A little more than a year ago, I moved far away from my beloved family and mountains to attend medical school in Pennsylvania. The first months, in particular, were harrowing, and all my time here has had been challenging. The other night, though, I found myself feeling particular trepidation because, in January, I will begin work in the hospital. I will replace the endless parade of powerpoint slides with patients–living, breathing, ailing, suffering humans who need our help to get well. The burden, as you might imagine, can seem daunting and the expectation is almost worse. I include here an e-mail written to my parents that night, slightly edited for presentation here, but hopefully remaining true to the urgeny of my feelings that night; I would appreciate the thoughts of anyone who has ever scaled a peak that, beforehand, seemed nearly insurmountable:


Published in: on October 9, 2006 at 3:51 pm  Comments (22)  

The Heart of the Matter

Every ten years you live, your heart pumps enough blood to fill a rocket’s fuel tank. It does this by contracting and relaxing approximately once per second, over and over and over and over again, during every moment you breath. Every cell in your body has constant need both of new oxygen and of waste removal and blood serves both purposes. Your tissues can survive a few minutes without blood but anything more than that and they start to die–your heart can’t take any time off, it has to keep pumping interminably until the minute you die.


Published in: on October 7, 2006 at 12:31 pm  Comments (2)  


The United States is nearly unique among developed nations because it allows direct to consumer pharmaceutical advertising. The pharmaceutical industry is enormous and these companies ensure their ads are slick and alluring. To site just one example, I have often found myself nearly salivating for Claritin when I see ads for it on television. One particularly effective series of ads shows the world passing by as if obscured by a haze–it looks distorted and blurry, kind of like it might without glasses. Suddenly (upon taking Claritin, we are told), the haze disappears and the world shines with crystalline clarity. Anyone who suffers from hay-fever knows the truth of the first image and that same set of people, including me, can tell you how tempting Claritin becomes as a consequence.


Published in: on August 3, 2006 at 11:18 pm  Comments (2)  

Who Hath Sinned?

On an early summer night in 1998, Kipland Kinkel was in trouble. That morning, officials at Thurston County High School found a pistol in Kip’s locker and expelled him immediately. Furious, his father picked Kip up from the polics station. They had never gotten along very well–their relationship strained at best–and, on the way home, a terrible arguments ensued. Kip’s father had, over the years, bought Kip a few guns in an attempt to “bond” through target-practice. In retrospect, this step seemed misguided; when he bought the guns, however, Kip’s father was meagerly searching for a way–any way–to bond with his ever-more-distant son. As they approached their a-frame home some twenty minutes outside of town, Kip’s father informed Kip they had reached then end of the line: Kip was going to have to give up his guns. Shouting and swearing ensued and, when they finally pulled into the driveway, Kip bolted from the car and ran up stairs, incensed.


Published in: on August 3, 2006 at 11:13 pm  Leave a Comment  

Body of Knowledge

Having just finished our gross anatomy course, I have mixed feelings about the use of cadavers in medical training.

Before our final exam on Monday, we visited with our “lady” one last time. I know the scene sounds strange, even macabre, but there was a certain reverence there. Her body, I am sorry to admit, is only the tattered remains of what it once was. We have dissected much and it is difficult now to look at her and remember she once was a person.


Published in: on August 3, 2006 at 11:05 pm  Leave a Comment