Last night, I watched a documentary titled “The Bridge.” It was about how the Golden Gate Bridge is a popular place to commit suicide. They showed it at my med school.

I have a very personal connection with the topic, so I knew I had to watch it.

The documentary starts off with the most beautiful shots of the Golden Gate Bridge. And when you think it’s just more footage of tourists walking on the bridge, you see an older gentleman climb over the rail and just jump. He didn’t even hesitate. The camera tries to follow him as he hits the water.

The documentary shows several of these jumps. And for each one, it’s as if the camera is purposely recording that person. I don’t know if it’s coincidence or if it’s someone’s job to record the bridge all the time. Either way, there’s something very odd and sad about video recording a person’s last moment alive.

One of the most powerful stories from the documentary was the story of someone who survived a jump. He said the moment he let go of the ledge, he regretted it and wanted to live. And I can’t help but think about my aunt, if she regretted it in her last moments. Or she might have felt relief. I’ll never know.

After that man who survived the jump fell into the water, he was kept afloat by a seal circling under him. And he said in his interview, “You can’t tell me that wasn’t God.” I don’t believe in “God” in the organized religion sense of the word. But I believe this man’s statement. I would call it “the universe.”

“The universe tends to unfold as it should.” Words that have shaped my life. Words from Harold and Kumar Go to White Castle believe it or not.

I donated blood for the first time this week. And I had heard that the sensation of bleeding to death is emulated when donating blood. So when I was lying there and seeing that bag fill up with my blood, I felt very emotional. I was lying on my back as I imagine my aunt was also, wondering if maybe she didn’t feel much pain. Maybe she just went to sleep.

Wow. What a day. One of the proudest days of my life next to my White Coat Ceremony.

Today was the Body Donor Memorial Service. The culmination of 8 months of planning interspersed with stress and worry. Now that it's done and even during the event, the stress seems so petty. But it affected me at the time. I don't get stressed in terms of academics, but when it comes to extracurriculars where I have responsibilities to other people - I get gray hairs. And for this event, we're talking about 500 people I had to please and 140 body donors I had to honor. This is an extremely important event.

And it went great. Nearly perfectly. And way beyond my expectations. I was on top of everything today - running around, tending to what needed to be tended to. But at the same time, I feel like the event just happened. It still doesn't fit together in my mind that my hard work (with the invaluable help of others) created the wonderful event that everyone is praising and thanking me for. But I know - I know it was my leadership that made today possible and everything happened the way it was supposed to happen. And I'm so high on life right now.

Besides everything running very smoothly, the event was also beyond my expectations because of all the people who approached me afterwards.

- I hugged a man I've never met before when he told me he was a future body donor, and his wife who had Alzheimer's was a body donor last year. He was attending his "living funeral." The healthiest 94 year-old I've ever seen.

- A veteran thanked me for including the military honors (not my idea), and I got to thank him for his service. The military honors was such a great addition to the memorial service, I don't know how this was the first memorial service to have it. My good friend Melissa teared up because her grandpa had military honors at his funeral.

- The PR guy for UCDMC, who I've been in touch with since February, brought his girlfriend to meet me. Her father donated his body...this past September 11th.

- There was a hauntingly beautiful display of an old nurse uniform with a wool cape and the old-school nurse hats. And next to it was an old black-and-white picture of a nurse wearing that exact hat. I got to meet her family and her teenage granddaughters told me they loved the event.

There were several other family members and so many classmates and staff from the Body Donation Program that said thank you and good job to me. It's hard to think of another time in my life where I accomplished something this great.

Funny to think that I was filled with such self-doubt and that I accidentally fell into this leadership position. Oh universe, you tend to be so good to me.

I will leave you now with kind words from my classmates.

Hey Jenny.

I just wanted to tell you how much I enjoyed the service this morning. I wasn't able to attend the one last year, and was so impressed with how polished it was. I know it meant a lot to both the med students and families of those who donated. Thanks for doing such a great job putting everything together.

-Eric


What an amazing memorial service for our incredible body donors. It was a beautiful way to honor these generous individuals. Thanks to all the organizers and performers, with a special shout out to Jenny Phung for all your hard work. (Erin's facebook status)



Hi Jenny,

Just wanted to thank you for the hard work you put in for the Memorial Service this morning. I can imagine that was quite time consuming and I really appreciate it. I'm also very impressed how supportive your boyfriend was of you. You guys make a great couple.

