Asia Watch: "White or Wrong?"

NY times, Sunday:

"An ad for a skin-whitening product in Hong Kong says: "White or wrong? The right choice. Beauty White makes your whole body white."

Ah yes. I remember seriously freaking out when I watched a 5 minute commercial in Tokyo advertising L'Oreal White Perfect cream before the screening for War of the Worlds. My friends and I were stunned. I thought only my backward community had this obsession. My mother and her family instilled this nasty little bit of wisdom in me, and their paranoid relationship with skin color is, at times, down right racist. At least now it's good to know that it's not just my family; it's most of Asia too.

Skin bleaching is a booming industry in most of East and South East Asia, and while the message is disturbing or strange to non-Asians, apparently people are very open about admitting their own use of such products. Skin bleaching even extend to bleaching nipples to achieve a pinker hue. Given the prevalance of these creams, it's no wonder that at some point somebody will get hurt using cheap brands. I guess not everyone can afford L'Oreal 'White Perfect'. The name says it all.

White skin is desirable, not unlike tanning in the West. However, my own observation (and this article) seems to confirm more dangerous dimensions to this obsession. While the West prides tanning, it doesn't actively denigrate those who don't tan or insinuate that those who don't tan are of a lower socioeconomic class or belong to an inferior race. Asians actively denigrate those who have darker skin colors. The association is harsh, and it starts with language. Case and point: phrases calling people 'black as a duck's liver' or 'black like savages' are commonly used as insults in Thai and Vietnamese. The Vietnamese one is most telling, isn't it?

I frankly do not buy the argument that white domination in the form of colonialism or cultural global influences plays a large role in creating this trend. Rather, Asians have always had an intrinsic notion of class and race that is tied to physical attributes, and skin color is the most obvious. What is truly sad is the inability of these cultures to shake these beliefs from within, co-opting the message of beauty from the West to bolster existing prejudices and intrinsic racism. Quite pathetic, really.

another one bites the dust

Just took the final for Physical Diagnosis, which included me pretending to know what I'm doing on a standardized patient (a trained actor who pretends to be a patient). He was really cool about it, and afterwards, gave me pointers on techniques that he said was "usually meant for 2nd or 3rd year students". I'm proud to say that playing pretend with Mike really helped. I only forgot to examine 1 thing, but really, who needs intact hearing anyway.

My hands however, were uncooperative. They were not shaking, just bone chillingly cold, the kind of thing that I have vowed not to inflict my future patients because I hate doctors with cold hands. I apologized at least 4 times. Nothing I did to warm them up worked. Not even sticking it in between my legs, although that looked awkward and I decided to stop. Fun times. Fun times.

Can't say I did equally well on the written portion though. Stupid cranial nerves. If you have peripheral nerve palsy or something like that, don't ask me, because apparently I have no idea what the hell is wrong with you. Oops.

What's in a name

Harvard Medical School. It really shouldn't hold any sway over me. It really shouldn't. I thought I gave that up, the pangs of jealousy mixed with respect. I thought I left it in highschool.

While perusing thefacebook after some friends here at the medschool friended me, I found myself searching for alum'05, and an old aqquaintance popped up. We were never friends. Ethan, not his real name, and I took two semester of organic chemistry together, and on occasions, in class, we chatted. We had the same Teaching Fellow, and eventually, we sought this man's help throughout the semesters. Organic chemistry was one of those courses that can make or break a pre-med, and we knew the stakes were high, both because Orgo is a hard subject, and failure at it had consequences for our supposed futures. But Ethan didn't ever seem to me to be the intellectually inquisitive type; he was more cavalier, the premed-by-day, final-club-party-by-night kinda guy. I guess he knew how to live.

I still remember the time he asked me for help to study for the Orgo final. I never got any good vibes from him as a student, and truth be told he was terrible at it, but not because he was dumb. It just seemed like he didn't study enough. I explained the problems to him. He thanked me. We never talked after that. All the years at Harvard, he rarely acknowledged me when we pass on the way to the same dining hall, even though we live in the same House. I felt used. I still do.

He's at Harvard Medical School now, an MD-MBA candidate. I'm not.

It really shouldn't matter; it's just a school. His success does not mean my failure. It shouldn't mean anything at all.

But in this game, clearly, he did something right.
He always knew how to live.

MI III needs better medical consultants.

I am ashamed to admit that I've watched MI III and enjoyed the 2 something hours of Tom Cruise in human skin, doing what only a Thetan level 7 being can do: defy gravity, death, and logic. I can't say the same for the writers though. Whoever decided that a crucial plot point has to hinge on a defibrillator requiring 30 seconds to charge needs to be shot. Haven't they ever watched ER?

Common Denominator

Mona Kuhn

I've received words from dear readers (okay, who am I kidding, 'reader') regarding the length of recent entries. As any attention-starved publisher will admit, sometimes it is just easier to give the crowd what it wants. Brief. Frivolous. Innuendo. Have fun.

Night walks

I love rain. It makes sidewalks glisten in the city lights. It layers onto the air at first a veneer of dampness, then slowly infuses it with a haze that dithers the light and makes everything glow.

I took my usual, post-examwalk earlier, after sunset, around Chinatown, up toward the Lowes and caught the afterglow light across the Common. Had to wear my wool winter jacket because it was rainy and nippy, the kind of cold that was just enough to weave one's breath into wispy strands with every heave of the chest. Times like these, I wish I had smoked. Something about it seems appropriate for this damp, monotone cityscape all around me. I walked pass the new Ritz Carlton hotel restaurant, with its dimly lit mahogany interior and glass tables perched on top of glowing bands of marble, backlit to highlight bejeweled simplicities, while svelte people posed behind half-tinted mirrors as they drank cosmos and popped nuts into their mouths. Casual glamour. Tonight, the sidewalk along the strip of the Ritz caught my eyes; something about the concrete they use and the kind of sand that, at night, reflected light to create the starry constelations beneath my feet. On this night, when everything was wet, it more than glittered. A fine diamond dusting lit my way.

People in Chinatown always stare at me. Maybe because I stare back with the same glazed, overcast eyes. I don't know. Cooks from little restaurants the size of matchboxes tend to spill out onto sidewalks around 7:00 pm to steal smokes. I see them, but then again, I don't. Their gawkish looks and manners often fade into the muddy browns and reds of Chinatown, as nondescript as any one of those blinking neon signs and greasy windowfronts that line these streets. They hang around dumpsters, never too far away from those unmarked doors cracked ajar and held in place by an old newspaper, or a shoe. I follow the lights.

That KV thing

Is there life after national (scratch that, international) humiliation?

I'm clearly late to the media table, but just in time to "internalize" the word schadenfreude, adding it to the vocab list I have always promised myself I'd learn before taking the SAT, exiting Harvard, or anytime thereafter. I will admit, I have had my share of emails to friends commenting on this bruhahah, in part gleefully, with a sprinkle of morbid fascination thinly veiled as an attraction to 'literary news'. Like many, my attraction to this story began with a mixture of admiration and envy of the girl before news of plagiarism broke, when the superstar landed at Harvard, and after the story broke with a mixture of shock, amusement, disgust, and finally, dissapointment. Now, I'm even beginning to feel sympathy (Salman Rushdie's admonition is the latest low; surely no one deserves that much wrist slapping). Pure, unadulterated, exasperated, sympathy. That is, until a nonHarvard friend rightfully pointed out the most obvious spin that will make everybody happy:

"How Kaavya Viswanathan Got Sorry, Got Redeemed, and Got a New Life"

Yes, in perhaps much more clever wordings and stylish fonts, KV will write a book documenting her fall from grace and her journey back into respectability, complete with bits of Prada studded Hallmark moments thrown in, because we all really, deep down, love that kind of prose. Speaking of love, everybody loves a sinner, but Americans worship sinners who repent publicly, and on occasions have made said sinner President (Dubya), or buy his book (Clinton, anyone?). For old times' sake, Alloy Entertainment will again 'package' her book, providing help for those tricky plot points and those bits of character development that are best left to the 'pros'. Even a nonfiction (one can only hope it's nonfiction, ala James Frey) needs a good born-again plot. Little, Brown will publish it, her agents will rave, and she will be on Oprah's couch recounting the trauma and lessons of a hard public life two years from now. Oprah, America's populous patron saint, will grant KV ultimate amnesty and millions in readership. Even better, I doubt there will be new charges of plagiarism. Afterall, redemption is the most plagiarized, hackneyed concept in the world; it's practically vetting-proof. Again, unless she's another James Frey...but that's a can of worms we won't go into.

