Doctor Death

Photo by Phil Spiegel

Since a child I could feel a wind in my bones, something stirring under my skin, in my breath, in my bloody, pumping heart. Attention defective, speech impeded, psychologically charged, there were plenty of things to calculate and point to, but above and despite them was that same shapely shivering of my veins, the call of the moon, the hum in the trees. Something else ... something else...

I remember a distinct feeling on my 14th birthday, from nothing in particular, that I was destined for something, that I had a gift to be discovered. Dismissed as wanton importance I forgot about my youthful insight.

Long past the years and with them came too many passings of friends and family...

SR - 15 - leukemia
PH - 42 - Chron's
CA - 49 - heart attack
P - 24 - suicide
PPS - 90 - stroke, old age
ABS - late 80s - heartbreak, old age, diabetes
LEA - late 80s - kidney failure, diabetes
JB - 50 - heart attack
IH - 70s - medical complications
and just last month,
PS - 23 - medical complications

...to name a few. And to become so intimate with Death, comes a change inside, a determined fight weathered by a complacent acceptance. To digest tragedy with such calm sharpness is both a gift and a curse. I oft wonder where go my sentiments seemingly un-felt... do they hover unknown and ominously? do they dissipate in the beckoning winds? do they flutter constantly in my belly and root in the ever myserious faceless pain of my chest? Or is this my staff and sword?

Then some more years passed and I approached the time for my medical school departure. Floating back in time across a daylight dream, I remembered that distinct sensation and uttered aloud, "Oh I see now. I'm a healer."

Though my plate piles high it turns to stone and stands unwaveringly, but curiously weightless. And with each vivid crest I absentmindedly close my eyes and contentedly await the crushing waves, washing and drenching, but recoiling all the same. The ebb and flow of death and rejuvenation that turns the world over both steals my breath and fuels my flames and it is this constant cycling that forms the rungs of my ladder. I fall from time to time but somehow I never lose my ground. This is what keeps me bloody and pumping, this I know and this I trust.

So be it, a graceful torture, my gift: Doctor Death.

I welcome it all.

The Potential

Last week, over a GnT, my fellow clinic officers were giving me the low down on the psych clinic I'll be co-managing for the next two years. As is expected in a bitty place like Cowtown, one officer ran into an old fling at the bar. With mild discontent, she turned to me and asked if I were dating anyone, and, as is expected with a love-drunk, heartbreak veteran like myself, my romance skeptic answered first, "maybe," trained never to assume the best but always the worst (in this case, it's in my head or a ploy of ill intent). Being a third year she instinctively offered my lowly M1-ness some advice, or really, no advice at all, to just "go for it," saying this is the year of exploration. She told me about her first med school interests: the first was "false" and the second was "too good." With the last she explained, "not 'good' in the sense that I'm not worthy, but that I'm too..." and here she quoted an old movie I thought no one watched: Anne of Avonlea. Anne's best friend Diana has just accepted a marriage proposal to a good man, much to Anne's dismay:

Anne Shirley: Fred is... extremely good.
Marilla Cuthbert: That is exactly what he should be! Would you want to marry a wicked man?
Anne Shirley: Well, I wouldn't marry anyone who was really wicked, but I think I'd like it if he could be wicked and wouldn't.

There's a precise moment when you meet someone new when you know beyond doubt whether or not they are going to understand you. This was it. "Exactly," I replied with flourish. It's not that she and I are wicked but we've mischeviously flirted with that edge, well intended of course, and to find a kindred spirit in another would be to match heart to heart, the same potential for... cleverly playful behavior. What is intriguing about this new development of mine, is that, new for me, his cards are played close to chest and I, for once, can't read him with the definitive reassurance I usually have. I suppose this is what everything is supposed to be like, not to know, but to play to find out.

Serotonin

"If you're happy and you know it clap your hands..."

As bitty-bye kinderkids, we learn our lefts and our rights, our rights and our wrongs. We learn to share, we learn to care. We learn to stand up and to sit down, to speak up and to speak out, to zip, buckle, and bow. We learn to dot, we learn to cross, and to stay inside the lines. Simon says this and simon says that and we eat it up with our paste and crayons.

As young adults with our growing pains and acne, we learn ego and we learn id. We learn judgment, we learn rejection. We learn to question. We learn to challenge. And we start to change.

As masochistic medical students we learn our limits. Fifty two lectures on a quiz, thirty six hours on a shift, and twenty four usable hours in a day. We learn to count down, we learn to cross fingers, we learn to never give up ever ever ever. But we're never taught how to be happy. We're never taught how to live with life. We're never taught keeping in touch and how to sleep in. We're never taught how to relax. We're never taught what defines friendship. These are things we find, things we pick up, things we cope with.

