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The start of medical school is a somewhat surreal experience. You work so hard to get there, and then you find yourself standing on a stage wearing a white coat while someone puts a stethoscope around your neck, and you can’t help but feel that somewhere someone has made a terrible mistake. Looking at the sea of smiling faces watching you, the stethoscope newly slung around your neck feels weighted with responsibility, and you wonder if you’re entirely up to the task. At least, that’s what some people have told me it felt like. Personally, I just heard an angel choir, and had to be led from the stage as I stood there yelling “I have arrived!” Odd how things strike people differently.
I have quickly discovered that medical school is like a hard candy, into which a certain group of people are busily and relentlessly trying to drive a soft, chewy centre. They didn’t quite ask us to hold hands and sing healing songs together, but the gleam in their eyes suggests that they’ve got the necessary supplies to do so if called upon. I can see how some folks would believe that this sort of stuff will lead to more humanistic doctors, but evidently they don’t understand that by piling it on so thickly, they’re turning even the most soft-hearted, heal-the-world idealist in our class into a chain-smoking cynic.
For example, take this one course called “The Cadaver as your First Patient”. The aim of the course is to get us to think of our cadaver as a person, rather than just a collection of parts. I’ve got mixed feelings about this, as I firmly believe that what’s laid out in front of us is just a collection of parts; the light of intellect that was the person is long-gone, and what remains is the machine that served as its life-support system. I’ve got a lot of respect for the folks who donate their bodies to serve science and/or medicine, as it strikes me as one last constructive act at the end of an all-too-brief stay on this planet. I also believe that a baseline level of respect toward the remains is appropriate, because it’s a pretty cool gift. But I’m not going to hug my cadaver, and it sure as hell isn’t my first patient.
The odd thing is that if they’d entitled the class something along the lines of “Cadaver as your teacher” I’d have been fine with it. Yeah, I’m learning a lot from the machine laid out in front of me, and I’ll let myself get emotionally invested enough out of respect to call it a “teacher” intead of a “teaching tool”, but that’s as far as I go. In my mind, the doctor-patient relationship is pretty damned special, and even though it’s been eroded, warped, and corrupted by companies answering to shareholders rather than the patients, what remains is still staggeringly awesome. By trying to take that awesomeness and pretend that it applies to what is happening in the cadaver lab is both insulting to the students and cheapens the doctor-patient relationship.
I’ve never talked to the guy whose body is laid in front of me. He never confided in me, sharing his worries about his health or the health of his family. I don’t lay awake at night considering his condition, nor do I muse in the daytime about his lab-values, or the outcome of a procedure. To be someone’s doctor is to be trusted by them in a way that few people trust others, and I never earned that trust. I’m not, and can never be my guy’s doctor. He can never be my patient.
So yeah, I’m really not down with the whole “first patient” thing. Meeting some family members of those who donated their bodies was touching, and I went out of my way to give them a handshake and a sincere “thank-you” for sharing their stories. I yield to no-one in my respect for the donators, and it’s because of this that I get so irritated with the emotionalists trying to turn a cool teaching experience into a sob-fest. Sure, you guys got some med-students and family members to cry, and you tore down some defense-mechanisms that people were using to deal with the fact that we’re cutting humans apart, but what did you really accomplish? Did you really think that we had forgotten that the corpses in front of us were living, breathing, loving, dreaming humans at some point? Did you think that we never wondered what our cadaver’s name had been, where he’d lived, what he’d done? Did you miss the rush to the paper listing our cadaver’s age and the cause of death, the only information we’re allowed?
We didn’t need to be reminded that we’re dealing with humans, with people. I haven’t spoken to a single person yet who has anything disrespectful to say about our dead folks in the lab. And if we’re laughing a little more in lab, if the mood is more relaxed than it was when we first arrived, don’t think that it’s because we’ve forgotten that the cadavers on the humidors were once people. Instead, understand that it’s a relaxation born of familiarity and that rather than breeding contempt, it has allowed us to take possession of our cadaver as the ninth member of our team. That he is our teacher–not our patient–and we’re now learning from him, rather than viewing him from a distance.