At least this is what I would do. Lemons make lemonade. The world goes on. And this saga is not over if KV is as smart as she looks. There's spunk in her yet--I trust Harvard will bring that out of her, sooner or later. Can you smell a college speaking tour about the dangers of "internalization"? I sure can, along with her agents, I'm sure. In the meantime, I do hope to run into her at some point and maybe get an autograph. I may not be able to meet John Updike, but KV is within reach. And a celebrity on campus will always be a celebrity.

Oh and, in case someone else out there has already thought of this last contorted twist to the KV story, all I have to say is, "I'm sorry for internalizing your work. Really."

It's a guard!

Me: "No Seth, you need a thyroid guard before you go in."
Seth: "What's a thyroid guard?"
Me: "This." [handing him mine.] "Put it on, apparently it prevents radiation cancer."
Seth:"Yo man, can this get any tighter?" [adjusting straps]. "jeesh, it smells."
[Seth enters the operating room.]
[loud laughter ensues]
[nurse comes out.]
Nurse, to everyone: "okay, which one of ya made the med student wear a groin guard on his chin?"

I've got a bonechip in my eye...and more substantive updates

We cracked open the head today. "Crack" really isn't the operative word here, since it was more like a wet, sloppy sound as the calvaria (skull cap) was being removed. As any shellfish eater can tell you, it's the sound made when opening a crab or severing a lobster head from its tail. Yeah, that sound. Aside from the prerequisite mechanical saw, a hammer and a chisel were also involved. While the saw was a lifesaver (I can't imagine doing it with a handsaw), it came with a spray radius of approximately 4 feet as bone dust flew literally everywhere. In retrospect, I could also compare the process to opening a coconut, because approximately the same amount of liquid came pouring out, to the delight of our professor wielding the saw, as the rest of us try to hide our grimaces and not think about cleaning up the mess later. At least Barbara's keeping herself hydrated.

It's been brain back-to-back these past 2 days, what with open head surgery yesterday and the cadaver dissection today. I wish the order were reversed, so that at I had more of a clue while watching the surgery. Well, probably not. I still don't have much of a clue, although I did learn that the absorbent pads the surgeon, Dr. M, placed between the brain and the suction tube were there to prevent him from accidentally sucking out the brain. Yep. Accidentally sucking it out. I'm glad he thought of everything.

The most interesting episode during the past 2 days for me actually came from watching how this surgeon dealt with delivering bad news. The surgery mentioned before was actually considered a 'heroic effort' by Dr. M, or as one of his colleagues put it, 'an academic exercise' because of the extremely low survival rate predicted due to the condition of this patient. That explains why Dr. M didn't react when the anesthesiologist reported that the patient's pupils were bilaterally dilated and unresponsive, as this is never a good sign (the brain is dying). As I later found out, the family had requested the surgery even though the patient was found in this state, and had remained there for at least 4 hours, possibly more, at another hospital. The surgical part was easy--it went by without a hitch. Telling the family afterwards that there is less than 10% chance of recovery was hard. Very hard. Lots of crying, tissues everywhere—confusion abounded. I applaud Dr. M for his textbook delivery of the news, despite the fact that he was addressing a crowd of 14 very distraught family members. Still, he sweated a lot.

We grabbed an ABP break. Dr. M devoured a chocolate covered pastry. We went back to his office where he began to review the next case. With a few clicks, his computer screen flowered with images, scans of all sorts, from all different angles. I'm flabbergasted by all the imaging technologies available. From a distance, it looked as if Dr. M was playing Zelda on his computer.
Another patient soon came in. It was more bad news: a brain aneurysm. That meant more tests, and possibly open head surgery. The patient and his wife were young: mid-forties, maybe even less. The wife asked all the questions. Dr. M spent 40 minutes explaining procedures. He had to rush it; the patient wanted to leave to pick up his daughter from school. They nodded awkwardly to me as they headed for the door. I think I smiled, although in retrospect, that was probably inappropriate. How do you smile to someone who's just been told that his aneurysm could pop any moment, and that'll be it? Dr. M, meanwhile, is back on the phone. He had another case coming in. And I was on my way out.

Hilarity

There is a tendency for hilarious things regarding bodily functions that seem to always happen around me. I admit, I most often am the gifted engineer, the blind watchmaker, if you will, guiding such events to fruition to the delight of everyone around me, or at least, myself. Our PBL seminar class was covering a case last week involving infertility, and it was my job to deliver a mini presentation on the causes and diagnostic signs of male infertility. The conversation that began as soon as I opened my mouth, went like this:

Me: "....On average, the sperm count of a normal fertile male should be around 20 million/cc, and our patient has only 10 million/cc. In total, the typical male produces 100 million/cc per ejaculatory period, with 5 cc being the average...and"

Girl : [interuppting me] "Oh wait...really? Only 5 cc? Because I swear it's more, sometimes, I mean..." [turning bright red] "Oh, god, well, that's... I'm going to stop talking now."

The fact that she was the only married person in our seminar made it abundantly obvious about to whom she was referring. My group leader, a 4th year med student, added a final comment:

"Well, I'm sure it depends on how often the guy gets off and how much gets emitted. Phil, you wanna research that too?"

boredom, continued

This roll came out better than expected.

boredom with camera

BGLT issues in health care

There are many. Below is a sampling of shocking findings that (if true) are just really sad.

1990: survey of lesbians in Michigan: 61% would not disclose sexual orientation to their health care providers

1996: survey of physicians in New Mexico: 4.3% would deny gay and lesbian people acceptance into medical school; 10.1% believed gay and lesbian physicians should be discouraged from OB/GYN training

1998: survey of nursing students: 13-24% 'despised' LGB people or thought they were 'disgusting'; 40% believed LGB people should keep their sexuality private (from their health care providers)

I got these stats from a conference talk on BGLT issues in health care delivery yesterday at school, and while I've not had a chance to verify the stats above (sampling error? investigator bias? how were questions phrased?), they are from a credible source. I hope the future looks better.

delerium

Freedom, horrible, horrible freedom!

The 3rd anatomy exam is over.

Now I have to start studying for physiology and pathology exams next week.

It never ends....

S2, 3, 4...!

Anatomy can be a huge drain. Its effects on the student body here are varying, but the quotes below, I think, capture our sentiments up to now:

***A female 2nd year anatomy lab tutor:
"You know what, that's the one thing about taking antomy that makes me sad. It takes all the mystery out of sex. I mean, take the cremaster reflex. I thought it was so cool when I tried it 'for real' and saw that it works. And then you realize that it's an automatic response, and that just kills it."

note: cremaster reflex: the reflexive action of the cremaster muscle to retract the testicles if the inner thigh is slightly stroked, presumably to protect them.

***A fellow classmate, enacting a 'cheer' thought up as a memory device for the nerve roots of the pudental nerve:

"Ready.....S2, 3, 4, keeps the penis off the floor!"

Priceless.

Ipanema...what girl?

I'm too busy to blog right now, except to note that the weather in boston is balmy, with blue skies and a hint of manure due to spring plantings. I also wish I were in Brazil right now, because apparently this is what Brazil looks like: pure eye candy. Thank the lord!

brotherbrow photoblog

I've felt every sinew beneath those abs...for my anatomy exam next week.
Thinking back, of all the places in the world I've visited, why didn't I go here?!?

installation part 1

Partial mock-up of the art installation at the SMFA. The final installation at SCCHC would be 12 feet tall, floor to ceiling, on a wooden support. It's finally crunch time.

the camera works

Hmm..lenses

Out of sheer boredom while studying for an exam 2 days ago, I went online and made the biggest impulse buy of my life to date: a camera. It's a Canon film SLR, the 'cheap' kind with only 1.5 fps and a plastic body, but it's something I can afford. I've always wanted one. No more ripping off other people's wonderful talent online; from now on, I'm on the straight and narrow. Feel free to read whatever meaning you want into the previous statement.

The impulse camera purchase forced me to think hard about buying lenses, and the result was 3-4 hours of online research for lenses that could have been used for studying. That said, I didn't think studying for this test actually mattered too much. I think I was right. Let's hope the results are as rosy as I thought it would be. As for the lenses, I've done more than 18 hours of reading about various kinds and comparisons by now, and am no where close to feeling comfortable with any of them. I decided to buy two low end Canon lenses, a 50 mm f/1.8 and a kit zoom lens that's been rated by everyone to be crap. We'll see. There's plenty of beauty in a blurred photograph.

Spring break is almost here. yay. bermuda shorts! In boston (hopefully!?!)

