Monday, June 19, 2017

Sartorial lessons from surgery

As an introduction to clinical medicine, we first years were individually placed with various school-affiliated physicians around Boston. I feel very, very lucky to have spent my Wednesdays at a surgical clinic at our teaching hospital, with a preceptor and mentor (Dr. M) who I hope to become one day. I could fill an entire blog post on clinical knowledge, surgery knowledge, life knowledge, and how-to-be-a-doctor knowledge I have accumulated, but this post is about the sartorial lessons.

In this clinic, the surgeons wear dark suits, ties, monograms, polished shoes, and no white coats. All other MDs and MDs-to-be wear white coats. What did this mean for me? These three outfits represent the only things I thought appropriate to wear to clinic, where male M3s in pastels and khakis looked exceedingly out of place.

Purple top - Ross | Trousers - Banana Republic (too fitted?) | Shoes - Fitzwell | Maroon blouse - NY&Co | Dress - Uniqlo | Watch - Casio

Lesson #0: I am a first year medical student unaccustomed to dressing professionally and have no idea what I'm doing

Lesson #1: when the attendings wear suits and look like bankers and politicians, go as formal as possible without wearing a suit

For me, this meant charcoal grey and quiet jewel tones. The sleeveless tops were fine because I always wore my white coat (not true for all placements). I generally dislike collared, button-down shirts because fit is so fickle with them. Blouses are more forgiving and read a bit more formal. I think I was in the minority of my female classmates who regularly wore a dress to clinic, but I am much, much more comfortable in a dress than in trousers. This one was long enough where sitting, standing, kneeling, etc were all very comfortable.

Lesson #2: accessories and layers matter. Comfortable shoes and a watch are necessary.

On top of these base outfits, I wore a black cardigan and black tights to stay warm during the winter. Because I had a locker at school, I never had to commute far in these clothes and could easily walk to clinic without snow boots, even in blizzard conditions. Because I err on the side of being too formal, I usually wore a dark grey overcoat instead of a parka.

Corollary to #2: an anecdote

Though I spent most of my time in clinic, I often accompanied Dr. M around the hospital to talk to radiologists or other services. Following around a much taller person while wearing heels can be a chore: the dress + low block heel made it manageable.

Dr. M's advice from one of these occasions: "I noticed that you're always walking a few steps behind me. Don't walk behind attendings, walk next to attendings. When a young female medical student walks behind a male attending, it looks subservient, especially if you're the only one there."

How does one young female medical student follow an attending around without looking subservient? Wear comfortable shoes and take longer strides.

Also Dr. M: "Always wear a watch."


Lesson #3: details matter when trying to look like a competent, clean, and professional adult

I got a lot of this kind of advice from my high school job at an ophthalmology clinic where my primary grooming objective was to not look like a high school student. I think that patients may be less inclined to trust someone who looks quite young and unkempt, and attendings less likely to take one seriously. I combed my hair and made sure my makeup looked okay before clinic, and that I wasn't tracking in salt, snow, slush, or ice. Unlike these pictures, I did try to make sure my white coat look like I had not just dug it out of my backpack.

Lesson #4: dress for the job you want?

These are just thoughts I've had from my placement at a surgical clinic where the surgeons wear suit. But also, I haven't seen what female attending surgeons wear when not in scrubs. Yet another thing: I want a woman surgeon as a mentor.

Any advice on how to dress professionally? Thoughts on how to succeed as a young female in a male-dominated field?

Thursday, May 18, 2017

Mt. Monadnock | New Hampshire


I realized that since coming to Boston, I have blogged very little about the city of Boston, ye, the state of Massachusetts. Instead, a good portion of my content has been excursions to Vermont and New Hampshire. Here is another one of those adventures from earlier this month.


Mt. Monadnock is one of the only geological points of interest in New England that I knew about prior to moving to New England. It has featured in the poetry of Ralph Waldo Emerson, Henry David Thoreau, and (quite curiously) H.P. Lovecraft. While internet sources disagree about precisely how many people climb Mt. Monadnock each year, it is generally agreed that it is one of the most summited mountains in the world, trailing Mt. Fuji.


We took the White Dot Trail up to the summit. It's a 3.8 mile loop with an elevation gain of 1771 ft, to the summit at 3165 ft. Mt. Monadnock is not a particularly tall mountain, but it is the most distinguished feature of the landscape by far.


