week in review.

I finished my surgery rotation.
I turned 27.
I leave for my Spanish holiday.

...in my book, that's not a bad week...

See you in 2010.

This picture made me think of my sister.

 
p.s. I'll eventually muster up enough energy to put some actual thoughts into words. Eventually.

Fall is here.

[photo courtesy of dreameveryday]

Do better.

When you try your best but you don't succeed
When you get what you want but not what you need
When you feel so tired but you can't sleep

I am humbled every day: by patients, by patients' families, by doctors and nurses, by other students. In the face of illness and disease, there is so much information to retain with so little cranial space to contain it. I'm not used to feeling inadequate. But I do, daily. I thought that by the end of medical school, with the extra M.D. and M.P.H. letters behind my name, that I'd be this vessel of knowledge, or maybe a gourd of knowledge at least. (Gourd, I like that word). But perhaps the greatest lesson I'll leave Emory with in a few years is: I won't ever know all the answers. It'd be so much easier if the world was painted in only black & white, but where's the beauty in that? Gray, it's the new black.

And the tears come streaming down your face
When you lose something you can't replace
I admit it. I've become a crier. I spent years of my childhood and adolescence bottling my emotions away and functioning as a tomboy independent hard-ass. All of that has been thrown out the window though. I am one of two regular tear-shedders during small group meetings. I often turn away during patient encounters to hide the welling tears. When it gets really bad, I feign the need to pee and bawl a bit in a bathroom stall. And now, I write if it gets to be too much. But I don't care. Emotions, they're also the new black.
I promise you I will learn from my mistakes
And I will try to fix you
I don't have any semblance of a "God complex." I recognize that I will make mistakes. I already have. I expect my bad days to get worst but also for my good days to get better. But ultimately, I expect this from myself:

DO BETTER.

-Coldplay's "Fix You"

p.s. Listen to the moving version of Coldplay's "Fix You" from the film Young@Heart

p.p.s. Don't be fooled. I may cry but I'm still an independent hard-ass ... only I'm in a dress these days.

Taste of Chicago

some things never change

partial 829 reunion

mca = hipsters' playground

take your time: olafur eliasson

movies in grant park

my kind of town, chicago is

Kids say the darndest things.

Overheard today in the pediatric brain tumor clinic:

"Mom, I'm going to glue your mouth shut. Your eyes too."
- 9 year old boy with a relapsed medulloblastoma that had metastasized all over his brain, who now had right-sided weakness and looked plain tuckered out sitting in his chair, one hand on his IV stand, one hand playing Pac-Man. He was waiting to be admitted for a 5-day inpatient stay of hardcore, heavy-duty chemo.

"Owie. Owie. Owie."
- 12 month old girl with an optic pathway glioma as she saw the needle coming toward her to access the chemo port in her chest. Her dad tried to avert her attention with a Piglet stuffed toy.
"I just want to go to school and be with my friends."
- 11 year old girl with a non-germinoma germ cell tumor who is currently homebound after a recent hospitalization for swine flu and was in the outpatient clinic for cycle 5 of her chemo. We talked about Zac Efron and High School Musical. Yeah, I've got my ears to the streets, folks. I know what's hip.

"Owie. Owie. That's going to hurt."
- 3 year old bilingual girl with a diffuse intrinsic brainstem glioma. We ate Goldfish and played with toys on the floor of her room before the Benadryl knocked her out.

"Please take it out. PLEASE! PLEASE!"
-6 year old boy with a pilocytic astrocytoma that had wiped out the satiety control center in his hypothalamus so that he was now weighing in at well over 100 lbs

Lesson #1: It is never fun to hear a child whimper in pain and fear. Period.
My heart has been simultaneously breaking and singing this week. Oncology is hard. Pediatric oncology is harder.

Lesson #2: Kids are just kids, even if they are sick.
I coo at the babies and bounce them up and down. I talk about boys and clothes with my pre-teen girls. I even chatted about Nascar with one boy who had just recently met his hero, Tony Stewart, over the Labor Day weekend thanks to Make-A-Wish. Seeing as how I know next to nothing about Nascar, it was fun to have this little boy, weakened by chemo, still be able to roll his eyes at me in scorn and disbelief.

Lesson #3: Heroes can come in so many different packages.

Rise up this mornin',
Smiled with the risin' sun,
Three little birds
Pitch by my doorstep
Singin' sweet songs
Of melodies pure and true,
Sayin', "This is my message to you-ou-ou:"
Singin': "Don't worry about a thing, worry about a thing, oh!
Every little thing gonna be alright. Don't worry!"

Some mornings, I need a little Bob Marley to get me going. Today was one of those mornings. I was tired and cranky and about to start a 13-hour nursery shift while on my pediatrics rotation. Then I saw Baby D, swaddled in hospital blankets and lying in his neonatal ICU (NICU) crib. I grinned widely to myself.