In Defense of Flirting (for those who judge)

(Ken Rosenthal)
A look, a smile, an eye contact that obliterate the outside world to leave only the interaction between people: this is, among other things, flirting. Some people have problems with it. I want to defend it. Sure, there are plenty of other ‘ills’ of the world that may need a rhetorical defense, and this one is the most frivolous of all. But frivolities often reveal something more fundamentally important than their innocuous shells. Flirting as something frivolous--and how one may respond to the act of flirtation--is a window into our individual moral qualms and judgments, our perception of acceptable personal expression and outlook on human relationships, and even perhaps our self-esteem--all things that demands serious attention if we are to live happy, contented lives.

Kate was right. She and I had this conversation a long time ago, when we were still freshmen--it was about, of all things, flirting. At the time, I was practically puritanical about it. Several years and a coming-out later, I concede defeat. Kate has always been right about flirtation. It doesn't always have to bear a sexual burden, anymore than a skimpy dress is an open invitation for getting yourself molested. A flirtation is not an indicator of sexual promiscuity, or intentions of infidelity. Webster dictionary defines flirting as being able "to behave amorously without serious intent" and "to show superficial or casual interest or liking." Clearly, those people at Webster can instruct me on the true meanings of 'behaving amorously', but I'd prefer to stress the 'without serious intent' or 'superficial' part of the definition to make my case.

There are many uses for flirting, and woe is the person who reads it as only a prelude to sex. In the animal kingdom, flirting in terms of sexual relations for nonsexual aims abound. Male giraffes stimulate each other to erection, but they seem to do it to reinforce social bonds. In certain societies of monkeys, females rub their external genitals together for many things, including saying hello. While I've yet to see this behavior between 2 women at a bar, it's not a stretch to understand that humans, too, use sexual identity and sexuality in social contexts that go beyond the sexual act.

Nurses flirt; doctors (the good ones that patients like, and plastic surgeons) flirt. Flirting is flattery, endearing if done with taste. In many instances, it allows the user to get what he wants out of others, which is, after all, the point of most social interactions aimed at specific goals, be it extra help on an assignment from the TF, or getting a co-worker to do a favor. It is, coincidentally, a way of self-expression, of relating to others in a social context. Casual flirting makes the day more colorful for all involved, gets attention, opens up conversations and boosts self-esteem. It doesn't necessarily have anything to do with relationship status, age, loose morals, or predatory behavior. Like anything else, it is about context.

True, flirting is a romantic act. But as Webster defined it, it is at best a superficial romantic act, done without necessarily an expectation of something more. In this context, flirting is a way of being kind to others, paying complements to that which any of us, deep down inside, wants: desirability. As a medium of exchange, flirting thus becomes a potent social lubricant; like alcohol, it intoxicates those who are on the receiving end, breaks down barriers of communication, and lays open the opportunity for further interactions. Whether the result is sexual, or casual, or business, is entirely up to the persons involved.

People define the boundaries for flirtation, so it is true that what some find as permissible may not appeal to others. This is only fair, but it beckons the question: what defines permissibility anyway? Is it relationship status? Is it intent? Is it content? It is easy to criticize the one who flirts, because we superimpose ourselves into the situation and use our lens of experiences to cast sweeping judgments. But if we all take a step back to see the myriad of contexts that exists outside our preconceived notions and experiences with flirtation (i.e. previous flirtations were about sex, therefore all flirtations lead to sex), then we can begin to appreciate how others may use the act for different ends--fun, humor, conversation…are all good applications of flirting. As a bonus, we may even realize that we have misread flirtations in the past, that our experiences have been colored because of our inability to appreciate the nuances of human interactions, leading to missed opportunities for friendship, discovery, and dialogue.

In a world so hung up on what one does in the bedroom, can't we all just relax about casual relations between people outside of the boudoir? Judge not, lest ye be judged.

Confidence...

My art pieces are now hanging in the school of the Museum of Fine Arts, Boston, in the student gallery. After 3 hours of hammering nails, fussing about borders, and trimming edges, finally, I think it looks decent. I feel an undeserved sense of accomplishment, even though the bulk of the piece is not yet made and I'm only displaying about one half of the final installation. The piece is thus half dressed, half nude, like the guy here, open for criticism. So far though, I've had 3 SMFA students commented favorably on the installation. I was further pleasantly surprised that they all looked just like this guy. Mmmm art students.



Mona Kuhn

I have a job!

Okay, so it doesn't pay, and I don't have an office with a window (ahem, Mikey!), and I'm pretty much the office bitch, but still it's a job. With any luck, I'll be able to crank out 3-4 papers this summer: (it's clinical research, with pre-op and post-op data, so things move faster) possibly some review articles (it's just a giant book report, except you use Medline instead of the local library), and/or some interesting surveys (again, highschool stuff).

The beauty of this is that my boss is an MD, who is on the residency committee, and understands exactly what a first year medical student like me needs: papers, papers, and more papers. He's not any random Ph.D who has all the time in the world to ponder the big questions and drag on the quest for truth; no, he's a "get the most bang for your buck" kinda guy. Me likey!

I just have to learn everything about the cornea now. Dry eyes anyone?

All things Indian

Jo Whaley

This weekend has been all about community, Indian style. I went to Ghungroo, an Indian cultural show sponsored by the Harvard South Asian Association. Lots of Bollywood, some dark satires, and overall a great time. It was great to see old faces (very old faces...like people who graduated 2 years ago...) and the usual turnout of so many people on campus who are not South Asians to participate in or watch the show. For a brief moment, I believed in multiculturalism.

Back at old sleepy Med School, my dorm-mates also coincidentally decided to have Indian food night, and went out to buy a bunch of exotic ingredients (fenugreek anyone?) to cook things like Chicken Tikka Masala and Keema and Kofta, and even Roti. I decided to chip in with the cooking. I had great success with the chicken tikka masala, and although we did set off one fire alarm, evacuate the building, and have the Boston police and fire department visit our humble abode, we pulled off the night with all around successful food. The roti was seriously good; it even puffed and everything! In retrospect, chicken tikka masala takes a looong time to make (3 different recipes in one!), so I will reconsider that choice in the future, but the keema and kofta was simply decadent. There was a real sense of community that was created simply from us all cooking together, rolling roti dough balls, and setting things on fire. The smoky, charred smell of success and cardamom was overwhelming.

Upon leaving after the alarm, one police officer turned around and told us, "damn, that there smells good!" as he gestured to my chicken tikka masala.

oh yeah.

True resident stories....

These colorful stories are not meant to be humorous or making fun of patients, but were presented to us as a sampling of the myriad of delicate issues encountered in a hospital. They are, conveniently, stories having to do with the abdomen, because we're covering that region this month. I'm reproducing them here because I am fascinated by the pathos inherent in each.
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An ER resident was called in late one evening to see the case of a man, in his early 20's, with a bowel obstruction. Upon entering the room, the resident heard a persistent buzzing noise and couldn't identify it.
He asked the man, "Do you hear that buzzing? Or is it just me?"
The man replied, " Um doc, yeah that's me."
The resident asked, "So can you tell me what happened?"
The man, timidly, recounted the story of how his girlfriend had stuck a small vibrator up his anal canal, and it got stuck there. Previous attempts at another hospital to try to remove it using an enema did not work, and actually pushed the object further up, pass the bend into the colon.
The resident then asked, " So how long have the buzzing been going on?"
The man replied, "The vibrator has been on the whole time...we just changed batteries..."
The resident ordered an x-ray, which confirmed the location of the object. Using a rubber covered metal wire, which was bent to resemble a hook, the resident went fishing for the vibrator. He managed to grab hold of the object and drag it back toward the anal canal, when the man exclaimed " Okay doc, I think I got it now..." The man then forced a bowel movement that ejected the black, plastic, still buzzing vibrator.
The resident proceeded to clean up, when the man asked: "Um, so doc, can I keep the thing?"

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A 3rd year medical student doing his psychiatric rotation was called down for a consultation on a patient on the surgery ward. Reading the patient's chart, he found the following story:
"the patient had a ruptured colon due to his partner fisting him in an act termed 'spleening' whereby the goal was to travel through the colon to reach the spleen and massage it in an effort to induce a 'high'. According to the patient, he was high on crystal meth during the act, and did not notice the pain. The ruptured colon had to be surgically tied at two ends, with the descending colon emptying bowels into an externally placed bag, and the anal canal tied off for at least 6 weeks in order for the colon to recover. The primary reason for the psychiatric consult: the surgeons didn't know how to assess whether the patient might attempt fisting again, thus rupturing the colon before it could heal. They thought a psych consult would know how to do it better.
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An 82-year-old woman comes into the ER complaining of pain in her lower abdomen. An abdominal X-ray revealed the presence of a bottle cap inside her vagina. The attending kindly asked the woman: "I see what looks like a bottle cap here, could you tell me what happened?" The woman replied, " Well, it was my 82nd birthday yesterday...and I felt lonely after my husband died..." (Apparently this case is a common one, as in beer bottles used as dildos can sometime loose their top, or in other cases, glass objects may break inside the vagina, thus requiring surgical intervention)
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A 30 yr old man comes in and complains of lower abdominal pain, claiming that he "accidentally sat on the sprinkler" after an x-ray reveals the sprinkler head well within his anal canal.

