Two Hundred and Sixteen, Carburetors

     Puttering along. No, that would imply I work in a factory or office setting. Unfortunately the profession I'm in is increasingly being run like a factory improving efficiency however the acceptable losses is still considered to be zero. Unlike carburetors–of which the worst case scenario is a flawed shipment costing $$$–people are not expendable. When a carburetor isn't functioning properly the usual treatment is to replace it.  Not so with human beings. There is no reason for a mechanic to be on call to fix a car emergently in a night.
     It is enjoyable though and satisfying. That little part that glorifies in fixing problems while interacting with people burns brightly every day for me. Although every now and then I fix a problem or two and then my patient happens to pass away from something else despite the improvement he or she had shown.
     But those thoughts are for another day.

Two Hundred and Fourteen, The Spark!

Often I'm reminded by a few friends why I need to stay in my college town. Why? They love me. And I do love them. So what pushes me to go away--far far away? My father went around the world for his education, then career, and brought me into the world here as well. Talking to him teaches me that none of it was preplanned. It just happened that way. With the sole exception of that first foray over here. What spurred him to it? That is what I wonder because I'm searching hard for that part of me that will send me off into the corners of the country. I need to know who I am and cut my own path through this world. I love my friends. At times I feel stifled by that love because I worry about meeting enough people to find some who think like me while hanging out in the same places. I need to get out and away--someplace where I can meet others in a similar boat and we can explore our new boundaries, such as we choose to set.

Another sun-soaked season fades away...

Two Hundred and Thirteen, Departures

I watch as some of my friends in the past month have proceeded to pack up their belongings and either move or prepare to move as their residencies begin, husbands return to jobs in other cities, and simple need to get outta Dodge sets in. Some of our crew here would fight this, the general erosion of our people out of the cracks of the city to other places. I say Go, Go Boldly and announce yourselves. Whether you go simply to the suburbs, to states a goodly drive away, or to the other side of the nation, Go! Chase your dreams and your education and your spouses. If you must return, come home with the knowledge that you lived while you were where you went. And always remember that we all love each other lots and we can draw strength from that wherever we are.

Two Hundred and Twelve, Wildfire

It's amazing how fast news can spread in today's day and age. If we go back simply two generations, news traveled as fast as the post did and even then not necessarily to everyone. First the immediate family would get notice and then they would inform close friends in their locations. Dire news such as deaths often had a travelling family member who would go around telling other family members of the death before everyone went to the town where the person used to live for the funeral and such. Friends of those folks would be brought in to take care of the farms/shops/plants while the family was gone.

Now, less then twenty-four hours after the fact, folks connected online have knowledge of deaths of people they might not have seen in years. Those folks tell their friends who are not online about it and then they end up calling others and so on and so forth. It amazes me the speed with which the news spreads, good or bad. Wildfire.

Two Hundred and Ten, Stagnation

It's not that life is stopping all around, it's just that my personal development has slowed down to a crawl. I see myself as the same person who entered medical school four long years ago. Have these years meant nothing to the personable side of me? Can that side really have remained unchanged as my professional side underwent immense challenges? I look around at people moving forward with their lives--their real ones that matter! and see that I will have to work just as hard at my life as I do for my future career. While I rarely assume things will fall in my lap in most things, I see that in this area I have remained quite naive. Things will work out as they usually do but I will have to help it along a lot. And that means I have to learn, and learn quick.

But what is it I need to learn?

Two Hundred and Nine, Reactivate

[cough] [splutter]

Life happens. More on that at a later date!

Off to Canada for a week and who knows, I might be better at posting up there where the weather is nice....and hot as well!

Two Hundred and Two, Girls and their Fathers

Reading a facebook post put up by a girl that says she misses her Daddy breaks my heart when I remember her Dad died almost a year ago.

Two Hundred and One, Time's Endless Progression

My world is static to me.  I wake up, go to school, come home, hang out with the same peeps, sleep.  Rinse.  Repeat.  Ever since high school, my life has consisted of this same pattern.  There were some derangements such as weddings or the birth of some new kids or the passing away of some folks but my immediate life has had no change.  At home people still argue a lot and do things the way they want instead of compromising.  At my friend's place, we still get together and play games.  In my college town, I still go out to dinner with people to have a good evening.  I still play computer games like crazy.  I still make mini road trips to see other friends in nearby towns.  

