GIE song

Here's Anna and I playing the song at the GIE ceremony... turned out okay, I think... :0) was fun.

What happened to last week... ?

Wow. Busy week. Didn't get much studying done but made enough progress to feel like I was still a med student. Was mostly working on the GIE body donor service and preparing for a worship service last night.

The GIE memorial went quite well, I thought. I had been assigned the chair of the performance committee, so was making sure intro/outro music was ready, a choir was set up to sing a marvelous piece led by a former operatic singer, I was ready for a guitar/cello piece done by myself and another student, a student who put together a fantastic slide show of the lives of the donors had all the assistance he needed, and generally that things were being done, so they would flow smoothly. All in all, everyone performed beautifully, and the families were deeply touched. They said a ceremony like this afforded them a special type of closure for the special gift that their loved ones had provided. Sounded like it truly made a difference for them.

The worship night went great, too. Had to learn a dozen or so songs and get my fingers callused enough to play for a couple of hours (practice sessions). Bit of a light turnout but enjoyable for all and a pleasure to play again. Had been about 6 years since I'd really even picked up the guitar. Had to put new strings on it and get it cleaned up from years of sticky stuff slowly attaching to its surface. Put the fingernails on, too, as it's much easier to play with them on.

Much to catch up on. Getting there today. Will hit the books hard for the next couple of weeks and see where I end up before Christmas.

Where I Live

This is my view, my window to the world.

I live in a small efficiency apartment a stone’s throw away from the classroom. The unit is about 450 square feet. It has a full bath and a separate kitchen. It’s clean and comfortable. I like it. Both the bath and the kitchen are on the back side of the building and have windows. I can see across the top of downtown Portland and over to Mt. Hood and Mt. St. Helens on clear days. When I look out of my back windows, I can see the Science building through the trees.

On cloudy days I can see the layers of grey form and slide across the earth as they envelope the city and dim its lights at night. Some days I wake up, and the fog and mist have crept up our little valley. It obscures all but the closest trees that I can barely discern as thin, black fingers in winter. On sunny days, especially after a rain, the air is remarkably clear as the moisture settles the dust and pollution and allows the sun to penetrate every living thing. Colors are made bright and vibrant. There is also a skybridge that connects the main hospital to the VA hospital. It presents a phenomenal view of the mountains to the east. On clear mornings, it is filled with nature lovers who remark on the sunrise over coffee and scones.

Some would say my home is cramped, but I have room for all I need. I fold up my futon bed every day to make a comfortable couch and view powerpoints on a big screen TV hooked up as a monitor for my computer. I’m very thankful to have this new set-up. I had been having terrific headaches last year, and I seem to have been successful at narrowing the main source of my headaches to being bent over desks made too low for tall folks as I studied. My headaches occur a tenth as much as before. Pretty much everything is up on the screen now – controlled by a wireless mouse and keyboard.

I see people pass by when the front shades are open. They walk along the road that is about 30 feet from my front door. It’s not a busy road. I imagine that they are all affiliated with OHSU in some way, but I know that many aren’t. Most of them look like science people to me. They look like they like to work in labs or at tasks that engage them completely. They look like they would be happiest observing and thinking and synthesizing data.

The neighbors have been noisy. Thank goodness the noisy girl next door has gone. Unfortunately, the new girl upstairs walks heavily on her heels at a rapid pace. It echoes through the wood floors and reverberates in the walls. I’m pretty sure she crossed the floor over a hundred times in 45 minutes this morning. Doesn’t seem particularly efficient to me. Maybe it was too cold to walk outside this morning. I can hear her phone vibrate from where it sits on a table or chair, and the sound is transmitted to me when it is finally released from my ceiling.

I eat simply. Cereal and oatmeal with fruit in the morning. I take juice and donuts to class to snack on while I enjoy the show. I suppose popcorn would be more appropriate, but it doesn’t taste as good as donuts do and there are some bizarre chemicals in microwave popcorn. Even the unbuttered stuff, I think… Donuts are pure and wholesome. Sometimes I eat microwave dinners. They have too much salt. I like salads and tomatoes and bananas and whole wheat bread. I eat turkey and ham with too many nitrates (and too much salt, too). I have eggs every once in a while. I don’t cook much. Just keep it easy and try not to kill myself all at once.