Slowly I've given up my destracting, destructive vices, one by one, and I'm now left with this gaping void, this vulnerability, just skin deep. I feel a fragility in my breath and slowly am coming to realize that I'm finally catching up with myself. It's like the blood has finally rushed back into my body, as if I've been dead for these past 25 years. It's a peculiar thing to describe. I've been lost for so long, and now that I am finally exactly where I mean to be, I can finally take the world off my shoulders, put down my bags, and call this home.

Time to time when I'm driving home from school the waves crest and crash and it sucks the air right out of my mouth. I cry. I cry like a little baby. And I have no shame about it. Because I made it, despite it all, I made it. It's overwhelming, this gift. And it's becoming harder to forget how lucky I am to be here.

This is home.

This is me.

This is mine, my one and only.

You, Me, And Everything In Between

(photo: the late Francesca Woodman)

While getting my regular Radiolab fix this morning with Jad and Robert, I began a decent into my introspective meaty bits (I could lose days to this obsession of mine). The selected episode of the day was one analyzing the roots of fate and fortune. In one section, they suggested that good fortune in life may began early on in youth when a child learns about delayed gratification and how that leads to aiming higher and achieving greatness. Now I'm am not a greedy person but I have been known to indulge in the occasional immediate desire. Though I appreciate the benefit of self control and investing in the future, I don't believe in constant denial. All things in moderation, right? At the heart of Buddhist principle is spontaneity and how can one live in the moment if one is constantly focused on an undetermined, unpromised next event? On the other hand Buddhism is all about not giving into desire for desire is suffering ... so in the end I'm just as conflicted as the next kid. I believe in a bright, shiny future, but I have no illusions about entitlement. What I know for sure, as much as you can know anything for sure, is what I have right now and I'm not about to deny that in lieu of a dream, though I dream heavily and dream big. Does that make me less likely to succeed, because I flirt with the present? That seems pretty shitty. In fact, I'd be ok achieving less if it means I get to live a little.

Granted they presented all sorts of convincing data in favor of this idea, success still seems to stem more from a growing sense of self worth and confidence. In effect, good fortune comes from within, from this thing we call self esteem. Growing up and going through all that yucky life stuff like death, rejection, failure, betrayal, &c, I developed this sense that if I wanted anything I'd have to fight for it. Nothing is going to just majestically flutter onto my plate, I'd have to earn it.... and even then it's no guarantee. Hand in hand with that I never gave much thought to how I came off or what people thought of me, I was just too focused on my constant tête-à-tête with reality. Any wax or wane of my self esteem had little to do with my environment and everything to do with my mind, which leads me to my closing argument: perspective is everything.

When realizing that all my previous downward spirals came from an inner battle with myself and not a me-against-the-world phenomena, I had a profound moment of insight. I was choosing to have a shit time with life. Having a bad day was, for the most part, my doing, in the sense that I was choosing to respond with perpetual self deprecation and negativity. What does this have to do with good fortune and success? To bring the pieces together, if I am successful at all, it has little to do with whether or not I deny myself indulgences and everything to do with choice and assuming full responsibility for the ensuing pattern of consequences.

Life is too short and you only get one. So if it hurts, you're doing it wrong.

---

Somewhat related side note: The one thing I can't wrap my mind around in medical school is this notion of prestige. Yes it's a bitch to get in, and yes most people dont, but to me this is just another thing I do. I am uncomfortable with this imagined hierarchy and societal ranking. Maybe I'm missing something but I think we're all tangled up together and that the success of the doctor has just as much to do with the confidence, trust, and respect of the patient and fellow medical staff. They are not mutually exclusive but depend on each other. In relation to self esteem, I suppose this means that if you're feeling low about yourself then I have some shared responsibility to help pick you up again.

We're a team. You, me, and everything in between.

Be Cool, Honey Bunny. Be Cool.

What is it about a person that reaches up and grips you, right in the ribs, and holds you? What is it in the look, the touch, the smell of them that peculiarly gathers up the senses into profound liberation? What is it, if a thing, that marks them outwardly to inwardly, for painful lack of expression, as "cool?"

What is this transcending coolness we envy, evoke, and envision? A week or so ago my sister asked me what precisely this cool thing was that we've come to torture over the centuries and what I had to say, I sensed, unsettled her quandary more than quenched. You can look it up, there will be words to dissect words. They have been deemed by Merriam and Webster to be an adequate answer to this inquiry, but if that were all that is "cool," it would soon, in its own due time, fade into a sorted blandness, deprived of all its sensationally capable meaning, as of't becomes of abused vocabulary. It's not merely an aesthetic appreciation, a determined nonchalance, or confronting harmony. It's a breathtakingly pure honesty, rough and raw.

