Tag Archives: About Me

Thankful

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This post comes after a several-month blogging hiatus. The break wasn’t intentional, but life has a way of carrying us forward in unexpected ways. The past few months I continued to write, but in a different genre. I drafted several novels. I have two fantasy series that occupy my imagination currently. I’m not done with them. Novel writing is a long-term project, like most things in my life. Yet, despite stories unfinished, the flow of my days has brought me back to this blog. Afterall, the doctorhood quest isn’t over. It begs the question of whether the doctorhood quest will ever be over as there is always more to learn, but that introspection can be left to the future.

The past few months oscillated between easy schedules with plenty of time to contemplate life and my least favorite part of residency, night shift. I’m gleeful to report that I finished my last scheduled night shift of residency last week. Of course, I’m in residency. Another week or so of nights will sneak into my schedule before I graduate. Such is the way of residency, unwelcome and unfriendly work schedules. I skipped Thanksgiving because I was on night shift. I celebrated Christmas on November 30 because December is a doomsday schedule in my residency program. I wrote this blog at 3 o’clock in the morning because my sleep-wake cycle was still upset from night shift despite a week of day shifts under my belt. Schedule challenges aside, December is a month of reflection and giving thanks. I find myself in an interesting place – seeing how far I’ve come while also noticing a long road ahead.

I have 7 months left of residency. I have a job for post-graduation (more on that in a future post). I completed the administrative hoops to get official physician’s licenses. I scheduled my last exam – the board exam. Once I pass the board exam, it signals that the past 9 years of training taught me what I need to know about doctoring…at least on paper. Completing those tasks is enough to be grateful for without needing to look below the surface or consider the complexity that made them possible. But giving thanks is more than checking off one’s to-do list. So, let me dive deeper into some of the things I’m most grateful for currently.

On the top of my “thankful for” list are the countless people who helped me get to where I am. Many of these people are unnamed and their time in my life was brief. Together they made me the doctor I am. I must first give a nod of thanks to my patients. They have taught me more than they know. To be a patient is to be vulnerable, and they navigated that vulnerability with bravery. Next, I give a nod to my professors and peers in medicine. Medicine is a team sport, anyone who tells you otherwise is lying. Every day I learn something from my colleagues in medicine. Collaboration for the better good is one thing I love about the medical field. And last, but not least, I’m thankful for the friends and family who have supported me on this journey. They are the force that keeps me on the path forward. I will not imagine what this journey would have been without them. 

After the people in my life, I’m thankful for my circumstances. I’m thankful to live in the sunny city of Richmond where native passionfruit and pawpaws hide in the park. Where the river flows under and around osprey in the summer and ducks, geese, and cormorants year-round. Where snow falls occasionally in winter and daffodils bloom in February. Where cultures born of many pasts and futures come together, not always smoothly but always with hope. I’m thankful for my apartment where I can track the exact location of the sunset throughout the year – knowing the season by the building behind which the sun dives first. I’m thankful for the plants that dominate my living room. They ensure that there is no day without a flower blooming in my home. I’ve always said that I’ll know I’m rich when I can always have a fresh bouquet of flowers without concern for budget. When I thought of that definition of wealth, I didn’t realize that tending plants would make me rich faster than working. In retrospect, I should have realized that “wealth” is a nebulous term.

And finally, I’m thankful for my experience. My experiences on the doctorhood quest and in other aspects of life. I have never had a job that is as consistently rewarding and infuriating as being a physician. Most days the reward outweighs the frustration, which is why I continue to return. I had over 20 jobs before entering medical school, some were fun and others inspiring, yet I would not return to any of them. Apart from work, this year’s vacations, day trips, and glorious hours lounging I cherish. As December unfolds, I’m thinking about the experiences I’ve had and those ahead. There is never a dull moment when one accepts that the only constant is change. With the days of 2025 numbered, I’m thankful for what this year was and the hope next year holds.

Spying on Birds

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A flash of color. A movement out at the edge of my peripheral vision. A song so sweet it lingers in the mind after it’s done. These are the taunts of the birds as I try to spot them. Brown. Gray. Yellow. White. Black. Sometimes bright colors. Blue. Green. Red. Orange.

