Little boxes in my basement...little boxes full of ticky-tacky...

When I moved out to Vermont from California in 2009, I wasn't super-organized (or prepared).  I just sort of threw everything haphazardly into plastic storage bins.  I was really excited to be leaving California, but the end of medical school had really wiped me out and I just didn't have the energy left in me to be organized about the moving process....and what it boils down to is that I wound up moving a lot of c-r-a-p.  Crap that has been sitting in my basement virtually untouched for 3 years.

Currently, the future is starting to share frightening similarities with 2009.  This coming June, after a beautiful 4 years in a beautiful state, I will once again be packing up my belongings and heading off to the (great?) state of Michigan for fellowship.  And if moving across the country several times has taught me anything, it has taught me that I am far happier when I am not toting crap with me.  So, since I am a super-senior resident who no longer works or takes call on the weekends, I decided it was high time to examine the state of my basement.

But first, I strapped on these...

for a short and sweet little jog.

Then, I looked around the stacks of boxes in the basement (no pictures of that attached, because it's pretty embarrassing) that had never been opened in the 3 years I've been here in VT and decided that it was high time to start the cleansing process.

Lemme tell ya what - I am amazed at all the junk that got hauled across the country.  Some of this stuff is legit (blankets, extra pillows) but a lot of it is not (like the non-functional cordless telephone that wouldn't work anyway because I don't have a landline).  Some of it was sentimental stuff that I knew I'd kept around but just couldn't find (pictures from college) and some of it was sentimental once-upon-a-time stuff that I had no idea that I'd kept or even why I'd kept it (like a packet of letters from an old boyfriend during his tenure in bootcamp in 2003 found stuffed into a nondescript manila file folder).  There were monthly statements from the Southern California Edison electric company from 2008 and bank statements from the La Loma Credit Union from 2006 that I'd never gotten around to shredding.  There were receipts and pool cleaning advertisements...and...like I said - there was a lot of crap.  In that moment, every episode of "Hoarders" that I've ever watched flashed before my eyes and I decided it was time to take charge and tackle a few of the bins.  Turns out, the ones that I peeked into all dealt with medical school (not a shocker since my 20's have essentially been eaten up by the medical profession).  

Like this stack of books.  Once upon a time, I knew them all by heart.  Now, I haven't used most of them in at least 6 years and I'll be damned if I'm taking them with me yet again.  

...and this stack of papers, all of which represent some of the notes from the 1st and 2nd year of medical school.  Surprisingly, this isn't even the entire set of notes - I'm sure the rest will crop up later in a box where they clearly do not belong thanks to my mad organizational skills.

I found good things...like my pricey, not-used-in-more-than-3-years medical instruments (minus my stethoscope, which I am sure is lost for permanent)

I found useless things...like a whole box full of the purple envelopes of nauseousness (grades that were passed out into student mailboxes after every exam).  I kept them in case a score ever was in doubt or didn't get recorded, but since I graduated 3 years ago I'm pretty sure they can go.

I found bad things...like an empty bottle of antibiotic which I required when some snotty little child passed on a nasty bacterial pink-eye to me during pediatrics (which is also when I picked up honest to goodness pneumonia as well, but that's another story for another day).

And then I found just plain ugly and disgusting things...like the zippered plastic kit containing the instruments which I used to dissect cadavers during Gross Anatomy in the fall of 2005.  (Please note: since I am a pathologist, it is almost impossible for me not to try and put items against a solid color background before a photo).

I found uplifting mementos...like this grading sheet from a standardized patient exam which pretty much proves that even pathologists can interact meaningfully with patients.

And then, I pitched most of these items into garbage bins (I'm still not entirely sure what to do about my dissecting kit although I am certain it does not need to accompany me on my Michigan adventures - and the voracious reader in me cries in horror at the thought of throwing away any kind of book...) I got tired of cleaning.

So if you know of anyone who might need a used dissection kit or medical books that are several editions out and fairly worn - let me know.

