Curse

I'm going to go on the record and say that I'm pretty sure that God didn't create any kind of microscopic life intentionally. I doubt there were bacteria and viruses and other parasites - intracellular and extracellular - in the garden of eden. All of that lovely stuff was waiting when Adam and Eve screwed up and were kicked out. What I'm trying to say, is that disease and its vectors must have been part of the curse handed down at the Fall of Man - a curse that still persists today. What I'm trying to say, is that when I sit here, staring at various types of bacteria and viruses, and their various types of resistance, and all of their antivirals and antibiotics (their name is Legion, for they are many) until I want to claw my eyes out - what I'm trying to say, is that it doesn't just feel like I'm being punished, I actually am.

E. Coli. S. aureus. B. Burgdorferi. C. trachomatis. They're invisible demons sent to torment us.
Ciprofloxacin. Methicillin. Doxycyclin. Erythromycin. Sure, they save lives - but right now, they make me want to take a long walk off a short pier.

I'm actually going home!

We had our first test of the cycle on Monday - it was a beast of a pathology lab exam. Previous tests like this were composed primarily of idenfication and secondary questions. This one, while incorporating the accompanying images, was more of a random, unholy chimaera of disparate bits of details, cobbled together by what must have been the departmental equivalent of a food processor, or, perhaps more fittingly, Dr. Frankenstein.

You see, for these classes, we have laboratory workshops - contrary to their name, they don't involve microscopes, but rather digitized slides of various gross or cellular issues. For the histology and neuroscience lab practicals, the questions came directly from those lab sessions - such was not the case on Monday. I might as well have dispensed completely (well....almost) with the lab presentations, and just pored over the previous details of the course. Nevertheless, I did pretty well, so I guess I can't complain.

This morning, we had our behavioral sciences shelf exam. Ignoring for a moment the regrettable lack of question-writing prowess afflicting the department here, there seems to be a very simple algorithm to answering BS questions, that I can't quite put my finger on. I read through the Board Review Series chapters, I did their comprehensive exam, and I did some other questions, and I can say that the more one does these questions, the more sense they make - there are just a few things you have to know. There's a little bit of epidemiology, a little bit of diagnosing psychotic and mood disorders, only the most cursory understanding of drugs, and a basic knowledge of normal, age-related changes. Whether or not you can answer what's left is basically determined by whether or not you're a nice person. That must be why some of my classmates had such trouble with it.

This brings me back to the algorithm I mentioned earlier - there seems to be definite course approach, just as there is for the more hand-on sciences. (1) Primum non nocere. If someone is in imminent danger, nothing else matters, be they a suicidal waitress or a battered husband. (2) Be nice. Any answer that starts off with "I see that you're upset" is a step in the right direction, and anything that sounds too harsh, is a step the other way. (3) HIPAA reigns supreme. You can't tell anyone anything unless the patient says so, unless they're acutely mentally impaired. (4) The family that stays together...is probably somewhere near the correct answer choice, provided it doesn't conflict with the first three.

Two down, two to go. I actually bought my ticket home yesterday, after much procrastinating. I can't wait to get off this island.

it's that time again.

The tests begin tomorrow, and they will conclude on the 17th - none down, four to go. This will have been the longest I've ever been away from home. I want nothing more than to brush aside all the pictures of deformities, profiles of bacteria and the mountains of drug information so that I may swiftly and resoundingly trounce my little brothers in a Halo deathmatch.

Scent of Death

My hands still smell like formaldehyde. I left the lab hours ago - this morning we went over all sorts of fun in the abdomen (kidneys and nerves, testicles and arteries), and my hands STILL smell like formaldehyde. I'm sitting here, working on a paper about hypertension in diabetic patients, and what should be done with them. I don't particularly want to be doing so, which is strange - not long ago, I'd have gleefully thrown myself into the tangled web of indications and special circumstances, but now I'd really rather just be reading through environmental pathology. I'm sitting here typing away, and as I reach up to rub the tiredness from my eyes, my hands still smell like formaldehyde.

But you know what? I don't care- I'm probably going to end up as a head-TA next semester, and my hands will ALWAYS smell like formaldehyde. Everyone I touch will know that I love dead people, and the scent of unnaturally preserving chemicals will cling to me like an aura of unholy alchemy; everyone I pass will be reminded of dead and dismembered bodies, sacrificed so that we may learn. There's not enough Old-Spice on this whole damn island. Sorry Nicole.

All sorts of bread crumbs

Hot on the heels of Monday's assessment of our physical exam skills was yesterday's assessment of our interviewing skills. All semester long, in addition to our bimonthly physical skills sessions, we also had weekly interview sessions, in which a group of students dressed up, sat around a table, and tried their best to elicit a coherent history from a paid local Dominican patient. We used very specific interview sheets, complete with all of the questions we needed to ask, but the goal of the sessions was to teach us how to elicit a broad spectrum of information while subtly guiding and funneling the conversational contents in such a way as to develop a succinct story of the patient's illness, complete with their psychosocial, personal, family, and medical history. Typically, one student per week would take point, and everyone else would add in questions at the end. It wasn't the best practice for the test, for several reasons.

First, we had 2 hours at our disposal to make sure we collected every detail from the patients - however, the graded practical was a 10-minute sprint. Also, many of us don't have that much experience interviewing anyone, and of the 10 or so sessions, we only had a facilitator twice - the blind led the blind the rest of the time.

That being the case, Nicole and I decided to do our best to replicate the interviewing style that would be graded - we researched various interview rubricks, and condensed them down to a few alphabetic mnemonics, to make sure we covered all pertinent aspects of the history (ex: ABCDE - arthritis, high Blood pressure, Cancer, Diabetes, Epilepsy; OPQRST - onset, palliative factors, quality and quantity, radiation, severity, timing; HAS TOLD ME - hobbies, alcohol, sexual activity, other drugs, living conditions, diet, medications, education, etc). So we figured out a quick method of questioning - next came the practice. That we had fun with - Nicole pretended to be a womanizing banker with ED, a football player with G6PDH deficiency (her best one, I think), and a drunk party girl. I pretended to be a carpenter with leukemia, a pregnant medical student, and, my piece de resistance, a bookseller going through a manic phase. We practiced tailoring our questions to the presentation while still collecting possible pertinent information - all, ideally, within 10 minutes.

There's a bit of a disconnect with the interviews - almost all of the rubricks available center around pain. Logically, the first few questions are concerned with describing the pain - "What brings you in today?" "When did you first notice it?" "Is there anything that makes it better or worse?" "Please describe the pain for me." "Does it radiate anywhere?" However, this particular section of our education is run by the behavioral sciences department - full of therapists and Ph.Ds, whose first instinct is to ask "How's your life?" Now, that's an important question, but I'm not about to let someone ramble on and on when I've got ten minutes; even though they praise the utilization of open-ended questions, for the purposes of this test, I tried to minimize them. I just knew that the BS department would pull something, so I wasn't surprised in the least when the presenting complaint was "I can't sleep".

We were all sequestered in a classroom next to the BS department, so as to minimize cheating, while we waited for our names to be called. I was towards the end, but when my time came, I went and greeted the interviewer and the student-pretender-patient, and go down to business.

"Good afternoon Mrs. Jane Doe, my name is Farley Neasman, I'm a second-year medical student, and I'll be interviewing you today. I just want to let you know that everything said here is confidential, unless there's something that I feel could be a danger to yourself or to someone else, in which case, I'll have to notify someone. Now what brings you in to see us today?"

"I can't sleep."

That threw me for a loop initially. Out of the window went all the questions about rating it on a scale from 1-10, as well as those about radiation and quality. However, as things went on, I realized it was a psych case. Inside, I was greedily rubbing my hands together; I knew I was about to rock this. I teased apart the threads of the pretend history that were pertinent, diagnosed a major depressive disorder (utilizing the lovely little SIG E CAPS mnemonic), and, even provided a little counseling. The facilitator actually looked rather surprised when all was said and done; she'd said that I'd hit all of the main points while being incredibly empathetic, and even provided a bit of consultation. I think I did well. I realized that, whereas MCQ (multiple choice questions) utilize my cluster-bridge model, actual medicine is more like detective work - you're gathering clues and putting them together to form a coherent disease picture. Somewhere in between, though, was the interview practical - someone laid down a trail of bread crumbs, and like Hansel or Gretel, it was my job to follow them home.

This was one of those things that reminded me of why I was at first drawn to psychiatry; it just seems to make sense to me, and it's exciting. There's nothing that shakes the central pillars of who a person thinks they are like mental illness, and that, in turn, affects everything else. I keep going back and forth on what I'm interested in; Nicole says it changes every day. I was telling her yesterday that I might enjoy surgery; I knew I'd be a very good one, but I probably wouldn't do anything groundbreaking. However, regardless of the relegation to drug management foisted upon psychiatry by insurance companies, I felt that I had a very good chance of making a name for myself in that field. Needless to say, I still don't know what I'm going to do, and I don't intend to decide any time soon. I read an article the other day that essentially said that even the clerkships don't really introduce med students to what actual doctor work is like in those fields - so I'm in no rush to nail it down.

HOWEVER: There was an MSNBC video article the other day about endoscopic surgeries. In addition to allowing much greater control and dexterity for highly trained physicians, minimally invasive surgery allows patients to heal more quickly, and lowers their risk for infection. The thing that got me, though, was that part of the application process involved playing X-box games with the program head - you see, with endoscopic surgery, hand-eye coordination in the setting of adapting a 3-D world to a 2-D representation is very important; it was a screening process to weed out those who couldn't adapt. I'm wondering - would playing Halo with my little brothers count as CME? I can dream.

Yesterday was Thanksgiving - continuing the tradition of trampling on patriotism, we had a test yesterday (last time it was an anatomy practical on the 4th of July). Since there's not a turkey to be found anywhere on this island, Nicole and I made do with what we had - instant mashed potatoes, stove-top stuffing mixed with chicken from the shacks, and some locally purchased veggies. It was the best turkey day possible, all things considered!