I very wisely wore many layers and my fancy hiking boots. The hike begins with very modest uphills, and then very abruptly transitions to some steep scrambling over boulders. We kept a brisk pace because the clouds looked ominous and we definitely did not want to be caught in the rain during the ascent. I personally really enjoy scrambling and thrive on steep, steep uphills...but rain would have made the ascent very precarious. I'd say that this hike is one where good traction and ankle support are especially important.


We hiked up in short, fast bursts on major uphill sections, taking in the rolling New Hampshire valleys under threat of rainfall with each break. Because I use my iPhone for all my pictures and generally go nuts editing on VSCO, I am prone to sort of amateurish landscape photography. I'm also not used to taking pictures under such ominous clouds and mercurial sunshine (or lack thereof), so please forgive the visuals.



The second major snack break

There are two major stretches of steep scrambles, and at the end of the first was where we had a major snack break. This stretch of flat was perfect for boulder hopping, looking at all the trees growing between rocks, and stretching out. We rested a bit and then made our last push to the summit, which was a bit farther than we had initially thought.


Looking for stunted trees at the second major snack break

Lunch at the summit, which was ridiculously crowded but still very enjoyable. I can see why Mt. Monadnock is one of the most-climbed mountains in the world: it's very close to Boston, it's fairly accessible to novice hikers, and they pay-off is wonderful, both in the summit itself and the feeling of digging in to get there. I don't know if any of my photos can express how steep it was in some sections, but it took real effort, perhaps more than any of the hikes I've documented here so far.



Getting ready for the final push to the summit, which was farther than we thought

We didn't spend quite as much time at the summit as I had wanted, but it began to drizzle and we wanted to get some of the steep, scrambly descent behind us before it poured. It never did quite pour but the rocks were at some points completely covered with rain, and some of our party did slip. The descent is more anxiety-inducing, and my joints did take a beating...but luckily, I didn't fall.

Some trees on the way up. I tend to write before I edit photos, and am still not great at spacing things out. Here, the text describes the descent and I haven't even gotten to the summit pictures yet!

All in all, we left Boston at around 9 AM, stopped at McDonald's, got to the mountain and hiked up and down, went to Taco Bell, and returned to Boston at around 5 PM. I chipped in $7 for the rental car, bought hash browns for $1, bought a honeydew for $3 near Taco Bell, and mooched off some of the junk food that someone was too full to finish.

The summit

  • Location: Mt. Monadnock, in Mt. Monadnock State Park in New Hampshire
  • Distance/duration: 3.8 miles loop, about 2 hours to the summit
  • Elevation gain: 1771 ft
  • Difficulty: moderately strenuous thanks to the really steep, really fun scrambles; could be harder in rain or winter or hotter weather
  • Points of interest: that sweet, sweet view
  • Overall: this was a really fun, satisfying hike. The scrambling was tough, but entirely worth the pain. I can see why this place is so popular, but at the same time, the trail and summit are very crowded.



By the time I got around to editing the photos and finishing the honeydew (I froze some of it), I realized that my first year of medical school was just about over. How do I describe this first year? I can't articulate it well in this addendum to a blog post about hiking up a mountain, but here are a few thoughts about this year and the summer to come.


My first year of medical school was a lot of things. It was an affirmation in that I know more than I began that I am where I want to be doing exactly what I want to do. It was a challenge, academically and professionally, but I learn best in challenges and in failure. I made some good friends, and had more fun than I am used to having. I also found mentors: a resident who wants me to succeed, an assistant dean who let me cry in her office twice and then helped me find my courage again, a preceptor and role model who taught me not just about surgery and how to care for patients, but how to be more confident and capable.


I think I always had an impression of Boston being some kind of intellectual ivory tower of medicine, and it kind of is. However, our hospital is decidedly blue collar, safety net, and deeply concerned with the intersection of medicine and social good. I was lucky to have found and stayed on the same research project since the autumn, and will work harder at it this summer. It's about both medicine and social justice; orthopedic surgery and opioids. The opioid epidemic in New England (and the Rust Belt and Appalachia and small town America) runs deep. It's systemic and demands policy at all levels of government. It's a fight I have been waiting to enter.


