Seeing the sights

One of these days I’m going to have to go to Washington DC with no agenda other than seeing the monuments, visiting the museums, and generally basking in the historical glow that seems to permeate the city. On my latest foray through the nation’s capitol (this past weekend), I was once again heading for an AMSA meeting. I saw a bit of the city as we flew over it, and then promptly took the shuttle from IAD to the hotel in one of the somewhat creepily planned suburbs near the AMSA office. I didn’t have nigh hopes for seeing the city, as I’d seen the 8am-9pm meeting agenda already.

We did get to head into the city on Saturday night though, and in a new departure from the usual bar-themed evening outings, we went to see some of the monuments. Complications of time and trying to meet up with folks meant that we didn’t see many, but those that we did were brilliantly lit, and beautiful. First we saw the George Mason monument. We were skeptical at first, but after seeing some really beautiful quotes about the equality of all people and the evils of slavery, we were converted. At that point we all wanted pictures with George – the results are shown above. We also saw the Jefferson and FDR monuments. Jefferson was a classic man-in-a-set-of-columns monument, but was nonetheless inspiring. Reading the words of thoughtful and interesting men is inspiring and motivating. The FDR memorial was less typical, and I think I would have enjoyed it more had it not been rapidly approaching midnight. I thought the waterfall and reflecting pool were beautiful (not surprising as I love water), and I was assured that the rest of the monument was also striking, but was too tired to make it through.

Seeing the mall lit up for the evening was a wonderful break from a long meeting, and made me wish I could see more.

Summer of Detroit

Alicia and I biking on Belle Isle

A few years back Alicia and I decided to have a summer of ice cream. We weren’t necessarily planning to eat more ice cream than usual, but we wanted to branch out a bit and try places we hadn’t previously considered. We stuck to the greater Ann Arbor area, trying Kilwin’s, Washtenaw Dairy, both Stucchi’s, and Dairy Queen, as well as the notable Ice Scapes - a fabulous place for soft serve and Italian ices located inside an old Jack-in-the-Box building. I learned yesterday that Ice Scapes is apparently now closed, and mourned the loss for a few moments. At any rate, we had a great time - we had a lot of fun exploring Ann Arbor and we both love ice cream. This summer, we have another plan. We’re hoping to have a summer of Detroit. We both grew up in the Detroit metro area, and have been going to events (sports, music, theater, etc) downtown as long as we can remember. There are things we haven’t done though, and places we haven’t explored that we’ve been talking about for years. Don’t let anyone tell you there’s nothing to do in Detroit, or that it’s dangerous. There is, and it’s not! Spending lots of time at the DIA, visiting MoCAD when they have new exhibitions, shopping at Eastern Market, looking for new places to eat, and riding the bike routes in Detroit are all things we’ve talked about doing, but often in the middle of the week in the middle of winter when we have neither time nor daylight in which to do any of them. This summer, we’re doing them all.

We started a few weeks ago with a bike trip around Belle Isle. I’m pretty out of shape, so it had to be a fairly gentle ride, making Belle Isle the perfect destination. It’s pretty flat, gives a lovely view of both Detroit and Windsor, and is only about a 5-6 mile loop all the way around. We did it twice, and then had a picnic lunch on the river. The park was designed by the same person who created Central Park in NYC, and all of the buildings are beautiful. It’s clear that there isn’t enough money going into the city - the zoo is closed and some things look a little shabby - but it’s a nice ride and the bathrooms seemed much more well-maintained than the guidebook would have suggested. Making sure our summer of Detroit was off to an awesome start, we headed to the (relatively-) newly redesigned DIA to check it out. It is, as all previous reports have indicated, wonderful. They’ve moved things around, arranging them thematically in a way that makes sense to someone without an art history degree, and added lots of informational placards that narrate the entire experience. I really enjoyed it, and am hoping to go back soon. I can’t wait to see what the rest of the summer holds…

Recovering from prelims

The dog has been instrumental in my burn-out recovery plan. He is very willing to go outside with me whenever I wish, and will play or snuggle at almost any time of day.

I realized that there hadn’t been enough cute pictures of the dog featured in the blog lately… This post is an attempt to remedy that.

Everyone told me that it would be difficult to get back into the swing of things after prelims. I half-heartedly believed them, ever convinced that I would only need a weekend break before I could get started on my summer plans. In spite of my vast experience with being burned out at the end of the semester, and should have extrapolated that knowledge to guess how I would feel after finishing a busy semester and then taking a stressful two week exam.