When I filled out my paperwork for Ross, one of the things I had to sign was a statement saying that they could use my face in their brochures. Here's why - that's me on page 38, in the anatomy lab. Apparently, all new students are going to see my mug.

You win some....

...and you lose some. We had our practical exams over the physical exam today, and I definitely lost some.

We all got dressed up and slipped into our white coats and stood around, waiting to be told what to do. By the time we actually got into the room, my heart was going a mile a minute (as generally happens before any kind of evaluation). A group of 11 of us were clustered in a room used for ICM (introduction to clinical medicine), sitting along the wall, all facing the patient sitting on an examination table. The proctor and a 4th semester student sat behind a desk facing us, and, like pagan fortune-tellers, laid out the cards that would determine our fate. People did their tasks - everyone missed a few things, and thankfully the girl before me picked the JVP card (jugular venous pressure). So, it came to my turn, and I drew the examination of the respiratory system without auscultation.

This is a really, really long one. Some of them - like the examination of the spleen, or the search for ascites - are very short, including only about three tasks. Mine however, was doozy. First I greeted the patient and commented on the symmetry or her chest wall, noting the lack of abnormalities. I made sure that her trachea was in the middle (deviation is an ominous sign), and that she wasn't in any visible cardiorespiratory distress. Then I palpated for tenderness, checked her AP diameter, and started percussing. I've gotten pretty good at it; the body is like a drum, and different sounds tell you different things. Resonance in the lung fields is good; it means that there's air where there should be air. Dullness, however, can signal a mass or lobar pneumonia. That complete, I moved on to diaphragmatic excursions - the idea is that you have the person exhale all of the air in the lungs, an percuss down their lung-fields until you hear dullness - the signal that you've reached the diaphragm. Then you have them breathe in as deeply as possibly, percuss again, and measure the difference. This is one way of determining diaphragmacit paralysis, and it's a hell of a lot easier to do when your patient takes a deep breath when requested, and exhales when requested, and sits up straight when requested. The local Dominican woman who posed as the patient for our exam clearly didn't want to be there, and made the whole thing difficult. It was like she couldn't be bothered to comply with any but the most simple of requests.

It was very annoying, but even if she'd been the best patient imaginable, I doubt it would have changed much for me - I forgot to measure the respiratory rate, I forgot to have her cross her arms, and to continue the examination on the front of the thorax. I answered the follow-up question like an encylopedia, though ("Please define Kussmaul Breathing"), and I did everything else, so I may still make it out of this experience with an A.

The Behavioral sciences have launched all their salvos as once, it seems - next up is the interview (which is worth significantly more of the grade), and then the itnerview write-up. Also, the questions for mini three, instead of differentiating between the types of schizophrenia, or epidemiological inferences, will be composed of psychopharmacological details. So, I've got some work ahead.

Scavenger Hunt

Nicole and I spent all day going over the procedures for the clinical skills assessment practical on Monday. For some reason, I keep on forgetting that the umbilicus is part of the abdominal exam, but hopefully, I'll have it down in two days. I need to just sit and read through Bates Guide to Physical Examination -I especially need to go over the breathing abnormalities and the JVP waveform abnormalities. It all feels so important, from the presentation of findings, to the correct procedure for examination, to knowing what the findings mean - it's a shame that it's just not worth that much as far as my points go.

The second semester class has their anatomy practical over the abdomen today. Spotty attendance at my TA sessions has caused my enthusiasm to wane somewhat, but I still enjoy it; I had fun pulling out tags today. Essentially, I had to hunt through bags of guts and bodies to find the structures the students would have to identify. I even had to dissect out the Greater Splanchnic, because, apparently, they haven't done that lab yet. I'm going back to help with the cleanup in a couple hours; not too many people signed up for that time-slot, and I'll help out where I can. This is one of those things that leads me to think that surgery might be something I enjoy, but I'm keeping my cards close off the table 'til I hit the clerkships.

It's fun to think about the ultimate scope of my practice, but right now my attention has narrowed to a very few things: the physical exam practical on Monday, the interview practical on Wednesday, the HPI write-up due on Monday, and then, at the end of the semester, the Behavioral Science shelf exam, the pathology lab practical, the third mini exam, and the final. That may sound like a lot, but I had twice as much last semester.

Pestilence

I haven't written in a while, but that's ok - nothing new of too much interest has been going on. I have come not to check in, but to whine and to complain.

I do not like microbiology, which is odd, because it's currently my highest grade. Beyond just not being enthralled with the subject, I feel that a large part of what we're being taught (at this very moment, actually) deals with details that doctors don't really care about. Do I need to know the diseases caused by Neisseria meningitidis, as well as the signs and symptoms? Of course! It causes meningitis, by the way, and it's got some interesting characteristics that dictate how you treat it - but I absolutely do not care what kind of agar medium it grows on. I don't care what color changes happen; nor do I care about the specifics of the tests that differentiate it from all of the other bacteria than cause infection. That's the job of the lab - I could be wrong, but I'm fairly certain that your average doc doesn't spend his time streaking agar and trying to grow plates of absolute pestilence. That's why there is a diagnostic laboratory. That's why you send off the samples - because it's someone else's job.

Truthfully, this isn't just because I dislike the subject - I admit that freely. It's that I like some of my time is being wasted on this; it's being taught because it's the pet project (by that I mean life's work) of the Ph.D who was hired to teach us. In the grand scheme of things, it's probably better to have too much detail rather than too little. If I had wanted that mind-numbing myriad minutia, I'd have gone the Ph.D route myself - but such is not the case. I have better things to do with my time than study how you run a microdilution automated system (something I will, i guarantee, mentally binge and purge like an unrepentant bulimic as soon as this test is over - unless it's on the Step, in which case I'll binge and purge again). One of those things is studying for the physical exam.

Over the course of the semester, we've had little workshops introducing us to the nuances of the physical examination - seemingly a lost art in today's culture of defensive medicine and space-age diagnostic imaging. The tasks in and of themselves are not difficult, but confusion creeps in when I'm trying to keep things straight - i.e. one should auscultate (listen) prior to palpation (feeling) in the abdomen, so as to avoid distortion of bowel sounds; or that the general survey should be performed at the beginning of the liver exam to search for possible concurrent jaundice - but not for the spleen exam (another story for another day - I've been doing little else other than studying what can go wrong with blood). It's enjoyable, if not a little bit awkward - feeling up folks always is. At least Nicole and I have each other - a significant other is a much better subject than a random stranger, especially when you have to do the kidney punch. I still have to practice, and I still have a lot to memorize, so that will be my task over the next few days. Several ironies are at work here: of all the things they're teaching us, this will probably be the one that I use the most for the rest of my practicing life, but it's it's got such a small point value right now, that I've heard some people simply don't show up. Also, even though I believe it to be incredibly important, I feel like it's a HUGE waste of my time right now - I'd rather be studying exactly how to run all those bacterial tests which I'll never run in real life, because those will be big points on the upcoming exams. Doesn't make any sense to me either - I just learn, purge, and hope that some of it sticks long enough (1) to help me on the Step and (2) to just maybe actually help me be of use to someone someday.

A Sky Afire

When heaven and earth pass away, consumed in a cataclysmic, cleansing firestorm, I'm sure it'll look something like this. I'm actually thinking of putting together a little coffee-table book of all the shots I've gotten of Dominica - but only of the sunsets from this particular vantage point, with the broken dock taking center stage. It's so breathtaking that, for a few moments, the rest of the day just kind of melts away. It's easy to forget about the mind-numbing exam we had Tuesday morning.

It wasn't so bad, but it was pretty bad. I genuinely dislike getting into an exam and realizing that I've never heard some of the terms before. What makes me even angrier is the fact that my grade may be side-lined by someone's bad-grammar or lazy question writing. Things would be so much easier if the professors were held to the same standards I am. Seriously - I'm going into a profession where people will die if I screw up, so if you're going to grade me and determine part of my future, you'd damn well better write the best questions you can come up with . It's absolutely unforgivable that some of these professors write questions stems and answer choices with even the hint of shoddiness. Of course - everyone makes mistakes, but if my mistakes are going to determine my future, it's obscene that some of these professors can just shrug off their mistakes with a "well you should have known what I meant."

I think the bridges held up. I won't know for a few days, of course, in which case I might have to (maybe) amend the metaphor. Maybe we're more like shipping magnates - we run around checking the bridges, assuring their structural integrity and strength - but when that day of reckoning/examination comes, we can only hope that whatever precious cargo has been entrusted to us has safely made it across the bridges we were tasked with securing. When the grades come out, we'll either find out the extent of the damage, or the spoils of success. I ran the bridges, I checked everywhere I could, and I hope that everything got to where it was going.

Injustices abound. Complaints will never cease. We've got a grievance process, thankfully, but these things will continue. However, the world perhaps became a little better on Tuesday when we elected the first Black (that's right, capital "B") president. Ever. Honestly, I never really doubted it would happen - I knew last year that senate was going to flip to the dems, and with everything going on, I knew that Americans wouldn't elect another republican. This race might have seemed close, but in mind mind, the selection of Palin and the economic crisis were the two final nails in the coffin. I've realized that, while I might disagree with some of someone's values (no one's ever going to see 100% eye-to-eye with anyone else, after all), the people have hopefully chosen someone who's going to make the best choices for us as a nation. There are unrealistic expectations from some - Rome wasn't built in a day, and our economy would be resurrected in short order either - but let's hope that President Elect Barack Obama makes good on his promise of change we need.

I don't want to be in class today.

