Get It Done: Revived

If you haven’t yet seen this video of Anjali Appadurai addressing the U.N. Climate Change Conference, you should.

Last night I was talking to Frond about a friend of his from the India Fellowship, who had taken ideas from her year in India and was applying it to a new clothing line she was starting, with a business model based on developing the local economy of Detroit.  I thought about my roommate’s sister who went from International Development into Jewelry Making (“metal-smithing” she calls it), and makes amazing pieces that are out of this world.  I thought that it would be nice to have a passion that was more whimsical, that was more creative, and less emotionally draining than some “cause” like Climate Change.  In response, Frond told me about the advice he was given back when he wanted to go into music and philosophy.  Basically, not to do it.  That unless he found an academic position, he’d be another artist working hard in music, pouring their passions in, and having to scrape by.  Or having to accept struggling to find students to teach music to, in order to make a living out of their passions.

I can see how any passion can be draining, just as much as it drives you.  So although Anjali Appadurai is preaching to the choir when it comes to people like me, it is so invigorating to see someone so angrily, eloquently, and – there’s no other word for it – passionately express why you were drawn to this passion in the first place.

The transcript:

CHAIRPERSON: I’d now like to give the floor to Miss Anjali Appadurai with College of the Atlantic, who will speak on behalf of youth non-governmental organizations. Miss Appadurai, you have the floor.

ANJALI APPADURAI: I speak for more than half the world’s population. We are the silent majority. You’ve given us a seat in this hall, but our interests are not on the table. What does it take to get a stake in this game? Lobbyists? Corporate influence? Money? You’ve been negotiating all my life. In that time, you’ve failed to meet pledges, you’ve missed targets, and you’ve broken promises. But you’ve heard this all before.

We’re in Africa, home to communities on the front line of climate change. The world’s poorest countries need funding for adaptation now. The Horn of Africa and those nearby in KwaMashu needed it yesterday. But as 2012 dawns, our Green Climate Fund remains empty. The International Energy Agency tells us we have five years until the window to avoid irreversible climate change closes. The science tells us that we have five years maximum. You’re saying, “Give us 10.”

The most stark betrayal of your generation’s responsibility to ours is that you call this “ambition.” Where is the courage in these rooms? Now is not the time for incremental action. In the long run, these will be seen as the defining moments of an era in which narrow self-interest prevailed over science, reason and common compassion.

There is real ambition in this room, but it’s been dismissed as radical, deemed not politically possible. Stand with Africa. Long-term thinking is not radical. What’s radical is to completely alter the planet’s climate, to betray the future of my generation, and to condemn millions to death by climate change. What’s radical is to write off the fact that change is within our reach. 2011 was the year in which the silent majority found their voice, the year when the bottom shook the top. 2011 was the year when the radical became reality.

Common, but differentiated, and historical responsibility are not up for debate. Respect the foundational principles of this convention. Respect the integral values of humanity. Respect the future of your descendants. Mandela said, “It always seems impossible, until it’s done.” So, distinguished delegates and governments around the world, governments of the developed world, deep cuts now. Get it done.

Mic check!

PEOPLE’S MIC: Mic check!

ANJALI APPADURAI: Mic check!

PEOPLE’S MIC: Mic check!

ANJALI APPADURAI: Equity now!

PEOPLE’S MIC: Equity now!

ANJALI APPADURAI: Equity now!

PEOPLE’S MIC: Equity now!

ANJALI APPADURAI: You’ve run out of excuses!

PEOPLE’S MIC: You’ve run out of excuses!

ANJALI APPADURAI: We’re running out of time!

PEOPLE’S MIC: We’re running out of time!

ANJALI APPADURAI: Get it done!

PEOPLE’S MIC: Get it done!

ANJALI APPADURAI: Get it done!

PEOPLE’S MIC: Get it done!

ANJALI APPADURAI: Get it done!

PEOPLE’S MIC: Get it done!

CHAIRPERSON: Thank you, Miss Appadurai, who was speaking on behalf of half of the world’s population, I think she said at the beginning. And on a purely personal note, I wonder why we let not speak half of the world’s population first in this conference, but only last.

