Review of Systems

One common practice in meditation (at least from the few apps that I have learned from) is the body scan. You go through your body head to toe noticing any sensations that exist or arise, not necessarily doing anything about them, but just taking note and moving on. I always thought of it like one of the futuristic body scanners that you may see in movies which shoot of plane of light at your body and evaluate your health status slice by slice.

The body scan is often one of the first things I do when I start my meditation, and while I always thought it valuable, I also thought it was tedious and would kinda rush through because (1) it’s not like there’s that much going on with my body as I’m just sitting quietly and (2) I want to get to some of the juicier parts of the mediation, or just be done with the meditation all together.

Recently though I’ve been starting to think of the body scan as review of systems and physical exam like I would do with a patient, basically a primitive version of that futuristic laser scanner, checking in with myself from head to toe:

Any fevers, chills, headache, nausea? How’s my vision (even though my eyes are closed at the time)? Am I smelling and tasting ok? Are hearing and balance normal? Any issues swallowing? What about swelling/ lymphadenopathy? Any shortness of breath or difficulty breathing? How’s my heart doing? What about my tummy? Any pain or discomfort? Issues with peeing or pooping? How’s the strength in my arms and legs? Any swelling, tingling, or numbness? Etc. etc.

Going through it this way as actually made it the body scan a lot more engaging (though perhaps overly thorough) and is also a nice way to review some of this stuff for myself.

Afraid to be Seen

Recently I’ve been particularly aware of a phenomenon that occurs when I go out to study with friends; we don’t talk or collaborate much at all. And if we do talk it’s always about something unrelated to school or just a brief question about what we’re learning. Working and learning in groups, to my understanding, is a great way to improve one’s mastery over the material. It requires us to think critically and understand the material so we can talk about it appropriately and it allows us to find flaws in our thinking and logic. And it’s for these reasons that I think I have an aversion studying collaboratively.

It’s the same reason why I don’t like getting cold-called to answer a question in class, or the same reason I don’t like to get singled out in any activity, even those I’ve been assured to be proficient in.

I’m afraid to be seen. I’m afraid to expose myself as the fraud that I know myself to be. I don’t belong here. Someone must have made a mistake.

Those are the thoughts that would play in my head, and having been around other med students for over a year now I know that a lot of other people have these thoughts too.

The thing is though, most of the people I’ve met here are brilliant and compassionate and definitely deserve to be here, and it’s low-key upsetting to me when I see them devalue themselves or be self-deprecating*, because if they saw what I see they wouldn’t be so hard on themselves, regardless of how ginormous their Anki queue is or the number of practice questions they get wrong on UWorld.

Recognizing this in others has helped me cultivate self-compassion and also has helped me shift me perspective on my imposter syndrome. It’s ok to feel behind, it’s ok to feel overwhelmed, it’s ok to feel like I am not enough, but I am here for a reason, and even if someone did make a mistake and I got in on accident, so what? Wallowing in that is not going to do me any good, I am here now and I will prove to them and to myself that I belong.

*I also think it’s a cultural thing to be self-deprecating nowadays ’cause no one wants to be seen as that arrogant asshole who thinks they’re hot shit, but we gotta find a balance ’cause this whole thing of competing about who is more behind or who has the most work to do is also a bit annoying and also ends up being a self-fulfilling prophecy.

Death of the Waiting Place

One of my favorite children’s books of all time is Dr. Seuss’s Oh the Places You’ll Go. As a young starry eyed lad, this book reinforced any ideas I had that I could be someone and make my mark on the world. At one point I had the whole thing memorized, and while those days are long gone (I maybe can still recite a few lines), there’s one part of the book that always stood out to me because of how starkly it contrasted with the book’s tone as a whole; “The Waiting Place,” for people just waiting… waiting for a train to go or a bus to come or a plane to go, or the mail to come, or the rain to go… etc etc. The way I interpreted it as a kid was, if you want to make something of yourself you can’t just wait around, you have to take action and just go!

