A Life, and Medicine

Tests of the Time

As coughs and sniffles echoed through Hogness Hall this morning, as I sat through yet another exam. The furrowed brows and scratches of freshly sharpened #2s were the only applause as our wits were tested on the three different subjects we’re currently studying (Histology, Biochemistry, and Systems of Human Behavior). 

This is just one exam of the hundreds I’ve endured during my 7 years of university studies. It was fitting that last week Bill Gates gave a talk at UW concerning the many arenas he has sought to impact through his philanthropy. One of his big interests is education, and specifically the evolution that SHOULD be happening but is not. He made many interesting points, but the one that resonated with me was that engagement is much more important than we currently acknowledge in “traditional academics.” 

For example, my classes daily are in an auditorium with ~100 students, a powerpoint, and an instructor. There usually is some questioning during the lecture, but it is basically a linear dialog running down the path. BORING! Not to mention inefficient as most people bounce back and forth from facebook to lecture whenever they overhear something that seems interesting (how awful to invest 2 hours of time for a net gain of ~30min of instruction?). 

Back to testing. Khan Academy has it right when this linear approach should be first, followed by exercises, and THEN followed by in-person instruction/exploration. So how does this change testing? Well in a perfect world an instructor could have real-time data about where the class is with understanding. This could happen by how many / how fast / how accurate a student is completing problem sets. With enough data on a daily basis - an exam would be irrelevant. 

With all of the ways to capture and analyze data today, when ALL of our interactions are already digital, why in the hell are we still engaging education on principles established centuries ago. 

I know it won’t change while I am still in medical school - but I am really curious when it might. 

Thanks, as always, for your time.

Art of a Good Mistake

If life is an art, then I’m barely beyond finger paints. Lines appear to dash in front of my strokes, often resulting in a hodgepodge of color. But sometimes it works, and a masterpiece is born of the chaos. So should we have pride in these occasions? Should we credit ourselves for fortune that finds us?

In a word… absolutely.

Although I enjoy pointing to the providence in the world - I think this conversation is more similar to evolution mechanistically. I liken these pleasant accidents to radiant evolution, where mutations happen with no particular aim (and in all directions) yet within these options selection nullifies all except ones that create lasting advantage. The elegance and subtly here is nature is rewarding action and change, leaving static forms behind.

A less cerebral is example of this is a story my father tells when he was working in the woods. He was a bit green and working for an old man (lets call him Paul) whose family had been logging for ages. Paul is one of the hardest working men on Earth and a back-woods-old-school-hard-ass (still is). My father was kind of spinning in circles, not really understanding the flow of labor up on the landing (link above). After a minute of getting bitched at Paul yells, “God Dammit Son, Don’t care if what ur doin’s wrong er right… JUST DO SOMETHIN!” The point is simple, you can’t get something right unless your doing… well… something! 

I’ve experienced this lesson recently, finding myself in the company of people I greatly admire. I found at moments my vocabulary was slipping away, with the only replacement being audible grunts (or clapping?). At the precipice of inaction I heard the lessons shared above and felt empowered. 

That action is rewarded before inaction. That in order to get something right, you by definition have to be doing something. 

So don’t let yourselves blend into the background in fear of mistakes, simply because some of those possible mistakes will be good ones.

Thanks, as always, for your time.

… Good Work

A day of classes, a 3hr drive turned 6 hours by Seattle traffic, I arrived to a note left for me. It meant an alarm was set for 7:45am just for me and precious few hours of sleep on my first day off of studies in 3 weeks. The next morning I was heading crabbin with my uncle, because that is what men do for fun when its in season… and everyone knows I’m a man’s man (funny history here I may post in the future) and thus no need for a conversation. Its a done deal.

The air was sharp, clear, and cold. The boat was well worn and the obvious object of love - as the owner’s name was boldly painted across the bow. As the youngest man aboard - by about 40 years - I was quickly designated, in fine country fashion, the slow and clumsy cabin boy. While in the background I hear my Uncle bragging me up to the owner of the boat, “Smart, Blah Blah, UWSOM…” I start in baiting the traps… Rotten fish guts from somewhere. I slopped them into the bait cages trying not to recognize livers, bowels, and other tidbits floating in my mind from anatomy. The captain swings back and makes some comment about the smell, my soft doc’ter hands and a cheap prostitute, setting the stage for a warped and amusing day of humor. A few minutes pass and I hear the first holler. I grunt and toss the pot. SPLASH! The first pot is soaking.

Six hours later. Many laughs - mostly at my expense. 36 hard caught crab left two old men proud of their catch. My uncle and I whipped through and cleaned up the gear, sprayed off the deck, put away the bait, stacked the traps, and I kicked back (picture above) day dreaming about how to make-up the time away from my wife/nephews/niece/mom.

On the way back while my mind still wandered, my uncle walked out of the cabin to the back of the boat. His face, though wrinkled and weathered, was glowing with contentment. We had some small talk on the way back to dock, about dinner, and other small details. Then he turned, just before walking back into the cabin, pauses and says “…Good work Al.” 