After all, we spend a lot of time here. More time than our friends and family see us. We’re living with the Dead, and the Dead are our teachers.
The Damned
Once upon a time, in a land far away, I played a text-based adventure game. Younger readers should understand that we engaged in such activities between riding dinosaurs and banging rocks together to communicate with distant communities. In this game, there was a phrase that appeared with a frequency evidently designed to unhitch even the soundest mind from its moorings: “you are surrounded by many passages, all alike. N, E, S, W?” With the aid of graph paper, it was possible to sketch out the labyrinthine nightmare which one sought to navigate, stopping only when it became clear that the sketch actually culminated in a satanic rune which, upon completion, would suck the player’s soul screaming into the abyss.
Suburbia is much like that.
I’m convinced that if one drew out the many twisting roads, cul-de-sacs, and parks on a piece of parchment using an appropriate medium–say, the blood of virgins–it would reveal unto humanity the dark language in which the Damned will sing the song that ends the world. Never have I been so cognisant of the swirling mass of mediocrity that inhabits these wood-and-plastic dwellings as I was when I chose to walk through such an area some days ago. When the Damned sing their song, it will be to the refrains of minivan honks, ESPN commentary, the sobs of alcoholic wives, and the crystalline tinkle of shattered dreams. Too harsh, you feel?
Know Your Role
Our society is sick.
More and more, I notice that people seem unable to break beyond the traditional roles and boundaries of society. People have roles, we’re told, and to not fit into that nice little package is to be strange, untrustworthy, immature, or deviant.
Are you thirty and want to dye your hair some interesting colour? You’re immature! Grow up, and stop pretending you’re a kid. Like animated movies? Those are for children! Don’t want children? You’re selfish! After all, everyone knows that the key to happiness is a house in the suburbs with a large mortgage, two or three children, and a steady 9-5 job that pays the bills. Ignore that hollow gnawing inside as what’s left of your soul begs for the final mercy of a bullet’s oblivion; that’s just what it is to be a grown-up!
Bullshit.
There’s an excellent comic over at xkcd.org that rather eloquently supports my point: we should get to decide what adulthood is, not the people who come before. Each generation has its own identity, and each generation before it tries to smash the newer generation into a shape that fits the prejudices of the old. For some reason, the Boomer generation (which, as you all know, I hold in the highest esteem) has decided that their youthful activities were folly and happiness lies only in the most rigid conformity. This is a lesson they have passed on to my generation, who are paying the price for so pestilent an idea.
Witness the endless sea of over-priced identical houses writhing through what was pristine farmland or wildland. The curves, ostensibly to create a feeling of neighbourhood, are utterly wasted on individuals who gaze mindlessly out of their air-conditioned SUVs, ferrying their offspring to mandatory piano lessons and sporting activities. There’s no sense of community, because a community requires individuals and everyone who lives there is a goddamned robot. This is not a community, it’s a hive-mind.
A Young Boy’s Tale
Watch carefully as the little boy tries to run around, shout, and revel in his juvenile masculinity. Once, he would have grown up and had his exuberance tempered by life experience and the responsibilities of manhood. Despite this, he would have been a man and all that entails. Today, he is drugged into oblivion.
Tired from working incessantly to afford the empty paraphenalia of a materialistic existance, his parents have no energy to deal with his antics. Hoping to raise his grades upon which rests the desperate hope that vicarious success through their son (look how far little Timmy went!) will silence the bleak emptiness of their own failures, they drag him to whatever physician will diagnose ADHD. Drugged into a compliant stupour, the spark of creativity and zest for life lost, the child will doubtless grow into the next generation of people who believe that a quiet life and fitting-in are appropriate long-term goals.
Or Not
What the hell happened? When did we decide to surrender our individuality? Sure, living in a community requires a bit of compromise here and there, but why the hell are you so threatened by the guy with green hair? Why do you feel the need to scoff at someone being “so different”? Is it really so scary that a young woman has no desire to have children, instead choosing to travel the world and work in a global effort for some cause? Why is “childless” an acceptable term, but you get so pissed off at “childfree“? Why does dancing in public embarrass you? Why are you so afraid of others witnessing you taking an almost childlike joy in something?
