Night Shift

A few months ago, I started working the night shift in an emergency department (ED). Those who have known me awhile were surprised that I decided to work owl hours. When no other forces are at play, I happily get up at 5 a.m., even 4:30. Until I took the ED job, I got up early to study or run before going to work. In college, I worked the opening shift at Starbucks. In high school, I got up to work out or study before my sibling hooligans stirred. I love the stillness of dawn before most people rise. Growing up, I saw deer, foxes, and herons in the gray hours of misty summer mornings. I like the dampness of dew on the grass before it’s evaporated by the sun. I enjoy watching the sun creep over the horizon as I listen to the bird songs crescendo.

I wasn’t particularly surprised I started working the night shift. I’d suspected it’d come to that a few years ago, when I was still in Paraguay. I remember thinking about my return to the US, and my terrible tendency to lay my paper planner out in front of me and plot how to fill the blank spaces. I remember thinking, “Going into healthcare is very dangerous for someone like you. It’s a 24-hour business. Make sure you block out time to sleep or you just might not get enough rest.”

The night shift was the most practical choice when I started my ED job. The wage is higher and it leaves the day for studying or errands. Flipping my sleeping schedule was no light matter, however, especially because I started going to bed an hour before I used to get up. It’s also been a challenge finding a new eating schedule that works for me–I now eat meals at completely different times than before I worked nights.

There’s a strange stillness in the ED when the early hours of the morning approach – 1 a.m., 2 a.m., 3 a.m.. Even when a very sick person arrives who requires many hands to care for them, the ED is strangely quiet in the morning. Many patients are sleeping or too sleepy to chat with their family members anymore. The patients staying with us until a bed opens in a facility that can help them heal their mental health challenges are usually sleeping or partaking in quiet activities. Sometimes a drunk patient arrives and disrupts the silence, but often they too fall quiet as the morning creeps onward.

Now instead of waking to stillness, I head to bed in its midst. As I drive home from the hospital, the birds are just starting to sing, but the sun’s rays aren’t yet seeping into the sky. The roads are empty save for a few souls coming home from a party or, perhaps, going to work. I arrive at a silent house, those there are sleeping. Not even the dog, when he’s visiting from my parent’s home, greets me when I open the door.

When I first started working nights, I was always tired. But, now that I’m used to it, I’m no more tired than I would be after any long day at work. There’s something about the night shift that keeps you coming back. Perhaps it’s because I like quiet, or perhaps it’s because I like the self-efficiency that’s required when you’re providing quality health care without all the resources of regular business hours that excites me. More likely, it’s that the people who work the dark hours are different than those who work when the majority of society is awake. Many of us won’t work nights forever, but we have some reason to do so now. It’s the fact that we have a reason to be nocturnal, I think, that creates a sense of comradery that’s different from any dayshift vibe I’ve known.

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Prayers

Trying to get into medical school is a bit of a slog at times. I’ve been lucky to have people support me during each leap through the hoops of fire. Recently, I’ve had a few folks tell me they’re praying for me, and then qualify their statement by saying they know not everyone believes in God. I was surprised that they felt the need to acknowledge I may not believe in their God.

In Paraguay, my adopted mothers prayed for me almost every time I left their house for mine (so almost daily). I am and was always thankful because of the sentiment. I believe it’s tremendously generous and kind when a person cares enough to think of me, to support me, and then to ask for help on my behalf—whether they communicate with their God or simply wish me luck.

In America, I think we publicize the extremes. I see politics radically divided. Political opinions are often based on extreme visions of how things should be or a rebellion against others’ interpretations of right and wrong. These hardline stances don’t allow for more than one opinion to thrive. To me, holding an unweaving “I’m right and they’re wrong” stance is limiting because it creates rigid definitions of aspects of life that neither the State nor another individual can interpret for me or you.

