Symbiosis

After so long...

2011-10-22T22:11:00.001-07:00

Here I am...a few short years after my last post...back today...time has just flown.

Finishing my training in cardiology...started looking for jobs..time to be all grown up..finally!!!

Its awesome to know that soon I will be making all the decisions..about time.

Things have changed for me in a lot of ways...both good and bad these past few years...left NY and moved back to the mid-west for my training. These past 3 years were gruesome, tiring and frustrating...but I wouldn't trade it for 1 minute...I love it, which makes it all worthwhile at the end of the day. The only things that sometimes bothers me is the personalities in my profession...can you imagine putting a bunch of type A, successful doctors with God complexes in 1 room and communicating..its harder that you think!!

On my personal front, my brother is separated from his wife of 8 years. They have no kids (thankfully). He moved back last year and has had a tough year. So did my parents. Mom had a heart attack last year, of which I found out 1 month later...so much for being a cardiologist!!

We are selling our house back home, the house I grew up in....I think practically it was the right decision for multiple reasons. Today, I thought to myself that I will never see my house again...it is MY house...so many memories...so many. It makes me feel like I am losing an essential part of my being. I don't think I can return to say goodbye, the construction will start soon. New memories will be born for some.

The big 3-0

2008-04-20T17:29:00.001-07:00

It seems like its been ages since I blogged.
Just been one of those lulls... one of those that makes a fairly expressive person like myself also run out of emotions and words.
I am not sure how many people do this, but I try to take stock of my life (so to say) every now and then...tomorrow I turn thirty...so cant think of a better time to do this....watching "pretty woman" for the nth time and eating strawberries all at the same time!!
So here it goes...what did I get and what did I give back..thats math I can handle.

Career wise great year...love the place I work at and what I do...could easily do it for the rest of my life...have been productive and like the people I work with....am interviewing for Cardiology positions and thats been going pretty well also...some great appreciation of the offbeat path I have taken to reach my goal...refreshing and encouraging..at the same time interviews are somewhat nerve-racking. Dont know where I will end up and that element of uncertainty is the most challenging to deal with. June will be here soon enough and I will know.

My relationship with my brother that has always been strained to say the least finally seems to have resurrected itself from the dead. Having acknowledged our differences and fought them for the longest time, I think we are finally dealing with them in a mature way.

In terms of what I gave back, not enough, but I have made some choices that I am very proud of. I have channelled my emotions constructively and not impulsively.
I have tried to lend a helping hand where I thought it was needed and made committments to some new charities. Plan to go back part-time to clinical medicine to continue some of the magic that I miss being totally research.

On a more personal front, "devastating" would be a fairly well placed adjective for this year. I got the love of my life and lost it. I dont know how one recovers from something like that or if it is worth even trying. That was not the only damage done, I have lost a part of myself and my faith in my spirituality which is hard to explain in words. But what I do know is that at some point, one has to move on and do the best to focus ahead and not be held back.
I have a theory about soulmates. A theory that very very few people know of. Today for some reason I feel like sharing it.
Every being has a soulmate. Everyone. No exceptions. God has created us in pairs. Kind of like a lock and key. But, the caveat is that even though we are made in pairs we dont necessarily end up with our soulmate. Why? you may ask. And here is the answer.
It is because he gives everyone something to live for. Noone gets everything. I often wondered when I use to see patients in my clinic...I saw a terminally ill 70 some with a gorgeous 50 some yo third wife of his who stood by him all the way...he said ...the third time i finally got it right...but looking at her i knew that she could have probably left a long time ago for greener pastures...but all i saw was pure divine love...she was his soulmate and although he didnt have a penny to his name or health he was in the presence of God. God gave him his soulmate, finally.
This is just one of the times when I saw how sometimes people dont recognize it they are blessed with their soulmates.
If you think hard enough you are sure to know when you have come across such love, it doesnt make sense most of the times but its the most amazing thing you ever saw. The bizarre red rose in the middle of the desert.
So, clearly most people dont end up with their soulmates but I do believe that by the end of this journey of life one can clearly see in retrospect and know who their soulmate was. The connection is so pure that eventhough your mind or body may not take note but your soul recognizes its counterpart. Timing, circumstances, morality...whatever the reason to let them go or not be able to recognize them. By the end most everyone has the spiritual capability for introspection and know them.
To everyone I know and all I dont, I not only hope they find their soulmates but more importantly pray they end up together.

