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.

Back from Mexico. So now what?

OK. So, first of all, my return to the dUSA begs the question, "Is a 'Marcel in Mexico' blog still appropriate?" Do I have to change the name of my blog every time I move? Was the blog just a one-time thing? Is there something particularly special about Mexico that calls for a blog?

Who knows. But apparently I have enough motivation to write this entry post-Mexico. So here it goes...

I've been back from Tijuana for about 3 months now and the transition still feels less than 50% complete. Does that mean I'm expecting a return to a previously defined state at which point I would be 100% transitioned? Perhaps I envision a "post-Mexico" Marcel more globally aware, with a deeper knowledge of the human condition. Yet these are already true. Somehow, I've been thrown into some unforseen vortex along the way HOME. Lost in my own being, I got sidetracked and haven't been able to return. What exactly got me here, I'm not sure. I have similar knowledge and skills as before, indicated by a similar MCAT score ("35" in 2006 vs "37 "in 2003). I am now nearly fluent in Spanish and have a new understanding of the Mexican culture. But the Spanish has replaced some German and French that was previously accessible. Is this just a crisis of identity? I thought I had that resolved in college.

So do I have a goal...a direction for my post-Mexico transition? Yes!! I want to get to know myself once more. I want to re-introduce myself to the 10 year old I once was, yet I want to retain the skills, knowledge, and wisdom I have attained in 25 years. I imagine my ideal state as similar to that of the HH Dalai Lama who, I have read, carries a childlike curiousity and wonder coupled to great wisdom. I want to be in this state. But that means I have to meet the 10-year old that was inhibitively shy as well as abundantly curious and creative. That's it! Creativity. I don't feel creative. My conversations are dull. I'm trapped beneath layers of social-training, trauma, etc. And there I am, sadly laughing at the outermost skin that is so far removed from me, that I can barely feel it. And yet, I just tapped the inner voice. But there it goes again. Slipping away from conciousness. I am less than 50% acclimated. One day I hope to be 0%. Just be. No transition. Like the ferry-man taking people across the river: always present in the current flow of life.

Happy Resurrection Day

Easter marks the reunion of Jesus' spirit and dead body after his crucifixion three days earlier. Thousands of years later, here I am on Easter Sunday I'm trying to unite my spirit with my still undead body. Yoga, meditation, healthy diet, exercise, and reflective discussion are my methods.

In my path towards becoming a doctor, I recently stumbled upon the "integrative medicine" movement where contemporary Western medicine is mixed with other medical systems (ex. Chinese medicine, Indian Ayurvedic medicine, etc.) and techniques (ex. hypnotism & chiropractic). Although these "alternative" medicine techniques are not new - they are in fact much older than our current biomedical practices - they are becoming increasingly popular in the dUS, with about a third of the population employing their services.

Why are a large number of people turning towards these systems? In many cases, modern disease (i.e. heart disease, cancer, obesity, diebetes, & chronic back pain) are not adequately treated by Western techniques (usually intake of chemicals or surgery). Unfortunately, people turn to alternative medicine as a last resort after having had many painful surgeries and/or after chugging harmful-side-effect-laden medications. In the process of undergoing "alternative" treatments, they then find success. Furthermore, it's less painful, less costly, and longer lasting.

In a greater context, this shift in practice seems to be a response to the stiff & uncaring health care system overburdened by profit-seeking insurance & HMO bureaucracies that is reflected in its practices. As most common "alternative" medicines revolve around philosophies of self-healing or natural healing, they require listening to the patient - the person - instead of listening for the prescription or surgery to come. That is, the answer often comes from within and not from without.

It seems that, as in other aspects of dUS society, we seem to look for problems and answers outside of ourselves (i.e. war in Iraq and undocumented immigration "problem"). Instead, we must also look within and question the path we are heading down. How can a country that, of all developed countries, spends the most money on health care tie for 29th place in life expectancy (UNDP Human Development Report 2005)? We need a dramatic shift in the focus of our national healthcare system. At the base of such a shift is a change in perspective from without to within. Again, I'm talking about the (hu)man in the mirror (see "(hu)Man in the Mirror" from June 29th, 2005).

