My Fail-safe

Word War II Memorial

A couple of weekends ago, I embarked on a spontaneous road trip to Washington DC. Having just completed 3 months of surgery, the surgery shelf, and my Step 2 CS, there were areas of my life that felt a little repressed from the iron heel of medicine. Escape doesn’t even begin to describe what I craved.  My friends were gracious enough to cancel their last-minute plans and take me on a tour of the sites. However, I often felt a little at odds when touring all of the war memorials. A waterfall, a statue, or  slab of stone erected in commemoration of an individual who long ago sacrificed their life for a cause doesn’t seem to do the sacrifice any justice. Of course, there’s no adequate repayment for anyone that gives up their life for a principle, but, all the same, it still feels a bit hollow.

Washington Monument seen from the Lincoln Memorial.

Upon walking through the World War II Memorial, we unknowingly approached a gathering to recognize the anniversary of D-Day, that fateful day where exactly 71 years ago, thousands of free men stormed the beaches of Normandy in a seemingly impossible mission to overtake the Nazis in the hopes of liberating Northern Europe. Perhaps being enshrouded in those stone pillars, ceremonial canopies, and golden stars signifying deaths in combat with those that survived the conflict fostered a deeper sense of appreciation and breathed life into the past, elucidating the magnitude of what it was that was being memorialized.

Even as I sauntered through history in Washington, I failed to recognize my own past. Five years ago at this time also marks a personal milestone for me: the start of this blog. With the myriad of photos I’ve taken and books I’ve read and posts I’ve written, this creative offspring of mine has far outgrown its purpose of simply documenting the trials of one person tackling graduate and medical school, but developed into an outlet and haven for reflection and expression. It’s been my fail-safe, something I’ve reverted back to in both times of indecision and uncertainty and moments of anticipation and exhilaration. Five years strong, I never really imagined I would ever have so much to share or revel in. Shah Blah Blah was supposed to be just for me, really, but in the end, it became the better version of me, perhaps grittier and far more eloquent than I could ever be in real-time.

Jefferson Memorial

Dissecting Grief

My rotation through Internal Medicine started off with a month-long stint in the Intensive Care Unit (ICU). Names were often misleading in the hospital regarding what types of patients you were going to encounter; I would see patients strolling into the Emergency Room for the common cold and another patient with trauma and major parts of his hand missing to the “low-key” walk-in outpatient clinic. However, the ICU was perhaps the most aptly titled unit I had rotated through, and the experience was intense in more ways than one. Where I was often used to seeing ten different patients with one acute problem elsewhere, I now saw one patient with ten chronic problems here. Looking back now, the entire month was one big blur where days bled into one another, quick rounds turned into endurance-testing marathons, and one dysfunctional organ system precipitated the downfall of another, like dominoes.

The ICU renders itself as a gateway for the acutely and chronically weak, patient’s whose lives are literally placed in the mercy of a higher power: what that power is depends on who you ask. I would be lying however, if I didn’t admit that the ICU has a distinct aura of holiness. Family members often tiptoe and whisper in profound deference to the medical team and to the patients as if the patency of the patients’ airways depends directly on their ability to minimize all sound. All who enter seek antidotes for their crisis, a distress composed of both physical and emotional elements and sometimes, the emotional masquerading as physical. Replace the pews with endless stretchers, the stronghold confessional with a curtain-veiled bed, and a priest cloaked in black bearing a cross with a physician shrouded in white bearing a stethoscope. Trade religious fervor for actual fevers, church bells for code calls. Some find God in a stained glass, we see god in a CBC. What we lack in offering salvation and moral and spiritual guidance, we make reparations for by providing physical and mental relief often in the form of pharmacological deliverance.

However, just as prayers are often not enough, so are the limitations of science. What do you do when your knowledge is failing, your faith wavering? When you’re forced to make a home out of a barricade?

An Ode to Grenada

In what could be one of the greatest satirical pieces of work, Catch-22, Joseph Heller once wrote:

What is a country? A country is a piece of land surrounded on all sides by boundaries, usually unnatural. Englishmen are dying for England, Americans are dying for America, Germans are dying for Germany, Russians are dying for Russia. There are now fifty or sixty countries fighting in this war. Surely so many countries can’t all be worth dying for.”

