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Stages of Grief (1 of 2)
The 5 Stages of Grief were defined by Dr. Elsabeth Kubler-Ross as follows (parentheses mine):
- Denial (”This can’t be happening to me!”)
- Anger (”Why is this happening to me? This isn’t fair!”)
- Bargaining (”I promise I’ll be a better person if…”)
- Depression (”I don’t care anymore.”)
- Acceptance (At peace with new reality)
In a way, my experiences in med school lately have been a grieving process. This obviously isn’t a case of losing a loved one, but any loss or significant change can invoke a grief response, regardless of how trivial that might seem to others not having personally experienced it. Few would question the grief over a deceased relative or the loss of a job, but a voluntary career change? Moving to another city? C’mon, those are changes in life you just deal with; there’s nothing to grieve.
Wrong. In roughly 2-3 months, the following changes have happened to me (and I’m sure many of my classmates):
- I have lost a well-paying, nearly permanent job
- I have lost a standard of living that said job afforded us, such as not thinking twice about ordering out for dinner, buying some cool toy, or not sacrificing for important things like medical care and car maintenance
- I have lost living in my home country, going from the most developed nation in the world (don’t argue with me on this one, please–other countries do certain things better, but not as a whole) to a third-world country with a patriarchal, corrupt government whose corruption extends from the highest offices to the lowest traffic cop, where I have little, if any, rights (especially as a foreigner)
- I have lost the ability to come home after work (see unemployed above) and do whatever I wanted, whether it be personal hobbies, more work, or just lounging
- I have lost valuable time alone with my wife, relegating much of our small excursions/outings when I can fit them in with my school schedule.
- I have lost an identity (information security and internet services specialist) in which I had multiple supervisory roles, in exchange for a new one, “1st year medical student,” where I’m the gum on the shoe of the established medical hierarchy.
I think these first brush strokes on this canvas is enough to show where this is going. I don’t put 100% stock into the neat, compartmentalized stages above, but I know I have done at least some of them since having moved here and started school.
It would be enough to say it has been just all the change and school itself that has caused such upheaval, but the indifference to communication that our school seems to have on certain academic matters has left me more disillusioned about being here than I would have thought. We had a guest speaker in a anatomy lecture for two days. He’s a pharmacology professor, relatively young, and an alumnus of the school. He was lecturing on two “big” cranial nerves, the trigeminal and facial CNs, and it was a breath of fresh air because for the first time since the first week of school, any real clinical information in terms of evaluating patients was shared. While we are not going to be conducting gross neuro exams anytime soon in clinics, we can at least understand some of the obvious tell-tale signs of lesions involving these nerves and their branches in a meaningful way, rather than the dry, morphologic approach in a vacuum. I’d love for him to teach more topics, but he’s going to the states soon having participated in the match.
He’s been a general doctor here (and teaching to supplement income) for several years, but when asked why he wants to go to the US when he’s already “set” here, he used as an example that attendings here are always right, period. When you ask, the answer you get is law. Even if you go to Medline or the like and print citation after citation proving your approach at least has merit, if the attending doesn’t think so, you don’t even get a “well that’s not how we do it here,” you get more of a “So?” at best, and at worst, marked for being “difficult.” Remember that Mexico is very patriarchal, so authority and respect aren’t necessarily earned, they are expected and conferred with a title. As such, how can a trainee know whether or not a given set of protocols, procedures or the reason why it’s done is really “right” at all when the litmus test is (may be) solely how your boss does it? Period. This mentality sets the stage for you, my dear reader, to understand this very difficult week for me.
To be continued Friday…(registration/login required to read conclusion so I can speak a little more freely)
New evac plan for Houston annouced today
Due to analysis of the Houston evacuation, those of us at the medical center have been given initial word of a new, tiered evac plan to be put in place for the next metroplex emergency. This is to be annouced by Gov. Rick Perry at an upcoming conference.
It will be tiered by higher learning status.
Those from UT Dallas, SMU, and UH will evac up 45 north to dallas
Those from UT-austin will evac up 71 to austin
Those from Texas A & M will evac via 45 south towards the gulf coast
And those from Oklahoma will take the 610 loop and drive around and around until further notice..
apologies, but that was the funniest joke I had heard in a long time, those from OU, A&M feel free to adapt that the other way, of course…
yes, I’m from UT austin…..
