A Rant. Of Farley.

I've complained a bit over the past few days. I complained to the director of campus life about the dance club across the bay, which likes to turn up the volume between 10pm and 2am. Sure, I understand the need to dance, but I'd be more than happy to kill the music if it gets me more sleep. I complained about the cow-trail I take to school. Sure, I could take the bus, but c'mon, Ross - pave the damn path. I complained to one of the lab directors about how students don't take care of the bodies - I get very possessive of them, and perhaps unreasonably angry when students don't show them proper respect.

Now I'm complaining to you. We've got this thing here at Ross called squatting - this is essentially the spreading out and leaving behind of one's belongings in any room devoted to study. I used to believe that these things were artfully arranged in a manner so as to suggest "I've only stepped away; I'll be right back" - but now I see that these things mean "This is my spot". They usually consist of handouts, a few books, a sweatshirt, a water bottle, and some trash. Within days of the beginning of the semester, every table in my favorite study space (the one closest to where I live) has been covered by this selfish land-grabbing paper trail. It may seem as if I dislike squatting - but that's hardly the case.

You see, students will walk into a room, look for an empty desk or table, and leave - because there are none. I, on the other hand, will pick a table I like, and push the pile of papers and books onto some other, inevitably occupied (though not at this second) table. This works rather nicely for me; most people are loathe to relocate another's belongings, so I don't have much competition. Now, there is a bit of a double standard; I have friends who squat, and I'm not going to move their things - I like them. Squatting is the status quo here, and if I were just to find a space and squat, things might run more easily. However, I never leave my things behind (I take it all with me for lunch and dinner, and when I'm done for the day), and that justifies my behavior. Nicole thinks it's because I secretly long for the confrontation....that may be part of it.

There's this particular spot I like right in the middle of the room. It's a great spot - I've got a view of the door, and it's directly under the lights. It had been occupied by this guy and his girlfriend this past week when I came in to study, so I sat elsewhere. Saturday arrived, however, and there was no one to be seen - just the artfully arranged pile of papers and sweatshirts. So, I rearranged the tables to my liking, and moved all of the crap onto one of the desks (two were pushed together - no one needs more than one). I sat there all of yesterday.

So I'm sitting here today, going over pharm when "guy and girlfriend" return. The guy has the audacity to ask how long I'll be here, do I plan on squatting, didn't he see me sitting elsewhere earlier in the week.....etc. He said that he and his girlfriend wanted to sit together, etc. I told him that I'm always going to move someone's stuff because there are no empty seats. What I meant to say was "I like this spot, and whenever given the chance, I will take this spot, by removing your things. What you tried to do through selfish, passive-aggressive squatting, I am doing through open confrontation." He did not seem to understand that "I'm not making you any promises" meant "I'll sit where I want, and that's right here, unless you're physically in this seat." But I've got to wonder....does that make us the same, somehow? I want to deny others the usage of this spot just as much as he does, but I'm' a bit better than that. When I leave, I leave the spot clean - if someone else is going to come and sit there, then that's the way things are supposed to work. However, if they are going to decide to come and squat on the only clear table - they're just going to have to find somewhere else to sit. I'm more than happy to move someone's stuff every single day - so it's in everyone's best interest to just keep their crap off my table!

Squatting isn't even allowed - here's an excerpt from an e-mail I received this very day, from our president of student government:

" ETIQUETTE REMINDER:

These are within the student handbook and should be followed by ALL students. Remember the Honor Pledge you signed in 1st semester at Orientation.

Squatting: Please DONT SQUAT. As administrators have continuously reminded you, if you have to leave for longer than the 2 hour time frame take your materials with you. Also don't take more space then you need to. This is especially relevant for those who study in the Swing Building and CAC 2nd Floor (above the gym). Essentially DONT BUILD A FORT AROUND YOU."

That being the case, is my righteous indignation not only validated, but necessary? There are no security guards walking through and sweeping off detritus at the end of the night; there is no enforcement of these regulations.....except me. I stand alone against the hordes of squatters like Samson against the thousand Philistines (where he had the jawbone of an ass, I have this e-mail). People will always do what's in their own best interest; they will get away with as much as they can - until someone stops them.