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"call me Kevin..."

Physical diagnosis class: 4:00 pm

We were working on diagnosing the thorax and associated structures. I, meanwhile, couldn't hear a thing through my stethoscope. In came a resident. He wasn't very tall; brown hair, Spanish features, or perhaps Italian--I couldn't tell. He looked in his mid twenties, spirited and clean shaven. There was no ID badge in sight, but I have ran into him wearing his white coat in the past . Hazel eyes. Always smiling.

I stopped him and asked," I'm sorry, what is your name?"

He stopped. Laughed a bit. "Call me Kevin."

"Would you like us to call you Dr. Kevin?"

"Oh no, no." I think he blushed. " Dr....I mean Kevin is fine."

"Could you help us?" I asked with a smile. "All I hear is meat." I smiled again.

He chuckled loudly. "All you hear is meat. hehe."

He had beautiful hands.

Chapter 1; Casa Fleming

Medical school is mind numbing. My Id longs for escape. Lots of thoughts have been roaming through my head lately…Now, if you're tempted to stop reading right this minute, wondering if this is one amuse-bouche-for-the-mind too many--relax. 'Chillax' if you will, as I attempt to convince you that my mind's musings are worth your time, during lunch breaks, at your cubicle. To start, Molly's meditation on traveling has spurned me to conceive what I hope to be a series of entries on my travel experiences, in bite size, stylized vignettes. Call it a retroactive travel journal if you want.
Here goes...

-CASA FLEMING-

We arrived in Tuscany via bus, crossing the Swiss/Italian border on a day trip across luminous fields of wheat and tall cypress that I glimpsed intermittently between naps. The driver left us at the bottom of the hill, forcing me to drag my uncooperative Samsonite up-hill, grinding the wheels against the coarse gravel pavement lining the path to the house. From the drive way, the house was reminiscent of an old barn, and it was not until I cleared the row of cypress blinding my view that I realized how gracefully proportioned it was, this old thing, with red tiles for a roof and stone facades and uneven ledges, worn from years of use. Casa Flemming was old; apparently the house stood on a medieval fort, its foundation a collection of stone slabs gathered from all across Italy by long dead descendents of Roman gods. The stately house stood on a tall hill that oversaw what seemed to me an endless carpet of olive trees--their waxy leaves fluttering in the midday sun--stretching as far as the eye could see. The nearest neighbor was at least four hills away, I counted.

Mrs. Flemming, our host, grabbed my hand. "Welcome! It's good to see all of you." Her bejeweled wrist flickered as she talked. Casa Flemming was her summer residence, her rejuvenation before returning to the business of running the 'American Schools,' a European educational empire stitched together by her own two hands half a century ago. Except for Mrs. Flemming, her cook, and assistants, we had the house to ourselves. In her opera night robe, she cut a billowing trail of black embroidered silk and perfume as we followed her to the back patio to see the stone swimming pool buttressed on one side by 2 tall cypresses, the white cast-iron benches strewn about with ease, and the fuzzy hills of Tuscany undulating before us, unfolding into a misty haze before emptying into the blazing sunset.
I think I gasped.

Lovely Train Ride...

Traveling. A metaphor.

Molly is the greatest.

blue: fixed.

Mona Kuhn

some changes

I've decided to fiddle around with a new template, and this is the result. I admit the blue is a bit odd, but I've yet to figure out how to change that...if you can help, I'd much appreciate it. Oh and, of course, I WISH medschool were like the people in the artsy photos above--languid, oddly hot, and full of gratuitous nudity. Eh, one can dream right?

Confucius, why won't you die already?

A disturbing article in the NY times Education section gave me a mild temper tantrum today. I usually don't get this bitchy except maybe over bad decor, but still....

The article was about rich asian immigrants (they're shopping for homes in Scarsdale, people! Scarsdale!) moving to the US in order to...you guess it: train their sons for MIT. It is highly ironic, I might add, that the purported reason for this departure from the motherland to America is to 'free' their children from the stress of competing in the rigid formal educations of the Far East (i.e. drone factories for future Microsoft programmers). Apparently, over there, it's just too much pressure; but over here, it's all fun and games like SAT prep courses in middle school, college coaching to get into MIT., and violin lessons even though the son is tone deaf (but Harvard LOVES to see forced-labor overcoming intrinsic lack of talent, so I guess there is a sick logic at work here).

The quote below, from an immigrant mother whose businessman-husband in in Beijing while she lives alone in in the States to tend to their coached prodigy, sounded freakishly familiar to me:

"Seven more years before he finish[sic] college. Then? I don't know," she said. "Whatever he will [sic] do, where[sic] he will go, I will go. To give the boy good life[sic]. That is all."" (Sick!)

Damnit woman! It ain't the 1800's anymore! Get a life! Let your son get a life! Jeesh! Enough with this Confucius bull crap about the 3 duties of a female: 1) attend to parents until you marry 2) attend to husband until he dies 3) attend to son until he...is sufficiently suffocated to death from your relentless cultural tyrrany!

Just you wait until he tells you he's gay, dropping out of college, and dating a black transvestite name Yvonne. Oh yes. God has a great sense of humor too.

Okay, so I actually pity her, and the son, and this whole warped mindset of achievement that makes victims out of everyone. After 5,000 years of cultural brainwashing, Confucius is still going strong. Damn old bastard.

Maine...

If I am ever going to a frozen tundra (again), I must remember to bring long underpants. I literally felt myself disappearing into...myself, sensing what it must be like to be a woman with penis envy.

Otherwise, the trip was fantastic. Mikey and I ate too much curry (because I had mistakenly planned to cook for 12 people instead of 2). We rented a cottage by the seashore, where the water was so cold we could hear its ice sheets cracking and churning in the shallow depths, crushing gravel. We had roaring fires, which began at first as smoky plumes that rose from the hearth and spilled into the living room because of dampness in the wood. My clothes still smell of charred timbers.

This was a rare weekend--thank god for President's Day--that made possible the plan for an escape to Bar Harbor, Maine. We took the scenic route from Boston, getting lost several times due to my habit of navigating via intuition--he was good-natured about it. There was no snow in Maine, so all of our plans for skiing or snowshoeing were dashed. Our adventures outside were brief-- snapping photos on a cragged jut of rock here or there, trespassing on private property to sneak a view of moss-lined valleys emptying into the pale-gray emerald bay, and getting yelled-at by an impish woman, in spandex stockings and a facemask, for picking up a few rounded stones along the coast. Maine was desolately beautiful: bulbous mountains appeared to tumble into the sea, leaving tall evergreens to hover perilously above the icy gray water below, with a surf driven by wind that pummeled itself against the juts of granite on which the pines stood tall. We defrosted ourselves in the car and watched gulls hover on the sub-zero gusts that whipped and howled around us. The air tasted of frozen salt.

Indoors, I cooked. We played board games and watched HGTV as I discussed the merits of mauvre over taupe for dressing recessed beams. Mikey tended to the fire, avoiding my musings on interior decorating by smiling and nodding his head repeatedly no matter what I said (I'm used to it by now). On the way back, we stopped in Portland Maine, where waitresses greeted us as 'friend' and streets with eclectic buildings had patriotic names like Congress, High, and Free. How very Quaker of them, I thought. We caught a movie. We drove home in the dark.

It was a largely uneventful vacation. And it was exactly what we needed.

Happy President's Day.

damnit!

The problem of going to a second tier research school: MONEY, and available research jobs. I've never had to be near the state of groveling that I am in right now. This sucks. I didn't even get to submit my application, and the research position is filled, one week after it is open. It's research, not I-banking! The freaking receptionist won't even return my inquiries for an application! It shouldn't be this hard, or demeaning, for students who are willing and able to do work to find positions at their own freaking school!

Screw this. I'm calling Harvard. At least they don't treat me like dirt.

Much Ado About Nothing

For fear of loosing my readership, I figured it was damn fine time I started posting again. The time of course is 2:30 am, but then again I've slept for most of the day.

"Match Point" is a very good movie. It was so good it made me think. A central theme of the movie involves luck, a theme that is very cleverly woven throughout the plot. Talking to a friend afterwards over greasy chiken quesadilla at Rock Bottom, where the drunken fratboys of Emerson College go to pass out (Emerson frat boys...is there such a thing?), I stumbled onto some unfortunate truths: my life has been a series of lucky/unlucky accidents, proven over and over again by my meeting people at the a certain place, at a certain time. While I pretend to be weaving a master plot of career planning to delay an impending midlife crisis, I was overcome by a sense of inadequacy, realizing that it's all largely beyond my control.

