Humility

People often seek out stimuli for specific emotions. They watch horror movies to feel fear, volunteer at a soup kitchen to feel altruism, dress up to feel sexy, or attend church to feel pious. However, most don't go about looking to feel humility. It is a rarely sought experience. I, for one, did not go to the ER today to tag along with the doctors there, intending to be humbled.

I was hanging out in the doctors' room, listening to the banter and waiting for something interesting to happen. The kind of talk that ER doctors partake in is very similar to firehouse banter. It must be a function of being privvy to the nastiest, most private, raw aspects of a patient's life. I think the irreverence with which doctors and firefighters/medics alike talk about patients is refreshing. It is a welcome departure from political correctness. The particular story that one doctor was telling was about a fellow who came in after a car crash, fully strapped to a board with his neck in a collar and utterly unable to move. The doctor went into the room a while later to examine the patient, and found someone standing at the foot of the bed, but with her head bobbing up and down under the sheets. The patient, seeing the doctor in the doorway, cleared his throat, and the bobbing stopped. Everything was still for a moment, then as the doctor decided the patient could wait and turned to leave, the bobbing started again.

As the laughter died down, one of the doctors asked if I wanted to see a "really nasty abcess." I perked up, "Sure!" and we headed off. A Latino woman was the lucky bearer of this malady. She could have been the sister of my aunt's housekeeper, who I used to help fold laundry because I was uncomfortable with the idea of someone cleaning my stuff in servitude. I nearly asked the patient if she was related to her, the resemblance was so similar. She was in the ER because she had an abcess under her armpit, on the side of her chest. The abcess was about the size of my fist in diameter, angry red, stretching the skin taut, and oozing pus. I had seen abcesses before, and they always looked like they were very painful. They are usually from shooting up dirty drugs under the skin instead of into a vein, where they are supposed to go, but the doctor said that women that speak only Spanish don't do drugs. The men, maybe, or maybe the second generation, but usually not the first generation women: a useful un-PC-ism, an anecdotal, practical truism, that I mentally filed away. He didn't know how she got hers. He then passed me off to the resident who was doing the actual procedure, and stepped out. The resident explained that he had numbed up the skin slightly beforehand, but he couldn't numb everything so it was going to hurt the patient considerably. Sure enough, as he made the two-inch incision, the woman started wriggling her legs around and making muffled pained noises. Pus flowed out of the incision, and I peered in and matter-of-factly muttered, yes, I see, you're right, it is a lot of pus. He asked me to hand him the suction, and sucked up the thick fluid that resembled melted vanilla-butterscotch ice cream with raspberry sauce, and the lady continued to kick her legs about. Then, the resident explained that with abcesses this big, there are pockets of pus branching out from the main pocket, so he would have to dig around for them in order to get it to all drain out. So he jammed in his scissors and poked into the gaping hole under the skin. The pus that I thought was all gone gushed out anew, and the woman screamed louder than I can remember anyone screaming in a long time. This was unexpected. I figured he would make a cut and squeeze the pus out, but the digging around seemed rather torturous. I felt a little bothered. I wondered if it was because causing more pain, aside from starting an IV with a needle to the arm or splinting a broken limb, is not really in my paramedic experience. I wondered if it was because he was poking around so much and that I didn't expect him to be so visceral about it. Maybe it was because I didn't feel that great when I woke up this morning. And this wasn't making me feel better. The gaping hole, the river of pus, the screams, the suction, my head felt a little funny, the resident asked for the suction again, the lady screamed more, the gaping hole, the stabbing scissors, I felt kind of stuffy, more suction, I swallowed, I was going to be fine, I took a breath, the scissors inside the open wound, she screamed louder, my vision got dark on the periphery, I couldn't make it stop, the scissors went deeper, more screaming, writhing legs, my vision finally tunnelled. I tried to put the suction down neatly as I told the resident that I was going to step out. "Sure, sure, no problem," he said, as I left the room and leaned on the handrail in the hallway. I found that standing upright wasn't so easy, so I sat down on the floor, taking deep breaths. I was sweating, parts of me cold, others hot. My vision wasn't so good. The attending came back around the corner and said something to me. I couldn't understand him. I peeled my head off the wall and a gravelly whisper came out, "I'm sorry?" He took one look at me, either said or waved "never mind," and left. A nurse came out of a room, and saw me there. "You okay?" she asked. "You want to come in here?" I didn't know where "here" was, so I laughed weakly and said I was okay. She held out her hand and I promptly changed my mind. She helped me onto my feet, and let me into the nurses' room. I found a chair, put my feet up in another, and she remarked that I looked awfully pale as she switched on the fan for me. I felt really silly but I was sweaty and cold all over, and the darn darkness of my visual field wasn't going away as quickly as I hoped. People moved in and out, variously comforting me and informing me that my face was shades of green or grey. Another nurse brought me apple juice and a packet of crackers. My vision was getting back to normal. I was very confused why my brain was doing this to me after ten years in EMS, the last six of which were as a medic in what most would call a hard-core environment. When I felt better, I went back into the room to watch the resident pack the wound with gauze. It went fine.

So now I sit here, pondering why I reacted that way. I slept in until almost noon today, and was parched when I woke up. I had two bowls of salty egg soup and a half a bagel for lunch, then a granola bar just before I went into the ER. Not the pinnacle of nutrition. I think it was also the causing pain part, and maybe the unexpected scissor-stabbing part of the procedure. Maybe I've seen so much so far that I was caught by surprise by something I didn't see coming. By comparison, cadavers are no sweat (although who knows how I’ll be when we start dissecting the face). At first, I wasn't that worried, but I did hope that I would make it through okay. Now that we have been in lab several times, I think they are distasteful, but they don't scream and cry and flail about. You can't hurt them. Living people are different though, and I think my tolerance of cadavers and prior patient experience has made me too comfortable. In any case, I certainly didn't see humble pie on the menu for the afternoon, but I got a slice of it. It doesn't taste all that great, but I suppose it's a necessary thing to have from time to time.

