Friday, April 16, 2010

Pulse - Becoming a Doctor (Part I)

As a little girl I dreamed of becoming a doctor. When I was in elementary school I used to wish on wishbones and first stars in the night sky that it would really happen. I was excited by the idea that such a great person could one day be me. I could go through the crucible and be turned into one who knows what’s wrong and fixes it. I could help other people and make things right. I would envision myself running down a hall, with the open sides of my long white coat flying behind me, on my way to save a life. I knew that when I could do that, I would feel the way a person should feel: worthy and good and right with God.

In my culture, the belief is that a person who is bright with a mind for science could do no better than become a doctor. I love science, especially biology and physiology. As a little kid I would examine the scabs of my perpetually skinned knees with wonder. “Some day I will know what this is made of,” I thought. I remember the first day of my second year of medical school, when my pathology professor explained the mysterious scab. It was made of special proteins with scientific names. It required a whole system of cascading reactions to come into being. I was hooked.

I was fascinated with birth defects. Instead of turning away I wanted to know what exactly is wrong and how exactly did that happen. In junior high school I learned that the reference desk at my local library held a book called the March of Dimes Compendium of Birth Defects. I would trade in my library card as collateral and carry the heaviest, most enormous book I’d ever seen to a table where I would sit alone for as long as I could and flip the pages slowly. Each picture drew me in. It was like walking in the Louvre; even in a lifetime I would never see it all. The secret mechanisms behind those pictures were revealed to me in my embryology class. I loved learning how 2 “half-cells” became a human being with all our physical complexity. But even more so, I savored the pages of the text with pictures from that March of Dimes book and captions that described the process that went awry.

Years before medical school while an undergraduate at an Ivy League university I surprised myself by becoming sidetracked from my career path. I started to learn American Sign Language at a nearby school for the deaf. My thirst for understanding shifted from science to people, language, and culture. I majored in anthropology and stopped studying for my medical school entrance exam. I made forays into the insular “Deaf World” and spent a semester at Gallaudet University, the liberal arts college for the deaf in Washington, D.C. I moved to Israel and lived on an agricultural commune called a Kibbutz. I worked in an archeological excavation and led tourists on archeological adventures on our dig. I completed my bachelors degree from abroad. I explored the world and a little bit of myself. Despite all the wonderful experiences I was having, I felt empty and not worth much.

When I returned to the United States, it seemed that becoming a physician would fill that emptiness. Again, I pinned my happiness on that dream. Many times when I was feeling low, I would revisit the fantasy of saving a life, and feeling right. In some ways the culture of medical school puffs up the students egos in the same way we plump up chickens with steroids. There is a myth that we are the elite, just being there. To be honest, for someone like me, a natural test-taker with a great memory and a strong will to succeed, medicine is almost an easy path.Yes, it is a long road and it requires self sacrifice. But, it is a very well trod path. Once you jump on, it is almost hard to turn off. There’s a machine and a system in place to keep you on, and help you succeed.

I had thought I was enchanted with scabs and birth defects. But, putting my hands on a woman’s beating heart was the pinnacle. I had this opportunity in the operating room as a third year medical student rotating on the surgery service. I could tell that the surgeon had a little crush on me despite his being 50 years my senior. He let me be part of the team that removed a cancerous lung. He wanted to “show me a good time” and so during the operation, he encouraged me to put my hands on the patient’s heart when it was exposed. There was a tremendous energy in that rhythm. It passed like an electric current into my own hands and coursed through my own veins. I experienced the the power of the origin of the human pulse! It was the life force condensed in its most primal physical parameter. It was a beautiful summer day with the sun shining and a light breeze blowing outside the walls of the hospital. I had worked long days everyday of the past seven. I had woken up exhausted and dragged myself to the hospital. Yet, cloistered away under those artificial lights I was alert and energized. I could think of no other place I’d rather be than in that windowless bubble of the OR, with my palm on a beating heart.

