There are at least six hundred variables in the physical body acting to maintain homeostasis at any given moment.  Proteins combine and combust.  Hormone signals attach to intra and extracellular receptors to set off multiple chain reactions. DNA is created, altered, and destroyed. Glucose is stored and glycogen is broken down.  Six hundred different processes are going on simultaneously at this very moment so you can wake up every day, make decisions, think your thoughts, and live your life.

It is amazing to think about how if just one of these six hundred variables is changed, all hell can brake loose.  One amino acid in a sequence can make the difference between having normal blood cells or oddly shaped blood cells.  One toxin can affect a single enzyme, halting the body’s ability to create energy or carry oxygen to tissues.

Environmentalists would say this idea is akin to our planet’s various ecosystems; the “web of life,” or, “the food chain.” If one species is destroyed, no matter how small or insignificant it may seem, its absence affects how the entire world functions.  Flora and fauna die or adapt to survive.  As the climate changes, as humans pollute the air and oceans, as wilderness is groomed into city, the web shifts.  Plants, animals, and humans alike suffer.  If a butterfly flaps its wings in North America, it really is possible for a tsunami to happen in China.

Yet life always finds a way.

In the hospital, doctors can manage about twenty of the six hundred variables that make up our body’s microcosm.  With the aid of machines and various drugs, doctors can control everything from blood pH, the rate and contractility of the heart, how fast and deep the breath is, serum electrolytes, how much fluid the kidneys filter, what nutrients go into the body, and which are expelled.  By controlling twenty out of six hundred variables, people who would otherwise be dead are kept alive.

I do not consider pharmaceuticals a physiological adaptation but rather a representation of how we as humans view and manipulate our world.  If we don’t like the hot weather outside, we build a house with air-conditioning.  If we want to get from one country to another, we fly across the world in an airplane we created.  If we want to produce more food at a low cost, we genetically engineer plants and animals to fit our growing consumerism desires.  There is little consideration of how these actions affect the world around us and ultimately ourselves.

Who cares if thousands of children have developed allergies to foods they would otherwise not have due to genetic engineering as long as large companies are making a profit?  Who cares if I am destroying the ozone layer as long as I can live in the desert at a comfortable 70 degrees Fahrenheit?  Who cares why someone has high blood pressure if they can just take a pill to fix it?

I’m not saying that we should all go back to our hunting and gathering days of living in grass huts, foraging for fruits, and killing wild animals with our bare hands.  Innovation and changing our environment to suit our needs is part of what makes us human. Higher order thinking and problem solving skills have allowed our physically weak species to rise to the top of the food chain.  Often overlooked however, is human self-awareness.

Seeing sick people all day can really change your perspective on disease.  You begin to notice similar personality traits in people with similar problems.  For example, those with fibromyalgia are generally fifty-year-old women with kids that have left the home and a husband who is still working.  They tend to be very needy, complaining a lot about various aspects of their life.  I am not saying these things to be judgmental, nor am I saying this type of person represents 100% of the fibromyalgia population.  This is simply my observation.

The question then becomes, how do you treat this person with fibromyalgia?  Do you simply give them an SSRI or whatever else is in the fibromyalgia protocol and call it a day (SSRI=selective serotonin reuptake inhibitor=antidepressant)? If you are a doctor practicing “standard of care” the answer to this question is yes.  You write her a prescription and send her on her way.  She is still going to be needy.  She is still going to complain.  She is still going to have all of the personality traits that led her to this disease in the first place.  But this treatment follows our species-prone way of decision-making.  If we can manipulate our environment to make ourselves comfortable in a simple fashion with as little effort as possible, then we do it.  It doesn’t matter which of our six hundred variables we affect in the process.  Is this woman going to care if her sex-drive tanks, affecting her already strained relationship with her husband as a result of taking an SSRI?  I don’t know.  It depends on the person.

Now, in typical ShanaShow fashion, I am ready to talk about some articles I read and then throw in my “spiritual” or “cosmic woo-woo” plug to wrap all of this together.

A few months ago, I read an article (I think it was in the Huffington Post) about a woman who actually cured her spinal stenosis through yoga.  Those of you in the medical community might be thinking, “that sounds like a load of B.S”.  For those of you not in the medical community, let me explain why the medical mind might be thinking this.

Spinal stenosis is a physical problem you can see on an MRI.  The holes where spinal nerves travel through each vertebra in the spinal column calcify and narrow, impinging the spinal nerves causing intense neurological pain.  Usually stenosis is progressive, getting worse over time.  The woman in the article had gone to a neurosurgeon who told her that if she did not have surgery, she would not be able to walk within a few months.  Having seen many of these procedures myself, the surgery involves physically sawing the spinal foramen on the vertebra open to decompress the nerve, permanently destroying the bone.  This procedure relieves pain affectively in 45-90% of patients (yes, that is a rather large window if I do say so myself…).

In our humanistic and mostly physically based minds, why not just have the surgery?  Who cares if you permanently change your skeleton if the pain is relieved?  Never mind the well-documented viscerosomatic/somatiovisceral reflexes between internal organs and the spine…a system Chiropractors and many Osteopaths have based their entire belief system on.  So, you might get some intestinal problems after the surgery…what does it matter?  And does it matter WHY you got the spinal stenosis in the first place if you can fix the result via surgery?

Not wanting to go through such an invasive procedure, the woman told the neurosurgeon, “thanks but no thanks” and decided to try yoga.  Here is another thing that might make anyone who has had neurological pain cringe.  How on Earth does one do yoga with incredible neurological backpain?

First off, not all yoga is standing on your head and downward dog.  Yoga is about connecting your physical body with your mind, a sort of physical meditation if you will.  Just like anything spiritual and physical, it takes time to develop awareness and strength.  You can’t expect to be able to do everything your first try…or even your 100^th try. It takes time and dedication.  But wait…that sounds much more time consuming and takes far more effort than going through a day surgery, right?

A few months after starting yoga, the woman in the article could still walk.  Not only could she still walk but also her pain had decreased.  A repeat MRI six months later showed a reversal of the spinal stenosis.  She her physical condition was getting better. She also noticed other changes in herself.  More awareness, more calmness, and clarity of thought…her whole being as it seemed had changed.  And she was happy.

I am not suggesting that everyone start doing yoga to treat physical ailments.  I am using this as an example to prove a point.  This point being that there are thousands of factors we humans do not necessarily have the mental capacity to acknowledge which affect the six hundred variables governing our physical body.

Our tendency is to manipulate physical factors we can see and touch in order to achieve a desired result, no matter the consequence.  Each tiny change we make can affect our entire life in a chain reaction, for better or for worse.  We often look for the quick fix because it is easy, effortless, and results in immediate gratification. Don’t kid yourself, that woman with spinal stenosis probably suffered in pain for months and worked her little mind off before she even began reaping the benefits of her effort.  But in the end it was worth it because she was truly cured of her disease and became a better person in the process.

