Beginner's Theater: I'm not a doctor but I play one on TV

Lately,  I haven't slept well.  It's not stress (I think); It's not caffeine (lies), It's not the paper-thin walls where I can hear every last apneic gargle/grunt/snore/choke from the neighbor next door.
Underlying sleeping disorders aside, I keep waking up to memories. Specifically, songs. This isn't abnormal; most people call them dreams, sans the visuals. But Monday, Tuesday, Wednesday all yielded a similar routine of 11pm, toss/turn, sleep, wake at 2AM, something on my mind. Lyrics. Music. Routines. Lines. Dialogues. An omnipresent musical backdrop, a mental movie-montage that punctuated my sacred REM time.

Some of these memory-dream-things date back as far as 2007; a familiar sense of a resonating, ground shaking bass from Grease dress rehearsal, the melody to an overplayed, over-covered Journey song in a summer stock while slapping a wireless mic to my sweaty face backstage, silently freaking out about an impending ball-change, pas de bourre, pirouette, leap, sing, jump.

My sleep specialist tells me, "Veronica, if you can't fall back asleep within 30 minutes and you feel rested; get up.  Make breakfast.  Start your day."

And so, at 2 or 3AM, there I am, cooking eggs and planning my outfit for the gym, which won't open for another 4 hours.  And while I open a book, or another laptop, I have even more time for my already busy mind to race for the 1000th time and think about why I'm sitting exactly where I am today.
This theme of mine (which you should get used to for the next 4 years); this motif of really taking a step back to look at the person you've become and continue to evolve into dictates much of what I choose to do, how I choose to behave and how I interact with others.

I keep thinking: Veronica, you are so dumb. Why are you worried about the person you are?  It's weird.  It seems narcissistic.  It seems self-absorbed.  It seems way too introspective. FOR THE LOVE OF GOD GO STUDY.  When will you STAY somewhere? Will  you ever go back to California?  Do you WANT to go back to California? When, more importantly, where, will you (::shudder::) ever settle.

And I realize, sometimes I lie awake at night after these weirdly irritating musical-theme dreams, that when I'm stressed (always) I have the tendency to fall back on those memories and rituals that are safe and habitual, those formative experiences and circumstances that made me brave enough to be in front of 400 people, although I claim to dislike many, to be afraid of many.

My first test in Cardio/Renal/Pulm was less than satisfying.  About 5% short of satisfying.  And so, to ensure that I was never 5% short again (not hard when SPEC committee gives you the proverbial slap on the wrist speech) I did as any good Theater major should.

I rehearsed.
I rehearsed because that's what I know. I never was good at memorizing things I could not feel, things I could not touch or ascribe an emotion to.  But I am good at anthropomorphizing. When it came to scripts in Theater; that was fine. Pages and pages of lines memorized word for word; committed inflections, concomitant actions, the right walk here, an appropriately-timed head turn there, the perfect pregnant pause right before a gun-shot goes off in the distance, the way you had to move and flinch to make it look real for every audience member watching your every move.

That was easy.  And here I was, eating my eggs, feeling sorry for myself before the crack of dawn, because I can't "memorize" 40 kinds of Cardiomyopathies.  40!  It seems nominal, silly, trivial now.  40 diseases and yet my whole undergraduate (and prior) MO was based on method acting. Stanislavski (for the people who are shaking their heads saying 'Veronica, make sense please': he was a famous Russian actor and theater director who formed the groundwork of the discipline I "studied") approached theater as a serious endeavor requiring dedication, discipline and integrity. Throughout this dude's life, he scrutinized and subjected his own acting to a process of intense artistic self-analysis & reflection. Stanislavski's system, specifically,  is a progression of techniques used to train thespians to elicit believable emotions in their performances. His technique evolved to be a method of physical actions whereby emotions are produced through the use of actions. For example, if an actor needed to cry, he could sigh and hold his head in his hands, a physical manifestation that many who are weeping instinctively do. On stage, if an actor experiences only internal feelings or only physical actions, then the performance is pretty much useless. Stanislavski's reasoning was that there ought to be the union of psychological and physical to make a performance come "alive". The two go hand-in-hand and are not mutually exclusive.

Yea yea yea ok, who cares.  True to the med student mantra: "How does this relate to school and do we need to know it for the test?"

Well, for me, actually....yes.  

It was weird. It was annoying.  But it's how my brain works.  And so, for every pathology, every disease, every medical jargon we were given...I gave them attributes. I imagined people-patients, or myself.  I told the "story" of the disease.  And even when the narrative was abstract or strange, I turned it into a logical one.  I had to. And only then did physiology start to make more sense.  I could see it.  I could understand how it affected people beyond an obfuscated vignette that began with "a patient presents with...."