I am easy-going. I am reasonable. I am, for the most part, fair. I smile more than I glare. However, I am not passive. I am confrontational. I take advantage of the fact that most people are not. So no, "guy and girlfriend", I don't care if you sit together. Go sit somewhere else. Do not ask me not to sit at your spot. This is my spot. Do not leave your crap here again. If, on some afternoon, you find this spot unoccupied; rejoice! For I am kind and unlike you. But know that if you leave your things here again, you may not be able to find them. I have spoken.

The Week in Review

Inertia is the tendency of a body in motion (or at rest) to remain as thus until acted upon by some outside force which must necessarily be proportional to the mass of the body. Inertia also applies to non-bodies; it applies to sluggish economies as well as to the minds of students just returned from Christmas vacation. It's very difficult to jump right back into the information after coming back from a break - those 2-3 weeks of waking up late, relaxing, working out frequently are something all parts of me - conscious and unconscious - are loathe to let go of. I had so much fun over this break, that I still just want to sit around watching TV, reading my novels, and working out everyday. Every semester it's like this - every semester, it's harder to get back into it, and every semester, it's more essential that I get back to it right away. It generally takes a few days to get back into the swing of things, and I think that how long it actually takes is generally a reflection of how intense it was before the break.

Semester 4 started off with a bang - cardiology. We started with vessel pathology and the approach to a patient with heart failure, infections affecting the heart and antihypertensive medication. I wanted to do well on everything else because I want to be a good doctor, but this time around I have a bit more of an incentive. Since I'm the child of a cardiologist (how many other 9 year olds know about the Vena Cava?), I've got a little bit to prove. That's just as well, because this is the first semester in which I'm more concerned with the actual learning than the number grade. Sure, those grades are all important - I'm getting ready to start preparing for the USMLE step 1, and the structural integrity of my cluster bridges will soon be all that matters. However, the things we're dealing with now feel much more important. In the first semester, we studied gross anatomy and biochem -not that high-yield, but necessary. Neuroscience was added in the second semester, and it was interesting - but not that practical (unless you become a neurosurgeon). Third semester heralded the beginning of the theoretical understanding of pathology and pharmacology, as well as microbiology. Now, though, the stakes are higher - every doctor will see patients with cardiovascular issues; every doctor will see patients taking nitrates, beta blockers, Calcium channel blockers, or some diuretic (unless they're pediatricians). This is important.

The facts that we're being presented with now are the things we all as physicians (speaking of my class) will use when we treat people. We're no longer talking about some extremely-rare-but-cool condition like cystic ovarian teratomas, but rather biggest killers of everyone in the developed world. This is no longer just school - this is real; this is the awesome gravity of realizing that what I'm studying right now will matter every day for the rest of my life. This is the ambivalence - the excitement that I'm finally spending my time meaningfully, and the fear of inadequacy that comes with that responsibility.

Though the applications of pharmacology and pathology will have far-reaching implications, the heavy-hitter this semester is Introduction to Clinical Medicine (ICM). You know those old movies, where someone gets hurt, and some other guy says "Is there a doctor in the house?" Yeah, well that's because doctors know stuff - lots of stuff -and are expected to, if not be able to fix any situation, at least be able to make it a whole lot less serious. That knowledge they're (soon to be we're) expected to hold is not arcane or, for the most part, that conceptually difficult; there's just so much of it that it seems that way. In a few weeks, I will have a practical exam, in which a fictional patient presents complaining of chest pain. Instead of just asking questions this time around, I'm going to have to know what to do to get more information, and suggest treatments and interventions. I'm going to have to know, from those signs and symptoms, how serious their condition is. Sure, if it was just chest pain, it wouldn't be so bad, but doctors are supposed to know how to do that for EVERYTHING that a patient can present with.

I think I'm really starting to enjoy this "medicine stuff".