“God Dammit,” I though bemusedly. It just happened again. Perspective.

Good work is one of those things often avoided, just like I tried to avoid this crabbing trip. Up early, dirty, and smelly verses a lazy day with clean giggling kids  amped to hang with Uncle Al. However in the end good work always rewards. The real poetry of life is that the reward often come in a form we don’t expect but really need. I needed this reminder, as in the last week I found myself lazy and apathetic after my intense A&E boot camp. I felt like I deserved it. So this was a great reminder - a jab in the heart - to push through hardship and reap the unseen benefits of a duty done well.

So here is to good work. The wonderfully simple lessons and rewards it has to offer. And let us never evade it, and if we do let Good Work track us down and get in our way again and again.

To Good Work!

Thanks, as always, for your time.

Life In Each Moment

What do you picture if asked to describe a situation where you would learn as much about yourself as you did about a science? 

Does it involve steel gurneys? Gagging daily for nearly 5 weeks? Elevated levels of Cortisol while simultaneously sticking your face very near where it was once made? 

Well I have just gone through all of those, and find myself better for it. 

There are rights of passage everywhere. We all put our heads down and blast through. Or maybe do all we can to avoid them. Either way we experience the moments that make us transport our minds into the future - and say - “It will all be great when this is over…” 

I had this moment often over the last 5 weeks but it made me pause recently, and I am now sad to admit that. 

For the last 5 weeks I have been fighting up stream in a right of passage here at UWSOM. Hearing “immersion anatomy” to anyone who did their first year in Seattle inspires looks of pain, misery, and anxiety. I’ve even heard classmates say “This is making my soul hurt.” On the very surface the class is insanely fast paced. Involving a completely foreign language whilst completely smashing many major societal taboos. Not to mention being the first class where 100 students with various backgrounds are all wide-eyed as we battle “imposter syndrome,” having no proof that we indeed belong in medical school. 

Like and infant into an adult. Fast forward two Pin Tests, two Written Exams, and 99% of the class, I see a class transformed. Red faced and shaky hands now hold probes and scalpels with conviction. Probes flicking through tissues while rattling off arterial branches of branches, embryological origins, and CNS/ANS innervations impervious to the stench of embalming fluids leaking from our subjects. 

It is amazing. It is a boot camp. And although the kind white-haired wizards that push you up the mount-seems-impossible would never admit it, it is a crucible methodically designed to create exactly this epiphany…

… that the privileged access to 40 willed cadavers goes by WAY too fast. Getting to look beneath the surface of the human body is truly inspiring. And finally that we (my classmates and I) are exactly where we are supposed to be and should relish in every moment of our fantastic opportunities at UWSOM, even though we often may loose that perspective.

Enjoy the moments, and the new life in each of them. 

Thanks, as always, for your time.

PS - Thank you, to individuals and families that donate their bodies to science. What a great and powerful last act to better the world. 

Shadow Boxing

First Post.

So, I admit that I’ve though about how or even if I should pull the trigger on this blog. And wouldn’t you know it, now is no special time (really). However in the expanse of arbitrary dates, I did strike a relevant chord to start off this dialog… journal… archive… err… thingy.

Shadow boxing.

No, not the thing sweaty guys do before pummeling each other in the octagon. In this version it is the art of letting other people’s “apparent” goals slip into your mind and keep punching you in the chin until you find yourself fighting a battle that you never wanted to fight in the first place.

You see, I am a first year medical student and find myself currently surrounded by some extreme type-A personalities which I am not. These individuals seem programmed to reflect your goals as their own, warp them into a hyper-competition, and get you to freak out about winning before you even know you had a goal, wanted to win, or knew you were competing.

It is really amazing.

Having discovered this uncanny ability on accident in my peers, it has let me to ask myself the question “Is this your priority or not?” Every time I’ve caught myself competing, I’m embarrassingly off the mark and am in need of getting my head back in MY game.

My game is simple, consisting of both do’s and do not’s.

I do not want to get bogged down in pissing contests. I’m programmed to win and have a long history of competition, however I don’t respect that motivation much. In conversation I generalize this type of behavior as “Monkey Brain Mentality”, in that it is an innate piece our biology built to keep us valuable in a tribe, fed, and reproductively viable.

Basically chest beating to prove your worth.

What I do very much want to accomplish is growth in perspective and self. I want to suffer, and scar. To learn from all the knowledge and emotions that I encounter. I want to be a resource and find resources as I explore the depth of humanity, and earn the trust physicians enjoy.

Most of all I want to be intimate friends with human frailty in all its various forms, physical and psychological.

My dream is to be a physician. A profession solely concerned with addressing imperfection and keeping it at bay.

This is my personal dream as well as professional. To succeed because of my frailty and not in spite of it. Something that I, like most men, have had an acute fear of recognizing.

I hope that sounds interesting to anyone reading this, as I plan on sharing my story as I go through the grinder of medical school. I’d especially love the dialog with anyone interested in order to help maintain a firm connection to reality as the institution tries to beat it out of me.

Thanks, as always, for your time.