And it's cool if you think it's bizarre. Because...it is.  

And somehow, by the grace of God or Stanislavski-God or that crazy gypsy San Franciscan fortune teller who said everything would work itself out....it did.

I finally passed.  Like, for real passed.  Passed without a curve passed.  I still inherently struggle; that won't change.  I won't become a CRP savant overnight (or probably ever).  And good old Stan probably won't be much help come Neuro.  But for now, it works.

For now.  For now, I am still a borderline crazy person who needs to figure out how to stay asleep past 3AM (unlikely).  For now, I am still afraid that suddenly this won't work out and I'll be where I was before with no system, no working method, forced to just "memorize...because...you do" for Test 3.
But I have a week to relish in super minor successes of the month, like successfully half-embalming a person (gross, yea, but pretty cool too), and running 8 miles in one day without dying, and asking that one guy to ask that OTHER guy if the latter guy has a girlfriend. Tertiary inquisitions are way harder than they seem, trust me. I have a Master's in Awkward and know all about it.

It's 9:48PM, which means it's time to do dramaturgy...and by that, I mean note-taking, for lectures tomorrow.  Because that girl who didn't know jack about medicine is employing every means possible to act like a student of  medicine. From what I've observed, apparently it's a lot of pacing, freaking out, buying study aids you don't need, and pretending you know more than you do.

But that's a pretty good method if I've seen one. And as an audience, I'm pretty sure you're buying it. :)

xo,
V

Introduction to Epidemiology: The Prevalence of Boringitis in My Post-Meridian Routine

I swear, I had a better, more profound post in progress, but it got pushed to Blog Draft Purgatory because I'm in the midst of studying for our second Cardiology exam (er, I was).

Lots of people-and by lots, I mean my grandma and sometimes a bright eyed bushy-tailed college student-ask me "so, what do you do in medical school?"

This is typically followed by something analogous to "Is it hard?", at which I usually shake my head no and say that anyone with a copy of a medical curriculum and access to Wikipedia can probably learn what I am, sans the 250,000 dollar expenditure.  There's a couple other factors involved, obviously; I consider them mostly swag (my stethoscope is about the only cool device to make me look fake-important around non-med student society).  That whole licensing thing is probably a big deal.

I present to you: the boring day in the boring life of a boring student preparing for a boring exam (Actually, Cardiology is pretty cool.  My brain is just really tired of seeing words that end in -itis, -oma, or acronyms). Up next post: Why not to blow off OMM if you want to be a fancy pants orthopaedic surgeon, how avoid dressing like you're still 20 years old and in a sorority while seeing your standardized patient and other frilly formal grad school events (I once thought this would be kind of fun....recent observations have made me deem it necessary.  Le sigh), and other nuggets of golden talkity-talk.

Tuesday, the eve-eve of Exam 2 in Cardio.
5pm: Park myself in the Anatomy Lab Lounge.  Probably the only perk of snaking the drains in work study is the super quiet, non-argumentative or passive aggressive atmosphere of the Cadaver Lab.  I kind of love it.
7:15pm: Pandora is on.  I read at a rate of about 2 words per minute because every song is distracting although I'm lying to myself to say it's not.
8pm: Medication time.  I have a "condition" (I quote it because it sounds ridiculous and everyone makes me spell it aloud) called idiopathic hypersomnolence disorder.  For anyone who doesn't like 10 syllables, it's essentially a close cousin to Narcolepsy, which unlike many movies portray, is not randomly falling asleep everywhere....although it CAN be like that, but think more of your brain shutting down, not necessarily sleeping (i.e., can't talk effectively, poor motor control, laughing or even getting emotional is exhausting...it's weird).  I'm annoyed and uncomfortable because that's what CNS stimulants do to you.  I eat Grant's (my study husband) entire pack of gum out of nervousness.  I have a problem.  I LOVE GUM.
9-ish: The freak out stage commences.  THERE IS SO MUCH !@#(*&!@#(*&!@#(*& TO LEARN AND I HAVE NEVER SEEN IT BEFORE OMG WHAT AM I DOING WITH MY LIFE.
10pm: the munchies stage.  I eat everything I can find.  Redbull counts (it tastes like gasoline; why do people pretend to like this?).   I resume Pandora in hope of a serendipitously timed inspirational song.  Kendrick Lamar disappoints me.  Subliminal lyrics are telling me to drink heavily and then fall asleep and reminisce about the pool for liquor then you dive in.  Or something.

