Tuesday, October 23, 2007

nothing keeps me up at night

Today, a classmate sitting next to me popped up in the middle of lecture as though his cell phone propelled him out of the room, and returned about 20 minutes later, sweating and nearly clammy. He tapped me on the shoulder and informed me that somehow he found himself daydreaming in class, convinced himself that he had to give an important presentation, and bolted to go practice. He got all the way to the place where he was supposed to present before he realized it was all in his head, and that his presentation wasn't until next week.

So, you know, people are a little stressed out around here.

I find I spend a lot of my actual time devising ways to allot my time. I think this is some attempt to be more efficient, but I ought to give it up, because all that happens is that I make big plans and fall short of my own expectations.

There has also been grappling with some lousy instructors. For the most part, I shrug off such instructors because I like what I'm studying such that I can usually overlook that the subject matter may not be taught perfectly. However, when the instruction is so bad that you have to actively turn a deaf ear to the instructor because he reverses your comprehension of material, that's a bit uncool. One of my classmates called him the "Jackson Pollock of Medicine" today because of his indecipherable lecture slides.

Other than that, I baked cookies the other day. I've been in a war with my oven. In addition to being ancient, it refuses to cooperate when it comes to maintaining a proper temperature. But through a few rounds of trial and error, I think I have it down to something reasonable. The cookies were peanut butter and chocolate chip. I figured something out- people tend to think the key to a good cookie is the sugar and butter, but the right amount of salt gets short shrift. I'll post pictures when I find my camera adapter, and then you can decide whether there is any point in posting the recipe.

Monday, October 22, 2007

I chose to listen to that filthy mouth

First of all, thanks a billion times plus a billion to the billionth power to everyone who left me birthday wishes on Friday and over the weekend. Talk about sweetness. I’m never melancholy about my birthday, but I’m usually somewhat reflective and brooding. Or annoyed that it somehow didn’t work out the way it should have according to my master plan (see last year’s hilarious, possibly drug-tainted party with a bunch of people who didn’t even remember my birthday this year- and that was a sigh of relief you just heard from me). So, it was interesting that this year, I was wholly in the moment. There was a lot going on, and a lot of it had nothing to do with festivities, and it wasn’t really until Saturday afternoon that I really had a chance to breathe and stew, if I wanted to.

But as it turns out, I didn’t want to. There isn’t much to look back on now in some ways. And there’s so much ahead, it’s like a tidal wave waiting to crash over me if I don’t keep my eyes focused on it. I have to tell you that it’s strange to be my age and to be experiencing that feeling for the first time.

On to the next order of business though. This week’s song. Truth be told, I was never some frenzied Fiona Apple fan. You have to understand that when she first broke onto the scene, she seemed to be too young for her voice. She also seemed to embody that whole heroin chic, waif thing that Kate Moss has decided to put a lock on. Also, her videos were getting plastered all over MTV, but she was pulling that Avril Lavigne/Pink stance of telling everyone to suck it. Also, she put out a sophomore album that had an absurdly long title. The title seemed like the kind of thing Axl Rose would mutter at the end or beginning of one of his tunes.

In fact, I think Apple was too young for her voice. She was precocious, and partly what put me off so much was that she seemed to be prematurely jaded- the video for Criminal always gave me a hefty dose of the creeps. On the other hand, from her second album, Limp happened to come out at a particular moment in my history when I benefited greatly from her rage-fueled lyrics and piano banging.

So, I’ve revisited her older songs, and I’ve checked out some of her newer songs, and I have to admit that she’s a solid artist. Criminal still gives me the heebie-jeebies, but maybe that’s the whole point. But when she put out Extraordinary Machine, I caught the video for Not About Love and then I really couldn’t frown at Fiona Apple anymore. You should really view it, for Zach's interpretive dance if nothing else.

