Life and loss imagined

When I was little, my family used to drive up to Toronto on weekends to have dim sum with the grandparents and cousins, and to pick up some Chinese groceries for the week. I didn’t want to go but once I was there I didn’t want to come back either. My mom would bribe me with Chinese candies and I’d drag my feet in our Toronto apartment, enjoying the plush carpeted floors while I could. These memories feel so far away, but also so familiar as if it could happen again this next weekend.

On the drive back I’d pop in cassette tapes of Fairy Tales – readings of silly and sometimes serious or creepy stories for kids – or Classical Music for Children – famous pieces done in synthesized beeps and boops. Being the youngest, I always wanted my brothers to be my friends, and I’d hope that they’d stay up on the car ride home and be in good enough moods to sing or joke with me. When everyone was too tired, I’d just look out the window at the stars and my mind would wander.

I’d think how amazing it was that the stars were so old and everyone sees the same ones. I’d think it’s strange how each of the other sets of headlights on the road had at least one person in them. I’d think how unbelievable it was that one day I’d be older and an adult and living a life somewhere. I wanted to live in an apartment with carpet and lots of Chinese sugared jellies and chocolate original Pocky. I wondered if my mom would still be nearby. I wondered if I’d still be alive when my mom died. I’d assume I would be, and I’d feel so sad that she would die one day that I’d start silently crying to myself while my mom, alive and well and unaware of her suddenly tearful distraught little daughter beside her, drove down the 401.

Obviously I’ve always been a sensitive kid. I grew up with anxiety, a healthy level usually but sometimes a little too much. It makes me indecisive but also careful and thoughtful. The trouble is I have a hard time telling when my worries are justified or when my mind is just getting away with itself.

I was driving through the ice sheets and snow today and my wipers were iced, useless. I was thinking about loss and feeling loss of things that haven’t happened. I’ve been mourning death of memories that haven’t been made, as if these moments once had life and now are sick, shriveling. There has been so much good and happiness in my life and in friendships but I find I’m wishing to have things returned to me that haven’t even happened. “Keep your promise!” I feel, out to life, the universe, or nothing. “I have lost!” I want help finding it, keeping it, preserving it before it’s all gone.

I’m not sad about anything that’s happened, which makes all this so strange. I’m so happy for everything. Yet I feel so much loss right now and I hope it’s just my mind getting away with itself but I think that I need to just let myself be quiet and let myself see that life continues to move and all it is in the end are memories made – lived, lost, and yearned for.

Shorts too short, and other lessons in culture

The school Healthy Grenada is working with had a PTA meeting tonight, so Frond and I went to introduce the program to the parents. As we were sitting waiting for the meeting to start, the principal pulled us aside into another classroom and asked who was going to be presenting. Frond said both of us. But she replied that I wouldn’t be able to do it because of my shorts. I don’t have many shorts, and the one pair that I wear a lot while here are pretty short I suppose. Not by North American standards, but for a Roman Catholic Elementary school, I could see what the principal was talking about. She said that I could hand out the fliers we had made, but I couldn’t be presenting. In the end, I went home to change and we presented together.

I appreciated the principal pointing this out to me, as it’s important. But I felt bad because I had worn these shorts to the school before, while doing activities with the kids. It really hit me that for all my trying to make Healthy Grenada a culturally competent program, I had overlooked many basic things.

We stayed for the entire PTA meeting, where parents shared some things they had learned about food, artifacts, and songs that their “forefathers” used. Grenada’s independence day is coming up in February, and judging by the efforts going in to it around town, it’s a pretty big deal. The principal and vice went on to talk about programs they are running for the students, including Sports Days (with an “Infant Cross Country Race” where the kindergarteners run a cross country course — incredible! People were saying how it was such a short course, but to me it sounded like quite a length), Spelling Contests, Reading Contests, and an ongoing school-wide Physical Activity competition. I was thinking the whole time about how I had came in to the school with so many assumptions about what the school had to offer their students. It had me wondering what exactly Healthy Grenada had to bring that would benefit the school. Was the school doing us more of a favour, by giving us a chance to volunteer with their kids? During their school time? I felt like a silly tourist.

After the meeting, we went to thank the Principal for inviting us to the meeting. She asked where we were from, and when we told her she said how we’re three different cultures. We agreed, adding that we’ve got a lot to learn from them, and she said, “Yes a lot to learn from each other” and gestured her hand back and forth between the 3 of us.

When you don’t like your patient

I’m still on the way home, on the second leg of my trip.  I am eavesdropping on the conversation going on in the row in front of me.  13C is coming home from Guyana where he’s been working in mining exploration.  He looks like a young guy, maybe around my age, with a kind of Western or Southern drawl.  He’s describing what he does to 13D and I’m trying to listen for any indication of gross injustices against the environment or local communities.  He’s an outgoing guy and seems really friendly.  He leans over the empty seat beside him and is now chatting with 13A, whose contribution to the largely one-sided conversation is the occasional “ah” or “huh”, “yea…”.  He’s talking about his life working overseas.  He proudly mentions having 4 girlfriends, who don’t know about each other “no, they don’t know about each other”.  He sounds jovial, like someone talking about how fresh the fruits are at the local market or maybe how a dad would talk about his son’s little league team.  I wondered how I would approach this if he were my patient.  Would he tell me about his 4 girlfriends?  How would I respond?  Impassionate, matter-of-fact: “Oh, well do you use protection? Have you been tested for any STDs?  Alright, well we have the facilities here to do that”.  I pictured the movie effect where you have a map with a pin-point on it that just spreads like a black wave, sludgy and oozing across the continent.

