On Doing Things That Scare Us

I feel like there's no point in life during which people like to tell you how to live, more than during your twenties. It seems like every time I open up Facebook, someone else has posted yet another Buzzfeed or Jezebel "list" of things one must do in one's twenties: places to travel, cities in which to live, things to do, books to read, movies to watch, things about which to be nostalgic. I suppose the digital era magnifies society's desire to tell us twenty-somethings what to do, but it still seems as if this urge to guide the lives of young adults has always been there.

"Do something every day that scares you" is an urging that makes an appearance in all of these "lists" in various forms. Either it's written verbatim as one of the items, it's reworded in some clever, themed way, or it underscores the entire list itself ("7 war-torn regions worth visiting in your twenties." I'm kidding. Or am I?). 

Now, most of the items on such lists kind of confound and mildly annoy me. I think it's up to me to decide how I'm going to live my twenties, and more often than not, reading about how others wish they had lived theirs doesn't really change my behavior or ideas. As John Mayer sings, "Is there anyone who really recalls ever breaking rank at all for something someone yelled real loud one time?" And to be perfectly honest, I think people who tout traveling at a young age sometimes just sound really entitled--not everyone has that kind of money to spend, or the freedom (literally or figuratively) to just drop their lives and go gallivanting across the world.

However, I've always liked the idea of doing something every day that scares you. It's a simple concept, it doesn't have to cost anything, and it leaves a lot of room for interpretation. Different things scare different people. Hell, I'm scared of birds and fish, and doing something that scares me could be as silly as staring at a fish tank for a while. [I've done it. It's unpleasant.]

But the truth is, I'm a pretty fearful person. I am terrified of rollercoasters. I am so entrenched in my fear and aversion that when I went to Universal Studios earlier this year, I literally brought a book to read while my friends went on their joyrides. When I was in dance performances in college and the choreographers wanted us to do flips, I point-blank refused to participate in such shenanigans, cause I just didn't like being upside-down, suspended in the air and at the mercy of both gravity and some random guy who was just as frightened of dropping me as I was. I have tried a rollercoaster once or twice. I even tried a flip a couple times. After the rollercoaster, I promptly decided that the fear and knee-knocking and trembling and anticipation weren't worth the 10-second euphoric high afterward. When I tried flips, I ended up dropped on my head. On more than one occasion. So, that was a no as well. 

And so trying to do things that scare me, things that REALLY scare me, often hasn't yielded the best results. Or at least, not the sort of results those lists would have me believe I'd get. Doing something that scares you should lead you to unexpected places, both literally and figuratively. It should expose you to unexpected vistas, set up that perfect photograph for your Facebook cover photo. So far, doing something that REALLY scares me has only shown me that I had good reason to be afraid, and I'll continue to live in fearfulness, thank you very much. 

Still, I guess fear is unavoidable. After all, the unknown is at the heart of life. No one knows what will happen tomorrow, or a year from now. No one knows how we'll look or who we'll be or where we'll work when we're in our thirties, giving advice to those twenty-something whippersnappers. And let's be real: that's scary, whether we feel like it is, or not. Because not all of it is in our control. And perhaps that's the real reason we are afraid. There's no way to mend that. There's no way to control it all. So we keep living. And we keep scaring ourselves. And we keep learning which fears are worth holding onto, and which we can let go. That's what I'm trying to do, anyway.

Wifehood, Motherhood, Doctorhood, Womanhood

Tonight I met two bright, female high school teachers who love science. They were closer to my mother's age than to mine. Both told me that when they were in college, they wanted to be doctors. But both of them decided to forego that career path and chose teaching instead. Both said they made that decision because, as one of them put it, "I realized I couldn't be the wife and mother and doctor I wanted to be" all at the same time. They don't regret their decision one bit, both of them said. They don't make a lot of money, but they're happy and love what they do. Now, normally my English major mentality would leap forth at a moment like that and scream "Methinks she doth protest too much!" But I really don't think those women meant anything negative by what they said. I really do think they're happy, and they love what they do, and they don't regret their decisions at all. 

I reassured the AP biology teacher that as a medical geneticist, I won't be making a fortune either, not compared to people in business and certainly not compared to physicians in many other subspecialties of medicine. And then I stopped to think.

For most of my early childhood, my mother was a stay-at-home mom. Though she started working outside the home after my sister and I got a bit older, and continues to work outside the home, she and my father demonstrate very traditional gender roles. My mom does all the cooking. My dad cleans up after dinner. He pays the bills and drives the family around and is the family's primary breadwinner. She tries to teach my sister and me to cook, say Hindu prayers, and generally gain other skills that will make us suitable wives someday. It surprises me a little that I didn't give motherhood even a moment's thought when I decided to become a physician. Believe me when I say I wasn't one of those kids who dreamed of being a doctor all her life. I resisted the idea of going to medical school for quite some time, but by the time I was in college, I knew it was a field in which I would excel, and a career that would give me deep satisfaction. And that's where my thought process more or less stopped. Sure, I wondered if I'd ever have time for anything outside of medicine, but my focus was more on a vague sense of a personal life, and not caring for a family the way my mother always did. 

