Author: nanimov

This is my last week on pediatric pulmonology. Something a lot of people say when you are applying to a pediatrics residency is, “Wow how can you do that, it must be so sad.” And it’s true, we see heartbreaking stories and children with severe, debilitating, sometimes terminal diseases all the time. But we also get to be participants in stories of intense joy and hope.

During this rotation I’ve had a chance to work with a lot of patients with cystic fibrosis (CF). These patients often can get very sick. There was one patient who I had a chance to see a few times in clinic and peripherally once in the emergency department. He is only about 6 months old around the time I’m writing this, but in his first few visits after he was born he just wasn’t gaining weight the way we would expect. He got admitted a couple times because of this, but his poor weight gain kept being attributed to poor feeding at home. Eventually he did get a work-up and diagnosis of CF, but it took way too long and something that I will continue to reflect on and think about throughout my career. I serendipitously had a change to see him in CF clinic while on this rotation and see him now getting proper treatment and growing well and looking healthy fills my heart so much.

We have another kid on the inpatient side who came in very sick and just has severe pulmonary disease due to his CF. He is only 3 years old. When I first saw him and he was still early in the course of his acute illness, he was just not a happy camper, understandably. Over time I’ve gotten to see him perk up and be more playful and interactive. Today he wanted to borrow my stethoscope and wanted to listen himself and then listen to me. He’s been smiling and happy, saying hi to us and bye to us enthusiastically these past few days and I just melt.

It’s these stories that keep me going. Especially for these kids who spend so much time in the medical system, in and out of clinic appointments and hospital stays, we as medical providers have an opportunity and privilege to try be a part of their reality, and hopefully bring some joy into situations that others may see as tragedy.

Telling you how I really felt
would only making letting you go that much harder.

But for you, when I say dude
what I mean is, I want to be the mirror that reflects the light from your bright, starry window.
What I mean is, I want to turn you into my first tattoo so I can keep you clinging to my arm.
What I means is, I want to be the story hidden in your perfect smile.
What I mean is, I want to lift you up to scale the wall to your future, even if it’s a place I can’t follow.

So for now I’ll wave to you from down below
twisting my mouth into a smile of my own
to keep my heart from calling out.

I’ll put a dream catcher above my bed
laced with magic from when we met
in hopes that your energy finds it way back to mine.

In the seventh grade, I learned the concept of linear functions
and intersecting lines.
It always made me sad to think about these lines that crossed once
never to meet again.
A cruel, unfair joke by the gods of math.

Fast forward 16 years and that same god made it so our paths would cross
and I feared our fate would be that of lines.
Perfectly together, just for a moment
and tragically distant for infinity.
But I’ve learned a lot since seventh grade,
including that not all paths are linear.
Some meander off on their own adventures
to one day find their way back
to one another.

I pray to whatever god may be that brought us together
that they made our functions nonlinear.

And if it can happen for Guppy the cat and a damn shoe,
maybe it can for us.

This may be obvious, but it just occurred to me today that the real reason 80% of Disney productions in the last 10+ years have been sequels, spin-offs, and live-action remakes (I actually calculated it and its closer to 53%, but still) is that they are afraid of failure. I always knew it was about money which makes sense given that they are business and they would rather invest in something that has a track record of success, but just never connected that to them being so afraid of a flop that they forgo creativity. It’s just a bit ironic coming from a company that is supposed to represent magic and imagination, that’s all.

A family member of 2 of my patients (twins) told me about an unfortunate experience they had during their admission. A staff member of the hospital, threatened not to perform their duty because the family member and one of the nurses were speaking to each other in Spanish. This was pretty shocking and upsetting for me to hear, and I can only imagine how it must have affected this family member. Our hospital serves a diverse community, but with a large majority of that population being Spanish-speaking, so the fact that someone in who works here can carry that kind of attitude in their heart made my heart sink.

I just sat for a while and listened to what this woman had to say, as she was understandably angry and shaken. What surprised me though was the good things she had to say about this hospital besides this isolated event. That, at least prior to this incident, she felt this hospital genuinely cared about the community and the patients that came through our doors. And how she trusted this hospital to see her and her family members as people, not just as patients. It was affirming to hear that many of the reason I wanted to stay here for residency, are ways the people in the community view this hospital. It was a good reminder to always do right by our community in the face of emboldening bigotry, and actively fight against it.

These were the words if my attending today. Of course, here he was talking about the literal heart in the context of cardiorenal syndrome (specifically type 4, which is technically more of a renocardiac syndrome), but it kinda hit me hard on a figurative heart level. Recently (but also chronically) I feel like I put off doing things that move me in the direction I want to go with my career, my relationships, and my life in general, often for the sake of more transient things. And over time, that “lost” time weighs on me more and more as the dreams I had for myself become more distant, and that hurts my heart a bit, ya know?