Birding, the act of watching birds, can be passive or active. In the passive form one simply observes birds that flit or swore on the path of one’s normal travels. In the active form the purpose is to see birds, discover their hiding places, and learn their names.

Growing up my mom liked birds and knew the names of most of the ones we saw in our rural home. My mom’s side of the family was a bird-loving side. As such, bird names – blue jay, cardinal, chickadee, hairy woodpecker, osprey, red-tailed hawk, wood duck, mallard, etc. – were part of my normal vocabulary. Just like, I imagine, brands or celebrities’ names were part of the vocabulary of other children. I didn’t know it was unique to know birds by name until I moved away for college. There I found myself on an urban campus where I wasn’t convinced that some of my colleagues could identify a live chicken.

Life unfolded. I stayed urban for a time. Then I moved abroad where there was too much to learn to also learn new birds. And then the doctorhood quest took off like an ultramarathon – slow and steady but always busy in its own way. Fast forward. I found myself in Virginia. Virginia and Vermont share many birds. And some of the birds Vermont sees only in the summer Virginia sees at other times of year. As I wandered the forest and wetland trails on my days off from residency, I started to notice the birds again. Somehow, having spent 10 years learning other things and more than that away from my childhood home, the birds I knew as a child resurfaced. Old knowledge was not lost despite filling my brain with an additional zillion factoids on medicine and the human body. Birds. I still know the song of the hermit thrush – Vermont’s state bird. I remembered the nuthatch and the tufted titmouse.

I have a good partnership. My spouse likes to take pictures of birds and I’m good at spotting them. My binoculars are my superpower. The only challenge is that when one starts actively spying on birds it’s hard to stop. My spouse and I now seek out birds on our vacations. I find myself toiling over bird books and using Merlin Bird ID.

Birding escalates. It starts with just trying to see birds. Then it’s about naming them. Then it’s about finding rare birds and memorizing new bird names. A harmless pastime. Another excuse to be outside. Another reason to love wild places. Another reason to also learn about the trees and plants that birds, themselves, adore. What fun it is to go on a walk and be able to name the birds, trees, and plants I see. Almost everyone used to be able to do that. Now it’s a dying art. Funny how the world changes. It’s never too late to circle back on the knowledge we once had. It’s never too late to learn something new. Just ask the birds migrating on ancestral routes and adapting to new cityscapes. They’re experts in learning.

The Branching Plan

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I’ve arrived at the phase in residency where colleagues ask what my next step is. The 3 major options after internal medicine residency are:

1) work as a hospitalist (a generalist who only works in the hospital)

2) work as primary care physician (a generalist who only works in clinic)

3) do additional training in a medical sub-specialty (like infectious disease, pulmonology, etc.)

Yep, I know you’re amazed. It’s possible to do more training after residency…it’s called “fellowship”. Medicine is the kind of profession where one starts planning their next step year(s) in advance so now (over halfway through my 3-year residency) is exactly when I need to know my next step. Luckily, I have a plan.

My plan is branching which allows for wandering and discovery along the way. I’ll start as a hospitalist both to enjoy a pause from training and strengthen my financial foundation. Then, I’ll either start fellowship or tailor my generalist work to focus on the populations and medicine that interest me most.

As the residency tunnel starts to show its brilliant end, I’ve been thinking more about the bigger goal – why I decided to become a doctor in the first place. I started the Doctorhood Quest because I wanted to have a career that tangibly helped people. I wanted my daily work to involve direct interaction with the people I was helping. And the help I wanted to give was empowerment. Improving health and banishing illness is empowering because when we are sick, we simply can’t achieve our full potential. As a doctor I’m an ally with my patients on their quest to fulfilment. I love seeing my patients get better from acute illness. I’m honored to help patients die with dignity or to be part of the reason their suffering is minimized. I’m stoked to keep people out of the hospital by optimizing their chronic medical conditions and overall health.

