Sunday, August 20, 2006
I struck a happy balance of singing and science while I studied at the University of Vermont (UVM). For two exciting and rewarding years, I led a double life. In the daytime, I was a dedicated student of molecular genetics, a tutor and an undergraduate researcher. At night, not unlike a vampire, I emerged from the lab smelling pungently of glacial acetic acid to band together in song with ten gentlemen, the Top Cats.
In the fall of 2002, I auditioned for the all male A Cappella group at UVM. Before then, I had only sung in Rock bands. The A Cappella singing style—beautiful and raw—was markedly different than Rock’s familiar, but overpowering, instrumentation. However, I loved to sing and summoned courage to audition. That next morning at 1am the ten current members towing five surly alumni stormed into to my room to “sing me in”.
My time in Top Cats was demanding, enjoyable and chalk-full novel experiences that would later shape my aspirations. I adapted to not only the new singing style, but to working within a group—all of us having distinct egos and expectations. Soon after my initiation, we were performing at philanthropic events all around the North East. We sang, among other things, old Doo-wop standards such as “In the still of the night”. Smiles, accompanied sometimes by clapping, would fill the room. Everywhere Top Cats sang, either planned or spontaneous, we left an impressed and grateful audience. I was impressed that my presence and skill could affect such gratitude in people. This feeling was entirely novel and completely enthralling.
In college my love in the evening was song; my love in the daytime was science. I researched cell differentiation at UVM under Dr. Cedric Wesley. He became my mentor and model of a shrewd scientist. In the year that followed my graduation, our research blossomed into my first-author publication. This was exciting, but something was missing. Certainly, a life in basic science would be rewarding: exactly what a career should be. Yet, I felt disconnected from people, as my days in Top Cats were now over. I realized I wanted to strike a balance between these to facets of my personality. Medicine seemed to have this balance; I began consider medicine more seriously.
What is it like to be a physician? I had to answer this question. Since I was twelve, I have witnessed the trials that await a perspective student of medicine. My mother had returned to college, then medical school, late in life, and was just finishing her residency when I graduated college. She inspired me with her passion, tenacity, and regaled me with many rousing stories. Nevertheless, there was only so much I could learn from oral accounts. Personal experience in a clinical setting was what I required to make a solid decision on medicine as a career.
Clinical research was the marriage of the medical experience I sought and research skills I had. Also, I was ready to be out of my element. I’ve always been curious about city life, having grown up in rural Maine and spent most of my days in Northern New England. I decided to couple new employment in clinical research with a move to a city. After careful consideration, I chose San Francisco for two reasons. First, it is home to the University of California San Francisco: one of the most progressive and respected medical institutions in the country. Two, I would be most decidedly out of New England, and my element. I established a plan: find employment at UCSF and make San Francisco my new home. So, I bought a one-way plane ticket. Once there, began flooding the inboxes of investigators with my resume and a cover letter designed to pull at heartstrings. I received a reply from Dr. Karin Petersen of the Pain Clinical Research Center (PCRC) and was invited to a daylong interview. In the end, I was offered a position as a clinical research associate at UCSF.
My days in San Francisco have brought me closer to answering my original question: What is it like to be a physician? I will not be able to fully answer this question for many years yet. Although, everyday at the Pain Clinical Research Center brings fresh, enlightening events, all solidifying a choice well made. Every subject I interview, every piece of data I collect, every interaction with the doctors who oversee the studies, brings me a step closer to the answer. I am currently running a study that requires me to spend many hours with the subjects while they receive morphine. Every person I meet is different, and that is exciting. They’re as different in their aspirations, stage-in-life and humor, as in their response to the drug. Other ways they are the same. Each subject is curious about their body and what is happening to it. Each person has questions; they need a tailor-made and informed explanation. I am again excited that I never cease to learn. There is a unique dichotomy in medicine that suits me. This dual role of a physician—I’ve half experienced and half observed—is the perfect balance between scientist and singer. As an audience expects a singer to be skillful and passionate with song, a patient expects a physician to be skilled and keen with knowledge. I seek to fulfill that expectation. For now, I remain committed to my research, always edger to learn more.
In the fall of 2002, I auditioned for the all male A Cappella group at UVM. Before then, I had only sung in Rock bands. The A Cappella singing style—beautiful and raw—was markedly different than Rock’s familiar, but overpowering, instrumentation. However, I loved to sing and summoned courage to audition. That next morning at 1am the ten current members towing five surly alumni stormed into to my room to “sing me in”.
My time in Top Cats was demanding, enjoyable and chalk-full novel experiences that would later shape my aspirations. I adapted to not only the new singing style, but to working within a group—all of us having distinct egos and expectations. Soon after my initiation, we were performing at philanthropic events all around the North East. We sang, among other things, old Doo-wop standards such as “In the still of the night”. Smiles, accompanied sometimes by clapping, would fill the room. Everywhere Top Cats sang, either planned or spontaneous, we left an impressed and grateful audience. I was impressed that my presence and skill could affect such gratitude in people. This feeling was entirely novel and completely enthralling.
