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fifteen

Lunch break in the financial district, New York, NY 2 May 2013

Lunch break in the financial district, New York, NY 2 May 2013

 

I bought my first digital camera in October of 2001. And the photographs I have of New York before then are pretty scarce–film cost money, after all. So most of the day-to-day life that I remember of the city live only in my memory. With every trip back, I keep trying to find remnants of that past and photograph them, in perhaps an act of preservation, or even resurrection.

All I usually end up with, however, is evidence of how much the city has changed, and while this evidence of the ever-changing urban landscape would otherwise mean that I could never want for things to photograph, I leave the city feeling even more distant from the New York I remember.

The essence of life in the city has not changed, however, and even though the backdrop may change, with the landmarks I remember long disappeared and new exteriors in their place, I think I’ve managed to find examples of it and capture it.

I used to work summers in the financial district. A few of my classmates did, too, and every so often we’d get together during lunch breaks and find somewhere outside to sit, eat, and chat. We were surrounded by the thousands of other workers doing the same thing. Any place that can be sat on, will be sat on, turned into an ad hoc meal table. It’s something I think is quintessentially New York, made unique by the sheer density of humanity that’s found on a summer day anywhere in Manhattan. Sometimes, we sat in the plaza of the World Trade Center for our lunches. A perfectly common activity, unworthy of saving it on film.

It’s okay that I don’t have photographs specifically of those moments. The memories, the feelings they evoke, are the key. But I’ll continue trying to save proxies for those memories, for their potential to trigger those memories. I guess you could say that’s just my motivation in general, why I photograph what I do.

Fifteen years ago, I was studying in New York to be an engineer. Were I any other place, were the Towers not to come down, maybe today I’d be doing just that. But because I was so close to tragedy and could do nothing to help, could not help with communications despite having become a licensed amateur radio operator for just that reason, last night, on my last night float shift for the month, I was directing resuscitation for a young patient in shock and close to dying.

I do miss engineering. But this… this is a privilege. The sum total of my four years in New York helped steer me here, shaped who I am, and for that I don’t need a photograph to remind me.

on the consequences of this career change

Lakeview, 4 June 2016

I’ll be up front. It’s been a painful year. No big surprise—residency has a tendency to suck, intern year especially. No one who goes into this enterprise is unaware of this. Coping mechanisms are essential—hobbies, friends, family. Alcohol’s in there somewhere, too. Social media tends to be a double-edged sword — I would feel on some superficial level connected to the family and friends I’ve left behind, but my conclusion after checking my Facebook or Instagram feed for the twentieth time that day was that everyone is spending all their time vacationing in exotic locales and eating exquisite food. (That’s an exaggeration, of course, because no resident has time to putter around on the Internet that frequently. But the end result is the same.)

(Continued)

the first

On morning rounds, my attending asked me a question. “How long do you think he has?” It wasn’t the usual test-your-knowledge pimping that we’ve gotten used to as doctors in training.  She genuinely wanted to know what I thought.

* * *

I’ve been privileged to stand witness only twice.

Six years ago, I drove down to McHenry from Wisconsin to be with my aunt. With her family—her sister, my mom and dad, my brother and his wife–we stood at her bedside as the ventilator was switched off. It was anticipated and planned, for as much as such a thing could be planned given that it was only two weeks earlier that she had successfully had a heart valve replacement and her room was decorated with the well wishes of “get well soon” balloons that were still there.

I really hate those balloons.

Four years ago, we—Scott’s friends—were in the middle of working out a schedule so that one of us would always be around to provide support for his mom, who had been with him every minute of his hospital stay. It was nighttime and I was getting ready to go back home to Wisconsin to show my face at work before coming back for my scheduled support shift, but our plans were soon to become moot. I don’t know what his prognosis had been—did he have hours? days? weeks? months?—maybe I was being purposefully ignorant—but we had been preparing for the long haul.

Scott had a group of close friends that had been with him since high school, but he and I only became friends many years later. They were present for his passing, with the exception of Joe. I asked Michael why I should have been there and not Joe.

“You needed to be there to get the story,” just as he so often is, to be the keeper of the story.

* * *

I wasn’t present when he passed away. I arrived at the hospital in the morning and asked my intern if he had seen him yet. “He passed away about an hour ago.”

When my attending asked me how long I thought he had, I sighed and shook my head. I thought of my aunt. I thought of Scott. “I don’t know. Maybe a day.”

Sometimes, there is no reward in being right.

your mileage may vary

First year. It started out as a joke. “I left my career for this?!”

Med school and I were still on our honeymoon. There was a lot to study, but I remembered enough from my prerequisite science courses and I learned enough physiology on the job that it was bearable. There was still free time, time to volunteer, time to hang out with friends and family. It was almost like being in college again.

Second year. The fire hose of knowledge that one is expected to handle was wide open. The stack of pancakes that is daily studying grew high enough to rival the tallest buildings. People were unhappy with the recent changes to the curriculum. Negativity was everywhere. The stress of studying for our first board exam was wearing everyone down. I was worn out. “I left my career for this?!”

It wasn’t that I loathed my job or that I wasn’t good at it. I was good at it. My manager’s manager told me up front, in an effort to get me to stay, that there would be an irreplaceable void in the team when I left. But the truth is that it took me a long time to get to that point, to develop competence and credibility.

And here I was starting all over again.

(Continued)

2012 post-mortem

With just over three days left in the calendar year, I caught up with Joe, an old friend from my post-bacc. It had been about four months since we last hung out, but with the way life has been going, it might as well have been ages. “How’s it been?” he asked.

I said, “Well…I’m still standing.”

