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In Closing: No End In Site

It’s been almost a year since my first day of medical school, and this first year, “MS1”, is finally coming to a close. Writing as a form of procrastination, I’m staring in the face of my last final and will fly to India the following day, where I will spend three weeks working with the widows and women of rural Andhra Pradesh on feminine hygiene. I promise, dear readers, that you will hear more about this project later, as time allows.

It’s been a wild year, so wild in fact that I can hardly differentiate or recall many of its details, as days tend to blend together while staring at my computer screen… That said, this year has had many highlights, many memorable moments, and more than a few “learning opportunities”…

All in a day's (24 hrs) work

All in a day’s (24 hrs) work

Going into medical school, I was convinced that I would take care of myself, maintain friendships both in and out of medical school, continue to write, and somehow get enough sleep. However, with an all too often empty refrigerator, free pizza several times a week, and an ever crushing workload, it’s been difficult to take the time to luxuriate in past enjoyments or even finish conversations (much less the copious amounts of “me time” to which I had grown accustomed). Instead, I languish away in medical school, watching others live their twenties through the lens of facebook, while I torture my brain and preserve my skin, enjoying the great indoors of lecture halls, libraries, and my cluttered office. This past year and for the foreseeable future, time off is not really time off (it is a time to sleep, or, better yet, watch the several weeks of classes that I have yet to stream…).

Almost one year in. How do I feel? Tired. I don’t have the same energy or enthusiasm for my studies that I had during my first semester. However, for the most part, I still enjoy what I am doing and am happy with my decision to go to medical school. As my reader can tell from my tone, I’ve had my fair share of frustrations, but mostly I’m just tired. (And a little bit stressed.) I also wish that I had more time to devote to intellectual and personal pursuits outside of medicine, as demonstrated by the forty or so tabs currently open on my browser (to “read later” of course…). But for now, I am learning. More than ever, I know what I am working towards and I know that the sacrifices I am making will be justified.

One thing that this past year has reminded me of is that the active pursuit of knowledge must be part of my life (these past few weeks, distracted from my course work, I’ve missed the stimulating environment and intellectual freedom of Reed College). Whichever specialty I choose, I feel that I will fit best into an academic setting, one where I can have side pursuits (public health, global health) and where others share similar ideals and desires to expand knowledge.

Until then, I will work.

More on India soon.

A&D

An Introduction to Medical School (The Hanna Edition)

Underneath the Platysma

Underneath the fine lace (aka the nightmare inducing Platysma)…

My first five or six weeks of medical school have flown by in a haze of adrenaline, gratitude, information overload, and sleep deprivation. I wake up most days well before my alarm, work for a few hours, cook or blend breakfast (one day I decided to blend, only to find that I had no fruit–my breakfast consisted of unsweetened almond milk blended with a few cups of kale and a spoonful of plain full-fat yogurt…), and head to my 8 am classes. With eyes wide (as to prevent drooping lids, luckily for me in this case, not ptosis), I absorb and absorb beyond saturation, sometimes spending my afternoons and early evenings with my nameless cadaver, sometimes spending them tucked away in a sunny corner in the library or curled up in my home office until my computer, or the position of the sun, tells me it’s time to try for some sleep. Often still inspired, I stay awake writing bad poetry until my mind and body can take no more. If I’m lucky, my eyes close and my mind shuts off (or fills with images of peeling away the platysma), and five hours later, the cycle begins again.

Seriously. I thought we already had this conversation 40 years ago.

Seriously. I thought we already had this conversation 40 years ago.

Outside of classes, there are ten billion things in which I would love to be involved (and once again I wish that I had another few centuries of life in my twenties…). I have committed myself to Global Health, so I will be traveling abroad this year. And, being myself who is now located in Texas, my eyes (and mouth) are open wide for opportunities to advocate for improved women’s health and the de-politicization of the female body. Adrenaline is also running high for Wilderness Medicine and Emergency Medicine, and I am really looking forward to both gaining skills that I can use in the backcountry (and other resource-poor settings) and learning more about access to care for our nation’s poor (I see so many opportunities to put my MPH to good use in Emergency Medicine).

Outside of medicine, I am practicing my handstands daily and am trying to expand my yoga practice in the moments between classes. There is very little time in my life for the things I need to do, so I am trying my best to use the little free time that I do have to the best of my abilities.

So, my dear friends near and far, this is a little vignette of my life (and perhaps a call for forgiveness of the lag time in making and returning phone calls and emails).

Hanging out with some friends on a Friday night

Hanging out with some friends on a Friday night

 

(An Introduction to) Life in Texas

On my drive to Texas...

