the baby

I could tell a lot of tales from the last week of peds surgery. If you talked me recently, you probaly know I saw my first case of child abuse in America this week. I am not going to blog about it because of the sensitivity of the issue not even under password protected. I was surprised how hard it was for me. I seen so much gross neglect and abuse of children overseas. But most of it has been at the hands of the state and not at the hands of the child’s own parent. But it didn’t make me want to run from pediatrics, if anyting it motivated me. Little kids are so worth fighting for, there are few more just causes than protecting a child from harm and comforting them when they encounter it.

Today I was on rounds call. I went in and we were done by 7. I learned how to do an arterial blood gas and then found myself wandering the NICU. An idea came to my head. I presented myself to the nurses and asked if I could feed a baby. I explained that I had volunteered before I came to medical school. I spent 45 minutes holding a baby who happened to also be my patient. He had screamed all morning and his Mom never comes to see him. The nurse sent me to him when I asked to be put to work. I put on the gown and and sat in a rocking chair and watched the sun finish coming. I kept waiting for some doctor to walk in and send me off to do scut. But no one ever came and bothered us. I sang softly to him and stroked his little head and watched his eyes slowly droop When I left him in his crib, he was content and for the first time all day not crying. The nurses offered me a grateful glance. I nodded, grabbed my white coat and headed home.

There is more to these children than numbers and orders. My profession is really good at forgetting that.

grateful fear

I spent my first day off from studying in four weeks sprucing up my living room. My wonderful Mom helped me build some shelves (she did it I was too busy having a mental breakdown) last Tuesday. Today I filled them with books and pictures and momentos from my journeying. I have a travel shelf with my little Belarusian village house and magic doll (a gift from a developmentally disabled woman, it supposed to keep the evil eye from looking my way), travel guides, essays and such. I have a shelf with all my books on doctoring (not textbooks, memoirs, stories, fiction,etc) and some med school friends pictures. Another self devoted to college pictures. On the bottom shelves I put children’s books and various toys and things that I have accumulated so that my roomate’s nephew who spends at least one night every other week with us will have full access. to the toys and books  even if I am not around when he comes.  As a result of moving books and pictures out of my room, I finally have desk space and got rid of the random piles of crap that used to live on my dresser.

I also got some pictures framed. Ariana (my best friend from childhood) and her husband Jimmy are professional photographers these days. They sent me three beautiful photographs printed on really cool shiny, metallic paper and already matted for Chris. All I had to do was provide the frames. The finished product of shelves and pictures was lovely. I feel for the first time settled in my own home.

I am actually sitting on my sofa (people will have to make out elsewhere tonight) rather than holed up in my room. Its liberating. I feel a little ridiculous I can’t believe I let it get this crazy.  I should never be afraid of my own living room. I should never hate my life like I have for the last while.  I whine and complain but in reality I have not done much to help myself of late.  I think I left my self advocacy in a box waiting in my closet next to my travel guides. It was safer there tucked away where it couldn’t get me in trouble.

Similarly I have let stuff pile and fester without thinking to the point I have beaome so overwhelmed that I just want to purge everything that is overwhelming me so I don’t have to deal with it.And even the smallest addition to the piles makes me want to do this. And of course the mess is NOT MY FAULT, I am great at blaming and justifying my lack of action. Not healthy or helpful.

So today I reorganized. Today I hung some pictures and finally unpacked the last box from college. And I pondered.

and I decided that I was going to blog on my sofa tonight just for starters.

14 heads

Maybe the point is to be miserable.

I had a revelation today sitting in the middle of the labor section of ZSR (ugrad library) studying STDs. Maybe I am not supposed to like medical school. Maybe academic medicine is supposed to get under my skin. Maybe living in a culture that finds me at best strange at worse down right heretical is the best thing in the world.

Let’s discuss some of the things that have made me hate medical school .L et’s discuss some of the reasons people look at me like I have fourteen heads:

 “Yes insurance companies discriminate against sick people How do you think they make money?”