I run 4 miles a few times a week and do calisthenics when I don’t run. I wish I would do more, but I need to study and am getting older. My strength is declining and my endurance continues to require greater effort. I do love to exercise. Am pretty sure I wouldn’t be here if I didn’t. Looking around, I seem to have more capacity than my same-age peers, and my energy levels drop quickly (within weeks) when I don’t maintain a workout schedule. I definitely look forward to including regular exercise in my life. I truly wouldn’t be happy any other way.

VA Adventure

So, you may be wondering how things went at the VA (alluded to in the previous post).

All in all, it went quite well. I was able to shake the hands of and say 'thank you' to 50 or 60 veterans. Spent about 3 and a half hours over there. I just started at the downstairs lobby and worked my way up a floor at a time until I got to the top of the building. I met folks who were well and heading home and some who appeared to have no idea that I was attempting to speak with them. Some were having new parts put on. Some were having old parts taken out. Some were sad and afraid of dying. Others felt restored and ready for the next big thing. All seemed grateful for the hospital and the caregivers who were providing so well for them. My old school chum Allen joined me for the last hour or so.

I met a Pearl Harbor vet who wasn't able to talk much. One fellow told me about his post-military CIA adventures. Another described the way Agent Orange melted the scenery, and how he and another crew member were the only two who survived their exposure to it. Everyone else died within a few months. He says he figures the mask he wore to maintain commo is probably what saved him. He builds "motorsickles", now.

I met pilots and boat drivers and truck drivers and pen-pushers and crew chiefs. All were glad to be remembered. None really had anything they cared to complain about. Even the ones who were actively dying. They were accepting life as it came at them. They made me proud to call them brothers and sisters. They are part of the best stuff this country possesses. They rose to the challenge. They answered the call. They lived without holding too tightly, giving so much of what they had and believing they could be of good use. They touched my heart and reminded me of why I'm here. I hope I did them as much good as they did me.

Good people, man. Good people.

Veterans Day Note to Class

Hello Classmates

Most of you know today is Veterans Day. We don’t make much noise about it here, so I wanted to raise some awareness and make a request.

At OHSU we have a large, blue building filled with 303 beds just for veterans, and the main road that courses through our campus is a reminder of these special persons in our midst. They come from all walks of life. For the last forty years or so, they have all been volunteers. They almost all begin their service as young, idealistic women and men who desire to serve their fellow citizens in a deeply personal manner. They literally sign their lives away and stand ready to place themselves in harm’s way believing it may be the only means by which we might protect our freedoms, our families, and the ideals that bind us together. They then carry these experiences of sacrifice in their hearts and minds until they lay themselves down for a final rest. They are worthy of our thanks.

Indeed, they are not unlike all of you. They choose to serve others. They hope that they will make a difference in the lives they touch. They press on with courage and honor and a sense of duty knowing that giving our best for the people around us is what makes us unique on this earth. They put hands and bodies into motion for the sake of persons who are weak or hurting, fearful or oppressed.

In that we are all the product of the intentions of those who come before us, and we are currently in a relative state of safety, free to speak our minds, provide well for our loved ones, and gather as good people, please take a moment today to remember the best intentions of our veterans. If you know one, give them a call. If you see one, say ‘thanks’. I’m headed to the VA today to do just that. Maybe I’ll see you there.

Thanks for your thoughts and service,

Paul Reynolds
SOM MS1

Lifeline

My oldest and best friend has been watching his mother die slowly over the last few years. His Mom has been obese most of her life. Diabetes has stolen her energy, freedom, and eyesight. Each year she is carried to the hospital one more time than the year before. She really didn’t think she would make it to last Christmas. Now she is approaching another.

She has refused all meds but comfort care meds. No more insulin, heart pills, or drugs for hypertension. Just the fentanyl, an antiemetic, and something for acid reflux. She lies in bed and mostly sleeps. She has a bowel movement once a week, or they induce with a suppository. She doesn’t want my friend to clean the mess it makes because she says it affords her some dignity.