Back to the Jungle

Perhaps the most enjoyable break I've experienced in all of my academic life is slowly grinding to a halt - I'm back in Dominica. Some folks would say they're back on the "rock", but I believe a more fitting epithet would be "back to the jungle" - because, you see, Dominica doesn't have anything else. I've come to realize that it's a third-world country among third-world countries - the Ghetto of the Caribbean, as I like to call it. I've not been to all of the Caribbean nations (just Dominica, Jamaica, St. Lucia, Barbados, Antigua, the Bahamas), but they're all WAY more developed than this little island jungle. It may be the presence of tourism money - where those other islands are known for their resorts and their beaches, the only tourists Dominica gets are either just stepping off their cruise ship to stretch their legs or tree-hugging eco-tourists, and the beaches we have are narrow ribbons of charcoal black sand between the Caribbean sea and the imposing jungle. Perhaps the mountainous terrain we have here makes any land development nigh impossible - whatever the case, my nicknames stand.

I left home on Thursday, and spent some time with family in Miami - I'm fortunate that I still get to see nearly everyone, even as far away as I am. I enjoyed more home-cooking, shared hunting and travel stories, and put a serious dent in my book Shadow and Claw. My uncle and I picked up Nicole on Friday, and she and I stayed at the Red Roof Inn, close to the airport (because of finicky temperament of certain airline companies, FLL changed to MIA, and we scrambled to adapt). The next day, we flew to Barbados. You see, Barbados is beyond Dominica - but, due to the way things work out with our flights, we had to take a day layover. So we stayed at the Silver Point resort - a wind-surfer's paradise, with a beach that put St. Lucia's to shame. Looking back, we've stayed at some luxury hotels - granted, Sallie Mae own my soul, so I'll be paying all of that back with interest, but it's luxury nonetheless. That being the case, we only take luxury that comes with amazing bargains - hotels.com has been incredibly good to me.

As I said above, the beach was breathtaking - it was perhaps the most pleasant sand to walk on I've ever experienced. The sea was a bit choppy - it may not be the best place for families with little kids, but it's a haven for water sports. This hotel is located at the southernmost point on Barbados, but I'm sure the beaches elsewhere are just fantastic as well. Why couldn't Ross have been here? I think it has something to do with the fact that Dominica is desperate for American dollars, and everywhere else gets tourism dollars. I tend to like to get away from my medical school colleagues; they tend to be straight out of undergrad, and still fond of partying and being loud. Much to my chagrin, a few of them followed Nicole and me to Silver Point, but instead of joining them and getting sloshed, we walked around taking pictures.

As we were driving from the airport to our hotel, the taxi took us through a residential area - the squat, colorful Caribbean houses you see everywhere in the Caribbean. I felt, though, that it was a little exposed - if I walking through, I would have felt very exposed. I didn't understand why until we were back in Dominica - every other island has cut their jungle down. While it's great to preserve the island's natural beauty, those tourism dollars lead to better health-care and better schools - although, I'm not sure if that extra money makes the indigenous lives any better; the Dominicans have more centenarians than just about anywhere else. I think it has something to do with (1) all the mangoes and (2) the fundamental lack of stress here on the island. That devil-may-care attitude drives me insane around test time, but it' probably keeping people alive.

Classes start tomorrow, and then vacation will be over. It's been a great break; I got in some serious relaxation, but I suppose it's time to get back to work. One more (maybe two) semester to go! It's a little daunting to realize that, in a year's time, I will have taken the United States Medical Licensing Examination: Step 1, and set up a schedule for my clinical years. Looking back over the past year, I've been very fortunate to be able to have a great time while doing what I feel I was meant to do.

What a wonderful world

Everyone's got a tag-line - not just companies and movie stars. Sure, Ahnold had "I'll be back", and Maxwell House was "Good to the last drop", but, in undergrad, my was "Life is good". There have been some rough patches between here and now, to be sure - the perhaps the roughest of my meager 25 years. Nevertheless, a peculiar thought hit me as I listened to the pastor's New Year's Sermon. He spoke about how he was not teaching his children to make resolutions - that trying to do things of their own and failing made it difficult for people to step out in faith when God called them to it. He'd had a heart attack this year, and was bitten by a snake and a spider and, like anyone involved in anything financial, was not the least bit nostalgic about 2008. Understandable - a lot of people were happy to see it go. Now, I have some regrets in my life, but as I sat there in the pew, I realized that there was not a single thing in 2008 that I regretted.

