Resurrection

Yes, I'm still alive. I was a bad blogger yet again. I left the blog defunct over break but with good reason. It's such a short break and I was enjoying myself as much as possible before being shipped back to the "Rock".

The end to second term was largely uneventful. I did pretty well on finals and was generally pleased with the outcome of the whole term. I even got on campus housing again which is a huge relief for me. Moving out of the large house we were in last term was slightly eventful. Long story short my hand wound up going through the rental car window right before I got on a flight off the island. Not too big of a deal though at the time I was not pleased. Second term was interesting for the fact that at the end of it, you really start to feel like you're learning what you came here for. As you get a good hold on the physiology and neuroscience it feels like you actually have a clear picture of whats going on inside the body. Now that MS1 is over we know in general terms whats going on inside the body during normal conditions. Now MS2 is spent primarily learning what happens when the things go wrong.

I have now entered term 3/4. Term 3 is 6 weeks and consists of behavioral science, biostats, ethics, and medical law. The hard part begins in Term 4 after that. Pathology, communication and physical diagnosis, clinical microbiology are the classes that fill term 4. Now there are alot of things I could say about this. Those who have gone through it before me have mountains of evidence both hard and circumstantial that point to what some may consider a "Stacked Deck". Like everything else I've found here though, you can't rely on the rumors you can only comment on your own experience as you go through it so while I won't be able to update the blog everyday I plan on keeping a daily journal, of at least a page a night, as soon as 4th term begins.

This will also be the longest amount of time spent on the island in one shot. Six months straight, January to June. Last term toward the end due to the isolation of my houses location I noticed myself becoming slightly depressed at times and increasingly paranoid. Being on campus was definitely necessary for a term this long and supposedly stressful. Last term I kept no records of what I was feeling when but 4th term I'd like to keep some kind of consistent record so that when I return home again I can review it and see what exactly the effects of this kind of stress and distance have on me personally as well as what coping mechanisms or lack there of I employ. Maybe it would be the kind of thing to help the next person to come through, maybe it'll be me re-reading alot of whining and complaining, either way it's a non-time consuming and constructive hobby to have on the side to clear my head when things are so busy I can barely stop to catch a breath.

Will I actually be able to keep something like that up? Knowing myself and from the looks of this blog I doubt it. I'll try though.

So this is the beginning again, year two is starting of slow but I'm sure it won't be long before the speed is almost too much to handle.

The Knife and Gun Club

If you don't recognize the title of this post you will understand it by the time I finish. First off, I forgot to blog. Ok, so you can't really blame me, I had alot to do. It's hard to find time for little luxuries like this but it's even harder to remember that it's even on your list of things to do when the list is twenty pages long and single spaced daily.

Right now we're in a post-midterm slow down so I have a few minutes to sit down and collect my thoughts. Speaking of midterms, this time as opposed to last term I'm very pleased with my performance, far more on par of what I expect of myself. It was to say the least, a confidence booster. It also reaffirmed a fact that I desperately needed to prove to myself, that I do in face belong here and in this profession. I have what it takes to make it through and even do well. In MS1 (Med School Year 1) that fact is critical for one's mental health. It's a very unsure time, it's like an odd limbo, another test to see if you have what it takes. Especially here in a foreign med school where the drop out rate is far higher than in the states. The school I'm in takes in X number of students and expects Y number of students to fail or drop out by the time we reach clinicals and the number of clinical spots they reserve yearly reflects this fact, as it does not nearly equal the number of students in the first term class. X-Y= The number of able students who will more or less become MD's. This is a business, income insuring model. A U.S. school has much smaller class sizes and makes sure that 99% of that class makes it through to clinicals and residency. So out here, if you do bad in MS1, chances are you might not make it through MS2.

I can attribute alot to my upswing. I study harder and more efficiently, I have good routines down, I don't waste much time (I do waste time though, everyone has to) and while those are the most major factors that shoved me forward there are two others that were significant in my opinion. A loving, supporting family who is always there and a set of friends that are both supportive but also studious. My friends would actually make me feel guilty for slacking off when they would spout out some random need to know fact that I had never heard. I would now remember a new fact and then study even harder to make sure I was on level with my friends so as to not, and this may seem childish, feel stupid around them. Though they will tell you I'm a few cards short of a deck if you ever asked them, and if you ever asked me I'd tell you they were a bunch of slackers that played way too much ping pong.

Lessons I've learned in med school that will follow me throughout life:

-No man is an island and if he is he most likely is miserable. When it comes to tough times, there's nothing like going through them with a good set of comrades by your side.