My love for Zach Galifianakis has been documented previously. He’s an acquired taste and not for everyone. I’ve seen him live three times- he was hilarious twice, and drunk and offensive the third time. But he is naturally funny- especially when music is incorporated. But Galifianakis causes me problems. The most serious problem is that of possible institutionalization for use of the expression: ”That is so Raven.” Now, if you have seen Galifianikis’ act, you will appreciate the need to interject this expression into conversation. But if you have not seen his act (and sadly, most of my friends and colleagues have not), you will think that I watch the Disney channel and have an odd fixation with that jump-the-shark Cosby Kid. Or that I'm just plum out of my mind. That's how I'll know when I've met my soul mate. I'll remark, "That is so Raven." And he will nod his head knowingly (or at least tolerate the comment- my standards have dropped over the years).

And now, with that incoherent bit of rambling, I will return to reeling from my disbelief that the Red Sox actually got their act together and came back from 3-1 to win the ALCS. The Patriots and the Red Sox both winning in one weekend is proof that the global warming crisis is real, in my opinion.

Thursday, October 18, 2007

like a full force gale, I was lifted up again

This week has been a long stretch of oh well, of good intentions that don't amount to anything. Something in my brain put on the brakes, some kind of self-preservation mechanism. The important thing, though, is not to fight it. Normally, under these circumstances, I would take a break and go to San Francisco. But that's a bit too easy. It's too easy to run back to the familiar-- I need to learn to find balance in the everyday, in my surroundings. Oh wow. That was so new-age and cheesy that it is clear I need to get it together.

I don't know how to explain that, even though I feel tired, dead tired, and even though I spend most of my time with my nose buried in my books, and even though I mention wanting to strangle my classmates every other day, I know at certain moments, in certain precise seconds of awareness, that this makes me happy. Little, stupid things contribute to this feeling, so that it makes no sense to catalog them.

Maybe that's what the best things are like, though. I remember, a long time ago now, my friend Jersey told me that he was completely opposed to writing special vows for his wedding, and that, if he had it his way, he would do away with the whole idea of saying vows out loud at a wedding. "I know how I feel, she knows how I feel. What the hell should we care if anyone else knows how we feel about each other?" he would reason with his thick, swashbuckling-to-me accent. It's kind of true. Over the years, he did not spend a lot of time talking about how crazy he was about his wife, but he did not have to, because it was evident in his very essence, and in his every action.

People think that not being able to articulate a feeling is a cop-out. That maybe you can't talk about it because you don't feel sure how you feel about it. But sometimes you know exactly how you feel about something and that is exactly why you can't put it into words. You can put up a hundred, a thousand, a million words around it, adjectives and descriptors and metaphors galore, but you won't really get much closer to putting your finger on it, to really pinpointing it.

For now, it has to be enough to say, things are good. I don't know where I'm headed, but I know it will all be okay.

Tuesday, October 16, 2007

or altogether just taken apart

My godchild, on another continent, really spurred this week's song inadvertently. I do not have much to offer a child of one. She's too far away for me to bake her anything, and besides which, her parents would not approve of a cupcake or cookies, unless it was made of such things as honey and spelt and wheatgrass. Okay, I don't know what spelt is. I only have a vague notion of what wheatgrass is, for that matter. Sufficed to say, I'm still unclear as to how I got the godmother-title, given that I am writing this while eating a Cadbury bar that I purchased simply because I'd never heard of the flavor "soft toffee" before. In case any of you are wondering, as far as I can tell "soft toffee" is just a fancy way for the Brits to say caramel.

I feel odd buying clothes for babies. They could not care less what they are wearing. They grow out of things so fast that it seems completely illogical to outfit them in anything expensive. And honestly, my friends tend to have definite ideas as to what their children will and will not wear. And given my lack of fashion sense with adults, I know I have no business buying anything for a child.

Then we come down to toys, but people, I haven't been surrounded with babies for a while. I don't know what a 1-year old plays with. And most toys that babies actually enjoy are like a cross for their parents to bear, so annoying are the sounds that come out of the little gadgets.

This was all causing me quite a bit of paralysis, and then I took a breath. These fools wanted me to be a godmother. The only thing I could give this kid was so obvious, I almost laughed when I realized what it had to be. Music. I don't care what you say. It's never too early for a mixtape.

