Tag Archives: Development

Hello 2025

Posted on by

The Red Wheelbarrow

By William Carlos Williams

so much depends

upon

a red wheel

barrow

glazed with rain

water

beside the white

chickens

~

2024 was a toilsome year interspersed with joy and success. My themes were quietness, pause, and connectivity. It was the first calendar year spent 100% in residency: the lack of time off, no control over my schedule, and too many hours worked made me weary. Yet, despite these challenges, my year was fulfilling. I took several amazing vacations – a highlight was going to Costa Rica which included a 4-day trek in the mountains. I’ve enjoyed camping, sharing moments with family and friends, and completing my first half-marathon since I started medical school. I added back a few non-medical activities I’d put on hold when I started residency because (back then) I didn’t have the bandwidth for them. It’s exciting to have tangibly more time simply because I’m more efficient than I was in the beginning of residency (hard work paying off). This year I’ve seen my ability as a doctor grow and am proud of my progress. I feel more confident in my clinical decisions and more able to help my patients than ever before. I’ve also started to envision my career after residency – I can’t wait to be an attending physician.

2025 will be the second (and last) complete calendar year of residency. I’ll be halfway through residency on January 1, 2025. On December 31, 2025, I’ll only have 6 months left. 2025 will be a practical year for me. I’m hoping to solidify my medical knowledge and my abilities so I’m ready for residency graduation. By the time I write a post welcoming 2026 it’s highly possible I’ll have a job lined up – amazing how time flies. Yet, while I’ll focus on professional development in 2025, I’ll also work to maximize my life outside of work. On the nonwork side, my focus will be cultivating time with loved ones, embracing non-medical pursuits, and spending as much time outdoors as possible. My themes for 2025 are curiosity, resilience, and gratitude.

Curiosity

Now that I’m settled in Richmond, residency, and my 30s I’ve found that I’ve fallen into a routine of familiarity. This year I’d like to shake up that routine by jumpstarting curiosity. I’d like to see things through new eyes and challenge myself to answer questions I’ve brushed aside because they aren’t central to my daily trudge. I’d like to dig deeper and challenge myself to learn and do new things.

Resilience

Residency is hard and I feel worn down. Further, I find the negative aspects of healthcare sit heavily –examples are healthcare’s money focus and its inequity. When I’m baseline tired because of work I find it hard to flourish in non-professional aspects of life. I think 2025 is a good year to acknowledge how hard residency is and find ways to turn its challenges into strengths. While I don’t have the energy or time to do everything I’d like – I have so many opportunities. I think working as a doctor is a privilege because it allows me to touch people’s lives. I’d like to take 2025 to emphasize the good things residency offers. These good things won’t make up for the negatives but focusing on the good will help me remember that incredible growth occurs during challenging times.

Gratitude

In 2025 I’d like to take more time to be grateful. I’ve achieved my dream – I’m a doctor. I have an amazing husband, a lovely home, and a sunny place to be. It’s easy to forget to be grateful when I’m busy. I’m looking forward to carving out time for it this year.

The Doctor’s Dilemma

Posted on by

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.

Sights Set on 2024

Posted on by

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.

The Social Determinants of Health

Posted on by

I was walking home from a series of hard shifts. My mind slid back to the first code I ever worked. “Code” is medical slang for when you do CPR and try to get someone’s heart to start again after it stops. My first code was a trauma-code. The story was that the patient lost a literal game of Russian roulette. The injury they had from the close-range bullet was not compatible with life. But the patient was young and when their heart stopped, the doctor overseeing the case didn’t pronounce them dead right away. Their heart didn’t respond to CPR; they died.  

That code was years ago. I hadn’t thought about it too much since it happened. Medicine is full of sad stories. I was surprised that the memory of the code entered my thoughts as I walked home. I wondered why I was thinking of it. I realized quickly: I was angry.

