doc w/ Pen

Only in medical school (#4) …

… is this set of transitions possible:

Test question about a tumor
⬇︎
novel ice cream flavor
⬇︎
Google image-aided illustration complete with
organic chemistry molecule sprinkles

But that’s exactly what happened last week as I was doing practice questions in advance of my medicine shelf exam. A question came up about pheochromocytomas, which are tumors usually found in the adrenal medulla. These tumors cause inappropriate secretion of catecholamines such as epinephrine. This can cause episodic headaches, hypertension, sweating, and a fast heartbeat. I don’t remember if I got the question right or wrong. What I do remember is that in the answer explanation, there was mention made about how these tumors can cause elevation in the urine of a catecholamine breakdown product called vanillylmandelic acid (VMA).

You have to understand that doing these questions is hard work. The questions themselves are incredibly difficult, often to the point of being demoralizing, and the detailed answer explanations require exquisite attention. It’s easy (and tempting) to get distracted. And on this particular evening, I did.

“If I owned an ice cream store,” I thought to myself, “I would name my vanilla ice cream flavor ‘vanillylmandelic.’ ”

I chuckled (probably out loud). And then, reluctant to return to the practice questions, I thought about how I might illustrate this hilarious (to a medical student) concept. I minimized the test question window, and brought up Google images. I found a luscious bowl of vanilla ice cream, in a turquoise bowl to boot. (Turquoise is my favorite color.) I also found the molecular structure for vanillylmandelic acid. (Whew, definitely brought back memories from organic chemistry.)

My sense (of dedication? guilt?) returned after perusing Google images though, and I went back the practice questions.

This morning, with medicine behind me, I finally completed my illustration: a bowl of vanillylmandelic ice cream with multicolored vanillylmandelic acid sprinkles. Here is the final result:

On a side note, I also learned today from Wikipedia that not only is vanillylmandelic acid a metabolite of catecholamines, but it is also a chemical intermediate in the synthesis of artifical vanilla flavoring. So really, my idea isn’t so crazy after all. Right?

Don’t answer that.

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February 12, 2018

My window to the world

I didn’t get much natural light while I was on my medicine rotation, so I made a point to look out the picture windows near the unit where I worked. It’s a lovely view.

This morning at 9 a.m., my class has an orientation meeting to our four-month research block. When I exit the door of my apartment building around 8:45 or so, I hope to see something I’ve had very little of on my medicine clerkship: sunshine. (The forecast today calls for clouds, but that’s ok — there are other sunshine-y days ahead.) For the last several weeks while on medicine, when I’d leave my apartment in the morning, it was dark. When I left the hospital in the evening, it was dark again.

It’s disorienting. Without daylight, you lose track of time. It happens to everyone in the hospital. I remember seeing a patient in the ED late one morning. She asked me what time it was. I told her it was 11:30. She looked surprised, and told me she thought it was later than that. I quickly realized she thought it was 11:30 p.m., not 11:30 a.m. Granted, she was rather confused to begin with, but the lack of windows in the ED (and the lack of a clock) only made matters worse. I honestly told her that being in the hospital, I sometimes lost track of time too.

I was fortunate enough, though, to get regular glimpses of the outside world that grounded my circadian rhythm. To get from the elevators to the ward where I worked, I had to pass a series of gigantic picture windows. Look straight out, and you got a lovely view of the East River, and one of the bridges in the distance. Turn slightly to the right, and you got a lovely view of the New York City skyline. Every morning on my way in, and several times throughout the day, I would take a moment to look out those windows. To chronicle the various views — of sunrise, snow, and sparkling city lights — I started taking pictures through the windows with my phone. Here are my favorites, broken up into two groups, the skyline view and the East River view.

Click on any of the images to open a larger, slideshow view. Oh, and pardon the glare — you know, those harsh hospital lights.

Skyline view:

East River view:

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February 9, 2018

My post-medicine to-do list

While on my internal medicine rotation, I’ve done lots of steps and stairs, as my iPhone attests. But when the clerkship ends, I need to get back into a regular gym routine.