I attended church often in Paraguay because the church was the center of everything in my Paraguay community. I did not and still do not believe in the God of that church. But, I could feel how strongly my Paraguayan friends and family believed in their God. To them, their God was not only the source of life and reason for living but also the definition of love. Going to church allowed me to better understand how they saw the world. The Paraguayans who welcomed me into their lives knew our views of God were different, and they still embraced me as a dear friend. They included me in their secular and religious activities, answered my millions of questions that began with “Why?”, and they accepted it when I sat out from certain rituals because they were “too much for me.” What these shared experiences taught me was that we do not need to have the same definition of life and love to build friendships. We just need to be comfortable knowing that even though we see eye-to-eye on some things and share some history, we also hold very different views of certain aspects of life.

My hope is that someday the US won’t just be tolerant, but that each of us will be comfortable standing side-by-side with folks who are different from us, be strong enough to ask questions to learn more about how those different people see the world, and be proud enough of our belief system to follow it without expecting others to pledge allegiance to our view.

When I think of those who prayed for me before I took the MCAT, I’m thankful. Perhaps their prayers didn’t mean to me what they meant to them, but I think we share the knowledge that what I was doing was hard and whatever assistance they gave would be part of my success.

Christof

There’s a guy, Christof, in my neighborhood who collects returnable bottles from the recycling we put out on the corner for the city each Friday. One day when my father was visiting me, he struck up a conversation with Christof. One of Christof’s daughters went to college and the other didn’t–Christof joked that the daughter who finished college doesn’t have a job while the other one does. He collects bottles to help both of them.

I don’t often drink anything that comes in a redeemable bottle, but since chatting with Christof, my father started saving his seltzer bottles…he drinks a lot of seltzer. My father brings the bottles to my house (even though I live about 2 hours away) when he visits so I can give them to Christof.

I work nights, so it’s challenging to put out the recycling before Christof passes. One morning I saw him, though, collecting from the neighbors. As he walked by, I ran out and asked him to wait a moment. He paused, a smile lighting his face. I handed him 2 huge trash bags of bottles I’d squirreled in the garage for a few weeks. He thanked me a million times, wished me a blessed day, and was on his way.

At first, I thought my father was ridiculous for saving bottles for Christof. But, that morning when I saw Christof’s face after I handed him our bags of bottles, I realized that my father was right. We can get so caught up in all the big things we should do that we do nothing. Christof reminded me that it’s the small things that add up in the end. And, luckily, life is full of small things.

Determination: 2 Girls, 1 Hill, 1 Tree, and 1 Ladder

As children, my friends and I spent hours wandering the woods. We lived in rural Vermont in the middle of hills covered with sugar maples. One of my best friend’s families made maple syrup as part of their living—they collected their sap using draft horses. And it is with that friend that this adventure took place.

Far up on one of the hills behind her house, maybe a 40-minute hike across a river and bushwhacking through the sugar bush, was a monstrous tree. It was a Pippi Longstocking tree, a tree of wonder and stories. It was the most perfect tree for a tree fort you can imagine…and the branches didn’t start until 20 feet above the ground.

Those high branches spread out in such a way as to almost make a floor. My friend and I thought that if only we could reach those branches it would be the best thing in the world. We dreamed of hanging a hammock from those taunting limbs and eating a picnic up in the canopy. We thought about our future tree fortress on many occasions, staring up from the ground, until one day we contrived a plan.

Her father had a very tall ladder—one of those aluminum ones that has two sliding parts so it can get even longer than it appears at first.

We started in the morning. She took one end of the ladder and I the other. Those ladders, though hollow, are not light. We discovered this not long after crossing the river and starting up the hill. We also realized that zigzagging through trees was a lot harder when you are attached to another person by an 8-foot, stiff ladder.

We stopped occasionally. We argued about the best way to go through the trees. We sweated and got scratched by brayers.

And, after what seemed eons, we reached the tree. We lay the ladder against it, expanding it to its full length. We observed the ladder. We were scared. It was so tall and the ground wasn’t even. Surely, we’d fall if we climbed it. Surely, if we fell we’d die. We talked about climbing the ladder. About falling. About how amazing it probably was up there. “Fine, hold the ladder,” I said. And I put my foot on the first rung. I was shaky. It was high. My heart pounded. I got about 6 feet above the ground. I paused. The ladder felt wobbly. I wasn’t sure if I should keep going.

Slowly, carefully I reached the top rung. The branches were still overhead. I’d have to grab them and then swing my legs up and hang sloth-style to get up in the tree. I stood at the top of the ladder a long time. My friend first shouted up that if I wasn’t going to do it I should come down so she could. Then she suggested that we not do it at all.