In college my love in the evening was song; my love in the daytime was science. I researched cell differentiation at UVM under Dr. Cedric Wesley. He became my mentor and model of a shrewd scientist. In the year that followed my graduation, our research blossomed into my first-author publication. This was exciting, but something was missing. Certainly, a life in basic science would be rewarding: exactly what a career should be. Yet, I felt disconnected from people, as my days in Top Cats were now over. I realized I wanted to strike a balance between these to facets of my personality. Medicine seemed to have this balance; I began consider medicine more seriously.
What is it like to be a physician? I had to answer this question. Since I was twelve, I have witnessed the trials that await a perspective student of medicine. My mother had returned to college, then medical school, late in life, and was just finishing her residency when I graduated college. She inspired me with her passion, tenacity, and regaled me with many rousing stories. Nevertheless, there was only so much I could learn from oral accounts. Personal experience in a clinical setting was what I required to make a solid decision on medicine as a career.
Clinical research was the marriage of the medical experience I sought and research skills I had. Also, I was ready to be out of my element. I’ve always been curious about city life, having grown up in rural Maine and spent most of my days in Northern New England. I decided to couple new employment in clinical research with a move to a city. After careful consideration, I chose San Francisco for two reasons. First, it is home to the University of California San Francisco: one of the most progressive and respected medical institutions in the country. Two, I would be most decidedly out of New England, and my element. I established a plan: find employment at UCSF and make San Francisco my new home. So, I bought a one-way plane ticket. Once there, began flooding the inboxes of investigators with my resume and a cover letter designed to pull at heartstrings. I received a reply from Dr. Karin Petersen of the Pain Clinical Research Center (PCRC) and was invited to a daylong interview. In the end, I was offered a position as a clinical research associate at UCSF.
My days in San Francisco have brought me closer to answering my original question: What is it like to be a physician? I will not be able to fully answer this question for many years yet. Although, everyday at the Pain Clinical Research Center brings fresh, enlightening events, all solidifying a choice well made. Every subject I interview, every piece of data I collect, every interaction with the doctors who oversee the studies, brings me a step closer to the answer. I am currently running a study that requires me to spend many hours with the subjects while they receive morphine. Every person I meet is different, and that is exciting. They’re as different in their aspirations, stage-in-life and humor, as in their response to the drug. Other ways they are the same. Each subject is curious about their body and what is happening to it. Each person has questions; they need a tailor-made and informed explanation. I am again excited that I never cease to learn. There is a unique dichotomy in medicine that suits me. This dual role of a physician—I’ve half experienced and half observed—is the perfect balance between scientist and singer. As an audience expects a singer to be skillful and passionate with song, a patient expects a physician to be skilled and keen with knowledge. I seek to fulfill that expectation. For now, I remain committed to my research, always edger to learn more.
Thursday, May 11, 2006
Needle Exchange
"Now I am a LONG way from home." I thought I as strained against steep grade of the hill; the ever-present pull of gravity. Michelle and I were walking down from Nob Hill, a relatively rich neighborhood in SF, to the Tenderloin: the city's most crime ridden and impoverished. Yesterday--Wednesday--was my first time at the Needle exchange. I'd been threatening to observe this most controversial and necessary of humanitarian projects first hand, to see if I might want to volunteer there. I finially tagged a long with Michelle.
Michelle is a very attractive East Bay native with whom I work. With long blond-red hair, a confident stride and darlingly feminine eyes, she easily caught the attention of the groups of loitering black men. Michelle has been walk through this neighborhood for years, showing up on Wednesdays to help the city's large population of intravenous drug users by exchanging their dirty needles for HIV, Hepatitis B/C free ones. "A noble effort." I thought when I first heard Michelle talking about it.
There are few neighborhoods that I've not explored in SF, one of them--up until Wednesday, at least--is the Tenderloin. I'm not at all sure why it was dubbed with such an ironic name, but that is apparently what stuck. The irony of its name is that the Tenderloin is the worst part of the city. To quote some stand-up by Dave Chapelle, "There ain't nothin' tender about that place!"
The civic center and city hall are both proximate to this area, as is a stretch of Market street. Just North is Nob hill: one of the more prosperous parts of SF; just east, the financial district. This kind of rich-abutting-poor geography is the norm through this City of San Francisco. In a way it was the same in Central Maine. My guess is that it is the same in both rural and urban areas of this country, the exception being large suburban areas that can afford to hedge out all the poorer folks by making housing and transportation services too expensive.
