Mexican Food and a Saturday Night

So, there we were, the three of us, driving through downtown Champaign on a rainy Saturday night, looking for Mexican food. I was at the wheel, my room and classmate from school in the back, and a smart, sweet, down-to-earth young woman from Northeast Ohio was riding shotgun and deftly handling navigation. The Red Hot Chili Peppers were red hot on the radio but the outside temps rendered navy sweatshirts the evening's dress blues.

Now, I admit I wasn't sure what to expect. Mexican food can be good, great, or merely an approximation of edible, depending on what part of the country you're in. Back east, I'm afraid to say, it's called Mexican but that's about as close as it gets to the real thing. Illinois is closer to the Source, but one never knows. Anyhow, new in town and weary of our own cooking, any risk seemed tolerable as we pulled into the parking lot of what was probably once the home of fast burgers and fries. We were ushered without delay to a booth where our waiter, a gentleman of Hispanic descent, quickly placed a basket of fresh, hot chips and two bowls of homemade salsa on the table. One bite told me we'd made no mistake.

Crowded with students and parent-types, Dos Reales is clearly a local favorite and for good reason. I don't recall hearing Mariachi music in the background, but the walls are painted in desert tan overlaid with murals reminiscent of life in the Southwest, making me feel right at home. I ordered my usual chicken enchiladas while my partners, a poblano pepper dish and vegetarian something or other. I didn't quite catch the latter's name because the gal with us ordered in Spanish, a little tidbit I realized would be helpful when I asked the waiter for more time to reflect on the menus and he looked at me with a face like a question mark.

In between quizzing each other on board review questions -- this was meant to be a "working" dinner -- we made fast work of the salsa and then forgot all about the Comlex and USMLE when our meals arrived. The last time I recall having freshly made refried beans was in Southeast Colorado when I served as a substitute pastor for a small Hispanic church in La Junta. But that's what I discovered on my plate last night. I wouldn't be surprised if the tortillas were made on the premises. It was simply sumptuous. At one point, my female friend commented she wished she'd ordered more -- until she finished her meal, that is, and then said, "I couldn't eat another bite." We knew exactly what she meant.

Ordinarily, I'm all for a bedtime snack, despite the fact that my instructor has admonished us that any food consumed after 8.00 PM gets metabolized straight to cholesterol -- an fyi to anyone who wants to lose weight and, like me, can't always resist a late evening close encounter with the refrigerator. Last night, the thought never even occurred to me. If I was rich and self-indulgent (which I'm not -- rich, I mean) it would be tempting to fly out here just to have dinner now and then.

If you're ever on a trip and you can reroute near Champaign, I'd encourage you to do so. Dos Reales is located on North Prospect Ave. and my guess is, all you have to do is follow the crowd and bring an appetite. The staff is attentive, unobtrusive, and the food, like my program, is one of the mid-West's best kept secrets.


(Creative Commons image of The Red Hot Chili Peppers via Wikipedia)

A Fellowship of Failure

It's fair-skies and 48 this morning and the view from my patio penthouse includes the sun trying to reach me through the cottonwoods. Maybe by mid-October they'll feel more generous, but right now they're holding onto their leaves as though the last days of summer depended entirely on them. If they know Wednesday evening saw the Autumnal Equinox, they're not telling.

I was thinking, the other day, about the one thing nearly all of us have in common (aside from being medical students) -- failure. Some, to be sure, come simply as a supplement to their education -- not a bad idea at all, frankly. They’ve yet take their stand in the middle of some dusty street at high noon while spectators scurry for safety and then anxiously peer from windows or peek around corners, waiting for the bad guy (board exams) to go for his gun. But, they're in the minority; most of us have had that experience already, at least once, and the outcome hasn't been pretty.

I suppose this is why we’re inclined to be accepting of one another, why no one sighs impatiently when another student doesn’t correctly answer a professor's question, why hands don't shoot up like a flock of geese startled by sudden movement, eager to show they know what you don’t. Perhaps this is why asking the instructor to repeat a point isn't accompanied by snickers and rolling eyes and why busy hands copy down what their owners also missed the first time around.

