Books of summer

In the scheme of things, not much is going on. I’ve been diligently working at my research, and actually getting things done. In addition to the work of summer, however, I’ve been relaxing a little more than usual, and reading a reasonable amount. When medical school is at its craziest, I rarely have time to read for more than about 2 minutes before I fall into a zombie-like sleep. As such, this summer has been a wonderful reminder of all that is fantastic in the literary world. A disclaimer: I am a literary critic, but by no means a professional one… That being said, here’s my list, and some thoughts about it:

Caramelo by Sandra Cisneros

Truth be told I actually started reading this long before the summer started. But I didn’t have time to finish it until the summer really got started. Additionally, there’s something I should mention early in this post: I was a Spanish major in college and continue to love most things Latin-American (food, literature, dance, etc.). I definitely miss the freedom my undergrad education offered, and the literature courses I took. While I’ve found reading literature in Spanish a little too time consuming for my limited school year time, and my brain hasn’t been ready to work that hard this summer, I anticipate that as this list grows it may include some Spanish-language gems I’ve been just waiting to read… But I digress – I enjoyed Caramelo because it was a mystery, although not in the typical sense, but rather in the family sense. It had a host of both likable and horrible characters that I loved. Additionally, I feel somewhat at home with Mexican literary characters and settings, and enjoyed the chance to relive some study abroad experiences.

How the García Girls Lost Their Accents by Julia Alvarez

I’d never read anything by Julia Alvarez before, but Larry (Spanish professor extraordinaire) had recommended her books (and assigned her work in some of his classes that I didn’t take). This one was about a Dominican family, which I particularly enjoyed after traveling there over Spring Break. Although the narration took some getting used to (the story switches between sisters), I enjoyed it.

I, Carmelita Tropicana by Alina Troyano

Carmelita Tropicana may be my favorite performance artist of all time. Actually, I’m sure she is; she’s amazing. Before I break out in completely reverential tones, let me explain: Carmelita Tropicana is the alter ego of Alina Troyano and Carmelita is one of the most fantastic, fabulous and dare I say campy, Latina lesbians the world has ever seen. I highly recommend the movie on which she and her sister collaborated, “Your Kunst is your Waffen.” It’s amazing, and this book, which is a collection of her performance pieces, is also fantastic. I rarely laugh out loud when I’m reading and subject Alicia to a reading aloud of a particular passage, but I just had to share parts of this book.

Uncle Tungsten: Memories of a Chemical Boyhood by Oliver Sacks

This book wholly appeals to the nerdy scientist inside (or on the outside too) in all of us. While recalling his memoirs, Oliver Sacks also recounts bits, pieces and sometimes very large parts, of the history of chemistry. This makes for an engaging read during the course of which I felt like I learned a great deal. I’m looking forward to reading more of Sack’s work.

Breath, Eyes, Memory by Edwidge Danticat

This one is take on the Haitian experience, and I preferred it to How the García Girls Lost Their Accents (a story from the other half of the island). This narrative seemed much more personal, and went deeper emotionally. Although parts of this book were hard to read, and the book in its entirety deals with difficult issues, it is, to quote the summary on the back of the book (which I generally dislike, but am content to use here), a “passionate journey through a landscape charged with the supernatural and scarred by political violence, in a novel that bears witness to the traditions, suffering, and wisdom” of this family. While the back of the book finishes “of an entire people” I think that the story is more personal than that. While it provides insight into some aspects of life in Haiti, it is a distinctly individual story heavily influenced by a cultural and national experience.

Fun Home by Alison Bechdel

On loan from a friend, this was a quick and delightful read. (This is a notable achievement given much of the subject matter.) Written and drawn by Alison Bechdel of “Dykes to Watch Out For” fame (well, fame within certain communities), the book (or maybe graphic novel? I think she calls it a “tragicomic.”) is autobiographical. I’m always impressed when an author (this would extend to the above novel by Oliver Sacks) is able to present memoirs or an autobiography without taking themselves too seriously, and even with some humor. Alison Bechdel definitely accomplishes this, and I had a great time reading the book.

The Perks of Being a Wallflower by Stephen Chbosky

Alicia recommended this one, with the caveat that she didn’t think I’d like it. She was wrong. But I can’t blame her for being unsure. Again, I found parts of the book hard to read, and sometimes disturbing, I couldn’t help but find the protagonist (Charlie) endearing, even when I was frustrated by him.

Right now I’m reading another book that I can’t mention yet, because I really don’t like it and I feel bad saying things like that about a book I haven’t finished. I’m usually pretty good and choosing books that I’ll at least enjoy getting through, even if I don’t love them, but I didn’t do a great job this time. Alicia is reading The Historian by Elizabeth Kostova, an UM MFA graduate and winner of the Hopwood Award (a prestigious UM writing award). Apparently (according to my sister), my mom is also reading it. Both have given it rave reviews and I’m hoping to snag it before it makes its way back to the library.

Commitment

Whenever I talk to people about medical school, the first thing they ask is where I am in the process. When I tell them I’ve only finished my first year, those in the know acknowledge that I’m still at the beginning, while those who aren’t ask how much longer I’ll be in school. The conversation generally goes down hill from there. What started as innocent small talk devolves into a lengthy explanation of what I’m planning to do with my entire life, starting with a lot more school. I explain that I’ve always been interested in public health, but that I want the serious research training offered by a PhD. That’s usually followed by an explanation of the typical schedule: two years of medical school, three or four years of PhD work, and then two years of medical school. If their eyes aren’t glazed over by that point, I usually ask if they themselves have several advanced degrees. Otherwise I politely change the subject.

