Why does everything have to be about race?

Because it is. 

How about a more inclusive stance? You ask, lovingly, with peace/#alllivesmatter/harmony in your heart. 

Here you go: Because it is, until it isn't. 

Before you close this page and refuse to engage (hey, that rhymes..), that question is mine. It is what I asked myself some three, or four or five odd years after living continuously in the USA after having lived 18 years in Zambia. I grew up in Zambia, a small, land locked and peaceful country in the region of sub-Saharan Africa. A former British colony, this is home to the Bantu languages and traditions, to the carbohydrate staple Nshima, to the opening and welcoming arms of a culture that tends to see every person as individuals. 

I recently had a conversation with my Mom as follows: 

Mom: do you have any Black friends? 

Me: 

Mom: ? 

Me: umm, not really. Most of the potential Black friends I know are not quite friends yet - we agree to meet up for coffee, or drinks once in a while and might see each other once every six months, but have never gotten to the stage that we've become friends. 

Mom: that's because you are Zambian 

Me: what do you mean?! [read, what does THAT have to do with ANYTHING?] 

Mom: Zambians tend to see people as individuals, rather than for the color of their skin. In order for you to have Black friends, you would have to [slight pause] make a special effort to seek them out. 

 My Mom is American. She was born and raised in Houston, Texas in 1947. She was brought up through the education system in America, was brought up by black Americans in America, was a part of multiple marches and protests on Civil rights in America and thus has a perspective I do not. 

Until now. 

The person who is able to ask "Why does everything have to be about race?" is one who is blind (willfully, or as in my case, ignorantly) to the very foundation of these great United States of America from which everything today is built upon. 

Turn your History books to page 1, please. 

1619's - 1863: Race was used to justify slavery. That is, Black people in early USA were regarded as an inferior race, as sub-human, in needing of enlightenment and work that was provided to them, graciously, by their White masters. The economic boom that resulted came literally, on the backs of Black people in the USA. You know this. Due to the emancipation proclamation on 1/1/1863, [*most] slaves then became free. 

1863 - 1900s: Then came the Reconstruction period in which Black people started to become self sufficient, owning business, becoming literate, voting and generally just being awesome. What happened next, you ask? I'll tell you - the black codes, or what we now loosely refer to as Jim Crow laws. These laws were designed to limit the freedom of Black people in America. Again. 

1900's - 1940's: with more and more Black people speaking truth to power (I love this phrase) and realizing their worth, you have Booker T. Washington and W.E.B Du Bois (and others) raising their proud Black voices. So you know what comes next - segregation aka separate but equal laws. Just another way to limit the freedom of Black people in America. 

1940's - 1960's: now we have more unapologetic Black people speaking truth to power, Malcolm X., Rosa Parks among others, culminating in Martin Luther King and the Civil Rights Act of 1964. Dare you ask what comes next? The war on drugs. This is a war that on the outside seems to be non-racist and color blind. What is wrong with a war on drugs? How can you, deadrocketcow, a seemingly well educated, law abiding citizen have an issue with a war on drugs? This is a long discussion for another day, best started early, when no Godly person should be awake - but let the facts speak for themselves with these questions: 

1. Why does crack cocaine have heftier penalties and prison time compared to an equivalent amount of powder cocaine? 

2. People of all colors use and sell illegal drugs at similar rates. When you count the number of people in prison for drug crimes, why are they overflowing with minorities? 

These are rhetorical questions, for you to think on while you drink your morning coffee. Don't come for me. 

1960's - now: 

 As recently as August 1965, Black people did not have the right to vote. As recently as 1967, it was illegal in sixteen states for a black person to marry outside of their race. Redlining - a heinous and disgusting practice that exists to this day, allows neighborhoods and districts to be placed into groups that make them ineligible for federal funding and services. Black people are more likely to receive higher interest rates on their mortgage compared to White people. Black people are 23% more likely to be pulled over by the police than White people, 1.5 to 5 times more likely to be searched when they *are* pulled over (while less likely to turn up contraband), resulting in a 3.5-4 times higher probability that they will be killed by the police. Black mothers with a college education have a higher infant mortality compared to White women who have a high school diploma. More Black people (and minorities) die from COVID19 than white people. I could go on. The examples are legion. 

I was not raised or (before college) educated in the USA. I had the blissful ignorance provided by being raised in my formative years, in a country where people are seen as individuals and not immediately judged by the color of their skin. (This is not to say that Zambians do not suffer from their own post-colonial syndromes). 

