10:45 pm and another unproductive day. Nothing profound to say, no deep insights into the seemingly ordinary aspects of daily living, it's just me. Hehe, i can't seem to think about much else except daily survival. Nothing but my continual lament at my wasted hours. These days I have an ever growing list of things to do. They're all in my head or on the dozen or so electronic post-it notes on my desktop. I've given up on my planner- there's just not enough room! However much i have to do though I still find excuses to dally about doing nothing or for instance this evening in my first social outing in a while go to a friend's house to have some food and fun in celebration of hte recent mid-autumn festival. Between mooncakes and popcorn and good conversation with a diverse and highly eclectic group of med students (a rare find, I assure you) I actually forgot about my silly little lists. I'm not back up from the bottom of my little mood circle, still wading through the bog of general apathy. However, I'm hoping that 1) finishing the second neuro exam 2) my conferences in detroit and DC on Health Disparities and global health, respectively, and 3) seeing "the motorcycle diaries" will all collaborate together to re-elevate my mood at least to a productive level. Not to mention my social life. So, it's late. time for bed once again. And to the rice ball with giraffe camo: A QUOTE from Dorothy Sayers "A facility for quotation covers the absence of original thought" :) how very true indeed, don't you think?
¶ 22:47

I am once in again in the upswing face in my activism mood cycle...feeling idealistic these days :) So bear with me and my current thoughts if you are reading this blog. Life continues to be a struggle and a challenge to make a difference- whether as a medical student or as a Christian. I am still constantly plagued with the doubts that my idealism is just a dream and that the weight of reality will eventually crush me into living a life that doesn't leave a dent in all the causes I struggle for. I look at the great figures of history..great men and women. I wonder how they did what they did. I wonder if I can do what they did; if i would step up to the challenge if it came. At the same time, i feel so ordinary and so powerless to change anything from the situation of many of my patients who lack healthcare insurance to the much bigger healthcare access problem in this country. What can one person do? But then in my newest obsessive reading craze- the life and works of Che Guevara, I hit upon something that's given me some insight. Perhaps it is this culture that teaches us that change only takes place through single extraordinary, moralistic or righteous figures- Martin Luther King, Jr., Che Guevara, Winston Churchill, or perhaps more modern heroes in medicine like Jack Geiger and Paul farmer. While,we, the multitude, the masses, of ordinary folk are impotent in making change. But I cant help but think as I read biographies that these folks were ordinary as well in their lives and actions, but unique in their unwillingness to be labeled as impotent faceless members of the population. Perhaps the belief in these demi-god like solitary heroes of history is just an illusion, a myth. We retell their story to fit our paradigm. I have yet to sort out the kinks in my argument and my thoughts are obviously still a bit scattered, but I am curious to see what people think about this point.
So here is my current voice of inspiration (although I'm not too sure I approve of the guerilla tactics of revolution he chose to employ) "On Revolutionary Medicine"
¶ 18:54

Life has been rushing by lately. My desk is full of paperwork that must be worked through for various applications for jobs, volunteering, projects, conferences, and other miscellaneous things. How in the world does this society generate SO MUCH paper?! It's been a strange readjustment to life back in medical school and back in the US. But not a bad one overall, i need to get more organized and someone to help me get all my priorities straight.
Anyways Just thought I'd share a photo from a few weeks ago...good times... It's been nice getting to know my fellow med students a bit better, I suppose my last year was spent with mostly Steiner house folk. These Yanks aren't so bad after all :)

Mi Pueblo- Matt's Bday 
¶ 20:08

Medical school gives you a healthy appreciation for the strange and bizarre in life. Nothing's sacred. Where else can you walk into a room and find wrinkled, preserved heads propped up and sticking out of body bags with scalp + hair flopped over their faces. It's a scene out of a haloween costume store or a horror movie. Teh faces look like plastic halloween masks of zombies. Everyone just goes about their business in the lab and I just want to shout, "Doesn't anyone else think this is WEIRD?! Is anyone else disturbed by the fact that we're scraping and peeling the faces off these people?!" But no...nothing unusual here. I peer into our cadaver's body bag and see a head attached to a mangled torso that's missing most of its contents, 2 legs and a hemi-sected pelvis in a red bag, and yes a brain sitting in a little plastic bag by the head. But what can I do? So, I sigh and refer back to my anatomy book and start trying to sort out facial features from the mangled mess we've made.
This morning I saw my first 2 autopsies. It's not that I expected teh experience to be a pleasant one, I just thought it would be more interesting given my long standing interest in forensics and forensic pathology. It was just unpleasant. 3 bodies were rolled out in the basement 1 stroke, 1 possible foul play victim, and one guy who had died in the ER after being dragged by a car and being slammed into a telephone pole. I was suprised at how sick I felt during these procedures. I had participated in cadaveric organ harvests and numerous surgeries all summer, not to mention having taken apart an entire human cadaver. Nothing new here, right? Guess I was wrong. Autopsies are a cross btwn the cadaver dissection and surgery. You have all the blood and smells of the OR and the indelicate methods of the cadaver lab. There was lots of blood, metallic and bowel smells, and with one of the bodies the sweet/sick smell of the beginnings of decomposition. THe worst part for me is always the smell of bone dust. i just cant stand it! I get sick when i eat doritos these days. It was especially bad with the 2nd patient, bone dust + bowel + decomp smell all rolled into one. the Pathology assistant seemed immune to teh smells as he danced around to Simon and Garfunkle tunes as he unceremoniously took organs out, block by block and placed them in plastic containers and buckets. The bodies were soft and pliant (rigor mortis wears off in about 48 hrs, fyi) and jerked with eerie life like movements as the slices were made. The worst part was teh soup ladle used to scoop out blood from the cavities...yech...or perhaps the worse part was seeing someone's scalp peeled...I cant tell anymore. It's all just greusome. So I guess in summary...I think I'll leave autopsies to pathologists and participate in them as an avid viewer of such shows as CSI. ¶ 17:53

Cognitive dissonance (i've been running across this phrase for awhile...)
I've realized that since starting medical school I've stopped thinking. Does that make sense? and does that scare anyone besides me? Doctors dont think. I think we all start out thinking...but in the end we forget how. they swallow ideas and flow charts wholesale and regurgitate exactly as prescribed by their positivist paradigm. I dont reflect anymore on ideas or question what is given to me. I focus so much on absorbing immense amounts of information (from the descending pathways in the nervous system to the origins and paths of the 12 (13) cranial nerves in the head and neck) that I dont stop to think about anything else going on around me. It's irrelevant. These days I read the news the same way, skim for important info, store data, and once in awhile I will retrieve data about events around the globe but i have neither processed it or critiqued it. Patients arent people, they're bags of symptoms and syndrome that HAVE to fit into certain clinical categories. Patient has a, b, and c therefore i do d, e, and f and prescribe expensive meds for treating disease X. It bugs me that there doesnt seem to be a way around "how medicine is done". Why do I feel that there is a disconnect btwn my Health Inequities course and my Neurology class. We want to put people in place and time, in socioeconomic context, in their personal narratives, but we cant seem to do that AND practice medicine as well. The two encompase divergent pathways of thought and action. So what do i do? To pass med school and get licensed i need to be a proper "doctor" but to be a true doctor to my patients I need to be a whole different person...argh....i dont even have time beyond this blog to think about this. I'm off once again to study more neuroanatomy and review enzyme kinetics with a friend of mine. ¶ 13:41