Let there be equatorial light

le 27 mars 2013

I used to think of writing (or doing anything inside) by headlamp as spelunking. It was certainly more practical than my first year PCV strategy of candles and kerosene lamp propped on various books and papers—before I had a table—and sitting hunched over to the in the right part of the penumbra.

It’s a funny thing about light.

The Constant Gardener came out weeks before I left for Peace Corps in Cameroon. Without mention anything else I love about the movie (which was great for terrifying many parents of about-to-be PCVs about to move to Africa), the light struck me. The quality of it. I’d noticed years before that Paris has its own quality of light. Some photos, movies capture it (Amélie does). I don’t think you can successfully pretend that something is filmed in Paris.

This light, though, the Kenya-in-the-movie light, was unlike anything I’d ever seen.

And then I moved to Cameroon.

It’s the same light. Gazing across the city at very familiar views this morning (Yaoundé, like Rome or San Francisco, is a city of hills), I remembered it. I have photos of the same view, and in the US they look—faded. Light-stained. But that’s how things actually look.

The forest almost never comes out, either. I think it’s more greens than the human eye can discern (we can see sixteen shades of gray, I recently learned, on CT scans).

On Love and Medicine

Part old, part new. The first part was originally posted November 15, 2010, about halfway through my third year of medical school (edited for length). It takes place during my anesthesia and integrated medicine/neuro/psych rotations. Rereading, though I have changed many descriptors and diseases, I can picture the patients again. Still. What remains is what matters. Then, I had many fewer patients and many fewer responsibilities; in some ways, it was easier to really care. There was more space and time.

And the second part was written tonight.

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November 15, 2010

Fresno and San Francisco, California

MSIII

I think a lot about “for better or for worse” these days. In medicine, you see a lot of “worse” and “worse”, and I see a lot of partners who are there for both. For anything. Siblings, children, grandchildren, nieces, nephews, friends. I guess these would be the ‘chicken soup’ or whatever stories (are they even still publishing those?) But it’s true – rushing around, where so many things are difficult and sad – it’s something to stop and think about. Or try to remember to stop and think about. With the sickest patients, it’s their loved ones that I know. The ICU patients, the altered mental status patients, dementia, kids…whatever. I’ve spoken with a lot of family members. In anesthesia, wheeling people into surgery, you leave Loved Ones at the corner. (They call it the ‘kissing corner.’ Really). And you see them into the waiting room, point it out, say go get coffee or whatever, we’ll be ____ hours, and don’t worry, we’ll take really good care of X. Your X. I’ve seen the wide eyes when we push through the doors again, X is barely waking up from surgery, likely has an oxygen mask over her face, and we’re rushing into the PACU. It doesn’t mean anything’s wrong. It’s normal, and it means the surgery’s over, and if people don’t look like they’re freaking out (The doctors), everything is probably fine. It’s a vulnerable position to see someone in. And in the OR, they’re alone.

There’s the couple who came in with the wife’s entire medical history typed out – each had their own version – with a list of questions. She suddenly went blind, no one has any idea why, no one has any idea if it’s part of something more progressive – probably. So they’re searching. And with each doctor, they get more frustrated at not having answers. But the other point, to me, is that it’s always both, it’s really about their health, and the patient is – almost – both. Making sure you do speak to both.

When Patients Care About Doctors...

http://primarycareprogress.org/blogs/16/276

The Luckiest

I wrote this in the middle of my fourth year of medical school, before taking a year off to go to New York for an MFA in poetry.

August 2011


It’s said in many ways.

Absence makes the heart grow fonder.

Nostalgia in looking back.

Selective memory.

And, per Ben Folds, “The Luckiest.”

This usually refers to, I think, people/place/thing. Certainly people. Certainly place. Time period. Self at a different stage of life.

It’s not usually used in reference to career.

It’s now been three days since I was an active medical student.

And I miss it. A significant lot.

I can’t wait to be a doctor.

Before I started med school, I couldn’t believe how lucky I was to get to go to medical school. I’ve had a lot of privilege in my life. This is one of the greatest, most amazing, most incredulous ones.

What I’ve done, what I’m doing, what I will be doing.

I was let into this hallowed profession – in some places, hallowed, darkened halls – in which I get to learn all about the body. Get to. And I get to interact with people in the most intimate way, at their most vulnerable – they trust me, let me in. I have to earn that trust.

Starting, and before starting, I didn’t understand that sacred trust. It’s something I continue to learn, every day. And I am amazed.