doc w/ Pen

journalist + medical student + artist

Tag: new york

A newly prudent pedestrian

Medical school is one of the most intense experiences I can imagine. As such, I expected it to change me. It has. And in some unexpected ways.

On a recent summer evening, I walked some 15 blocks to a Thai restaurant to meet a friend for dinner. It was a lovely evening. I enjoyed the fresh air after spending so many hours cooped up in the hospital over the last several weeks. On my walk, I noticed something. Since completing my four-week trauma surgery rotation, I’d become a much more cautious pedestrian.

When waiting to cross a street with lots of traffic, I didn’t tip-toe into the street, or even stand at the edge of the curb. Instead, I hung back a few feet. I still jaywalked, but only if there were absolutely zero cars in sight. None of this dashing across the street to beat an oncoming vehicle. And when I saw someone else do that, I shook my head (literally). Even when simply walking on the sidewalk, nowhere near an intersection, I found myself paying close attention to the traffic running parallel to me — something I’d never really done before.

I had abandoned my aggressive pedestrian stance because darting into traffic saves you no more than a few seconds, and can cost you so much. I paid more attention to my surroundings because even when you’re on the sidewalk, minding your own business, a car could jump the curb and smash into you.

Technically, legally, pedestrians may have the right of way. But legality melts away in the face of a 2-ton steel monster barreling toward you.

That reality is now all too clear to me. While on trauma surgery, I’d seen too many pedestrians hit by cars. In medical lingo, this type of trauma is referred to as a “pedestrian struck.” Often the collisions resulted in simple lacerations or minor broken bones. But sometimes they resulted in coma, intubation, and craniectomy (removing part of the skull to relieve elevated pressure in the brain).

Maybe increased caution and attention won’t make being a pedestrian in New York City much safer. But they make me feel better. And that’s something, I suppose.

Good hospital food?

On Tuesday, I was scrolling through Yelp listings, looking for a place to dine that was located near my apartment on New York’s Upper East Side (UES). I saw the standard fare, as expected — Italian, Indian, Japanese, Thai, and so on. And then I saw this:

I did a double take. I expect Yelp to be comprehensive, but Memorial Sloan Cancer Center’s hospital cafeteria? I wasn’t expecting that.

I’d actually just been to this cafeteria the day before, the morning I started a four-week rotation on colorectal surgery. (This is the second four-week block of my eight-week surgery rotation.) I didn’t buy anything at the cafeteria, just peeked in. But after reading some of the reviews, I have high hopes. As usual, there were complaints. But there was a positive theme to the reviews, as evidence by this pointed comment:

It really is the best when it comes to hospital cafeteria food. Crab cakes, paninis, chicken pot pies, macadamian crusted fish. Enough said.

I’m not sure if the same could be said about the Garden Cafe at Cornell.

The Garden Cafe, for those not familiar with the UES hospital scene, is the cafeteria at New York Presbyterian Hospital. This is the main hospital affiliated with Weill Cornell Medical College, and where I do most of my clinical rotations. I agree wholeheartedly with this reviewer that the food there is nothing to write home about.

Even though it takes extra time and effort in the morning, I usually bring my own lunch — both to save money and because it’s healthier. But one of these days, I’ll have to try the cafeteria food at Memorial Sloan Kettering. See what all the fuss is about.

The theme of my summer break: exploring the integration of art and nature

Today marks the beginning of a new clerkship, surgery. I’m sure I will have plenty to say about that in the coming 8 weeks. But right now, I want to write about the marvelous summer break that just came to a close. Without intending this, my vacation decidedly had a theme: art, nature, and their integration. I explored this three-part theme both in New York City with a dear friend who came to visit, as well as during a brief trip to Chicago to see my family.

Taking a break to hug a tree at the Morton Arboretum.

It all started while I was in Chicago, with a visit to the Morton Arboretum. The weather was perfect for seeing this outdoor plant sanctuary, a favorite of my mom’s, and I had never been there. When my mom and I arrived, we discovered there was an origami exhibit underway. The beautiful arboretum grounds were sprinkled with immense metal sculptures, precise replications of miniature folded paper creations. We oohed and aahed as we walked around, both at the plants and the intricate folds of the sculptures, and took lots of fun photos. At the end of our visit, we stopped by the gift shop. I came across a craft kit on how to make origami flowers. It had everything you needed: instruction booklet, paper, and a DVD showing how to make the folds.

