Wednesday, January 23, 2008

The Call of the Sirens (Part II)

{Disclaimer: From this point on in this series, we will be talking about med school and beyond. There will be blood, guts, dead bodies, poop and other gross things. If this bothers, please don't read. It's not that thrilling and I'd feel bad if you had nightmares. Really. There's plenty of nice things to read on the 'net. No one will think less of you. Especially me.}

The night before the first day of med school found Charles and I (an engagement ring with the teeny-tiny diamond chip still feeling new on my finger) sitting on the grass in front of the house, both in a fog, feeling as though we were poised together on the edge of a cliff with one foot in the air and the other about to follow. We knew, based on rumor, television and novels, that medical school was a harsh, rewarding, soul-stretching, bankrupting, monster-creating experience. We'd been together for four years (not counting that 4 month split the prior winter where we both lost our senses but fortunately found them again) and knew we were bound together, but weren't sure where we were bound for.

Very scary. Very surreal. Very big debt if I found out that I hated it.

Backtracking, in high school I had a friend, Linda, who was in the majority of my classes. Linda, another friend (Doug), and I all wanted to become doctors and decited to re-unite as members of the class of 1991. Linda, indeed, was there and it was lovely to see her. (Don't know what happened to Doug. I heard a rumor that he went into something with finance but who knows?) Also in class was another high school alum, Essie. Essie had gone off to a nursing program in college but decided that her personality was more in line with that of a doctor rather than being the one following the orders of the asshole doctor. Knowing her, this was clearly the case. Essie was never one to suffer fools lightly nor silently. There was this incident our first year when she told one of our instructors not to be such a "fucking jerk", to his face and in front of several others students. I wasn't there, sad to say, but he was, indeed, a fucking jerk and he was less of one after she pointed it out to him.

That first day was of orientation, where we were herded around here and there, given lists for hundreds of pounds of books (literally, as this was in the pre-internet days), talks about what was expected of the behavior of future doctors (including the unspeakable sin of not paying off one's student loans), bowed, cowed, wowed, and photo-ID endowed.

That last ended up being a lesson I've since taken well to heart. See, it was toward the end of that exhausting first day and one by one we were sat upon this tall stool and had our pictures taken. I had no idea how important this photo was but it was to follow us about, displayed on our chests, attached to paper work, sent off to off-site clinics and so on for 4 years. Being strung out and frankly pooped, I didn't show a sparkly smile, but just sat and gazed back at the camera in what I thought was a non-expression. Nice and benign, neutral, trusty-looking. In short, what came out was a face that looked like a cranky, crazed Charles Manson, with bangs, on a touch of Thorazine. There might also have been drool. If there wasn't there should have been.

The next day started the real deal.

What did the first year of med school involve? In short 8 hours a day, 4+1/2 days a week (Thursday afternoons off for good behavior) of sitting on your ass in solid blocks of lecture after lecture, broken up with lab in the afternoons (sitting at microscopes or standing cadaver-side). The lab afternoons were preceeded with an hour or more of lecture before the actual lab work, just so we'd not lack for sitting and drooling. Evenings, nights and weekends were spent studying.

The first year was learning about 'normal', the second year about 'abnormal'. The first year broken up into courses like gross anatomy, biochemistry, embryology, and organ system after organ system of physiology: cardiac physiology; gastroentestinal physiology; dermatologic physiology; neurophysiology (The worst. THE WORST. I could never get more than 2 pages of the damn neurology read at a time without falling asleep or succumbing to a task like scrubbing the bathroom grout for mental relief) and all the rest, ad nauseum. Exams thrown in liberally, of course. After the first anatomy exam we went out and drank ourselves silly, as was only right. Actually, as you will not be surprised, we usually drank after most exams. The better to dump the old brain cells so that they'd not clutter the pathway for the cramming in of the new information. It was all about passing the tests. Test after test after test.

