Sunday, November 29, 2009
how far have i come? if theres anything i've learned being here so far is that any expectation i came here with, and everything i thought i was fleeing from, is all my own creation, existing only so long as my uncontrollable consciousness makes it undeniably real. one could say theres nowhere else to turn but inside... or one could say i should keep running fastfast, and maybe i'll never catch myself!!! that'll teach me!
Thursday, November 12, 2009
suprised by:
how great i feel when i sleep 8 1/2 hrs! im honestly shocked by what a difference it makes in my reaction, my attention to things.
touched by:
we did a home visit exercise today- myself and two other residents visited the home of another faculty doc's patient. she was super nice, very open, reasonably fucked up. family affected by alcoholism/domestic violence in multiple generations, but also many family members doing awesomeawesome. one thing i love about medicine is the naked self of a patient, alone in a sterile room, discussing their deepest values, darkest fears, brightest dreams. hanging out with a 60y/o lady in her little apartment, with doilies and tons of famliy pictures and a turtle and fish and a cat, to see where she keeps her meds (not far from the cat's), to see the stairs she climbs (4 flights) to come and go from home... very touching, very real.
inspired by:
a specific fellow 'tern, who is gonna be a great ally against systematic injustice, a fact (or theory) which hit me hard while we did this sort of "mindfulness in medicine" exercise where we described our innermost goals as physicians, making our own hippocratic oaths. as you can imagine, most people didn't think much about it, and most "answers" were generic, good-natured, and absolutely not-challenging-status-quo, like "i hope to care for my patients to the best of my abilities". not that they were insincere... but one of my fellow interns... i forgot what she said/wrote, but it made me realize that she's on the level (CHALLENGE! REFORM! HULK ANGRY!!!), recognizing oppression in it's most systematic forms. but, to be honest, i've been pretty inspired by the program in general this past month: partly awesome speakers, awesome topics, and awesomeawesome faculty. but, when i imagine the average intern across the nation, even considering just family med interns... i'm with some amazing people! so surprising and reassuring that there are others that think like this... i was also inspired by another intern who i had discounted as being not really on the level, though a nice/caring/capable person anyway. but, as we discussed our "oaths" afterward, she remarked that she was so happy to be in a program where her colleagues were "good at the politics of medicine", and that it helps her recognize that the politics in medicine are important for her to learn more about. how inspiring is that!!!
how great i feel when i sleep 8 1/2 hrs! im honestly shocked by what a difference it makes in my reaction, my attention to things.
touched by:
we did a home visit exercise today- myself and two other residents visited the home of another faculty doc's patient. she was super nice, very open, reasonably fucked up. family affected by alcoholism/domestic violence in multiple generations, but also many family members doing awesomeawesome. one thing i love about medicine is the naked self of a patient, alone in a sterile room, discussing their deepest values, darkest fears, brightest dreams. hanging out with a 60y/o lady in her little apartment, with doilies and tons of famliy pictures and a turtle and fish and a cat, to see where she keeps her meds (not far from the cat's), to see the stairs she climbs (4 flights) to come and go from home... very touching, very real.
inspired by:
a specific fellow 'tern, who is gonna be a great ally against systematic injustice, a fact (or theory) which hit me hard while we did this sort of "mindfulness in medicine" exercise where we described our innermost goals as physicians, making our own hippocratic oaths. as you can imagine, most people didn't think much about it, and most "answers" were generic, good-natured, and absolutely not-challenging-status-quo, like "i hope to care for my patients to the best of my abilities". not that they were insincere... but one of my fellow interns... i forgot what she said/wrote, but it made me realize that she's on the level (CHALLENGE! REFORM! HULK ANGRY!!!), recognizing oppression in it's most systematic forms. but, to be honest, i've been pretty inspired by the program in general this past month: partly awesome speakers, awesome topics, and awesomeawesome faculty. but, when i imagine the average intern across the nation, even considering just family med interns... i'm with some amazing people! so surprising and reassuring that there are others that think like this... i was also inspired by another intern who i had discounted as being not really on the level, though a nice/caring/capable person anyway. but, as we discussed our "oaths" afterward, she remarked that she was so happy to be in a program where her colleagues were "good at the politics of medicine", and that it helps her recognize that the politics in medicine are important for her to learn more about. how inspiring is that!!!