The doc I worked with on my away rotation went through medical school not expecting children since his wife had had extensive radiation for an early cancer and was deemed infertile.  To his surprise, a few years into his established family practice, he had a couple little girls.  He told me how before the girls, time for him was at a standstill.  Now with the little ones, he sees old mannerisms disappearing while new ones begin all the time.  To him time is running rampant and he cannot get it under control again.  He loves his daughters very much but still admits he misses things they used to do when they were younger.  

I don't cuddle up with my dad anymore.  I also don't fall asleep on my grandmother's lap while we watch an evening movie.  I also don't cutely offer to help with cleanup after dinner and instead make sure I do the heavier cleanup so no one else must.  I do still run over to my friends' home but stay much later than I used to.

Tomorrow I go to take another test in a multitude of tests I have taken and that I have yet to take.  After it is over, I will celebrate by either running around outside a bit, paying bills, or playing Warcraft.  Then Saturday I'll drive home for a night.  All of it has happened before and will happen again.

But one day it won't!

One Hundred and Ninety-nine, 1812 Overture

I had a really bad weekend a long time ago.  September 7th - September 9th, 2001: I first got caught for going 30 over the speed limit in a residential zone--a mandatory court date--and then I proceeded to twist my ankle on a putt putt green.  Of course, in the grand scheme of things, it wasn't that big a deal with the following Tuesday to come but at that point in my life, it sucked.  My ankle healed well enough.  I learned that I really did NOT have the upper body strength to walk all the way across campus on crutches without stopping for a break every hundred feet.  But as the week wore on, I began building up some strength and I managed to go two hundred feet without stopping by the time I finished with them the following week.  The anxiety from the speeding ticket, however, did not cease.  The court date was set for Oct 22nd or 23rd--somewhere around there.  Court was in my hometown, school was over an hour away, I had no car.  Oh, and I never told my dad who pays my car insurance.  Yeah, I was freaking out.  I turned then to those who I go to when I'm in trouble--the Beatnik, Lord Chaos, and the Engineer.  They helped me crack a plan where Beatnik and Lord Chaos' older brother came down Sunday night, took Monday off to drive me to my hometown and court, and then return me to my schooltown later that day.  

The elder brother--Politico for short--and I really grew close that day.  He helped coach me on dress as well as making sure to show the proper respect to the judge.  On the way up north he had classical music playing to help relax me.  It didn't really work.  I was a nervous wreck all the way up.  Getting to the courthouse, we went in and sat down--us in our suits, everone else in their everyday clothing.  I might have been self-conscious about it except again, I was a nervous wreck.  Then he called me up...incorrectly saying my name.  My brain went into auto-pilot as I stood up and walked to the front; I corrected the judge on the pronunciation.  Part of me cringed as did Politico back in the benches (I learned that later).  He spoke the offenses then reduced them on the basis of it being my first one.  I believe I said guilty when he was done talking and he then told me I had the choice of points on my license or driving school to rescind them.  The rest is a blur in the courthouse except for the stop at the payment desk where I shelled out court costs of around $76 from my carefully collected rainy day fund.  Then Politico and I began our trip back to schooltown.

The Beatnik is the English major, but storytelling runs in their entire family.  For some reason, Politico began the story during the start of a Tchaikovsky piece.  Both the story and the music began softly enough up to the point of the cop pulling me over.  There a major musical announcement came forth.  Again the music quieted down and proceeded along with the story in much the same fashion that I simultaneously ignored the situation with moments of utter terror for the next month.  Then the planning stages of the court date were upon me.  Slowly all the pieces began fitting into place as odd as they might have seemed and the situation promised to move forward as smoothly as we could manage.  The drive up to the courthouse was a tense, advice-filled time and proceeded up to the entry into the courtroom.  Then the great battle (ok, this part was slightly off between the story and the music) during which the decisions for my mistakes were made.  Then, as we left, great relief!  Wave after Wave, Bombardment after Bombardment, everything was finishing up and the pounding noise massaged my relaxed self having survived the ordeal.  That song is now forever associated with that event and with the Politico in my mind.  In the grand scheme of things, not a big deal, but to me at the time, it was my world crashing down.

