the worst things come from inside here

I don't even know and am not going to pretend to know, I'm really not.

But I thought of something last night right before I was nodding off to sleep and I realized it's something I'll carry with me always.

Because see, I grew up in New England. All my formative years were spent in the vicinity of Boston. I'm forever tied to that place, there are streets that I know in my bones. I hear echoes of that city when I'm elsewhere. It's the place I first learned what company you can keep with a city, how you might never be lonely if you let the river and the winds nudge you along.

It's not the same now, nothing ever is. But some things come back to you. And this is hard to write. Because I grew up in New England, and to some extent, I'm of that land and of those people.

And to some extent, I'm not.

It makes me cringe to recount it, but it's what popped into my head last night and it wasn't some random thought. When the towers fell, the next day, the company where I worked held a moment of silence, but then demanded we all participate in a rousing rendition of the Star Spangled Banner in the cafeteria. I should have felt united with my coworkers. I should have felt we were one. But I didn't. As soon as it happened, as soon as everyone solemnly but angrily slapped their hands against their chest, a chill ran down my spine.

I stupidly confessed to my friend KP that the entire exercise had made me nervous. When tragedy strikes, everyone wants to talk about the outpouring of support and good will that occurs, but the first, palpable emotion in the air is often pure, angry hate. There was so, so much hate in "the rockets red glare" that I foolishly told KP that I was scared I couldn't walk around by myself at night in my little town in NJ. It felt, even moreso than all of my upbringing in EBF, like an us vs. them moment.

And I wasn't part of the us anymore.

I recount the confession as a foolish one because it caused irreparable harm. KP gave me an impassioned lecture about my self-absorption and paranoia and how I was making this whole thing about me when no one would have associated some brown girl from EBF with any of this tragedy. No one would blame me. She said it over and over again, and eventually I told her she might be right, and maybe I was being an a$$hole, because after all, people had lost their lives, and that was a true tragedy. That was certainly more tragic than me feeling nervous about walking to Trader Joe's.

Then the next day, in a town 25 minutes from mine, an Indian girl was heckled, called a terrorist, and was hit in the head with a brick.

KP called me, sobbing, and apologized, and I realized it was the first time that she really, truly understood that she and I were not the same. We may have grown up in the same area, we may have majored in the same subject, we may have had the same taste in music. But at a moment like that one, the difference between us was shoved right in her face in a way that she could not ignore. I couldn't ignore it either.

And despite having some of the closest friends ever in my years in NJ, I felt starkly and terribly alone that week.

I have very young cousins who live in Boston. They grew up completely unaware of the idea that there is an us and them, and I never had the heart to explain this to them. Yesterday, when I heard the news about Boston, I was worried about them at first because I was worried they might have been injured in the explosions. But when that worry subsided, I had a worsening dread, and I worried about their safety for a different reason. I wanted to tell them to go home and not to come out for weeks, for months, until it was safe. I don't want them harmed. I'm hoping I am wrong. That I am old and that times have changed. That there isn't such a line between people anymore, that being a Bostonian trumps all.

Last night, though, when that memory flashed into my head, I knew that for some of us, the line can never be blurred and we'll never feel entirely comfortable. Which is a tragedy too.

most of the time

First- let me say that I am horrible at editing. Writing something down, sign me up. I can give you verbal vomit for days (to which those who have ever read this blog can attest). Make me edit it into something suitable, worthy, succinct, FML (to which those who have ever read this blog can even more heartily attest).

Second-

"Best cure for heartbreak is (meaningful) work. Though it will not be easy- that's the point." - Joyce Carol Oates

Who says Twitter is full of nonsense? Well, actually, most of the time I do, but there are exceptions, like the above noted quote.

I don't know how to believe in those words more than I already do. It's not that the work replaces heartbreak either. It's a strange phenomenon that way. It doesn't take its place.

There are a number of large blood vessels which supply the heart- the coronary arteries. Over time, with hard living, too much cholesterol, whatever, one of these coronary arteries can become completely occluded. It can happen with major coronary arteries- the ones on which the heart relies upon the most to keep beating. But often times, the heart finds a way. Without any intervention externally, the heart finds a way, it builds a collateral circulation, and learns to function, bypassing that original occlusion altogether.

It's like that.

This work, it's deeply satisfying. It's oftentimes other things too, other things less glamorous. But most of all, it's deeply satisfying. Every time our team went to see a patient this week, an old woman with a rare type of leukemia, she told us the same thing when we asked her how she was doing: "I am content."

I thought to myself, that's how I feel too.

since we found out that anything could happen

Well, my batting average is way off. I've still wanted to write, but sometimes now my thoughts get so ensnared in medicine and I don't care to dwell on that in this space, at least not all the time, and as a result, I haven't had much to post. It's not medicine, but medical training that sometimes engulfs me a bit too much.

But I don't feel like complaining about medicine right now, or really ever.