Goodbye July

August is finally here. I have mixed feelings about August - one the one hand, it signals that my summer is more than half over. All too soon the leaves will change, chilled winds will blow, and snowflakes will twirl and tumble. As this is my last summer in Vermont for the foreseeable future, there is a part of me that wants to gather up the summer months and hold them tightly in my fist so that they will never leave.

 One the other hand, it means that July is finally over and I've been waiting for that moment for about 31 days. I suspect that for the rest of my life July will be a difficult month because it brings back a multitude of painful memories that I'd rather pretend never happened in the first place. It's the month of my brother's birth and it's the month of his death and it's the month where all of the joy in the world can't quite overcome the sorrows and stresses of the last year.

 I spent the entire month rotating through the Office of the Chief Medical Examiner. I could say many things about what that means, but the upshot is really that I spent (almost) the entirety of the month with the dead, helping out with the daily autopsy schedule. In a way, going to work every day was almost more than I could mentally handle. It's hard to face death on a daily basis when there are still so many unresolved issues and agonies in my personal life. It was a struggle to stand toe-to-toe with the dead, to look at them and read about their final moments and wonder about their lives and piece together their stories and not run kicking, screaming, and crying from the autopsy suite. And with each Y-incision that I made, it never stopped feeling like I was cutting open my little brother and laying bare his agonies to the world.

I wish I could say that I faced down each day with a professionalism, dignity and grace that would make my medical school mentors proud but I'd be lying. There were some days where all of the mental pep-talks in the world couldn't get me down into that morgue in a good mood and some cases, like suicides, in which I simply could not be anything more than haunted and angry. Each day was repeatedly traumatic and each night a struggle to stop my mind from spinning long enough to catch even four hours of sleep. When I did manage to fall asleep, my dreams were haunted by moments in which I eviscerated random deceased persons on the side of a highway - and, if you can believe it, that was the happiest of my dreams.  There were many nights where sleep brought me only pictures of my brother and one particularly nasty dream in which I was responsible for eviscerating Chandler. Yes...it was a long and relatively sleepless month.

But as traumatic as July was, it also made me realize just how fortunate I am to be in an institution where I have fabulous co-workers, because otherwise I could not have managed this month and come out with even a semblance of sanity. I am grateful for those that let me shut the door to the back office and simply let me be. I am grateful for those that sat and listened to me in moments where the world became far too heavy for my shoulders. And I am doubly grateful for our awesome autopsy techs who wordlessly and seamlessly stepped in and helped me with cases when I simply could not do the job on my own, no explanations necessary and no questions asked.

 So goodbye, July. While I'll miss the living people of the morgue, I can't say that I will miss the dead.

 And welcome, August.

To my brother one year later

You died one year ago today.

 365 days.

It doesn’t seem like it has been that long because the pain is still as fresh and deep as it ever was. And although I feel compelled to write something to you today, I just do not have the words for all the emotions that are swirling in my heart. I feel compelled to tell you that living a life without you has not been easy; in fact, of all the years in my life, this has been by FAR the worst and it's mostly, but not entirely, your fault.  I feel like I should tell you that remembering you – your life and your death – still hurts every bit as much today as it did last year; I suspect that this is the kind of pain that hones its edge on passing time, becoming sharper as the years march forth.