I grabbed the branch and I swung up. “This is awesome!” I said, sitting and staring down at her on the ground. She joined me, with the greatest care because the ladder was unsteady, especially without someone holding it.

We sat up in the tree until we got hungry. The only reason we ever left the woods was because we were starved.

Some people will tell you your dreams are impossible. Don’t bother with them. Someone else will help you carry a ladder.

Framing: Beautiful Microbe, Beautiful Molecule

Before I started down the health science path I studied communications. In communications, there’s an idea called “framing.” Framing is a theory that’s often applied to the media and how it shapes public opinion about certain topics. The concept is that how you talk about a specific topic (ex. healthcare)—such as the tone you use and the details you include (or leave out)—can shape other people’s perceptions of the topic.

I’ve noticed that several of my science professors use framing as a teaching tactic. And, despite knowing exactly what they’re doing, I still fall for it.

I’m currently studying microbiology and organic chemistry. There’s a lot of new information to learn and for organic chemistry there are a few new thinking skills I’ve been practicing—such as being able to think about molecules in 3D. It’s an interesting challenge to train your brain to be able to rotate different molecular structures using only your imagination. I’m lucky enough to find microbiology and organic chemistry fascinating, but still it’s hard work. That’s where the framing comes in.

My organic chemistry professor introduces particularly complex or tricky molecules as “beautiful molecules.” “This is a beauuuutiful molecule,” he’ll say. He’ll also start a new chapter by saying “This is an important chapter. This is very cool…let me tell you why.” And, somewhere in that explanation of how awesome the challenging topic is, he’ll make a few comments about needing to practice the skills he’s about to show us. “But I will teach you how to…” he will conclude.

My microbiology professor does the same thing. I always know when he’s preparing to introduce a particularly complex metabolism, process, or cycle used by bacteria because he’ll pull up a picture of a microbe and say “This beautiful microbe…”

Those are current examples, but my general chemistry professor did the same thing. His word for hard concepts to learn was “interesting” rather than “beautiful.”

So what’s going on with this inappropriate use of descriptive words? Framing. Why? Because it works. As absurd as it sounds, it’s way easier to fight with a beautiful molecule than a molecule that’s “annoying” or “difficult” or “challenging” from the very start. I don’t think microbes are necessarily beautiful, but I approach them with much more interest and forgiveness when they are presented to me as “beautiful” rather than “ugly” or “evil” or “bad.” And, when trying to complete long chemical equations, it is a lot easier to complete the “interesting” problem than it is the “hard”, “tricky”, or “terrible” problem.

What’s my long-winded point? Before I dove into science I heard that it was “hard” and “confusing” and “dry” and “boring” and many other potentially negative adjectives. Sometimes I completely agree. But, most of the time, I do think it’s amazingly interesting. I think we’d do a lot of young people thinking about their future (and older people looking for something new) a service if we framed science as something wonderful. Sure, there is plenty about it that’s hard, and even monotonous, but most of it (all of it maybe) is not beyond most people’s reach. We’ve just conditioned our population to think science is either too complicated for them or not something they’d find interesting by describing it as scary, trying, and a thing that only geeks and brilliant people do. It’s worth a frame-shift around science. Why? What better way to find answers to medical questions, renewable energy questions, etc. than having more people researching and exploring those topics?

Energy Levels

Atoms cling to, share, or pass electrons. They do whatever it takes to make themselves more energetically stable—not reactive and content as they are.

I think we have some lessons to learn from atoms and their energy lowering endeavors—let’s say we are the atoms, the electrons are aspects of our lives, and the energy state is our emotional state.

In the world of negative electrons and positive atom nuclei, the more energetic the relationship (imbalances in charge, which basically means repulsion and attraction forces aren’t equal) the less stable and the more likely the atom is to undergo change. Electrons in high-energy states, unstable, cause chemical reactions from little ones like putting baking soda in vinegar to big ones like bombs exploding.

