Little Things

Day 26

Med School is tough. Some days it seems like I spend every last minute studying, and it isn't enough. I've been told that feeling behind is totally normal. Monday marks the first exam in Medschool, the Unified. Each class contributes 25 questions. This next weekend will be spent studying, barely surfacing for food and air. Even so, its nice to know that there are beautiful things around us, even if sometimes we're too absorbed to notice. Seeing the sun set over the Caribbean sea is a little reminder to myself that even though it may seem like there is no time left, there are lots of little moments in the day. I like to stop and watch the sky paint itself orange and red and blue. 

Med school is tough, but its the little things that help you through. 

The sun setting near the library, St. George's University

Realization

Day 9

Four  hours of lecture again today was much easier after having slept well. I finally managed to tape down the edge of my window shade, a vital need because the light would shine into my room directly on my face every morning. This meant I was rudely awoken at daybreak. It didn't help that on Tuesday, Anatomy lab starts at 7:40 am. 8 am on Wednesday is not much better. I have a feeling that coffee may become an intimate part of those mornings.

In Anatomy lecture today we examined more closely the spinal cord. The cord itself runs from the brain down through the vertebral column, and ends (in most adults) at the second or third lumbar vertebrae. The sac of dura mater extends down to the first or second sacral vertebrae. This means that between L2 and S1 there is an area of cerebrospinal fluid that can easily be accessed without harming the spinal cord itself. Clinically, that is done through a lumbar puncture. The theory of this procedure at least, was the subject of this particular section of lecture.

Because we were seated in the back of the lecture hall, I was carrying on a side conversation about the correct level to perform a spinal tap on a child, which had come up the night before during my evening studying. The lecturer got our attention; saying the next piece of information was important.

He asked us to imagine that a patient came into the emergency room presenting with a headache. A spinal tap could help to assess if the patient had meningitis. However, if the patient had suffered a head injury, it was possible their pain was due to increased pressure in the cerebrospinal fluid. If we were to do a spinal tap under these circumstances, the resulting pressure change would cause the brain to be sucked downward out of the skull, thereby killing the patient.

I was momentarily floored by what he had said, not just because of how awful that sounded, but because I realized in that moment that this was unlike any class I had ever taken. In all my other classes, If I fail to remember information, I might get an F.

In this class, if I fail to remember information, someone could die.

Welcome to medical school.

My First Day

Day 7

Since I was young, I could never wake up early for anything. Today, I couldn't sleep. The light streaming through the side of the shade of my room woke me up at 6:30 AM. I tried to roll over, to cover myself with my sheet, but the insistent caribbean sun would not be denied. Drearily, I climbed out of bed and trudged to the kitchen to fill a bowl with corn flakes and milk (one of my best purchases so far.) On the way back to my bedroom, I glanced at myself in the bathroom mirror. I looked tired. I felt tired.

I gulped down my breakfast and headed out the door at 7:25, dressed in shorts and a T-shirt. My roommates (upper termers) had told me that no one wore scrubs around campus.  Upon looking around I saw that they were wrong. I couldn't run back to my room and change but that was okay; I had my surgical greens in my bag. I couldn't run back because it wasn't just any other day. It was my first day of medical school.

From when I was a child, people assumed that I would follow my parents footsteps toward medicine. It was without thinking that I set myself on that path. It took a life-changing event for me to realize that medicine was my own choice. I knew the curriculum, knew the steps I would need to trace to make it from the first year to the fourth. I knew that road was starting today.

I almost ran to the top floor of the science building for anatomy imaging lab. I ducked into a bathroom and changed into my scrubs. I was nervous.

This was my first day, and how it went might change my life's path forever. After a brief orientation, our lab groups split up into various stations. At each station was an ultrasound machine, a MD tutor, and an actor portraying a patient. Our teacher demonstrated the use of the machine on the patient. He asked for a volunteer to try the machine. My hand flew up.

As I walked to the machine, I realized that all of the agonizing over this past summer was for nothing. I introduced myself, shook the patient's hand, and got his name. I started to explain the procedure, and was interrupted with my first lesson of the day.

"Always ask the patients permission." the tutor said, In my hurry to show the group my skills I had forgotten this important step. Unflustered, I rephrased my words; "Is it okay if I examine your arm with this ultrasound machine?"

I picked up the wrong probe. It wasn't even connected to the machine. Even so, I went back to my seat elated. I had started the process of learning medicine. Not just memorizing Anatomy and Biochemistry, I was learning how to be a doctor. On my first day!

Wet lab was next. I was at first a little apprehensive about the cadavers. As soon as the exercise began that melted away. I was here to learn. We rotated through the various stations. When we reached a tray containing what looked like a large deflated black kickball, I started to prod what was obviously a pair of human lungs with the probe.

The lab instructor picked up the lungs and demonstrated some large cancerous lesions on the underside. Here, she said, after she had finished, and deposited the organ in my gloved hand.

The rest of the day seemed to fly by, group discussion, lunch with friends, and our daily four hour dose of lectures. Afterwards, I went about making a snack, and headed to the meeting of the Humanitarian Students Organization. I signed up to help paint a nursing home.

Yesterday, our White coat ceremony had an unexpected distinguished visitor. Five minutes before the event was supposed to start, one of the organizers got on stage to inform us the event would be delayed ten minutes. The Prime Minister of Grenada was on his way from a cabinet meeting. When the ceremony started he spoke to us about the history of SGU in Grenada, and our place as students. What struck me most of all was how lucky I was to be studying in such a welcoming country. I may not owe SGU more than the balance of my loans, but I feel like I owe Grenada a little community service to balance out their hospitality.

