Well into my twenties, I've found that the idea that we can go through life just doing what makes us happy is not the whole story. How anyone thought that happiness was the appropriate litmus test to determine a fulfilling career is beyond me. While pursuing my undergraduate degree, I'd been involved in a student organization that gave me satisfaction––I'd toiled blood sweat and tears for it, all the while happy, then had come out the other side wondering what it was all for. Happiness? On the flip side, going into medical school was one of the most ridiculously masochistic things I'd ever done in my life. I'd never worked for something so hard, never felt so hopeless, never felt like wanting to quit every single day of my life until going through medical school. Only to find myself nearing the end of my formal schooling quite relieved that I hadn't thrown in the towel. I was very rarely happy, but I'm glad I did it.
Even in medicine, my days are filled with routine. Yes, the work I do is dynamic, but all people fall into routines regardless of their career paths. We get up, go to work, come home, go to bed. Then, we go at it again. It's not wrong to do this. I grew up being fed a myth that growing up meant being able to live life with selfish hedonism. I now find that it's a ridiculous model. Still, with routine, there's a tendency to fall into a pattern of doing things for the sake of getting them done. Where do we end up? What do we achieve? Are we fated to become what Japanese call a salaryman?–a peon in the workforce, uninspired, unmotivated, unthinking, unfeeling. Maybe I'm thinking about this because the coronavirus threatens to end life abruptly. I'm thinking about what I have to show for living out nearly three decades of life.
I thought that the existentialist dread of having to make a life altering decision had been dealt with after I decided on what I wanted to do with my life. What personality did I have? What are my values? What career suited me best? What did I want to accomplish? Who did I want to become? What I didn't understand is that the answers to these questions may change at different points in life. (Living through a pandemic, for example, being a very definitive point in a person's existence.) The reason is quite clear: people change. I am no exception. I have lunch with friends who I haven't seen in nearly a decade, and am taken aback at how different they look. I'm surprised at people with whom the only common ground we now share is the fact that we had common ground in the past. So these life altering questions– What personality did I have? What are my values? What career suited me best? What did I want to accomplish? Who did I want to become? –are part of an ongoing process of my own change. These days, I find myself stepping back and wondering how I got here. Am I the problem or is my environment the problem? Is the work I do stimulating? Does my work allow me to grow professionally? What do I want?
Allowing ourselves the leeway to step back and ask difficult question–especially the ones that may derail us from our well laid out tracks is necessary if we want to continue living a fulfilling life. It's got nothing to do with routine, but the inability to confront the idea that the answers to your questions may well take you away from your current life and into an entirely new one. And maybe that's what's so dangerous about this idea of a salaryman–they are the type of people to accept that they must stay the course, and in no circumstance stray.
I suppose, we are all given the option to stray. But how much courage it takes to do so! Ah, but what is so terribly wrong with straying from the path especially when death may be knocking on my door tomorrow (thanks coronavirus)? Whoever said life was meant to be linear anyway?
P.S. I realize how privileged I am to be afforded the option of thinking this way–of having existentialist dilemmas in the middle of a pandemic. And maybe that's exactly the point–I'm so privileged. I find myself wondering more than ever: am I using my privilege properly?
I'm in my final months of medical school, and I spend my nights ramping up for the board exams. For the first time in five years, I'll be home for more than a month long stretch. You'd think I'd enjoy the experience more than I do.
After spending the day attending online classes, and reading textbooks, my dad and I have a drink in the kitchen. I've recently identified the fumes of his cigarettes as the scent of my childhood. Every time he smokes, I'm reminded that he's more likely to get infected with the coronavirus than if he didn't. As anyone who has a smoking Asian parent knows, telling them off doesn't do anything.
"If we get the virus," he says suddenly, "will the hospital you study in take us?"
I don't answer immediately. It's a trick question: the system in my country operates on money and power. We have neither. I say: "they will if there's room." Which is the official statement.
What my dad means to ask is: if any of us contract the virus, will the system you've gone through protect you?
He then shows me an article about advance directives. I shrink a couple of feet and feel like a child again. I want to say that we don't have to worry about that yet, but who am I kidding? Death is playing his own Russian roulette game throughout the city, and who knows which door he'll knock on next.
I don't mind dying. I've accepted it. It's a hazard of my profession. But I don't want to bury my dead. I didn't spend five years away from everyone I cared about just for their lives to end like that.
But who am I kidding? When did death ever listen to the living?