Best,
Hasmik


Of course I had to end with that one. lol

I wrote the following e-mail to one of my mentors:

"The second thing I wanted to just tell you about is an incident involving a white classmate. This classmate is involved in RAP sessions (Real Answers from Peers), which is a panel of MS2's giving advice to MS1's about studying; this is for all MS1's. LMSA and SNMA* are holding their own RAP session for the MS1's who are interested in LMSA and SNMA. And this white classmate said, "I don't like segregated privilege." I haven't said anything to him and don't know if I will. His comment brings me back to our summer institute. And now I have this internal conflict about saying something or not, and disappointment in myself for fearing confrontation. =T"

*LMSA is Latino Medical Student Association and SNMA is Student National Medical Association, which is focused on the needs and concerns of medical students of color.

And this was her response:

"Finally, I get it about the dilemma about what to say. What do you think he meant? That it's a privilege to be only one of a few whatevers....women, LGBTQ, African Americans, Latinos, children of immigrants, etc. and these groups need to get out of the "majority' group's session whatever support they can, but not have the opportunity to receive from their own gathering things that might be distinct for that particular dimension of identity that is salient to them? Does that mean there should be no AMWA, no AMSA, because there is an AMA? Does he mean that he is not allowed to come to the Latino or African American presentations?

I can't tell you what to say and if to say it. I feel the weight of your calculus, as I have had that decision to make so many times.

What is it you fear in saying something to him? Is that thing worth it to you to not say anything?

Will it be useful to say something, or will it make it worse? Will it be worse only for a time, but worth it in the long run?

Will this person receive the feedback, or is he just toxic?

Is there a way to voice for these impressionable students and classmates that YOU believe there is a place for groups where people feel comfortable, that recognizes that some issues may be distinct to some identity dimensions?

For you personally, Jenny, with your work and whatever emotional load in your life you are carrying, is it worth remediating someone else and the energy that takes? I'll tell you, I should have energy to have conversations with strangers and acquaintances about "the Help" book and movie, but I can't right now.....I just don't have the energy to monitor my responses and what that person needs from me to have it be a constructive situation.

Is this someone you have a special "in" with that someone else might not, and thus he won't receive feedback in a constructive way unless you are the one to give it to him. Is he a friend?

Is he hostile about the topic, in which case, someone has to counter him and not let his daggers go un-neutralized. Someone has to be gangsta about it, just as he was so aggressive and forward...

Is he someone you can take aside and talk to in private, so that it isn't confrontational, and it isn't received confrontationally because you embarrassed him in public.

Lots of questions, Jenny. The answer is "It depends," but yes, you do have a special responsibility, given what you know, and that you are in a relatively privileged class of folks (the unfairl social construction of Asian American) who roll within the academic medical center (more so than say, LGBTQ folks, Latinos or African Americans). It would be a constructive, impactful surprise, coming from you.

As always, Jenny, so many of these things depend on timing. I have missed so many opportunities I thought I should have taken advantage of, given my relative privilege, or propensity or knowledge without privilege, within that context. Sometimes the best thing you can do is think through what you might have said or will say if the opportunity comes up again. Your heart will listen for him and anticipate his comments in similarly charged situations, believe me. Even a question like, "Can you explain more about what you mean when you say that?" is powerful. It takes the silencing power away from an act like his that's meant to silence, intimidate, or even notify others that he is struggling, perhaps seriously albeit sarcastically, with something.

Unfortunately, only you can answer these questions. Make a decision, develop a plan based on that situation, then let it go. There will be a million other times in your life, and this may be one of very few opportunities you were attuned to this dilemma and your sense of responsibility in it, yes? It is terribly important that you answer them for yourself before you are the senior resident, or Attending, or senior medical student....Remember, think developmentally, not just like you only have one chance to make a difference and this was it.

I hope this helps. It's a great question. Please feel free to call if you want to talk more. I support you and am proud of you either way. It means alot that this is on your radar."

A lot to think about. Man, I already think too much.

Ever since I started my Psychiatry class, I've thought a lot of people in my life have aspects of psychiatric illness - myself included. And today, I thought my dad was psychotic. I still do.