In spite of wholly underestimating the required recovery time after my prelims, I think I’m ready to get back to work now. I’ve had a few weeks of “working” while actually reading a lot of the New York Times, knitting, watching movies, walking the dog, and listening to podcasts I’d neglected for most of the month of May. I felt excited about getting some work done yesterday for the first time in a while, and I’m pretty pleased. I think this summer will be a productive one, and I’m also looking forward to getting some intense knitting and reading time. Yay!

Moving on, when everyone else is moving out…

Graduation is such an exciting time. After match day, when everyone finds out what that magical algorithm has in store for them for the next stage of their lives, most of the fourth years have a fairly easy coast to graduation. They need the rest to prepare for the internship that starts relatively shortly thereafter! Watching my class walk across the stage was really inspiring, realizing that they are actually doctors now, and will be residents in a few short weeks. It was also inspiring in another way - I’m ready to move on too! Unlike the other bloggers who’ve been here for four years, I won’t be graduating this year. As an MD/PhD student, it’s likely that I have another 4 years left before anyone will be calling me doctor. I’m certainly not the only one - there are lots of other MSTPs, and the other folks who took 1-2 years off for an MPH, MBA, MPP, an international internship, or a variety of other reasons (research and babies being the two that come immediately to mind) were all sitting in the seats with me, cheering on our classmates as they walked up the stairs, “got hooded” (I swear that’s what people say) with their green velvet-lined hoods, had their names called (“Dr. So-and So”), and accepted a diploma. “But isn’t it depressing?” you ask, as you realize how much time I have left, noting perhaps as I have, that I will be an M3 with this year’s incoming class.

In truth, it’s not depressing. Match day was a little rough, as it became increasingly clear that there was no way to head out to some exciting new place until I finished what I’d started, but since then I’ve been reflecting on why I’m still here. I was certain that I wanted to do this, as were most of the other folks who’ve gotten other degrees, spent substantial time doing research, or had babies. Though that certainty is invariably tested with statements along the lines of “if only I hadn’t [insert whatever here] I would be a doctor today,” overall I haven’t done much questioning. Graduation fell right in the middle of prelims, and a little circumspection was just what I needed. I realized that I really love what I’m doing, but that I want to be as efficient as possible so that I can keep going with the plan, and with my life. Notice I didn’t say “get going” or “get started,” but rather “keep going.” I think most of us who’ve taken time off would tell you that we’re not putting off getting started, we’re just running a longer race.

Spring things…

Every doctoral program has a different kind of preliminary exam. There are lock-you-in-a-room-while-you-answer-essay-question exams, theory prompts, oral presentations, proposal drafts, and combinations of all of the above. My department gives us two weeks to write two large papers - one theory/conceptual paper and one proposal. Although this isn’t a ton of fun, I have to give them credit and acknowledge that I have spent the last few months really digging in and getting ready, and now that it’s almost over, I feel pretty good. (I felt especially good after entering the majority of my references into the formatting software - so tedious…) I’ll feel better on Friday when I hand it in, and then, hopefully, I’ll forget about it until it’s time to get it back.

While I’ve been working on my prelim, I’ve been doing lots of other things. I’ve discovered that I can’t write for 14 hours a day, and even sleeping 10 hours a night (which I’m not really doing anyway) that leaves a decent amount of time for other pursuits. My most recent is planting little herb seedlings in my various pots and planters. Jake got me a Chia herb garden for Christmas, and I planted the little seeds in February or March. They’ve been thriving in their tiny clay pots, but I realized that you can’t really expect 15 basil plants to peacefully coexist in a 2.5” container. So I pulled out some empty pots from the closet and I am now the happy container gardener of 14 basil seedlings, 4 baby parsley plants, some rather tragic looking cilantro, and the most delicate looking little mass of marjoram seedlings (still in the clay pot). I think I probably need some more containers to really do it justice, and I’m simply thrilled. Even if I lose a few (which I inevitably will), I’ve got high hopes for pesto and tabouli later this year. And they are so cute, with their tiny little leaves.

