Forgetting to Remember not to Forget

"Make eye contact, but not too much, aim for 80%"

Introduce yourself, shake hands, sit down, give non verbal feedback, summarize, listen.

My professors have relationship building down to a scientific formula.

Sitting there in class I looked around to see if anyone else thought this lesson on patient-physician relationship building was as absurd as I thought it was. I mean, these aren't machines you have to figure out, no IKEA assembly required. They're human beings like you and me, right? When I performed our mock interviews later with the camera recording and thirteen of my classmates plus a moderator watching me fumble my way through a chief complaint assessment with a mock patient I could feel the formula creeping into my natural progression as I tripped over my own thought process. Definitely cramped my style. But this is a different world I'm in now, this isn't Venice Family Clinic, I'm not home, these aren't my neighbors and friends. This is the land of the professionals and figureheads. When I put that white coat on in four years I'll be bearing the weight of great responsibility and it's slowly dawning on me how big a change that is going to be. As I prepare for a hellish next few weeks I am beginning to feel a shift inside me. It's not painful like it was in grade school... and high school... and college. This change is more a natural evolution of perspective, of spirit, of mind and body. But I worry that I may inadvertently lose touch with my own person in the process.

It's so easy to forget myself, forget time and place, forget family and friends, forget the past and dismiss the present while I forge ahead for a pressing future here in med school. Finding time for laundry washing, bill paying, car refueling even, has become an annoying chore. It's easy to let that formula take over, to become a robot, a drone: study, eat, sleep, study, eat, sleep. This is a brave new world I have immersed myself in, and I have to remind myself consciously not to forget that I am a human, too.

But I must remark how frighteningly easy it is to forget your own humanity as you work to save the humanity of others. It seems a vicious cycle... unless I remember not to forget.

Don't forget.... don't forget... don't forget....

Life is Not for Robots.

While discussing stem cells in today's MCB lecture I wandered back in time...

An example of intestinal stem cells came up, and the first thing I thought about was PH. His funeral was one of the few if only where I cried, correction, bawled*, something I loathe doing publically. For some reason I have a complex about showing weakness, but Crohn's disesase is one of those plagues that penetrates, deep into the heart of you and everyone around you and will of steel or not it gets emotional. Remembering PH made me remember SR, that one was a very terminal, fast acting pediatric leukemia. SR made me remember SH, probably one of the most aggressive cases of breast cancer I've come across. And so on...

Given that I didn't know medicine would be my battle field until, truthfully, a year ago, remembering these people, these diseases, and how they did and still do affect me, how I've lost friends and family to other personal battles, how I nearly lost myself to my own -- have all given me a guiding light through these long steady hours of endless studying. Though I wasn't looking for it, life just sort of has a way of teaching you a thing or two about yourself. And what I'm learning, slowly and surely, is that I'm both bigger and smaller than I thought I was. I'm bigger in that I never thought I could achieve anything like this, no, not ever. And smaller because there is so much I have yet to learn, from class, from my classmates, and from life.

The last one is probably the most important. And something you so easily forget here in the receptionless walls of medical school.

This is the eve of our first MDQ. It's technically only worth 3% of our grade but it'll reveal if we've managed to master a semester's worth of material in a week and a half for a quiz that roughly covers the scope of an undergraduate final... I've taken maybe 5 hours of "me time" in the past 10 days... but today I'm taking it easy. It's not even 6 and I'm already in my jammies. I'm slowly learning how to center myself in all the crazed intensity around me. With my notes in hand it's a work in progress, clearly, but I'll keep at it.

--

All that we are not stares back at what we are. - WH Auden

3 - 2 - 1 GO!

It's 9:30 on a Saturday morning and I actually felt great starting my kitchen chores before rushing to school to meet up with my study buddy, because it was at least some semblance of a normal life. Med School is a whole different kind of beast. One of my M2 friends said there's something wrong with the M1's, we're studying too much too early, we're supposed to be out getting sloshed, she said. But as my study buddy says, working hard and wanting to do well is not gunning it's being responsible. My impression of what it means to be a gunner is someone who's just throwing fire wildly and intensely in the hope that they'll hit a target without burning themselves up in the process. My study buddy and I are more just terrified of failing, far too pressured and focused and determined to start mowing people over... ourselves aside.

