The World

Tonight I'm going bowling with my family to celebrate New Years.  I'm going to work out as soon as this headache subsides.  I might go to a dance, but probably not.  Whatever I do, it won't make me sad.  Whatever happens, it won't happen if it doesn't serve me and feed me.   

I really love my brain on joy. 

Last year at this time, I wrote about the tarot card Judgment, and about how for me, everything about 2012  was about being reviewed and held accountable.  And that is one interpretation of the card, but it's also about acknowledgement of inner callings, rebirth and absolution.  So because of that, 2013 was about the consequences of judgement.  It stands to reason that 2014 will be best represented by the very next card in the deck,  The World, which signifies "completion, achievement and fulfilment."

Happy New Year, whatever card you've drawn from the deck.  Be well. 


Back Stroke

I was asked recently what I've learned from the last five years.  An administrator at Midwestern Medical School asked me that question, and wanted to know what made me think I was ready to try again.  It was not an optimal situation - she was busy, and I had just dropped in on her to wish her luck because she was moving on to a better position.  I don't think I even tried to answer her question, and even if I had, I don't know that she would have found my answers satisfying.  In fact, I'm never sure what people are looking for when they ask me that question.  When East Coast Medical School asked me during the interview, I said, "I learned a lot - maybe most importantly, to trust myself and my own process."  But actually, that was kind of a glib answer.  So if I ever get to talk to this administrator again, here is what I'd tell her:

The cure for anxiety is pretty much always forgiveness and compassion - for others and for self.

Reminding myself that I can afford to have patience in almost any situation helps, too.

When I am frightened or overwhelmed, that is the moment to find a way to be of service to someone else.  That's the moment to call a friend and ask how they are, or do something special for my family.  That is not the time to engage in omphaloskepsis or to let hollow distractions numb me out. 

I really, really need to concentrate on my health.  Like, that is no longer optional.  I need to sleep enough, eat enough, exercise and meditate.  I can't skip out on my meds.  I can't smoke because I'm stressed out.  And I'm not always going to be perfect at this, but if I don't make my mental and physical health a priority, I will notice right away, and it will get bad so fast that I might not be able to get through.  It's that simple.

No matter what happens, or what mistakes I make, I don't grovel before anyone.  I own my behavior and do what I can to make it right.  If I do my best and it's not enough, it will likely never be enough for that person or situation, but that has nothing to do with the value I place on my soul.

Action is the only cure for fear.  You can't feel courage, or experience mastery or success without it.

My value is intimately tied to my word.

I must stay true to myself, meaning not only that I need to follow my truth - I need to know my truth before I can follow it.  I have to tell myself the truth.

*Edit to add:  Gratitude.  All day, er' day.  

It's not like I didn't know this intellectually before I came here.  I did, and when things were going well, I was able to (suboptimally) behave in ways that supported my success.  But when things got hard, that's when it became clear that I understood these concepts in a very surface way.  They weren't a part of how I lived, and they weren't a genuine part of my character.  Can someone change that?  With practice and support, yes they can.  People can recover, genuinely heal and then grow.

When I think about what happens next, I almost can't believe that it's really going to happen, it's so awesome.  I wrote myself a letter when I started medical school here, outlining my hopes and dreams.  I wrote another one shortly after I was dismissed.  I cut myself short, but I had no idea how deep shit would get.  And yes, it absolutely feels like something beyond just serendipity is at work.  I feel like I'm being pulled along in a tide that has a guaranteed destination, and there's no use struggling against it.  Might as well float.



"Life is either a daring adventure, or it is nothing."  - Helen Keller

I spent the two years after I got kicked out of medical school wondering what the fuck I had been doing here at all.  And it wasn't so much a WTF kind of what the fuck, but a long swim to the surface of an existential sea.  I was searching for a purpose.  There had to be a reason, and I looked for them as the days unfolded.  It was like every person in my life was an upside-down teacup to be looked under, because maybe my purpose here resided in them.  All of the teacups were empty, or at best held trinkets that couldn't explain or pay for my loss.  I had a hard time keeping my temper.

For most of the last four and a half years, I've just wanted to go home.  For the last two, I suppose we could have found a way.  But the first of those two years was spent trying to redeem myself academically in hopes that I could return to medical school.  The next was spent trying to come to grips with the fact that my youngest is autistic, and remedy that. 