As I write this, I’m almost done with my internal medicine clerkship. Just 12 hours to go. Wednesday was my last day in the hospital. Thursday I crammed for my exams. Today I plow through a 110-question multiple choice test, and a 2-hour EKG-reading test.

It’s been an exhilarating, and exhausting, eight weeks. I’ve taken more ownership of my patients than in any other clerkship. I’ve gotten to know them better, and been more intimately involved in their care. All of that has been immensely rewarding. I’ve truly felt like part of the team, like I’m contributing in a meaningful way. It has also been devastating, for example when a patient took an unexpected turn for the worse, a turn from which they were not expected to recover.

The work schedule has been intense too. Monday through Friday were generally 12-hour days, counting both in-hospital time and time I spent chart-reviewing my patients at home in the morning. Saturday, we generally were let go a couple of hours early. Sunday was my day off. But not really. It was really my day to catch up on studying. Because when I got home Monday through Saturday, it was hard to bring myself to do more than 10 (maybe 20) practice questions before my mind shut down. Forget trying to read or memorize anything. So Sunday was my day to study. Doing “life stuff” got put on the back burner. “Survival” was my mantra.

It’s been too long since I’ve visited the Tiffany windows at The Met.

That means that this coming weekend, I have a lot of catching up to do. It won’t all happen in a day. Thankfully, next up is my four-month research block. This will be plenty of work too, but won’t involve the same crazy schedule. So here are some items on my to-do list, in no particular order:

Spend time at places other than the hospital and my apartment. I’m looking forward to seeing the sun (other than through a window), and visiting some of my favorite NYC haunts (like The Met), as well as exploring some new ones (like the 9/11 Memorial).

Spend time with my friends and family. I’ve done very little of that recently, given my lack of time and energy post-work. It’s time to catch up, both in person with those who live in New York, and on the phone with those who live elsewhere. (You know who you are!)

For too long, my vacuum has sat abandoned in my closet.

Clean my apartment. I especially need to vacuum. Now that I have long hair, fallen strands have a tendency to collect in little clumps along my baseboards. Scooping up the biggest ones with my hands is really not cutting it.

Do laundry. I mean ALL of my clothes, and in actual washing machines, not just emergency items in my bathroom sink.

Do my dishes. Regularly. The other morning, I had to use a fork to stir the sugar and half and half into my coffee. Not ideal.

Eat better. I need to get back to cooking regularly, rather than slapping together a ham sandwich for dinner, or picking up unhealthy take-out. (E.g., no more orange chicken from Panda Express, which is directly on my way home from the hospital.)

Exercise. While working in the hospital, I run around a lot, from floor to floor, so get in quite a few steps and stairs. But I need to get back to a regular gym routine, and back to doing my mat Pilates.

Meditate. This is something I’ve wanted to try for years. Medical school is stressful, and I know residency will be too. I think meditation could help with that. Ironically, all the stress lately has prevented me from trying something that might reduce my stress. So as I head into a less stressful block of time, I want to establish the habit so it hopefully sticks when I really need it next. A friend of mine recommended a couple of apps to try, including the Headspace app pictured at left, so that seems like a good place to start.

On a side note about stress, I’ve had multiple residents tell me that they much prefer the stresses of residency to those of third year. In residency your day off is actually a day off; you don’t have to study. You’re also not worried about constantly being evaluated by everyone around you, which is one of the major pressures of these clinical rotations (and something I plan to write a separate post about). A classmate said that one resident told her: “My worst day as an intern was still better than my best day as a third-year medical student.” I’m not sure everyone feels the same, but at least some of the stresses of medical school (studying for exams in the evenings and on your day off; having to always be “on” since you’re always being evaluated) will dissipate. And, I’m sure, be replaced with other ones.

Be creative. Using my hands to make things is such a rewarding outlet for me. I simply haven’t had the time or energy for it lately. I’ve missed it.