Discovery

I discovered today that red wine in moderation is not only good for your heart, but also makes studying funner.

Random Thoughts Post-Exam

I've discovered the key to excellent pesto sauce. I've made and eaten a lot of pesto in the firehouse. My favorite can be found at the Nob Hill Cafe in San Francisco, in -oddly enough- Nob Hill. Yesterday I experiemented. The secret ingredient is a little bit of cream. Yes, in addition to the olive oil and sausage. And Italians are slimmer than Americans? Hard to believe. It must be the wine. Also, the key to making good cranberry sauce from scratch is not necessarily adding more sugar, but a little orange juice. Of course, that has sugar in it too, but the OJ adds a little sumpm-sumpm.

My genetics professor really pissed me off. Today was the final exam. Her spelling and grammar were insultingly bad throughout the course - in the handouts and in the presentations. She didn't know how to punctuate either, and sometimes it would convolute the meaning of the sentence. If we are being held to such high academic standards, then the professors should be held to even higher standards. Medical school is supposed to be the pinnacle of higher education, so it's depressing that the faculty can't even spell. AND, she's from Britain! It's her first language! They're supposed to be the originators of the freakin' language! Rrrrgh. Poor spelling really makes a person look either stupid or lazy.

There are no good music stores in Orange County to go buy sheet music for my violin. The music library at UC Irvine is a joke - they have no music librarian, and all the music that they have is tucked away in some corner at the top of the library. Cal has a whole building dedicated to music, with its own librarians. I miss Cal. I didn't appreciate it as much as I could have when I was actually a student there.

I wanted to drive to Napa this afternoon, but it's too far. There's no place like that here that's within an hour's drive, like Napa is to Oakland. So I drove around the endless concrete jungle for a while instead, looking for a musical instrument store. It was rather unsatisfying. I miss Northern CA.

On a happy note... for our fake patient exams last week, we conducted a physical on a normal person who didn't have medical problems. I didn't do the reading beforehand, so I was winging it. The doctor who oversees me and my partner asked some questions to which I had no answer. I let my partner answer those questions and chimed in for the ones I did know from background knowledge. My partner had done the whole reading about how to do a physical exam. He is a very precise, intelligent guy with somewhat businesslike, but good bedside manners - he said "please" and "thank you" every time he asked the patient to do something. During the session, I could tell that the man was bored and not so impressed with what was going on. At one point as the doctor was rambling on about some technique, I quietly asked the man, "How are you doing?" with a slight smirk on my face, because I thought that the whole situation was rather silly, too. When we were finished, the doctor didn't single me out by name, but he mentioned, "...and you should always say please and thank you when you do something to the patient. They really like that." I didn't say please and thank you every time I had the "patient" do something; in fact, I didn't give him much direction because we were repeating what my partner had just done, and he seemed intelligent enough to get it. Plus we both thought the whole situation was rather silly. At the conclusion of the exam, as my partner and I were about the leave the room, the man asked, "What did you do before you came to school?" Taken aback, I told him I was a firefighter. "Paramedic?" he added. "Yes... You're good! How...?" He looked at me over his glasses and said, "It's the way you interact with people, the way you carry yourself. Keep up the good work." I know that there is more to being a good doctor than being a whiz in biochemistry, but sometimes you lose the forest for the trees. It was a nice reminder.

My Feelings Exactly

At the UC Irvine School of Medicine, we often send each other study guides in the spirit of cooperation. I received one such study guide today, courtesy of one of my classmates, Shaun Chung. (Note: it's not plagiarism if it's cited.)

Hey Mitochondronauts!!!
I know there are a lot of people right now throwing there hands up in the air in frustration concerning Wallace's material. Seeing that there is just way too much convuluted mitochondrial minutiae, Greg and I sat down today and made a pretty comprehensive yet concise Wallace review sheet. Hope it helps. If there is any confusion or if you disagree on anything please let us know. Thanks.

Enjoy your weekend,
Shaun and Greg

Anatomy

Today was the first day of anatomy. More specifically, today we started cutting up people. It’s supposed to be the course that makes you FEEL like a medical student, because it is the hallmark course of a medical education, a rite of passage, steeped in the tradition of grotesque assailings on the senses. I certainly haven’t felt like a medical student so far. It’s all just been more biochemistry, yucky chemistry, in the same lecture hall, day in and day out. Finally I feel like this is something more suited to me. I hope my combined paramedic knowledge and time in anatomy lab from last year gives me a small advantage over my classmates. They all seem to know everything about microbiology and biochemistry because that’s what most of them majored in, while I run around in circles trying just to keep up. I’m tired of feeling stupid. I want this to be MY time. They picked me to be in medical school because of my background; it’s about time it came in handy somehow. So far, it seems promising. My first trick was instinctive - breathing through my mouth so I won’t gag on the smell.

My person died just three weeks ago. They preserved her not with formaldehyde, but with some new chemical that they are trying out. One of my classmates is very pregnant and can’t participate in lab until she has her baby, because inhaling formaldehyde while being with child is not the best idea. The reason behind the new chemical is to get away from formaldehyde and to something safer. Great idea, but the stuff doesn’t dry out the cadaver like formaldehyde does. Consequently, our lady is very juicy.