In spite of what seems to many an insurmountable number of years of schooling, I’m really excited to be in this program. If I’d realized at my high school graduation that I was only half-way through my schooling, I’m not sure what my reaction would have been, but at this point, I’m willing to do almost anything to get to do the things I love. From my current vantage point, it looks like I may have to. Chances are I’ll need to teach or be a research assistant during my PhD work to fund my education. Most people in public health do. This may or may not add another year onto my time here. Basically, I’m not thinking about how long I have to go, but how much I have to learn and what I’m preparing for. It will be difficult, but I’m looking forward to the challenge.

It hasn’t exactly been easy getting this far. When I applied to MSTP and MD/PhD programs during my last year of college, I knew that my application wasn’t strong, and that my public health research experience was lacking. I didn’t anticipate being accepted and, not surprisingly, I wasn’t. I started my first year with every intention of applying again, this time with a summer dedicated to a combination of field placement-type work and research. I applied again, and it actually worked out. I’ll be an official “mud-phud” as the MD/PhDs are fondly referred to, and I couldn’t be happier.

10 things that tell me summer has arrived in Ann Arbor…

(in no particular order… or parallel structure… sorry…)

1. The sunlight in the morning is lovely. The picture at the top was taken on one of my training walks and still doesn’t quite capture how nice it is. It’s always just the right temperature, and there are lots of little animals out enjoying it. Right after I took this picture I saw the cutest baby skunk. I was afraid that if I took a picture of it, the mother would come after me, so there isn’t a picture of the cute little ball of black fur…

2. The Farmer’s Market is going full tilt. It’s crazy every Saturday morning, and much more subdued on Wednesdays (when I hardly ever make it). I’ve procured for myself almost enough plants to make me stop wanting a pet, and am thoroughly enjoying the basils and parsleys that now grace my window pane. If this year has taught me nothing else, it’s that what I thought was a black thumb of death is actually a fantastically green thumb. I think my plants can tell that I love them, and grow for me accordingly. They sense that I’d love to have a pet but that “pet rent” in my apartment is so outrageously high that they have to fill in for something furry and snuggly.

3. I feel sticky much of the day. And I don’t think it’s just me. Although it’s not yet at it’s most humid (August here we come…), it’s still sticky during the hottest part of the day. This is doubly so when it’s going to rain.

4. It’s safe to drive around campus. This is because the undergrads are gone and are no longer darting out into the street at the most inopportune times.

5. Research. Much of my research experience has taken place over the summer, and this summer is no exception. I am working with a professor in Public Health, evaluating aspects of the HIV/AIDS Resource Center outreach programming. It’s fantastically rewarding, although somewhat overwhelming. I never thought I’d say this, but I actually kind of miss having quizzes at the end of the week that tell me when I can take a break. (Instead I have to police myself and get everything done on my own…)

6. My brother had a birthday. He turned 9 this year, which is crazy. I mean, he’s only got this year and then… double digits. It’s hard to believe. This year we went to the Potter Park Zoo, which is in Lansing. It’s quite a nice park, with a smallish but fun zoo inside. Some of the highlights of our day were seeing a baby camel, watching a white peacock do what my brother termed “the butt dance” with his feathers all fanned out, and feeding a llama, whose lips are remarkably like fingers.

7. Sunscreen has once again become a major issue. I always wear it on my face (even in the deadest of winter), but summer always seems to offer the opportunity to slather large portions of my arms and legs with the faintly coconutty cream that I love and hate at the same time.

8. Baby ducks! Actually, now that it’s summer there are sort of awkward-looking teenage ducks, but in the spring they were baby ducks, and they’re still cute. This family of ducks is another stand-in for a pet. Because we live in front of the little stream, we seem them periodically. They were even sitting in our bushes as a little family (but the pictures didn’t come out too well, because they were hiding in the dark shady area).

9. Free time? I always think that summer will bring an insane amount of free time, and I always seem to fill it up with all kinds of things. I guess in theory I have more than during the school year, but there are so many fun (and some less fun but necessary) things that I’ve put off since August that I feel like I’ve got just as much stuff to do. This is perhaps an unfortunate consequence of my personality, but a girl can only work with what she’s got.

10. I really am trying to schedule a vacation. This is the ultimate summer excitement.
Since our school year doesn’t start until August 21^st, and my walk is the 11^th-13^th, there’s definitely time for a vacation. I’m sure where, and I’m not sure what, but we’ll be going somewhere…

Sorry if this post was sort of scattered, but summer’s here. I guess that number 11 is that my brain is fried from the school and so my life feels kind of scattered. Give me another 10 weeks or so…

Just keep going

Somehow it's been almost a month since I last posted. I'm not sure how that happened, because I usually write it in my planner every two weeks. At any rate, here I am, writing again as the school years is finally winding down. The title of this entry is something I find myself thinking a lot, about a lot of things. Not the least of which recently has been school. With only a week and a half of real school left (our last two weeks are clinical weeks that are not only usually fun but also significantly less dense), I'm running on fumes. Thankfully, ID (infectious diseases and microbiology) is fantastic and it's far easier to pay attention and focus than during a sequence I liked less (let's just say that if I was doing renal right now I might not make it)... But apart from class, I'm also training for the Breast Cancer 3 Day.