-=dedicated to bobby=-
Students get jacked at top 20 med schools too
Nobel Laureate Alfred Gilman (of G-protein fame), Dean of the UT Southwestern Medical School in Dallas, Texas did a bait-and-switch on incoming students this year. Apparently, he single-handedly changed grades after-the-fact, in spite of many professors’ objections.
An excerpt from one person’s story:
At a lunchtime meeting today with the first year medical students at UT Southwestern, Dean Gilman announced that a new, heretofore unnanounced grading paradigm would be in effect for this year’s incoming medical students. The dean explained that the objective of this change is to create a wider distribution of grades among students. [read: they need fewer As] The details of the plan were not revealed, however….the dean also disapproved of using normalized distributions as a way to achieve grade spread, in spite of the fact that at least one professor has specifically stated such.
When students raised the issue that the new paradigm will introduce an element of unwanted competition between colleagues…that they might have made different admissions decisions had it been known that a new, competitive grading paradigm would be implemented this year, the details of which have not been specified, the dean admonished them, “Life’s a bitch, and then you die.”
This place is crazy
From The Weather Channel forecast for Guadalajara:
Mon - Scattered Thunderstorms. High: 85 Low: 57
Tue - Scattered Thunderstorms. High: 85 Low: 57
Let me tell you, 85 in some places here that don’t have A/C is hot. I can’t believe we’re getting to a point where there’s nearly a 30 degree temperature difference.
Houston, here we go again
Ay Dios,
Poor Houstonians, open their hearts and homes to Katrina only to have to flee from Rita.
I know my huband and he loves Houston. He is a UH Cougar all the way. I moved there to be with him and got to know the city through his eyes. One thing that surprised me about Houstonians was their attitude. They could be fiercely proud and tough–there was more than one time when I heard people say stuff like “This is Houston baby, get used to it.” Houstonians are known for being the toughest most “ghetto” of all Texans. Texans know this, when somebody askes a person what part of Texas they are from and the person answers “I’m from Houston”, that’s instand respect cuz nobody messes with Houston. Austin is the weird town, or our San Francisco if you will. San Antonio is the sleepy town full of raza and familia. Corpus is our beach town while Dallas is our metropolitan high-society place. The Valley, well most everyone forgets about the Rio Grande Valley unless you have family ties there. Nobody forgets Houston.
And yet, with all it’s so called rudeness, the nicest bosses I have ever had in my professional career have been the directors in oil companies I worked for. Sure I had some rude co-workers, and some mean ones to boot, but I also had the pleasure of getting to work with some of the nicest, most wonderful people I have ever met. I miss them. I hope they are safe.
Seeing what the city might endure makes my heart ache. I worked in several high rises in the Houston downtown area as well as in the Greenway Plaza area and feel like, I don’t know, sadness I suppose. These buildings will most likely sustain major damage from the winds as they are constructed in the “skin and bones” architect style made famous by Ludwig Miles van de Rohe; not to mention one of the building of the Houston Fine Arts museum was designed by the maestro himself.
Let me tell ya, there are many, mant high rises in Houston and they are spread throughout the city not just in the in downtown area. Shell, Exxon, El Paso, Continental, Halliburton, Schlumburger and many others all have their headquarters in Houston. In fact, Houston was just starting to boom again as a lot of the oil companies that left in the oil bust of the 1980’s were moving back to the city.
The tunnel system of stores and shoppes that link the downtown highrises to each other like a never ending umbilical cord will probably be ruined by the flood waters. The new light rail system that I took to work will most likely not do too well either. We lived south of Bellaire in Meyerland on Braes Bayou, I know that our old neighborhood will not survive this without massive flood damage. Meyerland is known for it’s Jewish community and I so enjoyed their celebrations, especially Hannukah. In my apartment complex, the Jewish people proudly put up their Hannukah celebrations up with bright blue lights that at times seemed to outshine their neighbors’ Christmas decorations. I loved it all and I miss it.
I fought my husband’s decisition to move to Houston with everything I had. I even had a saying that I would live anywhere in Texas but Houston. Now I realize how much Houston has become a part of me.
God Speed Houston. My heart is very heavy tonight.