You don’t really need that SUV. Let’s face it, that thing will never leave hard pavement and the snowy days you invariably bring up are, what, a few times a year? Odd, most non-SUVs seem to do just fine on those days. Did you really need that big of a house, crippling yourself financially? How is that adjustable-rate mortgage working out for you?
What about your dreams? What happened to them? That thing you always imagined yourself doing, why aren’t you pursuing it? Having kids isn’t an excuse; it’s not a social duty and you won’t always be at their beck and call.
Go Be Magnificent
Our lives are so ridiculously short that it’s a tragedy to not make the most of them. Stop being safe, secure, and mundane. Take a risk: do something scary, or new, or thrilling. Screw getting that new giant TV; use the money to visit somewhere you’ve never been, invent something new, or fund something beautiful. Compose a song or poem, and then go perform it in your local park. Get out of the damned vehicle and try walking to the store, even if it’s miles away. Wear daring clothes, walk along walls, and make those around you laugh just for the hell of it.
You’re beautiful, passionate, and bursting with potential.
Sod the Damned, go sing the song that moves the world.
You know, it’s funny how things can strike you. I’ve always been far less tolerant of cruelty or violence towards animals than I have towards humans. Of course, I’d prefer that neither humans nor animals were on the receiving end of such behaviour, but such is the world we live in.
Accordingly, I’m more than a little irritated by a video reportedly showing a puppy being tossed over a cliff by a couple of Marines. Now, I understand that they’re in a high-stress environment where normal rules of civility are often non-existent, but they knew what they were doing. Evidently an observer even commented that it was “sick”.
To be blunt, someone should have tossed those bastards over the cliff to see if the dog was okay. They’re clearly not worthy of being called Marines. What an embarrassment to the Service.
I have, as I’m wont to do, been thinking a great deal lately. The topic over the last few days has been on the progression of life, and our relationships within it. I am, as I’ve noted elsewhere, starting medical school in August. My path to medical school was such that it ripped almost everything away from me that I’d had before then, for the promise of newer experiences to come. A career, a relationship, financial security, friends, time, and a vision of myself–all have been sacrificed upon the bloodied altar of medical school admissions, mingled with the blood of countless others who have walked the same path or, worse, fell by the wayside, unable to summon the necessary strength to go on.
Holding On
I’m moving out of my apartment right now, and the experience is already wearing on me. Despite brutal cullings of my possessions in previous moves, I still have too much stuff. I understand now why those monks in saffron robes decline to own anything. It has nothing to do with spirituality, they just don’t want to move the crap when it’s time to change monasteries. Harder, though, are the reminders of my past.
Here, an origami flower, kept safe after she’d made it for me, just for fun. She didn’t know then that I liked her, nor that we’d end up in an eight-year relationship. Eight years, and the flower is less crisp than before, but it has travelled over 4000 miles and its colour is still bright. It’s a reminder of her, as she heads to the other side of the planet, and I disappear so thoroughly that I might as well have. Medical school was the final hammer-blow to that relationship, although the friendship that began our journey together somehow survived, and we part as friends with rueful glances.
A picture of my grandfather. An infantryman in the Second World War, he was so proud of my flying. Watching the aircraft overhead in the war, they’d represented a higher craft than he’d ever been able to do. He’d been almost a father to me as I grew up, and held me highest in his regard. I recall his disappointment when I stopped flying to pursue admission into medical school, and I was never able to express to him the driving urge, right at my core, that made any other path less fulfilling. He never heard that I got accepted–he died almost a year before that decision was made.
Piled high, endless textbooks, mementos of my academics over the years. Each yields a memory of where I lived when I took that course, and of the people I knew.
In a tin, military insignia, coins, and my beret. A host of images arises unbidden. Laughter, tears, struggle, and happiness. Voices from the past tease me, remind me of faces I knew in the service, scattered now across the country and the world.
