Dear Diary

Doctors are insane people. Starting from medical school, all we do is learn about the thousands of...

Mon, 24 Oct 2011 20:20:00 -0400

Doctors are insane people.

Starting from medical school, all we do is learn about the thousands of ways that the human body can malfunction. Last week it was cancer, and this week, it’s metabolic diseases. How are people still alive? And how do doctors face disease day by day, and watch so many patients lose their fights? It’s death! It’s sad. It’s final.

It knocks the wind out of you because you finally know what it’s like to be deprived of a future with someone you loved. It’s not that you forgot to call. It’s not that you forgot to email. It’s just that they’ll never be on the other side ever again.

It is so damn casual whenever they mention death in our notes at med school! It’s scientific and so so cold when they say “the starving person does not usually die from hypoglycemia but from the damage done by the effort to prevent hypoglycemia.” I feel sick to my stomach.

It’s been half a year since Grandpa passed away, and coincidentally, it’s Dad’s birthday today. Happy birthday Daddy, and I’m thinking of you Grandpa.

Wisdom: THE VELLUVIAL MATRIX

Sun, 19 Jun 2011 14:19:00 -0400

June 16, 2010

Atul Gawande gave the commencement speech at Stanford’s School of Medicine last week. Here is what he told the graduating class.

Many of you have worked for four solid years—or five, or six, or nine—and we are here to declare that, as of today, you officially know enough stuff to be called a graduate of the Stanford School of Medicine. You are Doctors of Medicine, Doctors of Philosophy, Masters of Science. It’s been certified. Each of you is now an expert. Congratulations.

So why—in your heart of hearts—do you not quite feel that way?

The experience of a medical and scientific education is transformational. It is like moving to a new country. At first, you don’t know the language, let alone the customs and concepts. But then, almost imperceptibly, that changes. Half the words you now routinely use you did not know existed when you started: words like arterial-blood gas, nasogastric tube, microarray, logistic regression, NMDA receptor, velluvial matrix.

O.K., I made that last one up. But the velluvial matrix sounds like something you should know about, doesn’t it? And that’s the problem. I will let you in on a little secret. You never stop wondering if there is a velluvial matrix you should know about.

Since I graduated from medical school, my family and friends have had their share of medical issues, just as you and your family will. And, inevitably, they turn to the medical graduate in the house for advice and explanation.

I remember one time when a friend came with a question. “You’re a doctor now,” he said. “So tell me: where exactly is the solar plexus?”

I was stumped. The information was not anywhere in the textbooks.

“I don’t know,” I finally confessed.

“What kind of doctor are you?” he said.

I didn’t feel much better equipped when my wife had two miscarriages, or when our first child was born with part of his aorta missing, or when my daughter had a fall and dislocated her elbow, and I failed to recognize it, or when my wife tore a ligament in her wrist that I’d never heard of—her velluvial matrix, I think it was.

This is a deeper, more fundamental problem than we acknowledge. The truth is that the volume and complexity of the knowledge that we need to master has grown exponentially beyond our capacity as individuals. Worse, the fear is that the knowledge has grown beyond our capacity as a society. When we talk about the uncontrollable explosion in the costs of health care in America, for instance—about the reality that we in medicine are gradually bankrupting the country—we’re not talking about a problem rooted in economics. We’re talking about a problem rooted in scientific complexity.

Half a century ago, medicine was neither costly nor effective. Since then, however, science has combatted our ignorance. It has enumerated and identified, according to the international disease-classification system, more than 13,600 diagnoses—13,600 different ways our bodies can fail. And for each one we’ve discovered beneficial remedies—remedies that can reduce suffering, extend lives, and sometimes stop a disease altogether. But those remedies now include more than six thousand drugs and four thousand medical and surgical procedures. Our job in medicine is to make sure that all of this capability is deployed, town by town, in the right way at the right time, without harm or waste of resources, for every person alive. And we’re struggling. There is no industry in the world with 13,600 different service lines to deliver.