I don’t often get angry when working in medicine. The more common emotions I have on the job are excited, interested, happy, annoyed, exhausted, and sad – sometimes within the same interaction. I’ve only been angry a few times in my ever-lengthening medical career. I wasn’t angry at my first code, so why had I thought of it when I was angry?

On that day when I remembered my first code, I had cared for a patient who was dying of advanced heart failure even though they had the unblemished skin of youth. At first it would seem my current patient and the patient who died during my first code had nothing in common except an early death. But as I thought about it, I realized that they had more in common than it seemed at first.

Both patients would die harsh deaths. The code was fast, and the heart failure would be slow. And while both patients had easily observable health conditions, I found myself wondering if they were dying of those conditions or if they were dying because they were victims of something much greater. Could their deaths have been avoided if society hadn’t pushed them down so many times in their short lives? Were they dying of disease or of the social determinants of health?

The social determinants of health are non-medical factors that influence health; they’re the social and structural realities that shape how people interact and live. The social determinants of health include access to education, food, and secure housing. They include neighborhood exposures (the positive like puppies and playgrounds and the negative like violence and drug misuse). They include skin color, first language, sex, and gender. The list goes on.

I was angry because there was nothing more I could do for the patient with heart failure, just as there had been nothing more I could do for the young patient whose heart stopped all those years ago. Society had failed them. Collectively the two patients had experienced racism, the jail system, drug use disorder, mental health struggles, unfair treatment by employers, barriers to education, and likely countless other obstacles that I did not uncover during my short interactions with them. The patient dying of heart failure was difficult. They didn’t trust the healthcare system and they were profoundly unpleasant to work with. As I learned more about their story, I came to understand that while it is never okay to be mean it is also sometimes easy to see why a person could become mean. This patient had been knocked down so many times throughout their short life that it seemed all they knew how to do was fight. And, unfortunately, they were fighting for their life. And while they had not yet acknowledged it, they were losing. Would it be months before they died? Maybe a year or two because they were young? Maybe they’d be a miracle case and live much longer. I, however, don’t count on miracles.

I was angry because I thought the healthcare system was the last part of society to fail my patient with heart failure. I (and my team) tried to build a case to make them eligible for advanced heart failure treatments, all of which have strict criteria. The criteria are strict because all advanced therapies for heart failure are complex and require incredible collaboration between the patient and their care team, otherwise they fail to work. Among the options for some patients (not all) is heart transplant which has even stricter criteria because organs are scarce. In the end, the patient I was caring for was deemed not a candidate for any advanced therapies. They were not a candidate because they showed a consistent record of disregarding medical advice and missing their follow up medical appointments and prescribed medications.

After days of long conversations with the young patient with heart failure I understood that it wasn’t just personality that drove them to fight against medical advice. It was a fear of death, a desire for independence, and a long history of mistrust built on a life of the system failing them. There were many negative social determinants of health which had worked against them their whole life. I was angry because what is done can’t be undone. Just as death cannot be stopped when it comes calling. It’s unfair when and how death calls; it’s a metaphorical game of Russian roulette.

Being angry about the social determinants of health doesn’t solve them, but sometimes being angry is a place to start. And so, on that walk home and for a little while after, I let myself be angry. Part of writing this post was sorting out why I was angry. The next step is figuring out what can be done to address the social determinants of health. They are numerous and complex so there isn’t one solution and they’re slow to change. The young patient with heart failure reminded me that while I’m focusing on learning the science of medicine right now, I can’t forget the public health and community work I did before I jumped into residency. I can’t forget because when I’m an independently working physician, my patients won’t come to me with just disease. They will come to me with life stories that influence every aspect of their medical care.

10 Years Blogging

Posted on by

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?