“This would be fun,” I told my mom.

Ever the supportive homeschooler, she replied, “I’ll buy it!”

An orchid bouquet that my mom and I crafted together.

So she did. We learned how to make orchids, plumerias, and leaves. I bought floral tape and wire, and we made bouquets. We found YouTube videos detailing how to make cards. We did all this not from the paper included in the kit, though — that paper was plain and boring, so we used it for practice only. But I’d left dozens of sheets of fancy paper at my mom’s apartment, the remnants of my decoupage days. They were still in her basement. I lugged them up the stairs, thankful that most art supplies find use in multiple projects.

I had so much fun that I mailed all my paper (in poster tubes) back to me in New York, and on my plane ride home checked an extra suitcase full of other art paraphernalia. Now I’ve got another way to express my creativity — one that doesn’t involve sitting in front of a screen.

I told my dad one morning a day or two later about the Morton Arboretum and our origami adventures. Along the lines of Japanese culture … he asked whether I’d ever visited the Anderson Japanese Gardens in Rockford. I hadn’t. The afternoon forecast called for rain, so we hurriedly got ready and hopped into his Corvette for the drive to Rockford. Our walk among the Japanese maples and other carefully cultivated plants was sublime.

Enjoying the falling water and beautiful foliage at Anderson Japanese Gardens in Rockford, Ill.

Posing with one of the Chihuly sculptures at the New York Botanical Garden.

Back home in New York,  a good friend of mine came for a brief visit. We headed to The Met, of course, at her request. At my suggestion, we also visited the New York Botanical Garden to see the Chihuly exhibition. I’d seen a similar show at Chicago’s Garfield Park Conservatory several years prior, and had been blown away. His immense blown glass sculptures, which have an unmistakable signature, dotted the garden’s landscape. Some stood alone; others were mixed into the actual plant beds or flowing fountains. For those of you in New York City, I highly recommend going to the botanical garden before this show ends on Oct. 29. Pay the extra few bucks to see not only the outdoor sculptures, but the indoor ones too. It’s totally worth it.

Below are additional photos of my art and nature adventures. Click on any of the photo galleries to see a slide show version with larger images.

Morton Arboretum:

My origami:

Anderson Japanese Gardens:

Beautiful blooming dogwood tree on the grounds of the Japanese garden

New York Botanical Garden / Chihuly:

Subway syncope

The view from inside a NYC subway car, where I evaluated a woman for syncope (fainting).

Sitting on the New York City subway, immersed in the world of my true crime podcast, I suddenly heard a commotion. I looked up and saw that a group of passengers had stood up and gathered in front of me, staring at the woman directly across the aisle. She was slumped over against the shoulder of the woman next to her.

I pulled off my headphones, my ears alert. What I gathered from the murmuring passengers was that the woman had suddenly passed out. In doctor-speak, she had a “syncopal episode.” She was awake now, but obviously woozy.

Usually in this sort of situation, someone with medical qualifications presents to help — a doctor, nurse, PA, paramedic. No one did so. I realized I might be the person with the most medical qualifications in the train car. That was a scary thought.

You are 9-1-1.

The words of my CPR instructor from nearly two years ago rang in my head. That was his response when one of my classmates proposed “calling 9-1-1” as the appropriate course of action in an emergency. Of course, there is some truth to both perspectives. When an emergency happens outside the hospital, you should call 9-1-1 if that’s an option. The paramedics have equipment and knowledge that you don’t. The CPR instructor’s point was, though, that in that critical moment you are the one who is actually there and can make a difference. So if you are appropriately trained, you should act.

With that in mind, I yanked my stethoscope out of my backpack, slung it around my neck, and crossed the aisle to evaluate my “patient.”

By this time, we had pulled into the next train station. Someone alerted the conductor about the emergency, so we stayed put while the paramedics were summoned. In the meantime, I conducted my initial assessment.

I explained that I was a medical student. I cradled the woman’s wrist in my hand so I could take her pulse — faint and slow, I noted. I tried to listen to her heart but it was difficult to hear anything with everyone around me talking. I decided it was more important to take her history. I asked whether this had happened to her before, if she ate or drank sufficiently that morning, whether she had any medical problems.