On my drive to Texas…

New Starts. I love them. In my life, for better or worse, I have had many (more than I can even think of counting). I had seven high schools appear on my college application (I was only physically at five…) and attended three different colleges fulltime (not counting the other three or so where I have taken courses…). I have also traveled extensively, where every day essentially becomes a new beginning. And now I have started the next phase… Oh how I have loved the tabula rasa!

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(Hopefully) my little cottage!

I’ve been here, in San Antonio, for almost three and a half weeks. My time here has been busy, filled with my master’s courses, nearly completing my biochemistry prerequisite, working on SHELTER International’s Sanitary Napkin project, and an attempt to explore my new city. I also spent my first few weeks here scrambling to find housing, which I finally (hopefully) have. After visiting several over priced and mostly mediocre rental properties, I decided to buy an adorable little house in a historic district, mid-way between campus, Whole Foods, and my new hangouts. The house closes just a few days before classes start and I cannot wait to move in! I have been essentially living out of a suitcase since April and am anxious to settle. After a transitional few years (but isn’t all of life traditional?), I know I will have the motivation (of both relaxation and resale) to make the space beautifully my own. The decision to buy essentially happened overnight and I joke that I went from twenty-five (or whatever I am, some claim ninety…) to thirty in a period of just hours, as my free time suddenly became filled with thoughts of interior wall colors, countertops, how to tastefully match exterior paint with the new (green) roof which I will not replace, what to do with my front lawn, and my planting calendar…

A real first…

Other than buying a house and living around my homework schedule, I have had the chance to explore the city and meet a few people. The classmates that I have met so far are wonderful and I am excited to be around similarly motivated individuals. Also, actually very surprising to me, I actually really like San Antonio! Yes I have had “conversations” with conservatives who corner me with monologues of disbelief that I actually want to go into medicine in this day and age (can you believe it?!) and I will be driving past pro-lifers protesting Planned Parenthood (an organization to which I have proudly donated the last several years) on my daily commute. But I like it here. If anything, these oppositions will remind me why I have chosen the path that I have and will only serve to make life more interesting…

The road

The road

Other positives about San Antonio: I love the heat. I doubt that I will have to use my “happy lamp” often and will not need to make daily or even weekly trips to the sauna. I’ve found little corners of the city where I feel at home and have even found a few restaurants where I can eat!  More positives. I was asked out more times in my first two weeks here than I was in my six years in Oregon. Very few men here wear skinny jeans (they traded them in for cowboy hats and boots, a different story entirely…). It is a diverse city with a lot of culture to explore. Hill country is lovely. Most importantly, people are nice and I have encountered very little pretension. In short, Texas has welcomed me and I am doing my best to embrace a culture very different from my own. I am really looking forward to the next four years here and think that I am going to love it.

So, far away friends… come visit me once I partially reemerge from the stressful first semester of medical school!

A great fresh start!

A great fresh start!

Solo Adventures on the Kilalaua Trail

I have just returned from a visit to another world–Kilalaua Beach on the Nepali Coast of Kauai. I ventured alone–my first solo backpacking trip–and each step I took, my eyes opened impossibly wide as I questioned myself, “Can this place actually exist?”

It was that fantastic. Mind blowing. Beautiful.

I can see how easy it is too loose (or find) oneself in the mystic Kilalaua valley and beach. The valley is truly sacred.

As this post is rather long, I will break it up into several sections so that my dear reader can peruse only what he or she finds interesting and/or useful.

Topics include:

The Hike Itself
The Locals
Advice for Future Hikers

The Hike Itself

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Looking back at the Napali Coast

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I began the trip with myself, a 65 liter backpack loaded to an estimated 40 lbs with my tent, thermarest, silk sleeping sack, steripen, various other items, nutritious but heavy and calorie dense foods, and my old pair of trekking boots that at this point must have seen thousands of miles (and the tread, or lack thereof, shows). I had my injured right ankle (oh the pain it gave me only a week ago as I hiked through the streets of NYC!) wrapped in a brace. Because of my injury, I have been unable to do much in the way of my normal physical activity since March and so was hesitant to do the trek. With the possibilities of being out of shape and reinjuring my ankle, I set off cautiously a little after 8 am.

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At least I'm wearing sunscreen!

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A glorious portion of the trail

The eleven mile hike, with about 5000 ft of elevation gain up and down the valleys of the Nepali coast, took about 6.5 hours. I swore my pack became heavier with each step (surely my sweat had to go somewhere!). Despite my physical excursion, I smiled most of the way and, when I made it to the beach, I felt like running. How gorgeous it was!

My trek out, I felt so much lighter in every sense of the word and my pace reflected this lightness–I flew through the trail in just 5.5 hours. The hike out was fantastic. The weather was great and I could not help but smile and thank the world for providing me with such a wonderful life.