As far as Lord of Three Realms goes, I have a few posts waiting in the wings. I also realized that I have half of my Germany posts from last summer yet to be written. I hadn't expected my blog to turn into New England day hike report central when I first started medical school, but I do have some hiking planned this summer, and I will take pictures and write about them. More recreational reading, and more excursions out of my culinary comfort zone (I have recipes to try).


Last thing: I'm thinking about working on the blog itself...like actually adding headings and categorizing things reasonably.

And that's it.

Sunday, May 7, 2017

Sperry classic A/O boat shoes | Review



I have always wanted a pair of boat shoes. Why? My family does not own a boat, and even in my college summer days of lazy kayaking on Lake Merritt, I would not think to wear these shoes. I bought these shoes after I knew I would be going to medical school in Massachusetts, so perhaps I was a copycat, WASPy prepster wannabe this entire time.

Anyhow, on with the review.

Since buying these shoes in March 2016, I have worn them almost every non-rainy day between 65 and 80F; 40 - 65F is shared between these shoes and my long-suffering Dr. Martens Chelsea boots. Cost per wear is without a doubt under $1, perhaps even $0.50. I like them a lot, but would like them better if the leather were darker and the sole were not white -- my mistake, but I wear them to death nonetheless. They are effortless to slip on, comfortable, and practical. They are casual without being too sloppy, and are consistent with my standard level of formality.

I am a US women's 6.5 and am happy with the 7, even if I'm wearing thicker socks. They have almost no arch support to speak of, but I have worn them on heavy walking days (and even hiking in Germany) with no issue. That depends on you, though. The insole detached within the first summer. They smell if you wear them for too long without socks on a hot summer day. Or even a warm summer day.



The leather has been scuffed, stepped on, bathed in rainwater, splashed with scalding hot coffee, dipped in lakes and oceans and rivers, covered in dust and sand, and also plaster in the emergency department as I helped the ortho residents reduce two fractured and dislocated joints on the same patient. I normally don't wear these when I shadow in the hospital, but I had forgotten to bring my sneakers. I scrubbed off the plaster before I realized it gave the shoes character.

The soles are specifically designed for good grip on a slippery deck -- they do this job well, but have insufficient tread for muddy stone staircases in German forests, or dry Californian hillsides covered with leaf debris. They have been wearing down quite quickly, but that may just be because I wore them so much. The leather laces seem like they too are wearing down.

Overall, I love these shoes, but obviously don't care for them well and wear them fairly recklessly. They were the next in line from casual beater shoes of my youth -- black Converse, and sometimes blue Converse -- and I wear them with the same irreverence and joy as I did those that came before.

P.S. -- I plan on properly conditioning the leather this summer. They...basically look like hell right now, but hopefully some maintenance will improve that.

Tuesday, April 4, 2017

Snow in April in New Hampshire

It's not spring in Boston until the Red Sox home opener. Yesterday, Tom Brady threw the first pitch, and it's time for the good people of Boston to retire their Pats beanies until the autumn. Of course it was Tom Brady.


Our class had planned a trip to a cabin in New Hampshire for this past weekend. Forecasts originally declared mild springtime weather, which then changed to snow to the tune of 12-18" in the north. Well, snow did fall on Boston, but never stuck around. New Hampshire, however, was not spared. Out were the plans for a nice spring hike, and in were plans for skiing, snowshoeing, and sledding.


As usual, I have a lot of photos I wanted to share, but not a substantial amount of content to go with it. Instead, I'll do as I have done before and include an assortment of thoughts that I've had lately.


School

I'm having more difficulty with medical school this semester than last semester. I'm not entirely sure why, but I'm working harder and trying to figure out how to improve. On the clinical front, I'm more comfortable interviewing patients and just being in the hospital or in clinic.

I also recently shadowed OB/Gyn on their Labor & Delivery service and saw two births. I think I may enjoy OB/Gyn, but I wonder if that's only because I saw a C-section.


Research

I applied for a grant and I hope I get it. For the application, I had to update my CV, which had been untouched since I applied to medical school. Well, I went trawling through conference program books for all my college contributions and found that my lab in college had "posthumously" presented my project. I was given second authorship, which is the highest I've been yet, but...

...it isn't fair. I had sent my lab emails two months ago asking if anyone had taken up my personal project, and got a resounding NO, that they had abandoned it and that I need not follow up. Now I see they've published it, used my code without my permission for very similar project, and expected me not to notice.