The 3 Day is just what you'd think from the name. I'll be walking 60 miles over 3 days (20 miles/day for those of you who dislike mental math) in August, right before the start of M2 year. For those of you not from Michigan, this may not sound quite as difficult as those of you who have experienced the 90 degree 99% humidity weather common in August. But I promise that it will be challenging, but also rewarding.

So far, my training walks have totaled over 100 miles. Training for a long walk or not, time for fitness in medical school can be difficult, but definitely not impossible. Many of my classmates use exercise as a study break. I find that I focus better on the treadmill than almost anywhere else. In fact, on a recent 10 mile walk one Saturday morning I reviewed a full 3 weeks of ID notes. By mile 9, and most of the way through my studying, I kept saying to myself "just keep going." My commitment to the 3 day has motivated me to make time for exercise even when school is crazy, and I definitely feel better for it.

In addition to the physical benefits, however, my commitment to the 3 day has made me think about my own patient experiences and my future care-giver experiences. As the bearer and compulsive checker of a fibroadenoma (a benign fibrous lump of breast tissue identified only a week after I learned what the word meant in our first pathology sequence), I know what waiting for a diagnosis is like. It's a time filled with worry, what-ifs, and pre-emptive decision making. It's hard, and even harder to describe. At the same time, I can only imagine that the pain of waiting for a diagnosis and wondering what was going is nothing compared with the pain of breast cancer treatment both emotionally and physically. It's the kind of pain that you probably can't treat with medicines...

So I'm walking. I'm walking and fundraising to raise awareness about this issue, and to push myself. And hopefully, someone reading this will decide to pick up a breast self-exam card, hang it in their shower, and keep themselves healthy. Or maybe someone will pick up 10 and pass them out to female friends, family, co-workers, neighbors, and maybe even strangers on the street. I can only walk and hope.

To read more about my walk, and to hear from my mom, who's on my team, check out: http://www.our3dayteam.blogspot.com/

The medical Babel-fish

Many people in my class have experienced the odd sensation of hearing about the diagnosis of a friend or family member with a condition we had just covered in class, or learning about something in class that echoed a recent diagnosis. It’s a surreal experience, and one that places me, at the very least, in a strange situation with a bizarre sensation of disorientation. To illustrate, consider the following two situations, both of which occurred fairly recently:

Firstly, my grandmother had several pulmonary emboli. She didn’t die instantly, which is clearly a step in the right direction, but her outcome is not the focus of my post. Throughout her ankle surgery (and immobilization… and subsequent re-hospitalization after the emboli) I was only connected to her and her care through my dad on the phone. I was neither the patient, nor even an immediate family member present in the hospital, nor her physician, nor even a medical student on the team that was caring for her. With my limited experience, and the reference of last fall’s pathology sessions and my path book, I could only explain what was going on to my dad, and offer enough insight to agree timidly with the course of treatment prescribed by the attending physician. Placed in this awkward position of medical interpreter, I alternately gloried in my ability to help my father through what was a very difficult situation, and wishing that there was more than I could do.

Fast forward to several weeks ago, and we’re presented with the second experience of the medical twilight zone. My stepmother was diagnosed with an infection, and put on antibiotics, following beautifully the course of my infectious disease course. After the antibiotics didn’t work, it was determined that the infection had spread upward to the kidney, and she was given a different course of antibiotics. This too followed the ID sequence perfectly. As we learned more about more serious infections, her antibiotics continued not to work. Here I may recount my first triumph as a medical student. It went something like this: “Dad, if she still has a fever you need to call the doctor. Something’s wrong. I have no idea what it is, but just call the doctor again.” They called the doctor who sent them to the emergency room where she was diagnosed with an abscess from an infected diverticulum. She was hospitalized and I was once again thrown into the strange place between doctor and patient. Better prepared this time because of my recent ID sequence, I was again able to translate for her doctors to my dad.

I’m not sure that I like this position, though it feels wonderful to be able to make something scary and unclear a little easier to understand. I can only imagine that this will get both easier and more difficult as my medical career continues. On the one hand, I will know more about what is going on, and be in a better place to narrate (and annotate) my family’s journey through the healthcare system. On the other hand, I will know more about what is going on, and be equally powerless to care directly for my ill family members. Since this medical land of ambiguity and my role as Babel-fish will probably never really go away, I’d better start getting used to it. Just don’t squeeze me too hard when you hold me up to your ear.

A strange symmetry

Last September, near the beginning of the month, I was at a BGLAM meeting. The September GLMA (Gay and Lesbian Medical Association) Conference was being discussed, as was whether or not several M1s would attend. It sounded exciting to me, though I was a little distressed by the date: it overlapped exactly with my first anatomy practical exam. I'd never deferred an exam before, and it didn't seem like a great plan. (Basically, deferring any exam or quiz allows the student to take the exam during a make-up window, after the exam has been closed to other students. Making up a practical, because it is proctored, requires our class counselor scheduling a make-up time with Dr. Gest, or some other member of the anatomy faculty.) It didn't seem like a great plan because I had seen our schedule for the first Clinical Foundations of Medicine week. We were all over the place, literally. My schedule that week definitely involved my traveling to Plymouth to visit a yoga therapist, to several locations in some of the farthest reaches of Ann Arbor, and of course, sessions back at the medical school before which I would need to park my car at home and walk back. But that's not the point of this post. I ended up deferring the practical, was really stressed out during Clinical Week, and it all worked out for the best. The conference was great.

