as if you didn’t know… i’m hibernating. between boards studying and wedding planning…
as if you didn’t know… i’m hibernating. between boards studying and wedding planning…
It’s hard to say who should be homeless. No one should be homeless. Yes. But we cannot save everyone. No. So we triage. We triage the homeless into three typical types:
1 - the mentally ill. these are by far the most common… and unchanging
2 - the addicted - this could be a mental illness, but it can also be on it’s own…
3 - the ones in crisis
Now, this is going to be a short blog, because, well, because it’s likely to make me cry, and I’m trying to be a tough cookie. But we run a women’s clinic. And the most difficult patients for me are #3. Because they’re the most scared of being homeless. #1 and #2 have their defenses - they’ve probably been on the street for a while, they have their addictions or mental handicaps… #3’s just don’t know what to expect and as their crisis goes on longer, they get more and more scared - especially when they’re 40 or 50 years old and are homeless for the first time. We had two women come in for birth control. Not my type of birth control. Not the type for the person who is dating someone and doesn’t want to get pregnant. No. The type of birth control for the woman who knows she’s going to get raped and knows she wont be able to stop it. The type of birthcontrol that is followed by “I just never know,” and “it happens so quick.” And they say it nonchalantly, because it’s not an if, it’s a when, and it’s normal. It’s almost a non-trauma. And then comes in a woman who’s homeless for the first time, and she is traumatized. She’s shaking. She can’t even speak straight. And i think, “you shouldn’t be homeless.” i think, “it’s not fair to you.”
Somehow, I’ve entered the mindset where there are the inevitably homeless, or at least where it’s more fair for some than it is for others. And I wonder if that’s just a mechanism to protect myself. But then I find, again and again, moments where “you shouldn’t be homeless” cross my mind. And I shake my head, and I wonder who put me in this shit. Who made this shit exist so that I had to give birth control to a shaking woman because she was afraid of the men on the street? And I want to ask, why are you doing this to me? Is it so easy to sit on political high horses and not see this? I want to drag every politician into that clinic and make them give a woman birth control for inevitable rape. That’s what I want them to see.
I finished a novel today, Samuel Shem’s “House of God”. I can’t say it’s good, I can’t say it’s bad, but I can say it spun my mind, which means, it must be good. Other ideas spun in my mind, I thought they were disparate ideas, unlinked, but then they fused in an uncanny way. I get it. I get the title - House of God. It’s a novel about learning medicine, about learning how to mediate our medical “God” roles.
I’ve dilemma of pressuring a homeless woman w/ substance abuse to get an abortion (shed had two other children removed by child protection services). I thought of how wrong that notion felt to me. I thought about treating the children of drug abusive women, and what generally happened to them. And that notion felt wrong to me too. And I felt that suddenly, all medicine stemmed from God, basic teachings of who/what/how god is.
Ob/Gyn: mediators of the CREATION of life
Anesthesiologists: suspension of life
Surgeons: reCREATORS of the living organism
Internists (of all types): determinators of death, coaches of path to death (or path of life)
Pathologists: determiners of why we die (why we live?)
It really makes me wonder about christian scientology. And wonder if I’ve chosen a sacrilegious field. It makes me wonder if I need to become much closer to God (however, whoever, whatever) to do this. It makes me very scared of decisions that are made. It makes me feel unworthy - not in an intellect way, not in a character way, but in an unholy way, or maybe an un-whole-y way.
A professor told us a story of brain death, of trying to show/teach/convince a family that their grandmother was in fact dead and life-support should be stopped. He said the son finally turned and said, “do what you think is best.” The professor said that should be our goal. Not to get them to say “pull life support”, but to release the decision into your/our hands as doctors. In this way, we take the responsibility, not them. He said, “you should not want your patients to live with the fear that they pulled life support from loved ones.” But because we know, because we understand, we take on that responsibility. We show them, teach them, coach them, give all options, for the purpose that they will either 1) see what we see, the way we see it, or 2) put their choices in our hands.
So, wow. I have my work cut out for me (do I choose PANS or SANS? freeze or run?). To work on myself to become more holy or whole-y, and then to decipher which part of God I can best represent?
I am a bulldog. I very quickly forgive transgressions against me, I often forget them completely (w/ med school, my memory space is precious). Ask Jen or Nelly, if angered, I merely need to put on orange pants, or go for a walk and am done. But, sadly, I do not, nor have I ever, been talented at forgiving transgressions against my circle of women. I do not, I repeat, I do not, put up with under-par men.