Back to work…

National Conference of Physician Scholars in the Social Sciences and Humanities

Michelle at the singular ATM in Philadelphia International Airport

I finally found where all of the cool MD/PhDs find one another! After a (very) chance encounter with an MD/PhD in the RWJ Clinical Scholars program here at Michigan, who did her PhD in the History and Sociology of Science, I was directed to the following website:

http://scholarsinmedicine.blogspot.com/

I promptly called Michelle, the other MSTP in Public Health, to tell her of this amazing find. We agreed that we should try to go, and that submitting something jointly might allow us to make the deadline that was coming up in just a few short days. We pulled together our network analysis paper, and they asked us to give a talk! Having secured a presentation slot, we subsequently applied for (and received) funding from Rackham to attend the conference in Philly. Yay!

We thought we were set, and Michelle took care of making hotel arrangements and all of that. We knew it was a short train ride from the airport into town, and were excited to see a bit of Philadelphia. We got off the plane even a bit early, and thought we were off to a great start. Enter Philadelphia International Airport. After leaving security and going down to the train stop, we discovered that you cannot buy tickets before you get on the train at the airport, and you must have cash in order to buy tickets on the train. This combined with the lack of an ATM anywhere near the train made things much more complicated than they really should have been. We trekked back up past the sleeping information desk attendant and asked the security guard where we might find an ATM. She told us we’d have to go down a few terminals (what!?!) in order to find one. We mostly believed her, and started walking.

We stopped another friendly-looking airport employee, who directed us to the check-in kiosks one floor down. Pleased to have circumvented the long walk, we headed down the escalators. Only to find that there was not an ATM. There was a white information phone, however, and I called to see where we might actually find an ATM. The kind gentleman on the phone said that baggage claim was the closest. (Note: When we were at the train stop, we were about 30 seconds from the baggage claim. At this point we were retracing about 10 minutes of walking.) We set out for the baggage claim.

Upon arriving at the baggage claim, we seemed to have hit another dead end. We looked around a bit, and asked another attendant. He said that there wasn’t one in this terminal, and that we would have to walk to terminal B. This echoed the advice of the first security guard 20 minutes before. Somewhat dejected, we headed outside (into the warmth that was Philly) and made the left turn he had instructed. As we walked, we realized that there were no outdoor signs indicating which terminal was which. This was like some kind of sick joke. We kept waiting for the some kind of candid camera-like people to jump out, laugh at us, and produce an ATM out of nowhere. Sadly this did not occur.

From the outside of one of the terminals, we saw a public transportation desk. This seemed promising, and we waited for her to finish dealing with a slightly-less-friendly client. When we asked about the train, she informed us that we would need to buy tickets on the train and that we couldn’t buy them there. We asked where we might get cash, and she said in terminal B. We asked her where we were, and how we might get to terminal B. Turns out we were headed in the right direction… We kept walking, and finally reached the promised ATM. Above you can see Michelle rejoicing after our 30 minute hunt was over. We were just in time for the next train, and the rest of the trip was much less eventful.

The conference itself was fantastic. I got to meet and chat with all kinds of other MD/PhD students, and some who have gotten through the program and have jobs! It was inspiring, and all of the talks were great. I knit a bunch, and enjoyed myself thoroughly. Now, it’s time to get back to work… There’s always more grading, more prelim preparation, and work for my classes.

So much reading, so little time…

I’m convinced that the experience of being overwhelmed is the same in any field: one day you’re completely on top of the to-do lists, the post-its, the schedule; the next you’ve fallen to the bottom and can hardly see the light through the little yellow sheets. As a chronic over-committer, I’ve been overwhelmed at various points throughout my life. I was overwhelmed with school work and extracurricular activities in high school, with courses and activism in college, and with studying, student organizations, and having a relationship in medical school. Now, as a graduate student, I find myself overwhelmed once again. At the end of last term, I was looking forward to this one as a semester of ease. I had only registered for two classes (though I was hoping to attend four) in addition to teaching and preparing for prelims. Though I constantly feel like I am saying no and stepping-down out of high-commitment positions, my life seems to have a knack for filling itself.

This semester, I blame it on prelims. In retrospect, I recognize any event that is widely defined as the most horrible part of any doctoral program could not be easy. Looking back, I see that the short papers I had crafted “in preparation” were laughable in their lack of rigor and data. Reflecting on it, the amount of work that remains to be done before May is daunting at best and impossible at worst. And yet here I am, reading like my life depends on it and trying to sleep/stay sane.

I suppose the lesson in this for any prospective student (or any student really) is that it never gets easier. It gets different, and hopefully it gets more interesting, but it doesn’t get easier. The further along you go, the more there is to do. And, fortunately or unfortunately, the further along you go, the fewer people there are to tell you to get it done. I’ll leave you to think on that while I go and do the one thing that I never struggle to complete: snuggling the dog…

I was there…

It seems almost dated to write a post about the inauguration now, but I’m going to do it anyway. It will be short, because life is crazy right now, but it will be here.

