Thursday, March 10, 2016

Little Giants

The following is my piece published in the Spring 2016 volume of the Creighton University School of Medicine quarterly, the Wellness Chronicle.
Look at this obnoxious prick. Who even does that? Did he really think this photo would be cool, just because it was the world-famous Dvořák Hall of The Rudolfinum in Prague?

Yes, yes I did. I was eighteen and raised by a PlayStation, all right?

The only reason this pretentious, self-absorbed, overweight man-child had the chance to pose in such an absurd manner was because my youth orchestra, the El Camino Youth Symphony, took an international tour every two summers. After my sophomore year, we performed up and down Italy; a month after graduating from high school, we toured through Budapest, Prague, Vienna, and Leipzig. Our concert audiences ranged from curious crowds of two thousand in the heart of Budapest to two dozen monks in an Austrian mountaintop monastery. I ate it all up. We fed off their looks of disbelief when they discovered we weren’t even in college yet. (Hell, a couple really talented ones hadn’t even hit their growth spurts.)

So why am I reminiscing about music in a medical newsletter? Because over the years, I’ve learned that truly great teaching transcends any one field. Learning to follow my section Principal player may not help me intubate patients any better, but it sure taught me the value of paying attention to others. Team communication is key to producing the best possible product, be that a perfectly assembled meal in a busy restaurant, a stellar symphonic performance, or the best possible medical care. Some people aren’t the best at verbalizing their needs, which puts the onus on the rest of the team to react to their body language or anticipate the next move. A great surgical assistant slaps the next tool into the surgeon’s hand with nary a command; a great orchestra can tell from the conductor’s face what direction she wants the next few bars to go. In the end, it’s all about the team working together seamlessly to deliver a coherent product or optimal outcome. Whereas most of you probably learned teamwork through team sports or a strong family dynamic, neither of which I really had as a kid, I learned it best in music ensembles.

Dr. Camilla Kolchinsky, the fearless leader of our little band, was not the first to teach me music. But she was the first to teach me to love what I played. My early years in music were as a soloist, playing violin since age 9 and piano as soon as I came out of the womb. Along the way through middle school, I picked up clarinet because Band was a required class in sixth grade. (Nobody warned me that I was only digging myself a deeper social grave by choosing the geekiest instrument of all.) Discovering the joy of ensemble playing, melding melodies and harmonies with other instruments, was a seminal moment in my development. Who knew that other people actually mattered? After I boosted my teenage sexiness 500% by teaching myself the saxophone and joining jazz band, I auditioned for violin in ECYS, one of the “Big Three” youth orchestras in the San Francisco Bay Area at the time.

My first ECYS rehearsal transformed the way I thought about music. Camilla was a tour de force at the helm. Not only did we hammer down the technical points to damn near perfection, but she taught us the stories and history behind the pieces and their composers. She did her best to make sure we cared about what we were playing beyond black notes on white pages. After every concert, the way she beamed so proudly toward the audience, then back toward us, was reward on its own. She approached every piece with both iron-clad mastery as well as a child-like fervor for discovery, as if there were still new layers to unfurl on her umpteenth time teaching the piece.

A year after stepping down as the director of ECYS, she suffered a massive stroke in December of 2015. Since I happened to be home in California at the time, I was asked by the long-time manager, Cathy, to go see her in the ICU.

It was heartbreaking to see a woman I once knew as a firecracker of energy, smiles, and intensity to be floating in such unfamiliar waters. Fully paralyzed on the right, minimal movement on the left, and her speech gone, she looked at us helplessly. I didn't know if she even recognized me. My friend Kevin and I held her hands and hummed some of our favorite tunes that we had performed under her.

"Hey. Did her fingers just move?"

"Here, let me try. Yeah, I think they did! Keep going!"

Beethoven, Tchaikovsky, Strauss, Stravinsky -- we took the room on a Greatest Hits whirlwind tour we played together over a decade ago. She stared at us, but nothing else. Not a twitch, not a smile. Did she know we were singing to her? Or were we just two strangers making annoying, off-pitch noises? Like a mirage of an oasis in the desert, our desperate cling to hope was mere fantasy.

It crushed me. At lunch, Kevin laid out his plans for how Camilla could recover and lead some semblance of normal life again. I had seen too many major strokes and their sequelae to know otherwise. Even with the best rehabilitation and kisses from Lady Luck, she would never be her old self again.

Dr. Camilla Kolchinsky passed away on the morning of Tuesday, February 17th, 2016. She was so much more than just a conductor. She taught us to tell stories through music, to remember the past but inspire the future, and to play with love -- love for the music, for our friends, and for ourselves. She made sure we traveled to the very countries in which the pieces we performed were written centuries ago so we could better develop an understanding for the cultural and historical significance of the music we played. She especially loved teaching the old warhorses. "You know this music because you grew up hearing it, but do you know the stories behind them?" she'd challenge. We were so fortunate to have such a giant be passionate enough to teach a bunch of amateur how to not only play, but to live, the notes. We are all more well-rounded, cultured individuals for having learned from her. I know that I'm going to be a better doctor by carrying on her lessons of teamwork, empathy, and above all, love.

I'll miss you, Camilla. May your baton stay swift and your Russian mistranslations adorable.

Monday, March 17, 2014

I miss Shamrock Shakes. Yes, I know they're available.

Last year, when I was volunteering at an elementary school to teach kids about obesity and how to fight it, one rather chubby student asked me what my favorite sports commercial was. I thought it was an unusually specific question - why not just ask me what my favorite sport is? I figured that, like me, the kid was a couch quarterback, prefering to vicariously take in the glory of beating a rival team by drinking and yelling at the screen rather than actually putting in some effort by playing the sport.