There are many spiritual healing modalities and ways of life that work this way: homeopathy, osteopathy, yoga, acupuncture, massage therapy, religious studies, meditation…these modalities help you become more aware of the world around you, the world inside of you, and how these worlds are connected.  People shy away because most people cannot physically see instant changes or benefits.  And lets face it; it’s a lot of hard work!

It has been scientifically proven you can actually change how your brain is wired over time by changing the way you think.  This is the basis of psychotherapy.  A depressed person with the tendency to think negative thoughts works on becoming more positive and over the course of a few years (yes, years), thinking positively becomes second nature and the depression becomes a thing of the past.  Our thoughts emit alpha and beta waves, thus physically affecting the world around us (if you remember your physics).

Imagine how much things would change if everyone realized the power we each have inside of us.  Maybe we would stop throwing grasshopper genes into our tomatoes and cancer rates in this country would decrease.  Maybe instead of drugging our children to force them to pay attention in school we would focus on the real issue: how little attention is given to the educational system.  But then pharmaceutical companies wouldn’t be making as much money…it’s all connected.

How we treat ourselves, how we think, and the way we live our lives is reflected in our world around us.  The American obesity epidemic, our nation’s deficit, the polluted environment, our drugged children, and our shitty healthcare system are all symptoms of over-consumption, instant gratification, and greed.

Yet here we are, each and every one of us, with our six hundred chemical processes going on simultaneously in attempt to keep us balanced to ensure survival in this crazy world we live in.

The only thing we can do individually is be the best person we can at this very moment with our own actions and thoughts.  Whether it is having an intense spiritual study/practice, or saying no to that extra piece of chocolate cake.

Life is what you make of it.

All I’m saying is we might have a lot more control over it than we think.

Its 4:40am.  I slink around my sister and brother-in-law’s kitchen, using my cell-phone as a flashlight.  Do I have everything? Lunch? Check. Money? Check. Directions? Check.  3.5’’ heels? Check.  Cell phone? Check.

I zip up my wind proof jacket over my Banana Republic suit and slip on my Ugg-style sheepskin Costco boots.  It’s a little over a mile to the bus stop.  I better get moving to catch the 5:05am bus from New Jersey to Port Authority station in Manhattan.

It’s freezing outside, much colder than the 50 degree winter mornings I am used to in Phoenix.

I make it to the bus station by 4:50am, briefly considering taking up speed walking as my next sport to excel in.

There are a lot of people at the bus stop.  I always wondered what kind of people besides medical professionals are awake this early to go to work.

It is 4:53am.  A bus pulls up.

Shana #1: Is this my bus?

Shana #2: No…it can’t be.  It’s 12 minutes early!

People begin filing onto the bus.

Shana #1: Dude.  Shana.  That’s totally your bus. Get on that bus or you are going to be late!

Shana #2: It cannot be.  12 minutes early is crazy talk.

Man behind me: “Are you going to get on the bus young lady or what?”

Me <stupefied>: “Uhhh…”

The man behind me gets on the bus.

Shana #1: Shana.  Seriously.  What is your problem? Move your ass and get on that bus!

I look at the bus driver.  “Excuse me sir, what is the last stop for this bus?”

The driver closes the door and drives away.

Shana #1 and Shana #2: SHIT!

Half of the people are still waiting at the bus stop.  I’m internally freaking out.  How the hell am I going to make it to Brooklyn by 7am?  So much for this residency…

“Where are you trying to get to young lady?” One of the men at the bus stop asks me.

I look at him with tears welling up in my eyes.  “I have to be in Brooklyn for an interview by 7am”.

“Oh, and you wanted to go to Port Authority station?  Where in Brooklyn do you need to go?”

I tell him which hospital and the subway stop I need to get off at.

“Oh, just follow me young lady.  I’m headed that way.  The next bus comes in about 3 minutes.  We will get off at the George Washington Bridge, then we have to RUN to catch the A train…” he paused and looked at me in my suit and boots with one raised eyebrow. “We really have to run fast or we will miss the train.”

“Not a problem!  Thank you so much for helping me!”  I decided not to assure him of my athletic capabilities.

We sprinted across the George Washington station and leaped into the A train just moments before the doors shut.

As I sat down on the subway, I released a huge sigh of relief.  I felt so fortunate and grateful to have run into this nice man.  He didn’t have to help me.  He just did.  I love moments like these because I am reminded that there actually are nice people in the world.

We start talking and it turns out his daughter has a medical issue.  He is upset because he does not have the money to take her to see a doctor to find out if the problem is serious.  Fortunately, when he describes her history and symptoms, I am able to get a clear picture of her situation.  Feeling quite confident in my diagnosis, I give him an explanation of what I thought it was, what causes it, and what to do for it.

While it was not a big deal for me to help out (I just regurgitated things I had learned in school), the look of relief on his face I’m sure surpassed the look of relief on mine.  At that moment, it became clear to me why I had missed the first bus.  My faith in humanity had been restored (for a short time anyway), I was now going to be ½ hr early to my interview, and I was able to use my medical education to help someone.

As I maneuvered through the rest of my day and week, I became more aware of this, “doing good” equilibrium I have unconsciously created in my life.  Such as asking a homeless man to help me navigate the subway/bus station then giving him enough money for dinner, or giving a random person I met at the Phoenix airport a ride to their hotel located only a few miles from my apartment.  Paying it forward.

I used to wonder how it is I am so lucky.  Not to say I haven’t had my fair share of trials and tribulations, but usually, whenever I am in a pickle, help is not hard to find…in fact, help always seems to find me.

I never felt like I had much to offer anyone.  I don’t have a lot of money or nice things.  I am always the one to ask to crash on a couch, borrow something, or bum a ride.  The only things I feel I can offer to anyone are my brainpower, listening skills, and friendship.  Of course, I try to make it known my couch and kitchen is always available (if you enjoy my five major food groups of veggies, fruit, cheese, almond butter, and 88% dark chocolate).  What more can a girl living on student loans do?

I recently read this Yoga Journal article about the art of receiving.  It was a relatively short article talking about how the ability to receive a gift without question is actually very hard for some people.  You can easily get into the habit of refusing gifts without even knowing it.

Say someone gives you a compliment like, “wow, that speech you gave was really wonderful!” and your response is, “Ahh, it was nothing.”  By saying that, you are refuting the kind words someone was trying to give you, as if by saying, “you are full of shit.”  Instead, it is better to accept the compliment and let the compliment make you feel good in the present time, not worrying about reciprocating right away.  Their time will come, as will yours to return the favor. Paying it forward.

I realized after reading this article I am guilty of being a bad receiver. My tendency is to worry about how to pay them back right away, over think the person’s motives, or sickly believe I don’t deserve the gift.

