Tuesday, January 31, 2017

What Internship Looks Like XXVI: Step 3

This is what being done with Step 3 looks like. Step 3 is the last of four board exams all would-be doctors must take before they can be licensed to practice medicine independently. Step 1 tests basic science knowledge. Step 2 addresses pathology and diagnosis. Step 3 is more of the same, with a particular emphasis on management. (There's another Step 2 with fake patients.) At the end of the series, which typically takes 3-4 years to complete, it is assumed you have a basic understanding of a large swath of medicine and can make a variety of simple diagnostic and therapeutic decisions. The first three parts are very stressful, as a student's scores may determine what residency s/he can apply or match into. The last part use to be known as the easy one; there was a saying, "Two months for Step 1, two weeks for Step 2, two (Nr. 2) pencils for Step 3." That tells you how old the common wisdom is, as the exams are now all computerized. And the format of Step 3 has changed to include simulated cases, where you basically type orders into a box and advance a timer. Step 3 now takes 16 hours over two days in a standardized testing center with strict protocols. The premises are video monitored, and every time you go into the computer lab, you have to turn out your pockets, sign in with a fingerprint reader, and take your glasses off to be inspected for video recording devices (!). Hence the exercise pants, sweatshirt, and bedraggled look you see at left. 

Half smile for finishing Step 3, full smile when I pass. Next standardized medical exam in T minus 3.5 years...


Wednesday, January 25, 2017

What Dreams May Come

One recent Sunday afternoon Dear Husband and I drove down to Oakland to watch Woody's Order, Ann Talman's autobiographical one-woman show about herself and her older brother, Woody. The title--which I hate--is imprecise; you have to know the joke already to get it, and at first I didn't know that I would be interested in this play about growing up in the 1950s and 60s with a sibling with cerebral palsy. Once I found out what it was about, of course I bought us tickets! Maybe I would have been more excited if I had known who Ann Talman is. Anyway, she uses her considerable acting talent to portray a cast of characters that ranges from herself at various ages to her drawling West-Virginian parents to an abashed neighbor to Woody's roommate. She plays Woody himself, who is minimally verbal, with facial expressions and grunts or whines that taken out of context could be seen as derogatory but here are clearly a loving and accurate representation. According to Talman family lore, Woody wanted a younger sibling, so he conjured one up by pointing suggestively to his parents' respective reproductive parts. Their mother wrote "Woody's order" on the bottom of a Polaroid of Ann after her birth.

Ann became her brother's keeper. As a child she adored him, and for the most part she accepted this role with enthusiasm, until her acting career and marriage drew her to the coasts, but Woody lived here in the Pittsburgh area. When their father's health declined precipitously, she was suddenly caretaking for both of them as well as jetting to LA or NYC. The climax of the piece comes during this vignette, when Woody refuses to eat the favorite dish she has prepared for him, and she tears around the house ranting about how much she dislikes the stress of always caring, planning, doing for him. She then realizes she had forgotten to take his mouth guard out so that he could eat. There are so many rich details in this dual biography of herself and her brother. One that stands out to me is when Talman reveals that the strain of her responsibility as Woody's keeper initially manifested itself in recurrent dreams, in which she is faced with the choice of saving herself or drowning with Woody. She comes back to this thread a few times in the play. Finally, one night, Ann releases Woody in the water...and to her surprise, they both float.

~ * ~ * ~ * ~ * ~ * ~

In my dream, I am canoeing around an island in an unfamiliar lake. My father's parents are with me as I stroke furiously for the shore. I am dissatisfied about something, but I cannot remember what, as the canoe ploughs up onto the dry land.

In another dream I am running--jogging, I think, although that is not something I do--down a city street. The sidewalk is raised above the level of the road, with a metal railing. Only the public path seems to run right through the first floors of the townhouses on the street, as if the private living space begins upstairs. I might be running up and down some of these stairs, front stairs, back stairs. I don't know if I am chasing or being chased, good-naturedly or not.

Photo by Fairy Godmother
In the last act, I visit The 1840 House, a now-closed museum in Baltimore, MD. It is closed in my dream, too, turned into a historical research archive, I think. The first floor is open to the public, and there are cases set into the walls holding objects from the collection. We (who am I with?) look at them as we walk down the corridor, which empties into...a shopping mall. The first store, which sells expensive evening gowns, is set up like an open department store. I make my way up to the second floor, then ride the escalator back down. On my left I see a rack of gorgeous peacock gowns. I reach over and pluck one from the rack. But the feathers in the train get caught in the gears of the escalator, and by the time I reach the bottom, the machine has eaten this whole beautiful dress. Just before I find out from the saleslady waiting for me below how much I owe for something I coveted but can never wear--I wake up.

