Saturday, October 30, 2010

SF-NYC Love Affair

"You too? Does everyone in Berkeley have a total hard-on for New York? Why doesn't the entire Bay Area just pack up and move to New York and get it over with?"

- Ben Tanaka, from Adrian Tomine's graphic novel, "Shortcomings"

Thursday, October 28, 2010

Eating Animals

"Humans are the only animals that have children on purpose, keep in touch (or don't), care about birthdays, waste and lose time, brush their teeth, feel nostalgia, scrub stains, have religions and political parties and laws, wear keepsakes, apologize years after an offense, whisper, fear themselves, interpret dreams, hide their genitalia, shave, bury time capsules, and can choose not to eat something for reasons of conscience. The justifications for eating animals and for not eating them are often identical: we are not them."

- Jonathan Safran Foer, "Eating Animals"

Tuesday, October 26, 2010


Tonight I decided I wanted something warm to eat, since the days getting chillier here in NYC. I popped open the box of Eden Organic soba I'd gotten yesterday at the "Food for Health" store nearby, which has shockingly cheap prices and reminds me dearly of California's health nut groceries like Country Sun and the now unfortunately commercialized and overpriced Whole Foods. I rarely use the stove in my apartment, preferring to just eat most of my homecooked meals raw, but today I boiled water, added the noodles, and stood around tapping my feet and wondering how long it'd take for the noodles to become "tender" (according to the box, 6-8 minutes). Finally, when the noodles looked appropriately ready to eat, I dumped them unceremoniously into a small bowl, added a dash of toasted sesame oil and reduced sodium tamari sauce (both also purchased from the health food store!), and settled down to eat.

And tastes exactly like what my mom used to make for me back home! It was hard to stop myself from inhaling everything all at once. It was like a blast of home and comfort and satiety.

Who needs to eat out when you've got this going at home?

Saturday, October 23, 2010


Excerpt from "The Elegance of the Hedgehog," after a retirement home visit by a precocious thirteen-year-old and her family to see her paternal grandmother:

On the contrary, we absolutely mustn't forget it. We mustn't forget old people with their rotten bodies, old people who are so close to death, something that young people don't want to think about (so it is to retirement homes that they entrust the care of accompanying their parents to the threshold, with no fuss or bother). And where's the joy in these final hours that they ought to be making the most of? They're spent in boredom and bitterness, endlessly revisiting memories. We mustn't forget that our bodies decline, friends die, everyone forgets about us, and the end is solitude. Nor must we forget that these old people were young once, that a lifespan is pathetically short, that one day you're twenty and the next day you're eighty. Colombe thinks you can 'hurry up and forget' because it all seems so very far away to her, the prospect of old age, as if it were never going to happen to her. But just by observing the adults around me I understood very early on that life goes by in no time at all, yet they're always in such a hurry, so stressed out by deadlines, so eager for now that they needn't think about tomorrow...But if you dread tomorrow, it's because you don't know how to build the present, and when you don't know how to build the present, you tell yourself you can deal with it tomorrow, and it's a lost cause anyway because tomorrow always ends up becoming today, don't you see?

So, we mustn't forget any of this, absolutely not. We have to live with the certainty that we'll get old and that it won't look nice or be good or feel happy. And tell ourselves that it's not that matters: to build something, now, at any price, using all our strength. Always remember that there's a retirement home waiting somewhere and so we have to surpass ourselves every day, make every day undying. Climb our own personal Everest and do it in such a way that every step is a little bit of eternity.

That's what the future is for: to build the present, with real plans, made by living people.

Friday, October 22, 2010

Moments to Savor, Savory Moments

Yesterday was mostly spent on anatomy. After some preliminary morning errands, I settled down to some alone time in front of the computer with the practice exams from previous years. Then a classmate and I headed over to school, where we went to each of the small group rooms with white boards completely covered in anatomy review diagrams, pictures, lists, tidbits, and various other "high-yield" points (I never really heard the term "high-yield" much until medical school). I walked from room to room, staring at white boards, hoping that there is truly such a thing as learning by osmosis.

So this post really isn't meant to be about anatomy, but I suppose that's the subject hanging in everyone's mind this past week. Anyway, to wrap up that part of the story, I ended up taking the exam last night, even though we have until 11:59PM on Sunday.

