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!

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. 

Spring into summer update

View of the green, green Colorado River from the South Kaibab trail

None of these pictures are in order. I think my dad took most of these. But since I'm probably going to take an eternity writing up a post about the Grand Canyon hike itself, here are some pictures.

Hello from third year of medical school. I'm starting on OB/Gyn and like it so far. Still waiting nervously for my Step 1 score and having catastrophic thoughts of not scoring high enough for my dream specialty. Felt all kinds of sadness and guilt and inadequacy when my research attending and some of the ortho residents I worked with last year said hello to me on the day I thought I would get my score back (they're delayed and I have to wait longer). Felt something similar when the resident who mentored me since first year called me volunteering advice for my surgical rotation (and then gave me some advice as a new parent whose wife delivered her baby on the floor I'm working on right now). Keeping an open mind is surprisingly not hard, since OB/Gyn is really cool, but it's also not hard to remember how happy and excited and home I felt in orthopedics.

I'm learning some things about myself. I'm getting better at talking to patients. I like our patient population (safety net hospital, non-white, non-rich, many immigrants, many complications). I have more role models now: two gynecological oncologists whose patients trust and adore them. Gyn-onc doc #1 speaks fluent English and Spanish, and proficient Haitian Creole and Cape Verdean/Portuguese Creole. Gyn-onc doc #2 speaks fluent English, Spanish, and Mandarin. About 1/3 of the patients that go through our hospital don't speak English (most common languages Spanish, Haitian Creole, Cape Verdean, Vietnamese...I would have lost my fucking mind if I had heard Doc #1 speaking Vietnamese). I don't think I'll go into OB/Gyn, but I do think I'll eventually work somewhere where I'll need to speak Spanish on the regular. Eventually I'll find my way.

My Spanish is getting good. I thought it was good until I heard Doc #2 speaking with perfect, perfect grammar. Subjunctive tense, correct yo forms of irregular verbs in all tenses, correct conjugation of mandates and everything. The feedback that I treasured most from last week was when a patient I interviewed asked me where I was born and raised, and if my parents were from Latin America. Like everything in third year, I'll get better at the things I want to improve on if I actively seek out opportunities to try. So on I go.

I'm moving into my new apartment at the end of the month, and I'm doing it slowly over the next few weeks. Always kind of been into ~~~minimalism~~~, but I've accumulated some junk during my first two years in Boston and am downsizing. Namely, I'm giving away some of my plants, since I propagated too many of them.

Lastly, I was really affected by Anthony Bourdain's suicide. I loved his shows, and his overall attitude and approach to life. He, too, spent some of his formative years in Massachusetts, and I'll spare the details so you read Kitchen Confidential. Part of this was because it came after the death of one of my friends and mentors from the free clinic I was part of in college. The O was the coolest almost-octogenarian I've met. He helped me find my feet when I was struggling with new leadership and more responsibilities in the running of the clinic. He gave me lots of solicited and unsolicited advice. I owe a lot to him, more than he knew. Wouldn't be in med school if it weren't for him, wouldn't have even wanted to become a doctor if it weren't for him. He said he'd thought he'd die in his 20s, then in his 40s, then went quietly a few days after a stroke pushing 80, surrounded by friends. I wish I could have seen him again.

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