I, Dragonslayer

Studying is going well. Blessedly, we have a three day weekend (nearly 2/3 done with at this point), due to Dominica's celebration of her thirty year independence from Great Britain (November 3rd, 1978). Monday's a national holiday, and from what I hear, there's going to be some impressive partying (carousing, as my mother likes to call it) going on as well. We were advised to take care of any and all domestic concerns - buying food, visitting the ATM, purchasing electricity - prior to the start of the weekend, because, as we all know, Caribbeans take their time off seriously. I got things squared away, and set up a study schedule for the weekend. Friday night included some questions, reading through bits and pieces of neoplasia, and reviewing pharmacology (absolutely wretched this time around, due to the fact that it's cumulative and the utter lack of any rhyme or reason). Yesterday saw a complete review of everything microbiological (all I'm gonna say is Thank God I have tomorrow too), more pharmacology, and a little bit of behavioral science.

I had everything planned out for today - all pathology, behavioral science, and lot of pharm. After heading over to Nicole's for pancakes and coffee, I was packing up to go when she came over, looking a little timid - and politely requested that I remove a lizard that had been staring at her. I almost laughed - I'd been doing this kind of thing for years! My mother designated me "lizard-remover" in an attempt to halt the passage of her unease with the spineless little critters, and I must say it worked. I'm generally pretty calm around them (aside from that one time I felt on crawling on my arm when I was sleeping - not fun). Also, they're ubiquitous in these parts, and I'm pleased and a little surprised that I don't find them in our rooms more often. So I walked back with her, and found what can only be described as a Grandaddy gecko, resting peacefully on her window sill. A while back, Nicole had put in a maintenance request to have the mosquito netting fixed down around the corner of one of her windows - that must have been how this thing made its entrance.

First of all, I'm used to gently removing things about a 10th the size of this one - I'd never even touched one this big. Second, I had a really good study day planned, and I wanted to get to it. The mosquito netting wasn't fixed, so I suggested Nicole call maintenance and let them handle it. She called down to the front desk, and was told that all of the maintenance guys were off for the holidays, but that one of the women would be up shortly. I poked it with a pen for a while, watching it swim up and down the screening in that boneless, slimy way that only little reptiles can, and I got ready to go - but then I got to thinking. I'm by no means sexist, but I wasn't going to let some front desk girl come up and wrangle this sucker - if I was going to decline the task. My ego wouldn't have been able to take it.

So I grabbed a rubber glove (who knows where that thing's been?), grabbed it, and took it outside. I was expecting much more of a fight; the little ones wriggle and squirm like it's why God made them. I must have forgotten that the little ones don't really bite. So I was holding it while Nicole was getting the camera ready, but the vicious little reptile opened its gaping maw and valiantly attacked my hand. I threw it over the balcony. Other than that, great study day.

Just running the bridges

They say it's a marathon and not a sprint, and I partly agree; we all spend time just running up and down those bridges. Sometimes it's a nice, even jog, and other times it is, in fact, a mad sprint. The finish line isn't a line perse, but a solidification of the bridge, such that crossing it is second nature. Maybe the bridges also get shorter; the longer I run them, the less time it takes. The bridges scattered everywhere throughout this mental landscape - some of them are parallel and have nothing to do with each other, and some of them are in series, connecting a winding pathway of clusters of information, ripe for an academic pilgrimmage.

Rome wasn't built in a day, and one can't run all the bridges in a day either - part of making sure they're all strong enough come test day is balancing them out. You can't spend all your time running the bridges that provide the prettiest scenery - you've got to cover them all, otherwise, the ones you've neglected will fall through and, come that inexorable, imminent day of reckoning, you won't reach one cluster from another. They don't last forever; if you don't run them, they'll fade from existence. At the very worst, though, they'll just crumble to the bottom of the mental chasm. At least you'll be able to rebuild. So I spread them out and jog them all. Yesterday, I ran a circuit of the bridges between parasites, those connecting the clusters of antiparasitic and antifungal drugs, the bridges spanning the chasms between hypersensitivity, and those connecting bacterial genetics. I also revisted some bridges I'd built for the first test - those connecting autacoids (headache medication, serotonin blockers, etc), and those spanning NSAIDS ( basic, non-opiate pain meds). I hadn't been throug those bridges in a while, and they'd faded more than I'm comfortable with - they weren't entirely gone, but I'll have to run them a few more times and make sure they're sturdy.

You know what's funny? Pathologists have the most interesting sense of humor. First, they always liken things to food - nutmeg liver, cheesy tuberculous necrosis, cafe-au-lait spots, banana-shaped ventricles, etc. Also, they like to take beautiful sounding words, and describe something absolutely wretched. If I hear necrotizing fasciitis, I know it's bad. But if I hear Anasarca, I think of an attractive woman - not edema all over your body. What about Melena? Lovely sounding name, right? Not bloody stools. Those pathologists must have had very strange romantic lives...

Cluster Bridges

If ever you wonder what it is I do all day - I build bridges. Some are as simple as a plywood plank across a backyard stream, while the importance of others rivals the size and scale of the Brooklyn Bridge - I build bridges all day, and then I walk them - back and forth, and back and forth.

I've realized that that's pretty much all they want us to do - walk down the cluster bridge. When I say that, I'm referring to the learning style here. There's a definite right answer and all the other answers are almost definitely wrong - that being the case, there's usually only one path: the Cluster Bridge. The clusters I refer to are groups of information, which, for my purposes, are given to me in the stems of questions. It is my task, then, to travel down a cluster bridge and arrive at the complementary cluster - the right answer. I call them clusters because they are always groups of pieces of information. If, for example, the cluster I'm given consists of a two-year old with mental retardation, aggressive behavior and hyperuricemia who bites himself - the cluster I respond with consists of Lesch-Nyhan Syndrome, HGPRT deficiency, and X-linked recessive inheritance. Those two clusters are, in my mind, linked by a firm bridge, so well-traveled, that by the time I read the bit about self-biting, I'm already way across the mental chasm, already at the end of the bridge.

Of course, we're being taught to be compassionate, and to relate to patients as people who have placed their trust in us. Right now, though - as I study for the exams which will determine my career, of course thinking of patients will help - but what I'm really trying to do is solidify the ephemeral mental bridges between oftentimes disparate pieces of information. Every time I walk across, the bridges become just a little firmer; repetition and explanation make those cobblestones easier to see. When I'm starting out - just learning something - I have no idea why the hell one bridge links two things. Chloroquine treats malaria? Sure - I'll buy it. I have faith that there's a bridge there. If that's all I had to go on, though, I might just forget where the bridge is - it's hard to see. Wait...what's that? Chloroquine makes it impossible for plasmodium vivax, a malarial parasite, to convert the heme it eats from red blood cells into hemozoin? And regular heme is toxic to the parasites? I may not know exactly why hemozoin isn't toxic, but I can see those cobblestones, and now I have a much firmer, much more comfortable cluster bridge. I'll walk over it again and again, maybe widening it here and there, adding to the supports, slipping in pillars and columns - I build bridges all day.

Exam day is a structural assessment.

The Rainstorm Cometh (cameth?)

There's been talk of hurricanes and rumors of hurricanes, but up until yesterday, all we saw was a little bit of rain. Granted, it was a rain that seemed to be timed with maddening precision - occuring exactly during the lunch hour, especially when the morning had been sunny, so I of course never brought an umbrella - but it was just rain. Yesterday was a different story.

After getting up for the weekly Case Presentation - a teleconference between the Ross campus and the Princess Margaret Hospital in Roseau, this week covering prenatal corticosteroid administration (to help little babies' lungs develop), Nicole and I returned to our normal classroom for a rousing series of lectures - some anxiety disorders, a little bit of human sexuality, some psychopharmacology, a little neoplasia, etc. However, 5 minutes shy of 10:00am, one of our professors came in with an urget announcement from the prime minister of Dominica: effective immediately, all businesses on the island were to shut down due to the approaching storm - everyone was to go home.

Great - day off, right? My first thought was for the student I tutored - their head and neck practical was today, and they'd lose the rest of the day to study. Next, I wondered when our already rigorous schedule would allow for making up the classes. Nicole and I filled up some water bottles, and then headed on back to PBH. And now, allow me to quote Genesis 7:10:

"And it came to pass after seven days, that the waters of the flood were upon the earth."

I've been in heavy rains before, but this was something else. We decided to wakl back along the street, because the little cow trail we normally walked to class every morning was sure to be a sloshing mud-hole by this point. So we're walking down the street, and I'm holding the umbrella (I remembered it!) darn-near horizontal, because the wind is coming so hard. This torrential downpour hit us all at once; 5 minutes before, the skies were merely a dusky gray, and I was thinking "they're shutting down the island for this?" So we're making our way down the road. I might as well have forgotten my umbrella, because within seconds, Nicole and I are absolutely soaked. We made it down past the study space, and then around the pool by Ross housing - to find a rushing, muddy river has materialized from the sidewalk between the pool and some buildings. By river, I mean more than ankle deep - but soon after, we were home free.

The storm is raging around us, and what do I do? Take pictures! The bucketfulls of rain had largely subsided by this point, even though it maintained a steady drizzle for hours. That being the case, I snuck out onto the top of the building (shh....that's between you and me).

Now I know that it may not look like much, but keep in mind that all of that swirling seafoam you see is normally as clear and smooth as glass. I made my way down from the top of the building to get right into the middle of the action - I snuck down into the seaside, open air restaurant close to where we live. Looking back, it probably wasn't the best idea because I was up to my ankles in muddy water and I couldn't see the crabs (or whatever other disgusting things had been evicted from their hovels in the dirt by the water), but I was out of there quick-quick.

Everywhere you see water is supposed to be luscious, neatly kept grass, and quaint stone walkway.