Wednesday, November 11, 2009
Tuesday, November 10, 2009
another oldie and embarassingie, but a goodie
wow, i figured out a way to open some old sparkle reflections i've carried around with me... they were saved as WPS files, lord knows why, and word had it all scrambled, but i realized that it was still retrievable.
and man, the season of reflections the summer i got kicked out of highschool are REAL bad... it's funny, cause i have this 18y/o patient, son of bangladeshi professional class immigrants in the bronx, who comes to me with patellofemoral syndrome (from soccer injury) and self-admitted depression, seeking counseling. So, i manage his overall care, but i don't do the counseling... but talking to him, he sort of comes across as arrogant, thinks he's smarter than everyone, but also with feelings of alienation, negative thoughts, low energy, poor sleep... really suffering. so, obviously i feel so much empathy for him, but still put off with his pompous attitude...
until i read my reflections from when i was his exact age! i sounded like the definition of pompous! which is, i'm sure, how i will sound now, if i read myself years from now. nevertheless, i certainly don't regret what a silly child i was back when i was a silly child, so the lesson here is to not only realize that my patient is just a person trying to do his best in life, but that all beings in all circumstances, are just doing the best they can do. and that's something to help me empathize with everyone.
by the way, my fave definition of empathy (though not consistent with internet Merriam Webster): the ability to understand someone else's experience AND the ability to communicate your understanding to the other.
soooo.... here's that reflection, dated 10/1/01, a little over 8 yrs ago. I thought it was interesting enough to copy and paste because i am in a similar situation nowadays, new life in a new situation, with a new "role" to play in society. and my reaction to it back then is similar yet also really different to my reaction to life as a bronx doc now. (which reminds me, i plan to write a postive vibe-ing post here since so often i only write to vent bad days rather than conscientiously reflect on my experiences).
Shuchin Reflection #3
I’m exhausted. Not physically or emotionally or psychologically or spiritually or any other –ly word. But, at the same time, I am. This summer, though I was only complaining and waiting for the school year to start, was much more direct and concrete. I went to sparkle, went out every few nights, and was out on the weekends. Same kids, sometimes I went to Baton Rouge, same activities. And yet I complained that life was stale and those kids were stale and the circumstances were stale. At Tulane, it’s the same it some different way…
I think I spread myself out too thin. It’s supposed to be a mentally healthier way to look at life: have a variety of pursuits and connections with your environment. I feel like I’m juggling the many things I have to do, the many things I’d rather do, the feelings I can’t help having, the feelings I feel I’m supposed to have, baggage and expectation and compulsion and commitment. They all seem wrapped up together. And don’t get me wrong; I’m not trying to make this some bitchy reflection. I’m quite optimistic of where I think my life is going and I feel quite in control of the parts of me that I usually feel are out of control. But I feel drastically unconnected. Being at a new school but being tied down to your past sucks. Of course, the home life restricts me from going out, but it’s more than that. I don’t feel a part of Tulane, I don’t feel a part of freshman life, and I don’t feel like a college student. I juggle my intellectual pursuits: I have Sparkle, academia, personal dimensions of all of that… but it’s juggling. It’s scheduling it around… what? Maybe stuff that matters. That Maslow article made me think a lot, though many of you might not have read it. What really matters to me? The Right Thing has been taught, retaught, shoved down my throat. Not that I really want to do the wrong thing. But it’s so hard to tell when things such as what makes a person happy is qualified by people that are nothing like me.
I don’t know where this is going, but I’ll spin it all around to make my original point (hopefully). I feel like my life is a video game system, and each segment of my scheduling book is one of the little cartridges, and each game has rules and goals and legitimate rewards, but they each have nothing to do with each other except that I’m the main character. I don’t quite know what I’m complaining about, but I might be used to having more centrality. Lsmsa, as terrible as it was, was still a place where you know everyone and they all know you, you learn and eat and sleep and have sex and make friends and break rules and do homework and complain and exercise, all in the same one-mile radius. And I fit in so well, the enemy of the state I was over there, I was still an integral citizen to whatever the hell was going on over there. At Tulane, and in most parts of my days, I’m a zombie, a shell, a foreigner. I’m not trying to sound jaded, God knows that I do, because I have heart in what I’m doing, most of the time. At sparkle, I’m excited (or as much as I can be at goshdarn 8 in the morning) to be there, at soccer I’m excited, when meeting people I’m hopeful, in classes I’m anxious for new material, with the family (on good days) I’m happy that I’m blessed as I am, when I’m chilling with New Orleans acquaintances I’m in good spirits…etc. But I’m not really there. Most of these situations, all of my interactions are robotic and so are the people I’m interacting with. Even the kids at Sparkle. They come to a camp or whatever they think it is, learn some chemistry stuff, learn some math stuff, hang out with kids like them… but are they really there. Maybe it’s because I’m not used to regular semesters instead of the summer, maybe ‘cause it’s early in the morning, but those kids are there like they have to. There are exceptions, but it’s not like there are some kids that are closed up and can be worked on and nurtured to a truly honest connection with learning or people or themselves. Some kids, with their behavior and attitude and countenance, just make me feel hopeless for them and for everyone. They, too, are juggling this Saturday morning activity just like everything else. The summer, as most of you know, was terrible because of my INCIDENT, but I retained a sacredness for my life, even on the worst days, because I just considered it all so precious. Now, even on my best days, with a smile and with joy in my heart or whatever, I can honestly say it wouldn’t really matter to me what I was doing at the moment. And that scares me about myself.