What it is, is something personal, something splendidly oblivious in possession, something that grows in your bones with blood cells, cartilage, and fat. It seeps from your pores and drips from your eyes. It swims under your skin and bounces in your gate. It's unavoidable when it takes you and we all know it, all but you. The most beautiful thing about it is how unaware you are that you have it, and the most excruciating thing about it is how completely aware I am. If it were possible I would pluck out your eyes and exchange them with mine and pull your brain into my bleeding split skull and share my reflections with your blinded hemispheres. Friend, lover, foe, or family, what confirms the suspicion of coolness, just so, is exactly this humbling humbleness, however unintended, however ignorant of that fact. It's a sobering honesty, and enviable oblivion. You just are, and have always been, with suffering justice in terminology, a straight up, brilliant, fucking Cool. Broken, obliterated, fixed, or true, that thing about you that silences the encompassing world is innately indestructible. Fight it and flail all you want, but you'll always be cool.

Permanence

I have been known to temper my more sinewy thoughts with the occasional free writing exercise on scraps of paper, countertops, book covers, emails, lose them, and then find them years later. And when it happens that I rediscover these portals to a past I claim to forget, I am always caught off guard by how foreign the words sound. It is as if some other force had taken a hold of me and for that moment I am a stranger to myself. The lastest find from mid July 2006 is as follows, from unknown context, unedited, and raw. Enjoy:

If I were to take back my venomous, spiteful, hateful, hurtful, malicious words and pack them in a suitcase, lug that case into the back yard and set it on fire, there would still be ashes left. If I took those ashes and shot them into the ocean from a canon for the whales to suck into their infinite bristles with micro-plankton some Japanese fisherman will harpoon that motherfucker and fry that ashy flesh up and some poor soul will devour that beast only to crap it out into some backed up sewage pipe that'd burst in some field in middle America. Even if the earth were to unite that ashy whale shit with the dirt some plant will sprout out and some cow will eat that plant and that same cow will turn into the bloody lump I eat for dinner with pickles and lettuce. It'll never go away at least not while I keep reminding myself with every night alone, and not while I'm running with no place to go, or searching obsessively for answers in endless pages of fiction. I want to do something stupid. I want to carve my heart out and hang it from my tree. I'll smash it until candy comes out. I'll make soup out of it. Soup's good for you, it's half digested already. Steps one and two are all done, cut and chew, done and done.

Two Percent

According to some supposed tried and true personality profile, what I am comprises approximately 2-8% of the world's population (thank you Wikipedia). The first time I took said profile I was probably about 14 or so and took that as a confirmation in my weirdness and, let's use unique, my unique perspective and approach to thinking, experiencing, and understanding life. In a word, I was convinced beyond a doubt that I was destined to be none but a loner, lonely in company. It stopped bothering me that I made no sense to most people and that their expression of such confusion was to categorize me as that itchy word, "quirky" because apparently I only made sense to 2-8% of the population anyway so it was only natural that I'd stand out, be separate, and alone.

Then I came to medical school.

And it was impressed upon me further how dissimilarly minded I am exactly. I'm not just a kinetic learner, but auditory, and visual and and and. I actively involve every possible realm of sensation I can and not quite out of want or desire but a sort of necessity, like an unquenchable thirst for a full, surround sound visceral experience of everything. Beyond that my brain is a potential I have only barely tapped. There's something stirring in there and it's big and exciting but it's horribly trapped behind all my other superpowers like my anti-routine power, my functional insomnia power, my constant rapid cycling thoughts power, my alarmingly accurate intuition but still suck at tests power, or my unnerving ability to compartmentalize and digest life's little horrors in split seconds power...

I'm still working on my living up to my potential power.

But somehow, despite all my splendidly frustrating uniqueness, I managed to find not one but a small crowd people who are as deliciously different as I am. Point in fact, one of them is the exact same kind of 2-8% as I am! And another is simply pure magic, the kind that feels like finally all the madness that got me to this exact point was worth it, like this is what I was fighting for. Suddenly through this most terrific of discoveries I'm not an island, I am not lost in the 92-98% of normalcy. The world is once more a blissful scale of greys, no longer the white of them and black of me.

I'm still weird and different and not like most people but in this great big small world of six degrees and Kevin Bacon, I found a home where I am no longer threatened by my separation but finally at a point of embrace. Still a round peg in a square world but I am completely falling in love, beyond a reasonable doubt, with my curious 2%.