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.

Resolutions for 2011

I hadn't really thought of any resolutions for this year, and I wasn't planning to do any, but a few ideas came to me earlier today, so I thought it would be good to write them down:

1. Focus on my own faults and overlook others. The only things I can change are my own bad qualities, so why waste time pointing out others'?

2. See God in every person and act accordingly. Each person holds God within him- or herself, and I need to remember that constantly.

3. Write in my journal at least once a week.

4. Work out at least once a week.

5. Be less quick to anger and indignation and be more patient, loving, and tolerant. Give others, and the world, the benefit of the doubt.

6. Be more decisive.

7. Recite one of the many slokas I know once a week. It's not that hard. Do it.

8. Be more productive.

9. Read this every day to remind myself of my goals.

Here's to a year worth remembering, complete with [at least] two weddings (one for my sister, another for one of my oldest friends and college roommate), the end of my basic sciences curriculum in medical school, and my last real summer break.

Thanksgiving

I love that the one holiday that is truly American is Thanksgiving. What a lovely concept encapsulated in just one word: giving thanks.

Let me be honest about something: I don't love the holidays the way most people do. I'm in that somewhat pitiful minority of the population that dreads the holidays because they inevitably bring with them filial strife. There is nothing intrinsically festive about the Christmas season for my family, and trying to bring a holiday spirit into the house during that time sometimes feels a bit forced, even futile. Layers of issues emerge during this time, not least of them the difficulty of being an immigrant family. So I always tiptoe around the holidays, because I never know what they will bring. One day the family could get along wonderfully. The next we could frown at one another terribly.

Let me be honest about another thing: it's been a tough year. I've cried a lot, questioned a lot of things I've taken for granted all my life, and had really high ups and really deep downs.

And yet.

I still want to give thanks. So here goes:

I'm thankful for my friends, who have proven their incredible worth to such a degree that I cannot begin to express my gratitude. I'm thankful for the family that could only cause me so much heartache because they have given me so much love. I'm thankful for college and all that it has taught me. I'm thankful for the words that help me make sense of this world. I'm thankful for the music that has so often been my loyal companion. I'm thankful for critical thinking. I'm thankful for being a medical student, difficult as the road may get. I'm thankful that despite legions of unhappiness, I am still surrounded by joy that can't be kept down. I'm thankful. And I'm glad there's a holiday that reminds me to take a moment, or a day, or a week, to give thanks for all that is good in my life, because there is so much. What are you thankful for today?

Selection Bias

I've been playing my iTunes on shuffle for the past three days, and I've been continually impressed with just how good the playlist has been. Owl City and Ingrid Michaelson and Imogen Heap and Kate Nash and Hellogoodbye and some great Tamil songs thrown in, along with some of the new Maroon 5 album. It made me really happy that such great songs were coming up on shuffle.

...

And then I realized that I'm loving all the songs that are coming up because they're, well, my library. Selection bias works its magic: I chose all the songs that went into my iTunes library, so of course a random playlist of them would be filled with all my favorites. It ruins the magic a tiny bit, but it also makes me smile. How circular our lives can be.

Another example of selection bias: patients on peritoneal dialysis are more likely to survive than those on hemodialysis, even though peritoneal dialysis is less effective at renal clearance than hemodialysis. Why, you ask? Well, because of many factors, including better retention of renal function in those on peritoneal dialysis, the lack of biocompatibility issues for peritoneal dialysis [unlike the ones rampant in hemodialysis], more cardiovascular complications on hemodialysis, and better clearance of middle molecules [which may be toxic to dialysis patients in the long run] in peritoneal dialysis. But most importantly, patients on PD might have a selection bias phenomenon: those who choose to do the more independent and demanding form of dialysis are likely to be better-educated (and thus take better care of their renal health overall), less sick, and have better family support.

^I wrote that entire paragraph to review something I studied today. Exams start in 6 days, and it's time for lockdown. Not long till I see the light!