I’m looking back at some of this to see how retarded I am. I am. But let me try my best to stay on track: maybe I’m the one that’s stale. Or not a maybe… I don’t want to make it sound like I planned out this reflection to point out the inadequacies of life and society and existence, and then I did some genius move and made it sound like all of that is a reflection of me or something all poetic. No, the possibility of myself being stale is just as valid as anything else; I’m trying to look at all this hella important dilemma of mine as objectively as possible. Hmm… I know I’m on the right track, I feel like in the past years, through all my mistakes and shit, I’m making insanely awesome progress from where I am to where I want to be. I think, though, that every so often, especially when everything calms down, I feel myself getting too situated and too accepting and I see all that as a rut. And as I cycle through different motivations for different motions in my life, be it for the day or for the semester, I can never re-use another one. I always strove for, as I called it for myself, a unifying principle for my life. Something that, for any situation or problem or delight, I could say “this is all connected to [insert unifying principle here], which is connected to everything else, which connects me to everything and everyone.” Honestly, I did not mean for it to sound like this, but it does seem like I’m referring to God, depending on your religious orientation.
That’s very interesting, for me at least. I didn’t know I’d end on this, which is a good thing because now I have a topic for another reflection. Maybe it’s time for a change…
and man, the season of reflections the summer i got kicked out of highschool are REAL bad... it's funny, cause i have this 18y/o patient, son of bangladeshi professional class immigrants in the bronx, who comes to me with patellofemoral syndrome (from soccer injury) and self-admitted depression, seeking counseling. So, i manage his overall care, but i don't do the counseling... but talking to him, he sort of comes across as arrogant, thinks he's smarter than everyone, but also with feelings of alienation, negative thoughts, low energy, poor sleep... really suffering. so, obviously i feel so much empathy for him, but still put off with his pompous attitude...
until i read my reflections from when i was his exact age! i sounded like the definition of pompous! which is, i'm sure, how i will sound now, if i read myself years from now. nevertheless, i certainly don't regret what a silly child i was back when i was a silly child, so the lesson here is to not only realize that my patient is just a person trying to do his best in life, but that all beings in all circumstances, are just doing the best they can do. and that's something to help me empathize with everyone.
by the way, my fave definition of empathy (though not consistent with internet Merriam Webster): the ability to understand someone else's experience AND the ability to communicate your understanding to the other.
soooo.... here's that reflection, dated 10/1/01, a little over 8 yrs ago. I thought it was interesting enough to copy and paste because i am in a similar situation nowadays, new life in a new situation, with a new "role" to play in society. and my reaction to it back then is similar yet also really different to my reaction to life as a bronx doc now. (which reminds me, i plan to write a postive vibe-ing post here since so often i only write to vent bad days rather than conscientiously reflect on my experiences).
Shuchin Reflection #3
I’m exhausted. Not physically or emotionally or psychologically or spiritually or any other –ly word. But, at the same time, I am. This summer, though I was only complaining and waiting for the school year to start, was much more direct and concrete. I went to sparkle, went out every few nights, and was out on the weekends. Same kids, sometimes I went to Baton Rouge, same activities. And yet I complained that life was stale and those kids were stale and the circumstances were stale. At Tulane, it’s the same it some different way…
I think I spread myself out too thin. It’s supposed to be a mentally healthier way to look at life: have a variety of pursuits and connections with your environment. I feel like I’m juggling the many things I have to do, the many things I’d rather do, the feelings I can’t help having, the feelings I feel I’m supposed to have, baggage and expectation and compulsion and commitment. They all seem wrapped up together. And don’t get me wrong; I’m not trying to make this some bitchy reflection. I’m quite optimistic of where I think my life is going and I feel quite in control of the parts of me that I usually feel are out of control. But I feel drastically unconnected. Being at a new school but being tied down to your past sucks. Of course, the home life restricts me from going out, but it’s more than that. I don’t feel a part of Tulane, I don’t feel a part of freshman life, and I don’t feel like a college student. I juggle my intellectual pursuits: I have Sparkle, academia, personal dimensions of all of that… but it’s juggling. It’s scheduling it around… what? Maybe stuff that matters. That Maslow article made me think a lot, though many of you might not have read it. What really matters to me? The Right Thing has been taught, retaught, shoved down my throat. Not that I really want to do the wrong thing. But it’s so hard to tell when things such as what makes a person happy is qualified by people that are nothing like me.