Why am I at school in Boston right now? If you say incompetence and a laissez faire attitude that was perhaps too 'laissez' and not enough 'faire', you'd be half right. I sung in college. And it was this serendipitous pairing of my many delusions of grandeur coupled with a voice talent equivalent of Billie Holiday post-heroin that got me traveling the world. I coincidentally also met some very interesting people, like the drunk businessmen in a seedy Tokyo bar that told me a cash-strapped, doe-eyed boy like myself could make a lot of money in this town, in one night, at that steam bath place, in the Harajuku district. I politely declined the invitation for extra cash. Other invitations, however, were more substantial: working in an orphanage in south east asia, for example, sounded like it could have been fun. Four years later, I go to a health conference to find that the position I was offered before had connections to a project I could possibly be interested in. Lucky that. The project manager knows my contact. I could be off in 6 months.

I doubt I'm going to go, however. This opportunity didn't present itself at the right time. I need another round of luckily bumping into people, to work my 'magic' and razzle dazzle my way into a research project, here, in Boston, because it's part of my career planning. And so I'm stuck again in square 1, revising my initial assumptions about luck. Maybe I need it to come in pairs, like twin-prime numbers, ad infinitum. It's only lucky if you have time on your side, along with opportunity. Otherwise, it's just coincidence.

Values, fundamental

It takes a lot for me to get drawn into politics, but my immigrant inclination and vantage point have moved me to comment on the crisis raging through Europe and the Middle East. The freedom to question, to dissent, and to discuss is what enables things like weblogs to exist, but more importantly, it enables the West to be the icon of enlightenment that it is. And it is, correspondingly, irresponsible for the US to stand idly by as long time allies like Denmark, Norway, and (to a certain extent) France are being attacked for the same virtues that we proudly share, the very virtues that millions have fought and died for throughout the course of modern history.

Here are some much needed truths, from a fellow immigrant, the dissident muslim Ibn Warraq on why the west needs to stand in solidarity against this attack on one of the central tenets of Western civilization.

Money quotes:

"The great British philosopher John Stuart Mill wrote in On Liberty, "Strange it is, that men should admit the validity of the arguments for free discussion, but object to their being 'pushed to an extreme'; not seeing that unless the reasons are good for an extreme case, they are not good for any case...."

"A democracy cannot survive long without freedom of expression, the freedom to argue, to dissent, even to insult and offend. It is a freedom sorely lacking in the Islamic world, and without it Islam will remain unassailed in its dogmatic, fanatical, medieval fortress; ossified, totalitarian and intolerant. Without this fundamental freedom, Islam will continue to stifle thought, human rights, individuality; originality and truth."

"...Be proud, do not apologize. Do we have to go on apologizing for the sins our fathers? Do we still have to apologize, for example, for the British Empire, when, in fact, the British presence in India led to the Indian Renaissance, resulted in famine relief, railways, roads and irrigation schemes, eradication of cholera, the civil service, the establishment of a universal educational system where none existed before?... The British even gave back to the Indians their own past: it was European scholarship, archaeology and research that uncovered the greatness that was India; it was British government that did its best to save and conserve the monuments that were a witness to that past glory. British Imperialism preserved where earlier Islamic Imperialism destroyed thousands of Hindu temples....The west is the source of the liberating ideas of individual liberty, political democracy...It is the west that has raised the status of women, fought against slavery...No, the West needs no lectures on the superior virtue of societies who keep their women in subjection, cut off their clitorises, stone them to death for alleged adultery, throw acid on their faces, or deny the human rights of those considered to belong to lower castes."

And finally:

" When the Chinese students cried and died for democracy in Tiananmen Square (in 1989) , they brought with them not representations of Confucius or Buddha but a model of the Statue of Liberty."

We cannot be ignorant of the delicacy of situations, nor can we be ignorant about the values that enable us to live freely, and we must pay the cost of defending these values. This is a war of civilizations, and I hope the West wins.

Un-doing

A one-liner message. A phone call. An argument. This is how relationships end, as I've found out from my unfortunate friends, whose breakups come at the cusp of the season of Hallmark cards, long stem roses, and chalky candies that taste good only because of the messages you devour.

A fellow classmate of mine had just broken up with his girlfriend, amicably; another, with much bitterness. Change is hard, I suppose, for these relationships that were hold-over collegic ties that couldn't bare the strains of new situations. Perhaps it was distance, perhaps it was time. I told them that they saved on valentines' day gifts. A lame excuse for consolation I know, but it was the best that I came up with, my not wanting to be overly sentimental, or worse of all, depressing. The remark gave my friends a slight chuckle or two.

(I know, I promise not to be a psychiatrist.)

For an old friend of mine, the news of an old boyfriend about to get married unglued the ties, once and for all. The relationship had ended, but then again it hasn't, the two of them, lingering in limbo. But the recent news was the death knell that needed to be rung. It's time to move on and have new valentines, I want to say to them all.

But I know un-doing is hard. Change is hard.
And for once in my life, I don't know what to say to make it better.

Buy Danish!

This is sad. Really sad. I understand hurt feelings, but this response is medieval and uncivilized. If you don't know what I'm referring to, visit CNN.com, or turn on any news source.

Doctrine

I'm not Catholic, but if I were.... Hat tip to Theologienne. You scored as Liberal Catholic. You embrace the social justice mission of the Church, and the view of Catholic community as seen in the Acts of Apostles. You have a great love of the American democratic tradition, but tend to want to apply these traditions to the Church itself and the deposit of faith. You want a married and female clergy, decentralization of power, and an endless list of reforms. You feel that you are a true champion of the Second Vatican Council. Like the Neo-Conservative Catholic, your views may be too determined by American culture, and you may uncritically accept many theories that may be harmful to yourself and society; instead you may need rediscover authentic Catholic thinking. You should emphasize the love of God, as your Creator and sustainer. http://saint-louis.blogspot.com - Rome of the West Liberal Catholic 74% Lukewarm Catholic 52% Traditional Catholic 38% New Catholic 33% Neo-Conservative Catholic 33% Evangelical Catholic 26% Radical Catholic 21% What is your style of American Catholicism? created with QuizFarm.com

New beginnings...

According to Mark Twain, there are two constants in life: death and taxes. I'll add a third: new beginnings. New job, new friends--newness is a perennial theme, and just when we least expect it, something new pops up, like cancer. But can there ever be newness with something old, something worn, something you once thought was abandoned, left for dead, unsalvageable? Friendships for example--old ones, broken ones--are they, too, deserving of new beginnings?

I hope so. It's just so damn hard to make them new again once the stains of the old have already settled in. There's never going to be a pristinely fresh start. Too much history, too many guarded feelings and cautious words make rekindling a chore, something to be tended to, like a young plant, too vulnerable and easily crushed. I, in my quest to reclaim what was lost, question whether that which was lost was ever that good in the first place, good enough to be remade. I have doubts, and so does my friend. We are friendly but we are not friends, at least not the way it used to be. That is my new beginning, a place much colder and grayer than I anticipated. The truth is ugly.

But friendships, like old toys you gave up on, get accidentally unpacked, are hard to get rid of, and if nothing else, they grow on you once they're gone. The smell of them, the feel of familiarity and old warmth leave you longing for the past, when you thought things were simple, and the games you played were innocent. The colors seem so alive back then, when truth mattered less than sincerity. And so you pick them up again, these old friendships, and dust them off only to find cracks and tears underneath the silvery patina of memories, valleys running deep against the grain that no effort can ever make them heal, and you realized why they were abandoned in the first place. Your only option now is not to mend the broken, or bring back the dead, but to forge something new. You hope that your old broken friendship would at least be ignored so the new one has a chance to grow unmarred. It's a hope, a dream that you can easily wake from, but it's all that you have. A hope for new beginnings, where the cracks of the old are remembered for what they are: imperfections of a life, lived.

Tiling the fluff

What does Home Depot grout, broken bathroom tiles, and an unfinished wooden violin make? If you say junk, then you've obviously not been introduced to contemporary art. No, really, if Damien Hirst can 'paint' a canvas with feces-covered flies, then my crappy 'mosaic' of things-I-found-at-the-recycling-center is a modern day, Caravaggio's David. Okay, that's a stretch, but I made my point.

