Good Signs

Hats off to Ross.

Refreshing

Imagine a society that not only values happiness as much as success, but understands it as a means to productivity.
A community that sees pursuing passion in even the most obscure direction as critical to the community's survival.
Picture a place that gives folks freedom, and trusts them to make responsible decisions.

Then shake yourself and stop fantasizing.
Or don't and go work here:

This is whimsical, with some good points thrown in there at the end.
I am less than happy with the way the media is treating Hillary. After several conversations with folks (my sister-in-law included), I have realized that she IS getting bashed, and a good 2/3 of it has to do with her gender. It makes her appear that much more attractive, really. And if I were a conspiracy theorist, I would note that maybe that's the grand plan after all: attack her so much that she gains popularity again, gets put up as the democratic candidate, and then the republicans take the election because people will actively vote against her. Now that would be some reverse psychology, Mr. Rove

The Choice

Very interesting article on what it is we are actually choosing between when we compare Obama and Clinton.


That link may not be around forever and I'm not very savvy in the ways of making things stay around on the internet, so let me know if you want to read it after it's gone (I have a copy of it I can forward to you).

Corrected

I've been meaning to write this entry for a while. Usually I think of something I want to write about and I put it off in the name of focusing on my tasks at hand. And then time slips by fast and furious and the thought becomes forgotten, or more tragically, obsolete. This entry is important. It's so overdue it is now awkward, cliche, overdone, but it's still important, so I'm going to push aside relevance and say it. Short and sweet like.

I stand corrected. I was wrong. And I'm happy about it (shocking to hear/read me say that, I know).

A few weeks back I wrote an entry titled Physicianhood and talked about the lack of political engagement from folks in this country. Well, I stand corrected. The last 2 months (and really this last month) have seen an incredible surge of passion and concern from people everywhere in this country. My fellow medical students got excited about the caucus. They attended, they volunteered, they buzzed. The anticipation made it feel like Christmas morning. It's hard to know what it is. Maybe people are fed up, maybe people are scared, maybe people suddenly understand that politics really do effect their day to day lives, maybe people are inspired. Perhaps it's the fact that the image of the politician is getting reshaped. It's no longer just an older white male, entrenched and overdone. A politician can be female, it can be black, it can be young, it can be inexperienced, it can make mistakes, it can change it's mind. And a politician has the potential to be anyone. The cynic in me says it's a trend - it's the hip thing to do right now. Politicking has new faces, new controversy - those things create popularity. Those things get stale. But my optimist tells me to believe that this is the beginning of a new phase in our country's history. It's a baby step towards recognition of what it truly means to be a member of this world. And it's a motion, a small gesture towards changing our unsustainable ways.

Of course, more needs to happen. None of the candidates are putting forth proposals for real change. They are magicians, we are willfully enthralled. But maybe our country needs illusions of change before we can embrace the real thing. A model before construction, a dress rehearsal before the show.

Still, for now, I'm content, gleeful even, to be proven wrong.

I'd love to write more, but medical beckons with the crooked, scolding finger of an old lady.

Downsides

There are some things I love about medical school. These days, I talk about all of the things I dislike about medical school. There is so much to complain about: the busy work, the long hours, the anxiety, the feeling of perpetual incompetence. In truth, most of those negatives are just talking points, things we (medical students) use to keep the conversation going, things we use to mar the fantasies that others have about medical school. When one gets past the long hours and tedious studying, we are lucky to be learning such amazing things and privileged to get to enter into that sacred healer-patient relationship.

What is hard, what lacks any sort of consolation prize, are the relationships that are drastically altered. I knew before I started that there was sacrifice involved in this process. And I knew that I would change, my life would change. But I did not expect such an erosion of my friendships. Some of my conversations have become hollow and rushed, remnants of what once were full-bodied, lively relationships. Now exchanges are empty and the awkwardness is amplified by the echoes of experiences once shared. There was no natural end to the friendship, no easy fade-away. Instead, the separation was sudden, drastic. We were both pulled apart and thrown into our respective realities - neither party has had time to adjust to the changes, and we are left with a disconnect between the reality of our situation and the lingering memories of a friendship that once was. And this is pervasive - with my closest friends, my oldest friends, and my family. (Although an interesting side note is that some of my relationships (most familial) have improved since starting medical school, likely due to an increase in the level of respect afforded me - I can now be taken seriously, and, since communication was sparse B.M. (before medicine), the time constraint had no negative impact).