Banning together in h-town
As I hunker down in houston for the storm, I am actually in a small way actually having a decent time. This is this nicest I have EVER seen houstonians act toward each other. I chatted with a complete stranger for easily 20 minutes in one of the few restaurants open over a very good dinner. We talked to the person standing in line standing behind us for the past 20 minutes at Tom thumb. We met and talked to at least 3 of our neighbors in our complex, and sat in the pool with one of them for about an hour.
There is an incredible sense of community and togetherness formed between all of us staying through the storm. Some because they too turned around after spending hours on the highway. Others because they identified with me because they too were in a profession that required them to stay through a disaster at times. (such as one IT manager from MD anderson, she was on call the entire weekend).
This is easily the first time I felt a sense of belonging in this city, and the most sense of community since I lived in austin during the early ’90s (before it became tres’ chic) . Not that h-town is UNfriendly, but natives seem to feel that they are much open and lovey lovey than all the other big cities in TX. I hate to say it, but normally I have not found this city to be any more welcoming or friendly than the next big burg, despite the PR blitz they give about this being a ‘friendly’ big city, especially in comparison to their big city Texas neighbors (Austin, San Antonio, and especially Dallas). Not that Dallas was welcoming at all when I lived there for 4 years , but there is certainly no appreciably big change in ‘neighborliness’ on a day to day basis from there to here. If dallas is a 7/10 on the ‘don’t bother me I’m busy” scale, and austin was a 4.5/10, then houston has been a 6/10 normally.
But now, I definately feel a sense of community, and feel of “hey you, how’s it going?” from an entire neighborhood.
Here’s to hoping it lasts.
Guess who is back in Houston?
Several HOURS after dehydrating in my car on I-10, I made a U-turn while I had enough gas to make it back and am now IN MY APT waiting out the storm. I know people always say, “how can you take a chance, just drive?”, you cannot understand until you are in it:
1) We took 3 hours to travel 5- 10 miles in stop and go traffic, using over 1/4 of a tank of gas for JUST that, with the AC OFF.
2) People were starting to cuss and become hostile in the heat.
3) We KNEW, through the news, that no gas was available for about one hundred miles, and following trends, we would run out of gas in under 50 miles EASILY.
4) I was feeling initial signs of heat exposure, and we forgot to pack a cooler
5) Our cat looked like she was about to start shaking (remember animals pant, not sweat, to cool, so they burn alot of energy and lose h20 in exhalation much faster than us) This normally indoor kitty was going to last max 7-8 hours in 106 degree weather with no water.
6) In stand still traffic you have no breeze because it is blocked by all the other cars, and with the pavement and engines, the temp was way above normal ambient temps.
6) Brand new, well maintaned cars were stranded on the side of the road, either out of gas or broken down. In that traffic and environment, even “good” cars were overworked.
We thus decided that the risk of being stranded on I-10 with no gas was MUCH higher than the risk of being harmed in our relatively newly built and well designed 3rd story apartment. I turned around, and took about 20 minutes to traverse the roads back home. WE stocked up, and will ride out the storm here.
We are not alone, though. I already secured clearance to ride out the storm in the VA hospital here.(yes, our wonderful homeland defense dept required that I send in a formal request for pre-authorization to enter VA in the event of the storm. This is the same place that required I have my request for a parking sticker NOTARIZED. No joke). In addition, if I agree to volunteer to staff St. Lukes over the weekend, I can use it as shelter, also. So if it gets nasty, we leave the cars in the covered parking garage, and walk to the shelters before the storm hits.
We shall see. they don’t have WiFI.
Choice: Hot carbon monoxide vs. running out of gas
Raul is stuck on what his wife Kris called “the I-10 parking lot.” Like so many people right now as I type, they are forced to not run the A/C in 100+ degree weather (the inside cabin temp read 106 when I called) to avoid as much as possible not running out of gas, since there’s practically no more to be had. I would have said “I told you to leave at 3AM!” (such a loving cousin I am >:D ) except that there was a guy on the news who left downtown at 4AM and had barely made it to Beltway 8 as of 12:00pm, about a 12 mile drive. Granted, that was on I-45 going to Dallas, except that now the hurricane has taken a more easterly turn.