There are so very many things I want to say to you today but… I just don’t have the words. The English language has no words that can adequately describe the deep kind of grief that I feel; I can’t blame Webster because I’m fairly certain that God never meant for the human experience to contain moments like these. I feel obligated to tell you that as sad as I am, that I am still so very, very angry with you. I am so angry that you could throw the love of your family away like it was no more precious than a used Kleenex. It makes me sick that you could ever have thought, even for one moment, that your life didn’t matter. It infuriates me that you thought taking your own life was a solution to everything screwed up in your life. But most of all, I will never, ever forgive you for involving me in your last day and I cannot ever forgive you for breaking your promise to me. That broken telephone call on July 8th, 2011…the one where you PROMISED ME that you would answer when I called you back and then promptly broke that promise…is the most cruel thing you ever did to me, and that’s really saying something because you could be a real shit when you put your mind to it.  You reached out to me that day, but only a small fraction of the way and if I had known what you were about to do/had already done, I would have done things so damned differently. And maybe the ending would still have been tragic, but maybe my last words to you would have been different and maybe your last words to me would not have been a heartbroken cry that still lingers in my head at night.  I wish to heaven that I could forget that sob, but I have a feeling that when I'm ninety and riddled with Alzheimer's, forgetful of all else in my life, I will still remember that phone call.  I cannot forgive you for the feeling of utter terror that surged through me when I called you repeatedly that day and you did not answer your telephone and I cannot forgive you for the stabbing in my chest when I heard what you had done and knew with absolute clarity that it was already too late for you. Perhaps if you had given me a bigger glimpse into your world I would not have failed you so epically – and perhaps I would not feel so responsible and so miserable and so damn broken. You were my baby brother and I failed you completely and for that I cannot forgive myself. You were my childhood partner in crime – we grew up together and we were supposed to grow old alongside one another – and now you are gone and one day I will be completely alone, the last branch on our family tree. It was not supposed to be like this and for that, I cannot forgive you.  At least, not today.

I feel obliged to tell you that I still do not understand why you chose to give up on life when it had not yet given up on you. I will never understand how you believed so little in your tremendous potential and how you were never able to escape the shadows that haunted the corners of your mind. They say that to everything there is a season and I will never understand why your season was only 26 years short when it should have been 90 years long…and I guess that the timing is between you and God but that doesn’t mean I understand and I definitely do not approve. There are so many things that I wish I could have told you – and that I wish you could have understood. I wish you could have understood how very deeply you were loved by ALL of us and I wish you could have really understood that none of us ever stopped believing in you, even though you couldn’t believe in yourself.  I wish you could have realized that life is too short and too precious to be wasted on one moment of darkness. I wish you could have comprehended that at some point in life, ALL of us feel used, wasted, friendless and alone even though none of those things are true. I wish you could have had the foresight to see that even the dreadful moments in life pass, that nothing terrible lasts forever. And I also wish you could have understood that sometimes the bad things pass on their own… and unfortunately, sometimes you have to apply a little elbow-grease and force the bad things to move out of the way. But what I wish for you is, in a sense, moot – because if you had understood any of this, you would still be here with us today.

I know that I will see you again one day and maybe one day I will be able to forgive you for some of what you did when you doused your fire with amitriptyline – but right now that day is just too damn far away.  I’m still no closer to understanding what happens when we die but if there is some form of consciousness left in you somewhere, I hope a small part of you misses us even a fraction of how much we miss you, and I hope that small part of you will run to meet us with open arms in heaven.

I love you, baby brother. Always did….always will.

Happy birthday, Dad. Even if you probably won't read this.

On that hot July afternoon, I was fifteen years old and just beginning to sample the sweet taste of freedom that driving could provide.  I had a valid learner’s permit but limited driving experience, always in the company of a fully licensed parent.  I felt (too?) confident on the back country dirt roads in my neighborhood; I think my parents picked up on this and in their wisdom told me in no uncertain terms that I was never to drive any of the vehicles by myself, not even down the road to the neighborhood mailboxes. I listened – until my youthful hubris decided that it had had enough of silly rules.  After all, I was a good driver (!), so why were my parents stifling my youth?  One day, after a long internal debate about the best way to get to the mailboxes in the July heat, I grabbed the keys to our old, dented International, my father’s “camping” truck, and set out down the road.  My parents were both at work, and no adult accompanied me as I entered the truck. I turned the key in the ignition, rolled down the windows, and flew down that road watching as dry dirt swirled in my wake.  At fifteen, there is nothing more freeing than the wind through your hair as you drive by yourself.  And oh!  How sweet that freedom tasted!