I pause here to ask Grant, "What ELSE did we do Tuesday night? I need more to write for this post."
Grant replies something gross and inappropriate (and untrue).  Make up your own joke here because it's probably verbatim.

almost-11pm: I go to print stuff out in the Library: Let me start by saying...I hate the Library.  I used to love libraries.  Knowledge!  Musty smells of the annals of journals!  Intellectual curiosity!  Your own private nook to nap/read/laptop/Facebook/stare at pigeons out the window!  A place to take Instagram pictures of your coffee juxtaposed to your stack of books (as if you actually knew how to read)!  But alas, no more.  The library is a dark, dark place for me.  I don't do well with that 'atmosphere' of panic, especially if I'm going to contribute to it.  I see a couple friendly, less-intimidating faces.  I print out my junk and run, and say hello to remind people (or myself), that I'm not a totally reclusive a-hole, that I'm just pretty much terrified of human beings in general.

11:15pm: I do lunges upstairs in the lab.  I'm so awake it's annoying.  Grant is on the steady decline.

midnight: I leave.  I shower, I watch Family Guy, I make the mistake of thinking about tomorrow/today.

Wednesday, 1:40am: I fall asleep...I think.
Wednesday, 5:50am: I go to the gym, box up some cadavers, and resume the above cycle all over again.

Tada!

xoxo,
V

Dr. Mexican: Introduction to Chicano Studies

Today, I received a text from my unusually good looking and ethnically-vague friend, Nicole (she lives near San Francisco, and ironically enough, went back to school to complete her bachelors at the same little hokey college where I completed my postbacc). For the record, Nicole (like me), is half Hispanic, although her variation sounds much more interesting because even saying you're Chilean just sounds so much hotter than saying you're Mexican. Le sigh.

Nicole: "I got my eyebrows waxed yesterday and I'm literally convinced they hold the key to ethnic diversity.  Unwaxed eyebrows make people wonder...is she Latina?  Mixed?  White?  Ungroomed? (kidding).  Then the second I get them waxed it's like BOOM, you're definitely Armenian or Persian."

Veronica: [replies with .jpg of hot cheetos and a diet coke with the subtitle "lunch."]

Anyways, you get the point.  While this is possibly the weirdest segue to a meaningful post, it got me thinking about a broader issue I'm actually very passionate about. 
Labels.
It doesn't matter what kind; racial, relationship-oriented, cultural, religious.  I wish I could say I dislike them, but to be honest, that's not true. There's a reason we say we "identify" with others...and I find it hard to argue that we are all kindred spirits on the basis that we all are vertebrates who walk upright.  There are certain societal roles, values, and interests that help shape our personality; I don't need to belabour the obvious.  But what Nicole says, even benignly, addresses a good point.  Whether we are conscientious of it or not, we often rush to categorize people.  I use that word selectively because I don't see it as synonymous with malignant stereotyping. Before this easily becomes a blog about a blog, I present to you the Throwback Thursday variety of Blogger: something I wrote for a competition not long ago.  Did I win? Nah, but I got a really cool pin in the mail for my submission.  #worthit.  Anyways, I present to you:

Dr. Mexican

What’s in a name?

Throughout the latter half of my life, I have embraced and opted to identify myself as firstly, a Latina, and secondly, a white female. I say this because it took many years to explore and accept my cultural heritage as something beyond my phenotype.  At first encounter, many assume my freckles and pale skin classify me as white, and in the past, I reacted almost indignantly.   “My last name is Williams because my mother wasn’t married; I don’t know my dad…but he’s Mexican. I’m half Mexican” was a standardized response.  When peers remarked that I was awarded a grant upon entering college because I “checked the Hispanic box,” I felt a flare of defensiveness, although I feigned indifference. Where had this notion of minority equals sympathy money become propagated?  More importantly, why was it perpetuated amongst intellectuals who were supposed to represent equality in a field made competitive not by affirmative action, but by meritocracy?

For years, I had entertained myself with a psychosocial “name game.”  What if I had been given my Mexican father’s last name, Reyes-Iboa? I imagined what it would be like to be paged as Doctor Reyes-Iboa, and by contrast, Doctor Williams. Even my imagination would elicit starkly different scenarios; one of a fluent Spanish dialogue, taking a patient history in an inner city clinic in Los Angeles, and another in a seemingly vanilla, big-city hospital, probably as a specialist.

But the irony was that I was neither of these things.  At the time, I was still a closet pre-med majoring in Theater and barely passing a minor in Biological Sciences.  My inability to excel in the hard sciences made me reluctant to openly admit my dream of medicine, knowing that once I vocalized it, I would be held at a standard that was seemingly unattainable from both an academic and financial outlook.  My obsession with how I would be perceived racially had me inclined to keep mum; I didn’t want my accomplishments attributed to this phenomenon of “Hispanic-box-checking” and I didn’t want my failures to be a racially charged statistic of “x percent of minorities struggling in science.”  And so, as I was trying to form a career path that suited my genuine interest in promoting the welfare of my community, I was also trying to form an identity.  Was I too white to be Hispanic, too Hispanic to be white?  Was I too middle-class to be socioeconomically disadvantaged?

