quote of the rotation (why would he even tell me this?!):
me: do you have sex with men, women, or both?
42 yo M: oh, women only. only.
me: ok, wha...
42 yo M: [interrupting] but i let a guy go down on me once.
Sunday, December 14, 2008
Saturday, December 06, 2008
But who may abide the day of His coming?
it was passing, transient, ephemeral. it was fierce while it lasted, and i thought i there wouldn't be an end of it, but looking now, the swelling's gone, and if my memory was poorer i'd wonder if it was ever even inflamed.
it's called atopy, and it seems to be involved in eczema, allergic rhinitis, asthma, and anaphylactic shock. basically, anything allergic. it hereditary, so it's part of a family history, just like diabetes, hypertension, cancer, and autoimmune disorders.
it is a hypersensitivity reaction that affects parts of the body not directly exposed to the allergen. in this way, the body is quite retarded. it takes a small signal, something rather meaningless, and amplifies it completely out of proportion. and while you can use antihistamines and steroids, the best thing is to avoid the stimulus entirely.
palpitations, anxiety, insomnia, chest pain
i had pericarditis last year (no, not from atopy. i'm done with atopy, unless i talk about limerence or Flow, which happen to be things i know quite a lot about, strangely enough. ok, not strangely. i dont throw out big words or concepts like that unless i'm trying to make links. what, like i don't know what i'm doing here? please. if i may remind you, this is mostly a logbook for myself, an encrypted black box, so of course it will be, at times, impossibly obscure. the purpose of my writing is to remind myself of things. there you go, the organization's mission statement. wind tape).
i had pericarditis last year, which i suppose is much better than carditis, because the heart itself isn't infiltrated. not that it can't be complicated. the major problems that arise are pericardial effusion (which can lead to tamponade), fluid that accumulates between the heart and its soft shell that applies pressure to the heart externally, impairing it's ability to fill, and constrictive pericarditis, which also is restrictive, but by way of thickening of the casing, not fluids.
mine wasn't exciting in any of those ways, and the cause probably was viral, or post-viral, probably (non-infectious causes are much less likely in my case). no big deal. hit the NSAIDs hard for 2 weeks, and hope i don't end up with adhesions (fibrous attachments) though even those aren't very remarkable (no long-term sequelae).
it's called atopy, and it seems to be involved in eczema, allergic rhinitis, asthma, and anaphylactic shock. basically, anything allergic. it hereditary, so it's part of a family history, just like diabetes, hypertension, cancer, and autoimmune disorders.
it is a hypersensitivity reaction that affects parts of the body not directly exposed to the allergen. in this way, the body is quite retarded. it takes a small signal, something rather meaningless, and amplifies it completely out of proportion. and while you can use antihistamines and steroids, the best thing is to avoid the stimulus entirely.
palpitations, anxiety, insomnia, chest pain
i had pericarditis last year (no, not from atopy. i'm done with atopy, unless i talk about limerence or Flow, which happen to be things i know quite a lot about, strangely enough. ok, not strangely. i dont throw out big words or concepts like that unless i'm trying to make links. what, like i don't know what i'm doing here? please. if i may remind you, this is mostly a logbook for myself, an encrypted black box, so of course it will be, at times, impossibly obscure. the purpose of my writing is to remind myself of things. there you go, the organization's mission statement. wind tape).
i had pericarditis last year, which i suppose is much better than carditis, because the heart itself isn't infiltrated. not that it can't be complicated. the major problems that arise are pericardial effusion (which can lead to tamponade), fluid that accumulates between the heart and its soft shell that applies pressure to the heart externally, impairing it's ability to fill, and constrictive pericarditis, which also is restrictive, but by way of thickening of the casing, not fluids.
mine wasn't exciting in any of those ways, and the cause probably was viral, or post-viral, probably (non-infectious causes are much less likely in my case). no big deal. hit the NSAIDs hard for 2 weeks, and hope i don't end up with adhesions (fibrous attachments) though even those aren't very remarkable (no long-term sequelae).
Wednesday, December 03, 2008
Kal Hat'haloth Kashoth — all beginnings are difficult
Two funny things happened this week. Well, not funny. Wonderful. Things that seem like milestones in their own little way, even though I’ll be the only one marking them. But they’re kinds of things I think I was hoping for when I signed up for all this in the first place.
A patient asked for me by name. This wasn’t a medicine patient. It was actually one of the people I’d been taking care of while on pediatrics. A 20 year old boy with cystic fibrosis. One of my first patients ever; I think I picked him up on my first day as a real 3rd year, back in July. As a beginning 3rd year, I didn’t really know what to do for any of my patients. Even now it’s difficult, though I’m getting better and contributing more (today was particularly good; I pointed out to my intern that we should probably start p.m. CPAP on the woman with OSA that we just took off the vent, and that we should probably start ibuprofen on our pericarditis patient (but what if he has uremia from kidney failure?)). But this story was before I’d done so much studying. At this point, I was just a vitals-taker and a medication reconciler.
CF (I’ll refer to my patient by the initials of his disease) wasn’t a difficult patient. He was just in to treat pseudomonas pneumonia or something. Probably on pip/tazo and cipro. Contact precautions, so MRSA, tx w/ vanco. Some of it I learned 2nd year. Some of it I learned from him. What I’m trying to say is that the things I had to offer him were not medical. They were the same things any 25 year old could talk to a 20 year old about. I guess the one real difference was that I knew his disease, so I could somewhat understand what he was going through, and what he was up against. And communication was easy, and we got along well, and I enjoyed having him as a patient on my peds service.