Middle income

Middle income households back home live pretty comfortably.

Grenada is a middle-income country.  Meaning it doesn’t quite qualify for a lot of international aid programs, in some ways is doing quite well, but still has pretty dire poverty in many places.

The other night I slipped out of Frond’s place to head to the gym, hopping out quickly to try to keep mosquitos from coming in.  I saw the silhouette of two little boys, maybe 10 or 12, drinking cartons and rummaging through the trash bins outside Frond’s apartment.  Not wanting to embarrass them, or maybe embarrassed myself, I started walking towards school as if I hadn’t just seen two kids looking for food in my trash bin.

I had seen them before, one time during the day.  It was a few weeks ago and I was backing out of the parking lot.  I noticed them lingering around the garbage cans and I wondered what they were up to.  Something shady, I thought.  One boy, the taller one, was acting kind of like a look out and the other littler one was fiddling with his backpack behind the fence that the garbage bins sit next to.  I thought maybe they were drug lookouts or maybe they were child thieves.  They had backpacks and clothes without holes and shoes.  They looked like regular kids, except a little shifty eyed.  I’m not sure what it says about me that my first suspicions were that these young boys were part of a drug ring rather than that they were hungry and waiting for a chance to look for food.

I remember going through primary and high school continually hearing how lucky we were to be living in Canada.  I thought maybe they meant no war, clean water, no dirt roads.  I heard it so many times that it became kind of a cliche.  But Grenada is a middle income country.  On a scale of all the countries of the world, Grenada is average.  If you just arrived to the planet and asked to see how an average country lives, Grenada could be an example.

I still don’t really comprehend fully how lucky I am to have grown up where I did, but I think it’s a step to realize that you don’t really know.  It’s like realizing you don’t really know what the rest of the world is like, even what most of the world is like.  I’ve been raised in a bubble and it’s almost ridiculous how safe and easy it is there.

 

After the final no

http://www.guardian.co.uk/theguardian/2008/apr/05/climatechange.usa

It’s an old article, from 2008 (I always find it a bit funny to hear professors say that, when the year doesn’t really feel that old to me), where Jeffrey Sachs talks about negativity standing in the way of solving global problems.

Yesterday Frond asked me what drives me.  I said it was the feeling that if something isn’t done, nothing will be done.  In my experience, the most common and most frustrating problem to run into when trying to solve any problem (or keeping a good thing going) is defeatism.  So I suppose I just feel like I’m just trying to keep things a balanced.

And then he offers a quote by poet Wallace Stevens: “After the final no there comes a yes / And on that yes the future world depends.”

Chins up!

“I want to be white too”

This afternoon A, Frond, DJSherv and I went to a primary school near by.

We rumbled past lush greenery on a semi-deserted road in DJSherv’s new jeep, turned a corner and there were tons of little knee-high kids running around in twos, threes.  They were each dressed in either all green, all red, or all yellow and were maybe in grade 1 or kindergarten.  It was like a multicoloured ant hill.

On the other side were older kids dressed in long navy blue pleated skirts, white collared short-sleeved blouses and red ties or navy pants and white dress shirts.  These kids were leaning over the railing, yelling, sometimes throwing food, sometimes just chillaxing coolly.

We had came to talk about a new pilot program we are starting.  In light of the diabetes and obesity epidemic on the island (not unlike the one back home, except here you don’t get the meds or the same infrastructure support as home, so it’s not uncommon for young people to lose limbs because of their uncontrolled diabetes), we’re going to come in and help teach some life skills, healthy food choices, on the backdrop of fun physical activities.  Sounds great, right?  Well…

It was great to meet with the principal and tell her what we had planned.  She seemed really supportive.  It was cool to see the field and school grounds, and to be amongst so many kids.  So strange but nice to be surrounded by so many!  While the four of us were standing under the sun discussing how we would run the first session, planned for next week, a pair of grade 2 girls in their pleated dresses giggled their way behind me and were trying to get my attention.  One mouthed “What do you doooo?”.  They wanted to talk to me “behind the trees”, pointing back.  They asked me for candy, then asked me if I had candy on my paper (I was holding a piece of paper with a cartoon carrot on it).  It was cool, it was fun to banter with them a little.

