A lot on my plate

I've always felt that doing things is the best way to learn.

Lately, I've been out cross country skiing, downhill skiing, figuring out plans to bake bread in a woodfire oven once a week, sledding, and even started working on an upper valley drink special website. Read: very very distractable these days, not having much luck focusing on the science.

The volume of what we're here to learn limits how much room there is for active learning or creative thought. This equates to fatigue without much fulfillment. Fulfillment I will make for myself.

First Day of Anatomy Lab

This is our bag.

Meeting our first patient in the anatomy lab is a whole host of introductions that all happen at once.

It’s a presentation of the deep privilege given to the members of our profession - the license to carefully examine the parts of the body and their behaviors, which align to create a complete person.

It’s an introduction to the skills of handling a tray full of tools to delicately manipulate the body. A strange capacity that will allow some of us to remove deranged tissues, welcome new people that might not be able to safely leave the womb, and to allow others to have an active life after trauma. Others of us will never again spend so much time working with the insides of a person, but will regularly use the three-dimensional understanding of anatomical relationships assembled in lab for the diagnosis and treatment of disease.

Perhaps most stirring of these introductions, meeting our cadaver is also an intimate presentation of the end of life that comes for you and me. Who he once was is who we are now. Who he is now is what we all will be some day.

When I was working with a psychiatry study looking at civilian PTSD, one of the general health surveys we administered asked participants to rank on a scale the likelihood that their health would get worse. Not one person in a year of interviews said that they expected to lose their good health. Though many of us are not mindful of our ultimate end, our cadaver was more than capable of refreshing my perspective.

Unzipping the blue tarp bag with our gloved hands revealed a room-temperature, naked, elderly man. Since we were beginning with the back, our first act was not an incision. Instead, it took all four of the members of our lab group and our professor to work to turn our patient over. After this maneuver, we began our careful dissection of the skin, muscles, vasculature, nerves and connective tissue of his back.

When I worked in an urban hospital in Quito, Ecuador, I assisted in a number of minor surgeries and a few highly involved operations. At times I would have to sit down, step back, or even leave the operating room when a squeamish feeling creeped in. The doctors used to joke with me saying “tengas phobia?” or “are you scared?” At the time, feeling woozy seemed to be a pretty natural response to watching someone cut another person.

Last Friday though, I didn’t have a touch of phobia. I don’t think it will ever stop being strange to work in a room full of dead people, but a profound interest in the material grossly outweighed any reservation. Beyond interest or reservation though, one feeling dominated the complex mix of emotions I felt working in the lab last Friday. I’m so deeply thankful for the rare gift that our patient chose to give our class, and that he decided to be our introduction to this new life.

Paging Dr. Howser...

We've been learning lots during orientation for medical school. Where to get cheap scrubs, tasty suds, and how to email your buds using the campus email system called Blitzmail.

Blitzmail dates back to before the Roman empire, and was actually Phidippides' last name. It has all sorts of bugs and quirks, but my favorite feature is the ability to choose a nickname that you want to use.

And choose I did.

Friends you can now email me at doogie(at)dartmouth(dot)edu. I think I'm gonna get some business cards printed.

Classes start tomorrow. We get scrubs, text books, and order our stethoscopes. Seems like it's happening!

Blood turning green...

The scheduled parts of the first day of med shul orientation are all over.  All that's left is the picnic at the outdoor club, and drinks at the canoe club.

More than anything, the dominant feature of the day was an introduction to the incredible amount of support this learning community seems to provide.  Not a shred of arrogance, or even mention of leagues of the ivy persuasion.

And the class is really an incredible group.  I got a taste yesterday when we did a hike up Mt Cardigan in Vt.  So many interesting people who have done so many interesting things, and who seem genuinely warm and concerned about other people.

Lots more to write, but I think I'm really gonna like it here.