My classmate paged me a day or two ago. CF wanted to know where I was, and if I’d stop by and see him. Sure I would. And I’m right back in there. Does he have a job? Yeah, he’s been working at the community center for a few months. Has he started college? Nah, never liked school. Figures he needs some education eventually, but for now he just wants to take it easy. How’s the girlfriend? She’s fine. Working, taking classes. She’ll be in to see him later today. Her grandparents probably come too. They’re really nice.
I haven’t asked him yet if he knows that he’s sterile. The vas deferens just don’t develop. Or rather, they do, but get clogged up just like the lungs, and involute (unlike the lungs, which dilate, which is why bacteria grows so nicely in there).
CF made a movie. I’m gonna go see it tomorrow. I’ll probably ask him how the paperwork for the lung transplant is coming along. I doubt he gets approved. He’s not an ‘ideal candidate,’ I’m guessing. But I hope he does, and I’ll push for him to. He’s my patient (even if it was for less than two weeks, and this all happened 5 months ago). I think I’ll always consider him my patient. I guess this is continuity of care. So that was the first thing.
A patient thanked me for saving his life. I didn’t personally save his life, but I was involved in the process. I know DKA when I see it. Nausea, vomiting, polyuria, polydypsia, ALOC. Anion gap acidosis, hyperkalemia, hyponatremia. Classic presentation. Fluids (we gave him 13 liters the first day), insulin drip (0.1 U/kg IV. blood sugars were initially 1670!), remember to add some D5 and potassium as things start to correct. Not too fast, don’t want him to herniate his brainstem. No problem. But wait. 52 year old, previously healthy individuals don’t get insulin dependent diabetes just like that. What else could be wrong? Maybe this guy has pancreatitis. Get a CT, amylase, lipase. Aha, so that’s it. Calculate Ranson’s. Amazingly, he’ll probably be fine. And today he was. We’re advancing his diet currently. No, I didn’t order any of this stuff. But I knew what to do. My senior asked what I would do, and I knew. Blow for blow, turn for turn. And it was right. My plan would have corrected this guy’s problem. And he’s getting better, and we’re just monitoring to see his pancreatitis doesn’t have further complications. And he thanked me. He said to me, “Thank you for saving my life.” And his brother said, “thank you for saving my brother’s life.” And I know I didn’t. I know it was the senior who ordered it, and the nurse who placed the bags, and the scientists who studied hormones like insulin, and the physicists who figured out how to make 3D images the human body with ionizing radiation, and the pharmaceutical companies who learned how to synthesize the stuff, and the clinicians with their placebo controlled randomized prospective trials. But still, a small part of me feels like I finally did something that mattered to someone else. And I try not to get all worked up over feelings, but this is kinda new and wonderful. So that was the second thing.
A patient asked for me by name. This wasn’t a medicine patient. It was actually one of the people I’d been taking care of while on pediatrics. A 20 year old boy with cystic fibrosis. One of my first patients ever; I think I picked him up on my first day as a real 3rd year, back in July. As a beginning 3rd year, I didn’t really know what to do for any of my patients. Even now it’s difficult, though I’m getting better and contributing more (today was particularly good; I pointed out to my intern that we should probably start p.m. CPAP on the woman with OSA that we just took off the vent, and that we should probably start ibuprofen on our pericarditis patient (but what if he has uremia from kidney failure?)). But this story was before I’d done so much studying. At this point, I was just a vitals-taker and a medication reconciler.
CF (I’ll refer to my patient by the initials of his disease) wasn’t a difficult patient. He was just in to treat pseudomonas pneumonia or something. Probably on pip/tazo and cipro. Contact precautions, so MRSA, tx w/ vanco. Some of it I learned 2nd year. Some of it I learned from him. What I’m trying to say is that the things I had to offer him were not medical. They were the same things any 25 year old could talk to a 20 year old about. I guess the one real difference was that I knew his disease, so I could somewhat understand what he was going through, and what he was up against. And communication was easy, and we got along well, and I enjoyed having him as a patient on my peds service.
My classmate paged me a day or two ago. CF wanted to know where I was, and if I’d stop by and see him. Sure I would. And I’m right back in there. Does he have a job? Yeah, he’s been working at the community center for a few months. Has he started college? Nah, never liked school. Figures he needs some education eventually, but for now he just wants to take it easy. How’s the girlfriend? She’s fine. Working, taking classes. She’ll be in to see him later today. Her grandparents probably come too. They’re really nice.
I haven’t asked him yet if he knows that he’s sterile. The vas deferens just don’t develop. Or rather, they do, but get clogged up just like the lungs, and involute (unlike the lungs, which dilate, which is why bacteria grows so nicely in there).
CF made a movie. I’m gonna go see it tomorrow. I’ll probably ask him how the paperwork for the lung transplant is coming along. I doubt he gets approved. He’s not an ‘ideal candidate,’ I’m guessing. But I hope he does, and I’ll push for him to. He’s my patient (even if it was for less than two weeks, and this all happened 5 months ago). I think I’ll always consider him my patient. I guess this is continuity of care. So that was the first thing.
A patient thanked me for saving his life. I didn’t personally save his life, but I was involved in the process. I know DKA when I see it. Nausea, vomiting, polyuria, polydypsia, ALOC. Anion gap acidosis, hyperkalemia, hyponatremia. Classic presentation. Fluids (we gave him 13 liters the first day), insulin drip (0.1 U/kg IV. blood sugars were initially 1670!), remember to add some D5 and potassium as things start to correct. Not too fast, don’t want him to herniate his brainstem. No problem. But wait. 52 year old, previously healthy individuals don’t get insulin dependent diabetes just like that. What else could be wrong? Maybe this guy has pancreatitis. Get a CT, amylase, lipase. Aha, so that’s it. Calculate Ranson’s. Amazingly, he’ll probably be fine. And today he was. We’re advancing his diet currently. No, I didn’t order any of this stuff. But I knew what to do. My senior asked what I would do, and I knew. Blow for blow, turn for turn. And it was right. My plan would have corrected this guy’s problem. And he’s getting better, and we’re just monitoring to see his pancreatitis doesn’t have further complications. And he thanked me. He said to me, “Thank you for saving my life.” And his brother said, “thank you for saving my brother’s life.” And I know I didn’t. I know it was the senior who ordered it, and the nurse who placed the bags, and the scientists who studied hormones like insulin, and the physicists who figured out how to make 3D images the human body with ionizing radiation, and the pharmaceutical companies who learned how to synthesize the stuff, and the clinicians with their placebo controlled randomized prospective trials. But still, a small part of me feels like I finally did something that mattered to someone else. And I try not to get all worked up over feelings, but this is kinda new and wonderful. So that was the second thing.
