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?

One Hundred and Eighty-one, Everyday Doctoring Stuff

Last week Wednesday I received an email from the Beatnik.  He'd recently done 129 questions to see what Dungeons and Dragons character build he would be and was curious what our friend circle would get.  This was in the morning.  I set aside this task since I was heading into the hospital and decided to confront this monster of a quiz later on that day.

Wednesday continued and I learned that I would be participating in a big surgery starting at 2 PM called a "free fibula flap" surgery.  If you Google it, the second hit that comes up does a good succint job of describing it.  I describe it below in brief.  Anyway, we didn't finish the surgery and I didn't get back to the apartment until 1:00 AM Thursday morning from the hospital.  I had a pounding headache from lack of food and liquids but I had just seen an amazing surgery.  I saw a slew of emails from all of my friends who had replied their character builds throughout the day as they completed the 129 question quiz.  The last one was from the Beatnik again, addressing all of us.  Here it is, and pardon any language that might be offensive to you.

The Beatnik's question to the world:

"Well our party is pretty varied.  We have Drock as the all powerful wizard.  I'm the tree hugging hippy druid.  Crazy Blonde is the know it all Wizard.  Woodwind is the touchy feely Cleric and Lord Chaos is our soul devouring Fighter/sorcerer.  The Engineer is our totally not gay Bard.  And I know you are all wondering the same question I am,

 

WHAT THE FUCK IS DAVE!?!? TAKE THE GOD DAMN TEST!

 

Our group make up would put Lord Chaos in the front.  Me and Woodwind in the middle with the Engineer close behind (Dancing or doing whatever the fuck bards do), Crazy Blonde and Drock as our artillery in the rear (tee hee).  And I know you are all curious about one thing,

 

WHERE THE FUCK IS DAVE?

 

I know me too.  Kinda fun, maybe we should all cosplay sometime (shudder) 

love,

The Beatnik 

p.s.  TAKING THE FUCKING TEST DAVE! "

Reading this at 1:00 AM, I quickly sent out a reply to everyone:

"I just saw a guy’s left jaw taken out, then a bone from his leg taken and put in with a metal bracket to work as a jaw, then his pec from his left chest pasted over the bone, and then multiple skin grafts.  This morning I briefly read your email at 6:00 AM before running off to the hospital.  There I have been until 1 AM right now.  I don’t think I need a test to tell everyone that I’m some type of good cleric

I’ll take it one day. 

-Dave"

I felt that while this might be harsh, it helped explain why I hadn't replied and that I'd get to it when I had a chance.  Little did I realize but in the couple of hours of sleep I got, the Beatnik had responded:

"Lol, now was that so hard?  I kind of realized your crazy schedule after a little while.  You're doing something right now that I could never do.  I know that you're in a world of doctors and people who do this shit all the time.  But, those of us who don't have MD in front of our names are pretty impressed by what you're doing right now.  Just thought you should know. 

Keep up the good work Cleric Dave,

The Beatnik"

This was 6 AM Thursday morning after a 4 hour nap.  I paused.  

and continued to pause.

I have become so inundated with cholecystectomies (gallbladder removals) and hernia repairs (fixing weak areas of bellies and groins) and other surgical terms that I was missing out on the simple fact that the majority of humanity never sees the things surgeons and the OR staff do.  Yeah, during the surgery I wondered who the hell thought up taking someone's bone from a leg to rebuild a jaw, but the actual procedure never amazed me because it made sense.  To laypeople though, it's practically magic.  The patient sees the difference between what they used to look and feel like compared to how everything is after a surgery and it's amazing.  

That's what my two months on Surgery have boiled down to: Amazing.

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-three, Day 3

Today was Lecture Day. I sat through eight hours of lecture while my phone charged in a corner of the room. I took my milk over to a friend's home who has a powered fridge. I also picked up a couple sandalwood scented candles and lithium 123 batteries. I'm thankful I have a powerful flashlight that doesn't use C or D batteries and, having grown up Hindu, that I love the smell of sandalwood.
In 2004 I went for a week without power. They're saying the same again this time around. I'm ok with it although a little frustrated. Maybe it's karma. Saturday I played Warcraft with the Beatnik and had a good time and picked up useful loot and now I can't play. Of all the weeks to lose power, this one is the best since I have a midterm coming up. At least this time the weather is cooler than during the previous outage. Back then my housemates and I stayed at school ALL day and returned to sleep at night. In the mornings, we'd shower and head back to school. It was miserable. This one is much better!