I had this whole brilliant notion of how, every year, I'd mail the kid a mixtape. Eventually, it could become a mixtape of hey, these songs are cool. But the first one had to be something that summed up the idea, I thought. The list-making started and my explanations to the kid were all planned out as follows:

  • We're from Barcelona- because, when you're young, you like clapping your hands, and when you're old, you like acting as though you're young.

  • Grace Kelly by Mika- because you must remember to be yourself, even though someday someone will come along who will tempt you to forget that.

  • Love and Longing by Stellastarr*- because, well, mostly because of the band name (this has to do with the kid's name).

  • Me & Julio by Simon & Garfunkel- because sometimes songs don't have to make sense to be great. Life can be like that too.

  • Tamacun by Rodrigo y Gabriela- because it is my great, fond wish that one day you will rock the guitar like Gabriela (or Rodrigo, for that matter).

  • Jackie Wilson Said by Van Morrison- because your parents undoubtedly think 'and when you walk across the room, makes my heart go boom, boom, boom!' And because the whole world must think, when they see you, 'I'm in heaven when you smile.'

  • What Light by Wilco- because with light comes great responsibility to be true.

  • Smile by Pearl Jam- because 'I miss you already, I miss you always.'

Here's the thing though. When I made the list, I really wanted to include this week's song, No one's gonna love you. Because I believe that, about your parents. If your parents are saying it, they're probably stating a fact when they inform you that 'no one's gonna love you more than I do.'

The problem is that's not what the song is all about, really, at least I don't think. Figuring out songs like this is difficult. I never know whether to think of this idea as romantic or not- no one is ever gonna love you more than I do. Is it a threat? Is it a putdown? Aren't you really saying that a person should consider themselves lucky to have you when you say something like that? On the other hand, maybe it's really true. And maybe some people would find it flattering? I don't know.

In the end, the song created an impasse and stalled me out such that I never finished the CD. After getting stuck on that song, all the songs on the list started to cause me great doubt. Maybe it would come across as ridiculous (which it is). And do you know how hard it is to find a CD's worth of songs that are actually appropriate to send to a child? Maybe it's just my iTunes playlist, but every song I like tends to be about dysfunctional relationships, heartbreak, drugs, or, okay, being a playa (don't hate!). Maybe that says more about me than it does about music. But really, I spent some time thinking about it, and it's not all that easy to come up with really good music with lyrics worth inflicting on a tiny child. If she were 15 and filled with angst, oh, then I'd know exactly what to send her. Her father claims it's those teenage years he had in mind when he singled me out as godmother-- probably because I never really outgrew my adolescence.

It sounds like I'm disparaging Band of Horses, but I am not. I really like this song. It's old school, even though it's from their new album. When I think old school, I think of early 90s music that had those large sounds, the big choruses and the rousing opening riffs. Kind of what Coldplay tried to keep up afterwards. Band of Horses do it better, and with more interesting lyrics. It just wasn't right for a 1-year old.

So, if anyone's still tuning in, leave me some suggestions about what I could include on a CD for a 1-year old child. No Sesame Street or Spongebob sh*t either, okay? We're talking real music, adult music, that you wouldn't mind a child hearing as well. I guess I find this really important because I can't remember a time when I didn't know what music was. And that's the only thing from my childhood that I would really want to pass on to a godchild.

Monday, October 15, 2007

when you were young

It’s not really the time to be thinking backwards and reflecting, but I realized today that this here blog turned 3 without me noticing. It’s strange to look back on what was going through my head back then. In some ways, many things have remained similar- I still get wrapped up in a good song or a frothy nothing of a television show or a beautiful foggy San Francisco day. But I don’t live in San Francisco, and the number of uncertainties in my life has certainly been reduced. And I haven’t been anywhere near as dedicated to writing as I was back then. But I don’t really want to think about that today.

There’s this concept called degrees of freedom in molecules. Because we all have infinite possibilities. And then we constrain ourselves. Every time you pin yourself down on a certain point, you lose a little energy. Because you’re at your most dynamic when you are unreliable and random. You're unsteady and insatiable and that's when something, inevitably, happens or you make it happen.