The lecture hall was one of those amphitheater-type things with the speaker down in the pit and the seats arranged in ascending rows with steps going down the sides. All dark grey cement and exposed floursecent lighting. Think industrial chic without the chic. Cold. Ugly. Hard. And yet you were still able to nod off. Most of the lecturers were deadly dull, primarily because most of them were PhDs with narrow interests in their own narrow fields, such as optic nerve degeneration in the hairless rat. The lectures from the few MDs that presented to us lowly first years were usually a breath of fresh air, primarily because they were so much more practical and gave us a glimpse into what we'd be doing in a few years.

What's that? Tell about the cadavers?


Yes. Gross Anatomy. ('Gross' in this case meaning 'large' as opposed to 'micro' anatomy, a.k.a. 'histology' where we used the microscopes to look at slide after slide of tissue, and used them well, although to be honest, most of it all looked like 'spleen' to me.) They gave us the standard 'treat this gift of a human body with respect' chat and all that as we looked around at each other, some laughing nervously, some green, most a combination of both. We split into teams of 4 to a body: Myself, Linda, another friend from college, David, and Mark, who was going into orthopedics to specialize in knees. He was focused, Mark was. We were told the age of the cadaver and the gender (87 year old female), which wasn't immediately apparent as they were completely encased in hard, white, opaque plastic. They looked like futuristic mummies. They would be our companions for 8 months and we would know them intimately. You have to be amazed at the preservatives. The cadavers literally ended up falling apart as they were dissected to bits, but they never decayed. Scary that.

No one barfed. No one fainted. We started with the chest, and over the months worked down through the abdomen, then the arms, legs, pelvis, ending with the back and finally the head and neck. A fun fact: The vessels had been injected with colored latex, which helped greatly. Unlike a non-preserved body, all the colors become dark, muted shades of tan, dark red, deep eggplant, bright lines of red and blue (the vessels) running through, or the creamy white of the bones underneath. We named ours "Emma" after the feisty Fruit of the Loom underwear ad character popular back in the day. A couple of tables over, some more college friends of mine named their male after our despised college organic chemistry professor, Dr D.

The other thing I remember is that, as anatomy lab ran for 4-5 hours at the end of the day, twice a week, I'd end up famished before the end of each session. I'm not saying that I was craving beef jerky or anything, but it was a bit disconcerting: Scalpel, flesh, extreme hunger pangs. The course was proctored by two professors as well as this professor emeritus who was about 150 years old and looked like this tiny, fat gnome with a cloud of white hair. I think he was Dr S. He was frightenly enthusiastic, academically brilliant and had this way of dissecting something so that everything was clear in the field, but the bits o' human would go flying through the air. He'd end up covered with flecks of tissue all over him, especially around his mouth and you'd have to stand there and listen to him, ignoring the gore. He was an amazing teacher, though, unlike the PhDs. I'm guessing he's still there, unable to die, with all the formaldehyde he's absorbed and inadvertantly ingested over the years.

And, oh, that dizzy smell of formaldehyde drifting over all. We all wore neck-to-shin, long sleeved dark green gowns over our clothes, but that provided little protection from the odor and we had the habit of wearing old grubby things for anatomy lab. At the end, the gowns and tennis shoes were discarded as the smell had irrevocably seeped in.

The antomy exams were pretty brutal, too, first the written part and then down to the cadavers, each with tags and pins indicating what you'd have to identify. My favorite was the question on the final that had a jaw bone (mandible) broken in half, inverted, lying on the chest of one of the cadavers with one of the small slips of ripped muscle end tagged to identify. Seemed pointless to me, that question, as the only time we'd be presented with that in real life would be at the scene of a particularly horrific accident, and if that were the victim's jaw, that'd be the least of their problems-- whether or not if I knew the name of that slip of ripped muscle on the shattered half of their jawbone, now sitting on their chest wall. Nope. Not so practical.

So we went through it all. All 90 of us. And you know what? It wasn't as bad as Charles and I had feared. It was often miserable, always stressful, exhausting, frequently boring (yes! really!) intense (but the least intense of the 4 years), brutal, but it was what you had to do to get to where we needed to go. And often it was truly fascinating and exhilerating and even fun.