This brings me to now. Last weekend was the National AMSA (American Medical Student Association) Convention. When I first heard about it I was excited, but again, a little stressed by the date: it overlapped with our final anatomy/histology/neuroanatomy practical exam. My last experience with deferral was that first practical, and really, it was one of the most stressful times of medical school. In retrospect, however, I'm really glad I did it, and I think that at this point I can also say that I'm really glad that I deferred the neuro practical and exam, because the convention was fantastic, and I had a great time in Chicago.

But at the heart of making up the exam was a strange kind of symmetry. It forced me to reflect about how much has changed over the course of the year, between that first practical exam and the last one, and realize how much anatomy I had really learned. It seems like it was just yesterday that we were meeting our anatomical donors. The first time we uncovered our donor was terrifying, yet incredible. The promise of an amazing opportunity to learn far outweighed any other feelings. Now, looking back, it's hard to believe that it went so quickly, and that it's over. This is not to say that I’m not overjoyed to have some free afternoons and to never experience the sweet smell of biostat again, but rather to say that I’m reflective about the experience.

BGLAMerous

It's that surprising time of year. Those of you involved in any organization know what I mean: the time of year when the current leaders are looking forward and moving on, and those of us who up until this point have been working in the wings step up and take the lead. I say it's surprising because, at least in medical school, it kind of sneaks up in the middle of the year. The M2s are finished with classes now, and are officially off studying for boards, but we (the M1s) still have about two months of school left. It's surprising because some of the current leadership is actually disappearing somewhat abruptly and going home for 6 weeks to study. Others are still planning to stay in Ann Arbor, but will be cloistered in their apartments, the library, and possibly the LRC until the board exams. But surprising or no, it's an exciting time. As I'm taking on the "coordinator" position for BGLAM (Bisexuals, Gays, Lesbians, and Allies in Medicine), I'm reflecting on what we've done this year, and what we have yet to accomplish.

September: The Gay and Lesbian Medical Association (GLMA) Annual Conference in Montreal was a great start to the year. Apart from having to defer my first ever anatomy practical exam, it was great, and the exam went well enough. I met other LGBTQ (lesbian, gay, bisexual, transgender, queer) identified medical students from all over the country, and was impressed that Michigan had the largest representation (eight of us attended at least some portion of the conference). I saw some great speakers, met people in workshops, and also got to know a few of my fellow UM med students a little bit better. I came back excited about what had been done in previous years (BGLAM actually got an award for the work that was done before I arrived!), and eager to work on other exciting projects.

October: We put together a panel of LGBTQ-identified medical students to speak and take questions over lunch. It was a little crazy to put myself out there in front of so many people that I was just getting to know, but I think it was a good experience. Lots of good questions.

February: BGLAM sponsored a day during the Minority Health Symposium. After discovering how busy everyone who works in health-related fields is, we finally found a great set of speakers. We had a panel from the HIV/AIDS Resource Center of their Director of Prevention Services, a case worker, and a member of one of their support groups. They had amazing things to say about substance abuse, HIV, and the LGBT community.

March: LGBT Health Awareness was a fantastic week of LGBT-related programming. Our keynote speaker, Dr. Nick Gorton, spoke about transgender healthcare. He gave an amazing overview of the nuts and bolts of trans healthcare! We also had a panel from the Lesbian Moms Network, a local group of families. They offered lots of suggestions for us as future physicians, as well as a unique perspective on forming families. Finally Dr. Jennifer Myers presented a discussion of creating an LGBT-friendly practice. We brainstormed ideas to make our practices as open and welcoming as possible, and her ideas helped to lead the conversation.

Now: I'm about to head to the AMSA National Convention to run for an Associate Coordinator Position within LGBTPM (LGBT People in Medicine, our AMSA-affiliated subtitle). Liz, an M3, is currently one of the national coordinators, and I'm excited to work more closely with her.

April: My first real undertaking as the new coordinator for BGLAM will be an event in April. We’re flying out Ben Singer to talk about culturally competent transgender healthcare, and give a talk on the generation of images of transgendered individuals both within the medical community and outside. I’m really excited about the event, and by the broad co-sponsorship (the Women’s Studies, Sociology, Anthropology departments, several undergrad LGBT organizations, and the student government are all on the list!). So that’s what the picture is: me working hard at organizing for BGLAM. Wish me luck!

The DR

The last few weeks have been crazy. Women's Health and Fitness Day was the 11th. Last week was the Minority Health Symposium, this weekend was the Galen's Smoker, this week is LGBT Health Awareness Week. And the week before last was Spring Break. Don't worry, I'm not going to write about all of these now. But rest assured that you'll still be hearing about the month of February in April, because there's so much amazing stuff going on. Maybe it's all concentrated because the M2s are about to fall off of the face of the earth to study for board examinations. Or maybe people get excited in January and schedule a million things that *of course* they will have time to organize before March. At any rate, the focus of this post is actually my trip to the Dominican Republic over Spring Break.

It all started months ago. After what seemed like an arduous selection process, the organizers of the trip had narrowed it down to 20 students (both M2s and M1s) and the fundraising began. The group received a grant from the medical school, and hosted several different fundraisers to cover the cost of medical supplies as well as the plane tickets to get us down there. By the beginning of February, we were all pretty tired of organizational meetings, but there always seemed to be just a few more things that we hadn't covered. As it turns out, our trip went much more smoothly thanks to the dedication of our fearless leaders and their interminable meetings, but hindsight is infinitely clearer than foresight...

All of the sudden it was February 17th and I had a lot of packing to do. I had acquired a mosquito net, which seemed exceedingly exotic and exciting. I'd also started my course of chloroquin (slighly less exciting, but necessary). I'd also asked Alicia if she thought she might have time to take me and another group member to the airport. She said it would probably be fine and asked what time. When I told her I needed to be at the airport at 4:00am she said that she didn't think she had plans then, but that she'd need to get back to me.