It should be no wonder that you have not mastered the understanding of them all. No one ever will. That’s why we as doctors and scientists have become ever more finely specialized. If I can’t handle 13,600 diagnoses, well, maybe there are fifty that I can handle—or just one that I might focus on in my research. The result, however, is that we find ourselves to be specialists, worried almost exclusively about our particular niche, and not the larger question of whether we as a group are making the whole system of care better for people. I think we were fooled by penicillin. When penicillin was discovered, in 1929, it suggested that treatment of disease could be simple—an injection that could miraculously cure a breathtaking range of infectious diseases. Maybe there’d be an injection for cancer and another one for heart disease. It made us believe that discovery was the only hard part. Execution would be easy.

But this could not be further from the truth. Diagnosis and treatment of most conditions require complex steps and considerations, and often multiple people and technologies. The result is that more than forty per cent of patients with common conditions like coronary artery disease, stroke, or asthma receive incomplete or inappropriate care in our communities. And the country is also struggling mightily with the costs. By the end of the decade, at the present rate of cost growth, the price of a family insurance plan will rise to $27,000. Health care will go from ten per cent to seventeen per cent of labor costs for business, and workers’ wages will have to fall. State budgets will have to double to maintain current health programs. And then there is the frightening federal debt we will face. By 2025, we will owe more money than our economy produces. One side says war spending is the problem, the other says it’s the economic bailout plan. But take both away and you’ve made almost no difference. Our deficit problem—far and away—is the soaring and seemingly unstoppable cost of health care.

We in medicine have watched all this mainly with bafflement, even indifference. This is just what good medicine is like, we’re tempted to say. But we’d be ignoring the evidence. For health care is not practiced the same way across the country. There is remarkable variability in the cost and quality of care. Two communities in the same state with the same levels of poverty and health can differ by more than fifty per cent in their Medicare costs. There is a bell curve for cost and quality, and it is frustrating—but also hopeful. For those getting the best results—the hospitals and doctors measured at the top of the curve for patient outcomes—are not the most expensive. They are sometimes among the least.

Like politics, all medicine is local. Medicine requires the successful function of systems—of people and of technologies. Among our most profound difficulties is making them work together. If I want to give my patients the best care possible, not only must I do a good job, but a whole collection of diverse components must somehow mesh effectively.

Having great components is not enough. We’ve been obsessed in medicine with having the best drugs, the best devices, the best specialists—but we’ve paid little attention to how to make them fit together well. Don Berwick, of the Institute for Healthcare Improvement, has noted how wrongheaded this is. “Anyone who understands systems will know immediately that optimizing parts is not a good route to system excellence,” he says. He gives the example of a famous thought experiment in which an attempt is made to build the world’s greatest car by assembling the world’s greatest car parts. We connect the engine of a Ferrari, the brakes of a Porsche, the suspension of a BMW, the body of a Volvo: “What we get, of course, is nothing close to a great car; we get a pile of very expensive junk.” Nonetheless, in medicine, that’s exactly what we have done.

Earlier this year, I received a letter from a patient named Duane Smith. He was a thirty-four-year-old assistant grocery-store manager when he had a terrible head-on car collision that left him with a broken leg, a broken pelvis, and a broken arm, two collapsed lungs, and uncontrolled internal bleeding. The members of his hospital’s trauma team went swiftly into action. They stabilized his fractured leg and pelvis. They put tubes in both sides of his chest to reëxpand his lungs. They gave him blood and got him to an operating room fast enough to remove the ruptured spleen that was the source of his bleeding. He required intensive care and three weeks of hospital recovery to get through all this. The clinicians did almost every single thing right. Smith told me that to this day he remains deeply grateful to the people who saved him.

But they missed one small step. They forgot to give him the vaccines that every patient who has his spleen removed requires, vaccines against three bacteria that the spleen usually fights off. Maybe the surgeons thought the critical-care doctors were going to give the vaccines, and maybe the critical-care doctors thought the primary-care physician was going to give them, and maybe the primary-care physician thought the surgeons already had. Or maybe they all forgot. Whatever the case, two years later, Duane Smith was on a beach vacation when he picked up an ordinary strep infection. Because he hadn’t had those vaccines, the infection spread rapidly throughout his body. He survived—but it cost him all his fingers and all his toes. It was, as he summed it up in his note, the worst vacation ever.

When Duane Smith’s car crashed, he was cared for by good, hardworking people. They had every technology available, but they did not have an actual system of care. And the most damning thing is that no one learned a thing from Duane Smith. For we have since had the exact same story occur in Boston, with an even worse outcome. Indeed, I would bet you that, across this country, we miss the basic, unglamorous step of vaccination in probably half of emergency splenectomy patients.

Why does anyone receive suboptimal care? After all, society could not have given us people with more talent, more dedication, and more training than the people in medical science have—than you have. I think the answer is that we have not grappled with the fact that the complexity of science has changed medicine fundamentally. This can no longer be a profession of craftsmen individually brewing plans for whatever patient comes through the door. We have to be more like engineers building a mechanism whose parts actually fit together, whose workings are ever more finely tuned and tweaked for ever better performance in providing aid and comfort to human beings.

You come into medicine and science at a time of radical transition. You have met the older doctors and scientists who tell the pollsters that they wouldn’t choose their profession if they were given the choice all over again. But you are the generation that was wise enough to ignore them: for what you are hearing is the pain of people experiencing an utter transformation of their world. Doctors and scientists are now being asked to accept a new understanding of what great medicine requires. It is not just the focus of an individual artisan-specialist, however skilled and caring. And it is not just the discovery of a new drug or operation, however effective it may seem in an isolated trial. Great medicine requires the innovation of entire packages of care—with medicines and technologies and clinicians designed to fit together seamlessly, monitored carefully, adjusted perpetually, and shown to produce ever better service and results for people at the lowest possible cost for society.

When you are sick, this is what you want from medicine. When you are a taxpayer, this is what you want from medicine. And when you are a doctor or a medical scientist this is the work you want to do. It is work with a different set of values from the ones that medicine traditionally has had: values of teamwork instead of individual autonomy, ambition for the right process rather than the right technology, and, perhaps above all, humility—for we need the humility to recognize that, under conditions of complexity, no technology will be infallible. No individual will be, either. There is always a velluvial matrix to know about.

You are joining a special profession. Doctors and scientists, we are all in the survival business, but we are also in the mortality business. Our successes will always be restricted by the limits of knowledge and human capability, by the inevitability of suffering and death. Meaning comes from each of us finding ways to help people and communities make the most of what is known and cope with what is not.

This will take science. It will take art. It will take innovation. It will take ambition. And it will take humility. But the fantastic thing is: This is what you get to do.

Guilt

Wed, 18 May 2011 01:50:00 -0400

Nathan wrote:

“your email hits on a central theme of human experience: as much as we live as biological creatures in a physical world, we also live as authors creating meaningful narratives out of the events of our lives. From the first perspective, death is a rather simple phenomenon, and there is nothing mysterious about it. But from the second perspective, an understanding of death is much more elusive - it creates a rift in our narratives, and the living we’re left with the rather intractable project of patching the rift back together, of making some semblance of sense out of it. We’re confronted, face-to-face, with the rather uncomfortable fact that the universe does not care about how our narratives are unfolding.”

I’m glad he pointed out the distinction and discrepancy between our physical world and our metaphysical perceptions.

To first speak about the physical…my grandfather’s things are still everywhere. It’s hard to imagine that only a month before, these were items he touched, used, and felt. Now, they sit on shelves, unmoved, yet they somehow speak about the common interests of an uncommon man. Probably because the physical environment remains unchanged, Grandma and I share the feeling that he’s still around. I think this deepens her grief because she’s obligated replay his death over and over in her head to correct the perception that he’s alive. Each moment is laden with her sadness, regrets and guilt; this is her way of showing devotion and loyalty to 50-years of marriage and love. She’s taking it day-by-day, and I’m happy to see little improvements in her spirits.

