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. 

Beehive and Precipice | Acadia National Park 2017 part II | Maine

Note the iron rungs on the rock behind my head. The trail continues when you climb up them

Here I am with the second installment of my mini-vacation to Acadia National Park back in early October. I can only imagine how the landscape must look in the full blaze of autumn. Can you imagine sitting on this cliff overlooking a flaming red, orange, and yellow pit of foliage below? I tried to imagine that, and I imagine it would feel as if I were escaping from the pits of Hell. But the leaves were just barely beginning to turn when we went, and I can only imagine.

At Acadia, we went on two steep, strenuous hikes. All of us were fairly in shape and thoroughly enjoyed ourselves, but I would caution against anyone not accustomed to hiking, or hiking with improper footwear. The first of these hikes was the Beehive Loop, which has an elevation gain of 534 ft over about half a mile (the loop is 1.3 miles long, but the descent is much, much milder). Short and very sweet, with gorgeous views of the land and the sea. I deliberately did not include any photos that included the big cruise ship.

It is me

Beehive consists of a steep ascent from the forest floor up the side of a cliff, with narrow, rocky, and steep switchbacks and sections of ladders with little thin iron rungs. In this picture, I am cautiously lowering myself to sit down. It's a straight drop from there.

Don't look down. Or look down and try to spot the cairns

Barely getting started. The trailhead is at the elevation of the road, with a mild ascent to the cairns in the exposed rock at the upper right quadrant.

I read that this trail is reminiscent of ferrata hiking in Europe, which sounds very appealing and exciting.

This was about as summit as it got, and I admit that the views were not as awesome as I would have hoped for. But in this hike, the journey is the fun! We were a large group on this hike, and passed two families. It's a popular, but congested trail and we sped through it to thin out the group. I wish we could have been a smaller group and taken it a bit slower.

Next, we went along the ocean trail to check out the local wonder, the Thunder Hole (kind of cool, and the ocean trail was pretty cool).

As you can see, there were plenty of these jumbles of boulders to climb up and over, which we did with glee.

Climbed up high to get a view of the shore. The rock is an orange-ish color.

Another deceptive photo -- I am about 20 ft above the shore

The Thunder Hole was crowded with people and not worth photographing.

Down to Precipice!!

On the second and last day of the trip, we hiked the Precipice Trail, for which Beehive was the warmup. This was the coolest hike I've done in New England. In a half mile ascent, we went up 1072 ft, double that of Beehive in almost the same distance. Very steep. Very thrilling. I'm getting riled up just thinking about Precipice.

Shortly after we began the hike, we came upon the first challenge: a huge tumble of boulders to scramble up and over. Need I say it again? I love scrambles. This was just a taste of what was to come.

What was great about Precipice was that this trail essentially took us up the side of a cliff, meaning the views were always there, and getting better by the moment.

The first of the ladders. There were more than double the amount of ladders on Precipice than Beehive. After this point, it was steep, steep, steep all the way up. If you get to this point and find yourself exhausted, it is safer to turn back.

Interestingly, Precipice is closed for significant parts of the year for peregrine falcon nesting. We were lucky to come here when we did!

A rare flat stretch...and a precarious drop

Regrettably, I didn't take too many photos of the truly steep portions. The simple truth is that there wasn't really a place where I felt safe to do it. Between this photo and the last were crazy steep and narrow switchbacks, long ladders, and mere inches of rock between us hikers and a deadly fall. Admittedly, we were on a tight schedule and really booked it up the mountain (recommended at least 2 hours for an ascent, but we got up there in 1.5). We were exposed, exhausted, and I don't think my heartrate has ever been higher.

I admit, I had a dangerous light-headed moment when I was clinging for dear life on a ladder on an exposed cliff face, and looked over my shoulder.

But this photo is cool. I scampered up to the next highest boulder to take a picture of my friends seemingly emerging from the depth of the mountain.

The summit!

The views were worth all the effort.

There are a few other trails -- longer, less steep -- that lead up the mountain. But I was very happy we picked this one. How much more thrill could you pack into half a mile?

We took a long descent that still managed to be tough on the ankles and knees, but that's New England hiking for you. Here is a photo of the cliff from the parking lot. How exhilarating it was to climb up that exposed rock. It was the highlight of the trip.

Maritime Maine | Acadia National Park 2017 part I | Maine

Seal Harbor Beach - went to roam around while some more adventurous friends went swimming

It's been quite some time. I had a few adventures and mini-adventures over the summer and autumn that I wanted to blog about, but I think this one beats them all out. After a tough cardiology module, I got out of Boston with some classmates to experience Acadia National Park and Bar Harbor in Maine. We camped two nights in an admittedly very comfortable "campground," saw beautiful Atlantic coast, and nabbed some of the coolest hikes I've ever gone on.

Part I will be the scenic stuff, while part II will be the hike reports. Short, but very sweet.

Kelp

Even more kelp

From Boston to Bar Harbor

Driftwood

Acadia National Park is located on Mt. Desert Island, a large island shaped like the anterior and posterior pituitary glands off the Atlantic coast of Maine. The most notable town on the island is Bar Harbor, which we visited briefly for a pricey dinner on our second night. The road from Boston to Bar Harbor is about 300 miles and 5-6 hours away depending on traffic. On the drive up, we passed through a town founded in 1643 (???) for gas, Portland (location of Maine Medical Center, the only level I trauma center in the state of Maine, compared to the six in Boston), Augusta (the capital), and Bangor (birthplace of Paul Bunyan).

Other remarks about Downeast Maine: (1) they take their outdoors extremely seriously, (2) they take their lobster extremely seriously, and (3) we drove past more antique stores or markets than I have seen in my entire life before this trip.

Really sick piece of driftwood

Our car got to the campground first and we set up as many tents and chopped as much wood as we could. Sun sets fast so far north. However, I say this after having read this blog post about a doctor's road trip through the Maritimes of Canada, which are substantially more northeast than Maine.

Acadia National Park

I've long wanted to visit Maine. Maybe I romanticize it a little bit in that it is perhaps the most wild of the New England states. Maybe it's because its bid for statehood kicked the Civil War into motion (among a great many other things). It has wild mountains and forests and sea coast. It has Katahdin. My boots come from Maine. Many things.

Acadia National Park has been described as the only national park on the East Coast that comes close to the grandeur of those in the American West. I think it's fair that it's the closest to grand that I've seen here, but not quite close enough. And perhaps it's because we visited just too early to see the foliage in its full glory. You'll see hints of red and orange in these photos, but I couldn't begin to imagine how beautiful it would all look later in autumn. Perhaps it's like that right now.

Brackish water

I think for the next post I'll add in what I packed for this trip. Any later in the season and I would have worried about being too cold at night. Anyhow, the text of this post is a bit rambly so I've tried to add comments about the places I took pictures of in the captions themselves.

At the top of Mt. Cadillac, which we drove to and did not hike - really interesting lichens!

That's it for now. Next up will be a post about the hiking we did in Acadia National Park. It's going to get precarious.

The view from Mt. Cadillac - I cropped out the huge cruise ships in the background

Sand Beach - relaxation before our afternoon hike

Sand Beach - full of people

Lots of rocks to climb up and over

This picture is quite deceptive - I'm about 30 ft above the shore

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.