Chairs Missing by Joe, resident at the New England College of Optometry

26Aug/13Off

Road Rash

In the last week of June, leading up to the first day of residency, I was considerably more nervous than I thought I would be. It was like the feeling of starting a new school all over again; like the transition from junior high to high school. This was getting called up to the big leagues, the big show, the main stage. With that, the expectations were going to be elevated. And thus that familiar feeling of nervous anticipation filled my stomach. Yes, now I am a doctor, but am I truly ready? Would I be rusty, given my last rotation was light on letting us do complete exams? Would I flub a major finding (miss a retinal detachment) or try to initiate a treatment that was wrong (antibiotics for an allergic conjunctivitis)? Would I make my attending docs rue the day they ranked me for their program?  In the lead up, I had a series of anxiety-fueled, recurring dreams based around a traumatic incident during a summer twenty or so years ago. It is one that I have had time and time again over the last several years whenever stress levels run high.

The summer of 1990 was a transitional one.  I turned eleven and was gearing up for the big jump into sixth grade and junior high school. I wanted to make myself feel more like a teenager and ready myself for having to deal with the older, cooler kids. At the same time, this summer was the first time I was essentially left to my own devices during the long school vacation. I could leave my house free from supervision, obstensibly to keep out of my mother's hair, so long as I left in the morning and didn't come back until dinner.  The previous summer was the summer of Batman, where my friends and I had spent most of our time playing out scenes from the movie with action figures, or otherwise playing video games in our basements. That behavior wouldn't fly for someone in junior high. So the decision was made; this summer was going to be different. We needed to grow up and leave behind the toys of the past. And so we decided to venture by bike out of our neighborhoods, across town, to hang out at parks and parking lots, or if we were feeling really adventurous, at the malls in Springfield.

We also tried to co-mingle with my cousin and his older friends, some of whom were known for being "bad" kids.  They would do crazy things like race dirt bikes in the woods or jump off old train bridges into the Chicopee River. Or maybe even smoke a cigarette.  Needless to say, we were too chicken to do any of the things they did for fun, and so we were rejected pretty quickly despite my cousin's efforts to get us accepted into the group. But to my surprise, one mid-summer day I was invited on a trip with them to the local ski hill, Mount Tom. In the summer, the mountain stayed open with a mini-water park complete with a few water slides, a wave pool, and also something called an alpine slide. I didn't ask my mother as she would probably say no, so I snuck off with Jay and three carloads of kids I didn't know for a day on the mountain. It is around this time index that my dream usually begins.

After a while of hanging out in the water-based attractions, the group set its sights on the imposing alpine slide. For those who don't know what one is, it is essentially a smooth, long, winding concrete track built into the side of the mountain. This allows people to harness the awesome power of gravity to ride sled-like plastic carts down the mountain, at speeds controlled by the user via a hand brake. Kind of like a summer-time version of Olympic bobsledding. This being the early 90's, there were no helmets,  no real adult supervision, and "suggested" speed limits, and with two tracks side-by-side, people would compete and try to blaze down as fast as they could. And injury would often ensue. On a side note, amazingly there are still several of these still in operation today, and a quick YouTube search can confirm that people are still getting busted up on them to this day.

So as we all took the ski lift to the top, that sinking pit of anxiety entered my stomach. Everyone was talking about racing each other down to the bottom. I had never gone on one before, and at times from the chair lift you could just barely see the people on their sleds flying down the tracks in the distance. It seemed very dangerous, more so since I was pretty undersized for  my age, just barely able to meet the height requirement to get on. But at the same time, I had to go down, otherwise I'd look like a baby in the eyes of these older kids. Once at the top, a few of of my cousin's friends ran over with sleds and started down the track, boasting that they wouldn't use the brake for the entire ride. This prompted the attendant at the top to warn the group that if we were caught going too fast, we would be kicked off the mountain. This got a good laugh out of the group and when the signal was given, the two junior racers flew out of the gate and disappeared around the first bend of the track.

Meanwhile, I had tried to hang back in the line and maybe somehow wait until I was last so that I could go down slowly without getting called out by the others. But wise to my plan, they noticed me at the back and decided to pair me up against the shortest member of their crew, with the goal of seeing who was more aerodynamic. So I was pushed to the front of the group, plopped into a sled, and forced to wait for the signal to meet my doom. As I stared nervously down the slide, I made note of the serenity of the treeline and view from the top of mountain.