Don’t get me wrong, I’m very happy with my life overall right now. I love the work that I do and I feel lucky to have so many good and fulfilling personal and professional relationships, there’s just a part of me that feels like I could and should be doing more, not sure for myself, but for the people I care about and for my community (locally and globally). But if I keep holding off on working towards the things that I think I have to offer this world, I may well go into acute heart failure which as we know requires some diuresis (of like ideas, as in I need to do the things [or maybe forget about some] so that they don’t just build up inside me).

Now that we’re a couple weeks out from it, I wanted so share some of the thoughts I had following the night of the election:

Words can’t fully capture how I feel right now, so these are just words. I’m angry, sad, disheartened, disgusted, appalled, furious.

I’ve been hearing a lot of talk and seeing a lot of posts on social media about people no longer wanting to associate with anyone who voted for him. First of all I want to acknowledge that this is a valid sentiment for any individual who feels this way because yesterday the majority¹ of our country essentially invalidated multiple marginalized and vulnerable populations (and some that have been disregarded regardless of yesterday’s outcome), which includes a lot of people who I hold dear.

Another part of me thinks the solution to the situation we are in cannot be to further isolate into our echo chambers. This is not meant to shame any one who has decided that they no longer want any part of the population that has in invalidated their existence, you have every right to do whatever needs to be done to protect yourself and your wellbeing, and no one should be telling you how to feel or how to act in this moment. For myself, who has the privilege of being a cis-hetero-man, a US citizen, educated, from an upper middle class family with all the opportunities in the world afforded to me by the work put in by my immigrant family (some of whom are supporters of his), I feel like I can’t step away. I owe it to all the people I hold love for — my family members, my patients, and everyone else out there who are going to suffer because of the direction our country may head in these coming four years — to fight the affliction of heart and mind that has seemingly taken hold in so many people.

Despite what the election results show, I (perhaps naively) choose not to believe that all those people are hateful, idiotic, misogynistic, sexist, xenophobic, transphobic individuals. It’s possible that a large number of them may be one or multiple of those, but they are also people with their own priorities who were made promises through cult rhetoric of a better life for themselves and for their loved ones.

Something is missing. I ask myself, How can intelligent people, people who I have at least at one time called my friend, support a man who represents so much hatred and idiocy? There has to be as disconnect. Maybe not… perhaps every single one of those supports are themselves representative all those things. But if so, then where do we go from there? Because based on how this country elects presidents (i.e. the electoral college), leaving both sides fester in their own bubbles will not turn out well for progressive ideals, as we’ve seen. And something tells me that process is not going anywhere soon — call it a hunch.

It’s so easy nowadays to shut off and shut out beliefs and perspectives that differ from out own. Algorithms, socials media, likes, and follows all exacerbate this, if they are not indeed the root cause.² Unlike, unfollow, report; sure it makes us feel better because then we no longer have to see it, but rarely will that stop it from existing, and those who do resonate with that content will find it and come together, free of any dissenting thoughts thus hardening their beliefs, and making it inconceivable that anyone else of sound mind would think differently.

The change we need comes in culture shifts, not in elections in and of themselves. Culture shifts come through changes in believes and values. Those changes can only come when you are challenged by beliefs and values that differ from your own. It comes from not demonizing other people for having a different world view or having different lived experiences. It comes from finding common ground, as difficult as it may be. It comes speaking up, but perhaps more importantly, from listening. It comes from being disruptive for the sake of change, as well as being open to change.

I could have done more, even if it wouldn’t have changed the outcome of this election. I failed to speak up in casuals conversations for fear of embarrassment, retribution, or not being knowledgeable enough to back up my beliefs. I stayed in my comfort zones only engaging in spaces where I knew my ideals would be validated. These are things that need to change, even if they are coming woefully late. I anticipate that 9.5/10 times doing any of this work will leave me frustrated, hopeless, angry, and desperate, but the alternative is equivalent to me personally giving up and choosing to live with my privilege relatively unscathed, which beyond complicity, would be an injustice and waste.

Again all of this is just words. Words that are basically meaningless in light of what is at stake, and in the absence of action.

I know not all the people who read this will share my perspective. If you are one of them I want to hear your thoughts. I can promise to come into the conversation with an open heart and an open mind, and I hope you can do the same.

¹Which might not be quite true anymore, but that doesn’t change the outcome.
²The roots cause is human nature, these technologies just feed off of and augment it.