Little Giants

The following is my piece published in the Spring 2016 volume of the Creighton University School of Medicine quarterly, the Wellness Chronicle.
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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.

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.

Keep Dancin', Kate Hansen

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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.

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.

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.

Return to the Motherland, Part I: Nineteen Mosquito Bites and Counting

My old man is sitting behind me, relaxing in his boxers and enjoying a riveting battle in Cowboys and Aliens on HBO. We're doing our best to keep cool in his relatively cramped apartment in the Tianmu neighborhood of the Shilin district in Taipei. The sounds of scooters revving past wailing ambulances and a symphony of cicadas float through the air outside the window.

Eat, Pray For Passing Classes, Love

It's supposed to be spring, and yet we've had four days of gorgeous, warm sunshine followed by a week of hail, sleet, and rain. Come on, Omaha. Pick a season. We can't give out clozapine like candy like the good ol' days anymore.

Summer after the first year of medical school is widely considered to be the last summer of our lives. Many of us will go abroad to do medical mission trips or work in clinics. Others will lock themselves in a lab doing research, gunning for that orthopaedic surgery or anesthesia residency. Some will actually be smart and take the summer off to just travel for fun and chill.

Along with the twilight of every summer, then, comes thoughts of finally cracking open those books that we've purchased but never had the chance (or, more likely, motivation) to read. The sad tomes sit on shelves, collecting dust while you tell yourself, "I'll start reading it tomorrow, I promise - I just have more important things to do." Next thing you know, you've marathoned every episode of Game of Thrones and eaten three quarters of a Domino's pizza. And, sadly, your books remain unread.

Here, then, is my recommended reading list for those of you looking to keep your brains active.

Fifty Shades of Grey by E. L. James. I personally haven't read it, but apparently it's about a colorblind artist who, despite the odds being stacked against her, manages to paint some of the world's most critically acclaimed works that the critics hail as the most brilliant use of color since Pocahontas did that thing with the wind. Unfortunately, the artist is unable to fully appreciate her own genius due to her condition, and, unable to cope with the stress of her new-found celebrity, eventually commits suicide by drowning herself in a bucket of paint, hand-mixed from various shades of grey lead paint. I think there are also some sex scenes.

War and Peace by Leo Tolstoy. Again, I haven't read it, but based on the title, it sounds like it's fairly light reading, perfect for a sunny day at the park. If what the drunk man at the bus stop last week told me is accurate, it's a short novella in two parts. First, Tolstoy describes in intricate yet mundane detail about various weapons of the 19th century. (Now's your chance to learn how to build an old-school crossbow and play The Medieval Walking Dead in your own backyard!) In the second part, he talks about married life in white picket fence suburban Ohio. People walk their dogs in the morning and cordially yet insincerely greet each other as they rush in and out of their houses in their bathrobes to collect the paper. Nothing dramatic happens, everyone is generally happy, and life is peaceful. The end.

The Hunger Games by Suzanne Collins. In a wildly creative re-imagining of the popular children's tabletop game Hungry Hungry Hippos, Collins creates a flowing, vivid world of lush jungle green in which intelligent, anthropomorphic hippopotami (hippopotamuses?) with immeasurably high rates of metabolism must eat as quickly as possible on a constant basis. This need for consistent sustenance has created warring tribes of hippos. With gold being a meaningless mineral, currency has boiled down to the number of calories per food item. Underground hippopotamus scientists have found ways to skew the caloric values of certain food items, thus creating a disparate bartering system in which the poor get poorer and the rich get morbidly obese. Among such turmoil and mistrust, two particularly aggressive factions have risen up and begun a war for food unlike any before. Brace yourself for the most thrilling, heart-pounding adventure of this summer as Collins describes in vivid, gory detail of the First Great War of Feasts between the Zimmernians and the Acolytes of Bourdain and their never-ending quest for caloric dominance.

Gluttony: The Greatest Virtue of All

The following is my article that was published in the Winter 2012 issue of the Wellness Chronicle, Creighton Medicine's newspaper of record. Shut up, it's 20 degrees outside and I'm being lazy.
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"Hey guys. Do you realize that we're actually sitting down for dinner? And actually having a four-course meal? What is this nonsense?

I guess that's one way to say grace.

I looked down at our salads of radicchio, frisée, and sliced carrots, topped with dried cranberries and honey-roasted almonds. To the left of my plate sat a Pittsburgh Steelers shot glass, topped off with a honey dijon mustard and champagne vinaigrette. Each of my five guests had a similar arrangement, only their glasses came from various academic institutions I had visited.