I used to worry. I went from being someone who had imagined shackles locking her to the mud to someone who was uncomfortably teetering, suspended on a hot air balloon that could pop at any moment. Having gone from one extreme to the other, I really worried that it was just a matter of wanting. I used to think that maybe once I got what I wanted, I’d want something else altogether.

It’s an important question, I think, the question of whether you want something because you want it or because it keeps you from standing still. Some of us are afraid to stand still. Some of us are afraid to be constantly on the move. And some of us are in between.

I had all my degrees of freedom three years ago. I had no idea where I was heading, and whether it would end in triumph or a spectacular disaster. But thinking of it today, three years later, with a lot more pinned down, there’s still a lot of freedom. I still feel very much like there is much that is unknown in the future. I still could be headed for a fall. But I never thought it would all turn out this way, and I mean that in the best possible way. And therefore, I am temporarily at peace with the notion that there are still a lot of surprises ahead, even as I am also at peace with the notion that my feet have been planted, somewhat, in the ground now. I’m on a path now, even if I’m not sure where it is heading.

An explanation for this week’s song will accompany tomorrow’s post. Maybe. Or you could just listen to it and enjoy.

Wednesday, October 10, 2007

on a long taxi ride

Even though it's entirely likely that I've become so boring that no one is interested in any of my ramblings anymore, and it is an absolute certainty that I should be studying right now, I am still inclined to put a little something out there.

So there are two guys that are seeing me through this whole experience, guys that are not in med school with me, but are in med school with me, if you know what I mean. Both of them have toyed with the idea of becoming a physician at some point, but they have very different ideas about my decision to do this:

  • RR is living vicariously through me in some ways. He cheerleads, he tolerates my whining about missing some stupid question on some stupid quiz, he allows me to brush some of it off but he also encourages healthy fear. He wants me to get some scary board score and match to a ridiculous residency. He has threatened bodily harm if I were to change my mind at some point during this process and decided to become a basketweaver (not that I have any problems with basketweavers, but we can safely conclude that RR has a big problems with them, and with me becoming one of them).

  • W constantly struggles with whether I am doing the right thing. It tickles me a bit because he's more worried about it than I am. In a recent email, he worried that I would lose my soul in the process. He thinks poorly of medicine and the medical profession. I would never dare tell him about any anxiety about an exam, because he would probably fly to the US and stage an intervention. On the other hand, he's kind of hilariously channeling one of my masi's right now, because he recently told me he's convinced that I'm going to swoon for someone during this experience (for the record, I find that notion laughable, and the idea of dating another medical student/doctor makes me throw up in my mouth a little).

So, they're two very different dudes. And they are both bringing their own biases and demons into their ideas of my life. But I don't mind that really. Actually, I feel rather grateful to have them at all involved in my life. They serve as my yin and yang. To one, I can discuss the details of class and annoying medical students and all such minutiae that in the moment feels much more momentous. To the other, I can discuss the philosophical conundrums, the concerns about not wanting to become someone I am not. I feel, in a way, that they keep me anchored at the right point with their tugging in opposite directions. I care so much about both of them, and value both of their opinions so that I like them both pulling at me. But at the same time, I'm happy they're both there, counteracting the other.

In other news, Indian Uncle came through with two more moments of awesomeness:

    #1: He said, "I have a great uterus!" at one point in lab. This is funny coming from any male, but coming from Indian Uncle just sent it over the top.

    #2: He was talking to me about an upcoming exam, and said, "I'm shit-scared yaar!" As my fellow classmates would probably say, OMG, I heart you, Indian Uncle!

Also, yay for new Radiohead! I've only heard Reckoner but I love what's happening with it. I kind of feel like Radiohead knows how to give electronic music soul, if that makes any sense.

Monday, October 08, 2007

now I know I want to win the war

Some of my East Coast peeps have been telling me it's very un-autumn-like over there, and that sort of amuses me, since finally, for the first time since I started school, the mornings and evenings are that nice, perfect level of chilliness that is associated with fall. I had this thought yesterday, pausing from tearing my hair out, that I would be having a much harder time of it if I lived in some of the other places I could have potentially lived. Weird how you can just feel fall in the air, know that winter will be mild, and how that can provide such a comfort.