I realized then that if I ever got a chance to do something similar for someone else, I wouldn't hesitate.  The world gave me the company of people I needed at the time and I wouldn't hold myself back for my friends if such a time came for them.

Thank you my friends.

One Hundred and Ninety-five, Whoa

I haven't read a blog or webcomic in three or four months...

The thought just floored me. It's not that it's freedom; it's not good or bad; it just is. I do realize I've missed reading some close friends' blogs which I would enjoy. But things are as they are right now and I won't fight it currently. Maybe upon residency and possibly moving to Land's End, USA, I might drag myself more to there to catch a glimpse of what my peeps are encountering and doing.

One Hundred and Ninety-four, Cardiac Arrest

I have been remiss from this forum for quite a while mainly because I did forget about it in the jumble known as life.  This entry doesn't herald my sudden return to all things blog but it is to point out a small event that occurred earlier today.

A patient in the hospital for whatever reason stopped breathing and pumping his own blood.  Doctors rushed in along with nurses, I stood outside the room with my three colleagues.  I hear different orders being shouted through the air, "Get the crash cart!" "You start compressions!" "I'll get the kit" "Push another atropine!" "Stop! Does he have a pulse?" "Rotate on compressions" "We have a pulse!" "Ok, he's stable" "I lost the pulse!" "Quick, start compressions again!" and on and on.

At one point, one of the residents turns to me, points, and beckons.  As I near him, he tells me to leave my white coat outside the room.  I hurriedly rush in sans white coat and grab the gloves he gives me.  

"You're going to relieve the guy giving compressions."

My mind's jaw drops.  My physical body continues as directed to the side of the room where the folks giving compressions are standing and doing their job.  As I stand behind the fellow whose shoulders are heaving as he pushes heavily onto the old gentleman's sternum, someone tells him to pause to check pulses.  They find one!  Everyone relaxes (again) as the people in the room prepare to move the bed to the ICU.  As the connections are dropped, they notice his pulse is gone again.  Matt, my resident, turns to me and points me in.  I step up, place my hands as taught and practiced on rubber dummies, and start counting while doing my job.  I count ~50 compressions when the lady next to me says, "I can feel your compressions, stop so I can see if he's beating on his own."  I halt.  She still has a pulse.  I step back after glancing at Matt as the bed is wheeled off.  As I exit slowly behind the bed and its horde of people, my two colleagues come up to me and congratulate me on saving a life.  I stutter like I always do when I get a compliment.  Jokes continue into the night about using the story to score chicks at the bar.  I'm just happy he lived.  And constantly reminding myself in my mind about how oddly the feel of the elderly gentleman's chest felt just like the mannequins we practice on.  The only odd part was the face staring up at me slowly turning first purple, then pink with compressions, and with a mouth slightly parted in the agony of the situation...

One Hundred and Eighty-nine, Passion

I had a surgeon tell me about a procedure he was going to help perform back when I was on surgery.  The procedure was the one mentioned briefly in this entry.  And while to you or I it might seem like a long, amazing, and possibly tedious surgery, to him it was why he lived.  The excitement on his face was a beacon for me.  As I go through pediatrics and look back on Ob/Gyn and Surgery, I realized that I want what he has.  I want to experience the same glowing feeling, the same Drive for a particular line of work.  Doctors are in their profession for life.  I want to do something that I will thoroughly enjoy for the rest of mine.  

One Hundred and Seventy-five, The Elderly

I went into a room to check on an 83 year-old man's progress that day.  "Good morning sir." I said clearly as I turned on the light and approached his bed.  His eyes perked up and his head tilted slightly towards my voice.  In the corner the television was blaring away on some news channel some family member or nurse had put on for him.  I realized as his eyes stared at the ceiling that he would not be focusing directly on me.  I involuntarily speak louder asking him how his night was.  In reply, a slew of noises issued from his toothless mouth.  I put my ear close to him to hear him better.  No avail.  How was I supposed to gather information from this fellow?!  I stood at the side of his bed despairing that this man with a rich history (all 83 year-old people have a rich history) couldn't communicate what he was trying so hard to tell.  I continued explaining my exam steps as I checked his heart and lungs and operative site and legs.  He never stopped with his trail of words.  In fact, I couldn't hear clearly at all in his chest due to his larynx sending sound waves down through his body into my stethoscope.  As I said goodbye and left, he quieted down in what I imagine was frustration.  He might have had a stroke, but he obviously was aware of people.  He just couldn't communicate effectively and that is what made me saddest.

