Monday, December 13, 2010

Interview Season - The Road

Doing my share of traveling these days, I would say more than any other time in my quarter century life. Have met a lot of new people and visited new places; pondered a bit about what the important things in life are and lived a few moments that will be forgotten 10 years from now.

Interview season is an exciting period in life for us 4th year med students. Actually, most of our senior year may be spent deciding on questions like - "which specialty do I want to practice the rest of my life?" and "Which part of the country will I find myself for the next 3 years?". With uncertainty comes excitement.... or anxiety. I once heard a person say that "People with too many options to choose from are rarely happy.", where as people with only option G (good) or NAB (not as good) are more content in their decisions.

All 12 of my interviews are complete now. I have driven to Colorado (twice), Kansas, parts of Texas, Tennessee and North Carolina; flown to Oregon and Washington; even cancelled a few in CA, VA and PA.
The hulking Colorado mountains astounded me as they cast their minute stature spells
The vibrant Kansas sunsets distracted me from important things like driving in the proper lane
The communities of Western North Carolina painted pictures of life in an earthy artsy place
Texas said it can train me the best and keep me close to family and old friends
The Northwest lured me in with culture, saying they were progressive and into nature stuff
Tennessee snowed heaps and iced the roads to keep me in the Appalachian hills For - e - ver (no, you are not hearing the distant but menacing strum of an ill-tuned banjo).

I wish all these recent memories could be part of daily life:
- a concert with my cousin in Leipers Fork, TN

- backpacking at the Colarado National Monument

- disc golfing well planned courses in Asheville, NC

- running from the law in Spokane, WA (really just city park surveillance for relieving myself underneath a bridge... big waterfalls always give me urge incontinence)

- buying fried pies dripping in grease from Davis, OK
- relishing the flavor of my best cup-o-coffee ever in Seattle, WA (stereotypical right?)

- playing board games with my 2nd and 3rd cousins in Elkins, WV

- climbing snow laden trails to the top of Hump Mountain, north of the Great Smoky National Park

- sharing meals with Dan, Emily and Fiona in College Station, TX
- building random friendships in Johnson City, TN
- getting a dear friend married off in McGregor, TX

- power walking with my Aunt in Denver, CO.

So it seems I have slipped into that category of people who have many options. Each program and geographic location has it's strengths and weaknesses, not one seems to meet every criteria in my ideal head. Trying to trust that my Father in Heaven will guide me in this decision and give me peace about it is like waiting for Christmas Morning to finally arrive as a kiddo... you're so excited about the biggest present in the corner yet secretly praying it's not a life sized poster of Mr. Rogers.

When I began pursuing the field of medicine at the end of high school, I knew there was a great need for doctors, but it didn't click that meant lots of job opportunities too. And yes, it has taken a little longer to reach beyond the student leg of this journey than many of my college friends, but I'm loving it. The real deal is this - people with lots of options have nothing to complain about because they at least have options. Underlying this the "wow, you're about to get a paid position" craze, I keep upfront my hopes and dreams for serving the poor, domestically or internationally... which complicates the whole "earning money" idea. It has been good to chat with residents doctors and attendings at my various interviews about underserved and international medicine. Lots of ideas and current examples of doctors going for it are out there. Several books about service ministry are on my night stand such as "Preach and Heal" and "When Helping Hurts", trying to identify what a beneficial medical mission is --> something that allows access to a community and then empowers it to become self-reliant. The faith of a high school student is still at work in me, but the reality of adulthood and the present is not making it easy. Since I have 4 years before I even consider solo practice though, I'm in no rush.

You know what?... God has been better to me than I deserve; not only allowing me the excitement of adventure but also the less attractive aspects of a transient life - like feeling alone and spending too much money(credit); and He grows me. And everything works out for the best.

Trust the Lord with all your heart and do not rely on your own understanding of this crazy world. Submit your life to Him and His GPS will guide you down the sure road to the destination.
paraphrased from Proverbs 3:4-5

The Green River in NC after a few inches of rain. "Killer" kayaking.

Well, I will be doing some of this trusting business over the holidays, working in NYC for the month of January, then back to rural Cuero, TX in February/March. Merry Christmas friends.