I have sussed out more of the things I need to keep me happy. Somewhere along the way the past few weeks, I lost the obsession with getting the grade. Yes, I still obsess like every good med student seems programmed to do. But I had a kind of reset occur the past few weeks, a reminder of what it is all about, from the most unexpected source.

This is going places I probably shouldn't go here, so I won't go into the details, but I put some puzzle pieces together about the cadaver my lab group was assigned to dissect. The information that is given to us is very sparse, and is probably sparse on purpose. However, there was just enough of it to go on an expedition last week to sort it all out.

It was fascinating, because a lab partner and I had a completely different reaction to what we discovered. Her reaction was: how depressing, doctors suck- they try to fix one thing and screw something else up in the process. Mine was: medicine is not an exact science, and you have to make the best decision with the facts you have at your disposal in the moment. For me, there was something fulfilling about it, about figuring out the whys. For my lab partner, it was about the what, which was death. But death is a inevitability. Death, I'm comfortable with. And to some extent, I'm also aware that death is not something that can be prevented in every case.

And some would say the why isn't really the why that I discovered- the why might be about some bigger plan or about fate or about time running out. I'm not opposed to those why's, but to me the body and how the body works is one big why-- and it's gratifying to me that science explains so many of the mysteries. To me, it makes the other mysteries all the more profound and mystifying.

I might be making it sound like I want to be a coroner. That's not the case. It's just that we're still all little muppet babies in class right now- we're not really exposed to situations where we can do a whole lot (and that's probably for the best) for patients yet. But it's quite easy, given that, to get sucked into the classroom mentality of making it all about how well you answer multiple-choice questions. But the last few weeks, I remembered that important detail, that everything I'm learning right now can quite legitimately be applied to thinking about treating a patient. The point is to learn it well enough such that you have it at your disposal in those critical moments when you have to make a difficult decision that will sometimes have a poor outcome.

And now I've gone and made it seem like I consider being a physician some high-and-mighty office, and I really don't. I am maybe the least idealistic student in my class, because I make no excuses for myself-- I'm not going to save the world by becoming a physician. But I can tell I am going to like it, thinking about the complex variables and bringing it all together and having to take responsibility for decisions. It's a thing too easy to forget in the madness of memorizing nerves and signaling pathways.

Sunday, October 07, 2007

my sleeves have come unstitched

A part of me really wanted to just post this song, give you the title and let that be the end of it. I feel like anything I’m going to say about this song is going to ruin it. Words cheapen it. But I’m kind of shameless that way.

There was another, much, much newer song that I contemplated posting, but it’s going to have to wait until next week. This song returned from the past, got into some crevice of an atrium, and just refused to let go. I don’t know if I was just occupying the wrong space and time or was just an idiot when I first came upon this song, because it really didn’t register with me. And then out of nowhere, I was watching my favorite television show on Friday (and, yes, it’s still my favorite show despite the dubious storyline that has been unfortunately introduced). At first, I was just marveling at how perfectly the music fit the show. But then it was nagging at me; the song sounded so familiar.

And now it’s gotten so that I don’t really know how to write about this song without getting uncomfortably personal. It’s like this song knows things about me it shouldn’t, or like it cracked a combination and whoops, all my guts just spilled out on the floor.

It really makes no sense, on a lot of levels, and then it makes perfect sense on others. It makes no sense because I’ve been single for eons, have had mostly disastrous relationships/quasi-relationships, and have been almost always happy alone. And most people assume I’m the sort of person who stomps on rainbows and pops colorful balloons with glee; most people assume I’m fairly jaded. Yet, here’s this beautiful song and I am totally a sucker for it. More than a sucker for it. I know all about this song. I know this feeling like the back of my hand and would welcome it back into my life in less than a heartbeat.

But then again, it makes sense, because if you really listen to this song, it’s all about illusion or self-delusion. However you want to characterize it, here you have someone walking on clouds in a world that may be entirely of his own creation. And whether it’s real or not is not really a question he’s yearning to answer. The unknown is much prettier, after all.