We drove out to DC to see our new president sworn in. We sat in the car for 9 hours on the way there Monday night, on a bus for 20 minutes on the way to the subway Tuesday morning, stood in the Metro station for 45 minutes, and then in the Metro for approximately an hour before we were even close. Then, we walked with the hordes of people toward the mall. We were right near the Washington Monument. Apparently most of my friends were also “right there” but shockingly I didn’t see anyone I knew. It was amazing. My favorite part was seeing the kids there - they had little or no idea what they were seeing (depending on their ages), but I know they’ll be able to look back on it and recognize what a historic day it was. I know that some people weren’t impressed with President Obama’s speech, but to me it was a lovely list of things I’d been wishing/dreaming that our country would do during the last 8 years, but never quite got around to actually doing. (Actually, we willfully did the opposite of many of them, but nevermind - I’m hopeful…)

I think that’s all - I have more reading to do and I’m tired, but I wanted to check this one thing off of my to-do list.

Finding a Community

Sometimes wandering into a meeting to which you have not been invited can be a great way to meet people… Yesterday I happened by a meeting that had paused and went in to say hello to a friend. Most serendipitously, she introduced me to a colleague. This colleague is an MD, PhD and works on social science questions! I knew these kinds of people existed, you know, people like me only further along and with real jobs, but until yesterday I was somewhat convinced that they were a highly ephemeral, difficult to track down, and perhaps even dwindling group. Through this chance meeting, however, I discovered a whole conference dedicated to MD/PhD students working in the social sciences and the humanities (http://scholarsinmedicine.blogspot.com). I was so excited yesterday that I even drafted an abstract to submit as a potential poster or presentation at the conference! (I also called the other social science MD/PhD at Michigan and we are jointly submitting the abstract for the paper we worked on last semester.)

In retrospect (even just one day later), this all seems like a fairly small thing. Yet, in reality, it’s huge. I’ve written before about how the MSTP retreats are like a vacation from explaining why I’m going to be in school until I’m 30. It is really refreshing to be able to discuss your work and your program with people who truly understand. This conference holds to potential to be a vacation from explaining why not only am I going to be in school until I’m 30 but that I’m not doing my PhD in a basic science lab and that’s why I’m still a pre-candidate instead of a candidate like the rest of my class, why I’m still taking classes, and why it’s crazily more difficult to get funding. I can’t even describe how wonderful this will be.

No matter what kind of program/job/set of life circumstances you’re in, having a community who understands you is critical. Often, we’re left cobbling together people who understand little parts of our lives - the school friends, the family friends, the yoga friends, etc. Occasionally, we meet a few people, or find a place where we truly feel like we fit in. My advice to you: hold on to those people, and hang out in those places. When you are feeling low, these are the people who will bring you up.

Holidaze...

Wrapping paper is one of my favorite parts of the holidays...

The further along I get in grad school, the more I feel like I need breaks, and the less it seems like I'm really allowed to take them.

In my last meeting with my advisor, she strongly encouraged me to do some of the prep work for my prelim "before the holiday." I thought this sounded great, but failed to consider that I would be writing 4 final papers during that time (a total of approximately 70 pages of text and some absolutely pain-staking tables for my stats paper) and dealing with a level of burn-out I hadn't encountered since studying for boards. Suffice it to say I did not get much done before my exams were finished (exams used loosely here, only to mean important assignments that happen at the end of the term). This left only my "break" between December 19 and January 7 in which to complete this preparation. It¿s been a little rough.

Immediately following my exams, I entered what I somewhat-less-than-fondly call the post-exam ADD period. It's during this 1.5-2 days in which I feel a more sincere form of empathy than I'd ever thought possible with individuals who suffer from ADD and ADHD, as well as potentially those who suffer from coming down from highly addictive drugs, from manic episodes, and from insomnia. During this time, I cognitively acknowledge that I need a break from school work, but am unable to actually relax. I am fidgety (much more so than usual), unable to focus on anything, and often end up compulsively cleaning the kitchen, doing the dishes, and purchasing groceries. (Note that these last three items often rise to the top of the compulsive to do list because I have not done them since exams began 3-4 weeks earlier.) In addition to running around my apartment like some kind of hamster on a wheel, I am unable to sleep, cry periodically, and am generally horrible to be around. This is not the time for accomplishing great things. It is the time for accomplishing all of the small things that have accumulated around the apartment for the last month.