Friday, November 28, 2008
a new low [into the rift]
i am so completely disappointed in myself. (this, of course, being in addition to my general, smoldering malcontent)
and this after a pretty good spell. over the last few days, i started really picking up the pace in my BMS (best medical student) campaign, i found a present that i was supposed to get on my 17th birthday (from my grandfather who has been dead 23 years), i watched a reasonably good movie in The Diving Bell and the Butterfly, i studied more than is characteristic, i was practicing trumpet almost enough to start improving, i was exercising almost as much as i should, i was eating almost as well as can be expected. i was almost sleeping well. (those 'almosts' probably sound like a bad thing, but given that i'll always expect more from myself, they're as much as i can hope for)
and then this. this. this, after all my careful planning. this, after all my reconditioning. this, after all the rebar and bricks and sandbags and sutures. this, after all the brooms and rags and bleach and ammonia and acid. this, after all the knots and bolts and lids and locks and caps and corks. this, after the aspirin and motrin and amitryptiline and methadone and lidocaine and ketamine and liquor and cocaine.
/often go awry
/gang aft agley
all i wanted was an empty room.
all i wanted was a quiet space.
all i wanted was an all alone.
all i wanted was a time erased.
~ oh no, not back here
The woods are lovely, dark and deep,
~ you know where this ends
But I have promises to keep,
~ it's an interminable darkness
And miles to go before I sleep,
~ and we were just there...
And miles to go before I sleep.
i need an excuse. something, anything to make my contribution to this mess less categorical. a starting point for rationalization, justification, exoneration, vindication, whatever word might apply. i never want to be completely defenseless (even if my situation is indefensible, of which i'm like 99% sure. one who repeatedly makes the same mistakes = idiot)
goodbye, productivity. fare thee well, peace. au revoir, sanity. i barely knew ye.
my purest heart for vou / mon cœur pur pour toi
kimochi warui
and this after a pretty good spell. over the last few days, i started really picking up the pace in my BMS (best medical student) campaign, i found a present that i was supposed to get on my 17th birthday (from my grandfather who has been dead 23 years), i watched a reasonably good movie in The Diving Bell and the Butterfly, i studied more than is characteristic, i was practicing trumpet almost enough to start improving, i was exercising almost as much as i should, i was eating almost as well as can be expected. i was almost sleeping well. (those 'almosts' probably sound like a bad thing, but given that i'll always expect more from myself, they're as much as i can hope for)
and then this. this. this, after all my careful planning. this, after all my reconditioning. this, after all the rebar and bricks and sandbags and sutures. this, after all the brooms and rags and bleach and ammonia and acid. this, after all the knots and bolts and lids and locks and caps and corks. this, after the aspirin and motrin and amitryptiline and methadone and lidocaine and ketamine and liquor and cocaine.
/often go awry
/gang aft agley
all i wanted was an empty room.
all i wanted was a quiet space.
all i wanted was an all alone.
all i wanted was a time erased.
~ oh no, not back here
The woods are lovely, dark and deep,
~ you know where this ends
But I have promises to keep,
~ it's an interminable darkness
And miles to go before I sleep,
~ and we were just there...
And miles to go before I sleep.
i need an excuse. something, anything to make my contribution to this mess less categorical. a starting point for rationalization, justification, exoneration, vindication, whatever word might apply. i never want to be completely defenseless (even if my situation is indefensible, of which i'm like 99% sure. one who repeatedly makes the same mistakes = idiot)
goodbye, productivity. fare thee well, peace. au revoir, sanity. i barely knew ye.
my purest heart for vou / mon cœur pur pour toi
kimochi warui
Sunday, August 31, 2008
yay science. yay protocol.
Request for application: whether parachutes are effective in preventing major trauma related to gravitational challenge
As with many interventions intended to prevent ill health, the effectiveness of parachutes has not been subjected to rigorous evaluation by using randomized controlled trials. Advocates of evidence-based medicine have criticized the adoption of interventions evaluated by using only observational data. We think that everyone might benefit if the most radical protagonists of evidence-based medicine organized and participated in a double blind, randomized, placebo-controlled, crossover trial of the parachute.
And while we're having fun, some useful definitions:
Clinical experience: making the same mistake with increasing confidence for an impressive number of years
Evidence-based medicine: perpetuating other people's mistakes instead of your own
Compliance: (1) change in volume per unit change in pressure; (2) a tendency to give in to others; (3) obedience to a dictate given by an authority; (4) doing what the doctor wants
Delivery system: something that connects "providers" with "consumers." Examples include vending machines, Federal Express, and managed-care companies. "Health care delivery" is to be distinguished from the practice of medicine by physicians.
Management: the process of directing a patient through an institutional protocol mandated for his condition without furthering one's understanding of his illness.
Specialty: a practice that is restricted in some way
As with many interventions intended to prevent ill health, the effectiveness of parachutes has not been subjected to rigorous evaluation by using randomized controlled trials. Advocates of evidence-based medicine have criticized the adoption of interventions evaluated by using only observational data. We think that everyone might benefit if the most radical protagonists of evidence-based medicine organized and participated in a double blind, randomized, placebo-controlled, crossover trial of the parachute.