I talked to my friend last night. He said he was exhausted. He said he was more tired than he can ever remember being. He said he knew what it was going to be like when she died, but I wondered how anyone could know. He hoped for the best goodbye possible and some quality moments in her final days. I wondered how he would live in the vacuum that would exist after she is gone. He seemed to distract himself with the busy-ness and final details of death. I wondered when the moment would come for him to stop and come to grips with what was happening, ask himself how he fit into two lives that were such a part of one another.

He worried about her when she was in the assisted living apartment and spent most of his time there when she was ill with an infection or a complication of her condition. His sister died a few years back from an overdose. His brother is in town but has only dropped by once last week to see his Mom because they thought it was the end. His Mom and Dad have been divorced for over 20 years. His Dad is in town, but he doesn’t come by to see the grand-kids much.

She got out of the hospital a couple of weeks ago for a drug-resistant infection. The doctors thought she was going to die because she had stopped her meds, so they allowed her to move into a hospice facility. A day or so after she got there, her condition improved. The pain meds seem to lower her blood pressure, and she began to be more alert for more hours of the day. The doctors said she would have to move out of the hospice facility. In the state where they live, you only have five days to die.

If she doesn’t die fast enough, my friend will have to move her from hospice to his one-bedroom apartment. She will stay in the living room. He will have to get her hospital bed back out of storage and get it over to his place. He says at least he can sleep at night because he can check on her easily and not have to travel to her old place and spend the night in a chair.

The way we live affects the way we die. Our culture and society, the choices we make, and the hand we were first dealt all impact our dying. My friend hasn’t been a saint by any means, but he keeps trying to be the best person he can. He has been obese for many years and wants to get his weight down to something manageable. His wife is divorcing him after 20 years. It should be finalized this month. He’s in between jobs. He has three daughters. The oldest will be out of high school next year. I wonder how he will die, and who will be there to take care of him. I hope it’s me.

Before our parents die, we grieve knowing we will miss them. When they die, we have to experience it. We remember how we’ve lived our lives. We ponder what these people who’ve cared so much about us may have wanted for us - and maybe from us. We realize that in the same way we hope for our children, they hoped for us. Death certainly provides perspective.

Time machine dream

Oooo, I'm a bit groggy. Just got up. I woke up this morning thinking abut the advances medicine has made over the last 40 or 50 years. I imagined what it would have been like to treat a small boy my age when I was growing up in the early sixties and what it will be like to treat a small boy like me 50 years later. I will soon be tending to someone like me.

I think of research I've recently read and the things we knew back in the day. Every once in a while I'll come across articles from the 70's and the 80's and the 90's and then the post-century mark. And, of course, even after I'm out of school, I'll be studying articles in 2014 and beyond. I remember even in high school - in the advanced biology class I took - how we really didn't even understand mitosis, and now every molecule has a function and a name. We understand how alkylation affects genetic outcomes, and the entire genome has been sequenced. We know which parts of that genome are common to us all and which parts contain the variation that makes us so unique. We're beginning to home in on the genetic source of so many differences between us and so many causes of disruption in our phenotypic lives.

So, I'm reminded again of the incredible gift of being able to have this second life, if it's not a second chance at this life. With new clear sinuses, good sleep, exercise, and good food, I feel like I can live this long again. It feels like it might just be glorious.

Hey... great idea! Except...

Got an email today advising students that a new blog forum had been created on OHSU's website. It will record the experiences, ideas, and opinions of 5 selected, representative students at the med school and in a couple of PhD programs. Figured it was worthy of a post here.

All I can say is, "Nice job."

For all of the reasons I've written and about and many more, I think this is a great way to chronicle med student life and lend insight to inquiring prospects. I look forward to posts they create and wish them all great success.

Currently, there's a bit of a problem, however... You have to have an OHSU username and password to access the site. No access for outside folks who would like to see what student life at OHSU is like... The email says it will be opened up "externally" at some point. I think that will make it much more useful. Hope it happens.

If you have the login codes, you can access it here.

Events

It seems I have finally begun to settle into the new place and establish a routine I can live with. I am getting rid of things I don't need and accumulating those things that I do. The initial rush of school is over and folks have found friendship circles and comfort zones where they might operate. I listened to some first-year students talking last night and heard one say how exhausted she was. I didn't mention how far she had to go before she would be able to rest. It seemed as though it might have been too hard for her to hear. Will try to encourage her when I see her.