All 20 students, one of our doctors (the other flew from NY) and her family arrived at the airport just in time for them to tell us that we couldn't check in until 4:30. Jerks... So we sat around with our 28 boxes of medical supplies and a million suitcases waiting. Once we got everything checked it was as though the weight of 28 boxes of medical supplies had been lifted from our arms. (Medical school has killed my sense of metaphor.) We flew to Atlanta and then into Santo Domingo.

After several hours of waiting for the rental vans (who knows what happened... I didn't organize the trip...) we finally got on the road and drove the church camp where we stayed. It was a luxurious resort that featured running salt water from the ocean, occasional electricity, and toilets and showers within the confines of the cabins. We all stayed in one cabin with the boys and girls separated by a wall. It was close to the beach, which was nice. (Although unfortunately it put Al, my new M2 friend, painfully close to a jellyfish...)

Monday through Friday we ran a clinic in a small community outside of Santo Domingo. We'd divided one room of the schoolhouse into 7 exam rooms and set up a little pharmacy. (I say we, but most of us just followed directions. Kate and Courtney, two of the M2s masterminded the clinic...) Teams of medical students saw the patients (took histories and did focused physical exams) and then presented to the doctors. It was an amazing experience and I definitely learned a lot. At the very least I can identify fungal infections of the scalp with some certainty. I also know that parasites should show up in poop. (I also learned other, more philosophical lessons, but those will come later.)

The last few days in the DR were spent up on the north coast (Sosua) in a hotel that actually had running hot fresh water. It was an amazing experience. We spent a ton of time on the beach. I got sunburned in spite of my religious application of SPF 45, but I still had a great time. Perhaps most importantly, I got to know some amazing folks who, in spite of their busy schedules, I will force to routinely hang out with me.

As far as what I really learned from the trip, it's hard to express. I've been interested in international work for a long time, I spent a few months working as a volunteer in Honduras before my junior year of college. Working in a location that is so resource poor never fails to remind me not only of how much work must be done abroad, but also at home. It may be emotionally easier to work in other countries with women who are afraid to ask their partners to use condoms, but they exist all over the world. It's easy to criticize a system in another country where the lighter your skin is, the higher up in society you sit. Yet racism, sexism, and prejudice of every other form exists everywhere, it's just more well hidden in some places than in others. There's so little that can be done in a week. We brought a total of 23,000 vitamins. It sounds like a lot, but every patient only got enough for a month. We gave some patients pain medicines for their headaches and body aches, but they are a result of not having enough clean water to drink and working outside in the sun. It seems futile, but it doesn't make sense to stop doing it. So, when I come back, I like to think I've reached at least one person, worked with her to make her world a safer place. I can usually picture one face who really seemed to understand what I was saying, and whose story resonated particularly with me. And, if I haven't changed anything, perhaps it's worth it just to have renewed my resolve to do so.

Keeping the love alive

Happy Valentine’s Day! (Sorry it’s a day late.) Being partnered, married, living with a significant other, or committing to a long-distance relationship during medical school isn’t easy. In fact, I, as well as several other members of my class, might argue that it was (and occasionally remains) the most difficult part of adjusting to medical school. The challenge comes with balancing a program that is supposed to consume your life with a relationship that matters to you. Obviously, relationships can be difficult no matter who you are dating, and when, but medical school brings in some specific challenges. I currently live with my partner and know that I tried to avoid addressing the issues our relationship would face in medical school as long as possible. I thought I’d share a bit of our story.

The first hurdle occurred even before med school started, deciding when, and how, and where, and if we would move. We were both in school, and the medical school admissions process wasn’t exactly a short easy one. We talked a great deal about whether she should look for a job somewhere, and we would live apart until she could get a job near where I went to school, or whether she would wait and get a job where I got in. We ended up deciding on the later, though I think we’ve both questioned the wisdom of this decision. The fact that the admissions process is so drawn out made it difficult for Alicia to look for a job, and as it stands she doesn’t love the one she’s got. We’re together, but she’s in a constant state of looking for something better to come along.

Once medical school actually began, there were a whole host of issues to address. Alicia’s job didn’t begin to take up the amount of time that lecture, lab, and studying demanded of me. I’d anticipated that I’d never see her. Instead, it was worse: I was always home because I like to study where I can eat and listen to music, I just couldn’t hang out with her when I was there. It was like the proverbial kid in the candy store, wanting something that she could see, but knew she couldn’t have right then. There were some bad days, arguments about my inability to say no to extracurricular activities, and unconscious demand that she work around my schedule. In my defense, we were both adjusting, but I wasn’t doing a great job.

The administration does its best to make it easier: flex time, the much touted, sometimes loathed, but nonetheless there privilege of taking quizzes and exams at any time over the weekend allows me to free up time to spend with Alicia. It doesn’t, fortunately or unfortunately, help me figure out in which of the 1,000,000 activities I should get involved.

Thankfully, after approximately 6 months of medical school, I feel like we’ve reached a comfortable place. I try to focus on my schoolwork so that I can be as productive as possible and have time not only on the weekends but during the week for Alicia. She understands that every Thursday I’ll freak out about my quiz/exam and that it is usually baseless and will get everything done. She’s also submitted herself to occasional cardiovascular, respiratory, and abdominal exams, and enjoys making up ridiculous histories for me to practice taking. I’ve committed to the student organizations I care the most about, and accomplish as much as possible while she is at work. We’ve also taken up racquetball, a new hobby for both of us, so that we can exercise together. Appropriately, yesterday as I was writing inside her card I realized that things actually have worked out, and that I don’t think I could get through it all without her.