My flight-bag. Old maps, a line marking the course of a flight. My headset. A set of wings. My log-book, most perilous of all.
Photographs–of friends, of family, of old lovers. Smiling at the camera, in eternal embraces in the light of yesterday’s sun. Each with its special feeling, each with a story known only to myself and one other.
I realise that, despite an almost pathological cynicism and well-accustomed enjoyment of solitude, my life is very much a collection of the things that have gone before. That each step I’ve taken has been witnessed by someone else, and thus the threads of our lives have intertwined. To do a thing is to simply do it, but to have one’s actions witnessed by others is to have meaning attached to what we’ve done. In some instances, the act of witnessing provokes little more than a laugh, or a frown of disapproval. In others–more rarely–our actions create a ripple effect that can quite literally redirect the lives of others. To reflect on those who have walked beside us for a while is, in some ways, to reflect on oneself.
Letting Go
And yet, despite this, one must eventually let go of the past, surrendering ourself to what we are today. Too often we live in the past, or in the future, never realising the full savour of the present moment. How strange it is that the gentle discipline of acceptance should be so wrought with difficulty and pain. To remember the happy times with past friends and lovers invites that heart-bound pang of regret that we no longer see their smiles or hear their laughter, and yet who would give up their memories to avoid that bittersweet pain?
Better then, to learn to appreciate what has come before without being bound to it. To accept that even the most hardcore, cynical, and absolutist amongst us have been shaped in some measure by past experiences, but also that we are not constrained by them. The ephemeral future contains immeasurable potential, and we cannot grasp it with both hands if we continue reaching one hand back into the past for what once was, or we wished once was.
When we have come to terms with our experience, when we have assimilated the lessons of past endeavours and come a place of peaceful gratitude for the good things we’ve experienced, then it is possible to live completely. Unbound by what came before, we can freely walk our path, open to what will come next.
And should we sometimes stop a while on our path, to linger over a person or time from our past, this too is okay. Though we have shrugged off the shackles of regret, we have not forgotten the value of those we loved or the experiences we’ve had. And if, briefly, we still experience a moment of sadness, we should understand that it’s because a particular person or experience was especially meaningful for us, and such momentary sadness is the price we pay for so valuable a thing.
So, I’ve been trying to get signed on with the Navy to do a stint as a doc for them. In a fit of what I can only describe as the most egregious display of pure optimism since Bush landed on an aircraft carrier, waved a flag, and said “right boys, nice work, we’re off home soon,” I imagined that my prior service would make it easy to go back in. After all, the administrative harpies that rule the U.S. military with an iron claw already have every piece of information about me that they possibly could. Hell, I seem to recall having every wrinkle in my body inked and pressed into paper at some point, although that might just have been a really good party, now that I think about it. I mean, how many bloody times do you need to take someone’s fingerprints? Do they change? Wouldn’t it be better just to ask where I’d lived and worked since I’d been in and, just in passing, had I planned the violent overthrow of the United States Government (hello FBI! Sorry about that last sentence, but glad you’re here) in the meantime? I actually filled out more paperwork to get back in than I did when I was running around with automatic weapons on a fine USAF installation.
On a related note, it seems that the U.S. military is having a bit of trouble recruiting enough doctors to serve. Here’s a thought: don’t make me fill out more paperwork to get into the military than I did to have to get into medical school! Here I am, motivated as crap to don the uniform, and a bunch of administrative wankers are holding up the process. Now I was in the military long enough to know that, in the event of a national crisis, we can all shelter behind the massive stacks of paperwork that admin types use to justify their jobs, but I can’t help but wonder if a brand-new applicant faces the same hurdles. Pictures of servicemen grinning like idiots, playing golf, and riding around on jetskis with improbably good-looking girlfriends will only carry recruiters so far before the more astute applicant begins to notice a marked propensity for bugger-all getting done on the paperwork front. Streamline the bloody process and you might find that a few more people are willing to step up and fix the broken bits on those who have been put in harm’s way.
Christ, second post and it’s already turned into a rant. You lot are in for a right treat, it seems.