In what seemed like an eternity, the attendant finally gave the signal to go. I eased the handle of the brake backward to release the sled and the next thing I know I'm shooting down the mountain, starting off faster than the guy I was racing.  I heard the cheers of Jason's friends meander off in the distance. When I effortlessly navigated the first big bend and the first sharp drop, which I clearly can envision to this day, I remember thinking, "Hey, I got this, I can go as fast as I want." So I pulled back the handle further and picked up even more speed. I was going to win and earn the respect of everyone. The mountain side became a blur as I accelerated.  The next thing I remember was looking down the track to see a series of sharp switchback curves coming up ahead. Rather than slow down, I pushed ahead at the same speed. Somewhere inside those series of turns, going much too fast, I went up the side wall of the track and went airborne.

At some point I remember thinking, "Holy cow, I am upside down and still on the sled". I think I almost landed the flip unscathed. But at some point the sled came out from me, flew forward and landed right side up, successfully completing the 360. Somehow the brakes on the sled failed and it continued down the track on its own, all the way to the bottom. I was ghost riding the whip years before the term had been invented. I landed face first on the track and skidded from full speed to full stop. At some point, I blacked out. A while later I came to, dizzy and throbbing with pain. I realized my forehead as well as a good chunk of my arms and legs were blistered and bleeding. My sled was gone and no one else was in sight. I looked to the side of the track and saw a woodchuck in the distance. Its eyes met mine for a moment and then it ran off into the woods. As I got up, I burst into tears and began to run down the mountain side, with the taste of sweat, blood, and salty tears in my mouth, embarrassed as much as I was hurt, I prayed no one else would find me in this state.

It is at this point  that I usually wake up.

So now the first two months of residency are essentially done and the recurrent dream has stopped for now. Days have come and gone faster than I could have realized.  The first couple of weeks were actually much less stressful than I expected; in fact, my new commute of about 50 minutes was at times the most stressful thing, until I adjusted to it. As new residents, our early days were spent attending the mandatory VA training and we had several days of reduced patients to become accustomed to the patient flow again. Having been at my VA as a student helped the process to be more familiar and smooth. Then the residency conference came, giving us another day off from patient care and a chance to catch up with some old friends doing residency across New England and allowed us to hang out at 424 Beacon for the first time since graduation. It was very nice.

August was the first full month of patient care on regular schedules, with the expectation we see eight patients a day with accuracy and formulate treatment plans without help from anyone. The safety net is that our attending doctors come and double check before we leave and discuss what went right and what went wrong. For a time, my anxiety and frustration level with myself rose again. I missed my share of findings, though nothing very dangerous. I proposed treatment plans that weren't quite in line with what the attending thought was appropriate. After hours, I had (and still have) plenty to look up in terms of articles or photos of stuff I was shaky on. There were some late nights where I ran behind and was forced to catch up on charting long after patient care hours were over. In other words, the experience was exactly what I was expecting it to be: lots of learning and lots of eating humble pie.

Last week was the first week that I was able to finally say to myself, " Hey, I think I know what I am doing here, maybe I'm smart enough to be here after all." And all through the process, the people who I thought I had to impress and be mistake-free in front of, my attending docs, were simply there for me. Not to judge, but to teach like any other professor I've had over the years. Their knowledge, support, and help is what is making the experience thus far all worth it.

One thing I didn't mention. Sometimes my dream ends when I fall and scrape and pick myself up, forced to walk down the mountain bleeding and alone. Other times it keeps going, and I am able to remember what actually happened after my accident. After a few minutes of stumbling down the mountain in a daze, I hear a familiar voice. It's my cousin, coming  down the track on his sled. He comes to a stop and yells out, "Is everything is alright?" I wipe my tears with a bloody arm, trying to look tough, and say,

"Yeah, it's fine." He says,

"There's room for you on the back anyway speedy. Hop on."

I get to the bottom of the mountain and on to the first aid tent. Besides having to explain what happened that day to my parents, the rest of that summer ended up being pretty good after all.

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7Aug/13Off

The Move

This weekend my wife and I packed up all of our worldly belongings into a Budget rent-a-truck, pulled out on to Harvard Ave, went through the toll booths of exit 18 in Allston/Brighton and drove west on the Mass Pike out of Boston one last time. Thus brought a close to the time I could call myself a Bostonian and gave final closure to the chapter of my life about my time in optometry school. The next time I come to Boston it's as a visitor; for that matter, the next time I step foot on 424 Beacon it's as an employee and a doctor.