And, for the first time in my life, I didn't feel like a freak. For the first time ever, I finally felt that I fit in. That it was OK to be smart and to study hard. I wasn't at the top of the class trying to hide the fact that I was doing well. I wasn't the brain. I was in the middle of the class, a class with cool people and dorks and average-type schmoes and we were all OK. I can't tell you how beautiful that feeling is: to finally belong.

I guess I was where I was supposed to be.


Monday, January 14, 2008

The Call of the Sirens (Part 1)

Now is the winter of my content. I am at peace. I am back to normal after the flurry of the past several months. I am dull.

No complaints. No sir. But, well, there's precious little to write about if one's days are a nice placid counting of the hours. The kids are fine. The pets are fine. Most of the appliances are fine (we'll see about the bread maker in a few days).

So that leaves me with no alternative but to trot out the past.

Yes, I've decided to take a page out of our Dumdad's book, not to mention the head of our Rotten Correspondent and the rest who've regaled us with tales of their mischief and misdeeds of yore.

It's time to shamelessly prattle on about my love affair (and not always an emotionally healthy affair) with medicine. I've also got a nice, young (lord, but she is young) newly minted nurse practitioner who's mentoring with me a bit for the next several Tuesdays. As she really doesn't need to trail me around seeing mostly sore throats and coughs (the season being what it is), today we'll work on her suturing and skin biopsying techniques. To what end I could be found at 6am in a grocery store buying a packet of turkey wings and a couple of dozen doughnuts. (The clinic needed doughnuts. I could tell.) Teaching always makes me feel nostalgic about my profession. It's that young idealistic look in their eyes that takes me back away from the growly, jadedness of life as usual at the clinic. We do love what we do but it's nice to be reminded.

So. High school finished. College finished. 8 years potentially wasted on nose-to-the-grindstone studying and solid afternoon after solid afternoon in various very smelly labs while all other normal college students were off getting drunk and sitting under trees with (I'm sure) other attractive college students pondering the merits of whatever they thought needed pondering. I wouldn't know. I was seriously studying. Science-y things. Very seriously. And doing extra lab work for those all important letters of recommendation. I may not be much fun but I'm a single minded little thing when driven. And, boy-howdy, was I driven.

Then came the time to put all this silliness to the test and actually interview: MCAT scores, letters of recommendation and rather good grades in hand. In my combination of financial hardship and either witless optimism or downright arrogance, I only applied to 2 med schools, one of which I shouldn't have wasted my time on as they only took in-state applicants and a few required students from states that didn't have a med school. (I spit on you U-Dub. You could have let us applicants know and saved me the time and the fee. Oh. I get it. You want the free money. Bastardos.) So in reality, only one school applied for: OHSU. Oregon's own and only med school with a nice, relatively modest, public university tuition.

In due course, I was invited to come for an interview. It was pretty standard fare with tour and two sit-downs with two faculty persons. One I don't recall at all, but the second one stuck in my mind as I was certain that she was some sort of cyborg, with the interview questions printed on a virtual screen centered on my person. As she went down the list in a humorless monotone, her eyes went from a space about 2 cm above my head, to my forehead, to my upper lip, to several places down my neck (several short questions), to finally end, with question #20, on my upper abdomen. I soon realized that my breezy manner of speaking and trying to establish rapport was futile and just answered her questions concisely.

I was not surprised to find that she was a pathologist.

All that formaldehyde, in my experience, seems to have one of two effects on the human being: It either causes chemical lobotomies or makes them loopier than a rum-soaked fruitcake. Social skills are apparently a minus in the profession, at least if they are in a teaching institution, or at least if they are in any teaching institution that I've had the honor of working in. (There, that should cover my libel bases.)

In any case, about 2 months later, one cold, gray February, I happened to be at my mom's house getting their mail (I think they were at the beach) and I saw that a thin letter had come for me. 'Twas from OHSU and I just remember things swimming and swirling around the driveway. I'm not one to freak, but I figured the occasion deserved it, so freak I did, in my quiet, 'let's not cause a scene' WASP way, which basically was me standing in the driveway, quietly shaking.