I then decided to make one of my new personal growth goals to be a good receiver.  So far, it has been going fantastically!  Not only have I been receiving more gifts than ever before (and by gifts I mean everything from compliments to physical support), but I have also been giving more gifts than before, which is actually an even bigger gift to me because my favorite thing in the whole world is making people feel good (which is why I chose to be a doctor).

I have always felt an appreciation for complements and support; however, I would feel awkward and uncomfortable.  I enjoy these gifts more now that I simply let myself receive in the present moment without worrying about the future.

I am also much more aware of the appropriate times to pay it forward.  I smile at someone who looks like they are having a bad day.  I hold someone’s hand as they awaken to find themselves hooked up to a respirator in the ICU.  I reassure my friend that everything will be okay when the world seems like it’s crashing down.

I have always done these things…I am just more aware of it now. I now watch myself as I paint each brush stroke in the intricate masterpiece of give and take.

In the end, we all win by receiving and paying it forward because in my opinion, you need one to really appreciate the beauty of the other.

(This painting is from Aesop’s Fable, the Mouse and the Lion)

I’ve always been the kind of gal who wears her heart on her sleeves.  Growing up, I never left my emotions a secret.  If my feelings were hurt, I would cry.  If I was happy, I laughed…loudly. In the third grade there was a 5^th grade boy who always called me fat and ugly…until the day punched him in the face.  I was never afraid to tell anyone what I thought or how I felt.

As I matured through high school and college, my emotions continued running the show.  I have never been one to get violent or yell (except that time in the third grade), but laughing, crying, and showing my emotions is just what I did.  It is who I was.

I always wondered if people felt emotions as strongly as I did.  No one else seemed to be as excitable.  Often, I felt that even though I let my emotions show, what I showed was only about 10% of what I actually felt inside.  I thought if I really let out how I felt, I might explode.

I used to tell my ex boyfriend, the last guy I dated (and most serious relationship I’ve ever been in), “I love you!” every time we parted.  I could feel my eyes get wide as I said it, and as the words left my lips, I felt my heart nearly jump out of my chest.

One day he said, “Shana, why do you always say ‘goodbye, I love you’ like you are never going to see me again?  I’m going to see you again in like five hours.”

He looked at me with the, “you silly girl” look on his face he often gave me whenever I got excited about something.  I didn’t know what to say.  In my head I thought it was normal to tell someone every day how much you love them. So I did. Plus, how could we be sure we would see each other again in five hours?  Maybe I watch too many romance movies.

“Oh, I didn’t realize I did that,” I giggled, smiling back.  But it was a lie.  I had thought about it.  And through my smile, I felt his question and the look he gave stab me in the pit of my stomach.

4 years of medical school later, I feel like a changed woman.  It isn’t that I am no longer an emotional person.  I still am.  I am just a lot better at hiding it.  Too much better sometimes.

Thus is the topic of this ShanaShow.

When starting medical school, we are lectured about how much our lives are going to change.  They told us a lot of things but really stressed the importance of not loosing ourselves or ignoring friends and family.  Rumors of students getting divorced and loosing important, close relationships turned out not to be rumors.  There are no words I can say to describe the overall life changing stress of medical school and becoming a doctor. However, I can explain one thing now; a common issue (I’m sure) for many people in medicine.  The issue of emotions.

I remember the first terminal cancer patient I saw.  It was the fall of my 2^nd year at the family practice clinic I was “rotating” at for the year.  Dr. Smith (I will not use his real name, although he is a really great doctor) asked me to do a history and physical on a patient he had.  I did not know anything about the patient before opening the door to the room.  Behind the door sat a young, good-looking guy around 34 years old in a wheelchair.  It turned out he had just had multiple surgeries for metastatic stage 4 osteosarcoma (bone cancer).  I felt so weird, talking and joking with him while I was doing his history and physical.  All I could think in my head was, wow, this guy, who is only 10 years older than me is going to be dead in 6 months.  What do I say to him?  How am I supposed to act?

Of course, I acted natural and cheerful the entire encounter, as did Dr. Smith when he entered the room.  I couldn’t believe myself as I said, holding the door open upon his departure, “Well, it was really nice meeting you.  See you later!” See you later Shana?  There is no later for his guy! 

He looked up at me, smiled, and said, “The pleasure was all mine young lady. You are going to be an excellent doctor.”

At the end of the day, Dr. Smith always asked me, “So, tell me one thing you learned today.”  Usually I came up with some medical jargon or treatment plan.  But that day was different.

“Today I learned how hard it is to talk to someone you know is going to die… Especially when there is nothing you can do to help them.”  I looked up at Dr. Smith.  I could feel my eyes starting to well up.  Don’t cry Shana.  Don’t cry.  He sees this every day.  Don’t cry.  I didn’t cry.

“What are you taking about Shana?  You did great.  Don’t worry about it.  You smiled and laughed with him.  You treated him like a normal person.  Studies show that what terminal patients have the hardest time dealing with is not the fact that they are going to die.  It’s that no one talks to them.  No one talks to them because they don’t know what to say.  You did the best thing you could have done for him.  You can’t think about the fact that he is going to die.  Right now he is alive and I’m sure he appreciated seeing your beautiful smile and hearing your funny laugh.  You can’t let these things get to you or you will never last as a doctor.”

I will never forget what Dr. Smith said to me that day.  Nor will I forget the first terminal patient I saw.

Over the course of my second year, as I saw more and more dying, hopeless, and traumatized patients, I had to figure out ways to not get emotionally affected.  When I was younger and I did not want to cry, I always thought of a commercial on TV that really irritated me.  My oldies but goodies are those, “Behold, the Power of Cheese” commercials they used to make.  Yes.  It’s true.  What do I think about when I have to tell a mom we can’t see her baby’s heart beating?  The power of cheese.

Overtime, I have resorted to the power of cheese less and less (it is reserved for only really tough situations).  I don’t think I have become cold, just more protected.  Over my second year and beginning of third year I have built, brick by brick, a protective wall to hide behind.  My problem is I have always been an emotionally sensitive person.  Naturally, I began hiding behind my brick wall not just at the hospital but also in my personal life.

By the beginning of my 4^th year, I had built an entire brick house.  In that house, lives the little girl I used to be.  A girl who only comes outside to play when the external environment is a perfect, sunny, 70 degree day; when she is either alone or around people she deeply trusts.  And sometimes not even then.  I’ve changed from the girl who never looked before leaping into the girl who measures everything from the barometric pressure to the phase of the moon before taking a single step.

I still feel everything the same with the same intensity.  The sadness, the sympathy, the happiness…but the feelings are stuffed in the house all day.  I open the windows to relieve the pressure when I run or do yoga.  If I don’t do that every day, the pressure builds up inside and I become pretty dysfunctional.

It’s interesting to see how doctors deal with the emotional side of the job.  Or don’t deal with it.  Some attendings become cold and callous.  Some make jokes and laugh about the horrific things we see every day.  Some don’t try to hide their feelings at all, while others are pure evil to medical students and residents.  I have worked with all of the above.  There have only been a few who act like normal people around the patients.  However, in our solitary interactions, they confide that they never get used to tragedy…but it is part of the job.  I think there was a scrubs episode about that.