The Locals

I met very few locals and am far from an expert on the subject. I am just providing my most interesting experiences and I am sure that the majority of people living at Kilalaua are not mentally ill or addicted to hard drugs. I myself can see the allure of living so close to nature in such a beautiful place.

After arriving at Kilalaua, I decided to take a stroll on the beach. As I ventured from my campsite to the beach, I passed a strung out looking emaciated young man passed out on the beach a few yards from an occupied tent. I had heard that people lived on the beach and in the valley and correctly assumed that this man must be a resident. As I returned from my stroll, the man was sitting up and staring at me as I approached. From far away it looked as though he had somehow painted his face with red paint (oh, hippies…). As I moved closer, I saw that his face was actually swollen and bleeding. So, I ran up to him and asked him what he needed. Up close, his body was so thin and  the swollen lump under his eye provided the only bit of flesh on his face… He saw my water bottle and said he needed my water. I could barely make out his words as he tried to explain that he was beaten up. As I poured him some water, another man approached with some ice. The injured man cowered and mumbled something about not hitting him. The approaching man explained that he was just there to help and wouldn’t hurt him. I left him in the helpers hands and went on my way. A few hours later, a rescue helicopter arrived and the man was flown out on a stretcher. I asked around about why the man was beaten up and managed to learn a little about his background as well.

The man had lived at Kilalaua off and on for several years and, after his first trip out after a bad break-up, has never been the same (some postulated that he took too much ecstasy on the first trip, others claimed that he was possessed). It turns out the man was schizophrenic and would come to Kilalaua when he was having episodes. The night before the attack, he had supposedly been wandering around tent sites asking for heroin.

This man was attacked by one of his old best friends (visiting the beach to see other friends/family living there) because he stole all the beer and food from his ice chest after having been told multiple times to stay away. The young man had gone so far into whatever world, that no longer recognized is friend (who eventually attacked him).

So, the second rescue helicopter of the day was called and the young man was flown out for treatment (a chief or something like it, who helps resolve conflicts, also has a mariners radio that he uses to contact passing boats, who then call in emergencies. The turn around time is pretty quick.).

The first rescue helicopter was called for an episode told to me by the “rescuee,” a rather portly and good humored Kauaian who came to the beach to visit friends. He had found an abandoned kayak on a beach and, after waiting weeks to see if someone claimed it, decided to pack it with beer and supplies and kayak to Kilalaua. Well, several miles in, the boat starting sinking. After swimming alongside the sinking boat, the passengers abandoned it and somehow managed to escape the ocean by climbing up a waterfall (had the boat sank anywhere else along the coast, they would not have had this escape route…). I actually saw the boat from the trail and just assumed that its occupants were snorkeling. A helicopter on tour reported the kayak and determined the situation to be an emergency, as they saw no one and just saw beer floating in the ocean along side the sinking kayak. Luckily, the passengers survived, managed to salvage some of their beer, and hiked the remaining miles into Kilalaua. I really enjoyed passing a rainy afternoon with the survivors and their friends.

Advice For Future Hikers

For those of you wanting to hike the Kilalaua trail, if you are an experienced hiker, it’s much easier than the guidebooks say. If you are fit and travel light, the trail can even be done as a day trip, although lingering on the beach is just so delicious and I would highly recommend staying. For less fit hikers, budget 7-10+ hours and consider breaking up the trip by staying one night at the 6 mile point, Hanakoa, where a man might jump out of the shelter with an “Aloha, wanna smoke some hashhh?”

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My site

If you do choose to stay at Kilalaua, try to stay for at least two nights and try to get one of the sites near the waterfall, as they are convenient for getting water and are just so much better than the first sites you reach in the forest. I actually stayed in the forest one night and then moved my tent early the next morning to a freshly cleared prime bit of beach front real estate. It was glorious.

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I bathed and drank in the falls...

So linger if you can, for I have traveled a little bit of the world and have seen my fair share of beautiful beaches, and this one might just top that list…

One fellow hiker described the beach as “kinda like a hostel where you camp”. Mingle with other hikers, the locals, hear their stories, and be moved and intrigued by the diversity of man (as well as the beautiful solitude that you should seek and bask in)!

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The end of the hike!

On the (few) Downsides of Traveling Alone

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So I’m on the road again, in another transitionary phase… I’ve moved out of my little abode in my beloved Portland, OR and am roaming around Arizona, NYC, and now Kauai, as I scramble to finish the biochemistry prerequisite for medical school and move to Texas in June to begin my MD/MPH. It’s been an interesting few months.

Now that we have caught up, I will point out the few disadvantages that I could come up with about traveling alone.

