While walking along Third Avenue, I turned my head to look West. The sun was sandwiched between the dark clouds overhead and the pewter waters of Elliott Bay. I squinted.
“Ms. Maria!”
I turned around. Someone had said my name twice; I just didn’t realize it until he repeated my name. Very few people address me as “Miss”, let alone on Third Avenue.
He was smiling at me. I smiled in recognition and reflexively greeted, “Hello! How are you?”
His hair was longer and he was wrapped in a puffy jacket. We both stopped walking and comfortably occupied a small section of sidewalk. The downtown crowd naturally parted around us.
“I’m good, I’m good,” he said. He was not looking at my face; I sensed that he was looking at my neck. “Ms. Maria, can I make an appointment to see you?”
“Of course,” I said. I had actually seen him only once in the homeless shelter; many months had passed since that first meeting. I had hoped to see him again, but he simply disappeared.
A few emergency rooms in the area, however, had contacted me since our introduction.
“There’s a guy here who says that you’re his psychiatrist,” the disembodied voice would say. “He’d like to follow up with you. He’s asking for [antipsychotic] medications, though it sounds like he hasn’t seen you in a while.”
“Yes, please tell him that I’m looking forward to seeing him—please send him my way,” I would enthusiastically reply.
And he never showed up. And he continued to appear at various clinics, occasionally reporting that I was his psychiatrist; other times, he would state that he was receiving services from other medical centers. Consistently, though, he never showed up.
“Can I make an appointment to see you directly?” he asked. His eyes darted to my face, then darted back to my neck.
“Yes, you may,” I repeated. “If you go directly to the building over there”—I pointed—”you can make an appointment.”
“Would it be okay if I had an appointment to see you?” he asked. He was starting to move towards me, his eyes now fixed on my right shoulder.
“Yes,” I said again, becoming increasingly concerned. “You can just stop in if you’d like; at least we can talk briefly about how you’re doing.”
This was not the kind of conversation I wanted to have on a busy sidewalk.
Still intently looking at my right shoulder and saying nothing, he abruptly outstretched his right arm and reached out to touch me. It wasn’t until after I had taken two quick steps backwards that I realized what had happened: I had automatically rotated my torso and leaned away, just as his fingers were approaching my arm. His hand grasped only the cool afternoon air.
We stood facing each other. The space between us had grown. He smiled and a little laugh escaped his lips.
Was that self-consciousness on his face?
He dropped his arm and took two obvious steps backwards.
“Okay,” he simply said.
Standing my ground and noticing that he continued to gaze at my shoulder, I quietly said, “Make an appointment to see me. I want to know more about how you’re doing.”
“Okay,” he repeated.
“And I’ve got to get going,” I concluded. That was the honest truth.
“Okay,” he said again. “Good-bye, Ms. Maria.”
“Good-bye,” I said before turning away to resume my forward motion.
And he never showed up.
21 Mar 2008 | 3 comments.
Three Observations.
The stars were still visible within the folds of the purple velvet sky this morning as I ran along the sidewalk in a new pair of running shoes. (I retired my first pair of sneakers!) The beginning of mile three is a decline down a gentle hill. Along the curb sat a garbage disposal truck, engine running and yellow lights flashing.
I purposely shifted my weight to lower my center of mass, leaned forward from the hips, and succumbed to gravity. My frequency of my footfalls increased and I flew down the hill.
I passed the truck and spied a man wearing a reflective vest about twenty yards away. His body was leaning to the left and his right hand clutched a filled trash bag. As I continued my flight, he shouted, “HEY LADY! You should slow down!”
I thought I heard playfulness in his voice. He didn’t see me smile as I dashed past.
Though we often believe that we only have words to use in the currency of communication, this simply isn’t true: There are all the gestures we use, the facial expressions we exhibit, the tones and inflections in our voices, the way we position our bodies….
Take the woman who remain psychotic. We meet. She greets me warmly. She talks to me. I honestly do not understand over two-thirds of what she says to me. We converse anyway.
We sit together for about half an hour, though we could probably sit for longer. At the end of our time, she thanks me and eagerly invites me to return. She likes me. I like her.
I leave confused. I have no idea what we talked about. And somehow, we continue to get along.
This is my fourth year participating in the MS Walk.