-Ants can get into everything, no matter how well you seal something or how much poison you spray.

-BOP, a local insecticide used in the home is in fact illegal in the U.S. and both carcinogenic and mutagenic. I had breathed in alot of it before finding that out.

-Medicine is alot of science when you're in school, alot of technique when you're in clinicals, and an art when in practice.

-Don't leave a bag of clothes in a friends apartment if you think they might do something to them, like put them in the freezer.

-Shaving in public restrooms gets you some odd looks.

-The age old idea that hard work and determination will in the end yield excellent results holds true today, but most people try to bypass it in this new age of immediate gratification.

You were probably expecting me to say a bunch of random medical facts or tests but chances are I'll forget half of what I learn in my classroom years as most doctors do.

Another first happened this term, the girlfriend came to visit. She finally got to meet my friends, see how I live, and see where I spend most of my time (Taylor Study Hall). It was a blast having her here after midterms for a few days. A mini-tropical vacation with my girlfriend that ended way too soon.

As a follow up to my previous post after living in a replacement villa for a few days me and my roommates were moved back into our original place. All the fire damage had been fixed and so far it's been an awesome place to live minus the distance. I got back on campus for housing next term seeing as it's the most intense term of the two years here and the easiest most convenient place to live really is on campus.

"The Knife and Gun Club" is a photo essay written by Eugene Richards. It chronicles Denver General Hospital's ER and Paramedic services for several months in the 80's during a time of extremely high violent crime. My father owned it and it was definitely one of the first glimpses I ever had into the world of ER's and medicine. It's what originally interested me in the idea of becoming a doctor and later working in an actual ER for several years during undergrad. When this term is over in a month and a half MS1 will be over and I will be one step closer to hopefully returning to "The Knife and Gun Club" and being a physician in it.

Where There's Smoke

The vignettes are coming, don't worry, but my first week back in Grenada must be discussed first because it has been by far one of the worst weeks I've had in a long time. Despite a 6 AM wake up (An hour earlier than I would if I was on campus) the new place off campus was amazing. A 5 bedroom villa with a pool and all. It had everything we could need and was only slightly more than living on campus.

The amazing place only lasted so long. On my third day there I woke up at noon to the sound of pounding on the door and people yelling. As I reached the door after getting an electric shock from my computer I noticed something was off, an odd smell. When I opened the door to my bedroom the room quickly filled with black smoke, the living room was in fact on fire. I hit the floor and crawled out the back door in my bedroom to the backyard. Apparently the islands power grid was having issues, in that 24 hours several fires broke out including on campus due to powerful surges. The cable box in my living room blew and set the TV on fire, creating a high intensity electrical fire.

With the help of some great friends here, namely Youssef, John, and Mike, and my landlord who set me up in another property of his I had a place to live within an hour. This place though has shotty internet, two broken AC's, and just simply isn't my place. Me and my roommates can't actually settle in anywhere and feel like we're home until we're back in the other place when the repairs are over in a few weeks.

This on top of a few other minor problems just keep compounding things and stressing me out quite a bit, none the less, the show must go on. I'm still going to class, putting in the hours on campus, studying, and gearing up to dive into this term.

Summer

This is my summer post, since I leave this evening heading back to the rock. I know I'm a bit late but between studying, seeing friends, seeing the girl, shadowing, and so on my schedule was a bit hectic and blogging hit the bottom of the pile.

Returning home was a shock to the system the first week. After months of intense discipline is studying and the constant fear of not doing enough, coming home and not having those things dangling over my head like a two ton weight held up by a thin thread felt odd. I quickly got into the swing of things though and learned how to relax and be plenty lazy again though and it was a welcome relief.

Real television, fast internet, the city, my car, friends, family, and good food were the things that I missed most and having them at fingertips again was revitalizing. Upon closer examination of the differences between living there and here I came to a surprising conclusion. My biggest problem being there and what causes me the most anxiety is the fact that over years of living in NYC, between family and friends, I have built a network. Not just emotional support but so called "tactical support". The importance of having anything I need at a moments notice, from speedy entrance through an Emergency Department at a local hospital for a friend to last minute reservations at a nice restaurant, through my connections from family and friends I can have any of those things with several phone calls. Here I'm a "somebody". A very small somebody however when you get down to it I could accomplish a lot in a pinch. I've spent several years building up a small network of people I trust and without them in a strange land with few friends I'm on my own. The only weight I can throw around is my own, anything I need I have to take for myself and that's not something I'm used to. It's not worth it to spend time gaining new "contacts" so to speak because in a year and a half they're useless. Here even in a room filled with my enemies (politically or otherwise) my name and the things I know protect me, sometimes thats enough to keep you out of someone's crosshair's. My reputation keeps people on their toes. When I'm in Grenada I'm out in the cold. The only thing you can do there is keep your head down, stay off the radar, and accomplish your goals. Staying off the radar and not trying to right wrongs I see is admittedly something I wasn't very good at. I stick my nose in places it doesn't belong, I open my mouth, I fight until what I see broken gets fixed. I did it in High School, I did it in College, and now I can't do it. So learning that trick is keeping me busy on top of my studies.

