Finding Home

Finding Home

Since starting college I have lived in a new place every year.  Every year I have packed my things, placing picture frames and books into boxes, wrapping porcelain figurines and glass vases in layers of paper, sifting through my clothes to decide what will stay and what will go.  Every year I have done this—every year for 8 years now.  First my college dorm.  Then my sorority house – one room for a year then another for 6 months.  Then Chile, where I lived in a small apartment with a host family who took to calling me Brennita. Then the house in Tacoma with the porch swing out front and the bedroom I couldn’t stand up in because it was a converted attic.  Then Thailand where first I lived in a small house with two broken bathrooms, one with a nonfunctional shower and the other with a nonfunctional drain.  Then a lodge, that was really a guesthouse meant for only a two week stay but which I and three other foreigners lived in for 10 months. Then the split brownstone with chicken wire to divide the two sides at the top of the second-floor hallway wall.  Then home to the U.S. where I lived with my Mom and sister in a house I didn’t grow up in but which held all the things I’d known since childhood.  Now here in Denver, in a small house where I sleep in the basement and our entire furnishings were bought from either garage sales or Craig’s List.

Perhaps because of all this movement it struck me when during our first session as a problem based learning group, in the first month of medical school, our facilitator asked us: Where do you call home?  The question surprised me because it wasn’t your typical Where are you from?, although this is how everyone else in the 8-person group decided to answer the question.  Instead it was getting to something else, the place you chose as home rather than the place you were simply born or grew up.

Since I moved home from Thailand I have struggled with this question.  I call Nan home.  I call Wapiyapi home.  But the very place I live right now – a small 3-bedroom house on Magnolia Street in Denver, Colorado – does not quintessentially feel like home.  Perhaps it is this exact longing for home that has contributed to the challenging year I have just experienced.  I am now on a break from school, a much-needed break I might add.  Unlike many of my classmates, I intend to do nothing related to medicine during this 10-week summer vacation.  In my last blog post I wrote about the subtle doubt I’ve had about choosing a career in medicine.  I wish I could say I found the clarity I spoke of in that post, the clarity I knew (and still know) would come with time.  However, even after finishing my first year and with a few weeks off, I still question whether being a doctor is what will fulfill me most in life.  So for me, this summer is a time to reflect.  To write. To come back to myself.  I want this summer to be spiritual.  To be uplifting and cleansing.  To be rejuvenating and self -forgiving.  Most of all though, I want this summer to be about finding home.

Already I have returned to one home – Camp Wapiyapi.  Although camp for the first time since I started attending over 14 years ago was in a new location, I still felt at home.  Driving there, I felt anxious and distracted.  I had just finished with school the day before. I thought I would be overjoyed to finish my final test and head up to camp the next day, but I still had diagrams floating around in my head.  Multiple choice questions haunted me at every stoplight.  The overwhelming exhaustion that afflicted me this year still weighed heavily on my soul.  The worst part of all was that there was a glimmer of regret that I just couldn’t shake. Why did I sign up for two weeks of camp? I kept asking myself.  Camp was an exhausting endeavor where even after one week I sleep for 20 straight hours just to begin to recover.  Here I was though, just having finished school and already I felt drained.  How was I going to do two weeks?!  I was actually dreading the very place I felt most at home in the world!

It took two days for me to forget that I was ever even in med school.  Two days for me to melt into the ease and warmth of camp, to become comfortable, once again, in singing songs at the top of my lungs and cheering everywhere I went.  Two days of donning rainbow tutus and candy-striped socks.  Two days of laughing until my belly hurt more times in a day than I could count.  Two days for me to, once again, become completely and wholly myself.  What bliss, I thought, when on Thursday I realized I hadn’t thought about medical school since the first night I had arrived.  I could barely even remember what it was like to be in school.  Why had this past year brought me so much anguish? I thought.  Now, in hand-painted overalls and tie-dye shirts, a visor decorated with rainbow swirls on my head, I couldn’t possibly imagine why I had ever been unhappy at all.

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Now I am in Nan, the one other place on earth that feels most like home.  It’s been two years since I left and yet it all still feels oddly familiar, as if I were only just here last week.  I’ve only just come to the lodge, where I lived during my first year here and where I will stay for the next two weeks, but already I feel myself simultaneously opening and screaming in petrified fear.  This is what I needed, I think briefly as the songtao taxi drives me through town to the lodge.  Already I can feel my soul becoming calm, reuniting with a part of itself it thought was lost.  And yet, there is another noise, a quiet, ear peeling screech at the pit of my stomach.  What am I doing here? it bellows out long and slow.  I don’t belong here anymore. 

I have anxiously awaited this moment now for two years.  With every passing day since I have left Nan I have imagined my students’ faces, dreamed of the aromas of fried rice and fish sauce in the night market, strained to hear the rain pounding against the tin roof and the peaceful bliss it brings with it when you wake to it in the morning. But what if I have forgotten all my student’s names? What if they don’t recognize me or don’t care that I’m even there?  What if I’m bored?  What if I have forgotten how to exist in this space, how to be the polite, quiet American who smiles when I don’t have the Thai to express what I want?  Despite all these fears, I know this was something I had to do.

Within five minutes of sitting down on the porch of the lodge, waiting for my room to be ready, a young Thai woman sits next to me.  She nods, sips on her tea, then looks up.  “Can I ask you a few questions?”

“Sure,” I say.  She is wanting to practice her English.

She asks where I am from – Colorado in America.  I ask where she is from – Bangkok.  She asks if I am alone.  I nod yes.  She then asks why I came to this province.  It is not a common thing to find a foreigner in Nan traveling alone.  I tell her that I lived and worked here two years ago and now I am just visiting.  She reveals it is her first time in Nan.

“How do you like it?” I ask.

“It’s a quiet life.”

“Yeah,” I nod.  “I came here to visit but also to find that quiet life again.”

It is only now, when she points this out that I realize this is exactly why I needed to come back to Nan.  Slow, peaceful days and solitude is something I need desperately right now.

I went to the Haim concert with Maggie Rogers in May.   Right before her last song, Maggie Rogers mentioned a brief documentary she had just released.  I looked up the 12-minute documentary on YouTube the next day.  The video starts by Maggie explaining the overwhelming year she has just completed – after graduating college she had gone on tour for a year, a tour that initiated her career in the music industry.  The documentary features her final stop in Alaska, the place she named her first hit single after.  In it, Maggie says that with such a chaotic year she needed to find space in order to come back to herself: “I think making space to remember who you are can be one of the most important things.” I have felt that to be so true about my year as well.  Medical school is chaotic and challenging and amongst all that, there is so little time or space to come back to you.  Coming to Nan is not so much about visiting this place or even the beloved students and friends I left behind here.  Instead it is about creating the space I need to come back to the woman I felt I was when I was here.  A woman who was confident and strong, self-assured and creative, and above all, who was happy.

Finding home then, is not really about reconnecting with the places that make me feel most myself, but learning how I can cultivate that self in any space or time.

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Doubt

Don’t compare yourself to others, they repeated over and over at our orientation.  It is something I have continually come back to, reminding myself that it doesn’t matter how well my classmates did on the exam or what they are doing in their spare time outside of class.  All the while though, I have been comparing myself.  Not to my classmates or even to others outside of medical school – although I do occasionally imagine what it would be like to go for a hike on a Saturday and enjoy a beer in the middle of the afternoon. But that I realize is not the mindset that has fostered my doubt and stolen my ability to appreciate the present. No, that comparison is only to myself.  I have compared myself now for months on end, perhaps even years, to the self I was in Thailand.

I was happy then, so happy that I woke up smiling and excited to go to work.  I want that  now, but instead I struggle to get out of bed.  I dream of beta blockers and ECGs and when my alarm rings I hit snooze for an hour before I finally crawl out of bed.  There, I felt acutely alive with each passing hour.  Sure, there were times where I was tired, where I fell asleep at 8 pm and didn’t wake until 7 the next morning.  But I relished in each part of my day regardless.  I loved the walk from our office to the cafeteria at lunch time, being bombarded by sticky fingers and ice cream cones, students yelling Teacha! Teacha! and then reaching for me with sloppy hugs, their arms wrapping around my legs so tight that I thought I might fall over.  I loved the end of day chaos, weaving my bike through their blue skirts and brown shorts, waving to a few of them as I cycled through the front gates.  Now I feel as if I am drudging through my day, getting from one hour to the next, trying to keep my head above water.