One Hundred and Sixty-seven, Deliveries and Home

My days this past week included two Cesarean sections, one normal delivery, and one ectopic pregnancy. I've managed to find many babies' heartbeats while they're inside mommy using Doppler devices. I've met a woman who is pregnant for the third time after having lost her first pregnancy because the baby developed no brain and lost the second in a miscarriage. She and the doctor are ecstatic that this third pregnancy is going well and she's getting really close to term with a healthy baby growing inside her.
This past weekend I saw the Engineer and some other friends. I came to realize that while I had become slightly desensitized to bar smoke in the past, my year or so of abstinence from smoke-ridden air caused my throat to heal up and feel Friday night stronger than usual. My grandmother's birthday was on Saturday. And Valiben showed up just before I ate dinner and then drove off to my schooltown. Sunday I managed to get laundry done and I had some good chats with a couple friends.

One Hundred and Sixty-six, Humanity's Progress

I had a family member who witnessed a terrorist's bombing. I will work with my family to make sure she gets the psychological help (from family and professionals) she needs to work through it in her mind. I do not wish for revenge on the ones that did that and killed others. I just wish for proper justice based on the transgressed laws of that land.

Evolutionary fight between physical might and the ability to protect/kill versus moral understanding and the ability to understand/forgive?

One Hundred and Thirty-nine, Obdurate?

For years, I have this little game of hiding my birthday from the world and congratulating those who successfully remembered it. Some part of me was joyful at this minor power play to see who would be as psuedo-OCD as me and keep track of my birthday. Another part of me just didn't care as much. Growing up birthdays were signified by a sumptuous meal and a visit to the temple. Yeah, my American friends would have grandiose parties and eventually I tried emulating them but my heart was never in it.

This year my birthday will be lost in a weekend where I will be helping throw a charity concert and resting from a hectic week and driving home for a couple nights. One of my best friends is in Texas; the other in California. What I want doesn't necessarily factor into what I get. I want second year to be over and a month off before starting third year rotations. Instead, I'll be working hard to pass my classes. I'll be working hard to pass Step 1 of my Board Exams. I want to go to Chris' town where a gathering will commence on the first of the next month. Instead I'll probably be doing some much-needed vegging-out after a heavy week of studying. I want to be fifteen again. Instead I'll be turning twenty-six.

One Hun'red and Twenty-four, Texan-speak!

As my travel partner pointed out in the previous entry's comment section, we learned some new words while down south thanks to the Engineer. We had fun with them so here they are in no particular order!

doing = durin'
ex. How you durin'? How's your Momma* durin'?

Texans are always "fixin" to do stuff.
ex. I'm fixin to go to work and my Momma's* fixin to take care of my dog!!

dumping = tumping
ex. Well, I'm fixin to tump your Momma* dear son/daughter/offspring.

poke/ticklish jab = joog (spelling is approximated)
ex. You'd better not be fixin to tump my Momma* or I'll joog you!

hundred = hun'red
ex. This'll be the last time I ask how yer Momma's* durin' because I'm fixin to live through a hun'red lives before I interact with that woman I'm tumping, joog or no joog!



*always ask about Momma!

Seventy-nine, Uttran

As I write this, people in India are going crazy up on the rooftops, especially in Gujarat. Kites are amassing in the air fighting each other and adding a sense of festivity to the cities that is only felt here when large firework shows occur.

The two days of Uttran and Vassi Uttran are a lot of fun. My extended family wonders when next I'll be able to go back and enjoy this time of the year with them. As I glance at my schedule of classes (which began on January 2nd), a part of me wonders the same. Hopefully I'll be able to go around this time of year once before I'm settled into someplace finishing up my residency. We'll see. In the meantime, enjoy these two pictures of one of many unique holidays in India.