As the post-exam horror begins to fade, I can usually negotiate a peaceful time of quiet accomplishment - getting a little reading done, sleeping more than usual, knitting, but also doing some work. Not so this year. I have been unable to sleep through the night since I started trying to sleep during the night (after exams ended) and as a result am sleeping sporadically during the day (napping, if you will). Though these naps provide much needed rest, they are also profoundly disorienting, as I'm unable to restrict myself to the not-long-enough-to-be-disorienting-but-long-enough-to-be-restful 20 minute siesta. Instead, I find myself sleeping for 2 hours between 8am and 10am and wholly thrown off for the rest of the day. You see, one of my rules for break is that when Alicia gets home from work, I chat with her, and watch movies, and knit, and have fun, since (in theory) I have done some work during the day and deserve to enjoy part of my break. I have been pulling off the evening schedule pretty well (and will share some movies I have seen this break later), but not so much the getting work done during the day. I have been sucked into blogs, stared out the window, stretched out on the couch with the dog, and continued to clean the apartment, as well as doing ~50 paltry pages of reading over the last few weeks. This is unsettling to me, and even as I try to convince myself that I really just need a break, it's hard for me to buy. What I really need is to find a balance between assuaging my deep-seated fear that I will fail my prelim at the end of this term and releasing all of the tension from last semester. Also finding funding and health insurance for next summer¿ To top things off my yoga teacher is out of town and the sub last week was like a pilates/synchronized-swimming/aerobics instructor. Welcome to the holidaze...

Walter!

Walter and Alicia in the back seat on the way home from Walter's foster family.

We've welcomed a lovely new member of our family into our home. His name is Walter and he is a 2-3 year old Boston Terrier. We adopted him from the Midwest Boston Terrier Rescue on Sunday and have been having fun with him since then. He's quite a bright little dog, and we've had a pretty easy time getting him used to our house.

So far, one of the most exciting aspects of dog ownership (apart from the joy of carrying a little baggie of dog poop in your coat pocket, of course) is that he somehow learned to do this army crawl-type move. He does it when he's stretching in the mornings, or when he's trying to be very good (and thus stay laying down) and also get toward something (like his ball). It hilarious... He stretches his back legs out completely behind him and moves forward with his front legs. At some point we'll catch it on video and post it for everyone to enjoy.

Time to go for a walk!

Hoping...

Apologies for the long gap between posts. I should be writing a paper right now, so this is short...

We are finally adopting a dog... It is an exciting process, and we're most of the way toward adopting Walter. We have our home visit tonight (I know, it seems crazy, but they want these rescue dogs in good homes), and then I think we should get to adopt him. I still don't know when we'll pick him up (assuming the home visit goes well). Keep your fingers crossed for us!

Can we vote on your marriage now?

Me in DC at the Marriage Equality Rally with my sign

I have mixed feelings about gay marriage.I don't like that it has taken the focus off of issues like employment and housing discrimination that I think are a lot more pressing for our community than the right to marry. I don't like the thought of a "gay movement" that seems to be a movement of middle-aged, wealthy, white men and women, where it seems that men are directing many of the efforts, and transgender people are completely left out of the dialogue. I don't think that the government should be in the business of recognizing relationships at all, and so find it difficult to argue my way into an institution that I think should be wholly left to individual families and religious institutions. I don't want my ability to be the legal parent of my child, or the health insurance status of my family, to depend on what I chose to call my relationship with my partner.

And yet, while I busily list the things I don't like or support about the idea of gay marriage, I am quickly brought back to reality. The reality is that right now, gay marriage has taken on the symbolism of equality of lesbian, gay, and bisexual people. Someday, when I can call the shots, the government will get out of the business of recognizing marriages and can simply recognize the legal documents I create to define my civil contracts. Until that point, however, having the right to marry is the only way to really ensure that my kids will have two parents, that my partner can inherit my (even minimal) stuff in the event that I die, and that she will receive Social Security benefits after my death. There are also a million other benefits that I think should probably come with citizenship, but actually only come with marriage. Unfortunately, that makes marriage important.

Finally, and for me this was particularly frustrating, it just seems wrong to give people rights and then take them away. The California Supreme Court ruled that same-sex marriages were required by the constitution so that everyone would be equally protected under the law. This was really exciting, and lots of people got married. Now their marriages are being taken away? Few things illustrate the tragedy of this as poignantly as Judith Warner's blog entry.

