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.

I'm not an expert on racism so I find myself struggling to articulate the significance of racism, and sometimes even the existence of it. So I won't try to here. I'm just going to write about how I feel about my classmates' resistance to the required reading Why Are All the Black Kids Sitting Together in the Cafeteria? by Dr. Beverly Tatum.

She defines racism as a systemic advantage based on race. So through her definition, all White people are racist because they benefit from this systemic advantage. Though I agree that White people in America are born into privilege because of their race, I don't agree that makes them racist.

Even though I disagree with her definition of racism, I still embraced the book and all its wisdom and insight. My White classmates, however, closed their minds after reading that definition. They felt they were being attacked. Rightly so, I wouldn't want to be called racist just because I'm White. But we all have racism in us, why deny it?

It's not all my White classmates that "don't get it" (a general phrase I use for social consciousness). But the ones who don't get it...I immediately feel a disconnect with them. They're offended that they're classmates of color barely remember any White friends from their undergrad. We weren't avoiding White people, but White people were irrelevant to the development of our racial identity. We sought out people of color to figure ourselves out, not to exclude White people. Undergrad was a big, big place and you could only get close to so many people. So the people I got close to were people of color. That was a specific phase in my life.

Now I'm in medical school, and in a class of 93 students, I'm going to remember a lot more people. It's a different phase in my life where I feel comfortable forming meaningful relationships with anyone in my class. Well, not so much after the reactions to this book.

One argument of a White classmate is that life is hard for everyone. Do you see any scholarships for Caucasians? Do you see any clubs for Caucasians? Again, I'm not an expert so it was difficult for me to counter his argument in words. But I felt the error in his argument, even though I couldn't articulate it. Now that I've let it stew in my mind, I would argue that even though life is hard for everyone, and each individual faces unique challenges, racism is pervasive and harmful to groups of people. So the scholarships and clubs are to help the groups of people who have historically been treated unfairly.

I completely respect every medical student's struggle to get into medical school. And I even admit that it is very possible/likely that the road to medical school for some of my White classmates was more difficult than my own. But racism, to me, is not about the individual. Of course, individuals suffer or gain from racism. But racism is about society, and how society views race. Our society is racist. We judge books by their cover, just not as verbally as we used to. But those judgments we make in our mind are influenced by everything we grew up with. We weren't born to prejudge, but we were sure taught to.

I feel a bit weak-minded for not liking those White classmates who so adamantly opposed the book. They are nice people. But they are nice people who aren't aware of their privilege of being White. I acknowledge that they worked hard to get here. They didn't get here simply because they were born White. However, I want them to acknowledge that people of color have extra obstacles to overcome simply because of their race. Since they don't acknowledge that, it's hard for me to connect with them. They are from a different world than me.

I can't remember the last time I spent a birthday without friends. I think it might have been my 18th birthday. Anyway, I spent my 23rd birthday without my friends. Just David. But the time I spent with David was so wonderful, I didn't notice the lack of friends. It's not that I don't miss them, nor is it that I would rather spend the day with only David. It's just that, since moving here, I've gotten used to not having my friends around. So spending my birthday without them was like any day in the past 3.5 months. I used to see Lilian and Tiffany every day, and I had to quickly adjust to a life without them in medical school. It was difficult at first. I did feel lonely at school with a class of 93 students, but no one to really call my friend. Like all good things, it took time. I have now found a handful of people I really click with and can share things with. I actually like that it's only a handful, because I'm a firm believer in quality over quantity when it comes to friendships. I can definitely call them my friends, but they're not my best friends.

Best friends are people you can text random things to for no reason. Best friends know your past and understand where you come from. Best friends stay your best friends no matter where life takes either of you. Just friends don't meet any of that criteria. Not in my life anyway.

I actually didn't even mean to delve into this right now! I meant to blog about my birthday with David. I had an epiphany this past week. It really was a lightbulb moment. Where I suddenly confirmed, "Yes, I want to marry him." He was resting his head on my abdomen and talking to our unborn children. He said, "Hi, it's daddy."

Provided that David and I stay the people we are, I predict that our marriage would be a happy one. One with communication, respect, appreciation, fun, support, and love of course. I've had this prediction for a long time now, but was always a tad hesitant to confirm with myself that I want to marry him. There were several reasons for hesitation, some of which I don't even know. But the idea of a legal commitment intimidated me at the age of 22. And isn't it funny that soon after turning 23, I'm not intimidated anymore?