After a bit, I decided that the damn envelope wasn't going to tremble itself open, so I helped it along and read something along the lines of, "We wish to offer you a place in the School of Medicine class of 1991...."

So I shook some more, as clearly there was more freaking out that should be done. I may have teared up. Perhaps even emitted some "Eep! Eep!" sounds. There were certainly large smiles. All I remember clearly thinking was that I was going to get to do what I'd dreamed of doing with all that single minded focus for almost 8 years, and that perhaps it was all going to be worth it.



Tuesday, January 08, 2008

Foul Play

Pictures for you

I had just finished a run when I heard the news, Hitachi.

"Five minutes ago, I heard the crash in the kitchen and I found the bread machine on the floor!" was what Charles, who was first on the scene, found.

There you were, obviously fractured, lacerated, possibly internally hemorrhaging.

Presumed dead.


At first I blamed The Dog. Makes sense. The dog is naughty.

The cat is also often naughty but as you weigh 10 lbs and the cat only weighs 5 lbs, I didn't think that she could accidentally knock you off the counter. I suppose if she used the butcher knife as a lever and jumped upon it as one might a see-saw, she could conceivably do the deed, but it really seemed like far too much effort for the cat. Perhaps if it happened late at night when she's looking for mischief and willing to expend the energy, but it was mid-afternoon, at the peak of her laziness.

Nah. Not the kitty.

Obviously The Dog.

Unfortunately, her alibi was cast iron. She had been curled up next to Charles the whole time.

"I think it wobbled off the edge of the counter by itself," was what Charles postulated.

Preposterous. You were set well back from the edge. You've never wobbled, even with the heaviest and hardest to work doughs. Not in 12 years. Not a wiggle.

That leaves a rather shocking alternative: Suicide.

I had thought I'd shown you over and over how much I appreciated you. I'd place you at the top of my "Indispensable Small Appliances" list each of those 12 years running. That's ahead of the food processor (you know, 'Cuisinart', the funny one that lives in the lower cupboard next to the stove) and each of the toasters (both 'Oven' and 'Slot', who seem to be so very clique-y) the rice cooker, the crock pot, and all the other gadgets. Yes. You even beat out the espresso machine, who does get me going in the morning but can be replaced by French Press in a pinch.

Perhaps I didn't let you know of my deep feelings of trust and dependency, let alone adoration as you brought the smell of a variety of fresh breads into the house. And let's not forget the ooohs and ahhhs from dinner guests as you let me casually pull out a freshly baked loaf of fragrant herbed or sourdough or baguette type bread. Some people are impressed by such things. But I always gave credit where due: "Oh. It's nothing. I have a bread machine, you see. It's so very easy."

But maybe I took you for granted. Or maybe it was my not letting you take things the final step that gave you a feeling if inferiority? I mean I know I'm prone to just use the dough cycle, preferring to do that last kneed myself, shaping the loaf and tossing it in the oven rather than letting you take the job to completion. Part of it was me. I just enjoy that part. But part of it was you. When I have let you, on occasion, bake that loaf yourself, it's turned out a bit (how to say this diplomatically?), er, gummy. Not horribly so. No, no, no. Just a trice. I hate to even bring it up.

Or perhaps, even though I do try to shake things up and try new recipes, I did over do it on the light wheat baguettes and you leaped off the counter out of a mixture of tedium and ennui?

(NOOOOOOOOOO! Not another bloody batch of light wheat baguettes!!!!!!!! Goodbye cruel world!)

But then I re-imaged the crime scene in my head. You. The counter. Sara's art bin. The knife blocks. The Cuisinart. The fruit bowl. The tomato bowl. Wait.

The Cuisinart.

The Cuisinart!?!

The Cuisinart. That was sitting on the counter, a mere foot from you. The Cuisinart with the biting sense of humor, sometimes much more on the cruel side than was absolutely necessary. The Cuisinart with the wicked-sharp blade that has cut me on 'accident' more than twice as I innocently reached in the dish water to clean it.