It looks like I will be able to volunteer at one of the local clinics. I will be able to practice my history-taking and exam skills there. Also a good chance to learn how to present patient info to doctors - something I haven't done before. Will use it as my PCM course until I start that back up in December.

I am feeling very much that this is where I belong and where I must concentrate all of my efforts. I have been allowing too many other things in life to distract me from this task. Easy to do for anyone and more so for an old guy with so many memories dancing around in his head. - I have a sense that I will be experiencing a major change in the next few months and then over the following year. Some sort of a renewing or reestablishing of an original position. Something special. Am curious as to what it might entail. - Of course, I watch my classmates being changed by the experience, and I wonder how aware they are of what they are becoming. I wonder if they understand the power of this institution to change them. I wonder how much they give themselves over to it and how much they are convinced they are doing on their own. I wonder these things for myself as well.

Sent a few of my poems off to a contest for review. Will be nice to have someone read them that may appreciate them. Might get some feedback.

Time to do some reading.

I blog, ergo…

Sharing ideas in a public venue allows for a proper vetting of ideas and prevents sidetracking as others help us avoid pitfalls in our thinking. All of the other people in the room may be incorrect at times, but not often. We just don’t have access to that type of clarity. We are mostly only able to think in a linear fashion and must spend at least some effort organizing any random genius ideas that may flit and bounce through our awareness. Writing here, then keeps me honest above all other goals. Indeed, it protects me from trundling down trails that will get me nowhere. It forces me to assign an application and good reason to my descriptions and discussions. It’s good to have a point, I think.

So… my point is to have a point. I like to remind myself of why I am in medical school, why it matters to me, what goals I might achieve, and how I might become better at achieving those goals. From a larger perspective, honest introspection and evaluation of ourselves - our actions, our motives, our methods – on a regular basis and stratified in some way seems to make a significant difference. These activities might be a weekly consideration of performance, a monthly or project review, and an annual summary assessment of how the previous year has gone and how it might have gone better. These appointments with yourself would need to be deliberate and not ignored. Good habits for med school, I think.

I recall reading that after studying success rates among college graduates, a group found that the only students to achieve success in life were those who had a plan and followed through with it. Unfortunately, it only amounted to 5% of all graduates. Rather telling, if I am remembering correctly. So, in looking back at our performance and then assessing how we might create a vision of the future, we might actually have a chance at arriving there. Otherwise, it seems we will only stir the pot and never dish any soup out. Heck of a way to starve with all that soup at your fingertips…

Goosfraba, baby

Was talking to some new students at a picnic last night. Had some thoughts.

We came to school to get some things wrong. In a place like this, we have the opportunity to get things wrong without actually hurting anyone. As we get things wrong, we learn to get them right. So, don’t beat yourself up for making mistakes, even if other people do beat you up. Just keep trying. And, maybe even relax a bit and enjoy the ride. Then, maybe, when people really need you, you will truly be there for them, and they will be safe.

When you are then in a position to help others through their mistakes, remember that a kind word and encouragement is what got you through the first grade. The reasoning still applies.

To Consume or Commune?

It seems to me that one of the defining continuums upon which we reside is the one in which we either live to consume or live to commune. The former defines a person who devotes energy to survival and to taking any good or service deemed to have value in creating a better moment or in adding comfort or in increasing the likelihood of another day. They are existential in that they must choose what they do with themselves, and they have chosen their own needs over the needs of others. Any connection to others is only to further personal ends. The latter, in contrast, devotes energy to connecting with something outside of themselves. They are primarily concerned with developing relationships and considering a possible existence beyond the tangible, measurable, or perceivable. They are not dreamers in that they still attempt to sort out the how and the why of their connections, but they are convinced that these relationships and something beyond themselves must be of more import than they are as individuals.

We all, of course, live somewhere along the line. We all must take, and we all must consume to survive in this place, or relationships will never happen and any greater purpose will never be fulfilled. However, I am absolutely convinced we must all lift our eyes from the sweater we are knitting and climb Maslow’s hierarchy as soon as we are aware of our presence on the pyramid. We must find context and choose to allow our essential core to connect with the common source of our existence. We may do this by degrees, I think. First, as we meet others and come to realize we are all made of the same stuff. Then, as we pursue the origin of the stuff. Eventually, we realize that either we are accidental and that any pursuit was fruitless, or that we are not accidental, and we have no earthly idea as to why. Therein, I think, lies the beginning of wisdom.