The Dehra Dun Express

After a looooong day on the Bollywood set, I walked into Mumbai CST at 10:00, the main railway station for the sprawling metropolis. To my chagrin, when I checked the schedule I couldn't find my train. Asking every other uniformed person for help (including the cranky samosa fryer), it finally became clear that the Dehra Dun express would be leaving from Bandra station, not CST. Okay, I thought, looking at the clock, which read 10:30 by this point. "How far to Bandra?" "Oh, not far, maybe one and a half hours by taxi."

Panic creeping in. I'd worked so hard for this damn ticket, I wasn't going to miss the train. Is there any other way to get there? "Sure, the commuter train runs every five minutes and will get you there in 45 minutes."

Finally after getting on my train and finding my berth, I got set up and took a snooze. Chatting the next day, I got to know Abimanyu and Chaitan, two young guys from Dehra Dun who were interested in Social Entrepreneurship and Che Guevara. This, they told me, was why they were riding second class (there's a third class mind you) - to see "how the people travel." They were really great guys though, and once we got to Dehra Dun, they offered me a place to sleep and showed me around town.

Abi took me to meet two of his aunties, one of which, the wife of a wealthy army major, insisted that I tell her all about my girlfriend. "Honestly, I don't have one right now," "no, no, don't be shy, you can tell your auntie." The other auntie took more after her father, a famous sitar player, who insisted on my coming back and staying with her for a month to learn Hindi and Sitar.

"We'll see..." is coming out of my mouth these days so much more than ever before.

After spending the night in Dehra Dun, they took me up to the hill station of Moussourrie, a popular site for Indian honeymooners. We had a lovely omelette at a highly-regarded shack before the guys helped me hop a shared jeep to Danulthi.

The hospitality here is a bit overwhelming. I can't help but feel wonder about what expectations they have for what I can offer in return.

Smiling, Talking, Silence

Bad News: my camera memory chip seems to have picked up a virus. My photos seem okay, i'll just have to find a computer that I can sacrifice to upload them... The anti-virus software in the few cyber cafes I've tried haven't let me copy them. In the mean time I'll go back to borrowed pics.

Anyway, Mumbai is a wonderful town. If only it wasn't hotter than blood, and if the places I ended up sleeping weren't crawling with bedbugs (don't worry there's a photo of the awful bites that will come some day) it'd be a quaint place to spend a week. The architecture of the town blends Arab, Hindi and British styles in a way that makes the place feel like London went summering in Western India.

After I spent my first night in the worst hostel ever (see guiness book of records 1999) (just kidding) I took the boat out to Elephanta Island which made me feel much better about the place. Then I made my way to a great berry pilaf lunch at an old Parsee place. Just then, after I got back to my hostel after lunch, fate struck.

"Hey mate, want to be a Bollywood extra? We'll give you lunch and pay you 500 rupees." After a quick call to my agent (who reminded me that she is, in fact, not my agent and would I please stop calling) I signed up.

Later that night I met some guys in the hostel that were going out with a Mumbai local, who turned out to also be a Bollywood scout. She was recruiting for a big film, but it was going to go too late for me to catch my 36-hour train to Dehra Dun. I'd have to settle with the first folks.

I met my costar on the Mumbai commuter train (think of those crazy clips you must have seen of public transit in Tokyo with lots of shouting and pushing). We traveled an one and a half hours to the set and got in costume. Then we sat, stood, pretended to drink, rinsed and repeated for 13 hours. A long, but interesting introduction to the life of a Mumbai extra. Plenty of people do it professionally, and make good money. So much that they won't take a speaking part because then they can't be extras anymore in case someone recognizes them. Even foreigners do it full time. Take the shady Russian, for example, who wanted to borrow my shoes.

"No," I told him "these are my shoes."

Apparently he lives in an Extra den with six other Russians who pass their days walking back and forth, smiling and talking, silently. Which is good because that's what they shouted at us all day "Smiling, Talking, SILENCE!" It began to feel a bit like a Buddhist Koan.

a few pet peeves...

People who spread their legs on the bus who get all up in my comfort zone. Back off shorty, I know when Baba in front of me leans back it's only going to get worse so just keep to your side.