As a student and soon-to-be young doctor, I am still trying to figure out how to balance everything.  I am often thankful I am not in a relationship or have kids because I’m not sure how I would handle it.  Would I be distant?  Or air out the house when it is not appropriate?  Would I say every single, “I love you” like it was going to be my last?  Or would I not say it at all?

Sometimes I listen to people’s conversations about things that are bothering them and I can’t believe the thoughts that go through my head.  You are bummed out because you farted at a meeting?  Quit your complaining.  There is a guy in the ICU who has scrotal edema so bad we can’t find the tip of his penis and he can’t pee. Or, you can’t run because of some tendonitis?  Well there was a guy in the ER last night who was impaled in the head with a lead pipe and how he is literally missing half of his face.

True stories.

What stops me from turning my head and talking some sense into these people is the thought that, although it may not seem like a big deal to me, for some people, farting in a meeting can be just has horrifying to them as I felt assisting in an autopsy of a dead, at-term pregnant woman, or telling someone the cancer we thought was localized to her left ovary had actually spread to her peritoneum and stomach.  Maybe having tendonitis is the most horrible thing that has ever happened to them.  Who am I to judge?  All I can do is be there, listen to their story, offer advice, and treat their drama like it is the most important thing in the world. Because to them it is.  Then again, this is coming from a girl who has soiled herself in front of a stadium full of people just to win a 10K…but that’s another story.

I often find myself switching into “doctor mode” when talking with friends and acquaintances.  I know I look normal on the outside.  I smile, give advise, make some jokes…but inside I feel the little girl run into my house, slamming the door shut; a move I must have made many times in my last relationship without realizing it (when I wasn’t thinking about the power of cheese…).

What I hate the most is when I do this with people I really care about.  But honestly, that’s when I need to do it the most.  Why do you think there are laws against doctors treating/operating on family members?  Because it is too hard to separate your emotions from a medical situation and a person you deeply care about.  I’m willing to bet that most surgeons would quit if we did not drape the patients in blue and cover their faces in surgery.  It isn’t just for sterility we do this.  It is also to separate what we are trying to do to save their life from the real person underneath.

I know I am not alone in this dilemma, although I have never actually talked to any other young doctors or students about it.  I can, however, see what happens to doctors when they don’t deal with it well.  Their health deteriorates.  They drink.  They eat bad food. They become cold and mean.  What I have been doing is probably not the healthiest, I admit, but it at least I am able to show compassion and understanding while I stuff my real emotions into a box.  I don’t know what I would do if it weren’t for running and yoga.  I’d probably go crazy.

I wonder if I will ever figure out a better way.  Or if this is my best way. Or if it ever gets any easier.  Or if I am, indeed, alone with this dilemma.

All I can say for now is thank goodness for running, yoga, and the power of cheese.   It’s helped stop me from bursting into tears a lot.  One commercial at a time.

The first time I went to the bathroom on an airplane I remember thinking, “Where does it go when I flush?”  Immediately, the image of human excrement landing on some unfortunate individual while walking down the street flashed in my mind.   I was probably about 5 years old at this time.  It wasn’t until I watched the scene in Christmas Vacation where cousin Eddie empties his camper’s waste into the sewer system that I realized the truth behind airline toilets.  Of course, this did not ease my thoughts as I pondered the idea of airlines carrying thousands of people’s poop and pee across the world.  Where did airplanes empty their “cargo”?  Who has that job?  How do they decide which country to leave it in?  With all of these questions coming to mind, I decided I would rather laugh and think about my first idea…and hope that most people went to the toilet while crossing the Atlantic or Pacific Ocean.

It can be a little disappointing when you realize the truth behind a fantasy you have believed your entire life.  Like the time you realized that the reason your parents had you put your fallen-out baby teeth under a glass on the kitchen counter instead of under your pillow was not because the Tooth-Fairy may not be able to find the tooth under your pillow but because your parents were afraid of either waking you up in the middle of the night or accidentally dropping the bloody tooth into the black-hole of the space behind the bed head-board.  However, I must admit I felt a huge sigh of relief when I realized that, despite what my sister had told me, if I swallow a watermelon seed, a giant watermelon won’t in fact, grow in my stomach.

Realizations do not only happen when you are a child growing up.  They continue to happen as you age and grow as a person, intellectually and spiritually.  Adult realizations are often more shocking and harder to deal with then the seeing the secret compartment in the magician’s hat or the fact that American Furniture Warehouse indeed only sells furniture and does not sell an assortment of large, exotic cats.

Most of my life-altering realizations began as I was working at a job I hated between College and Medical school.  This is when I realized that, in general, most people work to live.  They go to work every day so they can pay to have a roof over their head and calories to fuel their bodies… so they can wake up the next morning to work…eat…and sleep again.  Perhaps somewhere in there they find time for a relationship, pop out a few kids, and carry on the genetic code.

I got really depressed when I finally figured this out.  Until that point, I had always had this magical view of the world where anything and everything I ever wanted was possible.  Where life was fun, exciting, and ever changing! But this…this wasn’t fun at all…this meant that everyone I ever looked up to…my parents, my friends, great authors and teachers, were all just people.  People working.  People paying.  We were all just people trying to figure out what exactly living life means.

Any hero I ever had in mind? Gone. Because everyone out there has what they have and is where they are because they either worked really hard or their ancestors did and they are living off of the proceeds.  What an existential nightmare!

Then medical school started and it got even worse.  I remembered the days of going to the doctor with a medical problem and feeling this sort of relief that somehow, this person could magically cure me of anything.  They would be able to take one look at me, wave their magic wand, and everything would be perfect.

Lies.  All lies.

I now know what is behind the green curtain.  Within the first week of medical school, I realized that anyone who can work really hard, memorize a ridiculous amount of information, is a good test taker, can follow a protocol/flow chart, and has the guts to gain half-a-million dollars of debt can become a doctor.  I’m not saying they can become a good doctor, but they can get a diploma.

We don’t learn anything special.  It’s just like any other job.  It just has expensive, painfully long, excruciating, training hours.  We learn how to take someone’s symptoms and place them in a box.  If your symptoms don’t fit into a box we are familiar with, we refer you to someone else who might be able to figure out which box you belong in.  Treatment goes according to your box.

“Oh, you are having a heart attack?  Let me follow the hospital protocol written right here in this handy-dandy computer program! Abdominal pain?  I have a chart for that too!  God forbid I treat you like a unique individual because the insurance company won’t reimburse me and the hospital might fire me if I don’t follow their protocol. “

Yep.  There you have it.  That’s allopathic medicine in a nutshell.  There is no magic wand and at the end of the day, doctors too, work to live.