After a few minutes we were ready to head back to campus, and I hopped back into the back of the jeep with the rest of the guys.  The two girls followed us to the back of the car.  One of them was had been something to me as I was walking to the jeep but between child-speak and my inability to completely learn the accent yet, I couldn’t tell what she was saying.  As we were about to back out, DJSherv asked A and I if there were still any kids standing behind the jeep.  We turned and just as she was getting out of the way, the girl who first tried to get my attention said “I want to be white too.”    A and I yelled “Nooooooo!” as DJSherv backed out and we drove away.

“We colonized them!”, A yelled.  Great.  The very last thing we wanted to do.

It’s alarmingly amazing how easy it is to plant the totally wrong impression of cultural superiority in kids this age.  Granted I don’t know if she already felt this way before we visited today, since I’m sure even someone as young as her is really attuned to the class and racial differences she has seen with all the healthy looking, well dressed, blackberry and iPhone carrying “white people” like us walking around, complaining loudly about stupid things, buying tons of expensive foods at the supermarket.  (NB: In terms of ancestry, A and DJSherv are Persian, Frond is Indian, I’m Chinese).

It just underscored how important it is to plan these kinds of things right.  It may have seemed like an appealing extra to have a Grenadian or at least Caribbean volunteer with us at these sessions, but after this girl’s comment, it seems like an essential thing.  We should definitely not continue the program without someone “non-white” there leading it up.  Luckily we have lots of people who we know would be interested.

When school hits reality

One of the things I struggled mentally with in first year med school was how abstract the idea of a “patient” was.  It’s this body, barely even, more like just a presentation.  A patient was a canvas that you could toss any collection of signs and symptoms and lab findings onto, and then you owned the patient and you owned the diagnosis.  But patients don’t really exist, that’s just an idea and label that dissolves away in the real world.

In Microbiology Epstein-Barr Virus has come up a couple times.  It’s found in almost all nasopharyngeal cancers, which has a higher than average prevalence in Asian populations and males.  See how textbook this can sound?  And we’re encouraged to talk this way, to use our anatomical terms and multi-syllabic words that mean simple things like “it’s hard to poo”.  I understand the need to have a scientific grounding and vocabulary with precise definitions and a professional context but at least during the Basic Sciences years (for most schools, the first 2 years of med school), we get used to seeing a patient with nasopharyngeal cancer as nasopharyngeal cancer and not as a person.  It’s when we do cover a condition where you know someone who was deeply affected by it, that you get a reality check and realize that this study of signs, symptoms, diagnosis, treatment, prognosis is someone’s reality.

A good friend of  mine and fine arts grad did a series called “Cancer” which brought me to tears when I first saw it.  Growing up I had heard so much about her dad from her, my parents, and my family friends but had no memories of him.  He died when we were 7 maybe 8 years old from nasopharyngeal cancer and complications of.  In her photoseries, Victoria really brings home what med students need to be reminded of daily: that behind these definitions and X-rays there are fathers, husbands, people who have touched countless lives, who have said silly things, gotten angry, been scared, traveled the world, and have reflected on life.

But yes, feel free to use it however you choose – and just for reference sake (not that you have to mention it), the X-ray imagery is of my dads head scan when they found the tumor in his sinus cavity (he had Nasopharyngeal cancer, I believe), and the photo is of my dad in the delivery room holding Juliet when she was born in Oct. 1990. – V.S.

Today we covered pancreatic cancers.  To illustrate how terrible the prognosis is, the prof posted a picture of a little guy struggling against a sumo wrestler. I remembered visiting my Auntie Grace, such a vibrant woman, 3 days before she died in the hospital.  At her wake she looked so yellow and her face bloated.  I remember thinking the mortician did an awful job “preparing” her because she didn’t look herself; I thought they had stuffed her with cotton balls.  But the yellow was jaundice and the bloat was edema.  I remember so well when she was getting her diagnosis of pancreatic cancer from my mom, with her husband (also a doctor who must have known how terrible the prognosis was) in the room.  I had no idea what was going on and was impatiently waiting outside the office room for them to finish so my mom could take me to swim practice.  Anxious that I’d be late again and get in trouble, I knocked on the door and told my mom angrily that I was going to be late.  Auntie Grace and Uncle John felt so badly for making me late, and my mom was SO PISSED (rightfully so) that I had been such a brat when someone else was basically hearing their death sentence.