Friday night

2007-12-02T08:27:00.000-08:00

I have to write about Friday night.
I feel compelled.
I had to work late, asusual the ER was being delinquent about getting our patient on the table for his CT which eventually I would read. So I sat there, waiting annoyed. And as it turned out my favourite person was also at work next door completing her tasks. I am going to skip any specifics here to ensure anonymity.
She is in her 50s and has two boys in their early twenties, is divorced and now has been with someone for a few years. She is one of the warmest and giving people I have known, the kind that you actually like seeing first thing in the morning because you know their smile is genuine and when they ask you how you are they actually mean it. To give you an example, a couple of weeks ago it was Diwali, the biggest Hindu festival something that I celebrate and was hugely excited about. Always miss home and family during that time. I bought in some Indian sweets to work and offered to everyone, I know she is on a strict diet ( strict is an understatement, she is living on salads and I havent ever seen her eat anything with more than 10 calories!) yet she unhesitantly took a piece whereas someone next to her, did not even attempt to fake interest. To me, small things like this are very important cuz they speak volumes about a person.
Anyways, so we finished work at the same time Friday and decided to go out for dinner.
Somehow, she started talking about her divorce.
She had been married for 20 years and had 2 sons, when one day her husband, 6foot 1" and 300+ lbs came to her and said he had a secret.
(I am thinking - great - the ass was having an affair)
His secret was that he was a woman...not only was he a cross dresser ( he had been doing that in the privacy of his bedroom in the basement which his poor wife never went into...cuz she trusted him...she never opened his mail or looked thru his clothes) but also a transsexual...and now he wanted the complete transformation...he wanted to be a real woman.
So, as her world shattered in front of her eyes, as she faced the worst form of betrayal she stood by him as they spent $$70,000 on sex change, electrolysis and facial reconstrcution...as he went from John to Caroline..till finally one day she couldnt do it anymore. She wanted a divorce. He didnt want to leave the house or her and threatened to kill anyone she ever dates...
Finally she did get a divorce..not only that she also got...painful memories of her past that continued to threaten her future..and two messed up teenage boys...
I almost choked on my food...I couldnt believe that this actually happens to real people..I have seen this on tv....but to real people???...and to someone as nice as her - why???
Why did I always dread going to the oncology wards cuz my favourite patients were dying the most painful deaths or worse still living even more painful lives????
Why is it that the most outstanding human beings end up in a social, emotional, financial rut for no fault of theirs and those that are much less deserving lead fulfilling and accomplished lives????
I wish I had the wisdom to understand that, but as of today I dont...

The mystical recluse

2007-08-01T14:49:00.000-07:00

Emily Dickinson...she is poetry to me...I have grown to appreciate each and every poem of hers...a recluse, a mystery, a loner....the more I read and understand her work the more I connect with her.

Her niece described her as a poet of the unpoetic. So true. Her poetry has a universal appeal and it knows no boundaries...the unlearned foreigner, the busy, practical, inexpressive man as well as woman, the wise young and groping old, the nature worshipper, the schoolgirl, children caught by her fairy lineage, and lovers of all degree.

Here is one of her poems that was one of the first ones I ever read...and I still remember how I felt. I have had those times of utter despair when I have unknowingly compared my suffering to someone else's, when seeing someone else hurting has in a undescribable way provided companionship to my pain ...I dont know of anyone else who could have put those feelings down on paper with so much ease and honesty....

I MEASURE every grief I meet
With analytic eyes;
I wonder if it weighs like mine,
Or has an easier size.

I wonder if they bore it long,
Or did it just begin?
I could not tell the date of mine,
It feels so old a pain.

I wonder if it hurts to live,
And if they have to try,
And whether, could they choose between,
They would not rather die.