The Happy Stillness Between

Posted on by

I find myself sipping mate and gazing over my desk and plants out at a new skyline. Several days ago, I moved to Richmond, VA from Danbury, CT. The move was a grueling 28-hours of loading the truck, driving overnight, and unloading the truck. My partner and I took only a 30-minute nap to get us through the driving, knowing that there are an infinite number of less tiring ways to move, we wanted it done as quickly as possible. Our main hiccup was finding a way to navigate the ~400 miles along the East Coast on highways that allowed trucks because our U-Haul was quite robust. We learned that there is no setting on Google maps for truck routes. Luckily, we know how to read maps despite the prevalence of technology in our lives and found a route using our brains, yes unusual.

We’re mostly unpacked now, just a few more projects to do before we will be completely settled. We’re chipping away at these tasks, such as hanging paintings and donating no-longer needed items. Knowing our apartment is in a good place, my focus has shifted to the next adventure. Later this week we travel to Paraguay to visit my friends there. It’ll be my partner’s first time to the country where I did the Peace Corps and where my mind always wanders when time slows. Slow as it is now.

Medical school, at least as it is organized at my school, is a sprint that comes to a halt not at graduation but at Match Day, several months before graduation. It’s not a bad system. It leaves time for vacation and residency onboarding tasks while also giving us students a moment to enjoy non-medical pursuits before we plunge into the rigors of residency. But, when one is accustomed to a sprint too fast to breathe, as those of us in medical school are, the slowness of these days between Match Day and residency is as strange as a journey to a new, very different country. I’ve read more books for fun these past few months than I have in years. I’ve hiked and slept and pondered life. I started baking again, something I hadn’t done since I returned to the US from Paraguay in 2016. I’ve planned trips and moved.

I wanted to come to Richmond early, many of my peers won’t move to their residency locations until weeks prior to our start date this summer. I’m a person who centers at home, regardless of how new the home is to me. I like moving, but I also like time to settle before I’m expected to excel in life pursuits. I like time to find the grocery store and walk the neighborhoods that’ll be my stomping ground. Yesterday I did both of those things – I found a grocery store which had nice spinach (the primary way I grade grocery stores) and I strolled through a giant cemetery not far from my house with trees that had new, full leaves and singing birds.

It’s beautiful in Richmond and the politeness of the South is a welcome kindness after living in New England for years. New Englanders don’t, for example, say “hi” when you pass them on the street in a city or let you cross the street without threatening to run you over, even though there’s a red light for oncoming traffic. I’m too new to Richmond to have major complaints, but so far, the things that bothered me in Connecticut aren’t present to the same extent. I do admit, I’m not used to having streets named after important people from the Confederacy. I don’t yet fully understand how those imposing names from the past will impact my life though I know they already do and will in new ways here.

Richmond is green and quiet for a city. My apartment is high up without taller buildings around it. It has ample windows. What this means is that I’m surrounded by sun and have a stunning view of the sky. My few days living in Richmond have taught me that it’s a place of expressive skies – which is something I always loved about Paraguay too. The clouds cross the sky with bright colors and exciting shapes. The morning, afternoon, and evening look different in the clouds and sky of Richmond. My apartment, specifically, has a magnificent view of the sunset.

I lived in Washington, DC for 6 years before I did the Peace Corps. And while Richmond is distinct from DC, coming back to the DC-VA-MD area feels like returning home. I’m happy to be back. I’m happy to have arrived when the weather is absolutely perfect, just before the humidity and heat of the summer set in. I have about a month to explore Richmond before I start work. Richmond feels completely different from Vermont or Connecticut. I’m happy to uncover the opportunities hidden in this new place. Opportunity to learn to be an excellent doctor but, also, opportunities to explore life beyond medicine. I’m excited to reconnect with the urban passions I have and to find new ones that suit me in a green, urban home. And small mountains aren’t too far away in Shenandoah. I’m grateful for the slowness of these days so that I can sit with my happiness. Life has taught me that, much like sorrow, complete happiness is fleeting. So, I’m pleased to have time to revel in this happiness storm until the next emotion rolls in.