And while we're having fun, some useful definitions:
Clinical experience: making the same mistake with increasing confidence for an impressive number of years
Evidence-based medicine: perpetuating other people's mistakes instead of your own
Compliance: (1) change in volume per unit change in pressure; (2) a tendency to give in to others; (3) obedience to a dictate given by an authority; (4) doing what the doctor wants
Delivery system: something that connects "providers" with "consumers." Examples include vending machines, Federal Express, and managed-care companies. "Health care delivery" is to be distinguished from the practice of medicine by physicians.
Management: the process of directing a patient through an institutional protocol mandated for his condition without furthering one's understanding of his illness.
Specialty: a practice that is restricted in some way
Thursday, August 07, 2008
The brightest star in the sky is Sirius. It has a magnitude of minus 1.4
twinkle twinkle little cell
i don't think you're doing well
can i cut you from my brain?
will you cause me any pain?
you light up my MRI
and within a year i'll die
i don't think you're doing well
can i cut you from my brain?
will you cause me any pain?
you light up my MRI
and within a year i'll die
Thursday, July 31, 2008
doushite
she said, but only to herself, {i don't care for you. but i care less for being altogether alone}
{heartless bitch}, thinks the one waiting for happiness.
ask the one who is not afraid, but she too, if she lives long enough, will run out of people that truly love her. or will run away from them. run away so they don't have a chance to change their minds. run away so she doesn't have to make up her mind. run away so she doesn't have to see the mess she's made of herself, of others. run away so she doesn't have to clean up the mess that other have made for themselves, for her.
things get lost. the running only disorients.
come and find me! someone...anyone...
stop it stop it stop it stop it stop it stop it stop it i hate it dont look at me that's not for you it's gross it's impure it's it's it's stop stop it isn't me it's not it's not it's not it's not i hate you i hate you i hate you i hate me i hate myself so much
The lack of demonstrated empathy is possibly the most dysfunctional aspect of Asperger syndrome (AS). Individuals with AS experience difficulties in basic elements of social interaction, which may include a failure to develop friendships or to seek shared enjoyments or achievements with others (for example, showing others objects of interest); a lack of social or emotional reciprocity; and impaired nonverbal behaviors such as eye contact, facial expression, posture, and gesture.
Unlike those with autism, people with AS are not usually withdrawn around others; they approach others, even if awkwardly, for example by engaging in a one-sided, long-winded speech about a favorite topic while being oblivious to the listener's feelings or reactions, such as signs of boredom or haste to leave. This social awkwardness has been called "active but odd" This failure to react appropriately to social interaction may appear as disregard for other people's feelings, and may come across as insensitive. The cognitive ability of children with AS often lets them articulate social norms in a laboratory context, where they may be able to show a theoretical understanding of other people's emotions; they typically have difficulty acting on this knowledge in fluid, real-life situations, however. People with AS may analyze and distill their observation of social interaction into rigid behavioral guidelines and apply these rules in awkward ways—such as forced eye contact—resulting in demeanor that appears rigid or socially naïve. Childhood desires for companionship can be numbed through a history of failed social encounters.
well, can't they fix it, like the way they fix left-handed kids?
hurts (herself) just to feel. but isn't this what you call a beautiful day?
this is not me! it can't be. there's more. there has to be. it's deeper. much deeper. the places where other people can't go. the places where i dont go. the places that come visit me. in dreams. in the bed that i'm afraid to be in alone. with the person with whom i'm afraid to share those dreams. what are you waiting for? what are you hoping for?
what are you waiting for? i'm living my life!
what are you hoping for? i do what i want!
what are you waiting for? is everything so fateless?
what are you hoping for? i dont mind
what are you waiting for? i dont care
what are you hoping for? what's it to you?
what are you waiting for? i dont want this
what are you hoping for? i dont want this
what are you waiting for? i dont want to be alone
what are you hoping for? i dont want to be alone
dont leave me dont desert me dont forget me
[this is what you wanted. these are the choices you made. it's all been up to you. this is your world, and this is what you've done with it. you aren't a spectator in a clockwork universe. this is your life. this is YOUR life. this is your story. (and you can tell everybody) this is your song. this is your darkness. this is your salvation. this is your friendship. this is your love. this is your weakness. this is your loneliness. this is your sorrow. this is your defeat. this is your emptiness. this is your despair. this is your closet. this is your bright idea. this is your endless possibility. this is your event horizon. this is your existence.]
the hell are you talking about? like this was all my idea? like this was all my choosing? like i wanted this stupid nose? like i wanted this useless arm? like i wanted this tyrant family? like i wanted this lame school? like i wanted this social awkwardness? like i wanted this prudish church? like i wanted this tard boss? like i wanted rape, like i wanted cancer, like i wanted betrayal, like i wanted failure, like i wanted age spots, like i wanted freak roommates? like i want to bleed? i dont even want kids! are you even listening to yourself, or do you just trying to convince yourself you're in control?
why is it up to me? why is it always me? why am i the one who has to do everything? this is so tiring. why can't things just be easy for once? why can't things work themselves out on their own? why do i have to be the responsible one? i'm not the best. i'm not even good. so why do i have to do it? why do i get stuck looking out for everyone? people dont care about me. no one cares about me. not really. not for the things that really matter. of course it has to be up to me, because no one else will. not for me.
well, it is what it is. and sometimes there's something i can do and sometimes there isn't. right now i'm useless. i'm weak. i'm good for nothing. i'm not helping anyone. i should be thrown away. i should be discarded. no one should pay any attention to me. i should be ignored. i should be banished. i wish i was invisible, so no one would see how worthless i am. so no one could see that their not caring isn't wasted.
but then, isn't that what the face paint and boobs are for? so people can look at other things and i can still be a little less alone and be told what i want to hear if only for a little while.
she wishes getting back to sleep wouldn't always be so difficult, especially since it always takes her back to the same place.
