Friday, May 8, 2020

My acne journey thus far, intrepid adventures in skincare, and using isolation as time to try out The Ordinary




When I first started medical school, I was hoping that at the end of it I would have a few answers to my questions:

1. Why was it that for several years in high school, I would become nauseated and have belly pains so bad I dreaded to go to class - every weekday, like clockwork, from 7 AM to 9 AM?

2. Why did I have acne, and what can I do to get rid of it?

The answer to the first question is probably that depression and anxiety can manifest as physical symptoms, particularly in young people. As for the second, I don't really know, but my skin has slowly, slowly improved.

Over the years, only three things have actually made a discernible difference in my skin: hormonal birth control, topical retinoids, and salicylic acid. I thought that coming off birth control would cause a rebound in my acne and asked my PCP to prescribe me spironolactone (I got an IUD, which does not provide the systemic androgen suppression that my combined estrogen and progesterone birth control did). Being the intrepid medical student that I was, I decided to see what my skin would do without hormonal birth control and without spironolactone, and to my surprise...it looked fine.

I've used a topical retinoid (Differin, available OTC) since college, and it's really the only thing that reliably keeps closed comedones away. Because of the prophylactic anti-aging benefits, I see no reason to stop using a topical retinoid, and my next adventure will be to see if I can get tretinoin prescribed for a lower cost than Differin (this could be a gamble, and I'm not sure if this will pan out.

All of this is to say my acne is actually, for the first time in my post-pubescent life, mostly gone. This great source of teen and young adult angst and self-confidence issues is...gone. By my standards, at least, since I know some people in my life with truly flawless skin. For some people, my skin with all its post-inflammatory hyperpigmentation, is the worst it could ever look for them. For me, it's the best it's looked in over a decade.

So why am I trying new skincare? Simply put, my goals are changing. I've locked into a routine that reliably keeps my acne at bay, but now I have PIH to tackle, and skin tone to even out. I want to prevent aging - and I would like to add I am a religious SPF user for years.

Before isolation, I bought a few items from The Ordinary, and also received some from a friend who was going to start Curology. With this unexpected windfall, I saw the opportunity to try a bunch of products, fuck up my skin, go back on my progress, and experiment. When the pandemic hit and it became clear I was going to spend my days at home, I decided to try these out.

So this is what I ended up doing:

AM: Niacinamide + Zinc, moisturizer, SPF
PM: cycling between Differin, Vitamin C, and Mandelic Acid; moisturizer

Preliminary thoughts are that I'm tolerating Niacinamide + Zinc after an initial breakout that resolved. The Argireline actually works, but now that the lines I was concerned about are gone, I stopped using it and am saving it for later. Jury is still out on the Vitamin C and the AHA, but again, because I started all of these around the same time, it's hard to say what did what, other than my skin does actually seem better. That's what before and after pics are for, after all.

Once I'm done with the Mandelic Acid, I'll start using my Lactic Acid in its place. I'll try out that AHA+BHA mask eventually. I'll do it slowly, and try to be meticulous about tracking how my skin reacts. It seems pretty contrary that I'm going from a relatively simple skincare routine to one that is more complex, with new products, but I'm doing so to address the reality that my skin has changed. The old problems have resolved, and now I can address the other things.

Saturday, March 21, 2020

A review of the clothes I bought in 2019

The first half of this year was taken up by clinical rotations largely spent in a small capsule wardrobe of all the wards-appropriate clothes I own. June to November were spent in scrubs: one month of anesthesiology elective and four of orthopedic surgery rotations. Other than that, I've been schlepping around my apartment in loungewear and wearing the same three outfits to friends gatherings and dates just for fun. So, not much new added to the wardrobe this calendar year, but some key items like my black leather boots.


January to June
  1. Frye black leather ankle boots - $112 - after years and years of thinking about buying black leather ankle boots, I finally did, and it was worth it. Is there more to say?
  2. Red crop top - gift from roommate - birthday present from my roommate, who also wears crop tops in our mid-20s. It's pretty loud and bright for my skin tone, but I've found occasions to wear it out.
  3. Black and white striped dress - secondhand, from roommate - cute little dress that I wore to many a summertime date. It was too short for my tall roommate, so she passed it along to me, and it fits me just right.


July to December
  1. Leather saddle bag - vintage - $25 - I bought this purely on impulse when I was wandering around downtown Charlottesville. There is an abundance of cute vintage stores and could imagine myself living a cute life in that cute town. I even tried on a few dresses from the 1940s just for fun, chatted with the people working there, and definitely felt like I needed to buy something. So I did, and it barely fits my phone, wallet, keys, and small miscellany. But I got a lot of use out of this little bag and I'm glad I did buy it, even on impulse.
  2. Asics running shoes - $60 - my old ones were wearing out badly, and I found a colorway I liked on discount on Amazon.
  3. Muji green merino wool turtleneck sweater - $55 - actually, this was an impulse purchase, on sale. I've wanted a green turtleneck knit for a long time, and tried on all the ones offered by Uniqlo and Muji one day (they are very close to each other in Boston) and bought my favorite. I actually do feel guilty about this one because it was not well-planned.
  4. ExOfficio underwear, 3 pairs - $28 - Black Friday deal. Am phasing out my shabby underwear and wanted to get some that were high quality, lightweight, and designed for handwashing and drying quickly.
Total 9 items
Total $280

My post-mortem of my 2019 purchases is that despite the relatively small number of items, some were poor decisions. The green sweater was an impulse purchase that stemmed directly from me wanting to dress my fantasy self, a more put-together, poised person than I actually am. The color drew me in! I tried on four different sweaters in that color at MUJI, but really, I don't think I needed it. The green blouse doesn't suit me at all, and now that I'll be mostly in scrubs, I don't need to have more blouses at all. I feel like I'm aging out of some of my clothes, and that I do need to reassess my wardrobe, but the unhealthy thought patterns and impulses are still there. I'll need to work on that.

I'm actually staying at my home program for residency, and staying in my apartment. I was kind of expecting to have to leave, and undergo a massive decluttering and cleanout of my belongings. Despite my staying put, that's a worthy endeavor and I'll use this quarantine time to do that.

By the way: I'm patting myself on the back for the underwear purchase since I now know I have another year of handwashing ahead of me!

Tuesday, March 17, 2020

A one-bag minimalist sprint for interview season



First of all, the itinerary:
  • 1/9 AM - travel to NYC from by bus
  • 1/9 PM - interview social for Hospital #1
  • 1/10 PM - interview at Hospital #1
  • 1/10 PM - travel to Boston by bus, sleep at home
  • 1/11 AM - interview at Hospital #2
  • 1/11 PM - interview social for Hospital #2, sleep at home
  • 1/12 AM - travel to California by plane
  • 1/12 PM - interview social for Hospital #3
  • 1/13 AM - interview at Hospital #3
  • 1/13 PM - travel to parents' house by car, sleep at home
  • 1/14-15 - sleep at home
  • 1/16 PM - travel to LA by plane
  • 1/17 - Hospital #4 interview and interview social
  • 1/18 AM - travel to NYC by plane
  • 1/18 PM - interview social at Hospital #5
  • 1/19 PM - interview at Hospital #5
  • 1/20 AM - travel to ABQ by plane
  • 1/21 PM - interview social for Hospital #6
  • 1/22 AM - interview at Hospital #6
  • 1/23 - sleep all day in ABQ
  • 1/24 AM - travel to PHX by plane
  • 1/24 PM - interview social for Hospital #7
  • 1/25 AM - interview at Hospital #7
  • 1/25 PM - red eye flight back to Boston

And now, what I packed:
  • Suit
  • Blouse
  • Grey dress
  • Black wool shirt
  • Grey Uniqlo heat-tech shirt
  • Grey t-shirt
  • Black gym shorts
  • Black tights
  • Nude tights
  • Heels
  • Black ankle boots
  • Navy blue Uniqlo ultra-light puffy jacket
  • Watch
  • Black Fossil handbag
...and necessaries like underwear, computer, Kindle, chargers, toiletries, chocolate. Surprisingly everything fit comfortably and the bag was always accepted for United Basic Economy, whose luggage restrictions are one single item that can fit under the seat in front. I am very proud of being able to make the trip with such lean, lightweight luggage. In fact, I think such a trip would have been bearable only with such little burden.

Why did I do this to begin with? Mostly to save money and save the hassle of keeping track of all my stuff, at the cost of having a perpetually wrinkled suit. Some of it was a challenge in seeing if I could do it, kind of prideful, I admit. The bottom line: I did it, and it was convenient. And now it's done. This two weeks of travel coincided with a nasty upper (eventually lower) respiratory infection for the same duration, complicated by sore throat and very diminished voice in the beginning.

And now it's done, and I get to rest and agonize over my future.

I wrote this post in February and it stewed in my drafts for all this time. I matched into orthopedic surgery! I'm going to be an orthopedic surgeon! I'll find out where on Friday, but for now, I'm just happy happy happy that I've fulfilled a dream of almost eight years. More coming soon!

Sunday, December 22, 2019

I started reading again: 18 books in 2019

Somewhere in Sacramento

Looking at the title, this seems a pretty pitiful number, but certainly much better than previous years (close to zero). Despite four months of 90-100+ hour workweeks, this year I have had more free time than all the other years of medical school, and suddenly began to read for leisure again.

I remember what it was like to be a voracious reader as a child and a teenager, and was increasingly disillusioned with myself for numbing my brain with endless social media. I even throw podcasts into this since I definitely use them as a way to pass time without really gaining anything from them. So my month in Chicago kickstarted what will hopefully be a habit of reading more, writing more, and being more critical and deliberate with the content I consume, and how I choose to use my precious free time.

Bolded and highlighted titles are those that I strongly recommend. Italicized titles are those I am currently reading and expect to finish before the year is over.

  1. The Hazel Wood - Melissa Albert
  2. I'm Not Dying with You Tonight - Kimberley Jones, Gilly Segal
  3. The Priory of the Orange Tree - Samantha Shannon
  4. The Seven Husbands of Evelyn Hugo - Taylor Jenkins Reid
  5. Big Little Lies - Liane Moriarty
  6. Becoming - Michelle Obama
  7. The Woman in Cabin 10 - Ruth Ware
  8. An Enchantment of Ravens - Margaret Rogerson
  9. The River at Night - Erica Ferencik
  10. Little Fires Everywhere - Celeste Ng
  11. Six of Crows - Leigh Bardugo
  12. Murder on the Orient Express - Agatha Christie
  13. A Little Life - Hanya Yanagihara
  14. This is Going to Hurt - Adam Kay
  15. Brain on Fire: My Month of Madness - Susannah Cahalan
  16. No Exit - Taylor Adams
  17. The Outsider - Stephen King
  18. Everything I Never Told You - Celeste Ng
I expect to keep up this pace of reading into the first quarter of 2020 since I'll be traveling for residency interviews and not socializing with my classmates while I'm on the road. I don't really have a set TBR, but here are some of the books I definitely intend to hit in 2020.
  1. The Secret Commonwealth - Phillip Pullman
  2. Dear Girls - Ali Wong
  3. House of Leaves - Mark Z. Daneilewski (RR)
  4. Crooked Kingdom - Leigh Bardugo
  5. Catch and Kill - Ronan Farrow
What does the future hold for me, and this blog? I really don't know that answer (other than I seriously hope everything works out and I match into orthopedic surgery), but hopefully I can use this space to log my books and talk about them in manageable batches. Looking at this list, it definitely seems my tastes are shifting away from fantasy and science fiction and towards contemporary mysteries and thrillers. Additionally, my goal is to read more medical humanities since my medical school library has an abundance of them (and everybody is too busy studying to read them for fun, except the graduating students).

Saturday, August 3, 2019

Half measures: minimalism game 1-15


The Minimalism Game is likely new information for absolutely nobody, but the spirit of it is to get rid of (give away, donate, recycle, trash) n items for n = 1:15 consecutive days. I participated because though I think I have been pretty good about keeping my consumption in check, I do have clutter that I am sick of seeing. I also didn't have a good sense of how much extraneous stuff I had, and wanted to challenge myself to purge my space of things that do not have a place. As much as I like Marie Kondo's methods, I understand that where I have the most room to shrink is the komono = "miscellaneous things" category, and not so much the others. So these first 15 days of the Minimalism Game, 15 non-consecutive days over several months, was my ease into decluttering.


I don't think I ever embarked in any massive full court press decluttering campaign before, maybe because I always favored a slow fade. I revisited a blog post I wrote in January 2016 where I was clearly overwhelmed by stuff in my apartment, and am glad that the feelings of being trapped and being despaired by a space have never resurfaced. I think too that even now, I use minimalism as a framework to process my need for control in a life that often feels out of my control. Those feelings in January 2016 came mere days before I was accepted to medical school, at the peak of what may have been my closest scrape with depression. The past few years of medical school have not had nearly the same ups and downs as college, yet I'm still coping with the old ways: trying to exert control over my life through what I own.


I read something on Reddit recently about the very topic: minimalism cult as a proxy for coping with depression and anxiety, and perhaps there's some truth to it. But take my participation in this game as lighthearted tidying up and self-improvement. Practically speaking, I am moving next year somewhere unknown across this country - hopefully because I have matched at an orthopedic surgery residency program. I actually am now in Virginia for a month for an away rotation enjoying the lovely 3-story home of some medical students who own an order of magnitude more things than I do (but I do appreciate the Southern hospitality) while some other medical student rents my room in Boston (the tidiest it's been in a year, Chinese hospitality). 

Last photo is not relevant, but just needed something to complete the line since I lost one of the photos

Anyhow, maybe an excessive amount of words for an insignificant post. Somewhere around day 10 I decided to fuck all the random pieces of paper I was counting and just recycle them all. So, all in all, I needed the kick in the ass to get rid of the detritus in my room.

And lastly, a sentence from the last post: A general goal that I have is for each item in my possession to have its specific, designated location.

I'm closer to that goal, and I still think the same. Minimalism Game will resume with the much more challenging half when I return to Boston in November.

Monday, July 8, 2019

Makeup inventory


Every year or so, I am overcome with the need to gather up all my makeup, arrange it just so, take a picture, and write a blog post about it. Maybe a bit more frequently, I write out all that I own from memory, to see if I can do it. If I can't, it's a reminder that I have too much. I think maybe the stars aligned and I've been thinking more about makeup and beauty and expectations for female beauty and groomed-ness and put-togetherness that I write this post today.

First, the inventory itself, and then the rambling:
  • Maybelline Fit Me matte and poreless liquid foundation - 220 Natural Beige (2018)
  • Sephora powder foundation - Golden Fawn (2016)
  • Wet 'n' Wild blush x2 - Pearlescent Pink and Mellow Wine (2010)
  • Estee Lauder kohl pencil - black (2010)
  • Wet 'n' Wild eyeliner pencil - brown (2010)
  • Wet 'n' Wild eyeshadow palette - Comfort Zone (2014)
  • Urban Decay eyeshadow palette - Naked2 (2013)
  • Burt's Bees matte lip crayon - Redwood Forest (2019)
  • Revlon lip butter - Pink Truffle (2016)
  • Bite amuse bouche lipstick - Chai (2015?)
  • MUFE lipstick - N9 (2014?)
  • Maybelline mascara - Snapscara (2019)

Note: I picked my favorite pans from the two eyeshadow palettes and put them in this little metal business card holder. It works for me. The matte black from the Naked2 palette fills in my brows.