We started with the thorax (the chest), and began by cutting the skin over the breastbone. But wait! The incision was made by scalpel. This is huge! The scalpel is a forbidden tool for paramedics. The general school of thought in EMS has been that scalpels are for doctors, and needles are for medics. Give 'em huge needles, but by God, don't give 'em scalpels. Knowing the lot that make it into the paramedic field, maybe that's not so unwise. So anyway, today’s exercise with the scalpel should have had much gravity. Actually, it was like using an Exacto knife to cut open cardboard boxes. I don’t see what the big deal is. So the incision went. Our lady had quite a bit of fat. It looks like yellow blobs under the skin. It took a long time to scrape the fat off the appropriate layer of membrane, peel it back, dissect the breast, which is just a big hunk of more fat with some stringy stuff in it, peel back the breast, peel back the muscle, first the pectoralis major then the minor, to reveal the ribs. The firefighter was nominated to saw through the sternum. Because, of course, firefighters saw through people’s chests with hack saws all the time. So I dove in. As I sawed, the juice started pouring out all over the place. There was slight pandemonium as my groupmates ran to get the turkey basters and plastic tubs to keep her from flowing all over the floor. Scheduling the first anatomy lab to be AFTER Thanksgiving was probably by design. The more I cut, the more she leaked. But we completed our task, which was to cut through the ribs and the sternum to remove the “lid” to the chest cavity. Just think of cutting the top off a pumpkin to expose the inside when you make a jack-o'-lantern, and that's kind of what the objective was. It's pretty neat in there.

When I took anatomy last year, I remember getting all spiritual about the whole thing. The dissections were all done for us ahead of time because we were just undergrads, so mostly we just moved things around and pointed and poked. But once all the organs are taken out of the body, you realize that the body is truly a shell. Where is the soul? Is there a soul? What is the person thinking as we cut her up? Is there such a thing as bodiless thought? Is it an "it" or is it still a "she"? Is she watching us? Where would she be watching from, still inside the body, or floating around above us? Or maybe from below. Or maybe through one of us. Before she died, did she imagine she was donating her body to more serious, appreciative, thoughtful, mature students than us? Did they assure her that her body would be treated with the utmost respect, when really we laughed about how we couldn’t tell she was a she until we checked between her legs because her breasts were so flat? Is tasteless humor as a coping mechanism disrespectful, or is it acceptable because most people understand that it’s a shield from the strong emotional response that dissection elicits?

So far, anatomy is creating more questions than answers. I haven't really answered those questions I had from lab last year. This time, it is more involved, because we are actually starting with whole bodies and doing the dissections ourselevs. Perhaps I will become more spiritual, perhaps not. All I know is that I was starving by the time I was done.

A Journey in Time

When you take on a new interest, you generally learn things. Surprisingly, my new interest in pearls has led me to Japanese history.

I've been reading some Japanese web pages on pearls as well. I can't read like I did 15 years ago, but it always pleasantly surprises me that I can read at all after so long. Reading or speaking a rarely used native language is like an old song that you used to know by heart - you have a general sensation of the words that are about to come up, even if you can't formulate them, trapped and eager to pop out, but just stuck at the tip of your tongue. Immediately after you hear them, you think, "yeah, that's it!" and then they come back to you as if you had only forgotten them for a little while. You may have to relearn them to sing them by heart, but they are familiar and fit well, and you know that because you knew them before, they will come back again easily if you want them to.

The Power of a Compliment

My parents bought me a pearl necklace and earrings for my birthday. Actually, they sent me a check and I got to go pick them out. It was the best experience I've had in a long time.

I didn't know where to go, thought that an independent jeweler would be out of my price range, so after doing my online research, I went to Macy's for some clinical education on pearls. I was helped by a woman who was very nice. She didn't seem to mind my obviously un-millionnaire outfit, and spent time showing me several necklaces. I was only there to learn about pearls that first day, so I thanked her and left. I went back another time, but she wasn't there, and no one helped me or asked if I needed any help. I left again, a little disappointed. Today, I had decided to not let indecision get the better of me, and to go ahead and buy one. I headed to the infamous South Coast Plaza, thinking that they might have a larger inventory to choose from. I had been out to dinner and was dressed up a little bit, so I thought I looked rather decent. They say when you are going to buy quality items, you want to look the part so that they treat you as if you are a real potential customer, not a window-shopper or a dreamer. Or a thief. My outfit did nothing for me though, as no one even cast a glance my way in the ten or so minutes that I eased around the cases of jewelry. I left, somewhat bitter at the pretentious Orange County merchants who wouldn't even say hello to someone who might want to spend money. In the Bay Area, thanks to the dot-com boom, many merchants learned that they could never know which sloppily dressed Joe Shmoe might be some wealthy programmer that was ready to buy out the store.

Despite the snub at South Coast Plaza, I did still want to get my birthday gift, so I headed to the original Macy's that I had been to before. I found the nice lady, Valerie, still working late on a Friday night. She was very sweet again, helping me and letting me try on whichever strand I wanted. She was an older aunt- or a young grandmother-type woman. We looked at different strands and mused over them together, she calculated with the sale discount what my final price would be, and gave me time to make my decision. When it came time to ring me up and open a new credit card to get me that extra discount, she wasn't so keen with the computer. Her co-worker, a very bejeweled, make-up-wearing, perfectly coiffed man with a bracelet that declared him to be "Blair," took over the computer and impatiently showed her how to do the transaction. He was slightly curt with me as well, but Valerie didn't seem to pay much mind that he was trying to hurry her up, and happily wrapped the necklace up for me. She made the whole experience rather sweet and sentimental, like a motherly figure, celebrating with me and lending a symbolic bent to my purchase. As I left, I beckoned her to lean over the counter and whispered, "I'm so glad it was you that helped me." She gave a little squeal and squeezed my hand tight, delighted and a little flustered, and said, "Oh, come back and see me, won't you?" It made me nearly tear up later when I thought about it, she was so happy. On my way out, I asked to speak to the managers. When I told them that Valerie had been so wonderful, they all lit up - with real, genuine smiles - as if I had personally praised them. As I walked away, I could hear them saying, "Oh, how sweet!" and "What a nice thing to say!" It might be a sad commentary on the ordinary clientele that they were so excited about a simple compliment.