1. No one to share beautiful moments with (other than my glorious self, of course)

2. No one to watch my belongings while I use the restroom, swim, wander about…

3. Cost (my lodging and car rental is twice as expensive…)

4. No one to call for help when/if a rope breaks as I scramble up the side of a muddy, slippery cliff (don’t worry, I’m using my best judgment…)

5. (Most importantly at this moment in time) No one to assist in applying sunscreen, resulting in the sunburn from hell, but only on my backside…

6. Taking selfies while getting said sunburn from hell (or while doing any other various activity in a secluded location)

Other than these six considerations, traveling alone again has been fantastic and I have been getting a lot of much-needed “me time” to indulge in solo hikes and long walks on the beach. Bellisma.

(For more on traveling alone, read “The Solo Traveler“)

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On Unemployment

Shit

A poem I wrote a few weeks ago

Unemployment. The one easily identifiable benefit of this period of my life is that it has given me the ability to empathize with a group of people whose situation I thought I would never experience. I now understand something many people from my background overlook. Finding a job (any job) is actually quite difficult—Unemployment is hard.

And, in Portland, Oregon, with one of the highest rates of unemployment in America and a city where twenty-somethings with college degrees “go to retire,” finding any job, much less something interesting and meaningful, is all the more difficult.

(On the unemployed: It’s not that we are lazy and don’t want to work. It’s not even that we have too much pride to take positions that we feel we are overqualified. We want to work. It seems as though there just aren’t enough jobs.)

Returning from Asia, I felt at the top of the world. I received good grades from a well-respected college and had more energy than I knew what to do with. I had (and still have) so much that I wanted to contribute and felt that, more than ever, I was in a position to put my passion to work, help save the world, all while giving myself valuable experience in the “real world” before I ventured back into the realm of academia and towards my career as a doctor.

So I wrote cover letter after cover letter, getting excited about the possibilities and all that I could learn. I honed and re-honed my resume and wrote more and more cover letters. I started to expand my search, first to include more job-hunting websites and then into “less interesting fields.” I even convinced myself that working at a restaurant would provide valuable experience working with people that I could use my in future interactions with patients (I still think that it would).

Jellyfish In all of this effort, my confidence has been shaken. Unemployment sucks. Of the I-don’t-know-how-many jobs to which I have applied, I have had one offer ($10/hour, 12 hour shifts, with a commute and no benefits), one preliminary phone interview, and a smattering of rejection e-mails and postcards. I occasionally find out that the job I applied for (along with over one hundred other applicants) went to someone with a master’s degree in a related field and ten years of relevant experience. All for $14/hour and decent benefits.

With the free time that unemployment has allowed, I can’t really do too many interesting things as I happily blew the majority of my savings traveling around Asia (and most recently registering SHELTER International as a 501(c)(3) organization). I do spend a fair amount of time researching and applying for jobs and do my best to not get too excited about the possibilities that will most likely not come to fruition. I try to stay positive and continue to apply. But there are only so many jobs openings in Portland to find and I am left with the little known phenomena, “free-time.”

I am a workaholic. Unemployment has thus been particularly frustrating. Though I love stillness, I can only have so much before I crave stimulation and engagement. To solve this problem, I have reached out to organizations where I would like to volunteer, but with so much in the air around my schedule, am unable to commit to a regular shift. I am also looking into reading and thinking about academic topics that interested me in college but never had the opportunity to explore. Luckily, I can keep myself occupied with the development of my NGO and have enjoyed dreaming up ideas to turn this vision into something more concrete. I also have my long-term future to think about. Yesterday, while strolling for miles along the Oregon coast, I found myself longing for my secondary applications for medical school.

This period of time has also made me thankful that I have parents who, however reluctantly, are willing and able to help support their ambitious twenty-four year old college graduate who can’t even find a job at a grocery store (because there aren’t any and these jobs might be even more competitive than most). So, thank you for paying my rent and not forcing me to move into a moldy basement somewhere on the outskirts of town.

I’ll stay positive and hopefully something (anything?) will come my way soon.

Portraits of Indian Widows

I have completed my research and have now interviewed one-hundred-and-eleven of India’s poorest rural widows. I have entered some findings into a spreadsheet and now have some basic statistics. I interviewed women ages nineteen to eighty-nine with an average age of fifty-one. Sixty-four of these women live alone or are the sole supporters of their families (only forty-four report receiving support at all). Of these one-hundred-and-eleven women, the average age of marriage was just 14.48, with the youngest being married at just ten years and the oldest at twenty-five. The mental health scores from the mental health questionnaire, with a range of 0 to 8, averaged 4.18 (and I am not sure how accurate this number is as I always had trouble with my translator here–but I will go more into that issue in a later post).

This experience has been transformative to say the least. I have been deeply moved by these women and amazed at their strength and endurance for life at its worse. I have loved my time here and feel honored to have had so many women share their lives with me. I know that I will somehow continue this work in the future.

Below are portraits of thirty-four of the widows, including the nineteen year old and the eighty-nine year old.

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