In opposition to that experience, I met a nurse later on that day who was from the Philippines.  She had immigrated 58 years ago.  At the spry age of 79, she worked regularly in the operating room as a circulating nurse--the nurse who makes sure everything runs smoothly in the OR and gets stuff we don't have in there.  She was telling us stories about her younger days and stuff about her husband.  Her husband is Japanese and apparently when she married him, the Philippine government took away her Filipino citizenship.  She told an elaborate story about how she eventually kept from being deported to Japan through friends in high places and even getting her name on a bill that Lyndon Johnson signed.  And then there was the story about her husband who was to be deployed in the war "in just a few days when the war ended."  At one point a newer worker in the area, some nurse or tech, came by asking if she would help move the patient back to the ready OR.  The 79 year-old fixed a look on the intruder which clearly meant, "Let me finish my story, then I'll take care of it!"  She picked up where she was decribing a kamikaze's underwater counterpart, a Kaiten.  Her husband had been training as a pilot for one of these and was scheduled to be deployed a couple days after Nagasaki.  Her wrinkled face was animated throughout the storytelling.  Deep furrows appearing in her brow when reciting the parts regarding her possible deportment and the fact that her husband was a Kaiten pilot.  Wrinkles clearing out with her smiles when she reached the happy conclusions of remaining in the States and her husband not being deployed incidentally.

In one day I encountered two people who showed me the wide variability in human function and communication.  I also grew to appreciate different qualities in each.  From the gentleman patient, I had a glimpse of future disability that is more likely to strike than sudden death and the possibility of unheard stories.  From the nurse, I learned the richness of a life and the joy of knowing the lives others have lived.  In fact, it gave me hope hearing her realizing that the gentleman probably had regaled other people with his own stories prior to his mishap.  I hope those people take those stories and remember them time to time.  

What are we but the sum of our experiences and knowledge? 

One Hundred and Seventy-four, Day 4

The following is an excerpt that I can apply to various people I know who are going through this power outage.

"I still don't have power but it's OK [cue hysterical laughter] because who needs power? Not me. I don't need power at all. I'll just read by candlelight for the rest of my life UNTIL I GO BLIND IN FIVE DAYS BECAUSE DO YOU KNOW HOW HARD IT IS TO READ BY CANDLELIGHT? IT'S HARD THAT'S WHAT SHE SAID.

Ahem. At least people I know have power. If I couldn't get out of our dark apartment, I'd have jumped off the balcony by now, which wouldn't have even killed me. I'd have just broken my leg or something and sat there in the dark crying about my stupid, broken leg. Wah wah waaaaaaaaah."

For those who do have power, enjoy the music at this MySpace site!

One Hundred and Sixty-nine, Start of a Queen's Reign

"Go on, get in there!"

As I stepped forward, a fleeting moment of nervousness and panic entered me and left as I strengthened my resolve. I was ready for this. I'd seen it done many times by now and felt comfortable with the process along with the doctors there. I held the little girl's head as it came at me. I moved the head and the shoulders downward until the top shoulder came free. Then, before I could blink, she popped out! I wasn't prepared for the speedy exit she made so I was holding her with both hands as she started crying (the practiced physicians develop a one-handed safe baby-holding technique). The resident put the clamps on the cord and Papa leaned in to cut it with the scissors. Finally I handed the little girl off to the pediatric crew ready to assess her health.

Later on I asked the resident, "Does it ever get old?"

"No."

One Hundred and Fifty-eight,

Influence exists, there's no doubt about it. Up until now, however, its power over me has not been that powerful. My merits and personal traits have carried the day even in the face of influence at times. Going through medical school though, it's going to be tougher to fight influence. And I successfully made that fight tougher for myself by accidentally hitting "Reply All" to an innocent email. I'm clumsy, as my friends know. Apparently that conveys to mouse-clicking too at times.

