rosemary & research

here's a great, short article i caught on new york times' science section today:

the claim: rosemary helps reduce toxins in grilled meat

it's widely known/studied that grilling meat can create certain chemicals that have been shown to be carcinogens - a term that means they are compounds that can potentially cause some types of cancer. this article presents some evidence that treating meat with rosemary (and to a lesser extent with onion, garlic, and lemon juice) can help prevent some of those compounds from being formed. awesome! especially if you like these tasty herbs anyways.

but - i have to say as a total geek and firm believer in scientific research - one of the best things about this article is the hyperlink in it to a REAL RESEARCH ARTICLE. (the abstract on the pubmed search engine, in fact.) holy cow. i breathed deeply, sighed, and teared up a little bit on that one. bravo, new york times. eternal kudos for you tonight. ::electronic hug!!::

buddies

henry took this picture of our two cats lounging all over me a few weeks ago.

i love our cats. regardless of their sometimes silly (and at times annoying) antics, they defy the stereotypes of their species and make us melt.

millie (striped) plays fetch like a dog. throw the right toy, and she'll bring it back to you every time. she's fastidious and proper. you'll always find her curled up in a sunny spot or cleaning herself. she's the first to greet me when i get home (and also the first to ask for food at any meal time, although she's the skinnier of the two only eating a small portion).

fuzz (black & white) is the lazy, laid back, goofy one. she follows henry around the house like his shadow. in the mornings he has to throw a toy to keep her from following him right out the door to work. she grazes at the food bowl, slow and steady, and has surpassed millie in weight because of it. she's slower moving, but tender and affectionate.

both are surprisingly social for cats, which keeps things fun around our place. it's hard to believe millie turned 2 this month and fuzz turns 2 this fall. i don't think either of us had any idea what kind of buddies our kitties would be when we picked them up from the humane society, but we're grateful daily that we did.

feeling

so there's this relient k song - "this week the trend" - that i think probably sums up the way we all feel a lot of the time. here's a taste:

and this week the trend
was to not wake up till 3pm
i picked the few conscious hours that i chose to spend
and slept away the rest of them

and this week the trend
was to crash and burn and then return again
to practice the life that i pretend
provides enough to get me through the weekend

so i say get me a solution
and watch me run with it
and then you gave me a solution
what have i done with it?
cause i was absolutely sure i had it all figured out way back then
and now it's this minute, this hour, this day

and i just want to get mugged at knifepoint
to get cut enough to wake me up
cause i know that i don't want to die
sitting around watching my life go by
and what we take from this is what we'll get

and we haven't quite figured it out just yet
because all of us are all too stuck
strapped to a chair watching our lives blow up
stuck watching our lives blow up

...wow. it's true, though. what is this thing we call life when we are sitting in a chair, watching and waiting? misery. the singer is begging for something horrible to happen to him, so he can FEEL. so he can live.

i sometimes hear people say things like "life is hard." i often wonder what they mean. getting mugged at knifepoint, at first glance, seems like it would qualify as something that would "make life hard". on the other hand, the passive, numb way of living i've described would also make life hard. if given the choice, knowing life has to be hard, i think many of us prefer the latter because it is safe. we may be numb, but we're not bleeding. in so doing, we miss out extravagantly on the range of emotions we've been created to experience. we miss out on giving and receiving grace. we miss out on mourning and having our joy restored. we miss out on life.

although i didn't specifically ask or sing for it, i was recently "mugged at knifepoint" so to speak. my heart has recently been opened to a range of emotions... and i've let them pour forth. what a painfully human journey it has been and will be. how thankful i am for this opportunity to open my eyes and my heart and get up from my chair.

dear brothers and sister, when troubles come your way, consider it an opportunity for great joy. for you know that when your faith is tested, your endurance has a chance to grow. so let it grow, for when your endurance is fully developed, you will be perfect and complete, needing nothing.

