Select Page

Whole world in his hands

There’s nothing at all like holding another person’s brain in the palm of your hands. As I stood there looking over a mostly-empty dissection table, the stark contrast was real. On the table, nearly nothing. In the palm of my hands, my donor’s brain. Immediately I thought “every thought, pain, joy, love, hate, worry, wonder and delight was processed through this rather weighty organ.” It was the first time I held a brain in my hands. It may be the last. This is one of the most unique experiences in medical school. If you pause for a moment, all of the richness of that encounter is there for you. But don’t pause for too long. There is an awful lot of material to know for CNS unit, and I was relieved to be joined at the table by my late-coming lab mates, who greeted me with a look a puzzled awe, masked disgust and intellectual wonder. What a thing it is to explore the human body. What a shame we can’t pause for longer and simply reflect. We had just that kind of moment earlier that very day in our small groups. The topic, medical student depression.

We discussed an article published a few years ago that looked at the ideas of University of Michigan Medical School students in regard to depression, its stigma and complications. This lead to a bit of venting for some students, who expressed their dismay at the perceived lack of resources for mental health for medical students, and the lack of emphasis on the matter. The fact is that there is empathy and understanding abound, and UMMS provides a variety of ways to engage with mental health as a student. However, the criticism is real; mental health and wellness as an integrated issue within the confines of medical education across the country – from medical school through residency and beyond – has a long, long way to go. The irony that many of us get sick just in the process of learning to get others well was salient that morning during our discussion. At least it is a talk being had. And just as this heaviness descended over my experience at medical school, with my mind absorbed with how the CNS actually works and all this talk of medical student depression, the Smoker happened. And did it ever.

For the uninitiated, the Smoker is the med school’s annual satirical romp through the various inside jokes of life here at Michigan med school. It was like nothing I’ve ever seen. The sheer release of laughing with hundreds of other students and members of our school’s community was a wonderful feeling. I couldn’t believe I didn’t participate in the show. My classmates were so talented and funny. I brought my parents with me to the event and despite some incredible on-stage irreverence, we all had a really great time. There is no recording of the show, but here is a Serial Podcast spoof that was produced to hype the show. UMMS Serial Podcast Spoof – Get ready for the Smoker

Let me allow you in on one of the many little jokes on stage at the smoker. We have one particular professor, Dr. Owens, who is very popular amongst students. That being said, he tells these wonderful little stories during lectures about boating on the lakes around Michigan. During the Smoker, a classmate dressed up as a sailor. It was a nice little touch. In the spirit of Dr. Owens, here is some random material to break up this blog posting. Traveling Wilburys – End of the Line.

A new week starts tomorrow for UMMS M1s. We continue CNS. Lots and lots of spinal tracts. It’ll be nice to see the classmates from the stage and congratulate them on their incredible performances. Nithin even shaved his head so he could portray a bald man. One day I’ll be a bald man, so I appreciate the solidarity. I’ll take it as a personal “do your thing” for those among us who are headed down the hall of hairlessness.

Road biking in Atlanta for Valentines Day

One nice thing about going to a great school with a flexible testing schedule is the ability to maintain a long distance relationship. These arrangements are never easy, and I’m regularly jealous of my school friends who are dating someone who actually lives in Ann Arbor. But I do have the chance to go visit my loved one fairly regularly thanks to our generous curriculum.

Today, I rode from midtown Atlanta through Decatur, home of Emory University. I rode with a friend who graduated med school several years ago. We laughed about how the process of medical school is so intense that you rarely have chance to stop and reflect on the material you are learning. The way he put it, “it’s a life-changing amount of information.” I like that. And this bike ride gave me a chance to reflect and be appreciative. For one thing, a family member recently had an inguinal hernia. I actually knew what that meant. I asked if it was direct or indirect. They didn’t know. But I knew what I was asking. How cool is that. Also, at the top of a hill on this ride, I paused (having left my bike partner in the dust because I crushed it so hard). I stopped to feel my femoral pulse. It was booming! It is a small thing, but even having an appreciation for the distribution of blood through the body that allows me to bicycle and enjoy the day added to my appreciation of the moment.

