Hope and aspiration

Evening ensemble, from metmuseum.org

From Jeff Nunokawa's note today:
"One thing essays have always been about (not all of them of course, but enough of them to notice and call part of the tradition) is everyday life: things that come with everyday life (the death of a moth; the rise of the sun). Well, there’s something about everyday writing, especially the kind that aims to help keep you company while you start everyday that reminds me of the morning as it’s been handed down to me. It’s a little repetitive (to say the least, as my mother would say), but also a little hopeful. It’s some weird combination of routine and experiment: writing everyday, starting everyday. I guess what I’m trying to say is this: the faith of our mothers and our fathers you can also find in the everyday writing I’m trying to do here. That faith inheres in a hopeful feeling that goes along with and a little beyond the less than hopeful feeling that you have when you first wake up and realize you have to to get up and do the same damn thing you did yesterday and the day before. It’s the faith that believes that there’s something on the other side of our everyday trying and it’s not all dark."

And a poem my classmates and I discussed today in our Narrative Medicine session:

Aspiration
Henrietta Cordelia Ray, 1848 - 1916

We climb the slopes of life with throbbing heart,
And eager pulse, like children toward a star.
Sweet siren music cometh from afar,
To lure us on meanwhile. Responsive start
The nightingales to richer song than Art
Can ever teach. No passing shadows mar
Awhile the dewy skies; no inner jar
Of conflict bids us with our quest to part.
We see adown the distance, rainbow-arched,
What melting aisles of liquid light and bloom!
We hasten, tremulous, with lips all parched,
And eyes wide-stretched, nor dream of coming gloom.
Enough that something held almost divine
Within us ever stirs. Can we repine?

Tomorrow, I'll have my evaluation on history-taking and the physical exam ('H&P' History & Physical, in med-speak). I'll share songs written for patients and evaluate the impact of those songs. I'll write a final patient case write-up on chest pain. Next week, I'll take the Shelf Exam in Ambulatory Medicine and give a presentation on the songwriting project. Lots to study, learn, write, present! But in the spirit of Jeff's note and Henrietta Ray's poem, I shall climb the slopes of life with throbbing heart / and eager pulse, like children toward a star.

It’s the faith that believes that there’s something on the other side of our everyday trying and it’s not all dark. 

In New York you can be a new man

Hamilton proudly stands today in my favorite outdoor reading-writing spot!
(near Butler Library, Columbia University)

This is too good not to share: Hamilton at the White House! You've got to check out these video performances:
Alexander Hamilton
My Shot

When I watch these, or listen to the soundtrack on Spotify, I'm filled again with the belief that music matters because it instills us with collective feeling and belief--to take pride in the democracy we have and its true values, to remember that we are a country rooted in immigrants, spirits in opposition to the wave of exceptionalism or superiority or divisions of otherness,

to stand up for others, especially the weak, especially the vulnerable, knowing that each of us is only here because somebody, somewhere, stood up for us.
~2016 State of the Union Address

Snapshot of a moment

So many moments to remember. The 90 year old man in the ICU, head down, back hunched—I needed to hold his hand. I know it matters. Wife also hospitalized—lupus and dementia—he kept saying "oxygen." The defeatedness in his face. "Lymphoma" his first whispered words. The bright, white hospital light—too bright. There needed to be tenderness for this frail, strong man. As the resident and intern walk away, the patient turns to me, eyes bright and wide, hand still in mine, squeezing. I lean in close to listen: "I need oxygen or I get violent." The resident waits for me, at the door. O2 sat 94%, fine, but he was short of breath. Resident shrugs, "he's okay."

I wanted to stay. I wish I could do more. We are in the presence of such vulnerability, such humanness, and every little thing—touch, listen, glance, leaning—matters, I think, I hope, as I walk down the hall with the residents, back to our ward.

There have been a couple of encounters like this in the past weeks (another week gone by, already?). It's hard to stop and write and think. It's hard to collect my thoughts and process them. It's easy to let my emotions dictate myself. I wanted to write about Obama's State of the Union Address. About America the Philosophical. About e.e. cummings at Book Culture. But right now I need another kind of mental processing. I'm yearning, toiling, praying, loving.

First Day

AH, I'm part of the medical team! (Island Med Student blog)

I'm writing to capture this sense of gratitude and appreciation for today, my first day on the wards in general medicine, and my first rotation ever. This is a day to remember! I'm working as part of the team at the Bronx Veteran Affairs hospital, and I'm feeling 1) relieved, 2) grateful for the education and support I've received, and 3) optimistic and hopeful about this rotation, and this year.

A couple of thoughts:

1) I cared for Mr. M, a patient with gangrene. True, I've taken the H&P (history and physical in med-speak) multiple times before, but this time I felt like I had a much more substantial role in making a difference for him. When he wanted a salad, I could try to find one for him, and go back and check to see if he'd gotten it. And I think he appreciated having a hand to hold during the blood draw. I hope I'll get to see him tomorrow again, if he's still here (he's scheduled for a surgery). He's not my assigned patient, but I'm feeling this sense of "myness" for him. 

2) I presented Mr. M's case to my intern (1st year resident), who seemed impressed by the completeness of my presentation, and gave a lot of good pointers. I'm excited to start doing things on my own: presenting to the attending, writing progress notes, drawing blood, really helping out the team--as soon as I can! It felt validating to have prepared for the H&P, and to be able to do well on it, and I'm going to work to get it better, fluent, and memorized. 

3) Tonight, I don't have to worry about studying. Yes, it'll be learning, but I'll be reading and learning on my own accord, to learn everything I can about my patient, and it feels real and meaningful.

4) I'm grateful to my intern for spending such a great deal of time with us medical students, spending two hours going through my presentation. I will make it a point to get better and smoother. I'm still quite loss at to what to expect in terms of the daily schedule, how to use the computer system, how to write progress notes; yet the laid-back atmosphere of the team and their expectations has put me much more at ease. Still, I want to take charge of my own learning and challenge myself so I can help the team and patients the best I can.

To communicate, present, learn, connect--art really is at the heart of medicine.