To clarify, I am not writing off my B.M friends, I know that my friendships will last this - the bonds are strong and those people I love are even stronger. Time and distance impact, but they do not destroy. But it is hard to watch this transformation without trying to control it. This will elicit groans, I am sure, but it is reminiscent of a doctor who has to accept that a patient will suffer before he or she will improve.

So this is one of those unexpected, slap-in-the face side effects of medical school. This is part of that change in identity that they talk about on the first day of medical school. It is hard to maintain connections with people you love while fostering new friendships in such an intense, demanding environment. And I know that these are choices I make, and I guess that’s what makes this so hard. Certainly the structure of medical school is not conducive to relationships, but I’m not a huge fan of using that as an excuse for choices I make. I used to think I was stronger than that. I guess that's why they teach us that song in preschool.

"Make new friends, but keep the old ones
One is silver and the other's gold."

An Opinion

Bye Bye John

Why did he drop out?
Well, there's a lot of speculation running around out there, but I found this this afternoon and thought it was a somewhat interesting analysis of the situation. Not sure I agree with all of it, but some interesting ideas.

More later, I'm off to physical therapy for my elbow.

http://onegoodmove.org/1gm/1gmarchive/2008/01/
why_john_edward.html

Physicianhood

I was at a dinner party the other night and I got into a political conversation with a friend of a friend. It was heated (warm, but not hot) and fast, fairly superficial, and we didn't completely agree with each other. It was certainly intense, but it wasn't an angry, loud or aggressive political conversation. Still, in a matter of 3, maybe 5 minutes we cleared all but 1 person out of the room (I think something like 8 people left). I know I can be overwhelming in conversation, and this guy was too, but these are my classmates, fellow medical students. These are the students touted as the cream of the cream of the crop; these are the people who are some of the most highly educated members of our society, these are the people who are supposed to change the world. And, yet, these are also the people who are made physically uncomfortable by 10 minutes of a superficially political conversation.

I left that night feeling depressed and frustrated. When did our community get so afraid to express opinions? When did our community get so passive? Of course this is not an affliction suffered by only the medical community; political apathy is one of the most insidious epidemics of our society. Among most communities in the United States, speaking of politics with any conviction is a conversational taboo worse than religious beliefs, earning power, and sex. I spoke with a friend and colleague the other night about this and she noted that labeling yourself political is almost viewed as negative – a black mark against you. It is not surprising that people have become so alienated from politics – corruption, failure, and insulation from the consequences of governmental decisions make anyone frustrated and disillusioned. But why is our accepted, indeed, encouraged, collective response detachment and distance from the political process? Why don’t injustices and suffering galvanize us to question, probe, and fight for change? Without doubt the former is easier. Some argue more that apathy is more consistent with human nature, but this theory is weak against the reality that in general, people in other countries are politically engaged. In most communities around the world, to be apolitical is abnormal; that is the socially awkward stance.

So then why, why does the most powerful, richest country in the world have the most apolitical people? Or maybe those two statements answer each other. We are apolitical because we have little to worry about (being buoyed by the illusion of power, safety, and wealth). And we are the most powerful, richest country in the world because we are the most apolitical people. And then we must ponder how? What part of our system, what shaping forces in our country’s history brought us to this point?
**
I have had several conversations recently centered on politics, medicine, and the safety net. There is no lack among future physicians of good intentions. There are only a small number of my classmates who are NOT interested in working with underserved populations in some capacity when they are practicing physicians. And we all spend much of our time volunteering in local food banks, tutoring centers, free clinics, and at homeless shelters. And most of us, myself included, do it out of a genuine desire to help, a sense of responsibility to give back. Whether altruistic or not, these are generally understood as noble motivations.

So we all want to help, which is wonderful. The gap of awareness that is disconcerting is the emphasis on charity work as an alternative to (or separate from) work towards change (which, for linguistic ease, I will call politics). There are many who believe that charity work without political work is one of the primary things that sustains and perpetuates our current societal

system. Indeed, it is possible that charity in isolation actually harms the underserved since it insulates people from the outrageous injustices being forced upon them: charity work prevents things from getting totally unbearable and it makes those inclined to help feel as though they are doing their part – thus perhaps Marx was wrong – it is charity work that is the most dangerous opiate.