You can actually see how the raging storm has smashed our little dock into kindling - part of it washed away towards the Cabrits. Now I know that, in the grand scheme of floods, this wasn't so bad - first of all, the water has someplace to go; the sea is only 20 feet away. Also, it wasn't that much water, but it did all come at once. So, we just relaxed for the rest of the day. I finally finished Stephen King's Liseys's Story and Dave Eggers's You Shall Know Our Velocity. There was also quite a bit of reading done over neoplasias, and a little bit of reviewing fungi, yeasts, and bacteria. There was actually more reviewing than I would have liked - the cable was out.

Halfway through the day, I sent out a really long e-mail to my anatomy group. I hope they're doing alright - they're taking the practical exam right now.

In honor of the presidential election, Nicole and I have made the joke realized that, the first antibody to bind to a pathogen, IgM, actually means "immunoglobulin Maverick". However, that first response isn't enough, and if thats all you've got, your blood runs thick like syrup (it's called HyperIgM). What needs to happen is a process called "isotype switching". I guess you could say that our antibodies go through a change we need.

Just checking in

We've had deceptively little to do over the past few days - the week of a mini is always like that. I go from panicking about not cramming as much learning and reviewing as I can into every minute, that, as soon as the test is over, I catch myself going - "what do I do now?" Of course, there's relaxation to be done and sanity to be recaptured, but it's still a bit of a strange feeling. This past week, though, we truly didn't have much class - a bit of microbiology (most of which was review), some hardcore epidemiology, and a little bit of behavioral science. Oh yeah....I forgot about the pathology.

Here I have a tiny complaint - after spending 15 minutes telling us how qualified he was to teach, our professor for hemodynamic dysfunction then proceeded to make the subject boring. I'm sitting there thinking "How DARE you!" Look at it this way - no one cares what an E-cadherin is, or about the innervation of the stylopharyngeus muscle, or which pyrimidines are made. Everyone, though, knows someone who's had a heart-attack or stroke. How blood works and what happens when it doesn't (clotting, thrombi, emboli, shock, etc) strikes me as TERRIBLY important, and I'm a little offended that it wasn't done justice - this is something that, no matter what specialty I go into, will kill some of my patients. However, I can't really rail against the professor; I should be placing the blame on whoever built this schedule.

Though I've felt like there really hasn't been that much to do (even though I still haven't finished Stephen King's novel Lisey's Story), I'll tell you one group of folks who are running around like newly decapitated fast-food fowl right now - the second semester. You see, this Friday, they have their practical over head and neck. That means that I'm going to be pulling some extra TA shifts, just to make sure they've all got it down. It should be fun; I'm perhaps the only person I know who enjoys going into the lab.

Another test complete

On Monday, we had our first test of third semester - and I have to say, I was a little surprised. We have 5 credits worth of behavioral science this semester, and I figured that, with my major in psychology, I'd have a far easier time with this subject than anything else. For one thing, I didn't pay enough attention to epidemiology - I'm pretty sure I did alright, but if there was anything this exam reinforced, it was that Behavioral science is not just B.S. Also, there was blistering ambiguity on the part of those professors charged with constructing questions to test our knowledge of early childhood development. Granted, it's more of a soft science, but writing a decent question shouldn't be that difficult. So, strangely, by the end of the first twenty questions, I found myself craving some pharmacology or pathology. Both of those went very well, I think - I know I missed at least one pharm question, but only because I took it too literally. Pathology was nice to us - they were fair. Micro and immuno, however, though they were fair, obfuscated the questions unnecessarily, I thought. All told, I think it went well.

The night of the mini is always a big party night. I distinctly remember growing too old to party like a 20 year-old - I was at some frat party during my junior year of undergrad, and suddenly just felt very old, and very out of place. So, I didn't join in the revelry. I did, however, go to the Beach bash - a cookout/t-shirt giveaway/party on the beach - and am still wondering why, whenever t-shirts are ordered (1) they never fit and (2) they never order enough. That night, Nicole and I took some time off to relax and went to see a showing of Indiana Jones and the Kingdom of the Crystal Skull. Much of the filming was done at Yale, and I was pleasantly surprised to see streets I'd walked a hundred times, and I'm pretty sure they even showed several buildings I lived in. When all was said and done, though, it was bit far-fetched. Ark-robbing Nazi? I can deal with that. Finding the Holy Grail? Sure, why not. I kind of have to draw the line when it comes to aliens, though.

I thought I'd add this follow-up, on that double-arm transplant for the German farmer - he's doing well and is learning to use his new appendages. This is one of those things that's just absolutely fascinating.

Third Semseter and Memories of Buenos Aires

I've been negligent again. This time, though, it's with very good reason - this semester is simultaneously far more interesting, and far more difficult than anything I've done before. We've begun the classes that actually feel doctorly - gone are the banal prerequisites of biochemistry basic histology. In their place, I find myself faced with pharmacology - something I feel I'll use forever; pathology - the stuff I imagined when I envisioned medical school; microbiology and immunology - all the bugs that make us sick, and how we fight them off; and behavioral science - or the class I call how to act like a doctor. I'm loving it, needless to say - I find it far more interesting to immerse myself in the complexities of the different types of inflammation, with all of their signs and symptoms, causes and presentation; I find much more pleasure in constantly reviewing notes on indications and counterindications for the first of what I'm sure will be hundreds of drugs I'll have to commit to memory - than I found anything I've done thus far. Hopefully, I've been doing a good job studying - the first test is on Monday.

I've also made my way to something I've been looking forward to since I learned it was a possibility - I'm an anatomy TA. My sessions meet twice a week, and thankfully, I've got the second semester class (reviewing head and neck anatomy is much less painful than, say, the brachial plexus). Due to the rectification of some bad planning (through which I personally suffered), the current second semesters are now learning head and neck at the beginning, along with the various tracts and cranial nerves they're also memorizing for neuroscience. However, much to my chagrin, this class is far more careless and lazy in their dissections than my class was. Seriously - I'm not just over-fondly recalling my times spent inhalling formaldehyde while elbow-deep in cadaverous cavities - I received an e-mail today from the head TA attesting to the shoddy work. I'm encouraged to encourage them to do better and, moreover, if I want to go in and clean up some of their dissections, I'm more than welcome. I know you can't see my smile, but believe me - it's there.

Time is different now. There's simply less of it, and I don't think the trend will change any time soon. Technically, we're taking fewer credits, but this information just seems so much more important to me. Part of the reason for that is surely our ICM (introduction to clinical medicine) clinics, in which we're learning not only how to elicit a patient history and organize the information, but how to examine the patients. The physical exam, it seems, is traditional mainstay of medicine that, time and again proves its worth. While some things like the Water Hammer Pulse are more tradition than useful (no one uses it, but it'll still be on the test), most of it feels incredibly important, and, if what everyone says is true, is the most important tool physicians have in treating patients.

Memories of Buenos Aires

One of the things that Nicole really wanted to do when we first decided to make our way to Argentina was to go to a Tango show. After arriving, we decided to solicit the local opinions, and the gentlemen who sold Nicole and I our leather coats all agreed - the best tango show - bar none - was La Ventana. At the hotel front desk, I made reservations, and we decided to make this our big "anniversary dinner". Everything was taken care of for us - a rather obese gentleman in an old, threadbare sweater arrived promptly at 7:00 on Friday and bussed us, along with a few other hotel guests, to the best tango show in all of Argentina.

Much like everywhere else we visisted, the food and the wine were fantastic, and we enjoyed our dinner before the show ever began. Here's a picture of us taken by the gentleman sittin at the table next to us, with his young dauther, mother, and trophy girlfriend (who may or may not have gotten along with the daughter too well).

Now - I'd never seen tango before (TV doesn't count), and I must say I was quite impressed. Tango happens everywhere, it seemed - a little square on the pedestrian street in front of our hotel turned into a nightly stage for comedians and tango-dancers alike. However, La Ventana was the cream of the crop.

It wasn't just tango, though - it was a historical Argentinian culture lesson. We were treated to some traditional, native (I think) music, and even some Gaucho dancing, which led me to dub the gentleman below The Argentinian Ninja.

This guy was really, really good. Little wooden balls were tied to the ends of his strings, and he swung them around, beating on the floor with a rhythm and speed that made my jaw drop. Easily, this guy was my favorite performer of the night. It must have been a little difficult for him - for all of the other performances, the stage was full of dancers and singers (whom I'll get to in a bit), but this guy came out all alone, and started on a not-very-exciting dance. I felt bad for him, until he whipped out his props, and really got into his act (as is evident from the picture).

The singers were fantastic also - I'd have probably enjoyed it a bit more if I'd paid better attention in my high-school Spanish classes. Apparently, the owner of La Ventana sang in the show - here's a picture of him below. He worked the room, singing Por Una Cabeza, the famous Argentinian song about a love - and gambling on horeseraces. It must have been one of those songs - you know the ones. They come on the radio, and everyone breaks out into song (like Bonjovi's Livin on a Prayer). As soon as he hit the chorus, the room joined in with him, and I wished I knew the words. Here, though, I've got to disagree with Nicole - I think it still romantic, regardless of the horseraces ("por una cabeza" roughly translates to "by a head" - of a horse).

Continuing the history lesson, the performers of La Ventana paid homage to Maria Eva Duarte de Peron, singing "No Llores por Mi Argentina" (Don't cry for me Argentina, written by Andrew Lloyd Webber for a 1973 musical).

Clearly, we enjoyed our Tango show very much. When we left, a long, long line was forming across the street as a strangely heterogenous group of folks (teenagers and middle-agers alike) waited to get into some club, and I couldn't help but feel a little smug. Next time, I'll revisit our tours and more walking around the beautiful city, as well as updates on the Second Year of Medical School.

BUENOS AIRES (day one)

Nicole and I just got back from Buenos Aires, Argentina, and I wish we hadn't; I wish I was still there. It's my new favorite city on earth!

