Musings on Boston

In my absence from writing, due to a variety of factors (cross country road trip, Step 2 studying, sub-internship, moving apartments), there came up a few things about Boston in the news that I felt warranted my blog's attention.

1) GQ Magazine named Boston the country's worst dressed city. It comes as no surprise to Lawrence and me- for years now we've been remarking on just how poorly dressed people our age are here. Red Sox hoodies are just not acceptable attire for a night on the town. (Now the other issue is of course that "a night on the town" consists of going to a sports bar, i.e. paying for expensive drinks so one can watch television with other frumpy bar customers. I can't even begin to address that here.)

2) The University of Michigan researchers have found Boston to be the meanest city in America. In a survey conducted by these researchers measuring the "character strengths" of individuals living in cities across America, including "strengths of the heart" (i.e. kindness), Boston came in dead last. Again, no surprise to Lawrence and me. In the 6 years we've now lived here, never have we felt at home. We're consistently attacked (verbally) for being New Yorkers, yelled at by pedestrians crossing the street when they don't have right of way at lights, and told we "speak good English".

3) Tow train intended to pick up broken down redline train breaks down in the process of towing. I've blogged about the T here being inconsistent, unreliable, and inconvenient before, but this one takes the cake. During a July heat wave, the tow train that was supposed to tow a broken redline train between Porter and Harvard Squares during the morning rush hour commute broke down in the process of towing the train. As a result, after hours of waiting, a little less than 500 sweaty commuters had to walk through the redline tunnels to find an alternate route to work. I was on my sub-I that month at MGH for which I relied on the redline to commute. I guess this was the one time that having to catch an awfully early 6:20AM train to get to the sub-I by 7AM actually worked in my favor.

Ahh Boston. At least this city's quirkiness (to put it nicely) is amusing and easily feeds the fire of longing for our home cities that we non-natives often fan.

Ding Dong! The Wicked Witch is Dead!

"Ding dong! The Wicked Witch is dead!"

I sang these lyrics on April 21, 2011 in the afternoon, after my last day with OR responsibilities. The Surgery Wicked Witch was dead!

And I found myself continuing to sing these lyrics into the next day, the last day official day of Surgery and of third year, both happening to be my on 28th birthday. (Happy Birthday to me!)

"She's gone where goblins go, below-below-below. Yo-ho, let's open up and sing and ring the bells out."

I sang these lyrics in my mind as I continued to celebrate all good things happening on Friday, during lunch with friends, during a walk in the park around the MFA, while sitting on the lawn of the Quad at HMS greeting fellow classmates, "Congratulations! You've made it!" And I soon realized it was also the Third-Year Wicked Witch being dead too.

Though I found myself elated that what is supposed to be the second hardest year of medical training (after intern year) as well as the toughest rotation of that year was over, I was saddened that my elation was not out of a sense of accomplishment, but out of a joy of escaping the wicked witches, a joy of it just being over.

Don't get me wrong. Third year and surgery are tough, and one would be crazy to want to go through it all over again. I'm not crazy. But isn't it intrinsically sad that after the first time I'm allowed to be truly a part of patients' care, after the first time I can act like a doctor, that all I can celebrate is its' end?

To be fair, of course, it's everything else about third year and surgery, everything other than the patients, that made me want to escape. I guess I'm just saddened to realize that a gift as special as being able to take care of patients can be couched in attitudes and workplaces so toxic as to make me be happy to run away from it all, all the way, in fact, to a Master's in Education for a year.

I guess that's just the way it is? Maybe we can change it one day? Ack, too heavy of a topic for me to think about right now as I try to cram for Step 2 of the boards that I'll be taking in just a week and a half. Ignorance is bliss, for now.

But one thing's for sure; no matter how dire I view medical education to be, third year and surgery are still over for me!

Coroner: "As the Coroner I must aver, I thoroughly examined her. And she's not only merely dead, but she's really most sincerely dead."

Mayor: "Then this is a day of Independence for all the munchkins and their descendents."

(Wise) Barrister: "If any."

Mayor: "Yes, let the joyeous news be spread! The Wicked old Witch at last is dead!"

One Day More

I have stolen a small bit of my time on-call this beautiful 63F Saturday to blog about a moment fresh in my mind. This morning, I was walking to the hospital at 5:30AM, when it was still 36F and before the sun even thought about rising. I was happily thinking that today is my last call day. (That's right, it's finally my last call day, not just for surgery but for third year!) Unexpectedly, I starting to sing a song in my head.

"One day more! Another day, another destiny. This never-ending road to Calvary."

"Really?" I thought to myself. "Is this day that momentous, requiring so dramatic a song to pop into my head as the one sung in Les Miserables before the French Revolution?" (And why do I know all the lyrics to this epic song? I can't remember risk factors for certain surgical diseases after being on a surgery clerkship for 10 weeks now, but I can remember the lyrics and tune of a song I haven't heard in years.) Even with this sort of perspective, I still couldn't help but keep singing the song in my head.