Mommy D had been my patient at the end of July when I was on the Labor & Delivery OB service. She was 25 years old, just a year younger than me, and she was pregnant with Baby #4. Of her 3 kids, she only had custody of one; she wasn't even sure if she was going to keep Baby D.

Mommy D was addicted to crack cocaine.

It could have been the reason why her water ruptured prematurely at 30.2 weeks. And now Baby D was struggling in utero with almost no amniotic fluid to cushion him. On ultrasound, he wasn't breathing or moving much. We tried to prolong Baby D's delivery as long as possible, to give his body a chance to mature, but he was eventually welcomed to the world, albeit 2 months early.

Fast forward one month. Mommy D has not visited or called about Baby D in the NICU since she was discharged from the hospital. Baby D has periventricular leukomalacia and some calcifications of the brain (maybe due to a maternal TORCH infection). He may also have microcephaly and neuro deficits. Essentially, Mommy D's addiction has caused holes in Baby D's brain. It was like one of those Saturday morning public service announcements - this is your brain on drugs - but in the flesh, in the form of this infant in my arms.

DFACS has been called and Baby D will probably be discharged to foster care once he's stable. As I rocked him for almost an hour, holding him tight to my chest and humming a song, I couldn't keep the tears back. What a sweet, sweet baby. With so many cards stacked against him already.

I'm going to listen to Whitney and my mentor on this one: Crack is whack. It ruins lives. It strips people of their futures. It kills hope.

So often, I'm plagued by the question: Is every little thing gonna be alright? I'd like to think so. But I know the truth is: not always.

So, I'll make sure to hug Baby D extra tight tomorrow, even if it does cause tears to roll down my face.

I ♥ Hagrid

My sister just started law school. It is only Day 4, but this is her assessment of the situation.

Law school sucks. It's like a death eater, slowly zapping the happiness from the world and sucking out your soul."

Lessons of the Day:
1. There's a Harry Potter analogy for everything in life. Thank you, JK Rowling.
2. My soul is intact. Thank god for pass/fail during the first 18 months of medical school.
3. Death eaters are scary. I'm also scared of the dark.

[Addendum: This is my sister's email to me later the same day. "Dear God, Please give me wings so I can fly far far away from here." Clearly, melodrama runs in the pham-ily.]

(500) days of summer

It's almost Labor Day but I feel like summer just began. A few reasons why it mustn't end:

1. Sensation of hot sunshine on bare shoulders
2. Blasting Beyonce's "Halo" every morning on morning commute
3. Grilled peaches and vanilla bean ice cream for dessert
4. Summer ale on my patio
5. Summer ale on any restaurant/bar outdoor patio
6. Grilled meat
8. Impromptu poolside lounging
9. Impromptu shopping sprees
10. Anticipation of fall right 'round the corner
11. Seeing sunlight when I wake up and when I leave clinic/hospital
12. Sleeping in a muggy apartment with only a whirring fan on bare skin
13. Driving with the windows down and blasting Beyonce's "Halo" (sorry, I just ♥ that song)

Clearly, the list wasn't going to continue until 500 nor are there actually 500 days in a summer (what a silly but lovely movie). And besides, summer is a state of being, not a season defined by a solstice and an equinox. It ain't over til it's over, son. And in a week, I'm off to reunite with J-Yun and to return to the city I so dearly love and adore: Chicago. Chi-city in the summer is a magical and wondrous place.

Do you think about me now and then? Because I'm comin' home again, comin' home again.

(Kanye, your ego may be larger than some Pacific islands but a part of me doesn't give a damn.)

Food for thought

What has belligerANT been up to for the past 1/2 year? I went to East Africa (hujambo rafiki!). I started clinical rotations. I went to Puerto Rico (hola amigo!). I watched yet another childhood friend walk down the aisle and saw a different childhood friend undergo a protracted 30+ hour labor (for her second child). I even delivered a few babies myself. A lot has happened.

And in June, I spent a week in rural southwest Georgia providing free health care to migrant farm workers as a part of my family medicine rotation with the South Georgia Farmworker Health Project.

Did you know that approx 85% of fruits and vegetables produced in the US are still hand-harvested and/or cultivated?

Did you know that there are more than 100,000 migrant and seasonal farm workers in Georgia? 

Did you know that the life expectancy of migrant farmworkers is 49 years, compared to the nation’s average of 75 years?

The project was started in 1996 by Tom Himelick, an Emory PA, and is a collaborative project between Emory’s Physician Assistant Program, Emory’s Dept of Family and Preventive Medicine, the Southwest Georgia Area Health Education Center and community partners in Valdosta and Bainbridge, GA. Every spring, students (both PA and medical), medical residents, faculty and volunteer interpreters spend two weeks providing free basic health care and routine dental care along with clothes & food donations.