I don’t know where this is going, but I’ll spin it all around to make my original point (hopefully). I feel like my life is a video game system, and each segment of my
I’m looking back at some of this to see how retarded I am. I am. But let me try my best to stay on track: maybe I’m the one that’s stale. Or not a maybe… I don’t want to make it sound like I planned out this reflection to point out the inadequacies of life and society and existence, and then I did some genius move and made it sound like all of that is a reflection of me or something all poetic. No, the possibility of myself being stale is just as valid as anything else; I’m trying to look at all this hella important dilemma of mine as objectively as possible. Hmm… I know I’m on the right track, I feel like in the past years, through all my mistakes and shit, I’m making insanely awesome progress from where I am to where I want to be. I think, though, that every so often, especially when everything calms down, I feel myself getting too situated and too accepting and I see all that as a rut. And as I cycle through different motivations for different motions in my life, be it for the day or for the semester, I can never re-use another one. I always strove for, as I called it for myself, a unifying principle for my life. Something that, for any situation or problem or delight, I could say “this is all connected to [insert unifying principle here], which is connected to everything else, which connects me to everything and everyone.” Honestly, I did not mean for it to sound like this, but it does seem like I’m referring to God, depending on your religious orientation.
That’s very interesting, for me at least. I didn’t know I’d end on this, which is a good thing because now I have a topic for another reflection. Maybe it’s time for a change…
Thursday, October 15, 2009
fun in hell (hellisfun)
patientA= 63F: stage IV uterine prolapse + INR 10.0 + intractable nausea/vomiting + Cdif relapse + MORBID obesity + (can't leave this one out) personality disorder === internship fun times!
patientB = 47M: CD4 of 87 + HIV dementia + ascites + GI bleeding + not all family on same page === internship fun times!
and then there's others
patientB = 47M: CD4 of 87 + HIV dementia + ascites + GI bleeding + not all family on same page === internship fun times!
and then there's others
Friday, October 9, 2009
hey! new alice in chains album!
jerry misses layne. he's weeping until he dies, as awesome as he is. he is awesome, tho'. there is fullfrontal grief saturated in this album. that's why it's good, cause otherwise its just a-o-kay modern metal.
i like it!
i like:
time
to start living
like just
before
we died.
i miss home. and i knowknowknow i hated it while i was there. this. is. me.
i'm tiredtiredtired of this!! workwork. not so interesting. HEY a day off! that's about it. sleeping, dreaming, working. this city is a fucking petri dish! of disease: jesus the tb and hiv and diabetes and MR/disability/deconditionedobesitynursinghomenothingness. and: as per the parlance of mah program: lord the petri dish of psychosocial pathology. no one had a chance out here. and i thought nola was the land of suffering. what a way to live, sprouting from such infertile land. i tell myself "lord what a place to learn and from which to be influenced..." but there's nothing to change out here. change is not here, this place bleeds of money, drinks of money, international greed vs. international disparity. because, only foolish east coast leftwingers believe in the indisputable noble savageness of the impoverished. cause, just as the enron business man wants to shit on your grave if that makes him rich, so does the poor man (want to shit on your grave, if that makes him rich). richrichrich. sicksicksick.
H1N1: funny observation, based on aside conversation during rounds with super awesome guru chairman of my program (superawesome HIV badass, family medicine too!!! super soft demeanor, ridiculous fund of knowledge, dripping compassion) who happens to be attending ahora mismo:
this is the fucking newyorker:
the flu!!!!! holy shit!!! guv-ment- why aren't you creating a cure/vaccine for us hardworking citizenry!!!!
(government makes vaccine, does research, determines best way to defend against the viral onslaught of virus-that-is-no-more-important-than-normal-flu)
the flushot!!! holy shit!!! you can't make me take that poison, even if i am a healthworker!! i don't wanna inject that, i don't trust you!!!
