Monday, August 3, 2009

One Year Later.

Saturday was the one year anniversary (or, as my friend Nicole calls it: "Vermontiversary") of my most epic life upgrade to date. One year ago, I began -- quite literally -- an entire new life. I shed my boyfriend of two years, 85% of my hair, my access to 24/7 Internet takeout, and completely and utterly started over.

I learned to drive. I learned to compost. I learned to be still, and breathe, and trust myself. I learned how it feels to carve out a world entirely of my own making.

My departure was not without drama. Taking a break from loading up the moving van for a Diet Dr. Pepper at the Duane Reade across the street from my home of 4.5 years, my first cold swig triggered an episode of vasovagal syncope. I blacked out and hit the tile floor HARD, losing consciousness for several minutes. An elderly woman waited with me for an hour until my father could come take me to the hospital; turns out, she was my next-door neighbor. We'd never met before -- how New York. Just as I would be tempted to bid my city adieu with the taste of coldness, isolation and detachment I'd come to develop in my mouth over time, here I was being reminded that there really was a sense of 'community' -- even if it were masked 99% of the time by exhaust fumes, deafening horns, and swearing cabbies. Symbolically, I was prompted to take an entirely different farewell snapshot to New York than I was prepared to stage.

My experience at the Emergency Department was symbolic in its own right. In three hours' time, I experienced EVERYTHING possible that I would never, ever, EVER do to a human being. I was made to sit exposed in the waiting room in a patient gown. I was left completely topless for 20 minutes behind a half-open curtain waiting for an EKG. I was put into a bed soaked in someone else's urine. I was passed along a string of strangers, none of whom introduced themselves or even asked me how I was feeling. I was ignored by more than a dozen residents, nurses and techs evading eye contact as I bawled on a stretcher in a desolate corridor. I was dismissed and discouraged by the physician entrusted with my life. I was scared and alone and helpless, struggling to navigate the unknown amidst a hostile sea of strangers. There, literally "on the way to medical school," I had one of the most powerful training experiences I will ever have. Thank you, New York University, for contributing to my education. You'd better believe that this, too, was a snapshot moment.

What's in the snapshot I take today, one year later?

Here I am, on the screened-in porch of a rural Vermont cottage up a dirt road. I'm training at the clinic of my dreams, at the side of some of the most inspirational characters I could ever have invented to contribute to my development as a physician. I have a ridiculously elaborate new set of neural circuits that contain hundreds of thousands of new words and concepts and patterns, some of which have already contributed to human beings' lives. I've built a utopian coaching world here, where I can "do my thing" uninhibitedly. I've successfully acted on some pretty daring, quirky ideas: mindfulness trainings on a Spinner, an Intro to HR Training course, a legit scientific inquiry into the psychology of HR training (16 responses away from the finish line...). I'm 6 weeks away from my first 100 mile bike ride. I've invested in myself and in the things I've decided I want. Nice shot, indeed.

Last week, my preceptor returned to the clinic. I was ecstatic. Over the course of eight weeks, we've only been in town at the same time for maybe eight days -- he's been traveling a lot, which is disappointing because he's my absolute favorite person to train under. Everyone else teaches me well, extends me opportunities to practice various tangible and intangible skills, etc. But this guy is the only one who really directly empowers me to flex my 'usefulness muscles.' He lets me educate patients about diet and exercise (even heart rate training!) with great specificity. I'm not merely "filling in holes" -- for those particular moments, I perceive that I am genuinely contributing some specific added value. He knows that confidence is everything, and he takes it very seriously as his duty as my mentor to build my confidence through experiences he knows that I a) really enjoy and b) at which I am decent at worst, if not occasionally pretty good. I really only know 1% of useful medical concepts -- but he has a way of teaching me in a way that doesn't force me to frame it as such. "You remember that..." (when it's an entirely brand new concept). He describes his thought process to me on the fly ("I saw this, and thought that - so I tried this, and it worked/didn't work, so I knew this..."), which is a format I totally adore and am now making a 'note to self' to express my appreciation for that aspect of his style, as I work to develop my own thinking style. It's collaborative and gentle, and just WORKS. It's like that poster in the UVM library I reference a lot: "Knowledge is the ability to make the people around you feel smart." This guy is brilliant.

Upon his return, he took me out for a quick bite to eat during a gap in the night clinic schedule. "So you've got a week left," he started. "What do you want to learn? What can I do to contribute to your experience? What do you want more experience doing?"

Rewind back to the day I met him, in February.
"What do you want to do with your summer?" he asked me, then. For all intents and purposes, he was asking me what I wanted to do with my life.

And I didn't know. I didn't know anything, and thus I wanted to see and do and experience EVERYTHING. To the end that I couldn't specifically request ANYTHING. I was limited by my lack of limits.

If this summer has been about nothing at all, it's been learning to appreciate that it's OK to ask for what I want. And, without expending much effort to ponder this, the "what I want" part has presented itself on its own. Now I could answer the question, without hesitation.

I told him what I wanted. I told him I lacked confidence in working with my hands, and in describing my findings. I told him I wanted experience presenting patient histories and findings to him.

"Done," he said. "We'll do that."
And that night, we did. Right away, BAM. I got exactly what I asked for, just like that.

I didn't always know what I was doing or seeing, and I wasn't always useful. But I was confident enough to ask for clarification or elaboration when something didn't feel fluid. That confidence had absolutely nothing to do with my abilities or some sort of "natural progression" of events; it had everything to do with the deliberate, specific efforts of my mentor to contribute to the deliberate, specific experience I had expressed that I was seeking.

Knowledge is the ability to make the people around you feel smart, after all. One year later, the characters, the experiences, and the opportunities that mark my new life continue to remind me that this move was the smartest thing I've ever done.

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