The highlight speech of the night, however came from the Dean of Medicine, an aging New Jerseyan, Dr. Jacobs. He told us stories about his own residency, when he knew he was a doctor, about honesty with patients, and the joy of saving a life. He framed our journey in a way I hadn't considered.

The doctor exists to heal bodies and minds, to support himself and his family, and to contribute to medical knowledge. Dr. Jacobs made it all real however with his closing. We were to be more than scientists and physicians. "Go," he said, "and do good."

The Worst Trip Ever

Day 2

I'm writing this at my desk in my room at St. George's School of Medicine, Grenada. I don't want to spoil anything, but I eventually made it to school, despite the best efforts of "THE Caribbean Airline." A little lesson I've now learned extremely thoroughly: Never, ever, ever fly with LIAT. It actually stands for Leeward Islands Air Transport. Most locals have some other names for it including;

Leaves Island Any Time

Languishing In Airport Terminal

Luggage in Another Terminal 

I flew American Airlines from JFK (New York) to San Juan, Puerto Rico. All this time, I had been nervous about going to St. George's but it was nothing compared to how I felt actually doing it. I felt slightly sick to my stomach the whole flight to San Juan. I arrived five minutes early, which I expected. I made my way to the LIAT terminal and managed to check my bags. Despite the website's assertion that passangers were limited to one carryon of 15lbs or less, they didn't say a word about my two bags, both of which easily weighed thirty apiece. I took this as a good sign: I had no idea how wrong I was.  I had to go through security again to get to the terminal. They made me open my carry-on bag and searched through it, but I made it through with ten minutes to spare. But in addition to my two carry-ons, I had another passenger following me that day. His name was Murphy (of Murphy's Law fame) and he would make sure that anything that could go wrong, would go wrong. Before the end of the ordeal of my trip was over, I would personally experience the reason for each one of LIAT's nicknames.

Despite the fact that the islands of the Caribbean lay in the same time zone as the Eastern United States, it feels like they are a part of an entirely different time zone: Island time. Most people move at their own pace, and schedules mean next to nothing. I ran to the LIAT departure gate, which was down a level from the rest of the airport. I realized this was because, we would not be taking a gangway, but instead would walk right out onto the tarmac to board the airport.

Boarding the LIAT plane in San Juan.

The plane was small: it could seat maybe thirty or forty people. More harrowing for me was the fact that it wasn't a jet. Unlike any other plane I had flown in, this one was kept aloft by two turboprop engines. The result of this was that the plane made a deafening noise whenever we were in flight. The other result of this was that the plane was incredibly slow. 

My flight was scheduled to leave at 3pm and arrive in Barbados at 6:05pm with one stop in Dominica. The flight crew arrived casually at 3:30pm. Onboard the flight, I was told the plane would also be stopping in Antigua, but that we wouldn't need to get off. I was worried about the additional stop, but I was assured that we would make our connection. This was my first taste of LIAT's particular brand of customer service. I have to say that all of the employees are extremely helpful and pleasant, but unfortunately, most of what they say is wrong. Partially this is because the higher ups in the airline lie to the employees (and by extension us) about everything from arrival and departure times to what planes are where. There's a reason that my iphone autocorrects "Liat" to "Liar." 

At Antigua, LIAT's headquarters, we were told we would be switching planes. We went through a mob-like line at the "In-transit desk", where they took one of our boarding receipts and directed us through security. My backpack was opened and searched. After I had made it through, they directed me to departure gate one where we lined up, showed our passports to the security officer for inspection, and walked out onto the tarmac. We were directed onto the same plane, almost two hours after we had left it. 

I met three SGU veterinary students on the flight, upper termers who mostly spoke amongst themselves in rapid-fire spanish I couldn't follow. We flew to Dominica and after a brief stopover where they luckily didn't make us leave the plane, we flew on to Barbados. By this time it was almost 8:30pm, so I asked the flight attendant if there would be a flight to Grenada waiting for us. She spoke to the station over the phone, and reported back to us that the last flight to Grenada was waiting for our arrival. Once at Barbados, we hurried through the modern airport to the LIAT departure gate. The woman at the desk told us the plane had not waited. She told us that the next flight was at 7am the next morning, and that it was probably cancelled. 

They put us up in a hotel for the night; It was comfortable, and they paid for our dinner. They awoke us at 5am and we were driven back to the airport where we rechecked our bags. I was polite to the clerk at the desk, and she didn't say anything about my clearly overweight carryon bags or the fact that my checked luggage was 5lbs overweight. 

We hurried to the departure gate, where we were told that the 7am flight was delayed until 8am. At 8am we were told that our flight was delayed until 9am. At 9am, they called our flight number and asked we assemble near the boarding gate. The supervisor of the desk staff came over and told us that our flight was going to be a little late. It would be arriving at 5pm. We were stuck in the terminal for the rest of the day. The monotony was relieved only by the wifi in the terminal. They gave us breakfast, which I skipped, and lunch which I didn't. Things in Barbados are expensive; my meal, which consisted of a fish sandwich, fries and a small drink cost 25 barbados dollars ($12.50US). 

While we sat in the terminal, these planes sat doing nothing for hours, and then were given to people whose flights were scheduled after ours. 

Around 12:30pm we were told our flight was cancelled. The news was followed up by a small piece of good news: that another flight, 687 had been cancelled as well, and that the plane would instead bring us to Grenada at 5:40pm. 