Bed bugs. Ick. And Itch. And Ick. Same goes for mosquitoes.

Deet. Go figure.

Happy Journey!

Oh, where to begin...

This morning, at 5:45 am, I quietly crawled out of my mosquito net cot and walked until I found a rickshaw for hire.

I didn't want to wake up my roommate, the other volunteer here at Ashraya, since this was not my first early morning trip to the railway station. In fact, it was my fifth.

Four other times I'd been to the crowded home for beggars that functions, from time to time, as a place to trick yourself into thinking you might get on a train.

At 6:15 I walked up to counter 30, which is kindly reserved for the special-needs population of India (being the handicapped, senior citizens, women and foreigners). "Great," I thought. "There's no one here. I'm first in line," which is exactly where the angry ticket salesman hinted, oh so delicately with his spittle-soaked-shouts, I should be. Thank God/Allah/Ganesh/Emory or whichever is the proper deity of obstacles for providing me with that glass window. I'd have to be number one to get my ticket to Dehra Dun.

Then a short, squat, oddjobish looking fellow taps me on the shoulder and says something I don't understand. "Tatkal?" he asks, "uh huh," I reply, "you are number eight." I turn to see the seven people that have been waiting since before 6:15 for the window to open at 8:00. I'd underestimated the mad rush for tickets too many times before, but I had to resign myself to my eighth-place fate. For nearly two hours I elbowed and was elbowed, shoved and got shoved, prayed and was prayed for to get this little scrap of paper, but I finally got it. Even the sweet lady who was number nine and praying for my trip got her ticket. It was a good morning.

Now that I have my ticket, I feel like I should frame the thing instead of using it.

Instead of a $250 plane trip to Bagdogra, or a less-civilized bus ride, I'll be riding the 36 hours to the northeast of India in sleeper-class style for the price of 613 Rs, roughly $15. I bought a couple more books today (The Argumentative Indian and Krishnamurti's Commentaries on Living Vol III).

The plan now is to bus to Mumbai on Monday, mess around there for a couple days and take my train on the 23 to Dehra Dun. From there I'll take a bus to Sikkim and look into a bit of trekking for a week or two. After that I'll work my way back west by way of Varinasi, Delhi, Maybe Rishikesh and Agra for the Taj Mahal. Then back south to Mumbai to fly home to the Atl.

I can't wait for my happy journey to start.

don't even know what to call this

Apparently today is a holiday - i'm not joking here - where everyone takes sticks and branches and saris and sweets and pots and hangs them outside. i keep asking and i still don't have an answer what it's about...

Rickshaw with a view

I haven't had much cause to go out beyond riding along to visit hospitals since I've been with AIC.

But when I do, it's always a treat. And that's mostly because rickshaws are fantastic.

These go karts get people around with remarkable efficiency - if not breathtakingly risky cornering. Riding in these things brings to mind the Seinfeld routine about taxis in new york. You could be up on two wheels, cutting people off and hitting pedestrians, but since you're in the back seat, it all seems perfectly safe. "Hm, wouldn't do that in my car."

Some friends from home are talking about participating in the rickshaw race that happens every january here from the south of india all the way to the north, which of course culminates in a cricket match.

Anyway, there's some photos up on flickr from a recent trip on the rickshaw. I've also included a video below with what it looks like to ride in one and a song I wrote that keeps running through my head when riding...

Ramu Power

Captain planet came to visit when I was in middle school.

I know what you're thinking. "He's a cartoon... how can he walk and talk in 3D?" We were all busy wondering that ourselves when he came into inman middle school's auditorium talking about how the power was ours.

He went on to ask which power we thought was the most important. Of course, we all knew that fire was the best, especially since the guy with the fire ring was SOOOooo much cooler than the others. But fire was not why some strange man had dressed in a foam body-sculpted suit to address a group of middle schoolers as a strange cartoon. No no.

He was there to tell us that the power of Heart was the most important, the most powerful.