My hope is that we all find our hearts. I hope we can connect, so we may be properly born into lives of purpose and, eventually, become wise. Not a bad goal. I'll keep trying.

Didn't break an ankle

So... I was traveling horizontally over the earth at several hundred miles an hour, and I bailed out of the plane. Nice plane, too. Within a few seconds I was traveling at a hundred miles an hour at roughly 90 degrees to initial trajectory. After feeling the adrenaline rush and wind screaming by in head-down orientation, I formed a hard arch, found the handle, and pulled hard. Chute opened. And, I began a controlled descent.

I had a terrific view as I guided the foil down to an LZ, flared nicely and seem to have landed back on campus. Nothing broken. Just need to get ready to get back in another plane. Same pilots, new team. Will be good to get to know them over the next few months. So far they seem like great people.

The last four months have been busy. Hillary finished her program with flying colors (4.0 GPA) and accepted a position as a K-12 principal in an idyllic town in the heartland of America near her two boys. All in all, it couldn't have turned out much better. We have said many prayers of thanks along the way.

We seem to be getting along better than we have in quite awhile and have established some new rules of living that will hopefully keep us more positive and constructive, more focused and deliberate as we recommit ourselves to each other and the challenges of the next four years. We will see what the horizon brings because we won't be standing still.

My plan is to study as I can in order to prepare for reentry. I begin in 5 and a half months. There is much to learn, and I will do my best to make it my own. Thank you to everyone for being there, for your teaching and support, and for this amazing chance to be a doctor. It's time to take a deep breath and start making a difference for my patients - and anyone else that I might meet along the way.

B+

Yesterday, I sent out a letter to friends and family updating them on the break from med school. The process itself and the kind, supportive feedback I received compelled me to consider the positive effects of the decision to take a break. So... in an effort to retain honesty and transparency in this exercise, I have made some notes and added them here.

1. Better, continued relationship with Hillary – At some point in the journey we have to realize that our lives are almost always a “we” and rarely an “I”. Every choice we make is always our own, and we are solely responsible for all of them, but they almost always effect the people around us. Indeed, we do all live together and are waves washing over one another every day. Even decisions that seem insignificant are usually not. Think: ‘habit’ or the effect of wind and water on the landscape. We unfailingly become what we choose... Too, people that we appear to be insulated from are usually closer than we are perceiving. Think: ‘degrees of separation’. - Choosing relationship allows us to confront the most important challenges of life and to put the “why” of life into perspective. It also provides the greatest joy and most profound satisfaction. Do forgive my selfishness.

2. Finish Hillary’s program – This, of course, is a critical priority. My job is to see her through to the end of it. Only when she has successfully done so will that piece will be over. Time being the limited resource it is, this experience is what we can share right now. It will be a win for us both.

3. Chance to study ahead – For an old guy with less capacity and slowing, rusty neurons, this is a very useful thing. Nice to be able to choose the pace, as well.

4. Rest and relaxation – See “old guy” above. I was getting pretty tired.

5. Work on the book – I have pulled the book out and looked at it. As a project, it seems like too much of an uphill climb right now, but as I write here, I am effectively adding to it. It’ll be good enough if I never get to it again, but the opportunity exists now to chew on it if desired.

6. Chance to exercise and improve my health – Again, see “old guy” above. Metabolic milestones are inevitable. Working out again feels wonderful. - If someone tells you that you can be ‘balanced’ in med school, don’t believe them. Your physical health is one of the first things to receive short shrift. You know how important it is, but you end up sacrificing one thing for another. The pressure is on to perform, and youth provides an advantage.

7. Specialty focus – This has actually been a true, unexpected windfall. I had been thinking I would head toward anesthesia, but had also had the thought of a rural practice in mind. In examining myself sans school clutter, I am seriously considering the rural option. There are many pluses, and it feels like a much better fit for me. Suits my personality, temperament and lifestyle. This will give me a chance to research it more and then try it on when I return.