I am sorry for all the Black friends in college and in medical school and in early residency who were hurt by my question. They opened up the most vulnerable parts of themselves, to me, a fellow Black person, and were hurt by my ignorance. 

But now that I see, I cannot un-see. 

The question you should be asking is "How can we make everything NOT have to be about race?" 

 *not in the states loyal to the Union

A day on call

Over here is a lady who can only communicate by sticking out her tongue. She has reverted to her child hood state and won't respond to questions in English. "Saco la lengua!", you command, because who knows if she's still alive? She sacos her lengua. Don't feel sorry for her though - she blew her own brains out high on a combination of heroin and cocaine and now she lies in a $10 000 a day neurosurgical intensive care unit bed, sucking on your tax dollars. At least, this is what my attending tells me.

Over there is a 15 year old, undergoing a tracheostomy cap trial. He has a big indentation in his head on the side his bone was removed in an effort to save his life. His crime? Playing basketball in a bad neighborhood. His mother found him, lying in the street across from his house, with a gunshot wound to the head. If he passes this cap trial, maybe that special rehabilitation facility that deals with pediatric neurosurgical patients will take him. He's failed three times. But he's been in the hospital for 80 days. What's another week while applying to a different facility?

I can see you in the face of your 95 year old aunt. She gets restless at night, calling out for your uncle, who's been dead for 30 years. This time she fell and broke her neck. You weren't there to prevent this, because although you try, how is it possible to watch her 24/7? You've fed her her meals, coaxing her to take a few more bites. You've bathed her. You've read the newspaper to her. How could you not? No one else will. I can see the scratches on your face, on your neck and on your arms. Last night she didn't recognise who you were and panicked, thinking you were a burglar. You still put her in her yellow dress and brought her to the emergency department though.

She told me she didn't use drugs. There are amphetamines in her urine drug screen, but that's ok. Maybe she ate an extra large bagel with poppy seeds on it. Oh wait, that's heroin that does that. We found out why her brain is so swollen though. She has had untreated high blood pressure, probably for many years. "Sign off! Let the medicine doctors deal with her. This is not a neurosurgical problem." That's my attending. He cuts to the chase.

Here comes the guy who fell down the stairs, drunk last night. He had bleeding in his brain and we asked him to stay in the intensive care unit overnight so he could be watched closely. We wanted to repeat his head CT in the morning. He had things to do at home though, *cough* get sloshed *cough* and left, "against medical advice". He's back now - on the ventilator.

Say, isn't that the woman who was just in the hospital last week for x? Now she has x AND y.

Don't worry, sir, we'll take good care of your mother.

Hey, mister, this won't hurt a bit.

2014

It's 2014 and I am 6 months into third year. That means...in 6 more months, I will be a fourth year and back on the wretched main service. Hell on wheels, in other words.

Right now, I have the luxury of a less stressful schedule (sometimes) and more time to study. More time to be that all-star resident I always wanted to be.

It means making choices though - do I sleep, work out, study, work on research or do something social? It's always a challenge.

But, like Dr. R says, if you don't think you can handle it, you're probably in the wrong specialty.

Third year - it continues

So continue the blessed rotations of third year.
I am doing two months of Pituitary/Endoscopy in a state that took 11 hours to drive to. I work three days a week and live in the basement of a couple that takes in medical students, residents and other stragglers of the medical persuasion for a fee. (I'm assuming there is a fee...the money that changed hands between program and host did not involve my hands. Or any other body parts, for that matter).
In any case, I have A LOT of free time on my hands.
Incidentally, the two attendings I am working with during this rotation are away at a conference this week. So. I get an additional week off.
The downsides to this rotation
1. Way too much free time
2. Very bad phone reception at this place I'm staying
3. I know no one here

The upside:
1. Way too much free time
2. Did I mention I have way too much free time?

So, I've been working out. A LOT. Like, twice a day a lot. Don't judge me - it beats watching an entire season of Breaking Bad. Per day. Of which, I am fully capable.

Speaking of the gym:
Is your workout so intense, so totally consuming, that you - weightlifter guy/gal, must insist on throwing your dumbbells onto the floor after each set? Yes. I'm talking to you. You there, in the wife beater, carrying the Costco [so you know they have like, 40 of these at home] gallon jug of water. Is that your way of announcing to the gym world that you just pressed three times your own weight? Is that how you mark your gym territory? Don't answer - I don't really care. If you do not have the strength at the end of a set to lower your weights to the floor in a controlled and civilized manner, you should be lifting a lighter weight. No matter how many pounds of gnarly muscle you have on your shoulders.