Medicine vs pancreatic cancer

I swam for a swim team last year while in the UK.  My swim coach had just received a diagnosis of Multiple Sclerosis a few months before I started swimming.  As we learned about it in class, about the gradual course of blurry vision, then paralysis, total body shut down, I thought how hard I would find it to have so much information available about something that is happening to you, but no way to stop or slow it.  It was my first time feeling, as I’ve felt many times now through school, that this job although I’m sure it will be rewarding, will be really hard emotionally as well.

Thank you Tinsley.

It’s about 60 some odd days until the end of term 4.  We’re two weeks out from our second round of exams, the dreaded systemic path exam.  4 hours of class a day, plus 2-4 hours of lab Monday to Thursday is grinding everyone’s nerves down a little.  It’s like that time mid-season where you’ve got a lot of work under your belt but you’re just a little too far out to feel like the end is in clear sight.  I know this is going to end and that when it does I’ll look back with more than a little nostalgia.

So thank goodness for Dr.Jhala, our visiting prof for Pathology of GI Tract.  He’s a big fan of Dr.Tinsley Harrison, the author of Harrison’s aka internal medicine bible.  I have memories of my dad telling me how in med school the big secret was just to read Harrison’s and you’d know everything you’d need to know.

Dr.Jhala opened today’s lecture with this:

“No greater opportunity or obligation can fall the lot of a human being than to be a physician. In the care of suffering he needs technical skill, scientific knowledge and human understanding. He who uses these with courage, humility and wisdom will provide a unique service to his fellow man and will build an enduring edifice of character within himself. The physician should ask of his destiny no more than this and he should be content with no less.” – T.Harrison.

It felt so good to read that at this point in time, when school feels never-ending but overwhelming.  There’s an ominous feeling, like you’re in the pitch dark with just a tiny flashlight to flash on one spot at a time.  This quote was like a glimpse of the big picture, like the real big picture, after all the lab slides, note taking, sleep-dep, caffeine migraines, tingling legs and finger callouses are said and done, the big picture of why I want to do this.

Edit: I apologize if the quote sounds the whole “nothing better than being a doctor” vibe from the first line of the quote.  Not necessarily true, obviously

Wii-nners!

The final leaderboard.

“hey guys we really need some volunteers for the wii tournament, you don’t have to be good at all, like me who totally sucks at any video game but its all for fun and charity. The event is going to be this saturday oct 8. Please by tonight, if you are interested please write back on here or send me a message. Thanks”.  – M

“hi m! i’ll play in the wii tournament if you still have space. i’m not so great but maybe i’ll have some beginners luck!” – me

Wii Olympics champs!  Having 3 older brothers who loved video games and subscribed to Nintendo Power has finally paid off.

Over $500 000 EC ($30 000US) raised and to be matched by the school to donate to:

1. The only psychiatric hospital on the island, which we visited in third term and met patients of.  An honest institution, but with a bare concrete room for solitary, and a small 20 bed ward.  Lifers, teenagers, drug dealers, people coming off drug-induced schizophrenia and delusions, people with families and children whose progressive schizoaffective disorders made them alone and visitor-less in the hospital, on the island, and in their heads.  Hard working doctors who don’t try to hide the limitations of their institution or the state of affairs on the island, but who are working wholeheartedly to do the best for the wards.
2. The Santa Claus Project, started by a student of my school, based in NYC where children of families below the poverty line get the chance to enjoy the excitement of getting a gift on Christmas.
3. Doctors Without Borders in Somalia.  Decades of drought, scarred over-top with conflict, displacement, and now the most extreme food shortage the world has seen and perhaps the worst humanitarian crisis as well.

Plus, had a great conversation with Dr.B (my landlord) about charity and issues of accountability when making donations.  Sometimes it is better to give cash: , sometimes it is better to give supplies.

What an amazing night!  Unexpected. Top prize: Boat cruise, here we come!