I can’t wait to make more crane cards …

… and more beaded spoons.

One of my new favorite songs, Snake River Conspiracy’s cover of The Cure’s “Lovesong.”

Write. I have a long list of essay ideas that I simply haven’t had time or energy to tackle. Several of them relate to things that have happened during my medicine clerkship. I look forward to sharing those experiences with all of you in the coming days and weeks, as I process all that’s happened lately.

Find new music. Over winter break, my youngest sister, Joy, convinced me to join Spotify. I’ve managed (barely) to keep up with the “Discover Weekly” playlist that Spotify sends me every Sunday night, saving the songs I like to a new playlist I aptly call “New discoveries to explore!” I’d like to delve into that list (which currently has 119 songs on it) and to investigate some of those artists and their albums more fully.

Watch TV. I don’t normally do much of this to begin with, but I haven’t even turned on my set in weeks. It would be really nice to relax on my couch in front of a good movie or TV show episode without feeling guilty.

My purchases at City Hops. Several of the beers are local, brewed here in NY state — pretty cool.

Learn about beer. And drink it, of course. For the longest time, I thought beer was simply gross. The closest I got was Mike’s Hard Lemonade. I stuck to wine, or my favorite, gin & tonic. Then I dated someone for a little while who enjoyed beer, so I would try what he bought. Turns out it wasn’t so bad, though still not my choice of adult beverage. Then my sister started bringing craft beers to family gatherings, and not only did I tolerate them, I actually liked them. It was a revelation. I’m particularly partial to IPAs, of all things. But the selection at the grocery store down the street is atrocious, and a six-pack costs about $5 more than it should. There’s a place called City Hops on 2nd Avenue not far from me. I’ve walked by it dozens of times, and often thought about going it. Yesterday I took a study break and did just that, and about $40 later, was the proud owner of seven different craft IPAs. I’m definitely drinking one tonight night to celebrate making it through medicine intact.

Pamper my plants. Many months ago, I bought some lovely houseplants from Home Depot, and some lovely plant stands online. The idea was to infuse a little bit of “green” in my environment as I live amid the concrete jungle. Unfortunately, I dramatically overestimated the amount of natural light that would be cast onto the corners where I put these plant stands. My poor plants became bedraggled over time. Luckily, they quickly perked up when I put them on my kitchen windowsill. But I can’t really enjoy them there. So I want to buy and install some grow lights, so I can put my plants back on their stands, where I can see them better, and enjoy them more.

My plants are fine on my windowsill, but once I get some grow lights I can put them on my plant stands (which are in places that don’t get much natural light, but are where I can see my greenery better).

The home page for FREIDA, the American Medical Association’s online gateway to exploring residency programs … *gulp*

Think more about my future. Before I know it, September will roll around, and I’ll be submitting my residency application. That means I need to figure out where I’m applying. And THAT means I need to do some leg work (well, more like “finger work” as I explore residency programs on the Internet). This is a little terrifying, as you might imagine. It’s also thrilling.

Clearly, I have a lot to catch up on. But it’s good stuff, fun stuff, stuff that’s rewarding in a different way than patient care.

Now, in anticipation of this upcoming reprieve, I wonder where my TV remote has gotten to …

7 Comments

February 7, 2018

The anatomy of a heart, and a water bottle

As I explained in my last post, medical descriptions are sometimes a little … strange. Some of them, as I learned yesterday, are also generation-dependent.

I was sitting at my desk after a long day in the hospital, studying for my medicine shelf exam (aka final exam). While doing cardiology review questions on my laptop, I came across a scenario in which a woman had a pericardial effusion. Essentially, this is a collection of fluid surrounding the heart. The chest x-ray was described as showing a “‘water bottle’ heart shape.”

Below is an image I found online that’s similar to the one from my practice question. Think about your conception of a water bottle, then look at the image.

This is the chest x-ray of a patient with a pericardial effusion.

