I just can't imagine the fear the average hospital visitor would have on entering. It's like a foreign country minus the tour guide/interpreter. Except, I would think it's worse because at least in a foreign country, you can ask the mundane questions without feeling completely humiliated. But in the hospital, there's a level of humiliation in the process. The patients know the doctors are speaking the same language thus making it all the more difficult for them to say simply, "I don't understand" or "please explain". The way we tell our patients what is wrong with them is in an air of superiority, again, making it difficult to allow the patient the security to pipe up when he or she is lost in the jargon. The constant sense of urgency, of lack of time, of rush makes the patient feel even more compelled to remain quiet. The "well, I just don't want to make my doctor angry by making them more late with my stupid questions" takes over. Sometimes I wish we could be more patient with the patients. 

Ramblings of the Sleep Deprived Student

I love cooking. Like writing, I don't think I realize how much I enjoy either activity until I take it up again after a period of inactivity. Surgery has been my two months of inactivity, but I'm starting to break free. On the weekends, I force myself to take time just for me. Like this weekend. Yesterday I spent the better part of the afternoon planting, enjoying the sun on my back, the soft, loamy first between my fingers, and the beautiful green of newly planted tomatoes and herbs. I await the day that the secrets of the seeds and corms I planted burst forth in splashes of color, a welcome "hello" from Mother Earth, herself. 

Today, I invented "everything but the kitchen sink" breakfast quiche. I threw whatever veggies I could find into a pan to cook, added eggs, milk cheese, and poured it all over a wonderfully toasty hashbrown crust. See cooking for me is something entirely different from baking (except bread). Certainly, similar tools are used, but cooking is much more like art, while baking is something of a science. Baking requires exact measurements, exact times, exact exactness. My life is the human version of baking. I have to be exact, precise, no more, no less. When I get home, I shed my perfectionistic skin for something more fluid, more dynamic. Like cooking. Cooking is all about a little of this, a little of that. Timing is when it's done. The ingredients change each time I make the dish, so it's never a clone of the time before. I like it that way. I have in my head an idea of what the end result will be, but the road to get there rambles, visiting different areas each time. It never looks the same.

Just like writing. I can write ten different poems about the same thing, and they will say it all in different ways. Each will have its own rhythm, some will rhyme, many won't. Some will be a more somber view, some seductive, others downright risque, but all talking about the same entity. When poems become too rigid, their meaning disintegrates, the reader is left feeling like they just weren't quite to the full meaning, and the author is left frustrated by the lack of communication. But fluidity, allowing for a moment the suspension of rules, constraints, the weights of life, and that's when ideas soar and communication meets understanding. Like love.

Love is indescribable. Everyone knows when they've felt true love, but no one can describe what it is. We all have images, moments that we describe when asked about true love. Mine is knowing that I never have to go through the most difficult parts of being a doctor alone; knowing that I can always talk to my mom and dad, that they will understand what I'm going through because they have been there before. Mine is knowing that my life jar is overflowing with the rocks that keep it full and steady, that make less room for the unimportant sandy small stuff while still providing support for the pebbles that ultimately help to fill out the enriched life I live. Love is knowing that there's one more special rock out there for me, and we're going to bump into each other one day while he's using my yellow umbrella to keep the rain off him (HIMYM reference, fyi). Love is being patient enough to allow that moment to happen when and where it's supposed to. Like life.

Life is one's rambling across the timeline of the world. We each are like ants following the scented trail. We all have an idea of where we are coming from, and a semblance of an idea of where we're going. But watch the ants sometime. Although they are all following the same trail, each one has his or her own unique way of tracking it. Each ducks, weaves, and swerves across the path in a different way. We are all like those ants, we know where we've come from and where we are going, but our paths are all different. I suppose at this point I've rambled on enough about nothing and everything. I have lost found and relost my train of thought, my organization waxes and wanes. Perhaps one day I'll be able to make sense of it all.

A New Nugget

I feel my creativity has all but run dry recently. I have had the energy sucked out of me by keeping it up for everyone around me. I think it's part of being a medical student. I can easily put on the face at the hospital. That's not to say that I don't love what I do. I just find that all of my energies go into being the best I can at the hospital. I just feel like when I'm done with the day, I have little energy for anything else. I wish there was a way to have more energy.

I also feel like I need to write more. I need to do more creative writing. I miss it. I've decided I'm going to start writing stories about my new pet. His name is nugget, and he is a monkey. He's actually a stuffed animal, but I think it would be fun to come up with adventures for this new little guy. He is precious and I'm sure quite mischievous. Right now, though, he is a little subdued. He's trying to get used to his new house. He says that the store where my cousin found him was horrid! He had to sit on a shelf with little food and it would get so cold and dark at night! He is very glad to be here, and has found a favorite spot to sit:

He is still working on getting used to Chewy. He finds that Chewy reminds him a bit of a lion. I keep telling him that Chewy won't eat him and probably doesn't care about him at all, but Nugget doesn't quite believe me yet. I'm sure he'll get used to Chewy, but for now, he much prefers sticking as close to me as possible :) Needless to say, I'm sure he'll have plenty of fun adventures in the new year for me to write about and allow me to use my creative writing minor for something other than a conversation piece.