Seeing my friends was great, they're growing quickly into themselves. I like what they're becoming for the most part and still consider myself lucky to have them despite some differences in opinions. Learning what I missed, seeing the new dynamics in the social circles I knew, and examining life progressing without me around was weird but educational, I guess.

Cecilla got a job which is great, she's miserable and ecstatic at the same time. She got a job in the closed and difficult field she studied for, and now the real world suddenly isn't as nice as she thought it would be. She's keeping up though and making proud, she's becoming a little fighter where she works, not letting people step over her to get what they want, I think I may have rubbed off on her a little. I know I'm quite a bit more reserved than I used to be which I think is partially thanks to her.

The family is good, my sister is taking the LSAT's in October which is great. I think she's going to do great. My father is doing the same thing in school that he did as a detective and an ER nurse, kicking ass and taking names. I expected nothing less. My mother is doing well and actually starting her own little business venture. If anyone needs Avon products let me know, I'll give you her number. For the most part, some small hiccups excluded, I think the pieces are really beginning to fall into place for my family. I'm of course weary, because we all know what they say about the best laid plans of mice and men.

Speaking of plans, packing and planning return trips is a nerve wracking thing. There's a saying in the military "Even the best battle plans rarely survive contact with the enemy." So I pack like the world might end while there, prepare for the worst, and hope for the best.

I'll post a few more times in the coming week with vignettes from experiences I had this summer.

So dear readers to quote Shakespeare instead of a punk band this time
"Once more unto the breach, dear friends, once more."

Last Call

Yes, another long gap. Get used to them. I disappeared once more to prepare for finals, hardcore. Which actually worked out since I aced the two hardest ones (Biochem, Anatomy) and got a solid B in the softer subject (Histo). Those finals were my saving grace and put me into a good place. They said (As opposed to Midterms) "I know what I'm doing, I've found my sweet spot, I can do this. I can do this well." It was truly an amazing feeling. Accomplishment, vindication, self awareness, these are just a few terms I can think of to describe what was quite honestly indescribable for me. If you know me well you know it's rare for me to be at a loss for words, but I was.

The past few days have been spent pack, saying goodbye's, and dining out with drinks and billiards for dessert. I've met some incredible people here and my world view has definitely been shaken a bit by some of the friends I've made. All for the better I assure you. One of the reasons you come to love and hate this place is that you meet these people and make very strong bonds because together, with one another's help, you get through the enormous and taxing undertaking that is medical school. Friendships forged through hardship, hardened by a collective goal, are strong and fast forming. This is why you start to love it. You begin to hate it however with the knowledge that in less than 2 years, we go our separate ways once more. You begin to wonder if when this is all over, despite the promises and plans made, will you ever see these people again?

On another note, I can finally relent to that nagging force, the sideways gravity pulling me north. The one pulling me back to New York, the one I've felt and resisted every day I woke up and walked out the door. I can see my family, girlfriend, friends, and the Manhattan skyline once more. Everything from the Subway to the cornerstore deli will have a brand new shine to me and I eagerly await to see them again.

Is this place as bad as the rumors say it is?

Yes.

What the rumors fail to tell you though is that all medical schools are like this. All medical schools are scary. All medical schools tax you physically, emotionally, and intellectually unlike anything you've probably experienced. The difference is state side students don't have much to complain about, it is what it is. When you're an island school, everyone and everything is under a microscope. I'd tell you most medical schools probably have the same issues we do with the exception of residency placement concerns and travel plans. Sure the school has it's flaws, but they all do. This school doesn't hold you by the hand, you either have to put up or shut up and get out. Thats another one of the big differences, but I think it gives us more of an edge. We've had the fear of God put into us by the prospect of having to leave due to academic reasons, it makes us work harder then the other guys.

So yes, the rumors were true, but they failed to mention that the very people spreading them had the same problems themselves.

Soon enough I'm getting on my plane home, and despite my relief upon boarding, I know in the back of my mind this place will be waiting. This was only round one of the fight, round two starts in August.

I can't wait to get back into the fight.