I've often wondered, quite truly, what it would be like if a class was almost entirely composed of people like me. Not like me in the sense that everyone has creaky knees (I've known athletes with them in their 20s, by the way, so there) or can't wait for the 9:30 coffee break. Nor people like me who pound the treadmill in the late afternoon hoping to generate sufficient energy to keep the Rack Monster aka Mr. Sandman at bay long enough to spend the evening studying. 

 

I mean people who've had to wrestle with medical school – people like Jacob, who dared wrestle with an angel, holding onto him with all his might and through gritted teeth declaring, "I will absolutely not let you go until you bless me." People who, like Jacob, got the blessing all right, but had to pay for it when the angel dislocated his hip, so that he walked with a limp the rest of his life.

People like that.

Well, now I know. To tell you the truth, it's been refreshing. For one thing, it's delightful seeing the faces of my MD colleagues light up when I've done a little osteopathic manipulation on their cramping wrists after a day of writing like their lives depended on it. They've heard about our little secret, they know us DO types can do things with our hands they never learn, but seeing it up close and personally, they act like any one of us would when a magician pulls a rabbit from a hat and this time you know the magic is real.

More than that, it's good being among persons who’ve seen failure face to face and are determined to not let it define them. Part of this stems from the atmosphere created by our professor who knows from his own experience what it's like to have a dream behave like your nemesis. Medical school was hard for him, too. So was life, growing up on the South Side of Chicago. In his family, new clothes meant a trip to the Goodwill, not Macy's. He told us his story yesterday, holding back none of the unpleasantness, describing how he discovered the Faith that changed his life.

He reminds me of something I wrote in my very first blog post, i.e. he's one beggar sharing with others where he's found bread and then showing them how they can find it for themselves. In so doing, he inspires confidence when things seemed very much in doubt. As you walk in the main entrance, six metal letters are arranged on the counter in front of you, spelling out the word "Believe." Every day, someone on the staff drives home the message that our achievements depend as much on faith in ourselves and each other, as they do hard work. In this fellowship of failure, I suppose you could call it, we're becoming not only better future doctors, but better people. Little did we know.

(Photo copyright 2010 by the author)

Hard Places

Good Morning, Happy Sunday, Greetings from the Trenches.

The sky from my patio perch is cloudy gray mixed with distance blue; I'm not complaining, though, because it's pleasantly cool. By Tuesday, it will be in the 90s again, as autumn continues to play a waiting game here.

I had an interesting conversation over breakfast this morning with one of my roommates, who happens to be a veteran as well as medical student. Despite my having not served, it wasn't hard to establish a meaningful connection. For one thing, I know the life and for another, at least right now, we're in the same foxhole. And even after we've advanced past the current obstacle, we'll always be comrades in arms.

This is something I can't ever quite get over. It surfaced the other night as well, while chatting with a young woman who is a student in a neighboring state. One minute we were strangers and two days later, we're pals. I'm talking, of course, about the instant intimacy that so easily develops between medical students and physicians. To a certain extent, it's as though our radar is attuned to picking up on another of our own kind.

Part of this may be simply due to the fact that we're all immersed in a community of intuitive types, but I've run into it in other contexts as well. Medical ones, that is. Where it hasn't always been so readily apparent, oddly enough, has been among ministerial colleagues. I've often wondered about that and I really haven't come up with a satisfying explanation. I've noticed that whenever I've met up with a minister who's been battered by a pastoral experience or had some sort of personal crisis like a divorce, the camaraderie is there, right off.

Just thinking out loud for a minute, I wonder if hardship is what makes the difference. Seminary is tough, make no mistake, but it's not tough in the sense that it confronts inadequate defenses, teaching you to build up new ones in their place. The ministerial focus is on formation, challenging one's thinking processes and predispositions, but it seems less painful in retrospect. As a result, it's not until life gets to that point, i.e. painful, that collegiality becomes so important.