I joined medicine because of the opportunity to work with patients. My branching plan is a strategy to ensure that no matter what happens with healthcare, I can adjust and adapt to achieve my bigger goal of fostering empowerment. People have inequitable access to healthcare and the healthcare industry is flawed but, despite healthcare’s many shortcomings, there is much opportunity to do good as a physician. In an ever-changing environment (like medicine) one must be flexible and adaptable. Having a multilayered and branching plan acknowledges that I’ll have to change throughout my career to achieve my bigger goals. What fun it’ll be to see where I end up 20 years from now!  

No Alarm Today

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I woke up because my body was ready to leave dreamland behind and start the day. There was no beeping alarm or bright light from my sunrise alarm clock jolting me awake. Today my schedule is fluid. I have a to-do list (I always have one) but today I can ignore every item on the list if I want to. It is a rare day with no objective and no place to be. I could, if I really wanted, lie in bed and watch the day start without leaving the warmth of my covers. Or I could get up and sip mate for several hours. I could sit on the couch and watch the plants grow. I could go for a walk, do a workout, or write. I could do anything or nothing. The lack of expectations and requirements for today is freeing.

No alarm days are rare and lovely. Having spent the past many years in medical school and then residency my life has been filled with productivity and hard work. But, just as too much free time makes me stir crazy, too long spent with an overly packed schedule depresses me. Letting the day begin spontaneously reminds me of my years in Paraguay. In Paraguay, most days flowed in a semi-planned way. My life was free in Paraguay. Even though I had work, obligations, and social activities in the Peace Corps, I’ve never had as much free time during my adult life as I did in the land of the Guarani.

Sometimes, when the sun shimmers into my apartment and my houseplants glow with the joy only photosynthesizing entities have in the sun, I’m transported back to my Paraguay naps and meditations under the shade of the mango trees with the nearby palms swaying in the breeze. On those mental journeys, I’m reminded that quiet is an underappreciated aspect of life. Of course, us humans need purpose and connection to be happy. But every moment needn’t be assigned. The happiest folks I’ve met are those who embrace the slow days when they come, sometimes even setting aside calendar days for nothing. I want to be among the ranks of the happiest people. I think this goal starts with no alarm days. My no alarm days are for basking in the strange meandering that occurs when I decide to let spontaneity determine the agenda.

Today is a no alarm day. The sun is shining. The mate is perfect as the steam curls up from each pour of water over the yerba leaves. The yerba is fresh and so it bubbles. The plants in my house look good. Maybe I’ll water them later because it’s sunny and they’ll need it. Some of my orchids are blooming, some will bloom soon, and some are pondering their future (deciding if they will flourish or die for no reason). My house trees seem tall today. Beyond my plants, through the window, and past the balcony the cranes move. Richmond is constructing several new tall buildings. There are 4 cranes to watch from my balcony. The cars bustle below, sometimes their music is loud. Life continues. I sit. Today is a no alarm day. I’ll probably go for a walk later. But this moment is for drinking mate and observing my plants. What a beautiful moment it is.

The Last Stop on the Bus Line

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I looked out the window. I’d been here before, almost 2 years previously, it was the end of the bus line. Arriving here meant I’d taken the wrong bus. There were several buses with the same number that had overlapping routes but ended in different places. The last time I’d caught this wrong bus was shortly after I moved to my Peace Corps volunteer site in Paraguay. At that time, I was still learning my community and Paraguayan culture. The first time I ended up at this bus line end, I wasn’t sure how I’d get home. The uncertainty made my heart beat faster. I asked the bus driver for directions; he had been able to help. It took several hours but I ended up home, unharmed though slightly frustrated I’d mixed up the buses.

I’d learned so much since I first visited this bus depot accidentally. Since then, Emboscada, Paraguay had become my home. Emboscada was, perhaps, the first place I’d ever lived where I was certain it was home. As the days that added up to the previous two years had unfolded, I’d found a community and made friends. I’d been a schoolteacher and connected with youth over music, English, and dreams. In my Paraguayan community, older friends had died, younger friends had married, and I’d been to parties and celebrations of every variety and magnitude you can imagine.