I have my hunches that Valerie is working at a department store because she needs to augment whatever Social Security income or small bit of savings she might have. She didn't seem like she was trying to ascend the corporate ladder or get extra commission by rushing me through the transaction. She was simply very sweet, and treated me like my purchase was special to me. It didn't matter to her that it might take a few extra minutes to help me. Unlike buying a pair of socks, buying jewelry is a personal experience. Blair was technologically competent, but the interaction with Valerie is what I am going to remember. I felt powerful that I was able to make a perfect stranger feel so good with just a few words of thanks. I'll think of Valerie every time I wear those pearls, and it will make me smile every time.

Capitalism and eBay

In my efforts to make my new digs aesthetically pleasing on a student budget, I turned to slipcovers. I found that covers for my grandma's armchair can cost quite a bit. The slipcover store "Surefit" charges $99 for a cover that size. Macy's had it listed online for $89, but didn't stock it anywhere. Although I really like Ikea, I couldn't find anything that fits standard American size stuff, so I went to my good buddy Craigslist. However, Craigslist is only as good as the people who offer items, and no one was selling anything that I wanted. So I decided to reaquaint myself with eBay.

The evil eBay and I go way back. It was a quick relationship with a terrible ending. The address listed in my eBay account is 2505 Cedar St, in Berkeley, so it's been about five years since I last (and first) used eBay. I was a brand-new firefighter at the time and I bought a "Firefighter Barbie" for kicks. It didn't cost me much, but I got janked out of my money as the seller never sent it to me. So five years later, still without a Firefighter Barbie, I trepidatiously logged on and found something that could work for $4.99 from the Surefit Outlet Store. So when Surefit can't sell stuff for $99, they send it to their outlet store for $4.99! Amazing how much markup people can be conned into paying. If like the Surgeon General's warnings on tobacco containers, or the USDA's food labels, they required the Checkbook General's warning to outline what the markup was on merchandise, people might think twice about parting with their hard-earned dollars so easily.

So the bidding deadline quickly approached. I planned my day to stay at home until the bid was over. I had heard that one should not bid until the last minute, so that's what I did. I bid, was outbid, bid again... my heart was pounding. Incredible how one can feel at war when bidding on a $4.99 item (or should I say a $99 item?? -which would make me feel less silly). I could feel my face flush, my muscles tense, my concentration intensify. Total sympathetic response (a.k.a. flight-or-fight response), man! And I won! My wily predatory nature garnered my success, and now I stand proudly before you, the newest owner of the Surefit Separate-Seat Matelasse Chili-colored Chair Slipcover, and I am only $7.51 poorer for it. Sure beats $99 + tax and gas/time costs to get to the store.

I just hope I get it in the mail!

The Pros of Living in Irvine (However Far and Few in Between)

There are, surprisingly, some good things about living here. I've been trying to look on the bright side of things. Which leads me to the first thing: it's bright. The weather can't be beat. Even when I lived in the wonderful Bay Area, I did always say I wished I could bring LA weather to the Bay. Although it would be nice if it rained just a tad more. The other day it did rain, and it was great! I stood on my porch and let it rain around me because it wasn't cold. The other nice thing is that it's safe. We won't go into why it is so safe and people being economically discriminated against and bored cops pulling anyone over because they have nothing else to do. We'll just say that it's nice when you lock your bike up on campus, and your front tire doesn't fit into the U-lock along with your frame to the bike rack, you don't have to worry about someone making off with just the front tire as is bound to happen (and did, many a time) in Berkeley. And the third thing is that there is some neat wildlife around here. There are bunnies everywhere! Wild bunnies. They just hop along and are quite cool. I didn't realize that I'd gotten tired of looking at squirrels, but it's nice to see little wild rabbits scampering around my complex. And on the bike ride home from school today, I saw a roadrunner! I'd never seen a real live roadrunner before, but I could tell exactly what it was because of Bugs Bunny. So neat! Conclusion: Orange County is still a totally horrible place but there are a couple of neat things about it.

Where Have You Been?

I've been waiting for you to log on so that I could write something. It's about time you checked on my blog!

In the past few weeks, I've lost a lot of hair. The remainder of it has turned white. And it is all due to... Apple and its stupid Computers. Macs are supposed to be easy, man! But they aren't. I've become quite savvy at network connection-ese. I can rattle off my IP address, I know what an IPv6 address is, I know the first three digits to a bad (self-addressed) IP address, I know how the IP address distribution between your router and the computers that wirelessly hook up to it works, I learned how to trick my Mac into telling me "congratulations, you're now connected to the internet" when I'm not really, I know that renewing one's DHCP lease is one of the first things to do when troubleshooting for network problems, and a whole host of other things. It took me since 9/16 to figure all this out, a little each day, but now I'm ready for the Network Final Exam.

The only problem? I'm in MEDICAL school, not computer engineering school!