I wonder if when years have piled—
Some thousands—on the cause

Of early hurt, if such a lapse
Could give them any pause;

Or would they go on aching still
Through centuries above,
Enlightened to a larger pain
By contrast with the love.

The grieved are many, I am told;
The reason deeper lies,

Death is but one and comes but once,
And only nails the eyes.

There ’s grief of want, and grief of cold,
A sort they call “despair”;
There ’s banishment from native eyes,

In sight of native air.

And though I may not guess the kind
Correctly, yet to me
A piercing comfort it affords
In passing Calvary,

To note the fashions of the cross,
Of those that stand alone,
Still fascinated to presume
That some are like my own.

New York

2007-07-09T14:24:00.000-07:00

In NY...all moved and settled in.
If you didnt know already, let me tell you, its kinda nightmarish to move 75 pairs of shoes!!! (yes yes save it...I am a woman what can I say!)
I hate moving absolutely hate it, no monkey drills anymore, next time I am getting professional help.
So here, lets talk about NY some.
People dont smile, they really dont have the time or interest to. Coming from the midwest, this really seems different to me. I should mention my experience a few weeks back at a small intersection in Iowa, I was extremely preoccupied and didnt notice when the signal turned green. A young boy was getting ready to cross and noticed the green signal and then looked at me and gave the most genuine and heartwarming smile ever, I swear without saying a word it was like he said "its going to be ok u know" I smiled and turned. Just one of those things that happen in a second but stay with you.
My first date in NY, a metrosexual dentist, one of the few men who was better prepared for the date that I was!...fresh mani and pedi...lol. I should mention I come from a family of male chauvinists, so this is kind of new territory! Change is always good though. We'll see. I have to say though that his overly enthusiastic numerous and unnecessary text messages are actively killing my interest. I wish men knew the concept of moderation!
Work is nice, I love looking at pictures of the beating heart, absolutely fascinating. I really want to do this for the rest of my life. People at work very professional and courteous. Best part of it all...I have parking right outside my office! It doesnt get any better!
Oh btw I wanted to know how many of you actually gave into the whole 7.7.07 thing and did somethg...I had multiple calls from family and friends telling me abt it and asking me "to make the best of it"...lol...I finally gave in, we'll see if it actually brings luck!

Not far

2007-06-22T17:35:00.000-07:00

Just when I am convinced that giving up clinical medicine would agree just fine with me, I have a day like today.
I have been feeling particularly low the past couple of days, there are a few reasons personal and professional which were kind of being highlighted in one way or another. Anyhow, my team was oncall today. And ofcourse the code pager goes off. Its a thoracic surgery patient post op day 3 after a TE fistula repair, asystolic for close to 20 mins, atropine , epi , pacing ....nothing worked. No rhythm, no pulse. I am getting ready to call the code. And then, all of a sudden everything is back, a pulse, rhythm and a pressure. Everything is back. Everyone in that code was looking at each other...while leaving the room we said "he really wants to live"....thats all you can say sometimes!
And then, comes the time for my last, my very last clinic at the VA. I love my VA clinic, it has been one of the best experiences in medicine for me. I have the most wonderful cohort of patients and share a very good rapport with them. My last patient told me how I was one of the few docs who has been able to care for him in a compassionate way without being judgemental and trying to undertstand his struggle with his pain (he has debilitating back pain and is morbidly obese, which is not a combination internists feel compassionate toward in general) ...infact he likes me so much has even tried to set me up with someone..lol. His wife brought me the aboslutely delicious chocolate cookies and as I walked out the exam room, I thought to myself, I cant give up my patients. I really cant.
Yes people can sometimes drain the life out of you, there is no doubt about that. But there is no greater joy than seeing that rhythm back on the monitor and there is nothing more rewarding than helping someone feel better...there really isnt. I will miss it a lot.
I think this is a temporay hiatus till I can refocus and find a new direction. I promised myself today that I will never give up my patients. Thats the reason I did medicine. It will never change.