I had begun my official medical education, and had finished 3 semesters with a 3.7 GPA. That was probably due to my abysmal academic record in undergrad, and the fact that I'd taken a year off. According to my mother, it was those low points that kicked me in gear, and started me on the road to achieving things of which I was truly capable.

I am in a great relationship - after much trial and much error, I've found someone who not only makes me happy, but am in a place to appreciate her. This probably would not have been the case if I had not been embroiled in one hellish conflagration of a breakup a little over a year and a half ago.

As I sat there in the pew, I realized that it was my response to my regrets that enabled me to enjoy this year so fully; I guess you could say I learned from my mistakes. That being the case, I guess I wouldn't go back and change anything, even if I could - various chains of events and circumstances have made me who I am right now, as I sit here typing - and not regretting a single thing about 2008. It was a very good year for me. I went to St. Lucia and Buenos Aires while finally learning what I love on a tropical island, and excelling at it. Life is good.

I also love Texas. There are a few things available to me here that probably wouldn't be possible elsewhere. What you see below may look like a ramshackle fencing job, but it is in actuality something you won't find anywhere else - it's our private small-arms range. That's RIGHT - I have a shooting range in my backyard. The day before yesterday, Dad, the boys and I went out and did some target practice with a 9mm. The kick feels good; tearing 8 holes in 2 square inches at 30 feet feels really good - gnats swarming you as you try to concentrate does not feel so good.

Another thing that I love is bonfire night. Years ago, after we first moved into this house, Dad and I dug a little pit in the back, and that was it. Some time later, the neighbors were having construction done, and the workers needed access to more water. We let them use our well in exchange for (1) clearing a running track for us in the backyard, and (2) laying down brick around the fire pit. And so, we save up our Christmas trees and cardboard boxes, and just sit back like Nero sans fiddle, enjoying the burning. I don't know what it is, exactly, but this is one of the most enjoyable, most exciting things, the memory of which instantly takes me back home, wherever I may be.

There's the fire pit, and the new Christmas tree leaning against some sapling (we'll let it dry for a year before tossing it in - the burning tree you see above is from Christmas 2007). See those tiny little canisters? Those are for fireworks - this is another thing I love about the fact that my parents live where they do. Every year, more and more people set them off, and next year, I guess we're going to have to compete a little bit. We normally do 2 canisters each, for a total of 8 (Dad, Stef, Caleb and I) - but next year, we're going to do 4 each. Take that, neighbors.

Funny story: it's a good thing we went through all of the boxes before we tossed them into the fire - we found a forgotten single fireworks charge.

I have much to be thankful for. I've been here for almost 3 weeks now, and will be heading back to the island in time for classes to begin on Monday. I've gotten to do the one thing I'd fantasize about when I got frustrated with schoolwork - playing my little brothers in Halo. I got to read through The Name of the Wind by Patrick Rothfuss and begin Gene Wolfe's Shadow of the Torturer. (I had to put down Children's Hospital). I've been able to work out every day, and go to movies again (don't waste your time on The Day the Earth Stood still or the Spirit; do see Valkyrie, but don't expect much drama, and do see Body of Lies - and relish the drama). I was supposed to begin reviewing anti-anginal medication and diuretics, but I haven't yet - I may not get around to it, but I'm fine with that - because I'm on vacation right now. When the time comes (in less than a week, actually), I'll throw myself back into the nuances of physical examination, systems based pathology, pharmacology, and the lower circles of Hell (or microbiology, whichever you prefer) with a renewed fire. I can do all this; what's more, I can rock this. I'm not going to brag - all I will say is that I will continue to do my best.

Just a sprinkle of vindication makes my cupcake that much sweeter. Life is good.