Today around noon, I saw 2 missed calls, a voicemail, and a text message. I've received bad news several times this past year through my cell phone, so my thoughts immediately become negative when I see my cell phone blasted like that. I'm usually wrong, but today I wasn't. I see the missed calls are from my dad and sister. The text message was from my sister asking me if I've gotten a "weird" call from dad. So now I dread listening to the voicemail. It was in Cantonese, allow me to translate for you:

"Jenny Phung? It's daddy, today is August 1st [sic] 11:33am. If your dad dies, it'll be at ______ Benito Ave by murder. Do you understand? It'll be by murder, okay?. Don't delete the message, don't delete it. Okay, bye. That's it. Your dad is now (don't know what this means). Bye, bye. I love you, honey. Bye-bye."

Ok, it sounds weird in English that he greeted me with, "Jenny Phung?" But it works in Cantonese, so that part shouldn't weird you out. Of course the rest of it should. When I called him back, I asked him where he was. He was still at that address, that's how he described his location. He didn't want to say "Wendy's house." Wendy's a whore that houses my bum of a father in San Gabriel. I asked him why he doesn't leave if he's going to get killed there. He said he's too drunk to drive (yes, it's noon). I asked him who is going to kill him, and I think he said the "woman's boyfriend." Blah. He told me not to worry about it and study hard.

I didn't think much about it until a couple hours later when I was walking alone for 20 minutes. I felt this very intense emotion that's difficult to describe. The emotion felt visceral, like I had the urge to cry. I kind of fought the idea of crying, because I don't cry for him. I don't think of or feel much for him. But since I couldn't figure out what this feeling was, I finally let myself cry...but I couldn't. No tears came (which says a lot because I produce tears easier than anyone I know). But that urge was still there, that urge to release something inside me, to release that feeling inside me. The closest thing that brought relief was singing with deep breaths. Eventually the singing distracted me from the emotion, and my head was cleared.

If I had to choose vocabulary, I think what I felt was anxiety. Anxiety over my dad's very odd situation, and anxiety about feeling compassion for him. It really throws me off that he said "I love you, honey." It's so fucking weird to me and it really freaks me out. Not just that he said it, but my emotional response to it. So what's very interesting about the anxiety I was feeling was that associated urge for release. That urge for release transformed into an urge for action. It seriously pumped me up. I was walking to the gym, and I got so pumped to run and work out. I also got so pumped to tackle my stressors (aka planning the Body Donor Memorial Service), to just fucking deal with it because I have to face it some time. I've calmed down now, but I have to remember that ferocity I felt. I gotta do this shit!

Anywho, with the craziness of today, I had to call my mom just for the hell of it. I didn't necessarily want to tell her what happened because it could be really stressful. But she actually brought it up. Long story short, my dad's becoming a crazier drunk than he already was and was being belligerent towards Wendy. She wanted to kick him out; he wouldn't leave, and threatened that if anything happened to him, he'd tell his wife and daughters where he is. So that's what that voicemail was about. Basically a threat to Wendy and a desperate plea for help and attention from us. If the situation were more serious and my dad really was in danger, we talk so infrequently that it would be months before I tried to contact him (not counting that I would find out from other family members).

Wendy has 2 relatively young sons that my dad also lives with. Man, their lives must suck. They're getting a worse father-figure than we had.

In the matter of a few weeks, there have been a series of events that has led to a better relationship between David and me. Before I go on to tell you about these events, it’s important that I admit that I have always thought very highly of my relationship with David. We had never had an argument; we have the same hopes and expectations from our relationship; our silliness and cuteness and level of affection work well together. That second part is the most important: we want the same things and we know what we each expect from the other – that is probably the biggest reason for our success. Some couples don’t even talk about these things. And that’s why people get divorced – the other person didn’t turn out to be who you thought they would be. Ok, I’m just speculating, but I speculate that all divorces have a core of dishonesty (especially dishonesty with oneself). ANYWAY, as highly as I thought of my relationship, there was definitely room for improvement. I’m controlling and I can act more like a scolding, lecturing mom than an equal partner. There are reasons why I morphed into this type of girlfriend – David needed help growing up into a responsible adult, he’s forgetful, and he never talked back. I also just naturally want to be in control…in general, not every specific situation.