I walk for a dear friend of mine who was diagnosed with multiple sclerosis four years ago. We were both interns on a ward medicine rotation. I didn’t know her well and, thus, I was surprised when she asked if she could speak with me in the bathroom.
(Because that’s apparently what women do when they want to talk about sensitive topics: They retreat to the bathroom.)
I wasn’t expecting her to tell me about her diagnosis. I was stunned. I didn’t know what to do.
And then I started walking.
Each year, I am deeply humbled that people donate money to support this effort. I am continually impressed with the generosity of my friends and peers… and I consider myself wonderfully blessed to know these remarkable individuals.
Though I ostensibly walk to help bring hope to those who have multiple sclerosis, I invariably walk away from the event feeling more hope than I could have ever imagined.
18 Mar 2008 | 3 comments.
N’Awlins.
In New Orleans, I
>> met Brock’s wife (who has officially matched at a residency, though we know not where yet—congratulations!) who took me to Camellia Grill for breakfast. My meal consisted of a cheese omelette, french fries, over-buttered toast, and whole milk. I could feel the cholesterol plaques forming on the walls of my arteries. It was delicious. (I’ll be writing a lot about food.)
>> met another intueri reader. She’s a medical student at Tulane. She took me to Deanie’s Restaurant (I think the link is correct…), where I enjoyed my first shrimp po-boy. Bring on the fried stuff. She also took me on an impromptu drive through the more impoverished parts of the city, where there remain buildings that have not received any attention since Hurricane Katrina blew through. Though the water has since evaporated, there remain gutted buildings with roofs wrenched off, boarded windows, and mangled foundations. It’s sad.
>> walked along the Mississippi River. The blue-grey-brown waters endlessly churn past and carry vessels of all shapes, colors, and sizes along. Appropriately, I was unfamiliar with the water fowl in New Orleans and enjoyed watching the birds splash into the river before leaving en masse into the bright blue sky. I wonder if Mark Twain saw similar things.
>> toured a cemetary. City tours are a great way to learn history and observe how past events provide context for the present. The tour guide (a sassy woman named Madeline) informed us that the graves are above ground not because of the water table (i.e. causing the bodies to float), but because of Spanish tradition. (Perhaps any readers in Spain can corroborate this?)
>> met a voodoo priestess. She is apparently well-regarded, though, unfortunately, I understood very little of what she said.
>> walked along Bourbon Street. Loud music, open containers, flashing lights, off-key karaoke, green bead necklaces everywhere, young men travelling in packs, women wearing tight clothing, people streaming in and out of strip clubs. It was visually and aurally noisy.
>> heard a woman belt out Amazing Grace in a restaurant. A bartender suggested that we go to the Coffee Pot for breakfast and, while waiting for a table, we overheard a waitress sing. A light breeze was coming in over the water, unfurling the colorful flags along the street and causing the flowers and vines hanging down to sway. We listened and time paused for a moment. (Inside, I sampled calas cakes (fried balls of rice—tasty), creamy grits, and po-boy french toast. My sweet tooth was satiated.)
>> ate beignets. The air was warm and it was raining. Water trickled off of the green awnings of Cafe du Monde. A gaggle of teenagers sat at the table behind us, laughing loudly at their in-jokes and taking photographs of themselves as the night unfolded. Powdered sugar tumbled onto my black coat and the residue from the hot chocolate stuck to my lips. Romance blooms there.
>> did not have the opportunity to sit on a truck for dinner. Let me tell you about Jacque-Imo’s: The food there is delicious. Appetizers included cornbread drenched in butter, fried green tomatoes, and jambalaya. For the main dish, I ate the blackened redfish with mashed potatoes and collard greens. Oh. My. Goodness. Quite possibly the best mashed potatoes I have ever eaten (butter is a wonderful thing) and the fish rivalled the quality of that in Seattle. So what’s this about a truck? There is a pick-up truck in front of the restaurant that seats two. It’s cute.
>> eavesdropped on a taxi driver. He spoke primarily Creole (I think) and was clearly in a heated discussion on the telephone. One of the few phrases he said in English was, “Baby, it’s not what it sounds like.” That’s never a good sign.
>> sampled what are allegedly the “World’s Best Cookies”. And, no, they’re not the the World’s Best Cookies. Doubletree Hotels would like to think so. They’re not bad, but they are clearly engaging in hyperbole with such a bold statement.