“How are you?” my classmates ask one another.  They are looking for a real answer, not just a “Good, thanks. How are you?” And most days I do give an honest answer.  “Okay.” “Just putting one foot in front of the other.”  “I’m here.” –as if by simply showing up I have accomplished something. “In this moment, I am doing alright.”

Yet I am a little weary to tell my classmates the whole story.  I don’t want to admit that over the past few months I have questioned whether going into medicine was the right career choice.  Last year, for the first time since I had formulated my desire to go to medical school as a freshman in college, I felt a type of clarity.  “This is what I want to do,” I told myself as I hit the submit on application after application.  I made a firm choice of medicine over teaching.  And yet now that I am learning medicine each and every day, I find myself thinking of my classroom, wishing I could spend each day teaching instead.

When I was applying for school a friend, who was also in medical school at the time, informed me that I would feel selfish my first two years of school.  Like me, she had taken three years off between undergrad and medical school, working with youth in inner city Chicago.  “You’re not going to feel like you’re giving back,” she told me.  “We will eventually.  We’re going to be doctors after all.  But the first two years all you do is study and that feels really self-centered.  All you have to do is worry about yourself.”  This has all proven to be so true.  I do feel selfish.  I don’t feel as if I am contributing to society.  All I have to do is worry about myself.  Where are those 269 students who made me become a better person?  Who forced me to give of myself so that they could grow to their greatest potential?

I know that this is not what my life will ultimately look like.  I will not be spending 10 to 12 hours in a library on the weekend.  I will not have lecture for four hours every morning and assessments on physical exam skills with fake patients.  I will not have a test every two weeks.  I will not only have to worry about myself and my performance. But right now it is what my life looks like.  And many days it is challenging to find joy in it.

“How is school?” Shelley asks me as I drape the striped tablecloth across the rusted black, metal table.  It’s Easter and instead of spending the day studying, I have spent it with family, cooking potatoes and green bean casserole, baking a carrot cake and icing it next to the window, the sun hot on my sugar-coated hands.

“It’s really hard,” I tell Shelley.

“Are you having doubts?” she asks.

I nod.  “Yeah.” I don’t look up, instead focusing my attention on the zipper that needs to be pulled around the umbrella.

“I don’t know why I asked that,” she admits.  I haven’t openly admitted it to anyone yet, but she is the first person to ask point blank and I’m not one to be dishonest.

She asks me if it gets easier after the first two years.  “Will you graduate if you can just get to your third year?”  It’s not like that, I say.  And it’s certainly not where my doubt stems from.  I’m not afraid that I can’t become a doctor.  I’m afraid I don’t want to be a doctor.

“No talking about the test tonight,” I announce as soon as I arrive at my friend’s house.  A small group of us have created a tradition of making dinner for one another on the evening following a test.  We switch off whose house it is at and subsequently who makes the dinner.  We sit, gathered around a black IKEA coffee table, sipping chardonnay and munching on goat cheese and pita chips. Everyone agrees with the rule – no test talk – but yet our conversations still circle back to medical school.  There are so many times where I resent this.  I’m not studying so I don’t want to talk about it.  In Thailand my American coworkers would make the same rule at meals.  We would bike to the night market, sitting in the shack restaurant that served my favorite fried rice.

“No talking about school,” they’d say.

We’d agree and yet, somehow I would always bring it up.  I was the one who wanted to talk about it.  I didn’t need any distance or time not thinking about my students.  Now that I’m on the opposite side of that argument does it mean that I’ve made a mistake?

The scary part of doubt is not the doubt itself, it’s not even the thought of the possibility that I’ve made a giant mistake.  It’s more the fear of admitting the mistake.  Of undoing the mistake I’ve made.  Going to medical school, if it is a mistake, is a big mistake to make.  Would I feel this same doubt if I went into teaching?  If I quit school and became a teacher would I wake up each day with a tiny pit at the bottom of my stomach that grows each time I am bored or frustrated or apathetic?

“How are you doing?” I ask a second year who is preparing for her first board exam, a time in medical school that is universally known as one of the most difficult times during our early careers.

“Good,” she replies. “I wouldn’t want to be doing anything else right now.”  She means medical school.  She wouldn’t want to be doing anything else with her life except for medical school.  I wish I had the same sort of clarity. I seemed to have it even earlier this year.  During our first block, Anatomy, I complained about the amount of work that was to be done, the sheer volume of structures I had to memorize, when my roommate Rachel turned to me and asked: “What else would you be doing?”  Suddenly, then it became so clear to me.  I didn’t want to be doing anything else, not really.  Somewhere, perhaps in the middle of learning the immune system or while drawing out drug mechanism of actions, I lost that clarity.

So much of medical school is type two fun, like backpacking or camping in a rainstorm.  During the time you are somewhat miserable, wanting the rain and the weekend to end so that you can go home to your warm, cozy bed.  But once you return home you miss the flappy tent and pounding rain, realizing that you actually did have a good time.  Medical school is like that too.  Sitting on the grass at lunch the other day, I prepared with some classmates for our afternoon session performing cardiac exams on patients.  Our Tupperware sat in our laps, steam curling into the brisk spring air, as we pored over my physical exam book. We had learned the cardiac exam earlier in the year during Anatomy.  Then, it had felt so hard, so out of reach.  All the special maneuvers seemed so irrelevant—what is a Jugular Venous Pressure, why do you measure it?  Now we knew what all these maneuvers were.  We even knew what a murmur was, what it meant pathologically.  For the first time since learning the exam five months ago, it felt interesting, even a bit exciting.

It is the small moments like this that I must cling onto.  A brief flash of understanding.  The touch of a patient’s hand as she guides my stethoscope to where I can hear her extra heart sound best.  The camaraderie of a fellow student who admits they too feel lost most days.  I know this doubt won’t disappear in a day, or in a week, or perhaps even in this month. In the mean time I wait for my clarity to return, like a school child waiting at the front of her lawn for the bus, knowing it will come but it just might be a little later than expected.

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More for my own insight than yours, I wanted to share some of my thoughts of gratefulness during this time of doubt.  Each night before I go to bed I try to write at least one thing I was grateful for that day.  It doesn’t happen every night, but here are some from the last few months:

I’m thankful for five minutes to sit outside.

I’m thankful for time to do yoga.

I’m thankful for soccer.

I’m thankful for snow and the ability to sit near a window all day and enjoy it.

I’m thankful for time to cook dinner.

I’m thankful for good friends.

I’m thankful for Madeline and Kaitlyn and all the learning they help me with.

I’m thankful for Ninja Nerd videos.

I’m thankful for dinner with family.

I’m thankful that today I felt happy.

Vulnerable

Vulnerable

I’ve finished with my first semester of medical school.  Many of my peers have been posting pictures on social media with captions that wittingly – or unwittingly – claim they are now 1/8 doctors.  It seems bizarre that in only 7 more semesters I will have MD after my name.  While I have learned more than I ever could have imagined in this one semester of school, having the knowledge to be considered a fully-fledged doctor still feels distant, and at times a bit unreachable.

This semester has lived up to many of my expectations of medical school, and yet there have been challenges that I never anticipated.  Going into medical school I knew that it would be hard, that the hours of studying would be long and that the sheer volume of material I would be expected to know would be enormous.  I thought that a balance between work and play would be difficult, that my hobbies would need to take a back seat to my studying.  All this has proven to be true, although it hasn’t been nearly as difficult as I expected it to be.

What I did not anticipate from medical school however, is the constant rising of emotions.  Emotions that leave me fragile and vulnerable and at times have washed over me so unexpectedly and without warning that I find myself on the verge of tears in the middle of lecture.  Many times I am unsure of what has brought these emotions on and yet, other times I find myself thinking of my sister and her cancer and that year she spent in and out of the hospital.

I’m surprised that thinking about it now suddenly feels difficult.   I will be in the car, coming home from school when a whir of old memories stir in my head.  My cheeks become flushed and my stomach feels heavy.  I have the sudden desire to burst into tears, and find myself thinking of curling up in bed, a blanket pulled tight around me as my chest heaves up and down, forcing air into my lungs between the cries.  I haven’t thought about my sister’s cancer like this since I was in high school.  Of course I’ve thought of that time in our family’s life often, but it has never made my knees buckle or my stomach shake like it has this year.