Heller was right. Surely, all countries cannot be worth dying for. Only those countries you choose to regard as your own. I wasn’t born in Grenada, but a part of me is certainly alive because of this island. Some might even argue it’s the most important part: the piece that nourishes your what-ifs and gives substance to your wishful thinking. On the night of my own departure, as I try to test out my own wings from the land that’s served as my nesting grounds on-and-off for the past several years, will I ever deem Grenada as my own? 

Some of my favorite shots of campus:

Study hard, play harder.

Even alley ways have their charm.

View of campus from my bedroom window.

View from the Library.

Campus on a rainy day.

Only time can tell what Grenada will become to me as I continue my life elsewhere: a pit stop, a detour, or a makeshift home? Even more, what will I become to Grenada? An honorary citizen, or merely a temporary dweller, holding as much fondness for each other as a midnight traveler to a dingy motel room. Was Grenada merely a means to an end, or did it define a bigger purpose? All I know is that when I moved to a different country four years ago, nothing was harder than saying hello for the first time. As those years started turning into hours, it got even harder to say goodbye for the final time. 

The Beat of A Different Drum

As a student known to sleep through a larger portion of my immunology lectures, the material, for me personally, lacked a little oomph. IgM. APC. CD28. C4b2a3b. A litany of cells, cytokines, and receptor molecules with unimaginative names and, often, even less enticing tasks that sounded more like a roll call for Star Wars characters. Little did I know, however, that the lessons imprinted on me in immunology translated to a much broader message.

Our biological well-being relies on the body’s meticulous ability to distinguish between the innate and the foreign. Thus, recognizing our own self is a lesson imbued to us by our own immune system. If the crux of good health relies on our body’s ability to recognize the “self” from “non-self” then being a good doctor, in my opinion, is about recognizing one’s own motives, perceptions, and attitudes against the backdrop of competing interests.

While conducting a research study on undertreated pain in sickle cell patients in a small middle-income nation, I interviewed around 40 sickle cell patients. After several long weeks of talking to patients, they all seemed to blend together as one in my head. However, one particular patient would always stick out in my mind. William, as I’ll call him, was rather gaunt and scraggly when he walked into the clinic where I was conducting interviews. His uncharacteristically hollow and worn face spoke volumes about his disposition and how mismanaged his pain was as a result of his disease.

Nevertheless, it wasn’t his face or his stature that made him more noticeable in my mind, but rather something about his eyes. There was a glaring yellowish tone within them, signs of full-blown jaundice, a common symptom of the disease, but even that was far from what made them distinctive. It was, instead, the dejected look he carried about him, a man who lost that sustaining spark to carry on. More so than his body, it was his spirit that was crippled.

Perspectives from the Inside

Medical school is an anomaly for me: when I was striving to get in, I spent all my days languishing and sighing at the thought of just getting in. Now that I’m in, the nice rounded edges of my daydreams appear to be more sawtoothed after closer inspection. I’m still excited, as I’ve reiterated many a times, but still very much discomposed. I decided the best way to lay to rest any lingering anxieties besides actually starting medical school and living the experience, is to collect any perspectives from my fellow MD/MPH grads/students that have spent a few months on the inside already. While my main purpose for this comparison is humor, it’s futile not to realize that somedays, from what I’ve read and experienced vicariously, medical school is going to feel an awful like prison and its graduates, like inmates, have their own culture, their own routine, and their own restrictions–that is until midterms and finals are over and people are too busy downing shots to ever really take notice how they voluntarily signed up to be tortured like this. What’s not to be excited about, right?

Here are some responses from students who just recently wrapped up term 1 and term 2. Some are more in-depth and blunt than others which I think only increases their value. I want to applaud their generosity and thank them for their words of wisdom and insight. I feel it has the potential to hopefully assist anyone thinking about medical school, SGU, international medical schools in general, or to invalidate what people may think they already know about foreign medical schools: