Thursday, May 9, 2019

Lessons in minimalism: month in Rhode Island, out of a suitcase

My room, my suitcase, my sleeping bag. Missing in this photo is the other identical chest of drawers and the other identical broken landline

I spent the second month of my Internal Medicine rotation at a community hospital in Providence, Rhode Island, about an hour away from Boston by train. I took this as an opportunity for a minimalism challenge, and as a trial run for the three months I'll spend this year on away rotations for orthopedic surgery. Here was my attempt at packing light, with the safety net of easy trips back to Boston for things I forgot to bring in the first place, and things I didn't need to bring and took back to my apartment. Despite learning very little in this hospital (in fact, the medicine practiced there is comically bad), I did learn a bit about minimalism (in this very specific context). Namely, I can get by with not a lot, I have room to trim away, and I can sleep in a sleeping bag very comfortably for a month. Read on...

Clothes for a month

In brief, here is what I brought:

5 blouses for wards, 1 of which I never wore
3 t-shirts for exercise and for lounging
1 flannel

3 pairs of trousers for wards
2 pairs of shorts for exercise and lounging
1 dress for the wards, which I never wore
1 pair of jeans

Black boots, boat shoes, and running shoes

Not pictured are my raincoat, undergarments, socks, etc. Essentially, I got by fine this month with this limited wardrobe, but we had laundry in the house provided. Looking back, I could have done with less for the wards, and probably more for exercise since I found myself hand washing after every run. For my orthopedic surgery away rotations, I can shrink this down to one outfit for clinic, a suit, a set of scrubs just in case there is a delay in getting hospital-provided ones, and obviously at least another set of workout clothes, as this is, after all, orthopedic surgery.

As lean as I thought I was packing, there were some leftover items - my green silk blouse and grey dress - that I thought were just too formal for the wards. That's something I've found for myself, that the order of formality of dress code that I've seen is: surgical clinic (business formal) > medical clinic (business casual) > medical wards (business casual) > surgical wards/OR (scrubs). At least that's how I perceive it.

Left: the shoes | Right: perhaps the first and last time I show a stethoscope on this blog

As for shoes, I think darker soled boat shoes would work in almost any medical situation in New England (I say that with some humor, but actually I've gotten away with even these beaters). The black boots will come back in the winter, and my black pumps will come with me for away rotations. The stethoscope will become trauma shears and I'll bring a smaller bath towel next time.

While I was unsurprised that I could tolerate and enjoy sleeping on a bare mattress in my sleeping bag for a month, I was surprised that I so quickly reverted to convenience foods, fats and refined sugars, disposables and take out so easily. I gained weight and was eco-unfriendly, ate more meat than I'm proud to say, and indulged myself a bit too much. This is obviously not ideal since I normally cook all my meals and prepare them mostly with my health in mind, and I do have months of chaotic schedules and new living situations before I need to wear my interview suit. A suit that I wore at age 20-21 interviewing for medical school.

Despite having my metal tumbler, which I did use for all coffee, tea, and water, I treated myself to many disposable plastic bottles of juice provided in the emergency department (??? not going to question it). These kinds of things are my weakness so though I'll Refuse as much as possible, it's more likely Reduce and Reuse that will justify this behavior

So, less a collection of lessons than incoherent rambling, as per usual. I think I may try to pack everything into a backpack and a piece of checked baggage for my aways, and prioritize maintaining diet and exercise for the next few months and the rest of my life. Minimalism is a proxy for the lifestyle habits and changes that are in line with my values, etc, etc. 

Saturday, March 30, 2019

An update about medical school


My big plant, this time last year (it doesn't look like this now, unfortunately)

I am two months away from finishing my third year of medical school: two months of internal medicine before I take Step 2 CK, take a one month pit stop in anesthesia, and then four months of orthopedic surgery. Home and three away rotations I am (yet) applying to. Research has been stagnant. My mentor believes in me more than I believe in myself. I scarcely feel ready to apply for residency, but here I am, at the edge of it.

I agonize enough over this process on my own, so I won't belabor it here. Essentially, I haven't changed my mind about orthopedic surgery. I haven't changed my mind about orthopedic trauma, specifically. I am more afflicted now with impostor syndrome than ever before. I have never been more uncertain of my abilities and my talents and every other qualification I may or may not have than right now. At the same time, I have toured most of medicine as a student and determined that nothing is close to orthopedics, and that it must be my future.

I finished my neurology clerkship, which was one of the good ones. Unfortunately, I saw three people die in one day in the Neuro ICU/SICU. All were inevitable. Two were peaceful, with family around them. The third was a futile, but all hands on deck resuscitation attempt of a gentleman who was hemorrhaging all his blood and bags upon bags of more blood from his dural venous sinuses (could not be repaired). I felt kind of useless because of my inexperience and because of the futility, but I made myself helpful by running supplies around, measuring and dumping blood from his hemovac, cleaning up, and finding chairs and tissue.

I've withdrawn a lot from my first friends in medical school and leaned in to others, namely my roommate and our mutual friends, and other students applying in orthopedic surgery. I take care of my plants. I clean my room. I make food for myself, ignore my other roommate, and sleep when I can. Two of my patients on internal medicine are dying, one in a matter of days and the other in weeks. Time just moves on.

Monday, February 18, 2019

A review of my 2018 clothing purchases

Better late than never!


2018 was the transition from second to third year of medical school and all the responsibilities and growth and worry and challenges and accomplishments that go along with that. I did not, in fact, carefully develop and curate a professional wardrobe for the wards, but instead kind of just trundled along faking it with clothes that I already owned. I think I'm okay with that.

There are a lot of other things that happened in 2018, but as always, here is a roundup of the clothes that I bought. This is a practice to keep myself accountable, but also help forecast what I will need and want to buy in 2019. I think there has been a shift away from listing and counting in minimalism, but that kind of thing is in my nature.




January to June
  1. Calypso St. Barth green silk embroidered dress - secondhand, Poshmark - $46 - this was a dress I had saved to a Pinterest board sometime early in college, and I found it on Poshmark and bought it with two friends' weddings in mind
  2. Grey wool trousers - secondhand, gifted - $0 - my sibling bought these trousers from some thrift store and gave them to me. I didn't think I would wear them as much as I do.
  3. Uniqlo blue striped linen shorts - $20 - nailed it with these shorts, wore them all summer
  4. Eileen Fisher black silk t-shirt - secondhand, Poshmark - $30 - not a lot to say about this, other than I wear it weekly and hand wash it

July to December
  1. Uniqlo black ponte dress - $30 - bought after our cat died, a bit too short for some clinical situations, but I do wear it to didactics
  2. Uniqlo blue down puffy - $70 - as mentioned in this post
Total - 6 items, $196

Reflecting on this: it's not a lot, and I do see many flaws in my wardrobe pertaining to not enough. I am wearing through my hardworking black ballerina flats. A lot of my undergarments and socks are either falling apart or have undergone repairs - by the way, I'm pretty happy about increasing my skills in mending clothes! But I still anticipate replacing many things soon. While I don't think I look shabby, I do think I have room to improve my professional appearance. Ultimately, I'll be in a specialty that is in scrubs the vast majority of the time, so maybe I'm holding out on buying professional clothes to really nail in the quality over quantity point.

My last point of reflection is really about minimalism, and also about materialism. I think I understood this year that I actually am pretty materialistic in the sense that I have very strong, emotional attachments to my belongings, which makes decluttering hard. On the flip side, I really do subscribe to minimalism and hate excess in my life, so I restrict myself in owning things because I don't like to part with them. Somewhere, there is a balance between (1) being detached from earthly possessions and not letting them possess you, and (2) being attached to your stuff and in turn treating them with respect and care. Some intersection of the two is the basis of rejecting our modern disposable culture, and the basis for a ton of William Morris quotes/wardrobe curation/simple living and slow fashion/ethical consumption. Something something no ethical consumption under capitalism, but also, I don't know how I feel about influencers in this sphere. Greenwashing, too.

Anyways, that's it. Happy (belated) New Year to all!

Four years later, I finally bought a pair of black ankle boots! More on them later.

Saturday, December 8, 2018

On my third winter in Boston, I finally bought a puffy



I'm giving away my vintage leather jacket, and I bought a down puffy from Uniqlo for triple its price. This was a good decision. Watch me justify it.

I bought and loved this vintage leather jacket when I was 17, in 2012. It saw me through the coldest, windiest day in Berkeley. It even saw me through a torrential downpour in Berkeley when I was walking home, and saw two raccoons slide into a storm drain -- it stopped me dead in my tracks, and I forgot to worry about the effect of rainwater on old leather (no effect). But in truth, I almost never wore it because it was almost never cold enough to tolerate it in Berkeley.


I wore it a lot more in Boston, where there are a lot more cold (30-50F) and non-rainy days where a heavy leather jacket is appropriate. But the more I wore it, the more its flaws bothered me. Windproof, but way too heavy. A distinctive look, but it added so much bulk to my frame. It's an attention-grabbing piece in person, and I'm not one who wants all the same wow cool jacket every time I wear it. It also smells bad when rained on.

I had a gap in my wardrobe to the effect of "too warm for the parka, but too wet for the peacoat or the leather jacket." For a long time now, I've wanted a down puffy, a staple of Boston because of its practicality. Added bonus of being important when camping. Something lightweight, reliably warm, and easy to layer under or over.

Recently, my disdain for the leather jacket and disenchantment of the wild, wild west Americana look it brought reached its peak, and it got cold enough to wish I had a down jacket. So I did it. I decided to lose the $20 and not bother reselling the leather jacket, and shell out $70 for a hooded down jacket at Uniqlo.

Which seems at odds with the minimalism-sustainability-slow fashion ethos I admire: I'm ditching a secondhand, high quality piece for a more expensive fast fashion one. But it's a decision two winters and cold springs in the making, and one that makes sense given my shift in tastes and priorities. I can take the puffy camping. It weighs almost nothing. It's subdued and functional, and just as warm. It has a hood and a high collar.

That's the way it is. As goes my favorite William Morris quote: "Have nothing in your house that you do not know to be useful, or believe to be beautiful." I have replaced something that has never been useful and was formerly beautiful, with something that is extremely useful and kind of beautiful.

Thank u, next

And to further my point, this is a picture of me from college with that leather jacket. Possibly Halloween 2012?

Sunday, November 18, 2018

The most California cookbook of all - The Art of Simple Food - Alice Waters


California, my home state, is on fire. The air is smoky and people wear masks to go outside. Low visibility. School cancelled at UC Berkeley - if this were three years ago, maybe I would be eagerly packing up my laundry hamper to go home for Thanksgiving break a few days early. Now I'm in Boston watching this unfold from afar. Truthfully, I don't know how I would react or feel if I were in California now. Right now, we're expecting our second snow in Boston. It's a surreal nightmare happening far away, at home. Towns destroyed. People displaced. People missing. People dead.

In reality, this post isn't about fires or even about California at all, but just a jumble of thoughts about eating and cooking that have been cooking since my surgery rotation, begun in September, now a week ended. Long story short, thanks to long hours, I've been eating less and eating worse.


To bring these thoughts together, I'm sharing some extracts from Alice Waters' - of Chez Panisse fame - cookbook The Art of Simple Food. As a point of food anthropology (lol), her perspective on fresh and simple food was apparently revolutionary, and this food was emblematic of that kind of hippie Berkeley, California attitude. Fine dining gone green, French-inspired but with local ingredients because California is the center of the produce universe.

Anyhow this was a ridiculously rambling preamble to what should be a brief post. Also, I find it kind of cool but weird but awesome that our hospital has a food pantry, a rooftop garden, an apiary, and actual farmers in a city that is frozen for a third of the year and has zero compost bins.

Without further ado...


...Alice Waters' book begins with an introduction about how the food culture of America is terrible. Fast food, microwave dinners, etc. As a medical student on her surgery rotation, three years removed from the organic vegetable/fresh bread/cheeseboard/hella fruit paradise that was Berkeley. California, and now subsisting on black coffee for breakfast, half a Clif bar before the first surgery of the day, the rest of the Clif bar before the second, and ginger ale/peanut butter/graham crackers from the PACU the rest of the day, and instant noodles for dinner...I decided to read the rest of the book after the clerkship finished. Without really knowing a ton about Alice Waters while I lived in Berkeley, I devoured the book. I even noted recipes I wanted to try. Her kind of snobby attitude about how we must all be green goddesses and Luddites and foodies was kind of aspirational.
  1. Eat locally and sustainably - that's a lot easier to do in California than Massachusetts, but I've been known to drag home big bags of local apples and cider and cider donuts, local honey. Other than that, I don't know the last time I paid attention to where my food came from. 
  2. Eat seasonally - beyond seasonal offerings like stone fruits vs. apples vs. oranges, and Halloween-themed vs. pumpkin spice vs. Thanksgiving-themed vs. Christmas-themed things, I regrettably haven't given seasonality a thought. Actually, no. Tomato soup is only for the summer and early autumn, when tomatoes are in season. And I look forward to it every year.
  3. Shop at farmers' markets - this I actually do, when our market is open in summer and early autumn. Apples, mostly, and tomatoes. I'm a farmers' market kind of person, and it really makes me happy to go to them and just walk around, though the one I go to is small and more arts and craftsy than one where you can actually do your groceries at.
  4. Plant a garden - how I wish I could do this
  5. Conserve, compost, and recycle - there is no composting in Boston, but the other two I try. Recycling more than conserving, admittedly, with my zero waste attempts mostly futile.
  6. Cook simply, engaging all your senses - I realized recently that a lot of the food I cook has the same texture - mushy, mostly. When I try to make stuff my mom made growing up, it tastes approximately the same, but the wrong texture. That's something I can work on.
  7. Cook together - this is probably a universal joy. It's fun to cook with friends, and something that I miss. My roommates and I, in all the apartments I've lived in, have vastly different dietary requirements and tastes.
  8. Eat together - another universal joy. I like going to potlucks. My friends and college cooked and ate together a lot. It happens less often in med school, partly because we all live spread out over Boston, and because we're a lot busier now. Lots of good memories of being with friends crowded in a kitchen making messes, and then hanging out and eating the stuff we made. Doing dishes, even. This is something I miss and wish I could do more of.
  9. Remember food is precious - always. 


And so, I have a lot to learn from Alice Waters, and a lot longer to go towards home. And even though she's kind of a food snob, I don't mind trying to improve my relationship with food and cooking with this book as a model.

As a last, unrelated point, my home cooking has become a lot more like the food I grew up eating. And maybe my greater goal is to master the simple, quick, and comforting Chinese home cooking that makes it into no cookbooks. That, most of all, is going home.


Monday, September 3, 2018

Ten item summer clinic capsule wardrobe - Family Medicine, Radiology

Clothes, hand washed, drying

This is more of a capsule wardrobe by circumstance, not deliberate curation. A bit about the status of my personal style and wardrobe now: I was building my professional wardrobe slowly over the past two years, and have settled on an equilibrium that I am happy with. I also moved to an apartment with much more limited storage, and am content being confined by space and eye-stress from clutter, if that makes sense. We also don't have a laundry in the building, so I am hand washing for the most part, and dragging my stuff to the laundromat less frequently.

I had my Family Medicine rotation - primary care, outpatient, plus a train commute - for six weeks, and it's over. The weather is slowly changing, but still swelteringly hot into the 90sF some days. I'm on Radiology nowadays and though nobody is really going to pay attention to what I'm wearing in a dark radiology reading room, we are in the hospital and I do feel obligated to dress better than I did in FM (+ no commute).

Here are my pieces:



Tops

  1. Dark red sleeveless blouse - $20 - bought this for my medical school interviews and wore it to each one, looked very smart and professional under the suit that I babied it a lot. Now it's shown its nature as a cheaply made, fast fashion item and as nice as the color looks against my skin, I will definitely be spending more on my residency interview blouse
  2. Purple flutter sleeve blouse - $15 - bought in 2010 for my high school job. It's very airy and breezy in hot weather, but that hardly matters if I have to wear a white coat. Unfortunately, it's showing its age and the fabric looks pretty worn (100% polyester), but I like the cut and the way it looks on me. I would not choose this color for myself again, though
  3. Navy linen sleeveless shirt - $20 - this is a Uniqlo shirt that I wear usually for casual occasions, but it works in a pinch for the hottest of summer days. Very wrinkled, as expected of linen. I don't really want to buy more Uniqlo, but I am considering getting one of their rayon blouses
  4. Black silk t-shirt - $25 - secondhand Eileen Fisher from Poshmark. Really good-looking shirt and fabric. With some of the above blouses nearing the end of their useful lifetime, I am definitely looking at buying secondhand, higher quality silk blouses for clinic purposes
  5. Dark red mock neck shirt - $6 - from Uniqlo. This cheap little shirt is just barely appropriate for a casual primary care clinic, but I would not dare to wear this in the main hospital campus, even in the cover of darkness (again, Radiology). However, I did rely on it quite a few times in FM when it wasn't disgustingly hot
  6. Blue and white psychadelic dress - $14 - this one again. It's 100% polyester too, but the movement makes it comfortable for the summer. I don't wear it too often


Bottoms
  1. Black polyester A-line skirt - ??? - bought in 2010. Hardworking little skirt. I love it a lot, very versatile. I took in the waist and shortened (!!!) it to make it more professional, less witchy. It moves very well, and despite the 100% polyester, the cut is very breezy and comfortable in the hot, hot summer. I wear this about three times a week and hand wash on the weekends
  2. Navy trousers - $9 - from H&M in 2011, a bit too casual for the hospital, but when there were FM attendings literally wearing leggings in clinic, I didn't care. I feel like this is okay for Radiology, but I have more professional trousers waiting for cooler weather
Shoes
  1. Black flats - ??? - Lucky Brand flats dug up from my closet in high school. Don't remember ever buying them, and I never was a flats wearer until this year. I didn't want to tear up my pumps wearing them every day, and they were too formal for FM clinic anyways. These little flats are clear staples in my wardrobe now.
  2. Sperry boat shoes - $95 - I don't remember exactly how much I got these for, but they are my default casual shoe and work when I'm wearing the trousers. Not sure I can pull these off once cooler weather hits, with darker trousers. Wouldn't dare wear them on Surgery, though
Looking back at this, ten items is a bit...Spartan. But I do promise you I'm handwashing very diligently. I'm not always comfortable with the "minimalism" game, but I feel pretty good about this. I am still actively pre-buying, that is, browsing Poshmark and keeping track of items I would want to buy. The plan is to replace the purple blouse with one of a similar cut, and buy another one. Professional shoes, too, for the cooler weather. 