I was nervous. There is no other way I can describe it, although I would like lie and say that I was calm and had not been envisioning some crazed IV drug user, enlivened with withdrawal and jealous of my privileged life, stabling me in the neck with dirty needles and saying, "Welcome to my world, bitch!". Hmmm... I believe that would be rather unfair, though, as it would've given me all the disease and none of the high. Plus, right now I doubt I've got more capital than the collection bottles in his shopping cart.
Anyway, I was nervous. These are dangerous people, I'd been thought. My nerves were solely based on all my pre-exposure to IV drug users which is consists of watching images of these unholy and fallen souls on a cathode ray tube.
Shelly and I arrived at TARC (Tenderlion AIDS Resource Center) where the other volunteers and staff had already setup. The setup was totally not what I expected, well at least the layout and size of area it occupied. What I was expecting with this: a gymnasium full of crackheads with a sprinkling of suites (the dark CEO with a DARK secret). I envisioned tables of needles and other associated paraphernalia, and the jonzing masses would be grabbing what they wanted in a big free-for-all intravenous extravaganza. The needle exchange actaully looks like this: A old store front--about 8ft by 20ft--with plate glass windows (not bullet proof). Just through the door, to the left, there is a regular size desk upon which lay a variety of fliers, forms and pens. At the back along the wall on a long bar are bins containing different sized syringes, cookers, tourniquets, packets of vitamin C powder, sterile water. Thats it. Simple and--I'll explain why--effective.
The exchange is open for two hours on Sunday and Wednesday. IV drug users line up outside and are let in three at a time. The fill out a form on the desk, return there dirty needles to the bio-buckets and receive packs of 10 syringes at the back. Here are the rules of the exchange: if they bring none back we give them 1 packet of 10 syringes; if they bring back 10, we give them 20; after that we match whatever number they return. All the works that one would need to shoot up cleanly and safely.
What is the point of this program? Who are these individuals that use and vail themselves of this service? Why propagate drug habits of these individuals?
Before I answer these questions in my own manner, I would like to submit a small piece of advice I was given by a co-worker on the subject of the needle exchange and how it will reflect on my person during reviews by medical schools. Specifically, I was told to not bring up the fact that I volunteered at the needle exchange while being considered for some of the more "conservative" schools of medicine. This will surely reflect poorly on me and ultimately jeopardize my admission to many med schools. If this is indeed so, and my participation at the needle exchange does result in my rejection from a great many schools, then so be it. I believe the needle exchange is a more than necessary program and no amount of ignorance or prejudice is going to keep me from including this experience, for it is in large part WHY I want to be a doctor.
Which brings me to the purpose of this program. The benefits of needle exchange are clear if one educates themselves about IV drug use, looking past the obvious social and legal taboos and concentrate on the mechanics. Intravenous drug users must do just that: use their drugs by putting them directly into the bloodstream, into the veins. To be sure they've hit a vein they must aspirate or draw up blood. Before the prominence of disposable needles through needle exchange, they were a commodity and, because of needle scarcity, people would share them (still do). This mechanism of drug use and the affected mind of the addict (one who is prone to poor decision making) sums to very high risk for contraction disease.
But why should normal people care? Why would someone living in the Occasionally
Michelle is a very attractive East Bay native with whom I work. With long blond-red hair, a confident stride and darlingly feminine eyes, she easily caught the attention of the groups of loitering black men. Michelle has been walk through this neighborhood for years, showing up on Wednesdays to help the city's large population of intravenous drug users by exchanging their dirty needles for HIV, Hepatitis B/C free ones. "A noble effort." I thought when I first heard Michelle talking about it.
There are few neighborhoods that I've not explored in SF, one of them--up until Wednesday, at least--is the Tenderloin. I'm not at all sure why it was dubbed with such an ironic name, but that is apparently what stuck. The irony of its name is that the Tenderloin is the worst part of the city. To quote some stand-up by Dave Chapelle, "There ain't nothin' tender about that place!"
The civic center and city hall are both proximate to this area, as is a stretch of Market street. Just North is Nob hill: one of the more prosperous parts of SF; just east, the financial district. This kind of rich-abutting-poor geography is the norm through this City of San Francisco. In a way it was the same in Central Maine. My guess is that it is the same in both rural and urban areas of this country, the exception being large suburban areas that can afford to hedge out all the poorer folks by making housing and transportation services too expensive.
I was nervous. There is no other way I can describe it, although I would like lie and say that I was calm and had not been envisioning some crazed IV drug user, enlivened with withdrawal and jealous of my privileged life, stabling me in the neck with dirty needles and saying, "Welcome to my world, bitch!". Hmmm... I believe that would be rather unfair, though, as it would've given me all the disease and none of the high. Plus, right now I doubt I've got more capital than the collection bottles in his shopping cart.
Anyway, I was nervous. These are dangerous people, I'd been thought. My nerves were solely based on all my pre-exposure to IV drug users which is consists of watching images of these unholy and fallen souls on a cathode ray tube.