Around one, a small aircraft crash landed on the run way. Though it looked like the fire was quickly put out, the only runway at the airport was closed for more than two hours. It reopened close to three thirty, and flights started to go in and out. 

Finally, after hours of waiting, our flight number was called at 5:30pm. I squeezed to the front of the line. I was the fifth person to walk out onto the tarmac. I was directed to the first of two LIAT planes waiting. I got onboard. It was flight 727, the stewardess said, but would also go to Grenada. One of the veterinary students got on the plane as well. In all about eight people were put on the already packed plane. I sat next to a woman with a baby on her lap, which was screaming and kicking and grabbing at my arm. I didn't care. 23 hours after I was supposed to leave Barbados, I was finally about to leave.

A relieved selfie. 

We flew into Grenada. There's very little time difference between "starting to get dark" and "night" in the Caribbean. By the time we arrived 45 minutes later, it was pitch black out. We made it into the terminal, where I found out my luggage had not arrived. I asked it it might have been put in the next plane, thinking they must be right behind us. I was told that plane had not left Barbados, and would probably be cancelled. 

I made it through customs very quickly and was taken by cab to my room at St. George's. While much of the island (at least what I could see from the taxi) looks slightly run down, the campus of SGU is extremely nice. My roommates were home. Both were fourth termers in the school of medicine and spent the entirety of my first night studying. 

I grabbed some subway (located at the student center) and watched TV until it was time to fall asleep. My first night in Grenada was complete, and it felt like there was no way I could possibly adjust. As with most things you think exhaustively after two days of stressful travel, there was no way to tell if I would be wrong or not. 

The Homestretch

3 Days to Go

My Facebook page is blowing up with people who are already in Grenada. I'm on what is probably the latest flight possible.: I'm arriving at 9pm the night before orientation. I'm excited and a little jealous to hear what a good time people are already having on the island, but I'm sure ill catch up. 

Speaking of catching up, I downloaded the Nike+running app for my brand new iPhone! So far I've only run five and a half miles, but my goal is to run 1000 miles in Grenada over the next two years. I've been trying to get in better shape because I don't want to feel like a hypocrite when, as a doctor, I tell people to eat right and exercise to be healthy. Plus, I want to look good in a bathing suit! 

So here it is: just three more days before my life changes forever. The homestretch; but really a starting block. This whole summer, really my whole life has been a warmup lap. It's time to start for real. Three days to go. 

My Day Off

Yesterday was my day off. I’m lucky enough to live a blessed life. I only “work” four days a week, and even then only six hours a day. To be fair, it’s not actually work since I don’t get paid. On the other hand, since I’m currently living at home, I don’t actually need to buy anything, and since despite being over-educated as I am, couldn’t find a respectable job shelving things or distributing fast food, I was able to enjoy my Tuesday in the typical way.

                I woke up at 11:30 am. I decided to go for a run. To be clear, I didn’t go for a run, but somehow deciding to made me feel better about myself. Instead, I went downstairs to start my day. After grabbing a sweet and salty nut bar for “breakfast,” and availing myself of all the Royal Baby news I could get. For those of you who have been legally dead for the last week, a woman who happened to marry a man whose grandmother is the figurehead monarch of a country we aren’t a part of had a baby. Although technically, Grenada is a British protectorate, so it’s very possible my knowledge of the Royal birth could come in handy.

                After that, I accomplished one small thing. For the unemployed twenty-something, this is quite possibly the best sociocultural phenomenon ever created. If you accomplish “one small thing”, then ipso facto, your day magically transforms itself from “wasted” to “productive.” I filled out the health form for St. Georges. To be honest, It was supposedly due 24 days ago. Also, its been sitting on my bureau along with my test results for the past week. But after five minutes of filling out health history, and a brief google to find out how old my dad is (I thought he was born in 1963, not 1961), I was ready to have it faxed over to SGU. Not that I was going to fax it. I’m not even sure how a fax machine works. I know that there’s a telephone attached. Other than that, however, I’m entirely clueless.

                Having finished my “work” for the day, I could settle down to an afternoon of Netflix without feeling guilty. A few hours of this went by quickly. A sudden burst of productivity followed lunch, probably the sugar rush from the “lemonade” I made. (I only used one spoonful of sugar. Unfortunately, it was a serving spoon.) I measured the suitcase I’m planning on bringing down to school. After satisfying myself that it would fit the size requirements I emptied it of the things currently in it (largely books and clothes from undergrad that I hadn’t gotten around to unpacking) by throwing those things I might bring to Grenada in one pile on the floor, and those that wouldn’t make the trip in another. Now on a roll, I did the same for my closet. Having made a huge mess of things, I got bored and went downstairs to watch TV.

                I did eventually run after dinner. I finished a 5K. Sloppy Joes are not an ideal pre-run food. I ran the whole distance without stopping. My summer goal of dropping 15 pounds may not be going especially well—I’ve lost negative three pounds—but at least I’m in slightly better shape.

                After all, it’s the small things that matter in life. Getting my relaxation in now is probably for the best. I probably won’t rest for the next four years. 

Goals

It’s difficult to succeed at anything without an idea of the endgame. I found myself falling behind in undergrad when the goals were hazy. In order to prevent that from happening again, here’s a list of my goals (large and small) for the first semester of medical school.