The Cuisinart, with its jealous streak a mile long, apparently long tired of missing the top spot of the heavily sought after Indispensable Small Appliances List. Think Susan Lucci at the Emmys.

I think we have the true sequence of events.

The Cuisinart, sensing its opportunity to knock off the perennial favorite, left alone in the kitchen while the rest of the household was elsewhere occupied, started after the Hitachi, blade whirling. The food bowl that normally would have provided protection from this weapon, rendering it merely a way to chop, slice or julienne fry, was in the dishwasher. No protection.

It was either be chopped to bits or leap to certain injury and likely death.

You leaped.

My poor baby!

At least you won't have died in vain. Justice will be served. I'll make nothing but weak bouillon in Cuisinart from now on.

But wait! What's this? Your motor still works? The dough is rising? The dinner's bread is not lost and you, while not pretty anymore, are not dead?

Pictures for you

I'll give you a few days bed rest, and repair what I can cosmetically; then we'll try you out with a simple loaf. Perhaps a small loaf of cottage white.

Pictures for you

And then we'll notify the police.

I'm sure the oranges in the fruit bowl will sing like canaries.


Thursday, January 03, 2008

So Far, I'm Liking 2008 Much Better


Do you hear that? That's silence, that is. Golden, diamond-studded solitude. Well, except for the dog. There's always The Dog. Sort of like a shadow whose nails click on the floor. She'd really like for you to either just stay where you are, so she doesn't have to keep getting up from her nap to follow you to the next room, or she'd really like for you to go outside and play in the snow. But you're used to that sort of presence and judgement in your life.

But the's so quiet and peaceful.

Remember back at the end of the summer? School was to start, and for the first time in 9 years, I was to be alone in my own house for more than a couple of minutes at a time? I'd get to watch trash on TV without constant haranguing from the small handed ones. I'd get to nap in silence (yes, yes, except for The Dog). I could eat ice cream and chocolate for lunch and no one would be the wiser except for me and my sucrose-ill self. I could finally pee in solitude, no small girl barging in no matter how I explained that "Mommy really would like some privacy, NOW!"

And all that lasted, I believe for 2 whole days: a Thursday and its following Friday. Then Lilian had her fall and her heart attack and came to be with us, along with all my darling parents in succession, with surgery and recovery and meals on trays and visiting nurses. Everything fell together very fortunately, with minimal work lost, no permanent placement in an assisted care center, no daycare.

But, no solitude that I'd looked forward to with the same gleam in my eye that a prisoner has as he counts the days until release in hatch marks on his cell wall, listening to the living noise of his cell mates day in and day out.

Cell mates that he may actually adore; whose company he may have sought out and actively recruited, but everyone (and by 'everyone' I of course mean 'me') needs, nay craves, solitude.

And today, I have it. 5 whole hours from bus pick-up until bus drop-off.

I feel like a new woman. A new woman with rumpled hair from curling up on the couch, reading. A woman with no make-up (because...why?) a woman who's clothes may be a bit ripe but are comfortable.

I don't have the full 2 days at the end of each week that I'd planned on. Lilian still has her rehab that she needs to be ferried to each Friday afternoon, and tomorrow I've got to take The Dog to the vet, as well (Diarrhea. Dog and Diarrhea.) so that'll blow the Fridays, but if I can just have the Thursdays, I will be satisfied.

Happy New Year to me.


And speaking of years that are new, you'll be glad to know that I've already achieved my one and only resolution:

As I am beyond tired of shirts that are too short. I have declared war on shirts that are too short. I have purged my closet, shelves and drawers of any and all shirts that have a tail less than a full 8" below my belt line. I have freed myself from the drafty, horrifying double whammy of raising my arms in the course of living and exposing my white, dimply bare midriff to the chill and to the offense of the eyes of others.

I will accept words of gratitude from the general public.

I will look for some sort of award for Special Services To Humanity in the mail.

I will NEVER buy an inadequate shirt again.

Should anyone wish to start a fund to hunt down those who've perpetuated such misery in the name of fashion, I will gladly contribute time and resources.

And kindling.

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