Sometimes I think contemporary art is just full of bull shit, mental masturbation for the mathematically challenged. I count myself in that pool. What does all this have to do with medical school? Tenously, I'm attending an SMFA art course, and the instructor has given me a wooden, unfinished violin to decorate. The finished product will be auctioned at some event to raise money for health care issues in Boston. It's a noble cause, but I don't really have time. But she insisted, and I obliged, so now I'm staring at a beautifully carved Suzuki violin--naked without its glossy veneer--and thinking of ways to mutilate the poor creature. "I'll chop it up and make it useless (Picasso anyone?), I'll decoupage it with pictures of models' body parts (hmm, too literally Pop), I'll charr the surface and expose its innards (hmm, too serial-killer like)..." the endless possibilities seem to pour out of my head.

No, I think I'm going to tile it. I don't know why really, but I've just always had the urge to do some tiling and mosaic work, but never found anybody willing to let me redo the kitchen floor. Of course, I had to 'justify' my work (apparently, wanting to make something beautiful needs an explanation of what is beauty, too) and so I made up some metaphysical dish about entrapment and beauty and capturing the transient...blah blah blah to titillate my professors. I did this over lunch, 3 paragraphs in 15 minutes. The write-up is so vague it practically warrants its own explanatory writeup. They loved it, gobbled it up, ate it with an excitement that I could only imagine as similar to the way art critics practically wet themselves everytime Andy Warhol made another soup can print back in the day.

I sincerely hope that they were just being nice. I know artists can be on the fluffy side, but this was nothing but hot air.

!!!

Too. Much. Anatomy.

It's Friday night. Where is my life?

Edges

I just spent 3.5 hours in the anatomy lab today, afterhours, from 8 to 11:30 pm. Barbara seems to smell better in the evening, I don't quite know why. It was like a party in there, everyone basically camping out to study for our big exam next week. I knew it was time to leave when off handedly I asked Barbara a question, and she said no, as I was quizzing myself some structures on her arm. Barbara, being dead and all, can't talk, so it was my mind in a manifestation of her voice that answered my own question. I saw friends dancing with a skeleton in the corner. That was it. It was time to go home.

I am three quarter of the way through John Updike's novel, Seek My Face. I'm halfway through Cunningham's nonfiction novel Provincetown. If it weren't for Itunes and audiobooks, I think I would go crazy only dreaming of blood vessels and dancing skeletons. My favorite phrase from Updike in this book: "... the pre-dawn, before light begins to lift edges into being. I am trying, it may be, to paint holiness." Beautiful.

green papayas

A girl in class tapped me on the shoulder today and asked "Can you speak Vietnamese?" Startled, I replied with a "Yes," almost followed by "And are you stalking me?"

I know, me and my megalomania issues.

"Can you read and write it too? Like, literature?" chirped this petite girl behind her dark, all encompassing glasses that circumscribed her face most unflatteringly. I'm not quite sure what about her made me recoiled, maybe it was the florescent lighting that bleached her face, or the inquisitively darting eyes floating on a sea of teeth she kept flashing repeatedly. Her effervesence was spilling over onto my seat, dangerously close to my rumbling discontent, left over from this morning's run-in with the exam from hell. I distrust happy people.

"Um well, yes. I can read and write Vietnamese..." I hesitated before she rudely interrupted me. "Oh, so like are you a first generation immigrant?" I paused, contemplating her use of this very politically correct, sociologically accurate description. I was expecting something more coarse, like "so when did you get off the boat?", my mind in gear to protest the banal and stereotypical assertion it had concocted. No, she's too smart for that, and I, too ready to be offended. "Like, were you born there?" She thought I didn't understand her the first time around.

"Yes. I came here when I was 10." I declared.
"Oh, see, I was 4." She remarked quickly, pausing, then resumed darting her tongue. "Oh wow, you couldn't tell I was Vietnamese, not from my last name?"
I pounced quickly, feeling gleeful for having caught her off guard. "No, I don't notice these things. What is your last name?" I felt like telling her that not everyone looks for others of their 'kind' on the roster.
That was cruel. She was only trying to make rapport. Could I blame her for seeking sameness, maybe friends? I admonished myself.
"Um, so, are you from around here?" I asked in a gentler tone.
"No, I'm from Northern California." She stated.
I shoot. I miss. The ball's back in her court.
"Uh huh..." I continued the conversation, asking her about the New England weather, where she went to school. She's incredibly sharp: tongue, eyes, mind, a Smith graduate with a fiance. Now I felt safe.

She mentioned some movie she saw in Thailand. "It's called something 'Green Papayas'. It's by a Vietnamese American director, supposed to be really seminal. I didn't like it..." She was fishing for dialogue too.
'Well why are you telling me to watcht it then?' My internal monologue droned on.
"I don't know, you could check it out." She laughed awkwardly.
"Oh, um, sure. Maybe I'll look it up sometime. Thanks!" I hurriedly sped in front of the line. Class was over. I wanted to leave. She waved back, also awkwardly.

I'm so bad with strangers.

Nip Tuck

The message is everywhere: loose weight, bulk up, look tight, shave this, nip that, and your boyfriend will love you.

"So you're on a diet?" I asked my friend as we casually waited in line for 'Capote' last night.
"Yeah, I haven't had dinner," he replied.
"Starvation is not a diet you know." I quipped.
"I know...been busy. I do try to eat healthier though. Today at lunch I had a chicken breast, some sunflower seeds, carrots, and a small salad. Those damn sunflower seeds got husks or something, 'cause they stick to my teeth..." said my friend in his trademark Southern drawl.
"That's practically bird food for you." I snickered, looking at this 6 feet tall, stockily built, lumberjack of a man.
"Yeah well...I'm really hungry now. Was at the gym for like an hour." He conceded.
I waffled and waxed on some nutritional knowledge I learned in medical school, namely, that skipping meals was not a good idea. He seemed genuinely interested.

The movie ended. All we could talk about was food. We settled on Rock Bottom for its easy decor, proximity to the T station, and most importantly, a kitchen that wasn't closed.
"I'm so hungry right now my brain ain't workin' straight. I'm gonna get a nice, juicy steak,” proclaimed my friend. From a distance, he looked like a blond version of the Brawny Man on TV, husky, hirsute, a man’s man, practically oozing confidence. I felt safe around him.

A very late dinner ensued. I asked him about his recent motivation to diet. Twenty minutes later:
"He called me fat."
"What?" I shouted, raising my eyebrows, flabbergasted. "That's low. "
"Yeah. Totally. He was drunk, and he said that the reason we didn't have chemistry or whatever, was because I was fat. He was trying to let me down gently." Said my friend, disgusted, slightly hurt.
"You're not fat." I tell him. He doesn't believe me; I see it in his eyes, but I continued. "You're stocky. It's your build. Nothing wrong with that."
"No, no I know. It's also been something I've been meaning to change about myself. You know, be more healthy, eat right, exercise, lose a couple of pounds here and there." He retreated to the rational.
"Those are all good reasons. I just hope that you're doing it for yourself. What that boy said was an impetus, I'm sure, but..."I was interrupted.
"No. Yes, it's an impetus.” He quickly recaptured what I meant to say. “But it's not like all that important..."

"So deep down there isn't a part of you that said 'had I been thinner things would have worked out’?" I inquired honestly.
"No. Of course not." His voice had a resolute tone that declared the topic was over. I sensed the confidence in his blood rising, in time with his vodka tonic. We toyed with news of his other prospects, 'in the pipeline' as he called it. My friend had been busy, not letting the previous rejection curve his enthusiasm.

It was late. The last train was leaving.

"All right. Well, I hope you feel better." I spoke reassuringly as he wrapped me in his bone cracking, but friendly, embrace.
"What do you mean--feel better? You mean about my impending cold?" He questioned, fully knowing my answer.
"No, not just that. About everything." I smiled, walking away, the dim glitter of the city to my back.

ideas?

Nevermind anniversary. Valentines' Day. I've never had to plan/engage/act on anything on this particular day, except to wish ill on anyone who wishes me a happy... Yes, death to well-wishers.

Because I'm new to this, I'm pathetically out of ideas, or at least good ones.

Any suggestions from the peanut gallery on some good Valentine Day things for Mikey?

productivity

I came back from a night out at 12:50 am on Friday to the sounds of stifled giggling eminating from the common kitchen. "Have you ever put marshmallow in a microwave?" Seth, a first year medical student, asked me gleefully. "Um, no." I blurted, half wishing I'd said yes so I could be on my way. Seth pulled me into the kitchen. I watched, for almost a full minute, five other grown men glue their eyes to the bubbling, expanding sugary balloon as it turns brown and goopy inside the radiation chamber. The fluffy gop finally imploded in comical silence to a cheering crowd. "You don't know how many burnt marshmallows I've eaten tonight..." proclaimed Adam, as I, slowly, and with a drooping smile, walked away.

