Happy Birthday Leah!

Today, Leah - my best friend from elementary school and faithful blog reader - turned one year older. Recently, in an effort to recall significant details from my childhood for my Landmark Wisdom Course autobiography project, I rediscovered the pink diary into which I had written all of my deepest, darkest secrets from ages 7 to 14. Except that I had few, if any, deep dark secrets during most of that timeframe. So really, it was a place for my enthusiastic, mildly neurotic, seriously overambitious, fun-loving yet increasingly type-A self to recount important events, academic triumphs, heartbreaking disappointments, fears and worries, and - most importantly - everyday mundanity. The first entries (all copied without editing), with some notes from the 28-year-old me in brackets:

March 19, 1987
Tonight we had the Zimriah from 8:00 to 10:00. Then we went to a diner with grandma, grandpa, Nitza, Irwin, and the kids. Finally I went to bed at 12:00 and was very happy to be asleep.
March 29, 1987
Today I went to Simone’s birthday party at America On Wheels Roller Skating Rink. I fell down 8 times by accident and 3 times on purpose [I'm not sure if this represents the fun-loving me, the mildly neurotic me, or the emerging OCD in me...3 times on purpose??]. Right now I’m going to sleep. (Actully my mommy is going to sleep but that doesn’t matter.) Goodnight!
April 30, 1987
Today we had gym at school, and we learned more script. This is what I know so far. a d e g h I j k l t b c m n o p r s u y w [in my diary, these are all written in very nice script, if I do say so myself] Also, after school at about 6:00 me and mom found a nest and we also found the eggs.
May 1, 1987
We had our Snow Queen rehersle and I think everyone like my costume! Jacob came back today, and started going after my hair again. [he likely did this while shouting out one of the charming names he had coined for me: hair-head, butterball, or...the most creative - pint-sized possum] I had a skirt on and the boys almost looked under it. Abcdeghijklmnoprstuvwy. [cursive writing again] Rachel
December 5, 1987
Today is Natalie Ravitz’s birthday party. It’s a sleep-over. I hope I don’t sleep late.
December 25, 1987
Christmas is here once again! [says the Jewish kid going to Jewish day school...] Aunt Toby, Uncle Steve, Gregg, and Melissa came to Grandma and Grandpa’s house and I was there to greet them! We ate a delicous dinner and afterwards we got alot of presents. Monopoly, Wheel-of-Fortune, socks, a sweatshirt, paint for my shirt, and best of all, a trip to Florida! Goodnight!
December 26, 1987
I can’t wait to go to Florida. I have to pack, say goodbye, and go. Today I woke up, and went into Melissa’s bed (Melissa slept over last night) and rested. Then I got up and hung out with Melissa. I had a great day.
December 27, 1987
I woke up at 5:15 a.m. Gregg and Aunt Toby picked Melissa and I up from home at 6:00 a.m., and we started driving to Florida. We drove through: N.J., Delaware, Maryland, Wash. D.C., Virginia, North Carolina, South Carolina (South of the Border), Georgia, and finally Florida! We stopped for dinner in Georgia at 6:00 p.m,, stopped at South of the Border to get postcards and stickers, and stopped for gas 5 times. I ate and drank, played games and sightseed, and watched the sunrise. I had a great day. [aren't you glad you know how many times we stopped for gas? this is memorable stuff!]

And now, a few entries that mention the birthday girl herself:

Feb 13, 1989
I got into the school Spelling Bee! I’m so excited! Leah H. and Jacob L. will be in it. Amiable. Cadent.
August 28, 1991
I had a great time at camp. It was so fun. No trouble falling asleep. It came instantly. Made lots of new friends. Bunked with Leah H. Food was revolting. I had diarrhea 3 days and stomachaches the rest. [ever the emerging clinician, I documented all significant symptoms even then]
May 18, 1993
Today was so fun! We got up, talked to the boys (Melissa is in love w/ Jacob) and were going to Busch Gardens, but it rained. We toured Jamestown and Yorktown, and Melissa, Leah and I met a fisherman, but that wasn’t the good part. We went to the NASA Museum of Air + Space, and I had diarrhea, but at night was great. After dinner, the other class from Pittsburgh went to the mall, so we had the pool all to ourselves
May 20, 1993
We left Virginia today. [8th grade class trip] In the morning, after packing our bags, we left the hotel, a mess. The manager came after us, so we hightailed it for Busch Gardens. There, the 4 of us girls (Alisha, Leah, Melissa, me) went around together. The best ride, that I went on 4 times, was the Drachenfire, but the Loch Ness Monster and the Big Bad Wolf were okay. I bought mom a glass turtle, the only souvineer of my trip. On the way back everyone slept, and we got back after a huge, gross, burping symphony (by the boys, of course) at 10:16pm. Matt’s mother drove me home, and all in all, it was a pretty great trip.
September 9, 1993
Oh yeah! I had a great day at school yesterday. [first week of high school, freshman year - Leah and I graduated from 8th grade at SSA after 9 years of school together, and nearly everyone in our class had gone to different high schools] I got asked to sit at Jon Glick’s table (the smart, clean, mostly Jewish table). I decided that Algebra II is pretty easy, and S.S. is boring, and lots more busy work. We had a really funny substitute for Biology (Mr. Sattan wasn’t there), and Leah Ord is in Geometry and Bio and she’s fun. I know more people now. I talked to Jacob and Alisha last night, and they are having okay times. Neither have many friends yet. Last night I saw Leah and Danny at a U.S.Y. meeting. Leah is such a good friend!