While I wholeheartedly agree with this sentiment, I think we as a society, myself especially included, have taken this to unintentionally harmful extremes. Today it can feel like there’s pressure to always be doing something. A moment waiting is a moment wasted. When I’m eating lunch, I gotta be watching something or doing flashcards. If I’m in a lecture I have to multitask and write emails while I’m listening. If I finished a task early have some downtime I need to read that journal article about diabetes. If I’m stuck in a line I’ll scroll my phone desperately trying to find something to occupy my mind so I don’t have to deal with the existential dread or anxiety that comes with standing in silence with my thoughts. On the other end of this, if you’re anything like me, sometimes thinking of all the stuff I could and should be doing is paralyzing and I end up filling my time with unproductive things like video games to stay “stimulated” and feel like I am doing something.

The Waiting Place is empty, which if you’re familiar with Dr. Seuss’s version, would seem like a good thing. People are on the go! Taking action! Carpe Diem-ing! But is that really the case, or are we just making our brains feel that way? And even if people these days are being more pro-active, what’s wrong with a little waiting every now and then?

This is reminder to myself that it’s ok to be idle and to be silent. No that doesn’t include watching YouTube videos or scrolling through Instagram. It means savoring the moment, listening to things going around me and to myself, reflecting, being patient. Thinking back, the Waiting Place actually sounds kinda peaceful.

Us and Them

Having a community of like minded people is great. It’s part of what makes us human. It helps us promote things we believe in and move humanity (or at least our local society) in a direction that we choose. But as we’ve seen there is danger in community too. Just as communities can support justice and truth, they can also support bigotry and lies. Danger doesn’t come only from the latter though.

It also comes from when we start thinking of the world in terms of “us and them.”

We are just. We stand for good. People like us get vaccinated. People like us wear masks. People like us support this cause.

They are different. They are evil. They don’t do what we do or believe the things we believe know to be true.

We mythologize them, dehumanize them. That’s the dangerous part.

We forget that they are people (sacs of molecules), just like us. They weren’t born racist or ignorant; society and our broken systems made them that way. In no way should this absolve a person of wrongdoing, people need to be held responsible for their behaviors, but it’s important to recognize how the same systems that perpetuate oppression and violence, work at the other end to foster the ideologies that feed injustice on the individual level, which then contributes to those systems.

In fact I think subconsciously, or in some cases maybe consciously, we choose to outright reject people with discordant beliefs because we fear that if we actually get to know them, we might understand their perspective, or worse empathize with them. Justice is uncompromising and people with wrong beliefs don’t deserve empathy!! But there’s a difference between understanding where a person is coming from and condoning their actions and beliefs. You can learn how a person became who they are without supporting who they are.

Another reason we try to create divides between us and them is to protect our own egos. Because if we focus on the big evils done by others, then we don’t need to look at the small evils in ourselves. We put ourselves on a moral pedestal clearing ourselves of any responsibility to critically evaluate our individual actions and how what we do perpetuates hate or violence (of any kind to anyone or anything), because at least we’re not one of them.

I’m not trying to call anyone out here (if this is directed at anyone it’s mostly myself), but I will say that if you don’t think this is about you, it probably is.

Incomplete

It’s been a long time since my last post, and it’s not cause I haven’t been writing (well maybe partially). I have a lot of drafts that I just haven’t published ’cause I’m so afraid of putting out an incomplete thought without having a chance to fully explain myself…

Basketful

The basket will never be empty (a la Richard Carlson in Don’t Sweat the Small Stuff). There will always be something next on the to-do list; emails to be sent, flashcards to review, laundry to fold, dishes to wash. When I sit down to meditate in the mornings the thought of these things piling into my basket brings some anxiety. You’re wasting time, goes the little voice in my head, You’re falling behind, This isn’t productive. Sitting with that anxiety (as well as self doubt and failed/awkward social interactions) is often the hardest part of meditation for me, and sometimes I give in. Sometimes I speed through it and I tell myself a couple minutes is good enough so I can start getting stuff done. But I notice that when can I meditate consistently and with good “form” (whatever that means) I am usually able to go about the rest of my day with more focus and control.

