"A good time"

One thing that one learns shortly after matriculating into medical school is that the train has truly left the station.

Yes, there are short pit-stops along the way, but momentum soon builds and getting off of the tracks is difficult.  After first year the details are still fresh - starting immediately onto second year makes sense.  After second year the details of basic science have been burned into the brain by studying for step one - proceeding with clinicals immediately causes the relevant information (~10%) to stick.  After third year taking step 2 immediately happens right away as details from specialties one will not be entering slip through the cracks.  On a smaller scale non-stop nature applies, also.  During the first and second year the amount of material is a veritable mountain.  During third year there is always more to read, both relating directly to the patients as well as preparation for the shelf. And the principle repeats itself over and over:  life does not slow down.  If anything, along its path, the train accelerates.

The time passes, ever more quickly.  An hourglass is turned over, always, and sand is continuously dropping from the top to bottom.  A glance away, an hour passes.  Another glance, a week; a month; a year. I graduate in 117 days to go to a residency somewhere.

When is it a "good time" to start something new outside of medicine, given all of the other things occurring?  Simply put, there is not.

As time becomes more and more scarce, the more precious it becomes.  People who have to be at work for 95 hours a week understand the value of time away from work and choose to spend it accordingly.

A clear awareness of the passage of time combined with knowledge of its increasing scarcity makes the memories of what is done with the time all the more precious as well as lend keen insight into what one truly values.

On the trail.

Residency interviews have been happening since early November.  Overall the experience has been positive; I can honestly say that I could see myself being a resident everywhere I've interviewed.  Two more places to visit and then I am all finished wearing a suit, attending a dinner, and explaining what I'm feeling called to do with life.  Along the way I've met many incredible people, visited many incredible places, and managed to get my car hit by a deer driving through the middle of Wisconsin.

Early on in the process there was a newness and excitement; now there is a certain tiredness to the entirety of everything.  Meeting people who will be making decisions about your future is accompanied by a certain exhaustion. I have been doing a good job refusing to become anxious about where I will be for the next five years - there has been a peace about the search.

In the meantime I have been able to return to Zeeland and have spent more time with family than I have during all of medical school previously.   Seeing grandparents for meals; going to Faith Reformed Church; enjoying coffee at LJ's; playing the piano for my teachers; getting doughnuts with the neighbors.

The time away from medicine has made me appreciate it for what it is (the best career in the world) and gives me excitement for July.

Waiting.

There are different seasons of medical school.  Spring, the newness of first year and the steady hum of lectures and quizzes continuing on until second year.  Summer, third year, a flurry of activity found within clerkships and sub internships during early fourth year.

I am currently in the midst of autumn, the in-between season.  Applications have been submitted and preparations are complete to get back on yet another interview trail.  More suits, more dinners, more important conversations.  More being "on-point".  All of this to lead to a carefully considered, ordered list, followed by a Nobel-prize winning algorithm which will tell me (hopefully) where I will wind up for the next five years of my life.

The grooves of perpetual activity run deep.  After so much time of continually having things to do - the next quiz, the next rotation, the next shelf - all that I have currently is time.  Time to sit, time to read, time to have dinner with friends.  Time to wait.

It is into this place that the Word comes and speaks.  Do not be anxious about anything; consider the lilies - not even Solomon in all of his splendor was clothed as these; but those who trust in the LORD will renew their strength.  The season of waiting is an opportunity to be deepened in reliance in the plans that have been made, plans that are made to give a hope and a future.

A hymn from my past comes to mind, when I think about the uncertainty that permeates this autumn season:

Because He lives, I can face tomorrow,
Because He lives, all fear is gone;
Because I know He holds the future,
And life is worth the living,
Just because He lives!

Beethoven and the rain

Instead of sitting inside to to do some errands online I sat on the porch in the rain.   While outside I listened to Beethoven Op. 101.

The sonata is one of my favorites as of late, along with Op. 110. After thinking about it, there are slow passages in both in the middle-upper register, which I find the most beautiful of all the tones on a piano.

Despite my recent foray into Russian music, Beethoven remains an ever present friend, especially in the rain.

All thy fullness

I have been on the surgery rotation at the VA hospital for the past 2.5 weeks.  It has been a good experience - I am learning more and more every day about what it means to function as an intern and am getting an idea about what it means to be a resident, and ultimately, a surgeon.  The more time I spend on surgery the more I enjoy the time - I am beyond excited to have this as my future career.

On the drive to the VA every morning and back to my house I listen to the same song, recorded by Hope College's Chapel Band: All Thy Fullness: http://hopecollegeworship.bandcamp.com/track/all-thy-fullness-single.

All Thy Fullness

You are my fullness, firm and steady;
To lavish mercies, at the ready;
Despite my wand’ring, Despite my weakness
Unrelenting strength and goodness

Holy Holy
God almighty
All thy fullness
Here beside me

You are my courage, truth and wisdom
Guiding hand and purest vision
Hope in fear, joy in victr’y
endless song, hope and yearning

I am breaking, you are building
I am empty, you are filling
In my silence, you are speaking
In my dying, ever living

Holy Holy
God almighty
All Thy fullness
Here beside me

Holy Holy
Alleluia
All Thy fullness
Here among us

It is centering, to listen to this as I go to and from work. 

PAACS Conference, part 1

I managed to slip away from my pediatrics rotation for two days to attend the Pan-African Academy of Christian Surgeons (PAACS) conference in Des Plaines, Illinois.  A number of things had to go "right" for me to even get to the conference in the first place:  a rotation during the conference that would allow me time off, having an outpatient month during the conference, flexibility of the schedule to allow me to spend 2.5 days in Chicago.  Coincidences do not exist; God has sent me here for a reason.

The ride down was with Dr. Bob Cropsey, a general surgeon who worked for his career in Togo, a small country in West Africa.  Our riding down to the conference happened, again, coincidentally:  I attended a breakfast only this past Saturday and it happened, again, coincidentally, to come up that we were both heading to the same conference.  Again, more "coincidences".

Our conversation revolved around his experiences as a long-time mission surgeon.  Hearing about how he was used throughout his career was inspiring.  I get the sense that my time at the conference will be incredibly important for giving me a vision of how I can serve for the kingdom in the future.

M3.85

A theme in my thinking has been how the time passes.  Our memories to not respect the same linearity that time passes.  

Already M3 year is more than 5/6 done.  Six more weeks of pediatrics and I am along to the "promised land" of M4:  subinternships, applications, interviews, away rotations, matching, and graduation.  Less than fourteen months from now I will be finished with medical school.  It all went so fast.

The fourteen months are shaping up to be busy.  Step 2 in early June, studied for while on Anesthesia and leaving for multiple weddings on the West side of the state.  Three surgery rotations in a row:  Hepatobiliary, VA, and Thoracic.  Applications happening concurrently with all of this madness.  Finally, interviewing, during which I will be *hopefully* brushing up on my French and preparing a recital program to fundraise for away rotations at mission hospitals.  Finishing up the year by spending three months away at locations to be determined.  The time passes so quickly because of the fact that it is so filled to overflowing with all of the different exciting problems that come with planning out the future.

Confronting the busyness of medical school and the resultant perception that time is slipping through fingers like grasping onto grains of sand comes the concept of rest, like the sudden a minor cord in the second movement starting Beethoven's 7th. What does it mean to sit, to take time to listen to classical music not while studying, to take a walk not for the purpose of going someplace, to take the time to call a friend not while en route, to go to a coffee shop with nothing on the schedule afterwards.  The fact that there is less free time makes it a precious commodity.