The Unbearable Lightness of Being by Milan Kundera

Actually finished this book while I was in Bolivia in June

ironically and unfortunately appropriate for my travels

as I considered lightness and weight

and eternal recurrence

I began to read it again

and almost finished it for the second time by the end of July in Argentina

but not quite

but stuck in my mind

recurring as it were

are two particular phrases

"When the heart speaks, the mind finds it indecent to object."

Gears told me this on a run in May

and shortly thereafter got engaged

and then there is one particular phrase about music:

"While people are fairly young and the musical composition of their lives is still in its opening bars, they can go about writing it together and sharing motifs (the way Tomas and Sabina exchanged the motif of the bowler hat), but if they meet when they are older, like Franz and Sabina, their musical compositions are more or less complete, and every motif, every object, every word means something different to each of them."

This makes me wonder

about my friends who get married so young

and set about composing the opening motifs of their lives together

and about those who wait longer

already in the development section

many sharps or flats away from their home key

developing tension, reaching great heights

yet seeking resolution, tonality, and peace

assuming that sonata form can be applied to life

Return to medical school:

As my lack of blog updates indicate, the transition from South America to my introductory pharmacology course was rather abrupt and somewhat challenging. In fact I can't remember if I ever wrote a post about Chile. Since I'm already three weeks removed, I'll just give some general impressions as both my memories and Spanish skills fade away.

Viña del Mar reminded me of San Diego. If Argentina was first world, my first impression of Chile was that I was indeed back in the USofA. I again was lucky to find very kind hosts through CS and even had my own room in a high rise overlooking the Pacific. I explored a different direction each day on my runs and also enjoyed the large TV and cable coverage of the Olympics.

Valparaíso was really cool. Only. Few km down the coast from Viña, the modern high rises gave way to a Bohemian port city. A childhood of sailing novels came rushing back as I recalled how Valpo was a resupply stop for everyone from Cook to Slocum. Super hilly, but even more colorful. Each house seemed determined to outdo its neighbor with mural, fresco, or mosaic.

After three nights on the coast, it was time for Santiago. Definitely did not have enough time to get a good feel for this huge city, but I did go on a fascinating bike tour aimed at outlining the political divisions within Chilean society. It was a great review of the disgusting role that the CIA played in Pinochet's coup, but even more fascinating was how little has changed since Pinochet left office.

From Santiago it was a direct flight back to Toronto. Early Sunday arrival left me stranded a long way from the bus terminal, but some nice Albertians gave me a ride downtown. Then 5 hour bus ride back to Rochester.

Over the Andes into Chile

The tunnel at the top was really long

I took the opportunity to go to the bathroom in the back of the bus

we came out on the Chilean side just as I was walking back to my seat

no problem at customs, besides some raisins that I had

I decided to eat them all rather than throw them out

luckily I have intestines of iron after a summer of traveling

400grams of raisins does nothing

then 27 switchbacks down a very steep boulder field

super impressive that there used to be a railroad here

cool remnants of a covered track

though nowadays it doesn´t seem like it snows as much

the final 3 hours of the drive were a struggle to stay awake

warm afternoon sun and picturesque vinards in the Chilean central valley

the air gradually getting more humid as we approached the coast

smell more and more like San Diego

though temperatures like San Francisco

Viña del Mar reminds me of the Spanish coastline near Barcelona

I´ve decided to run a different direction for each of my four days here

On Thursday I´ll go to Santiago for my last two nights before returning to North America.

 