Course by course, we worked through the salad, the butternut squash soup (which, frankly, was ten bricks of caseous necrosis cream cheese with a side of squash), the beef stew with gravy over rice, and the Thomas Keller simple roast chicken. Along the way, bottle after bottle of wine mysteriously disappeared. Before any of us could get to the apple pie, a tidal wave of lethargy and guilt swept over us. As if at a Passover Seder, we all leaned back in our chairs, content yet fearfully debating whether Acute Onset Diabetes was a real thing and if we all had it right then.

Then we all thought back to the rhetorical question that kicked off our meal. Being busy medical students, cramming knowledge into our skulls faster than we can produce the tears to cope, seriously, how often do we get to do this?

This scene is fairly common in my apartment on Saturday nights. Change around the menu and the guest list a bit each week, sure, but my drive to entertain friends via dinners (and, more recently, brunches) has been one of my constant pillars since my college years.

One of my guests once asked, "How in the world do you have time to do this almost every week?"

The short answer: let's just say I'm not Honoring in any classes anytime soon.

The long answer is love.

A few months ago, Dr. Mark Goodman here at Creighton gave us a lecture in our Ethics and Legal Topics in Clinical Medicine course entitled "Care of the Dying Patient." One point he made in the lecture was regarding the difficulty in deciding to feed a loved one through a gastric tube instead of by mouth.

"Food isn't just about getting the nutrition you need. That's not why we cook for each other or get together for a meal. It's about sharing and being around each other. Food is love."

That darn line - "food is love" - hit me in the chest and stuck to me like Snooki's mouth sticks to pickles. As soon as I got home that night, I dug up my old Bittman cookbook and started creating a menu to feed eight that weekend.

As medical students, we stress ourselves out non-stop trying to handle the constant barrage of information presented to us daily. Selective decompression has now become more a survival mechanism than mere fun for the sake of having fun. We run, we lift, we climb, we read, we drink - we do whatever is necessary to take our minds off of cranial nerves and autosomal dominant traits, if even for an hour. Experimenting with new recipes, mastering old warhorses, and making sure my guests leave my home fat and happy is how I prefer to unwind.

More importantly, however, I would like to think that I'm also helping my peers relax by providing a hot meal that they otherwise wouldn't have the time to prepare. A Big Mac may be cheap and fast, but you and I both know that the McBrick sitting in your stomach and the inevitable McSweats are no substitute for the care that goes into a homemade dish. Taking the time and energy to cook for others is about letting them know that you love them. (I'd like to think that's why my Tiger Mom always asks me "What did you eat today?" instead of "How are you doing?" But I'm positive that she's just looking for more reasons to criticize me.)

Creighton has tried to instill in us the idea that medicine is not just about slapping a bandage on the wound and walking away. Hell, a robot could do that. But until Skynet Google Facebook takes over the world, we're going to have people doctors for the foreseeable future. The need for human input is exactly why the practice of medicine is commonly described as the art of healing. Compassion, empathy, and yes, love - these attributes matter. It's why we're here, learning to do what we want to do. We chose medicine because we all house that flame to reach out to others.

The upperclassmen reading this are probably already calling me naive and spooling up the hate mail. "Come on, M1. When you're on the wards, running on only two hours of sleep, trying to figure out why Mr. Smith's GFR suddenly dropped like a rock, do you really think you have time for compassion? You'll be lucky if you don't kill your patient first." True, in the real world, we probably won't have the time to sit down and do a full exploration of all the touchy-feely stuff. But that means that the little things that we can squeeze in matter even more. Working in a busy emergency department in Maryland last year taught me that a positive comment here or a smile there can really turn a patient's day around. Love matters.

So as I sit here, polishing off my Jameson in one hand while poking at Netter with the other, I leave you with my central philosophy: life is too short to not eat well, atherosclerosis be damned. YOLO, as it were.

Food is love. Stay hungry, my friends.

"I'm fairly certain that YOLO is just 'carpe diem' for stupid people." - Jack Black

I'd Like My Oscar, Please

Dang it, the Mayans were wrong after all. I guess that means it's time to put down the CapMo and learn about bacteria or something. Sigh.

I apologize for the months-long hiatus, but between burning out my nose hairs with formaldehyde in the anatomy lab and re-learning (and re-forgetting) metabolism for the third time, it's been difficult to find the precious hours for writing. I've never been good at keeping New Year's resolutions, which is why I rarely make them in the first place, but writing more frequently is my one resolution this year. So...um...hi.
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As future health care professionals, we medical students have a certain perversion with things most other people find appalling. A budding medical student's most carnal cravings are usually satisfied during cadaveric dissection labs in the first year. Exploring the nasal cavities? Twenty-inch hacksaw to the skull, please. Leftover green poop falling out of the colon? Tie that bad boy up like a Christmas roast, and then let's cut it out to take a look! Slicing the penis in half? ...Yeah, I'll be in the corner over there. That's just sick. What's wrong with you?

