Reflections – Anthony Nuval

the first

On morning rounds, my attending asked me a question. “How long do you think he has?” It wasn’t the usual test-your-knowledge pimping that we’ve gotten used to as doctors in training. She genuinely wanted to know what I thought.

* * *

I’ve been privileged to stand witness only twice.

Six years ago, I drove down to McHenry from Wisconsin to be with my aunt. With her family—her sister, my mom and dad, my brother and his wife–we stood at her bedside as the ventilator was switched off. It was anticipated and planned, for as much as such a thing could be planned given that it was only two weeks earlier that she had successfully had a heart valve replacement and her room was decorated with the well wishes of “get well soon” balloons that were still there.

I really hate those balloons.

Four years ago, we—Scott’s friends—were in the middle of working out a schedule so that one of us would always be around to provide support for his mom, who had been with him every minute of his hospital stay. It was nighttime and I was getting ready to go back home to Wisconsin to show my face at work before coming back for my scheduled support shift, but our plans were soon to become moot. I don’t know what his prognosis had been—did he have hours? days? weeks? months?—maybe I was being purposefully ignorant—but we had been preparing for the long haul.

Scott had a group of close friends that had been with him since high school, but he and I only became friends many years later. They were present for his passing, with the exception of Joe. I asked Michael why I should have been there and not Joe.

“You needed to be there to get the story,” just as he so often is, to be the keeper of the story.

* * *

I wasn’t present when he passed away. I arrived at the hospital in the morning and asked my intern if he had seen him yet. “He passed away about an hour ago.”

When my attending asked me how long I thought he had, I sighed and shook my head. I thought of my aunt. I thought of Scott. “I don’t know. Maybe a day.”

Sometimes, there is no reward in being right.

with only thirty days to go

life, Reflections

I never made much of an express effort to get to know Wisconsin. I didn’t want to waste time dating it if I didn’t think I was in it for the long haul, didn’t want to get attached. I’m only passing through, I thought to myself. Then, at some point in these last almost-eight years, these surroundings became so familiar, these people I have met have become such fixtures in my life, as to tinge this long-anticipated departure with a hint of sadness.

I’m moving back home, but in a way, I’m also leaving home.

project 365: epilogue

life, Reflections

(365/365)

On my last day of being a twentysomething, I thought perhaps I should try to make the 365th photograph somehow meaningful. I drove through the neighborhoods in which I spent my childhood, thinking the familiar might spur my imagination, trying to picture in my mind that last image…eventually coming to the conclusion that I was trying too hard. This wasn’t what I had set out to do one year ago. A photograph I took on that day of an El station seemed to connect nicely with the first photograph I took for the project; but after some thought I figured that I already had enough images of public transportation. In the end, this is what I chose to represent this day, ordinary on one level but with some serendipitous significance, hints of a tangential nature to an as-yet unwritten future. That this project concluded in the same city where it began is no accident; it is the city of my birth, the city I think will always be home.

In between, it was not altogether uninteresting; though there were times where the decidedly uninspired photographs reflected the ordinary, mundane days underlying them, quite a bit happened on both ends of the emotional spectrum. 29 was not without its moments of sorrow and grief, losing an old friend to cancer and having another friend go through a tragedy of his own, but in the realm of things I can control, I can say that 29 was the year I finally, successfully, made my ultimate career move. I think that this year, straddling two chapters of my life as it were, catalyzed a fair amount of introspection that no doubt informed many of the photographs that made it into the project.

On a personal level, I like to think I’ve managed to improve my skills a little along the way and also inject some narrative into the imagery. Having a decent camera on the iPhone helped immensely in keeping up with the demand of generating a photograph each day; using something with considerably fewer controls than what I’m used to certainly forced a different dimension of creativity.

When I began, I said that if I could say I lived and experienced each moment of every day, then I will have been successful. I dare say this to be true. To those who followed this project to its end and offered your comments and support, you have my thanks.

raison d’être

Medicine, Ho!, Reflections

“Why did you decide to be a doctor?” she asked. “And don’t tell me you wanted to help people.”

I was exhausted. I sat on the edge of Mandi’s bed. “It’s true,” I said. “I want to help people.”

“Ha!” She poked a mound of vanilla pudding with a fork. “That’s what they all say.”

–“A Fire, Deliberately Set,” Peggy Sarjeant

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what kind of fortnight has it been

life, Medicine, Ho!, Reflections

(with apologies to Aaron Sorkin)

Even as I charged ahead towards a new future in my trips to Boston and DC, in my visits with old high school and college friends I was reminded of an altogether different past—a past in which I envisioned something completely different than the path I now find myself following, a future characterized by Fourier transforms and Smith charts. Delighted as regions of my brain probably last exercised in college sprang back into action talking shop with Amanda and John the electrical engineers and Angela the computer engineer, I nonetheless felt wistful at leaving all of that behind. At the same time, in Donna the teacher, and in other classmates and friends who went onto separate careers, I found some reassurance.