Anyway, for some reason, this photo of ramu, the much discussed 12-toed current celebrity of AIC, seems like he's ready to use his power of polydactyly, as he routinely does, to take off in flight or maybe just communicate with animals. Who knows? He can't talk yet to tell us what he's got planned for the rest of us.

Too bad dem toes is around for a limited time only. They's a comin off.

In the mean time, count the toes in the photo below for fun.

They don't call it Indian Style for nothin

This guy in the picture is really good at sitting this way.

I am not.

The apparent chair shortage here will either - break my back - or - give me back STRONG LIKE BULL!

I'm not sure if I've written much about the Ashraya Initiative for Children yet, but this may be a good time before I tell you a bit more about how the past few days have been for me.

Liz Sholtys, along with a group of other young people started the organization to establish a home for street kids. Until a few months before I came, I thought most of their work was focused on the kids.

Emailing with Liz and Patrick though, I learned that they'd started health and education outreach programs to have greater impact. After being here a week or so now, I'm still consistently impressed by AIC's projects.

I originally thought I'd be helping out as a volunteer with their health outreach, but since lots of kids have exams coming up, I've been doing more teaching. Which has been quite a ride in and of itself. I've always loved kids, but usually in the way that I love a good book. I'm used to observing characters from a healthy distance, and then putting them down whenever I want to. Not so when you're living with the kids - or teaching them about brer rabbit and the "wonderful tar baby." Another unexpected element of working with the kids is that dada is a word for brother (i think) so i'm called dada all day...

"Dada what I doing this?" "Um, in this activity they want you to draw one less balloon than in this box." "Coloring?" "See there are five in this box, draw one less over here." "one, three FIVE!" "yes, five, draw one less than five here." "FIVE! Matching?" "Um, no draw four - one, two, three, four balloons here." "FIVE?!" "four. draw only four balloons here." "Dada?" "yes?" "what I doing this?"

So the other reason that I haven't been with the health outreach program as much is that Patrick, who normally runs that wing of the organization is still in the US waiting on a visa to return. When he was here until January, they apparently had a good thing going with office hours at the community center they run every day of the week. This has been reduced to three days a week. And, I'm concerned, may be reducing Liz. She takes care of so many folks, it's hard not to wonder who's taking care of her.

Walking with Liz is quite the experience. She's keeping a lot going right now - even with two hired live-in teachers, she is ultimately in charge right now of the 10 (plus one twelve-toed baby. pictures to come as soon as i get a camera...) residential kids, 30 kids in the education outreach program, dozens of families supported by the health outreach program (where did you go last night Liz? to the hospital again, the guy we helped back on his feet last year has nearly killed himself and we need to go to the blood bank for a transfusion. which, by the way ended up being the perfect time for a blackout and for the rickshaw we were riding in to get stuck in the mud. really.) and now... wait for it... Microfinance!

Apparently she asked around about having an interest session for a women's self-help finance club. Instead of interest, there ended up being commitment and excitement. When do we start?
I tagged along for their first official meeting yesterday, which was fascinating. I've always been interested in the way groups organize themselves. The Waghris are one of the lowest "criminal" castes, but not only do other groups not trust them, but they don't trust others. So three groups ended up forming yesterday with roughly twenty women each contributing funds to a pot that they can draw from at 2% interest. Each group was divided pretty clearly by caste, which because of the level of trust needed for something as dicey as finance, is probably not the first place to try and work on integration.

One of the most recent winners of the Nobel peace prize was a Bangladeshi man who started a huge bank that oversees several of these small loans giving credit to folks that wouldn't get it otherwise, at fair rates of interest, and a sustainable means of economic growth.

Last Thursday though, I went with Liz to help one woman get an epidural for back pain, another woman get a mammogram and a boy checked out for asthma and PTSD. The mammogram ended up being $10 with consult, which brings me to the plug. For a group that is getting so much good work done, they have the lowest operating costs I've seen. So a huge portion of donations go directly to project funding, which in turn goes a really long way given the strength of the dollar against the rupee. If you're feeling generous, there's a link to the right for AIC where you can donate online. OK, Sally Struthers is done.