“You hang out with some of the stupidest women” - Bri said, remarking on some of my acquaintances. (She is a woman snob)
“I may put up with some weaker women, but I’m not the one who puts up with ass-hole men,” - I said, with a look, that made her tail go under her bottom. I am a man snob. I love my male friends fiercely, and they are some of the most integrity-filled, kind, purposeful men you’ll meet. (Rachel on the other hand is a person snob - she puts up with no one, neither male or female who she doesn’t morally approve of)
Maybe this is my truest feminist feature. I forgive women because I feel they have been slighted by society. I empower them because I think that if they stand for their own respect of themselves, that men will follow. I believe that if they stand, in unity, then society can do nothing against them. I do not forgive men, for many reasons. One being that they will always find someone else to be forgiven by - often another woman, with a higher threshold than I have.
This is perhaps one of the features that my closest friends love and hate about me. They love it about me when they want it. They love that I stand up for them, that I defend them so fiercely. But then, when they forgive, or when they understand, I don’t. And sometimes, when going too far, I take it upon myself to show them, in as many ways as possible, how horrible the man is. How he will continue to hurt her. Every so often, I do defend a man, when my friend has gone too far, or carried things on too long - I defend them. But that doesn’t connote approval of the relationship. I can be fully supportive of them apart, if completely against them together. I am a firmer believer in truth than in friendship. If my friendships can’t be honest, then they often can’t be at all.
So, men who date my friends, I apologize beforehand, and warn, beforehand, that I am fiercely loyal, and fiercely protective.
adulthood=childhood mediated with consequences.
I wonder what life without consequences would be. What we would be if we could just be. I presume it would include more rolling down hills and getting our shoes dirty and leaving the house with our hair wet. I presume it would be looking around to understand instead of looking around to compare. I presume it would involve a lot less grammar, and more dancing.
And I wonder how i will sell my children on adulthood. I remember believing that adults knew what they were doing and were confident in themselves, because when you’re an adult, you know what’s right, and what’s wrong, and that’s that. And I realize, that being an adult comes with all the insecurities we’ve gathered up. We’ve learned coping, and mediating of them, but they are still there… And we make more decisions, but often not knowing if they’re truly right, truly wrong, and we just begin to touch the expanse of the grey between. Sometimes I want to run back to childhood, when confidence was blind confidence, when success was the epitome of being. Instead now confidence has a trepidation behind it weighed by the gravity of decisions, and success has baggage with it to prove.
And today, after a year of medical school (yes, 1/4 doctor now), I (with other students and doctors) opened a women’s homeless clinic. I sat, with women, for women, treating women, partaking in the consequences of their lives. Absolving bits of doubt, and fear. They did not have bras (we need to buy bras), they preferred pads (we need to buy pads), they said thank you for their space (we gave them space), they said thank you for the baked goods (life sometimes needs baked goods), and they remembered me. And they liked my SCCAP shirt.
I wore my SCCAP shirt on purpose (Santa Clara Community Action Program). Not sure of what purpose. It just felt right. It felt right not to change. It felt right to be, or to make myself feel, like I was the same person I always was - birkenstocks and a SCCAP shirt doing volunteer work. I guess it was a testament to not changing. It was a testament to dedication. That I dedicate my life to this. That I dedicate my life to caring for the (health) consequences of others’ lives. That in so doing, I mingle my view of the world with theirs. That I mingle my dreams and wishes with theirs. And that I bring into each new (patient) relationship, the history of what has brought me here - be it SCCAP or anything else.
I am longing for community. I am longing for the community SCCAP gave me, the community I found in public health. I am longing to ask these questions over breakfast, lunch, and dinner, without words, but with presence. I am longing for others’ consequences, dreams, and struggles to be bound with mine in similar purpose. And I am finding many old friends along the way (Ja and Jele), and am making an effort to be more intentional. I need to meditate. I need to stay tuned on my center.