{heartless bitch}, thinks the one waiting for happiness.
ask the one who is not afraid, but she too, if she lives long enough, will run out of people that truly love her. or will run away from them. run away so they don't have a chance to change their minds. run away so she doesn't have to make up her mind. run away so she doesn't have to see the mess she's made of herself, of others. run away so she doesn't have to clean up the mess that other have made for themselves, for her.
things get lost. the running only disorients.
come and find me! someone...anyone...
stop it stop it stop it stop it stop it stop it stop it i hate it dont look at me that's not for you it's gross it's impure it's it's it's stop stop it isn't me it's not it's not it's not it's not i hate you i hate you i hate you i hate me i hate myself so much
The lack of demonstrated empathy is possibly the most dysfunctional aspect of Asperger syndrome (AS). Individuals with AS experience difficulties in basic elements of social interaction, which may include a failure to develop friendships or to seek shared enjoyments or achievements with others (for example, showing others objects of interest); a lack of social or emotional reciprocity; and impaired nonverbal behaviors such as eye contact, facial expression, posture, and gesture.
Unlike those with autism, people with AS are not usually withdrawn around others; they approach others, even if awkwardly, for example by engaging in a one-sided, long-winded speech about a favorite topic while being oblivious to the listener's feelings or reactions, such as signs of boredom or haste to leave. This social awkwardness has been called "active but odd" This failure to react appropriately to social interaction may appear as disregard for other people's feelings, and may come across as insensitive. The cognitive ability of children with AS often lets them articulate social norms in a laboratory context, where they may be able to show a theoretical understanding of other people's emotions; they typically have difficulty acting on this knowledge in fluid, real-life situations, however. People with AS may analyze and distill their observation of social interaction into rigid behavioral guidelines and apply these rules in awkward ways—such as forced eye contact—resulting in demeanor that appears rigid or socially naïve. Childhood desires for companionship can be numbed through a history of failed social encounters.
well, can't they fix it, like the way they fix left-handed kids?
hurts (herself) just to feel. but isn't this what you call a beautiful day?
this is not me! it can't be. there's more. there has to be. it's deeper. much deeper. the places where other people can't go. the places where i dont go. the places that come visit me. in dreams. in the bed that i'm afraid to be in alone. with the person with whom i'm afraid to share those dreams. what are you waiting for? what are you hoping for?
what are you waiting for? i'm living my life!
what are you hoping for? i do what i want!
what are you waiting for? is everything so fateless?
what are you hoping for? i dont mind
what are you waiting for? i dont care
what are you hoping for? what's it to you?
what are you waiting for? i dont want this
what are you hoping for? i dont want this
what are you waiting for? i dont want to be alone
what are you hoping for? i dont want to be alone
dont leave me dont desert me dont forget me
[this is what you wanted. these are the choices you made. it's all been up to you. this is your world, and this is what you've done with it. you aren't a spectator in a clockwork universe. this is your life. this is YOUR life. this is your story. (and you can tell everybody) this is your song. this is your darkness. this is your salvation. this is your friendship. this is your love. this is your weakness. this is your loneliness. this is your sorrow. this is your defeat. this is your emptiness. this is your despair. this is your closet. this is your bright idea. this is your endless possibility. this is your event horizon. this is your existence.]
the hell are you talking about? like this was all my idea? like this was all my choosing? like i wanted this stupid nose? like i wanted this useless arm? like i wanted this tyrant family? like i wanted this lame school? like i wanted this social awkwardness? like i wanted this prudish church? like i wanted this tard boss? like i wanted rape, like i wanted cancer, like i wanted betrayal, like i wanted failure, like i wanted age spots, like i wanted freak roommates? like i want to bleed? i dont even want kids! are you even listening to yourself, or do you just trying to convince yourself you're in control?
why is it up to me? why is it always me? why am i the one who has to do everything? this is so tiring. why can't things just be easy for once? why can't things work themselves out on their own? why do i have to be the responsible one? i'm not the best. i'm not even good. so why do i have to do it? why do i get stuck looking out for everyone? people dont care about me. no one cares about me. not really. not for the things that really matter. of course it has to be up to me, because no one else will. not for me.
well, it is what it is. and sometimes there's something i can do and sometimes there isn't. right now i'm useless. i'm weak. i'm good for nothing. i'm not helping anyone. i should be thrown away. i should be discarded. no one should pay any attention to me. i should be ignored. i should be banished. i wish i was invisible, so no one would see how worthless i am. so no one could see that their not caring isn't wasted.
but then, isn't that what the face paint and boobs are for? so people can look at other things and i can still be a little less alone and be told what i want to hear if only for a little while.
she wishes getting back to sleep wouldn't always be so difficult, especially since it always takes her back to the same place.
Sunday, July 27, 2008
but time flows like a river, and history repeats itself
i tried to understand
i believed the best i could
i followed rules and regulations
just like in the Book
but something is amiss
i'm in a different story
i see no king, no wedding ring
no comfort riches glory
was my faith not on solid ground?
am i lost not to be found?
no piece of peace, not loved above
where is my rest, where is my crown
like the cruel angel
i went
but it's just as before
desolate, isolate, inanimate
inconsolable
i'm not surprised
at least i wasn't expecting anything this time
i believed the best i could
i followed rules and regulations
just like in the Book
but something is amiss
i'm in a different story
i see no king, no wedding ring
no comfort riches glory
was my faith not on solid ground?
am i lost not to be found?
no piece of peace, not loved above
where is my rest, where is my crown
like the cruel angel
i went
but it's just as before
desolate, isolate, inanimate
inconsolable
i'm not surprised
at least i wasn't expecting anything this time
Saturday, July 26, 2008
initially joss whedon
i make no apology for the fact that i invest much more in R&D than i do marketing. my administration budget is on the leaner side of sufficient, but i do so hate paperwork. and i like to think i manage myself efficiently, on the whole, despite being readily diverted by the likes of Dr. Horrible (PhD in Horribleness) and Josh Hamilton (BA in the .300s).