What strikes me most about medical school is how easy it is to lose touch with reality. I went to a show the other night, tickets for which I bought way before I knew what new world of crazy I was entering into, and it was the most incredible release from long nights of academia. I went with two people who are going to become great friends of mine... both of whom condemned me for even thinking about classes while we were out. (I'm going to need to keep them close by for my own sake.) Something so mundane and common back in L.A. as a music venue became this medical-free safe haven of pure stress-free bliss! On my way to the gym this week, something I've taken to not for exercise but for sanity, I had to remind myself that just the day prior I was wrist deep in superficial back muscle of someone's grandpa. I had to take a moment to remember that this hunk of dissected flesh was once a person, with stories, with scars, with memories. It's so easy to forget, and difficult to digest why. Why do I not cringe when I see images of anencephaly or skin harvesting? Burn victims? At the same time I am not altogether unfeeling, no, I appreciate the horror and the sadness, but where do those feelings go? How do they dissipate so quickly? What is this person I am becoming? And what is she capable of with so few limits and a stomach of steel?

In the midst of everything I remain resolved to win, to conquer, to succeed. I say hi to anyone and everyone, keep positive, lighten the mood with my casual self deprecating humor... then I get 5 hours of sleep and push push push! There's a monkey on my back and it's telling me to stop writing and start studying.

Every day I am reminded that this is the happiest time of my life. I am in love with the people, in love with the school, in love with the classes, and even in love with Cowtown. And that is what will keep me going.

I made it. I am here. And I am going to rock. this. hard.

The Zero Hour

The past week has blended into a blur of orientations and meet-n-greets but the reality of my new life here didn't really dawn on me until I woke up this morning after 5 hours of sleep eager to hit the books again. I have finally become more fully a nerd of the worst... and best kind.

I've given myself this one first week of classes to get my rhythm down and as I told my housemate EF, MUST WIN MED SCHOOL.

--

Today we meet our corpse. After my stint in the ER morgue and reading Mary Roach's Stiff I feel at least emotionally prepared for this cryptic rendezvous. Now, anatomy is another story...

"Natural is better" (TM)

** interestingly this photo comes from a Stanford University site featuring an article about how Univ of NE is considering restricting stem cell research... that's a beef for another time... **


Being a devoted NPR listener, the first thing I did when I arrived in cowtown was find the NPR station. Every city has to have NPR to stay informed right? said the arrogant city girl to the ignorant country bumpkin. Right. Well. About that. I did manage to find an NPR station, between the hours of 4pm and 7pm. In the early afternoon it's bible verses and homilies and in the evening it's a jarring union of smooth jazz and rock, country rock. But throughout the day on several radio stations there are these wellbeing announcements to help you stay good and healthy, and informed between the hours of 4pm and 7pm. First there was the series "Worst Place to Put Things," where I was advised not to put my purse in the shopping cart because I would contaminate all my produce. Then there was the water distribution bureau advising me to stay hydrated, but preferably with clear water because, and this was sung in a jingle, "Nat-ural isssss better!" Hmm, I thought, as I remembered the cute pink haired girl stopped next to me at the traffic light in Hollywood, the requirement to have at least six visible tattoos to work at Intelligencia off Abbot Kinney, and my fellow western european Snow-White-pale friend who hits the tanning beds before trips to Hawaii. All that seems very standard to me but out here I'm beginning to get a sense of how very not-standard most of L.A. actually is compared to the rest of the USA. For example, traffic doesn't much exist outside of L.A. though when they do mention a slower commute on the wires out here they also add, "So don't forget to bring your patience." Patience? When driving? Bitch please. I mean, oh heck!

Clearly I have much to learn.

Home Sweet Mansion

The best part about getting out of L.A. is how incredibly beautiful it is everywhere else...