Staring at my laptop screen, I thought to myself, “This doesn’t look like any water bottle I’ve ever seen.” I tried to think creatively, how one might fit a Fiji, Evian, or Aquafina bottle into that globular shape. Try as I might, I failed.

So I Google-image-searched this phrase: “pericardial effusion water bottle silhouette.” Most of the images that came up looked just like the one above. That didn’t help me. But when I found this image on Radiopaedia, an online collection of radiology cases, (see below) the analogy suddenly made sense. Whoever first compared the heart silhouette in a pericardial effusion to a water bottle probably never saw a plastic, disposable water bottle, like the ones we use today. His (and it was most likely a “he” since most doctors were men back then) conception of a water bottle was very different from mine. As Radiopaedia explains, “The fluid-filled pericardial sac casts a cardiac silhouette that resembles an old-fashioned leather water bottle.”

The “water bottle-shaped heart” in pericardial effusion explained, with a visual aid. From Radiopaedia.com.

I initially felt satisfied with my investigation, but the journalist in me cried out for confirmation from a second source. So I went back to Google images, digging a little deeper. And I found these:

This interpretation of “water bottle” was quite different. I don’t really consider these glass bottles “water bottles” in the same way I do both the plastic bottles of today and the old-fashioned leather bottle in the Radiopaedia image. But then again, what do I know? Maybe around the time x-rays were first being used clinically, in the late 1890s, the vessels above were considered “water bottles.” I’m a little skeptical of this, but the image with the greenish x-ray and the clear glass bottle comes from a well-respected medical journal, BMJ Heart. So it’s hard to discount this comparison completely.

To try and come up with a little more information, I Googled the same phrase “pericardial effusion water bottle silhouette” to look at text results too. The seventh result was a 2016 article from an international emergency medicine journal. The article is called “Message in a bottle: The use of chest radiography for diagnosis of pericardial effusion.” I didn’t read the entire article (I was studying for a test, remember?) but I did skim it, looking for “water bottle” references. The whole article is about using the “water bottle sign” to clue you into the presence of a pericardial effusion, and to help you decide whether to perform advanced imaging. The article actually refers to the water bottle sign 12 times. But not once does the article explain how this image looks like a water bottle, only that it does.

I am still studying for my test (I’ve got 48 hours left to master the field of internal medicine). So I must stop my descent into the rabbit hole of this question. Perhaps someone, somewhere in the world, still uses a water bottle that resembles the globe-shaped heart seen in a pericardial effusion x-ray. Perhaps that person would understand this arcane medical reference. But for the most part, at least to those of us in medicine who are using this reference today, it is outdated. It lives on, though, because as much as medicine is about progress, it is also about history.

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February 4, 2018

Only in medical school … (#3)

… will you come across the description “steamy cornea” and actually take it seriously.

I read said description this morning as I was doing UWorld practice questions in preparation for my medicine shelf exam. The description was in reference to the eye exam seen in angle closure glaucoma, which is also associated with a red eye and a nonreactive, moderately dilated pupil (see the photo below).

Just in case you were wondering.

What the eye looks like in angle closure glaucoma, a medical emergency that can lead to vision loss if not immediately treated.

3 Comments

January 28, 2018

Running the mental gantlet

This essay was first published in the online magazine The American. You can see the original version here.

Learning about a patient is like digging into a demanding novel: plot and characters need fleshing out.

Running the mental gantlet

Some people compare starting a new clinical rotation in medical school – something you do every six or eight weeks for an entire year – to starting a new job. A job you’ve never done, and one you feel wholly unprepared for. I liken the experience to being dropped into the middle of a novel. Dialogue explodes around you. But the speech lacks context and you struggle to make any sense of the words. Characters fall in love, have sex, shoot each other, but you can’t always tell the good guys and bad guys apart. For heaven’s sake, you don’t even know where you are. Russia? Iowa? The moon?