It wasn’t until I was desperately mailing off applications to premed post-bacc programs in a last-ditch effort to remedy my grades that I met someone who changed my life. I was at the post office, and had dropped all of my change.  His name was Tommy Hand, an MS-II at UC Irvine School of Medicine, and he picked up all of my coins as I fumbled to introduce myself, fearing he’d see right through to my academic incompetence, my racial ambiguity, my cultural wish-washy-ness.  The white Mexican that wants to be a physician living out of her car with a 2.81 grade point average.  I was terrified.  “Post-bacc, huh?  My friend did that too!  Good, hurry up, we need you,” he said.

We need you.  For a long time, I had approached my path to medicine in a way similar to the competitive aspect of auditioning.  You memorized a monologue and delivered it better than someone else to get the principal role. But as thespians know, that ideology, at least in the scope of performance, is not conducive to a successful show.  You have to be competent enough to get there, relentless enough to keep trying; that is fact. But more importantly, you have to be willing to work with and for others to create something bigger than yourself.  People come to see a show to feel; I aim to perform in such a way that I have catalyzed that feeling.  In the same regard, I wanted to prove that I was capable of the academic rigor of medicine- not for the sake of gaining credentials or demonstrating success “in spite of” my economic or racial background, but rather, with the intent of providing excellence in patient care.

My chance meeting (and subsequent friendship) with Tommy would restore my sense in confidence and focus.  He introduced me to Physicians for Human Rights, and he helped spawn a personal interest in global medicine. What truly impressed me, however, was his involvement in the Latino community of California. Tommy was part of PRIME-LC, a program created to meet the increasing demand for culturally sensitive and linguistically competent doctors who were in tune to the needs of Latinos and those marginalized in medicine. Tommy was as characteristically white as they came; Ray-ban donning, jean-short wearing, blonde and blue eyed.  But his interest in Latino medicine stemmed from something more important than immediate racial affiliation. He pursued PRIME-LC because he saw firsthand the social injustice experienced by Hispanics in Spanish Harlem, many of whom were uninsured and had difficulty seeing providers because of a language barrier or lack of representation.  Tommy reminded me that my personal experience and interest in medicine-whatever specialty-should be just that: personal.  Although Tommy passed away last year in a motorcycle accident, I am very, very fortunate to have met someone who ignited a radical change in my perspective of myself as a potential leader, less defined by racial parameters, and more by the motivation to equalize those opportunities and resources available to my patients and even to students who, much like myself, want to make a change but are unsure if they are reaching for a goal that seems beyond their “social or cultural archetype.”

I admit, it is hard to turn a colorblind eye to subtle racism if we are inundated with it every day and do not challenge it. Where someone sees advancement in minority representation in healthcare or science, someone else may try to undermine that by calling it a group-based advantage. Certainly, diversity should not explicitly be perceived through a racial lens, but gauged through the representation of unique talent and personal experiences (cultural or otherwise) that enable future physicians to be more understanding, approachable, and sensitive to the concerns of more than one demographic.  I will always strive to uphold an academic caliber that is representative of my personal sense of worth, irrespective of my color, but I am very proud to call myself Latina, a component that inspires me to address misunderstandings that are perpetuated through stereotypes.  As a biracial student and future osteopathic physician, I am honored and compelled to find ways of promoting racial equality, dispelling senses of entitlement, and showing prospective medical students that your race is neither a limiting nor advancing factor to being a great physician.  Inevitably, I'd like to  complete an international rotation in a Latin American county so that I may interact with a patient population that I am unfamiliar with while learning from their local physicians. I truly believe this is vital to foster a sense of collaboration and comprehensive patient care, where the focus is less on what you look like or what language you speak, but rather, what services you can render to those who do not care what “box” you checked on your college application.

My personal investment in Latino healthcare has been cultivated by 24 years of figuring out who I would like to be, not just what my birth certificate says I am.  While there may not be a universal language to help me linguistically address my patients needs (my Spanish has much left to be desired), there is a universal right that I feel compelled to work towards: equal access to healthcare in times of need, regardless of legal or socioeconomic status.

So whatever my Dr. “Surname” suggests (or doesn’t), perhaps I should be called Veronica.  Because the most important testimony to my title will be my actions, and for that, I never needed a name.

http://news.uci.edu/features/international-man-of-medicine/

Keep it short, Happy Thursday,
V