>> got a sunburn. I know, right? I look unnaturally dark here in Seattle.
One of my favorite medbloggers stopped writing about a year ago. He cited several reasons for his departure; a primary reason included competing relationship demands. And not that other people were nagging him to stop writing; recognizing that his time and energy are non-renewable resources, he wanted to devote his efforts towards these relationships. So he said good-bye.
I took a break from intueri over a year ago. An untoward event prompted that hiatus and, obviously, I resumed writing thereafter. No untoward events have recently occurred, though I have been contemplating the future of intueri. There are significant implications (both “positive” and “negative”) in maintaining this site.
While in New Orleans, I had a conversation with someone about The Book. The Book is what I should write for “real” publication—I haven’t started writing it for a variety of reasons (they all fall under the umbrella of “I’m not ready”/”I’m too distracted”). One could argue that I blog to avoid starting The Book.
And, that being said, I still enjoy writing very much. And it’s cool to meet people through this medium (hi Molly and Amanda and Jesse and Yasmine and Terry and Patrick and Joshua and Michael and Justin!).
My ambivalence about maintaining intueri amplifies (motivational interviewing, anyone?). I am not yet sure if I shall stop writing online completely or, like others before me, continue to write, but on non-medical topics only. In another location. Quietly.
Just to keep you in the loop.
17 Mar 2008 | 11 comments.
The Big Easy.
I shan’t be posting anything for the remainder of the week, as I will be in New Orleans. (This shall be my first visit to the South.) The computer is staying in Seattle. I intend to focus my energies on eating beignets, jambalaya, gumbo, and other local fare. Expect colorful commentary and maybe a few photographs upon my return.
12 Mar 2008 | 4 comments.
Punctuation.
My English teacher during my sophomore year of high school was a portly man with light hair, light eyes, and shiny skin. Khaki pants and polo shirts were his attire of choice. He shouted. That was the normal volume of his voice. The decibel level was often incongruent with the content of his speech, though he knew that the disparity would hold our attention.
His shouting was also particularly effective when he read Shakespeare, for when he recited the bard’s work, he sounded like Kenneth Branagh.
The curriculum for sophomore English included grammar and punctuation.
“So what do you say when someone knocks on the door?” he shouted at us one morning. “Do you say, ‘It’s me’?”
His light eyes twinkled. Teaching grammar brought him joy. (Yeah, we found that weird, too.)
“‘It’, the subject, refers to ‘me’, and thus”—he dramatically cleared his throat—”the correct reply is, ‘It is I!’”
He said “It is I!” with the gusto and flair of Cyrano de Bergerac’s prose. We giggled at his silliness.
“It sounds ridiculous, doesn’t it? My wife rolls her eyes at me when I come home every evening: ‘It is I!’ I crow.”
One morning, he shouted oratory at us from a college admissions essay. Some kid had written a college essay that went something like this:
I have waded through an ocean of tulips in the Pacific Northwest, scaled the walls of the Grand Canyon, and watched the traders create money on Wall Street (and on and on and on—some of the descriptions bordered on impossible)… but I have yet to go to college.
His smile shone almost as brightly as his oily face. “Now that,” he shouted exuberantly, “is an excellent college essay. It captures your attention, maintains your interest, and communicates effectively.”
The most memorable lesson he imparted upon me, though, is the use of punctuation when addressing a letter.
“You may use either a colon or a comma when addressing a letter,” he shouted. His eyes sparkled with mirth.
“A colon is formal. Use it when writing official or serious correspondence.
“A comma, on the other hand, is casual! If you are willing to hug the recipient of the letter, then use a comma. If there is no way in Hades you would touch the person for whatever reason, or, at best, you would only shake his or her hand, use a colon.”
His explanation struck me. Could a punctuation mark really embody that magnitude of intimacy?
Probably not. I, however, delighted in the discreet sentiment, the metadata aspect of it. A shift from a colon to a comma (or vice versa!) following the greeting could communicate something significant.
Nearly 15 years have passed and, to this day, I still consider that touch/no touch algorithm with each letter I write. It’s worked well, even if I’m the only one who recognizes the intention behind my choice of punctuation.
11 Mar 2008 | 2 comments.