I am supposed to know all about genetics and epigenetics and histology (yes, Darron - HistoTime is coming back) and immunology and statistics right now. But instead I spent my time learning about that other crap. Why couldn't all that have happened when I had a lucrative job with plenty of time off? I have to say though, genetics and immunology are pretty interesting. One of my classmates' strategy for learning about genetic disorders is to play "Genetics Charades." For those of you who don't know what charades is, it's a game where you act something out. So, those of us who in four short years are to be deemed professionals, are acting out genetic mutations in order to commit them to memory. How un-PC can one get than that? But I will tell you, I'll never forget what Marfan's syndrome is.

I got to visit Darron this past weekend. It was great! Long overdue. You know you got a good boyfriend when he spots a vista point after riding up a very steep and long hill, in his first bike race, without much physical activity in the preceeding months, on his buddy's wife's bike, in funny pants, and stores it in his mental rolodex long enough to take you to gaze at it three weeks later. =) There is much more that's sweet about him, but one only has so many hours in a day to type. I could use some sleep. Thank goodness we have an "online course" from 8-10am. Ha!

Thanks for reading. And next time, don't stay away so long!

Needy Patients

I had my first "Patient Interview" today. We were virtually thrown to the wolves. We had a short reading assigned about how to interview a patient, and that was about all we got before the fake patient walked in the door (they're actors). There were eight students and two faculty members to oversee us. Four volunteers got to do the interviewing. I was the second to go. My patient was a 53-year old lady who just lost an uncle to cancer and was propelled to quit smoking herself. I told her, "I'm sorry to hear that," and asked her some questions about him and made remarks along the lines of, "It must have been hard for you." At the end of the interview, her critique was that I wasn't sympathetic about the death of her uncle. I see a long and illustrious career as a caring medical professional ahead of me.

9/11 is a Weird Day

September 11th is a weird day for me. For some reason, I don't like to think about it. I'm sick of the hype, the spin, the ranting and the conning of the masses. Watching twisted documentaries and drumming up hate toward Arabs is not the way I like to spend my day. I'm tired of even calling it "Nine-Eleven". It sounds stupid because it's overplayed. Give it a rest, and give it a little respect.

On 9/11/2001, I had nine months in as a probationary firefighter. I was working at St. 8 that day, at 51st and Telegraph, on the "C" shift. I was woken around 6:30, earlier than my normal waking time, by an excited co-worker calling me. "Somebody just flew a plane into the World Trade Center!" he exclaimed. "Really?" I replied, thinking to myself, "You woke me up for a plane crash? In New York? I know you're a wanna-be FDNY, but come on, did you really have to call me so early?" I got up, got in the car, and made my way to work. At some point that's fuzzy to me now, I must have heard on the radio or something, that the other tower was hit, and that it was deliberate. And the rest of the day continues to be vague and cloudy in my memory. I think that was the morning that we relieved the "B" shift from an early morning fire they had -went to the house to continue overhaul- but I can't be sure. All I remember, and this is crystal clear, is standing around nearly all day, gathered around the TV. I don't even remember the things that I was seeing on the screen. I was a new kid, but I certainly didn't do housework that morning. Everyone was huddled in the kitchen, silently watching. At some point in the afternoon, the CISM team came through. That's the Critical Incident Stress Management team. They came to debrief us, because clearly this was a disturbing, stressing incident for all of us, even though we were 3000 miles away. It doesn't take a lot of imagination to begin to place yourself in the same situation: what would I do if the Twin Towers were in my city, and I was the one called in to walk up those stairs, knowing that the building was on fire? Or maybe not knowing. Maybe only knowing that there was a lot of smoke and dust and something terrible had just happened. Would I chicken out? Would I quit? What would I do if I ran away out of fear? How could I live with myself then? What if I knew the risks? Would I have a gut feeling that I would never see my family again? Would I rescue someone? Would I die in there? Would I be alone, or would I be at least with a co-worker? The Golden Gate Bridge was said to be a potential target, so couldn't I actually be in this hypothetical situation if they really did attack it?

The CISM team helped, but I don't know how much. We all did end up talking. I recall looking at my co-workers who were stereotyped as male firefighters to be the silent suffering type, listening to more and more comments and thoughts coming out as each successive person talked. I don't remember the night time. I don't remember much past the afternoon. One event in the afternoon did strike me though, and that was that a woman drove up in her Volvo and stopped in front of the fire station. She pulled her bagpipes out of her car and began playing. Tears were streaming down her face. I stood and listened, and soon my co-workers heard it and came out to stand and listen also. We stood in a large, somber group. I always thought that bagpipes sounded cool, but this time they were gut-wrenching and haunting. I will always get goosebumps when I hear the sound of bagpipes now. The reedy sound touches something deep inside me and I really can't explain it any better than that. It's like a straight shock of a little bit of electricity to someplace in my gut.

Probation is stressful enough, and I don't know if it was just the fact that I was on probation ---or if it was the extraordinarily crappy relationship I was in, if it was being new at work, if it was the 23-year old hanging victim I responded to a few shifts later, the media telling us that the GG Bridge was next to be hit, being on High Alert but not really knowing what that meant in terms of my new job as a firefighter, going to so many "white powder" calls in the middle of the night, thinking about death, and my own death in particular, or if it really was all of those things combined--- but in hindsight, I realized that I started having nightmares not long after 9/11/01. For about three years, I had dreams where I was killing somebody, being killed by somebody else, my family was dying, some other person was dying, or many people were dying. There was a hanta virus dream in there, an atomic bomb dream, a dream where I hit someone with my car and was desperately running from the cops, a dream where my brother got hit by a train, a dream that I was a small child and I was running around at the bottom of an empty pool with other small children, and men with guns were standing on the edge, shooting and killing us like fish in a barrel. It's been five years and I still remember my dreams. They continued for three years, and I often woke up scared. Miraculously enough, they abruptly stopped within a few days of taking my leave of absence to take pre-med classes, and they never came back, not even when I returned to work the following year.