So the first event was when my cousin Annie and her friend Debra visited us. We went out to eat at Cattlemen’s (yummy prime rib and twice-baked potato). After David calculated the tip and total for the bill, I immediately (almost instinctively or habitually) asked, “Did you do the math right?” The 3 of them had the same reaction - “Dang, Jenny.” We laughed about it and it remained light-hearted, but it looked bad on my part and it was.

The second event wasn’t a single event, but also a series. After Annie and Debra left, one of my best friends Randy came to stay with me for a whole 8 days. He had work to attend to at UC Davis, so it was like he was our roommate. I don’t necessarily act differently with David in front of people, but I got especially comfortable with Randy. So he saw me be a snappy bitch several times. Yeah, I’ll use the word “bitch.” I’ll even use the words “crazy bitch.” I don’t even remember exactly what the situations were that led to such snappiness. But there were several, and the reaction from Randy was very familiar – “Dang, Jenny” or “Gosh, Jenny.” “Crazy bitch” is an appropriate term to use. I use it semi-jokingly because of course I’m still quite sane, but it’s appropriate because often times the bitchiness is nonsense. It’s not unprovoked but it is uncalled for. Examples: David left the cheese out all day, or David doesn’t look up directions to a place he’s not certain how to get to, or David didn’t make the bed perfectly (when we were getting paid to use our apartment as a model apartment). Sometimes I’m stressed over something else and bitchiness is my release, other times it’s a habitual bitchiness. So Randy’s third-person perspective gave me a lot of perspective. I had recognized before that my bitchiness was unnecessary, and I had apologized to David many times…but didn’t change. After Randy though, I felt so demeaning and emasculating…to a man that least deserved it in the world.

With Randy’s reactions in the forefront of my mind, I was very aware of my flaws. But coincidence wanted to make sure, so then I had a lecture on personality disorders. Dr. Servis (the psychiatrist) told us we’ll recognize ourselves in several of the personality disorders, but that fact alone is very healthy. People with personality disorders are restricted in their coping skills and defense mechanisms. Healthy people have a wide range. Dr. Servis said something to the effect of “you guys might be controlling and perfectionists here in medical school as medical students, but it wouldn’t work so well if you were like that in your relationships.” I thought, “uh-oh.” I left that lecture thinking David and I need counseling, but I really am sane and my insight was enough for us to be healthier.

Obsessive-Compulsive Personality Disorder (not OCD)
•Perfectionistic, constricted, moralistic
•Rigid, formal, emotionally cool
•Driven, competitive, overly concerned with productivity and achievement
•“Workaholic”, unable to relax
•Need to be in control

Dependent Personality Disorder
•Excessive reliance on others
•Permits others to make decisions for them
•Subjugates personal needs to those of others
•Tolerates mistreatment
•Lacks assertiveness, helpless when alone

I resemble the first, and David resembles the second. We don’t fit those to a tee, but I definitely see ourselves in them. I don’t know if David was this way before I met him, I think those traits are specific to his relationship to me. I think I might have made him that way. He’s never been a real boyfriend before…he became the boyfriend I wanted him to be. God that sounds unhealthy. I’m the reason he’s dependent? Wow, it does sound like we need counseling.

And finally, the last event that confirmed what was already confirmed – spending 2 days with a couple that had similar dynamics to David and me. Trying to be as objective as possible, I observed that she had the ability to be a “crazier bitch” than me. Now I was Annie, Debra, and Randy. I felt sympathy for her boyfriend, which is probably what Annie, Debra, and Randy felt for David. The idea that I was the reason for people to feel sympathy for David was repulsive. He literally is always kind to me.

David and I had a great conversation about all this. I told him how I sincerely don’t think he deserves to be snapped at, but I’m going to slip sometimes because old habits are hard to break, so he needs to speak up and talk back to me when I do. It’s made a noticeable difference. I’m still the responsible one and he’s still the sweetheart. But we resemble those personality disorders a little less now.

The short 6 weeks we call "summer break" in between our first and second year of medical school was very, very eventful. Eventful is the perfect word. The month of May was one of the saddest of my life: bak long died, David and I put our ferret Jake down, and my big aunt got diagnosed with breast cancer. And though I didn't know her, David's best friend Justin's sister got into a horrible car accident in May that caused her to have to relearn how to do everything.