"Tomorrow we'll be far away. Tomorrow is the judgement day. Tomorrow we'll discover what our God in Heaven has in store! One more dawn! One more day! One day more!"

By the end of the song in my head, I had gotten so into it that I was on a march towards the hospital. I was ready to grab the call day by the cahones, ready to start a revolution. This was it. This IS it.

But after rounding with the team for 5 hours before jumping into a long consult, I realized I wasn't really that close to the end; surgery managed to beat down my spirit, again. I still have a full 8 days of being in the OR for surgery, a day for the dreaded shelf exam, and another day for an oral exam. And I have a summer full of clinical coursework, including a sub-I that will include many a call night. So really, not even close.

But tomorrow morning, when I walk out of hospital having spent my last night in the hospital for all of surgery, for all of third year, and if my sub-I has a nightfloat system, for all of medical school, I will feel an incredible sense of accomplishment and a relief that I've made it through third year (most of it). I won't care that I still have a way to go. I'll just be exhausted and happily marching home victoriously to the tune of Jean Valjean.

Addendum: Just got out of call night after 27 hours up. Tough hand to be dealt on the last one, and truth be told I was angry on the walk home. But now that I'm in my PJs sitting in my sunny living room, I realize that overnight call is over, finally over. Can't get me now, call.

I Don't Want the 1 2 3

I only hope my children one day will be as excited about the New York City subway system as Christoph Niemann's sons. With my odd love of maps, my neurotic need to figure out the most efficient route between places, and my (one time I feel justified in boasting) keen sense of direction, they'll have a 50/50 shot of referring to red things as "the 1 2 3". (Lawrence's sense of direction is, well, less than accurate.) Click here to read "The Boys and the Subway", his blog post on the New York Times website with words and art illustrating his boys' uncanny love of the MTA.

The 4th Quarter

I've made it to the 4th quarter, of third year. In football, the 4th quarter is the quarter that counts. Games are won or lost in the fourth quarter. (Just ask Eli Manning. Stupid Eagles.)

But in third year, many students, myself included, are hoping to slide through their 4th quarters. I'm not hoping to win; I just want to survive. We've all had 9 hard months of being the kid sibling (med student) who has to play with older siblings (residents and interns) but is never told the rules. AND, those older siblings, and thus rules, change every 2-4 weeks. Then there's the pimping (i.e. interns/residents/attendings asking you harder and harder questions until you get it wrong and feel completely inadequate); if only pimping didn't happen every 5 minutes, then I might not feel completely inadequate all day, everyday. Let's not forget that during all of this, our actual goal is to transform our minds from being encyclopedic to being clinical; we're supposed to figure out how to actually be doctors, starting as 2nd year encyclopedias of disease and transforming into 3rd year clinicians treating disease. No wonder I'm tired.

The 4th quarter (and 3rd year) ends on my birthday. My present to myself will be to get to that day no more wounded/hurt/tired than I am today. The name of the game now for these last 3 months is survival. Wish me luck.

Amusement at the Staten Island Mall

"You're definitely not from the Brooklyn/Staten Island area, " was the line from a sweet Staten Island, Italian mother who was selling me jewelry at the Staten Island Mall right before Christmas. We had been chatting about rubies when she abruptly asked where I was from.

"I'm from here, but I live in Boston now."

I had expected that she would next pose the usual next question, "I mean where are you really from?", usually referring to my unidentifiable ethnic background.

"Oh Bawston. That's far. You're definitely not from the Brooklyn/Staten Island area."

"No no. I was born at St. Vincent's. I went to Notre Dame Academy and Staten Island Tech."

"No." She looked me in the eyes. "You just don't sound it like. No offense."

Moral of my trip to "the Mall": Can't live in Staten Island; can't live without it.

Staten Island Winter Wonderland

The house I grew up in that my mother still lives in in Staten Island sits right on the hilly Silver Lake Golf Course. In the 24 years we've had the house, I never managed to hop the fence and hang out on the golf course. Until yesterday. I never knew how fun or, dare I say it, beautiful, Staten Island can be.

With 30 inches of snow on the ground and no plow this morning to clear our street at the bottom of a steep hill, we had nowhere to go and nothing to do, except play in the snow.

The snow adventure started yesterday with a walk through the golf course and a little sledding.



It continued today with some igloo wins;



and fails;



some acrobatics;



some moments of zen;



until it slid into a sledding bonanza.









and finally sledded into the Staten Island sunset.



Our street had still not been plowed by the time we returned to the house. NYC plows will likely not make it down to our little street today. Maybe tomorrow. If not, we'll continue to be stuck at the house with more snow adventures to come!