LANAMA

As you may know, they originally picked us as guest bloggers (some of you dedicated fans may have noticed the slight change in format), perhaps because we were involved in a lot of activities. And maybe they had some space constraints. At any rate, it became clear once we tried to schedule everything that we all had way to many things to write about to only submit three or four blogs per person. Hence, the change in format and upgrade to "regular blogger."

Today's topic is near and dear to my heart. After spending my undergrad years working toward a Spanish degree, I was a little afraid that I'd be forced to abandon it during medical school. Some of that has come true, which saddens me slightly. While I was invited to sit in on several of my professors' classes this semester (I did my undergrad here...), none of them really fit with the anatomy/histology schedule (lots of afternoons) or the lecture schedule (lots of mornings). As such, it seems like my days of analyzing literature from South and Central America are over, at least for now. I think that's part of why it's been so difficult to transition from undergrad to medical school. All during undergrad, I had two very different foci. I had my cellular and molecular biology degree, which took up about half my schedule, depending on the semester, and a Spanish degree, which filled the other half. Between the two of them, there was always something drastically different I could work on to keep myself sane. Now there is much less variation: if I'm sick of GI anatomy, I have only GI physiology or GI biochemistry to select from. I think it makes it easier to get burned out more quickly and makes getting involved extracurricularly really, really important.

Which brings me to today's topic: LANAMA. The Latin American and Native American Medical Association hasn't been the Spanish-language literature discussion group that I secretely hoped it would be before our meetings started, but it has provided me with some fabulous opportunities. Now, you may be thinking "that girl doesn't look very Latina to me." I struggled with the same issues: I'm not Latina, I just love Latina health issues and am passionate about working on them. And as the argument goes, there aren't enough minority people in any group to work exclusively to fix every minority issue without allies from outside the community. So as much as I questioned my place in LANAMA for a while, I no longer wonder about the being part of the small but dedicated following of self-identified white folks. We all get together because we're dedicated to Latino or native health issues, which is something that seems to quite easily cross boundaries of race, gender, and age.

Apart from forcing me to think about some philosophical questions, LANAMA has also given me venues to practice my Spanish (and some of the members are working on a medical Spanish course, for which the pilot has already begun) and work with the community. At Festival Latino we did blood pressure, glucose, and cholesterol screenings. It was great to get out and work with the community. Sometimes we get so caught up in textbooks and labs that we forget wat we're working for. Doing health-related outreach in the community is a great way to bring that back.

Going to lunchtime talks is another way to get outside the scope of the current sequence and learn about something new and different. The upcoming Minority Health Symposium should be just that. A number of different groups (including LANAMA) will be presenting speakers on different minority groups. I'll post more about it as it gets closer, but I'm looking forward to it.

Alright, I'm starting to feel like I'm rambling, so I'll sign off for today.

Galens is a Michigan original

For those of you who don’t know, here are some details (directly from the website, www.umich.edu/~galens):

“Established in 1914, the Galens Medical Society is a tradition at the University of Michigan Medical School. Originally conceived as an honorary society, Galens has evolved into a unique organization of medical students and faculty dedicated to improving the welfare of the children of Washtenaw County while making medical school life a little more enjoyable.”

Tag Days, arguably the largest Galens event, and certainly the most profitable one, took place early in December (this year it was the 2^nd and 3^rd, but it’s the first weekend in December each year). “Taggers” (read: medical students wearing every piece of clothing they own underneath a big red poncho, a “Tag Days” sandwich board, and carrying a bucket filled with little paper tags) descended upon Ann Arbor to ask passersby for donations. 100% of the money raised during Tag Days goes directly to different pediatric charities in Washtenaw County (members pay dues to cover overhead), so it’s a great cause! Although by then end of the two days people were holding their tags like garlic to ward off vampires, most of the queries to “Please help us help the children of Washtenaw County” were greeted with smiles and the sound of money dropping into buckets.

I did three shifts, four hours each. Picture the little kid in “A Christmas Story” and you’ll have a good idea of how much clothing I was wearing. While I may not have been able to bend at the waist, I was still able to approach people walking and ask them to donate. And I was warm through all 12 hours. I was also quite able to enjoy the food and drink delivered by the happy vans. (If the idea of raising money for the children isn’t enough to get folks into their ponchos and out on the street, the thought of happy faculty members driving around in minivans filled with hot chocolate and donated food items usually does it…) Here is a picture of me before I headed out (with Eric, who helped me assemble my sandwich board):

Last I heard we had raised over $53,000, and there were still checks coming in the mail. Activities like these add a lot to the medical school experience. While standing outside for hours might not seem like the ideal study break, it’s actually a lot of fun (we go in pairs). And, since most of us came to medical school because we want “to help people” (please pardon the overused, yet nonetheless true, statement), raising money for pediatric charities is a great way to start. Check out the Galens website (www.umich.edu/~galens) for more information on other great Galens events!

practicals, planes, and other words that start with p

Today is practical day! If only that meant that everything I did today was practical. No, instead I will be identifying structures (anatomical and histological) for a grade for 45 minutes. And then I will take my less-practical written exam. Here are the p-words in my brain right now:

practical - my exam today
plane - what I will take to visit Ash (yay!)
phosphate - main titratable acid in the kidney
purines - nucleotides whose synthesis I still need to learn
pyrimidine - more nucleotides...
party - what I will attend once my exams are done
presents - my main occupation for the coming week

Yay!