So even without my friends, my birthday was so wonderful because I spent it with him. He treats me well everyday. But he made it a point to make me feel extra-happy and extra-special on my day.

Disclaimer: I am not engaged. I want to marry him in my heart, but we cannot afford a ring yet.

I just realized blogger doesn't let me post pictures!!!!!! What kind of blasphemy is this?!?!!?!

An interesting comment: Abortion has been separated from medicine.

Society doesn't consider abortion as a part of health care. But it's a very medical procedure and often medically necessary.

Prior to medical school, I was pro-choice, but not very active about it. I have been very, very fortunate to have never gotten pregnant accidentally. So abortion never personally affected me. I just knew that if I were to get pregnant, I want the choice to have an abortion.

But now that I'm in medical school, I'm faced with more responsibility about my stance of pro-choice. As a physician, I will be an advocate for my patients who want an abortion even if I'm not the one performing it.

A part of me understands why people are pro-life. Besides religious reasons, it's difficult to empathize or sympathize with the stereotypical teenage girl who had unprotected sex. I can't empathize with them because I've never gotten pregnant accidentally. I can't sympathize with them because I use birth control. But this is very close-minded. I've just been lucky to not have gotten pregnant. I've had condoms break during intercourse or get stuck inside me. Thank you Planned Parenthood for free Plan B.

I feel that pro-life supporters don't even attempt to understand what a woman is going through when she makes the decision to have an abortion. Ok, that's harsh. Maybe they attempt to, but their closed-mindedness keeps them from being compassionate. It's so easy to scream from the picket lines. Screaming to bring another life into this world. But who is responsible for that life? They're surely not. They're not going to cough up the money to raise that life, they're not going to babysit that life, and most of them will not adopt that life. They just scream from the picket lines.

Sex is great. I believe in sex. I believe in sex for PLEASURE. If you're only having sex to reproduce, then I feel extremely sorry for you.

Accidents happen. But I believe in motherhood by choice, not chance. When a woman is able to CHOOSE whether or not to have children, it's beneficial for EVERYONE.

How has medical school been going for me? It's been over 3 months since I started, and now I'm only a month away from finals.

Academically, it's been going pretty well. I probably have a lower MCAT score, a lower undergrad GPA, and less experience overall than a lot (if not most) of my classmates. But it doesn't matter here. We're all starting over again from scratch. My MCAT score and GPA doesn't matter anymore, and it won't matter again for the rest of my life. So I've been performing just as well as, and sometimes better than, the rest of my classmates. I feel pretty confident about my academic performance for the next 2 years. It takes time and effort, but it's doable.

My stress level has generally been pretty low with the exception of a couple breakdowns. I'm just not the type of person to be chronically stressed. Medical school is demanding, but if I keep up with the demand, there's no need for stress. October is infamously known as "Red October" because we have a Biochemistry final, an Anatomy Practical, and 2 "quizzes." I put quizzes in quotation marks because they are 30-50 questions in length. So after the Biochemistry final, I had one week to study 3 weeks worth of material for the next quiz. That week was the most stressed I've been in medical school, and it's because I didn't keep up with the material. It's not like I slacked, it's because I was studying for the other exams preceding that quiz. I took that quiz last week and did really well, and now I can't even remember the actual stress I felt. I remember the fact that I was stressed, but I don't really remember how it felt to be stressed.

Clinically, I've gained some strides. I've successfully drawn blood 4 times now and have been unsuccessful once. That unsuccessful blood draw did take a minor toll on me, but a successful PAP Smear later that day helped me get over it. I've also done a digital rectal exam and breast exam. Since academics aren't what worries me, it's the clinical stuff. Because this is the stuff that really matters. I've decided to apply to become a co-director at Paul Hom Asian Clinic, and I'm excited to challenge myself and to learn so much. But I'm a little nervous about the responsibility. I'm proud that I'm not letting my nerves hold me back. I can't be afraid anymore. I'm going to be a fucking doctor.

There's not much else to say, even though there's so much I could write about. I'll try to update more often with various anecdotes and experiences in medical school. My life is really exciting, and I'm in a place in my life where I feel so blessed and appreciative of everything. I'm working towards a definite goal and it feels great.

I wanted to sleepover at my cousin’s house. If I could avoid sleeping at my grandma’s house, I wanted to. I wanted to avoid the space I remember her most. And I wanted to avoid the emptiness she left behind. But my mom told me that she didn’t want to bother my sick aunt, so we’re sleeping at grandma’s. I didn’t resist it, I accepted it maturely. David lived in his grandpa’s former room and his house for years, I knew it would be doable.