I talked to one of the medical school faculty about it. I should be happy to be able to add things to my CV, but that project was my personal project, and that lab was my home away from home.


Winter

I still get excited for snow. I feel like I got a bit cheated out of my first true winter, but seeing all the snow in New Hampshire that Boston was spared of was very gratifying.


Raw denim, a 3 month update

Remember awhile ago I mentioned I bought my first pair of raw denim jeans? I'm still wearing them, and I'm still...not washing them. The fades are slow to come, the fabric is still stiff, and the men's fit is not very flattering, but I still like them quite a lot. I hang them up and freeze them from time to time. I wear them almost daily, and found that they are warm enough for almost any time and place I am. I should take progress pictures, but I'm simply too lazy.


Blogging

I've recently become disenchanted with some blogs that I used to enjoy, and have found it hard to either stop reading them, or find new ones to read. I doubt any of them read my blog here. Sometimes it's camping on the moral high ground. Sometimes it's sneering at the other girls, the other bloggers. Sometimes the writing is a sermon filled with errors in spelling and grammar and word choice about the vapidity of other bloggers. Sometimes the comment section is an echo chamber. Sometimes they are just mediocre when before, they were a revelation.


Snowshoeing

I would gladly snowshoe again. Next time, I'll look for a longer hike and maybe go off-trail. As snowy as my photos look, there was no wind: a very peaceful snowfall at least until the trees dumped what they collected on their boughs right onto my head.

Snowshoe ownership, even if they are cheap ones, is now a goal of mine.


Friends

I'm still friends with the same people since early in medical school and we're getting closer. What surprised me on this trip was that I'm getting better at taking opportunities to socialize and bond, and that I'm getting better at finding common ground and having fun. In the beginning, I felt like my classmates were unapproachable and unfriendly, but that doesn't seem to be the case at all.


New Hampshire

I've been on a few road trips since medical school began and the little magic of the New England countryside has still not gone. Lots of picture-perfect little towns, ponds, covered bridges, reeds, woods come straight out of a Norman Rockwell painting. The vastness of the American West of my childhood road trips seem completely alien. I sometimes imagine that I could live in rural New England...

...we find a supermarket and do our shopping. I am suddenly aware of the fact that we are likely the only Asians for at least...I'm not sure, but there are definitely no other people of color in the supermarket. The people are friendly and kind, and the cashier asks me where we've come from.

"Boston," I say. That's far, she says.

She welcomes us to New Hampshire. Every time I visit, I wonder a little more if I could call New England home.


Sunday, March 19, 2017

S/S 2017 | Wardrobe Planning

It's a bit odd to think about spring and summer when there's active snowfall and literal piles of snow and ice from a recent blizzard, but it's about time to think about what I'll be buying for the next few months.

In reality, this post was prompted by a recent shopping trip. I wanted to buy a shirt from Uniqlo, went into Uniqlo, and walked out with that shirt and a dress I hadn't planned for. It is a charcoal grey ponte dress with a flare skirt that is appropriate for clinic and any event where I need to look sharp. But still, it was an impulse purchase.

Summer in Boston is hotter and more humid than summer in the Bay Area. Basically, I am looking for linen garments. Read on for more information.
All from Pinterest, sources spotty. The black one is from Ovate




  1. A linen dress, or two - I prefer dresses for warm weather. It's easy to look good and feel comfortable in a dress. It's a single, simple garment. I tried on some linen dresses last summer and loved the texture and the way the fabric moved. For truly sweltering days, I can only really stand to wear dresses. Here is a collection of dresses I've found on Pinterest, but really, the quest for the perfect linen dress is difficult because (1) there aren't many linen dresses for sale and (2) I am fairly picky when it comes to dresses
  2. Dark red high-neck t-shirt, Uniqlo - I like this color on me and bought this to replace the dark red t-shirt I've demoted to workout gear and the unattainable Red Polo shirt of my youth. I liked the look of the charcoal grey and the light blue versions, but the former was out of stock and the latter looked nice, but I am still afraid of light colors
  3. Dark blue sleeveless linen shirt, Uniqlo - I wanted to get one of these last summer, but was unsure about all the bright colors. Maybe this year will be the year
  4. Drawstring shorts, preferably linen - I bought a pair of black linen shorts last summer and they served me well. I wore them maybe a bit too often so another pair seems like a good
  5. Other - already bought the charcoal ponte dress from Uniqlo; I thought about getting a lightweight jacket for spring, but realized that I will probably just end up wearing my autumn outwear or knits; also, I'll probably need to get some thin no-show socks as well. 
I've been wondering a lot lately about ethical consumption and how my own consumption fits in. I mentioned Uniqlo quite a bit in this post -- I've written a bit about the evils of fast fashion, and yet the majority of my clothes come from Uniqlo and other fast fashion-type companies with questionable ethical code and ecological impact. I tell myself that I actually don't consume a lot, and find reasons for the things that I buy.