Joy

Posted on by

I most remember his rosy cheeks. The humidity and mosquitos hummed around us. We held hands under the shade of widely spaced trees in ferns as tall as our waists beside a beaver pond. There would be many moments I’d attempt to remember from our wedding day – etching them into my memory, writing them down play-by-play in my Spanish journal, and waiting giddily for our photographer to finally send us our photos. But, in those moments between words, I thought about how warm my cheeks felt and how rosy his cheeks were and how it was likely that my cheeks were rosy too.

I was joyful. Some cry when they’re overwhelmed with happiness, but that’s never been me. Happiness spreads across my skin like sinking into a warm swimming hole. The warmth then soaks into my core whereby settling my heart and obscuring all the things that normally zoom through my mind. Happiness is quiet. Contentment. Nothing but his rosy cheeks and my rosy cheeks on our wedding day.

The bright sunlight flickered through the canopy above alighting on my sister, who was our officiant, and our guests. The guests sat amongst the ferns as you might imagine in a scene from A Midsummer Night’s Dream. It seemed fitting that the cupcake shelves hanging from a birdfeeder hook and the brightly colored attire of the wedding guests would float across my mind like a scene from a play. As I gazed at the ferns, I realized that this was my midsummer dream. To make official what my partner and I already knew. These moments would give our relationship a label society understood. But despite the label, he and I knew that no one could truly understand what we meant because every relationship is its own unique product of its unique makers.

Which brings me back to his rosy cheeks. He was wearing his finest suit and the fanciest shoes you’ve possibly ever seen.  The paisley on his shoes and the paisley on his tie had nothing but their name in common, but they each worked well with the stripes of his suit. His tufty blond hair curled above his sparkling eyes and his cheeks were flushed because we were outside, because we had walked through the forest to get here, and because it was a hot midsummer day.

I thought briefly about our guests, the witnesses to the words we were saying. They were the people who had played the biggest roles in our lives since we became a couple. I listened to the words my sister said, then he said, and then I said. We had all thought about, written down, and practiced what we were going to say. Yet, it seemed more improv than rehearsed lines. How could any of us have imagined exactly how this moment would be? We couldn’t. There’s delight in comfortable spontaneity. As I replay those moments now, the rosiness returns. The memory is one of the clearest definitions I have of joy.

The False Limitations We Put on Despair and Happiness

Posted on by

The pit of despair and the pool of happiness are bottomless. Which means you and I can both suffer and revel in glee to any degree without limiting the pain and joy of others.  

My partner works in the emergency department (ED) and I used to work there too (that’s where we met). From time to time, our non-healthcare friends will ask, “So if I have to go to the ED, what should I say so my wait is shorter?” When this classic question is asked, my partner and I glance at each other and smirk. Anyone who has worked in the ED can tell you that you don’t want to be the first person to go back to a room from the waiting room…because the people who don’t have a wait are the people most likely to never walk out of the hospital.

No one wants to go to the hospital. It is miserable to be there as a patient. But, let’s say you go to the ED because you broke your arm skiing. Your arm is painful. The friend who accompanied you to the hospital is desperately trying to help you stay calm while also struggling to maintain their own composure because the odd angle of your arm makes them sick to their stomach. While you and your friend wait in the ED, there are others who have been in the hospital for days and there are some who have been there moments; in each of these groups of patients there are people who will die during their hospital stay. I tell you this not to diminish the suffering of your broken arm. I tell you simply to say that we don’t suffer alone. Your broken arm is not made less painful by the heart attack and death of Mr. Doe that occurred while you waited in the ED, but his death might remind you that we do not all suffer to the same degree during a particular patch of time.

The same goes for happiness. Some of the joys of this COVID era are the baby announcements, the engagements, the house improvements finally complete, the adopted fuzzy friends, and the fitness goals achieved. My social media feeds are full of cute kittens, puppies, and shiny rings. One of the things I love about all these great landmarks in my friends’ lives is that the engagement of one friend does not detract from the puppy adoption of another. It turns out that my friend with a fiancé can be dreamy about their forever while my other friend can melt with love for their new puppy.