Finishing up M1 year wasn’t too bad. If you asked me then, I would say that it wasn’t easy, but everything’s relative, of course. In this case, relative to our first block of M2 year, the first time my school was doing a block/systems organization for M2 year, M1 year was a cakewalk. Slogging through that first M2 block was like having to partake from a fire hose dispensing not water but pancakes at high pressure, which you might attempt bravely to eat but all that happens is you end up as the battered, worn-down survivor of flapjack-force trauma and maybe, hopefully, you ate enough to pass the exams.

With no time to recover between blocks, with stressed-out friends all around, the rest of the semester was spent treading water (or is it pancakes), not really being able to focus on anything but the immediate (and not even doing a good job at that). In the face of the ramped-up stressfest that M2 year was proving to be, maintaining my usual outward composure was coming at a high internal cost when I already had little emotional reserve to spare. I tried to remember how I handled things the last time I felt this way. I thought of Scott. I thought of the price I was paying for this change in direction in my life, the seven years (minimum) I was giving up in order to retrain; the lost income, the down-prioritization of friends, of family, of love. The implications of changing careers felt quite different now that I was firmly on the other side of 30.

Over Thanksgiving break, I finished a couple of books I had begun to read before first year started.

“To go through medical training, you have to resign yourself to long periods of time when you will simply do an inadequate job with all the people who mean most to you.” –Perri Klass, A Not Entirely Benign Procedure

“Life is bigger than what the trajectory of our medical careers will allow. And just because medicine tries to consume our entire lives doesn’t mean we have to willingly hand them over.” –Michelle Au, This Won’t Hurt a Bit (and other white lies)

If I read those words before starting school, they wouldn’t resonate quite so palpably. Those other things–otherwise stated, the more important things in life, the things taking a back seat to school–are what makes this worthwhile, what makes it possible to dedicate oneself in turn to the service of others.

The end of the semester eventually came, and with it no failing grades and a temporary reprieve from school, but no real resolution, for the cycle would only start anew in due time–and it only gets worse. All I can say is that this is the new normal–and hopefully I figure out how to reclaim what’s important in my life from this all-consuming beast that is medicine.

i can’t remember why she asked

“What are you going to do when a patient dies?” Vicky, the M4 I was pseudo-shadowing, asked me. Wasting no time in lobbing the hard questions at the not-quite-a-first-year, I see. And one who hasn’t yet fully wrapped his head around the fact that he’s no longer an engineer, but a doctor-to-be…

It’s not that I’m naive about the sadder aspects of my new profession, nor that I’m a stranger to death. I just think it’s one of those things that you can’t fully anticipate nor fully prepare for. And her question certainly wasn’t something I was expecting at a health fair for school kids.

I stood in silent contemplation for a few moments; but I dare say I wouldn’t actually be able to answer her until I’m actually faced with it.

raison d’être

“Why did you decide to be a doctor?” she asked. “And don’t tell me you wanted to help people.”

I was exhausted. I sat on the edge of Mandi’s bed. “It’s true,” I said. “I want to help people.”

“Ha!” She poked a mound of vanilla pudding with a fork. “That’s what they all say.”

–“A Fire, Deliberately Set,” Peggy Sarjeant

(Continued)

what kind of fortnight has it been

(with apologies to Aaron Sorkin)

Even as I charged ahead towards a new future in my trips to Boston and DC, in my visits with old high school and college friends I was reminded of an altogether different past—a past in which I envisioned something completely different than the path I now find myself following, a future characterized by Fourier transforms and Smith charts. Delighted as regions of my brain probably last exercised in college sprang back into action talking shop with Amanda and John the electrical engineers and Angela the computer engineer, I nonetheless felt wistful at leaving all of that behind. At the same time, in Donna the teacher, and in other classmates and friends who went onto separate careers, I found some reassurance.

Technology never stopped exciting me. Math and physics still excite me. But are they enough to make me want to wake up in the morning?

Only if I can directly help someone by doing it.

I’ll just have to find some way to be an EE-doc, I guess.

red cross training, part one.

(15/365)

Completing my first in a series of FAST training workshops yesterday, this one on trauma emergencies, it seems to me that this is not unlike what med school will be like: there’s a lot of information being launched furiously at you in a short amount of time and you’re expected to pick it up just as fast, but none of it will actually start to make sense or be internalized until you actually start on the job. It’s certainly not unique to medicine, but the experience is something I haven’t needed to go through in well over six years.

What I suspect isn’t quite like med school is the diversity of backgrounds of everyone who’s volunteering. There are medical professionals, sure, but there are quite a few self-proclaimed non-medical professionals–IT professionals/computer geeks–participating as well. Given my own motivations, it’s unsurprising. From my conversations with them so far, the running theme is that they aren’t completely fulfilled or otherwise satisfied by their jobs, usually because of the sedentary aspect of the job and because there’s little sense of having made a difference. And so it is that they came to volunteer for the Red Cross.

Beyond the full-time job holders are the students, some pre-meds, some of whom are switching into medicine after having studied something completely unrelated in their undergrad careers. I met two fine arts post-baccs who are slogging through pre-med classes, and of course I had to ask if they had already hit organic chemistry  (isn’t that the bane of every pre-med’s existence?), but they couldn’t relate to that particular misery yet. We talked shop more than anything else–classes, MCATs, applying to med schools–but I would have liked to have found out more about why they’re changing course in life. It’s always interesting to me to hear the reasons why people decide to pursue a career in medicine; plus, it gives me a chance to continue hashing out for myself my own reasons for what I’m doing.

All in all, it was a good session, learning a lot and interacting with a variety of people. There were definitely some insecurities to work through, though. It’ll fade as I get into the swing of things, no doubt; I just wish I didn’t have to wait until the next workshop in April.