Suddenly a month feels like a very short period of time. But while this stuff gets me excited about heading to school in the Fall, I'm trying to be intentional about taking it easy. Reading some. Drinking tea. Breathing. Sitting.

Holi

So far, my favorite moment of each day here is just after I get out of the shower. It's hot here. Hot as blood. And, after getting up a few times in the night to give the ceiling fan a hard push to get it going again and drinking a half gallon of water here and there - the best thing in the world at that moment is to jump in a cold shower. Being covered in cold water helps life get good again. After that, I'm happy to sit with a book, the rousing birds, and my jet lag before the day starts.

I don't sleep well in heat.

Maybe sometime I'll tell you about when my family went camping in southern Louisiana in the summer. In the mean time, feel free to let your imagination work up the horror that came to pass that night.

Yesterday was the second day of Holi, which made me happy to get in the shower for another reason. Holi is the festival of color, for reasons that wikipedia doesn't really help ellucidate. The most noticeable feature of the holiday have to be children running around with water guns filled with colored water, and packets of color powder. Interestingly enough, wikipedia does suggest that these colors used to have semi-medicinal value, green coming from neem, yellow from turmeric, and red from kumkum - all plant products with demonstrated health benefits. These days though, toxic ingredients are what make up these bright dyes - not the least of which include mercury, asbestos and silica.

Still, it's fun to paint each other like easter eggs. So, that's what we did. On the roof. 10, wait, now 11, now 14 kids on the roof spraying each other with colored water. Thankfully this is how the Ashraya folks play Holi. Not in the streets.

Around town, no one, including the policeman pictured above in the BBC photo series, is safe from the little spectrum-happy miscreants. Liz, the lady in charge here, says that she's even been attacked while riding in a covered rickshaw.

After playing for an hour or so, it was nice to get in the shower again and wash the dye down the drain.

highly ranked list of waiting

I often feel like I'm living my life all at once. Not sure if it's the source or result of being so laid back, but I slip into memories hourly and I rarely feel regret because often I get the sense that events are set. I joke sometimes that I'm living with the goal of being a very old man by the time I'm 40 - cane, highball of single malt, cigar, small change to pay off neighborhood kids to steal things from convenience stores - the whole time ranting about the good old days.

In my course on Confucian classics, one of the most memorable passages was when Confucius was going on about how much better things were in the past. You know, back in the 4th century BCE, before all the modernity of the 3rd century mucked everything up.

Still, I'm feeling better today about waiting for school.

I had my last interview at OHSU, and in each of the three interviews the interviewers asked where I see myself in 10 years. Oh, I don't know, 10 years older?

I called my top choice and talked with the Dean of Students and he was very encouraging. He says that they keep a pretty short wait list and usually pull several dozen into accepted status. So, depending on what I hear from the other schools, I think I may have to let two acceptances go before May 15th and then just wait until the mad rush this summer when spots open up across the country.

OHSU, it turns out, puts the majority of its interviewees on a "hold" list until it finishes interviewing. More of the Columbia style of being less rolling, interviewing everyone first and then offering seats in the class.

The waiting that I'm most excited about right now though is for a potential niece/nephew. It develops my brother and sister (in-law, we're not that southern) are going to try in august for a munchkin, and I'm tickled with the prospect of a new person coming.

Oh how I long for friction

Seattle with out tread on your shoes is a death trap.

I think I'm going to look for new kicks this week.

lovely limbo

I love being away from home. Getting out of the city, state, country - wherever - I think travel is wonderful.

A persistent challenge that comes with travel is finding what to do with the days just before leaving a place. I feel like I'm already in that realm of uncertainty. I've worked my last shifts at the coffee shop, i find out from my two top pick medical schools in the next few weeks, I leave for the west coast March 10th and then I'm hoping to leave for India March 17th.