I remember one time my mom came home from the office upset.  One of her patients was cheating on his wife who was terminally ill.  His mistress wanted him to promise to be with her.  He was stressed and depressed but didn’t know why.  When my mom asked if he thought perhaps it had to do with his relationship situation, he was surprised and hadn’t considered it.  My mom was boiling the whole hour of therapy, as she was reminded of being cheated on herself so publically by my dad.

As much as Western medicine is about micromanagement and control of biology (at least we like to think that), we’ll eventually end up with patients who we will feel crappy listening to.  I’m thinking of the simulated patient we had who was abused by her husband but didn’t want to admit it.  Doctors are legally mandated to report child abuse and elder abuse but not spousal abuse, and I can’t imagine what it will be like to have to see some women walk back out into trouble despite all the counselling you give.

I guess part of becoming a health professional is always keeping a professional front.  Obviously my mom couldn’t bring her own baggage into the care of her patient.  The trick will be finding the balance between being jaded and being human.

It’s not funny.

During today’s 8am Clinical Skills and Physical Diagnosis lecture, the professor was demonstrating various gaits and the class would guess which gait he was performing.  There was the hemiplegic gait (one foot sweeps out and around, kind of like a dragging on the floor), the Parkinsonian gait (stooped over, short shuffling steps), the paraplegic gait (scissor gait, criss-crossing legs) and the sensory ataxia gait (i.e. drunk gait, wide steps as if your feet are magnetized to the ground).

Maybe it was because it was 8am and a poorly attended lecture.  Maybe because we all looked disinterested and he was feeling desperate to get us to pay attention.  For whatever reason that seemed good to him at the time, after demonstrating Parkinsonian gait he joked “It looks kind of like a retard. Do I look retarded?”

My grandma died the winter before I started med school from complications of Parkinsons.  It was a slow but dramatic decline that spanned over a decade.  I remember my mom and my aunt arguing with my grandma about why she needed to take her medications.  My grandma didn’t want to because she was afraid of the side effects.  I sided with my grandma because she seemed so upset, and told my mom maybe she should leave my grandma alone because she really didn’t want to take the drugs.  I was about 11.  When I was in high school I went with my mom and brother to see my grandparents off at the airport to Hong Kong.  My grandma was put in a wheelchair for the first time and my grandpa told me and my brother in Cantonese that they loved us.  It was my first time hearing that from them.  They never came back to Toronto.  We finally sold their house this year.  For the last few years before she died, my grandma could no longer shuffle “like a retard” and was completely bedridden.  Her mind was still sharp but she spent her days staring at the ceiling of her bedroom or choking on food during meals.  She had told my mom she wanted to die, and had nightmares every night – another complication of her Parkinsons.  After my masters me and my brother and my mom visited my grandparents in Hong Kong, just as she started bleeding profusely from her GI and was hospitalized.  We spent our mornings and evenings sitting in her hospital room with masks on.  Sometimes she chanted Buddhist prayers under her breath and waved her skin-and-bones arms, sometimes she stared at the cartoons flickering on the TV in the corner, but mostly she slept.  They went in to scope her GI and found food and crushed up pills stuck in her oropharynx.  My grandpa, with his OCD tendencies, could barely get himself to visit her in the hospital because he was so afraid of germs.  She died with my mom, cousin, uncle, grandpa and my grandpa’s secretary in the room.  Me and my brother were outside joking around on my mom’s computer.  I was making a cartoon about him.  My mom came out and said “Paw Paw died.”

She was totally different when I went in to see her, just a body.  I was so acutely aware that her life was gone.  It was scary to look at her.  I thought she might jolt up, zombie-style.  I kept thinking “This is now an object.  We are just objects.”

Ten minutes after calling the Parkinsonian gait “retarded” the prof made a joke about Schizophrenic patients wanting to tear up and eat a sealed and stamped envelope, rather than mailing it like a reasonable person (part of the mental assessment test for judgement) and people in my class who are studying to look after people of all illnesses mental or physical, laughed.

I visited my grandpa last summer, just me.  It was my first time visiting him without my mom there, and he opened up to me about my grandma’s death.  He told me how she was the love of his life, that they were together for 80 years and that she had dropped out of high school to marry him when the war started and he needed to move to Macau to run the family factory.  He told me after she died his heart has been broken and he thinks about her every hour, 24 hours a day.

It’s not about me but I remember when it was.

It is 1:29am.  Someone just came home.  Romance is in the air.  I like being on this side of things!  And that’s all I’ll say about that.  G’mar Tov, all!