Ten minutes to downtown
Is ten minutes too far.
When my friends all say I’m crazy,
Maybe I’m being selfish.
(Maybe I’m being selfish.)
Maybe I’m just scared.
(Maybe I’m just scared. )

Don’t be gone when I get home…
I need you there.

If I had to explain it
I wouldn’t know where to start.
It’s like you’re falling in love while I just fall apart.

Ten minutes to downtown
Is ten minutes too far
When my heart is saying you’re crazy.
Maybe things are getting better…
(Maybe things are getting better…)
Maybe things aren’t so bad.
(Maybe things aren’t so bad. )

Don’t be gone when I get home…
You’re all I have.

If I had to explain it,
I wouldn’t know where to start.
It’s like you’re falling in love while I just fall apart.

Pockets empty.
How can you tell me that everything will work out…
A pointless fight
When you’re always right.
Everything will work out.
It works out.

Sometimes, I miss you more
Whenever I’m at home.
I’ve been home all summer…
Now I’m leaving you alone.

Pockets empty.
How can you tell me that everything will work out…
A pointless fight
When you’re always right.
Everything will work out.
Everything will work out.
Everything will work out.
- The Get Up Kids "Ten Minutes"

From a Whisper to a Scream

A little over two weeks since my last post. Time is short these days unfortunately. That's not to say I haven't wasted time, because I have, but it was spent more reading non-school related things and watching TV on the few occasions I slacked off. So one might wonder, where are we in the time line of events leading us home? We're nearing the end is where we are, but not quite there yet.

As the title of the post indicates, the work after midterms seemed to start off as a sweet whisper that quickly and without warning turned into an ear shattering scream. From the contents of the PT fossa to the finer points of nitrogen metabolism not a day goes by that I can say "I'm totally caught up." I may have given all the material to date a read, and fully understood the concepts, however the amount of memorization is simply far too much for me to accomplish the night we receive it, and in some cases, even by the end of the week.

This however doesn't worry me so much, it's coming along a piece at a time and my pace was great minus the enormous wall I hit last week and broke through by the end of the weekend. Last week I would definitely say I had this strange wave of melancholy and general malaise that gripped me hard and wouldn't let go. I got past it though by the weekend simply by staring at the material I had fallen behind on that week, it was a jaw dropping amount.

The days are passing quickly now, weeks melding into one another, and off blur of a day in/day out routine continuing with little variation. The goal is in sight. Not finals, finals are not a goal but merely an event in my way.

Getting on that plane home is a goal.

The strange mix of carbon emissions, sewers, subways, and city air will fill my lungs once more in less than a month and I couldn't be more eager to take that first breath outside JFK. I miss NYC like a land locked sailor longs for the sea. I didn't think it would be like this but everyday I walk out my door I can feel something, like sideways gravity, pulling me to a body on the east coast like the sun pulls the planets or the earth pulls us. For now I ignore it, but soon enough I'll give in and that is the day I eagerly await.

Until then? Work, work, work, and oh yes. Did I mention? Some more work. Cramming random coenzymes, inhibitory chemicals, deficits and build ups, arteries, communicating branches, bones and nerves. What they look like, feel like, smell like, where they lie and whats near them. I could say I hate it, but I'd be lying. As much as I have a distaste for biochemistry especially and for how little these facts will matter when I hit the clinical years, every piece of knowledge I gain makes me feel stronger. The more I master, the more I feel empowered. Every little piece will somehow add to the arsenal I'm slowly acquiring.

The eventual enemy?

Human suffering, disease, and death.

That's the other goal, the far off one, the other one I await to reach anxiously.

The day I get to beat death for the first time, from what I've heard it's one hell of an addictive rush.

Would this be a Punk Doctor's blog without a song? Absolutely not.

You, you try, you try to get by.
"You're never going to pull it off",
"You shouldn't even try"
"You're a wet cigarette",
"You're always second best",
But they're never going to give a shit about anybody but themselves.
So you fight for them to realize;
There's more to life,
There's more to you,
There's more than meets the eye.
And when you're done, the battle's been won.
You sit back, you smile and this is what you hum,
You hum: whoa, oh, oh, oh, whoa, oh, oh, whoa, oh, oh.
Whoa, oh, oh, oh, whoa, oh, oh, whoa, oh, oh 12341234....

You, you try, you try to get by.
"You're never going to pull it off",
"You shouldn't even try"
"You're a wet cigarette",
"You're always second best",
But they're never going to give a shit about anybody but themselves.
You fight for them to realize;
There's more to life,
There's more to you,
There's more than meets the eye.
And when you're done, the battle's been won.
You sit back, you smile and this is what you hum,
You hum: whoa, oh, oh, oh, whoa, oh, oh, whoa, oh, oh.
Whoa, oh, oh, oh, whoa, oh, oh, whoa, oh, oh 12341234....