A little early

Well, I looked at my calendar briefly last night and noted that I had class at 8:10a this morning. I was running a little late and practically ran up the stairs to class. Upon arriving, I found the lecture hall empty and after a brief panic (thinking that the lecture was somewhere else), I looked at my planner and found that class started at 9a. I might not have been so scared if we didn't have the professor that publicly berates students who come in even 30 seconds after he has started...

So, as you may have guessed, the Admissions Office blog has been delayed until "mid-December." As such, I'm going to try to post more regularly in this space. You see, I was selected as a "guest blogger," meaning that I'll get to post monthly about exciting things I'm taking part in. Which will be exciting, but less regular. Although, it's hard to be less regular than things have been thus far... At any rate, I'm going to make a solid effort... Even if it involves posting pictures of my knitting projects because those are the most exciting things in my life...

I'm sort of rambling (still have a fair number of circulating catecholamines keeping me a bit jumppy), but this week should be good. We are learning cardiac and pulmonary exams, so I will be jubilantly examining the hearts and lungs of my classmates (and probably Alicia once I get home)...

The Electron Transport Chain

Oh how I wish it could just transport me away. I'm sitting in my oh-so-miserable muscle metabolism lecture. While much of this insanely busy sequence involves a great deal of dissection and anatomy studying, a smaller portion definitely involves compromising with my professors "sick love of enzymatic detail."

And here we are at pyruvate kinase. For those of you who wish I would post more regularly, this is why I don't. What is there to say about pyruvate kinase? Other than that it catalyzes an irreversible reaction in the overall oxidation of glucose in the body... Basically, an enzyme only a mother could love.

Also, it's National Coming Out Day (NCOD, for those of you who find food word acronyms appealing)! Whee! (At least I have a fun rally to look forward to after this abysmal lecture.) Have a happy NCOD everyone!

I am so much closer to being Dr. Dre

Well, I've started school again. I am a happy M1 (the oh-so-cool abbreviation for a first year medical student) and am thoroughly enjoying myself. However, as my life has been reduced to typing up the answers to my "Intended Learning Outcomes" questions and intending to learn them, my posting may be a little less frequent. However, I thought I would take this opportunity to create my own list of some of the coolest things that I have learned in the past few days.

10. It can actually be funny when professors make sex jokes. Somehow they seem appropriate.
9. My medical education will apparently not be complete without drinking. As much as I try to avoid it, the faculty keep making references to it.
8. When you have acute appendicitis, it gets all red, and sometimes there's some supperative exudate (read: pus!). Then, when it dies, it turns all black! (Yay pathology lecture slides!)
7. There are very few genetic components to the following disease condition: a man is looks both ways, crosses at the crosswalk, and out of nowhere an 18-wheeler crushes him.
6. The immune system response can be adequately paralleled by the invasion of Saxon England by the Normans.
5. "It's not fair to just look at the liver histopathology slides and say, 'oh, this guy was on the sauce.'"
4. When a part of your brain dies, the immune system turns it into soup and you end up with a hole.
3. It's okay to cry in small group sessions, because secretly it makes everyone feel better even if it feels really tense and horrible at the time.
2. Good old German pathologists named lots of things after food. My most recent encounter: "caseous necrosis" = dead tissue that looks like Brie, or maybe Parmesan
1. "You just can't have 30 lbs of dead meat swinging in the breeze..." without getting gangrene.

You may have noticed that many of these seem to come from my pathology course. This is because I love pathology, and both my pathology lecturers are... wow... in two different ways... but wow...

Furniture, furniture, everywhere!

I'm definitely going to miss all of the folks who are out west/are heading out west... I'm just going to point out that Colorado, already acknowledged as one of the coolest states, hardly needs this influx of fabulous people. I mean, come on. Michigan, now there's a state that needs to hold on to it's cool people. Who's going to vote with me next year??? Anyone? Anyone? I know that there are a few of you, but I'll miss those of you who will be casting your beautiful blue/green ballots in another state. And for so many reasons beyond your votes.

On the plus side, you have all left me with your furniture and appliances. Apart from the fact that there is not an inch of wall space in my bedroom right now that is not covered with a piece of furniture, and that I will probably have to give up the microwave at some point, I am wholly appreciative of your generousity. To say nothing of the wealth of plants for which I am now caring. They are thriving, simply thriving, but I can tell they miss you. Although, since some of the plants may not have noticed that their home changed hands, and since others of the plants may feel that their previous home has only been compressed into one room, it's not surprising that the plants have not yet registered the shock.

But all sadness aside, here's a mental exercise for all of you: Start with one oddly shaped, somewhat small attic bedroom. Then, place the following furniture in such a way that you can still do yogalates on the floor: 6 bookcases, two dressers, a small chest of drawers, a bed, a music stand, and a cello. Good luck.

Why mothers should not dictate self-esteem...

Thank you to the three of you who have posted comments in the last few hours... Having engaged in some thoughtful self-reflection, and eaten a cookie, I've decided that you are right. I am not, in fact, a boring person. In fact, I am exciting! Yay me! And I will continue to post about my exciting life! And I will continue to use exclamation points where they are gramatically! unfit just to bother Ash! Whee!!!