8. Opportunity for centering – We all have a reason for being, and this has given me a chance to stop and listen to the still, small voice that reminds me why I am here. If you don’t have a reason for being, I think you should stop what you are doing and get one… just my opinion.

9. Maintenance – have had a chance to tend to some needed repairs that had fallen by the wayside. Reminds me of Zen and the Art of Motorcycle Maintenance. Those points still hold true. Life has sides. We choose how to approach them and embrace them. Life is what we make it. Thanks, Robert.

Taking Leave

In case there are folks actually reading this, I am taking a one year leave of absence from school. My plan is to help Hillary with her new schoolwork and make a real effort at our marriage and relationship. The distance apart and challenge of two difficult programs were more than seemed manageable at one time. We will get her program finished this summer and then see if we can’t improve ourselves as a couple moving forward.

I rested and became human again for the first month and dove in on some important tasks that were pending for Hillary. Now that things are on firmer footing, I will study when I can and possibly work on an old book I had started. This break has already given me a chance to realign my priorities and think hard about where God wants me. School has been both joyful and disappointing. At some point I may elaborate as to why.

I will likely write here over the next year. Hopefully, it will lend an extra-interesting perspective to an already odd student profile like mine. I begin school again next February. Hope this finds you in good spirits and in good health.

Living

I am alive today. Breathing. The sun is shining through clear air in leafless trees. I am reminded of my good fortune and many blessings.

A delightful wife with love in her heart.
Edamame with kosher salt.
Oatmeal raisin cookies with cold milk.
Gentle voices and people who care.
Strength when you need it.

There are certainly times on the journey when we long desperately to be home. Our hearts seem to break and our souls ache for some small moment of relief. We arrive at unfamiliar way-points and sleep too few hours only to awaken to stiff joints and sore muscles in frosty blankets.

But, the air is clean. And muscles and joints soon loosen and soften as we roll up our gear again. Every sound is delivered to our ears as our pulses quicken and our senses sharpen. The day begins on restless horses anxious to shake the cold from their bones as well.

Such is the stuff of journeys.

Catching Air

It’s Friday afternoon, and I’m just walking out of my Living With Life Threatening Illness class. I love being in proximity of people who care about other people. Those are great people. I’ve ended today and the week feeling lighter. I feel joyful. I’m walking across the common area toward the catwalk. I look up at the mist in the trees from under my umbrella, and it’s not raining. It’s just beautiful.

I take a deep breath. This week was a long week. We covered a lot of material. We’ll be taking another test in about another week. That test will cover all of the material from this block, and 27% of it will be from the previous two blocks or material - chemistry, biochemistry and that sort of thing.

I feel like my attitude improved this week. After not having done well on the last test, I just want to do better. I think the conversation with Dr. O yesterday was helpful. She tends to lift my spirits. She is a transparent person, I think. I really don't feel like she holds things back or filters her speech beyond what she has taught herself is allowable (professionally and socially) over the years. I like that. I remember years ago being told I shouldn’t let other people know what I think. God forbid I should ever write it down.

Transparency as a doctor is an important quality, I think. Seems as though most of us are on a covert op to not allow others to know what we are thinking, or to know what we know or don’t know, or to protect our territory and reputations. And, I don’t think we can ever truly care for others when we don't let go of those things. - There will be challenges. There will be paradigm shifts. I came here to turn my world upside down, to ripen fruit, and to make every day count. Once you’re here, that’s pretty much unavoidable… I have to laugh.

It’s been a good week.

3-Day Weekends are Cool

The biochem test could have gone better. Could have gone worse, I suppose. Have come up with some excellent excuses, but none really seem adequate. I persevere and resolve to improve.

Gorgeous day today. Sky was clear. Mountains were clean and distinct on the drive up from Salem. Listened to bullfrogs over the three-day weekend. Ate dinner at a nice Mexican restaurant. Had fattening Chinese food at the Panda. Talked about how great it would be to have some property in Montana and what we would do with it. Looked at websites and dreamed about specific places we would love to live.

The road seems long. Hillary has another 5 hard months until she completes the admin program, and I have several challenging years ahead. We decide to try to have as much fun as we can along the way.

Katy laughs at little things, and we envy her bliss. Life will be better when it's simpler and contains less pressure, we observe. We have had more long, hard patches than we would have preferred. We love each other a little more now.

