I. My days are plagued by what many call the fasting brain: a delirious, pulsating mix of alertness, fogginess, hunger, and thirst. This Ramadan occurs at an odd moment of my life, pandemic-aside. We’re learning so much about metabolism, about fasting, nutrition, and endocrinology right now in our courses (two quick pro-tips: sugar has no health benefit! If our metabolism professor had any say, he would ban sugar completely. Also, according to our nutrition professor, everyone should prioritize meeting their daily recommended fiber intake (30g). As I fast, I think about the timeline of blood glucose depletion. I count down to the hour where my body should switch over to ketone metabolism. And I think about the ebb and flow of insulin and glucagon, amazed by how cool and complex bodies are. Here are some articles our professor (Dr. Myers) recommended to us (in his hopes, so that we could be the star of our next cocktail party haha):
- Intermittent Fasting and Increasing Lifespan and Healthspan
- Nutrition for Optimal Athletic Training and Performance
- What is the intersection of diet, the microbiome and human health?
- Is dietary fat healthy or not?!?
II. This week was tiring and draining, filled with much-needed conversations with classmates: on race, white-savior tropes, power & privilege, paternalism, and neo-colonialism. Themes that emerged insidiously from experiences I did not expect to re-experience this week. Experiences that subjected my classmates and me to emotional burdens that we did not want to add to the different things we carry. Experiences that ask us to speak up but not over, to share our narratives but not arrogantly perceive that of others, to confront (unconscious or conscious) biased actions of others and that of our own doing, to know the fine line between empathy and exploitation. I am grateful for classmates with whom I can be authentic, with whom I can be at ease, with whom I can cultivate my critical consciousness. I am thankful for my classmates who share their narratives in their unapologetic tones and voices, who teach me and ask me to be a better ally, who ask me to testify to my lived experiences. And I am grateful for Audre Lorde, who asks us to remember: “Your silence will not protect you” — wisdom that reminds me of why it’s so important to have these conversations despite their difficulty, to question the dominant narrative and create space for mine and those of others.
III. Our classmate is giving birth in July. She is so strong, brilliant, and kind—what a wonderful mother she’ll be. Over lunch, we held her a baby shower: guessing the prices of baby equipment, voting on middle names, and sharing lessons of life we thought the baby might like to learn. I wish we could be there to support her in-person on a daily basis. They say having children changes you: I wonder in what ways my classmates will change in the course of this pandemic. I miss the experience of witnessing how friends change slowly but surely, and of experiencing the ways we change together.
IV. What went into the personal protective equipment goodie bags we put together for community nurses: physical distancing fliers, one bottle of homemade hand sanitizer, a bottle of disinfectant, two face shield, two cloth face masks, ten pairs of gloves, a book to read, a pulse oximeter, and some well wishes.
V. I think my favorite moments in medical school include studying for finals. At the end of a bloc, the terms, words, ideas, and manifestations of things we learned finally make sense, coming together like puzzle pieces or unveiling parts of itself until a painting comes into full view. I am always surprised by how much we learn, how different and odd things now are familiar and sensical in some weeks.
VI. I took my plants on a field trip. I took them off the windowsill and brought them beyond the glass window, brought them outside and watered them. And while these big indoor plants bathed in the unfiltered sun, I filled egg cartons with potting soil. I placed a seed or two in the small wells, buried them not too deep with more soil, and watered these containers too. In a few weeks, I hope some of these seeds will sprout into seedlings and then grow tall enough to withstand the unfiltered sun, air, and climate. On some days, I imagine that I will forget how these powerful plants grew from something so small: weightless seeds that felt like nothing at all.
VII. SOCIAL HISTORY (a clinical write-up)
Amal lives currently in the Upper Valley with her housemates. She grew up in Massachusetts with three sisters and her parents.
Occupation: M1 at Geisel
Habits: Unserious vegetarian. Unremarkable.Born in Massachusetts, twenty-something. Has traveled extensively.
Present environment: Her bedroom, and hardly leaves except to go for a run or forage for food.
Financial: See occupation.
Psychosocial: “Fine, it’s a pandemic” No complaints.
I wrote my social history, as one might find in a clinical write-up, to feel what was left out of the picture. We have an agenda of questions we ask patients in writing their social history. What is the importance of the questions we ask and the meaning behind them? What helps us argue for one diagnosis or the other? What helps us not reduce the patient to an object to test or evaluate? Do the questions we ask seek to affirm our suspicions and assumptions about someone or allow them space and agency to their narrative? When we write our social histories to form, what do we choose to bring forward and elevate? What do we decide to leave in the patient room?
VIII. I’ve had a glimpse into the bread-baking culture as the newest millennial to dedicate twenty-four hours to the rising and folding and proofing of sourdough. I report back to share that the effort was successful, that our starter named Paprika was giving and generous. That the dough was at first sticky and squishy, then took shape in letter-folds, burrito-folds, and ninety-degree rotating folds. I slept, however unsoundly at night, anticipating that the dough would collapse unattended, that my housemates would be breadless. But my worries did not come to fruition, as the dough was molded into bread by the high heat, and the air captured within created a honeycomb architecture. And that the bread was good. I understand how the act of bread baking orchestrates people’s weeks.
IX. In our On Doctoring course, we listened to fierce women unapologetically share stories of the abuse and trauma of domestic violence. In our On Doctoring course, we became increasingly more aware of the reality of people quarantined in the houses of their abusers during this pandemic, and during life in general. We learned of our duty as future doctors to listen to our gut when we think something is off, to create a haven for our patients in case one day they may choose to let us know of what darkness is their home. Hotline: https://www.thehotline.org/
X. I am grateful that most of my medical education can persist online. One aspect of in-person classes I miss a lot is anatomy lab. Here’s a poem about an anatomy donor (published on In-Training) from whom I had the privilege of learning.
Thank you for reading!