• Study hard- After taking a self-assessment for Biochemistry I can say with a fair amount of confidence that I have retained almost none of the knowledge I tried to acquire over the past four years. The only way to fix that is to work hard and focus on internalizing all the information I can in the next four months. My goal is to get an A in each of the three classes I’ll be taking- not an easy goal, but one worth undertaking
• Stay in shape- a recent physical saw me hitting 231 pounds, some of which is muscle but not nearly enough. I know it’s too easy to stop taking care of myself in stressful situations. Late night “study food” is going to look amazing pretty much every night. I’ve been running three times a week and trying to cut down on useless calories at home. When I get to school I need to figure out a way to make myself healthy, inexpensive food and keep active. My goal is to return to my fall season playing weight of 215 pounds.
• Be social- Making new friends isn’t exactly my wheelhouse. I’m not amazing at adapting to change, but I’d like to at the very least have a good relationship with my roommate, and classmates. Freshman year of college didn’t really work out super well for me roommate-wise. My goal is to reach out to the person I’m rooming with.
• Play Rugby- I know that a full-fledged club is out of the question on the island of greneda, where Rugby isn’t popular. I’ve seen that there are some pickup gams going on some weekends, and I’d like to do my best to play in those. My goal is to work on my fitness, passing, kicking, and ball carrying so when I return to the US I can play for a Men’s club either as a loose forward or a back.
• Don’t forget Anthropology- I may not be going to graduate school in the field, but I don’t want to entirely stop learning. I’ve noticed that there some medically oriented anthropological research projects going on at St. George’s. My goal is to involve myself at some point in research.
• Study Abroad- Just by showing up to class on the first day I will have achieved my goal. I always wanted to study abroad in college but never could for a variety of reasons. It will be an amazing experience to see what live is like in a foreign country, one that I’m sure will expand my understanding of the world. My goal is to study and live abroad.
• Appreciate what I have- Studying medicine in Grenada will give me the chance to better understand and appreciate how fortunate I am to have grown up in a country like the US, with almost unlimited resources. My goal is to learn not to take those blessings for granted.
• Have fun- Going to medical school will be an ordeal, but also the fulfillment of one of my life’s goals. I’m not expecting it to be easy, but I also don’t want to be miserable during the experience. I’m lucky enough to be learning medicine at an excellent school set in a lush tropical paradise. My goal is to enjoy my first semester in medical school. 

The Leap

30 days to go

                There is (or was) at my old highschool an adventure ropes course. One of the requirements to pass physical education was to make the trek across the parking lot and, in small groups work your way from the small elements on the ground to the bridges soaring 30 feet above, hanging in the trees in a vaguely threatening and exciting way. At fifteen years old, and scared to death of heights, I climbed my way up the iron rungs that had been nailed into a tree that looked frighteningly thin to be supporting my hundred and eighty pounds, not to mention the square wooden platform I was gradually, hesitatingly, making my way toward. When I reached the top, I stayed for a moment on all fours, working up the nerve to stand. The harness, connected tenuously to a thin strand of rope was tight, and the crouching position I had willed myself into made the thick woven straps dig into my legs, cutting off my circulation. 

                I pulled myself up using the trunk of the tree as a crutch, and felt the lump in my nervous teenage stomach drop a little lower as I felt the platform sway, ever so slightly. Human beings, I thought to myself, whatever our ancestry, do not belong in trees. I surveyed the course ahead. The course was composed of four platforms suspended in the trees in a straight line. They hung from the thick branches, suspended by a rope at each corner, so that even in the light spring breeze that was rapidly cooling the sweat gathering on my brow, they swung ever so slightly. The platforms were about five feet apart from each other and the end of the course, but to my mind the gaps stretched to five times that distance. The object, seemingly insane as it was, was to hurl yourself from the relative safety of the first stationary platform out into the void, landing on the nearest swinging one. This horrifying process needed to be repeated four additional times until you arrived at the final platform, this one stationary, and climbed your way down to the waiting ground.

                Egged on by the impatient gym teacher responsible for the safety rope currently connected to the harness at my waist, I inched forward on the first platform. Steeling myself, I looked out to the first swing, shut my eyes and expelled the breath I had unconsciously been holding in. I opened my eyes and took another deep breath. In through the mouth. Out through the nose. I breathed a quiet prayer, and without looking down, darted forward and threw myself into the abyss.

                I leave for Grenada in one month. It seems too short. Or too long. It’s hard to tell these days, because I’m vacillating between extremes of panic and excitement. On the one hand, excited and impatient, to paraphrase Colin Hay (via Scrubs of course) for my real professional life to begin. On the other hand, the island of Grenada is a big unknown for a New Jersey boy who’s never been out of the country (unless you count Canada, and for some reason, no one ever seems to). Fear of the unknown is the root cause of most of the anxious questions filling your head at two a.m.: Can I compete with other students? Will I make friends? What if there’s a mistake and I’m not registered for housing? Will I adjust to island life?

                The answer to all of these questions, of course, is to go back to sleep. No sense worrying when I’ll find the answers in a month. No sense missing out on the precious few hours of rest I had before the alarm went off at 6:30. No sense stressing over what I could not fix.

                I like to think of myself at 22 as relatively courageous. A huge part of playing rugby is letting go of your fear. I usually don’t watch horror movies, because I prefer comedies, but when I do I generally don’t find myself that afraid. The dark doesn’t harbor any monsters. Snakes still cause me to instinctually jump and cringe, but nothing else does.

                I’m hard pressed to explain, then, why the next four years scare me so much. Maybe it’s because it’s the end-game. There are no more buffers, no more room for error. I can’t use the excuses that carried me through my first year of college anymore. But it’s more than just academic anxiety. I know that with hard work, I can get the grades I need to graduate, the grades I need to ensure a good residency placement.