It's spring here, which is beautiful and heady and intoxicating. But like many an intoxicating thing, not so great for me. With spring comes pollen, and with pollen comes clogged up sinuses, headaches, and watery eyes. So the spring often turns me into a shut-in.

There are advantages of course. In the spring, the weather's not so hot here that I feel guilty about baking. And since I'm stuck inside, it's a good excuse to take on some new experiments. I'm not someone who ever becomes an expert at baking much of anything. For me, the process and the experiment is most of the fun. Last weekend, when the allergens first infiltrated the air, I got it into my head to bake cream puffs.

It should be noted that I don't eat cream puffs, I've never been inclined towards them. The broseph loves cream puffs- he was the first person to rave about Beard Papa back before it was the mainstay it now is. But I have to admit that I didn't set out to make cream puffs because I'm a good sister. Besides which, my brother's really become a full blown San Franciscan, which is coming to mean that he talks about pastries and decadence but actually consumes kale juice and quinoa. So, no. I took on cream puffs because of the reason I take on most projects. I thought I couldn't do it.

And what that usually means is that I can't actually do it. Not at first, at least. Cream puffs, like most French pastries, are temperamental. You have to get the dough (which is cooked before it's baked) just the right consistency, and then it has to bake just so, after which, you hold your breath and hope it's light and airy enough to live up to its name. The first attempt last weekend seemed to be going well. I thumbed my nose at all those reports of puffs being difficult to bake. Twenty minutes later, when I was staring at deflated hockey pucks of dough, I was singing a different tune. Well, in fairness, I wasn't singing, I was cursing.

Macarons are a major French mind****. They involve a lot of ingredients, and multiple complicated steps, and so messing them up makes you really see red. Cream puffs, on the other hand, are deceptively simple- butter, water, flour, sugar, salt, eggs. So I was not that daunted, because, and I know this sounds weird, but those are staples I always have in abundant supply in my kitchen.

So yesterday, after nasal rinses and antihistamines and whatever else I could think of to clear the allergies out of my system enough to think straight, I tackled cream puffs again. I went on faith, which is what you must do. Half of the recipes out there for cream puffs tell you to beat enough eggs into the dough "until it looks right" which always cracks me up- because how are you supposed to know what the dough is supposed to look like if you've never successfully made it before?!? No matter. I channeled the force and went for it, crossed my fingers while they were baking, and finally opened the oven door with one eye shut. Only to discover they'd turned out exactly the way I'd wanted them. Puffed up, hollow inside, perfectly golden. There may have been some fist-pumping in the air, and an Elaine Benes-worthy dance in my kitchen yesterday. Filled up with whipped cream, drizzled with caramel sauce, and the next thing you know- cream puffs!

Were they the most beautiful cream puffs ever made? No they were not. Did they taste okay? Heck if I know, I don't even eat the things! I brought them over to a friend, CS, who likes cream puffs, and who was having a rough day at work. She reviewed them favorably, but that's probably why I dropped them off to her- her bar was considerably low as she needed any form of a pick-me-up. We had tea while she had puffs and filled me in on her horrible day. Then we laughed. And I will most certainly be making cream puffs again.

keep myself riding on this train

There is this amazing thing that residents drool over called a golden weekend. It is an infrequent but cherished occurrence.

It is what everyone else calls - the weekend.

I'd just had a very long day today that ended a very long week. Today was a particular whirlwind, a mixture of insanity in the hospital followed by chaos and madness in the clinic. And all day today, I had been telling myself- well, at least you have a golden weekend. I kept telling myself that I'd get to sleep off this exhausting week if I could just get through this day.

And then I got paged tonight, and my dreams of a golden weekend vanished. One of the other residents fell ill, and I got called in to cover for them.

Just earlier this week, a former resident was having dinner with me. He, a to-the-bone Midwestern guy as masculine and together as they come, told me that he cried during his intern year. You think that the tears come during residency when people die, but that's not usually what triggers it, actually. For him, it was a very bad day in clinic, during which he encountered a patient who had a ton of problems, none of which he could fix. The frustration reached its tipping point, and the tears followed. At dinner, we were talking about how weird it was that I got through all of intern year without shedding a tear. My friend A concluded jokingly that perhaps I was dead inside.

Today, when I got that page that was just the culmination of badness in a tsunami of badness, I thought- ah, my time has come. I came close. I was telling another resident about my day, and I was getting more and more frustrated with how unfortunate I was. I still had a lot of work to do at that point, and I realized I was just getting upset sitting in clinic, so I went home to finish my work.

When I got home, I was still deflated about my weekend disintegrating into thin air. There's this thing that happens when you're tired and you feel overworked or overwhelmed. You start to feel like you have very bad luck and the sky is crashing on you and the whole world is against you. And it's very easy to just wallow in that and feel like you've been wronged and spiral down further and further.

