In the Arena

the war on cancer.

2012-01-01T07:59:00.000-08:00

They're common enough phrases: "She's battling cancer." "He beat cancer." There's no one that hasn't heard that phrase from a friend, family member, or the media. Or patients in my case. I'm trying to remember when it first started to bother me. I suppose it was around the time when I realized that not everyone does 'beat cancer.' I don't know why we choose to use this phraseology for cancer. If a diabetic patient "beats" diabetes (which few actually do), it's because they strictly maintained their medication regimen, started exercising daily, lost 100 pounds, and are exactly compliant with their diet. Diabetes is something that is actively fought by lifestyle changes. Beating diabetes can be done. (I should clarify that I mean adult onset, or non-insulin dependent diabetes in this description). Diabetic patients can DO something about their diabetes. This is not the case with most kinds of cancer.

The vast majority of times cancer is something that we can't prevent. It's unsuspecting. It hits people with no warning. Twice this month in the emergency room we found "suspicious masses" randomly when we scanned the patient. Often times patients won't know they're sick until the cancer has spread so far that it is beyond cure. When a loved one survives cancer, it is truly a miracle and a gift. I have taken care of enough cancer patients at this early stage in my career to understand that there is a resilience that comes into play in the treatment, therapy and survival of cancer. I'm not trying to minimize that struggle and challenge. What irks me about the phrase "They beat cancer" diminishes the same struggles and strength that were present in the patients that die from cancer. Is beating cancer about survival or is it about endurance?

Although this is a topic that has always chafed me, I was fighting back tears one day in the ER last month as it triggered a whole new frustration at the culture of cancer. A woman with stage 4 lung cancer with metastasis (spread) to the bone and brain (probably one of the worst cancer prognosis possible--very aggressive and at the point where little can be done to cure). The kicker? She had never smoked. She had only been diagnosed 4 months ago and had undergone persistent radiation and chemotherapy since that time. She came in to see us when she stopped being able to walk. Her husband explained her medical history to me, and I turned sympathetically and put my hand on her shoulder. She had tears in her eyes "I'm so ashamed... I'm so ashamed that i can't beat this..." An anger surged up as I realized how unjust our system is to this woman. Here she was with no strength, completely wiped out, and we as a society have robbed her of her peace. Why is she in a position where she feels like she's failed herself and her family by having cancer? Why are we so afraid of death?

Juxtaposition

2011-11-02T19:03:00.000-07:00

In the last 5-10 years I've often been struck by the contrast between two objects, two worldviews, or just two worlds.

With some time on my hands today, I headed to one of my favorite parks to read for a couple of hours. I started with "Half the Sky,"--a book recommended by a fell0w India-lover. I've been slowly working my way through this discussion of human trafficking and the massive injustices towards women in developing countries. As I was processing these stories of horrific oppression, beatings, abuse and rape, I switched to my second book: "Sacred Marriage." Tears came to my eyes as I realized that the expectation and goal of love and respect that I have of my coming marriage is a secondary point overseas. Many women would dream of just not being abused by their husband. I know in the US we don't have perfect marriages, but I live in a country where abuse isn't a socially acceptable practice in marriage (although I'm not naive about it's prevalence).

I was humbled when I realized (as I have countless times since I set foot in India for the first time) that to be educated at all, let alone to be a doctor is a privilege. "Half the Sky" talks a lot about how poor, uneducated girls are targeted--the more educated the girl, the more likely she is to know that it's possible to fight back. I remember the little girl, angry that she would be unable to move past 10th grade because then she would have to get married, and the 'lazy boys' got to continue their education. That encounter left me feeling so powerless and upset. And yet so unsettlingly grateful for the opportunities and value in which I was raised, and the loving and respectful man that I'm marrying. It's the tension that I hope to always live in.

a wake up call

2011-09-06T18:54:00.000-07:00

"The patient I saw today bikes! I wonder if he rides on this trail!" I thought casually as I ran down my newly discovered path. Instinctively I shot the idea down. "That's not real." I reminded myself. As I caught the direction that my thoughts were leading me, I was shocked at how 6 weeks of studying and 2 days of fake, standardized patients had trained me to see the key points instead of the whole story. When we're given exams, we're expected to take a clinical vignette and pull out all the high yield information and ignore the rest. During my clinical skills board exam, I was instructed that it's less important to empathize and more important to get the information you need quickly as we only had 15 minutes with each patient. After 6 weeks of dwelling in that mindset, how do we avoid an overlap into our patient care?

The better I've gotten at knowing "what's important," the worse I become at hearing the 'unimportant details.' The details that are meaningless to the medical diagnosis are often the most important factors for my patients. This is part of the essay that I wrote with frustration several months ago:

"As I mulled over the nomination to Gold Humanism Honor Society and the prompt for this essay, I couldn’t help but to remember all of the ways that I fall short in compassion, empathy, and patience. The countless days where I’m tired and my patience runs low with both colleagues and patients. The annoyance I feel when I walk into a room that’s full of family members with lists of questions when I have far too many notes to write before rounds. The urge to interrupt and cut off my long winded, lonely patients as they wax on about their long list of complaints.

I was frustrated and disappointed in myself as I realized all the ways that I fail to be empathic and fail at the very thing that drew me to medicine. But then I realized that what matters most in medicine is how we react when we’re tired, sleep deprived, busy and feeling burned out. My short-comings don’t define who I am as a future physician, but how I act on these emotions that will determine the type of doctor I become."

I was told by a mentor last year that if you aren't careful, you'll wake up in 10 years and be a doctor that you never planned on becoming. Compassion and care are something that need guarded and attended to. Perhaps this is an area that I need to attend to more carefully if I desire to preserve the gifts given to me in stewardship.

"Into the water--the clinical clerkships"

2011-05-18T13:53:00.000-07:00

Another NEJM essay that puts words to the surreal experience of the third year of medical school:

"There's nothing particularly natural about the hospital — ever-lit hallways, the cacophony of overhead pages, near-constant beeps and buzzes, the stale smell of hospital linens. This unnaturalness was strikingly apparent to me when I arrived as a third-year medical student — freshly shaven, nervous, absorbent — for the first day of my surgical clerkship.

As I joined my team, my resident was describing a recent patient: “He arrived with a little twinge of abdominal pain . . . and he left with a CABG, cecectomy, and two chest tubes!” This remark was apparently funny, as I surmised from the ensuing laughter. And the resident sharing the anecdote — slouched in his chair, legs crossed and coffee in hand — seemed oddly . . . comfortable.

As the year — known at Harvard Medical School as the Principal Clinical Experience — proceeded, the blare of announcements dulled to a low roar, the beeps and buzzes seemed increasingly distant, and the stale smell of hospital linens became all too familiar. Occasionally, however, there were moments that evoked a twinge of my old discomfort, some inchoate sense that what had just transpired mattered more deeply than I recognized at the time. These moments were often lost amidst morning vital signs, our next admission, or the differential diagnosis for chest pain.

At the end of the year, we were asked to reflect, in writing, on our first year in the hospital. What eventually filled my computer screen had nothing to do with vital signs or chest pain.
I began to write, “I have seen a 24-hour-old child die. I saw that same child at 12 hours and had the audacity to tell her parents that she was beautiful and healthy. Apparently, at the sight of his child — blue, limp, quiet — her father vomited on the spot. I say `apparently' because I was at home, sleeping under my own covers, when she coded.

“I have seen entirely too many people naked. I have seen 350 pounds of flesh, dead: dried red blood streaked across nude adipose, gauze, and useless EKG paper strips. I have met someone for the second time and seen them anesthetized, splayed, and filleted across an OR table within 10 minutes.

“I have seen, in the corner of my vision, an anesthesiologist present his middle finger to an anesthetized patient who was `taking too long to wake up.' I have said nothing about that incident. I have delivered a baby. Alone. I have sawed off a man's leg and dropped it into a metal bucket. I have seen three patients die from cancer in one night. I have seen and never want to see again a medical code in a CT scanner. He was 7 years old. It was elective surgery.”

In a 2005 commencement address, the writer David Foster Wallace told the story of two young fish swimming along.1 An older fish swimming by greets them, “Morning, boys. How's the water?” As the young fish swim on, one looks at the other and says, “What the hell is water?”

The third year of medical school is like being thrown head first into water. Although the impact is jarring, eventually the experience becomes natural. We become comfortable — legs-crossed, slouched-in-a-chair, coffee-in-hand kind of comfortable. Occasional moments, however, remind us that we are immersed in water. If we focus on them closely, we see that our lives are filled with these moments. The challenge is to collect them in a meaningful way — to spend time with them, wrestle with them, allow the discomfort they generate to sit inside us.

Loneliness of Visiting

2011-05-16T10:46:00.000-07:00

Article in New England Journal of Medicine by R. Srivastava
This hit home with me and thought it was thought provoking and put words to the tension and frustration of medicine and of the care of the sick.

“The problem is the poor chap is lonely. If they sat with him a little more, they wouldn't need to call us as much!” My harassed intern is venting her frustration with Mr. Wilson's relatives. The 76-year-old man has languished in the hospital for the past 3 months, a resident of practically every major unit in turn. He was first admitted to Surgery for an emergency laparotomy, which revealed bowel cancer. From there, he went to Rehab for a short stint. But he developed pneumonia and was transferred to the Medicine unit, where he needed an isolation bay. When he became agitated, the night resident gave him haloperidol. But he became sedated and, unable to find his call bell or attract anyone's attention through the closed doors, he got up unassisted — and fell, fracturing his hip. Ortho took him to the operating theater, after which he returned to Rehab. Two weeks into Rehab, his abdominal wound dehisced. So he is back in Medicine for antibiotics and wound care.

We, his medical team, sense another disaster lurking around the corner. His notes have spilled into another volume; his name tops the list of long-stayers, and although we try not to contaminate him with our sentiments, a certain pessimism clings to us. Just yesterday, I found myself telling the medical students, “Every day he spends here he is at risk for a new complication.” It was the most relevant teaching point I could come up with.

Mr. Wilson belongs to the diminishing category of people who have “never been to the hospital until this happened.” Now, he feels battered by his circumstances. He has no appetite. The wound is malodorous. His arms are bruised from regular IV changes. The repaired hip feels stiff. To the well-meaning psychiatrist he carefully explains the difference between being depressed and finding the situation depressing, though lately he seems even more withdrawn. He answers in affable monosyllables. Often he just listens passively, not bothering to protest or engage. His transformation from active citizen to dependent patient is complete.

Mrs. Wilson, though pleasant and concerned, is an old 85, troubled by an osteoporotic spine. Her daughters used to drive her in and sit with their father, but the visits have gradually become shorter and fewer. They have full-time jobs and families.

“Why don't they come anymore?” I ask the intern.

“I don't know,” she muses. “It's almost like they have stopped caring what happens.”

What happens next in my life seems to have occurred almost by design: “I have bad news,” an acquaintance phones to tell me. “Brad had a stroke — he's in the ICU.”

I have known Brad since my student days. Alarmed, I rush in. He lies in intensive care, intubated and senseless after undergoing emergency neurosurgery for a brain hemorrhage. His head is bandaged, and there are tubes everywhere. The ventilator displays reassuring numbers, but an intubated patient dependent on a machine to draw breath seems the epitome of vulnerability. His blood pressure is precariously high. A drain tube snakes out of his skull. A urinary catheter hangs off the other end of the bed. There are multiple IV lines, a nasogastric tube, bulky compression stockings on his legs, mittens on his hands. Even with his substantial build, Brad seems dwarfed by the surrounding paraphernalia.

Visiting on the days that follow, I edge my chair close to his bed. I say a few words, self-consciously wondering whether he can hear me. His extubation is the first opportunity to assess recovery. To everyone's disappointment, he exhibits unilateral neglect and excessive agitation. Within a day, he is diagnosed with pneumonia. It is impossible to ascertain whether he is agitated owing to pain, pneumonia, or the stroke.

The fog in his head seems dense. Even without sedation, he can stay awake only for minutes. If you stand in front of him, his gaze might meet yours, but it takes the eye of faith to read recognition into it.

“Take my hand,” I urge. Sometimes I imagine a weak squeeze in return, but other times his hand falls limply to the side. The effort of turning in bed is too much. His face becomes red and flushed as he rests back, defeated.

An uncomfortable witness to his situation, I reach reflexively for my phone. But I had to turn it off, so I cannot go through my messages and pictures, which are months old and of no consequence but would make for an easy distraction. My newspaper is unwieldy in the small space. The precautionary gown and gloves makes it even more impractical to hold Brad's hand. A touch through powdery gloves feels slippery in practice and intent. I look up, but there is not even a muted television screen to stare at mindlessly. The nurse busies herself with the next round of medications, and we make small talk. I tell her Brad and I go back 20 years. “That's special, Brad!” she enthuses. He looks at her blankly and innocently. My heart sinks. It seems unkind to leave but painful to stay.

And so it is during repeated visits to Brad that I realize just how difficult and lonely visiting a patient can be. In fact, the sicker and needier the patient, the harder it is. Sitting with Brad, with neither conversation nor technology to distract me, I am forced to consider the vagaries of life. There we were, only 2 weeks ago, relishing lunch on a patch of green and watching my children bounce on the trampoline. For all I know, we may have had our last full conversation. As I take in his tired body, I fear what lies ahead for him. Will his pneumonia worsen? Will his hypertension abate? Will he be able to recall the countries he has traveled to and the books he has read? No doctor knows. No test can tell. To be in the powerhouse of medicine and yet be stumped by these questions is maddening. Brad's fate could be anyone's fate — it is an introduction to one's mortality, and it gives pause for thought.

And slowly, I see why it might be easier to just make phone calls from the safety of one's home than to be witness to a seemingly unending stream of medical misfortunes. Or why it might seem like a good idea to slow down the visits or find a dozen other things that take precedence over visiting someone in the hospital.

In response to my expectant eyes one day, Brad's doctor summarizes his progress. Her first five sentences are laden with medical jargon, which I follow silently until she halts. “I am sorry — are you a doctor?”

“Yes, but I am here as his friend.”

“OK, so you understand.” She relaxes and continues her summary.

In fact, I have many questions and even more worries, but with her feet already pointed toward the door, I feel like an intruder.

I would like to deny it, but in her, I see a reflection of myself and my colleagues, and it makes me feel ill at ease. I wonder if we become so accustomed to speaking in jargon that it becomes the dialect of first choice. How little must patients and their relatives really understand of our attempts to communicate with them. How many cues are missed on an average ward round? Could the way we talk make relatives feel uncomfortable instead of involved?

My mind goes back to the Wilson family. Their reticence now seems somewhat easier to understand, their silence easier to sympathize with. I can't remember the last time someone arranged to sit down with them, although many teams diligently flock past his bedside every day. I am confident that our pessimism is matched by their lack of empowerment. I realize that their puzzling reaction to illness is not so much selfishness as self-insulation.

