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.

Past Medical History

This morning I did an initial History and Physical on a patient who was new to my preceptor's practice. Before I went in to meet him, I learned his chief complaint (rash), and his name: Wilbur. Funny, I remarked to my preceptor. That's a pretty old-fashioned name.

When I walked into the room, I was greeted by a sandy-haired balding gentleman in a crisp white shirt, khakis, and boots. He was wearing too much cologne, which portended sleaziness, but his manner was respectful, professional. We talked about his rash for some time. It had been around for about 5 days, he was developing new spots every day, and they were slightly painful. I think it might be shingles, he said, Or Ramsay-Hunt Syndrome. Usually, patients with shingles complain of terrible pain, I told him. Have you been taking any medication for the pain? No, he said. I've dealt with a lot of really bad pain before, took extra strength Vicodin (Vikodayn, with his Texan accent) for a long time, and now I'm off all that stuff. My eyebrows raised at this hint of a significant medical history. Yeah, he said, I was taking morphine IV and everything, because of a plane crash I was in, but I'm getting off topic. Yes, I told him. We'll get to all that later.

A few questions later, we arrived at the Past Medical History, that fateful part of the initial H&P. Finally, he could tell me what had happened. It was a plane crash, he said, in the mid '90s. Right femur broken. Right arm nearly amputated. Right ulna lost proximally, right radius lost distally. Both shoulders dislocated, sticking out "right here," he told me, indicating his mid-clavicular region bilaterally. He was in the hospital for months, out of work for over a year, underwent 27 surgeries in that time and many more for the reflex sympathetic pain syndrome he developed as a result. He underwent intensive psychiatric therapy and rehabilitation to wean himself off of the megadoses of narcotics required to manage his neuropathic pain. Nearly twenty years later, he was fully functional, working and traveling without any hitches.

The most remarkable thing in all of this was that I never would have guessed at this incredibly traumatic history until he rolled back his shirtsleeves. The scars on his right hand were barely visible, and the hand was stupendously functional, considering the trauma it had undergone. The man sitting before me was shockingly unscathed, at least outwardly.

The interview over, I examined his rash, listened to his heart and lungs, and felt his distal pulses (To my surprise, the right radial pulse was intact). Then I smiled at him and said I'd be back soon with my preceptor.

In the hallway, I gave her a quick rundown of his rash and his storied medical history. A plane crash? she asked. Wow.

When we re-entered the room, after some cursory questions about the rash, she asked what I hadn't: So tell us about this crash. You've gotta tell us the whole story.

It's a long story, he started. (And long it was; we probably ended up listening to him for 30 or so minutes; at one point, his wife called the receptionist and asked why his appointment was taking so long.) Little by little, the details came out. A private plane, a complete engine failure right after take-off. 78 seconds from take-off to hitting the ground again in a terrifying crash. The other passenger 76 years old, hurt, but not as badly as our patient. Our patient lost a lot of blood. His blood pressure was 40 over nothing, a first responder said. Our patient, declared dead on the scene. Our patient viewing the entire scene from above, in an out of body experience.

And there were three people there, he went on. I remember them so vividly, but I couldn't possibly tell you if they were male or female. I just know they were there. One placed my head in their lap, another held up my feet, and a third held my left hand and fed me some cool water. Later, I saw those three people move the other crash victim's gurney into the life flight helicopter.

Once he arrived at the hospital, my patient remembers being wheeled down a cavernous hallway, with a white sheet covering him. He saw fluorescent lights and ceiling tiles flash past as his gurney progressed, until finally he passed through a set of double doors large enough for all of humanity to enter at the same time. On the other side, he saw his wife in her wedding dress, his kids in their Easter clothes, and his father in his coveralls lined up along the right wall. As he began sitting up to speak to his family, my patient felt a hand on his left shoulder, pushing him back down. A voice said, "Lie back down. There will be time to talk to them later."

Next thing my patient knows, he sits straight up in his hospital bed, lines and tubes coming out of many natural and artificial orifices. "Holy shit, God's hand was just on me," he says. From her chair to his left, his mother turned to him and said, "There you are, son. I was wondering when you'd come back."

In bits and pieces, my patient learns that he's been unconscious for days. The doctors and his family had no idea if he would regain consciousness, no idea if he would be the same man he was before. But he has and he is. Over the next year, our patient is "put back together" by a brilliant surgeon who gave him back full function of his right arm, hand, and leg. He suffers from reflex pain syndrome, taking megadoses of Vicodin and other opioids, just trying to stave off the pain. Eventually, he undergoes intensive inpatient rehab and gets off the narcotics for good. Years pass, and now he sits before us, mildly distressed by shingles.

By this time, over half an hour has passed, and my preceptor and I have exchanged many a quick glance communicating anxiety over the increasing length of this patient encounter. There are other patients out there waiting for us. But our patient says, "I'll just tell you one more thing, and then I'll finish the story, even though there's much more to it," and we say all right. He needs to tell this to us.

A couple years ago, our patient entered a local grocery store in search of a squeegee for his shower. "I know, you're wondering where I'm going with this," he assured us as our eyebrows raised skeptically. "But don't worry." After searching the store himself with no luck, our patient asked a little old man working at the store if he could help him find the squeegees. Why sure, the little old man said. But, he said, glancing at our patient's scarred right arm, what happened to that arm there? A plane crash, our patient said stoically. I bet that's a good story, the little old man said gamely. Why don't you tell me about it while we walk? And so our patient related the whole tale to this perfect stranger. By the time they reached the squeegee aisle, the tale was nearing its end. The little old man cleared some space on a low shelf, and they sat together while our patient told the part that bugs him the most. "Whenever people hear this story, they look at me (and here, he squinted his eyes in a way that said goshdarnit I'm sure of it) and say, God saved you for a reason. You have a purpose in this life. But that's the whole problem. I don't know what my purpose is. Here I am over 10 years later and I still don't know what I'm supposed to be doing. God never told me what He wanted me to do," our patient bemoaned. The little old man put his hand on the patient's shoulder, said "Yes I did, son," and walked off.