This is probably the smallest my makeup collection has been since high school, and it's through a concerted effort of not buying new things, being honest with myself and tossing products that are old/not suited to me/etc. I think a longer post about my relationship with makeup and beauty and self-image are due at another time, and this is something of an easy appetizer to write. Over the years, I have progressively owned less makeup, consumed less beauty content, and worn makeup more often (but less of it). Though I always wore what I consider "minimal" makeup - as in, foundation only for special occasions and residency application photoshoot - these days, it's black eyeshadow brushed through brows with a very light hand, and a single coat of mascara. A little lipstick blotted on if there's time. Eyeshadow and blush for social outings. Priorities are to have a low maintenance routine that wears well - and wears off well - over the day, a slow, pretty fade instead of a ruined mess. Can't stand that, and I find foundation and liquid eyeliner suffer from that.

There is room to whittle down. High coverage foundation, be it liquid or powder, has almost no role in my life. Personally, any kind of base makeup makes me slip into uncanny valley, or at least distance my done up face from the one I am familiar with. There's redundancy in brow products. I've never gotten the hang of eyeliner pencil so that will probably go at some point. And most of the lipsticks look the same. I have no desire to try or buy new makeup, and will just replace what I own organically, as they run out or no longer serve a purpose.

With that, a vision of the future:
  • sheer liquid foundation
  • sheer face powder
  • blush, 2 of them
  • brow product, just 1
  • mascara - I'm happy with the one I use now, and I'll be better about replacing as it expires
  • small eyeshadow palette, likely constructed from single pans - the amount I have now is fine
  • lipstick - 1 sheer red, 1 my lips but better (MLBB), 1 more for variety
High quality, reliable products. With that list above, and the inventory I have now, I have all my bases covered, and happy with what I won't own. Hopefully minimal and timeless, as empty as those descriptors are. But that's what I want, and I think that's what I have here.

Saturday, June 22, 2019

Commonplace book

The concept of the commonplace book, a receptacle for information and thoughts, came to me from A Series of Unfortunate Events in elementary school. So started my habit of carrying a pocket-sized notebook to scribble in. We received a yearly planner from school from 6th to 12th grade, so I used those. And then in college and medical school, it was back to notebooks.


And that has continued. They have always been cheap dollar store notebooks or gifts. Days were always drawn out in wobbly colored pencil. Despite my best efforts to appear organized and orderly, the contents of my commonplace book - and, of course, it is also a planner - reveal me to be a disorganized, chaotic wretch. The basic format has not changed:

  • standard weekly planner format, always Monday to Sunday, six boxes with the weekend sharing the last. Deadlines and events and flights always immediately populated because I can't trust myself to not forget about them
  • blank pages for whatever else: lists, brainstorming, drafts for presentations, information, questions, pearls collected from the wards, steps to induce and emerge from general anesthesia, how to close a fasciotomy, wardrobe planning for autumn/winter 2019, etc
  • in earlier iterations of the CPB, there was one of each section, but I found it more convenient to have a few months of planner, a section of free pages to be used while that planner section is active, and then the next planner section, then the next free pages, etc


A sample of pages from past books loosely in chronological order: exams, deadlines, lists upon lists, course material, sketches, information, information, information, etc, etc, etc. When I went home last, I flipped through the old CPBs and took these photos, and tossed the books themselves into the recycling.



I don't know if this has increased my productivity or my focus because I have never been without it. I don't have any interest in buying a pre-made planner or improving the aesthetics or adopting any other system of organizing information at this time. Inevitably I will make a Google calendar for flights and interviews for residency applications, and will likely be subject to a shared calendar for residency, but for my personal use, I am happy as is. As much I admire the bullet journal movement, it is not for me. I am a person of habit. I am a person of habit.