Hope is a Sense of Calm in a Sea of Turmoil

Today I learned probably the greatest lesson in medicine. It had nothing to do with learning about asthma from probably the smartest man in pediatrics at Wake Forest. And nothing about learning about various chemotherapies, their uses, side effects, etc. etc. It had nothing to do with the biochemical, physical, biological mumbo-gumbo that makes us doctors pretend we're smart. I learned today that sometimes, the greatest message a person can bring is one of hope. Hope that, even though it's the darkest hour of treatment, you are not alone. There are others that have gone through these same exact moments before you, even at the same time as you. I learned that simply by saying, "everything is normal", it provides hope. Hope that as scary is it may seem right now, everything is going exactly as expected. That after feeling awful for right now, you'll start to feel better. I am awed by the power a message of hope carries. Humbled that I can provide that message. It's such a wonderful feeling knowing that simply by being present and continuing to be present, even after I've rotated off-service, I can help someone keep fighting through even the worst parts of their treatment. I am humbled and honored to be a doctor-to-be.

Word Salad

Psych's got me thinking: how abnormal do you have to be before you becoming pathologic? How messed up do your thoughts have to be before you are commitable? How eccentric is too eccentric? It's interesting to look at each patient and think about the parts of their personalities that are normal, and how the abnormal parts could be consider normal in other circumstances. For example, the bizarre thoughts and ideations of the psychotic patients could sound very similar to the bizarre reality of someone's dreams. I mean, I know in my dreams I can do just about anything, and some of them are completely off the wall. Yet, when I wake up I know they're dreams and that I'm not going to act on them. Sometimes I think I do hear my name when walking down the street, but it doesn't mean I am psychotic or becoming paranoid. Yet, in another person with a different psyche, that's exactly what happens. They act on dreams and become paranoid of nonexistent voices. They believe the dream world is a reality they have to survive. We are somehow incorporated into their worlds, and to us, it's scary. It shows us that our dream worlds could also become a sort of reality if we let them. It opens our eyes to a world we only ever imagined but never thought could be real. It's like Alice falling into the rabbit's hole. It's her reality but it's not the reality of anyone else. In the end, it turned out to be a dream even though it seemed so real to Alice. What happens when we wake these people up to what we consider to be the true reality? To the patients, does it just seem to be an alternate reality? Do parallel universes exist and we just choose the one universe that everyone else seems to be living in? Yet, are these "sick" patients really just living through one of their other parallel universes? And when we medicate them, and make them "better", are we just ripping them from the universe they are in and bringing them back to ours, the "correct" universe? And when they react angrily, should we think we failed or realize the pain involved in being pulled through space and time into a completely different arrangement of thought and ideas? Do they appreciate the tug? Do they want to be dragged back from their higher point of view? Do we really, truly understand what the world is like for them? And if not, why do we expect them to understand and accept our world as their new one?

Bring Me the Sunset in a Cup

Bring me the sunset in a cup
Let it's warmth caress my cheek
And remind me of our days gone by

Bring me the moon on a silver platter
Let it's dark side reflect in my eyes
And remind me of our hidden secrets

Bring me the stars on a gossamer thread
Let them dance around my neck
And remind me of your gentle touch

Bring me the sunrise in a chalice
Let it's spirit kiss my forehead
And remind me of our unbridled love

Bring me the rainbow in a satchel
Let it's colors envelope my body
And remind me of our passionate flights

Bring me the rain in a simple thimble
Let it settle at my feet
And remind me of our twisted past

Bring me the sunset in a cup
Let's sit beneath it's waning light
And remember ourselves again.

Reappearance from the Great Beyond

I feel like I haven't blogged in a while. In fact, it has been forever. Third year has officially taken over. Yet, I love every minute of it. Every day I'm at the hospital with patients, I feel like I come alive. I eat it up. I can't have enough of the whole experience. I'm hoping this is a good sign that this is where I'm supposed to be, even if most times I don't know where this is. Each day my idea of what I want to do changes. I'm just hoping at some point I figure out what I want to do with at least my first residency :D

I really want to be creative again. I know I can't force it, but I feel like I haven't been writing as much as I usually do. May try to write from a prompt a couple of times a week. Hopefully I can keep this up (starting with twice a week). It'll be nice to try being creative again :) Anyway, keep your eyes peeled for some creativity from this girl!