Tomorrow, I head back to Ann Arbor after a nice long weekend. The day after, I turn 31. Years. Old. Like a boss. So, it’ll be nice to get back and take this final exam for reproductive and endocrinology. It is…. a lot of information. But, I’m happy for these moments on bike rides when I can stop and appreciate all of it.

Showing up for Equality & Inclusion


Photo by Samuel Neher, UMMS Class of 2015

This is why I believe it’s important that I join my classmates to make a statement about current events. I want to be clear that I don’t know how to be a better police officer, or what it is like to be a minority in this country. I don’t have solutions to the world’s most pressing problems. But I know that we can do a lot better than killing people on sidewalks in our own country while fighting wars overseas, while suffering people die, while physician suicide rates are twice those of their patients, where we have a health care system that needs love like nobody’s business, and we have such clear lines between those that have and those who do not. I quit my career in political science and in public relations. I’m not a master of any political thought or any particular approach to governance, economic systems, or health care systems. I’m not a moral authority on anything. Anyone who really knows me knows that I’m no monk and that I’m not flawless. And it is from this place that I say we can do better. I don’t know how that will look. I don’t know what transformations the world is going to have to make. But I know that I can show up, walk and take a picture with my classmates for something that is so clearly so wrong, and so clearly a manifestation of a system and psyche deeply wounded, deeply flawed and in dire, dire need of attention. I’ve chosen to go in to medicine because I believe that my singular purpose in life is to allow myself to be healed as I stand witness for healing in others. There’s just nothing else that really motivates me. I’m done with political theories; not that they are useless; they’re just for someone else. I’m done with economics and figuring out what other people ought to be doing with their lives. I’ve had in my day plenty to figure out for my own self, wrong I’ve done, amends I’ve made, and it’s an ongoing process. But I know for sure that showing up, walking and taking a picture with my classmates to say “I’m with you guys, this hurts me too” is just the right thing to do. #blacklivesmatter

So we marched from the Medical School to the Chemistry Building while chanting, and then lied down for a symbolic 4.5 minutes. From the pictures, students observed us and pondered. The mood was somber. We then walked to the Diag, the center of Michigan’s campus. We joined with several hundred other students to listen to speakers and come together in solidarity. One speaker mentioned the need for more positive action. I hope that we can achieve that.

To anyone looking to apply to a medical school, know that at Michigan they start talking about health equality & inclusion from day one. There are regular lunch talks and ways you can get involved with working with underrepresented voices and people. I hope this is the experience of my classmates, too, and that it enriches their education as well. For me, there is so much more than political action that needs to be done. I understand this is a component. But I’m savvy to the statistics that we participate in bias whether we know it or not, whether we wish to or not. I’ve noticed it in myself. I really feel strongly that change begins internally, by noticing, acknowledging and owning and obstacles and places where love does not reside, and making a decision to let that stuff go. To me, that’s as integral a part of healing as any biomedicine. The cliché is that first year medical students are idealistic. So what. Let us have our moment. This is the way we need to move if we are going to make any real and lasting changes to healthcare. Might as well begin right here, right now, with us.

Moving right along

An applicant asked me if I’ve been able to maintain my interests while in medical school. It’s such an interesting question, and one that I asked at nearly every school I visited. I was looking for a “yes,” no doubt about it. And so should you. But the answer to that question, and the one you might as well get used to is that it changes. Everyone comes to this school from different backgrounds. I happened to have taken an 8-year “gap-year,” which of course is a term that only applies to me talking about my life now (as a current med student). For those 8 years, I didn’t realize I was in a gap. I was just moving along. Interests growing, changing, and evolving. And I must say, going into medical school I had a pretty set program of interests and activities, many daily rituals, that I was interested in maintaining. Heck, the rigors of academics would even be a test of my incredibly honed and polished self care skills.

Detroit Red Wings coach Mike Babcock's message is to "be an every day'er."

You know, of course everything changes. So, the answer to this question is “get ready to evolve.” Let me give you some examples. I wasn’t playing hockey before I started med school – I was on a 4 year hiatus. Now, hockey. I’m subbing for a couple teams, and my attention has focused around hockey. I read articles about the Red Wings, their system of prospects, their stars and their enigmatic coach (pictured at the computer’s anatomical left) who encourages his players to be “every day’ers.” It just means showing up and doing what it takes every day to be successful.