I looked out the window and I laughed. I was an expert, yet I still took the wrong bus and didn’t realize it until I arrived here at this bus depot. In a few short months I’d leave Paraguay. I’d say “goodbye” to the home I’d found and created. I’d return to my native country and start the Doctorhood Quest. I laughed because arriving at this bus depot wasn’t scary like it had been the first time I ended up here. I knew it would take a few hours to catch the right bus and travel to the bus stop in front of my house. I’d arrive home eventually. My little Paraguayan house would be waiting for me.

This event was about 8 years ago, yet I’ve found myself thinking about it a lot recently. I’ve been reminded of it because I recently turned a page in the Doctorhood Quest that is like what I was turning in my Peace Corps service at that time. I feel settled in my role as a resident physician. I feel comfortable with what kind of doctor I am. I am happy with what I’ve accomplished and look forward to my future goals. I had similar sentiments about my Peace Corps service while I waited for the right bus to pick me up at that last bus stop.

It might seem premature to have such contented feelings about residency. But I know that the remaining 20ish months of residency will be over soon. I have so much to learn in those remaining months. Yet I know I will learn what needs to be learned. For the first time in my journey of becoming a physician, I’m confident that I’m where I need to be. I know how to get home even when I take a wrong turn.

Being an expert isn’t about always catching the right bus, it’s about knowing how to find your way home when you catch the wrong one. It’s about being calm even when things are unexpected. It’s about embracing the journey. It’s about laughing at yourself because experiences that make you grow and challenge you also put you in ridiculous situations.

How ridiculous is it to take the wrong bus after having taken the right one 100s of times? “Quite ridiculous” is the answer. But mistakes are what make us human. We learn from mistakes, even if the lesson is simply a reminder to laugh at ourselves. Life is serious, but not so serious that we can’t appreciate its absurd moments.

35 for 35

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My white hair is coming in faster than ever, but it hasn’t brightened my dark hair yet. It’s only a matter of time before the salt-and-pepper sets in – a signal to the world of the wisdom I’ve gathered. I’ll miss my dark hair when it goes, but I’ll embrace my wise look when it arrives.

When I turned 25, I posted 25 goals for 25. Below I’ve reviewed them, annotated, refreshed, and added to create a new 35 for 35 goals list.

Key:

  • Italic font: the 25 goals I had at 25-years-old
  • Crossed out: 25-years-old goal that I completed
  • Regular font: annotation
  • Bold font: my goals at 35-years-old

35 for 35, listed in no particular order:

  1. Ask for it. Done. REPLACE WITH: Finesse effective negotiation skills. Remember to apply these skills not just when negotiating for others but also when negotiating for myself.
  2. Initiate: Don’t expect someone else to do it. Done. CARRY FORWARD: Initiate: Don’t expect someone else to do it.
  3. Look for opportunities to be helpful. Done. REPLACE WITH: Advocate for underserved and marginalized populations represented within the patient population I serve.
  4. Focus on living in the moment. Note the positive things. Done. CARRY FORWARD: Live in the moment. Note the positive things.
  5. Take time to be thankful. Done. CARRY FORWARD: Take time to be thankful.
  6. Get my novel ready for review. I did this then I threw it out. I have other novel ideas for the future should I wish to pursue that kind of writing again someday. REPLACE WITH: Create a home to call my own. By age 45 that home should include a plot of land.
  7. Rock the GRE. Done plus the MCAT, all my med school exams, STEP 1, STEP 2, and STEP 3. REPLACE WITH: Pass my Internal Medicine board exam on the first try.
  8. Be diligent about journaling. I journaled throughout my time in Paraguay. I lost the habit after I returned to the US until I started residency. I’ve been journaling at least weekly almost since I started residency. UPDATE TO: Journal using daily short snippets and weekly 1-pagers.
  9. Read more. >> I read a lot of medical writing. UPDATE TO: Read more fiction and nonmedical writing.
  10. Focus on health: Eat less sugar. Control portions. >> This is still a goal and a challenge. CARRY FORWARD: Eat less sugar and control portions.
  11. Exercise every day. >> I’ve learned that exercising every day is not necessary or realistic. Exercise is, however, essential for health. Anything related to health is especially hard during residency. My current hypothesis is that residency shortens one’s life expectancy. I’m trying to dampen residency’s effect on me. I’m also trying to be healthy in general. UPDATE TO: Exercise multiple times weekly such that I feel healthy and strong.
  12. Publish consistently on Connecting the Dots. Rocking it. Hit 10 years blogging in 2023. So far, my blog has documented my entire Peace Corps service, my premedical studies and getting into medical school, medical school, and now it’s recording my thoughts as I chip away at residency. CARRY FORWARD: Publish consistently on Connecting the Dots.
  13. Learn Guaraní. >> I know some phrases, never did become fluent. Learned the important words for me. If I return to live in Paraguay I will reactivate this goal. REPLACE WITH: Stay current on the latest medical information relevant to my practice as a physician. Review uncommon and complex topics periodically to keep them on my differential and understanding.
  14. Become fluent in Castellano. >> I made great strides while in Paraguay. I’ve used so much energy to learn medicine since I returned to the US that I’ve lost some of my Spanish. UPDATE TO: Practice and study Spanish to achieve better fluency with a focus on medical Spanish.
  15. Stay in touch with my US network. Now I have an international network which evolves and changes like all living things do. REPLACE WITH: Create more opportunities to connect with family and friends.
  16. Reach out to friends in Paraguay; don’t always go it alone. Done. Remember that time I lost my key in Paraguay? I didn’t have water and needed a shower in Paraguay? Got an upset stomach and asked my Paraguayan friends for the right herb to sooth my stomach? REPLACE WITH: Get involved in several activities/organizations to diversify how I spend my time and to meet like-minded people.
  17. Hone patience. Done. REPLACE WITH: Work on calm, clarity, and patience in the setting of becoming a better teacher of medicine.
  18. Smile more. Done. REPLACE WITH: Take at least one international vacation yearly. Travel abroad as much as is possible.
  19. Learn biology, chemistry, and math. Done. I also learned medicine. REPLACE WITH: Learn to identify more local plants, trees, and birds.
  20. Make listening to podcasts part of my routine. >> I like this idea, but I don’t think it will ever happen given how I live my life. REPLACE WITH: Learn about herbal medicine and explore what role alternative medicines play in helping my patients achieve their health goals.
  21. Solidify a positive self-image. Done. Seems like forever since this was a challenge. REPLACE WITH: Push myself to learn about people who are different than me to expand my horizons and to understand others better.
  22. Listen to understand, not to respond. Done. CARRY FORWARD: Listen to understand, not to respond.
  23. Share more. Done. REPLACE WITH: Protect time to be quiet and reflect.
  24. Let the little things go. Done. CARRY FORWARD: Let the little things go.
  25. Ask more questions. Done. REPLACE WITH: Remain curious. When things become routine remember to be curious about new ways, new views, and new opportunities.
  26. Explore every national park in the US.
  27. Hike the length of Chile (chunking it is fine, though it’d be cool to do it in one go).
  28. Hike the PCT (chunking it is fine).
  29. Visit every state in the US. A visit is defined as: at least 24 hours with 3 meals, one night stay, and at least one activity other than travel.
  30. Explore every country in Central and South America that is reasonably safe for US citizens to visit.
  31. Start traveling to countries in Asia and Africa.
  32. Retrace Darwin’s path on the Beagle.
  33. Cultivate my nuclear family – which will metamorphose as time unfolds.
  34. Attain financial independence by age 55.
  35. Stay open to opportunities in my career. Push myself. Be brave enough to change and adjust as my goals and priorities evolve.

The Doctor’s Dilemma

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Being a physician is a career that can become one’s life. There are many reasons for this including the 24/7 need for healthcare, the pressure from healthcare business for productivity, the need for advocacy to improve the system and increase health equity, and the desire to help others. There is also the added stress that medicine literally deals with people’s lives and wellbeing. Given these career features, being a physician historically was a way of life, not just a job.