There’s never going to be a shortage of boxes to check off the list so it’s important to enjoy the silence, even for just a moment every day.

Fruiting Bodies

When I used to think about fungi, the first image that would usually come up in my mind was that of a mushroom. Mushrooms are like the poster child of fungi. They come in all sorts of shapes and colors, ranging from bright and flamboyant to drab and unassuming. They can be tasty (to some), stinky, magical, or deadly. The diverse properties and bizarre beauty of mushrooms makes it easy to forget that they are just reproductive blooms whose purpose is to propagate more fungi, and that most of the heavy-lifting of these organisms is performed silently and out of sight.

Just because there’s no flashy “fruit” on display for everyone to see, doesn’t mean there’s nothing going. Most of the time things are cooking beneath the surface, but if you’re patient, and under the right conditions, a mushroom will emerge. Or if you’re like a truffle, the mushroom will stay hidden but will be evidenced by a reeeeally strong aroma.

Fiber

There are few things worse than an bad/uncomplete bowel movement in the morning. Likewise there are few better ways to start the morning than with a nice, full, fecal deposit. Imagine if there was a way to experience poo-phoria every day. Oh wait there is– it’s called fiber. Traditionally, I feel like most people, myself included, think of fiber as like a brush, made of this insoluble plant material that scrubs out our intestines like a chimney sweep. But as I recently learned there’s more to the story; it also draws water into our bowel making our poop softer and increasing the bulk, and it’s also great for supporting a healthy gut microbiome. With all these benefits, why is it so hard to incorporate fiber into our diets? I think a lot of it has do to with culture, as well as some evolution/biology/natural history.

When we make plans to go out to eat with friends, how often do people suggest all-you-can-eat salad? Maybe -3 out of 10 times. What about AYCE Korean barbeque? In the past month, among different groups of my friends it was suggested for maybe 60-70% of the outings. The other 30-40% of suggestions included ramen, McDonalds, and other miscellaneous options that may or may not have had a significant number of fiber-rich offerings on their menu, but even if they did it was definitely not the basis of suggestion. Of course craving protein and umami is part of our DNA, and businesses and restaurants work to cater to that, and that feeds into social gatherings, community building, and ultimately culture.

Makes you wonder if we ever could create a culture in which eating primarily vegetables was sexy or if our taste buds are just too averse to minimally processed ruffage for that every to happen on a wide scale. Though I think poo-phoria is a possible mechanism by which we could make it a thing, and our bodies would thank us for it.

First Day of School

Today was my first day of school in a lecture hall in probably about four years. It was strange being back, but also nice to be around other people in an academic setting again, especially after a year of Zoom medical school. I also feel like I was able to be more productive today than when I was stuck in my room. I was forced to have a change in scenery every now instead of having the option to stay inside (not that I don’t still technically have that option). Whereas I would often feel tired by 11am or around lunchtime, I felt energized being out an about. It could be that I’m still just riding the wave of novelty of in-person class and social interaction though, so we’ll see how long this lasts.

Saudade

Supposedly saudade is a (Portuguese) word to that describes a feeling of simultaneous sadness and happiness. It is the recollection of feelings, experiences, places, or events that once brought excitement, pleasure, and well-being, which now trigger the senses and make one experience the pain of separation from those joyous sensations. However it acknowledges that to long for the past would detract from the excitement you feel towards the future.

I feel like in our culture we have tendency to categorize emotions into being either good or bad. Happiness, excitement, love are good emotions, while sadness, boredom, anger are bad. Those categorizations aren’t universal though, and saudade is a perfect example of how that can be. I can feel sadness for the loss of a person or the memory of a time and place, but still be accepting of where I am in the present and have excitement for the future. I can miss a person while still being happy for them without regret. We need more words like saudade in the English language.