Seventy-three, Our Bonds which Art in Soul

What is the process of forming a friend? Obviously there's no quantitative formula, just many subjective ones. Is it the constant going out to places? Or just enjoying the same activities? Or does it require working together? Constantly talking to each other? I think it's a little bit of it all and most importantly, just being in close contact with someone. There is a flaw to my thinking though. Namely the Beatnik, the Engineer and the Alaskan. None of them are physically close to me or in regular contact these days yet they are very close friends. I've spent ~15 years with the Beatnik and the Engineer. And a couple years with the Alaskan. It blows my mind that I work to talk to and hear from them regularly when I can't even remember to call home once a week.

Why?

Thirty-nine, Compassion Overload

In my lifetime, many times have I been approached on streets by barely dressed 4 and 5 year-olds asking for money. Mothers holding babies begging for a few cents. In all these years I have never given them anything. Yet yesterday I gave some money to, not an individual or two, but an organization that specializes in feeding and caring for kids around the world. How can I condone giving to an organization and not an individual? For me, it has always been easy. I don't believe that anything going wrong can be fixed simply by throwing money at it. Rather, money works better if it's decided how to spend it first so instead of showering the destitute with colored paper with deceased people's portraits on them, it is used to pay for the creation of homes, for the purchase of foodstuffs and medicines, and hopefully on education for everyone--especially the children.

I don't deny that there are barely dressed children running around in American streets. But I guarantee that the number in this country is much lower than in most developing nations. The question then crops up: Do I support a National initiative to help people or a World-wide one? And this is where your individual ideals come into play. For me, the whole has always been very important to me. In classes, the learning occurs at the pace of the slowest learner to make sure no one gets left behind. Granted, this has changed in the past year and a half with the advent of Medical School but overall, the idea remains.

The Numbers. Percentage-wise, the US and India aren't at opposite ends of the scale in their poverty numbers: 12% and 27.5% respectively. But when I take into account the population, the US has ~36.4 million people under the poverty line while India has 321.5 million under the poverty line. For comparison, the total population of the United states is just over 300 million strong. This makes it harder for me to spend on people and organizations that service just the United States.

I do hope I have the nerve to offer up my services to groups like Doctors without Borders or go and provide free clinic care annually to areas that receive no care usually unless they travel hundreds of miles to the nearest hospitals which are too expensive for them and have overcrowding issues. That would be the best thing that I could accomplish to serve my fellow suffering human beings.

Thirty-four, Post-High School

In India (and possibly the UK), students have to take placement exams at the end of high school to see if they can get into college and how high of a level they can pursue. This way, professional schools can be entered directly out of high school. This is vastly different from our setup of go-where-you-will to get whatever degree you want and needing a four-year Bachelor's degree before pursuing professional degrees (ex. Law School and Medical School). I have one friend who was a fully-trained doctor after 4.5 years of college and 1 year of internship. You know, that's tempting when facing 8 years of college (3 undergrad and 4 medicine) plus another 2 to 6 years of further education as a resident or fellow. But then the competition is fierce. Of the total number of spots open each year, fifteen times that number apply. And it's all based on academics rather than personality.

I'm not saying it's better here or there, just different.

Six, Politics

The normal sequence of events when Important Things Happen is that my friends and I would react to whatever it was and then share views on it afterwards. Yet there are areas that do not directly impact upon us and so we just never discuss it. Examples are Darfur, fires in CA, how the euro changes in value to the dollar, and polar bears (outside the new movie "The Golden Compass"). But over the years, I've realized there are things that interest me for which my friends have no interest because there is no obvious impact upon them. This country that lies on the other side of the world from me causes this interest that I have. Whether it's cricket games, news on movie stars, events surround famous places I've been, or big changes in the government, I feel some draw towards it that the people I meet and talk to in the US never will, with the exception of other people like me.

I don't see it as a negative, it's just how it is. As I sit here listening to Musharraf's Hindi/Urdu voice coming out of my speakers, barely able to understand half of it when concentrating on it yet listening carefully, I realize it's just another difference between myself and people (and this country) with whom I share my life. If we all shared the same experiences we might grow closer, but it could also lead towards Sameness. So instead it's up to me to inform my American friends of things that happen to be important to me that they might not have given a second thought to. Maybe it's the differences that make our relationships richer.