Rain

2007-06-18T18:42:00.000-07:00

I love rain.
I really do.
Darkness, thunder and the lightening complete her.
Someone far away in the clouds rescues their loved one in the dry and starved lands.
I feel alive when it rains.
I feel my soul and yours too.
I hope these clouds rain tonight.

Men!

2007-06-17T15:47:00.000-07:00

So here I am...my friends were having a farewell dinner for me...a very close friend came home after work to help me pack...and we started talking. All of a sudden she started crying uncontrollably...gave her a hug and then she told me.

Her boyfriend of 4 yrs broke up with her and not only that he is now getting married to an intern in his program that according to him is a "better fit" since she is better matched culturally and socially. Not only this, he says he loves has fallen in love with her!!

The back ground for this story..my friend and her ex are both indians but different religions and v diff personalities...hes controlling and overly ambitious whereas she is mild but has a strong and independent personality...none of us ever could figure out what they saw in each other.....she always had doubts and he never did or atleast thats wat he said, pursued her relentlessly....in my mind he probably saw her as another conquest...sometimes its hard to tell love from something u want to be urs...the turf battle between love and ego is kind of hard to explain but for many overachievers, this can become a problem...so she had been asking for time to figure out their relationship for a while and they were on and off a lot...and thats when he called and told her he had been seeing this gal for a few weeks and was getting engaged soon...needless to say, this came as a complete shock to her...i have never seen her so broken, I worry for her. I have asked her to move in with me till I am here...

Weirdly enough when I heard this, it reminded me of a very similar story....someone I have dated and love dearly...he and his ex who were abt to get married.. had issues and he asked for 2 weeks to think abt it and in the meantime she decided to give someone else a chance and finally when he came back she was with that someone else...and guess wat...its been a year but hes still not able to deal with it...I know him very well...it breaks my heart so see him hurt...the most unfortunate part is that he is so lost now that he has emotionally isolated himself...I want to fill his life with happiness and love but he for that he needs to give himself a chance...which only he can do..

Both he and my gf, in their minds (atleast subconsciously) were fully aware that this was not the person for them...but decided to continue their relationships (my gf has tried several times to break up with her bf but he kept guilting her into taking him back and it kept working)...

One thg for sure was that at our age ie in late 20s its just so much easier to be with someone that u know rather than invent the wheel again...if u r a professional with a busy career u dont have the time or the emotional energy to do this multiple times...so one figures, wat the hell...i know everythg there is to know abt this person...let me give it my best shot eventhough in my hearts of hearts i know "he or she is not the one"...

But what gets me is that both these people are miserable...not because they lost their loved one...I know both of them well enuf to say confidently that neither of them was in love... but when the idea of being with someone, the security and the plan falls apart it hurts...whether you love them or not isnt the point...the most important ques is "he said he loved me and he would fight for me, and how can he get married to someone else now, how can he be with someone else so soon...how is that possible" the fact is that he probably reached his emotional breaking point (when u cant love anymore without being loved back) and found his solace and comfort with someone else...this was bound to happen and it happened but it still takes one by surprise...because there is no better feeling in this world than to be loved...and it hurts when you dont have that anymore....

I pray that both these very special people will find peace and love in their lives and will be able to make room in their lives when it comes knocking on the door....

I love you both very dearly....