Shelly and I arrived at TARC (Tenderlion AIDS Resource Center) where the other volunteers and staff had already setup. The setup was totally not what I expected, well at least the layout and size of area it occupied. What I was expecting with this: a gymnasium full of crackheads with a sprinkling of suites (the dark CEO with a DARK secret). I envisioned tables of needles and other associated paraphernalia, and the jonzing masses would be grabbing what they wanted in a big free-for-all intravenous extravaganza. The needle exchange actaully looks like this: A old store front--about 8ft by 20ft--with plate glass windows (not bullet proof). Just through the door, to the left, there is a regular size desk upon which lay a variety of fliers, forms and pens. At the back along the wall on a long bar are bins containing different sized syringes, cookers, tourniquets, packets of vitamin C powder, sterile water. Thats it. Simple and--I'll explain why--effective.
The exchange is open for two hours on Sunday and Wednesday. IV drug users line up outside and are let in three at a time. The fill out a form on the desk, return there dirty needles to the bio-buckets and receive packs of 10 syringes at the back. Here are the rules of the exchange: if they bring none back we give them 1 packet of 10 syringes; if they bring back 10, we give them 20; after that we match whatever number they return. All the works that one would need to shoot up cleanly and safely.
What is the point of this program? Who are these individuals that use and vail themselves of this service? Why propagate drug habits of these individuals?
Before I answer these questions in my own manner, I would like to submit a small piece of advice I was given by a co-worker on the subject of the needle exchange and how it will reflect on my person during reviews by medical schools. Specifically, I was told to not bring up the fact that I volunteered at the needle exchange while being considered for some of the more "conservative" schools of medicine. This will surely reflect poorly on me and ultimately jeopardize my admission to many med schools. If this is indeed so, and my participation at the needle exchange does result in my rejection from a great many schools, then so be it. I believe the needle exchange is a more than necessary program and no amount of ignorance or prejudice is going to keep me from including this experience, for it is in large part WHY I want to be a doctor.
Which brings me to the purpose of this program. The benefits of needle exchange are clear if one educates themselves about IV drug use, looking past the obvious social and legal taboos and concentrate on the mechanics. Intravenous drug users must do just that: use their drugs by putting them directly into the bloodstream, into the veins. To be sure they've hit a vein they must aspirate or draw up blood. Before the prominence of disposable needles through needle exchange, they were a commodity and, because of needle scarcity, people would share them (still do). This mechanism of drug use and the affected mind of the addict (one who is prone to poor decision making) sums to very high risk for contraction disease.
But why should normal people care? Why would someone living in the Occasionally
Saturday, April 22, 2006
Why here?
"Why have I come to San Francisco?"
One of our study subjects asked me this question. He, Shelly and I were sitting around exam room 2 at the end of the day Friday chatting in that way that twenty-somethings do. The conversation had turned to me and my expedation to the west coast. He asked this question I with a perplexed faced, or maybe it was inquisative. There appears to be little difference in some people.
I thought, "If this guy only knew what a deadend my life had become back in Vermont, at least with respect to my 'career'."
So I gave it some really thought. Deciding to depart from my normal shpeel and answered, "I needed experience."
I went on to talk about my aspirations of medical school, but my initial sentence was concise enough to say it all.
Turns out he was a graduate of Brown, majored in internation relations--some specialized political science degree I'm assuming-- and was headed to medical school himself.
My mind as returned to the answer I gave to this man: "I needed experience." The entire conversation wasn't quite that abbreviated, however that was the truest sentence I've uttered in months, the first time I've felt like myself in months.
THAT is why I've come here. I've come here to ride my bike in traffic. I've come to take public transportation and sit along side the homeless, the poor, the uneducated. To see the rich, the vain, the self-obsessed, the plastic. I've landed to be judged, evaluated, accused, vindicated. I've arrived to be confused, scared, happy, sad, lonely, loved and astonished, to help and be helped. I am doing this for the experience.
By some beautiful divine course I landed a job at UCSF as a clinical research associate. It could have turned out drastically different, as I had accepted--hastily--a job in a cancer research laboratory. I would be doing essentially the same thing as I did back in Vermont. Nothing is quite the same out here and I was slightly depressed that the majority of my time will be spent doing the same tasks, the same work.
Dr. Petersen called the day after I had committed to the cancer research lab, having gotten my resume by way of some pushy mass e-mailing I had done. She explained that she was a principal investigator at the Pain Clinical Research Center at UCSF, and the lab was involved in various pain studies involving human subjects. "Wait", I thought, "HUMAN subjects." Amongst my complement of skills applicable to medical school, none were involved people in a medical setting. I suspected for a long while that I would be good with people because I enjoyed my retail jobs, of which I held an accumulated horde throughout high school. They always entailed helping not so knowledgeable individuals with purchases in electronics, luggage, plumbing products.