PS - Wish I hadn't rashly buzzed my head just an hour ago. You see though, I have these do-it-yourself hair clippers that make it easy and saves me 10+ bucks each stylist visit... don't get me wrong, the new cut is great - just short - I'm getting the usual sad feelings after letting go. Bah

Oh and I'm not just gallivanting about the country side in my noble steed, Accord. We are also doing normal work on rotations such as emergency medicine, infectious disease, surgical ICU, radiology and sports medicine. Just in case you thought I was slacking off :).

I found some amazing ice formations along a creek in the Jefferson National Forest.
Laurel Falls - TN - and much bigger than this pictures gives justice to... probably 30-40 feet. Not really the nicest bathing weather, but definitely "gorgeous".

Monday, September 6, 2010

Final Year to go and Final Exams to take (well almost)

Hello Friends, hats off to you from the top of Machu Pichu!

Relatively major things have occurred or are about to occur and I want to share with you who don't mind reading.

First, a quick time-line:
June = backpacking trip in New Mexico
July = board exam study month, Peru excursion, skills exam in Philadelphia, PA
August = surgical intensive care service, 2 board exams, application to residency programs

(My dad ran after the end of this rainbow, wanting to find the "pot of gold"! I thought he would fly directly off the alpine plateau!)

In the last 8 months I have learned to call a new place home. The In-laws of my classmate from medical school have been amazing on multiple levels. Not only have they kindly let me "stay", they constantly reinforce to me that their home is my home, they encourage me academically and spiritually, and they are super fun! Jack is a veteran backpacker and knows the Pecos Wilderness like the back of his hand. He led a group, including my dad and I, on a wonderful 6 day trek. Although I tried, there was no way I could study in the mountains. I was forced to conversate deeply with my 6 companions and contemplate God's creation. The good life.
(Atop East Pecos Baldy, 12,500'... beyond the mountains behind me lies Sante Fe)
My Rocky Mountain aunt probably knows this already, but the alpine micro-environment is quite interesting. Think land of midget life. Up there, one may find most of the flora also found at lower altitudes, only they are teeny tiny! Midget plants ;)

In mid July, my friend Eric and I flew up to Philly together for an exam. This one was arranged in a practical format to examen our clinical and humanistic interviewing skills. The "pass" grade just came in the mail! Woo Whoo! After our exam, we rumaged about the city in search of the legendary Rocky Statue... eventually finding it next to the Museum of Art. And of course, we mastered some massive Philly cheese steaks at this genuine corner shop called Delarosa's. Delish!
This month was originally set aside for the dedicated purpose of board study... but when I learned that my dear college buddies, Evan and Jordan, were going to be visiting some other dear friends in Peru, I could not resist such a unique adventure. We picked up the "tourist" journey quickly, starting in Cusco (the ancient capital of the Incans) we walked, taxied, bussed, and trained our way up to the Machu Pichu ruins and back.
(left picture: The puma paw was the symbol for royalty. right picture: My Peruvian friend Alex says these flowers have great hallucinogenic properties, but this is not knowledge via experience :)

These ruins were hidden during in the age of conquistadors and have remained that way until the early 20th century when an archeologist accidentally stumbled upon them. Machu Pichu is now one the world's most frequented ruins. The indigenous people's culture is a mix between catholicism and Incan gods like the sun and the power that resides in the ancient rocks. To me, the mountains were the amazing part of machu pichu and it chilled me to see the semi/full worship that these man-hewn rocks received.

Surgical ICU was a crazy experience. It can make a normal person quite paranoid about how dangerous car accidents and gunshot wounds can be. I may have to support a national "Wear your helmet while you drive" campaign sometime in the future. But it was a great way to become familiar with who is really really sick and who isn't.

In the middle of that rotation I also finished my 2nd step of board licensing exams. Another Woo Whoo! I'm beginning to get antsy about when and how I can begin the kind of medical practice and community living that I've been subconsciously dreaming about these last 3 years. As my mom turned some unreported age this weekend, she made a comment about how quickly life goes by. We are here today and gone tomorrow. It immediately spurred me into action-thought mode (which are contradictory, but possibly precursors to something good in me). I want to finish life with more love poured out than textbooks read and degrees earned.

The interview season is gearing up for this year, Nov through Jan. I'm finally interviewing for a paid position! If any of you live in the NW USA, Colorado, Appalachia or various Texas cities, I may have to visit you in between.