So I will "never forget 9/11." But probably not in the way that the angry Midwestern corn farmers who voted for Bush again and want to deny women abortion rights will "never forget." It's a day of sadness and wishing things were better, not a day to vow to kill more people. It seems like such a fad to "remember 9/11" that I must have subconsciously rebelled against it yesterday. What should we be remembering? We should be remembering that on that day, 343 firefighters (and many other emergency response workers) walked into those buildings because they had the duty and the desire to help people that they didn't know. And we should remember them so that we can be inspired to live our own lives as better people.

Things I Learned Today While Studying for an Exam

1. A gunner is a student who is always trying to learn every detail and every mechanism of every reaction in everything. Nearly all the Asian medical student population is made up of them.
-1(a) If you study in the same Starbucks as a group of gunners (a.k.a. former biochem majors), you will freak out because they know so much and you know so little.
2. The student housing office will not call you all summer and will not offer you a place to live until the day BEFORE an exam, AFTER you've already been living somewhere else for a month. Then they will require you to sign a lease within the week or else they give it to someone else. Never mind that you might have to give 30 days' notice at your current domicile.
3. Your roommate will inevitably, although not necessarily purposefully, eat your food. Chances are good that it's going to be on a day that you don't have time to go get more. (In my case, he finished my box of cereal on Monday. I thought it might have been his houseguests that left that morning, so I said nothing and bought another box. This morning, Thursday, I went to get my nearly-full new box of cereal to eat breakfast before I ran out the door, and discovered it was all gone and the empty box was sitting in the trash.)
-3(a) The cereal that your roommate eats will invariably be the good granola that costs more than the crap that he bought. So if you, in turn, eat your roommate's cereal, you will be unsatisfied and disappointed.
4. Southern California can cool down on occasion.
5. Bugs walking across a window can be incredibly fascinating.

Hey, don't knock my internet activity when I should be studying for exams. Look what happened two years ago when I was "studying" for an exam! =)

Dogs in So-Cal

So, many of my Northern California compatriots heard me bemoan that in Southern CA I was going to have to start wearing makeup all the time, develop anorexia, get sunglasses that dwarfed my face, buy a Gucci purse and put a little dog in it. Well, I wasn't kidding. Darron came to visit, and we went to Laguna Beach, about 20 minutes away on Pacific Coast Hwy, to check out the little town. I was eager to go there because I'd heard that it was kind of a Bohemian place, as it started out as a crazy artist colony back in the day. South Coast Plaza with its gajillion chain stores scared me. Well, Laguna Beach turned out to be about as Bohemian as, say -again, for my Northern Cal compatriots- Walnut Creek. I was hoping more Berkeley than Walnut Creek, but clearly I had underestimated the power of SoCal superficiality.

At first, it seemed like a quaint, albeit crowded, little place, kind of like Santa Barbara. We wandered into a David Wyland gallery, just looking around. A really weird guy spotted us looking at a glass-encased underwater-looking sculpture of Ariel the Mermaid from the Disney cartoon, and beelined over. "If you look at her hair from this angle," he said, waiting until I joined him at his angle to the sculpture, "it looks like a rose." He paused, expectantly. I then realized that he worked there, and attempted to placate him by "ooo"-ing appropriately. Darron and I glanced at each other at the same time, and as quickly as possible, we untangled ourselves from the strange mercenary web and escaped to another part of the store.

Then the next salesman approached us, quite a normal guy compared to the last. Darron must have felt safer, so he inquired, just for curiosity's sake, how much the shark sculpture table cost. "Not that I could afford it," he disclaimed. The dealer took my guess, $5500 "at least," and shook his head. "It's going to be more than that," he said, thumbing through the catalog. It was priced at over $22,000. For a table. A glass table. With a shark under it. I told Darron he better start taking sculpture lessons. "It's a great conversation piece," remarked the salesman. I don't know about these Southern Californians, but I can think of a whole lot of things to talk about for a whole lot less than $22,000. Maybe I could market myself as an ever-changing conversation piece. I mean, all the shark does is sit there. I could rotate topics. I'd be a bargain!

So then we walked into a little store that looked like it housed crafts and art by lesser-known artists, you know, cute stuff that doesn't cost a fortune, to put on your bathroom wall. The art was fine, and I felt a little relieved after escaping the Wyland store. However, my relief was not to last for long. I spotted a little pink stroller behind me with a poodle in it. As I wondered where its owner was, I saw a woman and her little boy walking toward it. Naturally, I assumed that the woman had taken her little boy out of it because he wanted to walk, and put the dog in it, so she wouldn't have to worry about them both running off in different directions. Wrong! As the boy got close to the stroller, the dog let out a loud yelp that made him start crying, and even startled me. So it wasn't the woman's dog; whose stupid dog could this be? Soon, a young woman in her mid-twenties, with all her baubles and perfect little tiny clothes and perfect little heels appeared, apologized, and wheeled the dog out. I stood there, incredulous. The stroller was for the dog! And ONLY the dog. It was not a baby stroller-sometime-dog stroller, it was a dedicated dog vehicle. I wanted to run out and find the girl a sperm donor because clearly she was having motherhood issues.

All I can say about this place: Wow. Nancy, I sure hope Canada's treating you better!