With my optimism, I think I’ve rebounded to my previous happiness set-point. This, however, has evoked a great deal of guilt. I think I express too much outward happiness. I know that it’s not representative of the fact that I’m forgetting my grandfather, but in a way, I am forgetting about his death. I think only about his life, his work, his story, and the profound positive influence he’s had on my life. Sometimes, I worry that my happiness may upset Grandma. This manifested in a nightmare two days ago, where in my dream, Grandma accused me of not missing Grandpa. She took this as a sign that I never loved him very much. I woke up to a stinging pain in my heart.

(Updated) Medical School Admissions

Wed, 18 May 2011 01:36:57 -0400

Applied: UofT, Western, Ottawa, McMaster, UBC, Queen’s

Interviewed: Ottawa, McMaster, UBC, Queen’s

Offers: Ottawa, McMaster, UBC

Waitlist: Queen’s

Decision: UBC

Medical School Admissions

Fri, 13 May 2011 13:56:00 -0400

Applied: UofT, Western, Ottawa, McMaster, UBC, Queen’s

Interviewed: Ottawa, McMaster, UBC, Queen’s

Offers: Ottawa and McMaster

Waitlist: UBC and Queen’s

Choice: ?

Feeling: calm. No excitement nor disappointment to speak of.

"滴水之恩涌泉相报"

Fri, 13 May 2011 11:37:44 -0400

“滴水之恩涌泉相报”

- 奶奶

Treasure

Fri, 13 May 2011 10:33:00 -0400

During my latest treasure hunt, I stumbled upon a massive 600 pg hard-cover titled “Medicine：an Illustrated History” with the following inscription:

For Doctor Hu and his family with thanks for all their efforts which have made my trip to Wuhan so pleasant. Thanks for your work and I hope you will enjoy many years of success in your practice of Neurology.

- Earl R. Feringa, Prof. Neurology. The Medical College of Georgia. May 26, 1988

My motivation for entering medicine has never been ambition or glory. For me, it’s an emotional journey, made of memories, sentiment and love. It’s about being able to appreciate a dusty and forgotten book from the 80’s and treating it as one should - a gem. Years of education finally let me do what I couldn’t do as a kid: walk down the hallway and stare in awe at all the meticulously labelled books neatly stacked on the shelves. There sits the progress of medicine, the early naive visions of pure communism, and ancient Chinese poetry that rose from the depth of souls. What riches!

I hope my explorations will bring me continuity. It’s about learning history and weaving it into my own story.

中国

Fri, 13 May 2011 08:24:00 -0400

I arrived in China on May 3rd.

My flight itself was wonderful. I had the company of two wonderful books: “I am a strange loop” by Douglas Hofstadter, an philosophical and mathematical inquiry into one’s “I” and “Interpreter of Maladies” by Jhumpa Lahiri, a Pulitzer winner. I engulfed the latter with a thirst for fiction that I’ve almost forgotten. Quickly, I fell in love with the small anecdotes detailing the emotional journey of Indian immigrants. They, in a small way, anticipated and has since, echoed the experiences of my journey.

Since I’ve landed, I’ve had mixed feelings. I’m grappling to come to terms with my grandfather’s death while caring for my three remaining (and ailing) grandparents. Being in China itself is a shock. In my mind, the vision of China that I adopted through the lenses of my childhood still dominate, but more and more, it competes with the view of China I learned from the Western world and is sometimes marred by the disappointing China I see now.

There are a few things that I know for certain. For one, although my roots may be in China, I don’t think I’ll ever want to live here again. Here, I can list a million differences between the people and the environment here that provoked my previous statement; these are all things that I may adapt to, but find difficult to enjoy. How can you release a bird, let it conquer the skies, then ask that it happily stay in a cage for the remainder of its life? I can think of no better illustration for the government suppression of freedom. Fortunately, the invisible iron hand of China is only felt by those who’ve left and breathed the intoxicating air of freedom. Then again, one can’t make such a harsh criticism without extending due appreciation for the difficulty of governing such a vast and populated country with thousands of years of history. When I complain of oppression, I speak as a Westerner, because to the Chinese, these whimsical notions are impractical, selfish and dismissively foolish.