I’ve noticed a similar situation in my own life…and those around me. The higher the energy (emotion)—whether it be negative like stress as deadlines and huge projects loom or positive like an awesome vacation—the more reactive we are. Of course, our fizzing reactions might be petty arguments and our explosions could be bouts of extreme agitation, but nonetheless we are more likely to respond dramatically when our emotions are high or low.

The thing that’s clever about atoms is that they are willing to exert themselves to achieve a more stable state. In other words, they will do the atomic version of sweat it out—to ensure they’re living in a happy medium. And, they’ll go to great lengths to defend and maintain a stable state once they have it.

I propose, just like atoms, it’s worth it for each of us to build into our “to-dos” a little bit of energy maintenance. Atoms maintain stability by shedding or attracting electrons…what are the electrons in your life?

Optimism

I zoomed around running errands for work. My return-borrowed-items frenzy brought me to the opposite corners of the network of towns that make up this part of the state and forced me down some of the most congested (and my least favorite) roads in Vermont.

I was tired. I’d been studying and working extra to finish everything on my plate. It was another sunny, gorgeous fall day…another one I was missing as I toiled.

I crested the hill just past where the road was lined by strip malls—probably once farms. I felt like I’d climbed the hill myself (rather than my little car). At the edge of my vision, the largest smile caught my attention.

There in the beautiful golden sun under a tree that wore canary yellow leaves, its autumn coat, sat an elderly woman. She was laughing. Her face creased where laughs had wrinkled her face for decades. She bent forward slightly. I looked again, trying not to swerve or slow too suddenly as I drove in traffic.

Beside the woman was an elderly man. Both of their mouths were wide with joy. The fall breeze made their tufts of white hair flutter.

What were they laughing about? My face relaxed and the corners of my mouth rose, breaking line formation for the first time that day. The day wasn’t so bad—I’d just needed to look past my personal storm cloud.

Defining Friendship

On my EMT shift the day before my birthday, the dangerous topic of religion came up for some reason while we were reviewing the ambulance (something we do at the beginning of every shift) to make sure we had all the right supplies. Like most careful Americans, we ended the religion conversation before we needed to say much about our personal beliefs. It was amusing to contrast the politically correct nature of the conversation with my experience in Paraguay. In Paraguay, religion is not a topic that’s avoided and people have no problem asking you if you’re catholic (the dominate religion there). I went to Paraguay with almost no religious experiences (and most that I had had were very negative)…but Paraguay brought me up to speed on their version of being catholic. And they changed my view of religion forever (though they didn’t convert me).

As I wrote when I was in Paraguay, the Paraguay I know is Catholic. That means that to my Paraguay friends the entire world is seen through the lens of Mary, Jesus, and the saints. A lot of what Mary and Jesus and the saints talk about is how you’re supposed to treat other people. Paraguayans put people, especially family, first.

A little after 9pm on my birthday I got a video message from one of my families in Paraguay. When I say family, I mean I spent every weekend with them. I went to church, out shopping, and to soccer games with them (in Paraguay, soccer is the equivalent of all sports in the US combined). I went dancing all night with the daughters, studied English and history for hours with the son, ate many dinners and lunches with them a week. I showered at their house when my water was out. I was in both daughters’ weddings…

My whole family was there in the video message. First they sang “Happy Birthday” in Guarani…then it was “Happy birthday Jett. May you have a blessed birthday and many blessed years ahead. I hope you’re having a wonderful time. Send us a video, Jett, so we can see you…We miss you Jett. When are you coming back Jett?”

It’s so nice when you realize that the people you think about all the time also think about you. And as my family’s familiar voices and happy words sunk in I thought about friendship. Even friendship is defined using a religious metaphor in Paraguay. And, with the topics of religion and friendship on my mind, it seemed fitting to share (again) one of my favorite stories about both:

Overheard in Paraguay: Friendship
Repost from October 19, 2015

We sat in a half circle around the grill. The men were cooking large slabs of meat, ribs and some unidentifiable cut, for the mother of the family’s birthday dinner. The husband of one of the birthday mother’s daughters sat by the grill passing one can of beer among the men there. A nephew walked up to the daughter’s husband. The husband was around 30 and the nephew was about 11.