Originally I was going to write about my first weeks as a resident at the VA and about the residency conference, or my first days working for the school as a resident tutor/monitor. But jammed into the middle of my first month on the job was the stress of having to pack up and move.  Unlike the last time we moved, from Springfield to Boston, I would be working full time and have to MacGyver the bulk of Move-related activities into the weekends. Every night it became a "what can we do tonight to figure out the logistics of the move" night. Did we pack up everything in the storage space yet? Did we change this or that utility to the new address? Did we reserve the right moving truck? Thu,s as it has dominated my off-hours thinking, there was little else I could focus on writing about.

Moving day was something that I dreaded for months. The dread was multifaceted. The obvious factor is the stress of leaving the relative comfort of home to a new place. Our apartment was ours for four years, unlike many other friends and fellow students who moved from one "college" style apartment to the next after each year (or more during fourth year). And our place was a recently built condo. Probably because we were older than the average student, and my wife had a real job and real credit, we were able to a get huge and comfortable space that was somewhat reasonably priced for the size (or at least relative to Boston). We had central air, a parking space and a private roof deck with panoramic views of the city skyline.  The school was 15 minutes away by bike or 25 minutes by the T. Being in Allston, it was close to good restaurants, supermarkets and parks, but relatively quiet compared to the more densely populated areas near the Back Bay where most people who attend NECO choose to live . Yet it was also only a quick bike, drive or train ride right to where everyone lived and where all the activities and night life were.  It's saddest to leave if I focus on these facts.

When came the day itself, I kept wishing I could close my eyes and it would be done on its own. Yes, we were moving a month earlier than what is locally known as Allston Christmas, August 31st.  Yes, a late July or early August move is a less stressful day to move than when all the students move and the city becomes a paralyzed crazy quilt of  U-Hall blocked side streets and sidewalks jammed with old mattresses and broken microwaves. But there are still plenty of people with the same bright idea to try to dodge the traffic, so maneuvering is still somewhat limited. We accumulated so many new things, furniture especially, since we first came to Boston that we would need a bigger truck. Being about 5'4" with limited abilty to even see over the steering wheel made driving the 10 foot truck on the move in bad enough. Back when we were moving in, I nailed the side of a gas pump returning it, unable to correctly judge the width of the truck, but luckily we had bought the extra insurance. The added twist this time was that many of my (strong) friends had already moved. Thus I was faced with the Keith Hernandez moving scenario: I would have to ask people I didn't know very well to help us move. Would they think I was too forward? Was it too soon to "go all the way" on the friendship? In the end I was able to convince a few friends' boyfriends to help with the move (along with my brother, who is legally required to assist)  and it went off quickly and smoothly, virtually complication free.  We made it out to our new suburban location with nary a scratch on the truck, the extra insurance a gamble we lost this time. Today my back only still kind of hurts, mostly when I bend to the side doing the BIO part of the exams at work.

I really came to love living in Boston, and I could go on and on about all the things to see and do. A year ago I really felt like I could have lived here forever. But as friends moved away, I came to realize that a lot of Boston was in the people. The friends I made at NECO are truly what made living in Boston the great experience it was. As people slowly left for home over the last two months, I began to notice that Boston lost a little of its charm. I came to realize that I had been able to ignore some of the downsides of Boston life (or really of life in any city), like the traffic and crowds, or the lack of forests and really large green spaces, and now couldn't really look aside. And there's the price. For four years, taking out loans and paying (roughly) triple for an equal place outside the city was fine. But since I no longer have a job in the city, and my salary is that of a resident, it was hard to justify the cost when I was having to drive 25 miles outside the city anyway. So I leave with a heavy heart but also a potentially heavier wallet. As we settle into our new place, I'm sure I'll see the ups and downs of Boston metro-west life. I'm still getting adjusted to my new commute and the new traffic patterns to deal with. And to the eerily quiet nights, where I feel like it's strange to not see any people walking around. I do miss Boston, but in a way it's mostly the Boston circa 2010. And since I still have a few friends in left Boston (some of my fellow NECO residents), I'm sure I'll be back on the weekends more often than not.

Next time: the learning curve of the resident optometrist.

 

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