Of Pretense and Persuasions

Saturday, August 26, 2006

I am an artiste!

Great news today: My very first art exhibition has been scheduled for January 2008; kindly hosted by the Yale Medical School Library. Whoo hoo.... the deadline gives me much incentive to blow the dust off of my acrylics, finish some of my pieces, and otherwise put the rest of my visions down onto canvas. I am super excited. This, I promise you, is going to be flippin' awesome.

Looking: Maid for Hire

I need a maid. Seriously. In college, I used to secretly laugh in sheer horror and disbelief at my snotty upper-class friends who came from families who hired maids. I thought it was silly, excessive, and seriously weird. I mean, its like... uh.. you say you pay someone to pick up your nappy laundry up off of the floor for you? ... uh, come again?

Now, however, I think I've reached a point where I actually am willing to pay someone to pick my nappy laundry off of the floor from me. I'm too exhausted at the end of the day to do anything else and when I do have free time [rare] -- I have better things to do. Like blog, for instance.

The issue is time management. Do I want to spend my weekend cleaning or do I want to spend it learning and reading?

Well, actually, the real issue is that I am spoiled rotten.

So much changes, so much stays the same.

Teen pregnancy breaks my heart. Yesterday, I saw a pretty extreme case of teen pregnancy which just screamed WRONG in every angle that you looked at it [don't ask me for more details... pt confidentiality and all...]. What bothred me the most, though, was that the girl was someone for whom mountains had already been moved to ensure that her life would be brilliant. She was a poor girl from the ghetto who, thru pure luck and circumstance, met a very kind, very priveledged, future Yale Medical Student when she was six years old [the girl, not YMS]. YMS had, at that time, taken Girl under her wings and mentored her to the extreme for the following TEN years -- single handedly made a national champion track and field athlete out of this girl. Girl went on to meet lots of famous people and was exposed to the elitist world of academia which the poor in this town are generally excluded from. Girl's mom got weirded out by YMS, kicked YMS out of Girl's life and, lo!, two years later, Girl gets impregnated by a kid in middle school.

I mean...... seriously. There are several issues here:

[1] What business do people of priveledge have in helping the underpriveldged out of dire straits? Intuitively, I've always sensed a moral imperative that justifies such actions and, in fact, one that deems such actions as absolutely neccessary. In whatever way or form you can, it is important to help the poor help themselves. .... but are their limits?

[2] Failure. Is this girl a failure? At first, glance, I thought YES. Now her mother has another mouth to feed. Now she will have a harder time fulfilling her school requirements. Now she will have to start looking for a job or some sort of immediate source of income. So, basically, now, she's f***ked. But that's an erroneous way of looking at it. Yes, she's a failure by the standards that I set for myself --- but it is unfair of me to impose those same standards to form judgements. In her community, in her small part of the world, having a baby is the thing to do. You're a teeneager, you have a baby. And the cycle [of poverty] continues.

Midwifery

So far, I've delivered three babies and watched many many more. I think, at this point, if I was left out in the wilderness with two cans of soy yogurt, a sterile scissor and a heavily pregnant woman, I could probably survive AND deliver the pregnant woman on my own. I think. Maybe I need a few more deliveries under my belt to be REALLY sure ... but I am more or less confident.

The interesting thing is that most of my deliveries [2/3] have taken place in the setting of midwives who have taken me under their wing and shown me their secret art. Let me tell you : they do SO MUCH better of a job than the M.D.'s do at delivery. They are kind, they are gentle, they rely more on their manual dexterity and clincial acuity than on a million beeping monitors to make decisions. They are more successful at preventing tears and all told, they do a more human, more natural way of delivery. The midwife I worked with was massaging the back of one of the women I helped to deliver -- something no M.D. would ever stoop to do. In fact, the M.D.'s here mimize their contact with their patients to the extreme [ah, yes "sterile environment," huh?] and are, emotionally, one further step away as well. I would much prefer to do deliveries as Midwifes are trained to do it rather than the way medical doctors are trained to do it. The unfortunate part is that this is only possible if I move to Papua New Gunea and practice my secret art in a non-litigeous environment.

Tuesday, August 22, 2006

I delivered a baby!


Tonight was the first time that I actually got my hands dirty by going through the whole process of helping a woman push her baby out from start to finish. As in, this time I wasn't just watching, I was actually doing the delivery.

Turned out, my first deliver was of a baby girl named Gayathri; born at 10:26 pm [the same time I was!]. She was gorgeous with long tufts of black curly hair. And the parents were so cute and happy and very thankful at the end.