So I conclude with this: I have mixed feelings about marriage but I support it anyway, and I hope you'll join me. People should be free to have their families legally recognized and supported.

Snow

Amid weather predictions calling for lots of "wintery mix" and other unsightly weather conditions, I hoped for the best. I did have to brave a little bit of freezing rain the other day, but it's all worth it for the early fall snow. There are still some bright red and yellow leaves left on the trees and the ground, and the snow just makes everything look sparkly. Granted, it would be more sparkly if the sun would shine, but we can't expect miracles, can we?

Vote!

It's hard to believe that the election is almost here. Discounting the sleeping I'm about to do, it is here! I'm voting in person for the first time - having voted absentee during the start of my democratic participatory career - and I'm really excited. I'm excited to push the buttons or pull the levers or whatever it is you do inside a voting booth. What I'm moderately less excited for are the lines (though still somewhat excited because they mean that people are voting - take that apathy)...

I don't have much to say about this (particularly that I would feel comfortable publishing on a blog for a publicly funded medical school), so I will simply say this:

Vote! Vote like your life depends on it!

Remember that you are allowed to bring whatever you want with you to the polls, as long as there is no campaign material visible. This means it's perfectly legal to print out a ballot, mark all of your preferences and notes, and carry it in your pocket to the polls. If you have a button, t-shirt, etc with a candidate's name on it, you can still vote, you just have to cover the item when you get within 100 ft of the polling place.

And if you aren't sure where to go, what to do, or who to vote for, check out:

Mlive.com: Get your whole ballot and use their nifty side-by-side comparison to see what the candidates said and what their background is: http://thevoterguide11.mlive.com/?sfr

League of Women Voters: They also collect information about the candidates and line it up so you can compare their views on different questions: http://www.vote411.org/onyourballot/state.php

Still have questions? Visit www.publius.gov to print out a ballot, find your polling place, and find contact information for local officials.

No one is perfect...

Apologies for the delay in posting. This started out as a post about the presidential race and being a feminist. The post was, however, trumped by course readings, midterms, travel, and sleep. This month seems to be the fall version of March, also known as the month during which everything happens. This month I have already attended one wedding. Next weekend I have two conferences, and then have 3 midterms (two papers and a stats analysis) the following week. Finishing it all up I have another wedding on the 24th. While all of these things are wonderful (except maybe the midterms, but even that¿s debatable), it is crazy that they all have fall in the space of a single month.

I'll post more on the other side...

AIDS Walk 10

Today was my 10^th AIDS Walk. They haven't been consecutive, but only because I was out of town last year for an AMSA event, and that would have been my 10^th. So I've been walking for 11 years now. This weighs heavily on me.

If you had told me when I was 14 and stepping off for my first AIDS Walk that 11 years later I would be taking steps to devote my life to studying this disease I wouldn't have been surprised. I would have been a little disappointed that my enthusiasm and small amount of fundraising didn't quite go far enough to nip the epidemic in the bud, but I wouldn't have been surprised. Even at that point, I recognized that HIV/AIDS would define my life. We were, after all, practically part of the same birth cohort. Although cases were showing up in the late seventies, and very early eighties, 1983 still falls solidly at the beginning of the epidemic. As a high school student I learned about HIV/AIDS in a purely domestic context, blissfully unaware of what would transpire over the next 25 years across the globe.

When I first learned about HIV/AIDS and the discrimination faced by the gay and bisexual men who were the public face of the disease, I felt a deep sense of injustice. I'm tragically unsurprised that structural hierarchies of gender, race, sexual orientation, and class continue simultaneously to define the communities hardest hit by the epidemic and to limit the emotional and physical resources devoting to combat it. At the same time, I hold on to the hope that the world can change, and that we can come together to implement creative solutions.

I spent a few moments today at the beginning of the walk silently reflecting on the terrible loss of life from this disease, as well as the incredible strength of those living with HIV/AIDS. I walk for those I¿ve known and lost, as well as for those who continue to fight, and encourage anyone reading this to take a moment of silence, and then dedicate a lifetime to speaking out.

The last hurrah...

As I post this, I have already attended my first class of the semester.It has been a pretty good start, overlooking the fact that I missed a class I wanted to sit in on this morning because I had it in the wrong time slot in my calendar. But this post is not about the beginning of the school year. This post is about that gloriously tragic portion of the year we call the end of summer.