Re-invading Normandy, Part II: That Time I Ended Up at Church, Didn't Take Communion, and Somehow Got Hammered Anyway

I've been actively giving myself nose and eye cancer in the anatomy lab two to three times a week for the past month, so please excuse my lack of regularly-scheduled writing. (Bromaha will get ya like that, don'tcha know.) But as promised, let's take a few minutes on this gorgeous Labor Day weekend to hop in the Wayback Machine and revisit the night of my second time interviewing at Creighton.
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"A WHAT?"

"A fish fry."

"Again. What?"

"You're going to love it. I promise. You'll see."

Would You Just Man Up Already?

PROTIP: Tuna straight out of the can satisfies your hunger AND gets your roommate to call you a cat for two years.

And there you have it. Yet another wistful end-of-an-era transition, though this one was tougher than most. This dingy, overpriced, ant-infested house with cotton candy for insulation was the first place in which I've lived for more than one year since I moved away from mom's nest. It was also especially difficult leaving one of the best roommates I've ever had. I mean, it's pretty hard to beat coming home at midnight in snowy January to fresh, warm apple pie on the dining table. (Let's face it - I'm a cheap date and food wins me over easily. HEY LADIES.)

Re-invading Normandy, Part I: What Do You Mean We're Not Near an Ocean?

And there it is. Seven years' worth of blood, sweat, and Jameson have finally opened the door to my father's heart. I've been accepted to medical school. Now I just have to not fail out, pass the boards, all the while keeping my liver at least 50% intact. Then my father HAS to love me, right? RIGHT?

I came home on that Friday at around midnight, exhausted after taking my weekend guest on Gordo's The District Walking and Face-Stuffing Tour Experience: The Ride, Now in 4-D. My mail slot was still crammed with junk because neither of my roommates had been at home that day, presumably off doing actual adult things that required responsibility and pants-wearing.

Dreams from MY Father, or, WHY YOU NO DOCTOR YET?

…and we're back.

Sorry for the absence, but I've been traveling all over the U.S. and A. basically every single weekend for the past three weeks in my seemingly endless quest to become a depressed gunner and eventual doctor.

Lessons from the ER, Part II: Keep Your Mouth Shut

3:08am. Lord.

I sat there in my chair, constantly pushing F5, hoping that new test results would come back from the lab so I could update them in my chart and get rid of the patient. I felt my eyes start to droop.

Lessons from the ER, Part I: Leave Your Jimmy Choos at home

I sat at my computer station, staring at the ER patient status board on the screen.

Twelve patients in the entire ED. Twelve. Out of thirty-four beds, fewer than half of them had bodies. And about a third of those weren’t even real emergency cases, just whiny twenty-somethings with itchy va-jay-jays and blood in their urine.

The Mayans Got It Totally Wrong

I live in a state of perpetual fear.

I can’t help it. I grew up in a stereotypically science-based Chinese family, surrounded by doctors and nurses and scientists. As a child, I was always bombarded with warnings of “don’t touch that, it’s dangerous” or “if you put that in your mouth, you’ll get cancer.” Apparently, with the exception of fruits, vegetables, and twice-boiled water, every single thing in the world was bad for me.

Growing in California certainly didn’t help things.

An Open Letter to Posterity, or, Why I Shouldn’t Be Allowed Near Minors

Dear high school kids I met in the Georgetown Summer Medicine Institute,

You scare the crap out of me.

I Am a Menace to Sobriety

I turned 24 in Dahlgren Memorial Library. Fitting that the first random article Wikipedia took me to that day was on Ammit, the Egyptian female funerary symbol, a demon known as the “Eater of Hearts.”

The Freewheelin' Bob...uh...Gordon

Since my first year of college, I have not lived in the same place for more than a year. Yes, I lived in Berkeley for five years, but I went through the annoying process of packing and unpacking all my stuff at the bookends of every school year. I never had the chance to create years of memories in a single house. As soon as one place started to feel comfortable, June would hit us in the face and shake us out. We packed up our hobo bundles and, hitchhikers' thumbs up, ambled down the street to look for yet another place to sleep for the next year. It was always pretty unsettling.

Corporate Whoredom

Let's see how many of you are screaming "bloody sellout!" at the monitor by the end of this.

I'm currently sitting in SFO's brand-spankin' new Terminal 2, waiting to go back home to the medical library. The terminal itself is well-organized and just chock-full of that Bay-Area-smug-hubris that we know and love. Holla, Virgin America: slick purple lighting? Personal satellite TV and games?  Actual leg room? Welcome to the Mile High Nightclub. As Tom Haverford would say, "I have two questions for you. One, are you ready for the investment opportunity of a lifetime? And two, do any of you have pacemakers or a history of epilepsy?" (Because you know I'm gonna be looping the music video to 'Ye's "All Of The Lights" over and over while on that plane.)