At the end of it, I think I have reasonable clothing consumption habits, with plenty of room to improve. 

Thursday, March 16, 2017

More thoughts on diary writing


Here is my second post about diary writing. The first one can be found here and concerns the practicality of the habit -- how I do it, with what, and how often.

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I knew that this second post was going to be a bit more abstract than the first so I'm not too sure about the format. Thus, a looser structure is indicated.

Reasons why I write in a diary

I touched briefly on why I began writing, but not why I continued to write, and why I will continue to write every day, once a day, ad infinitum. To be honest, I don't have a concrete answer. It's become habit at this point where I feel discomfort in forgetting to write or not writing adequately. Writing at the end of the night unburdens me from the thoughts I've had that day. It's a conveniently private outlet for the daily stresses and emotions, which I feel could otherwise build up to unhealthy levels. At a more basic level, I write every day because memory is unreliable and writing things down helps me keep them.

I also like my penmanship, and use my diaries as a way to indulge myself there. I also recently bought a fountain pen and ink.

It's not journaling

And I get a bit defensive about that, in real life when people find out about this practice and internally when I see blog posts, YouTube videos, think-pieces, Pinterest posts, etc about journaling. It's a bit of an irrational aversion to the term, but I know that others may see these posts here and code my diary writing as journaling.

To me, journaling suggests deeper emotional content and creativity. A lot of journaling fads I've seen on the internet seem juvenile and hokey, but that's just me being judgmental about things that don't concern me.

If anything, I downplay my emotions in my diary and contrive to keep my entries restrained and cold. I can easily dissect my thoughts and emotions on paper, but seldom let emotions themselves guide my writing. Long story short, I still think I have issues expressing myself and being vulnerable in my diary, but that I really could benefit from taking the 'journaling' road of emotional catharsis. But then again, I do get some kind of catharsis after writing.

It's not meditation, either

Until I think about it.

I'm not really a follower of mindfulness or meditation or any number of techniques and products and self-help media that will help me achieve them. However, once I peel back the pretty social media influencer veneer, I see its value. I really think that setting time aside in the day to be alone with your own thoughts is important. Quiet time for reflection and self-awareness, protected time where self-centeredness and selfishness are mandatory.

For some people, meditation is the way to do this. For me, I need to write it down.

How has it helped me?

I don't know exactly. I have been writing in my diary since I was a teenager and don't know any other way of life. Writing about anger and interpersonal issues helps me prevent arguments and confrontations -- by the way, my cardinal sin of choice is, and has always been wrath. I think I'm a more even-keeled and disciplined person for it, but I have no way of telling that.

However, one thing I do know for certain is that daily diary entries help me identify my personality traits and flaws. I know myself fairly well. It's all written there.

I'm not enlightened

That goes without saying. However, I think that people may erroneously think that writing about yourself will make you a better person. I believe that I would not know myself as well or be as comfortable with self-criticism (or take self-criticism too harshly) if I didn't write in my diary, but I don't know if that has had led to distinct changes in my behavior or personality.

The Lord of Three Realms

The blog and the diary fill different niches and serve different purposes. The blog is a more longitudinal view of myself and my interests and was created explicitly to help me become a better, more advanced version of myself. The Lord of Three Realms as an imaginary entity lives at the end of the staircase of self-improvement. LL versions I through XIV may be distinct and show growth, but the daily variations in the writer are too small to appreciate or care about.

The next post

Let's talk about you instead

Friday, March 3, 2017

Preliminary thoughts on West Coast v. East Coast skiing

This title is a lie: I went skiing once last season at Heavenly in Lake Tahoe and once this season at Killington in Vermont. I had gone skiing a few times in my youth, but not nearly enough to have any authority on the sport. However, I like skiing, want to go more often, and have some thoughts on my different experiences at these two sites, and photos to share.