“Do you have any clue how much that drug actually costs? Do you realize how many children die overseas because the drug company won’t lower the cost” (in regards to some new TB drugs)

 “Actually, most disabled people are not waiting for magic cures.”

 “I’m sorry but I don’t consider myself a POOR OUTCOME.”

“Abortion is not a TREAMENT for Downs’ Syndrome.”

“I could care less about how much money I am going to make in 10 years, in fact I most likely won’t be making enough to leave off without support of donors.”

“I have a moral issue of charging someone who can’t afford or overcharging someone who can for me as a fellow human being to save his/her/their child’s life”  

“If I have the choice to give someone a condom and save their lives or preach safe sex and watch a young mother in Africa or an orphan in Romania die of AIDS. I pick the condom every time.” (yep burn me at the stake)

“Just because you can’t fix someone doesn’t mean they don’t deserve your time.”

“Just because something hasn’t been done (treat MDR TB in a slum to take a note out of Farmer’s book) doesn’t mean it shouldn’t be done now.”

Or to quote a friend:

“I wrote down my purpose’s statement as a physician the other day for a class, I wrote’…to show unconditional love’, I am waiting for my professor to laugh at me.”

 

And I could go on for hours.

 

Would I ever want to change the way I think about these things?

 

I hate studying 10 hours a day and all that goes with that socially, emotionally, physically but that will end in 8 weeks from tomorrow. The question of medical school is not how much more studying can I take?  I whine perpetually about how this not going to help me care for people better if anything its teaching me to be anti-social, selfish and resentful of people who seem to have it better than I do. In the mist of all that whining, maybe I have missed the point. Because studying really isn’t the point nor is being adored by my peers or professors.

It’s the culture that really gets me down and frustrates me to the point of tears not the lifestyle, not the work. Considering the life path I have chosen living in a hostile culture is pretty much exactly what I am supposed to want.  Maybe the point is to be miserable.

If I hate the way medical school is so frustrating and I want to quit maybe the best thing in the world I can do for my mental health and for medicine is to stay exactly where I am and fight it out.  If I can’t hack American medical education, I doubt I can hack 20 years in Eastern Europe with post-soviet medicine or even life.

When people stare at someone with 14 heads, they rarely forget it. I mean how many 14 headed people have you seen?

exactly.

 

I want to get off.

I think it finally hit me that in two months from next week I will be taking the Boards. And I just sort of had a panic attack sitting in ZSR (ugrad library). There is so much stuff I don’t know the way I should like Pharm and Pop-epi and renal and embryology and even more terrifying is the stuff I don’t even know I don’t know.

And it was a beautiful day as I sat here and listened to lectures about sex hormones and panicked. All I wanted to do was get in my car and drive away into the sunshine and rejoin life. I know I haven’t really left life. But I feel like I have. I feel like I am stuck in some time loop of repeating moments of inadequacy, frustration, shallow relationships (because I never have time I should to devote to them) and the feeling of gulit for all the things I don’t have time for and the time I wasting dreaming about what I would if I wasn’t in medical school. I live viacariously via the world of internet blogging, Facebook and You Tube and have developed an unusal interest in the 2008 Election Primaries because they are continualy covered live via the internet, my window to the world.

And I am ashamed of all of this. People are dying, children are starving, my parents and the federal government and several generous scholarships are shelling out money like no tomorrow investing in my medical education. Yet I just don’t care anymore. My apathy is growing by the hour. I am tired and frankly I would just rather be any where else. Someone told me I was closer to quitting medical school a year ago. Maybe, I was, maybe I repressed it but I have to be honest, today with the sun shining and the fact I can’t even get excited about sex hormones, with the crap that is gong down in the orphanage and a recently supplemented bank account. Its just too easy.