Okay, Okay.  Stop right here.  Didn’t I say before that I WAS depressed when I figured all of this out?  WAS implies I am no longer depressed…but come on, these last few paragraphs have seemed pretty bleak right?  What is the point of all this?   Why do we still get up and go to work everyday?  What is a life with no fun?

It all boils down to perspective.

Those of you who know me may have never heard me speak with such pessimism (unless you have talked to me during one of my existential crises).  In general I’m a laughing, happy, fun-loving gal with a unique, magical, and positive look on life.  In my opinion, if we are all working and living essentially to carry on our genetic code, we might as well have some fun doing it.  Life really becomes about living.  Living for the little things.  This statement is very cliché, but I’ll explain what this means to me.

Take doctoring.  Anyone can get a diploma and follow a protocol.  But there is something special a doctor can bring to his/her patient that is not learned from a textbook.  This is where the art comes in.  It is the ability to look beyond what is physically in front of us and see the miracle in each and every person.  In Osteopathy we call it the “health”.  Eastern religions call it Ki or Chi. It is the light in all of us, our vital force.  It’s what makes us alive. A good doctor is able to see this and help their patient by making the “health” stronger. It is an amazing, beautiful thing. You really CAN help someone feel better.  The best part is you don’t have to be called a doctor to do it.  Anyone can!

Listening to a heartbeat is one of my most favorite activities.  I’m not kidding when I say I could sit with my stethoscope and listen to someone’s heartbeat for hours.  It’s the sound of life; so rhythmic and spontaneous.  In my head I know it is just an electrical impulse depolarizing and repolarizing cardiac muscle cells with fluctuating levels of sodium and potassium, but I don’t look at it like that.  I look at each beat as a miracle.  Pumping blood throughout your entire body so you can run, jump, stand on your head, eat good food, and love someone.

And babies.  We can’t forget about babies.  You could look at babies as crying, eating, pooping machines…because…well…they are.  However, any parent will tell you they can sit and look at their baby forever.  As a doctor, there is nothing quite like helping a baby into the world and watching it open its eyes for the first time.  Knowing that for that baby, every moment from here on out will be different from the next, full of growing and learning.  What a great reminder right?  We were babies once too…and we still are as long as we are alive, growing, and learning.

Beauty is all about how you look at things.  When I say, appreciate the little things, I mean, the REALLY little things.  Like health.  Like taste.  Like smell.  Like a heartbeat.  Like the feeling of sleeping in on a Saturday, eating a tasty breakfast, and watching a good movie with a friend.

There are many more shocking realizations I have made over my short time here on Earth such as the fact that a government, which is supposed to protect its people, will lie and kill millions of its own citizens just so large companies can continue making money.  Or that someone could beat their own child to death… nightmares I never knew existed actually do exist.  And I have no explanation for this.  I guess in order for there to be light in the world, there must be dark (thank you StarWars).

A big lesson for me throughout all of this has been about my perspective.  It continues to change.  Every day my perspective adapts to new (good and not-so-good) realizations I have made.  Every day I see more and more of the truth in life.  The more truth I see the easier I find it to enjoy the small and large things in life.

And don’t think for a second I regret or forget any of my past perspectives.  Oh, I remember them. You bet my kids will be getting a visit from the Tooth-Fairy.  Because I remember how cool it felt when my tooth magically disappeared and was replaced by a dollar…even cooler was the ice cream I ate with my dollar.

And every time I go to the bathroom on an airplane I laugh to myself.  Even though I know the truth.

Well…most of the truth anyway…

First, they had to establish a control, where no variables were altered in order to monitor how the homing pigeons normally react.  To do this, they took the birds, put them in a cage, and drove all the way to Chicago with the birds in the back seat.  When they got to Chicago, they waited until nightfall (in order to take the sun’s orientation out of the picture) and opened the cage.  The birds flew out of the cage, straight up into the air, circled once, and took off…East.  A few days later, the birds arrived back at their cage in upstate New York.

Now it was time to start changing some variables.  Perhaps these birds are really smart.  Maybe, while in the car, they could see the outside and were monitoring where the car was going, conversing with one another, “okay Larry, we turned left onto 80W…remember that!” To correct for this, they drove to Chicago again with the cage completely covered.

When they got to Chicago, they opened the cage.  The birds flew out of the cage, straight up into the air, circled once, and took off again, East…arriving back at their cage in upstate New York a few days later.

So maybe their super power has nothing to do with reading road signs.  Maybe, these birds could read the stars!

On the road again…from upstate NY, back to Chicago with birds in toe, in the covered cage in the back seat.  This time, the students released the birds on a CLOUDY night.  The birds flew out of the cage, straight up into the air, circled once, and took off again, East…arriving back at their cage in upstate New York a few days later.

Wow.  Okay, new idea.

Maybe they just needed to be a little disoriented…

Back in Chicago, before releasing the birds again, the students put the covered cage on a turn-table and spun the birds around for a few minutes.  They opened the cage on a cloudy night.  After staggering a little, the birds regained their balance, flew out of the cage, straight up into the air, circled once, and took off …East…arriving back at their cage in upstate New York a few days later.

Clearly, things needed to get more invasive.  Next, the students decided to disrupt the bird’s vision.  It turns out that when totally blinded, the birds don’t fly at all, so instead of covering their eyes completely, they inserted opaque contact lenses in the birds eyes (don’t ask me how one would stick tiny contact lenses in a pigeon’s eye…I wonder who’s job that was?  Probably an intern…)

Back in Chicago, after driving there with the cage covered, they released the birds with opaque contact lenses on a cloudy night.  And guess what happened?  The same darn thing!  They flew out of the cage, straight up into the air, circled once, and took off …East…arriving back at their cage in upstate New York a few days later.

Next step: magnets.  Maybe the birds simply used the Earth’s magnetic polls to navigate.  To disrupt this, the students tapped magnets to the back of the bird’s heads.  For sure this was going to work!

Once again, back in Chicago after driving there with a covered cage, the birds were released on another cloudy night with magnets tapped to the back of their heads.  The birds flew out of the cage, straight up into the air, circled once, and took off …East…arriving back in upstate New York a few days later.  The only difference this time was that the birds landed a few feet away from their cages.

Now things were getting serious.  How could it be that these birds were able to find their way home after changing their orientation and sight in multiple ways?  There was only one thing left to do.

The students drove back to Chicago, with the birds covered in the back seat.  This time they had inserted the opaque contacts AND tapped magnets on the back of their heads, AND released them on a cloudy night.  The cage door was opened.  The pigeons flew out of the cage, circled twice, took off… and landed somewhere in New Jersey a few days later.

Its interesting how an animal can have such a strong sense for home that it takes manipulating multiple factors to throw it off course.  I wonder if it is the same for us? Do we all innately know where we are headed?  Would I still be here now had I made different decisions in the past?  Would I have made it to this same point, just on a different road?