What really impressed me yesterday was going over to my classmate's apartment, which is right above the N-Metro train tracks to the side of our student dormitory apartment complex. I haven't been in any other apartment aside from my own, and when I mentioned that point, my classmate remarked that it's been true for her as well. Gone are the excited, adrenaline-charged college days when we'd run from dorm to dorm, room to room, checking out what other people's living conditions are like. When we'd order cheesy sticks in the dead of the night, and hover around a friend's desk or bunk, dipping the greasy cheesebread concoction into ranch or marinara sauce, watching a movie perhaps, or just striking up a "deep conversation," trying all the while not to leave oil stains on our host's blankets or school supplies. There were more of those days in college, than in grad school, I'd say. I remember when there was a total blackout at the Clark Kerr campus at UC Berkeley, where my dorm was located. The darkness had instilled some sort of adventurous electricity in the atmosphere, and students ran around the courtyard with flashlights or open cell phones, jovially joking with one another, the unanticipated darkness a reprieve from one's normal sense of composure. My friend and I sprawled out on the concrete courtyard of the campus, near a trickling fountain, and saw stars in the sky. I think it was the first time, and perhaps only, time I noticed them while I was in Berkeley. It was rarely dark enough, and not to blame modern technology, I rarely had the mood or inclination to look up at the sky.

Fast forward six years, and here I am in medical school, on a sunny but chilly autumn day. My friend's apartment is painted a vivid red, while mine is a lavender blue. I like both colors. She dashes around, taking butternut squash out of the refrigerator (butternut squash! Have I ever even tasted butternut squash?), fresh salsa from the nearby Wednesday farmer's market, Turkish yogurt that she uses in lieu of sour cream, and lovely, fresh, green kale. Not sure how to apply myself, I stand around flipping through Gray's Anatomy, reading a bit aloud about the nervous system. "The sympathetic chain...," I begin reading, "oh, and the prevertebral plexus..."

My classmate hands me a block of cheese and a grater. That's a better use of my time, for now.

What resulted from her efforts was a kale and butternut squash quesadilla! I felt like I should have taken a picture of it. It's rare that I get to experience a home-cooked meal these days, other than the stuff I scrounge up myself. Wash it down with a glass of apple cider, and I was all set to take the midterm.

On another note, I finished "A Tree Grows in Brooklyn" by Betty Smith yesterday, after I took the test. It's a lovely book. Many tweens and teens apparently read this, but it's still a classic nonetheless, and though I didn't actually read it myself while I was tween or teen, I definitely found myself savoring the book even now. What motivated me to read the book in the first place was visiting Brooklyn three times in the past month. Williamsburg - now a premier hipster enclave - is no longer the poverty-ridden tenement-housing locale that Francie Nolan grew up in. It has gentrified significantly. Yet the brownstones, the feeling of being near Manhattan, being Manhattan's closest neighbor, yet being apart from it all, has not changed. Francie would look across the river, the bridge, and wonder what lay across from her native Brooklyn. She grew up in abject poverty, the product of parents who married too young and were uneducated. She adored her father, who was a dashingly handsome singing waiter, but also the neighborhood drunk. Her mother raised her on a page of Shakespeare and a page of the Holy Bible every day, insisting on her children's education, and she succeeded despite the odds. Francie grew up loving books, loving the library, loving to write, but when she wrote about unpleasant (real) things, one of her teachers scolded her. She burned up much of her writing, promised to give up her writing if God would only insure that her mother stayed well through an illness. But she eventually comes back to it, and at the end, she skips the typical high school education due to having to work and support her family, and finally attends the University of Michigan at Ann-Arbor.

I found the book to be a satisfying read. Now onwards to "The Elegance of the Hedgehog" by Muriel Barbery. Did I mention how wonderful the New York Public Library is?

Friday, October 15, 2010

Stand Up!