In half a year, I'll be done with medical school. Thinking back on the last five years overwhelms me. On one hand, so much good has happened: I've met wonderful, brilliant people; I've learned so much about the human body and how to approach a person with medical problems; I've been fortunate enough to watch a couple of friends get married, and have kids, and deal with everything in between.
On the other hand, I've forgotten how it feels like to get up in the morning without having a million things to do. I've envied friends who have been able to make plans on the fly. I've lost touch with all my old hobbies and all my old friends. I see my parents on free weekends, but fall asleep on the couch. I think about studying instead of church on Sundays.
When I mention that I've decided to take a break after medical school, the news is often met with shock and disbelief. Doing nothing and taking care of yourself is something we talk about as physicians, but it's difficult to do especially when you feel like you're at the tail end of the pack. My mentality was always: how do I fit everything I want to do within 24 hours? Maybe I'm not supposed to.
Arriving to this point has been a long journey of overwork and strained relationships. The best thing is being able to step back and confidently say that it's good for me to take a couple of months to rest.
"It's close to midnight," I say, before Kitty and I burst into insatiable laughter. This goes on for another 30 minutes. We spent the last two hours comparing summer adventures and exchanging half-mad glances over all the things we have to get done within our last school year (hopefully ever).
You need these moments, and you need these people. Most importantly, you need someone who can understand why you have the urge to ugly cry when you're at the near summit of your potential career–and you need someone who will understand why you summit anyway. We say this often in medicine–to the average outsider, what we do makes absolutely no sense. To the insider, it makes even less sense. Still, we grit our teeth and trudge through. We bank on light at the end of the tunnel.
In the midst of all the work, however, I've learned that the moments I treasure are 2 AM emergency phone calls coming from and going out to friends who really should've been sleeping peacefully. I remember heading back from a cafe at 4 AM, having played card games through an exam night, as if to say: it is enough that we are whole. It is enough that we haven't broken.
I tell Kitty I have to finish my report, but we catch up on everything and nothing instead. It's past midnight, and past both our bedtimes. Everything and nothing has changed, and we don't say how much we'll miss tonight after the year is over.
I'm tired, and I feel bad about feeling tired–it's insanely messed up to think this statement through. Still, it's how the past few months have been going for me. The idea that I have no right to complain has popped into my head too often–it's what you hear people say: you don't have it as bad as we do. When did life become a competition of whose lot is worse?
Ah, well. A poem:
Name Me Ghost
Not quite alive, and
not quite dead—gone
through both, but the afterlife
is bullheaded, and
won’t accept it.
photo reel of all the Saturdays, the
laughter stored in our throat. Replay
loop all the stupid things I’ve said.
Migratory patterns leave
shadows for those left behind--
sometimes, it’s the fragrance
of missing me. Maybe they do.
Still, this is goodbye: it’s
the natural swing of things
to move along when the
cold begins to bite.
I get back to work tomorrow after a long week off (during which I went through minor surgery and major introspection). Do I dread it? A little. Do I look forward to it? Not as much as I should, but I like the work.
At the beginning of medical school, I had a thought that has stayed with me: I am learning to suffer. Not something you really want to hear coming from an age that feeds on hedonism, but I had the thought and I've been carrying it with me, trying to figure out what it means.
What does it mean to endure life, for example? CS Lewis proposed in The Screwtape Letters that a long, peaceful, otherwise mundane life poses a greater threat to faith than a sudden instance of crisis. The more time I have to live, the more I understand this: at times the sheer weight of living makes me question whether God is real when I cannot see him, cannot feel him. It seems easier to believe in Him when I have a problem and need saving from it, and so difficult to see how equally I need him when life rolls ever on without obvious need for divine intervention. Thus, the necessary virtue of faith. And the necessary virtue of introspection.
In the same breath, the end of my medical training seems so far away. The current reality of my situation is bleak. There is little sleeping and little contact with the outside world. The suffering wears you down because you wonder: is this all there is? And everyone tells you it gets worse. Does it? Will I make it out in one piece?
There is no guarantee that anything gets better, but to endure is to take the daily burden of suffering and allow it to chip away at your character until you come out the sort of person you'd like to be. Will suffering properly mould me into the kind of person I wish I was? I certainly hope so.
For some reason, medical school is when I develop frequent sore throats. I'll call it what it is: my health is very poor, and I haven't been taking care of myself for the sake of my academics. Here are the consequences.
A professor once said that at one point in your medical education, you tend to think you have one of the diseases being described in the textbook. We just saw a kid with a bad cold the other day, so I'm now wondering if I've got what he's got.