I’m not going to lie, there have been plenty of times where I feel like I too have a magnet tapped to the back of my head, opaque contact lenses in, and no idea where I am or how I got there.  However, these moments are always temporary.  Lasting only days or weeks.  Eventually I find something orientating and I am able to get back on track again.  The funny thing is, I have no idea what exactly this track is or what drive is making me follow it.  It is just there.

I often fantasize about different roads I could have taken.  I could have been an artist.  I could have been a writer.  I could have been a stay at home mother.  I could have been a yoga instructor.  I could have been a wildlife biologist.  I could have been many things…

And yet here I am, alone, on this terribly difficult road, working long hours, feeling degraded most of the time, sleep deprived, accruing a large mansion’s worth of debt, working so hard for something I have no idea what it even is yet…

But the drive is here.  It is strong.  And when that darn magnet isn’t taped to the back of my head, and those opaque contacts are soaking in solution instead of making me blind, I know I am exactly where I need to be right now, headed down the road I need to take.

Is it the Earth’s magnetic field? Is it my physical senses to the outside world?  Is it beyond what anyone can see?  Is it the universe?  I’m positive it is all of these things.

And I don’t need to drive back and forth to Chicago ten times to prove it.

Thank goodness.

(I took this photo in Kodiak, Alaska)

Someone I know once told me that the kind of car someone drives says a lot about who they are.  At the time, I was driving the same car I had been driving since high school, a red, 1993 Nissan NX 2000.  I loved that car.  It was the 3^rd car I had driven and by far the nicest.  My friends and I had done most of the work on it (my friends in high school and myself in med school).  Despite the fact it was a 93’, I could still fly in that thing like a bat-outa-hell (although your teeth might be chattering at 90mph).

Old Blue was the car I learned to drive in.  Old Blue was a 1980, blue, Toyota pick-up, fully equipped with roll-bars and a broken CB radio.  Instead of a middle seat, there was a cooler for your convenience.  It could go from 0 to 60mph in five minutes flat.  I learned how to drive in the ice and snow in Old Blue; doing donuts in the off-campus high school parking lot back in Colorado.  Unfortunately, Old Blue was donated to NPR after the clutch literally fell out on my way to class one morning.  I rolled into my 11^th grade pre-calculus class with Mr. Price half an hour late.  When I told him what happened he actually believed me as he had seen me drive, “that pile of crap” before.  Poor Old Blue.  May you rest in peace.

The second car I drove, the “Toyota” as my family and I lovingly referred to it as, had a very exciting life.  We bought the brown Toyota Corolla new in 1987.  My sister learned how to drive in it and subsequently totaled it.  As if that wasn’t enough, I too began to drive this car after the demise of Old Blue.  No one believed me when I told them the brakes would lock in the car until two accidents later and a trip to the junkyard with my dad (at this point, the car had a red hood, a silver side panel, a right headlight from a different model car, and no back bumper).  The “Toyota” too was eventually donated to NPR.  It fought on until the bitter end when my mother finally determined the car was too unsafe to drive.

This brings me to my amazing new car I bought this year in January.  It is the first and only car I have actually purchased (I know, kind of sad for someone that is 26).  It is a 2011 Nissan Juke in electric blue.  A true sports-cross, it has a turbo engine and all wheel drive.  It’s small, sleek, agile, has great clearance, and, when the seats are folded down, I can pack everything I own into the back.  Exactly what a woman of my nature needs.  Never before have I driven a vehicle where I feel like the car is actually an extension of me; doing exactly what I want, when I want, how I want.  My car and I are entangled in a complex relationship, one I never thought I would ever have with an inanimate object.

I first realized this creepy connection in March while I was walking to my car at 5am in the pooring rain to get to the hospital for a delivery.  When I got to my car I saw someone had CAKED my car.  Yes, caked; like birthday cake.  I couldn’t believe it.  I felt personally offended; similar to how felt when the kids in my high school acting class would whisper mean things about me knowing I could hear them.  The NERVE!  And of course, the reoccurring thought that goes through my mind at least once a day, “why are people so mean?”  I can’t comprehend people’s actions most of the time because I simply never think about things like, “Oh, wouldn’t it be funny to throw a cake on a random person’s car?” or, “hey, wouldn’t it be great to make that girl feel like crap?  Lets talk about how ugly she is so she can hear us!” or, lastly, to make this relate to medicine, “I don’t care if I have a opioid-addicted baby, give me more dilaudid!”  Okay, enough with this tangent.  You get the idea.

Lets bring all of this car-talk back to the opening statement because I did actually have a point to make in this post.  People’s cars reflect who they are. It’s interesting to think about my current car and my past history of cars because it really does correlate with my life at the times I drove the cars.  For instance:

Old Blue was a weathered veteran who had been around the block a few million times.  He knew how to teach a 15 to 16-year-old girl the basics of the road while not being quite agile enough to cause any real trouble (there were roll-bars just in case).  He was strong enough to withstand her learning how to drive a clutch, and made it extra difficult to shift gears, that way, she would appreciate ANY other vehicle’s clutch in the future.  When the limit of his teaching had been reached, he retired.

The, “Toyota” fit the more mischievous teen-age girl type.  To be honest, I made a wreck of my life at that time and I made a wreck of the car.  Every time I fell, I would look for the easy and cheap way to get back up (cheap = less effort on a personal level). Similarly, instead of actually getting the poor car fixed, I went to the junkyard to makeshift a fix.  When my personal life made a huge shift for the better, so did my car.

The NX was a great car.  I took care of it the best I knew how.  I drove it many miles.  I kept the inside clean.  The back of it was large enough to fix all of my things as I moved from home, to college, to working, to medical school.  I could speed up reasonably quickly, however; it was always a bit sluggish until it reached about 3,000rpm’s…that’s when the burst of energy came.  The cruse control never worked.  Neither did the AC.  It supported me on many travels but by January of this year, it just couldn’t handle the demands I was putting on it.  Oh, and did I mention this is about the time I realized too much running was draining my energy and making me sick all the time?  Finally, in Medford, Oregon right before I was going to make the great schlep to LA, the oil tank exploded and oil backed up into the engine.  It was time for a new car.

And now I have my Juke.  Let me tell you, every time I go into my car, I am grateful for it.  I looked at my odometer the other day and I realized I have put 14,000 miles on my car since January.  That’s a lot of moving. Being in Phoenix now does not decrease the stress being that I am commuting at least 1-2 hours every day in 115 degree heat.  But my car is compound, fast, agile, strong, and it can surely handle anything Mother Nature throws its way.  I keep it clean inside and out.  I treat it with only the best synthetic oil and the highest quality gas.  I think if I keep this up, my car will surely last as long as I need it to. For me personally, life has never been more demanding.  Rotations, residency applications, exams, family changes…and I feed myself only the highest quality food and I refuel my tank every day with yoga, meditation, and other physical activities.  This girl’s gonna make it; she’s compound, fast, agile, strong, and she can handle anything the universe throws her way.