"I just accepted a position at a cancer research laboratory." I said with clear regret in my voice's timbre.
"Well, you want to go to medical school, right? I think clinical research is the clear choice for you. You'll need some medically related experience. Do you have any?"
"No. I've already committed to this position. I don't know if I feel right about ducking out of it."
"Well, you should think about coming in for an interview. If you are planning on applying to medical school, this would be an invaluable experience for you."
"Ok. I'll call you back either way. I'll just need sometime to think about it."
I slapped close my cell phone and spent the next five minutes pacing the floor of Bill's studio manically repeating "Shit, shit, shit, shit..."
What have I got to lose? The timing would be tricky. I was to start my new position asap and that would certainly interfere with any interview date I set. Do I piss off my new boss by pushing back my start date and go for this interview? Why wouldn't I? I called my parents and they reaffirmed my initially shaky resolution.
In true self-fashion and character, I'd forgotten to take down Dr. Petersen's contact information. After spending an hour on the UCSF website, I finally found her information.
An hour had passed since she called.
"This is Matt LeComte. You called about an hour ago. Yeah, when can I come in?"
I went for what turned into a day long interview. I got the job.
It's been one-hundred and one days since then. History and writing are not exactly human nature just yet. It is not COMPLETELY natural for us to count and record the days with such dedication and precision. It takes energy and diligence that few possess. And if this is all untrue, if my hypothesis is groundless, then I've just got more hunter-gather genes then I thought, cause I'm merely basing this on my self-observation. At any rate, I'm glad I at lease have the ability to share all this, if not as frequent as I'd like.
One of our study subjects asked me this question. He, Shelly and I were sitting around exam room 2 at the end of the day Friday chatting in that way that twenty-somethings do. The conversation had turned to me and my expedation to the west coast. He asked this question I with a perplexed faced, or maybe it was inquisative. There appears to be little difference in some people.
I thought, "If this guy only knew what a deadend my life had become back in Vermont, at least with respect to my 'career'."
So I gave it some really thought. Deciding to depart from my normal shpeel and answered, "I needed experience."
I went on to talk about my aspirations of medical school, but my initial sentence was concise enough to say it all.
Turns out he was a graduate of Brown, majored in internation relations--some specialized political science degree I'm assuming-- and was headed to medical school himself.
My mind as returned to the answer I gave to this man: "I needed experience." The entire conversation wasn't quite that abbreviated, however that was the truest sentence I've uttered in months, the first time I've felt like myself in months.
THAT is why I've come here. I've come here to ride my bike in traffic. I've come to take public transportation and sit along side the homeless, the poor, the uneducated. To see the rich, the vain, the self-obsessed, the plastic. I've landed to be judged, evaluated, accused, vindicated. I've arrived to be confused, scared, happy, sad, lonely, loved and astonished, to help and be helped. I am doing this for the experience.
By some beautiful divine course I landed a job at UCSF as a clinical research associate. It could have turned out drastically different, as I had accepted--hastily--a job in a cancer research laboratory. I would be doing essentially the same thing as I did back in Vermont. Nothing is quite the same out here and I was slightly depressed that the majority of my time will be spent doing the same tasks, the same work.
Dr. Petersen called the day after I had committed to the cancer research lab, having gotten my resume by way of some pushy mass e-mailing I had done. She explained that she was a principal investigator at the Pain Clinical Research Center at UCSF, and the lab was involved in various pain studies involving human subjects. "Wait", I thought, "HUMAN subjects." Amongst my complement of skills applicable to medical school, none were involved people in a medical setting. I suspected for a long while that I would be good with people because I enjoyed my retail jobs, of which I held an accumulated horde throughout high school. They always entailed helping not so knowledgeable individuals with purchases in electronics, luggage, plumbing products.
"I just accepted a position at a cancer research laboratory." I said with clear regret in my voice's timbre.
"Well, you want to go to medical school, right? I think clinical research is the clear choice for you. You'll need some medically related experience. Do you have any?"
"No. I've already committed to this position. I don't know if I feel right about ducking out of it."
"Well, you should think about coming in for an interview. If you are planning on applying to medical school, this would be an invaluable experience for you."
"Ok. I'll call you back either way. I'll just need sometime to think about it."
I slapped close my cell phone and spent the next five minutes pacing the floor of Bill's studio manically repeating "Shit, shit, shit, shit..."
What have I got to lose? The timing would be tricky. I was to start my new position asap and that would certainly interfere with any interview date I set. Do I piss off my new boss by pushing back my start date and go for this interview? Why wouldn't I? I called my parents and they reaffirmed my initially shaky resolution.
In true self-fashion and character, I'd forgotten to take down Dr. Petersen's contact information. After spending an hour on the UCSF website, I finally found her information.
