Two Corners of a Continuum

The psychiatric hospital is far away from the regular hospital, far away from the center of town and far away from the wealthy. It’s close to the major highway into town, but far enough away that a visitor would never be bothered by it. A bus stop that serves one line sits on smooth, new pavement. Regularly changed trash bags, lack of cigarette butts, and a two-way bike path–all luxuries in this city–are found in front of this hospital. On the other side of the street, a humped, dark, metal fence defends the slums from the true outcasts of the city. White-painted tin sheets re-enforce the five-foot fence.  Behind the double-fenced reinforcement is a steep drop so that the scattered hot water heaters, mismatched roofs, and patches of tarp are not visible from the bus stop. Only an expensive apartment building and distant trees building can be see in the distance, as if one of the wealthy could simply trip off his balcony and be engulfed by the deep abyss of poverty.

The hospital campus lies low to the ground, and slinks down into a valley so only the one-story entrance is visible. The front of the hospital looks like an elementary school. White walls are spaced between white columns, and between the columns are clay sculptures of people in windows. A religious man with his book, a couple, and a woman hanging clothes with her breasts resting on the clay windowsill–each one has an appeasing smile, as screws digging into their hands imprisoning them to the wall. The suffering clay people lead you to an equally low, open white hallway. It’s littered with twisted feminine clay figures with big hips, eccentric skin, and roses covering their groins. The only benches are occupied by troupes of  well-endowed clay women. I guess they’re the only ones allowed to rest.

In the very back corner of the psychiatric maze, a one story building looks particularly insignificant. It’s the library. No, it’s heaven. Unlimited access to the bathroom which is always locked in the hospital, unlimited coffee and left over cake, a sweet librarian who unlocks the door for you from her adjustable cushion throne and the soft blowing of the beach, I mean, air conditioning are just a few of the delights. The back wall of the library is lined with  floor-to-ceiling windows. When I arrive, I alleviate my shoulder from its cargo and place a water bottle and chilled contents on the frosted glass table. I pull a plump orange felt chair next to a yellow one and curl up into a kitten-ball. As my eyes blink with fatigue, the windows welcome my gaze. Tall and thin trees grasp their fern-feathers between the fingers of their branch-fists, like a young child with aeronautical dreams. With each gust of wind, ambitious trees ache for to aviation. These, other desert trees and a final fence provide a protection from the wilderness where tufts of dry grass and choking bush cling to dusty earth. Even the outcasts want a barrier between them and the natural desolation our ancestors endured.

Psychiatric patients did not chose to have a metal illness, but rich and poor alike were delirious enough to voluntarily live in one of the least sustainable climates for human civilization. Isn’t that madness?

Cluttered World, Conditioned Writing

My desk is cluttered with bills, lipsticks, lip balm, dishes from the night before, my nike pro watch, small samples of hand cream,  an open Bible, an old passport picture that makes me look like an ex-con, and an interpretative picture my friend painted of my uterus-galaxy. When I sit down, I can see an old bill hanging up on a clip, a giant paperclip stand that used to have a card in it, a very cluttered pencil cup, and tape markings on the wall where pictures used to be. But, if I write on my bed, my butt falls asleep on the old, hard, futon. I hear cars zooming by my window, children screaming in the park behind the apartment, and the neighbors fighting with violent words. Oh, and the cats. Cat sex, cat fights, and starving kittens are the springtime special.

You’re right, my life is suboptimal. The paint is chipping in my room and in my life, exposing blank drywall underneath. I’m in the middle of moving. Half my stuff is at my parent’s house, and the other half is here, waiting to be thrown away or broken by the airport security. Transitions are never fun, especially when they’re drawn out.

However, for a good writer, conditions do not deter word connections. In You are a Writer, Jeff Goins encourages everyone to write. You don’t need the perfect time, place, or situation to write. You just need to write.

I write after my 5 am workout with the birds chirping and my roommate blowing her nose from a night’s worth allergies. The endorphins, tingling muscles, coffee, oatmeal and wet hair focus my writing. Everything is taken care of. I only need to write.

A Different Path

If I only told you the short version of my  story, you would think I’m an exhausted medical student who can’t answer one more UWorld question, memorize one more drug name, or handle one more diarrhea case. You think that I want to play house while my husband takes care of my needs. While that’s not completely false, there’s more to the story. I, like most of my medical school friends, am only a fraction the person I was when I entered medical school. I’m less ethical and compassionate, but more cynical and numb.

A few weeks ago, I saw a diabetic’s finger that was dead — black, rotting tissue with an ashen nail and pus around the dead base. That illiterate, dirty, poor woman was going to lose that finger and possibly part of her hand. Previously, I would have wanted to talk to her in my broken Arabic to find out about her life and how her disease progressed to this point , but at the time, I was just worried about when I could get my next caffeine fix. Losing one’s finger should be more immediate than caffeine, but it wasn’t for me.