Technology never stopped exciting me. Math and physics still excite me. But are they enough to make me want to wake up in the morning?

Only if I can directly help someone by doing it.

I’ll just have to find some way to be an EE-doc, I guess.

aaaaaand…we’re back.

job, life, Medicine, Ho!, Reflections, school

Now that I’ve had a bit of time to recover from this whirlwind school year, I have to say that it really feels like the year went by kind of quickly. If you were to have asked me how I felt during the school year, my answer would have been completely different–the year couldn’t have been over fast enough–but in retrospect there is a twinge of sadness accompanying the sense of accomplishment at having survived a year of classes (and organic chemistry in particular).

The problem is twofold, I think: now that classes are pretty much done (I may have to take a couple more classes, but I have the next two years in which to complete them), it’s back to the [more than] full-time grind at the job for me, replete with the reminders of why I’m doing this in the first place. The slow realization that I’ll be at the job for another couple of years is, sadly, rather soul-crushing; it has caused me to wonder on more than one occasion if I shouldn’t try to find something else to do during this time, such as do something more healthcare-related, something that will help to answer the question “do I know what I’m getting myself into?” (Which is, apparently, what med school admissions boards want to know.) Normally, I think that would be a fine plan, but given the state of the economy, it’s probably best if I remain at my job and try to complete my responsibilities as best I can.

The other thing that makes this ending somewhat bittersweet is that I didn’t take the time until later in the school year to start to get to know some of my classmates… and now that school’s out and it’s back to 40+ hour work weeks, I just won’t have the time to hang out with them all that often. (Not like I had free time during the school year–but scheduled class time kinda counts. Ahh… that brings back memories of all-day cramming sessions before organic chemistry exams…) Whether or not that actually ends up being true is well within my control, however.

Oh yeah, and there’s the MCAT. I should, uh, get right on that.

It’s not a total downer, though. It’s admittedly nice to be able to focus more of my time and attention on a single thing, rather than trying to juggle multiple things. People seemed to be rather surprised (and perhaps a bit amazed) when I explain that I’ve been working full-time hours and taking two classes; in retrospect, I’m amazed I pulled it off. (Of course, I know how I pulled it off… by shortchanging at least one area of responsibility, though I won’t say which one(s)…) Speaking of, last quarter saw an A- in bio and a B in chem. My requirements were to not get C’s or lower–so I think I can consider that requirement verified. (eeew, engineering-speak.)

The best part, though, is being able to spend non-working hours actually doing fun/relaxing things, hence actually having the time to futz around with my poor, neglected website, finally putting up that photoblog I’d been meaning to do for quite some time now and actually writing this stupidly long blog post. (I feel as if I need to make up for a few months of inactivity… and also, a brain dump in this manner is remarkably freeing.) Of course, whether or not I’m just typing into the ether is a different consideration entirely (but some of us prefer illusion to despair).

What’s next, then? Catching up on what feels like a year’s worth of backlogged work responsibilities (not to mention culling/editing 1800+ photos from Jessup week), working on the whole med school application process, and maybe actually trying to enjoy life. (‘Cause there probably won’t be any time to do that once I’m actually in med school.) Who’s with me?

Six month eval

Reflections

Technically seven, but six months sound better.

I know that for someone who technically lives in Pittsburgh, I haven’t written much about it. I am still heavily attached to New York, and that manifests itself in what I choose to write about. This preoccupation probably prevents me from appreciating Pittsburgh more: despite knowing that this town has a lot to offer for those who seek it, I can’t help but think about everything I left behind and the perks of living in a larger city that I don’t seem to find here. My affliction isn’t specific to Pittsburgh, either. I’m sure that it would hold true for any place I would have moved to after having lived in New York.
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reminiscing

Reflections

Thinking about the proximity of ra ra’s temporary domicile not only to my old office but also to the World Trade Center site got me started on the following thread:

The summer of 2001 found a handful of us Cooper EEs working in the financial district. Tauseef, ever the social person, scheduled a weekly lunch for whoever could make it.

One week, only he and I were able to meet up for lunch. Having exhausted most of the more attractive lunch options east of Broadway, we went to a nondescript restaurant on Broadway and grabbed our lunches to go. It was a beautiful day. I don’t think it was terribly warm, but it was all blue skies as far as the eye could see (which arguably isn’t very far when you’re in the land of skyscrapers).