An hour had passed since she called.
"This is Matt LeComte. You called about an hour ago. Yeah, when can I come in?"
I went for what turned into a day long interview. I got the job.
It's been one-hundred and one days since then. History and writing are not exactly human nature just yet. It is not COMPLETELY natural for us to count and record the days with such dedication and precision. It takes energy and diligence that few possess. And if this is all untrue, if my hypothesis is groundless, then I've just got more hunter-gather genes then I thought, cause I'm merely basing this on my self-observation. At any rate, I'm glad I at lease have the ability to share all this, if not as frequent as I'd like.
Sunday, April 16, 2006
I guess I'm the same everywhere
There is something familiar about this place,
when I close my eyes...
I could be anywhere, but I'm the same.
Location does not change me. The miles have not morphed me,
into a world weary sun, the son is the same and the days are mostly August dust.
And though I trace long lines across the place, and I the mountains become plains
I'm feeling very much the same.
Judging the past and predicting the future, as if I've been there before. Cause, honestly, this is feeling like the past, therefore the future will feel like... So I know what's in store.
The end is somewhere in there too. So maybe I should do more, be more, love more, talk more, think more, write more, appreciate more, fix more, see more, and run more many many miles. Maybe I'll feel different, and not be the same, or accept my "same" or something, before I go.
Maybe I'll create something to leave behind, cause where I'm going I cannot return. And it is sad, cause I don't think I'll see you there--I hardly knew you in life. But maybe when I travel the distance that has no measure, we can sit and talk?
Cause I am what you'll leave behind. And maybe we just sleep. Then I'll never know. Never change. Be the same while I sleep forever.
Maybe I we should sit near the lake and talk in the sun soon. Cause your head is silver, life is making your heart tired. You can only expect it to toil for so long.
Toil on.
And I'll be here, far away. The same.
when I close my eyes...
I could be anywhere, but I'm the same.
Location does not change me. The miles have not morphed me,
into a world weary sun, the son is the same and the days are mostly August dust.
And though I trace long lines across the place, and I the mountains become plains
I'm feeling very much the same.
Judging the past and predicting the future, as if I've been there before. Cause, honestly, this is feeling like the past, therefore the future will feel like... So I know what's in store.
The end is somewhere in there too. So maybe I should do more, be more, love more, talk more, think more, write more, appreciate more, fix more, see more, and run more many many miles. Maybe I'll feel different, and not be the same, or accept my "same" or something, before I go.
Maybe I'll create something to leave behind, cause where I'm going I cannot return. And it is sad, cause I don't think I'll see you there--I hardly knew you in life. But maybe when I travel the distance that has no measure, we can sit and talk?
Cause I am what you'll leave behind. And maybe we just sleep. Then I'll never know. Never change. Be the same while I sleep forever.
Maybe I we should sit near the lake and talk in the sun soon. Cause your head is silver, life is making your heart tired. You can only expect it to toil for so long.
Toil on.
And I'll be here, far away. The same.
Monday, April 10, 2006
The ER
Anxiety
__________
I could've been looking into a mirror. I saw his face, instinctively mimicked it, drawing the outside of my eyebrows up and forcing my center brow in toward my nose. Oh, this expression I've worn a million times before, but never in His condition, never under watch. The world disappeared momentarily as I involuntarily played back one of the many anxiety attacks I had in Emily's presence.
[
Driving down 89 toward Burlington. Spring. Near Saint Albans. Looking west, the sun was effervescencing on the lake. My heart: pounding. "If I die now..." Something pops in my back. A flood of fear. "I'll never make it..."
"I wish I could help you."
"There is nothing you can do."
"I'm so frustrated. I can't help you? Why does this happen?"
" I don't know." Shaking. Clutching her knee.
"It's ok." Rubs my shoulders. Helps.
Only 26 more miles until Burlington. 26 more minutes until my mind can rest. ]
He was propped up on the gurney, pressure cuff on his right arm, IV in the left attached to a liter of saline, pulse/ox on his right index finger, electrodes connected to his chest. That look on his face.
The room in the ER room was spacious and nearly square. The gurney was in the middle, with a large surgical light array hovering above-like the smiling face of God. A large moveable very sturdy-looking caddy attached to a large boom arm loomed in the rear of the room covered with medical equipment. Urgent, that is the word I thought of when I first noticed it. In the center of the caddy there was a large touch screen displaying all his vitals: blood pressure, heart rate, respiratory rate and a dozen others. I noted, at a glance, that his heart rate still 100 BPM.
He was looking up pass me. I followed his gaze to a flat-screen monitor mounted to the facing wall. It showed the same information as the touch screen behind him.
"How are you feeling?"
I could almost read his mind, his face said it all,
"I can't believe this happened to me. Why did I do this? I just want it to stop."