Other discomforts stem of parts of Chinese culture that aren’t as deeply entrenched. For example, no one ever lines up for anything. People swarm towards buses when they arrive. Along the same vein, cars don’t drive in their lanes, they swerve and get within inches of one another. Somehow amidst this chaos, people still thrive.

Other differences between the cultures are much more neutral; I look upon these with some elements of fascination. Take the topic of funerals for example, in China, the philosophy is that “the dead only rest when they’re put into the ground.” Therefore, funeral proceedings happen as quickly as possible. After my grandfather’s death, he was cremated within two days. Simultaneously, a worshiping station was erected in our livingroom; friends and family came burned incenses and bowed to an old black and white photograph, a symbolic representation of an once great man. Every seven days, we go to the place where his ashes are kept to replenish the wilted yellow flowers and burn paper money so he can live a wealthy afterlife. He sits in a drawer amongst a wall of thousands of drawers. My god, I never considered the volume of the dead. I find the funerary rituals comforting yet confounding. It baffles me that we all gather to talk to a carved wooden box that holds what used to a person and asks that he watches over us, yet few, if not none, of the Chinese people I’ve interacted with actually believe in an afterlife. At times like these, I feel inadequate, but I’m not sure if it’s because I’m new to the whole death thing or if it’s also this country and its culture.

However, I don’t reflect negatively upon all things Chinese. There are things that beg my annual journey back to the land where I was first born and raised. I was recently admitted to UofOttawa and McMaster for medicine (horray), and during this application process, I came to realize that my grandparents are the most profound influence in my development as an intellectual and moral being. As long as my Grandma still lives, I’ll try to come back to China every summer. After? Well, I’d rather spend my summers roaming Europe and Africa, where my soul can be free and my heart can fill with art. Additionally, the rich history and the wonderful ancient philosophies of China also appeal to me. It occurred to me that I’ve actually internalized quite a great deal of Confucius thinking over the years without any conscious recognition of doing so. It’s only when my grandma reads ancient prose with me that I see where many of my thoughts and practices originate. I love her voice almost as much as the elegant Chinese prose:

“子曰：君子喻于义，小人喻于利。见贤思齐焉，见不贤而内自省也。”

B. Spears

Thu, 28 Apr 2011 00:27:59 -0400

B. Spears

"近墨者黑近朱者赤"

Wed, 27 Apr 2011 19:11:19 -0400

“近墨者黑近朱者赤”

假如我又回到了童年

Wed, 27 Apr 2011 19:04:54 -0400

假如我又回到了童年，我做事要有毅力，决不因为事情很麻烦或者艰难而撒手不干，我们如要光明，就得征服黑暗。毅力在效果上有时能同天才相比，俗话说，能登上金字塔的生物只有两种———鹰和蜗牛。

假如我又回到童年，就要养成专心致志的习惯，有事在手，决不让任何东西或事物使我分心如果及早养成这种专心致志习惯，它将成为我生命的一部分。

假如我现在可以重新开始我的生命，我就更要注意记忆力的培养，我要采取一切办法，并在一切场合增强记忆力，要正确无误地记住一些东西，在开始阶段要作出一番小小的努力，要不了多久，记忆力本身就会起作用，使记忆成为轻而易的事，我相信，只要及早培养记忆自然成为一种才能。

假如我又回到童年，我要培养自己的勇气，曾有作家说：世界上没有东西比勇气更温文尔雅，也没有东西比懦弱更残酷无情！

Memory

Wed, 27 Apr 2011 13:06:00 -0400

I’d love to be able to work out my neurosis on a daily basis. God knows that I have many of them.

Today, I’m particularly preoccupied with the notion that my memory is so selective. When I reflect on a person, I recycle the same five to ten images in my head over and over. It is comparable to watching a film, where all my memories of a given subject subsume to the standard hour and a half reel.

However, I’ve been alive for 22 years. Where are the rest of the memories?!