If you have not had a child with a life-changing disability, then you really can't imagine what it's like.  Before we had Asa, that lack of empathy made it difficult to believe that my husband or I would be able to parent a child with autism.  So when I found out he was autistic, I fell apart.  The woman who told me reminded me that he was the same child he'd been the day before, but I knew at a heart level that that was a lie.  Asa wouldn't grow out of it, and that hope that one day, like his dad, he'd just blurt out a sentence and move on with his life had been a part of who we thought he was. 

I sometimes wonder how I would have reacted to that news before I went to medical school.  It was in medical school that I learned that I could withstand hunger, humiliation, frustration, depression, self doubt and blind fury, all on very little sleep, for years.  Medical school is like having an newborn for a very, very long time.  I'm finding that having an autistic kid is like having a toddler for a very, very long time.  I went absolutely crazy when I found out that Asa was autistic, but I also bucked up enough to make sure he got the treatment he needed.  Medical school taught me how to do that.  Certainly I didn't learn that skill from my own caregivers.

And how would that part of my life have gone if I had still been drinking?  I mean, yes, I did have a few savagely drunken nights afterward, but how would I have managed if I hadn't have had a lot of practice at not drinking in response to pretty much, well, everything?  Who knows, but I'm pretty sure it wouldn't have gone better.

We'll be here for exactly as long as we'd expected to be.  Five years, one month.  I'll see both of my classes graduate, and I've had the opportunity to be there for my friends in meaningful ways.  My psychiatrist here was the one who told me about East Coast Medical School the day after I appealed to Midwest Medical School, and the one who encouraged me to apply.  Dylan got a solid start in grade school, and has seen and done more than he would have at home.  Our marriage was tested in horrible, tragic ways, and it survived. There was purpose to this - so much, in fact, that I doubt I know the whole of it, and I may never know.  But in reality, I walked away from this having lost nothing.  I still have my family, my marriage, medical school, the hope of one day having a deeply meaningful career.  Sure, we spent a lot of money here, but that can be recouped and we aren't starving.  If I chose to, I can say that we  spent that money to find out what we were made of, and quite frankly, that's worth more than money.


Social Normal

I'm going to be 45 in about 2 or 3 weeks, so I'm going to buy a motorcycle.  This is not an embarrassing midlife crisis.  Sleeping with men over a decade younger than me might be, but buying a motorcycle is not.  It is, however, a declaration of independence.  This is the nicest, bestest thing about getting older.  I give fewer and fewer fucks for what people have to say about [motorcycles, pants, hair, jobs, politics, art, music, swearing, parenting, body weight, everything], and more for honoring who I actually am.  If I've learned anything over the last four years, it's that not behaving in accordance to my belief systems and gut reactions to things results in chaos that is unbecoming of someone my age. 

It turns out that I'm the kind of woman who should ride a motorcycle, probably well into her 60's, and this should shock no one who knows me.  I should also be a doctor, a better house keeper, stay in shape and be a fierce mama.  Take advanced lessons on the piano.  Travel.  Wear nice clothes.  Be the kind of wife that make other men envy my husband. 

I've written about this a lot in my other blog, but that shit takes an enormous amount of courage.  When I first figured out how much of my courage that takes a few years ago, it shocked me.   The message, over and over again, was SETTLE DOWN.  I think I may have over-reacted.  I did everything except settle down, because I thought it was code for PUT ON YOUR MOM PANTS.  I also and maybe mostly thought it meant that I would have to put away the joy of letting myself change and grow, love and feel passion. 

I give myself a pass.  I think a lot of people interpret SETTLE DOWN that way.  I don't know if it's like that in other countries, but here in 'Murica, I think particularly for women, but really for anyone, as we age, conformation becomes less optional.  We digress to the mean more readily, because we're tired, and we've seen exactly what kind of toll being even subtly subversive to social norms will take.  We don't have anything left for that kind of drama - the gossip, being frozen out of needful social circles.  Our feet hurt, our hearts are broken, and learning new things takes time away from what we need, which is primarily sleep.  Settling down like that seems reasonable. 

But it's not just me who finds chaos running on or away from that path.  For a lot of people, its milestones seem to be:  Depression.  Affairs.  Divorce.  Fear.  Plastic surgery.  Illness.  Bitterness. 

I really don't want to go down like that.  I'd rather settle down into who I really am, because I can.  I'm pretty much the same person I was 20 years ago - I have most of the same interests and desires, although my taste is more refined.  But now I have money, courage and self knowledge that I didn't have even 10 years ago.  And no, I have no idea if this plan is even feasible, but that's part of what I like about it.  My feet hurt, my heart is also broken, I need more sleep, and additionally, I have readers now.  But everything in life is a trade-off, and I will trudge a little harder physically if it means I can lighten my load emotionally. 