That’s how I felt when I started my inpatient psychiatry rotation on a summer Monday last year. I arrived promptly on the unit at 8:20 a.m. as I’d been instructed. I knew the names of the attending, resident, and medical student I would be working with, but not their appearance or where I was expected to meet them. I sheepishly hung out with a kind, chatty nurse until the 8:30 a.m. team meeting – a meeting I had no idea I was supposed to attend until the friendly nurse told me. A dozen or so of us entered a room and sat or stood around a big table to discuss general issues – safety concerns, upcoming discharges, new admissions, staff absences, special activities.

After this combined meeting, we had another meeting just with my team to discuss more specific updates on our own patients. Since I was new, those present introduced themselves. Overwhelmed by it all, I promptly forgot most of their names and their roles.

I got slight comfort in telling myself I’d pick up the details after everything settled down.

I noticed that the woman running the meeting had two binders. One bore the name of my attending psychiatrist, the other the name of a different attending. Not all the patients were covered by my team, which made me wonder where exactly they wanted my focus.

As the meeting progressed, with notes and updates on specific patients, I noticed that my medical school colleague, who was sitting next to me, occasionally scribbled a few notes. “Should I be taking notes?” I wondered.

I didn’t want to be perceived as not paying attention, but I had no idea who these patients were, which ones (if any) were my responsibility, and which updates mattered.

One of these updates might consist of something like this: “On Saturday, Jane Doe took her medications. She spent most of the day with her family. She expressed her needs appropriately. She slept well.”

That sounds bland, but perhaps this was the first day Ms. Doe had agreed to take her medications. Perhaps sleeping well was a major improvement for her. I just didn’t know.

With patient names and behaviors swirling in my head, I did my best to keep the confusion at bay, reminding myself that this was my first day, my first hour. I couldn’t be expected to keep things straight. Not yet.

Then the team resident, my classmate, and I talked individually with patients in one of the unit’s small, private meeting rooms. The resident immediately launched into questions. Sleep? Appetite? Mood? Hallucinations or delusions? Medication side effects? Thoughts of hurting yourself or others?

Between patients, my classmate tried to give me a brief synopsis of the next patient: diagnosis, treatment plan.

With only that to go on, I struggled to make sense of the encounters. The journalist in me cried out for each patient’s fuller story. Understanding the past would help me understand their present, and their prognosis.

As the patients answered the resident’s questions, in my own mind the replies only provoked more questions. One patient made a vague reference to a brutal childhood trauma. Another hinted at magical powers. How could I not want to know more?

Making matters even more complicated I had little understanding of what my supervisors (the psychiatry resident and attending) expected of me for the next four weeks. The medical student told me what he’d been doing – interviewing two of our five patients one-on-one daily, and writing a progress note on each. But more concrete information was hard to find.

I finally went to the source, asking the resident what her expectations were. She told me to do essentially what my classmate was doing — pick a patient or two, spend some extra time with them, and write my own notes. I had figured as much, but now it was official.

I selected my patients and dug into their medical records, combing through the notes in each person’s electronic chart. I was back to reading the novel, starting at the beginning and working my way forward. I began with each patient’s presentation to the psychiatric emergency department. That gave me a sense of how they were when they first came to the hospital compared to how they were now. I then moved to the initial evaluation note from the psychiatric unit (where I was now working). These two comprehensive notes helped me understand each patient’s present psychiatric illness, as well as past psychiatric history, medical history, family situation, and other life factors. I also read what are called “collateral” notes. These are conversations between a medical practitioner (often a medical student) and someone else in the patient’s life — a spouse, friend, psychiatrist, therapist, or caseworker, for example. They provide an outsider perspective on how the patient’s current condition compares to their norm. Last, I read daily progress notes, finishing with the one written that morning. These brief and focused progress notes told the story of the patient’s day-by-day existence on the inpatient psychiatric unit. How they were eating, sleeping, behaving, and overall living while in the hospital. These daily updates clued me into whether someone’s delusions or insomnia had improved, for example, or whether they were tolerating an increased dose of a medication.