I am not quite sure yet how I will teach my young intern the difference, but I feel lighter for knowing it myself.

a bit of the past

2011-05-07T18:44:00.000-07:00

It's one of the more familiar places in LA. The rooms all looked down to a central "recreation room." It had a unique smell to it, and the air was california air. The noise routinely kept us up at night, along with the racing thoughts, stress and anxiety of that month. i remember the piano that I had to bribe the manager to unlock for me so I could play it to unwind. I remember walking to the pie house, the grocery store to track down squirt, and the hospital. I remember the busy traffic racing by on Santa Monica Blvd, and the car rides between CHLA and USC with my grandparents to visit much grumpy father and all too cheery uncle, both post-op. I remember pacing the halls walking on only one color tile at a time while I was banned from visiting in the ICU. I remember trying to find an internet connection to update Ross' blog for people back home back before the days of wireless. I remember waiting. I remember the waiting room of the hospital, I remember the lobby, I remember the phone that bridged the windowed walls of Ross' room which was my only form of communication with him for 2 weeks.

Being back in Ronald McDonald House (albeit a different one in a different city) and walking across the street to hang out with my brother brought a lot of old memories back. Ones that I haven't thought about in years. Silly ones too, like taking the bus to the beach with my grandpa and having him make friends with like everyone on it. And walking to the pie restaurant. My grandma "tsk-Tsking" in the backseat as my grandpa navigated the streets of LA. My uncle hauling my miserable dad out of the hospital and us finding them standing outside of USC with IV posts in their hospital gowns. My uncle bribing the nurses to bring him a steak and a glass of wine.

Just a trip down memory lane... A reminder of everything my family has been through in the last decade and how good Gods' been to us.

Home

2011-03-18T19:40:00.000-07:00

How quickly a place becomes home. 3 years. I’ve only been in this white-walled apartment for 3 years, but it’s the place that I’m comfortable. I’ve gotten so spoiled with getting to come home and sit on the floor of my best friend’s room while we talk about our days and life. Our messy cupboards are evidence of a busy kitchen. A wreath is always on our door. My roommate makes our house festively Christmasy every December. I love thelong walks around the neighborhood that have built some of my dearest friendships through discussions on family, faith, and past and future. The impromptu roommate dinners and movie nights. The particular spot on the particular couch where I do my devotions each morning. The windowsill that the cat perches on. Lily and Gil racetracking around the living room, stealing each other’s food and their perfect ‘sibling’ relationship. My long runs on winding, hilly roads in rural Ohio with the cars and the cows.

But when it comes down to it, I can’t believe that in a few short months my roommate of 3 years will be in Columbus… Iam going to miss telling her basically about everything in my life. I’m going to miss the level of community and friendship. I went to see my apartment for next year and am so stoked about the roommates I’ll have and they are a total God-send. Such a blessing and I think it’ll foster great friendships! And I’m beyond excited about how it all worked out so quickly. But as I stared at my new ‘resident application’ I was sobered to think about all that will change over the next 6 months.

Little children

2011-01-03T17:49:00.000-08:00

So.. after my first day of 8 weeks of pediatrics, I can say almost with certainty that pediatrics is not my passion. I like kids in real life. just not in the medical field. The commotion during the history, the crying when you're doing a physical exam, and not actually being able to talk with most of them... when it comes to medical stuff, I just think I like adults.

I found myself fascinated by the parents today:

The father who I immediately judged as I walked in the room by his loosely fitting pants perilously hanging from his hips, the long hair and the unsmiling demeanor. But as I watched him throughout the interview I was impressed with how loving a father he was. He seemed to always know what his nonverbal daughter needed~he suctioned her airways, he managed the feeding tubes and he lifted her weak body into his arms to hold her safely to himself. I saw his stressed and sick child crumple peacefully in the security of his arms.

Another mother came in with her 4 year old daughter. She was a single mom, frazzled, sleepless with dark rings around the eyes on her bare face. Her hair pulled back in the pony tail that tells the tale of a woman with no time for herself. She was harassed and short tempered and had unending exhaustion. I wanted to take her aside and know how she was doing. How she was holding up in the chaos of her life... And I wondered what happens when she lost her last straw of sanity...

I think I would be a pretty sucky pediatrician.

missing home

2010-12-10T20:02:00.001-08:00

Its in the moments where I'm alone in the quiet that the gnawing, pulling ache sets in. That desire to be far away. In all the chaos that was India, there was some strange quiet and peace to my life there... a peace and rest that I can't remember experiencing in my childhood, and most certainly haven't obtained in medical school. When the world is swirling around me and people are everywhere and I'm constantly having to be "on", I'm fully engaged in my life here.

But it's nights like tonight, where it's just me, that I crave that home. That little room that I shared with two dear friends on that campus that always felt safe, in that city that was busy in a way in which no one was really in a hurry to get anywhere.

Thank you for remembering that I'm a person too

2010-12-09T16:57:00.001-08:00

Patients desire their healthcare workers to treat them like humans. I am the first to understand this importance. My family was blessed with incredible doctors, nurses and others who took care of my brother and our family, who explained and who sympathized and who treated our family like human beings.

But there's something to be said for patients treating their healthcare professionals like humans too. I didn't realize it until I was taking care of this gentleman with end stage lung cancer. Our team almost fought over who got to see him. He might be the only patient on our service who had every one of the residents come and visit him in the morning. I tried to explain it later that day, and the only way I could, was to say that this man and his wife treated us like people. There was no fast interview. Before I could get any questions out about shortness of breath, they were asking questions about me and how I was doing. It was actually awkward at first. He was so active and at peace with where he was in life. His goal was to maintain mobility. His wife's goal was to love him and surround him by family. They were realistic and didn't expect us to be miracle workers. As selfish as it sounds, they invested in us and it was profound.

Dialysis

2010-11-18T06:26:00.000-08:00

Dialysis is a sobering place. And in the last several weeks it's come to stand for irreversible illness. I see people tethered to the area, unable to escape even for a few days, because on Monday they have to be back hooked up to the dialysis machines. Those lines connecting them to machines filtering out the toxins that threaten to be so deadly.

I guess I should start by telling you about the patient that has triggered my feelings towards that windowless room at the ground floor of Akron City Hospital. I first met Jane in the emergency room at 11pm one night when my team was admitting. I had just finished another patient's admitting orders when my senior resident got a call about her. "Umm... while I finish up this paperwork, take a look at her lab values and see what you think!" When residents have said this before, they usually mean some subtle lab difference that I'll never pick up on, so I was surprised when the Creatinine level of 21 jumped out at me. Normally, Cr is below 1 and I honestly didn't know it was possible for someone to have a level that high! I quickly glanced at the patient's age and looked over the list of other diseases she had, completely expecting some 90 year old lady with diagnosed (yet uncontrolled) end stage renal failure. But no. Jane was 51 years old and had no diseases that she had been diagnosed w/ or was being treated for. By her own accounts she had always been healthy. As I began to take her history and she told me her story, I learned that she had had a workup at the other major hospital in Akron which had proved to be inconclusive, and Jane, frustrated, stopped following up. I stood there in her room as she told me about her symptoms, the stress of a recent job loss, and the frustration of her persistent nausea and vomiting. I was in the suffocating ER as Jane laid in that inhuman excuse of a room, partitioned off from the next patient by 3 curtains protecting her privacy. As the word "dialysis" was stated as a likely possibility, I was there to watch the the instant reaction on the face of Jane and her daughter.

I saw her the next morning as resident after resident, and attending after attending visited her to talk about her prognosis. I observed the light slowly drain out of her eyes throughout the morning as she approached the catheter placement. And I visited her nearly every morning of her 10 day hospitalization. You've never felt so much peace as you walk into a room. Here was a woman with deathly low kidney functioning telling you how important it was for her to wash up every morning and "get ready for the day" so she could continue to feel human through this all.

And when she started dialysis, I went there to get her history morning after morning. I talked about how her body was responding and listened to her lungs and heart as the dialysis machine whirled on and on in the background--pumping blood in and out of her body as she lay there confined to her bed as that machine worked to keep her body from shutting down.

But I'll never forget that one conversation. I was pretty annoyed that morning, and I had 2 hours to see just one patient. But Jane was that one patient. I headed down to dialysis to do my usual check in. By this point she was only in the hospital to wait for medicaid to kick in and we really were doing nothing more than dialysis to manage her medically. But I still went to say hi. And I asked her how she was really doing. I find that's quite a different question that "how are you doing this morning?" And she answered me. I leaned against the counter in that crowded little space as Jane poured out her heart about the devastation of the diagnosis. How one day she was healthy with a job and a life and a future, and the next she's tethered to Akron and to dialysis. How will she work when she needs to be in that windowless room 3 days a week? Her dreams of "someday getting around to traveling" are over. She's here. Her health has now become her life. Her renal disease now dictates all of her activities and functioning.

I was, in short, humbled by this conversation. Here was a woman who was independent. Who lived life. Who had a family, had a job, and functioning completely as her own person. And yet she wasn't beyond disease. It made me re-evaluate how I live my life. It reminds me of my own conviction that I never want to wake up one day and realized that I've forgotten to live. I want to live. I want to love. I want to invest in relationships. And Jane reminded me that nothing is certain. That there are no guarantees in life.

2010-10-23T05:23:00.000-07:00

I'm not a huge fan of getting screamed at~ particularly when I did nothing wrong. This was my day on Wednesday. The patient had refused a rectal exam when we admitted her ('cause really who wants to get a rectal exam?) and it wasn't too important with her presenting symptoms so I didn't encourage it ('cause really, who wants to give a rectal exam?). When her Hgb dropped 2 points the next morning, I bit the bullet and told her that we really needed to rule out a GI bleed before we discharged her later that afternoon~ make sure it was just dilutional. So began my search for a hemoccult card. For those of you who haven't had the joy of being a surgical medical student, these card are simple little pieces of cardboard that you smear stool on, turn it over, and then squirt some chemical fluid on. If the paper/cardboard turns blue, there's blood in the stool. Really, really basic 'technology' and really really standard for the physical exam (depending on your attending...). Anyways, I asked the floor nurses for one, because at my last hospital they usually had them on the floor and would grab one for you out of their secret stash. I was met with an indignant "We don't keep those on the floor!" No problem, I thought, I'll just order them up to the floor (another standard option at the hospital I was at before, and what one of the residents told me to do). 3 hours later, there was no hemoccult card to be found. I cheerfully asked the unit secretary where I would find it if it got sent up, only to be literally yelled at~ telling me that they weren't ALLOWED to have hemoccult cards up on the floor. I went back into my patients room to do some diabetes education and could hear this woman complaining about my request to everyone around her. I ended up having to go to the lab, in the far corner of the hospital and literally BEG them to give me one. "I guess I will," the lab tech eventually told me, "but put in in your pocket and don't let anyone see that I gave it to you!"

Frustrated, I asked my resident why they keep such basic material in the dungeons under lock and key. It boils down to money. It's so frustrating when the bureaucracy and money game gets in the way of patient care. I know this was a taste, but I have a feeling that those moment of unrelenting frustration will only multiply as I progress through my education. I want to take care of my patients. I want to do the best thing by them. I want them to not live in the hospital, but I want to be as thorough as I know how to be as a medical student. Now I'm starting to realize that I'll be battling uphill to maintain this philosophy and I'll be fighting against a system that has to put other things first.

being the bad guy

2010-10-17T06:22:00.000-07:00

I stood there next to the hospital bed with chart in hand as the patient answered my questions through hysterical tears. "Please just call my pain doctor" she sobbed. I tried to explain that I can't call an attending about a patient I know nothing about. I calmly appealed to her to answer my questions and tell me about what was happening. I knew going into the interview that this patient would get no pain meds. She was being managed by a pain clinic which tied our hands to the ability to alter her pain regiment. As this painfully uncomfortable interview progressed, I learned that she had stopped the medication for her peripheral neuropathy and after we ruled out acute reasons that would justify a hospital admission, it was clear that this woman would be going home. I knew she was lonely, I knew she was uncomfortable, and I knew she was unhappy. But does that justify a stay in the hospital? Here was a 400lb woman who can't ambulate with an exacerbation of a chronic illness that needed to be addressed in the outpatient setting. If she was admitted she wouldn't have left the next day. She risked DVTs, pneumonias and all sorts of other hospital acquired illnesses.

I walked back into the room knowing that the conversation would end poorly. She had already fired physicians this year when they told her that she was getting better and I figured she'd have no qualms about yelling at a medical student. As I explained that we ruled out a DVT and cellulitis as possible causes and told her that we wouldn't be able to give her any additional pain medications, as I calmly told her that her pain doc recommended discharge and followup in his office, and as I told her there was nothing that necessitated her being admitted, the anger struck. And it was at me.

As medical students, the residents and attendings usually shield us from the anger of the patient. This was the first time that I and I alone was delivering news that was unwelcome. As I apologized that she felt so unhappy with her care and told her what the doctors said, I was the bad guy. I wasn't the smiling happy medical student that the patients love because we are the innocent bystander. I was the one she was mad at. I was the one she was criticizing and yelling at.

As a people-pleaser, this bothered me and made me uncomfortable. It made me feel that I wasn't taking care of the patient. That we were missing something. But then I brought myself back to reality. While I don't feel like I did anything good for my patient, I felt like i was acting on the principle "do no harm." It sucked and I felt awful that I couldn't make her pain go away. That I couldn't make it all better. But I guess this is life. Sometimes I'm going to have to make tough calls that aren't what my patients want in the interest of preventing harm. It was an uncomfortable feeling.

dove promise. and other random reflections

2010-10-09T08:23:00.000-07:00

I love dove chocolate. I really do. And I love the cheesy little sayings on the wrappers. I went on a 5 mile run this morning and obviously the first thing I did when I got home was to have chocolate :) The wrapper read "What would you try if you knew you could not fail?"

This is the second time that this question has surfaced in the past year and it's one that sticks with me. I've realized that I'm a human dictated by fear and timidity much of the time. I live in indecision because i don't want to risk making the wrong choice. The main criticism from my last rotation was that I needed to be more confident and assertive. I'm trying hard to take the risk of saying something wrong or stupid. To push myself to put myself on the line. I know I need to do that in order to be a good doctor, but for some reason I'm petrified of looking stupid. Thursday night when I was on call, I tried to be decisive, to be assertive, to not freak out when the resident handed the phone to me to give report to the attending at 2am. To give my opinion even when I knew it was wrong. I feel/hope it will facilitate better learning and adequately prepare me to be a decisive, confident physician who my patients can trust.

So in light of this new goal in my life, I once again ask the question "What would I try if I knew I couldn't fail?" What does my dream life look like? Is it policy, international medicine, working with youth? Is it something grand, or is it something that'll be a piece of the puzzle? Do I not attempt because I fear failure or because I'm overwhelmed by the possibility?

I miss India. I miss the dreams that it inspired in me. The goals and direction that it gave my life. I want to go back to that focus, that direction, that intentionality. "You get a strange feeling when you’re about to leave a place, I told him, like you’ll not only miss the people you love but you’ll miss the person you are now at this time and this place, because you’ll never be this way ever again.” Reading Lolita in Tehran. It describes my transition exactly. I miss the flexibility in my life, but also the intentionality and discipline that were present in my relationships, my quiet times, my exercise and my reading. How do I bring those pieces of me into my busy and distracted life here in the states?

2010-09-07T16:38:00.000-07:00

I crave something more. Something missing that I find myself inadvertently seeking.