And it was. Just being in the house I know so well and with family I know so well but haven’t seen since her passing was so…nice. I forgot how much I enjoyed just being in my family’s presence, just hanging out. I haven’t enjoyed that in awhile. Her hospital bed was still in her and Helen’s bedroom. But the empty bed didn’t make me sad; I felt okay. In the living room, they had her picture in a frame with incense. Boy, did reality sink in for me. That picture was all that I had left to always remember her face. That picture will be with us for the rest of our lives, but grandma won’t be anymore. She’s an ancestor now, and we’re praying to her now.
The next morning, the first day of the funeral, David and I woke up to loud conversations in the living room, which sounded to David like arguing. But it was definitely not arguing, it’s just the way my family converses. That morning was pretty stressful: running errands in a time crunch, having to take my dad to his mistress’ house because he forgot his fucking shoes, finding out my dad physically threatened my mom because she wanted to cut him off of car insurance. David could tell you I went crazy, probably crazier than he’s ever seen me. But whatever, it was finally time for the funeral and everyone just shut up.

Even considering the circumstances, it was still so nice spending time with family. I only see certain cousins a few times a year and I had fun hanging out with them for 2 days. Even at a funeral, several of them congratulated me about my acceptance to medical school.
Overall, the funeral consisted of a Taoist ceremony and a Buddhist ceremony. The Taoist ceremony was free and over a dozen members of the Lord of the Universe Church came to participate. According to my dad, there would have been twice as much if my youngest uncle didn’t have beef with the church. The Buddhist ceremony cost $1200 and we paid for police escort to Rose Hills. My family dropped at least $12,000 on the whole affair. Nothing but the best for her.
Unfortunately, it’s October 4, 2010 as I write this and her funeral was on August 13th and 14th. I will try to remember as best I can.

Both the Taoist and Buddhist chanting lasted extensive amounts of time. But the Buddhist chanting consisted of the immediate family kneeling during most of it. It was strenuous; there was one section of chanting that lasted at least 30 minutes straight. Most of us ended up off our knees after a few minutes. But my oldest uncle (bak fu), stayed erect on his knees the whole time. Then the monks led us in a walk around the funeral hall where we walked pass the open casket for the first time. That was tough; many of the cousins cried, especially Helen. We walked around it a second time right after, and it was significantly less difficult. I think they do twice on purpose, to help you come to terms. Though the chanting was exhaustive, the tone, the rhythm, the continuity was entrancing. The deep tones penetrated me and it allowed for self-reflection, to be alone with my thoughts and memories of her.

It was a 2-day funeral, so before we left on the first day, the funeral director had us tell her, “grandma, we’re leaving early now, but we’ll be back early tomorrow morning to see you.”
On the second day, we burnt the paper. Even though in college I was taught that Buddhism believed in reincarnation, my family obviously doesn’t. I guess you can call it “heaven.” But we burnt lots of paper money, I’d say at least $1000. And the following paper products: 2-story house complete with fridge, fan, chairs and balcony, Mercedes with a chauffer (perfect because my grandma never drove), 2 servants, gold and silver mountains (so she can have a view of everything), a bridge (so she can go anywhere), and lastly a very beautifully decorated box that contained whatever our imagine wanted to (e.g., credit cards).

Stacy gave a wonderful speech, which was the only portion of the funeral I understood. Everything was in Mandarin of course. She talked about how the one thing grandma wished was to be able to give money to all her grandchildren. That made me sob.

The funeral procession was cool, worth the $400 or so. Our heads were lowered as the casket went into the ground. Then we all put flowers over her casket. That’s when I saw Raymond cry for the first time. And Pam was so compassionate to everyone. I had to jet out of there with the rest of the elders because big aunt freaked out and thought I needed to drive her when I really didn’t. So I missed what happened next at Rose Hills, but I got to go the temple with the elders where my grandma’s name will be posted forever.

Overall, it was a wonderful experience. It was interesting and elaborate. As superficial as it sounds, I’m happy that so much money was spent on her. Not just by my family, but friends bought huge flower displays that cost at least $100-200. I loved feeling close to Buddhism again, and of course just bonding with family. As little as I see them or talk to them, family bonds are amazing. I thought the timing of everything would make grieving hard as I started medical school and anatomy lab. But I think the timing was perfect for me. It was easier for me that she passed away after I left for medical school, it was easier for me to deal with death in general with my grandma’s passing and anatomy lab. I really have this new understanding and acceptance of death. Death makes life worth living.