I suspect that more than a little of the hesitation of the women I mentioned earlier, and my lack thereof, has to do with the fact that those women likely had boyfriends or husbands with whom they were planning a future while they were considering medical school, and I simply didn't have that pull then, and don't really have it now. Because I don't have one person to mentally Photoshop into my imagined scenes of domestic bliss, I'm not very attached to that vision of the future. Here's what I know: I'm going to make a good physician, and my career will make me happy. Maybe someday I'll find myself in a domestic situation that causes me to change my tune and become a stay-at-home mother and wife. Maybe I just won't like the idea of someone other than me being at home with my children. Maybe none of those things will happen. Whatever the situation, I'm glad I decided to go to medical school, gender roles be damned. I think I can find a way to make doctorhood live in harmony with motherhood, wifehood, and womanhood, or whatever -hood life throws at me.

The n00b Files - Week 3 of Pediatrics

I'm on my third week of Pediatrics, which means I've completed 2 weeks of Pediatric ER, and am on my first week of outpatient pediatrics. I've also fully completed 8 weeks of Psychiatry, during which time I neglected to write down any n00b lessons. But never fear! More lessons await, below:

1. Turns out it's not that hard to look into a lot of infants' and children's ears as I had previously feared. More kids than you'd expect are pretty calm about the whole thing, which makes life a lot easier.
2. On a related note, you know how you're taught to pull a patient's ear back and up in order to straighten out the canal and take a good look at the eardrum? Yeah, with infants and young children, it's a LOT easier to see the eardrum when you pull straight back. Now that was a revelation.
3. The great thing about psychiatry is that you get to spend a LOT of time with patients, just talking to them. I like talking to patients, so I liked that aspect of it. 
4. After seeing a patient who suffered from debilitating generalized anxiety disorder, I'm starting to believe that having severe anxiety may well be much, much worse than having severe depression. I actually felt like crying while talking to said patient, whereas I don't think I ever got emotional while talking to depressed patients.
5. Um, apparently you're not supposed to feed your baby any plain water until he or she is at least 6 months old. Babies are not good at regulating their water balance until then, so if you give babies water, their electrolytes can go all out of wack and then they can have seizures. So, don't feed your infant water!
6. ^Then again, very shortly after I wrote this, I heard my preceptor tell a mother of a 4-month-old that she can give her baby water if they're outside for a long time....so I guess the other lesson here is that the advice that doctors give can vary from doctor to doctor.
7. Subsequently, it's amazing/borderline scary to think how much of my behavior as a full-fledged physician will be directly influenced by the training I receive. For instance, I've learned at school that it's best to hold an otoscope with the handle down when examining ears. My preceptor last summer said that holding it upside down was the "weenie" way, and I had been taught well. Then last week, another pediatrician demonstrated a really adept way of examining an infant's ears...holding the otoscope upside-down. It was just crazy to realize that, more than likely, the way I ultimately do things (including the advice I give parents on some topics, the way I do physical exams, and probably more) may well be determined simply by the last way I was taught to do said things.
8. You can learn a LOT by watching the way your superiors interact with difficult patients and other medical teams. I was super impressed by the way one of my psychiatry attendings handled small and large annoyances. That dude had an amazingly cool head.
9. Psychiatry can really be a very amusing rotation. When I was on inpatient psychiatry, my team and I had many a laugh-filled morning of rounds while discussing some of the unusual things our patients said. For instance, this exchange:

                    Did you sleep well tonight?

                    I was 14 once.

          Or this one:

                    Can you tell me a little bit about your childhood?

                    Absolutely not. 

          ...Okay, so maybe you had to be there.

The n00b Files- Week 3 of Infectious Disease Consult/Week 11 of Internal Medicine

I'm now approximately one week away from finishing MS2 and becoming a wise 3rd year. In preparation for moving onto the second half of my medical school career, I am frantically gathering yet more knowledge as I wrap up my last month of the Internal Medicine rotation. Here's the low-down:

Lesson 1:
Being on a consult service is frustrating in that you make recommendations and write notes and put in orders, but ultimately the primary team makes all the decisions, and sometimes even decisions in your field of expertise. For instance, the primary team stopped an antibiotic on one of our patients without consulting our team first. They stopped it for a good reason, but stopping it without letting us know beforehand was kind of a crazy thing to me. But I get the feeling this sort of thing is not uncommon when you're consulting on a patient.

Lesson 2:
One thing that makes me really, really happy is talking to people in their 60s or so who've already made it through all the hurdles I face now as a 20-something. Most of them have found their life partners, borne and raised children, and had their careers. In a time when I feel like very few things about my future are certain, it gives me hope to look at others who have come before me and made it through and are still smiling. This is probably why I like working with the Alumni Association at my school so much.