We left for the airport at 4:30 in the morning on Wednesday, August 27th. The taxi driver picked us up, and drove us - along with several other students - down the nauseatingly winding, jungle-lined, hour long road to the airport (a road not to be braved without the use serious antiemetics). Our flight left around 7am, taking us to Antigua, where we went through security again, before hopping on another plane to San Juan, Puerto Rico. From here, we flew with Copa Airlines, now a subsidiary of Continental Airlines, and, because of how well they feed and entertain their customers, my new favorite airline. We sat around San Juan for a while, and I had my first, blessed, cafe Americano from Starbucks since I left the states (little did I know that I was soon going to enjoy cafe con leche every single day). I read through Brian Sanderson's Elantris, while Nicole read through The Other Boleyn Girl. Then we flew to Panama.

We landed and acquainted ourselves with the curious Panamanian airport - composed of seemingly endless designer leather and tech stores - and exactly 1 little restaurant, and 2 hot dog carts. Duty free was the way to go, so we bought armfulls of Toblerone chocolates. By the time we left, it was something around 8 at night, and we made ourselves comfortable for th longest fligth I've had since returning to America from Germany - a daunting 6.5 hours.

We arrived in Buenos Aires at 5:50 Thursday morning - talk about a red-eye! After changing some cash into pesos with a blissful 1:3 (respectfully) exchange rate (the US dollar is stronger in BA than it is even in Dominica), we took an airport cab to our hotel. This was all done in Spanish, mind you - I hadn't studied the language in years, but I figured I'd do alright. I had a hard time understanding folks in San Juan - but I soon learned that it's just because San Juan's Spanish isn't as pure as the Spanish of the Portenos - the historical name for the residents of Buenos Aires, who lived along the port. Since we couldn't actually check in until 11am, Nicole and I went and had breakfast in a little corner cafe. It started out with a cafe con leche - essentially, an espresso with milk, which was absolutely delicious! I've had them in the states, but it was such a shocking contrast to the stuff I drink here on the island. I've come to the realization that this entire country has no clue how to make coffee.

We finally checked into our rooms at the Grand King Hotel around 11:30 in the morning. Situated on the pedestrian walk Lavalle, close to its intersection with the world-famous shopping Florida Street, the Grand King is right in the middle of the action.

After getting settled in and squared away, Nicole and I headed out to eperience what I now consider the best shopping I've ever experienced. Before that, however, we decided to take a little walk down the pedestrian walks. We found ourselves crossing out of the shopping district and into the general downtown area. There was a small park in the middle of the city, which we walked around, circumventing the young lovers (which seemed to be sprawled amorously and haphazardly across any open, public space in the city). We walked along the historic Puerto Madero, roughtly translated as something along the lines of "Wodden Port". We took pictures of the cranes they used to build things, the port itself - with some historical ships, and the Woman's Bridge.

After that, we returned to more familiar parts of town - the shopping district. This particular area, we came to learn, was an entrepreneurial paradise. The streets were lined by little "mom 'n' pop" storefronts. To call them street vendors would be incredibly unfair - this wasn't some third-world, open air market, with struggling sellers peddling their wares from cramped little stalls. The streets were swept clean every night, and the stores could all have easily been replaced by the biggest and trendiest of brand names. These vendors, instead, were crafstmen - cutting and sewing their leather jackets or purses upstairs, and displaying the goods in their shops downstairs. There were, of course, a fair number of touristy shops full of souvenirs, athletic shops full of T-shirts (Argentinians love their soccer), and delightfully quaint little cafes and restaurants.

It was so cold walking around that first day, that Nicole and I were easy prey to the sellers of fine leather goods - cueros, they call them. Nicole first stopped in to look for purses (and activity which would take much of our time in Buenos Aires), and fell in love with an elegant, light-tan jacket. As we were walking down some other shopping alley, a woman in a store called out to her. Nicole was wearing her new coat, but I came to learn that that's not really enough to deter folks from trying to sell you another one.

So we stopped into this little shop and met our first friends in Buenos Aires - Natie and Martin. We looked around, and I figured since she'd just bought one - and I really was cold - it couldn't hurt to try one on. I picked out a trendy coat with some ornamentation on the sleeves, but Nicole and Natey together pulled something more classical off the rack - and that's the one I bought. Over the next few days, as Nicole and I were walking around, we often stopped and chatted with Natey and Martin - they're good people. This shopping area of Buenos Aires truly was an entrepreneurial paradise - Martin worked upstairs in the shop, cutting and sewing leather coats in his factory, and Natey sold them in their shop downstairs. (If you ever stop in Buenos Aires, their shop is called "Che - Cuero Argentino. They're located at Lavalle 752, and can be reached at checueroargentino@hotmail.com. Seriously. Best leather in the entire country). Here's a picture of their shop - they were such good salespeople, I ended up with that coat, and Nicole ended up with a sweater.

I had to have the sleeves shortened, but it was definitely a bargain. That night, Nicole and I had the first of many amazing dinners in Buenos Aires. We'd been strolling down along the streets, and just decided to poke our heads into La Estancia! The first thing we noticed - immediately upon standing outside the restaurant - was that entire dead animals were split open, spread out on iron stands, and set to cook before an open flame - my kind of place! One thing about dinners in Buenos Aires - they eat around 10:00 at night, so that's about when we arrived. I must have been really tired (or perhaps we'd started on the wine already) - because I ended up somehow ordering my steak rare. Being the med student that I am, I rationalized away my choice: you see, undercooked hamburger is really a danger, because you're grinding up parts of the cow's digestive tract - which contains the infamous Escherichia Coli - affectionately known as E. Coli. However, a nice, juicy cut of steak is just muscle tissue, and unless something's really wrong, there won't be any sneaky, hidden infections. I'd completely forgotten about mad cow disease and hoof and mouth disease, which is perhaps why the dinner was so delicious and the company so pleasurable. There were still folks chilling in the restaurant when we left around 11:30 that night. I will say that Argentinian food spoiled me - when we got back to Dominica, I had about a half-bottle of wine in my fridge. I almost had to pour it out.

And there was evening and there was morning the first day. You'll have to forgive me - with the passing of the 2 weeks or so since I left, events have become a little muddled in my memory. That being the case, instead of organizing things chronologically, from here on out I'll just explain them as fun little Argentinian events.

On the Seventh Day, God rested.

It may not be the seventh day, but I've been taking a break since the hellish firestorm series of tests finished last Thursday.

After a few days of lounging around and finishing up R. Scott Bakker's The Darkness that Comes Before, Nicole and I will board a plane at 7 tomorrow morning, and wing out way first to Puerto Rico, then to Panama, and finally, we will land in Buenos Aires!

Today, we purchased a few books for next semester (mostly pharmacology and pathology), and sat out on the upper deck registering with the state department.

How sweet it is to have nothing to do -I finally got to read a bit, and am anticipating starting Elantris; I got to watch a few movies, including Hellboy 2, Taken, and My Big Fat Greek Wedding; and we've had the luxury of some much needed gym time.

Mini 3 grades came out yesterday. I must say - neuroscience unexpectedly spanked me - but I still might end up with an A in the class. This was a good semester for me overall - it looks like I'll have the option of being an anatomy TA, and, if the shelves don't lower things too much, I should still come out with some pretty decent grades.

I'm going to have to start thinking in Spanish - time to tango!

Firestorm

The scholastic firestorm is underway (because I'm now bored with the "marathon" metaphor). It technically began last week, but yesterday was the first of the Shelf exams - physiology. It wasn't that bad, actually - I'd been going over it all pretty thoroughly, and I've gotten fairly comfortable with the information. I still have to see how I did, but with the whole strange double curving and all, I don't know if it'll be an accurate representation after all is said and done. Today we had the biochemistry shelf, and I suppose it went alright as well. So far, I have the general feeling that these were written to see what we (as students) could figure out, or how obsessively we read. I don't think I could have studied too much more for either one of them and significantly changed anything. Not everything tested was covered in our classes, but I don't feel like we're getting any less of an education than our on-shore counterparts. I feel like I've got a decent grasp of the information (and I've been doing well academically), but this is the first real comparison. I guess I'll have to wait and see.

Even though I just got done saying that I completely believe we're getting an education comparable to that of U.S. medical students, allow me to add the following: a physiology professor (a Ph.D who shall, obviously, remain nameless), when questioned, did not know what dysmenorrhea was. It was not the case that he didn't know exactly the specific prostaglandin implicated in its etiology (an actual question on our physiology shelf exam). Rather, when asked about it, his response was "You mean amenorrea, right?" Perhaps more alarming is the fact that I knew the difference before ever starting medical school - it's not that rare of a condition. More alarming still, is the fact that this man taught us reproductive physiology! So, when someone says to me that they want to ask a professor something, and I respond with a sardonic "They probably don't know" - I may just be tellin' it like it is.

A few days ago - sometime last week - Nicole and I went strolling down the beach. Here are some pics from that evening walk - I think sunsets are this country's greatest natural resource. I mean - look at that. They're all different, and every one is absolutely picture perfect. I need an external hard-drive just for pictures of sunsets! I could stay here for my 5th semester AICM (advanced introduction to clinical medicine), but I'm pretty set on going back to Miami. Those sunsets'll be one thing I miss.

Fighting to concentrate

I have the physiology shelf exam tomorrow morning at 8am. I'm struggling to keep my head in the game. Yesterday, I went through some physio in First Aid after doing Dr. Linda Costanzo's comprehensive review at the end of the BRS. Today was filled with mini-3 reprodutive physio, and I currently have EKG basics open before me. It's hard to pay attention right now - I just want to be sitting somehwere reading a book. That being the case, I figured I'd add another chapter from that book I'll probably never write - this one through the eyes of a precocious high-school boy (I started ages ago, and can hardly remember what's in it). This is off topic, but aren't you glad we spanked France in the 400m men's swimming last night? That's what they get for smack-talkin'!

Ok, here it is.

