Studying...for what?

"I ask who's going to take the weight/And y'all shrug like Wednesdays are bad for me, I gotta study"
- "G'Dang Digg" by RA Scion of Common Market

I am a student of medicine. I am enrolled in classes at a school of medicine. To whom is it a responsibility that I learn the material I am "taught"? To my school, to my future patients, to myself? All of the above?

The first semester in medical school has rapidly passed by, yet I can already feel my soul being systematically removed from my body with the same amateur precision with which I removed the heart from the cadaver. Step one, "appreciate" the heart's location within the body. Step two, feel the spaces around the heart. Step three, cut the connections to the body and remove. A human heart is in my hands and I slowly learn to name all of the parts of the object that I'm holding. But I that doesn't mean I understand it as a whole. I don't grasp how it pumped blood through this person's body during 92 years of life. I don't understand the context of the pieces...mainly what was THIS heart in the context of this person. It's a question more philosophical than physiological. Yet it is of paramount importance in my training. And it never came up in class. Am I being short-changed in my education? $200,000 in tuition (+interest) for a partial education?

And so, I quietly steal away from studying Anatomy & Histology to form my own education. A short bus ride to a 2-hour community meeting in Mattapan: $1.25 (inversely proportional to the value of the lessons I've learned). Who are these BMC patients anyways? How and where do they spend the other 99% of their time when they aren't at the doctor's? Here is the other part of my education. I can see 30 hearts beating around the room. Pumping blood through vessels to deliver oxygen and nutrients to bodies that each have a purpose. Their kids. Their spouse. Their neighbors. Their community. Our community.

Our medical school is not geared towards these educational experiences, and so medical students fight a strong current to fulfill their responsibility to learn "medicine" (the art of healing). Too often it is a losing struggle. UNIDOS (http://www.unidosboston.org) offers a chance to reclaim ownership of our education. Circumventing the bureaucracy inherent in institutional medical eduction, our collaborative can facilitate experiences in "the other 99%" of our patients's lives. Through UNIDOS we can get to know the heart in a way that we never could in Anatomy lab...while it's still beating.

Take off your shoes...

A good friend of mine once said, "If you want to have your feet on the ground, take off your shoes."

So, here I am, about to embark on my second day of door-to-door surveying for Boston's Violence Intervention & Prevention (VIP) Initiative. My goal is to learn more about the community in which I live and about the community served by the Boston Medical Center (these are largely overlapping). Yes, the coverage is small - I've personally only spoken with 4 people about their concerns and needs for their neighborhood - but it's a solid foundation. Everybody so far cited "Drugs" and "Violence" as THE major problem of their neighborhood and then went on to talk about an increase in police presence and after-school activities as ways to improve these problems.

Yes, police presence and after-school activities have the potential to reduce crime. I imagine a stronger police presence would use fear as deterrent. Yet at the same time, I could imagine a greater police presence promoting an environment where crime might be more expected. One person commented how the police always seem to be just at the wrong place: violent crime always seems to occur a couple of blocks away.

And how about after-school programs? Why do they prevent violence (esp. drug/gang-related violence)? The common argument is that it provides safe and positive alternative activities for children and youth who might otherwise be misled to participate in negative and violent activities. How about the youth that are less able to participate in these programs? Perhaps they don't make the grade requirements. Or they don't have a parent or relative to transport them to/from these activities. Or they don't see these activities as within their realm of possibility.

I don't think these solutions as clear-cut as they are made out to be. They don't seem to directly address the ROOTS of violence: anger, frustration, saddness, loss...as a result of systemic disparities in income, health care, and general treatment. Yet, as Paul Farmer (Partners In Health) asks, "Is that statement meant to end a conversation...or to start one?" I hope that it starts many conversations. I hope that we can come to common understanding of the roots of violence. I hope that we can design and implement successful initiatives that directly address these roots. I hope the one day people can be free to live their lives in security of person and with the freedom to make important decisions about their lives without overwhelming negative influences.

So I'll start again today by knocking on one more door...barefoot in Boston (figuratively). I hope to see you out there.

REFERENCES:
City of Boston Violence Intervention & Prevention Program
http://www.cityofboston.gov/VIP/

In my cave...

Inspired by writings of the always-original G-Tron...

I am in my cave. Crouched in a corner, my body aches from months of disuse being shocked to life at the local Young Men's Christian Association. My body aches as my essence yearns to break free from the shackles of my own mind, my personally-programmed prison. And I know why the caged bird sings.

The few who dared to enter left just as quickly. Only a few linger in curiosity. Perhaps I don't even see them. Still my body aches and my eyes have opened. I feel the mind being unlocked by the body as the neural chains are pulled by dehydrated muscles. Gatorade and potassium-rich bananas help release my mind. My support group is here. ¡Gracias mis amores! I remember now what I have to do: Heal the world, starting with the man in the mirror (thanks MJ!).

Yes, I am waking up again. The imagined burdens of medical school applications, job responsibilities, and other societal pressures become lighter as I take off the Past- and Future-tinted lenses that have captured my mind from the Present. Thanks to weight-lifting and soccer. No. Thanks to my brothers and sisters who support me; who stood by unnoticed as I crouched in my cave. I knew you were there all along.