I get back from India the last week of May (insh'allah) and depending on where I go to school I could have as little as two weeks to pack up my things, find a new place and move to my new home for next 4/5 years.

It sounds like a lot, but today, it's more like a lot of nothing.

The last time I went to South America, I fell in with a group of lovely canadiennes. They spent a good deal of time planning their last day together: which markets to visit, where to dance, which coffee/pancakes to savor. If I remember correctly, that last day ended up being a lot of fun, but little of what we did was originally on the list.

Which, of course, is the way it usually goes. One of the most popular interview questions for medical school is "where do you see yourself in 10 years?" While I understand you could probably gauge for narcissism (chief resident with the best handicap on the course) or careful goal setting, it doesn't seem like all that important of a probe to me.

I don't think it's right to chalk up my feelings about my present uncertainties to anxiety, and it's not necessarily as though I'm wrapped up in my expectations - this situation keeps me from having any expectations at all.

That's the present challenge. Keep the future in the future.

Rumi

Don't grieve. Anything you lose comes round
in another form. The child weaned from mother's milk
now drinks wine and honey mixed.

God's joy moves from unmarked box to unmarked box,
from cell to cell. As rainwater, down into flowerbed.
As roses, up from ground.
Now it looks like a plate of rice and fish,
now a cliff covered with vines,
now a horse being saddled.
It hides within these,
till one day it cracks them open.

Part of the self leaves the body when we sleep
and changes shape. You might say, "Last night
I was a cypress tree, a small bed of tulips,
a field of grapevines." Then the phantasm goes away.
You're back in the room.
I don't want to make anyone fearful.
Hear what's behind what I say.

Ta dum dum, taa dum, ta ta dum.
There's the light gold of wheat in the sun
and the gold of bread made from that wheat.
I have neither. I'm only talking about them,


as a town in the desert looks up
at stars on a clear night.

This does not, N-O-T, not mean you suck

Eddie is a saint. The man that no longer owns Eddie's Attic, but still runs the acoustic venue's weekly open mic night, finishes every week with: "before I call the last finalist of the night, I want to reiterate that if your name hasn't been called, it does not, N-O-T, not mean you suck.

I haven't played at Eddie's - but - I have spent a number of nights going just to listen.

It's brilliant. Well, in the little league soccer kind of way. So much struggle, everyone going for the metaphorical broken heart/follow your dream/nostalgia-for-something-vaguely-american-that-our-generation-never-knew soccer ball, and no one really getting anywhere, unless you count the three folks that are selected as finalists. There's no shortage of songs by sensitive, misunderstood blokes writing about what they suspect songs should be about.

To be fair, it is extremely difficult to be or do what you are - and i don't pretend to have it right.

One of the great things of hanging out at open mics though, is the chance to build a song from a group of rules of what you'd hope to never do - given how it's playing out on stage.

My buddy Christiaan has been on the road with his band pretty much since we finished at Emory in '06. His band Brass Bed played at a house party this past saturday night (of course the police came. "everybody inside" says the tipsy host, to which mike's inner monologue replies "hmmm, uh, you know what, I'm not doing anything wrong so I think we should just go. i'm getting too old for this")

The last time I hung out with Christiaan, he gave me a bit of friendly guff for not taking more time before school to play music. His friendly jabbing was about my heading to medical school as premature, citing his own backup plans of going to law school if the band doesn't work out. I want to be clear, I have no thoughts about going pro. But I don't think folks that play personally important music ever stop. Playing something that has meaning and familiarity provides a centering counterweight to daily busyness. It's worth too much to walk away from.

The past few years I've become a bigger and bigger consumer of music, always looking for the next sound that pings something simple, creative and organic without trying too hard. I doubt the playing or the listening will stop because I'm hanging out with science a bit more.

If I had to guess what Eddie liked about open mic nights, it'd be the leveling that happens in front of a microphone. Fairly regularly people playing at other venues in town would stop by open mic before their own personal gigs, but they're on the same stage with the same sound guy. They get two songs to say what you've got to say, and once in a while, maybe three times in one night, you get folks that are saying something honest and worthwhile about what living is like.