[Indeed!!]

Goodbye Big Sky, Hello Big City

It's now been one week since I said goodbye to Big Sky (that's the aptly named Lone Peak in the rear view mirror - the one that astonishingly disappeared from view during the "smoky sky days" from nearby forest fires a few weeks ago), and I miss it mightily!

Everything came full circle in the end. My last patient at the clinic was the same wiry septuagenarian who had come in "to meet the new students" nearly three weeks earlier, at which time she'd generously given each of us a free copy of her widely read (well, in Big Sky at least) guide to local hiking trails. I thanked her for her excellent suggestions - my vigorous Beehive Basin Hike the previous weekend had been entirely due to her guide, which said it was the most popular hike among locals - and I obviously wanted to do whatever the locals digged. But the visit was not only nostalgic, but also a bit ironic, because her chief complaint was a sore knee that was precluding her from being able to hike any trails! And so, in keeping with my ever-lengthening list of new procedural skills, I deposited a nice fat syringe full of steroids into her knee; and in keeping with the standard amazingly gratifying nature of urgent care outpatient medicine, my patient was able to walk normally without pain within 5 minutes! I suppose the other ironic, and gratifying, piece to this story is that she was both my patient and my hiking guide - and as some of you may know, the word "doctor" comes from the Latin verb docere, "to teach", the same root as our word for museum guides, "docents". I have always imagined my role as a physician being more of a teacher, or guide, coaching my patients towards better health. And, as a medical student, I have undoubtedly learned far more from my patients than they have learned from me - in essence, they have been *my* 'doctors', or teachers.


Speaking of teachers and doctors - one of the passions that I rekindled out in Big Sky was making wire sculptures. Here are the ones I gave to Brad - who wears a million hats at the clinic, took me on some badass mountain bike rides, and seems to know and do almost as much as the physicians short of writing prescriptions, and Doc Daniels - it's supposed to be a likeness of him, wearing his stethoscope and drinking a shot of his velvety warm single-malt Scotch out of the bottle.

So, here I am back in New Haven. Not for long though. A week from today I'll be down in the Big City, preparing for my next medical adventure, a sub-internship in family medicine at a big hospital in the Bronx. I anticipate it being like the exact photographic negative of Big Sky - humid, crowded, tons of people, all my patients will be very sick and have hypertension and diabetes, I'll have little time or opportunity for mountain hikes or bikes, and - the differences aren't all negative - I'll be staying with my best friends and have wifi and cellphone access all the time!

But. I will never forget Big Sky. My heart sang every morning when I left my cozy cabin and headed to work on a road flanked on all side by soaring mountains and incredible beauty. Working at the clinic confirmed for me beyond a doubt that I wasn't crazy when I started having this dream as a 7-year-old that "I wanted to be a doctor" - in fact, even though I don't get my official degree for another 9 months, my three weeks at the clinic felt like the fulfillment of that childhood dream. My work there, suturing and counseling and fixing - really helping and curing people (imagine that!), instead of the dreadfully unsatisfying tinkering of meds and lab values that seem to be the m.o. of most medical care, was *exactly* what I'd imagined myself doing when I first ditched all prospects of going into ballet or ice cream trucking, and latched onto medicine. I can only feel lucky to have discovered something that I'm good at and *love* doing - and will...eventually...get paid for doing.

One last comment/insight about my time in Big Sky: it reminded me of the power of context. (I highly recommend reading The Tipping Point for more on that concept.) Out there, I was continually surprised by how genuinely nice everyone was, and how happy and content everyone seemed, and most of all, how chill and non-impatient all the patients were: for once, they lived up to their moniker! Not only that...I would consider myself to be a staunch Democrat, and a pretty leftward liberal at that. I might even confess that I think Republicans are...a little bit...well...stupid. I know, it's horrible. But. Out there in Montana, and driving through Idaho, far from Boston and New Haven and the other staunchly liberal Democrat cities that have comprised the majority of the places I have ever called home, I actually began to see the other side. There are so few people bothering you out there - it seems a natural extension to not want the government to bother you either. Hiking and biking by myself in grizzly and moose country, I'll be the first to say that the thought crossed my mind several times that I'd feel a *lot* safer if I had a gun on me. A gun! Me, thinking that it would be nice if I had a gun! I know, it's ridiculous. But out there, it wasn't. And so I have concluded, and I urge you to consider this in your life, with the people you seem to disagree with: until you powerfully and deeply understand a person's context, you will *never* powerfully or deeply understand their content.