I'm nervous, but I'll live. And whatever can't kill you, only makes you stronger. I heard that somewhere once.

One Hundred and Fifty-six, Wrapup Minus One

My Checklist:
Second Year Completed (& Passed) - Check!
Step 1 of the Board Exams Taken - Check!
Two and a Half Weeks of Vacation Completed - Check!
Step 1 of the Board Exams Passed - Waiting on Results...
Starting Third Year - In One Day
Started Research on my New Computer - Check!

There is the past 3 months of my life in six small bullets on a checklist. I am alive and well despite the wear and tear. Lot of life events going on with other people that I've attempted keeping track of and utterly failed in the past few months. I will be working to amend that as well as preparing for the third year. My first rotation? Ob/Gyn!

One Hundred and Fifty-four, Mind Stew

The past few weeks have been quite a rough road for me and others around the country. The part I keep trying to wrap my head around is that Life and Time don't stop. Every now and then you get into this point where you're having fun and enjoying yourself but it's hard to stay right in that position without something throwing a monkey wrench into your fun. I did spend some of my days off playing Warcraft like an addict and it felt great compared to the grind of the questions and study materials. But inevitably, I'd notice the time was 2 or 3 AM or my lids would automatically droop and I'd know that when I woke up, it would all be gone again traded in exchange for another set of grueling study hours. The Engineer just bought himself a house and is in the process of moving over there. He's had many points where he had decisions to make and time would force his hand when he would have rather had the chance to make carefully reviewed, forward-looking plans. Many of my friends are looking to the next few months and wondering how their life will look and where it will be. And for them it's probably the scariest. But that's what the rest of us are for and willing to help them cope with. Their minds are all in a jumble wondering what progress they're making on their goals and if they're going down the right road or just a screwed up one. Sometimes they can't even sleep well at night because of the cacophony of thoughts with them.

I still wish my mind would quiet.

One Hundred and Fourty-nine, A Step Back

I talked with Beatnik's mom today--it is her birthday--and we both mentioned how people can put in effort and in the end, you'll end up where you do and you work with that. It's an important lesson for kids to learn as they grow up. Many children (and adults for that matter), don't see anything beyond their own ideal pathway. This is handy in defining a goal or set of goals but if ever they fall off that path somewhere, everything comes to a screeching halt. Why? They just don't have experience with failing at something so they don't know how to react. People are tripping all the time (no LSD jokes please). It's hard to find a person who's never had to fall off her or his train tracks and have to redefine the pathway. That's an integral part of being a human being. Whether it's a big exam coming up or the health of an unborn baby, there are things in our control and things out of our control. Speaking from experience, I can control the amount of time I spend dedicated to studying for my exam. I cannot control most parts of my testing experience or what my score will be from that day. If I do well, I will be thankful and proceed onwards. If I don't do well and I pass, I'll be thankful for passing, and prepare to work harder down the road.

If I don't pass at all...well, let's just say there are other steps to be taken before I jump off my train tracks.

One Hundred and Fourty-one, Surrounded Yet Alone

Back in October the Engineer celebrated his birthday far away from us all by himself in Texas. In February, the Beatnik looked like he would end up celebrating his birthday in Louisiana far away from us, but the Engineer went up to see him that night. Today I went out in the evening with Roommate, Amish Girl, and another classmate to dinner and dessert.

I didn't realize until today how awesome it was that the Engineer and Beatnik were able to hang out together over something as simple as marking the day one of them popped into this world. I didn't realize until today what it meant to be able to spend part of that day hanging out with each other. I didn't realize until today some part of what it might have felt like to celebrate your birthday on your own. I realized today that we've been celebrating birthdays together since late elementary school. This is the first year where we couldn't all be together for each of our days. I've been receiving endless phone calls today, but only four uplifted me: Valiben, Engineer, Beatnik, and Lord Chaos with the family singing Happy Birthday.

I'm surrounded by great people, but I can't change the fact that I miss the people I've known for most of my life.