I think the infinity of the pit of despair and the pool of happiness are important to keep in mind. You can take as much as humanly possible from both or either and there will still be a limitless amount for the next person. Not many things in life are that way.

Since the COVID pandemic started and the death of George Floyd there has been arguing among individuals and over the news about the validity and gravity of the pain and inequity experienced by different groups in America. The argument goes some like, “I’ve also had a hard life. I’ve suffered from injustice. So, I don’t see why their hardship and the inequity they face is special.”

The suffering you’ve faced does not neutralize the suffering of others. The suffering you’ve experienced does not lessen the burden of suffering for the rest of humanity. Suffering and happiness have no bounds. The argument for equity is not that your suffering does not matter. Your suffering does matter. The argument for equity is that the systems we’ve developed so far to organize our government, personal lives, education, and work make it harder for certain people to access the pool of happiness while at the same time making the pit of despair easier to fall into. The underpinning of equity is simply that there should be no gatekeeper to happiness and no funnel to despair and, therefore, where they exist they should be eliminated.

Betrayal

Posted on by

I didn’t cry but my heart was heavy in November 2016 when I carefully folded up the American flag I’d always hung in my room and placed it safely in a box, making sure it never touched the ground. I folded it the way my father had taught me, which was the way his father (WWII and Korean war veteran) had taught him. As I folded the flag, I looked for tatters suggesting it needed a proper retirement—it didn’t. I swore that I would not hang the flag again until my country made me proud. Until my country no longer betrayed the promises on which it was founded.

The election in 2016 felt different than the others I’d experienced. There was a pit in my stomach about the future after November 2016 even though as a dreamer I am always hopeful about the future. It was uncharacteristic of me to care much about politics. I felt heavy. I told myself to wait and see how things unfolded. I told myself that US institutions were strong so it was unlikely that much would really change.

I was raised to believe the reality of the American dream. I took it as actuality that you could do anything and be anyone if you tried hard enough. However, as I grew older, I came to wonder if that was actually true.

My skepticism of the American dream increased as I worked through college. We all have our own challenges, but it’s hard not to notice how easy it is for rich kids to do unpaid internships and lead organizations that set them up for great success after graduation while poor kids work and try to fit in the internships and organization memberships they know are key to getting their dream job. That’s if the poor kids were lucky enough to go to college at all.

This year I no longer question the American dream because the beat of the American dream fell silent as a heart monitor goes flat when a heart stops forever. What took the place of my old belief that in America hard work is rewarded and anyone can pull themselves up by their bootstraps was a bitter taste. The bitterness was a truth I’d always known but refused to look in the eye: the American dream is an illusion. We don’t all have an equal crack at reaching our dreams. Some of us can climb, but the journey is largely about luck. Hard work pays, but being born the privileged sex and gender, class, and color pays more.

In the past 4 years I’ve seen America steal children from their families and put them in cages and call it justice. I’ve seen men supported and allowed to take positions of power despite overwhelming evidence that they had sexually abused women. I’ve seen the armed forces deployed against citizens, and I’ve seen military members accept that deployment.

I’ve seen so many people of color jailed and killed in the name of justice we could erect a memorial like that to the Vietnam War on the National Mall with their names and it would be more impressive than any war memorial. Just like for the soldiers who died in Vietnam, the people who were killed for their skin would have their names written on panels of black stone. Roses and notes would rest at the panels’ base, a tribute to the years the humans named there weren’t allowed to live and to the loved ones who miss them. When I lived in DC I visited the National Mall and Arlington Cemetery often. I visited these war memorials because it seemed the worst fate was to die and be forgotten. To have your name unspoken and your life discredited.

