Dream Deferred

I'd never really understood Langston Hughe's poem "Harlem" or "A Dream Deferred." Then, I heard it read by Morgan Freeman for one of the Olympics commercials...and it made sense. Call me a literary idiot, but I just didn't GET IT until then- I think I thought that he was talking about a dream that you have while asleep.


What happens to a dream deferred?
Does it dry up
like a raisin in the sun?
Or fester like a sore--
And then run?
Does it stink like rotten meat?
Or crust and sugar over--
like a syrupy sweet?

Maybe it just sags
like a heavy load.

Or does it explode?


We read it in high school, and I would challenge that high schoolers really have no business reading it, or at least reading it for being understood. Read it for historical perspective, possibly. But, I think it takes an adult to understand "dream deferred." I think you have to have had a "dream deferred" to understand it.

I also looked up the Merriam-Webster definition of "deferred"-- "to put off, delay OR withheld for or until a stated time."

That's the power of this poem, and of dreams--Langston Hughes didn't say a dream demolished, or dead....it's been deferred (but still has the possibility of exploding).

I think mine right now is somewhere between festering like a sore or rotting like meat... or sagging like a heavy load-- it basically depends on the hour of the day and who I see in passing or who I'm with.

A Thread That Joins Us

Today, I cried at school. It's happened before, and I'm sure it will happen again. But this wasn't related to my grades, my classmates, a patient, or even a human. I read this story about a gorilla whose 3 month old baby died. She's been carrying him around with him ever since. I hate to
include such a gruesome picture from the story, but I'm going to.

Her baby is on her back (where it seems she often carries him) and another gorilla's baby is in her hands.

I'm almost at a loss of words describe how much this affected me, and how deeply it resonated. I know some would say that animals don't have feelings, or a soul, or the capabilities of emotion that would come near what we have as humans, but I think that the power of motherhood and the sense of loss here clearly challenges those boundaries.

I feel as though she is looking at the camera, saying "Here is what I had, here is what I lost...and here is what I wish I still could still have."

I don't know about the long-term memory of gorillas, but I'm sure that she'll continue to carry that baby on her back long after his little body has been removed.

Square Pegs in Round Holes

I promised to do a blog on a summary of third year... now it's fourth year and I've not gotten to it, and this blog isn't the review of third year either, sorry.

Right now I'm doing research, which I started during our (3 week) summer break. It involves surveying patients, assessing their health literacy, asking them some true/false questions and then randomizing them to a verbal or video & verbal module designed to teach them about severe dementia and the end-of-life choices somebody could make before coming to that state of being. The choices are Life Prolonging Care, Basic Medical Care, and Comfort Care. The website for the video can be viewed here: http://gallery.mac.com/avolandes#100033

During this research, I've often been frustrated at patients not answering my questions to fit in my neat check-boxes. I've often screamed inside, "IT'S TRUE OR FALSE, STOP HEDGING/QUABBLING OVER ONE WORD!" But then I have to remind myself, they want to do well, and have varying experiences with dementia and end-of-life decision making. Still, fitting square pegs into round holes has been hard.

I've also been confronted with my too-much type A syndrome. There are times that patients tell me things and I'm just wanting to focus on the matter at hand--doing the survey, watching the video, getting through the protocol. I feel like time is being wasted by small talk, or interjections of "one time so and so down the road had this happen..."

But, they keep my type A in check because there are times when I've been blown away by some of the stories that complete strangers have told me. One doctor from olden days disclosed some of his former ethical battles involving too few iron lungs and too many critical polio patients (I would love to go into more detail, but think it's best that I not do that in this forum). Another lady related how she was responsible for one of the first Alzheimer's nursing units in the state. Another talked about her nursing career working with mentally handicapped children.

A man told me how much pain he was in after the loss of his wife only a few weeks earlier. He said, "and I'm about to explode right now" regarding thinking about the loss of his companion after 60 years, and how, although he knew it was coming, he didn't expect it when it did occur and how much her absence had overtaken his life.

Another man, who was still relatively young (and appeared younger than stated age), told me that he had metastatic cancer, but felt fine, and so didn't know how to answer the question "In general you would say your health is ... " They always tell us that the definition of health isn't just "being free of disease" but I didn't believe them until then.

A woman related some of her distrust in the medical field due to her mother (who was DNR) being brought to the hospital after a carotid blow-out. She felt that the surgeons tried to save her just to get practice in doing the procedure, and when she relayed her frustration to the doctor, he said "Well, why come to the hospital then? You only come here if you want saved."

One lady told me that she'd never told anyone this certain fact--that she had doubts about her one of her family member's choice of a husband.

I'm almost in disbelief of how much information people are willing to share with somebody who is in the medical field, or who the person sees as fulfilling a "doctor" role. I'm just a medical student doing research--I have nothing to do with their medical care or visit during that hour, but many want to share with me. I find it hard to imagine how much I'll learn while being a "real doctor." I hope my "type A" doesn't taint my encounters and that my patients see in me a willingness to listen and hear, and thus want to share those things on their minds that day. I'm sure my healing will be much more potent and successful if I can do that.

Lesson Learned--The power given to us as doctors is immense, and part of the power lies in being a ear for our patients to be heard.

What it's Worth--It's worth being satisfied with my job, loving my patients, and having my patients be satisfied with me.

Politically Correct ... Genital Warts?