At the end of that first day, I was still in the middle of the novel, on page 200 or so. But I’d gone back and at least skimmed the first 199 pages. And with that background, I was now ready to move on to the next chapter: the next day.

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January 25, 2018

Sit back and listen

The art for the fictional podcast “Alice Isn’t Dead,” which is about a female truck driver searching for her missing wife, is just brilliant.

Some time ago, I wrote a post about the true crime podcasts I’d discovered. As I explained in that post, I spend so much time in front of a computer screen both for medical school and in my personal life that the idea of relaxing in front of another screen (i.e., my TV) just doesn’t always appeal to me. Plus, there’s something about simply listening, hearing the narrative but without someone else’s visual interpretations, that sparks my imagination. I get to paint people’s portraits and create the contours of the landscape. So for all those reasons, radio is ideal. Magical, even.

But as I was listening to one of those nonfiction podcasts awhile ago, I realized that I really just wanted … a story. Not a real one, not one that truly happened. I wanted to escape into the world of fiction. I’m actually surprised that this didn’t occur to me sooner. I’ve always loved reading fiction. And as a kid, my dad would read aloud to my family each night from a chapter book — our own version of a serial audio story. So I started poking around iTunes. Before long, I had amassed an overwhelming list of fiction podcasts to try. Here are the ones I’ve tried so far and highly recommend. I’ll include each show’s link and official description, as well as a few words of my own.

The Black Tapes. This docudrama is one of my favorites. The best way I can describe this spooky and addictive show is that it’s like the podcast “Serial” meets “The X Files.” There are three seasons out now. From the show’s official description: “The Black Tapes is a serialized docudrama about one journalist’s search for truth, her enigmatic subject’s mysterious past, and the literal and figurative ghosts that haunt them both. How do you feel about paranormal activity or the Supernatural? Ghosts? Spirits? Demons? Do you believe?”

Rabbits. This is another addictive docudrama, just finished with its first season. It took me a couple of episodes to get into the show, but then I was hooked. From the show’s description: “When Carly Parker’s friend Yumiko goes missing under very mysterious circumstances, Carly’s search for her friend leads her headfirst into an ancient mysterious game known only as Rabbits. Soon Carly begins to suspect that Rabbits is much more than just a game, and that the key to understanding Rabbits, might be the key to the survival of our species, and the Universe, as we know it.” This show is from the same people behind The Black Tapes.

Limetown. I blew through this show’s remarkable episodes in a couple of days. My only disappointment is that there isn’t more to listen to, although apparently a second season is coming out soon. It’s another conspiracy-paranormal-docudrama. Apparently, this is my genre. From the show’s website: “Ten years ago, over three hundred men, women and children disappeared from a small town in Tennessee, never to be heard from again. American Public Radio reporter Lia Haddock asks the question once more, ‘What happened to the people of Limetown?'”

The Message. This show’s first episode didn’t really impress me, and I was about to move on. But I read some incredible reviews of the show, which hit No. 1 in iTunes when it was first released. so decided to stick with it. I’m glad I did. You will be too, if docudramas about aliens is your thing. From the website: “The Message is a new podcast following the weekly reports and interviews from Nicky Tomalin, who is covering the decoding of a message from outer space received 70 years ago. Over the course of 8 episodes we get an inside ear on how a top team of cryptologists attempt to decipher, decode, and understand the alien message.”

Life After. The premise of this incredible sci-fi show reminds me of “Her,” the 2013 Spike Jonze movie (also highly recommended). From the show’s official description: “The 10 episode series follows Ross, a low level employee at the FBI, who spends his days conversing online with his wife Charlie – who died eight months ago. But the technology behind this digital resurrection leads Ross down a dangerous path that threatens his job, his own life, and maybe even the world.” By the same people who created The Message.