And:
What is going on in the mind of the person who steps onto the treadmill, cranks the incline up to 100% and then hangs on for dear life? They must realize that defeats the entire purpose of the incline. And what a sight! Huffing, puffing, the sweat pouring down - honey, don't bother. You're really going at, like, 10% incline right now. And that's being generous.

So, yeah. Working out. Quite a bit. What I need to do - and God help me, I will - is use all the extra time to study and work on some solid research projects. Like a real neurosurgery resident.

For now though, I have three episodes of Scandal chapters of Neurosurgery Text Book to read.

Goodnight.

Happy Birthday, deadrocketcow

29. The countup continues.

I still hate presentations and other thoughts

I am close to the end of this three month Pediatric Neurosurgery rotation in this here, mid-western state and as such, I have a presentation to work on. This presentation is due on Monday. Yes.
I cheated and asked one of the attendings for topic suggestions. So now I have one: X-linked congenital hydrocephalus. I also have 5 solid hours of free time today before my OR case in the mid afternoon. A great opportunity to get some work done.
So, of course, I'm blogging.
My surgical skills are improving, and in turn, so is my confidence. I don't know if you can tell, but I'm a quiet/shy/reserved sorta gal. I err on the side of caution. If there is any doubt in my mind about something, I hold back and assume that I will be wrong. This is not your classical surgeon, and more specifically - neurosurgoen personality, which, as my program director (Dr. R) has reminded me over and over again, hampers my learning.
If I don't "take over" the case in the OR, the attending assumes I don't want to. I just assume that "taking over" like that is rude. If I don't have anything worthwile to say, I keep silent. My attendings think I'm not interested. I've never been one to always have something to say. You know, like that person. In my [humble] opinion, those that have the most to say, usually know the least.
However, my co-resident here is pretty much the exact opposite. Assertive is putting it mildly. There are other choice adjectives I could use to describe her, but that's material for another post. Out of a desire to survive this rotation and not be her doormat, my personality has taken some sharpening. Dr. R would be proud.
What else has improved?
My neurosurgical knowlege. My ability to communicate with patients and their parents in terms they can understand. Working with difficult people. Compromising. This rotation has made me a better neurosurgeon (in training) AND person.
I now know what it is to be so tired that you can't think.
To be so tired that you would rather sleep than eat (despite being ferociously hungry).
My patience has been tried. To the moon and then back again.
But I'm still here. Right?
After this rotation, I pretty much have no reason to ever complain about work ever again. It has been rough.
As such, I am counting down the days for my return to my home program, where I will begin a one month Endovascular rotation.
I'll miss everyone in the department. Everyone except my co-resident. But, like I said, that's material for another post.

I guess I should work on my presentation now.

Catching up

So, it seems that almost 8 months have gone by since I last posted. How did that happen? At the start of the year, I was half way through my second year of residency and was tired of being at the bottom of the totem pole. Woe was me. Now, I am three weeks into my third year and still feel like I am at the bottom of the totem pole (surprise!).
My third year is divided into four, three month rotations both at my home institution and at other institutions. This first rotation is Pediatric Neurosurgery at [redacted] hospital in mid-western state. The schedule has taken some adjustment - home call is both a blessing and a curse - so far, mostly curse...
Getting woken up every hour and or having to come into the hospital to see a sick child and or operate for hours at a time and THEN having to come back the next day (provided it was not so late at night that I just had to stay in the hospital) and work another full day the next morning is KILLER. It is NOT normal. Perhaps it is punishment for all those times I complained about taking in-house/overnight call.
Aside from that, I am operating a lot, learning tons and, can you believe it - working out 5 days a week. Needless to say, it doesn't leave much time for anything else. Sorry Mom.
I get up at 3:45 am, work out, get to work, leave anywhere between 6 pm and 9 pm depending on whether or not I am on call and try to be in bed by 7:30 pm. I kid you not.
But it's just three months. Right?
Right.

Things I need to do by the end of Sunday
1. Call my parents
2. Log my OR cases
3. Catch up on my research project
4. Do laundry
5. Replace the hubcap on my right front tire
6. And, as always, read, read, read.


Until the next time.