Ostrich

Every once in a while I get to acting like an ostrich with its head in the sand. I get ensconced in my routine, used to the way I run my life, and fail to reach out and grab the chances offered to me. Meetings of interesting organizations go unattended, simple surveys unfilled, because I'm just used to the way I've settled into things, because Grey's Anatomy is on and I don't want to miss it. It's a ridiculous and infuriating tendency in me, this love of sitting back and relaxing. Life would be better if I were always on my toes, at the edge of my seat. When I was finishing college, I realized that though it might seem on paper that my hand was always in something or other (metaphorically, not literally), I really didn't do nearly as much as I could have or should have or might have.

Because of that realization, and because I don't want to have regrets when I graduate from medical school, I'm trying to live with the concept of doing more than you think you can. Like Imogen Heap sings in Tidal, I want to "do it for all the times we wished we had." And that means stretch myself academically, extra-curricularly, socially, and with new experiences. I've been doing all right so far, and it was especially easy to stretch myself out of some comfort zones while medical school was still new and fresh and I hadn't yet settled into a routine, but I'm finding myself edging towards that dangerous complacency now, and I want to avoid it.

Also like an ostrich with its head in the sand, I can be completely clueless sometimes. Case in point: this evening around 9:30 I realized that I had failed to attend the FIRST SESSION of an elective this afternoon. I was really excited about this elective, too: Art of the Human Body at the Museum of Fine Arts. But instead of going to it like a responsible student, I completely. Forgot. Instead, I took a two-hour nap this afternoon (glorious, but not exactly productive), studied some, cooked a tiny bit, and watched two premieres of two shows. I'm not saying it wasn't a good day overall. I'm just saying I need to get my head out of the sand (or my ass, or my routine) and take a look around every once in a while, because I miss important things when I get this way.

The Good, the Bad, the Ugly

The Best: I met Amy Tan tonight! I love her books, though I haven't touched one in ages, and I didn't even get to hear her read because I had to leave early, but meeting her was such an honor, and I got her to sign my yellowed paperback copy of The Joy Luck Club and take a picture with my sister and me. All in all a pretty great Monday night.

The Great:

1. I went to a reading last Tuesday evening by my wonderful former creative writing professor, Emily Fox Gordon (www.emilyfoxgordon.com). She is one of the most intelligent authors I've ever read--in my adult life, other than when reading, say Moby-Dick or Midnight's Children, never have I had to look up words so many times while reading a book. Emily's cadences are nearly always spot-on, and I am so proud to have been taught by her. She struggled with trying to write fiction for many many years before realizing that personal essay was the genre for her (and, I think, the genre for me--this is the class I took with her), but she had to write two memoirs and one novel (the last a triumph for her, because she never thought she could write fiction) before FINALLY getting to publish a collection of her personal essays entitled Book of Days. I bought this book at her reading and had her sign it, and she signed it "To Chaya, one of my very favorites," which made me feel really special. I'm hoping to have lunch or coffee with her some time in the near future. That reading came at the perfect time: between my first medical school exams. It reminded me that there's a whole other amazing and happy side to me and my life that isn't sciencesciencescience, and I had nearly forgotten about that aspect. So it was just. Great.

2. I've realized that I can count on my best friends to see through my facades and know exactly, exactly when I need them and to be there when I need them, and that is comforting in a way I cannot even express. I don't know what I'd do without the wonderful people I have in my life.

The Good:

1. I've made soup twice since moving into my apartment, and both times, the soup has come out great. Really, great. This is absolutely wonderful, partly because I love soup, but also because I've always, always wanted to be a wonderful recipe-less cook like my mother, and I'm finally starting to edge towards the possibility of that. I've eaten tons of sub-standard Indian food (prepared by myself) for the past few years as I've tried to find my cooking rhythm, and I'm finally starting to get that magical intuition that all Indian mothers seem to have. And my newfound cooking savvy seems to extend to pastas and soups as well! This is wonderful news.

2. I'm one block into medical school, and I've not only made it so far, but enjoyed it. I'm a little loath to begin studying again now that a new block has begun, but I'm hoping that my enthusiasm will grow slowly but surely.

3. The new Sara Bareilles album is filling me with great joy. How wonderful when an artist one loves proves her worth with a second album that is quite possibly better than the last.