The point of this post is not to suggest that everyone should go out and get a new car.  It has nothing to do with that.  We are who we are right now at this very moment in time.  This car-talk is an example of how our physical surroundings are a manifestation of who we are right now.  Is the inside of your car a mess?  How has your life been lately?  Hectic?  Crazy?  When was the last time you ate a healthy meal? Changed your oil?

The good news is that although you are who you are right now, you are going to be different in 5 minutes.  So, if you have a stack of dirty dishes in your sink from the past week, you still have time to wash them.  If you haven’t taken the time to sit down and stop for a moment, you still have time to breathe.

Take a look around yourself and then inside.  What do you see?

PS: This is my photo.  I took it in Vancouver, BC.

The Rainbow Connection

 Written by Paul Williams; originally performed by Kermit the Frog

Why are there so many songs about rainbows
And what’s on the other side?
Rainbows are visions, but only illusions,
And rainbows have nothing to hide.
So we’ve been told and some choose to believe it
I know they’re wrong, wait and see.
Someday we’ll find it, the rainbow connection,
The lovers, the dreamers and me.

Who said that every wish would be heard and answered
when wished on the morning star?
Somebody thought of that
and someone believed it,
and look what it’s done so far.
What’s so amazing that keeps us stargazing?
And what do we think we might see?
Someday we’ll find it, the rainbow connection,
the lovers, the dreamers and me.

All of us under its spell,
we know that it’s probably magic….

Have you been half asleep
and have you heard voices?
I’ve heard them calling my name.
Is this the sweet sound that calls the young sailors?
The voice might be one and the same.
I’ve heard it too many times to ignore it.
It’s something that I’m supposed to be.
Someday we’ll find it, the rainbow connection,
the lovers, the dreamers and me.

Tonight, my sister and I sang this song together in Karaoke.  It’s a song the two of us grew up singing together.  I remember like it was yesterday; the two of us blasting Kermit the Frog in the living room of our old Denver home over and over…and over again.  Sometimes I would notice my sister crying while we sang it…mostly I think because of the shear beauty in its meaning and how much the two of us believed in the words.  This song explains a lot about how the two of us think and our unique outlook on the world.

“The Rainbow Connection” ranks up there as one of my top favorite and most influential songs in my life  (along with Louie Armstrong’s “What a Wonderful World”).  To me, this song is about the feeling of knowing there is something more to life, something magical, that one must believe in even if they don’t see it.  The real kicker is that this thing is actually apart of us all of the time.  Intuitively, we know this feeling is, “something that I’m supposed to be”, but it seems we spend all of our lives searching for it…whatever “it” may be.  The lovers seem to find it, the dreamers are always looking for it, and then there is me…is the feeling real?  Or are we chasing rainbows?

Is this feeling God?  Is it love?  Is it truth? Is it magic? I think it’s probably all of the above.

The song also brings up the idea of illusions and how we are constantly creating illusions and believing in them.  One could really argue that your whole life is one big illusion unless you become aware and honest enough with yourself to trash the illusion and start creating your own reality.  The concept of illusions is best illustrated in a book everyone should read called Illusions by Richard Bach (author of Jonathan Livingston Seagull, another great book I highly recommend).  Non-the-less, this song touches upon this incredibly in-depth concept wonderfully and succinct.  I won’t go into the idea of illusions in this blog entry, but I will another time if any readers are interested.  It is a wonderful discussion I love having and something I have put a lot of thought into (almost as much as the great question of “how is the world going to end in 2012?” but I read an article a few months ago that gave a rather convincing argument that the world would end due to solar flares).

It’s amazing to me how such a powerful song would be put into a kids movie and sung by a Muppet, but what’s even more amazing is how my sister and I instinctly knew, even when we were small, the significance of Kermit’s song in the swamp.

I would love to go into the meaning of this song more, but for now I think I will just keep singing it during Karaoke with my sister.  Even if it still brings tears to our eyes.

Enjoy!

PS: Sara Mclaughlin does an AMAZING cover of “the Rainbow Connection”.  I’ll post it for everyone to enjoy on my facebook

I’ve been doing Yoga off and on for about 13 years but it hasn’t been until the past 3 months that I have been trying to do it religiously every single day.  I was attracted to the warmed Americanized Vinyasa flow due to the excellent workout and six-pack side effects.  However, as anyone who has embarked on a yoga journey will tell you, many changes occur…ones you may not expect.

I never thought I would be one of those people who refer to yoga as “a journey”.  I was perfectly happy to admit I was doing it for strictly superficial reasons.  I always said running every day was my meditation and doing yoga was for strength and flexibility.

Over the course of this year, I kept getting plagued with nagging running injuries and was constantly feeling exhausted and overwhelmed.  I began dreading my morning runs because I knew it would lead to me fighting falling asleep while working 13hours at the hospital and stiff joints while schlepping up and down the stairs.  So, in the month of May, I decided I would try something different.  I told myself was going to do hard-core, sweat your ass-off yoga every single day (and okay, lets face it, I am a cardio junkie so I also throw in about a half an hour of light cardio if I have time) just to see what happens.

And it’s awesome.

For the first time EVER, can sit and study at night without falling asleep AND FOCUS!  AMAZING!  Stressful situations have stopped bothering me as much.  I’ve stopped obsessing about useless things.  Overall, I feel an overwhelming sense of calmness and level-headedness.  Plus, my abs, arms and legs are looking pretty stellar.

Of course, as I dive deeper into my practice, I’ve made other realizations in my life.  Realizations of things I would not have necessarily noticed before.

For example, lets talk about hand-stands.

Before the last 3 months, I couldn’t have cared less if I could or could not do a hand-stand. Now I really care.  I care because I haven’t been able to do it.  Finally, there is something physical with my body that most everyone around me can do (at least in yoga class), but I can’t seem to figure it out.

Every single class I see them.  Big people.  Small people. Older men.  Thicker women.  I find myself looking around, examining their body habitus, looking to see which muscles they are contracting…”they aren’t even using their arm muscles!”  I tell myself.  “I saw that woman trying to do crunches and she couldn’t last 5 seconds…how is it that she can stand on just two hands with her legs flying in the air like that?  There has got to be something I’m missing…”

I’ve been trying.  I’ve tried starting on my hands, forearms, even my head (which I don’t recommend…).  I’ve tried focusing on my hips and core then trying to flail my legs into the air.  The other day I got maybe a half of a second of air-time, but quickly landed on the ground with a loud THUD, slipping in a puddle of my own sweat.

I’m not gonna lie, this frustrates the hell out of me.

Then tonight, something amazing happened.

No.  I did not do a hand-stand.  I did the splits.  Yes.  The spits.