I’m not sure if i spelled that right… but if I didn’t, that would seem right in a way. There are moments where I feel like I’ve fallen back into adolescence. Where I don’t like my body again, am oversensitive to what people say, or how they look at me, or… And I wonder if that ever goes away. I wonder if I’ll ever learn to watch my tongue or at least realize it’s flapping. I wonder when I’ll be enough. I sit here, 26-years-old, masters in hand, medical school going well, engaged to be married, feeling like an insecure 16-year-old. No wonder I can still relate to my sister, she’s 15. But I don’t want her to be scared that it doesn’t get better… it does… but there’s lapses… ah, I need to go to bed. that’ll help me grow up…
This Thanksgiving I had a few more thanks to doll out than normal. I’d been ousted from my apartment, so many of my lovely classmates pitched in to give my stuff a home, give me a place to rest my head, and give me an ear to complain off. The other thanks goes to old friends, who are generally sane, always incredible company, and every time I stop to really contemplate my friendships, I am wowed. I have awesome friends! And we do the craziest, funnest things. And my family, for being, well, odd replicates of me. I do enjoy conversations like this:
“can you write the letter?” - mom
“yes” - me
“to sound like me?” - mom
“i am you, only with better judgement” - me
“and more of a brat” - mom
and then we laugh
Those, those are good times. Or when Angelique says “how’d you know what I was thinking”, and I say “we’re 50% the same, at least, and I think that way too” and she goes, “damn, so you can really read my mind.” and it works the other way. They know me, and we all pick on each other for fun. Or when my dad, for the 100th time tries to convince us that Pets Mart is really Pet Smart and that only smart pets can go there, and me and my sister tackle him (figuratively and literally), and he laughs.
My mom spent some time with a 2-year-old this weekend. This makes her think she’d like me to have kids. Only they’re “may’s kids” and not “her grandkids” she doesn’t want to be old enough to be a grandma. I can understand. She still looks 40. People will think she’s just a really old mom. My dad for some reason will fit better in a grandpa role - I mean, I think he’s always been grandfatherly for some reason. Angelique and I couldn’t figure out why, but he is really grandfatherly. My mom is going to be a renegade grandma. That should be fun. Not that I’m pregnant, or even going to have kids. We were just laughing and talking about the idea of it.
On another note, I’m uber excited about my new apartment. Niko is going to buy a Christmas tree. And we’re going to get corny family pictures with Santa Claus. We are also going to try to have a costume closet for when we’re feeling crazy - which often happens to medical students.
Last note, I finished my paper for Claude Bruderlein. I feel pretty good about it (especially the first half), and I really think it can lead to something… we’ll see. K, i’m off to do homework, as usual.
The fear of aging for everyone i suspect. there gets to be a point where doing great things for a specific age isn’t great anymore. a point where irresponsibility is no longer acceptable. i guess disillusionment is is a recurring part of life… well… let me start again… i’m coming down. off the harvard bubble maybe? off the impressive bubble? i mean, i may still be impressive… but i don’t impress myself anymore (ha, that sounds funny). But i don’t. because i’ve lost some grip on reality, well, if i ever had it. or maybe my focus on reality, that’s what i lost. or maybe never had. but that’s what i need, a grip on reality, a center on it. because if it’s not about me, but it’s about the reality that is around me, then, well, at least i wont be the only one on a cloud if there is one.
So, now I’m in medical school, as you know by now. And today is my third day with my ‘mom’ - my obstetrics patient who I’ve been following through her pregnancy. It’s her third day in labor and I’ve learned a lot of things about “down there” which I will not go into here, but I’ve learned quite a bit about the whole hospital delivery process. Such as:
1. try not to have diabetes
2. they don’t let you eat once you start active labor
3. epidurals LOOK painful, even though my ‘mom’ is soundly sleeping on hers right now
4. female urethras are bigger than you thought they were, and getting catheters looks awful (thank god she was on her epidural already)
5. nurses and doctors work on shifts, so communication is KEY
6. family does not work on shifts, so they do get tired/frustrated/involved - you’re not just treating the woman but the whole family…
7. nurses rock
8. sometimes epidurals take more than one try (ouch!)
9. giving birth seems a lot nicer when it’s on the 15th floor and you have a uber nice view of san francisco
10. the tone with which you talk to patients really matters
11. residents/students get WORKED. maybe buy some makeup to cover up the bags under the eyes
12. oxytocin is still my favorite hormone.
I really like my ‘mom’ and her family. It’s an interesting experience getting to know people through this - there’s an immediate intimacy… k, i’m tired, and I haven’t had any time to study, so now that she’s asleep…
I had two very San Francisco moments, both lovely:
1. While riding my bike back from school, i missed a turn in the park, wobbled/wavered for a bit, and kinda suddenly stopped my bike. This homeless man with his dog came up and asked, “are you okay? do you need anything?” and i replied, “I’m fine, but thank you!” So yes, you know you’re in SF when the homeless guys care about how you’re doing.
2. Taking my trash out, the trash-collector guy (seeing how I was moving and had all the empty box stuff) took 5 minutes to explain to me what could and could not be recycled. Only in SF do the garbage workers actively educate the local citizenry :).
I love it so far. Med school is no joke, but it’s captivating. Just hiked with the Ja, the new roommate, Guzel, and saw Jay for lunch :). So far SF is shock full of good times!