But the other part of my summer break was incredibly insightful, stimulating, awe-inspiring, maddening, but wonderful - the Summer Institute on Race and Health. Not only did I learn things that I would never learn elsewhere, but I grew as a person and gained some much-needed humility. I also built amazing relationships with amazing people. Dr. Jorge Garcia spoke to us applicants when I interviewed at UC Davis. He left such a mark on me that day that I felt like UC Davis was the perfect school for me (and now I'm here! I'm so fortunate). Then he spoke at our Induction Ceremony, and left a mark on David. And during the Summer Institute, I got to know Dr. Garcia and his wife Dr. Jann Murray-Garcia very well, and they even invited David and me to their home for dinner and a movie. I should have blogged about all the things I learned and my reactions to them. It would have been great to share with you, whoever you are. I think I will try to blog more often now.

And lastly, the last reason my summer was eventful - bak long's funeral. It's been nearly a month, and I will try to remember the best I can. David and I got to eat breakfast with Annie, her dad, her uncle from Macau, our big aunt and big uncle, and my sister Helen. I realize I used the term "got to" like it was a privilege or opportunity, but it really was. I miss my family so much, I miss having people nearby who love me so much. And I especially felt privileged to have shared time with Annie, her dad, and her uncle from Macau when they were so busy. When I got to the funeral home, I learned from Connie some heavy information. While Connie and Tammy were helping clean out Bak Long's clothes from the home (we put all her clothes and belongings in the casket with her), they found a letter. This was surprising because Bak Long didn't leave a letter, though she had before in her previous attempts. But as Tammy read it, she realized it wasn't a letter from Bak Long. It was a letter from Bak Fu (her husband) telling her how much he loves her and how everything is going to be okay - a love letter to his mentally ill wife. That is so hauntingly beautiful - I never think of my uncle as beautiful. When I think about this letter, I instantly cry at the idea of my uncle not giving up and trying so hard to hold on to his wife. It makes me happy that their love was so genuine, but also saddens me. So of course I instantly teared up when Connie told me this. Bak Fu saw me crying and patted me on the shoulder - the closest thing to a hug for Chinese people. I actually like the way we show love. Annie's uncle from Macau, who was Bak Long's only blood relative present (except Annie of course), sobbed throughout the funeral. We all noticed, he sobbed harder than any of us did. I wonder if it's because he barely ever got to see her for 20 years. Connie gave the English eulogy. It was really sad. Connie lived with Bak Long for a year. I gave her a hug afterwards even if it was a little awkward. I got to spend time with my mom one-on-one during the funeral procession, another privilege. I can not imagine losing her, nevertheless when I was 18. After the burial, we ate at the vegetarian restaurant. And the cousins caught up with each other, joked around. We got to spend time with our baby nephew Collin, which I'm pretty sure is rare for most of the cousins. Collin loved David, and even mentioned him afterwards about "nice guy talk about Cars." He's an impressive 2-year-old. When we left the restaurant, David hit the nail on the head when he said, "The reception after the funeral are always good because they make you realize that life can and will go on." I love being close to my cousins.

Annie and Debra came up to visit me during my first week back in school. I had to bring them to one class with me. As fate would have it, it was the one class that hits exactly close to home. It was a case study about bipolar disorder and major depression. I don't know what my aunt's official diagnoses were, but Annie recognized practically all the drugs. She recognized the generic name and even knew some of the associated brand names. She was so matter-of-fact about knowing these drugs and their side effects. She's amazingly strong. I felt a little guilty that I brought her to the one lecture out of all my med school lectures that she would understand the most. But she was fine, and she continues to impress me.

What I have experienced in the past few days has been a true out-of-body experience. When I think back to Wednesday May 11, 2011, the memories I see are like scenes from a movie or TV show or a dream. I see myself experiencing the events of Wednesday, rather than feeling like I experienced it myself. Reality has 2 parts: the part that actually happened and the part where your mind has to accept what actually happened. And if something happens that you can't believe, but know is true, everything feels like a dream.

I visited southern California last week for less than 4 days. With so many people to see, I set aside Wednesday as my day to visit family in the Baldwin Park area. On Wednesday morning, I called my sister Helen, she told me "let me call you back" and I heard a siren go off. I take the phone with me to the shower because I'm positive that the siren I heard meant bad news. I actually thought my uncle that Helen lives with needed an ambulance for some reason. That was the only possibility that occurred to me.