Despite the historical trend that being a physician was a way of life and an identity that trumped all others, there has been a shift in recent years. This shift started some time ago and was, perhaps, expedited by the COVID-19 pandemic and the severe toll it took on all healthcare workers. The shift is that newer ages of physicians don’t just seek to be doctors – they seek to be partners, parents, athletes, cooks, travelers, readers, vacationers, relaxers, and gardeners to name a few identities they claim beyond the physician identity.

As a member of the newest generation of physicians I find myself caught between the old dogma that to be a physician is to prioritize it above all other aspects of life with the newer view that to be a physician is to be a person with a serious career. I think of these completing identities of “way of life” vs “profession” as the “doctor’s dilemma.”

Sometimes self-imposed and sometimes externally-imposed the training physician (and all physicians really) are driven to do more. More reading and learning, more shifts, more leadership roles, and more research. It’s hard to balance the forces urging me to do more with the desire to also do nonmedical things like spend time with my husband, hike, and write. My medical training has taught me to hustle, be efficient, and work for long durations of time with high focus. As my training continues, I’m also learning how to say “no” and pump the break. Of course, these learnings are contradictory. The pendulum falls sometimes more on the hustle side and sometimes more on the relax side.

As I finish my 1st year of residency, I’ve been thinking about the doctor’s dilemma because in the remaining years of residency I’ll make decisions about my post-residency career path. While I contemplate my career’s trajectory, I also find myself thinking about other things in life. For example, living in a city apartment has made me miss walking barefoot on grass. I don’t suspect I’ll own a house anytime soon, but missing grass has made me think about homeownership more than ever before.

What do I put on hold and what do I pursue? What opportunities if not taken now will disappear? Where do I want to be in 5 years?

While wellness preaches “live in the moment” heavy careers, like doctorhood, require forward thought. Doctorhood requires the balance and blend of one’s professional dreams and identity with one’s personal dreams and identity. During my 2nd year of residency, I’ll become a team leader and gain more independence. With this greater responsibility doctorhood feels more serious than it did as a new resident when I had more people guiding me. As my training continues, it is my turn to step up with the answers. Patients will depend on me. Each choice, like whether to study or run, has a ripple effect on my future and (perhaps) on my patients’ futures. There simply isn’t enough time to “do it all” at the same time. Choices must be made along the way. The choice options are what pose the dilemma.

Springtime in Richmond

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The ospreys are back on the Richmond James River marking the arrival of spring in this city that sits at the hub of Virginia’s highways. Match Day, a different mark of spring, took place earlier this month. It always falls in March, an odd kind of Ides of March. This year, with that phase of the Doctorhood Quest behind me, I was unaffected by it. My Match Day will forever dwell on St. Patrick’s Day of 2023. That’s the day I found out I was moving to Richmond.

It was about this time last year when I saw Richmond for the first time. We visited the city only a week or so after Match Day to look at apartments. We wanted to move to our new home as soon as we could. I liked Richmond instantly. I’ve visited enough places and lived in enough more to know, as a gut feeling, if a place I visit is a place I could live happily. I had that sense about Richmond.

Spring is always a transition season but since I started the Doctorhood Quest it has come to mark additional important transitions that didn’t exist in my pre-doctor world. As I write this, I’m three-quarters of the way through my first year of residency (or one seventh through the whole thing). Residency years start on July 1, meaning that as spring slides into summer it marks the closing of one year and the opening of another year in residency. Residency years are hard years. As happy as I was last March when I transitioned from medical school for residency, I am enthusiastic to leave my first year of residency behind for the second year.

The seasons of my first year of residency almost followed the seasons as I knew them when I lived in Vermont. Summer was a glowing time when everything seemed possible because the leaves were new and vibrant; the sun stuck around longest. Fall was my favorite season because by that time the year was familiar; the weather was perfect. Winter was dark and gloomy; it was hard to understand why the world didn’t pause the whole season to drink mate and eat chocolate. Spring came with new hope and new beginnings.

With the ospreys back on the river and a recent vacation behind me, I’m excited to embrace spring. I love the ospreys and was so disheartened to learn last fall that they left for the winter. In Richmond there are numerous walking bridges across the James River from which you can see osprey nests and watch them hover-dive-catch fish. This spring marks a year living in Richmond and a year since graduating medical school.