When I went home over Christmas. I cleaned out of my bookshelves in my bedroom at home. I found some of my old journals from high school and even before. I read them for a while. Although I never said I want to be a doctor, I talked perpetually about how upset I was about the crappy care all the Kniest Kids were getting that I knew. The wheels were in motion. But I also talked about loving my classes, idolizing my teachers and loving being back home in VA, getting my first poems published, my first kiss (ha!), lots and lots of theater, writing all the church plays and dreaming. My life was not perfect and heaven knows I don’t want to go back to high school. Its the fact I was whole. I don’t feel whole any more. I feel like someone else is living my life for me.

Its not the boards. I will pass them if I try. Its the fact that somehow in all the deciding between grad school types and majors and life plans, I left behind or put on hold or cut out entirely things I really loved. Maybe its growing up. But part of me can’t help but continue to wonder if med school is the best way for me to really be the person I am meant to be. Just because I can do something doesn’t always mean its the right something to do.

I know there have been a whole series of these my life sucks I want to drop out of med school posts. But seriously I have never stopped wondering about medical school since the day I submitted my AMCAS application. sigh.

Free the Teddy Bears

I got an e-mail today from the British woman who I met on the airplane home who by what can only be divine planning happened to be about to start volunteering at Crinul Alb (home for disabled children).  Over Christmas they gathered 120  boxes (Operation Christmas Child esque), one for each child. Inside was a stuffed animal, crayons, a coloring book, socks, gloves and hat (its cold in ROMANIA!!!). My friend delivered them after spending months collecting and packaging the donations. She gave them out and was excited to see each child for the first time have a toy of their own. She played with the children she is working with on developmental milestones. As she was leaving she saw staff members loading the boxes into a storage room. She walked back to the common room where she had delivered the boxes, not a single child had anything from the boxes.  They were sitting in their normal places rocking against the wall with hands reaching out to her as she entered the room.

My friend was so disheartened, she cried out in frustration and told me she feared becoming cynical. As I read her e-mail, I realized with terrifying acuity that I wasn’t surprised. I am not shocked any more. In fact I expect it. I expect our efforts to fail. I expect to hear more horror stories. I expect ceaseless hopelessness. I expect indifference. I expect ignorance. No good deed goes unpunished.
            And I know exactly how she feels but I realize I stopped feeling it. I know exactly how crazy it is. I know how ridiculous it is for 120 children to sit day after day without even a toy for stimulation or socks to keep them warm. I know how futile it is that these things are right there available for these children separated only by a wall.

I know how crazy it is that although they are surrounded by human beings that they get hit when they should receive comfort, shushed when they cry in pain. I know how silly it seems to never pick up a crying infant when there are multiple adults in the room. There is no separation, not even a wall. At least not a physical wall, they just listen to them cry or turn up the radio louder or yell or even hit till they stop.  I know these things but I am not surprised by them.

I do not hate the Romanians. I do not question their intelligence or their capacity for compassion. I know their history well enough to know that it has been beaten out of them much the way it is beaten out of these children.

There is no logic to prejudice. It eats logic, compassion and truth. It gnaws its way into the human mind until it is the only lens the person sees the world. In the lives of these children it’s a shameless, guiltless, relentless beast that slowly devours their capacity to trust, to hope, to love and then slowly cuts off their ability to reason, to grow, to talk, to walk. And this is not some touchy-feely melodramatic rant. Its down right medical, we see the results in attachment disorders, criminal behavior down the road and children stunted in growth and development after years of neglect particularly during early childhood or as infants.

Why would a sub-human need a teddy bear?  I mean they might tear it up, a waste of a toy that could go to better uses, for more worthy beings, distribution of limited resources from teddy bears on up.

 

I almost ended my entry there then I remembered my own Christmas morning. Early before all of us were even up and ready for the festivities. My mom brought down the first two packages. She set one down in our ancient, fat cat’s basket and another at in front of our bouncy terrier. They being smart, resourceful creatures broke open the packages and found a small stuffed creature to play with and do whatever they want with. And no one has taken them away from them.

 

I must still have a heart after all because the irony is making it hurt.