The next post may be a roundup of outfits, and the one after that will be wardrobe planning for the autumn and winter. These are the kind of posts suitable for microblogging about minimalism in 2018.

Thursday, July 26, 2018

Finally a breather - and something about Spanish

Somewhere in Boston, there is a garden

So, getting used to being a third year has kept me away from writing, but here I am in a more relaxed rotation, ready to write.

The first thing: I got my Step 1 score back. Some combination of disbelief, relief, joy, fear, and anticipation. I will be going full steam ahead towards orthopedic surgery. My score is below average for ortho, but still within striking range. So now what lies ahead is doing my best on my rotations, keeping up with research, maintaining my relationships with my mentors, and looking far ahead at Step 2 and away/audition rotations.

I finished my first rotation, Obstetrics & Gynecology, a few weeks ago, and am just as many weeks deep into Family Medicine. I think I will eventually write more thorough, thoughtful update and reflection posts on each specialty, but that those will come eventually, much like my posts about my trip to Germany in summer 2016, and my Grand Canyon hike. Someday.

The changes in my life, other than the shift from pre-clinical to clinical education and the new three digit number that identifies me are my (1) new apartment and my (2) improvement in medical Spanish.

For the first one: I moved in with two of my classmates into their apartment, where there is a larger, more home-like common space, a smaller kitchen and bathroom, and a smaller bedroom for me. In strict terms of real estate, it's a downgrade, but I realized that my old digs were not great for my wellbeing. I got along fine with my old roommate, but I also tended much towards being asocial and a shut-in unless there was a place for me to specifically go or people I wanted to specifically see. My new apartment is a lot more like my college one, where I interact with my roommates more, and we get along.

That said, a big thing that I realized about myself is that I really miss my college friends. Like terribly so. Maybe it's that we're all scattered out at different rotations, but I don't feel as connected as I used to with my med school friends. We don't actually have that much in common, whereas I felt I was very close with my college friends (and in love with one, who is not my ex-boyfriend). So lately I've found myself really keeping in touch with old friends, and old-old friends (my best friends, the ones I've had elementary-middle-high school + two years of college, and I'm lucky to have two of them).

Hollyhocks will always make me happy

And I guess the last thing I'll say is that my improvements in Spanish have probably been what I've been most proud of in terms of soft clinical skills achieved. My Family Medicine clerkship is at a community health center where probably 90% of the patients are either from El Salvador, Guatemala, or Colombia. 5% more are probably from the Dominican Republic. The others are old white Italian-Americans. So I've had the very special challenge and privilege of learning primary care en espaƱol, which means going in to see patients on my own, collecting a history and doing a physical exam, reconciling medications (with some patients illiterate in English and Spanish), distracting the little people accompanying parents to their visits, seeing patients as young as three days old to as old as ninety years old. In the past three weeks, I've perhaps spoken English to ten patients. I feel a lot more confident and competent as a clerk and as an hispanohablante. I am making progress.

I've been getting good feedback as a third year student, but I get really proud when the attending physicians (all of whom speak Spanish themselves, running the gamut of gringa to fluent) ask me where and how I learned Spanish. Even better feedback is when the patients grill me about where I'm from and are surprised to learn I was born and raised in the United States with parents from China, and not Peru or Puerto Rico or Mexico where the Chinese diaspora has also touched. That's the best trophy I have in the road towards professional Spanish fluency.

So I think I feel a lot of things, and I think I need to write a longer post about this. But I now speak medical Spanish much better than I speak medical Mandarin, which makes me feel very guilty on one hand, proud on the other. The next step will be to actively seek out learning or patient care opportunities where I will use those languages.

This year will be one of many changes. I already has been. I'm growing a lot. I loved OB/Gyn, and though I don't love primary care, I look forward to every clinic day. And I'm ready to get back in the operating room. A lot has changed, but really, a lot has not.