It's Friday night in a medical school dorm. You wouldn't know it except for the sign.

the human stain

A certain smell startled me when I did laundry today. No, I usually don't jerk reflexively at the scent of Tide, but it was the too familiar smell of anatomy lab in my freshly washed clothes that made me gag. Barbara's smell was new death, I called it, because it was more pungent and intense than in other bodies, those that have spent longer in formalin. New death. And I just caught a whiff of it. Strange. I found the offensive garment after some mild rummaging. An undershirt, pristinely white on top, with big, sprawling ovals of grease seemingly intact, stared back at me in defiance. Stubborn stains. I had washed that shirt with my other offending undergarments from the lab in a separate machine, and thought to dry all my clothing together to save a dollar. My plan was foiled. I threw the garment again into the washing machine as quickly as I could. The shirt probably could have used a pre-treat the first time around, but I was unaware of its state until now. I doused and soaked the thing in a concoction of 3 detergents, hoping to undo what was done.

I thought about why I had reacted so violently to the smell of formalin and human fat, one I've grown accustomed to, made jokes about, and taken pride in as a medical student. It was ten times milder than in the lab, and I don't gag there. I suppose it was the unexpectedness of it, a reaction to something so out of place and wholly vulgar to my sphere of domesticity, of weekend laundries and household chores. To find the garment still soiled, after having gone through a process that rid clothes of their ordinary stains, rendered these stains somehow otherworldly in their existence. The reality of how the marks got there escaped me. I just wasn't prepared for an encounter with a remnant of the dead, here, in my domain of the living. A momentary panic ensued as I frantically sniffed my laundry, hoping the offending smell didn't infect the load. An infection. As if the un-cleanliness were a viral contagion.

I inhaled deeply. Nothing but the springy scent of Tide reassured my nerves.

pic by De-Bivort; 2005

awkward...

Physical diagnosis class is turning out to be one hilarious hour. We get to feel each other up. And by that, I mean practice the physical exams we've learned. We were on the lower extremities, and of course, that meant touching in all the uncomfortable areas around the groin. Yeah. My all male, mostly heterosexual group decided to avoid awkwardness by having each person palpate himself. This was only possible up to a certain extent. Half way through the session, no wonder the instructor thought it odd that in our group everyone had his hand down his pants, touching in silence.

Nothing like male bonding.

Shanghai Restoration Project

I have some really talented friends. really. Please support him by visiting this website. If you like Hip Hop, Electronica, or pop, this will blow you away.

http://www.shanghairestorationproject.com

Desert Bloom

I never thought I'd say this, but who knew orthopedics can be so...BORING?!? My mind began to wander after only 20 minutes of listening to the professor drone about the gait cycle today. Usually, I'd at least pretend I'm taking notes until half way through the hour. Recent word of the end of a friend's dating dry spell occupied my thoughts. The news sounded serendipitous. They met unexpectedly. A dinner. A dance. A third date. I'm having whiplash just hearing about events as they unfold. My head, meanwhile, is spinning with questions. How does one go about breaking a (?) year dry spell in 3 days? Is this engineering, or plain luck, or a senior spring fling that could probably use some speedbumps? More importantly, am I channeling Carrie Bradshaw?

Relationships have been on my mind recently, and not just the one my wonderful friend is enjoying. My one year anniversary with Mike is approaching. According to the 'romantic package' planner on Orbitz.com, 'Bed & Breakfast' getaways are' so' for my grandparents. It's about rock climbing and sweatiness for today's couples. In finding ways to properly celebrate my bliss, however, I am reminded of those who are less fortunate, namely, my single friends who undoubtedly will send me hate mail after reading this blog. Just kidding, they don't really read this blog.

If you are reading, these friends of mine in faraway (and not so far away) places, I hope that you will find the wonderful people that you deserve. It does rain in the dessert, and when it does, may it be a torrential storm.

Oh, but showers are nice, too.

musings

My art installation has gotten me thinking. I see images of an empty hallway awaiting something, anything, to fill it. Might as well stack soup cans along the walls and call it a day. Mainly though, I want art that is slightly uncomfortable, but not so much so as to be distracting. It is afterall a place where the sick seeks help. Being uncomfortable is probably not something they'd prefer. But like all clinics, I loath this one for its sterility and muted pastels. I see only white walls and uncomfortable chairs. Amidst silence and dread, a long corridor leads to anonymous doors.

My blank canvas is pretty blank indeed.

For this class, the point is to engage art in everyday life, whatever that means. Bringing the sick back into everyday life also happens to be a goal of medicine. And so, in my corridor, I want life with all of its lushness and vitality, somehow melded to the artifice of medicine. I see a ceiling path of thick green grass, tricking down onto those anonymous doors. I want test tubes as vessels for seeds, and herbs.... I want them to grow from my ceiling path of grass as any plant would, each test tube like a flower bearing seeds, and life. Thematically simple, hopefully uncomfortable.

If only it were feasible.

Some truths...

In case I ever forget:

1) Medical school is not cheap.

2) Skiing= more money for orthopedic surgons.

3) It's not nice to stare...especially at the boyfriend of someone with whom you once flirted as he's trying to deposit money at a bank.

4) Vapo-rub under your nose can make you cry in Anatomy Lab.

5) Sleep is good.

Gross anatomy

My long awaited moment of truly becoming a medical student came yesterday at 2:00 pm, EST, in the gross anatomy lab. It was loud, and the smell: unmistakable.

I've always imagined what the first day cutting into the deceased would be like. I pictured a dried corpse. Something blanched, exposed, and like a Barbie doll stripped of her clothes, it would be barely human.

And then I met Barbara. She was around her early 80's when she died, possibly of hypertension and coronary heart disease. We had a moment of silence for her and all the people who gave us their bodies--it was the only silence we'd ever hear again in the lab.

I found a strange peace with the blade in hand. Her skin was so surprisingly supple to the touch that it still responded to the pressure of the knife. I thought I was sculpting, cutting away soft bits of clay to reveal the wonder beneath. I peeled back, layer by layer, the skin and folds of fat, scraping away at superficial fascia to reveal nerves and tiny blood vessels. I was lost in the motions: gliding the blade, carving at flesh. For a while, it was beautiful.

Barbara, as it turned out, wasn't going to reveal herself that easily. Her flesh still had tonicity; her fat bounced with our touch. In the words of a fellow labmate:" She's juicy." We soon realized that clearing away structures was going to be much tougher than we thought. Whatever apprehension any of us had about touching/dissecting cadavers flew out the window. Pretty soon, we were all elbow deep in subcutaneous fat, ripping, gripping with our hands at the layer of superficial fascia, digging the inner thigh for the ironically named saphenous (obvious) vein. I've been told that human fat had a distinctive odor. Mixed with formaldehyde, the smell and experience became unforgettable.

Two hours and one bucket of human remains later, Barbara finally gave in. We found the femoral triangle (correctly!).

Barbara wasn't dried, or blanched, or perpetually stiff. Her flesh was moist, and pink, and supple. She made us work, hard, and still there was much work left to be done for the next lab. But I was too tired to care at this point. I rushed home, took a long, hot bath, and still smelled the odors of the lab lingering in the air. Everyone in the dorm had dumped their lab clothes in the hall.

And I'm glad I have plenty of air freshener.

scrubs:

Got them. Plus gloves, scapel, and plenty of soap.

Anatomy class begins tomorrow.

Can't wait.

Anatomy Class

I find her, on her back, trembling,

Her legs swinging high above her head

As if she were climbing an invisible ladder,

Or a branch.

I can't tell if she is really female;

To me, all dragonflies look the same.

I search the ground for a makeshift gurney,

Hoping a tissue paper will do.

The cold autumn kills.

I can’t save her.

In my room, she rests inside a pickling jar.

I watch her breathing, seeing

The vibration of seraphim’s wings

Trembling before God.

Her opalescence overwhelms me.

She twitches, occasionally, in quiet agony.

Her winged body,

Outstretched like a cross

Encrusted in jewels that glisten

In the light from my halogen lamp,

Lies ever more still.

I breathe on her,

Hoping the warmth reminds her of sunlight,

a breeze of summer, a bit of grass.

She barely moves now;

Only a relaxing of joints,

I tell myself,

Only a relaxing of joints.

Night out...part 2

Some people procrastinate by watching TV. Absent one, I write. Since there’s nothing more exciting going on in my life than looking at sections of preserved vaginas, I’m going to recount a sordid act of infidelity I witnessed some nights ago. Some history: Todd and Andy are friends. Andy has always wanted to be more than just friends, but Todd’s bed had no vacancy for several years straight, apparently- until tonight.