The husband hugged his nephew first with one arm and then the other, squeezing him. The nephew squirmed, and they both smiled. The husband held the nephew at arm’s length and put on an almost serious expression. “Will we always be friends?” the husband asked.

“Yes,” the nephew said.

“Even when I am old and you are my age?” the husband asked.

“Yes, even when you are old and I have kids,” the nephew said.

The husband smiled and pulled the nephew into another hug. The nephew pulled away again and they looked at each other, the husband still squeezed the nephew’s shoulder with one hand.

“Even when you are in Heaven and I am old we will still be friends,” the nephew said earnestly.

The husband laughed. “And I will look after you from Heaven.” They hugged again. “And, when you come to Heaven, we will be friends in Heaven. We will be friends forever.”

The boy nodded and ran off to find his playmates.

Birthday Eve!

We drove along in the old truck over the sine wave troughs and crests of a typical Vermont road that make your stomach drop. (The effect was exaggerated because my dad always sped up just before the peak). Then, our humming came to a crawl as we found ourselves behind a car with some white hair just sticking up above the driver’s seat headrest. I said something about them driving slow.

“Time is moving so fast for them they don’t even know they’re driving slow. As you get older each second becomes a smaller fraction of your life,” my dad said before passing the elderly driver.

Tomorrow I turn 28! I’ve almost lived a year for every minute in a half hour. I guess I’m not too old yet, though, because I think plenty of people ooze along with the viscosity of molasses.

I looked back at last time I wrote here about my birthday. I gave a robust list of accomplishments and goals. Don’t worry, I’m not doing that this year. These days my guiding principles are my 5 favs of Paraguayan culture—humor, gratefulness, details, relationships, curiosity— and everything else falls into place about them. For example, I smile at strangers…because smiles are contagious. But also, more importantly, it’s fun to catch passersby off-guard and watch the awkward expressions that flicker across their faces as they work to smile back.

I’m stoked about 28. This is the first birthday I’ve had (since adulthood anyway) where I don’t have any major changes I want to make. I have a lot of hard, exciting things on my radar for the year. Those wonderful things could dramatically change my life—like applying to medical school. But the only way to find out if the future is boring or exciting, is to keep putting one foot in front of the other.

Time does go fast at this age. It seems like I just started the semester and already I have a few exams behind me. I can’t imagine what studying will be like in my 30s, perhaps a jet race, but I’ll find out soon.

Happiness Comes from the Heart

Being a pre-med post-baccalaureate student, I take a lot of classes with humans that are 8-10 years younger than me. These young people are a dichotomy of vibrant energy and self-doubt. We are on same footing as we struggle to memorize microbes and how p orbitals shape molecules, yet we are not even in adjacent life chapters.

It’s nice to be a witness, rather than a participant, of the soul searching that comes with learning how to be an adult. I once was an 18-year-old too, but I’m glad that era is behind me. I know my young colleagues will come out just fine without any help. But, there’s one thing that I wish I could tell them so they wouldn’t have to go through the trouble of discovering it themselves. It’s simple but, alas, it’s something only experience can teach us: happiness comes from within.

I think many of us get lost in the weeds when it comes to happiness. We jump from shiny thing to shiny thing. We assume the next great object we possess will fill the holes in our soul. We look to family, friends, and partners thinking they can save us. We search for other’s approval of our look. We act based on strangers’ opinions, hoping that society will label us as “cool.” And as we skip and hop between all these outward forces, our emptiness expands until our core seems more like a beach ball than a rock. Hollow.

It’s not the doldrums, the pits, where the quest for meaning beyond ourselves drives us, but to stagnant waters and ships with limp sails. And, while some of my young lab partners might learn quickly that they are the only ones who can make themselves happy, many of them will take years to realize the truth. I’m not sorry for them. I know their journey will have many fun days and explosions of wonder. But, if they are like me, they won’t find peace until they understand that joy originates inside and spreads from there. I don’t wish the restlessness of the road upon anyone, but it’s a road we all must wander at some point.

While others might make our lives brighter, we’re the only ones who can decide if we’re going to let in the sunshine or draw the curtains. I hope that when the going gets tough and the days seem dark the young folks around me take the time to look inward. There are many things beyond our control, but our emotions and how we respond to the world do not fall among them.