Juan-Miguel's Chapter

Try as he might, Juan-Miguel was losing the war. This was no athletic challenge, nor even a game of wits; yet he found himself soundly trumped at every turn in the blistering, staggering war of attrition within his mind. It was as if his id had laid siege to his ego; as if the immemorial great, growling bear deep inside his being – that claws about hungrily and never says “enough” – had cornered the esteemed avatar of his intellect and humanity, and crouched - mere pulse-pounding seconds away from tearing the shivering thing limb from bloody limb. For, though he desperately wanted to concentrate on The Picture of Dorian Gray or the construction of his essay, or what his teacher was saying, or anything – all Juan-Miguel could think of were beautiful, luscious, tear-drop shaped breasts.

Ah, but Lord Henry Wotton was but poor cannon fodder in the onslaught against his raging hormones! For the glib corruptor himself offered not opposition, but seemed at every turn, in young Juan-Miguel’s mind, to offer only maddeningly logical reasons for indulgence. He sat rigid in his desk, gripping the edges with white-knuckled intensity, glaring off into the distance with grim determination, willing himself to concentrate. He had an essay due, and he’d better get to planning it – and slowly, but surely enough, the structure and shape of the essay began to take form. He saw magical, shining-golden lines coalesce as the form of his argument appeared, as he began to delineate the parallels between Dorian’s descent into perversion and the universal loss of innocence and coming of age – but the still rough-hewn, unrefined form of this majestic composition was smashed unto nothing, shattered in a cloud of mortar and of dust, by a beautiful, luscious, tear-drop shaped pair of breasts!

"Fine! I’ll yield to you", he thought, feeling his palms moisten. Just for a little while…..The walls were already breached; he could rebuild later. And he relaxed, straightening his glasses, cradled in the warmth of his thoughts, as the tempting flesh-pears danced before him. He could almost feel them in his hands, filling his palms with a near tactile fullness, his greedy finger molding to the inviting elliptical curve, as if one was made for the other. He imagined a firm softness that he knew would make him tremble, as these stately pleasure domes sat, smooth and delicious, gleaming pure and golden beneath a beaming sun. He heard the siren song not with his ears, but with his heart, with his hands and his loins – the tantalizing, tangible melody teasing him and torturing him beyond what endurance he thought humanly possible. He wanted to touch, to have and to hold, to -

“Oh, and let me remind everyone that the National Merit Scholarship Qualifying Test is being held here in the auditorium two weeks from Wednesday – I’m sure every one of you have been preparing oh so diligently.” Haha! The tide has turned, thought Juan-Miguel! He breathed a long sigh of relief, for with those few words, the English teacher had sent in the cavalry, buttressing his concentration with much needed, much appreciated reinforcements, effectively fortifying the gaping hole in the castle walls. The situation was dire for a second there, but now the fierce specter of academic achievement loomed even larger, darkening the horizon far more than the maddening insistence of his 17 year-old passion. He’d been prepping all summer; there was nothing to worry about.

Mrs. Robledo (decidedly not the object of his lust, to be sure) paced back and forth in front of the class, her thin lips drawing into a tight line, bunching up newly-formed wrinkles.
“But miss….I mean…..what’s a thesis?” A student to the left of Juan-Miguel had, apparently, just woken up. Mrs. Robledo rolled her eyes, making no attempt to hide her disgust. Juan-Miguel followed suit. The teacher lifted a pale hand, smoothing her newly dyed, newly coifed hair, and then extended a half-piece of chalk.

“Come here Eddie. I would like you to write this on the board so that you do not forget what a thesis is. Ever.”

“Yes miss………” A lanky youth with greasy, black hair down to his eyes slipped out of his desk and sulked up to the dusty green chalkboard. He took the chalk and waited while Mrs. Robledo turned back to the class. Juan-Miguel was suddenly very glad that he hadn’t been called on.
“A thesis”, Mrs. Robledo continued, “is the main argument in your essays.” She glanced over her shoulder at Eddie as the chalk tap-squeaked on the board. “An example of a thesis is ‘Shakespeare’s Romeo and Juliet has become the archetypal bittersweet romance’. You would then use your supporting points to build a cogent, cohesive essay. You all know how to write a paper. If you don’t, I don’t see why you’re in my class – but I can call some 6th grade English teacher.”

Juan-Miguel had stopped listening when she began explaining what a thesis was. It really irked him – some of these kids had no clue what they were doing here, and didn’t really care. Stupid distractions like this were a complete waste of his time – he should have been discussing serious stuff – not taking baby steps. Losers. He sighed heavily, shifting in his seat. You’re supposed to know how to write a damn paper in AP English 3. Losers. Damn public schools. Come to think of it, he could have chosen something a bit headier than The Picture of Dorian Gray. He’d considered expounding on hell and damnation with a look at Dante’s Inferno (Ciardi’s translation, of course), but somehow, he just wanted something more Glib – and Oscar Wilde had that in spades. Besides, Hell was cool and all – but it just didn’t have the allure of the corruption in Dorian Gray. That theme was going to hold a central place in his paper – the idea that everyone, somewhere in their coming of age had a corruptor, be it one person or a group. He scribbled down a few ideas for supporting points, as well as some phrases that he’d want to throw to look intelligent – like sine qua non and inextricably intertwined. Juan-Miguel chuckled at his own inventiveness; those college essays would be a piece of sweet, sweet cake. But at the thoughts of scholarship and writing gave way to the pleasures of corruption and cake, he soon pictured candy and apples and…..damn it…..melons.

Another siren called – this one in the form of a piercing, shrieking bell, marking the end of the period, and the end of another Wednesday. Finally those losers in the back could wake up and go home. He slammed shut his binder, slipped it into his blue mesh backpack and slung it over his shoulder, tucking a pen behind his ear as he joined the crowd waiting for freedom. The same thought popped into his head everyday around this time; the same sad, disappointing idea. “So this is what cattle feel like”. The crush was maddening; people didn’t just walk the halls – at the end of the day, the halls were packed. These were the mindless hordes, the cattle who, directly after graduating, would proceed to go work for a mechanic – if they got that far. Some of them would make it out of this sleepy little town – he knew he was going to be one of them. Swept by the massive throng he shuffled to his locker, pondering the merits of UT at Austin and UT Pan American, in Endiburg.

The halls were decorated with posters and blue and gold streamers, heralding Friday night’s big football game against their cross-town rivals – the West Camino Diamondbacks. School spirit was high and he could see people in the stampede who already had painted faces. He could feel the energy in the air; the East Camino Rattlers had lost the 2 previous “Snakefights”, as the students called the games, and felt that this was their year for redemption.
Mechanically spinning the dial on his combination lock, he grabbed a book from his locker, tucking it into his backpack. Suddenly a body launched itself from the crowd and pinned Juan-Miguel to his locker. Soft, wet lips pressed against his cheek.

“Hi!” She was petite indeed, a head shorter than the not-particularly-tall Juan-Miguel. She beamed up at him.

“Hey Gabby – I was just thinking about you!”

“Oh? What were you thinking?” She tilted her head, giving him a coy, innocent look.

“Just about ….y’know…..the football game and stuff. We’re going, right?”

“Yeah – of course!” She wrapped her arms around him, giving him a big hug. He smiled to himself; feeling her ample bosom pressed against his chest had been the underlying fodder for his frustrated fantasies. Looping an arm around her neck, he gave her a quick peck on her forehead.

She stepped back and he looked down, as always pleased at the sight of her body. Gabby was petite and curvaceous, with full lips and big brown eyes. She held one of his hands between both of hers.

“I like hugging you” she giggled. “You’re like a big soft teddy bear.

“Heh….thanks….” It was great that she wanted to be close to him, but Juan-Miguel would exchange all that softness for the defined musculature which many of his classmates had already attained.

“So how was class Gabby?”

“It was alright….we’re doing orbitals and stuff in chemistry now…..I kind of like it. How’s that project coming?”

“I’m so excited about it – I can’t wait to start! It’s -” but he was interrupted as a beefy arm threw him into a headlock.

“Hey Gabby – have you seen that loser Juan-Miguel? I haven’t seen him anywhere.” Juan-Miguel struggled under the arm, finally pushing it off.

“That’s because you’re too busy looking for potato chips, you stoner!” The three of them laughed. Alberto Garcia stood half-a head taller than his friend, and was nearly three times as wide. He brushed his longish black hair out of his eyes, shifting his books from one hand to the other.

“Man….I really hate this stupid extra practice with Mr. Villarreal – he expects to, like, know everything already.”

“Yeah, but think – it’ll help prepare you for the PSAT – it’s worth the extra practice at least.”

“It’s worth passing…” Alberto mumbled under his breath.

“Alright, well I have to go get started on this precal stuff. I’ll see you in an hour.”

“Laters, Alberto.” Gabby turned to Juan-Miguel as their rotund friend waddled away.

“Do you want to go outside?”

“Ok….right, your mom’s coming at 5?”

“Yeah, I got to wait again.” The halls were emptying out, as students descended upon the parking lot, or else milled around in front of the school, waiting to be picked up. It was still sunny and warm, even at this time in early October. South Texas was like that – it defied winter. Hazy clouds hung lazily over the trees on the small campus, and an ever-present breeze kept the warm air from getting too stagnant. The grass was still cool and green, but Juan-Miguel and Gabby opted for the benches, set in a semi-circle beneath the trees. From here, they could watch the parents pick their kids from the crowd on the circular looping road between the front parking lot and the school. Gabby kicked off her sandals, wriggling her toes in the cool grass.

“Have you started on your paper yet?” She crossed her legs, lightly bobbing her foot.

“Almost….I’m still trying to work things out just right. How are classes?”

“Oh….they’re fine. We barely started Oedipus Rex today…I like the ancient Greek stuff.”