I distinctly remember putting shampoo in my hair when my phone rang. Helen told me our aunt had stabbed herself and she was being taken to the hospital. We call her "Bak Long" in Chinese, which means my dad's older brother's wife. This was definitely sad and traumatic news, but Helen didn't tell me she died, so I thought she was going to be okay. This was at least her third attempt at suicide that I knew of, and she's always been okay. Well, survived is a better word, because my aunt was not okay.

Before I left David's grandma's house in Fountain Valley (where I was staying), I talked to his Aunt Barb and his grandma about having a BBQ the next day. Yes, right after getting news about my aunt stabbing herself, I still thought having a BBQ would be okay. Not out of insensitivity, but out of extreme optimism. I was worried about my aunt for sure, but the only outcome possible to me would be normalcy.

When I arrived at Helen's house, she and my other aunt (big aunt) had not returned yet. I called my mom to tell her of the news, she said "yeah, I know, bak long has died." I responded, "What?! No she hasn't!" And my mom responded, "oh thank god." You don't take a dead person to the hospital, right? When Helen and big aunt returned home, then I got the story:

My uncle (my dad's older brother, Bak Long's husband, we call him "Bak Fu") had heard that Bak Long didn't show up to work that morning. She didn't answer her cell phone or the house phone. Since we've had suicide scares before, Helen and big aunt had a key to their house. So Bak Fu sent them over. The story big aunt described to me was out of a movie, which is why it's so hard to believe. Big aunt found Bak Long passed out on the bed covered in blankets. She shook her with no response. When she uncovered the blankets, that's when she saw the blood and two big knives. She screamed to Helen, "Call 911!" Big aunt said the blood looked dry, at least 2 hours old. Bak long's heart had already stopped when she was found, but the paramedics revived her. So they don't take dead people to the hospital.

With all this additional information, I still believed everything was going to be okay. Bak Long was in the operating room at USC Medical Center, they were going to save her. Bak Fu, my cousin Annie (Bak Long's only daughter and child), my dad, and my aunt Tammy were already at the hospital, there was no need for us to go also. So Helen, big aunt, big uncle, and I went on with our day.

We ran errands that we were planning on running before the morning's incident. We ate lunch. We even laughed. Not only did we laugh, but I found my big aunt more funny and witty than I had ever known her to be. We were listening to Lady Gaga, and my aunt complimented how nice-sounding American music was, while Chinese music sounded so whiny with people singing about "not being able to live without you." She also seriously advised me to advise David that he’s too smart and too pretty to be working on cars, and he should be a phlebotomist. I wondered if my big aunt's humor was freed after my grandma's passing last year. Anyway, I think the four of us all felt the same way - she's going to be fine like all the other times.

Helen and I get text messages that she's finally out of the operating room (after 4 hours) and in the ICU. That's good, right? That means she's alive, right?

I texted Annie to see how she was doing. She texted back "I'm mourning, but idk." Mourning? Why? "At least your mom's still here," I text back. "They say she's not going to make it," she texts back.

It was probably less than 30 minutes after that text that we got the news she was gone. We were expecting it for 30 minutes, but only 30 minutes. This isn't like when my grandma passed. I had weeks to prepare for that phone call.

I got to see everyone that was at the hospital for dinner. We ate at a vegetarian restaurant, because it's custom to eat only vegetarian until after the funeral. Annie's eyes were red and she asked me to go with her to the bathroom. I later found out that she's scared of her mom's ghost. Connie and I bickered at dinner. I can't blame that all on her, but I'm disappointed in both of us. I told her that I want to go into Psychiatry, and she said, "Nooooo," and I said, "don't tell me what to do." "I'm not telling you what to do," she responded very defensively. Connie knows me well on some levels, but I don't think she understands my values. So I was upset at her presumptions.