[james 1:2-4 nlt]

sigh.

and the hardest part
was letting go, not taking part
was the hardest part

and i tried to sing
but i couldn’t think of anything
and that was the hardest part

oh and i
i wonder what it’s all about

everything i know is wrong
everything i do, it's just comes undone
and everything is torn apart

oh and it’s the hardest part
that’s the hardest part
yeah that’s the hardest part

the hardest part, coldplay

(no subject)

i got this feeling that they're gonna break down the door
i got this feeling they they're gonna come back for more
see i was thinking that i lost my mind
but it's been getting to me all this time
and it don't stop dragging me down

silently reflection turns my world to stone
patiently correction leaves us all alone
and sometimes i'm travelling
but tonight this engine's failing

i still hear the children playing
dead beat dancers come to us and stay

cause i don't care where you've been
and i don't care what you've seen
we're the ones who still believe
and we're looking for a page
in that lifeless book of hope
where a dream might help you cope
where the bushes and the bombs
are tranquilized

tranquilize, the killers

MS4

and so commences my fourth and final year of medical school! AHH! for those counting, i am now in 20th grade.

i'm currently on my last week and a half of a radiology elective. because of our research block during third year, i have one clerkship to finish during my fourth year this summer. here's the lowdown:

june: internal medicine acting internship

july-august: OB/GYN clerkship

september: anesthesiology elective @ VA, Step2CK

october: family medicine acting internship

november: off for residency interviews

december: medical ICU acting internship, Step2CS

january: off for residency interviews

[jan-april]: clinical skills teaching assistant for 1st years

february: master physical diagnosis

march: ambulatory internal medicine @ VA

april: infectious diseases elective

may 15, 2011 GRADUATION

i'm pretty pumped about all this. now i just need to figure out where i'm going to spend the next 3 years of my life training as an internal medicine resident and get them to pick me. !

death

this morning i met a patient. she's 92. she is blind. she reads rolling stone magazine in braille. she loves hip hop music. she's dying.

her next-door-neighbor is a patient who is 85 and loves country music. he has 50+ tattoos, some of which he has given himself. the nurses report he even has a tattoo on his you-know-what, although he certainly didn't give himself THAT one. he is also dying.

down the hall is a 55 yr old who is the primary caregiver for both of his parents who suffer from Alzheimer's dementia. he is angry at the world. he has six weeks to live.

yesterday, i met an 82 yr old patient whose daughter was by her bedside. she was sleeping, but i admired her freshly manicured nails. her daughter had painted them a deep pink, and completed the look by adding some flower decals. the patient died today.

---

where am i and what am i doing? i'm spending a week on the palliative care units at the VA and university hospitals.

palliative care is the type of care patients can receive when they have a terminal, incurable disease. many of these patients have cancer or other end-stage organ disease, and they attempted curative treatments without cure. many of these patients have multiple disease processes. palliative care focuses on the patient's comfort and symptom relief. dying is a natural process, and the focus is not to prolong it unnecessarily once it is imminent.

it's hard to simplify what i'm doing and seeing, and here's why: death is taboo in American society. we watch "shoot 'em up" movies all the time, but when it comes to someone we know dying, people are incredibly uncomfortable with death.

even in medicine, it is our goal as physicians to "cheat death" or at least prolong its inevitability. we constantly talk of "adding years to our lives" or "preventing mortality." we prescribe treatments to asymptomatic patients to prevent long-term consequences of high blood pressure among other things.

the premise of palliative care, then, where we basically say, "death, you win" has been paradigm-shifting for me. all bets are off. in a patient who has 6 weeks to live, he may eat whatever he chooses. there's happy hour on the palliative care unit. pain medicine is given out liberally. this is not "traditional medicine" as we are taught in medical school, but a hybrid of symptomatology and compassion.

i chose to spend a week on the palliative care unit to see what goes on, but also to sort out my own feelings about death. it's probably natural to be uncomfortable with death, even so, this discomfort undoubtedly stems from the mystery of death. we all fear what we cannot understand. for me, it's been therapeutic to participate in the dying process with these patients. they've taught me much in their few short last days.

in any case, waterproof mascara is recommended. and a box of tissues.