Thursday, July 28, 2011

His Nightmares

He sat at his desk and watched the setting sun turn the grass from green to orange yellow to evening shadow. Motionless seconds turned to hours to days all lost in his thoughtfulness. He sits at his desk in such darkness that he can longer see or write on the papers in front of him or even keep his eyes open. Only the piles of paper keep his head up.

In his eyes, fires burn. Blue, the hottest of all flames, flows outward. He is himself the source of the burn, the arsonist, but he cannot douse or fight fire. So, it slowly consumes the house, his wife of smiling white teeth and black skin, his daughters of no significant age, and himself. Before long, nothing is left except a pile of green now worth nothing.

Saturday, July 16, 2011

After Taking the MCAT

I will never hold the surgeon's knife,
Because I did not find the kidneys on the abdominal wall.
I will never prescribe drugs for anyone,
Because I did not hydrolyze amines to carboxylic acids.
I will never be a doctor.

Thursday, July 14, 2011

Dissection (I)

Her first cut is not sharp though penetrating; skin is soft and so easily sliced away from the tiny tendrils that tighten its embrace. She wields the blade with a quivering touch, carving cadaver into skin and flesh so cleanly as if they never were one tissue, one body, one person. Her knife stops once the pinkish outer layer is removed, and a yellow sheath lined through by blue and red vasculature is left. She looks at him, her handiwork. She can no longer recognize him or hate him for who he was.

Wednesday, July 13, 2011

Leaving Home

He hears little except the light chirping of the birds, the dulled protest of cicadas, and the awakening of the grass as the sun rises. Opening the door with an experienced grasp of hand, he steps from the emptiness of his room to the quiet space of the home. No one is awake yet. He grabs his backpack, not much to take, and walks towards the back door.

Outside, he squints in the brightness; maybe it will be a hot day here, and his father surprises him once again. The man is standing there, a straight back and neck. As his father turns around, their eyes align. No words are spoken. The man removes a large gold ring with a black stone in the center and hands it to him; as he wears it, he notices that it is heavier than it looks with edges smoothed by the touch of time. He reaches forwards and hugs his father and listens to the man's heart.

After a few moments, he walks away. But then he stops after a few breaths to turn back and look at the man he might one day become. He hears no breaths.

Writing About the Self

I have always hated writing about myself which is different than writing about my experiences. When I write about my experiences, I am trying to capture moments as I saw them, as I hope you will see them. When I write about myself, I am trying to portray myself as I hope you will see me but not necessarily writing about myself as I truly might be.
And perhaps, the former task of a limited personal statement is far easier than that of a true personal statement, but for once, I am publishing a personal essay, my MD/PhD application essay. Not because I am truly proud of it, but because I really have nothing to hide from anyone.

MD/PhD Personal Statement

Some things I will never forget. I will always see the wires and pipes hooked up to my aunt as she lay there, heart open, and hear the hideous pumping of the heart-lung machine, as if driving air and blood through her heart might have brought life to her as well. I have tried to forget the look of her face that last morning, when the machines stopped and she did not wake up, but shiny anger has kept the darkness well away from those memories. On that day, men and women in white coats and blue gowns had tried to console me and my family, tried to convince us that all that could be done had been done, and tried to help me through my pain and frustration. I cried quietly to myself, each tear a promise to fight death myself, to stop anyone from ever having to experience that feeling of helplessness ever again. I promised myself that I would become a physician one day.

I was just a boy then with no idea of the set of reactions and physics called physiology and no concept of medical science. Wanting to learn more about medicine as I grew up, I volunteered at the Mary Immaculate Hospital Emergency Room in Jamaica, New York, and was struck by the complexity of the medical system and medicine, encompassing not just patients, physicians, pharmaceuticals, and surgeons but also nurses, technicians, clinical aides, translators, social workers, and even business managers. Moreover, as I saw the different sides of medicine, I was humbled by the fragility of human life. Once, I witnessed a little boy of barely three being rushed in with severe trauma and bleeding. Hour after hour, the entire healthcare team fought a desperate war to save him. They ultimately failed. I will never forget how gently the attending physician cleaned the blood from the boy’s blue face with a piece of sterile gauze. Everyone had tried their absolute best, but saving a life is difficult even with knowledge, technology, and experience. In the face of such complexity, my childishness dissipated into a directed curiosity.