I’ve seen open fire on people in schools, places of prayer, and movie theaters. I’ve seen cities stopped by a pandemic, a virus that continues to kill and, yet, Americans would rather endanger grandmothers and grandfathers (possibly murder them with their breath) before wearing a mask.

I’ve seen taking part in global organizations and dialogue, environment protection, and offering refuge from persecution declared as no longer American.

Every time I’m bold enough to open the news I see more evidence that the American dream is not only dead but was never alive. Have we always been so cruel and hateful toward people different from us?

And I am angry. I know anger accomplishes nothing. Yet, as it becomes clearer how far America is from a country whose flag I’d proudly wave, I am angry and weary. I’m angry because so many of the horrors we’re seeing unfold today have always been there unaddressed. I’m angry because those in the highest places of power are clinging to the status quo which is one where only a select few are favored. I’m angry because the institutions I thought I could trust are weak.

Somehow, in the middle of a pandemic that has killed many globally and protests demanding equity long overdue, we must continue to live our lives. To love, work, study, and play. In some ways it is so easy to continue as if life were normal, even though 2020 has exposed many things that need our attention. Despite the desire and freedom to ignore what has been exposed this year, it would be an error to pretend that everything is okay. Should we choose to punt addressing our problems to a distant future, then it is not just the American dream but also America that has died. America is a place where all people have the right to life, liberty, and the pursuit of happiness and our country isn’t there yet.

I can’t help but reflect on how my life in a rural town is so different from that of someone living in NYC were people died in droves from COVID-19 and more people than the population of my hometown marched the streets to protest violence and inequity these past months. And just the tranquility of my life this year compared to many of the lives led by NYC dwellers illustrates how far we have to go to ensure that we all have a crack at life, liberty, and happiness.

As I slide closer to my second year of medical school, I continue to wonder what more I can do and what my role is in making America a place I’m proud to call home. When I think of action I am less angry, still weary, and very determined that though it will be a long journey, I might fly my country’s flag again. And while I don’t think I’ll live to see the American dream feel real again, I hope that we will lift ourselves closer to a society where every person is judged more for their work and kindness and less by factors present at birth such as the wealth of their parents and the color of their skin. I think if we can move forward, change, then we might call ourselves Americans with the meaning the American dream implied.

Friendship as a Trendline

Posted on by

When I was young and going through a rough patch with one friend or another, my mother always told me friendships go in waves. Sometimes you’re high on them, doing the most exciting things and seeing each other all the time. Sometimes it’s as though you don’t know each other (except you do, because you remember all the times that are past). I knew she was right, but when I was young I hadn’t had friends for long enough to see what she meant.

These days I’m not old, but I have friends who have been in my life for over 20 years and new ones who just arrived. Each friendship is different; the relationship components undulate as ocean waves do—always the same motion (hi…bye), never the same content (what is said and done, where and when we encounter). It’s only the movement, up and down, that’s constant over these relationships and across relationships.

When I think about friendships as waves, I envision the trendline as straight across with a sine wave tracing the points of each friendship. If you plot every friendship on the same graph, some will have wide peaks and dips, some will have steeper and more frequent slopes. But, regardless of the shape of each wave, when you follow the trendline as a representation of your life unfolding, you find that your time has been filled with moments shared with people you enjoy. Despite all the movement—especially the absences of certain individuals at certain times—you are surrounded by people you consider friends most of the time. In this way, the trendline makes you unshakable when one friendship wave becomes an outliner by dipping too low or dropping off the graph completely. And, also, it’s the trendline that helps you steady yourself if a friend becomes a partner and their friendship wave falls into phase (in sync) with your life wave magnifying your own emotional ups and downs.

For me, the visual of friends as waves (like an ocean view) takes a lot of the pressure off each moment because it makes me see them as part of something larger. It’s reassuring to realize that I can enjoy each crest before it crashes on the literal or metaphorical beach because it will be followed by others.