Lesson 3:
This is not a lesson by any means, but I took a picture with one of my patients this week, by her request. It made me feel really happy (she was a sweet, short elderly lady who reminded me of all kinds of grandmas), and it also made me realize that doctors take pictures with their patients all the time--and this was hopefully the first in a long line of photographs to come.

Lesson 4:
I may never get over the mental/emotional trauma of seeing patients in the ICU. I know it's a bit rich to say that when I'm, oh, less than 6 months into many, many years of working in and around hospitals. But seriously, how does anyone look at a patient, legs sprawled about awkwardly, mouth open with an intubation tube and orogastric tube hanging out, and catheters and lines coming out of necks, arms, and you-know-wheres, and not shudder, even if for a millisecond?

Lesson 5:
One of the toughest things about being a student is having patients with complex medical problems, whose prognosis you can't predict. Heck, who even knows if the attendings can predict some patients' prognoses? But what I'm getting at is, it sucks to walk into a room in the morning and examine an unresponsive patient while said patient's spouse sits in the corner in expectant silence, hoping you'll tell them something about the patient's progress. Unfortunately, being as inexperienced as I am, I have no useful information for families in a situation like that. It's rough to walk out without exchanging a word with others in the room, but doing that is better than trying to exchange pleasantries, or worse, telling them things about their loved one's medical problems that simply are incorrect.

Lesson 6:
There are 14 specific "systems" that Medicare and Medicaid look for on a Review of Systems; you have to hit 10 to get full credit. They are: Constitutional, Eyes, ENT, Cardio, Respiratory, GI, GU, Musculoskeletal, Neurological, Derm, Endocrine, Allergy and Immunology, Heme/Onc, and Psych. Isn't that wild?

Lesson 7:
I'm really grateful that I don't have inflammatory bowel disease. That stuff sucks.

Lesson 8:
Learning where all the free food is in any given hospital is a worthwhile endeavor. It feels good to walk around with ice cream and smile mysteriously when others ask you where you got it.

In My Day...

Today seems to be the day to romanticize the past [and revile the present] in lab. As I walked by our second-year grad student at her lab desk, she stopped me to say that she just wasn't in the mood to do anything today, not work on her papers, not work on her presentations, not shop for furniture, and not even work on her computer. To put it simply, she's kind of in a funk. Not ten minutes later, one of our postdocs told me, "Chaya. Life just gets harder from here on out. I'm just telling you that right now. It just gets harder." As I told her, that's probably true. And as she herself admitted, there are also many good things that happen in adulthood, things that seemingly outweigh the difficulties. But to her, the difficulties still win out.

It is true that as we grow up and begin our careers and train for our professions, as we build relationships completely outside the realm of our lives with our parents and siblings, as we, effectively, develop our own personas, new and whole perceptions of who we are as people and how we fit into the world, our responsibilities grow. We take care of ourselves physically, financially, and in other ways: we do our own laundry, clean [or not clean] our apartments when and how we want, and take ourselves wherever we want to go [literally], instead of waiting for our parents to take us there. Yet with all this new responsibility comes so much privilege, so much power. Isn't it great to develop a stronger sense of yourself, to make deep and lasting friendships, to mold your opinions and beliefs and wash your own clothes and drive yourself wherever you want to go?

Why do we romanticize our pasts so much, anyway? Yes, life is hard now. There are always struggles. But wasn't life also hard three years ago, when I spent the entirety of my freshman year trying to figure out how to transition to college life, constantly sick because of the mold infestation in my dorm room, struggling with making friends and figuring out who I was? Weren't there responsibilities in high school, too, when I woke up at 5:45 (I can't believe I did that anymore) to get to school by 7:10, spent seven hours in school, drove home in a car without air-conditioning in Houston, and also had homework to keep up with?

I'm not saying that romanticizing the past is a bad thing. In fact, it's probably a great coping mechanism. If we don't pick out the best parts of our pasts to focus upon as we look back on different stages of our lives, we would probably have a pretty hard time moving forward, especially if we truly believe that things only get harder as we get older. Additionally, romanticizing the past is one way to help ourselves grieve the closings of different chapters in our lives. If I weren't convinced now, as I am, that South Asian Society (the club that has shaped my college career in deep, unalterable ways, the one I have loved for four years) is somehow "different" now than it was when I was a freshmansophomorejunior, then I would be devastated at the prospect of leaving it behind at the end of this semester. It helps to tell ourselves that things were better before, because doing so makes letting go easier.

But maybe we should go about all of this in the opposite direction. Rhapsodize about our futures instead of longing for our pasts. The truth is, the future is bright, and we have a lot to look forward to. Yes, we'll miss what we had before, but we'll also continue growing and moving and becoming the people we were always going to be, and that's a good thing, if you ask me.

Or maybe we should just forget about yesterday and tomorrow and figure out a way to love today for exactly what it is.