Comparing this spring to last spring, I know the parks of Virginia way better now and so plotting my days off has become more exciting. And, more down to business, I’ve learned so much about medicine and how to be a doctor. The Doctorhood Quest continues just as the seasons march along unwaveringly. Year two of residency will be a time to develop independence and hone my knowledge. Internal medicine residency is three long years. So, I have two springs left before I get to confidently say I’m ready to work independently as a physician. Two more springs of celebrating the ospreys’ return as a resident. Then we’ll see where the Doctorhood Quest sends me. Perhaps I’ll also celebrate the James River ospreys as an independent physician too; only time will tell where I am three springs from now.  

Sights Set on 2024

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Stopping by Woods on a Snowy Evening

By Robert Frost

Whose woods these are I think I know.  

His house is in the village though;  

He will not see me stopping here  

To watch his woods fill up with snow.  

My little horse must think it queer  

To stop without a farmhouse near  

Between the woods and frozen lake  

The darkest evening of the year.  

He gives his harness bells a shake  

To ask if there is some mistake.  

The only other sound’s the sweep  

Of easy wind and downy flake.  

The woods are lovely, dark and deep,  

But I have promises to keep,  

And miles to go before I sleep,  

And miles to go before I sleep.

2023 was a year of change. My themes of focus were quietness, absorption, and forward movement. I wrapped up medical school, moved halfway down the East Coast, and started residency. Despite all the professional development, I enjoyed a 7-week adventure in Puerto Rico, visited Paraguay, hiked the 33 highest peaks in the Catskill Mountains of New York, and undertook other small hiking/traveling/outdoor excursions as the opportunity arose.

Residency leaves me tired and overworked, but my progress toward becoming the doctor I wish to be is rapid. On one hand, Frost’s line “miles to go before I sleep” is a literal interpretation of what I expect 2024 to bring professionally. I have many professional goals which will march along as the days pass. On the other hand, the “stopping by woods on a snowy evening” part of Frost’s poem (pausing in an unusual place), resonates with me as I think about my personal goals and themes for 2024. As I set my sights on 2024, three themes are on my mind: quietness, pause, and connectivity. It’ll be a year where I focus on personal health.

Quietness

This was also my first theme in 2023. I’m carrying it forward both because I think it is of utmost importance and because I still have growth to achieve in this area. Being a doctor and learning to become a better doctor involves constant stimulation and 1000s of decisions daily. Adult life is full of challenges including finances (bills and earnings), home management, and unexpected disruptions like illness. With so much happening, I find that it’s easy to get lost in the hullabaloo and lose track of my inner calmness. As the unexpected challenges of 2024 unfold, I will continue to cultivate my inner quietness because I believe it is at the core of resilience and central to success.

Pause

Related to quietness, my second theme is pause. As the hustle of life unfolds, I easily forget to stop to appreciate small and large successes and delights. In 2024, I will take time to pause so I can absorb the joys of life. Focusing on joy will train my mind to see the positive and diminish the negative.  

Connectivity

The aspect of connectivity I plan to focus on in 2024 is the mind-body connection. My medical training has been extremely demanding in multiple ways. I have watched my health decline as the doctorhood quest unfolds because of my schedule, external pressures of doctorhood and the healthcare system, and the stress of my work. While my medical training will remain vigorous throughout 2024 and beyond, in 2024, I plan to focus my free time and energy on re-cultivating my physical wellbeing. This focus on physical health combined with my focus on quietness and pause will strengthen my mind-body connection. I think cultivating my own mind-body connection will ground me as I seek to connect with my patients, colleagues, family, and friends.

10 Years Blogging

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September 2023 marks 10 years of my blog Connecting the Dots. I started the blog in 2013 to document my experience in the Peace Corps in Paraguay. When I finished my Peace Corps service in April 2016, I had already formed the habit of writing and decided to keep going to share my experience of becoming a physician. Some months and years I’ve written more than others as my life unfolded this past decade. My blog has documented my time in post-bacc and as an EMT as I strived to build a resume strong enough to get into medical school. The blog was a constant as I trudged my way through 4 years of medical school. And now, after 10 years blogging, I’m 2 months into residency.