This morning, I woke up at 5:30am to practice yoga in my room. This was because I had to meet a patient at 8am in the hospital, and the only way I could finish my practice was to wake up that early. So, when my alarm rang, I rolled out bed directly onto the yoga mat parked right beside me. I moved through the entire series I typically go through, and at the end, I reached the backbend section. I paused to assess my surroundings, having never done dropbacks in my small Manhattan bedroom. It looked OK, so I proceeded to drop into backbends. And then. I. Stood. Up. I was able to stand up from a backbend! Another milestone for me. My teacher had been hounding me about it for days. Every time I neared the backbend part in my practice, she'd turn to me and say, "YoginiMD, you must stand up." There was no room for arguing with her. She said it like it was a clear, unwavering fact of nature. Of course, I'd push myself forward again and again, failing to do what she'd explicitly said. "Harumph!" her facial expression seemed to say. She says I have it. My other teacher says I have it too, that I'm so close. So today, it was nice to...just do it. "DON'T THINK!" she always told me. "You're thinking too much!" "Just do it!"

And, I did.

There's a certain thrill in doing something new and something unexpected and something you thought you'd never be able to do. This carried me through the entire rest of the day, which was definitely filled with some rough patches. I spent hours in lecture, and then hours in the anatomy lab, where we trudged through the laboratory exercise of the day as best as we could, but still got broken-down and demoralized in the process. We barely finished the first half of the lab in time. The rest we'll have to save for next week. One guest instructor paused at our table to see how we were doing. He started to dissect our cadaver, since apparently we still had not gotten far enough to see the structures he wanted us to see. He revealed a ligament, and asked us what it was. None of us said anything. He looked at me, and asked whether we knew what it was. "NO," I replied.

"Thank you for being honest," he said.

Sometimes I wonder at the whole process of learning anatomy in the way I'm learning it now. We are literally tearing down the body. I looked up the word for "anatomy" in the online glossary for anatomical terms. And here's what it says:

anatomy: Greek ana = up, and tome = a cutting, hence cutting up of a body (c.f. dissection)

So apparently, we are doing exactly what the word "anatomy" means, literally.

Monday, October 11, 2010

Into the Unknown

Today is an interesting day. The date itself, October 10, 2010 (10/10/10), is special. It is also the birthday of the Republic of China (a.k.a. Taiwan). On a personal level, though, today was the first day I did dropbacks on my own. "Dropbacks" in Ashtanga Yoga refer to dropping from a standing, vertical position, into a backbend on the ground (urdhva dhanurasana, upward-facing bow pose). I'd been doing this on and off for more than a year, always being helped and spotted by my teachers. I'd never felt very comfortable with it until lately, since I had in general never felt very comfortable with backbends. I prefer forward bends. The chest-opening, heart-opening sensation of backbends didn't feel liberating to me, as it does to many. It was more like...scary and uncomfortable. I felt like I'd never do it on my own, and really, I didn't want to. So I always dutifully waited for my teachers at the end of the Primary Series when the backbend portion needs to be done, and they'd help me drop back, stand up, drop back, stand up, etc. Fortunately, I particularly feel like I can trust my current teachers in terms of physical manipulation, which was how I began to feel more and more comfortable with doing backbends.

Well, I'd known before moving here that NYC Ashtanga teachers are strict and don't let you just sidle through practice however you wish. My teachers here definitely live up to that reputation. One of them has been telling me during every practice that I "must" stand up from the backbend into a vertical position. I try, but haven't been able to stand up quite yet. But today, I was able to drop back on my own! I think it's a mixture of trusting your teacher (who says you're ready, and it's up to you to believe them), trusting yourself (ultimately, you have to do it on your own), and a trust in the process/practice/spirit of the thing in general (who knows what might happen?). I dropped back. I tried standing up, but ended up falling on the crown of my head. How do you make a room full of serious Ashtangis laugh? Fall on your head, banging the hardwood floor, crying out "OW!," immediately getting the attention of your teachers, who ask you if you're OK, and you sheepishly affirm that indeed you are fine, and laugh about it.