Anyway, we went to the Taoist church after dinner where we met with Annie's best friend Debra. They greeted each other with a long hug, and I cried just watching. We chanted and prayed for Bak Long. Then the church members and us sat around to discuss the funeral arrangements. They spoke in Mandarin so I didn’t understand. But when my uncle was describing the day’s events, I didn’t have to understand Mandarin to understand what he was saying.
After we left the church, Annie, Debra, and I went to go talk. Just the three of us in Debra’s car. I had my tissues on hand. Annie opened up about everything she was thinking and feeling. One of the most difficult things from this whole experience was hearing Annie describe what she’ll miss about her mom: she won’t be there to cook soup for me when I’m sick, she won’t join me in bed in the morning and just hold me, she won’t tell me to wear a sweater, she won’t fold my blankets. It was perfect that the three of us were there together. Annie’s my favorite cousin and I’m hers. Debra is her best friend, whom I made my honorary cousin. I wasn’t there for my family when my grandma passed and I was okay with that. But I had to be there for Annie. The timing of my visit worked out perfectly. It kind of feels wrong to use the word “perfect” in this situation, but I believe I was meant to be there for Annie.
The other most difficult thing from this experience was waking up the next morning. As soon as I opened my eyes, I awoke to the reality that my aunt was gone and that she died so traumatically. I started sobbing the moment I woke up. David and I then went for a walk, and it helped stop the tears.
Our plans were to leave for Davis that day (Thursday). But not before seeing Annie one more time, and not before helping my family somehow in some way. And we did help out in a small, but meaningful way – we helped move the mattress on which my aunt had died out of the house. As we walked to the bedroom, I asked David if he was ready. He said no. There was some blood on the floor, and the mattress had a circle of dried blood. It was like a scene from a movie, and that’s what it felt like. A movie. Yes, there was a dark red circle on the mattress, but my reality didn’t believe that it was my aunt’s. It was a king-size mattress and as we maneuvered it out of the house, the mattress would fold. And that’s when we saw it. I remember staring at it in shock. The blood was bright red oozing out of the mattress. As fresh as the blood I see when I draw blood on patients. It makes sense considering she lost liters of blood and it had only been a day, but it’s a sight I never thought I would ever have to see. No one does.
Bak Fu also helped us move the mattress. He’s a very serious man, who does what needs to get done. Annie told me he cried at the hospital when he kissed Bak Long’s cheek and said goodbye. I’ve never seen him cry. I wasn’t there to see it, but the image of the strongest man I know crying as he kisses my unconscious Bak Long’s cheek still instantly brings a lump to my throat.
Bak Long’s purse and sweater were sitting on the couch in the house. Like she was home. I remember staring at it too, struggling to believe that she will never use her purse again.
This tragedy was not just any death. She stabbed herself in the chest, and the knife went through to her back. She leaves behind my favorite cousin, who is about to graduate high school. She was one of the sweetest women in my life. She was so loving and nurturing and caring. But she was sick and suffering. She hadn’t been herself in the past year, the mental illness consumed her. So I am terribly sad and will miss her so much. But I’m not asking “why?” There really are no questions to ask, we can only move forward.

To quote the following overused quote:
Be the change you wish to see in the world. – Gandhi

So simple, it’s almost like, duh?

Of course it’s not so simple. We’re still human and we still need to look out for ourselves. And when it comes to doing the right thing, the situation often requires sacrifice – either a financial sacrifice, a sacrifice of one’s time, or making yourself vulnerable to attack and criticism.

I read the above quote many years ago, and it’s not a quote I can ever fully forget, but sometimes do. However, when I do act according to the quote, boy am I very proud of myself. There’s a delicate distinction between pride and arrogance, but I’m proud of my values, and especially proud when my values are manifested in action.

This is not a blog to toot my own horn. But I love to record strange coincidences in my life, so here it goes.

Two nights ago, a high school senior knocked on my apartment door selling subscriptions to The Sacramento Bee. If he sold a certain number of subscriptions, he would be entered into a drawing for a $1000 scholarship for college. Being my curious and slightly cautious self, I questioned his educational aspirations. He wants to be a doctor. And hey, I’m a medical student. So now I will have unwanted newspapers arriving at my door for the next 5 weeks. He’s a Latino student from a low-income family with ambition for higher education.
- Do I want to see underrepresented minorities in higher education? Yes.
- Will I cough up the money to make it happen? I did.

Most people (hopefully) would answer yes to the first question, but I don’t know how many would answer positively to the second question. It’s not so much the issue of money, because I can definitely understand people wanting to save in this economy. It’s more the issue that it’s not enough to just want something. I can’t just want social justice, I need to make it happen the best I can.

So after that incident, I was very cognizant about the thought process I went through when I decided to contribute to his education though I’m living off loans. I know why I spent the money, and it wasn’t just out of simple kindness or pity or an inability to say no. It was about living by my values, even if that meant some sacrifice.