The years go by, the time it does fly.
Every single second is a moment in time
That passes oh, so quick and it seems like nothing,
But when you're looking back, well it amounts to everything.
I've got myself. I've got my friends.
I've got my little family, but that's not where it ends.
This one goes out to you, it goes out to everyone.
It's in the name of honesty because life has just begun.
Whoa, oh, oh, oh, whoa, oh, oh, whoa, oh, oh.
Whoa, oh, oh, oh, whoa, oh, oh, whoa, oh, oh 12341234....

Look around little brother, can you tell me what you see?
You're a big boy now, so take responsibility.
You never had it hard, but now it's getting tough,
So you whine, whine, whine and you say you've had enough.
You say I'm full of shit, that I'm a hypocrite
I shouldn't talk, when I can't take the advice that I give?
Well maybe you're right, but open your eyes:
The main difference here is that I try, try, try.
-Catch 22 1234, 1234

Time Capsule Student

The Easter weekend has been filled with excitement for me. Ok, thats a lie. It's mostly been spent working or procrastinating. None the less I figured it was a good time for a post. Things are kicking up to the next gear here as we head into head and neck in anatomy and keep trucking along full speed in biochem and histo. So far I've been keeping up fairly well or so I think I am, time will tell. This post's topic is something I had to think about for a little since it was such an odd concept to me at first.

All of us here are in a time capsule.

You're all scratching your heads and wondering what in God's name I'm saying. Yes, I may be slightly psychotic, but I'm not incoherent yet. Allow me to explain.

So all of us here basically have fully detached from our lives at home. At home life is moving on without us at the same speed it ever did. All of our friends and loved ones are moving forward in their lives for better or for worse. Progress is being made in their lives, children are growing up, jobs are being gained and lost, etc. Our friends whom during hard times relied on us and in good times celebrated them with us are still doing these things, only without us. Yet we here are stagnant. We progress through classes of course, through our path to the MD, absolutely. Emotionally, mentally, intellectually we're growing at an exponential rate however our lives are remaining in one spot with no progress. That's for me anyway, and I can only speak for myself and generalize. As far as I'm concerned my life is at home, it will move forward at home, and be lived at home. Being here is like hitting a pause button, only when I walk away the song keeps playing. When I get home, who knows what the song will be like or in other words the way my life fit into the grand scheme of things at home may have changed dramatically without actually having been there to see the progression to that point. I'll have alot of catching up and adjusting to do.

Is this a bad thing?
I have no idea. It'll be interesting at the very least.

What I do hope for though is that when I return the helping hands I always relied on outside of my family will still be there, and that they'll understand that when I'm at home my helping hand is always there.

There's a girl at home (Isn't there always a girl in every great story? I like to think so.) and she's waiting for me. She's not doing great at the moment with the way the job market is so today's post will be wrapped up with lyrics from a song that will surely make her smile. She used to live in Bedford-Stuyvesant in Brooklyn and I'd often go through that area alone to see her, which at some point would lead to me singing her this song in my terrible and off key voice along with the car stereo as I shot down the BQE (And I can already feel my father's blood pressure rising from 1000 miles away as he reads the part about me travelling there at night alone.)

Friday night I crashed your party
Saturday I said I'm sorry
Sunday came and trashed it out again
I was only having fun
Wasn't hurting anyone
And we all enjoyed the weekend for a change

I've been stranded in the combat zone
I walked through Bedford Stuy alone
Even rode my motorcycle in the rain
And you told me not to drive
But I made it home alive
So you said that only proves that I'm insane

You may be right
I may be crazy
But it just might be a lunatic you're looking for
Turn out the light
Don't try to save me
You may be wrong for all I know
But you may be right

Remember how I found you there
Alone in your electric chair
I told you dirty jokes until you smiled
You were lonely for a man
I said take me as I am
'Cause you might enjoy some madness for a while

Now think of all the years you tried to
Find someone to satisfy you
I might be as crazy as you say
If I'm crazy then it's true
That it's all because of you
And you wouldn't want me any other way

You may be right
I may be crazy
But it just may be a lunatic you're looking for
It's too late to fight
It's too late to change me
You may be wrong for all I know
But you may be right

You may be right
I may be crazy
But it just may be a lunatic you're looking for
Turn out the light
Don't try to save me
You may be wrong for all I know
You may be right
You may be wrong but you may be right
- Billy Joel "You May Be Right"