(And just as a side note, Cliff Lee, are you kidding me?)
ok, it's true that i haven't written in a while, and i might be rusty, but given my recent difficulties along other lines of communication, i am resorting to this sort of broadcasting. what i'm getting at is that despite all of the interaction i have with people in the hospital, there's a level of connection that isn't being satisfied, and therefore i'm using this medium to exorcise my demons. not that i really care if anyone reads this. that's not the point. the point is that i'm making it external to myself, so that i needn't carry it around myself. i wouldn't wish it on anyone else (in case you're wondering, because i sure am, i don't know what exactly 'it' refers to in the last couple sentences. i think the whole thing is a lesson in the value of pronouns when a true noun isn't readily available).
but now that i have you here, there's nothing really to say. i'm tired. yeah, that's about it. and now i'm going to expound on it, for my own sake, just so i know what i'm talking about, and there's no real reason for you to read any further. especially since if you were to ask me in person, the conversation would end with the period that succeeds "tired." but, since i have nothing else to do, and since the following isn't too personal to withhold, i will break down my tired'sbajillion fourteen different meanings (i'm saving the parabola for when i really need it).
i'm tired of waking up at 5 to do a job that someone else is going to do anyway because they don't trust me.
i'm tired of studying every day.
i'm tired of my back pain.
i'm tired of not having anything to look forward to.
i'm tired of not knowing spanish and not having the time to learn it.
i'm tired of being asked inane (and at their worst, rhetorical) questions that don't merit a response.
i'm tired of my room being so hot that i can't fall asleep.
i'm tired of living alone in my head.
i'm tired of pretending i'm dead, especially since i've done an awful job at replacing brandon moor.
i'm tired of my worsening vision.
i'm tired of feeling sorry for myself.
i'm tired of being too tired to fix any of this.
i'm tired of being so careful.
i'm tired of having to do everything myself (well, i wouldn't trust it any other way, which may or may not be beside the point. but still i'm tired of it).
well that's pretty extensive. and of variable veracity / the parasol got out of hand (like might happen tatooine). {i have to stretch to follow that last bit there}
anyway, i'm done kvetching. really, all i want is a peanut butter and jelly sandwich, a moment to pray for Randy Pausch's family, and to fall asleep listening to FF8 piano music.
(And just as a side note, Cliff Lee, are you kidding me?)
ok, it's true that i haven't written in a while, and i might be rusty, but given my recent difficulties along other lines of communication, i am resorting to this sort of broadcasting. what i'm getting at is that despite all of the interaction i have with people in the hospital, there's a level of connection that isn't being satisfied, and therefore i'm using this medium to exorcise my demons. not that i really care if anyone reads this. that's not the point. the point is that i'm making it external to myself, so that i needn't carry it around myself. i wouldn't wish it on anyone else (in case you're wondering, because i sure am, i don't know what exactly 'it' refers to in the last couple sentences. i think the whole thing is a lesson in the value of pronouns when a true noun isn't readily available).
but now that i have you here, there's nothing really to say. i'm tired. yeah, that's about it. and now i'm going to expound on it, for my own sake, just so i know what i'm talking about, and there's no real reason for you to read any further. especially since if you were to ask me in person, the conversation would end with the period that succeeds "tired." but, since i have nothing else to do, and since the following isn't too personal to withhold, i will break down my tired's
i'm tired of waking up at 5 to do a job that someone else is going to do anyway because they don't trust me.
i'm tired of studying every day.
i'm tired of my back pain.
i'm tired of not having anything to look forward to.
i'm tired of not knowing spanish and not having the time to learn it.
i'm tired of being asked inane (and at their worst, rhetorical) questions that don't merit a response.
i'm tired of my room being so hot that i can't fall asleep.
i'm tired of living alone in my head.
i'm tired of pretending i'm dead, especially since i've done an awful job at replacing brandon moor.
i'm tired of my worsening vision.
i'm tired of feeling sorry for myself.
i'm tired of being too tired to fix any of this.
i'm tired of being so careful.
i'm tired of having to do everything myself (well, i wouldn't trust it any other way, which may or may not be beside the point. but still i'm tired of it).
well that's pretty extensive. and of variable veracity / the parasol got out of hand (like might happen tatooine). {i have to stretch to follow that last bit there}
anyway, i'm done kvetching. really, all i want is a peanut butter and jelly sandwich, a moment to pray for Randy Pausch's family, and to fall asleep listening to FF8 piano music.
Saturday, May 24, 2008
Sunday, April 20, 2008
BOOSH! (not boushh, sorry, leia-lovers)
i've come to the realization that at no point am i likely to become motivated to study for boards (or that any such sense of urgency will present itself at too late an hour to be considered useful. presently, we're at T minus 53 days and counting). armed with that conclusion and an uncharacteristic moment of clarity and reason, i decided that i would exile myself to a two month world of unhappy productivity. i am not driven to such a place by a feeling dread or apprehension. i don't give a damn about boards. i think i could probably pass them tomorrow if i had to. and it has nothing to do with residency. i have no respect for residencies that are all about high board scores. i hereby allow any of you to shoot me through the back of my head with a handgun if i ever start talking about wanting to do ENT, ophtho, or derm. really, i just have nothing better to do, so i might as well do well. you know, give me something to brag about. something to flaunt. since i dont have boobs.