Then yesterday, during our “Conversation Café” in Culture in Medicine, one of the questions posed for conversation was: “How will you be, as Gandhi says, the change you wish to see in the world?” And I already knew the answer, I’m already living the answer.

I’m nowhere near perfect, and sacrifice isn’t easy for me. But I’m proud that I’m aware at least. And that I care to be aware.

Besides dishing out money to good causes, I’m going to work on speaking up when I see wrong. I’m pretty scared of confrontation, but I’ve grown a lot since starting medical school. I’m going to be a doctor, I’m going to be confronted. So my skin is thickening slowly, but surely. So if there’s a homophobic or racist or any discriminatory, dehumanizing joke or comment or situation, let’s speak up. Whether or not you change someone’s mind, at least you were heard.

I recently read an article where Rudy Giuliani said that America has the best healthcare system in the world.

A very vindictive part of me kind of wishes he was uninsured, gets diagnosed with rectal cancer, gets charged $23,000 for the CT scan used to diagnose it, and that be the end of his options.

Of course I don’t really want that, but I want him to know how it feels. Because I saw a patient last Saturday at clinic that is going through just that. Here is how I would write the History of Present Illness:

A 55-year-old Mien man presents to clinic today with a diagnosis of rectal cancer. He wants to inquire about medications to treat his cancer. The patient is uninsured, but is paying out-of-pocket to the UC Davis Medical Center for the CT Scan used to diagnose his cancer. He has had rectal bleeding since July 2009, but delayed seeking medical treatment because of his insurance status. He was finally diagnosed in December 2010 when he was admitted to the UC Davis Emergency Department. The patient complains of rectal bleeding every time he has a bowel movement (3-5 times/day) and even when he isn’t having a bowel movement. The patient used to be a farmer, but is currently unemployed because his condition prevents him from working.

This man has had cancer for 19 months at least without any treatment. This is the saddest case I have seen yet in clinic. What can a dinky little student-run clinic do for him? (I love our clinic, but it is dinky). Not much. We did a physical exam, and I saw the bleeding for myself. It seriously looked like he was on his period, but out of his rectum. We drew blood to test if the cancer has metastasized to his liver, and to test other markers I don’t really understand.

But besides the lab tests, the most important thing we could do was to be his advocate. So our medical director wrote a letter advocating that he should receive Medicare despite his age. As of right now, I’m hopeful that he will qualify for Medicare. Thus, I’m hopeful about his prognosis. He is supposed to return to clinic this Saturday, and I really hope he returns with good news. Because right now, I’m very optimistic. But if Medicare rejects him…I don’t know how I will handle it.

So this is my story as a medical student. This is my story about why our nation’s healthcare system is so fucked up. I don’t have a nation-wide solution to the problem. But at least for California, WE NEED SINGLE PAYER!!!!!!!!

A miracle happened today. I almost never use the word "miracle." But there are no other words to describe it...it was miraculous.

I opened my patio's glass sliding door to air out the apartment. 15 minutes or so later when I go to close it, the screen door is open as well. I ask David, "why is the screen door open?" David replies, "Oh shit!" That's when I realized that our ferret Jake had opened it.

David and I both stared at the bottom of our patio fence. We stared at the spaces he could have possibly crawled under. Then we searched for him outside. It's dark and cold, and I don't hear any rustling in the bushes. David and I separate to different sides of the apartment complex. I had a gut feeling he went to one particular side, so I followed my gut, but didn't follow it far enough. I stopped short of the sidewalk and street...too short. I think I stopped because I already sort of gave up - it had only been a few minutes. It wasn't the time I spent searching that made me give up, it was the darkness and the abundance of bushes surrounding me. The odds were against us and I accepted it so easily.

So I turned back only to hear David, "I found him!" I ran to them, so happy and so relieved. A neighbor had spotted him on the sidewalk and saw that he had walked into the street. A girl was parking her car and Jake was under it. He could have been ran over, but he wasn't. He could have been lost forever, but he's not. David found him on the street that I was heading towards, but stopped short.

It was a miracle tonight that we found him. And though the ending is happy, it wasn't my courage and conviction that saved him. If I had walked farther, searched harder, David and I would have found him together. I'm just disappointed in myself that I failed to try. And I'm worried that this is a personality trait of mine that is not conducive to a career in medicine. Well, something I got to work on.