Winter morning

2007-06-16T06:36:00.000-07:00

Monday morning...cool dark and miserable...that is only how I felt...the weather was actually not bad for a winter Iowa morning.
Mr Nichols, I have some bad news. He said, I know I thought as much when you called me friday and told me to come in Monday as he held his wife’s hand. Sitting next to him all of a sudden the look in her eyes changed....they became with wider with anticipation or perhaps apprehension. The CT showed there is a tumor in the right lung. Oh she said. He didn’t say anything. How big is it he asked? I said, 28mm, as I tried to show them on my index finger how big that was. And he said...little sonuvabitch huh...u know it’s a miracle I am still alive...four heart attacks...they docs gave up on me but I made it. She was awfully quiet. I looked at her and she said, why is all this happening...our son in California the one who is an electrician...had an accident last week and broke half his bones...we wanted to go so bad but could not...why is all this happening. I asked, do u pray...she said yes but I don’t go to church he never went so I don’t go either. I said, my mother says prayers can do amazing things...try to keep your faith alive...you have to be strong for him.
Why didn’t we find it sooner, he asked. It seemed like from your symptoms that the blood was from a stomach ulcer and your CXR was normal...when the scope did not show anything I wanted to be double sure and get a chest CT. And then I said, we will get you through this I promise....I will do everything I can to make sure everything happens fast to get your diagnosis and start you on treatment based on what we find. He said, thanks for being here for us....when do u get done. I said June...and he asked u are sticking around right. I said, most likely not and he said darn it...with moist glistening eyes he clutched my hand. I will lose you too. And then, all of a sudden he paused and said...oh but I won’t be here either. Fighting tears desperately I walked them out and handing them the green check out sheet told them to go the pulmonary clinic for their appointment...1 south. He said, I don’t know where that is Do you. And his wife said, no I don’t. The look in his eyes reminded me of the look of fear and vulnerability 7 yr old nephew had the time he was lost in the mall. I walked them to the pulmonary clinic for their consultation.
Joyce saw me in the corridor and cornered me and asked how did he take it...and I paused, wasn’t sure what to say, something that seldom ever happens to me. Then I said, ok I guess. As I walked back to the chaos of urgent care I wondered...if my doc told me she thought I had cancer I would be crying up a storm probably would tell her that she needs to double check her facts may even break a thing or two. I thought about my best friend...if she were told she had cancer she would probably say..oh and then after a 10 sec pause she would say ok. Does that mean that she doesn’t feel pain anxiety anger denial....or does it mean she copes with these feelings better...if you ask me its neither. She feels and only tries to cope...but most of the time fails....just like most of us...so who took it better. Who’s to say. No no one can take it well...it’s not meant to be taken well...we can pretend we took it well...and then try to forget it, try to refocus our life on something else. And then one morning it’s just there and it doesn’t hurt quite as much, kind of like a fatty tumor on someone’s back...its not pleasant but not bothersome either. That’s what I want to be able to do for him. I don’t expect him to take it well. I will walk him to the next door till he’s not lost anymore.

Old memories and new beginnings...

2007-06-13T13:36:00.000-07:00

Residency is over...3 years...of long long hours, patients and medicine...wow...this is it...its overwhelming...my patients, my clinics, the nurses and the friends I have made here....leaving a lot behind but taking even more with me...the memories...have seen a lot these years...the hopes and desires, the sorrow and tears, death and suffering, smiles and support, depression and loneliness....medicine teaches you not only about disease and treatment but infact I think its a crash course on life...as a physician you have an insight about your patients life, health and well being in a way noone else does...its not just physical, its everything - emotional, social and spiritual well being...I am going onto research now...yesterday one of my fav patients in clinic came to see me and said I should never leave treating people cuz I am so good at it (when she was first referred to me, she tht she was having a stroke, turned out it was a panic attack..shes doing great now and loves me for getting it right)...I thought to myself...I love medicine I really do but working with people drains you...it really does. I want to spend some time with myself now...soul searching...travelling... and ofcourse doing research..there are some answers I seek and hope to find them...soon...but I think I will be ok away from clinical medicine for a little bit...I wonder sometimes if that is selfish...I wonder if other physicians feel that way too...I am not sure...
Anyways...moving from a small town in the midwest to Long Island will be huge move for me...I am a little excited, a little scared and dont know what to expect....kind of like the first day at school for a 4 yr old except that I cant plead the same degree of innocence!...we'll see how it goes...
Tonight is graduation....last time with many...most I will never see again...some I may....but there will be a lot of memories.....
Cheers to old memories and new beginnings....

Searching symbiosis

2007-06-10T17:38:00.000-07:00

My very first blog....
I am sure everyone has their own reasons for doing this...its kind of like sharing a part of yourself with the world...has its own pros and cons but for sure requires some courage and honesty (the latter is presumed I guess)....so ofcourse I have my own reasons...you know what I want to find out for starters...wat was your reason...