Couple of things:

[1] I just love being around Indian people and Indian families. There is just so much warmth and love in the room that eminates from a shared history, a common culture.

[2] The experience of having a family and having a child is so incredibly powerful and beautiful and I never quite appreciated the extent of either facet at all. In fact, growing up, I always considered familial and filial duties in life to be rather onerous and boring; but I think my perspective may start changing. The hope is that I don't get so consumed in my aspiration to be a brilliant doctor that I forget to live life to its fullest; to experience all that there is to experience; to love and be loved.

[3] I forgot to put shoe covers on and ended up getting bloody goop all over my super-expensive European Hotters. I truly don't mind. I'm much less bothered by it than I thought I would be. The only issue is that other maternity patients are visibly disturbed when they see me walking down the hall with blood all over my shoe. They have no idea that what they are soon going to go thru is a really bloody messy process.

Saturday, August 19, 2006


I'm going to be on night float starting Sunday evening at 7 pm. This means, that I'm on duty for all Ob/Gyn pts with the rest of the night team. Fun fun fun.

I'm already at work trying to flip my circadian rhythem topsy turvey. The goal tonight is to stay up past my usual bedtime of 8 pm and sleep all day tomorrow.

I am killing time by taking dweeby pictures of myself to show my mother the result of my most recent haircut. My hair keeps getting shorter and shorter and frankly, I like it. It looks like I stuck my hand into an electric socket, but hey, that's cool... that's style... I'll take it.

In college, I was a math major. I used to sit in the back row, for every class, slouched low in my seat, with the hood of my sweatshirt pulled over my head. I almost never said a word, never asked an intelligent question, and generally, had no idea as to what was going on. My neighbor, for at least two years, in the back row, was an equally mysterious guy. Math majors don't socialize with each other ... in fact, they refuse to engage in small talk of any sort ... and so what I know about this guy is based on observation and the one 30 second conversation we had.

His name was Talwar. He was in import from India, two years my junior. He was a nationally ranked Indian Tennis player who deified Leonard Cohen. He would sit in the back row with me, doing his Russian homework, occassionally looking up to the blackboard to see what the professor was doing. The one conversation we had took place towards the end of my senior year when, after watching him struggle with his Russian homework for most of the class period, I cooly said to him, in perfect Russian, "You know, I speak Russian fluently, I could actually help you with that."

It was hilarious.

Anyway, I was reminded about Talwar because today I went to see the film "Leanard Cohen: I'm your man."

Cohen was a master poet; often cited as the Byron, the Blake, the Tennison of our time. He wrote a song "Traveller" which, he said, was about being guiltless in the context of a destiny unfulfilled. The way he put it was like this: In our lives, we come out of youth bearing some sort of destiny, some sort of goal, some sort of mission. We live in a world full of hope and idealism, where we assume that we are the masters of our lives, the heros of our tale. And then, reality sets in and we find that our winning steak has ended. His point seems to be that success is not about fulfilling your destiny; in fact, according to him, you aren't supposed to fulfill your destiny. Success is about being guiltless in the setting of a path diverted.

I understand his point perfectly.

Thursday, August 17, 2006
















Goofball throws a birthday party.

I had a party at my house on Sunday. Cooked a lot of yummy elitist vegan organic Indian food and had a handful of friends over to watch Rang De Basanti with me on my *ridiculously* cool and extravagant INFOCUS projector/in-house movie theater set up. It was sweetness.

That's me in the picture. My hair has since gotten significantly shorter due to a haircut I got this afternoon ... possibly a mistake. Oh well. Anyway, Sheela is in the background. Duncan is standing next to Tarka who has the cake. Vegan chocolate cake. Mmm mmm goodness.

Sorry for not updating. I have no time to do anything but work and sleep and sometimes eat. I hate how everything in Ob/Gyn is suffuse with nervous energy. People run around like headless chickens freaking out at anything and everything. There is never a moment when the floor is not full of residents scurring hither and tither doing work, creating work, or otherwise pretending to be extremely busy. I hate it.

I hate it because I live in a world which I think should be calm and controlled. The unexpected happens, but you deal with it cooly and carefully. The noise, the din, the clamor, the complete disorganization of Ob/Gyn as it is practiced seems to me to be rather silly. Unnessessary, really. I mean really, do people really need to assume to roll of some lame rah rah college cheerleader when a woman is having a baby? Please, man... give her some peace.