As you've probably guessed, I'm not one of those who thinks pain is, by definition, a bad thing. Where it takes us can be destructive or constructive, depending on our disposition and willingness to change in response to its presence. The more willing we are to adapt, the more benefit we obtain. It's only when we become stubborn, resistant, and determined to head-butt our way through circumstances that are less amenable to power-oriented approaches that we come away with a headache.

Furthermore, it seems we most often find kindred spirits when we're in situations that tax our abilities to cope. Speaking for myself, those relationships are the ones I value most, those formed in hard places with persons I've never met, who nevertheless know what it's like to be me. And among whom I know what it's like, being them.


(Creative Commons image by Te55 via Flickr)

REO Speedwagon Way

I'm guessing the 80s rock group, REO Speedwagon, must have gotten their start here in central Illinois because there's a street named after them in downtown Champaign. I ran into it by accident on my way "home" from running a few errands, one of which took me to the northern edge of the University of Illinois. I was driving through the Greek community (sorority/fraternity row), when a turn onto my street led me across REO Speedwagon Way aka Main Street.

I'm mentioning this because it just seems so unlike what I expected. This is corn country where multiple FM stations broadcast church services on Sunday and you can walk around the local mall without feeling like you've tried out for an Iron Man competition. Saturday is clearly market day and the traffic reminds me why I've come to appreciate life in Maine so much. Not because people drive crazily -- far from it -- but simply because there are so many going the same direction as me. It was as though they all decided, "There's Beggar, let's follow him," while I felt like saying, "No, no, I'm new here, follow someone else!"

The past couple of days we've been reviewing the key elements of biochemistry, learning how to abstract a whole series of medical tidbits from a single concept. For example, let's take proteinuria, which means protein has been found in the urine. Now, urine is not where you'd ordinarily expect to find protein, any more than downtown Champaign is a place I'd have expected to find REO Speedwagon Way.

If a patient is losing protein, they would likely present with weakness, shortness of breath, elevated heart rate, and have problems tolerating exercise. So, then you start asking yourself where the protein might be coming from. It could be muscle tissue, maybe the kidneys, and that leads you down the path toward diagnostic possibilities. It's the kind of process a person would use in a clinical setting. Applying similar principles to taking an examination reduces the amount of brain cells you have to devote to rote memorization. And since I seem to have a relatively limited number anyway, memorizing tends to use them up fast.

Once again, I find myself surprised over what I'm discovering here. It's kind of like, who knew there was so much tucked away in middle America and all a person had to do was look.


(Creative Commons image of an REO Speedwagon by jcbwalsh via Flickr)

The View from the Treetops

The best laid schemes of mice and men gang aft agley ~ Robert Burns

Boy, did he ever get that right. I was planning on stealing a few minutes every day for writing, even if it was only a paragraph or two. Turns out, this program is just like medical school. Now, what madness possessed me to think it would be otherwise? I know, it's a review course. Uh-huh -- that and a buck something will buy you a cup of coffee at MacDonald's.

Let me tell you, as I said to one of my roommates, a fourth year student from Chicago preparing for step two of the USMLE, "I feel like I've been rode hard and put up wet." He knew exactly what I meant. And that's one of the things I've always loved about being part of the community of doctors and medical students. You can't be so tired, so overwhelmed, or so overworked that someone can't empathize and generally does. It's wonderful.

Anyway, this program is very much like medical school. You see, I've had the sneaking suspicion the material we cover in our first two years, that accumulates as rapidly as blizzard-quality snow piling high against the side of my barn, needs to be boiled down to the essentials for board preparation. It simply has to be. Some things are important and others are so insignificant even the writers of board questions don't care whether we know them or not.

The process of boiling down is what our professors here have undertaken on our behalf (thank God), teaching us how to look at our education and see what is critical, namely, the big picture. Now, the truth is, I really should have written, the BIG picture, because it's more accurate that way. There is an amazing amount of material to handle in the course of eight hours of lecture and Socratic dialogue each day.