I'll start by wrapping up the summer reads...

I know this much is true by Wally Lamb

I finished this, and it was an incredibly beautiful book. Wally Lamb certainly has a gift for capturing the bizarre and yet mundane about life, and for writing in a way that makes the incomprehensible absolutely quotidian. I really liked this though, as I've found with many great novels, it was somewhat disturbing. I've discovered that I enjoy books with multigenerational plots (think Middlesex by Jeffrey Eugenides) that are connected by more than a family tree. The story of the grandfather in this book is infuriating to read, but only more so when the same themes are echoed through the story of his twin grandchildren. Overall I really liked this one, and enjoyed the time it took to work my way through the thick volume.

Better by Atul Gawande

I didn't like this when I started it. It seemed like yet another doctor listing the amazing accomplishments of medicine: smallpox eradication, end of life care, etc, as well as bemoaning the difficulties in the profession. As I kept reading, however, I found myself enjoying the book, and appreciating the thesis. Gawande suggests that although good ideas are important, and definitely needed to make significant progress, the proper implementation of the technology we already have would make as much, if not more, impact on the world. Nevermind the fact that this is not a new idea, because it is a good one. I'd argue that people in public health have been struggling with it for decades if not centuries. Gawande makes a convincing argument though, and I can only hope that doctors everywhere will read his book, be inspired by a need to evaluate our healthcare system domestically and across the globe, and decide that funding public health is a good idea.

That's about all I've read since I last posted, in addition to assorted magazine articles and some riviting pieces on the theory of the total institution and incarceration in the US. The best part of this last piece of summer, however, is the vacation. The MSTP allows fellows to take several weeks of vacation over the summer. In practice, this rarely happens as we have work to do and want to graduate in 8-ish years. Most of us are able to take a few long weekends, however, and carve out a little bit more time than usual to read, bike, swim, sleep, and relax. Alicia and I decided to fly to Montreal for 5 days and really get away. It was lovely.

We walked around downtown quite a bit. Apparently Mark Twain described Montreal as "the city where you cannot throw a stone without breaking a church window." Despite what is probably rather sloppy paraphrasing, this sentiment is true. There are lovely buildings, many of them religious, scattered liberally throughout the city. We also biked along the St. Lawrence Seaway, which was wonderful. I got to see one of the locks where they raise and lower the ships, which I think is fascinating. Apart from a small amount of sunburn, and slightly more ill-fitting bikes than we¿re used to, this was great fun.

We also climbed the Mont Royal which gives the city its name. Oscar Wilde is said to have offended many by referring to it as a "hill" rather than as a "mountain," but I'd have to say I agreed with him. In spite of being a rather steep climb for a good 15-20 minutes, we did, in fact, summit the "mountain" in 20 minutes. I don¿t think this can count. It did offer a spectacular view of the city, regardless of its geographical classification.

In addition to all of this walking, we ate a lot. Montreal is a great city for food, and we enjoyed a lot of it. I must say, however, that the traditional Quebecoise cuisine left a bit to be desired for me. This is mostly because it is very heavy on the meat. Their signature dish is a smoked meat sandwich. Alicia gave it a decent review, after noting that she doesn't think she really likes red meat. I tried the "poutine," which consists of fries covered with cheese curds and gravy. I left off the gravy, and found cheese curds and fries to be a delicious combination. Alicia was unimpressed, however, which is unsurprising as she is a fry connoisseur and prefers only ketchup. Apparently there is also an option for "poutine Michigan" which substitutes tomato sauce for the gravy. This sounded horrible to me, and I was similarly put off by the fact that any food with the adjective ¿Michigan¿ appended seems to mean "with tomato sauce on it." Is Michigan really such a culinary low?

It is also of note that we were in Montreal for the International Film Festival there. We saw one of the feature length entries from Spain, titled "Bienvenido a Farewell-Guttman," and a short entry from France titled "Break." Both were entertaining, though we were pretty tired by the end of the films. I really liked "Bienvenido a Farewell-Guttman," and it was a somewhat novel experience to see a show after only reading a one sentence description and not having seen some kind of preview or trailer. I thought it was a well-done piece of cinema, and I appreciated the dark humor that permeated the film.

The trip was a great way to end the summer, if there can be a great way for a summer to end. My consolation lies in the fact that classes look good this year, and the beautiful cool season that is my favorite is clearly on its way. Not to bad...

Is global warming making my eyes itch?