This a very odd time in my life right now, in that I've never been so happy with life and so optimistic about my future, but at the same time I'm approaching the saddest event I will have ever experienced up to this point in my life.

As I near the end of orientation, I am so confident and pleased that UC Davis is the perfect school for me. One week ago, I still doubted my ability to be a doctor, I still couldn't imagine myself as a doctor. But now, I am very confident that I will be successful and UC Davis will give me the support I need. I know it will be stressful and difficult, but I know it's going to be wonderful. I am in love with my "big sib" who is so bubbly, nurturing, and very involved. She is the perfect mentor for me. I don't have to worry about being mistreated here because UC Davis is the first to have a policy on mistreatment, and they have made great effort in making us feel comfortable to report mistreatment. I didn't approach my professors much as an undergrad, but they're so approachable and supportive here.

However, as I go through each day of orientation, my grandma's condition worsens with each day. She will pass away soon, and I'm preparing myself by expecting it. Every time I receive a text from Connie or Annie, I anticipate that it will be the ultimate news. It hasn't happened yet. And when it does, I will be devastated. I wish her passing didn't have to be this way - full of pain and fear. I wish she would find peace, I wish she wasn't in pain. And coincidentally, there were several times throughout orientation where the staff mentioned "death in the family" and all the support and accommodations available to me in case of this.

I haven't got the ultimate news. But I got the warning call. Helen was crying. I never see or hear her cry. It makes me so sad. I hope she can be strong enough, but my grandma was her everything. My grandma wanted her and loved her when our own parents didn't.

Two weeks ago I visited my grandma and she was in a better state. She recognized me and seemed to understand that I was going to medical school to become a doctor. When I told her, she stared at me and smiled for several seconds. She couldn't talk because dialysis dries out her voice. But she looked at me, really looked at me, and smiled so sincerely. I am so happy to have that memory of her. I know I was one of her favorite grandchildren after Helen of course. Oh my goodness, I'm already using past tense.

Some time in the past month, I should have posted a blog about coming to terms with not getting into medical school this year and having to apply again this year. About how I'm confident I'll get into military medical school next year and I'll choose Indian Health Service instead of the Navy so I won't have to be deployed or relocated. About how I'll have a raise and a lot of hours at my work so I'll finally be able to pay off my credit card debt. About how I'm bummed that I would have taken 3 years off after graduating and that's 3/4 of medical school. About how I'm a little bummed because that's another year I have to put off having children (not that I want children yet, but I want to have them at a younger age rather than an older age), but I'm constantly reminding myself that I'm only 22, so it ain't so bad. About how after realizing that I'm still young, the only main thing I'm really, really not looking forward to is just filling out that damn application again. About how I haven't grown or done anything special in this past year and that it will show in my application.

I never wrote that blog.

I also never submitted my application for this year's cycle. I was waiting for my paycheck so I can pay for the $500+ cost (last year it was nearly $800, but I chose more wisely this time around). I was also waiting to make sure that I got into an EMT class at Santa Ana College. I wanted to take that class so I could beef up my application this year. So I didn't want to submit my application until I knew if I could include that or not because I was on the waitlist. Well the class started 2 days ago, and I didn't get a spot.

Then yesterday, I got a voicemail during work. I checked it after work and it was the Director of Admissions at UC Davis School of Medicine. "There has been a change to the status of your application." I got excited. They don't call you to tell you that you've been rejected from the waitlist (oh yeah, I found out earlier this month that I'm on the waitlist for UC Davis, didn't have much hope so I barely told anyone), they only call you if you've been accepted off the waitlist. But I didn't want to get to excited until I was sure and I called them back at 6:30pm, so I wouldn't know until the next day. I really did put up a mental block from believing that I'm accepted. I even forgot about the phone call. I continued thinking about new apartments for me and David in Orange County (we were planning on moving into our own place together). So with that mental block, I didn't know who would be calling at 8:10 in the morning...

..then I saw area code 916. I quickly perked up, "Good morning!" Then the director says his greetings..."How would you like to go to medical school?" I teared up by the end of the phone call. Then full-on cried after I hung up. David was hugging me and smiling the whole time.

It still hasn't fully processed yet. I somehow miraculously need to move up there by July 26th. I can't believe this is happening. Thank you to everyone who believed in me - wow, I've heard that line a million times before, but it's so resounding. People believed in me when I didn't believe in myself. This is fucking happening!