 

*          *          *          *

“Have you ever been to Children’s before?” the second year student asks me and two other first years when we arrive for the craft in the middle of the high ceilinged lobby.

I nod yes.  “I worked here last year,” I tell her.  I fail to add that my sister’s doctors are here, that she was treated in the old hospital, that in many ways I grew up within those walls.

The other girls say they’ve only been to the hospital once before.  “On the tour they gave on interview day,” one explains.  She tosses her hair behind her shoulder.  “It seems like a really fun, nice hospital, though.”

I am acutely aware of how different my experience is from theirs.  It is almost unbelievable to me that two girls from Colorado have only been in this hospital in the most superficial manner possible.

As kids begin to wander over to our craft table I am self-conscious of my own connection to them.  It is just before Thanksgiving and I pick my words carefully as they sit down and begin to assemble the pre-cut out shapes to make a pumpkin teddy bear.  Don’t ask what they’re doing for Thanksgiving, I warn myself.  You wouldn’t have wanted to be reminded then, either.  When Caitlin had to stay in the hospital for Thanksgiving, I had been devastated.  Any of my friends who were so bold as to bring it up or even to suggest that eating Thanksgiving dinner crammed into a small hospital room wouldn’t be too bad, were met with snide comments and sharp, shooting eyes.  I don’t want to be that person now.  I am aware that my classmates, sitting right next to me, might not even realize the power of such a simple question.  Surely my classmates back then hadn’t realized the sting I felt when they so casually told me that Thanksgiving in the hospital wouldn’t be horrible.  “At least you’ll be with family,” one of them had said.

I cringe now with the memory.  I want to reach across the table and tell the families that I understand what they are going through, but that feels insensitive too.

 

*          *          *          *

 

I ask two friends to study with me at Children’s one afternoon when I find the library too stifling to bear.  “I need somewhere colorful and at least a little removed from campus,” I tell them. They oblige me.  The three of us sit with laptops open and notes splayed across three tables in the cafeteria as the lunch hour dwindles and the crowds have long since dissipated.

When we go to leave, we go through the main lobby.  I point out the pinball machine, asking if they’ve ever seen it before.  They both shake their heads no.  “Oh, then we have to stop and look at it for a minute,” I say.

The three of us walk around the large, square, glass case watching as the balls race along the metal tracks. They are carried by a rotating conveyor belt to the top of the case, where they are released along the track.  A red moving scale with a dog attached moves back and forth.  The ball moves in either one of two directions depending on the way the scale tips.  We follow the tracks, watching as the balls bounce down a series of stairs that are cowbells.  On another part of the track a ball drops from a height of two feet, bouncing off a black, rubber pad into the mouth of a metal cat.  There is a caterpillar that fills up with four or five balls before releasing them all into a circular cage where they are pushed into two holes by a gorilla and his rotating arms.

I want to tell my friends why these metal tracks are so familiar to me, but I hesitate.  Instead I say: “It’s seems so much smaller here than it did in the old hospital.”  And later: “I wonder how old this thing is.”  I know it has to be at least 14 years old since I was twelve when I first found comfort in it.

My friend Madeline takes a video of the balls bouncing off the rubber pad into the cat’s mouth.  She posts it to Instagram.  As we walk out the back door of the hospital into the crisp late autumn air, I wait for a natural break in the conversation to tell them.  My heart is pounding and my stomach feels tied in knots.  I shouldn’t be nervous.  There is nothing to be nervous about.  Yet, I stumble over my words when I finally say it out loud.

“I would watch the pinballs every weekend when I came to visit my sister,” I tell them.

They nod.  The conversation moves forward.  I wonder if they can tell how vulnerable I feel.

Recently I re-watched a Ted Talk by Brene Brown where she speaks about vulnerability and its necessity in allowing us to love and feel loved.  In that talk she says that “the original definition [of courage] was to tell the story of who you are with your whole heart.”  She talks of how we so often numb our feelings of vulnerability because we are uncomfortable with being vulnerable.  I try now to sit in it.  Perhaps, I think, I have never allowed myself to be fully vulnerable when it comes to sharing my sister’s story.  Perhaps, this is why it has never felt harder to face than now, when I am elbows deep in the science of medicine and soon will be expected to have the answers for these kids and their families.

I struggle still to have the courage to share this story with my classmates.  In all honesty, I don’t know that I’ve ever fully shared this story with anyone.  I speak of it openly, yet am afraid to go beyond superficial facts, whether to save myself from reliving them or to spare the listener from the details, I’m unsure.

“Did you work with Dr. Handler?” I ask my friend Kyra after she tells me she spent two days with the neurosurgery team at Children’s during our class’ clinical interlude.

“No,” she says.  “But I heard about him a lot.”

“He did my sister’s surgery,” I tell her without further explanation.  We split ways then, finding the rooms for our assigned small group discussions.

I am aware that I have told her a small piece of my story without giving any hint as to the rest.  She must be thinking why my sister had surgery or how that surgery led me here.  A small part of me wants to fill in the rest, but there is not enough time and I don’t want to face her anyway when her eyes become bogged down at the end, her brows creased and her lips slightly puckered.  I don’t have the energy to tell her it’s all okay now when in reality it is and it isn’t.

“Cool,” Kyra says to me, without skipping a beat.  Her curly, black hair, newly cut, bounces as she waves and departs in the opposite direction.

I’m not offended by her comment, but it strikes me.  Perhaps some of the strong feelings that have struck me off guard this semester stem from this comment, or comments similar to it.  We have learned about disease mechanisms and drugs that treat them, looking at Kaplan-Meir curves, an astute name for what is essentially a death curve.  Each professor that has one in their presentation never fails to ask us if we have encountered this type of graph before, although they will fail to ask if we have enough knowledge to know the basic physiology of the kidney which the rest of their lecture will build from.  They each carefully walk us through the step wise shape that indicates with each month less and less survivors of a disease or a treatment method.  “You can tell that more people survived with Drug A than Drug B,” the professor will point with the laser to each respective curve.  We talk about people as if they are simply a dot on a step-wise curve.

“I like working at Children’s,” one fourth year student says during a student panel designed for students interested in pediatrics.  “You get to see a lot of really cool cases.”

The audience nods.  We all want to see “really cool cases.”  And yet I am uncomfortable with the word cool used in any context that relates to disease.  Having cystic fibrosis or cancer or a rare genetic mutation that leads to hundreds of doctors visits throughout your childhood is not cool.

At Wapiyapi this past year I was struck speechless when a fellow volunteer made a similar comment.  A few of us sat in a bedroom, the campers already in a bed and each of us in our pajamas.  “These kids are so awesome,” one of the volunteers said.  She sat on the bottom bunk bed, her legs splayed out and her elbow bent, the palm of her hand propping up her head.  “I mean it’s so cool that some of them have G-tubes and central lines.”  She paused.  “I just love science and can’t wait to learn about all this stuff.”  I didn’t think it was cool at all.  I tried not to show my emotions.

It’s not that my classmates are insensitive or even that the professors that teach us – especially the few doctors that give lectures – are crass, it’s more the way medical education is set up.  There’s not much time to talk about how these illnesses affect a human spirit.  Beneath all the facts – the disease mechanism and vital signs to look for, the medications and the way they interact with the protein or DNA or cell receptor – it’s easy to forget that there’s a person and a family and a story behind all that.

I can’t ignore the human aspect of medicine for too long, though.  Perhaps it is because of Caitlin—I was introduced to medicine in the most personal way possible.  But perhaps it is because I also identify as a writer and thus it is my natural inclination to find the story behind all the scientific facts, to pull away the threads of humanity tucked between treatment methods and risk factors.

“The parents just look so exhausted,” my roommate Abby relays to me about her time spent in the pediatric ICU.

I nod.  “Yeah, I know.”

“I mean they have this pull-out bed but I can’t imagine that it’s comfortable.”

I nod again.

“They must not be getting any sleep at all.”

I tell her how the new hospital – new to me, although it is now 10 years old – is far more comfortable.  “My mom had a window seat to sleep in.  She couldn’t even spread out her legs.”  I tell her how my mom used to love when I came to visit on the weekends because it meant she could get a cot from one of the nurses.  She’d jump up and down when they brought it in as if she were a little girl going to stay in a hotel for the first time.