As a parallel, the modern Christian interpration of a God from without that saves us from our sins through his death and resurrection must also be viewed as the result of an internal journey. Indeed, the recent translation of the lost Gospel of Judas invites the theory of release of the spirit from the prison of the body. In it, Jesus confides to Judas with regard to the other disciples, "But you will exceed all of them. You will sacrifice the man the clothes me." Scholars say that Jesus meant that by helping to kill his physical body, Judas would act to free his soul. This is similar to the Buddhist and Hindu quest for "nirvana" in which one tries to reach an absolute truth and, upon reaching it, the liberated mind no longer requires the physical body. Indeed, when Mohandas Gandhi was asked whether he was a Hindu, he replied, "Yes I am. I am also a Christian, a Muslim, a Buddhist and a Jew."

We are all on the same journey, as humanity and as individuals. One physical manifestation of this journey is health and the systems by which we, as a society, choose to address it. We no longer can afford to ignore our bodies and minds, it's too costly on our checkbooks and, most importantly, on life itself. That's why I'm sitting quietly in my room on Easter Sunday, the day of Jesus' resurrection, trying to understand who I am - today, yesterday, and tomorrow. I need to understand myselft to heal myself, only then can I begin to think about healing others.

"Every human being is the author of his own health or disease."
-Buddha Guatama Siddharta

"Natural forces within us are the true healers of disease."
-Hippocrates

"It is more important to know what sort of person has a disease than to know what sort of disease a person has."
-Hippocrates

References:
"What is Complementary and Alternative Medicine (CAM)?"
National Center for Complementary and Alternative Medicine, National Institutes of Health
http://nccam.nih.gov/health/whatiscam/

"Manifesto for a New Medicine: Your Guide to Healing Partnerships and the Wise Use of Alternative Therapies"
by James Gordon, MD

"UNDP Human Development Report 2005"
United Nations Development Programme
http://hdr.undp.org/reports/global/2005/

"In Ancient Document, Judas, Minus the Betrayal"
by Joan Noble Wilford and Laurie Goldstein
New York Times, April 7th, 2006
http://www.nytimes.com/2006/04/07/science/07judas.html

The True Cost of Entrepreneurship

How to put together an Internet Café in Tijuana for under $5,000...

5 donated computers from father's business contact: $0.00
BUT requires having a father with such a business contact: middle class income

4 used 17" CRT monitors, XBOX, & printers found on craigslist.org: $250.00
BUT requires having computer & internet access to browse craigslist.org: $2,100 + $30/mo.
AND requires access to flexible transportation + gas: $2,700 + $100

New optical mice, keyboards, and misc. computer-related supplies at electronics stores in San Diego using Mastercard: $300.00
BUT requires US Visa or US Passport: between $90 and $150 (plus requirement for adequate salary for visa)
AND requires ability to have credit card and to pay credit card on time: financial support from parents

Building with secure doors & windows, electricity, and telephone or cable service: $600
BUT requires self-wiring, self-construction, etc.: hernia operation, hurt backs, etc.

Put together the computers yourself: $0.00
BUT requires technological know-how to put together system in a legal & feasible manner: $27,000 in university tuition

Hmm...maybe it wasn't really put together for under $5,000. No wonder there aren't more Internet Café's around Tijuana despite the MSN messenger-crazed and video-game-loving teenagers all over the place.

Setting up an Internet Café

...is what I've been up to in my spare time.

It's been a process that's evolved over the past couple of months. Why do it? I could use the extra income, I want to work on a project in which I have a large say in how it takes shape, I want experience setting up a business with social goals as well as economic ones (aka social entrepreneurship).

The Internet café, dubbed "Casa Internet," will be located in Cumbres, a resource-limited colonia of Tijuana. The idea is to give access to the latest technology and information to people who normally have to struggle to gain this type of access. Using the "waste" of San Diego high-tech businesses and our own ingenuity and creativity, my partner and I are setting up shop for under $5,000 USD. We plan to offer digital camera rentals, inexpensive digital photo processing, copying, faxing, Internet access, gaming, and free computing classes, among other services.

Beyond that, I hope to organize programs that improve access to valuable information. Where instead of making a costly trip to the bank to make phone payments, people can pay their bills online. Instead of making long-distance calls for $0.30/min, they can be made at a fraction of that cost. Basically, I hope to distribute access to information technology infrastructures that are normally concentrated in areas with physical infrastructure.

Updates forthcoming...