Freedom

Last Friday night I decided it was time to let my hair down; there was a huge concert playing in Johannesburg, aptly named the "Coke Fest" (I'm endlessly amused by double meanings...) and what better way to spend a warm evening than watching Korn and Muse play live in the company of 46,000 goth-influenced, strung-out-on-coke-and-what-have-you high schoolers? But, really, it was a blast. Apparently, plastic cups of warm beer and eardrum-piercing rock was exactly what I needed to smooth over the tensions of the past few weeks and remind myself that, after all, I don't always have to be the "doctor" - sometimes I can let go and just melt into the sea of punk rockers moshing away into the night. I went with Craig, a South African I met through friends; we both searched for Paris Hilton (though, really, with only the vaguest desire to actually find her), but settled for just seeing her boyfriend. Good Chariot is *fantastic*. At some point during the concert, I was momentarily startled by a young man (god, am I old?) with dark brown hair gelled into six foot-long spikes projecting straight up from his head. It could have been NJ.

As the days in 163 (the trauma unit) go by, I find myself settling into routine more and more, approaching the resuscitations with greater ease and peace of mind, taking on more difficult procedures and increasingly being able to work independently. In just three and a half weeks, I have placed seven chest tubes, countless drips and ABGs, set fingers and shoulders back into place (well...usually), and sutured everything from skin to - yes!! - a tendon. Of course, everything I'm doing is just a sampling of things to come, but spending long nights in the trauma unit has reminded me just how much I love this kind of work; despite the difficulties, I know that I am exactly where I've always wanted to be. Over the past three days I've been auditing an ATLS course at the Wits Medical School; it's an advanced trauma life support course for physicians, but medical students and nurses can participate fully (I'll just have to wait till next year to get my actual certification). The class was great, but most importantly, early this morning, something dawned on me. Yesterday was our "procedures lab"; we watched a brief video and then spent three cold hours in the animal lab practicing cricothyroidotomies, DPLs, thoracostomies, and venous cutdowns on euthanized pigs. Sometime in the middle of my second pericardiocentesis (you stick a needle into the membrane around the heart to evacuate blood), a thought suddenly struck me: just nine years ago, I first became an EMT, first became enamoured with the idea of jumping out of an ambulance, lights flashing and horns blaring. Just a short while ago I was a nervous teenager fiddling with suction catheters and oxygen masks, trying to look confident as I repeated the ABC's over and over in my mind. Now here I am, in Africa, practicing surgical airways! And, more importantly, this is just the beginning. I was proud for that moment, standing there, thinking, I set out to accomplish something - not anything extraordinary, but nothing guaranteed, either; and, I'm doing it. For a moment I felt the power of having direction, of having the will to chase dreams... is it really possible that my wildest fantasies could come true? Do I really have what it takes to make it happen? It was a great moment... and then the moment passed and I was left standing with a goofy look on my face, needle still in hand. People talk about doors closing as you get older... for me, I feel long hallways all around me; they're dark and sometimes lonely, but I can follow them anywhere. I can feel it.

Just a few years ago, I remember on one particularly dark evening telling my best friend Josh that I felt as though I was walking on a thin wire, surrounded by so much life but unable to reach out and touch any of it. I felt as though I was suffocating; I hated medical school, hated the mindless minutia drilled into us, hated the endless labs and lectures and obnoxious classmates who had studied biochemistry since they were two. I look back at those days and shudder; there was nothing overly dramatic about my words; I really did feel trapped. I realize now that my frustration wasn't so much with the curriculum, but with myself. I felt that I was following a path I didn't really want to be on, with no foreseeable way out. At that point, everything I had done in my life was more or less prescribed - high school, college, and now medical school. True, I had gone that way because of my own choices; no one forced me to become a doctor. I did however feel that I needed time - time to reassess, to see more of the world, to learn about myself; I felt rushed through life, as though I was running towards some goal in the distance that wouldn't wait for me... if I slowed down and took a breath, would everything fall apart? This year was about taking that time, learning and seeing what I felt I had been missing... would I come to regret my time "out"? Would I return disenchanted, bored, sick? My parents thought this was a terrible decision; my friends, for the most part, either thought it was dangerous or just didn't understand the point. But I went ahead anyway, because I knew I had to; over the years, I had allowed my soul to slip away from me, I had lost my muse and no longer remembered why I was doing anything. I took a stand and left... and now, standing in the trauma bay in one of Africa's busiest hospitals, ready to do the things I have only dreamed of... now I feel alive, now I feel accomplished, now I have remembered who I am and what I want. After all this time and hard work, I have finally regained the serenity I lost a long time ago. My dreams and ambitions don't make my life any easier, but at least I know that I have something to look forward to.

Just for fun, as long as I'm going on and on about dreams, I'm going to import my list of "greatest dreams" from Facebook... I'm posting it below. Dreams, of course, are fluid, and I'm sure that this list will change over time; also, it is by no means all-encompassing or in any particular order. But, it's on my mind, and since the point of this blog is to share whatever randomness my neurons come up with, here it is.

Greatest Dreams/ Ambitions:

- Spend a year driving across Africa, stopping to do medical work and photography and following the trail of Dr. David Livingstone. Maybe write a book along the way? Or at least take lots of pictures.
- Become a photojournalist for the New York Times... alternatively, freelance for Reuters.
- Move to Israel, live on a kibbutz in the Galilee, and work for an activist NGO promoting human rights and providing free medical care to immigrants, refugees, and Bedouins.
- Spend a year living in the Australian outback, working as a flight/ emergency doc in the bush
- Come back to South Africa and work as a flight doctor/ ATLS/ paramedic instructor for Netcare 911, the largest air rescue service out of Johannesburg
- Adopt a dog
- Become fluent in Spanish and Hebrew
- Put together a photography exhibit on the melting of cultures and religions in Jerusalem, my favorite city in the world (hmm... maybe this is something for next year?)
- Learn to drive stick shift... on a Land Rover... in Africa? Well, ok, at least learn to drive stick, damn it.
- Let myself fall in love again, even if it hurts... at some point I have to be willing to open up my heart again, right? Still waiting on that one...

Ok, that's it for now... more updates and, yes, photographs! to come soon. For now, it's raining, and it's Saturday, and that means I should be putting on gloves and a gown upstairs in the trauma ward. I'm ready.