Trouble, LaMontagne-style

"Yesterday I texted him. I said, 'I love you.' And he sent me back a picture of a cactus."
-Med Student

Sometimes we're not good at expressing ourselves, we men. Sometimes, we laugh and we kid when inside we're singing Dashboard Confessional and hating ourselves. I mean, I don't sing Dashboard Confessional inside because it resonates at the emo frequency that causes my balls to fall off, but some guys do I'm sure. Probably the gay ones do that, sing that Chris Carraba inside themselves. But in any event, we're reclusive with our feelings. And we're giving up - all of us, slowly but surely.

The girl I quoted above told me that at about 26-years-old her boyfriend told her he had gotten just tired of it all, tired of the dating lots of beautiful women and the constant tiring parading of mixed affections, and then all he really wanted was her, to be there next to him, be in love, be boring like that. Reminds me of Harry in that movie with Sally: "There comes a time when you just get tired of that whole life of a single guy thing. You go out, you do the safe lunch, agree to dinner, go dancing, you do the white man's overbite (demonstrates), you go back to her place, you have sex, and the minute it's over, you know what you're thinking? How long do I have to lie here and hold her before I can get up and go home? Is ten seconds enough?"

It's a beautiful picture, that giving up, isn't it? It's saying, "You're not really what I wanted, but then again, no one else really is either, so you'll do." Not very romantic I guess, but the romantic notion is one filled with inconsistencies anyway. Romantically speaking, the difficult times take place in the rain and the cold and they resolve themselves shortly thereafter with the overwhelming force of EROS, Aphrodite's overwhelming idol of love. Then everyone relaxes in a hammock on the beach and kids grow up without dysfunction and no one gets alzheimer's, or if they do, they heal it from time to time with the force of their love and the power of THE NOTEBOOK.

I was reading in a non-medical book last night (SHOCK!) and in it the author talked about Eros as being the one form of love in which the lover kept after it even to their detriment. They made eros sound almost like a drug, in that you would desire it even when it ceased to be a "good". I guess that's the excuse people use all the time, that they can't choose who they love in the "eros" sense, and so they're off the hook when it comes to the unhealthiness of that affection. But that's lame after all. You can't choose to love someone that you don't love, but I think it makes all the sense in the world to say that you won't love just one person in that way, and so if you're in an unhealthy spot, you got to get out of it, and trust in God or your own desirability or whatever you have confidence in to bring that whole possibility-of-love back around.

Personally, I think I'm one of those that falls in and out of love too easily. But as I'm getting older, despite my easily enticed eye, it seems like there are fewer and fewer women around of any integrity, beauty, or gentility, and the ones that DO exist are already married, which is to be expected and who can blame them? I'm a bit overly-preoccupied with this at the moment, because I'm 24 now and it really seems like if there's a time to worry about it, this would be it.

But it all comes back to that trusting. Man I hate that. There's nothing to be done. Nothing to be controlled. All there is is the trusting, the patience, the waiting, the knowing that you're a damn-fine-looking medical student and that somewhere out there is a girl that's not whacked-out-of-her-mind crazy that can carry on a good conversation and is a real tiger in the sack.

Mandy Moore Blessed The Rain Down In Africa

At the moment, I have a couple of friends over in Africa, doing nice white-person work for the starving filthy masses over there. One of them is set up in a posh Christian Missions-For-Teens setup where the townspeople, in general, have learned the necessities of proper sanitation. The other friend is not so lucky, and while the locals are more than happy to help her find a spot off in the forest to leave her diaper deposits, they seek no such luxury for themselves, often dropping trow (or loincloth or whatever) in the middle of the street, much like a horse would do if you've ever gone horseback riding. I mean yeah that's disgusting but you've got to understand that it's tough explaining to these people that their delicious-looking booty chocolate is filled with nasty enteric critters that are the source of a lot of their health issues (they probably assume it's the total lack of dietary sufficiency. pshaw!). Even if they do speak French, and probably even because of that fact.

So all this gets me thinking about Mandy Moore and I've decided that if anyone can get the people of rural Africa to start paying attention to basic sanitation laws, it's Mandy Moore - the voice of the sufferers the world over. I mean, a lot of people got with Brittney or Jessica Simpson or what-not, but now look at those two - trashed out filthy rednecks, looking for their next fix, dating Dane Cook and what-not, with a huge portion of our cultural heritage now stained by their total lack of self-discipline. Mandy Moore however has never tried to take the world by storm, never forced her reproachful music upon unwitting ears, never sacrificed her all-around class for the sake of a painted body-suit and a bucket of Kentucky Fried Chicken. She has conquered, not through talent or hotness, but by sheer perseverence and the force of her infectious and girl-next-door personality. Oh and also being the most beautiful and stunning woman to ever walk the face of the earth. But mostly perseverence!

So I figure the day will come when Mandy and I make it official. I mean, eventually she's going to need a Doctor right? She's gonna get old. She's gonna need some lasix or something, and I'm gonna find a way to be there. The progression of Mandy Moore's love affairs will spread in this order: Andy Roddick --> Zach Braff --> Dr. Special K. I mean, you can see the trajectory right? From hottest tennis player on earth to likeably geeky tv doctor to likeably geeky REAL-LIFE doctor who also plays tennis and will, at times, take off his shirt while doing so.