I'm having a great time, rest assured, but it's still a lot of work and some days, like yesterday, I'll drag myself up the stairs to my third-floor apartment wishing the management office had seen fit to put me on the ground floor, instead. I like my treetop patio, and this morning, at 49 degrees, the solitude (excluding the traffic on the main road) is refreshingly delightful. But the intensity of learning and then knowing I've got 40 pages of notes to go over, reminds me that even when breaking things down to their essentials, the view from the treetops can be formidable in its own right.

(Photo by the author, copyright 2010)

Hogwarts West

That's how I'm coming to think of this place, though the reason has nothing to do with the overt expression of magic. It's more about finding oneself, like Harry Potter, in an environment where others have similar abilities as yours and have also had difficulties using them to their best advantage.

In other words, stuck out here near the mid-point of the mid-west, is a haven for conceptual thinkers and intuitive types, your typical odd-persons out. These are the people who, upon entering a home, notice a potted plant and begin talking about Africa, while everyone else is discussing home decor. The reason is, the plant reminds them of an article they've read in National Geographic about native flowers in Gambia. In other words, they deal in connections in much the same way as analytical types deal in facts and figures.

In the real world of clinical medicine, the ability to establish relationships between seemingly random pieces of information is important. As a result, my classmates will find they possess a definite advantage when it comes to determining what we call a differential diagnosis, i.e. one that rules out various possible explanations for a disease in the effort to establish the one that is most likely to be correct.

In medical school, however, especially during the years devoted to the basic sciences, conceptual types appear to be at a disadvantage. For one thing, they generally need more time to think through the implications of the material before them and under the pressure to digest massive amounts of it, resort to memorization. You'd think this would be a viable solution; it's not, however, because information thus acquired lacks the organizing principles these types rely on to make sense of things.

Enter a program such as this one, which not only celebrates conceptual-intuitive thinking, but teaches us how to use it effectively in the service of mastering physiology, the most basic of medical sciences. Not only that, it supports our need for interrelatedness by pulling pharmacology, anatomy, and all of the other subjects we rely upon as future doctors, into the overall approach. So, rather than thoroughly tackling one subject at a time, which appeals to linear thinking analytical types, we do better by taking on several at once, in order to help determine patterns that aid retention and deepen understanding.

In psychoanalysis, we call those instances when a patient arrives at a new insight about themselves, the "aha" moment. Many of these occur in the course of a typical day here. Concepts we've learned, relearned, examined, and dissected, are revealed as processes we can think through, demystifying them and helping us realize we really knew far more than we imagined. It's still a lot of work but it's not drudgery. Instead, there is an excitement involved in discovering our strengths are not the liabilities we feared. They are assets that just need affirmation and further development.

Welcome to Hogwarts West.


(Image of unknown licensure via Wikipedia)

From Maine through the Berkshires

I had just crossed the state line between Maine and New Hampshire when Mick broke into Gimme Shelter. By the time I was nearly across Massachusetts, it was the Boss with Born in the USA on Boston's 104.5 FM. That's one of the funny things about New England, or so it seems to me, being from the mountain West. You can pick up a strong radio signal and follow it across the state. Of course, it helps if driving 50 miles places you halfway there.

Take today, for instance. I started out in Southern Maine and less than six hours later, had driven through portions of three more states (NH, MASS, NY), and completely across one of them (MASS). The same amount of time might have gotten me from the Colorado-Wyoming line to New Mexico or, had I been driving west from Dallas, somewhere still in Texas.

But it was a beautiful drive, especially once I got into the Berkshires, in the northeastern Appalachians. The colors are just starting to turn and the air is cool. By the time I come back through, on my way home, autumn may very well be past-peak, it's difficult to say. Then again, I may be posting photos that will knock your socks off.

So, tonight, I'm in Albany and tomorrow, heading west once again, this time along the Erie Canal. Remember the lyrics from elementary school? "Low bridge, everybody, down; Low bridge cuz we're goin' through a town. And you always know your neighbor, you always know your pal, if you've ever navigated on the Erie Canal." My sixth grade music instructor would never believe it.


(Photo of sunset in the Berkshires copyright 2010 by the author)