Mortality

2010-08-15T12:24:00.000-07:00

I layed in bed last night with my mind racing. Planning how I would react if I got in a car accident on my way back to Youngstown this evening. Walking through what I would do and how it would feel to be in a trauma bay with my classmates in the room as I lay on the bed with my clothes cut off and tubing being shoved down my throat. As I was lying there, I remembered my drive home from the hospital on Thursday. How I played through the same scenerio. How I pictured the humiliation of being wheeled into the trauma bay at St. E’s with all the residents and attendings that have been my colleagues and teachers for the last few weeks.

These are new thoughts for me. Working in the ICU with teenage patients, healthy 40-something year olds and college students who have been taken out by a car accident, ATV crash, or any other freak accident you can imagine seems to have brought me to terms with my mortality. Seeing previously healthy people being knocked down by accident and illness with no prior hints has been humbling to me. Who am I to think that I’m above a freak accident? Who am I to think that “this” could never happen to me?

I had my first patient who was actively dying on Friday. It didn’t phase me much at the time. I was engaged and interested, but not really bothered by the idea that this man most likely could be ‘expired’ by morning. But then this morning at church we were singing “Sin has lost its power, death has lost its sting” and it all of a sudden hit me. I wondered if I could really rest in God's assurance that he's bigger than death. While I feel death carries no fear for me, can I say the same thing for my patients? For the human lives that I work with that aren’t walking with Christ? This has the makings for an interesting year.

2010-08-08T11:49:00.000-07:00

In the back of my mind, I always wondered if I'd love medicine and being at the hospital as much as I thought I would. You sit in classrooms and pouring through books for years anticipating that one day you'll be with patients and it will all be worth it. The funny thing is that it's a mere hope; that at the end of the day the years of work and the $100 thousand that you've invested in your education will be worth it. Well, last week proved that I do love medicine every bit as much as I thought I did. I think it's a good sign when you spend 30+ hours straight at the hospital and aren't counting down the hours till you can go home. I love the patients (as crazy as they can be), I love the residents, I love the smell and feel of the halls of the hospital. I love suturing, and procedures, and even being confused. I can't believe I'm lucky enough to go into a field that I'm this passionate about.

2010-06-10T04:35:00.000-07:00

Some days I feel like I'm more extroverted than introverted. I don't know what to do with that.

the book that I love.

2010-06-07T18:51:00.001-07:00

For 6 months I've carried around this book. It's not intimidatingly overwhelming from the outside--no more than your average textbook. It has "First Aid" plastered in large font over the front cover, implying a simpler topic than what's below it "USMLE Step 1". But it contains 80% of the information (in abbreviated form) of what I need to know. I've lived with this book for months. I've read through each page 3-4 times now. I've noted each bullet point that is representative of an hour of lecture. I've highlighted and I've neatly printed elaborating notes and important points in the margins. The pharmacology pages are neatly marked with post-its. This book has almost become an extension of myself. My own handwriting throughout. My own notes. My own emphasis on important points, or on points that for the life of me I can't remember. As much as studying has been tedious, I still love this book. I love the knowledge that it holds. I love the centuries of research and discovery that this little book opens to me in simple statements.

I've complained that it's tedious and a bit monotonous, but I had a realization on Saturday. Numbers 11 talks of how the Israelites complained about the manna--how there wasn't enough diversity and that they were "bored" of the manna. And while I know there are great spiritual depths here that i have left unexplored, what struck me was their ingratitude for a blessing. This was convicting in the wake of my life of studying. I've always said that my education and the pursuit of medicine was something that was a huge blessing to me. One of the greatest gifts that God has given me. Why, then, am I complaining for living in "only" this blessing for the time being? Shouldn't any blessing of God's be blessing enough? So the next morning when I opened my books, I had a new perspective.

Ok, that was a good study break--back to the books :)

2010-05-23T07:40:00.000-07:00

My God, the breath you have given me is fresh. You create it, you form it, and you keep me breathing. At some time you will take it away from me and I will have breathed my last breath in this body. And you will resuscitate me to the life of the spirit... For each breath still in me I thank you, Adonai, the God of my parents, Lord of all spirits, Master of all that happens. I offer you thanks, Cosmic Majesty and worship you for keeping me breathing. In this way, with each breath you give me Life anew.

Vacation

2010-05-13T15:09:00.000-07:00

Today as I frantically finished up my board review class online, ran back and forth between school and home and threw my suitcoat on top of my luggage, I pushed myself though the weariness because at the end of the day I was heading here. To probably one of my favorite "places" on the earth. The airport. It's a place of reflection. With a sea full of people around me, I can breath deeply. In a sea of busyness, there's always been some sort of peace. Nothing else for me to do. My computer has only so much battery life before I'm left with books and music and myself. India did this for me. Restfulness, peace and pending adventure go together for me.

But now my pending adventure is a gorgeously nice hotel, Disney world and just a short presentation (the whole point of my traveling). I'm giving myself a few days off. I feel so relaxed. so much...shalom. The 90 degree, sunny weather awaiting me doesn't hurt either :)

And here comes the sun

2010-04-27T06:27:00.000-07:00

What I've noted about transitions over the years is that they are often accompanied by regret for the path we're leaving, and fear of the path we're approaching. But for some reason I've had neither emotion as I approach this particular transition. I have an appreciation for where I am now and where I've been for the last 15 years of classroom education. I can enjoy (loosely used term) the next two months of studying on my own schedule and taking breaks when I feel like it. I've learned what discipline is (and how bad I often am at it). It's been a fun type of freedom and has allowed me to invest and build relationships and gave me time to wrestle with things outside of my profession.

But just beyond is a new type of learning. Just on the other side of this transition is a practicality and a set of skills, not just knowledge, for me to learn. On the other side is the immersion into why I've worked so hard towards for the last decade. And as scary as it is, there's a hope and an excitement of remembering regularly the calling that God's given me which is so easy to forget amidst books and papers and projects. I'm not naive. I know that next year is going to bring its whole set of challenges, humiliations, frustrations, inadequacies and sleepless months. But it stands for something. And for that reason, the anticipation and the hope far outweighs the fear.

2010-03-17T10:31:00.000-07:00

Since this blog is mostly for myself anyways, I feel like I need to save this devo that was sent to my inbox mere days after the previous post. Who can accuse God of not knowing what we need to hear.

Be Perfect, therefore, As your Heavenly Father is perfect. Matthew 5:48

Bob sat across from me at our monthly McDonald’s breakfast time together. We saw each other almost daily, rushing past each other in the hospital, but this was our scheduled time to be friends. He was struggling with an issue in his life.

“I was raised to do everything well. That got me through medical school and it has worked well to build my practice. But I’m dropping all kind of balls lately. I have a patient I was working up for back pain. Before I could get the tests done, he was paralyzed from a cord compression, a cancer in his spine. I have another patient with a mammogram that was positive; the report was lost and I didn’t see it for three months. She was not at all happy. I missed my daughter’s gymnastic competition because an emergency came in. I feel like I’m failing everywhere.” I answered him the best way I knew how, “So, you want to be perfect, like me?”

As doctors we are hardwired to be achievers. God placed within us the character to do our best, to get things right---for His glory and for mankind’s benefit. As doctors, mothers, fathers, spouses, church members, we are called by God to excellence; and we expect that from ourselves. But sometimes we carry that expectation too far. Sometimes we expect perfection from our efforts and make perfect performance into an idol. If we choose to do so, at some point that idol will topple over on us and cause us great pain, for we will never be perfect in this life.

There is a clear distinction between excellence and perfection. Excellence is measured by great effort. Perfection is measured by results. God cares about our effort but He does not expect perfect results. When Jesus calls us to be perfect in Matthew 5:48, He is not asking for perfect results; He is calling us toward wholehearted devotion to our Father in heaven. He wants us to do all things well for His glory (Col 3:23), to pour ourselves out in sacrificial service. He wants us to serve Him with our very best, but He expects for us to leave the results to Him (Phil 1:6).

We are called by God to strive for excellence by remaining well read and well skilled, by disciplining ourselves to do our best with each patient and with our families. God smiles on us when we pour ourselves out to serve Him with our best in all areas of our lives. But as we do, we must continually hand the results of these efforts back to Him. Only He knows how to use them well to write His story of redemption.

never good enough

2010-03-13T11:35:00.000-08:00

Perfectionists. The sad breed of humanity that feeds off of affirmation and action-oriented accomplishments. What drives these people to such a self-torturing lifestyle? Why the need to prove themselves? Why the need to control? I guess I should acknowledge the good in perfectionists. They're hard working, determined, motivated, disciplined and reliable. But they can't just let things be.

Group projects are the bane of their existence. "Just scraping by" isn't an option and inevitably they become the "mother" of the group emailing about deadlines, tracking people down and making sure everything gets done. All the while thinking to themselves "I could get this done SO much faster by myself."

I'm glad to say that my perfectionism has softened in the years of medical school (..and college...) I've learned to delegate, to rely more on my leadership than on my compulsion to do everything myself. I've learned that perfection is unattainable in a class of 115 of the brightest students. I've learned that I will never be able to learn everything that I need to know. I've learned the impossibility of knowing everything and being the best and being perfect. More than that, I've learned that I don't want to be perfect. I want to make mistakes in my life. I want to be stupid occassionally. To screw up. To have to admit that I'm human. To risk rejection. To really truly allow people to love me for who I am instead of loving me for the perfect image of myself that I try to project.

But every once in a while the perfectionist inside me gets the best of me, leaving me frustrated, discouraged and insecure. Knowing that as an M2 (2nd year med student) I should have certain competencies and I still feel incompetent. That I still can't do an effective physical exam with any level of confidence of what I'm trying to find. That I still get awkward when taking histories and get nervous and embarrassed in front of my attendings. That I can't remember diseases and criteria that i learned weeks ago. That my brain is just to small and my skills are too limited. The feelings of inadequacy flood over me and plague me with self-doubt and insecurity.

beyond me

2010-02-21T05:59:00.000-08:00

It's something I just don't understand in myself. Like I look at my life from the outside and want to grab my shoulders and shake them forcefully as if to shake sense into my own head. It's never been this way before where logic doesn't rule my thoughts and emotions. And I can't make up my mind how far to let it go. The swirling loss of control, the excitement of acting out of character and the anticipated arrival of brokenness all crash down into chaos and confusion. But in a twisted way the chaos has begun to feel like home and the confusion has become where I reside instead of a place that I fear.

I suppose something interesting must be going on...

2010-02-18T10:14:00.001-08:00

Meet Lily: she's the little one. And makes life happy! Seriously, you can't be in a bad mood when there's a 3lb puppy that's just thrilled to see you in the morning and when you get home from class.

And now I just have to get through June :)

I take boards June 26th which will be the hardest and most important exam that I have ever or will ever take. So when I emerge from the cocoon of studying, I fly to Ireland with my brother and two cousins to explore the land of our ancestors. This has been a trip that we've been planning and anticipating for 6 years now, and booking our flights earlier this week brought an excitement and adrenaline rush that we're actually going!! I've spent way to many hours this week on lonely planet finding awesome hostels.

http://hotels.lonelyplanet.com/ireland/dublin-r1975358/avalon-house-p1020875/

http://hotels.lonelyplanet.com/england/london-r1974887/palmers-lodge-p1038305/?lpaffil=lpdest-hhlink

Seriously, how cool is that??? Anyways, I need to get back to my day of board studying :(

My nagging question

2009-11-01T11:20:00.000-08:00

For the past 2 months, I've had a question perpetually on the surface of my mind. I can't get rid of it. In my quiet moments of peace, the question rises. It's disconcerting. It disturbs a sense of silence and placidity.

"What does it mean to live a life of significance?"

Some of the people I've phrased this question to are very skeptical because as christians we aren't supposed to be living for ourselves and to make our name known. But I feel my question isn't in conflict with humility. I feel like as Christians we are called to make a difference in Christ's name, but I can't figure out what that looks like. You have Paul who made a difference through vocal evangelism and leadership. You have people like Ruth who pretty much made a difference because she had a kid. And then there are priscilla and acquilla who worked--who made a difference through their normal, ordinary occupation. The practical side of faith: to take care of the orphans and the widows. The oppressed. It seems like leading a life of significance looks different to everyone.

So my question is... what does it look like for me? How can I best live my life so that I have no regrets at the end of it all?

2009-08-29T16:57:00.000-07:00

"While the bombardment was knocking the trench to pieces at Fossalta, he lay very flat and sweated and prayed oh jesus christ get me out of here. Dear jesus please get me out. Christ please please please christ. If you'll only keep me from getting killed I'll do anything you say. I believe in you and I'll tell every one in the world that you are the only one that matters. Please please dear jesus. The shelling moved further up the line. We went to work on the trench and in the morning the sun came up and the day was hot and muggy and cheerful and quiet. The next night back at Mestre he did not tell the girl he went upstairs with at the Vill Rossa about Jesus. And he never told anybody."

-Hemingway

2009-08-15T07:42:00.000-07:00

the sun's out. I can see the mountains from my little coffee shop that has become my second home (its probably 100 yds from my apartment and has free wireless while I have no internet at my apt.). It's a stereotypical gorgeous day here in Denver. Honestly, I don't think Colorado knows what yucky weather looks like. There have been maybe 2 overcast days here all summer. And when it thunderstorms, it rains for maybe 20 minutes and then the sky is blue.

But there's a piece of me that craves the overcast, rainy day where I sit cozy at home wrapped in a blanket or curled up in bed with my school books. I remember the same sentiments when I came home from India. I was in Nebraska on my way back to Ohio and I sat in this random coffee shop, sipping coffee as it poured outside--it felt like home. I'm strange I know.

But this train of thought pulled my mind back to India. It sort of feels like a dream. It sort of feels like some story that I read somewhere one time--I can remember the main points of the story, but it feels like someone else's adventure. It's getting hard to remember the squeltering heat, the intensity of accidentally chomping on a chili pepper, and the noise of 11 million people. I know it factually, but I have to be deliberate about remembering. And then it's even more difficult to remember the horror stories, the reality of the situation there. Occassionally I have a great conversation that keeps me from ignoring that truth, and I need those conversations. I can't afford to lose that year of my life to apathy. It's funny how easily apathy comes, though--how intentional one has to be in warding it off. It's amazing how easy it is to slip in a routine and live as if you don't know better. This is sadly a lesson that I have to be taught an embarrassing number of times.

The theme of the summer: Mountains

2009-07-22T11:53:00.000-07:00

So I'm pretty delayed on reflecting on my summer. The first, say, 3 weeks were CRAZY. But now life has calmed down significantly. I mean, I actually have a life, which is saying something.

Two of my favorite girls after our last neuro exam :)

But lets start with the very beginning. The day after my last exam of my first year of medical school (YES I passed my first year, and am officially an M2) I headed to Colorado. I should clarify that I obviously celebrated on Friday night and didn't get to sleep untill late. And then was wide awake at 5am (unintentionally, seeing as it was my first day of summer). Then drove something like 15 hours. My brother came with me, as he's always wanted to visit Denver. So we hung out here for a few days, then flew back to Ohio together (I basically needed to drop my car off so it would be here when I got back from Ecuador).-- (pictures from my day adventuring at Pike's Peak-Rocky Mountains)

From there, I drove with 96 of the Chapel's finest down to Gatlinburg, TN. It was gorgeous and an incredible conference. Well... I pretty much enjoyed being surrounded by Christians, the leader bonding and getting to know the students! Waterfall in the Smoky Mountains

I had been trying desperately for the previous month to "get my life together" and "figure stuff out." To get back to a place where I thought I should be and have my life look like I always imagined it would look. It was a pretty painful few weeks, as a couple of my dear friends can attest. But something switched when we were in Tennessee. Not that I have my life together now, or anything. But I actually felt peace. I gained a security to enjoy the journey instead of stressing about where I felt I should be, or where people expected me to be. And for the first time in a long time, I felt like myself again. I could elaborate on this, but will spare you.