Beware! Garish colors ahead. I was evidently very heavy-handed with VSCO last year. I promise that the real blue of Lake Tahoe looks astonishingly vibrant in person.

Lake Tahoe, California and Nevada

Last year, I went on a week-long trip with some college friends to Lake Tahoe, northern California's favorite retreat for mountain time. The trip was a lot more than just skiing, with lots of bonding time and board games and such, but I spent three days skiing and want to return. My best friend's family lives in South Lake Tahoe, and a trip to their cabin after high school graduation (and numerous short trips to the Sierra Nevada in my life) made me realize that there are no mountains more like "home" to me.

Lake Tahoe itself

The thing about Lake Tahoe is that it is a massive freshwater lake and shining emblem of the American West in and of itself. Though I've shown its frozen shore, it is blue beyond imagination all seasons of the year and a natural draw for locals and tourists.

Hanging around at the frozen shore

Lake Tahoe sits at 6225 ft above sea level in the Sierra Nevada along the California-Nevada border. An essential part of my Lake Tahoe experience is altitude sickness -- childhood asthma, low O2 saturation confirmed by medical school -- shortness of breath, tightness in the chest, light-headedness. Oh yes, and nosebleeds.


Lake Tahoe is generally pretty dry, and not too cold, as my friends in t-shirts indicate. Though this year gave California far too much precipitation, the recent drought forced Tahoe ski resorts to use man-made snow on the slopes.

Looking towards Nevada

Heavenly is a huge resort. It's expensive, it's expansive, and it straddles the border. I started on the bunny slopes on the Nevada side, played around on the blue intermediate slopes, then took the trails to get to the California side.

Looking towards California out of a dirty gondola window

Heavenly base camp sits at 6255 ft above sea level, which is plenty high for me. I reliably get some shade of altitude sickness in Lake Tahoe, which for me presents as an intense, crushing pressure on my chest, difficulty breathing, light-headedness, and misery.

Pygmy trees! And Lake Tahoe, of course

I challenged myself to take the Sky Express lift to the summit at 10040 ft above sea level. The summit left me literally and figuratively breathless, and that peak, with its variety of very long intermediate runs, remains my favorite.

This place is beautiful

Right turn off the lift to get to California; left turn to get to Nevada. The altitude hit me the hardest on an agonizing flat stretch at >10k ft, which I unfortunately needed to suffer through to get back to my friends on the Nevada side.

Weird colors, but I had to play around with editing because the sunset was kind of strange

My friend below in the orange said that one of his first indulgent purchases after entering the workforce (engineering in Silicon Valley) will be a season pass to Heavenly. That won't be realistic for me, but it's a nice dream to keep in mind.

Unlike some of the snow on the slopes, this is the real deal

Killington, Vermont


Okay. I really liked Killington, but not as much as Heavenly. In short, the great thing about Killington is that the summit of its highest mountain, Killington Peak, is 4241 ft, substantially lower than Heavenly base camp at 6255 ft. I had no altitude effect and could happily ski the day away without thinking about how difficult it was to breathe.

It's cold in Vermont

The other thing about Killington is that the snow is all real, the wind is vicious, and the cold is unlike anything I've ever experienced.

The same snowboarder got in the way of both my photos so I had to do some suspicious copypasta to get rid of him

However, I thoroughly enjoyed the mountain, especially since there was fresh powder from a storm the night before. I also felt like I could get more out of the day because I wasn't having any trouble with the altitude and could breathe comfortably.

At the summit of Killington Peak

As fun as Killington was, it was substantially more crowded than I remembered Heavenly to be.



In short, the tough thing about Killington was how cold it was. My phone stopped working because I kept it in a very superficial pocket, but at the hotel, it claimed a high of 12 F and a low of -1 F, not even considering windchill.

A pretty trivial difference: there are no deciduous trees to be found in Heavenly. The transition between evergreen to barren deciduous trees was a good indicator of how far down the mountain I had gone.

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All in all, this was a fairly brainless post to write, but I had fun skiing this year and last, saw beautiful mountains, took pictures, and my frost-nipped fingers suffered too much not to put them on the internet.