I probably don't, but it makes for fun poetry.
grape cluster tonsils in the
Send me skyward, to parts unknown, to paths feet have yet wandered, to prayers I have muttered. Send me onward. Though my shoes long to stay cement glued to the ground, send me forward. Away, to countrysides and skylines, to parched lands and endless seas, to scorching heat and biting cold.
I will follow: open armed, eagle spread willing. I will go: backpack ready, shoes on when I sleep. I’ve learned what it looks like to stay static, always fighting time and space and God. I’ve learned what it looks like to play with fire, taunting flames until one of us gets burned. Most often, the victim is me. I’ve learned what stars look like from the wrong side of the earth. I’ve learned reckless hymns, sung to justify my wrongs. I’ve learned the path of least resistance. I’ve learned contempt.
Send me forward, and I’ll learn to want better things: the steady turning of gears, a well oiled machine. Send me onward, and I’ll learn how to steer past pirate ships. I’ll learn how to keep dreams in my pocket, tend them quietly until they grow into realities. Send me patients, and I’ll learn how to love them. Send me typewriters, and I’ll learn to write again. Send me more, God, and teach me to have more faith again.
Send me skyward, and I’ll grow wings again. I’ll learn all the flying I’ve forgotten.
I've been on hiatus–nothing you couldn't have deduce from my archive history–for a couple of months in pursuit of my education. The short of it: I am learning to suffer. The long of it I shall attempt to type out soon.
On another completely unrelated note: hence forth, consider my title capitalisation literary blasphemy or a reference to E. E. Cummings decapitalisation of i's. Truth be told, the sharp edges of title capitalisation bothers me. I have no idea why. Perhaps I am compensating for... something... Clinical psychiatry may answer that question... Or I'm simply rambling and all this is a distraction.
Well, go on, poem down below.
The clicking of typewriter keys
have faded, and the ledger scribbling
ceased, and the sound of laughter
muted by heavy textbooks and headphones
tuning the rest of the world out lest I
decide this isn’t worth pursuing anymore.
This is my life now: stethoscope
amplifying your heartbeat while
tuning out what makes your heart beat
I am trying,
convincing myself, spitting
theories of delayed gratification, consoling
my weary heart
wants out, wants
anything but this, but
the heart is treacherous if it is consulted
for anything but its beating.
This is my life now: white coat wrap
dreams from reality’s biting cold, orphan
leave them on empty doorsteps, and ring the bell.
Someday, I will be back for you
when you have grown
aware of your worth, reject the birthright of my
arms when I finally have enough strength to hold you.
You have the right to.
I haven't been around lately, but there's a good reason for that! I'm nearly through with my first year of medical education. *Cheers!*
It’s been a surreal year. Medical school has always been one of my castles in the clouds, so to say I’m on the last leg of my first year after countless years of pre-empting excited relatives by saying “I might not even go to medical school” is amazing. It does feel a bit like an out of body experience. I’m still trying to comprehend what I’ve gotten myself into.
To be honest, I felt like throwing in the towel about two months into it. (My uncle talked me out of it after a phone call, fortunately, so I'm still in the rat race!) I have never studied this much in my entire life—and I wasn’t even studying as much as my classmates. I wasn’t used to putting so much effort into something and simultaneously failing to get the results I so wanted. I’m not being modest. My grades are quite unspectacular, and no matter what anyone says to cheer me up I can’t bring myself to believe them otherwise.
But somehow, I’ve gotten through to the last two sets of exams relatively unscathed. In fact, if we don’t count the damage medical school has done to my intellectual pride, I’d say I’m in a pretty good place.
I can already feel the lure of the summer—the guilt-free pleasure of sleeping eight hours a night, the liberty to wear anything but that restricting white blouse and pencil skirt, the privilege of reading at my own leisure. It’s very tempting to watch movies and read novels instead of putting in the effort for the last leg of the school year.
But as a future physician, that’s just not the way to do it. To become the woman I’ve been reading about and praying about, I know I have to do two things: press on & finish strong.
Recently, I’ve been actively following Megan Rapinoe, and devouring her presence on social media. For those who are unaware, she’s a professional football player—the soccer kind. She plays as midfielder of the US Women’s National Team, and she’s a bit of a maverick in the best way. She’s amazing on the field. Her cleverness manifests itself in the way she plays. She plays her opponents, and I think she’s wonderful if you haven’t already guessed from me writing this mini-fanatic paragraph.
She’s had two separate ACL injuries that have caused her to miss the 2007 Women’s World Cup as well as the 2008 Beijing Olympics—both extremely important football tournaments. I imagine it’s a difficult thing to work so hard for the great big fight only to find yourself incapable of participating. You’ve worked so hard for it!