Long Live the Starbucks Empire

Conglomerate coffee is a good thing. People talk about how they kill the culture of independent coffee houses. I don't care, because as far as I'm concerned, independent coffee house owners only employ their village idiot cousins. All Starbuckses have exactly the drink I want. It's like the "hidden menu" at In-'n-Out. They don't post it on the menu but when you tell the cashier, he knows exactly what you mean and there is even a pre-programmed key on the register that rings you up for that exact item. (Try your next burger "animal style.") My drink is called a "Misto." It means "mixed" in Italian. Quite apt that I should go for a drink called "mixed." But anyway, it's a very simple drink. It's also one of the cheapest things you can order and sip on for hours while you take up space in their establishment. It's about half the price of a mocha, and considering how much time I spend studying at cafes, that comes out to quite a bit of savings. It is made of half hot chocolate and half drip coffee. I like regular coffee, because espressos make me destroy the bathroom and the chocolate I like, just a little bit, to take the edge off the bitterness. Anyway, still with me? Fill your cup halfway with hot chocolate, then add coffee to fill up the other half, and -voila!- you have a misto. Not so hard.

However, apparently it is an impossible drink to make for anyone that hasn't earned the title of "Starbucks Barista." I never realized what a strenous entrance exam Starbucks administered until I started trying to order my drink at random, independent coffee houses. At other coffee chains like Peets or Tully's, I meet with success half the time. Which means I don't the other half of the time. In the manner of Darron's blogs, his is how a typical experience in a NON-Starbucks coffee shop goes:

Cashier: Hi, can I help you?
Me: Yeah, hi. I don't see my drink on your menu, but what I'd like is a small cup of half hot chocolate and half drip coffee, please.
Cashier: *quizzical look on face, long pause*
Me: It's kind of like your Cafe au Lait, only with one pump of chocolate in it.
Cashier: *long pause* Okay, so you want...?
Me: Half hot chocolate, fill up the rest with regular coffee.
Cashier: *cock head slightly, glazed look, silence, then pick up cup and start writing. Drink Maker wanders over.*
Drink Maker: What did you want?
Me: Half hot chocolate, and half coffee. Like a Cafe au Lait with chocolate. Or a Mocha with drip coffee instead of espresso.
Drink Maker: Oh, okay. No problem.
Me: (silently) Thank God.
Cashier: *calls to Drink Maker* So what do I ring it up as? Is it a hot chocolate or a coffee? *discussion ensues, minutes pass*
Drink Maker: Okay, ma'am. You're drink's ready.
Me: Thank you! *take a sip, realize that he has given me half a cup of pure chocolate syrup (!) and mixed a little coffee into it*

Insert your own variation on this conversation and I can guarantee that it's happened to me. Now, I can see the argument that you shouldn't get upset if you're doing all this special ordering and changing everything around. I used to work at McDonald's, and you should have seen the things we did to the stuff people special-ordered! So I have sympathy for the poor inbred at the counter, too. One should be happy with what one gets. We all know the type, at restaurants that have to modify every ingredient of the dish. Well, I don't like being That Person either. But if I'm paying for something, I would prefer that it not give me diarrhea. So for anyone who has wondered why I'm such a Starbucks fan, and also for the rest of the world that doesn't care, that is why I love Starbucks. Because I don't have to be That Person AND I still get the drink that I want AND I don't crap my pants while sitting in class or traffic.

Go Starbucks!

Med Students Study Hard

Okay, so I would like to amend the impression I left with you, that the doctors cutting up your heart and giving you magic potions never studied. These kids do study. We had our first week of constant partying, but it's slowing down. Starting next week, we have weekly exams on Monday mornings. Talk about a good way to get your whole weekend shot! So apparently we shall all learn how to party on Monday nights from now on. Where there's a will, there's a way. It's about having conviction.

Med Students Party Hard

As a matter of fact, they party every night of the week like it's 1999. Jeez. My first week here was hectic as just before a tornado hits. But this week the overarching concepts came together and I think I've figured out my approach to med school academics. Also helps that I am now unpacked. So, I went out clubbing last night with my classmates. It was $20 cover, so you can guess that it was a shwanky kind of place. So someone got us UCI med students in on the VIP list for half price. I wanted to shout to the people in line, "See? You shoulda stayed in school!" That would have been pretty dorky, so I didn't. But I thought it. For a bunch of nerds, we sure cut up the dance floor! Some of us are really not so nerdy. I, on the other hand, have not gone clubbing in several years. I pulled out my old "clubbin' pants," the ones that were tight on me in college (the first time around) and they still fit! Very tightly, but nonetheless they fit. So I picked out probably the one appropriate top I have and did something random to my hair, slapped on some mascara and went to party with the 24-year olds. Man! Was I in for a surprise! Back in *my* day when we went clubbing, people humping each other's legs was about the limit, maybe you'd catch a couple gyrating on the floor. Last night, I saw a girl tossing some other girl's salad! And no one around them was acting surprised! The whole night was rather surreal, as if I was in a show playing a medical student who was going out with her classmates to the club. It was fun to dance, but the overall impression I had was... now I remember why I stopped going to clubs. It must have been particularly bad because this is Newport Beach, in Orange County, where everyone has to look as bored and beautiful as they can, apathetically staring past you, not at you, so you would think they were super cool and oh so hot. The Paris Hilton look, you could say. So I stayed out on the dance floor for two and a half hours and had to leave when my poor little legs gave up. Then, I got home and realized that when I took my car key off my keychain to minimize my purse contents, I'd left my housekey inside. And my roommate had locked me out. And it was 2am. And he was leaving at 4:30am on an all-weekend business trip. So I slept in my party clothes in the car until 4am, then straggled upstairs and knocked on the door, hoping that he hadn't decided to go stay overnight somewhere else after I'd left for the club. "Maybe the parties are best left up to the kids. Particularly on Thursday nights," I thought in my drowsy, confused state. I have to give everyone props though, most of the people I saw at the club were in class at 8am this morning. So my conclusion: med school is one giant party.