I’ve periodically wondered if I should stop blogging. Life reflection/journal blogs like mine aren’t designed to become highly successful or business ventures like other types of more broadly relevant blogs. But I keep blogging both out of a love for the writing process and because my journey has been a unique one. I suppose a key lesson that the Peace Corps and then medicine have taught me is that every human has a one-of-a-kind story that if given the opportunity to be documented as a movie or book could be the next blockbuster/best seller. Most folks, however, will lead their amazing lives and die without much of a trace. My posts about people I’ve met and lessons I’ve learned are my way of remembering all the lives I’ve intersected with as I trundle along my life journey.

The warm welcome I received in Paraguay as a Peace Corps volunteer gave me an opportunity to learn about a culture different from my own and to make life-long friends with individuals who I could not have imagined if I never did the Peace Corps. Similarly, the experience of being a doctor gives me a window into countless lives that are nothing like my own. Medicine, above all, has taught me that there is nothing as fantastic, comical, tragic, beautiful, and surprising as real people’s stories. I’m often reminded that as outlandish as any fiction story might be, reality is more extra and harder to believe.

Just like when I started my blog 10 years ago, I don’t know where I’ll be in 10 years. Reading some of my first posts, it is amazing to me how far I’ve come. I’m sure the next decade will be equally full of surprises. I can’t wait to reflect on the inevitable unforeseen events to come and then write about the highlights.

To those who have read my blog for a while, thank you for your unwavering support. To new readers, thanks for stopping by to sample and for considering future readership.  

Here are some of my favorite posts over the years (I’ve left many out for brevity):

Getting Ready for Departure – DC Chapter, 12/8/2013, on leaving DC, the city I went to undergrad and built my first career, for the Peace Corps

Getting Ready for Departure – DC Chapter

Ideal Boyfriend, Ideal Girlfriend, 11/10/2014, quotes from the 7th – 12th graders I taught in Paraguay describing their ideal life partners

Ideal Boyfriend, Ideal Girlfriend

White, 12/12/2014, on being the only white person in my Paraguayan community

White

Crosses in the Sand, 8/6/2015, on a uniquely Paraguayan form of ant control

Crosses in the Sand

Overheard In Paraguay: Friendship, 10/19/2015, on friendship that last forever

Overheard In Paraguay: Friendship

Guardian Angel, 1/23/2016, on feeling cared for

Guardian Angel

See You Soon Dearest Paraguay, 4/11/2016, on finishing my Peace Corps service in Paraguay

See You Soon Dearest Paraguay

Determination: 2 Girls, 1 Hill, 1 Tree, and 1 Ladder, 11/12/2017, on childhood and the nature of determination

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

Christof, 6/25/2018, on kindness and thinking of others

Christof

Below the Surface, 12/28/2018, on returning to Paraguay and learning an unexpected lesson

Below the Surface

Q-tips and Time, 5/16/2019, on how our perception of time changes as we age

Q-tips and Time

True Love, 7/27/2019, on true love as witnessed in the ED

True Love

Memory, 5/24/2020, on thinking about how memory works

Memory

Goodbye For Now Vermont, 3/21/2021, on moving out of Vermont (again) and reflecting on my time there

Goodbye For Now Vermont

A Cup of Coffee, 10/24/2021, on acts of kindness witnessed in the hospital

A Cup of Coffee

Together,  1/7/2022, on working as part of a diverse medical team

Together

Echoes from the Third of Medical School, 4/12/2022, on finishing my third year of medical school

Echoes from the Third of Medical School

Windows to the Soul, 9/6/2022, on caring for critically ill patients

Windows to the Soul

Nothing to Do but Be Happy, 2/14/2023, on waiting for medical school to end while spending a few months in Puerto Rico

Nothing to Do but Be Happy

Goodbye Danbury, 4/15/2023, on my time in Connecticut

Goodbye Danbury, CT

What do you want to be when you grow up?, 5/25/2023, on becoming a physician

What do you want to be when you grow up?