So as you can see, we're destined. That being said, I feel fairly certain I can make the claim that with my direct approach to the health care needs of the indigent peoples, and with my Betrothed's help answering the lower-class hygeine problems, you no longer need to worry about Africa. You can go ahead and send my friends back home, where we have wonderful television shows, and people can afford to waste millions of dollars on movies like "Try Seventeen" and "How To Deal" instead of hording every penny to spend on grain. Relax, turn on some Toto, eat a big fat burger, and do your civic duty by forgetting to vote for one of two identical candidates. Get back to ignoring the rest of the world (except Mexico, keep them foreigners OUT) - it's the American way!

A Rediscovery of Discipline

There's nothing like a good kick in the ass to encourage you. Second year is that kick. I haven't so far found a way to make this material "interesting" or "engaging" and therefore "memorable" for any significant amount of time. As an offshoot of the fact that I'm human, I'm prone to comparative analysis with all the other students in my class, some of whom are gifted with being tremendous reservoirs of memory and can recall with ease the intricacies of eponyms used briefly several months before in an unrelated systems course. This is in mighty contrast to myself. This morning I took a test and had many recurrences of the theme embodied by the following statement - "WTF is a Mallory body?"

(Of course, I mean, I remember things like - Mallory bodies are associated with liver cirrhosis in alcoholics - but I can't recall what SPECIFICALLY they have to do with hyaline membranes in the lungs [nothing], so I'm now pretty sure I'll be somewhat like King Midus as a physician, except with DEATH instead of the gold.)

My mind is just not cut out for recalling, without tons and TONS of outside investment, and perhaps a few narcotics, the intricacies of everything I've ever read in Robbins and Cotran. And so it occurs to me - neither, really, is anyone else's. The difference is that other people ARE investing tons of time into their education, and the results are showing in their recall. My roommate spends literally at least 15 more hours each week engaged in studying than I do (maybe not actively studying, but at least making a show of it down at Starbucks, while I, disgustingly, lie in bed at home napping).

So mark my words innernet - today marks the return of my medical school level of discipline. Today is the only test day in the past twenty years that has known me to study EVEN AFTER THE COMPLETION OF THE TEST. Today is the day I become one of those medical students that can remember all that shit about mallory bodies and Lamellar inclusions and how dextromethorphan is an opiate that doesn't act at opioid receptors and how Pseudomonas aeruginosa smells like grapes and is the most common pneumonia acquired in patients with cystic fibrosis. Today I'll look up all those words that make no sense to me but all basically end up meaning the same thing (eg. suppurative, pyogenic, prurative, maturative, pustulating) and I will KNOW WHAT THESE TEXTBOOKS MEAN when they say things. I will read in advance and e-mail professors with my questions about the discrepencies between our pathology text and our internal medicine text when it comes to treatment regimens for chronic respiratory disease processes in overweight diabetics with complicating neurofibromatoses.

Today I will start studying for my boards which are still 9 months away - I will order those microbiology flashcards and I will look at a new one every day and they WILL BE MEMORIZED dammit! Today I will stop wasting moments of my life in sleep and laziness and arouse all noble sentiments within me to the rescue of my motivation from the clutches of apathy, ambivalence, and indifference! Today!

Actually, I'm pretty beat - I probably need to get to bed if I want to be awake at all in class tomorrow. Tomorrow! Yeah, I'll start tomorrow...

A Biopsychosocial History

Yesterday, we second year medical students were charged with the time-consuming task of presenting a patient's case. Since we have no patients, we were forced to either (a) find a case presentation in a prestigous medical journal or (b) make one up.

I chose option (c) - use a case presented on a TV show, especially an MD program (medical drama).

I started my presentation as such:
Dr. Gregory House is a 44 year old white male who presented to the Emergency Department with acute onset right upper leg pain, for which he was given IM morphine which was non-curative but alleviated symptoms for several hours.

I apparently was not the only wise-ass to show up on Monday. Other reported presentations included patients from at least three other episodes of House, that pregnant dude from Grey's Anatomy, and I'm pretty sure the angry lesbian doctor from ER was in there somewhere. [sidenote: why are lesbians on TV always so angry? I think they should be sweet and caring and really really hot. I mean, yeah maybe that's not accurate, but you gotta give the people what they want!]

Currently, I'm in a bit of a pickle in school. I'm spending the absolute minimum amount of time at it to maintain an average grade. This is a lifelong habit for me, and one that will no doubt curse me once I decide to apply for anything. I realize, theoretically, that I should embrace my medical education with the same fervent work ethic that I would embrace a profession, but then again, the only full-time job I've ever had required very very little of me, and I still did it badly. It makes me wonder if those who are good at jobs are good at jobs regardless of the skill required, and those that are bad at jobs are bad at jobs regardless of how much special interest they have in the job itself. Does your interest really define your success in a profession?

I'm really very hungry at the moment, and I'm reminded that no matter how many idealogical questions you'd like to answer so as to define your life and get a good grasp on your "self image", you really have to first cater to your physical needs. And in this I also include sex. So, can we assume that I only blog on here after receiving at least some defining sexual revelations?

Yes, you can go ahead and assume that. You can also assume that I only blog on here when I'm hungry, half-naked, and tired of studying. Generalizations maybe, but aren't they accurate thus far?