The Bad:

1. It's 9:10 PM and I've only reviewed one of the four lectures I had today. And I wanted to go to bed early tonight as getting up early (after four days of vacation) was particularly difficult this morning.

2. Crazy as it sounds, medical school is the simplest, most manageable thing in my life right now. On the one hand, this makes medical school not so bad. On the other hand, it shows how much of a struggle many other things are being right now.

The Ugly:

1. I'm trying to write a piece for my medical school's literary magazine, and I'm running into problems from the outset. I haven't written anything worth anyone else's revisions in an incredibly long time, and I really want to make this piece great, because I know there's substance there. I just feel like the lolcat in that lolcatz picture, the one that's sprawled across a keyboard with the caption "Writer's block. I haz it."

2. I just want so badly to be substantive, real. I feel that I'm not really either.

Like a Duck to Water

Crazy as it may sound, that's the way I feel that I've taken to medical school. To be perfectly honest, I wondered for a long time whether medical school was the right path for me, even as I was interviewing and deciding where to go to school. Once I got here, though. I quickly [very quickly] learned that it was exactly where I wanted to be, where I was supposed to be. Perhaps it's just the excited flush of new experiences and new friends, or the joy of learning, or the even greater joy of finally starting on the path toward my chosen career, but medical school, though challenging no doubt, is proving to be much, much better than I had anticipated.

I've been taking classes for five weeks now (our orientation was six weeks ago), and it feels like forever. I barely have a memory of the summer that was before school began. We've covered in five weeks what a college course would have covered in at least 2/3 of a semester, encompassing two tests or more. And we still have one more week of classes before we finally have an exam over our first "block" of material.

When I was still in college [now that's a weird clause; I graduated from college almost a year ago. Imagine that!], I heard from a lot of friends in med school that trying to study all the information thrown at you is "like trying to take a sip of water from a fire hose." It's hard to actualize that kind of workload until you're experiencing it for yourself, but I'll have to say that the simile is quite apropos. I would like to add one of my own, though: each week, I feel as if I'm stuffing more and more compressible cotton balls (information) into a container with a snap-shut lid (my brain). As the weeks go by, the volume of the container gets more and more filled, and each week I'm having to push the cotton balls down, compress them as much as possible, then pull my pressing hand away as rapidly as possible as I rush to snap the lid shut on those overflowing cotton balls. It's a set of expectations the sort to which I've never had to rise before, and it's not easy.

But.

I'm finding that I actually like learning about feedback regulation in glycolysis, the muscle that makes my knee jerk in that famous reflex, the tendons visible beneath the skin of my hands. I like my classmates. Their intelligence, while a bit intimidating, is inspirational. Medical genetics and embryology, basically classes about every way a human being's development can go wrong, make me grateful that my genes contain no deleterious mutations, that the oddly-named Sonic Hedgehog signaling protein was present in all the right places and in all the right amounts so that my neural tube developed properly less than three weeks after my conception. There is so. much. to learn about our bodies, but how amazing to know how our muscles contract, that there are tiny little fibers that "walk" across each other every time our motor neurons fire and excite a skeletal muscle? Every time I get to thinking that this is just too much, that no one person can do this, I try to remind myself that so many others have gone before me, so it's possible. More importantly, one day I could be taking care of someone's motherfathersisterbrotherfriendhusbandwifechild, and I want to know everything I can so that I can take the best possible care of that person.

And it doesn't hurt that I still have time and energy to go out with friends on the weekends, talk to my roommate about our respective days daily, see friends from college, visit my family back home, and, yes, waste time every once in a while. More often than I probably should, in fact.

I've been watching Saved by the Bell in the mornings while I'm eating breakfast before school, and I can't help thinking that the theme for "The College Years" episodes is rather relevant to my current situation: "I'm standing at the edge of tomorrow...the future looks bright to me." I am so excited to be starting this next stage of my life, and I can't wait to be a real MD, with all the knowledge--and responsibility--that entails. Not to mention, it'll be nice to finally be getting paid.

"We're young enough to say, 'Oh, this is gonna be the good life.'" Good Life-OneRepublic