Last Week in the Hospital

For lack of memory about what I was going to post about
I´ll outline my day

0640 up to make and eat oatmeal
0725 out the door to catch the ¨trolley¨ which is an electrified bus. Runs on tires but has those antenae to pull down electricity from overhead wires.
I only have a 2 min walk to the bus stop, and the bus comes at the same time each day.
0735 get on the trolley but ask anyway to make sure it´s going to the hospital today. I once got on a clearly labelled bus without asking and it took me to a different place. I thought it was strange that the driver reached over to switch the sign not long after I got on.
0745 Arrive near the hospital, walk the final 200m up the hill while enjoying the predawn glow of east behind me.
0800 The meeting starts promptly to review difficult cases with all the residents and attendings.
0900 On some days there are different activities at 0900. On Wednesdays are generally M&M conferences and today´s was particularly interesting. It started with an overview of the case, clinical history, and pertinent lab values. Then there was a comprehensive review of the clinical decision making process. Finally, a resident from pathology presented the autopsy findings. Then everybody discussed the choices they made, and what they might do differently in the future.
1100 Mediamañana which means food and mate. Today was one of the attending´s birthday so there was cake for all.
1130 Rounds started, later than normal, so they went on past 1300. There is some of the quizing and challenging that you see on tv but not as much as I expected, or was lead to believe on my first day.
1330 Wonderful hospital lunch. You know how much I like these...
1430 collected my things and cought the bus back to the center to do two hours of Spanish hw.
1700 hour of internet to write this and finish up the honor board orientation powerpoint that I´ll help to present in less than two weeks.
1830 jog over to the big park to join the running club for a workout.
2100 home for dinner, more Spanish, then sleep before 2300

Interview Questions

Preguntas para médicos y enfermeros

Función:
Edad:

Pacient (iniciales):
Diagnóstico:

1. ¿Estaría dispuesto a compartir sus ideas sobre las decisiones clínicas en este caso?
2. ¿Hubo más de una alternativa de tratamiento en este caso? ¿Cuales?
3. ¿Qué rol tuvo en esta elección? ¿Qué grado de participación tuvo en la elección?

4. ¿Cómo se siente con respecto a la forma en que se tomó la decisión?
5. ¿Cómo ha afectado el costo de medicamentos y de exámenes complementaros la elección que hizo?
6. ¿Los resultados de la decisión terapéutica fueron satisfactorias tanto para la familia, el pacientes y los médicos? ¿Fué satisfactoria para alguno de estos en mayor medida?

Preguntas para pacientes y sus familias

Iniciales:
Edad:
Relación con el paciente:
1. ¿Estaría dispuesto a compartir sus experiencias sobre la relación con los médicos del hospital?
2. ¿Piensa que habían otras opciones de tratamiento? ¿Los médicos le informaron sobre otras opciones?
3. ¿Cuánta participación tuvo en la elección de tratamiento?
4. ¿Como se siente acerca de la forma en que se tomó la elección?
5. ¿Cómo ha afectado el costo de medicamentos y exámenes complementaros la elección que hizo?
6. ¿Esta satisfecho con el tratamiento realizado?

Tupungato and Uspallata

The last two weekends have involved social events on Saturdays, and solo bike adventures on Sundays.

The trip to Tupungato was poorly planned. Slept in late, ran, ate, then around noon decided to go.

Messed up the busses, and by the time I was on the rental bike, free on the road, the sun was setting beyond the vinyards over the Andes. Still got in 50km though and found some delicious raisins (since i didn´t have the ganas to drink or carry wine).

Uspallata however went much more smoothly. Caught the 0800 bus, rental bike headed up into the valley by 1100. Perfect sunshine, dark blue altitude sky, inca rock carvings, bouldering in another location, nap on top of a mountain. 11 miles downhill to end the day. I´ve got to figure out how to get this pictures off of my virus infected camera...

Olympiada

Last weekend, no, two weekends ago, I was invited by some 5th year medical students (they have six years here after HS) to attend their end of year camping trip. Since it is winter, it was going to be in a camp with cabins.

While it is impossible to describe the experience in detail without forgoing other equally valuable experiences, I wanted to share the essence of spirit that I understood.

A powerful generosity, willingness to share, patience to listen, and sense of community as this group of students so fluidly accepted me into their midst.

1600 they finished their exams for the semester, and we piled onto the minibuses (traficos)

1730 arrival

1830 tea

1930 fire

2030 icebreaker games

2130 wine and fernet

2230 start cooking asado

2330 dinner

0030 some students have a rock band

0230 hook up computer to start playing dance music

0500 I fold and go to bed while most continue dancing

1100 up and breakfast

1200 mountain hike

1700 parting words

what a weekend