It’s odd that she motivates me so much at the moment, but she does. So much. It takes discipline to get back up your feet. It takes discipline to approach an injury without whining and to say from the start “what do I need to do to get to where I want to be?” Here I am feeling incapacitated, and there she was recovering from her ACL injury to go on to play in the 2011 World Cup and the 2012 Olympics. It’s a mindset, and you have to want to get to where you want to be.
To me, she’s the perfect example of pressing on. She’s the example of Philippians 3:14 that I’ve been striving to embody—you fix your eyes on the prize, and you fix your eyes on what you were called to do. In my case, it’s becoming an A plus physician. That’s the goal. I’ve prayed about this. I’ve journeyed through so many road blocks to get here, and now that I’m here, am I still pressing on? Am I still putting in the effort? I should be. I want to be.
I press on toward the goal for the prize of the upward call of God in Christ Jesus.
At the same time, I realise more and more the reason to be resilience—to never waving the white flag—to finishing strong. In my case, I want to do my best out of love for my God, and love for the kind of being He is. He values my hard work, and If I really valued Him and His opinion, would I be putting in any less than all my effort? If I love this profession, would I really be looking for ways to simply get by instead of persevering until the very end?
This is what it means to run the race—it means you’ve found something worth enduring for. It means you ought to endure. It means it’s going to be a long five years. It means there will be struggle. It means you will falter. It means you will fall sometimes, but you can choose to get back up. It means there’s light at the end of the tunnel. It means lean on Christ, and lean on your friends. It means through hard work, prayer, and nothing short of a miracle, you’ll get there someday—just as others have done before you.
It means press on. Finish what you started. Finish strong.
Note: Satirical. While spacing out in class sometime this week, I wondered what my thought process would look like when coming up with a differential diagnosis. Did my neuronal personas have whiteboards? Names? Completely unproductive side conversations? Probably.
“Our patient,” a greying Dr H said, doning his century old white coat as the clerk whispered didn’t they phase out those old things? as softly as she could muster. “Has hypertension, excessive acne, and asthma. What is wrong with him?”
Bespectacled Jace raised his sorry excuse of a hand even if he didn’t need to. “He’s lonely and can’t get a date. Probably depressed.”
“… Wrong… On all accounts. His wife has been here since dawn. You, Anson,” Dr H nodded at his most promising clerk yet.
“Autoimmune? Lupus?” if he means it as a joke, Dr H wasn't buying it. He wrinkled his brow and sighed.
Dr H’s wrinkles pressed further into his skin. How disappointing. “Anyone else?”
Jawn again—“Thyroid problem? Increased T3 and T4 could cause hypertension and cystic acne.”
“Thyroid hormone levels are normal,” Dr H nodded. “But good try. You deserve a pat on the back from yourself.”
Anson shoved his glasses up his nose bridge. “How old is he? Could be environmental. Toxic air, toxic food, toxic twenty-first century lifestyle.”
“This isn’t helping your lupus case, you idiot. It’s never lupus.”
“Corticosteroids,” Kale said. Dr H never took her name seriously, and usually took her answers less seriously than her name.
Today, however, Kale’s answer was “acceptable.” He asks her to go on.
“Primary asthma,” Kale began, staring down at her smart phone, “leading to chronic intake of corticosteroids. Hypertension could be drug-induced due to sodium and fluid retention. Increased sebum production from overactive glands (also induced by steroids) can cause the acne.”
“You googled that!” Anson complained.
Kale shrugged. “You didn’t.”
The gist of it: I've been trying to keep focused on the work at hand, but since I am here blogging versus actually popping open my textbooks, I am failing miserably at being a medical student.
So, without further pitiful ado, here's a short poem that reflects my perpetually distracted state.
I need to stop
I sincerely hope wherever you wander, you are doing a much better job at living than I am.
It will do no good to deny it--classroom hierarchy exists, and I mean not the social ranking amongst students. I speak of academic hierarchy. The students society sees as intelligent are perhaps ranked not by actual intelligence, but mainly the perception of intelligence. It hardly comes as a surprise that the students professors perceive as "most likely to succeed" in his classroom are those who sit in front, who raise their hands the second a question is posed, or who jump at any opportunity to prove themselves.
Honestly? I do none of those things. In fact, I sit near the back of the classroom, prefer to scribble my answer into my notebook when a question is asked, and try to evade much notice in general.