Archive 81. The show’s official description is short: “A podcast about horror, cities, and the subconscious.” I understand why. It’s hard to characterize this podcast. It’s about a guy who goes into this cabin deep in the woods to archive these weird tapes, and horrible things happen from there. It’s gripping. I don’t recommend listening to this one alone in a dark room (which is, of course, what I did).

ars PARADOXICA. Physics, time travel, awkward scientists, political corruption, and intrigue … this is the world of ars PARADOXICA. From the show’s official description: “ars PARADOXICA is a story about people searching for meaning in a universe that aggressively lacks one, and who occasionally find the next best thing in those around them. It’s also about the way power corrupts. When you’ve got a time machine and the backing of the most powerful nation on Earth, you start to get the idea that you can always tilt the scales in your favor, but there is cost and consequence for every action. Above all, it’s about science, America, and the deeply human desire to fix our mistakes.”

The Deep Vault. This is another super creepy one, which apparently is another thing I’m into. Also do not recommend being alone in a dark room for this one unless you like imagining that shadows are monsters. From the official description: “The story follows a group of longtime friends as they journey from the uninhabitable surface world into a mysterious underground bunker in search of safety, shelter, and answers to their past. Robotic servants, tooth-filled monsters, and terrible computers collide within the claustrophobic, steel-reinforced walls of The Deep Vault, a modern day homage to the golden age of sci-fi radio drama.” Like Archive 81, this one definitely has horror undertones, but I mean that in the best possible way.

Welcome to Night Vale. I saw one review on iTunes describing this as Garrison Keillor in “Lake Wobegone” meets Stephen King. That was enough to get me to listen to an episode. From the show’s official description: “Welcome to Night Vale is a twice-monthly podcast in the style of community updates for the small desert town of Night Vale, featuring local weather, news, announcements from the Sheriff’s Secret Police, mysterious lights in the night sky, dark hooded figures with unknowable powers, and cultural events. Turn on your radio and hide. ”

Alice Isn’t Dead. This show’s narrator, Alice, a female truck driver, is incredible. As is the writing. The official description: “A truck driver searches across America for the wife she had long assumed was dead. In the course of her search, she will encounter not-quite-human serial murderers, towns literally lost in time, and a conspiracy that goes way beyond one missing woman.”

The Bright Sessions. This show’s premise is unlike any other. It records psychotherapy sessions between a woman named Dr. Bright and her uniquely talented, but troubled patients. The official description: “The Bright Sessions is a science fiction podcast that follows a group of therapy patients. But these are not your typical patients – each has a unique supernatural ability. The show documents their struggles and discoveries as well as the motivations of their mysterious therapist, Dr. Bright.”

Homecoming. This is a psychological thriller about a human experiment gone horribly wrong. From the show’s description: “Homecoming centers on a caseworker at an experimental facility, her ambitious supervisor, and a soldier eager to rejoin civilian life — presented in an enigmatic collage of telephone calls, therapy sessions, and overheard conversations.”

Our Fair City. This podcast is lovably bizarre. “Campy,” according to the official description — and in the best possible, melodramatic way. It’s a post-apocalyptic drama complete with lunatic scientists, the woken dead, mole people, man-eating wolves, and so much more. All of this is packed into episodes that are usually about 15 minutes long, so great for a quick study break. Or a long binge … the creators (based in Chicago!) are currently on season 8, so there’s lots to listen to.

The Leviathan Chronicles. This is an absolutely incredible sci-fi show, another one of my favorite podcasts overall. It follows the lives of people who have become immortal, conflicts between different factions of immortals, and clashes between immortals and mortals. It sounds bizarre, I know, but the story is wonderful, suspenseful, and engaging. There’s also great acting, sound effects, music, etc. It’s supposed to be 50 episodes, but 30-some-odd in, the creator’s wife died of cancer, so there was a long hiatus. But he’s apparently back and working on episodes again, which is exciting news.

There are so many incredible podcasts out there, both fiction and nonfiction. This is truly a return of the golden age for radio (albeit radio you listen to on your phone or computer). While I’ve found some incredible shows, I know I’ve only scratched the surface. If you come across any other podcasts you love, post a comment or send me a message. I’m always looking for new ones to try.