(at this point, i should probably relate my test detestation. well, most of you would want only to read the abstract.
ABSTRACT: tests are like monopoly. being good at monopoly doesn't mean you understand how money works. it means you know how monopoly works. (also you probably roll well, but that's not my point. my point is that a thorough understanding of the parameters, both spoken and their unspoken corollaries, under which the game operates allows one to approach a game with the greatest ability to succeed)
INTRODUCTION: stop reading, comma)
having displaced myself to this impermanent internment, i have stumbled upon a place of surprising tranquility. perhaps this is the peace of an isolated and determined mind. however, my social disconnect is as evident as ever. i find conversations invariably tedious and stilted (usually this privilege is reserved for blonde girls that i find annoying. wait, i should draw a Venn diagram)
_______________________________________
|........annoying people...............|
|...............***********************|******
|...............*.....girls............|.....*
|...............*......................|.....*
|...............*...xxxxxxxxxxxxxxxx...|.....*
|...............*...x..............x...|.....*
|...............*...x..blondes.....x...|.....*
|...............*...xxxxxxxxxxxxxxxx...|.....*
|...............*......................|.....*
|...............***********************|******
|______________________________________|
fig newton 1.1 (sleeve not to scale)
)
ok, that takes forever. i retire from art using ascii (or wiscii).
and now it's time to learn more about diabetes (so i can justify watching hockey and basketball all afternoon and evening, which i intend to do anyway, justified or not. i <3>
(at this point, i should probably relate my test detestation. well, most of you would want only to read the abstract.
ABSTRACT: tests are like monopoly. being good at monopoly doesn't mean you understand how money works. it means you know how monopoly works. (also you probably roll well, but that's not my point. my point is that a thorough understanding of the parameters, both spoken and their unspoken corollaries, under which the game operates allows one to approach a game with the greatest ability to succeed)
INTRODUCTION: stop reading, comma)
having displaced myself to this impermanent internment, i have stumbled upon a place of surprising tranquility. perhaps this is the peace of an isolated and determined mind. however, my social disconnect is as evident as ever. i find conversations invariably tedious and stilted (usually this privilege is reserved for blonde girls that i find annoying. wait, i should draw a Venn diagram)
_______________________________________
|........annoying people...............|
|...............***********************|******
|...............*.....girls............|.....*
|...............*......................|.....*
|...............*...xxxxxxxxxxxxxxxx...|.....*
|...............*...x..............x...|.....*
|...............*...x..blondes.....x...|.....*
|...............*...xxxxxxxxxxxxxxxx...|.....*
|...............*......................|.....*
|...............***********************|******
|______________________________________|
fig newton 1.1 (sleeve not to scale)
)
ok, that takes forever. i retire from art using ascii (or wiscii).
and now it's time to learn more about diabetes (so i can justify watching hockey and basketball all afternoon and evening, which i intend to do anyway, justified or not. i <3>
Friday, February 29, 2008
itinerant repossession
is it still my room when i'm not in it? what if none of my stuff is in it? and what makes it my stuff? what makes it my bed, my books, my computer, my clothes? i didn't make them. i didn't write them. they weren't made for me, they weren't written for me. they're just, objects, separated from other spaces by a shell of walls. and somehow, no one else feels entitled to this space, or these objects. can i take this further? what makes it my prosthetic heart valve? or my dental fillings? what makes them my teeth, my hands, my eyes, my lungs? my memories? my thoughts? my dreams?
psychoanalysts and frequently psychiatrists have to be psychoanalyzed before they can practice. i think trauma surgeons should have to be shot or stabbed.
(i might want to rethink oncology. and no one would ever want to be a coroner. and pediatrics would flourish)
psychoanalysts and frequently psychiatrists have to be psychoanalyzed before they can practice. i think trauma surgeons should have to be shot or stabbed.
(i might want to rethink oncology. and no one would ever want to be a coroner. and pediatrics would flourish)
Sunday, February 17, 2008
inflammation
quote from our embryology textbook:
"Although mental retardation is not generally part of the syndrome, the more X chromosomes there are, the more likely there will be some degree of mental impairment."
(i suppose it should be said that this sentence comes in the context of klinefelter's syndrome, which is when you have extra sex chromosomes in boys, like XXY or XXXY)
"Although mental retardation is not generally part of the syndrome, the more X chromosomes there are, the more likely there will be some degree of mental impairment."
(i suppose it should be said that this sentence comes in the context of klinefelter's syndrome, which is when you have extra sex chromosomes in boys, like XXY or XXXY)
and yet you continue to talk to me like you know me
apologies are in order
dear
i'm sorry i won't be going. lobby day sounds very fun (the whole all-inclusive bit is especially tempting), yet i can't bring myself to act overtly in the political realm. i won't legitimize it. i won't accept that image is everything. sure, they'll patronize me and my 'concerns,' but it's empty. (i guess if you're an atheist, maybe you are what other people say you are. but if you believe in God, you are accountable to Him.) so thanks but no thanks; call me if you decide to go the sedition/subversion route. but go ahead and you can try the top-down approach. my work is at the bottom.
dear
of course i dont trust you. wait that sounds harsh. what i mean is that i dont trust you to hold my best interests as the top priority. yes i am that selfish. for that, i'm more sorry than you know (though i suppose i'm trying to tell you here).
dear
it's nice to know i'm not alone. sorry i'm not better company. i'd get frustrated too (though much easier than you).
i love you all (marta)
jw
dear
i'm sorry i won't be going. lobby day sounds very fun (the whole all-inclusive bit is especially tempting), yet i can't bring myself to act overtly in the political realm. i won't legitimize it. i won't accept that image is everything. sure, they'll patronize me and my 'concerns,' but it's empty. (i guess if you're an atheist, maybe you are what other people say you are. but if you believe in God, you are accountable to Him.) so thanks but no thanks; call me if you decide to go the sedition/subversion route. but go ahead and you can try the top-down approach. my work is at the bottom.