(if said government didn't make vaccine)
holy shit!! make a vaccine!!! goverment sucks, why won't you help us, we need vaccines and cures and television commercials tellings us about pigs and flus and handwashing!!!
whew!
sleep.
i miss you!!!!!!!!
i like it!
i like:
time
to start living
like just
before
we died.
i miss home. and i knowknowknow i hated it while i was there. this. is. me.
i'm tiredtiredtired of this!! workwork. not so interesting. HEY a day off! that's about it. sleeping, dreaming, working. this city is a fucking petri dish! of disease: jesus the tb and hiv and diabetes and MR/disability/deconditionedobesitynursinghomenothingness. and: as per the parlance of mah program: lord the petri dish of psychosocial pathology. no one had a chance out here. and i thought nola was the land of suffering. what a way to live, sprouting from such infertile land. i tell myself "lord what a place to learn and from which to be influenced..." but there's nothing to change out here. change is not here, this place bleeds of money, drinks of money, international greed vs. international disparity. because, only foolish east coast leftwingers believe in the indisputable noble savageness of the impoverished. cause, just as the enron business man wants to shit on your grave if that makes him rich, so does the poor man (want to shit on your grave, if that makes him rich). richrichrich. sicksicksick.
H1N1: funny observation, based on aside conversation during rounds with super awesome guru chairman of my program (superawesome HIV badass, family medicine too!!! super soft demeanor, ridiculous fund of knowledge, dripping compassion) who happens to be attending ahora mismo:
this is the fucking newyorker:
the flu!!!!! holy shit!!! guv-ment- why aren't you creating a cure/vaccine for us hardworking citizenry!!!!
(government makes vaccine, does research, determines best way to defend against the viral onslaught of virus-that-is-no-more-important-than-normal-flu)
the flushot!!! holy shit!!! you can't make me take that poison, even if i am a healthworker!! i don't wanna inject that, i don't trust you!!!
(if said government didn't make vaccine)
holy shit!! make a vaccine!!! goverment sucks, why won't you help us, we need vaccines and cures and television commercials tellings us about pigs and flus and handwashing!!!
whew!
sleep.
i miss you!!!!!!!!
Tuesday, October 6, 2009
finally got 7 hrs of sleep! and, it's ten to 9, so after this i'm gonna crash and maybe get 8 hrs!!!!!!!!!!!! this is after several nights of 4 hrs a night, including CALL on my BIRTHDAY!
so, i had dreams!! (can you tell i'm very excited about it?!?)
i only remember the last parts of it, but there was some walking through huge grassy areas, looking for something... i might have been running, and then ran across this area with outdoor exercise equipment, sorta like the fly and audobon park, where i used to run and shit back in sophomore year of college. but, then i found some cabin-like meeting places, and i think it was some orientation exercise for residency. and we met and got into buses to tour our patients' community. we drove out to these pretty generic, wide open suburbs, where all these black and brown kids were playing, and we got out of the buses with waterballoons, and started this big awesome water balloon fight with the kids, and everyone was having insane fun... and, as this was like moments before my alarm went off, i remember these details so beautiful and clear- i remember a few bigass waterballoons being launched between us and the kids, and they kept not busting and rolling along the ground, making everybody scream with laughter and excitement and surprise. well, it was a lot of fun. i woke up.
but, the hospital was sorta chill today, not a lot of patients and i got lots done. usually i end the day feeling that there were so many little errands and details i was supposed to get done, that will end up delaying discharge of causing patients to be dissatisfied... but not today. things worked.
anyway, i'm trying to put thoughts together, but i'm way too happy to crash out... perhaps more another time!
so, i had dreams!! (can you tell i'm very excited about it?!?)
i only remember the last parts of it, but there was some walking through huge grassy areas, looking for something... i might have been running, and then ran across this area with outdoor exercise equipment, sorta like the fly and audobon park, where i used to run and shit back in sophomore year of college. but, then i found some cabin-like meeting places, and i think it was some orientation exercise for residency. and we met and got into buses to tour our patients' community. we drove out to these pretty generic, wide open suburbs, where all these black and brown kids were playing, and we got out of the buses with waterballoons, and started this big awesome water balloon fight with the kids, and everyone was having insane fun... and, as this was like moments before my alarm went off, i remember these details so beautiful and clear- i remember a few bigass waterballoons being launched between us and the kids, and they kept not busting and rolling along the ground, making everybody scream with laughter and excitement and surprise. well, it was a lot of fun. i woke up.
but, the hospital was sorta chill today, not a lot of patients and i got lots done. usually i end the day feeling that there were so many little errands and details i was supposed to get done, that will end up delaying discharge of causing patients to be dissatisfied... but not today. things worked.
anyway, i'm trying to put thoughts together, but i'm way too happy to crash out... perhaps more another time!
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