Ok, a medical rant!!! I'm tired of the Gardasil (copyrighted) commercials which continue to shroud the prevalence and problems associated with all things sexual.


STOP SAYING "AND OTHER HPV DISEASES" and be out with it-- GENITAL WARTS, GENITAL WARTS, GENITAL WARTS!!!!!


Here's the website in case you're wondering: http://www.gardasil.com/


I guess the new euphemism for "genital warts" is "other HPV diseases." As if saying "genital warts" causes them to come into existence. Do people ACTUALLY think that the average patient, let alone the AVERAGE girl/young woman between the ages of 9-26 knows what they mean by "other HPV diseases"?


Honestly, I've seen genital warts. They're not pretty. At all...not to mention uncomfortable. (No, I don't know this because of my own personal experience.) You have to freeze them off, or burn them off with a laser, or use cream...and even then, they can come back.


It all comes back to the worry that vaccinating girls against this highly prevalent virus (between 1/2 to 3/4 of people have it) will remove all of the consequences from having sex ...either at a young age, unprotected, unmarried, with multiple partners (take your pick) and will all of a sudden cause them all to run out and have sex, since they no longer have to worry about *gasp* other HPV diseases. Come on. Honestly, I'm sure that it's the rare girl who said "No" to sex only because she was afraid of getting cervical cancer or genital warts.


That said, I'm completely for the vaccine, don't get me wrong. And I'm also all for waiting until you are in a stable, committed, adult (preferably married) relationship before having sex. But all of the rhetoric surrounding it, as stated above, is just silly. Young people need to know all of the consequences and responsibilities of sex--physical, emotional, social, financial. In the US, 1/2 of all pregnancies are unintended. Obviously, hiding behind euphemisms and sweeping things under the rug isn't quite cutting it.


Lesson Learned: Euphemisms, especially medical ones probably don't help anyone. Be clear and honest, especially about some of the most intimate things humans deal with.

What it's worth: It's worth saving some confusion and lots of uncomfortable explanation later.

Oh, and I apologize for not giving you references for the above stats...but I'm being lazy this evening, and they're true, I promise.

A Picture

Here's a picture I meant to post with the Red River Gorge post from last week. I've got more blogs to write, but I keep wasting time in the evenings on Facebook and oh, just wasting time in general.

Red River Gorge(ous) and a Wonderful Weekend

I have so many blogs in my head to post, I figured that I shouldn't let this one go too far past this weekend.





Friday, my husband and I left town to visit one of the best natural beauties in Kentucky--Red River Gorge/Natural Bridge. My best friend and her husband got a cabin for the weekend, and invited us along. The drive there was beautiful, and when we got there, the cabin was quaint, cute, and without air conditioning (not so pleasant, but bearable).





We had a dinner of steak and baked potatoes with salad and then dessert by the fire. MMMMM 'smores. I'd been craving those for quite some time. I can't remember the last time I sat by a fire, not worrying about the next test, the next day, the next hoop to jump through. Other than mosquitoes feasting on me, I can't complain at all.





The next morning, we had yummy bacon, biscuits, apples, and eggs. We went hiking for around 3 hours. I love hiking, and it had been forever. I like getting to find tiny things along the trail, like a snail with it's "antennae" outstretched, gliding along a leaf; a vibrantly colored piece of fungus growing on a log; an oddly shaped tree mimicking a pregnant belly, or making a perfect seat out of its branches. I love to see the motion of tiny things alive, juxtaposed against an overall silence and stillness.





We got tired and hungry after our hike, came back to the cabin and were quickly rained in by a down-pour. We took full advantage, and had a refreshing nap. Afterwards, we canoed a few miles UPSTREAM, and I jumped off of this rock:

Seriously, it's a LOT taller than it appears, especially from the top.

We canoed back to the cabin, had dinner of chicken and veggie kabobs, and sat by the fire again, roasting marshmallows.

Sunday, we came back to town for church, and had a wonderful service about the qualities of a Good Shepherd. I'm so happy to know that I have a savior who I can trust, follow, and lean on. Sunday night was VBS. Seeing the kids participate and learn is great, and I had fun along the way too.

Heaven on a Table and a Burrito?

Ahhhhhh. Freedom. TODAY WAS THE LAST DAY OF THIRD YEAR! WHORAY! I'm going to blog a reflection on third year soon, but I had to say what I did to celebrate first.


Last fall, my wonderful husband got me a gift certificate to use at a local salon and spa. So, today, I got my first ever massage and herbal body wrap, as well as my second ever facial. Heavenly.


I'm not sure which part I liked best. The facial was delectible. The herbal wrap, a little weird, but, I got to take a nap during it. The massage needed to last longer....ahhhh.


So, the burrito part. For the herbal wrap, they took these sheets which were steeped in some tea-looking liquid and put one under me, one over me, and then proceeded to wrap me up in this garb, which, seriously, had to have made me look like a burrito (aluminum foil included). There was a layer of plastic, then multiple layers of those hypothermia/fire protective tent thing type material, then more plastic, then blankets, and then more blankets. It would have been great to have gotten a picture of me in there!


This might have to do instead:

http://newmedia.funnyjunk.com/pictures/kitten-burrito-in-a-spinach-tortilla.jpg

After that was the massage, mostly of my upper back, shoulders, and arms, with a bit of neck thrown in.

Nice, very nice. I recommend it to everyone, especially after finishing third year.