Monday, April 5, 2010

The Gift of Sorry (The Healing Power of Facebook III)

It was late at night and I was doing some light perusing on facebook. When I saw Lily's picture on my friend's list of friends, my stomach flip-flopped with a familiar pang of guilt. I added her as a friend and was surprised to see the confirmation. It really didn't help, though. Seeing Lily pop up as my friend seemed only to remind me of the weighty lessons I learned many years ago at her expense.
It was December of seventh grade. Lily, three friends, and I were gathered together for a holiday party and small gift exchange. When Lily opened a giant box with her name on it, I was unprepared for her gift. It seemed that the 3 others had concocted a "gag" gift for Lily with deodorant, tampons, mouthwash, and toothpaste. As Lily pulled one item and then another from the box, I was speechless. What could this mean? Lily was clearly uncomfortable, blushed, and made the best of it with a nervous laugh.
The gag gift itself was nothing serious. But it heralded a period of torture for Lily. Although I was mortified by what came next, I stood by silently. I comforted myself with the idea that I wasn't participating in the harassing phone calls, mean behavior or whatever else they were conjuring up. Somehow, they knew not to call me into their inner circle of scheming. Nonetheless, I stayed on the edge, quietly tiptoeing along.
One evening I was with my mother as she was preparing dinner, when Lily's mother showed up at my house. There she stood, in my kitchen, determined to be heard. She had an accent from Europe and she was agitated and I couldn't understand everything she said. She started to cry and shout and I did hear her talk about how it was "just like when I was a child" and "the phone calls". What was happening to her daughter was bringing back memories of being a Jewish child in Germany. The mother of my friend had been separated from her family at age nine. They were all killed by the Nazis. Lily's mistreatment seemed to have triggered a flashback.
My mother helped her calm herself and assured her she would take care of things. Lily's mother turned and left. What came next was very difficult for me, thanks to my mother. She asked me a lot of questions. Beginning with "But I didn't do any of it", I told her everything.
What she said next seemed very unfair. "If you stand by and do nothing while you see others hurting someone, you are also guilty." She told me this was also a lesson from the Nazis. She said I had to be Lily's friend. I was sure this would herald my own downfall, as the others would turn on me. I had been afraid to give Lily her birthday present (lest the others find out). So it had been sitting in my room for a few weeks, all wrapped and ready. My mother said she was driving me over to Lily's house after dinner and I was giving it to her. She said, "This ends tonight."
I gave Lily the gift and she invited me into her bedroom. We both awkwardly acted as if nothing out of the ordinary had happened the last few weeks (or months, I can no longer remember). I didn't apologize. My own part in this had not yet become clear to me. My mom picked me up. I told her it had gone okay. I resented my mom for sending me on this suicide mission as I was sure that by the next morning I would be the next target.
Today, over 30 years later, I can't remember how the other girls found out I had gone to Lily's house and given her the gift. But I know they did. Because it did end that night. The next day at school Lily was just another kid. She was no longer their target. They never did turn on me. With my act of "normal" behavior, of doing what was right, my part in this incident became crystal clear. All along I had had the power to end it, and I had not acted. Therein lies my guilt when I see Lily's picture.
A few weeks after Lily confirmed me as her "friend" on facebook, the green dot next to her name tells me that we are both "on" at the same time. I start the chat. She responds. She's acting casual, but before I know it, my apology is tumbling off my fingertips. Tears are streaming down my cheeks. I tell her I have never felt right about it. I tell her about her mom coming to my house (though she already knew). I tell her that many times I have spoken out because of what I learned from that experience. She shares with me that what we did had a big impact on her. She's glad we chatted. I am too. I feel better. I feel purged, cleansed. It lasts a few days. But today, weeks later, as I am typing this another lesson rears itself upon me. I still don't feel right. Sorry helps. Being forgiven helps. Forgiving myself helps. Apologies and amends are powerful. But, in the end, what we do, is done, never to be undone.