11:00am, 20 September 2007. Sea-Tac.

Well, I have to say that I’m pretty disappointed that the airport doesn’t offer free WiFi. I guess I shouldn’t be surprised; it is, after all, an airport, and not a coffee shop. The Tully’s down the way has WiFi, too, but that is also restricted. So much for the freedom of the internet.

So I’m sitting a few hundred yards from my gate and facing one of those gigantic floor to ceiling windows that overlook the placid lake of concrete that defines the airline terminals. It’s a cloudy day out. It’s probably going to rain. I’m sure there will be plenty of precipitation when I get back.

My friend took me to the airport. She shared with me the experiences she has had as the psychiatric consultant to a family medicine clinic. She has told me some pretty alarming stories about the prescribing practices of some of the physicians in that group and, from what we can tell, the docs mean well, they just aren’t executing care in the most optimal way possible. (For example, she told me about someone who was receiving risperidone 8mg at bedtime for sleep. First of all, risperidone is an antipsychotic, not a hypnotic. Secondly, risperidone at 8mg is even hefty for someone with a diagnosis of schizophrenia. This medication was apparently one of several psychotropic drugs on this patient’s regimen.) As she told me about the eager enthusiasm the family medicine docs had for learning more about psychiatric diagnosis and treatment, I felt thankful that we were having this conversation. It is priming me for my interviews.

I have six interviews in nine days. I’m fortunate to have that many interviews (and condensed into that amount of time), though I worry that I shall be tired and potentially irritable by the time I interview at the sixth program. (Of course, simply because I am going somewhere “big”, I am now also worried about extremely low frequency events: “What if I fall down while walking down the hallway during rounds? What if I enunciate a little too clearly and spit on the person who is interviewing me?” etc.) I’m hoping that my eyes won’t glaze over in boredom/apathy/overwhelm (that’s not a good look on me).

While standing in line to get through security (why do we all put up with this 3-ounce fluid rule?), the person who checked my ID (her stamp was “37″) looked at me sternly after looking at my driver’s license. Yes, I could be a terrorist because I don’t exactly resemble my ID: I’ve since changed my hairstyle. Plus, I smiled at her. She didn’t smile back.

I’m getting into New York City later than I’d like; the flight schedule wasn’t particularly accommodating. Time change is interesting. I daydream/wonder about how we make up for lost time—or, really, if we ever make up for lost time. I’m “losing” three hours in traversing the country, though I will “get them back” when I return to Seattle. My mind begins to spin stories about a man who dies three hours before he should, specifically because he relocated to a place that is three hours ahead. This, of course, assumes that we are all slated to die at a specific time. Maybe we are. Maybe we’re not. Or how about someone who, in a desire to live as long as possible, is constantly flying East so that the days pass, though physiological time does not. If I end up in New York, I wonder how losing those three hours will affect me—could I have done something remarkable with those three hours? Could I have produced something? Could I have made a significant impact on something or someone had I not left for New York? Maybe; maybe not.

It’s hard to believe that 24 hours from now, I’ll probably be finishing up my first interview. And right now, I’m still sitting in the airport in Seattle.

I’m also having doubts about doing this whole New York thing, which doesn’t surprise me, only because it seems to be coming into fruition. I’ve met wonderful people in Seattle and have developed fantastic relationships with a lot of people. Yes, the same thing can happen in New York City, but it won’t happen immediately. I’m fortunate that I already know people in Manhattan, though why would I choose to leave my social network in Seattle? It’s not that I will lose these friendships and yet, if I end up in New York, it won’t be the same. I just wonder.

9:15am, 21 September 2007. Starbucks.

It is sadly ironic that I am sitting in a Seattle institution while in New York. It is also just plain sad that New York City doesn’t offer free WiFi in its coffee culture. Seattle has spoiled me with its liberal, free-WiFi-everywhere approach to purchased beverages. This has also shown me my great reliance upon the internet to provide me with information (like where I can find free WiFi in this city—anyone have any recommendations in the Upper West Side and Lower East Side? or should I simply resign myself to the public library?).

I got into New York City later than expected, since the plane circled above JFK for about half an hour due to overcrowding… and then the plane circled around the terminal for about fifteen minutes due to overcrowding. I’ve recently seen a patients with pulmonary embolisms and deep vein thrombosis (blood clots from the legs—usually—getting caught in the lungs once they break apart in the leg veins) and was a little too overconcerned about that. But since my legs do not hurt, are not swollen, and I am breathing just fine, I think I’m going to be A-OK.

After escaping the thick, heavy heat of the subway stations and finding cool relief within the subway cars, I was struck with the screeching of the cars on the rails. My mind’s eye envisioned banshees chasing the subway cars through the tunnels, while we all sat listless and unimpressed. I discreetly looked around the car and was surprised to note that there was only one white person (out of about twenty) in the car. (The proportion increased the closer one got to Times Square.)

There are a lot of people in New York. (Stating the obvious is part of my charm.) I arrived at my hotel a little after 11:30pm last night and the subway cars were still full. A couple with their kid was wandering out of what I think is a small grocer (the poster in the window said something about pineapple ice cream). This morning, while wandering around in search of breakfast (the bagels here are quite good), I passed at least three schools and trailed behind several gaggles of grade-school kids wearing backpacks that they could easily fit into. (Kids start school later here, too.) Drivers were already laying on their horns in an effort to get to where they are going (though to no avail); dogs and their walkers were meandering past marked trees; runners, aglow from their morning run, strolled past with earphones in place. Men in suits, women in dresses, students with fashionable shoulder bags, potentially psychotic people muttering to themselves outside of liquor stores. Garbage men loading mountains of filled black garbage sacks into their beeping trucks. Delivery men wheeling towers of boxes across crosswalks. People, people, people everywhere.

This visit to New York seems different from my last visit—I am more impressed (and overwhelmed?) with the sheer volume of people here (these canyons that I walk in while staring up at the walls of all these apartment buildings!). I am also wondering—seriously, rather than dreamily, as I had in the past—if I could actually live here (if given the opportunity, of course—don’t wanna jinx myself). So far, I don’t feel out of place. Then again, I never have.

My first interview is rapidly approaching. It is going to be a warm day and I’ll be tromping around (with poise and grace, of course…) in a black suit. (sigh)

But first, I shall buy some fruit and snacky type things. People weren’t kidding when they said that there are grocers on every corner.