I have all these assumptions, assumptions I dare not even share, but that I hold close to my chest, assumptions that keep me warm and allow me to float from time to time. I am certain some of them are false, but I am not keen to suss it out further than that. Which probably explains why I have such affection for this very brief Russian poem translated by Albert C. Todd:

Eagles and butterflies (and some other things)
Still live. Let’s leave them in peace.
And clouds. Don’t disturb them either.
Let there be you and I, two umbrellas and the rain.
And if everything gets broken, there’ll be nothing,
And people have broken so much inside.
- Nina Berberova

But setting all of that aside, just the gentle vocals and the delicate guitar and the quiet pauses for piano keys leading into a crescendo of vibrant electric guitar are enough to make you swoon. Maybe this whole post is just a friendly warning: soak up the song by all means, but pay too much attention to the lyrics and you could fall into my predicament.

Wednesday, October 03, 2007

when the world is running down

Sometimes I really get frustrated with how inefficient I am, and that is one of the moments when I'm most glad to be a geek. Because, we're designed to be inefficient. This is probably going to cause any few readers I have left running, but here's the thing- the body has this need to stay at a certain point. I mean, I've already gone off about homeostasis, sure. And I knew it wasn't some static point that we just tightly stay at, that there are always things throwing us off kilter and then other things that set us closer to where we ought to be. But I guess I didn't fully appreciate how inefficient and stupid we are. Or maybe that's not the right way to put it. Maybe the way to say it is that we do the best with what we have, and that doesn't always mean intelligent design.

So, for example, we have to keep our body's pH, or acidity, in a very tight range, and generally this is done with buffers. But we have a couple of different buffer options in our body:

  • A carbon dioxide/bicarbonate buffer, which is not actually a great, powerful buffer. Though it's not a great buffer, it does have one thing going for it- bodies know how to control the amount of carbon dioxide or bicarbonate they're letting go wild at any given time.

  • Phosphate buffers, which are excellent buffers, really the kind of perfect buffer we've always been looking for. The only problem is that they're not around in much supply.

  • Protein buffers, which are also great buffers. But they're a bit slow, and bodies can't control their levels very much.

It's like three boyfriends. One is not a great boyfriend but at least he does what you tell him to do- he's predictable and reliable, even if he is reliably late or predictably falling short. He might not make you happy, but he's also not going to upset you such that you start drinking and listening to The Cure in the dark. The second is the boyfriend you've been waiting for all your life, but you're starting to wonder if he's just a figment of your imagination because you sure haven't seen him around. And the third is the boyfriend that had the whole package but somehow you just never could get on the same page, and you knew there would come some time where your lives would just cause you to drift apart quite naturally.

If your body had anything to say about it, you'd choose the not-great boyfriend. You'd settle. It's not about being perfect, after all, it's about being reliable enough such that you don't end up dying of a broken heart, or in the body's case, of acidosis or alkalosis. The body is very pragmatic that way.

Anyway, I don't know what boyfriends have to do with inefficiency really. But I do know that my feeling towards relationships are sometimes similar to my feels about myself- nothing is ever good enough, and I'm constantly wondering why it can't be better or why I can't be better. Even now, in medical school, I am sort of awed by my ability to slack off or procrastinate despite healthy levels of fear that ought to motivate me into working harder. In the end, I have to remember that it's better to be not-great: after all, if you want to make it to the finish line, it's important to stay alive. I mean that metaphorically, but I don't think I need to drive the point home any further.

p.s. The song of the week is returning on Monday. I miss it, and I'm hoping it will prompt me to be better about posting regularly about something that has nothing to do with medical school.

p.p.s. Big Shots and Bionic Woman were so lame last week. So far, it's looking to be a really lame season for new shows (and no I did not like Aliens in America, in case anyone is about to throw that one in there). I also checked out Gossip Girl, but it turns out I really can't bring myself to care about another set of Dylan/Kelly/Seth/Marissa types all over again. Why are all these shows coming out about rich people anyway? Don't they have enough attention without fictionalizing their already nearly fictional lives as it is?