I'd say I'm about as environmentally conscious as your average person, or maybe slightly more so. I try to avoid driving my car when I can walk, bike, or bus, and I stick to organic produce as much as my budget will allow. Additionally, reports of northward migrating insect vectors and their tropical diseases have me a little worried. Today, however, may be the last straw. I think global warming gave me allergies.

Before last year I had never experienced the joy that is itchy eyes, nose, and throat, combined with the non-stop sneezing that seems to tear out the back of the throat and sinuses. As much as I tried not to judge, I considered allergy suffers to deserve sympathy, but often asked myself how horrible could it be when it was a little plant causing the whole problem? Well, last year I discovered that it could, in fact, be quite bad. When I couldn't stop itching my eyes last August, I went online to investigate. I discovered that the timing of my eye-itching corresponded directly with when some grasses were releasing their pollen. I felt some remorse for having laughed at a friends grass allergy at one point...

This year, things seem to have gotten worse. Yesterday I was unable to stop sneezing, and I thought my eyes might swell shut from all of the sneezing, watering, and itching in which they engaged. As I did last year, I went to the drug store, bought some newly-available over-the-counter allergy medicine, and went home. I seem to have forgotten just how awful the stuff is, however. Aside from feeling vaguely out of it, as though there were a veil and a sound barrier of some kind around my head, I'm also dehydrated to a degree I can't describe. I've used almost an entire tube of chapstick for my dried out lips, and other little tub for my raw nose.

Recognizing that you may not wish to read my whining, I will get to the point. I heard a news story on Michigan Radio the other day about increasing levels of pollen due to global warming. I can't find the transcript, but it was similar to this article in content. The reporter interviewed someone who had looked into yellow-jacket stings, and found that numbers of people seeking treatment for stings had increased astronomically over the past few years. Additionally, he reported that allergy sufferers everywhere have had progressively worse and worse allergy seasons ovver the past few years. Apparently the warming climate favors the ragweed, and other weeds that are common allergens. The larger plants are able to release more pollen, making allergies not only worse, but more common as more people¿s thresholds are reached. This is terrifying. The ragweed is taking over the world.

I'm not too sure just how to fight back, as my 10 mg of loratidine doesn't seem to quite be doing the trick. Somehow, however, I must triumph over over the weeds. At this point, I can only hope that global warming will accelerate quickly and send us into another ice age, killing the stupid plants and (perhaps?) saving all of humanity. If you can retain any hope at all, however, then I urge you to attempt to combat the plants, and drive less, recycle more, cut down on consumption, and make decisions that will save our (pollen-free) home. If you don't have allergies yourself, then at least do it to cut down on the number of mind-numbing conversations you have with people on allergy medications who haven't figured out how to appropriately dose themselves. Please, do it for us all.

Getting out of town

Alicia and our bikes in front of the lovely St. Clair River.

Yesterday, on the recommendation of a free-book room find Road Biking Michigan, by Cari Noga, Alicia and I took a short drive (1 hour 26 min according to Google Maps) to St. Clair, Michigan. It's on the eastern coast of the mitten, right on the St. Clair River. The St. Clair River connects the Detroit River with Lake Huron, making it an important waterway connection. More important to us, however, was the fact that it is one of the most beautiful blue rivers around. We parked at St. Clair High School (again, at the recommendation of the fabulous book), and unloaded the bikes. With only a few turns, we were on Riverside, the unambiguously named street that runs along the river and through downtown.

We biked through St. Clair, and stayed along the river all the way up to Port Huron. This turned out to be 13.3 miles, a distance I'm quite comfortable with. We locked the bikes and headed into Quay Street Brewing for in-house root beer, a salmon burger (me) and a chicken sandwich (Alicia) on their patio. It solidified my appreciation of the road biking book, and my good opinion of cyclists the world over, all of whom seem to appreciate not only beautiful bike routes, but also good food and drink. (Being somewhat dehydrated already, and recognizing the need to get back on the bike, I elected not to try one of their beers. Maybe next time...)

After walking around to let lunch settle and move our legs differently for a bit, we got back on the bikes and headed south. The wind wasn't with us as much going back, but the route was quite flat, so I did pretty well. It took us about an hour each way, adding on a little bit on the way back because I thought the backs of my legs might fall off. I'm proud to have made it 26.6 miles on my bike, which is a personal best. I was less proud to learn last night that the Olympic women marathoners run approximately as fast as I can ride my bike, and for just as long. That aside, it was a lovely ride, and I'd highly recommend it.