Truth be told, I wasn’t even trying.  It just kind of happened.  Granted, I can only do it on one side (my left hip flexor is looser than my right), but hey, I’ll take it.  As I sat there, breathing into this pose, noticing how weird it felt to have my peritoneum on the floor, I realized why it is that I have not figured out how to do a hand-stand yet.  I bet you may be thinking, “yeah, your trying too hard” or, “stop comparing yourself to other people.” But no.  I don’t think that is what it is (well…maybe the whole comparing yourself thing…but in my defense, no one has ever really taught me how to do a handstand so I have to watch others to figure out how to do it…).

I honestly don’t believe people can try too hard unless deep inside, they have no intension or belief they can do whatever they are trying to do.  Then all of the trying is just for show; a lie people tell themselves because they are afraid if they actually do try, they will fail…and then what will they say?  That they are a failure?  I see this pattern every day.  “I tried to stop smoking”, “I tried to stop drinking”, “I tried to stop dating self-destructive people”, “I tried eating healthy”, “I tried to stop switching lanes without looking”…the list is endless.  Bottom line is, most people don’t have the balls to say, “Ok, that’s it.  I’m going to stop making excuses for myself and actually believe I can make a change.  I am changing!” And change.

So what does this rant have to do with hand-stands and splits?

<Back to the Mat> As I sat there, doing the spits, with the sweat dripping off of my nose onto my mat, I thought to myself, “holy shit.  I never in a million years thought I’d ever do the splits!” I know.  Another episode of Deep Thoughts, by Shana Shosky… But in all seriousness, I had been spending all of this time and brain power focusing on doing a hand stand that I didn’t even notice how my body was changing to do something like the splits.

Then I started thinking about all of the other things in yoga I have been able to do this past month…I can do some balancing poses on just my hands (not quite a hand-stand), I can do that jump-floating thing to the top of my mat, I can hold chaturanga for like 30 seconds (in the correct alignment), and do many vinyasas in a row without my arms getting tired…among a long list of other things.  All things I could not do 3 months ago.

Tonight, with my left hip flexor and right extensor pressed on the floor and my arms in the air, high above my head, I realized that maybe it’s just not my time for hand-stands yet.  Maybe my body needs to figure a few more things out before it’s ready.  Maybe I need more strength. Maybe I need more flexibility. Mostly, maybe I need to let go of whatever fear is holding me back.  Let go of the judgments I fear I will put on myself if I try and fail.  I need to let go of that need for instant gratification and embrace the journey.  I know I will get there eventually.  I just have to keep trying.  And I will.  I will do a hand-stand. And goodness knows what else I will unexpectedly find myself doing along the way…

We all have things in life we want so badly all we seem to do is obsess about how we don’t have it…or make ourselves believe we will never have it because we are afraid we will fail.  But the truth is, if we keep trying, stop judging, and actually believe in ourselves, we might find ourselves there quicker than we think…enjoying some amazing experiences along the way.

So, what’s your hand-stand?

This past week I have been in a rather irritated mood…and, of course, tired as all get out.  I think it has a lot to do with the last few months finally catching up with me.  You see, in the past 8 months, I have lived in 5 different cities, worked in 5 different hospitals, 4 different clinics,.and worked with about 20 different doctors.  My car, which had 65 miles on it at the end of January now has 12,000 miles on it.  In the last 6 weeks alone, I have driven from San Diego to Portland, Oregon, taken 2 board exams, moved to Phoenix, flew to Philadelphia for another board exam, and then imminently  started working again.  I’ve gotten pretty good at this whole moving thing.

And every time it doesn’t really get any easier.

Being in a new place constantly is exciting.  But at the same time, I think we, as humans, need something that is physically constant in our lives.  Sure I know I can always call my friends when I am lonely, but there is something to be said by having someone you can call up and see a movie with, or have dinner with.  Simply put, it would be nice to physically spend time with another human being.  And dating?  Ha!  I feel like this is  near impossible.  Not only am I in a constant state of limbo, but who would want to date someone that works sometimes over 80 hours a week?  Not to mention I’m so socially awkward I have no idea what “normal” people actually talk about…

“how was your day?”

“Well…lets see…today I had to tell a patient their baby has a fatal genetic abnormality and its going to die.”

“Oh…that’s…interesting…”

but dating and social awkwardness is a whole other subject we can talk about later.

So what gets me, and us (those who understand EXACTLY what I’m talking about), through the day?  I’m not referring to motivating factors such as the feeling of inadequacy, the fear of failing out of medical school, being a horrible doctor, ext…I’m talking more about how is it that we can adapt to our world which is constantly changing.  That which causes the feeling of, “home” and “belonging” seem like a distant memory…

I think I may have figured some of it out.

It boils down to is a list.  A simple list of things we can always count on.

For example, at the hospital/clinic:

-You can always count on the fact that the anesthesiologist will never wear his/her surgical mask over their nose

-There will always be one really mean scrub nurse, and one really nice scrub nurse

-Office staff workers love cookies

-You probably won’t be able to get into the computer system on your first try

-You will learn your way around the hospital by the end of the first week but until then, you will feel like your head is spinning

-If there is another med student, odds are they are they are going to be annoying..but also nice.

-Free lunch means pizza. And drug reps.

-The attending will always be either 10mins early or 10mins late

-At least one patient you see during the month will have some kind of rare disease or complication that you just so happen to be there to witness

-You will learn the most on the nights you are on-call

-No matter how much you read and study, you will never know everything.

-There will be one attending or resident you will share a positive moment with; a moment  you are pretty sure they appreciate just as much as you do.

and then there is the things you can count on at every gym you go to, or for me, yoga studio:

-There will be one really hot male yoga teacher who’s class is filled with woman, just hoping he will adjust their posture with his sweating hands a little too high up on her hip flexors…

-There is always at lease one older creepy man in the class, who I’m pretty sure doesn’t choose the back every day just because he wants to be close to the door…

-There is always one really skinny chick who does not follow the flow but does whatever insanely hard poses she can think of just to show off.

-1/3rd of the class will be composed of woman who probably spend an hour putting on their makeup and  way too much money on their outfits

-If there are any younger, good looking men in the class, they are probably there because their girlfriend dragged them there (except creepy old guy, but he’s not good looking remember.)

-The yoga teacher will always say at least one thing that helps me let go of my day.

-In the gym, if a girl watches a boy workout, they both try harder

-I always feel better when I’m done and I’m always grateful I went.

After thinking of just the commonalities in the two things I do everyday (work and working out/yoga), I realize there are a lot of things in life you can count on to be there.  Friends. Family. My awesome car (yes, I have a rather creepy relationship with my car…I’m obsessed…)…and that makes me feel a little better. A little more stable…

A little less alone.

I will be changing names and perhaps places as I see fit.  I don’t want feelings to get hurt or to burn any bridges in things I may or may not say…any names or places and I fail to change or you think, “oh, I know that guy” or, “hey, that name is familiar” is simply coincidence…

….but honestly, if you read something and it makes you think of someone you know, I personally believe that in life, there are no coincidences…