When I finally made it to my destination, I pulled up alongside the old, rusted metal mailboxes and opened the door to our own box.  I grabbed the mail and stowed it on the seat next to me.  Looking cautiously in front of and behind me, I switched into “drive” and attempted to pull forward only to hear the ugliest sound in the world – that of metal creaking, grinding, and jerking against metal.  In my ignorance, I had pulled far too close to the mailboxes and had run the driver’s side of the vehicle into them.  I panicked and stepped on the gas harder and suddenly that same, once- sweet freedom became a dense mass in the pit of my stomach. 

When I finally disentangled the International from the row of metal mailboxes, I drove the half-mile back home as fast as the speed limit would allow, hyperventilating the entire way.  Once the vehicle was parked I hopped out of the car telling myself, “The International is a beast.  There’s probably nothing wrong.”  But, as it turned out, I was oh so wrong.  Jerking along the length of the driver’s side was a long, ugly scrape accompanied in some spots by unsightly dents.  I fought the mailboxes and the mailboxes had won.  Now I was really in a pickle.  Not only had I done something that I had been expressly forbidden to do but I had also damaged the vehicle in the process.  I was in full-on panic mode, fairly certain that my young life was about to end before it had really had much of a chance to start.

I turned to my go-to emergency contact, my best friend’s mother.  I dashed into the house and phoned Anne.  In a panicked voice, I asked if she had in her possession a blue Sharpie marker.  (Yes, that’s right…I was convinced that if I just colored in the scape with a blue Sharpie marker, my problem would disappear along with the scrape).  Using her own motherly intuition, Anne sensed that there was a deeper issue at work and she dutifully walked up the hill to my house with a Sharpie marker in tow.  Once she had arrived, the story spilled out and Anne walked around the side of the house with me to view the damage. 

I still remember Anne doing her very best not to laugh at the notion of a blue Sharpie fix as she looked at the International. Instead, she simply looked at me and said in her knowing way, “Chelsea, we can use this marker to color in the damage, but do you really think that the marker will fix this?”  I knew that Anne was right – no amount of blue Sharpie could fix the damage that my illegal jaunt had caused.  So I asked the only thing that came to my mind, “What should I do?”  She looked straight at me and said, “It will be better for you if your father hears it from you instead of finding out about this in a few days.  Trust me.”   And since even youth recognizes good advice when it is offered and with a heavy heart I spent the rest of the day stewing in my room, nervously pacing the floor and trying to calm the deepening hole that had invaded my stomach.  I practiced my carefully chosen words over and over again. Finally, when the sun had set and the house was quiet, I decided that the time was at hand.

Steeling myself for the yelling and dire punishment sure to follow, I trudged into my parents’ bedroom with my head hung low.  My father was already in bed reading a book.  He looked up as I came in, placed his finger between the pages to mark his place, and smiled at me.  He thought I had come in to give him his customary goodnight kiss and in that instant I felt so very terrible that the tears began to flow.  My father’s smile disappeared and worried creases formed in his forehead.  He patted the bed next to him and said, “Sweetie-pie, what’s wrong?”  I sat down next to him, he put his arm around me, and between wracking sobs the story took shape.

“Dad, I’m so sorry but I did a bad thing today.  I did a really, really bad thing.  I did something you told me I was never supposed to do.  I got bored and wanted to go to the mailbox but I didn’t want to walk because it was too hot and I’m a good driver.  So I drove the International to the mailbox to get the mail.  But then I ran the International into the mailboxes...and Dad…I am SOOOO sorry.”

My father didn’t say a word.  He bit his lip and thought for a moment before rising out of bed and putting on his clothes.  I followed dutifully behind him as he walked in silence to the International to survey the damage that my teenage foolishness had caused.  My father walked around the truck and paused near the driver’s side door, hands in his pockets, his face unreadable.  I was relatively sure that something very bad was going to happen to me and I waited for the yelling to start.  I was petrified.