Don't get me wrong. Now that I'm on obstetrics, I actually do like it. As in, at the end of the day, I go home feeling happy. At least, yesterday I did. The trick, I've discovered, is to spend as much time as I can with my patients and as little time as I can with my residents. Patients make me happy, because they are the ones suffuse with positive, hopefull, exuberant energy. Most of them, are excited about the new arrival to their family; most of them are so positive and optimistic even in the face of complications and unexpected hurdles. And most of them, are so unbelievably kind, considerate, and grateful. Motherhood is a beautiful thing.

Sunday, August 13, 2006

Its my birthday. I'm 23. Last night I helped deliver two babies ... the first will die shortly from pulmonary hypoplasia and the second will likely be a strong healthy boy. I'm exhausted. Yesterday was an emotional rollercoaster -- I started on the Gyn-Oncology service [depressing], did a consult in the Emergency Dept [interesting]; and then spent the night on Labor and Delivery [awesome]. And now I'm trying to read up on Obstetrics in preparation for the coming week. So far, I am pretty sure that Ob-Gyn is not for me. So far, the clerckship has been rather miserable. There are cool parts, for sure, but a lot of not so cool parts too. Eh.

I think I want to go back to California where people are actually friendly. And today I think I want to be a plastic surgeon.

Friday, August 04, 2006

Alright. Back up. Let me fill you in. Last weekend, NIB helped me move. Out of the 5 friends who had offered to help me, he was the only one who came thru on his promise. Bonus points for him. I am certain to feed him dinner at some point but first, I have to take care of myself.

This week, I have been a wreck. My week on Benign Gynecology was a crash landing on all accounts. I was super stressed, sleep-deprived, tired [from moving], and hungry [not eating]. Well, I was eating something, but that something was usually hospital crap since I didn't have any groceries of my own. I have not worked out all week [and yet, my body aches] and my meditation sessions have been half-assed, rushed and altogether crappy.

I was completely out of balance.

Nonetheless, things are turning around. Yesterday, Melissa took me to the grocery store, so now I have food. My day today went SO MUCH better, all because I had my own pure vegan organic elitist food to eat.

So, today I discovered the secret of making patients think that you are the world's greatest doctor... in 15 minutes or less. Here's the trick:

At 6:00 am, my resident told me that I had to scrub into a surgery case at 7:30 because they needed an extra hand. At 6:45, I found myself waiting idly for 7:00 rounds to start when, it dawned on me to bust my ass on over to the pre-operative waiting room and meet the patient I would be assisting on. I go over, introduce myself, hang out, ask the pt about what she does, her family, her grand kids, watch the cute anesthesia guy do his shindig with her .. and then after that is all done, tell her that I'm gonna be there with her all the time, in the room, taking care of her post-op and that if she ever needs anything at all or has any questions at all, I am her go-to girl who will take care of her no matter what. Ten minutes of that, and I was busting off to present my other patient at rounds. I skipped out early to then go back to this pre-op patient and help anesthesia walk her in and put her under.

I was in her surgery; it went beautifully. I was busy in Clinic all afternoon and was told to go home, but I felt guilty about doing so without seeing this my surg case post-operatively. So at 6:00 pm I went back up to the floor to check on her and ... dude.. she was so happy, so golden, so incredibly well. When she saw me she beamed and was like, "HEY TEJ!!! I'm so glad you came and talked to me before my surgery. That made me feel SO MUCH better about going in. And it meant so much for me to have you there all the time, and even when I was waking up. You are such a fabulous doctor!!!"

Wow. I mean, I'm not even a doctor. Seriously, all it takes is 15 minutes to give someone the impression that you are there to serve them, that you care about them, and that you will work hard to see that everything is done for them. And all of this is true and genuine, but sometimes Docs are so busy, overloaded, and stressed that they don't take the time to just chill and express this idea to their patients. I hope that in the future, when I am a stressed out chicken-scared resident, I will remember this lesson and be able to put my stuff down for a few minutes to just go and kick it with my patients. And the truth of the matter is that [a] it doesn't take much time and [b] patients feel and recover so much better if you do it. Its all about builing trust in the relationship.

Man, I love my job.

Wednesday, August 02, 2006

Sorry, haven't updated for a while. I've been busy moving my crap across town. Pretty exhausting, this OB/GYN thing. I was in surgery all day yesterday... and my feet are killing me. I have a more of the same today and would like to write more but I have to go meet my pt before she goes in. Bottom line: I'm doing well. I might be throwing a party soon -- an African-Indian fusion party of sorts to celebrate moving, life, happiness, friends, etc. Celebrando para celebrar. There is talk of running off to Boston for a weekend too... now that my side kick TA has a car.