                Everyone has told me how lucky I am to be studying in the Caribbean. A beautiful setting for a great education. Sandy beaches and clear blue water. Being away from Kayleigh will be tough, but it will only be a few months before she’ll join me there.

                As a scientist, I’ve learned that knowledge and evidence are everything. A decision made in the absence of evidence won’t be a good one. It’s hard to take on this new chapter in my life with so few answers. I can’t see what’s ahead. Life is like that sometimes. No matter how much prepare, sometimes the future is a blurry, fuzzy, unknowable thing filled with uneven terrain and missing the steady safety of solid ground.

                I stood (and stand) on the relatively solid, safe platform, and all I can see ahead is a chaotic and constantly shifting series of landings between myself and my goal. Fear doesn’t matter here. As I take that first running step and fling myself out between the trees, I can look down in that split second and see the people below, friends who helped me climb up the tree and convinced me to make the leap. Some of them have already been across.

                My fifteen-year-old self landed easily on that first platform. And the second, and the third and fourth. Today, thirty days away from another leap, I think about how it felt to land on the shifting wood of that first platform. How at first I was filled with fear, and how I realized, only after I had already done it, that I could.

                I leave for Grenada in thirty days. A leap to a platform 2100 miles away with almost no knowledge of what I will find when I land on the other side. I’m full of questions that have no answers. But when the flight takes off, and I glance down at the airport below, and the people who have brought me to that moment, I will think back to that first leap, filling my head not with the blind terror at the start, but the elation of safe landings. I know I will arrive on the other side stronger and smarter and more prepared for the future.

                After all, I’ve already done it once. 

A Brief Series of Open Letters

The internet is a beautiful, wonderful place where someone with no knowledge or information can spout baseless opinions while pretending they are valid conclusions[i]. For example, were you aware that Dolphins have seventeen different mating calls?[ii] As part of an idea I came up with less than a minute ago[iii], I’d like to present this brief collection of open letters to three ridiculous things I discovered on my trip from New Hampshire to New Jersey.

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Dear NBC,

I am happy to see you have persisted in filming and airing more segments in the series “the more you know.” For your viewers convenience, I would suggest a simple coding system to help interested TV-buffs keep them organized.

•           Things that are obvious to all excluding concussed two year olds. This is a good one because it can be used on 75% of them! Surprisingly, I was aware that standing up burns more calories than sitting down. (Thanks, Allison Sweeny!) I would suggest a picture of a dunce cap, potentially on the head of whomever[iv] green-lighted “Camp.[v]”
•      Uncomfortable dialogue. Please for warn me that there will be awful puns or half-hearted references to a show an actor was in. Also, stop doing this with shows I haven’t seen. I don’t like missing references, It makes me feel dumb.
•      Extremely forced PSAs from actors who just don’t want to be there. This might be the easiest category.

I am sure that with these simple labels we can all get back to doing what we love best. Watching Parks and Recreation to fill the empty hours between dinner and bedtime.

Sincerely,

John Rizzoli & Bethany Isles[vi]

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Dear US Government,

            My Federal Loan interest rates are too goddamn high.[vii] Seriously, its’ like you don’t want me to go to graduate school. I mean, I totally appreciate the money now. And it’s super cool of y’all to just give it to me like that. But what’s with paying back so much. I hope you know that at this rate, I won’t be able to afford basic necessities, like that Ferrari or the third house[viii].

            Rich (and Future Rich[ix]) people are always getting the shaft in America. It’s like I have all this money now, why should I pay more than a poor person? Besides they have plenty of extra money to pay for their own healthcare and education, right?

Sincerely,

Remy Buxaplenty[x]

P.S. That being said, I’m voting Democratic. Because I have moral values[xi].

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Dear New Hampshire,

            Just who do you think you are? Please stop being so far from New Jersey[xii]. That, frankly is bullshit.

Love,

Aaron

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[i] See? Doesn’t this look way more legit?

[ii] Probably not. Either way, not true.

[iii] While pooping. Sorry.

[iv] Not the correct usage of “whom”, but sounds way more official.

[v] A summer camp for kids AND parents? Isn’t camp where parents send their children so they can spend less time together? Also I haven’t watched this show.

[vi]  I don’t know if these are their actual names. Also I’m not sure if this show is on NBC.

[vii] I miss “too goddamn high” guy memes

[viii] That’s right, Department of Education. You’ve made me third-homeless.

[ix] Currently poor

[x] Lol references are fun

[xi] Until the minute my salary hits $250,000 a year. Then I’m all for tax breaks for the insanely wealthy.

[xii] This doesn’t mean you’re off the hook, New Jersey. The only reason you’re not getting a letter is I went to a New Jersey Public school, and I’m not entirely sure you can read.

The Bucket List

This actually started as a date idea back when Kayleigh and I were super poor college undergrads. (Now we’re super poor college graduates). Go to a coffee shop, and each take a pile of napkins. Each of you rights down five things you want to do in five years, five in 10 years and 5 in 15 years. Then you compare what you have and make one list for the two of you. Next, we took our best ideas and wrote them out on small cut out pieces of colored scrapbook paper and made a collage.

                A bucket list is made up of the things you want to do before you “kick the bucket.” Here’s (an abbreviated version of mine).

In 5 years;

1)      Marry Kayleigh- this one needs very little explanation, She’s amazing and perfect and wonderful and the love of my life.