Now Ecuador. Or, in honor of my previous trip there: Ecu-ador. We were only in country for a few days, which is a new experience for me. But the students were phenomenal. They stepped up and made the most of every second. I was incredibly proud of them. I could talk a lot about the work we did while we were down there. But instead I want to discuss the difference of being a leader. Going along with my strange few months prior to leaving, I was nervous about functioning in a leader capacity. But it went shockingly smoothly, and I'm excited about the relationships that opened up while I was there and can't wait to continue investing in them when I get back to Ohio. View from one of our work-sites: Andes Mountains

the difference.

2009-05-29T17:16:00.000-07:00

hour 53 of being at school since Monday....

Obviously my mind starts going after awhile, so I'm going to record my contemplations for the two dear friends who read this :)

I decided to listen to a music CD that my old youth pastor had put together of Spanish songs--all in preparation for Ecuador. I listened to these same tracts when I was 16 and 17 years old getting ready to embark on some of my first international experiences. For some reason, as it played in the background, I flashed back to the perspective I had on life during my high school days. I remembered what I thought my life would look like, what I thought I wanted in life, and who I thought I'd become.

And here, right now, as I sit in a silent library I don't feel like I'm the person that 17 year old girl imagined I'd be. I went from a 'calling overseas' to a passion for policy and politics. I went from having my entire social circle as Christians, to having only a small core group of Christian friends. The image I had of "my type" of guy has become jaded. My priorities and perspectives on life have shifted. I've lost my naivety and am comfortable in situations that caused me unmeasurable stress 4 years ago.

It hasn't been that long, but why have I changed that much? And what's going to keep me from migrating further from my goals and passions in life? What will keep me grounded and where do I draw the line?

All this begs the question: "Am I compromising what I really desired, or am I finally starting to realize where I should be going in life instead of living in a path of expectations?"

My first half-marathon

2009-05-17T08:03:00.001-07:00

Saturday's Ecuador Team Training. The lawn in front of the church. 16 of us with 16 pipes. And 5 marbles to transfer through the pipe to the little pink bowl 100 yards away. The goal? 100% team work. As the exercise progressed and we finally realized that we can bring the pink bowl to the marble instead of the other way around, the new question was "what does teamwork look like? does 100% teamwork mean 100% involvement?" In the end, just 4 members of the team were actually involved in the task while the rest of us cheered them on. Did we have 100% teamwork questioned one of the students.

Sunday morning. 7AM. Cleveland, OH. Probably 6,000 people running through the streets of Cleveland as we navigated a half or whole marathon. "Running is an individual sport" I was told in high school, "not a team event." but there they were. Hundreds of friends and family members lining the streets and turns of the routes, screaming encouragement, waving signs, and clanging their cowbells. "Run, [insert your name], Run" read one sign. And I promptly refocused and increased my pace. "Stay focused! You can do this!" screamed a random stranger in my direction. And I focused. and I ran. I don't know these people and they don't know me, but their encouragement and excitement kept my legs moving when I just wanted to walk. Our natural reaction as humans is to downplay the importance of those in a support position. "Why aren't you the one running?" would be the reaction. But it never is. As we finished the 12th mile, my friend commented, "If only these people were out every day, I could run more all the time!"

If only we, in the church, encouraged each other and cheered each other on every day, then we could accomplish more for him.

beauty in the tedious

2009-05-07T19:08:00.000-07:00

I have spent a ridiculous amount of time the last 3 weeks learning every bump on this brain (you think it's all random, but no, they all have names!) and every function of every one of those bumps. Every nuclei in the brainstem and the pathways of the cranial nerves through those nuclei and back up to the brain and down to control movement and sensation. And I was frustrated and bored beyond belief. I couldn't learn it and I couldn't see the big picture and I was pretty much just angry at the brain. Come on, WHY does it have to be so complicated?

Yesterday, however, I was laying in bed trying to will myself to get up so I could commence my marathon study day. As I laid there going in and out of consciousness between snoozed alarms, it hit me. I remembered why I loved medical school, and undergrad and all my crazy science classes. Somehow this spring I forgot how lucky I am. I get to spend every day for the rest of my life studying and appreciating the intricacies of God's creation.

That "blob" of gray matter is a sea of intricate pathways of creation that allow me to be me and you to be you. A non-descript and frustratingly detailed system is beautiful. And all those stupid nuclei that I've been killing myself to remember, are the reason that I am breathing and moving and thinking and relating.

I've noticed this trend in Christianity to make everything ambiguous in the name of spirituality (speaking of which, did you know that the nuclei that is responsible for speech and swallowing is your Nucleus Ambiguus?). We like big pictures and general concepts and ideals and not to get into the nitty gritty details. But when I think about how God created, he didn't create in ambiguous concepts--the reason we're alive is because of his precision and order. How should this impact how we seek God and how we study his word?

This never ceases to amaze me, and thankfully serves and a reminder of why I'm in the field I'm in and keeps me from entering too far into the cynicism that my hermit-lifestyle starts to produce.

Patience.

2009-03-31T10:57:00.000-07:00

and the answer is in..... I'll be in Denver for the summer!!!!!!!!

So... considering I got an email last week telling me my chance at getting this research position was basically zero, I've had a disappointing week. Wondering where to go from here, what to do, and dreading the awful, soul killing possibility of spending the summer in Ohio. And then, as I set in class today, compulsively checking my email, a subject heading "MSTAR UCLA" popped in my inbox. I've been accepted into the UCLA research program (geriatrics) and my worksite is in Denver, Colorado! Umm... considering I have some dearly loved friends there and thought it would be cool to live there, I'm pretty stoked :)

I guess things just work out sometimes.

apathy.

2009-03-13T18:21:00.000-07:00

To start, I know the irony that I'm commenting on this through the internet.

Is facebook the replacement for activism? Every day I get a "cause invitation." What does that mean? Does it mean you care, or do something about the cause? Does it mean you are involved or active or even know what you're supposedly "supporting"? I postulate that it's an apathetic approach to change in order to avoid having to do any work or risk anything. I think it's the lazy-man's way to feel better about oneself and to look better on paper without necessitating active involvement. Call this harsh, if you wish.

Politics Politics

2009-03-11T12:51:00.000-07:00

Who knew that I'd fall in love with politics and policy??

I spent an incredibly long (in a good way :) ) 48 hours in Washington D.C. Sun/Mon. I went with 5 other students to AMA's Lobby Day. Here are the 4 of us girls that drove down Sunday morning!
We went sight-seeing through the whole mall in an hour and a half. You should be impressed.

And then we met up with Reshmi and Brent and after walking around the city for a couple of hours, went to see the Declaration of Independence and Constitution. Which was sweet. And the middle-schoolers behind me were furious about how illegible the perfect calligraphy was. It made me laugh :)
After a ton of meetings, we went out for like a half hour with other AMAers. and Rathna and Brent decided to dance on the bar. For approximately 10 seconds. Note: both were completely sober :)
Then walked to Georgetown and saw the Kennedy Center. This is where our Nation's President was at the very time this picture was taken. So, we basically saw the President :)
Now that all the important stuff is out of the way :) The whole point of this weekend was to educate medical students and residents on how to lobby for healthcare related issues. Considering this is now President Obama's priority, it was a cool weekend to be there. We had different politicians and lobbyist etc. come and speak about lobbying and about healthcare reform. Then we went and lobbied. My first appointment was with Representative Sutton's (my district's Rep) staffer. It was actually quite enjoyable after I got over my initial jitters. Since I was the only one at Lobby Day from my district, I was by myself. But It was a good intro to lobbying and the political process for me. I also met with Senator Brown's staffer (along with several other Ohioans). Plus a tour of the supreme court and random networking with other medical students and residents. It was an incredibly exhilarating, yet exhausting weekend. And it piqued my interest in politics even more.

This is all 6 of us after the meetings with the senators.

I wouldn't wish back college...

2009-03-01T13:58:00.000-08:00

Today I gave tours for high school students applying to the BS/MD program at my school. They'll get their B.S. in 2-3 years, and then matriculate to good old NEOUCOM. My first tour was unique--I had two students with no families. When parents are around, the kids just walk silently and don't ask questions and just seem terrified. but the tour really was us walking in a circle talking about the college decision. I don't know why I love talking through decisions with people, but it was refreshing to be able to give students information that will actually help them make a decision--not to sell them on a school, but to talk them through what is best for them. One guy made the point "So basically, you endure college for medical school?" While this wasn't at all the point I wanted to convey, and quickly re-directed the conversation. But it had an ounce of truth. Even as I've been hanging out and studying more at University of Akron, I've realized how much I really don't miss undergrad. In reality, the coursework was easier. But there was a level of drama that doesn't hold up in med school. The disjointed interests and classes were more stressful that the exponentially more difficult material I've had in the last 6 months. I finally feel like I have some continuity and 'harmony' in my life.

I've also come to the question "What would I do with myself if I didn't have so much studying to do?" Given, I had 15 months with no school and I fared tolerably well :) But I can't imagine my life without a perpetual and complete learning. I can't imagine a time in my life where I'll be content with what I know and what I understand. I desire to be well rounded and have a variety of interests, and I think i'm managing this pretty well, but more than anything I love being challenged and pushed to the core of my being. To be presented with a challenge and rising to meet it gives me a thrill that is unparalleled.

just a reminder....

2009-02-26T11:00:00.000-08:00

On my left hand I wear a ring. I've worn it since my senior year in high school. Maybe you've seen it and not thought anything of it. But to me, it's my reminder that I'm called to live for something bigger than myself. Four years ago it meant something entirely different than it means to me now. At the time, it was my commitment to serve God overseas. And it's incredible to know that I've kept this commitment. At the time, my little 17 year old self thought it would mean living overseas for the rest of my life, but it looks different now. Don't get me wrong, if God calls me, I'll go, but I've learned a lot about myself and about what God has in store for me in the last few years. I've learned that my strengths are strongest here in America. And that there's so much work for me to do here and in this place. In my culture and in my society. In my country and my government.

Even though my dream has shifted, I still wear the ring. It reminds me of my responsibility and my passion. It reminds me of where I've been and where I'm going. I got this ring during a missions trip my senior year to Quito, Ecuador. It was a cheap little ring-- it symbolized a shift to a focus outside of myself. I wish I could say that I'm less selfish than I was when I was 17. But that wouldn't be honest. But I do see the world so differently than I did then. I've learned to see people and situations and circumstances for more than face value. I've learned to ask the question of "why" someone is doing that particular thing. I've learned to care about the big picture more than my tiny microcosm.

That time I spent in Ecuador catalyzed a pivotal shift in my perspective. It seems surreal that I'll be returning. That I'll get to walk through the transition that this will have on many students' lives as it did with my own. And it definitely already has stimulated my own thoughts regarding how far I've come since I was a student on the 'same' trip. I fell in love with the world on that trip. I fell in love with watching God work. I fell in love with community and fellowship. I'm praying that the students going this year will be able to have even a fraction of the amazing-ness. Even a fraction would be life-changing.

Happy List.

2009-02-10T12:27:00.000-08:00

I got TWO packages in the mail of books I ordered. I love new books, and I love getting mail.
it's gorgeous outside and I'm going to go on a run in 2 hours.
only two more weeks of biochem.
What we're learning is crazy interesting!
In 2.5 and 3.5 weeks respectively, I'll be at conferences in Dayton and DC.
This summer I'll be far away from Akron.
I can see grass. and wear a t-shirt without freezing.
Sunday is tapestry for my discipleship group.
My ILT group at school (of 20 people) is almost completely filled with hard workers.
I'm having to squint at the screen because of the glare from the SUN!!! (yes, the weather is a really big deal after the several feet of snow we've had in the last couple of months.)

who I want to be

2009-02-05T08:26:00.000-08:00

Have you ever met someone, even briefly, that makes you think "I want to be like that." There's this phenomenal woman that I met when I was in India. Relatively speaking, I hardly know her. But she mentored two of my fellow-interns, and the team she led semi-adopted me. She had this unique way of encouraging. I couldn't put my finger on it then, and for the life of me, I can't now. I saw her again briefly when I was in Nebraska last spring and had the same impression. Whether it was in her manner, or her personality, or what, I don't know. But I want to be like that. To leave the impression on everyone I meet that they have value and are understood and have value. To have wisdom treasured up, and to speak easily with people as to instill trust from the start. I realize how far I am from this goal. I realize how short I fall in this arena, but I so desire to be like that. To learn what it means to be a graceful woman of God.

P.S. The nicest people in the world are from Nebraska :) Despite the fact that they have more cows than people in their state, I think I'd be happy to live there some day!

I wonder

2009-01-28T10:28:00.000-08:00

so curious about where I'll end up spending my summer. Boston, LA, Colorado, Tennessee, New York... I just can't stop wondering. Too bad I won't know for another 2 months.

doctors.

2009-01-27T18:09:00.000-08:00

Today I had my first PACE (Primary and Ambulatory Care Experience). I will spend time over the next 3 years with an assigned Family Practice doctor, and I went for the first time today. The first time the doctor handed me a chart and told me to go and interview the patient, I felt myself freaking out. I'm so used to shadowing in high school and college where you sit in the corner and watch with summaries and explanations before and after each patient. I was amazed at the difference a white coat makes (symbolically, not essentially). get to interact with patients and talk with them as an authority that they'll divulge private information--all the while knowing nothing.

All fall I practiced interviewing and physical skills. And did pretty well at it. But I should clarify that all my patients were fake, "standardized" patients that were given a script of information and that we were videotaped watching. but,walking into the first room of the first real patient, I felt inadequate and nervous. I'm SO used to not really knowing what I'm doing, that it's crazy to realize that I'm acquiring skills. I can hardly believe that I'm a year and a half away from having my life be at the hospital. I have so much left to learn. So much. I can't imagine ever being able to handle these conversations competently. While I still can't follow all the medication lists and interactions, I can follow disease and anatomy. And lab results are looking less and less foreign to me.

But oh, it's exciting and overwhelming all at once.

alma mater

2009-01-03T19:28:00.001-08:00

Tonight I made the journey to my old high school. The place where I spent 6 years of my life. They were six good years, too. For some reason, it took me awhile to re-enter that part of my life. I think for awhile I was embarrassed of the person I was back then--of the bubble I lived in, or my naivety...and I don't know what else. But, time heals and I've come to terms with my journey, and gotten over myself.

Tonight, I pulled into a parking lot I've pulled in probably 2000 times. I went into a building that I spent the majority of my teens in. I felt the pressure to be grown up slip from my shoulders. It was strangely like coming home. I talked to a old friend who's known me since seventh grade and we were discussing what happens to us in college. We determined that we don't really "change." I'm the same person I was when I was 16 years old. At the core of my being, I'm still "Susan." But I've grown up. I've matured. I sat in the bleachers and couldn't help to think that I have no regrets.. When I first started college, I think I regretted who I was in junior high and high school. But in reality, I had to be there in order to be who I was in college. I had to be who I was in college in order to be who I was in India. And I was who I was in India in order to be who I am now. What's to regret in that?