Despite the limitations of medicine, the disciplined application of integrated scientific knowledge in medicine captivated me. As I became immersed in physics and engineering, I wondered how they applied to biology; every time I learned new biology, I considered the physical principles behind it. My research in instrumentation design and then in intervertebral disc biomechanics stimulated me with the challenge of considering both biological principles and physical constraints. I wanted to discover and invent for medicine. As I continued with interdisciplinary work in experimental electrical neuroethology, I vacillated between the possibility of a career in medicine and in science. I think engineering and physics are deeply entwined with the future of medicine.

However, I recognize that medicine is more than a science, that it is also an art. At a palliative care ward in Bethesda Hospital in Western Australia, I helped care for people with incurable conditions. Medicine could do little to heal them, and I was humbled by their appreciation of comforting words, a cup of tea, and a listener to their stories. The physician responsible for these patients seemed to derive satisfaction from spending time with them helping them feel better physically and emotionally. The patient-physician bond, a relationship of trust and empathy, was more beautiful and poetic than anything I had ever witnessed. Indeed, the power of medicine to change people’s lives and to empower them even in the face of death demonstrated to me that medicine cannot afford to have only one narrative, that of science. It is equally a human endeavor; it is compassion and kindness.

One day, I returned to the palliative care ward to see Mr. E, a patient who had spent months in a place where many came to pass peacefully and painlessly into whatever lies beyond. I had spoken to him in Spanish when I remembered the words, written letters for him to the government, and read newspapers and books to him. I had imagined that his kindness and concern might be like that of the grandfathers I had never known. On that day, he was gone, never to return; I will never the forget the emptiness of his room, vacant of his black and white photographs of Spain and his welcoming smile full of brown and broken teeth. Feelings of anger and helplessness did not accompany sadness. Instead, I also felt assured that all that could have been done had been done and felt hope that maybe one day more could be done to help people like Mr. E, like the boy in the ER, like my aunt. And, for more to be done to help them, dedicated investigators would have to first discover basic scientific principles and then translate these into medical treatments.

Having realized this, it makes perfect sense that I am fascinated with both science and medicine. I want to be a doctor who can personally care for patients and a scientist inspired by patients to seek new treatments, a true physician-scientist. I do not have to choose science or medicine but can use each other to sharpen the other. Both scientific research and medicine are indivisible aspects of one quest, the journey to health others. I seek to spend my life as an interdisciplinary clinician, a driven investigator, and a compassionate human being.

Saturday, July 9, 2011

Coming Home

He opens the door and he sees his father lying on the bed, eyes shut.
As he picks his way across the room, he is careful not to wake his father, a man that he could never before surprise, only be surprised by.
Yet, steps on the thick carpet are dull, mere whispers in silence. It is quiet and he wants nothing else but to be near his father when he awakens. How many years has he dreamed he would be home again?
He stops abruptly near the edge of the bed. He hears no breaths.

You Ask Me - Rumi (II)

You ask me,
Who we are and what,
How much I am in love,
You ask me,
How much do I love you,
When and where we'll go,
Above and beyond,
You ask me.

How do I know?
How can I reconcile heart and brain,
When I am just learning about the hypothalamus-pituitary axis,
And cannot share this with you.

You ask me.
How do I know?
My mouth was full of answers,
Before I was seduced by love.

Girl Looking Down

You read music in the subway,
Bars and dots that bewilder from afar;
You touch the pages with such care,
Remind me of the language of the blind.
I wonder, if the metal clanking and crackling
Add to the symphony in your head?

Why Why?

I'm not writing to change the world,
not even to change your mind or my mind;
I'm writing because the world changes me,
And maybe you are changing me, my mind.

I'm writing to be a drop of pigment
That you name a color and apply
Or not, to be a keyhole you look through,
I look through, or maybe even forget.

I'm not writing for you or for me,
I'm writing to you, sometimes to me.