2)      Get a Residency in Surgery- I’d like to be in a more urban area (maybe NYC?) but it depends on Kayleigh’s grad school plans. I’d love to work in a public hospital.

3)      Travel to Europe- I’ve never been, and the window in which I’ll be young enough to backpack is closing rapidly. My knees already hurt at the end of the day, I’m getting too old too quickly.

4)      Play Rugby for a Men’s Team- I won’t be able to play for a Men’s club while at SGU; my goal is to stay in good enough shape that when I return to the US, I can join a more casual division two or three team. We played a division three team at the end of my college season and while they were good, I think that I could easily play for their second or third XV.

5)      Have a family- I’d like to have a baby before 5 years (although it’s really not my decision). I’m not sure on the name, and I don’t care if it’s a boy or a girl; as long as it has ten fingers and toes and is healthy.

In 10 years

1)      Buy a car- nothing too fancy, but I do have a flashy showoff side. Maybe a convertible?  I love the idea of having a practical car as well as one that no one in their right mind would actually need.

2)      Buy first house- I’ll be 32 in 10 years and will have been pulling down some serious doctor money. My dream house doesn’t need to be huge, but I’d like a large, gourmet kitchen, a hot tub, and (see #3).

3)      A pool, with a real palm tree- I was born in New Jersey, I spent my college years in New England, and while I’ll be enjoying paradise for the next two, I know I’ll be in the northeast for good. I want a heated pool (I hate freezing cold pools) with a real, live palm tree growing next to it. I’m not sure that palm trees can live in this climate, but if they can grow an ear on the back of a mouse, they can grow a palm tree in New England.

4)      Have a family- Ideally, I’d like an even number of kids. Obviously, so they have even teams when they play games. I was one of three. There were many conflicts that could have been resolved that way.

5)      Visit New Zealand- New Zealand is a land of unparalleled beauty, Rugby is the national sport, and puns reign supreme. (National Rugby Team is the “All Blacks.” The youth Rugby team, the “Small Blacks”, the national basketball team? The “Tall Blacks.”)

In 15 years

1)      Have an established Practice- I’d like to either start my own or be a partner at an existing private practice by this point in my career.

2)      Find a new activity- Realistically, Rugby probably won’t be the best thing for me at 37 years old. It’s Important to me to stay active, I’d like to be in good shape, eat healthy, and be a good role model for my future kids.

3)      Drive on a track- maybe it’s the Top Gear my younger brother Jake used to force me to watch (I liked it too to be clear), but I’d love to take a car out on a track and put it through its paces.

4)      Change someone’s life- One of the most important reasons I’m going to medical school is to make a difference in someone’s life. I’d like to be able to look back and say that I made even a small difference in the way a person lives their life.

5)      Love Kayleigh Forever- This one is going to be easy. I never want to stop loving her and never could, ‘cuz she’s perfect.

Things I’ve crossed off the Original Bucket List

                We’ve covered a pretty solid amount of things on our original list, as of summer 2013:

1)      Take a Vacation- We’ve actually been on three vacations, once to Maine last summer, on a cruise for spring break, and to Disney world after graduation

2)      Be Engaged- As of 2/16/13 J

3)      Go Parasailing- we went on our cruise in Nassau, Bahamas

4)      Men’s Basketball Game- We actually had season tickets this past year for UConn Men’s Basketball. Not only did we go to the games, Kayleigh even sung the National Anthem with her acapella group, The Chordials at the Georgetown game.

5)      Bachelor’s degrees- We both earned our bachelor’s from UConn this may!

6)      Cool Proposal- I got down on one knee! J Unfortunately, there was “Andre” after. She still said yes, but it was touch and go.

7)      Learn to cook- Together, Kayeigh and I are awesome at most things, but I wouldn’t say we were good cooks. I’d say we were amazing cooks. Example; for a date last month, we made Fillet Mignon in an Apothic Wine reduction sauce with Sautéed Asparagus and Zucchini. I would have paid thirty bucks for that meal. It was amazing.

8)      Disney World- we went together with her family after graduation. It was awesome. The best part by far was seeing how excited her 5 year old nephew got (it was still magical for him) and laughing at how jaded her 7 year old nephew was (he told us it was all fake).

9)      Make a Bucket List- Although this one didn’t make the final displayed list, I always include it in any Bucket list I make. It feels awesome to cross off a life goal immediately. 

Time Travel

I don’t really like most episodes of the twilight zone. It’s not that I have anything against Rod Serling per se, it’s just that I think many of his viewpoints are depressing. In one particular episode, a scientist despairing at the state of the world builds a time machine and attempts to change three major events in the history of the world; warning the Japanese about the bombing of Hiroshima, attempting to assassinate Hitler, and trying to stop the torpedoing of the Lusitania. In each time period, he is unable to change the course of events, because history, in Mr. Serling’s view is static; that is events are predetermined, and one cannot change anything in the world.

I choose to disagree because if that is so, then there really is no free will at all. If all our actions are merely parts being played in a vast cosmic play, then what is the purpose of any of the decisions we make. Armed with foresight about the world, Serling’s protagonist attempts to escape to a Midwestern town in the 1800s, the epitome of the small town ideal. In this time, he is unable to prevent the fire that took the lives of several school children, and in the process of attempting to change the event ends up causing it himself.

I believe that history can be changed. Pick an apple in old England and Newton may never have considered gravity.