I carry your heart with me

2008-12-17T20:35:00.000-08:00

i carry your heart with me(i carry it in my heart)
i am never without it(anywhere
i go you go,my dear; and whatever is done
by only me is your doing,my darling)
i fear
no fate(for you are my fate,my sweet)i want
no world(for beautiful you are my world,my true)
and it's you are whatever a moon has always meant
and whatever a sun will always sing is you

here is the deepest secret nobody knows
(here is the root of the root and the bud of the bud
and the sky of the sky of a tree called life;which grows
higher than the soul can hope or mind can hide)
and this is the wonder that's keeping the stars apart

i carry your heart(i carry it in my heart)

ee cummings

Beautiful.

luck o' the Irish

2008-12-13T19:12:00.000-08:00

For 2 years now, my cousins and I have been planning an expedition to Ireland for Summer 2010. We spent much of thanksgiving afternoon plotting and exploring resources and options, as you can see by our intensity above. But something very interesting has come of our preliminary plans. My grandpa and aunt went to Ireland 13 years ago, and now that he actually believes that we're going to go, he's excited for us. I'm about half Irish and half German, but I was raised to value my Irish heritage and cling to it. I think I'm gonna have to marry an Irishman one day (to keep my irish last name as well as the fact that they have the most amazing accents ever). My grandpa has always instilled an appreciation for our heritage in us--even in the most simple ways.

Today at lunch, his eyes lit up. "Susan," he said with a twinkle in his eyes, "I have something for you!" He had collected all his old information from his trip, made copies of his travel logs to give to me, and attached ancestry lists from family who's traced us back to Ireland. There was something special about reading my grandpa's entries from his travels. When someone writes--I mean hand-writes, not emails and typing etc.--it shows their personality, and their heart. Even funny things, like details about what they had for meals made me laugh. I don't know why, really, but it was cool to read about things that my grandpa saw and what he thought about them.

I want to have something like that when I'm older. An experience, a set of thoughts that I can share with my grandkids. It just made me think!

Some Goals.

2008-11-29T18:57:00.000-08:00

What do I want to do in the next 5 years?

-finish Medical School
-Residency in some cool city (I'll try not to be unreasonably picky)
-Ireland with the cousins
-Run a half Marathon

What do I want to do in the next year?
-Orchestra Concert in Cleveland and/or Blossom
-Go to an Art Museum
-A rural health experience
-At least one roadtrip every 4 months (to Chicago, Boston, Washington DC, or New York)
-Read 5 fun books

my token political post

2008-11-03T09:38:00.000-08:00

I'm excited for tomorrow. There's something that always washes over me when I go to vote. The sense of national pride and belonging to a nation that I feel when I stand in endless lines of people to make little, seemingly insignificant marks on a piece of paper. Most people don't know this about me, but one day, my goal is to work for the government. Maybe this contributes to my love of participating in elections. During the months leading up to the key November day, I hate politics. I hate the nothing statements and the broad, unspecific dreams that are painted, with no practical ways of fullfilling them. This is one of the reasons I want to work for Washington. I want to be a part of working for the fulfillment of those promises and ideals. But once the votes are cast, the real agendas and character comes out. I love this transition. Who knows if it's good or bad, but integrity starts to enter the scene on election day. We have actions to match up with words and see what's really being said. I love it.

That being said, I'm also thrown back to where I was during the last Presidential Election. I was still in high school, and spent 2 months being berated by faculty about why voting for Bush is the only choice that lines up morally for Christians, and if you vote for Kerry you're an awful Christian (to be fair, only one person made this statement outright). Even though I wasn't able to vote, in nurtured a rebelliousness in me. Now I'm in medical school, where most people's number one issue will be healthcare reform and other related issues. I'm in a place where it's the assumption that everyone's voting for Obama. It's a pleasant place to be. I usually choose not to engage in these discussions, but it's fun to listen to people talk knowing that my opinions are actually the majority.

These should be my words

2008-10-27T13:36:00.000-07:00

Whenever family and friends found out that I'm traveling by myself, I would be met with sympathy and concern. They never quite understood the feeling that I get when I'm waiting to board a plane or a train with an impending adventure. It could be boarding a plane to CA, a train to Nebraska, flying to India or Europe, or just driving to Chicago. It's this special feeling that wells inside of me that I'm quite content to ponder and meditate on in my own heart. It made me glad when I read an essay in this amazing little book called Cold Tangerines. I'm not by myself in treasuring the joy of traveling alone.

"...It began a love affair with traveling, and even more than that, traveling alone. I felt so small and so anonymous, surrounded by the sounds and smells and sights of a place I'd only read about, and I could go as quickly or as slowly as I wanted to... When you're with someone else, you share each discovery, but when you are alone, you have to carry each experience with you like a secret, something you have to write on your heart, because there's no other way to preserve it."
-Shawna Niequist

"Hope" is a thing with feathers--by Emily Dickenson

2008-10-15T19:20:00.000-07:00

"Hope" is the thing with feathers--
That perches in the soul--
And sings the tune without the words--
And never stops--at all--

And sweetest--in the Gale--is heard--
And sore must be the storm--
That could abash the little Bird
That kept so many warm

I've heard it in the chillest land--
And on the strangest Sea--
Yet, never, in Extremity,
It asked a crumb--of Me

6 months ago

2008-10-11T07:18:00.000-07:00

Journal entry from 6 months ago, sitting in Hyderabad airport waiting to fly home.

"There's some finality about an airport. Something ominous and cold that I feel as I pull my carryon behind me, my purse hanging under my arm with a cup of coffee in my hand. As cold as I feel, there's an excitement of pending adventure. 34 travel adventures later, I feel more confident and more like I belong at the airport. I've stopped having nightmares about missing flihts. But this time, the feeling of excitement is almost nothing. I feel alone. Isolated. Small. I'm fully aware that I look more comfortable flying now than I ever have. But I feel like a little child. A scared little kid who's lost and misplace and alone. From today on, no one will ever fully understand me. From today on, there won't be the unspoken communication of frustration. From now on, I'll have to explain myself an dbe completely torn between lives. When I was here, I knew I was going back to the place my heart ached for. This time, I know better. I'm ready to leave, but I know that this trip signifies everything changing.

The moon looks like the s mile of the Cheshire cat. Or a hammock. I can't seem to make up my mind about which. I said goodby to my city tonight. I smelled th elast of the stale urine, and Ramesh told me to make th most of the sewage stench, seeing as I wouldn't have it at home. I had the last traffic experience. I was in the busyness of the city one last time. And the power went off 3 times in my last hour on campus as if to say goodbye. I had my last cup of dessert tea, walked my last lap, and waved to the last excited Indian child on the street. This phase of my life is done."

back in the swing of life!

2008-09-13T09:32:00.000-07:00

So I haven’t fallen off the face of the earth, I promise. I just haven’t known what to write. Basically, life in the US is a little less novel than life overseas. But a lot has been happening and I’m seeing things so differently than I was a few months ago.

First of all, I started med school 2 weeks ago. We’ve been practicing patient interviews this week, and I had to pretend to be the patient—bring a problem that another student can interview and counsel me on. My problem was reverse culture shock. I basically pretended it was 2 months ago when I hated my life a little ☺ . I’m through it now, but I remember what it was like so I put myself in that frame of mind for fifteen minutes at a time. The funny thing that happened though, was that I started feeling those emotions for real again. That strange sensation of longing and aching and of discomfort with where I am.

I love being back in the US. I really really am thankful to be back and to be placed where I am. I am so comforted that God has relieved my fears and worries with so many blessings. For example, I was worried about finding a community when I got back to be a part of. I’ve honestly had to ‘say no’ to things because God has sent me bountiful friendships and groups and opportunities. It’s pretty cool, and now I feel a bit sheepish that I doubted God when I first came back.

Med school is great (so far). Given I haven’t entered the crazy workload yet, but I love the atmosphere of school. I love the fact that there are 200 students with endless possibilities of friendships and relationships. While it’s overwhelming, its so exciting to me! We’ll see how I feel once the workload hits in another week! I’m sure I won’t be as excited ☺

And today is a rainy, dreary day. The type of day I longed for in the summer and winter of India. To be sitting in a coffee shop as rain persistently beats the ground just outside the window gives me a feeling of safety and comfort.

two months of recovered life

2008-06-14T13:54:00.000-07:00

So Lufthansa lost my bag somewhere between Hyderabad and Colorado and just can't seem to find it. Besides some certain journals and notes that I'm pretty bummed about not having, my adapter cords for my camera and my camera charger were MIA for two months. Now that they finally decided to compensate me, I splurged and replaced my cords and charger so I can finally get pictures off my camera. Yay!

So here are some pictures of the last couple of months of my life!

Colorado hiking with Ashley!

And then my train adventure from Colorado to Nebraska. Who knew that America still had such cool train stations??

Finally in Nebraska with Amy and Megan!

And then camping in the Smokies!

Then life back in Ohio.

The girls all dressed up!

Me and Hannah!

Me and Lile!

Stalking

2008-06-14T12:51:00.000-07:00

have you ever been car stalked? When the parking lots are incredibly full and a car follows 3 feet behind you in hopes that they can have your parking space? It happened to me a lot at Akron, but the mixture of me not driving for ten months, and then not attending college during the typical school year prevented my car-stalking exposure for the last year.

Then I started working at Summa. Summa likes to spoil it's employees, which as a current employee, I love :) Since the staff parking lots are on the far corners of a vast campus, they supply shuttles that can take us from our cars to our building. It's wonderful if you're in a hurry, or if it's raining, or if you just don't feel like walking. But I spend most of my day sitting at a desk inside, or in a stuffy classroom, so I typically treasure these brief spurts of walking in the sun. I pull into the parking lot and spot a shuttle. It's sitting discretely (as discretely as a huge half-bus can sit) in the shade on the far side of the parking lot. As soon as it spots me it begins to follow me around the parking lot until I pull into the empty space of my choosing. It stops. Waiting ominously for me to board, I almost feel guilty for waving it by as I begin my long trek in heels to the office. That poor shuttle-driver just really wanted to help me, and I shot her down.

Happy List

2008-06-06T17:17:00.001-07:00

My best friend and I used to play this game whenever one of us was having a bad day and felt like everything was falling apart. Whoever was feeling bad had to make a list of 10 things that made them happy that they were thankful for. Over the next few days, the other one of us would send this list as a reminder of all the blessings we have.

Well, I actually had a pretty spectacular day, and I want to make a happy list for great things that I saw and that happened.

1) It's gorgeous out--nice and warm and sunny

2) Running at 6am. It may sound awful, but being back in the wood when everything is serene--just priceless. If the exhilaration of a morning run wasn't enough, a deer walked out in front of me and just watched me as I stopped and walked by her. I've seen a lot of deer in my short life, but for some reason they still awe me when I see them up close

3) making progress at work--I typed some little summaries into a computer and started figuring out my email and scheduling. Little things, but I feel excited about my work. I'm already learning so much about the health system and special needs of older adults and how the geriatric field of medicine works. I enjoy researching these things 'cause I'm learning so much as I go and am being challenged and pushed.

4) It's AA Founders Week this week! Which means Akron is overrun with motorcycles. Honestly, my favorite weekend of the year in Akron.

5) Summa has pretty much the nicest librarian.

6) a man was walking in front of me and Hannah tonight with a coat-hanger slung over one shoulder with fifty-some hemp bracelets dangling behind him.

7) I ate a bowl of ice-cream while sitting out in the sun chatting with a friend and people-watching. Really, how does an evening get better than that??

8) the guy in the bagel line kept trying to joke around with me. yeah... I don't really get jokes early in the morning.

9) my grandparents got me special highlighters that they saw on Oprah.

10) Someone was riding a scooter around downtown Akron. Serious joy.

11) There are about 400 different shades of green in the world right now.

12) I finally finished a book on Wednesday after my 6 week reading-block!!

13. People I really love:

14) ahh I love them. good memories :)

Daisy

2008-05-29T05:38:00.000-07:00

This is my parent's new puppy Daisy

Our last dog actually acted more like a cat--this dog, is definitely a puppy though! She chews everything and digs and eats sticks.

Evidence of her love of chewing everything--oh and everything turns into a game :)

By the way, this is Katie--who'll be my roommate in another month (ish) :)

Anyways, thought I'd share some pictures of my puppy :)

I should really go to class now!

life in America: one month

2008-05-17T10:55:00.000-07:00

I just finished writing what should have been the easiest paper of my life. 10 pages on my experience in India. Easy, right? I must say that it was one of the most draining things that I have ever written. Every page I wrote made me more and more homesick for India. I think its actually pretty funny when people think it's an easy transition to come back into my home culture.

I was sitting in church my first Sunday back in the United States. "Blessed be your name in the land that is plentiful, where your streams of abundance flow, blessed be your name. Blessed be your name when I'm found in the desert place, thought I walk through the wilderness, blessed be your name." We sang the same worship song the Sunday before I left for India. I remember uncontrollable tears falling as I envisioned the material interpretation of that song. I was going from a land of plenty to a land of want. I was going from a place where I was established and have a support system to a place where I knew nobody and had no idea who would encourage and challenge me.

Sitting in an American church once again and listening to the same song tears started coming to my eyes for a very different reason. I was once again making a transition, but for the life of me, I couldn't figure out what transition I was actually making. I am clearly going from a land of material want to a land of material plenty. But I am also transitioning from a land of spiritual passion and vibrancy to a land of spiritual apathy. How do I reconcile this in my mind?

Elise and I had the conversation about 'being content' a lot while she was in India. I was inspired by Hebrews 4:12-13. "I know what it is to be in need, and I know what it is to have plenty. I have learned the secret of being content in any and every situation, whether well fed or hungry, whether living in plenty or in want. I can do everything through him who gives me strength."

In my observations, Christians living in dire poverty actually have less trouble with being content than those of us living in plenty. Every time I've examined that verse, I've seemed to focus on the 'being content while living in want' portion. But how often do we living contentedly while we have plenty. Do we horde our wealth for ourselves, or do we feel guilty about our wealth? What do we do with our blessings? I have actually begun to think that feeling guilty for God's gifts is nearly as ungrateful as the greedy consumption of God's gifts. Just something I've been thinking about and wrestling with for the last...year. We are a blessed country. What are we supposed to do with this?

on starting over

2008-05-08T21:05:00.001-07:00

"You get a strange feeling when you're about to leave a place, I told him, like you'll not only miss the people you love but you'll miss the person you are now at this time and this place, because you'll never be this way ever again."
— Azar Nafisi

Girl, 6, thrown on fire for being 'lowest class'

2008-04-30T10:44:00.000-07:00

http://www.cnn.com/2008/WORLD/asiapcf/04/30/india.caste/index.html

(CNN) -- A man, incensed that a 6-year-old girl chose to walk through a path reserved for upper caste villagers, pushed her into burning embers, police in north India said Wednesday. She was seriously burned.

Dalits, or "untouchables," are victims of discrimination in India despite laws aimed at eliminating prejudice.

The girl is a Dalit, or an "untouchable," according to India's traditional caste system.

India's constitution outlaws caste-based discrimination, and barriers have broken down in large cities. Prejudice, however, persists in some rural areas of the country.

