Sunday, August 9, 2015

[Poetry] words

the soft stroke of my pen
the faint flick of my mouth
penetrate your ever-ready mind
as i try so hard to follow your cues
to awaken you unto a heightened state.

but passion in words
comes in their final effect-
the vast unknown of open lips
allows roles to swap throughout
as our tongues playfully swordfight
and unite our two once-distant souls.

the rush of this exchange
depends on how much is offered:
will you give all of your words and
allow yourself to receive uninhibited?

or will you always finish early
and move on never knowing
the deep satisfaction of
pleasuring another
in conversation-
never valuing
the worth of

Saturday, August 1, 2015

On Honesty (in Third Year, Medicine, and Life)

Honesty is a tricky thing. 

I truly believe that, in honesty, you find better, deeper, more meaningful relationships with people who strengthen you (and whom you strengthen), and it can dictate your various friendships and other social circles. But, what happens when a relationship with family/a closer family-esque friend/a patient/a colleague (i.e.: a socially perceived "valued" relationship for whatever reason) can only be seemingly salvaged in hidden truth of one's feelings when conflict inevitably occurs? How does one reconcile such a relationship that is dangling by a thread when total honesty is necessarily avoided to preserve what's left? Is it as simple as cutting the thread and freeing oneself in unabashed defiance of the falsely positive value given to the relationship based on no-longer-applicable social mores? Or should one find a way to use that thread, however frayed, to reach out and rebuild the fine quilt that once existed in honesty? And is the judgment call further complicated when you are not sure if the other person sees (or wants to see) the damage...or even cares if it might be damaged at all?

I tend to lean towards repairing those relationships which have once carried you, defined you, and have meant so much in the past (and still do) with as much honesty as possible, but, if needed, even at the expense of honesty for a perceived greater good. I find myself throwing away all my own feelings and thoughts to satisfy and maintain the delicate status quo time and again to make others happy.

Make no mistake: I value this element of my personality; it is so much of who I am. I deeply value my ability to concede my feelings in the heat of the moment to expedite re-establishment of total honesty and good relationships after chaos. I perceive it as a strength to value another's feelings over one's own in an open act of re-perceiving and re-evaluating a relationship from an entirely different perspective. In fact, many of my closest friends share such a wonderful trait.

But lately, it has not been so easy for me to find that total sacrifice within myself. It disturbs me, and I am in a deep state of wondering why. 

I have started to wonder if the third year of medical school has perhaps affected my personality to give all of myself, including my feelings, in this newly-found sense of necessary self-preservation and value. Now, at the very bottom of my career's hierarchy, any shred of personal thought, opinion, and wishes are of ill use. I am devalued, scared, insulted, belittled, stigmatized, inappropriately criticized, and marginalized. Often, I am left to passivity, given no real ability to assist others, and feel ultimately unworthy of the more experienced doctors' understandably precious time. 

Certainly, these thoughts are not rooted in my disapproval of the "higher-ups." Such sentiment couldn't be further from the truth (speaking of honesty)! I fully understand that any mistake or mishap from my naïveté reflects negatively on residents (and the attending) in their own relationship within the existing hierarchy, including maintenance of ever-important rapport with patients and even patient safety and well-being. I also fully appreciate their perspective of the system's evaluation of their performance and overall worth and aptitude potentially could be based on my actions. Furthermore, my residents have overall been amazing teachers and mentors in their various (permitted) capacities. Obviously, as a third year medical student, I'm not ever going to be First Surgeon on any surgery (#lawsuit), but I can be (and am) engaged in the process as the surgeon explains his or her reasons for various steps in the procedure (and occasionally asks me to hold pressure on a vessel or retract an organ to help out). In a way, doctors and medical students share camaraderie in that we are all together victims of a system of constant, critical judgement. There's always someone criticizing you, no matter how high on the roster you might be.