Another example, yoga. I was doing yoga fairly regularly before starting medical school. I assumed (and even wrote on my application) that I would continue with a daily practice once school starts. After all, it is intended to bring more energy, clarity, calm and attention into your life. However, this is an activity that has dropped off a bit for me. I’m still meditating every day, but the process of hitting the mat and doing some yoga every day has lessened dramatically. I also noticed that my sleep schedule has changed. I’m staying up later and waking up later.

None of these changes are the problems I had imagined coming into school. There’s a part of me who doesn’t like change, who wants to have the secret life equation and then to go out there and execute on that well-intended plan. It rarely works like that. In the short while that I’ve been a medical student now, I have to say that yes, my lifestyle has changed. How couldn’t it? And so many of the questions and concerns that I had while applying or interviewing have transformed, gone away completely or frankly, been magnified in ways that I couldn’t have imagined. When I made the decision a few years ago to leave a successful company to start down the long road of becoming a physician, I didn’t do it to become a medical student. I did it to become a physician. The process of becoming one, though I am still in the early game of it, is so far (and I’m talking about starting with the pre-med classes) about persistence and putting in the work each day, addressing each day one at a time. Each day brings its own set of circumstances that Red Wings coach Mike Babcock comments in my head about.

The Dude abides

"The Dude abides. I don't know about you but I take comfort in that. It's good knowin' he's out there. The Dude. Takin' 'er easy for all us sinners."

Sometimes being an every day’er means studying seemingly overwhelming and incomprehensible information for days at a time with few signs of comprehension. Some days it means sleeping more. In the middle of the day. Other days it means agreeing to meet an old friend, because you know it will warm their soul. Other days, email, laundry and watching a Red Wings game. I have so many ideas in my head about the way I’m “supposed” to go through medical school – and they cover every bit of ground between never doing anything but studying and being something like The Dude from The Big Lebowski (pictured on the computer’s anatomical right). I even have caricatures of classmates who, while each in reality have their own inner dramas and complexities, represent these archetype med students. “Geez, why can’t you be like him, he’s crushing it effortlessly,” or “why can’t you…….” You get the idea.

It’s funny, when you can take a step back and look at all of these thoughts and emotions going on, being mischievous and distracting. But in the moment, sure, it’s as real for me as anyone else. The not knowing. And wondering. I can empathize with nervous applicants coming in for an interview, being told to be themselves while wearing a suit they just purchased and walking in to meet people who will decide their Fates. I remember on several occasions waking up, meditating for a solid hour and then struggling to find the right tie to wear for the interview. That struggle is real and internal. And the game only shifts in medical school. We’re already in, but the internal dialogue needs some new topic of conversation. So it’s off to the races again with comparing ourselves with other students and archetypal students and so forth. I’m just writing down to own the whole process. And so that, if someone reads this and is like “dang, that’s me,” they can feel more part of the broader experience of everyone else as we, in our own way, find ways to be “every day’ers.”

So what’s actually going on in medical school? We’re on the other side of halfway done with our musculoskeletal unit, where we focus on the structures of the limbs, their tissue types and energy needs. We’re learning how the human body works; that’s medical school. A great opportunity. I’m working with a fellow classmate who is interested in nutrition on putting together a series of nutrition talks that coincide with our curriculum. She’s a true all star. I’ve organized a set of lunch talks on addiction: Addiction 101, young people in recovery, and the medical needs of people in recovery.

Life is good. The Red Wings won tonight. Passed another quiz. Enjoyed the weekend with med school friends and some venerable townies. There was a big holiday celebration in downtown Ann Arbor. I studied a lot. This week coming up it’s more learning about human beings, their limbs and energy requirements, and I’m hosting an interviewee. We’re going to have a ball.

Freaking out, coming together.

