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.

Layers

As time passes, certain events are encoded into memory.  The slightest stimuli unleashes a flood.   A waft of fresh-baked cookies triggers fond remembrances of home; the sound of rain on canvas, camping trips.

It is our collected memories, and our perceptions that stem from them, that are the core of ourselves.

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Classical music is an obsession of mine.  I have played the piano as long as I can remember and I do not go a day without listening to it.  While studying I prefer Glenn Gould's Bach - the Goldberg Variations are a particular favorite - but while taking a long drive I prefer Rachmaninoff preludes.  I made the mistake of listening to Violin Partitas almost exclusively while studying for Step 1 and I fear I may have ruined listening to them for ten years, at a minimum. There is a reason that people still listen to classical music even though the composers are long dead:  classical music taps into the depths of human experience.  (What was the top song of 2006, again?)  I listen to the same works over and over again.  When I hear the Beethoven symphonies I can tell what's happening next; with his piano sonatas, I hum along. 

As a consequence of listening to the same things over and over again, they have acquired layers of meaning.  I reserve the 4th movement of Beethoven 5 for moments of triumph.  Walking out of an exam I listen to it nearly every single time.  Brahm's Intermezzo in A is saved for decompression - when I want to sit back and relax after a long day of work I close my eyes and let the sound wash over me.

----

Today I discharged a man to palliative care.  It was the first time I've done this.  He had a long and complicated stay in the hospital - over the fifteen days of his stay he was cardioverted, delirious, and sent in for an embolectomy secondary to critical limb ischemia.  Delirium imposed on his history of paranoia and dementia made him what the interns call a "rock" - someone who is staying on our service for a while due to the fact that no other place will take him.  Late in his course his oxygenation started to fail and he developed a wet cough, secondary to his failing heart and a month and a half of not eating.

As I went in his room to say goodbye he had a rare moment of lucidity.  I took his hand and started to say goodbye.  He looked at me, in between coughs with naked fear in his eyes, and said "Am I going to go?"  Not "go" in the sense of leave the VA, go permanently, as in die.  I did not know what to say.  I had no comfort to offer him, save that he was going to a place where they were able to take care of him.  How utterly inadequate I felt.

While I was sitting in the room blaring in my head was the opening to Mozart's Requiem; the ponderous d minor opening was playing as I was holding his hand.  The crescendo to the haunting entry of the baritones sounded as I left the room.

Requiem aeternam dona eis, Domine. Grant him eternal rest, Lord.

A new layer has been added to the work: the sight of an 86 yoM with a pmhx of dementia, paranoia, Parkinson's, and CHF being put on a stretcher to go and die.

I'm back!

As it's a new year, I thought I'd give another crack at it.  Previously my posts have been a bit more themed; I  think that I'm going to switch things up and go for a more free-form approach to blogging in hopes that it will result in more posts.  I'm not going to be writing for anyone in particular this time, just for myself.

1/4

Well hello!

M1 is officially over.  It's an odd feeling, knowing that I'm not going to have to sit through another lecture, open up the quizzes/exam window, or sit in the LRC for prolonged periods of time for two months.  To be more accurate, it's a marvelous feeling.  The year has dragged on.

Tomorrow I am leaving for Kenya - the next big adventure.  But before I go to Kenya I am visiting my friend Kathrin in Germany first!  I could not be more excited!  After 5 days in Germany I'm flying down to Meru, Kenya, to work on a community health survey looking at Long-term disability due to trauma from roadside accidents.  What I am most excited about, though, is that I'm going to be living in a manner completely different than I have ever lived before.  It will be good for me.

But it's late and I've got to play the piano at church tomorrow - I'll write a couple of times when I'm down in Kenya!

On an unrelated note, I'm 1/4 done with medical school! WAHOO!

John