Here our patient choked up for the first time, and my preceptor and I exchanged a look altogether different from the ones before. This was a special moment, a moment neither of us was likely to forget. Moments like these remind me how lucky I am to be in the medical field. Being a physician means being let in on the most intimate details of strangers' lives. People trust you immediately, and tell you things they don't tell others, even those they love and know well. It's a position of immense power, and one that keeps me in touch with my own humanity. For this I am grateful.

The Truth Is, I'm a Man.

A few days ago in one of our Behavioral Science lectures (psychosexual development, ie how people grow to "act" like their gender), the lecturer spoke briefly about a study that explored the difference between how men and women attempt to understand themselves and others...essentially, how do the two sexes approach relationships? The study concluded that while men feel that by understanding themselves, they can understand others, women go about things in the opposite way: by understanding others, they can understand themselves.

Funny thing is, I take the male approach much, much more than I do the female one. I am a personal essayist. I take a lot of pride in, and derive a lot of joy from, the fact that people think I know myself well. I am confident in who I am; I love holding forth on my beliefs and past and the way that I see things. I guess that sounds a little narcissistic..but all that is to say that I really do place a lot of value on understanding myself, and I think that by knowing myself well, I can manage my world, and my life, more effectively. Sadly, I've found that life doesn't quite work that way. I used to think that as long as I could regulate myself and my actions, I could deliberately and carefully guard and nurture my relationships with the people I care about. If I can control myself, why wouldn't the things that I call mine--that is, my relationships--also be in my control, right? But alas, I may have to modify my approach.

Other girls I've talked to have said that they really are the opposite way: they love to understand what makes other people tick, to people-watch and hear about others' backgrounds. I suppose I enjoy that, too. I like a good personal essay as much as the next girl. But I suspect that I don't actively unravel and engage the things I learn about others, don't come to understand how others' pasts and beliefs and experiences will color and inform their actions, their prejudices, their weaknesses. It's an interesting dilemma.

In short, though, turns out I'm kind of man-like. Maybe I should try being more of a woman and see if that wouldn't make things better. I hate to break it to myself, but I suspect it's never quite that simple...

At a Loss

I'm a pretty smart girl, but there are some things I will just never, ever understand. And I'll never figure them out. And I've done some truly stupid things. And sometimes I wonder how clever I really am.

What If

A lot of subjunctives have been on my mind lately, though I hadn't really put my finger on "what if" as the theme of my current or recent thoughts until today.

A few days ago, there was a suicide bombing in the International Arrivals terminal of the main airport in Moscow. At approximately this same time last year (February 7, to be exact), I was in that very same terminal. What if the attack had happened a little over a year ago?

I suppose we're all here for some reason, and that we're all only a minute, or a decision, or a chance away from our lives taking a wholly different path than we had originally expected. Makes you think though--what if you had taken a wrong turn somewhere, and weren't here anymore? I believe we'll only take that wrong turn when we're fated to do so. What do you think?

Fun fact of the day: warfarin, an anti-clotting drug, gets its name from Wisconsin Alumni Resource (or some other R- word) Fund, because it was developed at the University of Wisconsin. So every time a patient gets prescribed warfarin, the University of Wisconsin cashes in a little [or maybe a lot? I'm not sure]. What if warfarin had been developed at Baylor College of Medicine? It would be called barfarin. hahahaha.

Good Week

I found myself unaccountably and unusually happy yesterday. Starbucks gave away free brewed coffee to every customer who brought in a travel mug, and I took advantage of that promotion before I left for work, which meant that I was sipping on an inordinate amount of coffee all day long. I've found that, oddly, caffeine tends to make me feel sanguine, so perhaps that's what spurred my happiness. Additionally, over the past two days, prospective students [high school seniors] have been visiting Rice for the annual "Owl Days" event. I love witnessing their eagerness and awe as they experience college--for many, it's the college they've already decided to attend--firsthand for the first time. I miss that feeling. Prospective students, or prospies, as we call them, always make me smile. It has also helped that in just the past eight days, I've:

1. Gotten my new cute netbook
2. Decided to go to Imogen Heap's concert--and purchased tickets for said concert!
3. Decided to go see John Mayer AND Owl City (it's like my dream come true!) in concert
4. Had dinner with an amazing group of friends who always have me laughing like a maniac and feeling loved
5. Booked a trip to New York City to visit a friend right after graduation
6. Had a ridiculously good end-of-college night on campus

Ostensibly, it's been a relatively good week. Then again, it's also been an unpleasant week in many ways. A friend of mine from high school passed away on Easter, and I went to his funeral and wake this past weekend. I've been to too many funerals for people my age, but this was the first one for a person I could truly call my friend. I have a lot of memories with this guy [granted, they're mostly from middle school, and thus at least 8 years old], and he was truly a nice person. I'm still sad about his death, but more than anything it's made me painfully aware of how precious my own life is.

It's amazing how forcefully perspective can be pushed upon you--and also how easily it can slip away.