This isn’t New Orleans, much less rural Mississippi: this is the 4th largest city in the US, added to the peripheral populations of Galveston, Seabrook, Clear Lake, Texas City, Freeport, etc. etc. — I estimate 5 million people all told, many of whom are on outbound highways. I just hope as many people as possible get out–Texas Dept of Transportation (TxDOT) has a massive job mitigating those kinds of numbers along with necessary advance inbound traffic of food/supplies/materials, etc, so both sides of I-10/I-45 can’t be opened haphazardly. Let’s not forget I-10 is one of the top 3 most traveled interstates in the US.
Yes, I miss home, I miss the “action,” as I said earlier, but not this action. Regardless of where this storm strikes, I hope that the hard lessons learned from Katrina continue to pay off. Good luck to everyone.
Homesick
This seems really silly, but it takes a natural disaster (and in the case of Rita, soon-to-be disaster) to make me miss home. 750 miles from the border seems long, but let me tell you, Mexico is another country, so it seems way longer, but 750 miles to a Texan won’t get you out of the state, so you pick! I have been going to class, doing my thing, etc. and of course I miss friends and family, but I haven’t felt homesick until these last few days, especially now, seeing all the views of Houston and all other Texas cities that I’ve visited or lived all of my life. I want to go home. Obviously, I’d wait a bit before traveling to the Houston area, but there’s one each of a Vietnamese, Chinese, Thai, Indian, and Greek restaurant with a table with my name on it and I can’t wait to visit.
Speaking of food, there’s NOTHING in the way of any authentic “foreign” food, and by “authentic” I mean the way you know it’s made in country because the people that made it (back in the US) haven’t even acclimated to speaking English and menus are in the native language with small, bad English for the non-regulars. I can’t get decent sweet and sour chicken–a dish I’d never order in the States–much less anything “exotic” like, oh I don’t know, plain old chicken in black bean/garlic sauce, a dish I’d normally get as the “boring/safe” option. The idea of my sitting in a nice restaurant waiting for the dim sum cart to come by with my next round of delicacies is like an Eskimo imagining himself swimming in the water naked and sunburned–it just seems impossible.
I better stop, because as a person who loves to cook and explore flavors, combinations, etc. (yes, I know, I haven’t finished the “about me” section on the site), I could be here all day. It’s not about the food, of course, but few things make you feel “home” more fundamentally. I just miss everything right now.
Houston, we have a problem
Houston has been my home for all but a handful of years of my adult life. I see Hurricane Rita (hard after writing Katrina so many times in the last few weeks) barreling towards H-town with category 5 fury, and I can only hope that it does diminish before landfall, as meteorologists predict due to the cooler temperatures near Galveston. I was in Houston during tropical storm Allison in 2001, and a mere tropical storm leveled unprecedented damage, such as lifelong research in the Texas Medical Center (dense hospital network, including MD Anderson Cancer Center, two medical schools, Hermann Hospital), gone forever. The real damage came not from winds but from never-ending floodwaters from a TS that simply would leave the area (backtracking, even), dumping her contents to a city not below sea level, but not really that much above it either.
Houston has a man-made “ship channel,” allowing it to receive barges from Galveston Bay directly. In addition, there’s a man-made “drainage” (I say almost facetiously) system of “bayous,” basically, large canals to redirect water. Houston is full of them. My last address was literally on one of them, and let me tell you, it floods BAD when heavy rains come. I even made video of one day of unusually heavy rain totally stranding motorists for hours on our street…we were taking bottled water from our apt to a van full of kids, all because of Houston’s volatile weather.
I can’t help but think that so many parts of the city are going to be unquestionably flooded, but Houston is the 4th largest city in the US; it has some huge-ass skyscrapers in its downtown. How does 130 stories of pane glass fare in 130+ MPH winds (prediction for downtown if eye goes through Galveston at current speed of 165)? Not well. Neither do offshore oil rigs outside Freeport, Texas City, etc. People don’t realize how many petrochemical plants/refineries there are in southeast Texas. Even without a direct strike to Galveston/Houston, this will impact the gas prices for a long time.
Lots of lessons were learned from Allison, but the best of those lessons will be put to the test in the coming days. When I was working at UH, we set up our emergency IT infrastructure (mail, web essential services) to be hosted by Texas Tech in Lubbock and reciprocally, us for them. I was third in line for any catastrophic web server failure. As usual, you just shrug it off thinking “it’ll never happen.”
Houston will make it through, but I wonder at what cost. I’ve talked to almost all my friends and family by now, and I’ll be keeping a close eye on things.