Another example, I was in an APR surgery, a surgery that removes the anus, rectum, and part of the colon. Basically, this woman’s old pooping hole was sewn up and a new one was place on her stomach. You might think this sounds horrible, but it’s really not. You can go swimming with it, run marathons with it, get a six pack with it, have sex with it, or whatever you want. Yes, psychologically, it’s an adjustment, but you’ll have the same lifestyle as you had before the cancer. Okay, back to the story. As they were burning off the last part of the connective tissue, suddenly, two feet of colon and rectum plopped to the floor with a “splat!” The female anesthesiologist exclaimed, “It’s a boy! Because it’s an asshole from birth!” We all laughed as the nurse picked him up with long tweezers. By the way, none of this bothered me: not the jokes, not the surgery and not the plop.

Being in medical school makes you selfish. Each test, each pimping session (when a teacher asks a student questions until s/he cries), each patient report is survival. The first lesson of survival is to save yourself before you save others, and we learned that very quickly. Just don’t fudging fail, and you’ll live to see the next rotation. And you’ll be one step closer to getting out of this place. You justify the dirty tricks you play on your classmates to justify your survival, because when you get out of medical school, you will change back. You’ll be the doctor you always dreamed of being. Then, one day you wake up and realize that your survival mentality has been there for three years and might be there permanently if you don’t do something now.

I’ve been getting high off of my own success. It’s replaced sleeping and eating. Breathing in dark clouds of teacher’s praises have slowly eroded my lungs. The addiction of pride and presumed necessity made it hard to quit. Now, I’m choking on the ethical compromises I’ve made; I’m suffocating on the perpetual mess my life has been in. I worry that the structural damage is permanent. So, I’m taking a year off of medicine so I can heal, and I’m praying that God will be my physician.

Love

Musings after being sexually harassed by a patient

When I think of love, I want to think of you. I want to think about the time you bought me gluten-free cookies and we ate them in the back of your rental car, or the time you woke me up with a simple phrase that turned our relationship around. But, you’re easy to love. Not all the time, but most of the time. I can love you, because you know me. I can love you because you consider me as apart of you. When I hurt, you hurt. Like our brains are sending long axons across oceans. These axons flutter in the wind like ribbons as they withstand the heat of the sun, wind of hurricanes, and cold of hale storms, traveling so very far. You know my pain. I know yours.

When I think of love, I do not think of them. I don’t have the patience to care why they feel powerless or a need to hurt others. Patience and humility are wasted on them. Those animal who sexualize women for their own enjoyment, power, and accomplishment are low men with an even lower opinion of me to make up for their low, low position in life. They cause pain. I experience it.

It’s a symptom of death. Slowly creeping up his muscle-wasted legs, around his ready loins, under his sweat-stained shirt, tightly–so tightly–around his neck like a noose, suffocating the last deep breath of soot and cigarette-filled air he has left, through the hole where his front four teeth used to be, and down his throat. Death is a hard, long, bitter drink to swallow. He lives pain. I see it.

Love cannot come from me. I am empty and selfish only loving those who are easy to love. By letting go of my power and identity in the face of his, I also become entangled in this man’s death. I am too easily defined by a dying man. May Love do its work in me so that. I fight for his life. And Love heals him.

What I’m going to miss Medical School

1. Having an excuse to devour a hamburger and fries like an angry, starving, wild, wolf-liger offspring

When you haven’t eaten, sat down,or drank in 8 hours, you don’t care how many people stare at you and your ketchup-stained scrubs at the local hamburger restaurant. And if you do catch someone staring, you just give them a look back that says, “Look, lady, I almost fainted into an open body after I got sprayed with blood all over my face. What did you do this morning?”

2. Knowing who my people are

We drive each other crazy. Some days, we hate each other. Some days, we love each other. We fight and hug and run and stay up late together, because when you’re so far away from home, you have to depend on each other to survive. Family isn’t perfect, but it’s our family.

What do you do when you don’t have an automatic group of friends? How do you bond over things that don’t involve body fluids, death, crazy patients, and complaining about a doctor or classmate you both already mutually know?

3. Having access to an insane amount of potent drugs

…no comment.*

4. Having a reason got complain

“I hate taking old people’s blood! Why are there so many old people at the hospital?”

“Can you believe there’s a mandatory meeting on the weekend? That’s MY time!”

“Do we seriously have a test every 2-4 weeks on completely new material?”

“Can’t we just throw drugs at him already?”

“I have to study how many hours per day during Step prep?”

“ANOTHER bariatric surgery? She was just in here two years ago for a gastric band!”

Without this constant stressful force of “the man” controlling my pathetic student life, who will I direct my anger towards? And, what will there be to complain about? Traffic? Makeup? I have no idea!

5. Not having a reason to complain

In the hospital, there are always 5 other people within 5 yards of you that are having a worse day than you. The guy who’s got pneumonia superimposed on COPD is having a bad day. The intern who’s pulling a 36 hour shift with 4 kids at home really knows what tired means. The crying family members of a deceased loved one, just had their life change. The guy with degenerative neurological condition who you had to undress and dig into his groin with a very large needle because it was your last ditch effort to get the precious blood that your intern order that morning, didn’t wake up.

It’s a very humbling experience to live a whole day that’s not about you and your needs because there’s a whole hospital full of people who need medical assistance. It’s why I originally wanted to become a doctor.

*This is a joke. FBI, please don’t come after me.