I ran through my mental Rolodex of sports commercials, most of them funny ESPN SportsCenter clips that featured some star athlete putting his name in for the Razzie Awards. But then I remembered one during the London Olympics that hit so close to home that I still know almost every line by heart:

And this photo, among others, is why these 63 seconds are my favorite sports ad ever.

I entered college carrying 220 pounds on my frame. Though I was a decent badminton player in high school, I could never move around very quickly, and my stamina could barely outlast my mom's. And, of course, came all the drinking at parties, liquid calories that I had never consumed nor considered in high school. Top that with taking on the "all-you-can-eat" slogan at dining halls as a challenge, and by my third year of college, I had ballooned up to 255. For comical reference, LeBron James weighed 250 at the time. Based on that comparison, I, too, should've been able to single-handedly carry an NBA team to the finals. But alas, I was capable of nothing more than sitting on my couch, eating too many late-night burgers from Jack-in-the-Box. I couldn't even justify it by saying I was studying hard, because I really wasn't. I loved my music and literature classes, of course. However, for my science classes, I largely screwed around, crammed my butt off for exams, and miraculously passed. The rest of my time was spent wasted in front of the TV set, french fries in one hand, GameCube controller in the other. "Unhealthy" didn't even begin to describe the lifestyle I had chosen.

Then, in spring of my senior year, I hurt my back. Ironically, it happened while I was trying to get in better shape. While doing weighted squats at the gym, I suddenly felt a sharp shooting "pop" down my lower back and my right buttock. I thought I had strained a muscle, but after two weeks of rest with no improvement whatsoever, I went to see one of the school's sports medicine doctors. A quick yet painful physical exam told him that that the "pop" at the gym was likely my intervertebral discs popping out and pressing on my spinal cord, causing the shooting pain down my back and thigh every time I flexed my hip. He drew some blood and referred me to get an MRI.

At my next visit with Dr. D, I had one of those life-altering conversations that you only see in self-help infomercials. "Dude, I'm gonna be straight with you. I'm looking at these lab results and your MRI, and here's what I see: you're a 22-year-old with the body of a 70-year-old. You have three - three - spinal disc herniations, your blood pressure is sky high, none of your lipid tests are within normal limits, and your blood sugar is in pre-diabetic range. Get your shit together. You're a smart kid with a great future ahead - don't let it go to waste."

Five years later, I'm now much healthier in every measurable aspect. But one thing that never goes away is the mental struggle. For those not metabolically gifted, such as myself, the daily fight to keep ourselves from falling back into that hole is very difficult. This is especially true for me now, considering the amount of time that I'm spending studying for school. The worst part is that it's just so easy to fall back into the trap. I know the addictive properties of food intimately. When those salts and fats and sugars hit my palate, my brain is evolutionarily programmed to want more. My body's metabolism is designed to pack as much energy as possible. Unlike street drugs, the high we get from food is a completely natural, typically beneficial process. Unfortunately, no part of chugging a 64 oz. Slurpee is illegal. And the cost? All I have to do is rummage around my couch cushions for a few minutes. It's just too easy. That's why the struggle never ends, especially for someone who loves the experience of eating as much as I do.

Back when this Nike commercial aired, many took up their pens and grilled Nike for exploiting a young boy, mocking his unhealthy image for cheap points. I vehemently disagree. Twelve-year-old Nathan here is doing exactly what all the overweight children in America should be doing. More importantly, Nike's message is clear: anyone can do it. Not being good enough to play professionally does not preclude you from playing at all. Something is better than nothing.

America is a culture of now. We want the easy, magic bullet pill that will make us look like Hollywood stars in a week. We don't want to put in the effort because the reward is too far away. It's just too hard, and there's no glory in it.

Listen, the greatness and the glory will come. No, it won't come in the form of a shiny trophy and corporate sponsorship. It comes in smaller ways, like confidence and being more comfortable in your own skin. It comes in noticing that you can move around the badminton court much faster. It comes in knowing that you stand a much greater chance of seeing your kids walk down the aisle. Greatness is defined by you.

The human spirit is a damn hard thing to break, and when it's on fire, my God, you better stand back.

Saturday, March 8, 2014

Keep Dancin', Kate Hansen

Since the eighth grade, I have been a devout disciple of Pentel R.S.V.P. 0.7mm fine tip ballpoint pens. After whatever mysterious Writing Implement Dating Service in the sky fortuitously brought the two of us together, not once have I bothered to look for another brand. Anxiety overtakes me if I am forced to cheat on my beloved. When I ask to borrow a pen from someone and they hand me a bland BIC with a 1.0mm tip, my fingers blister with ire as I consider the barbaric marks forced onto my poor, innocent paper by such a ludicrously large tip. Cruelty, I say.

Monday, December 9, 2013

It's So Cute When They Try

“Gordon, why don’t you go and see Mr. M on your own and then we can discuss his case?"

Oh, thank you mystical powers above. It’s finally happening. My longitudinal clinic preceptor is throwing me the reins. I get to stroll in to a patient room with my white coat and my notebook and pretend I’m actually a somebody. I get to try my hand at diagnosing something real. I’m the boss. This must be how the NCAA men’s basketball national championship team feels when “One Shining Moment” blares as the players try to not choke on confetti.

Thursday, May 30, 2013

Return to the Motherland, Part II: Conglom-O

Think of the one thing you absolutely cannot live without on a daily basis. It's a hard question, I know. (And no, this isn't the start to some awkward middle school personality test/eHarmony screening.) Is it your smartphone? Your contact lenses? Pepsi? Your morning venti skinny mocha Frappuccino?

Here in Taipei, it's 7-Eleven.