We worked in migrant camps, packing sheds, apartment parking lots, fields, essentially any empty space. Typical clinic setting: 2 lawn chairs, patch of grass in the middle of a field or lot, medical tools in dirt beside chair. End scene.

In its first year, the project served about 100 patients. Fast forward to 2009, over 1700 patients were seen… in over 100 degree weather.

It was a humbling experience and yet another reminder that I love what I’m doing.
——-

“The hands that feed us are often invisible hands, hands of people who work in the shadows of a multibillion-dollar industry without enjoying its rewards.” – The Human Cost of Food

[originally posted at Emory "The Second Opinion"]

Lately, I've been lamenting the fact that I barely journaled during my first two years of medical school. Too busy, too tired, too whatever. When I'm traveling, I fill up pages and pages of my moleskin - some of it soul-baring, some of it mundane, lots of it embarrassing - but the process is usually therapeutic and cathartic.

It's been a mere five months since I started my year of core clinical rotations, but oftentimes, I find myself floored and slightly untethered by what my patients are facing, what I'm feeling, and the aftermath of what happens when pathology & poverty mix...

After six weeks of OB/Gyn, I'm currently on my week of palliative care. Think of it as the-cradle-to-the-grave rotation. Literally.

pal·li·a·tive
adj.
1.Tending or serving to palliate
2. Relieving or soothing the symptoms of a disease or disorder without effecting a cure.

n. One that palliates, especially a palliative drug or medicine

Today, I choked back tears about four times during a family meeting with the adult children of a dying Ghanaian woman. (Note: my tears cost negative cents; they're that cheap.) The family reminded me so much of my own immigrant family that while my heart was aching for their pain, I was also projecting into the future, imagining what my own family will inevitably experience when my grandparents pass. I thank that family for sharing their private suffering with me.

It's not about dying. It's about how to live until you die.

5 things you didn't know about the dik-dik

# 5. Home shit home. They mark their territory with dung deposits and with secretions from the preorbital gland.

# 4. Just say no to H2O. Dik-diks are herbivores and consume enough water in their food,making drinking unnecessary.

# 3. They are ri-dik-dik-ulously cute.

# 2. They belong to Kirk.

# 1. There is such a thing as a dik-dik

 

Ant and Jinna's Excellent Adventure

Guess who's back, back again. Ant is back, tell a friend.

For three weeks, I was sans watch, sans crackberry and sans internet. It was liberating, especially for someone so addicted to being "connected." But now that I'm back stateside, I've quickly re-established my need for speed.

Oh broadband internet, how I love thee.

Jinna bore the brunt of trip-planning as I was devoting almost every waking hour to cramming seemingly useless facts into my head. (Note: I checked my Step 1 scores while in Zanzibar. I passed). Inadvertently, we basically followed Lonely Planet's "bush & beach" itinerary.

Week 1: Nairobi, Kenya

The Idwasi family, the Rotarians who Jinna is currently living with, graciously opened their home (and kitchen) to me. Twas a glorious week. I slept in. I watched movies. I ate (lots). I shopped. I soaked in the sights and sounds of Nairobi and Karen (Nairobi's 'burbs). And most importantly, I managed to become human again. I also managed to acquire two additional little brothers. I already have two of 'em, which is trouble enough, but I'm adding two more to the pham-ily: Jason and Ben.

Week 2: Bush
5 day safari to Lake Nakuru, Lake Naivasha and Masai Mara Reserve with Wildcats Safaris (Go 'Cats!)

Week 3: Beach
Music festival. Zanzibar. Enough said.
Stay tuned. More pictures and stories to follow.

Do it for the story.

I’m a talker. It’s what I do: talk, think, usually talk without thinking. I’m not an expert at many things but I’ve pretty much mastered the art of foot-in-mouth. But after studying for over 6 weeks for Step 1, I find myself at a loss for words. I’m s/p 5 days (I guarantee you’ll do better at the bars/clubs if you use med jargon, trust me…), and I only almost feel human. Almost. I wanted to have something profound or even remotely funny to share but I don’t. I’m drained. Studying full-time somehow manages to suck up pieces of your soul and I need this next month off to scrounge up all the little pieces. It’s going to take that long to reacquire social and communication skills.

But as is my M.O., I’m headed out of the States - passport in hand, backpack strapped on - and spending 3 weeks in Kenya and Tanzania with Jinna "Afr.i.can" Yun. On the schedule so far: 5-day safari in the Masai Mara Reserve and 5 days in Zanzibar for Sauti za Busara. The rest, we will P.I.B.E. aka play-it-by-ear.

I temporarily hailed from the Hometown of Obama and now I’m off to the Homeland of Obama. My motto for life but especially for travel is: do it for the story. So, here’s to storymaking and storytelling...

Disclaimer: this entry was originally written for Emory SOM Admissions. Recycling posts is lame but I'm a busy girl.