Dugan, Todd, Andy and I went to Club Café with several people after the get together at Laurel. I, still analyzing what had transpired between John and me, was oblivious to the drama happening across the table. On the surface, Todd seems nice enough, and Andy’s manners would make him a great doc. He was rather cute. But the alcohol since dinner had made them more crude, and their intentions more obvious. Around us, the meat market was in full swing, set to the beat of Madonna and Cher. Let the games begin.

By my second Diet Coke Todd has introduced us all to his current boyfriend, whose name I didn’t catch but whose Aryan features I couldn’t ignore. He appeared gracious, debonair even, but his hand clutching Todd’s told me he was human too. He didn’t talk much and spent most of the time staring out at the dance floor. Todd and Andy were whispering beneath their breath, and I saw on Andy a devilish grin. Todd excused himself for a smoke. Andy followed. Todd’s boyfriend came running after.

We missed them for 20 minutes, when finally Todd came back, proclaiming exasperatedly “ I’m so fucked….I so want to sleep with Andy, and I want [the boyfriend] to go home, but he won’t leave.” Dugan suggested a solution. “Why don’t you just leave and come back in a while; we’ll make sure Andy will still be here.” It wasn’t as simple. This game of trying to ditch the boyfriend would continue for several hours into the night. Andy would bum a smoke, and Todd would follow with the boyfriend hung to his side. Finally, Todd came back with both his lovers and said his goodbyes, leaving with his boyfriend still attached. We looked to Andy. Sullen, calculating, with a flash of teeth, he has since ordered another martini.

Todd returned unaccompanied some time later to meet Andy. They danced. Hips, shoulders, sweat. “It’s just a one night thing. I used to like Andy, but he has such attitude.” Dugan scoffed. “I’m like, you’re cute, but not THAT cute to act that way to me!” I finished my Diet Coke, palming my phone, hoping my boyfriend would call.

Out of the blue minutes later Todd came running to us. “Shit, I’m busted. That was [the boyfriend]’s best friend; she definitely saw us. Shit!” Andy was now clutching Todd’s hand, beckoning him to leave. He still had that devilish grin. I guess Andy never really took the Hippocratic Oath to do no harm. Dugan schemed further with them, but not before I left. I heard Dugan remarking on Todd’s current relationship. “I’ll give it another 3 weeks at most.”

it's not all about studying

Social life is really hit or miss here, particularly for me. Harvard, being a hop and skip away, is where I spend most weekends with my boyfriend. But there are moments that beckon my presence, like the gay Christmas get-together with other doctors and med/dental students that any self-respecting homo would dare not miss. In my case, my exposure to gay-anything was new and exciting, a mixture of homecoming and coming-out, all for a bit of holiday fun.

We met at Laurel near Back Bay Station, and unlike usual, I was 10 minutes early. The hostess informed me that they were still setting our table, so I was free to sit by the bar and talk to the only other member of our party that was coincidentally extra punctual. His name was John, a tall brunette with a dimpled smile and piercing green eyes. I noticed him before; he smiled at me as I walked in. We talked. I ordered a diet coke; he ordered a scotch on the rocks. Within five minutes of conversation, I realized that I was in over my head. He was hitting on me, and I was flirting back. Badly. I’m not used to being hit on, much less do something about it. He had that look in his eyes, the kind that my boyfriend had (still does) when we first met that was electrifying, only this time it was one I didn't quite catch until it was too late to stop talking. It felt extra bad because we both have boyfriends. While his was slightly late, mine was faithfully typing away at a computer somewhere in the basement of the Science Center. When we finally got up, the bartender “assumed” we only wanted 1 bill.

We sat at opposite ends of the long, queer table. For the entire dinner, everytime I looked up I'd catch his eyes smiling at me, in full view of his boyfriend blabbering on about his workday with patients. I felt guilty, intrigued…more guilty as the night wore on. Before we left he made a point to shake my hand. I, meanwhile, awkwardly introduced myself to his boyfriend, who appeared oblivious to everything but the exhaustion evident on his face. He's a second year dental student, and works long hours. John said he'd offer me his card, but he doesn't have any on him without an expired email address (sure). I didn't offer mine. I faked a laugh and bid him good luck with his job. He promised we would definitely run into each other in the future. I know I'm not holding my breath.

My brief foray into the dating game has taught me this much: the game sucks. Even at this stage where my social life consists of ties with college and tentative relationships with the real world, I can't say I am ready to re-enter the dating pool as an 'adult'. More importantly though, I don't need to. Temptation is ever present, but stability and love is what I have. As a wiseman once said, " It don't matter where you get your appetite, as long as you eat at home." Amen.

Trust me...I'm a doctor (in training!!!)

I suspect that at this point in our careers, most med students are petrified at giving out medical advice when asked. This is a great thing of course, since like most med students I probably couldn't tell you the front end from the back end of an opthamoscope, much less give you cogent advice on your heart condition.

Inevitably, however, we do get asked. A couple weeks ago a friend of mine called nervously with the point blank question: "why is there blood in my stool?" Taking a moment to properly weigh the merit and urgency of the question, I wanted to yell back "OH MY GOD YOU HAVE COLON CANCER! That sounds horrible, have you visisted the emergency room?"

But I stopped myself. I mean, the words just didn't come out like that. Instead, I heard myself asking

"What have you eaten recently?"
"Do you feel sick/under the weather?"
"Can you tell me if it's dark brown/black or bright red?"
"For how long have you noticed it?"
"Are you on any blood thinner medication?"
"Was it hard/painful to pass stool? Was it loose or compact stool?"
"Does it hurt? Where?"

My voice slowed down as my tone deepened. I said things like 'uh huh', 'I see', and 'I understand' with every couple of sentences. I could see myself categorizing the information he was giving me and asking targeted questions to keep pace. I nodded my head as if he were able to see me.

After a while, I revealed that in class I ran across some common conditions that may cause blood to appear in stool. I told him what the research said, but that he should take everything I say with a huge grain of salt. However, I did tell him to make an appointment with his PCP asap. In the meantime, his best bet was keep making observations and bring a sample of stool to the doctors so they can analyze its content.

Somehow, I think the barage of information they keep on yelling at us in class is seeping in. At the very least, the method of questioning a patient for medical history, thinking logically and offering advice based on facts--they're all beginning to structure the way I think. It's exciting, and still very scary, but exciting nonetheless.

residency hours

Clearly, it's too early for me to be thinking about how long residents have to work, but the topic has been floating around my world often enough that it deserves my 2 cents. For the uninitiated, recent trends in American medical education have begun to limit resident work hours to 80hrs/week with some restrictions on 24 hr shifts and various other things. One of my upperclassmen was talking today about how surgical residents that she knew at MGH essentially under-report the hours they work per week by something like 10-30 hours (by the way, this is illegal). These residents apparently under report for fear of departmental backlash from program directors who would like their residents to work more than 80 hours (like back in the good old days) but legally have to follow the new laws. The monitoring board for this sort of thing has investigated programs that violate the law (for instance, Johns Hopkins was recently investigated--I don't know the specific residency program). Johns Hopkins, MGH...these are top places for residencies, especially for surgery. Is this the price for top trained doctors?

The controversy beckons the question: what is really at stake here? Is it resident training (surgical program directors argue that the training for surgery necessitate residents working over 80, even 100 hours in order for them to be trained adequately to take care of patients from A to Z) or is it patient safety (my impression is that there is a correlation between higher risk for patients with overworked residents making mistakes)? I know that the culture of medicine is slow to change, but at high powered and high stake places like MGH, what is truly going on? My understanding from the resident's perspective is that for some, they WANT to work more than 80 hours if it takes that much for them to take care of patients 'properly' and the new laws are compromising their superior training as physicians. For others, the requirement places them in a tight spot, especially if their program directors implicity want them to work over the limit, but by working over the limit they are legally held more responsible for their mistakes, and reporting the whole thing would mean being ostracized by their fellow doctors, perhaps even damaging their future career developments.

What depresses me the most is hearing/reading comments from surgical directors/ older surgeons who says essentially that students not prepared for this kind of work hour should choose another specialty or get out of medicine altogether. Mind you, I think this sentiment is rare, but nonetheless before the rules were applied surgical residencies were legally allowed to work you to death. 100-120 hours of work a week border on cruel and unusual punishment if you ask me, especially considering how a week only has 168 hours in it! It worries me that at the top training facilities in this country for surgeons, the cultural mentality of overworking residents still exist, and the peer pressure to interpret more hours as better training is still being encouraged. What kind of logic is operating if residents are asked to work without sleep, thus committing more errors and possibly compromising patient care so that they can be better physicians later on (to serve a richer clientele) because the patients they practice on now are generally poor?

If the aforementioned is a myth, I'd love to find evidence to debunk it before I have to choose residencies. I really do.