The girl was walking with her mother down a path in the city of Mathura when she was accosted by a man in his late teens, said police superintendent R.K. Chaturvedi.

"He scolded them both and pushed her," Chaturvedi said. The girl fell about 3 to 4 feet into pile of burning embers by the side of the road.

The girl remained in critical condition Wednesday.

The man confessed to the crime and was charged with attempted murder, Chaturvedi said.

The assault took place in India's Uttar Pradesh state, about 150 km (93 miles) south of Delhi. The state is governed by Mayawati, a woman who goes by one name and is India's most powerful Dalit politician.

Her Bahujan Samaj Party seeks to get more political representation for Dalits, who are considered so low in the social order that they don't even rank among the four classes that make up the caste system.

Hindus believe there are five main groups of people, four of which sprang from the body of the first man.

The Brahmin class comes from the mouth. They are the priests and holy men, the most elevated of the castes.

Next is the Ksatriyas, the kings, warriors and soldiers created from the arms.

The Vaisyas come from the thighs. They are the merchants and traders of society.

And the Sudras, or laborers, come from the feet.

The last group is the Dalits, or the "untouchables." They're considered too impure to have come from the primordial being. Untouchables are often forced to work in menial jobs. They drink from separate wells. They use different entry ways, coming and going from buildings.

They number about 250 million in India, about 25 percent of the population, according to the Colorado, U.S.-based Dalit Freedom Network.

"Dalits are seen to pollute higher caste people if they come in touch with them, hence the 'untouchables,'" the group says on its Web site. "If a higher caste Hindu is touched by, or even had a Dalit's shadow fall across them, they consider themselves to be polluted and have to go through a rigorous series of rituals to be cleansed."

Recent weeks has seen a rise in violence against Dalits in Uttar Pradesh, CNN's sister network, CNN-IBN, reported Wednesday."

Where the Sidewalk Ends

2008-04-21T17:59:00.000-07:00

There is a place where the sidewalk ends
And before the street begins,
And there the grass grows soft and white,
And there the sun burns crimson bright,
And there the moon-bird rests from his flight
To cool in the peppermint wind.

Let us leave this place where the smoke blows black
And the dark street winds and bends.
Past the pits where the asphalt flowers grow
We shall walk with a walk that is measured and slow,
And watch where the chalk-white arrows go
To the place where the sidewalk ends.

Yes we'll walk with a walk that is measured and slow,
And we'll go where the chalk-white arrows go,
For the children, they mark, and the children, they know
The place where the sidewalk ends.

Shel Silverstein

Planes and Trains. and cars I guess

2008-04-17T11:07:00.000-07:00

I've been in the US for a week now! crazy, huh? And I had the greatest mini-adventure yesterday. I took a train in the United States. For transportation. The price of the ticket was half of flying, and seriously, who takes the train for transportation these days??? The Denver train station was quaint and old fashioned with conductors in little conductor uniforms, and high-backed wooden benches. I didn't know places like that still existed in the US and I will totally have pictures up when I get the adapter for my camera back. I think that was the closest I got to culture shock yet. My train adventures in India consisted of massive amounts of people in the train station, pushing to board the train. Vendors walking incessantly down the aisle muttering 'panniwater, panniwater' and 'chaicoffee, chaicoffee.' I didn't know what to do with the quiet, nearly abandoned train station and a double decker, half-empty train that pulled in front of me. Anyways, I hightly recommend the train system. Just so you can tell people you took a train :) Plus, it was significantly more hassle-free than flying.

I lost a piece of my luggage, by the way. Sucks, doesn't it? I had packed it specifically with everything I would need for these 10 days of travelling--western clothes, toiletries, socks. At first this made it even more annoying. But now I'm just thankful that I have all of my 'priceless' Indian items. That would be horrible to have lost indefinitely. But I'm reaching my limit with airports. I think I have no desire to fly again too soon. haha too bad I fly again on Sunday to come back to Ohio!

So, you may be asking yourself, "What has Susan been up to this last week, if she STILL isn't in Ohio?" I mean, besides the coolness of taking a train. I got in Thursday night and spent a total of 2 days in the DFN office debriefing and another four with my friend in Boulder. I've been amazed at how quickly friendships form and solidify in India. I had made arrangements to spend time with my friends Ashley and Megan and Amy. But I ended up hanging out with several other people that interned with me for six weeks last summer, or who came out on short term trips. It was amazing to 'debrief' with people who knew India and who knew me in the context of India. I feel refreshed and rejuvenated and feel much more capable of handling re-entry. This isn't to say that I won't be a mess occasionally... but I may be able to at least answer questions that are asked of me :)

Well, last night I took a train from Denver to Nebraska and am now hanging out in a coffee shop (a consistent theme of my US travels) while Megan and Amy are busy with their real people jobs! It's really yucky out--raining, dreary and cold. But I distinctly remember wishing that I could be curled up with my book and journal with a hot cup of coffee and a cold, miserable day outside. So I guess this is actually perfect for me!

I'm supposed to be working on some more debriefing stuff so I should probably go.

I have a ton of pictures from my last month in India, so if you're interested, here are the links

Medical camp in UP

Kerala

More Kerala

the end is near

2008-04-05T08:18:00.000-07:00

I just completed 3 weeks of traveling. And am coming near to the end of my time in India. I feel ready to go home. I feel ready to start the next part of my life. That I'm here, right now, leaving aa place that's been my home for a year feels like a dream. One that's whirling around me, and I can't grasp the reality of it. And I almost don't want to grasp the reality, because I know when I get on the plane it'll be the jerking feeling that I get when the alarm wakes me each morning. But at the same time, being in India has worked on me in ways that I didn't expect. Its instilled in me a passion for work that needs done in my own country--for the needs both physically and spiritually that run rampant in our society. In a society where I know the language and the culture and I can relate to people in a way that I haven't been able to cross-culturally. Its given me a vision for America, and I'm really excited to start acting on that vision.

I'm just going to write about my first trip for now. We met a medical team from the US in north India. We spent five days running medical camps for villages that feed into the DEC schools. Most of the time I was helping with the physiotherapy section, teaching exercises, and taking histories for the patients before they went in to see the physical therapist. It was draining after awhile, but I loved getting to touch and connect with the patients that came in. A lot of the ones that came to us were older patients--mostly with arthritis. but you could see in their eyes the loneliness. It was wonderful to get to connect with them and relate to them. I loved it :) The American team was hardworking, and it was almost as if they were my preparation to re-entering American culture! I spent some time with the doctors also and got to see some pretty crazy stuff. One of the doctors was in her second year of residency and had never seen some of the illnesses that were coming though. It was hard, 'cause many of the patients needed long term care, and we were only equipped and able to meet short term needs.

I think I'll write about Kerala tomorrow--it's been a long few weeks and I'm ready to go get some sleep!

I like being a girl

2008-03-11T06:13:00.000-07:00

I sit in distracted thought at the moment. Trying to find direction to my random processing. A part of my brain is working today that I don’t think has been active in a little while.

I have this friend. Our time usually is spent hiking through the woods along the river talking about God and life. She’s my ‘philosophical’ friend. I’m always inspired and challenged when I hear from her (or when I’m in the states, after our hikes). I’m reminded how big the world is. How much vision matters. How amazing it can be to dwell on God. I start thinking more abstractly after we talk (or I read her blog ☺ ). And she reminds me to live my life big. And to dream big and to invest myself in big visions.

Lately I’ve been thinking about value. Sunday was “Women’s Day” here at church. It was a very cultural experience in a way I didn’t quite expect. It was approached through womanhood as a married woman. I never realized how different even the definition of a woman could change in culture. At home, we are taught about womanhood and femininity as a single. We’re taught to invest our gifts as a woman and use the attributes God gave us no matter where we are in life. We may even be chastised for wasting our gifts by our community (in a good way) if we are wasting our gifts as ‘life-giver’ and ‘helper-completer’ (to use the terms of the five aspects study). While the west usually takes feminism way to far, I’m thankful that my culture assigns me value as an individual, with or without a wedding ring. I really like being a girl. I like the gifts that I have, the qualities God's given me, and the glory of his purpose. I've never considered that I have less worth as an individual. Never even crossed my mind. It upsets me that other women face this battle. Its something I've seen a lot here, but it really struck me on Sunday.

In other news, Annika and I booked our ‘holiday’ trip to Kerala. SO excited for this. It’ll be a short trip, but it’s gonna be beautiful. 5 days to dwell on God’s marvelous creation.

March

2008-03-04T21:03:00.001-08:00

I know its been awhile since I’ve written, so I would like to fill you in on what life has been like this past month! After finishing auditing the masters classes in January, we (meaning me and my friend Annika) started working on some community health teaching for girls in their 20’s that are here for their Bachelors program. It was fun and they became really enthusiastic as we handed out chocolate for answering questions on our nutrition talk (I hope you see the irony). I then spent the next few weeks working on topical summaries of health issues that can be translated into different languages and used for community health education throughout the country. Currently, me and Annika are conducting basic health physicals and getting health histories for the Bachelors students on campus. There are 200+ students so we’re keeping pretty busy in the evenings ☺

Mid-march I leave to join a medical trip coming out from the US for about two weeks, and then Annika and I are planning to do some sightseeing in Kerala (southernmost India) which I’ve heard is one of the most beautiful places in all of India. We’re both really excited about these plans and are greatly anticipating the time of travel. But this means that my time in India is drawing to a close. Its strange to think that I have only a few weeks left living here, and I’m having trouble picturing life without some of the friends that I’ve made here! But at the same time, I’m very excited about the next stage in my life. A lot of mixed emotions.

Last week four more international girls came in for their 6 week internship. They’re sweet girls and are definitely still adjusting to India. Please keep then in your prayers as they process both their work and their free-time and also cope with culture stress and homesickness. You can pray for me as I wrap up my work in Hyderabad this next few weeks and seek closure in my time here. I also have a lot of preparations for coming home that I need to finish before I begin traveling. You can also be praying for safety as we travel from mid-march through mid-April.

This weekend we went to a place that I hadn’t been to yet. It’s called Little Rajasthan. Rajasthan is a state in North India with distinct culture—food, dress, dance etc. This is a place I haven’t been, but I’ve heard a lot about it. Anyways, Little Rajasthan is a cultural center nearby where I live where they present and expose people to Rajasthani culture. We made the trek there—and by trek I mean that we didn’t know where we were going and ended up walking WAY farther than we would’ve had to if we had gotten off at the correct bus stop. But it was worth it— We got to experience a lot that night. The food was unique to what we usually have, the dress of those there was different, the dancing was different. The reason I’m writing this, is that I know how easy it is to lump “India” together. But every state in India has a unique culture. It has its own special characteristics, languages, food, clothing, value systems, and composition. I’ve been here a year (nearly ☺) and I’ve hardly begun to grasp the diversity of this country.

I’m also sending a picture of my favorite place in Hyderabad. Golconda Fort. Its 1000+ years old and is spectacular. Plus it has a magnificent view of the city and the surrounding countryside!

long overdue post!

2008-01-26T04:37:00.000-08:00

I would like to share with you some cool things that I’ve found in my reading and studying. I should say outright that I realized that these last few months in India could quite possibly be my last chunk of time where I can read and study whatever I want in depth and I’m resolved that I won’t waste it. I’m determined that I will use the next (approximately) 3 months to develop my mind, my character and my relationship with God. This has resulted in a list of 20+ books recommended from the MA classes that I’ve been auditing in addition to books that I just want to read ☺ currently I’m reading a good one on different types of counseling. I would like to share with you a few things that I’ve found interesting.

The first one is on our guiding values that give meaning to our lives:
1) Do my values and priorities and the life-style they produce, allow me to maintain robust physical-emotional health?
2) Do my values and life-style allow me time to develop my midyears potential intellectually and spiritually?
3) Do my values and life-style allow me time to enjoy the good things of life and to do the creative, worthwhile and fulfilling things I could do?
4) Do my present values and life-style leave me enough time with the person or persons I care most about?
5) Does my life-style reflect the most significant and life-giving values—truth, goodness, beauty, wholeness, aliveness, justice, order, simplicity, playfulness, autonomy?
6) Do my values and life-style allow me time for a significant cause, a challenge beyond my inner circle, that will help others and improve our community?

There was also this great passage that I am going to include on developmental crises. These are the normal changes that come into our lives—the ones the come from moving away from home, starting college, getting married, retiring. There is like a 100 item list that is NOT all inclusive of things that cause us developmental stress—the things that just happen in life and we need to work through. I love this quote:

“When one puts on the glasses of hope and growth, each life stage from birth to death, offers a fresh set of emerging strengths and possibilities that did not exist in previous stages. This awareness is the source of an unfolding hope. Each stage also has within it a new set of problems, limitations, frustrations, and losses… The strategy is to help people deal with the problems and losses by developing the new strengths and possibilities of their particular life stage.”

Now those of you who made it through that long portion: Over the next few months, I’ll be working again on the Village Healthworkers Program. We have a nutrition public health presentation next week, then a lot of preparation and writing for a new aspect of the project—pretty exciting stuff!

We (and by we I mean my friend Annika and I) have been auditing MA classes here the last three weeks. It has been phenomenal! We’ve gotten to make friends with Indians and internationals from all over the world and learn from great professors. Although I took four classes, there were 3 that made a great impact on me: systematic theology, philosophical foundations of m*inis*try and leadership, and counseling systems. It will take me a long time to process and thoroughly grasp what I’ve been learning! Truly it was an opportunity I never expected to have, and I feel quite privileged that I got to learn just for fun—no tests, no required assignments.

Thanksgiving: Indian style

2007-11-25T03:22:00.000-08:00

While you all were having a turkey dinner, I was... well, to be honest I was probably asleep. But Thursday afternoon we went over to one of the American couples' homes and had a wonderful Thanksgiving meal (The only difference was that we had chicken instead of turkey)--Mashed potatoes, corn, green beans, bread and even gravy (I'm pretty proud of the fact that I learned how to make gravy from scratch!). It was quite a feast!

Thanksgiving is a big holiday in my family. We all gather at my aunt and uncles house and the cousins stay in the house and have a lot of fun! We get up at about 6AM to run 5 miles usually in the snow and sleet, and then come back to get ready for the day and to prepare the meal (mostly the aunts). Then, we eat and there are all kinds of "kids table" traditions that I could describe and you probably wouldn't think were funny but we love! After clearing the tables, we rush to the couches for naptime! Over the course of 3 days we have so many traditions and memories.

I thought it would actually be harder to miss Thanksgiving. Don't get me wrong, there were parts of the day when I was pretty homesick, but there isn't the snow or the intense cold here. I'm still freezing. you know, in the 55F weather. haha I've gotten so soft in the last six months. It'll be an adventure when i encounter snow again! But with no snow and no winter coats and no sweaters and boots, it doesn't feel like the end of November. This is the second Thanksgiving I've spent abroad and they're full of memories!

Like me, Annika and Elise all squeezing into the back of the car voluntarily on the ride back to the campus.

And the overall craziness that we bring to the table :) But the family were wonderful hosts to us and really made it feel like Thanksgiving. It was a good Thanksgiving.

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and

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2007-10-31T08:22:00.000-07:00

How has my life been transformed by Christ?

How about yours?

The purpose of my life has been fulfilled.