Overwhelmed?

That isn't the word. I just had my first biochem course today. Along with histology and cell biology and clinical correlates. It sure is a good thing I took biochemistry last summer, because we covered about three weeks' worth of last year's material in about two hours. This blog I started might be going the way of the dodo.

That being said, things might be a little less overwhelming once I am really settled in. Darron has been soooo wonderful in helping me move and trying to cheer me up in moving down here. One thing I can say: it is warm down here and you don't have to walk around dressed for summer/winter all the time. The beaches are nice. The second years put on a BBQ for us yesterday at the beach. But that's it! My heart still lives in Oakland.

Things I've learned or been told so far:
• I'm a First Year, aka MS1 (=Medical Student 1)
• But I get a fancy name tag that says I am a "Student Physician." Yay!
• You can still party while being overwhelmed.
• You need to party because you're overwhelmed.
• I unwittingly picked a great spot to live, and my commute is now 5 minutes by bike.
• People still show up to class an hour late, just like in college.
• They give you free food whenever they want you to show up for something.
• They are really friendly to you at first, just like orientation at OFD. I just hope things don't quickly deteriorate like they did at the OFD. There, they greeted us with donuts, coffee, fruit, lofty praise and congratulations from the funky podium while we were with our families. Then they separated us, still smiling, giving our family and friends the false impression that they were going to take us away and still be nice to us. In fact, the moment the door to the tiny classroom slammed shut, the torture began. I'll never forget G.W. raising his hand and asking our short-haired academy cadre leader - who happened to be a woman - if he should address her as "sir" or "ma'am." Actually, this feels like the calm before the storm. I just hope it's not a Category 5.
• My new email signature is going to be, "Gotta get going - I have to study!"

End of an Era

Yesterday was my last day at work. I've packed up all my stuff, left what I didn't need behind, and taken the tokens that I want to keep. It was a really weird day for me, not at all climactic. The guys didn't mess with me. In fact, Stew was super sweet all day long. Blue was pushing my buttons, but he made dinner for me, special request. It was so yummy! I sure am going to miss firehouse cooking. The chief came over for dinner, and they had an ice cream cake for me for dessert. This morning Lisa and Lamont gave me a goodbye gift. You'd think that with all that, I'd be crying my eyes out. I certainly thought I would be. Last night I got a little teary as I went to bed. But right now, I feel dazed more than anything. It's hard to believe that I've left. Is it really over? It doesn't feel like it yet.

I am so thankful to my crew - James Stewart, Jerry Blueford the Second, Dominic Antes - for being the best crew I could ever have dreamed for, and for making the past six months the happiest time of my firefighting career. They are a bunch of crazy guys, truly. Many of the stories are unfit to publish; some of them, you simply had to be there. Stew is the crazy Teflon Man: he can go out and talk to anyone, say anything, and he never gets in trouble for it because he is so disarmingly charming and funny. Blue is the pot-stirrer. He loves to cause problems with that devious grin of his, because he can read people so well and push their buttons for his personal amusement. I think it's a superpower. He is so sweet, and so teddy bear-ish, but he will *bleep* you up if you mess with him, or even if you're just quietly minding your own business. But he is the big brother figure and he certainly put up with me. Dom is the untameable one. He's still got that wildman 1 Truck tough truckie in him, and it shows. Sometimes I have to tell him to use his single house voice. He loves to blast bone-shattering music first thing in the morning when all I want is some peace and quiet as I slowly ease into the day. But he is one heck of a brave cook. Blue would always complain about everyone's cooking (even his own), so I couldn't handle the criticism and let Dominic take the shots most of the time. I'll chop veggies all day, but my skin wasn't tough enough for the scathing remarks that Dominic bravely withstood in my stead. He has that tough guy attitude but he is really a softie on the inside, too (I can only imagine how far they take that comment as they sit around the breakfast table). All three of them together, with their collective insanity and individual qualities, made the perfect crew. But they are also a little gullible, because I had them all believing that I don't boo-boo at work. "I don't play away games," I'd say. And for some reason, they didn't think it was at all un-humanlike to work three or four in a row and not have to go boo-boo.

So I sit amidst my boxes here at home, dazed and confused, going through the motions of packing up my stuff. I had no idea I was capable of such efficient storage, because it is amazing how much crap I have. And I'm not even moving my furniture because I'm renting my place out furnished!

*sigh*

Last Day

After numerous requests from my mother to record my adventures as a firefighter, finally, just before my last day with the Oakland Fire Department, I decided to begin a blog.

Last night, the guys stuck a wooden snake in my bed. This morning they woke me up with deafening music, dancing around my bed and yelling at the top of their lungs, "Wake up, Pam! Let's party!!!!" They know full well I'm not a morning person. Lamont definitely deserved some revenge, though. Yesterday I was cleaning out my locker and brought all my papers and books to the living room to sort out what to contribute to the firehouse library and what to throw out. L. got all sappy about how my departure was really happening, how throwing out my stuff was making it reality, that they were going to miss me, etc. I picked up a stack of about 30 pages stapled together, and he innocently asked me what it was. I tossed it over to where he was sitting, and inadvertently hit him in the nuts. After about a 30-second pause, he fell out of the chair in pain. Ironically, I had tossed him the sexual harrassment manual.

Tomorrow is my last day. I'm afraid to go to work, considering the mayhem that broke out yesterday. But if I call in sick, I live in the same city so they would probably just come bother me at home anyway. So I may as well take my lumps and go in.