I’m glad that I’ll be able to relate to my patients in this way.  Yet, now, it feels starkly isolating.  There have to be others in my class, I think, who are like me, who have had personal or family health crises, who have experienced the health system in an all too personal way.  Yet, no one talks about it.  They all hint, like I do.  My mom had breast cancer.  My brother has Down Syndrome.  When my mom had brain surgery… I wonder if like me, they too feel that each day they are abruptly confronted by that time.

When I was applying to medical school an advisor told me that there was no way my sister’s illness didn’t influence my decision to go into medicine. “People go into medicine for one of three things,” he explained. “You’ve had a brush with death, a family member has had a brush with death, or your parent is a doctor.”   I didn’t fully believe him.  I argued that I didn’t even need to include my sister’s story in my personal statement.

“I don’t want it to feel that I am using her for my benefit,” I said.  “It feels like exploiting her in some way.  I’m not so sure she’s even the reason I want to go into medicine.”

He disagreed.  “You’re not so unique,” he said.  He convinced me to keep her story apart of the statement.  “It doesn’t have to be a lot, but you have to include it.”

Now, I see how right he truly was.  My sister’s cancer had to influence me.  If she hadn’t gotten sick would I have gone into medicine?  I don’t know.  But what I do know is that I will use her illness and my experiences from it every single day to find the human aspects of medicine, to remind myself that a story lies behind every hospital stay, every vital sign, every drug taken or not taken.

 

*          *          *          *

 

It wasn’t until nearly a year after my sister was in remission that my siblings and I could begin to understand the full impact of what we’d gone through.  It was our second year at Wapiyapi.  After the talent show, an event that was notorious for making everyone cry at the end, we found one another.  We held each other like we never had before, crying into one another’s shoulders.  Words weren’t needed then from any of us.  We mutually understood just what Caitlin’s body had gone through, that Pierce and I had suffered silently, separated from one another, staying with different people while Caitlin was in the hospital.  We understood that this had impacted all of us.

Cancer had confronted us then.

I knew that cancer and its impact on all of us would continue to appear, but I never imagined that it would be this confrontational now.  I’m trying to be vulnerable, to allow these emotions to work through me just like they did that night at Wapiyapi so long ago.  It’s challenging.  I don’t want to feel like that thirteen-year-old girl I was then.  Yet, I recognize that she is a part of me, that in fact, she is me.

I want to share her struggles, which are my struggles. I realize that by writing this now I am only sharing pieces of that story.  But it’s a start.  As I continue through school I want to embrace vulnerability and have the courage to share the story of who I am with my whole heart.

 

[Below you can find some photos from my first semester]

 

Culture Shock

I didn’t anticipate how much medical school would mirror my time in Thailand, however, after one month and two tests I have discovered that medical school, in many ways, is like living in a foreign country.  There’s the most obvious connection of learning a new language. Yes, I consider medical terminology to be a whole new language.  While it might be one of the easier languages I have learned, I find myself constantly mixing up superior and inferior, artery and nerve.  At times I stutter, trying to find the right words to describe the structure I just found.  “It’s the subcostal artery—vein—muscle–” I attempt to tell my group as I pick up a thin, shiny band of tissue jutting from our cadaver’s gut to his exterior.

“You mean the subcostal nerve,” a group member kindly corrects me.

“Yes, that,” I say.  In my head I was saying subcostal nerve the whole time.

At least here when I mix up the words there’s no chance that I’ll accidentally call something a penis without knowing it.  Shopping for bananas in Thailand there was always a high probability that I would say penis instead as the two words were the same except pronounced in different tones.  “Just point, don’t ask,” a friend told me in the middle of a 7-Eleven after rehashing how embarrassed she felt in the public market when the vendor looked at her aghast and she later found out what she had said.

Like all good language immersion, speaking in medical terms all day means that I’ve forgotten at times how to speak naturally. When I moved home from Thailand I found myself inserting Thai into conversation without realizing it.  When I returned from Chile where I spoke the native language more readily, I discovered that Spanish slipped into my vocabulary for the next six months.

Now I catch myself thinking of locations in terms of superior, inferior, medial and lateral.

“Can you grab my chapstick out of my bag?” I asked my roommate when we went on a hike together one weekend.  “It’s just in the most superior pocket,” I said as I turned to face her.

She laughed but understood.

Here, like Thailand, I’ve found that bizarre things can occur without much explanation.  One day my schedule instructed me to go to one of the research towers for a TB mask fitting.  As I was leaving my study room to find the location of the fitting, I passed some classmates.  “Did you all go to the fitting already?” I asked them as they passed.  “Yes,” they both nodded.

“What is it?”

“It’s really weird,” one said.  The other concurred.  “You put these yellow things over your head and read.  It was strange.”

I nodded.  “Okay.”

Even with their warning nothing could have prepared me.  I arrived to a small, narrow conference room—six seats, each with yellow fabric boxes folded flat in front of them, a green mask lying on top.  Two young women at the front of the class asked us to place the yellow cubes over our heads.   It had a clear plastic screen with which to see through.  We all immediately laughed as we looked at one another with these large, clunky contraptions sitting on our shoulders.

“I feel like I’m in some weird sci-fi movie,” someone said.

Another person held their hands straight out in front of them as if escaping from the zombie apocalypse.

For the first time I wished I had Snapchat.

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The women walked around the room, spraying a chemical into our yellow cubes, asking us to tell them when we tasted something bitter.  The next step the instructors walked us through was to place a small, half circular green mask over our heads and do the whole procedure over again but while reading a paragraph about prisms and light refractions and how rainbows are made.  They’re preparing us for the contagion, I thought, only my eyes visible between the green mask and yellow box.

“Alright, just sign the paper and throw away your mask,” they informed each of us as we finished.

We did as we were told and left.

“So why did we have to do that again?” I asked a classmate as we left the building.

She shrugged.  “I don’t know.”

“I’ve done things that were more clear in a foreign language,” I noted.  Particularly, I thought of when I was dressed up in Thai traditional wear for Sport’s Day during my first year in Nan.  I was told to arrive at the beauty parlor across from school at 5 am.  I did so and sat in a chair all morning with Thai women babbling around me, drawing thick lines in my eyebrows and applying layer after layer of mascara.  At 7 am Thai teachers ran into the salon, frenzied, yet cooing at me.  “How beautiful!”  They took me to a back room and started dressing me without any pretense to see if I was comfortable dropping my pants and stripping my shirt in front of my foreign colleagues.  My hair was furthered teased and curled and hairspray was applied at full blast.  Later that evening when I pressed cotton ball after cotton ball to my eyes to remove the thick application of makeup I would find that half my left eyebrow had been tweezed off, only for them to fill it in again with a makeup marker.

 

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Similar to Thailand where my senses felt heightened with the new smells and tastes and sounds, here too I find that my senses are on high alert.  I take note of one my lab member’s quiet desire to disarticulate our cadaver’s leg, although she won’t say it out loud.  I observe the way our bodies shift in the chairs, some slinking down, as we discuss how to best approach colleagues who have strong opinions that do not match our own.  My senses are immediately piqued in lecture when I realize that I cannot study in public for the next week, not when images of genitalia are your main study tool. One morning, walking to class I notice the wing of a butterfly glued to the pavement.  It is perfectly erect, the body smashed into the concrete is no longer recognizable.  I sigh and without meaning to, say out loud – “What a shame.”  My mind whirls with all the information I must shove into it each day, yet it sticks, just like the butterfly wing glued to the pavement, onto anything unusual.

“You’ll have the opportunity to check out a skull,” our professor informed us at the front of the room on the first day of lecture of our third and final unit of anatomy.

Later that afternoon it appeared as if our entire class had arrived in the upper hallway of the anatomy lab to receive their skulls.  We all wanted the best ones.  Somehow, I was the first to receive mine.

“Do you want real or plastic?” the woman asked me as she checked my name off a clipboard.

I hesitated.  Did I really want a real skull to carry around?  One in which a brain once lived.  The thought of it made me want to shiver.  “Which is better?” I asked.

“Plastic.”

I sighed, relieved.  “Plastic it is.”

She handed me a square, black case, a number written in paint near the top.  There were various patches of tape in disarray – previous attempts to claim the box or renumber it.

We all looked like middle school band kids as we walked from lab to the parking lot, each of us with our small black cases.

“We’re going home to practice our instruments,” I joked with a friend.  “We’re going to practice playing our skulls.”

It was a bad joke but she laughed anyway.