Some sort of heaviness descended on our class as a whole over the last few weeks. Not sure where it came from, but nearly four months in we are collectively finding ways to support one another, find our common purpose and orient ourselves toward the center. Group emails have been flying back and forth, and several students have organized extracurricular activities to sooth, reaffirm and strengthen our ties with one another. I may have said in my first post that the strength of this school is its people. Still true, maybe never more so. We’re a very diverse group of 170+. Never been around so many brilliant people. And viewpoints. And willingness to articulate a viewpoint.
We’ve been absorbed with absorbing everything we can from coursework: how do the lungs work, how the heck do the kidneys have so many transporters? And so on. Maybe it started taking its toll. It snowed today. Who knows. We have a good group of class advocates who worked with administration to adjust some of our schedule to try to rebalance things. I’m glad we’re at a place where the school is open like that. But it’s definitely some kind of syndrome that we’ve fallen upon. Maybe we’re ready for Thanksgiving. Who knows.
For myself, I must admit to a bit of staring off into space. I’ve been thinking about the words of warning from mentors and friends: “med school is not for the faint of heart,” and “hold on to your humanity,” “we need people like you to become doctors,” and “you’re going to be a great physician.” I think of these things and cringe a bit when I hear something like “the basic sciences get thrown out the window after the first two years” from older students, residents and, frankly, The Internet. Holy smokes. We sure are learning a lot of basic science. Never have I put in so much work to be just an average student. We don’t have a class or a culture here that makes us compete with one another. It’s pure pass-fail, and there is a true spirit of collaboration that permeates our class. But nonetheless. I’ve never not been the master of whatever I’m studying. And I find myself needing reminders myself of what the heck that core of humanity looks like. I wonder if it’s normal to be experiencing this only 4 months in, to essentially wonder “what have I gotten myself into?” I venture yes. But sometimes it’s just not talked about.
A personal note that I promise to tie back into our experience in medical school:
One of the things I love doing, that bring true meaning and a deep sense of satisfaction into my life is working with alcoholics and drug addicts. There’s nothing that brings so much peace and joy to my heart than volunteering at some of the rehabs and detox centers here in Ann Arbor. Tonight, after studying as much renal physiology as my mind could manage, I got dinner with a friend and ventured over to a local detox facility. There, I met with a young lad who got sober as a teenager only to relapse during college and find himself bottoming out at a head-shop out west. He had recently been medically detoxed, and experienced acute renal failure. He couldn’t be more than 25. For the time I was with him, I cared for nothing more than his sanity, his feeling of connectedness, belonging and value. I didn’t think one bit about my own troubles as an early medical student. And when he mentioned his kidney failure, I thought, “I better get a handle on that kidney.” And then the thought just passed, and I got to spend the rest of my evening talking to this fellow, and sharing my time with him. I know that, as with patients in medicine, my role is to show up and do my best; my genuine and sincere efforts, and come from a place of love. There really is nothing else. And I have to believe that. That the whole reason I am going to medical school is to be of greater service and efficiency in helping people. And through this process, as I experienced tonight and on so many other nights, be healed in some way myself.
I have to believe that this experience is what I’m suiting up for when I put on a pair of unwashed pants, quickly brush my teeth and book it for another morning of bagels and cream cheese, and the memorization of countless transporters.
I’m going to close out this somewhat rambling post with a video from a time in my life that was deeply meaningful to me.
When I was 25, I had just started a cause-oriented PR firm that mostly did non-profit work in Utah. My clients were farmer’s markets, some classical music groups, political candidates, a chain of indie record stores, and a yoga studio that become somewhat of a home-away-from-home. Anyway, toward the end of the year I transferred my client load to a business partner and took a leap of faith by living with some fellow junior yogis for two months on the beach. I didn’t know what I signed up for, really, and going into the trip one of my goals was even to get into “the best physical shape of my entire life.” To be short, it wasn’t like that at all. Not all the times were pretty. It was a full-on experience that I won’t get into. But it included people freaking out about their lives on the roof, laughing, crying, and an overriding sense that we were each on this planet to do something unique and wonderful. And that life had great mystery and meaning.
It’s the rare individual who draws inspiration through slogging through medical coursework in the basement of Fursty. But where should the vital threads of life itself come together more than in the practice of medicine? Who knows. See you in class.