You do not ride with me, b you ride the marta bus

Since I've started working at Grady one of the perks I've enjoyed the most is the commute on the MARTA. Granted, it didn't help my germ phobias, but it has really helped other parts of my mental health. This makes for a good 20 minutes each day when I get to focus on nothing, and somehow the seasick rocking along at 45 mph along Dekalb avenue is actually pretty relaxing. One of the best parts of my day even.

I've always had a hard time with commuting, and the older I get, the more difficult it gets for me. It's just that any time I have to tread OTP for something other than an overnight trip, and maybe this isn't fair or appreciated, but I get really sad that people spend this much time in their cars. Every day. And, it's human competition dynamics at its worst, stirring up feelings of anger and frustration directed towards other people after a long day of the same mix.

So, and I'm feeling a bit Barbara Kingsolver preachy about the things that I like about my life that are really easy (sure, I'll take a year off and grow my own food), this is what I love about the MARTA. Atlanta mixed in these 8'x30' boxes smellin each other and listening to whatever music is about to blow some poor guy's eardrums.

Quick example, just the other day, a polite gentleman dressed in the latest urban fashion was explaining to a young mother how he could train her toddler to be a part of the true hustler nation.

This is how I learned that MARTA actually stands for Men Actively Recruiting TrueHustlers of Atlanta.

I submit for your viewing pleasure a recent public service announcement produced by the drum majors of the Southwest DeKalb High School Marching Band.

NSFW (not safe for work)

Whatsamatta U

One of my good friends from home (mutually identified hetero-lifemates) works at CNN, hoping one day to become an editor. Apparently, from time to time younger folks at CNN go abroad to film their own news segment, which can be pushed to the satellites that watch us from space if it's good enough.

I was telling him he should take a couple weeks off and come visit India while I'm travelling there. Of course, I already knew what he'd have to say about that, but half the fun of hanging out with him is provoking him to run a redheaded rant. "I don't mean to seem, you know, insensitive or anything," he begins, "but the whole AIDS in Africa, poor kids in orphanage thing is way overdone." "What I want is drug addicts - yeah, train-hopping, glue-huffing junkie graffiti artists."

At his housewarming party for his new and robotrendy loft in Grant Park, the subject came up again and it occurred to me that a segment on what's wrong with volunteers would be really interesting.

Last Sunday, working at the coffee shop, a group of cute girls that come in on the regular invited me to Five Guy's once I got off my shift. Brief preface here, there's a lot of cute girls that come in to our shop and this is one of the best parts of the job: drama-free 30 second dating. Tell a couple stories, have a good laugh, serve the latte and you're done. I got this wonderful system out of whack by taking the girls up on their invite. Talking to them about my plans for my next trip, they mentioned that they were looking at a program with a 24-year commitment. Four years of missionary school, followed by 20 years of living with a village without much contact with other people - learning their language, designing a written form of the language and translating the bible into this language. In her words "you go through the bible chronologically so they think that God is really terrible until you get to Jesus when they hear the good news and everyone gets saved."

Eeek. Fight flight fright. Though I'm always impressed that these folks can get out big words like chronologically, this brand of cultural pollution and judgment keeps me up at night.

Still, I'm sure their will be plenty of moments in medical practice when I'm the bad guy with the words from a made up language that were used to help someone that didn't want fixing.

Apparently the dean of Emory's medical school makes a point to remind each class that most medical students are high-functioning people living with mental illness.

Trying to pay more attention to my attitudes and compassion brings up words of Henri Nouwen, Pema Chodron and Rachel Naomi Remen - who all suggest that each person's brokenness or pain is what allows them to care for others. It's hard to be in that place, to stay with parts that are not where they should be. I'm still looking for how dwelling with the substance of struggle offers renewal.

One day I'll get my friend to put the film together, until then I'll stick to the overdone orphanages.