Seriously, all they had to say was, "We like you, and you should come to our school," and I would have been swoooooon.  But the acceptance letter (which I plan to frame and hang above my study desk, lest I forget what I'm doing there) did something to me that kind of felt the way a key opening a heavy lock does.  I felt it in my chest.  It set something free that not even the phone calls from the deans were able to achieve, as amazing as that was.  It's difficult to describe how I felt when I read that letter, but the word "dignity" springs to mind.  They need me to fulfill their mission, precisely as I am and with the skills and personality I bring, as much as I need them to fulfill mine.  I'm not there to fill a diversity slot, and I'm not there to be molded into something I simply can't be.  I'm there to learn how to be a doctor, and to make the most of my experiences to this point.  All of them.  That's what is valuable about me to them.  That's some deep shit right there.  That's a better gift than any scholarship or any accolade that I can think of. 

It doesn't hurt, either, that I feel like they built the school specifically for me.  For one thing, the curriculum is six hours of lecture per week, as opposed to the minimum of 15 hours at Midwestern Medical School.  Yeah, that's right.  I'm not going to be sitting in a lecture hall, struggling to not fall asleep, to pay attention, to put unfamiliar words and concepts (wait, I thought I read the lecture notes... wtf is he talking about???) into a pattern that I can barely understand.  Instead, most of my learning will happen with 10 people, a clinican and a scientist.  Kind of like having school sanctioned, well attended, motivated study groups, run by professors.

Other cool things:  Everything is strictly systems based, which means that when we're studying the nervous system, or the cardiovascular system, that's all we're studying for that block.  Weekly quizzes with remediation the day after you take them.  Exams are all old NMBE (National Medical Board Exam) questions, which prepares us far better for those licensing exams than taking an exam of questions that a professor thinks is important to know the answers to, but might not be applicable to the real world of medicine.

It's pass/fail all four years, so the inherent competitiveness of the students is hopefully held down to a dull roar.  They don't rank you, or at least they don't inundate you with emails that tell you your specific, exact place in the class - probably the most useless, unforgiving, soul crushing metric of success or failure that I can think of, no matter where you happen to land.  Passing is 70%, and if that had been the case at Midwestern Medical School, I probably would have made it.  I definitely would have made it through the first year.

The anatomy lab doesn't smell.  They have realistic sim labs and computers directly outside of them so that you can watch yourself directly after you do your thing.  The facilities are new and shiny.  There are four houses that the students are sorted into ... with a sorting hat.

But probably most impressively, the staff are genuinely mission driven people that seem to have a sense of humor and want us to have fun.  In fact, the dean of students called me to tell me that he was going to ride me and make sure I got through all four years, happy and smiling.  Because medical school should be transformative, but it should also be joyful.

Joyful.  That's the other word that comes to mind when I think about that letter.  I am joyful.  When I think back on what was going on when I wrote almost all of the other words in this blog, joyful wasn't something I even attempted.  My definition of joyful is a state of being that is devoid of fear and anger.  I'm not angry - every single thing that happened to me and to my family brought us here, and I'm unbelievably grateful, actually, and I'm not afraid at all.  My back is had.  I'm good to go.


And then it twists around again.

For two years I stumbled around in a psychic wilderness, and then I got my shit together, applied to another medical school... and got in.

Dear Improbable M.D.,

Congratulations! It gives us great pleasure to write this letter to you and to say that your dream of becoming a physician is one major step closer. You have been accepted to East Coast Medical School. You should be proud of all you have done - the sacrifices, the long hours, and the dedication to your personal mission. Your reflections and experiences speak for themselves, and your work from providing opportunities to underrepresented groups to support for HIV testing and treatment is testament to your dedication to build a stronger future for all. Your interviewer spoke glowingly of your accomplishments and character, stating that you are “truly an astounding person: grounded and dedicated; inspiring." You are a leader and a motivator, a person whose integrity and compassion shine through. We invite you to join your mission with ours, and we eagerly welcome you to the class of 2018.

East Coast Medical School has selected you because we know you resonate with our mission and will thrive in our curriculum. Your academic accomplishments speak for themselves. That you chose us first because we match your mission gives us great pride.

In the weeks and months that follow we will keep in touch and allow you to see our school grow. For now I encourage you to take this time to reflect on your accomplishments and celebrate.
We are proud to extend this acceptance and hope to have the honor of working with you as we build a school that will live by its mission as we change our community.


East Coast Medical School Deans