Until then,

Sunday, June 20, 2010

One month to live on Lake Atitlan

Santa Cruz la Laguna, Guatemala was to be my place of immersion in the Spanish language and developing world medical experience, but when I arrived one month ago I discovered a wealth of culture, mystery, politics and adventure.

It is a common story in Texas, the young student ardently studies a foreign language in high school only to become mired in the drudgery of it and never gain knowledge usable in a practical sense. Then the student studies abroad for a semester or so and returns home with the aroma of new idioms on his breath; the sounds of strange syllables in patterns quite foreign. After taking 5 years of Spanish classes, my hands needed to get dirty before I could really catch on.
Besides needing speak to my patients, other workers, people at the market or on the transport boats, living with a nurse named Guatalupe was the sweetest part of my immersion. We had a great time laughing, joking and cooking, yeah! (If any of you want to try out Guatemalan pico or other sorts of Guatemalan food, I feel fairly proficient in cookin' this comida.)

Although it seems like a possible vacation, this trip to a mountain-lake paradise was all about business. My work schedule consisted of: 2 half days of medical Spanish lecture given by one of my Doctors, 2-3 days of clinic which occurred mostly in small lakeside villages in El Departmento de Santa Cruz la Laguna, lot's of independent study

(pic on the lower left and middle right by Stephane / lower right by Jessica)

MY NORMAL DAY went as such: wake up at 5:30ish because Guadalupe and I would exercise a bit / walk up to the health post to pack up our instruments and medicines in travel suitcases, transfer them to a pick-up truck to be transported down the winding steep road to the lake's edge where we met the doctors and a boat to transport us across the lake a few kilometers to one of the various clinics / attend to patients until there were no more (usually 9am till 1-3pm) and then return home... bringing the equipment all the way back up the hill to the health post where it could safely be stored.

The doctors here were an ER doc from the states and a Pediatric doc from Guatemala. For 7 years they have been providing curative care, in coordination with the ministry, to 10,000 people on the northern side of the lake. I say curative because the Guatemalan Ministry of health focuses primarily on preventative care as they have limited funds and it is more cost effective. Currently ministry funds are so low that no health professionals have received paychecks in 2 months.

Kind of hard to work for nothing right? Thanks to the medical Spanish program that I paid tuition for, these docs are able to support their activities with little reliance on fundraising or ministry support... and us students are certainly not left out in the deal!

(these pictures of Dona Paulina by Jessica)
Last year the docs heard that a woman living alone above one of the villages needed medical attention. This cutest of tiny Mayan ladies above is Dona Paulina. She had no sons to care for her in old age and thus has lived alone for many decades. She actually had acquired a large circumferential sore wrapping around her left lower leg! They did not know if it would be the end of this woman or not, and for the last 9 months various students in the program and volunteers have consistently hiked up the mountain to clean and dress the wound and to support her with food donations. By the time I was able to take part in Paulina's care her ulcer had healed considerably, nearly 75%! And although I saw just a smudge of progress during my month, I felt privileged to help in the communal effort to help this poor widow.
(Our mountain path came across a full stream, necessitating a dramatic leap to the other side)
(my travel companion and Canadian medical student Stephane, behind Volcan Santioguito is passing some gas)
(Cerro de la Cruz, looking out on the old capital of central american during the Colonial Period)

Adventures were not hard to come by in Guatemala. Whether is was evading certain doom through Tropical depression Agatha, witnessing close-up volcanoes belch out plumes of ash, trekking through mountain cloud forests, spending time with a Guatemalan family or traveling by "chicken bus"...

(This brightly colored bus is affectionately known as "chicken bus" by us gringos because people are packed so tightly. Sometimes 3 to a seat and then standing room too)
(damaged/destroyed houses in Jaibalito, via mud slide)
(Damaged Gringo house from a rock slide, Santa Cruz; by Stephane)
(white out, normally this is a beautiful lake view, but the rain was rather thick)

Over all, this has been my favorite rotation in 3rd year; not sure if that is a certain sign of my future career in international medicine or simply that a tropical paradise is a fun place to live. I would definitely return to Lago de Atitlan for a year or more if the opportunity presented. Thank you all for the caring emails and emotional support.