This is a place and an experience, I’ve found, that’s difficult for others who haven’t experienced it previously to understand.  I quickly discovered in my first week that telling others about the details of your cadaver lab is not socially acceptable.  People generally don’t like to hear about the hardships of digging through a dead body.

“This is my sister,” my brother introduced me to one of our teammates at the indoor league.  It was my first game playing with this team. “This is Patrick.”

“Hi, Patrick.”

We shook hands.

“She just started medical school,” Pierce said after Patrick told us that he was working on his masters in teaching.

“Oh, medical school,” Patrick said.  “How’s that so far?”

I told him about cadaver lab, how scraping butt fat at 8 am in the morning was not my idea of a good time.

I could see him squirm a bit.  My brother looked towards the ground.

“Yeah that doesn’t sound like fun,” Patrick said.  He looked past me.

I hadn’t even thought to sensor the information.  I hadn’t thought how most people haven’t cut into another human’s body and how most people never want to.

I find talking to other people not in medical school is necessary to keep me grounded and sane.  Yet, when I am with these friends and family members I find stories of medical school bubbling to the surface.  I must repress them.  I must try and act like a normal person, like a person who belongs with the rest of society, not a person who cuts into bodies for 8 to 12 hours a week or who looks at pictures of genitalia that could easily be mistaken for porn.

Just as I anticipated medical school is hard, and time consuming.  It forces you to reevaluate what is most important to you.  For me it has pinpointed the activities that rejuvenate me, ground me, and allow me to come back to my studies a better me.  Writing and nature – those are my activities.  After an incredibly enduring week of studying for our second written test and practical a small group of friends decided to head up to the mountains to backpack.  The weather wasn’t promising.  In Vail, where we planned to go, it predicted thunderstorms through the afternoon and evening with possible snow the next day as we hiked out.  But we persevered anyway.

“We’re medical students and just took a test,” my friend Ally said to the couple we asked to take our picture just before we started on the trail.  “We know the weather is not going to be great but we had to get outside.”

They wished us luck, told us to be safe and stay warm.  We waved goodbye and started on the short six mile hike to our camp for the night.  Two miles in it started snowing.  We put on our rainjackets and covered our bags with waterproof rain pouches.  We smiled and continued on.  That night all four of us piled into a two person tent to stay warm.  It snowed almost three inches as we sat near the top of a mountain, nestled next to an alpine lake.  We hadn’t intended to camp in the snow or to hike in it for the majority of our time.  But it felt magical, majestic, exactly what each of us needed.  We woke at around midnight.  We felt crushed and warm beyond belief.  We decided to split into our other tent, sleep two and two as the tents were intended.  As Ally and Cory climbed out of the tent and into the other, I stuck my head out of the door flap.  The stars splattered the night sky.  The trees capped with snow, the world seemed alit.  I was perfectly at peace.  I would have been content to sit there the rest of the night, my head looking up, my body bundled in five layers and a sleeping bag.

The next morning we hiked through two seasons, watching the snow melt as the sun rose, the colors of fall peeking out.  As we hiked lower the orange and yellow leaves of fall bloomed bright on the mountain sides.  We stopped every ten to twelve minutes to admire the landscape.  “Wow, look to your right,” Cory would say, or one of us would just gasp and the others would stop.

“This weekend has made my heart so full,” I said as we arrived at the car, sad to leave the little slice of paradise we had created.

“I don’t typically like that phrase,” Ally said, “but it seems so fitting right now.”

Similar to my time in Thailand, medical school is filled with highs and lows.  There are days I doubt myself, doubt whether I have done enough to pass the test, doubt whether I am worthy to be here in such a privileged position.  And yet there are other days where I feel I am exactly where I need to be.  I feel at peace, a certain sort of calmness that only comes with deeply seeded happiness.  There are the highs that come with escaping for a bit—the high of backpacking in the snow dusted mountains dotted with orange aspen trees.  And of course there are the lows that come with returning to the grind.  Going back to school after a pleasant weekend spent away from books and my computer, I can’t help but feel a little tug in my stomach.  I wish I had one more day to rest, to drink tea on my couch while I write and read and watch Netflix.  Yet, I also know that all it takes is to begin, to sit down and start studying again, and within minutes I feel at home, at peace.  I feel that this is exactly where I need to be.

 

Unit One Review: Medical School

Unit One Review: Medical School

I started medical school over two weeks ago now.  Yet it was during my first week that I couldn’t help but think of how similar this all feels to my first few weeks in Thailand.

Walking to class on the first day I was reminded of my first week in Thailand when I realized the stark turn my life had taken.  I was standing at the front gate of the school, greeting children as they hopped from crowded motorbikes, emptied by the dozens from giant green busses secured by military men, and slipped from their parents’ air conditioned cars. Each of them bowed deeply in front of the Thai teachers.  As many of them reached me in the line they would smile and wave hello.  “Good morning Teacha!”  Others would hesitate, not knowing the proper way to greet me, then bow and run off quickly.  Yet others would skip acknowledging me entirely, chasing friends into the playground, their backpacks bouncing off the back of their knees and their too-big shoes sliding off their heels.

It was my first Thursday teaching in Nan, my first Thursday wearing the orange shirt that I would continue to wear every Thursday for the next two years.  It was that Thursday, as I stood there watching school aged children, some of them bowing so deeply that their foreheads nearly touched their knees, that I first realized how drastically my life had changed in a matter of a few days.  I had gone from walking to and from class on a pristine campus, my backpack weighed down by books, teachers talking at me; to being the teacher myself in a country I didn’t yet understand.  It felt daunting and yet I had a strange sense of calm.

Although I haven’t had quite the same definitive moment of realization that I had then, I know my life has changed drastically.  I have known that my life would change drastically for months now, probably even since the time I hit submit on the medical school application over a year ago now. But perhaps it is this exact anticipation that makes me feel so at peace now.  Despite the chaos of learning the speeding highways of our bodies’ arteries, veins, nerves, and muscles in under 3 weeks, I feel that this is exactly where I need to be.

And yet the similarities between these two experiences have made me nostalgic for my students.  My heart has ached for them.  My thoughts have turned to them during quiet moments in the morning and evening.  Before the first day of class I slipped two bracelets onto my wrist given to me by Namo and Gift.  Namo’s a pastel colored string of beads that resemble a candy necklace.  Gift’s a string of clear, shiny, perfectly round beads.

Myself and all of my classmates received the same stethoscope during our White Coat Ceremony the Friday before starting classes.  When we had to bring the stethoscopes to class on the second day I looked in my room for some sort of identifying feature I could add to my stethoscope, something to differentiate it from everyone else’s.  I went to the jar on my bookshelf, filled with dozens of Rainbow Loom bracelets, small colored rubber bands looped together with the aid of pencils.  My students had made each one of these for me.  For a few weeks during my first year they would run to me at the beginning or end of class and slip them onto my wrist or push them into my palm.  “For you teacha!”  My arm soon became decorated with them, stacking half way up my forearm somedays. I choose a small, ring sized one now and placed it near the end of my stethoscope.  It felt right to have them there, at the tip of the first medical instrument I have received.

After the first week of teaching in Nan I wrote a blog post entitled Unit One Review where I listed all the things I had learned that week.  I had learned that my first graders thought I spoke Thai.  I learned that the one year age gap between my first and second and second and third grade students made my classroom environments feel radically different.  I learned first and foremost that teaching was hard.

It’s interesting how much this experience now – medical school – mirrors my experience then.  In this first week I have learned a lot – in content, but also basic lessons that will help me approach the rest of my four years here.  With the nostalgia I’ve experienced this week and the similarities I’ve felt between the two experiences, I only find it fitting to introduce another Unit One Review.

Lesson 1: Perhaps what is more overwhelming than the actual material I must learn is the amount of resources I have to learn that material.  On the first day we were instructed to download a computer program called the Visual Human Dissector and then given a lecture about how this tool would help us learn anatomy.  But then classmates told me about Essential Anatomy and Complete Anatomy, two apps that they claim are much better than the Visual Human Dissector.  There is the choice of anatomy atlases – Grant’s or Netter’s – both of which have the same information but present it in different ways.  There are the files constantly being downloaded onto our Facebook page.

Hey Guys, I found this quiz tool helpful.  Thought I would share.

Hey Everyone, here are some electronic copies of the required texts that an upper classmen gave me. 

Hey, here is a link to a Wiki page for our school with lots of helpful information!