As you drive down the open highway the lights disappear, then the billboards, then all the noise, then all the people, and the world becomes so much bigger than you could possibly imagine. After growing up in one of the biggest cities in the world it's easy to lose sight of nature, of roots, of organic existence. But driving out here you see the raw, bare, open of the Earth and it altogether becomes a living thing, as it always has, but perceptively for the first time.



I loved my city life. I grew to appreciate the conceit, the noise, the crowds, the angst, the incessant dictation of the media. But out here, in this nothing, is peace, is civility, is calm and slow.




Over the drive out here my muscles released one by one into a pleasant looseness, weights of metropolitan tenseness built over 24 years, trickling off with the sweat of 110 degree heat. It was a purge of anxiety, of pollution environmental and subconscious. This is where I will find myself, where I will grow, where I will heal, and where I will become a better version of myself... far far away from the seething city lights.




Out here is everything I imagined bliss to be... that is, except for one thing...

When charting our route out here I decided to visit a place I've never been. Being great lovers of road trips my family's trekked over much of this half of the states but in the middle of that hot mess is a place that spelt disaster but I just had to see if for myself... just once...

..........

Take the worst crazy of LA, remove all the class, crank the temperature up 20 degrees and you have Las Vegas. You know you're there when through the car vent wafts a curdling stench of cheap hotel rooms, cheaper perfume, and cigarettes. It's the smell of sweat and desperation. Underneath the tacky lights and escort ads is a strict outward denial of and unconscious internal conformity to the illusion that is this city. Built on false hope, Las Vegas turns weakness and vulnerability into obscene profits. But the people, they come like little moths, tantalized by the flames, answering the call of a siren to the feeble minded.

And if the heat doesn't get you, the casino-hotel will. Lost in the labyrinth of our hotel as we twisted around dead ends in search of our alleged suite on the fifteenth floor, two similarly vexed and perplexed Scotsmen in matching kilts cried out, "How do you get out of here?! We've been here for three days!!!"

S: is that a hooker?
L: no, that's what over compensation looks like.

..........

After one short but much too long night in LV we hit the road again and just three days ago I finally arrived to cowtown USA, the great heartland, where I'm living in an old co-op style mansion. It's creaky and falling apart but the place has soul and you can't really beat $400/month for rent utilities and food.

So many elitist city folk (myself admittedly included not three years ago) have such narrow, harsh eyes for this land and its people. I hope in the next few years I can paint the real picture of life out here for all of you, from the converted eyes of a cosmopolitan girl attempting to wrangle the mid west country.

I can say for starters everyone here is every bit as nice, polite, and courteous as the word on the street, and it is doing wonders for my disposition. I almost feel it's illegal to get upset here, and I rather like that pressure to be good.

School starts in a week... we'll just have to see how long this peacefulness lasts...

Sequoia

Driving around with my grandmother today running errands she turned to me, after several wrong turns and swapped names, and in heavy breaths remarked how heartbreaking it would be to lose your memory, as hers makes its inevitable slow decline...

As my time here in my hometown comes to a close I have been preoccupied with the move that I have hardly given a moment's thought to what I'm leaving behind, as I make my dreams visionary. I am thrilled to be disappearing off into the great, exciting, and above all terrifically new world of medical school... but I find it curious. All I've ever wanted since I can remember is to go far far away from this place, to get away from constant reminders of lives past -- and now I'm leaving with the fantasy of blazing trails in neuroscience, with a specific aim at making a dent in the treatment and prevention of Alzheimer's.

Nothing terrifies me more than losing my memory. I do not believe in an afterlife, I believe in here and now, in legacies and footprints. What I cherish most is my mind and the entire capacity therein -- which means all my memories, good, bad, pleasant and painful. All I have is my catalogued experience of this world and I am a bit ashamed to have desired so strongly to erase, to run and deny.

I hope I may have the courage one day to grow roots, really plant myself, and embrace all the emotional costs that I am of the luxury to bare.

--

I will miss this tired place, but I look brightly to what lay beyond the great wide open before me...