“Are you a nurse or something?” asked the policeman who was standing in the open doorway of the train car, watching me.

I felt a prickle go up my spine. Clearly, old-fashioned assumptions about gender roles were very much alive, even in progressive New York City in the year 2017. I doubted he would have asked a man with a stethoscope around his neck the same question. But my goal here was to practice medicine, not feminism. So I swallowed, and calmly answered.

“I’m a medical student.”

This seemed to satisfy him. He told us the paramedics were on their way. Another passenger offered to stay with the woman who’d passed out until help arrived. The two women slowly stood up and exited the train car.

Minutes later, the doors whooshed shut, and we were on our way. I sat down, my own heart still racing.

My physician preceptor told me later that morning that as the medical professional, I should have stayed until the paramedics got there. Not necessarily because this woman was going to need more intervention. But because I could better communicate her condition to the paramedics, and because I could prevent bystanders from doing something like starting CPR if she passed out again. Lesson learned for next time.

I learned a lesson about myself that morning, too — about how I respond in an emergency. Namely, that I did respond. I remembered what I’d learned over the last two years and applied it.

In medical school, we hear about how being a physician entails great responsibility. There is a standard of professionalism, and the so-called “social contract” that we’re expected to maintain. As a medical student, I didn’t expect to put that into practice — at least, not without supervision — for some time. I’m honored I had the opportunity.

Central Park self-portraits

When I was in college, one of my favorite (and most time-intensive) classes was photography. This was before the ubiquity of digital cameras — we shot with 35 mm, 400 ISO film, all black and white, manually developed and printed in buckets of smelly liquids under red safety lights. My final project was to tell a “story” in a series of still photographs. I decided to share my daily jogging route. I started and ended with a picture of my running shoes to give context. In between were images of the route itself, the trees, bushes, houses, fences, and streets. I took each photo while slowly panning a scene, blurring the images slightly to give the impression of movement. For my presentation, I mounted each image on rectangles of black art board, with little cutouts along the top and bottom to look like segments of a film strip.

I don’t jog anymore; I prefer an exercise bike, an elliptical machine, or simply a long walk. The photos I present here (digital, obviously — how times have changed!) tell the story of my recent walk to, through, and from Central Park. I am eternally grateful to those who had the foresight to guard this giant swath of land as a nature preserve, and I visit it often. The park changes throughout the seasons. Here is what it looks like on a sunny, spring day.

The park has many boulders suitable for scrambling or simply sitting.

 

In April, there are patches of daffodils all over the park.

 

Blooming magnolias remind me of my childhood home in Forest Park, Illinois.

 

Central Park even has a castle — this is me against its wall.

 

From above, there’s a lovely view of one of the park’s ponds, a giant lawn, and the city skyline in the background.

 

The park paths meander, with many overpasses and underpasses. Here is one of them.

 

Commemorative statues dot the park, including this one of Balto, the sled dog famous for helping transport diphtheria treatment to combat an epidemic in Nome, Alaska in 1925.

 

My walk home was lovely too. This is me in front of the tulip-laden Park Avenue median.

Preparing for what’s next

Being unprepared is one of my worst nightmares. Literally.

The dream takes different forms. Usually, I’m at school. I discover there’s a huge test I didn’t know about (and so didn’t study for). Or there’s a big assignment due, and I completely forgot about it.

I wake up from these dreams unsettled, because in real life, I make a point of being prepared. I know that in general, there are all kinds of things that I can’t control. So the things that are within my power, I try to manage as best as I can.

Nowhere is that more true than with my upcoming clerkships. So much in that realm is out of my hands. I recognize that. But certain aspects, I can prepare for. Like having everything I need in advance.

Living in New York City without a car, shopping can be a challenge. So I’ve tried to get some of that done more conveniently (and more cheaply) while here in Chicago visiting my family.

Jeans aren’t exactly appropriate for the hospital, so I needed more professional attire. And to take a patient’s heart and respiration rates, I needed a wrist watch. Thankfully, I think I’ve gotten everything I needed. Christmas sales made it all relatively affordable — certainly more so than in New York.

I did roll my eyes when my mom explained our shopping trip to a sales clerk at the local mall:

“My daughter came all the way from New York City to go shopping here in Chicago!”

But really, she was right.