Maybe writing things down is the first step to remembering. Next? I should probably get myself a big expense camera that never leaves my sight. I’ll religiously document every beautiful experience with a photo and complement that with words.

Yeah, take that Alzheimer! I’ll be the only centenarian with an impeccable memory.

"In the middle of difficulty lies opportunity"

Wed, 27 Apr 2011 13:02:55 -0400

“In the middle of difficulty lies opportunity”

- Einstein

One day, I want to find love like...

Wed, 27 Apr 2011 01:55:18 -0400

One day, I want to find love like this…

颖子：祝愿你生日快乐！看你给我什么礼物。

zentrifuge: Toni Codgell - Pathways

Tue, 26 Apr 2011 23:06:50 -0400

zentrifuge:

Toni Codgell - Pathways

Fuck this shit. I’m quitting this moping, sleeping all day, crying, and having roommates offer...

Tue, 26 Apr 2011 22:52:00 -0400

Fuck this shit.

I’m quitting this moping, sleeping all day, crying, and having roommates offer to make me dinner pity-party.

Productivity, happiness, healthy eating and LIFE - welcome back.

Blue Valentine

Tue, 26 Apr 2011 06:03:14 -0400

Blue Valentine

You won't hear me cry

Tue, 26 Apr 2011 04:25:00 -0400

I’m not sure I understand what death means. Physically, it marks the end of a life. The metaphysical… well, that’s more controversial. Some people say heaven, angels and happiness. Well, I think I’m a pessimist. We, pessimists, believe that death signifies a void, one unlike anything we’ve ever experienced. It’s persisting nothingness with no light at the end of the tunnel, kinda like before we were born. Try recalling pre-birth. I can’t. No one can. I can only say with certainty that it’s a place without fear, without warmth, without any experiential component at all. That’s where I imagine Grandpa is now.

I still talk to Grandpa when I wake up and before I go to sleep at night. I tell him I’m doing alright. I tell him he shouldn’t worry about me, because I’ll take care of myself. I tell him he shouldn’t worry about Grandma, because I’ll be with her in a week. I talk to him even though he’ll never hear anything ever again. My reassurances go to waste, because wherever he is, he’ll never worry again.

When Grandpa was taking his last breaths on a hospital bed, I was jogging in the morning after a night of sleeplessness, with whiskey on my breath and little mountains of tear-stained Kleenex on my desk. It was ten o’clock on April 24th. I ran until I couldn’t catch my breath anymore. I thought to myself, now I can share the shallow, quickened breathes with Grandpa. When I got home, my stomach felt empty but my soul felt tired. I shakily poured soy milk into my oatmeal and started the microwave. I didn’t realize how little energy I had left.

I propped my legs up on the window ledge and sat watching cars pass by. How serene, I thought. As I dragged my spent body towards bed, I reclaimed my heart from the other side of the world and chose resignation. I crawled under the covers and closed my eyes. And this was the hour Grandpa left the world.

I imagine he died in peace. I imagine that even if the death itself was violent, he was aware that he was surrounded by people who love him. I hope he knew that I would have traded my entire future to be there for that single moment, but I’m comforted by the certain knowledge that he didn’t die alone. Whoever said that we all die alone lied. We all depart with love in our hearts and a mind full of our favourite memories.

I talked to my Grandma today. She talked in a brave yet shaky voice. She said she’s not ready to face Grandpa’s death. She wishes he died over the course of a year, long enough so that she had time to prepare herself. Maybe Grandpa suffered less this way, I offered. She also feels guilt-ridden that they didn’t seek treatment sooner. And I said it wasn’t her fault. Lastly, she told me that tremendous comfort comes from knowing that people had great respect for Grandpa and his life’s work. They say, he had the rarest blend of qualities. He had a clear mind coupled with exceptional integrity. Most of all, he was a good doctor, who cared about each of his patient.

“I hope you will be a good doctor just like your Grandpa someday,” she said.

“I will,” I promised.