I'm not training to be a gymnast. Though it seems like yoga can be a series of contortions, the use of the body in yoga is directly linked with understanding and developing oneself. You might agree in theory that faith and trust are crucial in spiritual growth, but when push comes to shove, are you willing to fall into the unknown? I wasn't even willing to drop backwards into a backbend on my own, let alone trust my existence to God, or anything like that. Dropbacks are particularly symbolic and significant towards developing courage, faith, and trust. For me, this is more difficult than doing many chaturanga dandasanas (a.k.a. push-ups), despite how tiring and pain-ridden my muscles might become. It's somewhat within the realm of my control to stretch, to do push-ups, to balance. But falling backwards, there's a split second when control is out of your hands, and you must let gravity do its thing. And I did fall today (luckily my head is fine), but I realized that falling isn't a big deal. I was able to do something I've never done before. And these small moments of personal transcendence are something to be treasured.

Now, I will just have to learn how to stand up!

Saturday, October 9, 2010

Food, Health, and the Like

It's getting chilly here in New York City, so I've discovered a new love - instant oatmeal. The morning bowl of oats, sugar, and fruit microwaved on high for two minutes is utterly delightful. Eat slowly - actually chewing and swallowing - with awareness, and it's even better.

I just skimmed through a book called "The End of Overeating," by Dr. David Kessler. It's a scientific and insider's look at the food industry and the gigantic problem we have in America today with obesity and overeating. Food problems, to sum it up. It's because food has turned into a huge industry, a money and profit-making empire. We all know that sex sells. Well, sugar, fat, and salt are the equivalent, in the food world. And to make it worse, overeating is not just a matter of lack of willpower. Not only is advertising carefully planned and structured, the food industry actively researches and studies ways to make food more appealing, easier to swallow, more entertaining, and more addictive. It's no longer a matter of just eating and the ability to say no or not, but the whole issue is a matter of neurological wiring that's been deeply and thoughtfully manipulated by the industry.

During my small group biochemistry discussion on Thursday, one of my preceptors, who's a pediatrician, spoke about how soon our world will resemble that depicted in the Pixar movie, WALL-E. I remember being disturbed by the images of huge, puffy people floating around in electric chairs in WALL-E. How they'd eat and drink continuously as they zoomed around the space station the living members of the world were inhabiting. My preceptor said if we want to see the obesity epidemic, just visit her floor of the hospital.

Then she asked us at what age we think plaque (from cholesterol deposits) begins to form in humans. And the answer is - they begin forming in school-age children! At this rate, when you're in your twenties, your arteries probably have a fair share of plaque deposited in them. Oy.

I've been vegetarian for about half a year now. I don't see myself going back to a meat diet. There's no motivation to, at least so far. I've known of vegetarians who've had to incorporate back some fish and eggs in their diet for various reasons, but at least in the foreseeable future I don't think I'll have to do that quite yet. In fact I've been contemplating going vegan. I did love eggs and cheese, but in view of the health and environmental reason for not eating these items, it may be worth it to make the change.

The more we can get back to eating "real" food, not the processed or dolled-up stuff we typically see in the center of grocery stores or restaurants, the better.

Thursday, October 7, 2010

My Future Profession

Despite whatever stresses or pressures that medical school triggers, seeing a patient always reminds me that it's worth it. All of it. Today I was presented with three patients with chronic illness. Having been blessed with a relatively healthy family, I don't have much experience with the chronically-ill in my immediate family. Especially the young and chronically-ill (my grandmother died from pancreatic cancer and my grandfather is currently ill with dementia). Today I was presented with a patient roughly my own age, who has Marfan's syndrome (mutation in the Fibrillin 1 gene the resulted in heart issues for this patient). Later in the afternoon, I met a high-schooler with Type I diabetes, as well as an elderly gentleman with both HIV and paranoid schizophrenia. Hearing from these patients was educational, to say the least. It is hard for me to imagine what it is like to be reminded day in and day out that your health is on the line, that your body could turn against you at any time, and that control is truly not in your hands. It's an illusion that any of us have control at all, but to be living constantly in the face of the reality of that myth is not easy. It's only been little more than a month of med school for me, I'm still trying to gain my bearings and begin to figure out what medicine will mean to me. How will I practice? What kind of medicine? With what population? Will it be my life, or only part of my life? Will I do research, or will I focus on clinical medicine? Where? Private practice or academic medicine?

It can be overwhelming at times to consider these questions, which seem so gigantic and looming and unanswerable. I suppose I can only go with the flow and see where it leads me. Every time I start doubting what I'm doing, all I have to do is meet a patient.