We had been in the ER for over an hour. The hospital staff had taken a chest x-ray with a huge portable machine, preformed two EKGs and ordered a dose of IV Adivan, at the behest of Him. I believe His exact words were, "Can I get something for the anxiety. Some Adivan? I've had that before. That worked in the past." Past?
"I'm still feeling really nervous. Where is the Adivan?"
"I don't know. I think they had to order it from the pharmacy. The nurse administers it."
"I'm still feeling really nervous."
"Well, that is one of the side-effects of the drug. Try not to look at the your vitals...
I know how you feel..."
'I know how He feels', I repeated in my mind.
I wonder how may people have died on that gurney... He caught me staring at his chest; I had slipped off in mid-sentence.
Snapping to my post immediately, I changed the subject. How to make His heart light? I would periodically glance at his heart-rate and saw it drop 10 to 15 BPM while He was distracted.
The nurse came in, saw the doctor's prescription of Adivan, collected the syringe from a cart and administered it through a port in the IV. The nurse was male, gay. intelligent, tanned skin with whit-blue eyes. More than just good looking, he had a compassionate intellect and the kind stare that made me comfortable in any attempt to communicate. The nurse listened while I described the study, properties and pharmokentics of the drug.
Then He asked for more.
I couldn't blame him. Judgement started to rise within me, that righteousness boiling in the the back of my brain.
"This person does not need another does. He will be fine. He should be straight and not reliant on substances." I thought, I preached
He received the second dose. 2 mg of Adivan in total.
"The half-life of modafinil is..."
"15 hours" I inserted.
"Therefore", he continued, "the modafinil will be in your system for the next 15 times 4 hours. It takes approximately 4 half-lifes for a drug to reach negligible amounts in the body."
This seemed wrong to me. It really depends on the drugs affinity for its target protein or whatever. Anyway...
"What if the nervousness comes back after I leave? Can you give me a script for Adivan, in case it comes back?" He asked.
"Sure."
The righteous boiling judgement came to the surface. I looked at Him, that face. The "I'm worried" face. Relying on drugs...
Then I saw myself, and I was ashamed.
Had I forgotten who I was? This much is true: I'm in no position to judge. I am on 25mg of Zoloft; self medicated.
We were there for 4 hours.
[incomplete]
DAD
The EMT
the nurse
the doctor
the billing
__________
I could've been looking into a mirror. I saw his face, instinctively mimicked it, drawing the outside of my eyebrows up and forcing my center brow in toward my nose. Oh, this expression I've worn a million times before, but never in His condition, never under watch. The world disappeared momentarily as I involuntarily played back one of the many anxiety attacks I had in Emily's presence.
[
Driving down 89 toward Burlington. Spring. Near Saint Albans. Looking west, the sun was effervescencing on the lake. My heart: pounding. "If I die now..." Something pops in my back. A flood of fear. "I'll never make it..."
"I wish I could help you."
"There is nothing you can do."
"I'm so frustrated. I can't help you? Why does this happen?"
" I don't know." Shaking. Clutching her knee.
"It's ok." Rubs my shoulders. Helps.
Only 26 more miles until Burlington. 26 more minutes until my mind can rest. ]
He was propped up on the gurney, pressure cuff on his right arm, IV in the left attached to a liter of saline, pulse/ox on his right index finger, electrodes connected to his chest. That look on his face.
The room in the ER room was spacious and nearly square. The gurney was in the middle, with a large surgical light array hovering above-like the smiling face of God. A large moveable very sturdy-looking caddy attached to a large boom arm loomed in the rear of the room covered with medical equipment. Urgent, that is the word I thought of when I first noticed it. In the center of the caddy there was a large touch screen displaying all his vitals: blood pressure, heart rate, respiratory rate and a dozen others. I noted, at a glance, that his heart rate still 100 BPM.
He was looking up pass me. I followed his gaze to a flat-screen monitor mounted to the facing wall. It showed the same information as the touch screen behind him.
"How are you feeling?"
I could almost read his mind, his face said it all,
"I can't believe this happened to me. Why did I do this? I just want it to stop."
We had been in the ER for over an hour. The hospital staff had taken a chest x-ray with a huge portable machine, preformed two EKGs and ordered a dose of IV Adivan, at the behest of Him. I believe His exact words were, "Can I get something for the anxiety. Some Adivan? I've had that before. That worked in the past." Past?
"I'm still feeling really nervous. Where is the Adivan?"
"I don't know. I think they had to order it from the pharmacy. The nurse administers it."
"I'm still feeling really nervous."
"Well, that is one of the side-effects of the drug. Try not to look at the your vitals...
I know how you feel..."
'I know how He feels', I repeated in my mind.
I wonder how may people have died on that gurney... He caught me staring at his chest; I had slipped off in mid-sentence.