The subject reminds me that there is currently a researcher attempting to make a time machine at UConn. Current scientific consensus is that if the time machine does in fact work, you could only conceivably take is back to the point at which it was invented. Barring all technological or physical obstacles, I can think of a few places I’d like to time travel to:

First, I would like to go to the “beginning” of human history and observe the first Homo sapiens. There are many hypothesis out there about when humanity first began to exhibit modern behavior and I think it would be the opportunity of a lifetime to go back and see it. Assuming changes were reversible—and I think I’m more in the territory of a “what-if” machine by now—I’d love to see what would have happened had evolution taken another path; what if we were the descendants of another hominin like Paranthropus bosiei or even if another genus had developed in our place (hyper intelligent ants? Birds? Elephants?)

Second, I’d like to take an afternoon and visit some of the greatest pioneers of science; Einstein, Edison, Tesla, Newton, Galileo, and see what they would make of our world today.

Third, I would visit some of the greatest cities in the Ancient world in their prime: Pompeii, Rome, Tenochtitlan, Babylon, Jericho, see the pyramids being built. I’d sit in Athens and hear the lyre music that has been completely lost to modern ears. On the other side, I’d love to see Manhattan island the way it was before Hudson “discovered” it. I’d like to feel the absolute wonder you must have gotten looking out on a forest and knowing it goes for hundreds of hundreds of miles.

In some ways, because I was born in the nineties, and have seen so many technological advances in my short 22 years, it feels like the future can’t be to foreign. Serling’s scientist never went to the future—at least in that episode—and I think it was a mistake. His fundamentally pessimistic viewpoint precluded the potential bright future that might lay ahead.

I think I would have gone ahead to see what we accomplish in ten, a hundred, or a thousand years. Unlike most people, it seems, I’m confident that we’ll find the solutions to disease, to global warming, and to war. Sterling may have been stuck on the evils we as a society have perpetrated in the past, but I’d rather look ahead. That future, it seems I can change, whatever Mr. Serling may have believed.

He might have been right. But since I don’t know what will happen, and time travel—at least for now—isn’t real, I’d prefer to go on thinking that what I do has a drastic effect on how the future plays out, because while my actions may not make a difference to the world, they make a world of difference to me.

                                                                                                                                                                 

The Return of the Medical Show

46 Days to Go

                I’m sure I’m not the only incoming medical student my age that has loved scrubs since I first saw it. I watched the first three seasons as reruns and the moment I caught up, I watched it obsessively. It was, without question, my favorite show. For the same reason that I get anxious around the pre-med society people, seeing the possibility—even the farfetched hysterical one portrayed in scrubs—of my future filled me with dread. Even thinking about it would give me cold sweats and a sinking feeling in the pit of my stomach.

                As the fall went on, and the spring began, and I got my acceptance to St. George’s, I still felt the anxiety. Scrubs, Grey’s Anatomy, and Private Practice—shows I watched almost religiously in my first two years of college—only made the anxiety worse. I would avoid episodes of Scrubs on Netflix, change the subject as quickly as I could when one of the three shows came up in conversation. I told people I stopped watching Grey’s because the “plotlines got too unrealistic.”

                It’s only now, as the anxiety is starting to fade and the reality is taking its place, that anything has changed. This morning, rushing to get out the door so I could make the train on time, I grabbed the first DVD in the messy cabinet; to give myself something to watch on the train. I didn’t even look at it.

                As the train pulled away from Hackettstown station, I worked on budgeting out my financial aid for the fall. I looked in my bag and pulled out the DVD. Without my choice, and a 2 hour train ride ahead, I popped in the first disk of the 4^th season of scrubs, and with a twinge of anxiety, pushed play.

                No sinking feeling. No dread. My stomach felt fine. I descended the mountain of med school applications and dredged my way through the valley of interviews and decision emails and climbed the mountain—which may have only existed in my own mind—of going to St. George’s, and suddenly I found myself on the other side looking out over the world, and I realized that my entire future is in front of me, and there’s nothing to be anxious or nervous about anymore.

                Well until the first exam…

Train Thoughts

48 Days to Go

I spend a lot of time on trains. It means that I spend more than my fair share of time lost in a book or a TV show or just letting my mind wander. When I was in High school, and some of the time in college, I wasn’t especially happy. I was overcome with indecision. I was anxious. For the final year of college, when I should have been enjoying myself, all I could worry about was when the next email from a med school would come, which waiting lists I was on, what interviews I went to. I did almost everything with the secret hope it would somehow transform my application into a “must have.” Oh he went to a CONFERENCE? FIND THE PHONE AND ADMIT THAT MAN!

As the alternatives fell away, and I accepted going to St. George’s, I realized how much stress and pressure I had put myself under.

I don’t want to feel that way for a long time. I still have barriers and rules and necessities and pressure. I go to my internship four days a week, and haven’t found a regular paying job. I do get worried about money, about going to Greneda, about lots of things. But now, I do whatever will make me happy.

Spending time with friends makes me happy. Talking to Kayleigh on the Phone makes me happy (visiting her makes me happier). Going to the museum makes me happy. Watching hours of Netflix makes me happy.

I tell myself not to worry so much. I’ve been pretty lucky so far and everything has worked its way out. I’ve lived an interesting and rewarding life. I get up (almost) every day to do something I love. I got the girl. I spend a lot of time on trains. A lot of time spent smiling. The people around me probably think I’m crazy. Fuck ‘em.

I’m happy, and that’s more than good enough for now. 