According to common belief, I am therefore a disinterested and disastrously average student. I am a ghost, content to flit in and out of classes. I am not the brightest, or I would participate more actively. This is the tragic assessment of the general population when met with such a person.
Upon further investigation, however, isn't this assessment rather unfair?
Are we not able to form our own opinions, and know for ourselves the correct answers to questions? Are we incapable of thoughtfulness? Are we worth any less because we'd rather listen quietly at the back than project our thoughts in front of the entire class?
Yet we quiet people are told to speak up. After all, how will we succeed in life? In my case, I am training to become a doctor meant to interact with patients. I should show eagerness! I should distinguish myself! I should be an effective communicator! I should not dread public speaking! I should speak to strangers without fear so easily lodging itself in my chest! I ought to be ashamed for not doing these things, should I not?
Quite to the contrary, I personally wonder why I shouldn't be a much better physician because of my introversion.
Allow me to speak freely about my own circumstance and feelings about this topic. Mind you--I, perhaps, am far from representative of any group of persons. I simply think it is unjust for anyone to judge my ability to become an effective physician on whether or not I am an eager beaver in class (or in any situation, for that matter!). And perhaps this short piece will help others understand those like me.
Society so often forgets that mankind is composed of different personalities and perspectives. Each kind of personality has something unique to contribute to one's chosen field, and yet it is so easy to have ideal characteristics in mind--a doctor should be personable, intelligent, professional, confident. These are desirable characteristics, yet it's so easy to have a stereotypical image of how these traits ought to express themselves.
Must one be talkative and loud to be considered personable? Must one be the first to answer in class to be considered intelligent? Must one be stoic to be considered professional? Must one have swagger to be considered confident?
Can't one be quiet and yet develop rapport? Can't one think hard on his answer before giving it? Can't one be candid and yet be professional?
I think the interesting thing about introverts is how keen we are in our observations. We learn others' opinions because they readily give it to anyone who lends an ear. We are able to filter our thoughts before they flow from our tongues. We are able to notice subtle changes of demeanour resulting from words said. We are able to say the right things at the right times because we notice certain things overlooked by others. These we are able to do precisely because we are less eager to be the most perceived person in the room. Our ability to find security in the background lends to our perception of the world. And is this not a good thing? Shouldn't it attune us more to the feelings of our patients?
The entire reason I chose this profession was because it was so keen on humanity. With any other field, though perhaps one could argue that the ultimate goal was to touch a human being's life, none does so as intimately nor as immediately as medicine. There's a certain degree of compassion a physician must absolutely have to practise medicine. The fictional Dr House is, arguably the exception but perhaps even he represents the bare minimum: how does a doctor treat a patient's disease if he doesn't wish to save that person's life? Taking it one step further: aren't introverts capable of a grassroots sort of compassion? Furthermore, perhaps there is something special in a physician who is less eager to speak--perhaps we have understood the fear that comes with having to say something out loud.
I suppose the question boils down to stereotypes: can't we deal away with such things? Shall we admit that a successful doctor may just be the medical student who prefers to shun any sort of limelight and simply go about his duties the best he knows how--unconventionally? quietly?
Apologies—this letter is rather presumptuous. To be honest, I’m not sure you’ll actually exist. We haven’t met yet. I have yet to earn my MD stripes. At the moment, I’m still wrapping my head around the idea that I’m actually getting into medical school—still mustering up the courage to go through five? ten? more years of hard work.
To be honest, I’m anxious. I’m about to embark on a training program that will allow me to hold a human heart in my hands, to deliver a living child into this earth, to transfer vital organs from one human being to another. I feel the responsibility weigh against my shoulders heavier than ten elephants. I haven’t done anything as important as this. I’m a very small person in a very big world. Future Patient, you might be concerned at this point. If I’m this much of a wreck, how am I supposed to be your physician?
Dear Future Patient, this is may come as a shock to you, but even doctors are human. I’m not entirely sure about everyone (who knows?) but I, certainly, am human. I have feelings. I have moods. I have perspectives.
My humanity, however, will not keep me from becoming a better doctor. In fact, I’m hoping that my humanity will help you as much as my medical training will. I know how much parents can worry over their child (hi Dad and Mum!). I know how embarrassing those first few years of puberty can be. I know how frustrating a knee injury can be. I know how the little things can seem so big. I know how difficult it is to lose someone so suddenly.
I know what it means to be human, and I am not inclined to forget.
If anything, I promise to stay human (unless aliens abduct me or I, for some reason, require a mechatronic heart).
I promise to see you as human.
I only ask that when I do stand before you as your physician, that you’d see me the same way.