But them something astonishing happened: my father simply turned to me, put his arm around my shoulders and said, “Well…it could be worse.  The International was never very pretty anyway.   The important thing, Chelsea, the most important thing of all, is that you were not hurt – and you didn’t hurt anyone else.  Accidents happen to everyone but the reason that you are not to drive without your mother or I present is because you are still learning how to drive safely so that you don’t hurt yourself or someone else.  It was only the mailboxes today, but it could have been a neighbor child that ran out into the street.  You could have taken a corner too fast and rolled the vehicle.  Cars are replaceable, kiddo, but people aren’t…YOU aren’t.  Understand?”

I understood perfectly.  And somehow, without yelling or screaming, without threats or grounding or loss of privileges, my father had gotten his point across to me with absolute clarity.  In that moment, I fully understood why my parents made certain rules…it had nothing to do with stifling my youth and everything to do with preserving that youth and ensuring that it would grow safely to adulthood.  My parents’ rules had everything to do with love.  I learned a lot of lessons that day, courtesy of my father.

So here’s to my Dad – the man who taught me that we are meant to learn from our mistakes so that we can do a better job the next time around, and the man who taught me that mercy and gentle words teach stronger lessons than angered denunciations.  But most importantly, here’s to the man who has always shown me, with every breath, just how much he loves me . . . and who has always treated me with care.

Happy Father’s Day (and birthday) to the best father a gal could ever hope to have.  I am so incredibly lucky.  I know you probably won’t ever see this, Dad…but I love you oh so very much and I hope that you always know that.

To mom, on her birthday

This year, more than any other, I feel so very thankful to have my mother in my life.

When she was diagnosed with colon cancer last year, the bottom (temporarily) dropped out of my world.  After my father finished relaying the news to me over the phone, all I could do was sit on the couch and cry for the rest of the evening.  I've always been scared of losing my parents too soon (although, is there ever really a good time?), but in that moment, I was terrified because cancer is a serious thing.  People die.  My mother could die.  I know that I'm an adult and have lived on my own for awhile now...but I am still nowhere near ready to say goodbye to the amazing woman that is my mother.

I've always thought of my mother as this incredible, invincible woman.  Through the years, she was always my Super Woman, ready to come to my aid or defense at the drop of a hat.  She was the woman that worked tirelessly to provide for our family during the years when my father was in college and still managed to make it to all of my high school concerts and piano recitals.  She was the woman who drove me at breakneck speed in a winter storm for nearly 2.5 hours so that I could join my friends on the school bus (whose local departure I had missed) heading to the state Science Olympiad competition.  She is the one person who can always tell when something's wrong in my world, and when I lie and say that "everything's ok," she always calls me out on it.  She's the person who has been by my side at every major turn in my life - whether it was driving me to college, to medical school, or to residency, she's been always been there for every journey.  And though she probably doesn't know this - she's the part of moving that I love the most.  I don't enjoy the packing/unpacking, the sleeping in hotels, or eating crummy food...but I do enjoy traveling with my mother and I am always thankful that she gives up her time (when she might have better things to do) just to spend it with me.  She's the woman who has never let me settle for less than my best and the woman who has never given me less than her best.

I know she'd argue and say that she hasn't always been the best mother,  but trust me when I tell you that's a lie.  Because the best parent isn't someone who never messes up.  It's not the person who always puts a homemade meal on the table, or the one who never yells at you out of sheer frustration - the best kind of parent is the one who is there for you in all circumstances and who loves you in all circumstances, who strives to show you how important you are to them every single day.  And by those standards, I'm pretty sure that I have the best mother in the world.

So happy birthday to you, Mom.  Thanks for being a terrific parent and for always giving me better than I really deserve.  I love you.