We walked a block west on Fulton, crossed Trinity, walked up the steps to the Trade Center plaza, and ate our lunches by the fountain in the center of the complex. The grounds were abuzz with people flitting from one place to another; benches and spaces were occupied with office workers dining alfresco; and there was a stage set up to the west where a live band, in concert with Mother Nature, provided the ambience for the midday meal.

It was a good place to escape from the dark and narrow passages that are lower Manhattan’s roads, from the often-littered sidewalks teeming with activity, where blue jeans and suits commingle in an epitome of urban living. Although you remained in the shadow of two towering structures with commanding presence, an abundance of open space was available for everyone’s enjoyment, and it was as free as the air itself.

Tauseef and I ate our lunches, talking about everything and nothing, enjoying the magnificent setting.

I dwelled on that thought for awhile, trying to recall the pristine images of that day without tainting it with memories of that which was to come only two months later.

The first few times I commuted from my home in Jamaica Estates, I would take the F to Union Turnpike and then switch to an E and ride that all the way to the end of the line. I’d ride in the first car, which would end up being the closest to the turnstiles at the terminal. At my destination I would zigzag through the subterranean shopping complex and take an escalator that brought me to the Borders store at ground level and the exit out of 5 WTC. Then I’d walk the several blocks to the office on Maiden Lane. Sometimes on my way home I’d stop at the Krispy Kreme and pick up some good old-fashioned artery-clogging treats for later.

Then I realized that the Fulton-Bway-Nassau station was much closer, so I’d instead take the F to West 4th and transfer upstairs to the A/C.

I still remember the view from my 12th floor office window of the tops of those towers.

I can’t help but think of how lucky she is not to have any associations with that neighborhood, that living there doesn’t freak her out as much as it potentially could. The site resembles a typical construction site now, with the exception that this is a construction site that inspires pilgrimages from all over. She has no memories to superimpose on the scenes presented to her today; her brain will not instinctively fill in the missing details whenever she casts her gaze at the skyline.

New York may be a daunting place to her, but she’ll be fine. All the same, I can’t help but feel…protective of her? That was my adopted home for four years, after all. But she’ll be fine. I know this.

On crisp, cool nights and speedy trains

Reflections

While I await the return of my pounding headache, I’ve got a couple of things on my mind.

I sit outside on a chilly metal folding chair on my balcony overlooking the rear parking lot, in full view of darkened houses and apartments, a thin layer of clouds obscuring the few stars that would otherwise be seen on a clear night. Inhale. Take in the refreshing smell of air relatively unpolluted by garbage, automobiles, and industry. Quiet, save for the occasional rush that marks a passing car on one of the streets nearby.

I look towards the sky. By doing so, I can push the images of man-made objects out of my mind’s eye, and only nature remains. I am taken back to the then-sparsely populated outer fringe of Aurora, Illinois, where a residential high school for the Land of Lincoln’s best and brightest sits, surrounded by cornfields that lay in wait for the developers’ bulldozers.

On many a night such as this one, I would escape the small population of adolescents, the beings that, with their insignificant worries and incessant noise-making, made me wish I were just a few years older. I would escape to a spot where I could tune it all out, where it was just me and the night sky. I would lie on the side of a hill and watch the stars, stars that are unfamiliar to a denizen of the city. There were no aural distractions. I was alone with my thoughts.

As I sit outside I remember how wonderful it felt to be able to escape like this. I remember, too, the feeling of sharing the experience with another, a single person, one capable of appreciating the emptiness just as I did. In those quiet times we shared, a great emotional link was formed. It seemed as if we had found the essence of life.

I miss that.

Earlier today, I left work early, miserable with a headache induced by spending another restless 90 minutes in the scanner bore. I caught a bus that travels along the East Busway, a two-lane road dedicated to bus traffic. Here, the lumbering vehicles can cruise at speeds up to 40 mph past scenic foliage that frame small pockets of urban here and there.

The experience tops the normal stop-and-go bus rides on surface streets. Such rides rank at the bottom of my good commutes list. After that comes riding local trains (here I’m thinking of the 6 train and the R train); then the bus rides on the busway.

But I absolutely loved my commute from Queens into Manhattan. I loved the stretches on the Queens Boulevard line between Queens Plaza (later 21st-Queensbridge) and Roosevelt Avenue, and Roosevelt and 71st-Continental Avenue. There, the trains rain express. Express runs, at least when the train is allowed to reach high speeds, are a thing to be savored. It allows for thoughts uninterrupted, the wheels maintain a steady cadence as it passes over seams in the tracks, and the lights that illuminate the tunnels whiz by your window, giving you the feeling of traveling faster than anyone has ever gone before. It is five minutes of pure speed, five minutes uncontaminated by unintelligible announcements over the public address system advising people to “stan clee da doe”…five minutes closer to home.

I miss that.