 ~ * ~ * ~ * ~ * ~ * ~

The protagonist in Pilobolus' "Shadow Land" has a dream, too. She has rebelled against her parents, fallen asleep in a huff, and is carried off to a strange land, where a magician turns her into a dog-girl. She then hitchhikes through the country, is kidnapped by a circus, swims in the ocean, is almost cooked in soup, and finally finds herself in Pittsburgh (a very clever epilogue designed to please the local audience). The performance Dear Husband and I saw at the downtown Byham Theater was sold out. We art patrons had packed the place to watch a troupe of very fit dancers use their bodies and a few props to create marvelous scenes both in front of and behind a shadow screen.

Afterward we stayed to listen to a Q&A with the performers, in which I learned that the troupe formed in 1971 from a group at Dartmouth; that the dancers learn the choreography from each other as one generation eventually moves on and another comes up; that they have a whole set of dancers who are affiliated with them for projects that need more bodies; and that there is another group touring Germany right now doing Shadow Land II, which is similarly structured with vignettes but has a different premise (they didn't say what). Basically Pilobolus members work collaboratively with improv until they have enough material for a piece. "Shadow Land" is their first evening-length piece among the ~125 in the repertoire; the group typically comes up with 2-3 new pieces a year. Also, after previews they changed the staging of "Shadow Land," because early audiences thought some of the material had been pre-filmed and was being projected onto the screen rather than being created live. So, they removed the borders around the stage so the audience can see the wings and props and know that these people are using a few pieces of equipment and their bodies to make everything that we see. Sometimes I wish someone would peel back the curtain on my dreams, but other times I just revel in them as they are.

Friday, January 20, 2017

Andy Warhol's Imperfect Body

Dear Husband and I recently took advantage of Free Friday Nights at the Andy Warhol Museum. It was an eye-opening experience for me, as I honestly knew nothing about him except Campbell's soup cans and Marilyn Monroe in psychedelic colors. I learned that Andy Warhol grew up in Pittsburgh, was gay, that he had had a nose job, and that he had been shot. I was particularly keen to see the My Perfect Body exhibit, which assembled a variety of Warhol's pieces this central object in art and subject in human experience. He loved the sensuality of the young, male body; was briefly fascinated by dead bodies; and had a fraught relationship with his own, aging body, which endured surgery both aesthetic and life-saving, and which he festooned with a variety of hair pieces. In two hours we barely made a dent in the large galleries of the museum, so here are just a few of my favorites among the artwork we were able to take in that evening.

Paint by Numbers
This painting reminds me of Maryland. If you look at nautical maps of the Chesapeake Bay, they have a similar pattern of lines and numbers indicating the water depth. Interestingly enough, this was the one piece of art in the entire museum that DH had photographed when he visited with my parents and aunt last summer while I was working and they were touristing in the city.

Hand and Foot
This collage combines one of my favorite mediums (collage) with one of my favorite subjects (anatomy/the human body). It reminds me of those phrenology heads that were so popular in the 19th century.

Enlarged off the internet for your viewing ability:

Finally, a Campbell's soup can. No, not one of the bright ones in red and white. I really like the texture of the tin can underneath the torn paper wrapping in this one.

Editor's note: If you enjoyed this vicarious museum visit, you might also like to see modern art in New York City; contemporary local art in Kerrville, TX; or glass art and miniatures in Chicago.

Tuesday, January 10, 2017

What Internship Looks Like XXV: Caring for Infants

Sometimes two parts of my life coalesce in surprising and pleasing ways. While I was on my Newborn Nursery rotation learning how to care for new babies and their mothers, I stopped by the library at the medical school to pick up a book and discovered a case housing books and materials from the history of medicine about the care of infants!


Thursday, January 5, 2017

That's So Pittsburgh: Carnegie Museum of Art

Dear Husband and I received a year's membership to the Carnegie museums for Christmas from family members this year so we decided to check out the Carnegie Museum of Art. We chose to see the exhibit on the life's work of Brazilian artist Helio Oiticica (1937-1980). Neither of us had heard of him, but we were interested in tracking his work in South and North America through the middle of the twentieth century. The early period in which he played with shape, space, and colors appealed to me the most. Later he got into more interactive, experiential, and performance art. For instance, he made a whole series of capes that were meant to be worn and experienced in person and in motion. While in New York City in the 1970s, he went through a drug phase that included a four-dimensional installation that involved lying in a hammock, listening to a Jimi Hendrix album, and watching images of his face with its features outlined in various configurations of powdered cocaine. Toward the end of his career, Oiticica fused his early interest in space with a more architectural bent. Although he was gay and I suspected he had been an early victim of AIDS, in fact he died young of a hypertensive stroke.

Here's another view of my favorite piece with better light:

This is a still from the Hendrix room:

Editor's note: If you are interested in museums in Pittsburgh, check out my review of the Andy Warhol Museum.