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January 23, 2018

Six-word stories: doing more with less

When you have limited space for your words, you choose those words very carefully. I learned that lesson well when I was working as a reporter for the weekly newspaper The Forest Park Review. Each week, I was given a newspaper page plan with allotted space for my stories — space that was, for the most part, set in stone. I learned to condense my thoughts into 500- to 750-word stories without compromising the content.

Ernest Hemingway set a much higher (or lower, depending on how you look at it) bar for word precision with this famous six-word story.

For sale:
baby shoes,
never worn.

In a half-dozen words, Hemingway conveyed a grief and emptiness that are all the more profound and affecting because of how short the story is.

I came across the six-word story concept recently while toodling around the Internet. Apparently, it became quite the sensation on Tumblr and reddit awhile ago. (I’m a little behind the times, I know.) I recommend doing a Google image search for “six-word story” — it’ll make you smile, laugh, think, and sigh, all in a few seconds’ time.

Here is my own attempt at a six-word story. Note that I am not a fiction writer. This is an autobiographical piece based on something that happened to me this past summer.

Manhattan morning stroll:
sandals, pigeon diarrhea.

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January 15, 2018

Friendly inspiration

When I was in Chicago over winter break, I spent most of my time with my family. But I also caught up with my old “crafternoon” buddy. We talked shop, discussing the best paper collage glue and the sharpest scissors for maximum cutting precision. We also wandered the aisles of Hobby Lobby, picking up random treasures to use in our respective craft projects. Going to Hobby Lobby with a fellow craft addict is both marvelous and dangerous. Marvelous, in that you inspire each other with ideas on how to use this or that trinket; dangerous, in that you rationalize each other’s ever-expanding pile of purchases. But it’s mostly marvelous. My friend also graciously gifted me some vintage children’s book and magazine images, as well as other colorful paper.

Below are some of my recent origami crane cards, made with these new acquisitions. Click on any photo to open up a slideshow with larger images.

Rhinestone-studded ribbon (front)

Rhinestone ribbon (inside)

Vintage children’s book cutouts (back)

Vintage children’s book cutouts (front)

Lime sequins!

Hemp/sequin ribbon

Fun background paper

Delicate lace

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January 13, 2018

Only in medical school … (#2)

The other morning, I was standing in front of my bathroom mirror, getting ready to head to the hospital. I had planned to leave at 6:50 a.m. It was already 6:45. I felt rushed, running late. I still needed to put my make-up on. But in this moment, I was struggling with my hair. My springy red curls just weren’t sitting quite right around my face. So I grabbed a comb out of a bin on my bathroom’s narrow windowsill and with it parted my hair just left of center. I examined the new distribution of my curly locks.

“There,” I thought. “That looks better.”

But as I stared at myself in the mirror, I noticed that the hair on either side of the part wasn’t laying down flat. It bowed upward, each side threatening to defect to the other. I reached into that same bin and pulled out a bottle of hairspray. I spritzed the part and gently smoothed down both sides to prevent mutiny.

“That will keep my part patent,” I said aloud, to no one but myself.

I laughed. “Patent”? Who uses that word to describe hair? That’s a word we use in medicine to describe tubular structures in the body that are open and unobstructed, like healthy veins and arteries, or a stent that has been placed to keep a diseased artery open. Only someone in medicine would describe a part in their hair as “patent.”

Later in the day, I thought again about what I’d said, and how I should write this blog post. Again, I laughed, but for a different reason. I’d inadvertently applied one of my favorite literary elements, alliteration, to my inadvertent use of medical terminology in a nonmedical context. Alliteration is repetition of the same consonant letter (or sound) in adjacent or nearby words. In my statement: “patent part.” Only a writer would be likely to notice that.

In the busyness of clerkships, I find humor where I can. Sometimes, that means laughing at myself, and the funny fusion of my many facets.

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