My mom says I'm boring

This will be a quick one:

Basically, my mom says that my blog is boring. So basically I won't be posting anything until I have something not boring to post. Please feel free to comment on this post and let me know what you'd like to hear about. (And also if you think that my blog has been so incredibly boring you can hardly stand it.)

San Francisco Part #3

Well, it's been quite some time since we were actually in San Francisco, but for those of you who require this kind of closure (me!!!), I thought I'd post one last update. On Sunday, we went to the Pride Parade. It was a bit of a let down for me, as Showtime was by far the biggest sponsor (maybe MGD?) and there were a lot of politicians in cars. But I love the babies, so that part was good. Lots of cute babies.

After the parade we went and saw Bitch, formerly of Bitch and Animal. Am I remembering correctly that Animal was/is dating Susan Powter? At any rate, she was pretty good, and I'm a sucker for anyone with an electric violin...

We went up to Fisherman's Wharf to catch our boat out to Alcatraz, and also had some dinner. It felt much more frenzied than that, I'm not sure why, but it did. Also, Alcatraz was really cool. We went in the evening, so it was all dusky and nice. The cell house wasn't as creepy as I expected, and I got the impression that Alicia was a little underwhelmed. We did get to hear them open and close the cell doors, however, which was loud and cool. This is apparently why they called it "the slammer." Our tour guide said that it was particularly those doors, the ones at Alcatraz, because they were the first ones of their kind ever. Such excitement.

Finally, as we were walking around the island, and seagull attacked us. Now, I'm not a huge fan of birds as it is, but I was really quite terrified. We were walking up a little road, and there were some cute little seagull-lings (baby seagulls, whatever those are called). We walked up the road, in theory past the baby birds. Their mom didn't think that we were far enough away, and I ran like there wouldn't be a tomorrow. I felt the need to warn another tourist headed down that way, though I think she was more afraid of me (picture me panting from the run, trying to explain that the seagull farther down the road might attack her)...

At any rate, Alcatraz was a hit, even though we didn't get back until late. Monday we got up and packed and caught BART back to the airport. It was pretty uneventful (thankfully, given the excitement of getting here). Mom picked us up at the airport, and that was that.

I was like a zombie at work on Tuesday, but that was to be expected.

San Francisco Part #2

Saturday

I woke up at about 6am (yay EST!), read for a while, and went to sleep for a few hours more. It was nice. We lounged about the hotel room until we made it out the door at about 11am. The plan for the day was: 1. walk up Powell to Fisherman's Wharf to check it out 2. walk to the Ferry Building to eat in the Japanese deli we saw 3. take the BART to the Dyke March.

We accomplished all of these things. The walk up Powell was longer than we expected, but we walked by Union Square and saw all of nice shops (I went to Lush and got shampoo... yay!!!), as well as Chinatown and the cable cars. We also walked up a number of somewhat large hills and noted that everyone was parked with their tires pointed in the appropriate direction. This was impressive to us.

Fisherman's Wharf was interesting, though we were mostly there to scope it out for our Alcatraz tour on Sunday. We got Ben & Jerry's, which was delightful, and walked the Embarcadero back to the Ferry Building. (To put this in a little perspective, we started at Pier 41, and the Ferry Building is just past Pier 1.) On the way there, Alicia dropped chocolate ice cream on her "I heart Michigan Vaginas" shirt. This seemed like fate. (Some background for you: When we were at the 89X show I somehow ended up with nacho cheese, the scary orange not-real-cheese kind, all over the front of my shirt. I think it's permanently stained now.) We're pretty sure that there is a higher power that does not believe that we should wear these beautiful shirts. That aside, we decided we needed to wash it out. The only public toilet was closed temporarily, so we snuck into a restaurant (with the help of the hostess) to wash it out. It worked pretty well. We made it to lunch and then took the street car down to the Castro. We got the kids fare on the street car even though we tried to pay the full fare. The driver told us we looked like angels, and that we only had to pay $1 for both of us (instead of $1.25 each). It was nice.

We walked from the BART station to Dolores Park, the start of the dyke march, and had a fabulous time. There were lots of performers, speakers, and, of course, dykes/lesbians/dyke-identified-bi-women/dyke-identified-trans-women/excitement. I bought a shirt and am still really excited. The theme this year was "Dykes Across Borders" which I really liked...

The most exciting part, at least for me, was the breast self-exam. Six women on the stage took off their shirts and demonstrated how to do a BSE and how to help your partner do one. It was fabulous.

Unable to participate in these things in a purely participatory fashion, I suggested that Alicia and I volunteer to decorate the truck and hold the banner. The truck decorating was moderately exciting, but holding the banner was the best.

The dykes on bikes went first, and they were so cool. Not so cool that I want a motorcycle, but cool. Then came the cable car filled with senior dykes (can I just mention that the "Old Lesbians Organizing for Change" are really cool...) and other folks who couldn't walk the parade route. After the cable car, the truck we helped decorate drove, filled with sound equipment and people dancing.

After the truck, Alicia and I, and about 6 other volunteers, carried the "San Francisco Dyke March 2005" banner. Then came thousands of women. It was fabulous. After a number of blocks (okay, most of the parade route, but not all of it) of being surrounded by a number of women marching topless, Alicia and I decided to join the crowd. I was sort of hot anyway, and it was really fun to walk around without a shirt on. Nice and cool.

The Dyke March ended in the Castro, and the truck parked to play music in the street. We dance for a little while, put our shirts back on, and went to find another bathroom. We walked around, got soft pretzles, and then walked back to the BART station. We were tired and while we made it until around 9:30pm or 10pm, we were exhausted.