“That one was so good!” Juan-Miguel’s eyes lit up. “It’s like, the archetypal tragedy, I mean, do you know what happens? He -”

“No no no! I heard it’s really good, don’t ruin it for me!” She gave her best little-girl pout, and Juan-Miguel just laughed. He sat back against the bench, placing his arm around her, and shifting as she leaned in to him.

“Ok, I won’t ruin it. It’s amazing, though – one of my favorites.”

“I hope it’s good – so what are you going to write about?”

“It’ll be….ah…..” His train of thought was momentarily and effectively derailed – from this vantage point, he had a frustratingly blissful view down Gabby’s delightful cleavage. He felt the familiar arousal, and quickly crossed his ankle over his knee, glancing off at the line of cars.

“I’m going to talk about Lord Henry Wotton’s suggestive corruption, and how that parallels every person’s coming of age.

“Oh? So everyone gets corrupted?”

“Yeah, something like that.” He spared another peek down her light-blue spaghetti-strap top. Her chest was so…….perfect…so full and round and….

A sharp elbow to his side brought him back to reality.

“Ow! What?”

“You were staring again – you know it makes me uncomfortable.”

“I only stare ‘cuz you’re so pretty, though.”

“Ok but…. what’s wrong with staring at my face?”

“I do……I mean………I’m sorry.” Gabby crossed her arms over her chest, obviously in a huff. Juan-Miguel readjusted his glasses, and leaned over to give her a peck on the side of her head.

“C’mon….don’t be mad……”

“Ok fine, just don’t do that anymore. I like you because you’re not a horn-dog like those other guys.”

“Right.” He nodded, slipped a notebook from his bag, opened it to a blank page, and stared off at the line of cars. They sat there, watching the crowd dwindle, and chattered the time away. One of the things he liked about her was that was sweet and innocent, and he knew that she’d never go to a party, get drunk, and hook up with anyone. “Ah…my nymph”, he thought. “I’ll figure you out soon enough. But if I didn’t have you, there wouldn’t be anyone…” She snuggled against him.
The sun was well on its way down – little more than a rusty orange marble low in the purple-gray sky. The crowd had dwindled to nothing, save for the stragglers. Alberto waddled towards them.

“Vamonos! I don’t wanna be late for mom’s enchiladas!” Juan-Miguel stood up and slung his bag over he shoulder, chuckling under his breath. Gabby stood up and threw her arms around his neck. Her shoulder-length hair smelled like hairspray, but he loved it.

“I’ll call you tonight, ok?”

“Ok.” He gave her a quick peck on her forehead, and headed towards the parking lot with Alberto, casting a quick glance over his shoulder.

They crossed the mostly-empty parking lot in silence and creaked open the doors to a 9 year old, blue Chevy pickup. The old engine struggled to life as Juan-Miguel looked back to the luscious light-blue blur that was Gabrielle Rosado.

“Man, this old piece of junk is gonna die and strand me some day, I just know it.” Alberto eased forward, crunching over loose gravel.

“Huh? Oh...nah, I think you’ll be alright, at leas for a little while.” He reached for the old radio and turned up a lively Tejano song. They were on a main road now, skirting the town of Camino.

“I don’t know if this college thing is for me.” Alberto stared straight ahead, his broad shoulders hunched over the wheel. “I mean….I’d probably do a lot better to start working on something….I dunno….be a mechanic or something…” Juan-Miguel squirmed in his seat, remembering his earlier thoughts about the kids who became mechanics.

“Yeah…..but, I mean, it’s worth a shot, isn’t it? You wouldn’t have to go far from home, and I’m sure you could get financial aid.” They rolled to a stop beside a Whataburger, the breaks squeaking painfully.

“You can say that ‘cuz you’re smart, and you’ll make something of it. What if I go and spend all that money and have to drop out or something like that? Ah…….I don’t know.”

“Don’t give up just yet, you never know what could happen.” But deep inside, part of him agreed with Alberto. Some people just weren’t meant to do certain things – like he was never meant to be an athlete. Alberto had been a linebacker, but he blew out his knee in the last Snakefight. He was avoiding bringing that up – if Alberto couldn’t take him and Gabby, he’d have to find someone else. He hoped Alberto wouldn’t be too bitter about it.

“Yeah, I know, I know. The teachers all say the same thing. But hey – I guess we’ll see what happens, though, right?” The light changed. They moved along, took a left, and rolled right out of town. The road they traveled was like an ancient, mythical barrier, separating civilization from the wild unknown. Juan-Miguel imagined that this road was like the fences that had protected wild-west towns from the hard, barren desert; or perhaps it was more like the reach of a campfire’s soft light – beyond that little circle of warmth and safety was the cold forest, filled with wild animals and things unknown. He imagined the hideous, ancient monsters from before the birth of mankind’s consciousness, snarling and crouching just out of sight, forever kept at bay by this blessed barrier. But here, there was only an old road – with subdivisions and neighborhoods to the right, and endless field of sugar cane to the left, staking out their lonely dominion beneath the big Texas sky.

Famous folks always die in twos.

It's a sad day in the world community. Isaac Hayes - the original bad-mutha *shut 'cho mouth* - has gone to that great recording studio in the sky. I hope this means that there'll be soul music in heaven.

His demise is hot on the heels of Bernie Mac's untimely exit from the stage, due to complications with sarcoidosis. Famous people always die in twos.

I almost see the miracles of the Saints

Except for a brief period - perhaps between the ages of 5 and 13, when I wanted to dig up dinosaur bones or be a marine biologist - all I've ever wanted to be is a doctor. I've thought of other thing, including perhaps a counseling psych Ph.D, but it's always only been medicine. I've never thought of being a career writer, but I love the escapist part of reading so much, that, over the years, I've tried my hand at writing. I have all of these ideas in my head, but right now I need to push them aside and focus on the upcoming storm of tests. That being the case, I thought it might help to symbolically and literally (briefly) set those things aside - by posting a brief glimpse here. This is an excerpt from a book I started once and will probably never finish. Just so you know, "Casimiro Milagros De Los Santos" roughly translates to "I almost see the miracles of the Saints". For those of you familiar with Harlingen, I think you'll see the similarities.

The Padre's chapter

Padre Dagoberto Casimiro Milagros de los Santos slipped behind the wheel of his maroon 1990 Ford Taurus. A look of heavenly peace graced his strong features as he rested his weathered hands on the dash and leaned his head back, thankful for a blessed few moments of solitude. It was a beautiful, bright afternoon –a cool, crisp breeze lazily rolled stray clouds across the sky like eiderdown scattered on cerulean glass. The passenger side door opened, and the Padre’s peaceful countenance fled as quickly and unceremoniously as a crow dodging a child’s stone.

“Good afternoon, father Dagoberto! My, but this is a blessed day!” Father Brian McFadden had that bright-eyed, bushy-tailed fervor of personality normally seen in caffeine addicts. The padre glanced over at him, thinking instead, of a yipping wire-haired terrier. It wasn’t a bad comparison – father Brian’s unruly red hair stuck out at every improbable angle.

“Hello, Father Brian.” The padre cranked the engine and took a quick glance at the fuel gauge. So much for peace and quiet. He eased the Taurus out of the yard of St. Angelo – one of the many Catholic parishes in Camino. He had parked on the grass, preferring the shade of one of the few oak trees to the too-small parking lot.

“I’ve got everything written down right here, father. First, we should go and see how Mrs….del Campo is doing, and then on to…hrmm….Mrs. Rangel…oh, and we’ll be back in plenty of time for catechism class!” The padre responded by merely fumbling for a cassette and popping it into the deck. He pressed play, smiling at the first few notes of the Dave Brubeck Quartet’s 40 Days. He’d always thought that the opening piano solo could have fit very well in the most solemn of masses, and he relaxed a bit.

“Excuse me father, but do you happen to have any…err…Gregorian chants? I feel like…..I mean…..” Father Brian had a way of appearing to be unsure of what he was about to say so that it would appear to soften his disagreement. “If we’re… going out doing the Lord’s work and praying for the sick….shouldn’t we attune our hearts to His will and….not…..divert our minds with….secular music?”

The padre rolled his eyes, sighing heavily. Father Brian had only been here a week and already thought he knew how to run things.

“There aren’t any words – how do you know this song isn’t glorifying our Lord?” His voice was deep with the thick Mexican accent of one who’d learned English later in life.

“It doesn’t sound sacred……it doesn’t feel holy.” Father Brian shrugged. “And you know where the first played jazz music, right father Dagoberto? It was in the brothels….surely we -”

“If I remember my Old Testament correctly, father Brian,” The Padre had tossed in that condescending tone he’d found himself using more and more lately, “Rahab the harlot was one of Jesus’ ancestors. Now – I’m not at all condoning prostitution; I am merely saying that this….eh….” he paused, making vague motions with his hand. “ This ‘holier than thou’ attitude could alienate members of the parish. Remember who Jesus’ friends were.”

“But father -”

“However, if you are unable, father Brian, to see the beauty in the rhythm and cadence of this song – as one might find in Pachelbel’s Canon, or even How Great Thou Art – then I suggest you spend a bit more time with Him, asking Him to reveal to you His wonders.

“Father, I see, but -”

“I like this song” the Padre snapped, turning his head sharply. “You would do well to pay a bit more attention to Paul’s epistles and not be so quarrelsome.”

“Yes father.” The Padre cleared his throat as he saw father Brian deflate. He hadn’t wanted to snap, but this idealistic youngster, fresh from seminary, had come with his head so full of theoretical ideals that there would be no place at all for any practical learning. It was strange having him here at all – the padre had agreed to help Father Brian learn to lead a parish as a favor to a friendly priest in Boston. This, among other things, added to the Padre’s growing sense of unease.

“Please forgive me, father Brian – I didn’t mean to speak so sharply.” He stared straight ahead, clicked his blinker and turned left onto a main road.