On Humility

It has been suggested to me by a person I value greatly that I may not have been as humble as I could have been as I have posted entries here. My principal worry is that I may be off-putting and prevent folks from thinking about things that may be important to them and interfere with their learning. Since we all are correct only a portion of the time we express an idea (say... 80%), I think we do need to realize that we can be wrong, and, usually, we have no idea as to when that might be. Therefore, we have a real need for some humility.

We do need confidence, however, in order to provide our views publicly, and the two qualities are certainly not mutually exclusive. I think we must be confident enough to make the effort to share our views, so we may learn from one another and refine our own ideas through the critical review process. Good ideas can be used by others, and we need to weed out the 20% of confusion. I do think this blog has and will make me a better sharer of ideas, and I hope it contributes to you all, especially as you think about medical careers. I am convinced this forum has potential.

So, please accept my apologies if I have appeared arrogant in the course of this thing. I readily confess to having many imperfections. Please read between the lines to glean what you may and set any flaws of mine to the side. Thanks.

Back At It

We hit the ground running after this past Christmas break. Right back into biochemistry. We will cover a couple of semester's material in 8 days. No, really. I'm not kidding. It includes genetics, too. Be a boy scout, Wannabees. Be prepared.

Caught a cold pretty much as soon as I arrived. Not terrible, but it does interfere with my ability to concentrate. Once again, as a caregiver, I hope I remember these moments and somehow gain the ability to truly place myself in the hospital booties of the patients who are lying on the operating table. We easily forget our sick moments and take our health for granted, but in those hours or days or months when illness strikes, our world is a mess and our hope ebbs. My goal is to recall this perspective.

From the words of Heraclitus: "It is not good for all your wishes to be fulfilled: through sickness you recognize the value of health , through evil the value of good, through hunger satisfaction, through exertion, the value of rest." If I can use these experiences of illness to change the way I treat others, I will not only recognize the value of health for my own sake, but I will provide better for others as I become more compassionate and seek more diligently to ease their suffering. As a physician, they will present me with the potential to become an enzymatic cascade of healthy change in people's lives. Yeah, Heraclitus, I think that would be good.

More on Relationships

After reading the Christmas post, I remember a poem of sorts I wrote a couple of years back about our blended family. Here it is:

This House

A lot of living has gone on in this house.

A lot of toilets have been flushed. A few have been clogged.

The old wooden floors have been pounded by the feet of grown-ups and children, friends and neighbors.

How many times was I sure the equity was being stomped out splinter by splinter?

A lot of living has gone on in this house.

More than one can of soup has been poured in a pot on the stove to simmer.

Ethan baked more cookies than I can count.

And, many pans of sweet rolls have sent the smell of cinnamon into Sunday kitchen air to catch unwary early risers. Never a burned finger. More than one thank you. And, I don’t feel one bit more tired today for those half hours I slipped out of bed a bit earlier.

A lot of living has gone on in this house.

The doorbell has been rung by every neighborhood kid and solicitor.

Halloween candy, the Christmas wreaths and the old, torn mat have shared the seasons on the front porch.

I can still hear Ethan’s clubs clank as he headed out for his first golf tournament.

Water balloon fights and paintball matches, car washes and early morning cans to the curb, boy-scalped lawns and candlelit family dinners have all graced this yard.

The back door frame holds the human ruler marking the growth spurts of youth and the lack thereof in maturity. It’s the only spot where we all squeeze together in one 24" space.

Harvey’s fingerprints have signed every wall and ceiling, every door and its frame.

Three kids would lay stacked like cordwood on Harvey’s bed in impassioned video game bliss.

Arguments and hugs with low-tone I love you’s, bickering and cajoling still ring in the hallway.

The north end of the dining room still holds Katy’s heart as she crossed her arms in defiance and sometimes gave her every effort to please and understand as she learned to read. Somehow, I think this is where she truly learned how much I care.

Echo ghosts roam about in the silence.

A lot of living has gone on in this house.

A lot of living will go on in other houses.

They will take this living with them.

It’s just a house.

By Paul Reynolds, the morning after Harvey and Katy went to Grandma and Grandpa’s and Mom and Ethan went to Japan. Thoughts on having to sell the house to pay legal bills. 6/18/2006