dear
of course i dont trust you. wait that sounds harsh. what i mean is that i dont trust you to hold my best interests as the top priority. yes i am that selfish. for that, i'm more sorry than you know (though i suppose i'm trying to tell you here).
dear
it's nice to know i'm not alone. sorry i'm not better company. i'd get frustrated too (though much easier than you).
i love you all (marta)
jw
Wednesday, February 13, 2008
passion
on sunday i attended the wedding of a man i greatly admire. it was a 'nice' ceremony; mostly traditional (as far as i understand traditional weddings, which isn't very well at all. surprise!) except that we had communion during it (which was brilliant. knock out as many sacraments as you can as fast as you can. gives me more time to return to my sinful ways. though i dont know if the transubstantiation occurred. so maybe it doesn't could. also, i'm not catholic, so maybe it doesn't matter).
after the service, all the guests were invited to take part in a group picture, and then attend a reception (najwa medina (jay razzouk's aunt) catered and she made her middle eastern fare and it was soooo delicious. my goal is clear: convince all my friends to get married and have najwa take care of the food.)
none of this really matters; they're little factoids from my weekend. but i had to set the stage (and forgive me if i did a poor job. i've never been a stagehand.)
there was music, there was the bouquet toss, there was cake cutting, and there was a toast. it was all fine.
the groom is a doctor. for many years he worked as a missionary in africa, and even still, africa is his calling. one of the projects he is supporting right now is an orphanage in uganda. and for a good hour, the focus was on this mission. the bride and groom both talked about their involvement, they showed a video on the place, and also gave the microphone to the project director to talk about the work being done. (i've forgotten to mention, but the wedding invitation expressly stated that if a guest wished to make a gift for the couple, he or she should support this organization). (but there was no appeal for moneys. in no way did the event become a fundraiser. the closest thing to that was that the groom-doctor did announce that he was hoping to put together a team to go fix cleft palates, which is a major cause of social anxiety and distress (as it is seen as some sort of curse from whatever gods africa believes in. basically, kids with these sorts of deformities never leave the house.))
what a couple! this is their wedding day, and the focus is on the intimacy and devotion they share, but what a special quality it is. i'm all sorts of inspired.
[and this is love]
after the service, all the guests were invited to take part in a group picture, and then attend a reception (najwa medina (jay razzouk's aunt) catered and she made her middle eastern fare and it was soooo delicious. my goal is clear: convince all my friends to get married and have najwa take care of the food.)
none of this really matters; they're little factoids from my weekend. but i had to set the stage (and forgive me if i did a poor job. i've never been a stagehand.)
there was music, there was the bouquet toss, there was cake cutting, and there was a toast. it was all fine.
the groom is a doctor. for many years he worked as a missionary in africa, and even still, africa is his calling. one of the projects he is supporting right now is an orphanage in uganda. and for a good hour, the focus was on this mission. the bride and groom both talked about their involvement, they showed a video on the place, and also gave the microphone to the project director to talk about the work being done. (i've forgotten to mention, but the wedding invitation expressly stated that if a guest wished to make a gift for the couple, he or she should support this organization). (but there was no appeal for moneys. in no way did the event become a fundraiser. the closest thing to that was that the groom-doctor did announce that he was hoping to put together a team to go fix cleft palates, which is a major cause of social anxiety and distress (as it is seen as some sort of curse from whatever gods africa believes in. basically, kids with these sorts of deformities never leave the house.))
what a couple! this is their wedding day, and the focus is on the intimacy and devotion they share, but what a special quality it is. i'm all sorts of inspired.
[and this is love]
Tuesday, February 12, 2008
unkept
hidden in my room is a small wooden box
my cousin made for me
and while right now i can think of nothing else
when i am old and even more forgetful
my (or is it your?) memories will only be found folded there
expectant words and exultant pictures
even now they look so tidy
with no tear splotches
of course
you only wrote to indulge me
i only smiled to indulge you
the air was awfully clear today.
back when we talked endlessly
my words all were without lies.
the pure dreams i showed you there
are the hardest to replace.
tomorrow morning brings no sun.
it won't matter.
i won't really awaken anyway.
my cousin made for me
and while right now i can think of nothing else
when i am old and even more forgetful
my (or is it your?) memories will only be found folded there
expectant words and exultant pictures
even now they look so tidy
with no tear splotches
of course
you only wrote to indulge me
i only smiled to indulge you
the air was awfully clear today.
back when we talked endlessly
my words all were without lies.
the pure dreams i showed you there
are the hardest to replace.
tomorrow morning brings no sun.
it won't matter.
i won't really awaken anyway.
Tuesday, January 22, 2008
imperative
yes i will lie here
where the wind blows clouds into shapes and i name them
and give them significance
and i tell myself that i will not think of you
but then spend all of my time crowding you out of my thoughts
and am so surrounded
i would stay here
without you, i care not where i am
and here is no worse than
"tomorrow"
place your faith in
if you yet have hope for me
or else
take me back to a morning
when seeing you wasn't the reason i opened my eyes
darkness is coming
it will be another day without you
and my dreams will again wait for sleep to be realized
where the wind blows clouds into shapes and i name them
and give them significance
and i tell myself that i will not think of you
but then spend all of my time crowding you out of my thoughts
and am so surrounded
i would stay here
without you, i care not where i am
and here is no worse than
"tomorrow"
place your faith in
if you yet have hope for me
or else
take me back to a morning
when seeing you wasn't the reason i opened my eyes
darkness is coming
it will be another day without you
and my dreams will again wait for sleep to be realized
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