I don't know if it's so much better, my maniacal approach. But I just snapped at some point tonight and started thinking HAHA- you cannot bring me down, residency! Nice try!! I shall caramelize onions and make cookie dough and frost cupcakes and you will bend to my will! I mean, who am I really fighting besides my own demons and negativity? But it makes me feel better. It makes me feel strangely victorious. Now if you'll excuse me, I have to make sure those onions don't burn. And by the way, despite chopping them up tonight, still no tears.

use your intuition, it's all you've got

Expecting big revelations is the hope of youth. Little secrets seem bigger now. Small realizations are all the more precious because they are fleeting, they light up the sky like transient lightning, illuminating your surroundings for a moment. But not blinding.

Some of my fellow residents were chatting with me today, and we were talking about restaurants. Somehow, it came up, that S only really would ever tolerate going out to eat at about four different places (Chipotle being one of them). Prior to this year, people would ask what went wrong. Today, it was all turned on its head, and everyone was more curious as to what had brought us together in the first place.

That's where the soft glow lit up through the gloom. Medical school, ugh. It's an odd thing. I love residency almost as equally as I disliked medical school. It makes no sense, because it should all be part of the continuum. But somehow, during those four years, I felt a constant pressure to keep my mouth shut, to hold my thoughts as my own, to make no big waves. I was indistinct, a speck of dust, a smudge on the windshield, and it was with great effort that I strived to be that inconsequential.

And in that state, all turned inward, compromising, resigned even, in that state, of course it would come to pass that I would settle. Of course.

None of this is a tale of woe. As soon as I earned my wings and became a physician, as soon as I started residency, I immediately became true to myself again. I was lucky, because to crush someone's personality for that many years in their 20s can be a permanent thing. It was not difficult at all for me to reacquaint myself. And everything I innately knew about myself, finally, after a long drought, others started to know too.

But it's just the flash of a camera, a temporary flicker of light. Some days, you feel known and understood, and you feel quite fortunate indeed. Other times, not so much. Life- I am getting used to it.

and in the instant we are

Plenty of more interesting topics to write about, I'm sure, and this is not exactly setting a good precedent for the new year. However, it is a good demonstration of that old adage- the more things change, the more they stay the same. Here's a recent text message exchange:

NG: Superbowl party at my place, be there.
NG: It's not optional.
NG: Don't ignore me woman!
me: Okay- as long as the Pats don't make it, I'll be there.
NG: What if they do?
me: Then for the sake of the free world, I'll be watching at home alone. Anyway, if I come, what should I bring?
NG: I don't know, I kind of like the idea of seeing you angry.
NG: Bring something sweet.
me: Yeah, except it's anger that turns into a tearful meltdown, which I don't care to share publicly.
NG: Oh yeah. No crying.
me: Yeah. I'll drop something off at any rate, if by some chance the Brady Bunch make it.
NG: Haha, fair enough.

In other news, I'm on vacation right now. I had toyed with going places, but in the end, I realized what I really wanted to spend my time off doing. I wanted to rest and get healthy. So the past week, I've been going to the gym and hanging out with good friends and just feeling a lot less rundown. There will be time for adventures in the future. Or so I hope.

Also, I'm not going to go on a rant about HBO's Girls, but I am going to share Santigold's Girls video. I think it actually points out the disconnect between what the show seems to purport being about (new! now! this generation! new york!) and what it's actually about (privilege! aimlessness! first world problems!). It's like Santigold wrote the song before she'd actually seen an episode. Either that, or she saw the show, and decided to write/create a video in response to it. Whatever the roots, it's classically infectious like Santigold can be. 2013 might not be so bad.

Yet again we're the only ones

Well, let's get it in before the end of the year, because here it is. The year came to a close quickly, before I could really wrap my head around it. And this is maybe the funniest year of them all, with the joke being on me, since I have to go to bed prior to the transition of 2012 to 2013. Such is the reality of my two week stint in the ICU.

About that I'm not sorry though. The holidays put on too much pressure, demand too much conformity, and I have no use for such things nowadays. Besides which, the ICU teaches you all about perspective. Family meetings every day, bad news broken on a steady schedule. Updates that end with hope or heartbreak. And of course, patients falling apart right in front of your face.

Some people have bad luck. Some people keep making the same mistakes over and over again. Some people are the few fortunate ones. Then there are those of us who get to watch it all unfold, who see that entire spectrum, and there is a certain privilege in that.

But the amazing thing I've learned is that perspective only comes to you if you are receptive to it. Even the anvils that the ICU deliver upon your head can go unheeded by those too caught up in their own nonsense to pay attention to it.

This year was so very necessary. That's the only way I can really describe it. I'm starting to understand how much the low points in life are intertwined with the higher ones. Despite my Eeyore-like exterior, my handle is brimful and the song which is the inspiration of my namesake is a pun about hope. This is the secret I keep for you and for myself. This is me, equal parts realist and dreamer, equal parts resigned and reaching. I have the capacity to be kind or to be cruel, and I try, try, try to do the right thing, to make the right choices. But I understand why sometimes others would see it differently. This is me, equal parts deeply flawed and perfect. None of that would be so, if it weren't for this past year.