Snapping to my post immediately, I changed the subject. How to make His heart light? I would periodically glance at his heart-rate and saw it drop 10 to 15 BPM while He was distracted.
The nurse came in, saw the doctor's prescription of Adivan, collected the syringe from a cart and administered it through a port in the IV. The nurse was male, gay. intelligent, tanned skin with whit-blue eyes. More than just good looking, he had a compassionate intellect and the kind stare that made me comfortable in any attempt to communicate. The nurse listened while I described the study, properties and pharmokentics of the drug.
Then He asked for more.
I couldn't blame him. Judgement started to rise within me, that righteousness boiling in the the back of my brain.
"This person does not need another does. He will be fine. He should be straight and not reliant on substances." I thought, I preached
He received the second dose. 2 mg of Adivan in total.
"The half-life of modafinil is..."
"15 hours" I inserted.
"Therefore", he continued, "the modafinil will be in your system for the next 15 times 4 hours. It takes approximately 4 half-lifes for a drug to reach negligible amounts in the body."
This seemed wrong to me. It really depends on the drugs affinity for its target protein or whatever. Anyway...
"What if the nervousness comes back after I leave? Can you give me a script for Adivan, in case it comes back?" He asked.
"Sure."
The righteous boiling judgement came to the surface. I looked at Him, that face. The "I'm worried" face. Relying on drugs...
Then I saw myself, and I was ashamed.
Had I forgotten who I was? This much is true: I'm in no position to judge. I am on 25mg of Zoloft; self medicated.
We were there for 4 hours.
[incomplete]
DAD
The EMT
the nurse
the doctor
the billing
Friday, March 24, 2006
On this day I had an experience like none before. It is almost scary how well I know myself, how well I know what I will like and dislike. Maybe I understand my destiny better than most people.
We are running a study at the PCRC (pain clinical research center, where I work). Without going into too much detail, we dose people with placebo or Morphine, and then we test there reactions to Hot Pain. It is extremely interesting work. There are risks to taking Morphine, however.
A really nice, intelligent guy enrolled in the study. He was a pleasure to talk to, and so we chatted back and forth in the small exam room in which our studies are run. The first injection went fine. The side effects were bearable,--so he said-- spacy, light-headed, dry mouth, sleepy.
The second injection was a vastly different story. About an hour after the dose, during one of the tests, the Morphine hit him like truck. Within 10 seconds he went from sleepy, to nauseous, to vomiting on himself and passing out. Scott, the study Doc and I heaved him onto a gurney; he immediately came to. I had reflexively elevated his legs and now he stared up at me in amazement. Clearly, he was astonished to be lying supine and have someone, who just a moment ago was running a test, now holding his legs up. As for me, I was shaking. I was scared, but another part of me knew that in this moment I had experienced an event that had been previously missing from me. It has physically become a part of me, the moment. The instant when I was lifting this person--helpless and limp-- to the gurney, the decision to rush to his legs and lift them, watching him come to and look up at me for explanation, me reassuringly patting his calf repeating,"It's alright. You're alright. You're fine.", all this is now in me.
This event has it's costs, of course. I feel guilty for learning through suffering, particularly when it is someone else's. The Greeks had this underlying lesson in their Mythologies: "Mathos Pathos", that is, learning through suffering. I suppose it is another of the harsh realities of a life in medicine that I am just not accustom to.
We are running a study at the PCRC (pain clinical research center, where I work). Without going into too much detail, we dose people with placebo or Morphine, and then we test there reactions to Hot Pain. It is extremely interesting work. There are risks to taking Morphine, however.
A really nice, intelligent guy enrolled in the study. He was a pleasure to talk to, and so we chatted back and forth in the small exam room in which our studies are run. The first injection went fine. The side effects were bearable,--so he said-- spacy, light-headed, dry mouth, sleepy.
The second injection was a vastly different story. About an hour after the dose, during one of the tests, the Morphine hit him like truck. Within 10 seconds he went from sleepy, to nauseous, to vomiting on himself and passing out. Scott, the study Doc and I heaved him onto a gurney; he immediately came to. I had reflexively elevated his legs and now he stared up at me in amazement. Clearly, he was astonished to be lying supine and have someone, who just a moment ago was running a test, now holding his legs up. As for me, I was shaking. I was scared, but another part of me knew that in this moment I had experienced an event that had been previously missing from me. It has physically become a part of me, the moment. The instant when I was lifting this person--helpless and limp-- to the gurney, the decision to rush to his legs and lift them, watching him come to and look up at me for explanation, me reassuringly patting his calf repeating,"It's alright. You're alright. You're fine.", all this is now in me.
This event has it's costs, of course. I feel guilty for learning through suffering, particularly when it is someone else's. The Greeks had this underlying lesson in their Mythologies: "Mathos Pathos", that is, learning through suffering. I suppose it is another of the harsh realities of a life in medicine that I am just not accustom to.