Future Choices

It seems casually arrogant to choose a specialty before even starting medical school. Other than books, television, movies and the occasional shadowing experience, I don’t really know what specialties of medicine are like. There are subspecialties, I’m sure, that I’m not even aware of. By the time I graduate in four years’ time, there might even be new emerging areas of medicine to get into. I don’t really need to choose for 3 and a half years (though knowing earlier could help structure my fourth year electives). If this whole thing is a game then, I don’t even know the rules.

I do, however, know myself. I have some useful abilities. I’m a quick thinker. I’m good under pressure. I’m good with my hands. I can follow instructions. I’m extremely competitive. I’m willing to work hard. I’m willing to work long hours. I also have weaknesses; I’m not patient. I have a short attention span. I have an average memory. I’m sometimes hot headed. I need to feel important.

All things being equal, the money isn’t that important to me. I don’t need to be rich (at least not while I’m young). I don’t spend a lot on myself, but I would like to start a small family at the right time. I would be more than comfortable driving a cheap car, living in a reasonably sized house, and spending the rest of the money on the people I really care about. I’m not sure what’s wrong with me, what part of the American capitalist spirit I missed out on, but I don’t see the point of buying nice things for myself. I’m sure it’s something to do with my childhood or self-esteem or something but I’d rather not tease that out right now.

So with the compensation out of the picture, I’m left with what might fit my personality best. I want to be challenged with something new every day, but most specialties will give me that. I’ve always been interested in solving puzzles, so I think I would very much like diagnosis.

One thing that really makes me interested in Surgery is the idea of immediacy. It isn’t universal, but most cases I would be involved in would fit this model. First you identify the problem. Then you actually manually fix it. I like this part because it involves some skill, a great deal of pressure, and a sense of importance. Then, as harsh as it might seem, the problem is either fixed or it isn’t.

Becoming a doctor for me has always been about helping others. As much as I think surgery is the best option for me right now, I’m not sure that over the next few years it won’t change. I’m willing to wait and see; sometimes the best part of the journey is when the destination is just out of sight over the next hill.

Good Morning Internet

The Drunk Biology Study

Freshman year, I was a much less responsible person than I am now. It made for some experiences that were less fun, but for much better stories. It worth mentioning again that I was a much less mature, stupid, freshman at the time this story occurred. An unsurprising amount of these stories involve alcohol.

The fall semester was just starting. As the deceptively nice summer weather gave way gradually to the hell that is winter in Storrs, CT, I was taking college classes for the first time. Since I had always done well enough in high school without studying, I just assumed that the same would go for UConn. I sat through my biology class with my friend Jake once or twice a week (the class met Monday, Wednesday, Friday).

The professor, Dr. Abbott was 6’5” and had huge bushy grey eyebrows. We naturally assumed they were so bushy because they were filled with knowledge. A quick digression if you don’t mind (and if you do, then this is the wrong blog for you). Dr. Abbott had a best friend at his post doc fellowship who was a “little person.” The LP was also a post-doc working on the same project. They quickly became best friends. This was my favorite fact about Dr. Abbott.

Our first exam for the class came about a month into the semester. Because we lived in the honors dorm (we were both honors students), we decided to try this “studying” thing we’d heard so much about. On the night before the exam, a Thursday, we sat in the ground floor lounge of our building and ordered Buffalo wings. In between mouthfuls of wings, we quizzed each other on the study guide. It was boring.

Karolina was a girl we both knew through a mutual friend. She was having a much better evening. We decided that studying could wait and headed up to her room. The cool thing to do in the honors dorm (other than studying), was to have parties in your dorm room. Since being an RA, I have found it almost impossible to understand why we ever thought this was a good idea. “Drinking underage and making lots of noise? Oh you know where that would be better? Remember that person being paid to stop you from doing that? Why don’t you do it next door? To where they live.” We were also not especially sneaky about the whole thing. After being on the other side for a year, I am shocked that we weren’t caught.

We got to her room and immediately took a pair of shots. Each. This, we rationalized, was absolutely responsible behavior in light of the circumstances. Karolina had squeezed at least 15 people into the tiny double room. There was music pounding and the overhead lights were off. One advantage of living in an extremely isolated dorm at the extreme far end of campus was that you knew everyone relatively well. That meant that we had probably ten friends in that room.

Two “responsible” shots each quickly turned into four, and then six. We were both starting to feel the effects. After an hour, we realized we needed to get back to what we were doing before we got distracted. And so, we left the party and ordered more wings.

After we ate those, we realized we still hadn’t studied in any meaningful way. We headed back downstairs and parked ourselves in the main study lounge. Again, the effective isolation of our dorm worked against us again because one table over were a group of our friends. After hanging out (procrastinating), we got out the study guide and started quizzing each other.

It was laughably easy. We always knew the correct answers. Our small group of friends gathered around our table. For some reason, they seemed very interested in our study session. They were even laughing along with is—we thought—about how easy the questions were! This studying thing was working out great! So far, I had eaten wings twice, gone to a “party”, and generally had a great time. Logically (and this made perfect sense to me at the time) since I never studied in high school, and got okay grades, any amount of studying at all would mean an “A” on the exam for sure.

The next day, we got up and walked to class, confident we would ace the exam. As I worked through the fifty multiple choice questions I found myself getting a little irritated. Dr. Abbott had given us the study guide after all, and it seemed like none of the material I had known so effortlessly the night before was on this exam!

It took a few days to get back the scores. Jake got a 66. I got a 72. And we never drank alcohol again. (Not really). But we did learn a valuable lesson: Never make friends. (Just kidding).