2007-10-18T22:38:00.000-07:00

At my going away party in June one of my friends seriously asked me what I was looking forward to most going to India, what my first most goal would be during my year-long adventure. My retort? “I want to ride an elephant.” I guess I can come home now!! Last Thursday I climbed atop an elephant which meandered around the Mysore Palace during a famous festival called Desara. It was fun. Last week we had a few days of touristy stuff! We visited the palace, which was magnificent. We went to see gardens distributed among an array of fountains. We hung out at a hospital, which definitely gave me an adrenaline rush. During the last few weeks we’ve utilized a plethora of transportation methods: crowded buses, trains, elephants, horse drawn rickshaws, an auto crammed with 12 people, boats, and we’ve crossed a rushing river. We’ve driven through countryside speckled with rocky hills, rice patties, coconut trees and cows. We’ve eaten off of banana leaves. We’ve seen temples, cathedrals, and mosques.

I’ll never be able to adequately describe the things we’ve seen, the people we’ve met, the smells that have reached our noses, the taste of freshly made dosa, the sounds of horns outside our window or waking up to a cow mooing on the street outside. Every once in awhile it hits me that I’m in India. I was sitting on the balcony yesterday journaling. I was on campus waiting to leave for Tamil Nadu. Sometimes I forget that I’m in the middle of a huge adventure. When you’re living in an adventure, that adventure becomes daily life in a way that I never expected to have happen.

I would also like to describe to you a few more things going on in India that have been important to me these past few weeks. October is a big month, with a lot of short term international teams coming in. Most of the teams we meet and hang out with and help the Indians with ‘cause they insist that we can explain certain aspects of India to them better than the Indians can. Me and Elise don’t believe them, but we help where we can. Anyways, one team in particular has blown us away. They are a team of mechanics. They aren’t actually mechanics by profession, but volunteer at their church every week fixing the cars of single parents. They are working on cars for two weeks here for the organization. I was outside before breakfast the other morning just meandering around campus. I was shocked to see them already at their work. They work all day and put their full energy into their tasks, but still have managed to have a lot of fun and build relationships with most people on campus. Elise and I have both been encouraged and challenged by their work ethic and servants’ hearts! I would also like to tell you about my favorite little boys! They are brothers and are simply adorable! Usually 11 year old boys are awkward and don’t know how to carry themselves, but this boy is poised and well spoken. He takes care of his little brother and they are very sweet to each other. And Jeffrey, the older brother explained cricket to me. I’ve had a bunch of people try to explain it to me before, but I never understood it until this kid explained it! I know kinda understand the game and its interesting!

I hope this post finds you well and you enjoyed hearing a bit about the things I’ve been up to lately!

more on my travels!

2007-10-09T03:26:00.000-07:00

I’ve been in Bangalore and Tamil Nadu for the last two weeks nearly. It’s been an adventure to say the least! I’m getting stretched and pushed in so many different directions. I’d like to give you one example: We were on our way to a house meeting last Friday. As we were climbing into the vehicle, the brother taking us commented: “Ok, so one of you will be teaching and the other will be singing a song.” We looked at him slightly confused. ”Just kidding!” he laughed. ‘One of you will be teaching, the other will be sharing a testimony.” Still assuming he was joking with us we start laughing. Well, he was serious. So I taught with 20 minutes notice. Its actually kinda cool. It’s always a challenge to keep us on our toes. You have to always be learning and spending time in God’s word because so many times you’ll be called to share what you’re learning—so it’s usually a good idea to be learning stuff from his word. And if you zone out during a prayer meeting, guaranteed you’ll be asked to pray outloud for the requests you just zoned out for. I Peter 3:15 has been made real to us in these last few weeks.

I had the privilege of doing some health and hygiene public health presentations since I’ve been here. I really love public health. Some of it has been common sense stuff, and other stuff has been stuff I’ve researched. I actually got to give a presentation to a group of 75 pastors. It was really strange talking to grown men about how germs are spread and boiling water and nutrition and AIDS. I definitely got nervous beforehand, but once I was up there, I really enjoyed it! There are things here that I would NEVER have had the nerve to try at home, but by being given a gentle push into these situations, I’m learning more about myself and my strengths and having confidence enough to at least try. Well, Elise and I did a swing dance in front of 100+ people. Yeah, I’ve been swing dancing like 2 or 3 times and am not good. Plus the fact that we are in India, so girls don’t dance with guys. This means that Elise had to lead. She is better at swing dancing than me, but—well we’re both girls and neither of us know how to lead. Anyways, it was the only “American” dance that we know. So we put together a swing dance. It was helpful that there were no Americans there, so no one knew what it was supposed to look like. We’ve had so many opportunities in the last two weeks. I mean, I’m just so thankful that we’re getting such a diverse experience in India. I am grateful for the opportunities that I’ve been blessed with here. We’re seen as ‘children’ so they don’t expect us to be great at everything, but still give us the opportunities to try things we’ve never done before. Its led to a lot of growth!

I would like to also share with you some of the amazing things we’ve seen in our travels. Last week we traveled to Tamil Nadu for a few days. We had the opportunity of hanging out with some amazing brothers and sisters who had spent a month in intensive outreach. We had the opportunity to hear reports of what God is doing in this country and spend time building relationships and hanging out with these girls! One of the places we got to see was in the mountains. Well, it was in a valley between mountains where rivers meet in waterfalls. We had a picnic day here. It was beyond gorgeous! I keep thinking that there is nothing that will be more beautiful in the world. Then we would turn the corner and God would reveal another facet of his majestic creation. Its days like these when I wonder at how blessed I am to be in this place.

I would like to share one more thought with you before I finish this update. I was getting ready to speak on Sunday and was growing nervous. Here we were, two twenty year old American girls getting ready to speak His word in front of a group of people who live out God’s commands daily and are passionately in love with him. Not to mention about 6-7 pastors were in the crowd. Anyways, I was sitting there feeling very small and wondering what on earth I had to say, when I turned to Jeremiah 1.

Jeremiah 1:6-7 says: “Ah, Sovereign Lord, I said, I do not know how to speak; I am only a child. But the Lord Said to me, ‘Do not say “I am only a child.” You must go to everyone I send you to and say whatever I command you.’ “

Thank you for your prayers—Elise and I are experiencing so many new things and traveling. Please pray for this organization as it is a busy month everywhere and there is a lot that needs done.

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Your sister in Him,
Susan

2007-09-25T04:23:00.000-07:00

I’m ‘out of station’ for this month as they call it here. I’m in S. India. Its funny, I lived in Andhra Pradesh for three months and thought I was in S. India. Turns out that the people in Karnataka and Tamil Nadu welcome us to South India like we weren’t in South India before. I’m pretty sure after composedly being shown to our room on a campus that is basically just a tropical paradise, into a room that is so clean and new and just lovely—pretty much me and Elise jumped up and down for a long time. Wait, that was just me.

We spent the morning (well, its 3pm but we just finished lunch, so there are long mornings here) working out our program for this month. We’re going to get to spend time in such a variety of different places and doing a bunch of different things. Basically, we got to devotions this morning and ended up being the speakers. And I didn’t hate it! Maybe I’ll be used to the whole public speaking thing by the time I’m done with my time in India. I’m going to get to do a pretty good variety of public health teaching on health and hygiene and nutrition. We sat down with leadership and they brought a lot to the table, and we shared with them what we would like to be involved in. It was actually a very encouraging experience.

I like the very relational nature of this culture. There is a chance it may drive me crazy by the end of this month, but going into it with flexibility is helpful when doing anything in this culture. In the past several weeks, I actually had some responsibility and stuff to ‘get done.’ At first I was so frustrated and tired ‘cause it would take hours to get two jsimple tasks done. By the end though, I knew to give myself a couple hours, so I was totally content to sit and talk with people while I was waiting.

One of these days my task oriented nature will be overcome  It is much diminished from three months back without a doubt!

Bangalore is quite different than Hyderabad. I’ve seen such a small portion—really just drove through the city, so I’m sure four weeks from now I’ll know even more ways that it is different from home. I saw much more modern, western, cleaner architecture. I could imagine much more that I was in an American city as we drove by a sign for Texas Instruments.

The most important thing you NEED to know about is that India won the Cricket World Cup. If you were unsure, all you’d have to do is to be in India last night and the fireworks and boys running around screaming would remove any doubt! As we drove through the city the most amusing thing I saw while I was there was a techy store with TV’s and stuff like that. It was a nice store, totally empty except the clerk, the storefront evident because of the glass windows. Outside this store probably 30-40 men were huddled, all gazing intently at the screens inside. It was hysterical. India is a happy country today!

North

2007-09-12T05:32:00.000-07:00

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This link will take you to more pictures!

I’m sitting in a hotel in Dehli. It is a bit surreal to be typing on my dear old mac again. I hardly recognize my lovely computer as the keys click familiarly beneath my fingers. For those of you who didn’t know, my computer crashed the end of last month and I just got it back ☺

BUT… the greatest thing is that I’m with my dad this week! He came out with a chapel team and I surprise him today. He thought I was meeting them up in Bihar tomorrow, and had his back to me when I walked into the hotel lobby this morning. I don’t think he quite knew how to respond!

Dehli is much different than Hyderabad. For the first, it is cleaner and more orderly. Cars actually drive in the lanes some to most of the time! It was shocking. The roads are well kept up and clean. And I even saw people using blinkers today. I thought I was going to have a heart attack. I love my city, but it is so cool to see different parts of India—the same India, but recognize the great diversity. I am aware I am just seeing the surfacy differences since I’m in Dehli under 24 hours. But just to recognize it at that level speaks something of the differences. I feel as if I were in a big city back in the US. Some areas of the city are once that I’m used to from Hyderabad, but other cities send me into a confustion of what country I am in. First impression: I like Dehli! I was expecting a city more congested and more dusty and overpopulated. But I was definitely pleasantly surprised with the aspect of India that I see here!

Six days later:

I had just a lovely time this last week. I met up with a team from the Chapel to help with some women's empowerment conferences. I am quite in love with the north! The chapel women were so enthusiastic and energetic. It was an encouragement to see them just jump right into the conference and invest full force into their teaching and into loving the women. And the Indian women in charge of WE were just lovely. I enjoyed building friendships with them and am excited to see them more in the coming months. I did also get to see my father, which was just an added bonus :) I'm thankful that he got to see India and be a part of the work being done here! It was funny watching the team go through culture stress/shock. Its a lot more obvious when it isn't you going through it!

The language barrier is always hard, but there was enough interaction, visual aids, examples that kept the women attentive despite linguistic difficulties. I must say that I was encouraged to see how easily the women on the Chapel team interacted with the Indian women. The comment in the feedback session that made the greatest impression on me was that she felt love in that place more than she had felt it in her whole life. I sometimes think I’m so used to the love of Christ that I often forget the power of his love and the power that a community in Christ really does have. It was such a good reawakening for me to the blessings of having a community. I just pray that God will remind these women that they aren’t alone. That they will be encouraged to remember that they arfe a part of a larger community in Christ. I Peter 2:9-10 has been made so real to me this weekend.

I was really nervous to give my talk. I was slightly paranoid that I would be oversimplifying things and they would feel insulted. Once I was talking though, I really enjoyed it. Even though I have a B.S. I still need reminded of these things. I still need to be reminded that being good stewards of God’s blessings includes my health. Nonetheless, I was still blown away when the women talked about how much they learned from the health topics. I thought everything was so basic, but realizing how much they learned in those two sessions made me realize how much awareness still needs to be there. It has challenged me and definitely is making me think about different ways I can spend the next 7 months.

And Ode to Laundry and other little joys of life

2007-08-24T07:36:00.000-07:00

A day in the life of Susan: Well, to be honest, lately it has been a day every two weeks in the life of Susan. At home I pretty much hated doing laundry. I mean, it was so much work to haul my basket full of laundry down to my car and drive to my parents house (‘cause there was no way I was gonna spend 5 bucks to do two loads of laundry), and then put it into two piles, load the first pile in and hang out for an hour. Then move it to the dryer and add the second load. Wait some more, visit with my parents, then fold the clothes and add the second load to the dryer and hang out with my family some more. I mean seriously, such a monotonous task, right? haha oh if only!

When the team came here from home last month, one of the women innocently asked me what the bucket in the bathroom was for. Me and the interns chuckled ‘cause really, it is used for EVERYTHING. That bucket is a necessary household item here. Let me describe how I do laundry in India. Like I mentioned, I sometimes just forget to do it for 2 weeks, until I am absolutely out of clean clothes and the not-clean clothes are beyond wearable. So… You fill the bucket up with water, add a load of laundry to it with some detergent. Swoosh it around and get all your clothes clean (or as clean as a 20 year old with a short attention span gets anything clean by hand). Rinse each item. Wring each item out. Take it up on the roof to hang it to dry. Wait for it to dry. Take it all down and supposedly iron said clothes.

As much as I sometimes find it a hassle—cause as I mentioned, I tend to forget about it until I have no wearable clothes left—I take much more joy out of my clean clothes. When you have to work for it, it’s actually more valued. I know this is such a basic concept and it’s kinda sad that this foundational life principle is hitting home most for me through doing my laundry. But I also enjoy doing laundry now. Although it is time consuming, it is so wonderful to have some physical labor! Its hard work! I’m quite in awe of the women who wash sheets and saris (I haven’t become brave enough to try those yet) because even washing the small items is quite vigorous, let alone 3 meters of material! Another reason I love doing laundry is having an excuse to walk around on the roof at night. Architecture in India is wonderful if simply for the roofs. To be above the busyness of the city, or the busyness of campus is so peaceful during the day, and at night to be a bit closer to the stars. I go up just to hang up laundry and end up stopping and being in awe of the one who made such beautiful, peaceful nights. Roofs are also quite wonderful for oatmeal breakfast picnics with friends :)

Eating. Who ever would have realized that eating with your hands is harder than eating with a fork? We’ve been told numerous times that we’re like little children when we eat. After years of being scolded to not play with your food and to not eat with your hands, I’m having to relearn it! It just makes sense! I might still be messy, but it is now easier for me to eat Indian food with my hands than with a fork. I’ll often just pick up a fork out of habit just to abandon it 5 minutes into the meal out of frustration!

Another random wonderful thing about India is that the cars play songs when they are backing up. And every car has its own little song. Not quite the annoying beeping huge trucks play when they back up at home!

And the head bobble. You never really know if the person is saying “yes,” “no,” “I hear you,” “you’re crazy,” or “I have no idea what this crazy fast-talking American is saying to me, I wish she would just stop babbling.” And when I ask a yes or no question and get the response of ‘no problem’ or ‘its ok.’ After 2+ months, I also don’t know what that means. The more I am here and the better I’m getting at communicating (I have acquired the ability to actually talk slower and to annunciate more! For those of you at home, you should realize that this is a giant improvement for me), the more I’m wondering how and if anyone actually understood me in the beginning.

Other things that make me happy:
Tiger ‘biscuits” (really, they are similar to shortbread cookies)
weekly (or bi-weekly) dinner dates with Elise

Internet is working

Being called ‘teacher’ by every child under the age of 15

I have two tailor friends who are going to help me have clothes that actually fit me!
getting chatty emails from people back home
one of the girls on campus who makes the most amazing crow sound (long story)
and...