Medicine is such an interesting profession. On one hand, you are held to the highest ethical and moral standards that any career can dare to expect of its practitioners. Yet on the other hand, it is one of the most competitive and draining careers there is. You hear of physicians who heroically save or cure their patients, and then you also hear of physician burnout and medical malpractice. It's expected that we fit into the "mold" of medicine, the hierarchical structure of the hospital, the "professional" behavior that must be exhibited at all times. But there's also the need for innovation, for creativity, for the courage to disregard "what others' think of you" in order for medicine to be practiced in a personal, individual way. Also, there's a certain level of ambition and drive to succeed that medicine seems to foster in those that try to practice it. And yet, equanimity, peace of mind, stability of character all seem to be necessary traits for a physician to have in the face of the daily encounters with death, dying, and disease. It is a training that can drain the personality out of you, and it could also be a process that brings out the best in you.

When the patients I met today were asked what they would most want to see from their doctors, it is COMPASSION. And the willingness to be patient with one's patients!

Tuesday, October 5, 2010

The Quiet Girl

The name of this blog derives from one of Patanjali's yoga sutras, perhaps the most famous sutra of them all: YOGA CITTA VRTTI NIRODHA (Chapter I, Line 2). It is sometimes translated, "Yoga is the inhibition of the modifications of the mind," or "Yoga is the cessation of fluctuations in the consciousness." Basically, thought-waves, disturbances, ripples, blips, bloops in the steady stream of one's consciousness. The activity of the mind. Thinking. Spend some time observing your thoughts, and you'll see what I mean.

I don't live in a society that turns inward very often. We're quick to judge someone on the street muttering to themselves as "crazy," when really, we're all constantly chattering to ourselves all day long. We just don't manifest that behavior on the outside - the social awareness that restrains us from doing that is the only difference, really.

So, I'm new to New York City, the Big Apple, a.k.a. the Center of the Universe and Capital of the World (according to some). There's much to explore here, and along those lines, much to think about. I practice yoga, so I suppose part of the practice is the ceasing of the turbulent ocean of the mind, reaching stillness and inner peace. For me, I find myself wanting to write and express my experiences. And so, these are my "vrtti," my thoughts.

An issue I want to address is that of being a "quiet" person. It seems to be viewed as a somewhat negative trait to have, especially in professional careers where verbalizing and communicating thoughts quickly, effectively, and memorably is so vital. Yet I've been a quiet student all my life. I dislike the "quiet Asian girl" stereotype, and people are quick to point that out when they discuss this topic with me. I suppose on the outside that is what they see, and part of me wonders if it's my duty to try to dispel it. Luckily, one of my friends pointed out to me that stereotypes are not my problem - they're the problem of those who believe and propagate them!

I then talked to several of my acquaintance and close friends who I've basically grown up with, gone to school with, and experienced numerous stages of life with. More than a few of us are rather similar in this regard - we're introverted, quiet, find it difficult sometimes to jump into conversations, find it worse to try to dominate conversations, are always conscious of whether anyone's left out (and seek to include them, if that seems to be the case), don't really feel totally at ease in large groups, dislike small talk. And yeah, we're all Asian, of Chinese heritage. Maybe it's something to do with our upbringing? Could be. We talked about that. Usually Asian parents find it disrespectful if their children disagree with them. So usually you have an opinion inside you that you don't really show or share to others. It's easier to keep it inside, unless you want to be fighting all the time. One isn't really taught to be opinionated. It's actually sort of negative to be opinionated - a sign of a disagreeable personality.

Another common thread I picked up on was how we typically think before we speak, and realizing that it's not really a matter of concern for the whole group, not that important, or just a "waste of words," we end up keeping quiet. Yet in class, if you don't talk, the teachers wonder if maybe you don't understand what's going on, didn't prepare for discussion, or are just plain dumb.

I often think of the Eastern sages and yogis of the past (and present!) who took silent vows and led lives of contemplation. Sometimes that's more than a little tempting to me. I think in Western civilization it's difficult to grasp why someone would "shut themselves up" like that. What's the use of observing the inner world? Why keep everything bottled up?

I'm still deliberating this dichotomy myself.