 The electronic set up of the schedule and assignments, lecture materials and learning objectives, self quizzes and learning modules is confusing.  I haven’t quite figured out a simple way to keep track of everything that’s due and when. Or even what I’m expected to do before any given lecture.

“Did you watch that video?” one classmate asks at lunch.

“No, were we supposed to watch a video?” No one told me we were supposed to watch a video.

And I’ve learned that our lecturers (they don’t call them professors for some reason or another) expect us to know certain things – like where we’re supposed to go next.

“So you all know your small groups, please split up into those,” the lecturer says at the front of the hall.

I don’t know my small group.  I look to the person next to me.  “Do you know where you’re going?”

“Yeah, it says all the small groups in this document here,” they show me their computer.  It’s an entire excel sheet, each of our names placed carefully in boxes with headings over them of the room number we are supposed to file into, like show animals going into pens.

“Where did you find this?”

She tells me.  I can’t even process what she is saying.

I haven’t even really figured out how to see when our tests are.  I know we have a test in 3 weeks (now 2 and half) but I only know this because someone else told me.  I haven’t written down the date, although I vaguely know it is sometime in September, perhaps after Labor Day weekend.  I could write down the date.  I’ve thought about it.  But to go out and find that information, somewhere buried in the mass amount of electronic sources we have at our fingertips feels too time consuming to someone who can barely navigate what small group I’m in.  There are bones and muscle attachments to learn.

 

Lesson 2: Don’t compare yourself to others.

They told us this at orientation.  I believed them, but I didn’t know then how essential it would be.

I check out a skeleton in the library.  From the corner of my eye I can see classmates in a study room, writing up a diagram on the white board.  I haven’t done that, I think.  I don’t even know what that diagram is.  Panic begins to settle in.  Do I need to know that right now?  Am I not doing something that I should?  What am I doing wrong?  But within seconds I shake it.  Don’t compare yourself to others, I remind myself.  Maybe they’ve taken anatomy before.  Maybe they already know the bones.

One morning I hear my roommate leave the house to get an early start on studying. It is before 7 am.  I am still in the basement, at my desk writing.  I haven’t dressed or even eaten breakfast.  I feel the press (metaphorically of course) of the bones on my back.  I must go.  She’s studying.  So why am I sitting here and doing something so menial as writing?  There are bones to learn. Notes to take.  Diagrams, that I haven’t even seen before, to draw.

I breathe in, then out.  This is where I am supposed to be, I say, sitting here writing, under the bright glare of my desk lamp and a lukewarm cup of coffee near my wrist.

Lesson 3: Take it one hour at a time.

Unlike many other aspects of my life, med school becomes an hour by hour entity. What lecture do we have tomorrow? Someone might ask.  I can’t answer them.  I only know where I’m supposed to be and what I’m supposed to be learning in the next hour.  Tomorrow feels too far away to worry about it.

If I thought anyway else I would begin to explode with the amount of material I must learn.

“We have three weeks until the test,” someone mentioned to me on the second day.

“Three weeks?!” I say.  The way he said it made it sound as if 3 weeks was a generally long time frame to learn what we needed to know.  I try not to think that I only have 2 weeks left to learn all this material before I’m tested on it.  Even seeing that number here, I flip through my calendar, panicked. No, 2 weeks can’t possibly be right, I think.  It has to be more than that. Right?  It’s not.  Two more weeks of class and then I’ll be tested.  I’ll have to know the over 40 pages of information, listed in bullet point form, on my study guide.  If I thought about that, though, each time I sat down to study I would never get anything done, too paralyzed with fear and improbability to pull out an Anatomy atlas and locate the carpal bones.  That’s why I must just take it all one hour at a time.  One structure at a time.  One lecture at a time.

“I’ve never learned this much by the second day of school,” a classmate says to me as we walk to class that morning.  We have just spent the last couple of hours in the bone room, going over the pelvic bone – which I will now know as the innominate.  Small notches and curves in the bone haunt me as I go to sleep.  Is that the conoid tubercle or the coracoid process or perhaps the coronoid fossa?  It all blends together at first and yet writing this now I am able to distinguish the three.  The conoid tubercle is on the inferior surface of your clavicle; the coracoid process jutting out from your glenoid cavity on your scapula; the coronoid fossa a divet on your anterior humerus where the ulna bone sits.  It’s insane to me that I have learned that much in three days time.  It’s perhaps more insane to realize I will continue to learn this much and more each day for the next four years, perhaps even for the rest of my career (although I really hope it does slow down at some point).

 

Lesson 4: Tell yourself that everything is fine, even if you don’t always believe that.

I’m reminded of a cartoon that a friend who was teaching with me in Thailand first introduced to me.  It had a person drawn in a room, sitting at a table, a fire sprouting around them, engulfing the rest of the room.  “This?” they ask to the reader.  “This is fine.”  I loved it then because it reminded me of my classroom.  Pure chaos would arise around me, children yelling, going every which direction, and I would stand at the front of the class, a flashcard for the letter E in my hand, trying to sing our alphabet song above the din, usually without success.

Now, I feel this way again.  Talking on the phone with my mom the other night as I drove home, she inquired how I was doing.

“I’m fine,” I said.

She did that mom thing where they read into the intonation of your voice and assume something more is going on.

“How are you really doing?” she asked.

“I’m fine,” I insisted.  “It’s a lot but I’m fine.”

“You don’t like it do you?”

“No.  I like it.  I’m fine.”

I relayed this story to a classmate sitting next to me in lecture the next day.  We laughed over it.

“I have to tell everyone I’m fine, too,” he said.  He told me that friends ask how med school was going and his only answer is fine.  “I don’t want to say anything else.”

*          *          *          *

Since the first week all of these lessons have continued to hold true.  The firehose of information has only become stronger and after the weekend I will have to prove that I’ve been able to sufficiently drink from that pounding stream of water when we take our first test.  When I had my first minor break down last week I turned to my roommate.

“Breathe,” she told me.

“Breathe?” I asked.  “There’s so much to know.  I don’t want to do it.”

“What would you be doing if you weren’t in medical school?” she asked.  It was a rhetorical question but I stopped to think anyway.

“I definitely wouldn’t be this happy right now.”  It’s hard – no doubt.  Yet, this is exactly what I wanted.  I breathed in, like my roommate had instructed, and felt a sudden pang of gratefulness to have 40 pages of muscles and bones to learn.

 

 

 

 

 

There’s a Reason We Call it Consumerism

There’s a Reason We Call it Consumerism

Instantly, I love them. Cream colored leather. Thick heel. They almost resemble fall booties, but it has a peek toe so they could be worn in summer. I look at the price tag – $70. Too much. I shouldn’t even try them on. Plus, they’re not even what I’m looking for. Stay focused, I think.

I decided to go to TJMaxx last week after I came to the stark realization that I had no good sandals to wear on Easter. I only owned Rainbow leather flip flops and a flimsy pair of black, strappy sandals that my roommate Jenica had given to me in college after she felt they were too worn in for her (they’re now decorated with spots where the fake leather has worn down and revealed the cloth core beneath).

I pass the cream colored heels, scan my eyes further along the shelf. I’m proud of my initial self-control, but the sparkly sandals I eventually try on disappoint and after I try another pair of baby pink ones with a gold plate down the strap, I pull the cream colored heels off the shelf. No harm in trying them on, right? But I know that I am trapped. They feel perfect, molded to my foot almost, as if they were made for me. But they’re $70, I think over and over again. I can’t justify spending $70 on shoes I didn’t come here to buy. What do I need them for?

And there’s the crux—need. I don’t need them for anything. But what about that wedding this summer that I still need shoes for? Or the white coat ceremony for medical school that’s coming up in the middle of August? The justification begins. When it comes time to whittle down my hefty selections from an after work shopping spree, the cream colored shoes stay for purely aesthetic reasons—they’re cute, comfy, versatile. I walk to the register, telling myself I’ll return the shoes if they don’t go with the dress I’m wearing to the wedding this summer.


IMG_6542It’s been almost a week now and the shoes sit in front of my closet, the tags still attached. I am no closer to making a decision of whether I will keep them. They didn’t go with that dress. But I could still wear them, I think. More justification. I recognize that my agony over this decision does not match the consequences of such decision. I recognize that my happiness is not tied to the purchase or return of these shoes, that these are only material things. It’s cliché, I know. It’s things we’ve all heard before—money doesn’t buy happiness. And yet, on the surface, they seem so intrinsically linked.