A small request, friends

Quit posting anti-abortionist pictures of fragmented babies on Facebook. You have a moral objection to abortion and want to share it with the world. Good for you. But trust me when I tell you that I already know what dead and fragmented babies look like. I wish I could tell you that the sum total of this knowledge was gained solely by gazing upon your useless, graphic, and ultimately Photoshopped Internet images but then I’d be a liar. I know what these little souls look like, but do you? Do you really know? I know what they look like because they are often a part of my daily job. I have reached into more formalin buckets and pulled out more fragmented baby parts than I really care to think about. I have prosected 16-week-old fetuses and watched as their organs are turned into a glass slide. My heart breaks for these tiny beings each and every single time, but this is my job. My job is sometimes messy and nightmare inducing, but it is also very intimate. I am a doctor and these are my patients. I am the last hand that will hold them and the last eye that will see them and the last doctor who will mourn them. So quit your Internet crusades, please. I see these images at work and I see them at night when I sleep and I see them when I look in the mirror in the morning. I’d rather not see them in front of me when I log into Facebook. I take enough work home with me as it is. Let these patients rest. Please give them some respect. Quit using them to further your own agenda. And on a related note:

Quit trying to legislate a woman’s right to choose. I believe in the beauty and the mystery and the miracle and the gift that is life, but I also believe strongly in the right of a woman to choose what happens to her own body. I have seen the abortion procedure, I have met women who have chosen to walk that long road, I have held the consequences of the procedure in my gloved hands, I have shuddered in despair and sadness over these tiny beings – and despite all of the horrors of each of these things, I will ALWAYS believe in the right to choose. I will always believe that what a woman does or does not do with her body and those that may dwell in its depths is solely between the woman and her God. It’s not between a woman and her pastor, her friends, the news media, or her political representatives. And it’s definitely not between an unknown, pregnant female and YOU. Knock. It. Off.

Beautiful days

It was an absolutely phenomenal Vermont spring day today. It was kind of day made for fishing or gardening or kayaking on the pond or hiking and birdwatching. But I did none of that, because today was also, unfortunately, the kind of day made for weekend call {insert a grumbly, frowny face here}. Reluctant to venture too far from home lest the black box of evil (also gloomily referred to as the call pager) begin to shriek, I pondered how to best enjoy the beautiful afternoon. In the end, I gathered up all of my sundry electronics and settled down into one of the wooden Adirondack chairs on the back deck. A perfect amount of gentle breeze was wafting around me – enough to cool down the 80 degree sunshine, but not enough to whip my hair into my face and annoy me. The leaves rustled, the scent of freshly mown grass filled the air, and the distant (and somewhat obnoxious) sounds of the neighborhood ice cream truck filled my world. It was a perfect moment in time. I looked up at the bright blue sky and for the first time in about three weeks, I felt completely relaxed. These quiet moments… the moments where my back doesn’t hurt from carrying around internal stresses, where my head doesn’t ache from all the noise that constantly envelops me, where the headache that lingers between my eyes dissipates…these moments don’t come nearly as often as I would like since I joined the world of medicine, so I’ve learned to seize them as they come and simply enjoy them. They are not

grand moments filled with adventure but for me, they are simply enough. I miss these beautiful moments desperately sometimes. But no matter how quiet and sweet a moment is, a pall always lingers because it is in these peaceful moments that I find I miss Chandler most of all. It is during these moments that my heart breaks over and over and over again. I miss my little brother still. I miss him so very much. It’s been ten months and my world still feels upside down and inside out. And after ten months, I am (still) not even remotely able to understand how Chandler could ever have given any moment of this world up. I can't even understand why that thought even crossed his mind...and I certainly can't understand how he decided that these small moments weren't worth his time, how they weren't enough for him. I am slowly learning to accept that I am not meant to understand these feelings, that none of us are, really, and for that I suppose I am grateful. At the very least this world and these moments are enough for me - so I will savor them enough for the both of us.