However, if the systematic totem pole is structured in such a way previously described, it is then expected that the "inferior" or "lesser" rungs get fewer (if any) responsibilities so to protect a deeply valued and objectively paramount goal of safe, quality patient care. Such stratification, then, has its side effects on perception of value and worth. I fear that, in such arguably necessary treatment of the medical student, I am denied so many opportunities, separated from many practical/useful skills, and deprived of the interactions essential to training a future generation of physicians. What happens when I "skate by" and get my medical degree without any objective means of showing ability? Suddenly, as a resident, the expectation of competency is high (after all, I will be a REAL M.D....and be treated with the rights and duties therein), and I will be responsible for maintaining such goal of safe, quality patient care without proper training. 

And even in returning my bothering of the troubles of tomorrow in good faith in the medical education system...even in the present, to feel so unwanted in something you are so greatly impassioned feels like unrequited love.

I have found the need to revalue myself in my dedication to patient care whenever applicable via the little things I can offer, in seeking out and finding meaning in otherwise menial tasks, in preparing my absolute best for rounds so to help my residents better understand the patient, and in speaking up for my patients as their personal representative. In a way, I think that's part of entering the medical system - to find a utilitarian role for oneself to achieve the previously stated patient-centered goal. The social recognition of my perceived value in utility has, for better or for worse, defined my entrance to my passion in medicine. 

Such needs have forced my honesty about my own feelings and newly-found recognition of their value into the open. Of course, I am always still respectful and courteous, in recognition of the hierarchy, and try to speak in times of conflict with tact. But, I have become unwavering in my reinforced importance of self-value. Surprisingly, such self-confidence and honesty have proven quite positive in defining relationships with colleagues, patients, and in medicine overall. It is becoming a part of what makes me "me" to "stick up for myself," as I have become completely honest (including about my immediate my thoughts and feelings in times of conflict) and refuse to devalue myself anymore than I currently am in the hospital. Luckily, it appears honesty is in fact appreciated in the medical working world in peace or in turmoil. But, such potential for sustaining conflict in self-defense is uncharted territory for me, and I have found that, a few times, it has nearly caused a total severance of a previously defined valued relationship. Admittedly, most of the time, things work out with potentially one or two metaphorical scars that (usually) eventually fade. But, I don't know if I have ever gone so far with my self-defense as I have lately to potentially permanently burn a bridge with someone dear to my heart.

In a nutshell, I found a shred of self-worth through total honesty even in heated conflict that I did not have before, and it is helping my career opportunities and many of my professional and personal relationships, but I don't know what to do with it when my new personality is too much for people I hold so dear.

I think my personal conclusion is that I am ultimately determined find some way to balance the "old me" and "new me." I certainly must hold onto the old piece of my identity: that is, to give all of myself to others, including my feelings. If my goal is safe, quality patient care, my service and actions are for my patient entirely, which may mean, at times, surrendering my feelings to them and to others on the medical team if it is in respect of the patient. What's more, the desire to give value to others at the expense of myself when times are tough have fostered my best relationships with colleagues, patients, friends, and family. It is personally altruistic, ideal, and moral. Furthermore, it is simply natural for me. However, this newly-discovered trait is not without its value, too, for it has imbued me with the self-confidence necessary for competency, for patient care, for medical teamwork, and for self-empowerment. These traits also contribute to the goal of safe, quality patient care and, thus, cannot be ignored. 

The equilibrium will come from learning to define my self-worth additionally through my total sacrifice. While I have stated my value of the act of total sacrifice, I don't think I ever have used it to validate my self-worth...and I SHOULD! It is through honesty that I have been honored and blessed with some of the greatest people I could ever imagine. And, it is also through honesty that I have found my role in the medical realm. But, perhaps this whole time, I haven't been honest with myself in my own perception of my worth in my ability to sacrifice entirely if the need arises. 

For now, it is a work in progress to find that happy middle ground, but I am excited to find that place in recognition of finally finding (and feeling) some well-needed assurance in myself.