Parasite Pals (… a children’s toy much like Polly Pocket) with characters such as ‘Holly Hostess,’ ‘Dig Dig the Head Louse,’ ‘Blinky the Eylash Mite,’ Zzeezz the bed bug’ and my personal favorite ‘Tickles the Tapework.’—I think I seriously laughed for 15 minutes when I first saw it)

The caption reads: “Here is the girl with small friends of life present for always. Some irritation she finds with them, but much fun and love is to be shared.”

Trust me there are a whole lot of more serious things that make me love India and make me joyful. But for lightheartedness’ sake I’m going to leave it at that!

Happy Independence Day!

2007-08-17T02:08:00.000-07:00

August 15, 2007:

Several weeks ago I saw these kids as a sea of faces, but as I’ve spent the last three weeks helping out a bit in the school, names are beginning to match with faces. More than that though, their faces are beginning to match with homes, with families, with stories. Once a week medical camps go out of the various slum areas nearby. Although I go to these places in the mornings more regularly to help, these camps take place in the afternoon when the school children are home. We get to talk with them, meet their families, see their homes. Without fail, the next day we will be greeted by these students dressed smartly in their school uniforms, actively engages in their chance for a future. Grasping the hope handed to them through school. Coming from a society where as I child I would be glad to be sick because I could avoid going to school, I am blown away by their devotion and enthusiasm for their studies. Speaking as a girl who pretty much has sold my life away to my education, I’m realizing how much I have taken it for granted. At the medical camp yesterday, Elise and I talked to a group of Muslim girls from the wealthy family whose home abutted the slum area we were spending time in. I could tell each girl was quite intelligent—particularly Nazine. She was outgoing, spoke English extraordinarily well, and was composed and self-assured. I had been learning that here wealth leads to education, as it does most of the time in the states. Nazine calmly informed us that her and her female cousins would be finished with school after the tenth grade. She commented rather indignantly that although the girls studied and worked much harder at their schoolwork than the boys, they would not be allowed by their families to go further than the 10th grade in their education. What does one say to this? All I could do is to encourage them to continue studying and learning on their own. It shook me up, but really reminded me all that an education stands for--no matter what part of the world one is in.

So today was India’s independence day. It has been such an amazing day thusfar! This morning was a program at the school. The students were dressed so smartly and sang and dance with such pride. They were dressed beautifully and radiated joy and pride in their country. The speeches told of their thankfulness and hope for continued progress in India as it presses on in its journey of freedom. It was powerful and really just so cute! The kids did a wonderful job and had worked so hard and performed so energetically! I loved it :)

The rest of Independence Day was just fun! There was a youth gathering--just a bunch of teenagers hanging out, playing games and watching a movie. It was refreshing! Its very cool to me that India has a sense of national pride that appears to be fast fading in the life of the average American.

2007-08-07T07:32:00.001-07:00

Life in India is already looking much different. I feel more this week that India is home. I’m beginning to get a feel for the different areas of work here and am getting my feet in many of them. I’m very bad at conveying the emotions that I’ve been feeling here. Most of the time in the clinic the patients have a cold or gastritis. But other times I feel fairly heart-wrenched. This little girl (the smallest one) came into the clinic about 3 weeks ago.

I had been very busy that day running in and out taking care of some patients, but Dr. Anna stopped me and told me to go and listen to the girls heart beat. The girl had a congenital heart defect—she was born with a hole in her heart. This prevents her from developing properly. She is two years old and can’t walk and is no where near where she should be developmentally. During the medical camp at the pipe village (her home) I was blown away at how small and frail she looks. She needs surgery so badly, but with her family’s situation there is no way that they can afford it. Her name is Neha. Please pray that money will come in to meet this girl’s needs. Kanchan also lives at the pipe village. She is in the ninth grade and is so intelligent! I was talking with her today (she speaks nearly impeccable English) about her family. She lives with her family (mom, dad, and 3 siblings) in the summer in a neighboring state and has spent every year minus that time with her grandparents in this village. It was eye-opening to talk to this girl. She has such faith and hope and such a strong foundation. She wants to be a doctor and I have no doubts that this dream will be attained. It’s strange to describe how uplifting it is to be there in the pipe village. These are families who are brought in to work in a pipe factory. They make their homes out of the discarded pipes.

I watched two of my friends work there every day for the last 6 weeks and to go into the same village with their same kids and to see the impact that they have left on their lives is beyond encouraging. It reminded me that sometimes the littlest things make an impact on those around us. The smallest sentence we utter can influence one person even a little. Me and Dr. Anna have gotten to know each other much better in the last few weeks and I’ve become more confident in expressing my own opinions and views on certain issues. Last year God taught me a lot about grace and convicted me on the subject in incredible ways. I had shared that with her a couple of weeks back and honestly thought she wasn’t listening to me. Turns out that telling my story encouraged her to show grace to someone close to her. It surprised me, really, but made me realize a bit more fully what my role is here.

I went on an airport run this morning. I had spent the night with a friend 20 mins from campus and I just LOVE taking rickshaws at 8 in the morning by myself (sarcasm). And there was an airport pickup so they just picked us up on the way and then took everyone back to campus afterwards. It was the first time I had been spent time in the airport since I’ve arrived here. It was just weird. I was forcing myself to recall all the overwhelmed, confused, naïve feelings and emotions I had when I still have no idea what to expect. It was strange, but it made me realize how confident and adjusted I’ve become in the last two months! I mean, given most of the time I am still really clueless, but I’m OK with being clueless (and for those who know me well, you know I usually like to know what on earth is going on and don’t like to be confused). But here, there’s very little that isn’t confusing so if every time I let it get me overwhelmed, I’d be fairly immobilized.

Random facts of India: When cars backup, instead of a beeping sound, they play little songs—its like a ringtone for cars!

Indian men have small bladders. I have gotten very good at looking straight ahead or determinedly at the road in front of me. But when you are riding side-saddle on a scooter, there are things that are just hard not to see as much as you desire not to!

Some major roads don’t actually have street names and business cards even put landmarks for directions instead of just an address.

So we may not be the wisest girls in India...

2007-07-30T06:17:00.000-07:00

So you see the top of that water tower-- in the middle of the picture, over the palm trees? Yeah at 4:30 AM THAT is where I was! We might have been afraid of getting in trouble, so we wanted to climb it when no one was around. We somehow came to the conclusion that 4:30 AM was a good idea :) We all had been wanting to climb it since pretty much our first day. And seeing as today is Andrea and Ashley's last day here, we just HAD to climb it. Yeah... it was a bit taller than we thought. And a bit scarier climb than we thought. haha. But we are safe and alive! It was cool to be so high up at night--India felt so peaceful. And we just sat and prayed. It was worth it. And it was an adventure!

Ok, well I'm gonna run and spend the next couple of hours with dear friends who are leaving tonight!

change of seasons

2007-07-29T02:14:00.000-07:00

6 weeks are up, meaning most of the other international interns are heading back. Amy and Megan left last night, which was very sad for me. And my other friends leave either today or tomorrow night. Very soon it will be me, Elise and Uwe. It's hard to describe my emotions right now. I'm sad to see people leave, but at the same time I'm excited to begin the next portion of my stay here. Things will be different. Oh so different. I'm already getting involved in some different things and pursuing different opportunities in the slum areas and in the schools. And I'm also a bit frustrated at stuff I'm missing back home. Its been an emotionally charged summer for all of us in different ways I believe. I feel like someone at some point needs to teach us how to process. I missed that lesson in school and I feel like I'm frequently just a mess 'cause I don't know what to do with the different lessons I'm learning.

This morning I remembered that I am definitely in India! As most of you know, I was quite involved in the jh at my church back home. Needless to say, I was very excited when I was made aware that they were trying to start up a youth program at my church here! I went to the 'vision' meeting this morning. What an adventure. I know I often got frustrated with meeting back home. I assure you it won't happen again :) The whole time sitting there I had no idea what the goals or purpose of the meeting was. It was everyone brainstorming and saying the same thing and in my western mind I kept having to remind myself that I'm in India and meetings aren't task oriented and linear and direct. It was my first mostly Indian meeting here so it was a good cultural reminder!

But it looks like there is a chance I'll get to lead a small group of teenage girls, which would make me SO happy considering it is my passion :) and I also found a community group/study that I can join. I'm really excited about it and the women are ones that I enjoy and it will be so beneficial for me to know while I'm here!

I'm in India??

2007-07-18T08:00:00.000-07:00

This week has been good... After a rather rough week last week... But Monday I took care of a boy with acute abdominal pain and sat with his family and prayed with them. Yesterday in the medical camp was somewhat sobering. After playing with the kids much of the afternoon, I was called over by Dr. Anna. She explained that the patient she was talking with had had a fairly rare medical condition resulting after the delivery of her child causing deformities of her hands and feet preventing her from walking or doing almost anything. And then we prayed. There was some strange power in it--knowing nothing but that could help this woman. In speaking to her husband afterwards the boys discovered that of course he had taken a second wife! What choice did he have? I felt sobered and silenced thinking of her position in life. How can I begin to fathom that loss--loss of your physical abilities, loss of your husband in a sense, loss of your ability and respect, total dependence for everything. This encounter was followed by a 4 month old baby placed in my arms, which i love :) It was then explained to me as I held this beautiful child that the mother standing next to me was 16 years old. She had been married for 4 years already--since she was 12 years old. To have been married for 8 years by the time I am at this point in my life? I can't begin to wrap my mind around the monstrous responsibility at such a young age. Seeing a face with the story stopped me in my tracks.

Today--I gave my first injection :) Basically, I was taking care of a patient with suspected malaria--fever, loose motions, vomitting. One of the nurses is from Germany and was explaining everything to me as he went. Finally he just handed me the syringe. The day overall made me feel 'useful' and that I was being productive! My task-orientedness was definitely coming out, but it was a good day!

I actually woke up this morning: looked out the window, heard the birds, saw the palm trees and wondered to myself that such a place should be my home for the next 9 months. Its incredible to me that I could be this privileged.

freedom

2007-07-15T20:07:00.000-07:00

There is freedom in humility. I feel like I’ve learned more this month even just about myself than I have in the last 6-7 years. I’ve always struggled with pride—that should be no secret to anyone. I made sure I was always strong, at least in appearance, at everything I put my mind to. But now, everything I placed my pride in pretty much just doesn’t exist here. I’m not in school so my grades and studying doesn’t matter at all—in the clinic there is no pride to be really placed in independent study and curiosity. Athleticwise I always pushed through walls and typically was fairly competitive. Here, women just don’t really do sports. Me and Ashley usually just merely walk (with some sprinting and skipping intermingled when no one is in sight) and people don’t admire us for our discipline but merely think we’re all the more crazy! I have no wisdom here or understanding of how things work or what should be done in any given situation. There's no place for my pride in India.

And it is freeing. Everyone expects us to be crazy and weird anyways. What really do we have to prove? I sing a lot here! I actually love to sing to myself, with my friends. Randomly to burst into offkey Disney, patriotic or praise songs gives me so much joy! I’m not a great singer, but I don’t really care! Today I started drawing. One of my good friends Ashley picked up the hobby on coming here and I was admiring her journal/sketchbook/scrapbook and decided, why not?? So I spent an hour drawing pitchers and vases and most likely will persist in this endeaver ‘cause I thoroughly enjoyed it, although I am not intrinsically artistic and have never nurtured that part of my mind! I don’t think I ever really even so much valued it as something I could ever enjoy, yet when I didn’t have to be great at it, but really could just do it ‘cause I felt like it and wanted to try something new—it was so joyous!

I'm attempting to discover the boundary of building walls around the heart and letting myselves learn from mistakes and hurts. But its somewhere in the middle, while previously I think I believed it to lie very far to the former. Its ok to expose ourselves to potential hurt, ‘cause without that vulnerability there cannot be much vitality to life. Isn’t it better to live life fully and work though the pains and hurts that it brings with it—to grow and mature and draw near to God through hurts and disappointments—than to just live steadfastly in low expectations, constantly talking ourselves out of what we truly desire? If we really believe that God is molding our desires, that shouldn’t we let ourselves desire?

I feel like a month ago I would never recognize the above paragraphs as something I would ever think to write! God is working so much in my heart and mind and I can see how much I’ve grown and matured in one months’ time. I can hardly imagine where he will guide me in the next 9! I know that these might seem random and disjointed from lessons I'm 'supposed' to be learning overseas, but I guess God's just surprising me in the very strange ways he's challenging me to step out of my comfort zone and wrestle with issues of the heart.

I went to the zoo with the kids from the pipe village--two of my friends work there regularly and asked me to help 'chaperone' the field trip. The pic above is my favorite little girl Depali.

So maybe blogging will be easier??

2007-07-10T02:29:00.000-07:00

Observations on life: Indias beautiful. The driving hardly phases me anymore, I’m less concerned about time and shopping stresses me out less! I just bought a gorgeous Sari ☺ It makes me happy! I am wrestling a lot about theology vs. culture and where to draw the line of what’s important and what’s just culture. I’m feeling a bit in a rut here… like I’m really just at a standstill and not sure how to process and work through some thinking and coping and am just not feeling too effective… But I have definitely started to process and work through things that bother and frustrate me. It is good to actually come to grips with the culture. I’m also building relationships with many of the Indian girls. They love to laugh and really are willing to be your friend if you’re willing to sit with them at meals and smile a lot! Most of all though, I’ve really come to love the other interns. Someone mentioned to me that last summer they made some of their best friends in the 6 weeks they were on their trip. I didn’t believe her… until now ☺ I love these girls so much! We have the randomest, most deep and thought provoking, conversation. I’m not gonna lie, we’re a lot of fun too! And we’re so incredibly awkward. I think I’d be lost without them processing through India and Indian culture, and the poverty and the religious and gender implications with me! Plus we have oatmeal for breakfast on the roof with mangos (better than any mango you’ve ever eaten in the states) on special occasions. We have adventures to the one coffee shop we know of in the whole cities and have adventures with plenty of Rickshaws. I’m blown away with how quickly I’ve come to love these girls (picture up top is of me and four of the other interns--(left to right: me, Andrea, Ashley, Amy, Megan)! And the guys are good to us and take care of us. They make our shower work and make us rotti (kinda like tortillas only better) and nuttella at random hours of the night and we have parties.

One particular change of note is my overcoming of my personal space! Same gender physical contact is the norm here and its expected that good friends walk down the street holding hands. Me and two of my dear friends here walked like a ½ mile holding hands! You should be so proud of me!

And the clinic is good! I’m focusing mostly on relationships at the moment and observing how things are done. Sometimes I’m really frustrated, but overall its good! i love the doctors I get to work with and am loving just being an encouragement to the women that come into the clinic.

Currently there are probably around 100 students here on campus all my ageish (a bit older). Many of them will be here through my entire time, so its good to get to know them! The girls just love to laugh and give us such a great chance. They have a sense of community among themselves that is so welcoming and loving and open to all who are willing to initiate that friendship! I'm excited to continue to get to know them over the next year!

Yeah, I’ve decided to use this blog, ‘cause then people can chose to read my updates rather than emails where they magically appear in your inbox all the time ☺ Don’t worry, I’m still gonna send an email every once in a while, but I’ll probably update here a bit more frequently.

I'm a bit homesick, but God is faithful and I'm loving India about 100x more than I was a month ago :)