Uncle’s romantic sentiments touched me even more than Grandma’s pragmatic comments. When he told me that Grandpa had left this world, and that I missed my last chance to see him alive, he said that I’ll only see him in my dreams now. I never thought that my uncle, who is an six-foot tall engineer, would believe in seeing the ghosts of loved ones. Neither did I think he would romanticize death and cry so much that his voice turned hoarse. He told me that when I go home (to China) in a week, I’ll be surrounded by Grandpa’s things. As he sat there in the livingroom, he told me it feels like Grandpa never left. And I believe him. We all sit in the shadow of his accomplishments. It’s hard to think that he’s gone. Maybe Grandpa’s just out on an errand. He’ll be back soon.

Tonight, I feel peaceful and numb. For the past week, I have felt such unbearable pain. During the dark nights, I hyperventilated and wheezed into my blanket so violently that I couldn’t breathe. There were nights when my loud crying woke up my roommates. These weren’t particularly dark or lonely times, but they were profoundly sad moments when I couldn’t handle how much sadness I felt. Nothing was within my control. No matter how much I willed and bargained with a god I didn’t even believe in, time ticked on, and with each passing minute, Grandpa was nearer the end of his journey.

When I finally got the call from Mom and learned that Grandpa had passed away, that sense of helplessness subsided. There was no longer anything I could do for Grandpa. All I could do is cope with my own grieve and take good care of the living he left behind. And I knew how to deal with living, maybe even the dead. It’s hardest to face the dying.

Now, I’m just afraid of forgetting. I’m compiling a list of our favourite memories Grandpa, and I’m also sketching you, even though you joke that my art’s not very good. I want to remember every wrinkle on your face, so that one day, I can sit with my Granddaughter and tell her about my Grandpa. I can tell her that even when my Grandpa was seventy, he was still moved to tears when he recalled his childhood. That’s how powerful memories are! That’s how important family is!

Playing on single loop: Penny and the Quarters - You and Me

All we ever want is more time...

Sun, 24 Apr 2011 07:19:00 -0400

I’m not ready for this to happen.

I wanted to talk to grandpa about the tea pot where he kept my baby teeth.

I wanted to ask him about our family history.

I wanted to know the secrets to being a great neurologist.

I wanted to know how to cook delicious Chinese meals.

I wanted to know what the communist revolution was like.

I wanted to learn how to speak in Chinese idioms and proverbs.

I wanted him to be a great-grandfather.

I wanted him to know how much appreciate him raising me.

I wanted him to know that I chose medicine as a profession because of him.

I wanted him to see me get married.

I wanted him to hug me and tell me that he’s proud of me.

I wanted him to know that I still have fantastic Chinese writing thanks to him.

I wanted him to know that he was the first and only person to instill in me the profound love for life-long learning.

I wanted to show him my medical school applications and see his name littered throughout.

I wanted him to know that I know he loved me.

But I wanted him to know that I loved him even more, when all he could say on the phone was…. “I can’t breathe very well.”

I’m so sorry Grandpa. I am so so sorry.

Yingzi, Look, the flowers are blossoming. Wish you were here to...

Sun, 24 Apr 2011 07:07:36 -0400

Yingzi,

Look, the flowers are blossoming. Wish you were here to see them. -Grandpa (July 9th, 2010)

Dear Diary

Doctors are insane people. Starting from medical school, all we do is learn about the thousands of...

Wisdom: THE VELLUVIAL MATRIX

Guilt

(Updated) Medical School Admissions

Medical School Admissions

"滴水之恩 涌泉相报"

Treasure

中国

B. Spears

"近墨者黑 近朱者赤"

假如我又回到了童年

Memory

"In the middle of difficulty lies opportunity"

One day, I want to find love like...

zentrifuge: Toni Codgell - Pathways

Fuck this shit. I’m quitting this moping, sleeping all day, crying, and having roommates offer...

Blue Valentine

You won't hear me cry

All we ever want is more time...

Yingzi, Look, the flowers are blossoming. Wish you were here to...

"滴水之恩涌泉相报"

"近墨者黑近朱者赤"