I came here to see my family, of course. That’s my main priority. But I also came here to get ready for what’s next. To get in the right mindset for studying for Step 1, and to get what I need for clerkships.

At this point, I’m prepared for what I can prepare for. And the rest? I’ll handle that as it comes.

Winter reflections

Looking out my mom's living room window this morning, through the frosted glass.

Looking out my mom’s living room window this morning, through the frosted glass.

My long-awaited winter break has arrived. And boy, is it winter here in Chicago. I’d avoided donning my down coat in New York until last Friday, when the temperature dipped to 18 degrees. I decided at that point, I could deny the cold weather no longer. Here, that denial is impossible. My iPhone weather widget tells me it’s 7 degrees this morning,  but feels like -7. That’s pretty damn cold, no matter how you spin it. Thankfully though, my internal Midwest thermostat seems intact, and I’m weathering the weather just fine, thank you very much.

Sarah and I were beyond excited about the alleged end of the frigid U.P. winter.

Sarah (on the right) and I were beyond excited about the alleged end of the frigid U.P. winter.

Flipping through an old family scrapbook this morning, I was reminded that even as a kid I had a high tolerance for cold. We lived in the Upper Peninsula of Michigan for a couple years when I was little. There, winter pretty much runs from October through April. Summer feels more like spring. But my sister Sarah and I had no trouble romping in the waves of Lake Michigan while my mom huddled in her jacket on the beach. One of the stories that my parents like to tell about our time in the U.P. was that in 1987, on the first day of spring, Sarah and I were so happy that winter was (supposedly) ending that we put on our bathing suits and ran outside, barefoot, yelling “It’s spring! It’s spring!” We did this in spite of the patchy snow still on the ground.

Looking back, that seems like such a crazy thing to do. Bare feet, bathing suits, and snow? Seriously? But then again, I think a lot of life is like that. In the midst of doing something, no matter how difficult, it seems completely natural. In retrospect though, you wonder how you survived. I wonder if that’s how I’ll feel about medical school. It’s certainly possible. There’s been plenty of craziness involved, and I’m only 3/8 through. But right now, medical school feels like the most natural thing to be doing. Just like running through our snowy lawn, barefoot and in my bathing suit, almost 30 years ago.

Remembering how I got here, with gratitude

Living on the Upper East Side of Manhattan, you encounter a lot of wealthy people. The zip code 10065, just blocks south of where Weill Cornell Medical College is located, made number 15 on Forbes’ “America’s Most Expensive Zip Codes 2015” with a median sale price of $4.4 million. As a broke medical student though, this is not a life that I’m directly exposed to. Not usually. But recently, I was invited to dinner at a private social club. I was to meet the person who funded my summer research, including my trip to Uganda.

Having grown up writing thank you notes for even the smallest of gifts, I was excited to say “thank you” in person for making this life changing experience possible. But when I found out where we were meeting, I was also nervous. Former club members apparently included people like Eleanor Roosevelt, Pearl Buck, and Margaret Mead. What in the world did I have to wear to a place like that? Of course my fretting was for naught; everyone’s attire there was classy but not fancy, just like mine. Phew.

The food at the club was excellent, but much more meaningful was the company. At the dinner I was reminded of two things. First, how important it is to support and mentor a younger generation. That support might be financial, emotional, or otherwise. And second, how significant the experience is for  both parties.

The person who provided my scholarship was thrilled to hear about my trip and my experience. And I was thrilled to share it. The money provided was a drop in the bucket to her, but meant all the world to me. I couldn’t have gone without it. I hope my gratitude came across during that short time.

I’ve had so much help to get here, and it continues to pour in. I’m grateful for all those gifts, great and small. And I fully intend to pay them back someday by paying them forward.

Sunny Sunday in Central Park

On this sunny, Sunday afternoon I headed to Central Park to get some natural vitamin D exposure. (And to revel in the fall foliage.) It was a lovely escape from the concrete streets and skyscrapers. Here are some photos from my excursion.

Note: Click to see larger images.

Sidewalk talk

You see a lot of strange things living in New York City. Some of them funny, others upsetting. But today as I walked down the sidewalk, I saw something pleasantly poignant. So much so that though I was hurrying back to my apartment to study, I paused to take a photo. The message, faded by rain and the elements, is a good reminder for us all.

sidewalk-talk

Apparently, there are more of these messages. See images of them here.