For much of my life I have struggled financially. I was raised primarily by a single mother and started working as soon as it was legal, right before my 16th birthday, so that I could have money to buy things for myself—clothes, shoes, tickets to movies. I don’t resent my upbringing because of this; on the contrary, I am appreciative that my family’s adversity made me aware, from a young age, of the value of money. Yet, it also has me continually striving for more, and not necessarily in a healthy way.

Since high school, I’ve found that I easily become jealous of others who have more. Classmates whose parents pay their rent for them and still give them monthly allowances to buy clothes and go out to bars; friends who make more money than me and consequently can travel with more ease; even strangers who seem to be dressed nice, drive a nicer car than me, or order an entire bottle of wine at dinner. I wish I didn’t have these thoughts. I wish that I didn’t size up everyone I meet by the amount of money they or their parents make. I wish I didn’t have to think about the balance of my bank account on a daily basis. I wish I could buy what I wanted without having to worry if I could pay the rent that month too.

I reflect now on my fixation with money because even though I have recognized for a long time that my relationship with money is not the healthiest, I began for the first time in my life to form a healthy relationship with money while I was in Thailand. My financial situation radically changed while I was there. No longer was I concerned about making enough money to pay the rent or having sufficient funds to go out on a Friday night for a drink. I had the extreme privilege to have a stable salary that not only allowed me to live comfortably, but also gave me the ability to save for trips and other travel expenses. For the first time in my life, I didn’t have to worry about money.

I also didn’t have the pulls of capitalism that exist so strongly in this country. The few ads I was exposed to were in a language I didn’t fully understand and therefore had no lasting impact on me. I was essentially in this bubble stripped of outside influences and thus, my purchases were almost solely based on the molding of my being. To add to this nearly non-capitalist approach to purchasing, I knew that I anything I bought there needed to have a purpose fulfilled immediately because most of the things I owned while there would not be returning home with me. It was as if I owned this transient set of possessions, material things that I knew I would not add to my permanent collection and therefore would not impact my self-image for long.   Because of this I bought items that I certainly would never have bought if I were living in the U.S. For example, I purchased a pair of orange Converse at a fair when I needed a pair of tennis shoes that would be more comfortable than flip flops to walk around in a city all day. I first tried on a pair of black Converse, something that was already a bit outside my comfort zone. I had never purchased a pair of Converse before, always thinking they weren’t my style and made my feet look too big. But there weren’t many other options at this fair in terms of closed toed walking shoes. As I was about to purchase the black pair, an orange pair caught my eye. What the hell? I thought. Why not? The last time I owned anything orange (outside of Wapiyapi) was a t-shirt I wore in the fourth grade with a sparkly zebra on front.

I loved those orange shoes. They fulfilled their purpose and always made me smile when I looked down on their bright, and a little bizarre, color. When they began falling apart on my way home, the rubber soles wearing through as I walked through town with them in Ireland, I purchased a new pair of shoes in the next shop I saw and threw the orange pair away in the trash can outside. No second thoughts.

This year hasn’t brought the same satisfaction with my purchases. I have bought in excess, whether it be because I have returned home after two years of living in a tropical climate and thus have a shortage of practical fall and winter clothes, or it be because I am starting medical school next year and feel an added pressure to build a varied wardrobe so as to decrease the amount of clothes I will buy over the next four years when everything will be on a loan, I don’t know.

Every time I have bought something this year I have told myself that this is the end of the purchasing for a while. I don’t need any more clothes for fall. Or winter. Or spring. But as soon as I buy one thing, I begin to want more. Just after I purchased a cardigan in the mall, on sale, I began to notice what women wore in the store while I was at work. I wanted the purple cardigan one women wore, who I spotted leaning over her daughter, wiping some stray juice off her cheek. I took note of the running capris one woman wore while pushing her stroller; they hit her calf in just the right place so they didn’t ride up. I observed the heels that clicked by and the brightly colored converse that caught my eye. Why, I thought, am I constantly wanting more just as I have obtained more?

When I first moved home I felt hypersensitive to the capitalism around me—the ads on TV, the radio, my phone, the Internet, the emails with sales and discounts and new products that filled my inbox on an hourly basis. They all drove me mad. I felt like there was no way to escape the noise, there was no way I couldn’t want more. I felt restless most days, going to bed with a slight buzzing in my ear.

Is this a condition of humanity? Or just of our Western societal structure? Or is it more specifically a construct of American society?

Or perhaps some of it as well, has something to do with the condition of my hometown. It’s a place filled with upper middle class families. A place where my high school spilled over with kids dressed in the latest designer clothes—Juicy Couture track suits, Coach shoes, Miss Me and Lucky Brand jeans—and the parking lot seemed like a high end dealership—BMW’s, Land Rovers, Mercedes. I was the only one I knew above the age of 16 who didn’t have their own car.

Now I find myself surrounded by that all again, just in a very different context. I am no longer influenced by the amount of name brand purses I see in the grocery store, but I do feel a certain pressure to look my best. For the first time in my existence I feel an urge to wear heels in an everyday capacity and not simply for formal events like dances or weddings or interviews.

When I was in college I once asked one of my teammates what they wore in terms of makeup. “Only mascara,” she said. “Sometimes eyeliner if I’m going to a party or something. But a lot of days I don’t wear any makeup.” I was a little taken aback.

I turned to my other teammate and asked her the same question. “Mascara and eyeliner,” she said. “But a lot of days I don’t wear anything either.”

“Really?” I looked at both of them, incredulous.

“What do you wear?” they asked me.

“Mascara, eyeliner, eye shadow, foundation.” My list felt long and unnecessary compared to theirs. I told them I always wore makeup, that I hardly ever went a day without it. “It’s not that I think I don’t look good without it, I just have never really thought about not wearing it on a normal day where I go to class.”

After our conversation, I realized that I had built my own makeup habit in high school and it had never left me. In high school I had noticed all the girls with intricate layers of foundation and blush, shades of eye shadow filled in up to their brows, thick lines of eyeliner that were impossible to miss. In class one day a teacher asked us to reveal our morning routines. Most girls said they spent 40 minutes to an hour on their makeup alone. I had the shortest routine at 10 minutes. I was tame in comparison to many of my classmates, at least that’s what I thought. Puget Sound, the place I attended college, however, was far different from my hometown and I felt it immediately.

“I like that people wear their hair natural here,” one of my friends observed at the beginning of our freshman year. It was true. Many girls didn’t feel the need to straighten their hair or even blow dry it and thus there were more people with wavy and curly hair than straight. It gave my friend the permission to ditch her own straightener and go natural as well.

Students at Puget Sound didn’t feel the need to impress others with how they looked. It was a laid back campus where designer brand purses were almost nonexistent and a natural look won over a highly made up one.

How much is the way I present myself to the world shaped by the town I grew up in? Was I never able to ditch my makeup regimen in college because it had already been so firmly cemented in me during high school? Was I never able to wear my hair natural because of the fear I had during high school that everyone would take note if I hadn’t straightened my hair for one day? If the answers to all of these questions are yes, then isn’t it reasonable to assume that my spending habits this year, especially in regards to building a more glamorous and varied wardrobe are tied to these same pressures? I am a product of my environment, as many of us are, and despite having traveled to different parts of the world and having lived in another part of the country, I am still vulnerable to the very thing I hate most about my hometown—its superficiality.

I think what bothers me most about this superficiality is not that I can’t afford the nice things so many people have around me, but that people feel the need to buy these nice things in the first place. The excess of luxury cars, designer clothing, and fine jewelry in my hometown is not so much a sign of higher income but a need for people to flaunt that excess wealth. What is the purpose behind buying a Lexus over a Toyota? A Kate Spade purse over an off brand one from TJMaxx or Target? There is something to be said of higher quality, but yet, how much of our decision to buy nicer products is entangled in what that brand represents and thereby what our status becomes when we can afford such luxuries.

As a kid, and even now, I have never understood why money ruled our world. I have always questioned how extremely wealthy people could keep all their money for themselves without ever giving much of it to others who need it more. How can one be so selfish as to live with far more than they need, and yet others do not even have the necessities of a home and clean clothes?