I am not arguing that politics is more important than ground level work. Paul Farmer has shown again and again the importance of providing underserved individuals with basic necessities. My point is that charity and politics are intimate bedfellows – isolated, they can cause great harm to the people they are trying to help.

I first started expressing interest in medical school at a time when I was frustrated by politics. I was burnt out on activism and exhausted by dogma and political absolutism. I was having a difficult time seeing truth in anything and I felt wrong putting so much energy towards controversial, ambiguous issues. I didn’t feel right pushing my agendas on others. Politics felt dirty, unfair, and unproductive. Wasn’t it all about community anyways? Wasn’t it all about changing yourself, your relationships, and your own personal environment? I wanted to live in a Gandhian way –be the change you want to see in the world. So I started seriously looking towards medicine. At the time, I saw it as a neutral way to help people and give back to my community.

I am older now, and my understandings of politics and life have changed, as understandings and beliefs tend to do. A few years have taught me that things are oh so much more muddled than I thought they were. I now understand politics to be inseparable from life. I read Gandhi’s statement not just as a suggestion to live the way that you preach, but also as recognition of the consequences our actions and our inactions have on the world around us. It is an acknowledgement of our inherent political self – just by being we make a statement, whether we want to or not. This is unendingly powerful, and frighteningly dangerous.

So I have learned that I cannot be neutral. There is no such thing as a neutral participant in society. There is apathy, there is silence, and there is inaction, all with consequences often as forceful as the consequences wrought by passion, speaking up, and action. Not advocating for change is a statement in and of itself. So perhaps that is the gap in understanding among us medical students. We have power. . .because of our personhood, because of our citizenship, and, now, because of our impending physicianhood. Just because we don't actively use our power towards something doesn't mean that the power dissipates. It stays, and with silence and inaction, we invite others to use this power to fit their agenda.

The Merit of the Majority

We need a leader who does not hold all perspectives and opinions as equal. While I believe in open discussion and acknowledgement and understanding of all sides of an argument, I also believe that not all ideas carry equal merit. The problem with this election cycle is that we have democratic candidates intent on unifying the diverse views in the country. Obama notes that “There (are) a set of things that I can do that no other candidate can do. I can bring the country together around a working majority for change in a way that Sen. Clinton, for example, cannot." But Hillary Clinton is no better. She is so tainted by politicking that she cannot commit to a position on anything, for fear of alienating some base. While she does not profess to be a candidate who unites, her actions show that she is reluctant to exclude anyone except the most fiscally and socially conservative, voters from her platform.

The problem with such a strategy is that this country’s problems should not, cannot, and will not be solved by more conservative methods. It’s not to say that the more conservative answers to our problems didn’t work at some point in our country’s history. They did and they were very effective; that is why they have remained so popular for so long. But times have changed, the world continues to progress, and the conservative response has become outdated and ineffective. The Merriam Webster dictionary defines progress as a “forward or onward movement.” It is not a recycling of used ideas, it is not a return to traditional plans and morals, and it is not a continued reliance on tried and true methods. Progress requires innovation, invention, and creativity. Innovators, inventors, and creators usually do it. And those people, the truly successful, truly brilliant who push our world to change are rarely obsessed with pleasing others. Indeed, those presidents who drastically altered the direction of our country were not making decisions based on popular opinion. They were taking risks and pursuing a vision, at most costs. (Of course, this can also be applied to our currently unpopular President, George W. Bush, undeniably he has wrought significant change, but change does not equal progress).

Compromise Versus Mediation

Without a doubt, a successful president must excel at compromising. But it seems that compromise has become an established virtue rather than the dynamic tool that it should be. Since a compromise is a merging of multiple ideas, one must have a foundation of concrete ideas from which to compromise from. This foundation is made of strong opinions, beliefs, passions, and the conviction that some solutions are better than others. From here, one can meet others in the middle and produce a unique outcome that, although it does not satisfy all aspects of it’s diverse origins, promises to address at least some of them. Compromise is a great thing, but one cannot be a good compromiser without taking a stand and risking alienating those with a different view. It seems that we have erroneously equated compromise with mediation.. A good mediator facilitates a compromise between multiple views. A good compromiser comes from one opinion and makes concessions to form a new solution. Both have value, both are important, and we need a president who is capable and willing to do both..