“Forgiven”, father Brian said, somewhat sullenly. They were an odd pair, the Father and the Padre – as different as different could be. One was a gangly redhead from the better Boston neighborhoods, and the other had chosen to serve the Lord rather than the cartels in central Mexico. They both wore black, short-sleeved clergy shirts with the instantly recognizable clerical collars. Both had a strong commitment to the work of the Lord, but where they differed most was, perhaps, experience.

For Father Brian, the choice to become a man of the cloth had been one easy decision among many options; he’d grown up in Somerville, and came from a well-to-do Irish-Catholic family. Always active in the local diocese, his decision to become a priest had been praised as much as his older brother’s decision to become an ophthalmologist. The Padre, on the other hand, had grown up in the lush, historical Mexican city of Zacatecas. As the drug cartels became more and more powerful, he honored his mother’s wishes and relocated to Monterrey to become a priest, and, with the church’s help, soon immigrated.

Father Brian had seen people struggling to survive, but only in the soup kitchens, or the other outreach programs that his parish performed. However, to him, it was like looking through a window. He felt pity for them, and even felt that serving them was part of his duty – but he did not identify with them. At the end of the day, he would always go back to his nice warm bed in his wealthy parish – truly thankful that he was not in their place.

The Padre, however, thought he knew better. The poor in spirit – these were his people. He had seen the things that people would do to survive; he had been there. He felt that he had a full understanding of true human need, and what it made people do. Always, he’d thought that the search for the Lord could overcome the baser drives of human nature. If only he could get Father Brian to understand that it was not easy, and that the choice was at times very difficult – he would have done his work.

It was on these things that the Padre meditated as he drove through Camino. He pulled into a gas station on one of the two main roads that ran through town, idling the car for a moment. Unbuckling his belt, he turned in his seat.

“Father Brian, there’s something I’ve been wanting to share with you.

“Oh? What’s that?” Father Brian looked caught off guard, as if he was about to be the recipient of a particularly difficult confession.

“Where you come from……the choice to follow the Lord has probably been an easy one.”

“Yes…..it wasn’t so difficult.”

“Well here, things are a little different. The Lord calls to the hearts of the people, but so do drug money, prostitution, alcohol – most of these people don’t have much hope, and it’s difficult for them to put their faith in something they cannot see….perhaps more difficult than it is where life is a little easier. I feel sometimes that the Walk in a place such as this can be very difficult. Do you see what I mean?”

“I suppose…..” Father Brian stared thoughtfully through the windshield. “I suppose you’re asking me to be a bit more sensitive?”

“I’m glad you understand, father.” The Padre brightened, shut off the engine, and opened his door. “Would you mind pumping the gas?”

“Of course, of course.” Father Brian pushed open his door as the Padre closed his and walked briskly towards the small convenience store. Lonely crows cawed loudly from the power-lines above him as he reached for his wallet, shaking his head in dismay at the unforgiving prices.

A tub of ice filled to the brim with canned beer singles was the first thing he saw, followed by the colorful lotto display. He stepped up to the counter, handing the teller a $20.

“Put it all on pump four, please.”

“Pump four….ok…..” The teller punched in the keystrokes, but frowned at an error message. Must be new – thought the Padre. He glanced around at the blaring assault of colors, waiting patiently for his receipt. Hot dogs turned slowly on steel rollers in their glass heater to his left, and beside them steak and egg breakfast tacos grew stale in their thin foil. Brief movement caught his eye – he had a slightly-blurred view through the glass to the other side – right to the booze in the back. Three youngsters were greedily eyeing the inviting aluminum cans and bottles. They kept glancing around nervously, just oozing with adolescent shiftiness. A flash of recognition hit the padre, and he stepped away from the counter, the frustrated teller still trying to figure things out. The padre shoved his hands into his pockets and put on his best fake grin.

“Ahh – look who it is! Luis, Josue – I havent’ seen you boys in a while! And who’s your friend?” Like kleptomaniac deer caught in holy headlights, the boys froze, and quickly exchanged nervous glances. Luis stepped forward.

“Uhh…hi Padre…..this is…uh….our friend…Leo.” Leo didn’t move. So, the Padre stepped forward, extending a strong hand. Leo shook it reluctantly.

“Nice to meet you, Leo. I see you’ve made some good friends here – Luis and Josue usually come to mass every Sunday, and I know some mornings one can forget to set the alarm – Don’t worry about it.” He paused, glancing from one boy to the next, not releasing Leo’s hand. “I hope they’ll invite you when they come back – you’re welcome at St. Angelo.” The color draining from their faces, the boys continued their silent collusion. The Padre took a small step back, not wanting them to feel any more cornered. The well-practiced grin still plastered on his face, he crossed his arms over his chest and glanced up to the ceiling, as if deep in thought – or perhaps listening to the very words of God.

“Hmm. I’m glad the high-school is giving you boys so much freedom at lunch time. It is good to know you can be trusted with responsibility. I hope your classes go well for the rest of the day – It was nice seeing you boys again – and Leo it was nice meeting you.” The Padre pointed at him, nodded, and turned on his heels. The register had taken pity on the poor teller, and obediently spat out a receipt. The Padre thanked him and returned to the car, brushing a hand through his salt-and-pepper hair.

“Everything alright?” Father Brian asked, as he buckled his seat-belt.

“Oh yes, just fine. I ran into some boy from the parish, and I saw how they were doing.”

“Boys…but isn’t it a school day?” Confusion spread on the father’s face as he glanced behind them at the little convenience store. Beside him, the Padre cranked the engine to life.

‘Yes it is, and they were skipping school. I hope they will go back now – but that is in the hands of the Lord.”

“Should we……I mean…..should we give them a ride back?”

“No – they’ll be fine. They know where it is.” They were back on the main road, riding with the windows down, the velvet jazz of the Brubeck quartet still forcing its way through the crackly old speakers.

Padre Dagoberto shook his head. That right there - he thought to himself - that was the perfect example of what was going on with the parish. No one seemed to care anymore – it was like he was waiting for attendance to drop until it was just himself, Father Brian, and a few old ladies with their rosaries. It was frustrating, but it also saddened him. In his most honest moments – of which he sincerely repented immediately – he wondered if God cared about Camino anymore. It wasn’t as if this town was a modern day Gomorroah (maybe Tyre, or Sidon) – but it certainly felt like there had been a change over the past few years. He’d watched everything from weekly mass and catechism class attendance to baptisms decrease sharply, and he wondered if perhaps it was not God who did not care, but the people. His mind was filled with passages from Isaiah and Jeremiah, in which God expressed His sorrow at being forsaken by the Israelites. Stories about the rise in high-school dropouts and municipal corruption, increasing gang violence and larger-than-ever drug seizures made him wonder what had happened.

The ever-humble Padre certainly considered himself no prophet, but he felt that his words were just as useless, were just as ineffective in the ears of those they fell upon. Those boys back at the store? Sure, they looked sorry – but only because they’d been caught. If he hadn’t been there, not a single thought about skipping school or mass would convict their hardened little hearts.

Shaking his head once more, trying to clear his thoughts, the Padre reminded himself that he should not be so hard on them – he should love them. What good would it do to get frustrated? Of course he was frustrated….but he still had to be a shepherd, and be there for the faithful few. What kind of priest would he be if he let his annoyance at delinquent parishioners cloud his ministry to those who needed him? He certainly didn’t want to set a bad example for Father Brian – then his speech about Camino being a hard place to follow the Lord would seem to apply to himself also, and that was not something he wanted. What was there to do? It had been so pleasant, so full of life and dedication to the Word only a few years ago…

Guíame por el camino eterno– he silently repeated. “Lead me in the way everlasting.” He knew that he shouldn’t mope about not having the same spiritual gifts as Padre Jaime – but his felt so small by comparison. He shook his head once more. All his life there had been the assurance that the Lord had a definite plain for his life….and he was still sure that that was true. He just…thought that it would be something more important. The Walk was not supposed to be easy…but all he felt that he was accomplishing was slowing the rate at which Camino turned from the Cross. The Padre shrugged wordlessly, staring through the windshield, forgetting that he wasn’t alone. Father Brian had missed the tinge of bitterness in his voice earlier, but now he picked up on his frustrated, unconscious movements. He sat silently, wondering if he should interrupt the Padre’s thoughts, and then figured that it couldn’t hurt.

Father Brian opened his mouth to speak, but instead slipped a string of dark-wooden rosary beads from his pocket, held them reverently between his fingers, and bowed his head.

“Eternal Father, we humbly adore Thee, and thank Thee for this day, which Thou hast seen fit to give us.” Padre Dagoberto glanced over at him, the lines of frustration and weariness softening. He slowly reached up and turned down the radio. Father Brian continued.”

“O Loving and Most Gracious Lord, Thy humble servants Dagoberto and I do so deeply thank you for calling us to your work, and we know that You shall not give unto us more than we can bear. We ask Thee O Lord to give us the strength to persevere through difficulty, and the grace to be sensitive to the needs of your Lambs. O Gracious Mary, Immaculate mother of Jesus, I implore you to pray for me.” He slowly lifted his head, letting out a breath. A peaceful calm filled the little car, broken only by the gentle hum of the motor.

Padre Dagoberto was the first to speak. “I thank you Father Brian.”

“It’s alright. You looked upset.” Father Brian slipped the rosary back into his pocket.

“That I was. If I had but bowed my head and prayed – as you did – instead of indulging my memories of bitterness, I could have saved myself much annoyance.” They continued on, the radio turned back up as they talked about the weekly schedule. The chatted like new friends until they pulled into the neat gravel driveway of a small house, the porch covered in houseplants and colorful chairs.

“Shall we go see how Señora del Campo is feeling today?” The Padre asked, unbuckling his belt.

“Sounds like a plan father.” With that, they closed the doors of the little Ford Taurus and crunched up the driveway to visit and fellowship with one of the faithful parishioners.