In high school I was strangely curious about communism. I thought, in many ways, it was more ideal than democracy because it ruled out capitalism and wealth and social hierarchy. But I knew better than to say these thoughts out loud, especially in a classroom. Even in a post Cold War world, I knew that saying communism seemed better than what we currently had in the U.S. was crossing a certain line, even if I didn’t entirely agree with that line.   Communism, to me, represented this world where people could be equal, where there was no choice in being selfish and everyone was taken care of. Since visiting some communist countries, I have seen that all of these ideals work out better on paper than they do in practice. Selfishness is a part of the human condition. There is no denying that.

I, myself, who has always criticized wealthy people for keeping their riches, am guilty of this crime too. I do not need those $70 shoes; instead that money could go towards Wapiyapi (a cause that many of you know is near and dear to my heart), funding a scholarship for one of my students in Thailand, or even selfishly—my student loans.

This whole post isn’t to mock my purchase, or your purchase for that matter, of a $70 pair of shoes. In the overarching world these are small things. Yet, I find myself gripped with buyer’s remorse each time I purchase something. Even weeks after the purchase I am engrossed with possible regret. I may have used the shoes several times or worn the dress and received many compliments on it; I may even have fallen in love with the item myself. But yet, I am still burdened with the thought of returning it because truly my life would be the same without it.

My relationship with money may be rocky, but I will continue to work on making better, smarter purchases and creating a healthier partnership with money in the context of a highly capitalist world where advertisements are thrust into my lap within nearly every minute of every day—

Wait—I just received an email with deals on winter jackets. It’s only spring, but if I want to get a good deal I got to act now. . .Where’d I put my wallet?

What Do You Do? – a contemplation on work and success

In our society we value work and success.  It’s something I’ve always known, growing up in a family where I was encouraged to pursue a future career that would utilize my education.  In high school I had a fairly blunt conversation with my mother on this topic. I was sitting on my bed, my mother across from me.  We were talking about what I wanted to do when I grew up, a question that around my sophomore year of high school seemed to suddenly morph from a light and friendly topic to something that carried far more substantial weight.  I told my mother that day, the sunlight pouring in through the sheer curtains of my bedroom window, that I wanted to be either a fashion designer or a photographer.  I was in both classes at the time.  They had surpassed my long time favorite – English.  But when I told my mother that this was where my current interests lay she didn’t show the slightest elation. Instead she sort of pursed her lips and I could see her shoulders grow tense.  “Brenna, you can’t be that,” she said.  

“Why not?”  The conversation had become serious and I found myself, like most teenagers are with their parents, combative.

“You’re too smart to be a photographer or designer.  You need to do something with your mind.”

That comment has stuck with me; although I realize for my mother it was most likely a fleeting comment, a passing conversation that she now has no recollection of.  It is something that over the past few years, as I begin to truly answer that question – What do you want to be when you grow up? – has continually replayed in my mind.  Did that comment change my projection?  Did my need to appease my mother force me out of a creative profession and instead steer me towards medicine?  I think I would have found my way towards medicine anyway because the comment my mother said to me that day was not fueled by her own belief that I should pursue intellect over creativity.  (Indeed I think there is much to be said about the intellect in photography, fashion design, and all forms of art for that matter.)  Instead, I believe my mother’s fear that I would choose a “wrong” profession was rooted in our societal beliefs.  

For one reason or another, we as a society, have created a hierarchy of professions.  There are certain professions we see as prestigious and noteworthy, and therefore we give certain people more automatic respect because of the connotation of what they do for a living.  It is generally thought that going into medicine is a good, worthy occupation.  However why is it that doctors are more generously given respect in comparison to nurses, or PA’s, public health experts, or health care administrators?  I don’t just mean when you are at a dinner party and say what your profession is to a stranger, but even within the workplace.  I’ve worked as a medical scribe this past year and because my job doesn’t automatically fit into any one health care role — i.e. nurses or doctors — I’ve found that I have been accepted by both groups within the office.  This mutual acceptance has allowed me to see the interactions between health care providers without any natural biases.  It continues to amaze me how even though everyone is working towards the common goal of providing the best care for a patient that an unspoken heirarchy still exists.

I must point out that this hierarchy is completely subjective based off the values of a particular culture.  In Thailand, for instance, teachers are highly respected and seen as one of the most important professions.  In public, teachers are given the title Ajarn, the Thai word for teacher, rather than their first name.  It is essentially the equivalent of being referred to as doctor if you have an MD, DO, or your PhD.


 

It was the other week, skiing the slopes on a weekday that I became confronted with the value our culture places on work and success in a way I was never aware of while I was a student.  Having skied solo for the day I shared many chair lifts with other single skiers, most of them older males.  Within the small conversations one question continually slipped in, usually at the beginning of the conversation – What do you do?  

I shouldn’t have been taken aback by this question.  But I was.  Living in other countries I have noticed that this is never the first question you ask a stranger.  You ask “Have you eaten?” or “Where are you going?” (Perhaps my perspective is a bit skewed here.  In Thailand it was assumed within my community in Nan that I was a teacher. Maybe that is why no one ever asked me What do you do?) Men in skinny black jeans on motorbikes would look over at me while we were stopped at a light and ask Bai Nai?  Where do you go? Women sitting on bus station benches would ask inquisitively, Gin leao? Have you eaten?   I loved the societal connotations of these two questions, although I never quite mastered the art of answering them–it can be awkward to say to the guy next to you at a traffic light that you’re just wandering the city on a Saturday morning, trying to kill some time before you meet your friends for lunch.  People didn’t necessarily care that you had achieved great success in your career or even that you had finished school, although they still do place great emphasis on a good education.    Instead, they cared about what you were doing in that present moment; they cared that you were taken care of and that you were moving forward in a positive direction.    

On the chair lift the other week I found myself wanting someone to ask me those questions again — Where are you going?  Have you eaten? — instead of What do you do?  I was a bit embarrassed, honestly, to answer the question.  I’m a medical scribe.  I felt that by admitting this, I was also admitting my failure to be successful.  Why was being a medical scribe equivalent to failure, I thought?  Why was it not good enough?  The answer to these questions probably all rely on the personal connotations I have with being a scribe rather than the societal connotations.  I’m sure nobody on that chairlift thought lesser of me because of what I did.  

But I found myself wanting to add more.  I felt the need to also tell everyone that I was going to medical school next year, that this job was only transitional.  Why did I feel the need to add that?  Why did I need people to know that I was striving for more than being a medical scribe?  

As I noticed this tendency to elaborate, I tried to stop myself.  The next person I shared a the ski lift with was an older man who lived in Keystone.  Inevitably he came around to asking me what I did.  “I’m a medical scribe.”  No flare.  No added boost of medical school.  Just I’m a scribe. I let the words hang between us.  There seemed to be no judgement.  But still, I wondered, why did I put so much weight on that 4 word question?  

Maybe, I thought, it was the fear of answering that question that gravitated me towards a career in medicine rather than a more creative occupation.  Ever since I could read, I have also loved writing.  My first (and truest) desire was to write a book.  As a kid I always imagined I would grow up to be an author, although even then, I would never admit this when someone asked me what I wanted to be when I grew up.  Perhaps I knew, even then, the perceived negative connotations I would receive.  Or perhaps I also knew my need to survive on a stable income.   Whatever it may be, somewhere along the way, societal expectations got the better of me and I too fell into my mother’s trap, feeling that I must utilize my intellect above my knack for creativity.  That’s not to say I will never write–clearly I have sustained this blog far past its conceivable life and continued writing even when I know so few are actually reading; and I still have the crazy desire to continue writing and formulating books and stories as I venture further into the realm of medicine. But that question – What do you do? – needed to be answered in more tangible way for me. I choose, very deliberately, not to make writing my entire career.   


At the end of the day I realized I had only asked one person I rode the chairlift with what they did.  Not only was I uncomfortable answering the question, I was also uncomfortable asking the question.  

Why, I thought, do we place so much emphasis on what we do?  Why does it seem that our worth is tied to our success? And that success is measured in career aspiration and achievement rather than our base happiness?  Instead of asking one another what we do, why cannot we ask: Are you happy?  Are you loved?  Have you eaten?  Where are you going?  

Because ultimately, I think, it is not what you do that shapes your life, but who you love and who loves you.  What matters is how you find joy in your life, despite the monotony of a job and daily living.  What matters is good food and good conversation.  What matters is family and friendships that sustain us.  What matters are deep life experiences that strip us of who we think we are and show us what truly matters.