"The Deadliest Sin" To-Do List 9/30/11

I'm keeping a list of questions that are coming up as I write, so that I can go and research them later. Obviously, some of the more telling details I might leave off.

To Research

• How states/counties deal with heat waves
• Who would ensure a city lake is safe to skate on in the winter?
• Best way to skip rocks.
• Raccoons --> do they live in Virginia? How do rabid raccoons act?
• Oval communities -- characteristics
• Dental assistant role
• Dentist office staff
• Dentist registry
• Dental operating room..?
• Massage techniques
• Process of pressing charges for third-degree murder

I need to sit down and create a timeline. I have the first few/several chapters outlined, but since I'm following multiple families in Pens with different conflicts, I need to know exactly when everything happens relative to everything else. It should be helpful to get on a whiteboard and just list out the days following the 'big event' at the beginning of the story, and then match them with subsequent events.

I need a new name. 'The Deadliest Sin' isn't going to turn any heads.

I need to finish outlining the first half of the book. The first half of the book is going to have a slightly (read: significantly) different structure than the first, so it's important to get that first half down.

Gordon Ferrell - Lunatic of Pens

Gordon was born on June 6, 1955 in Pens, Virginia.  His father, Edward Ferrell, had fought in World War II. Ed never talked about his experience, but Gordon's mother said he was a changed man when he got back. There was a fire burning in him that spared the need to sew his seed, and Gordon was the third of eight children over 10 years. For most of his life Gordon remembered his father as a drunk, and sometimes a mean-tempered drunk. Gordon managed to slip under his father's radar, unnoticed and untouched by his rage. Gordon learned how to be conniving when he needed to, and soon became used to throwing one of his siblings under the bus to save himself.

Gordon grew up in the church under the spiritual guidance of his mother. The memories he did have of his father were short, as he spent most of the time at the church. He joined the choir when he was eleven, although he couldn't sing. When that didn't work out, he floated around different positions in the church, until he became the treasurer when he turned eighteen.

It wasn't until Gordon was thirty that he began to embezzle money from the church. His mother had just died of cancer (his father had died by the bottle years before, but that hardly had an affect on Gordon) and Gordon began to see religion in a different light. It hadn't done much to help him, so he'd have to fix that.

But Gordon wasn't the only liar at Holy Pens. As a long-time church member, he noticed things others didn't. And he became quite sure that Pastor Leroy Cummings was taking more from the congregation than offerings. He 'accidentally' walked in on the pastor taking one of these offerings from Patricia Hawthorne in his office one Thursday evening after Bible Study developed a drug addiction from his newfound money. Pastor Cummings knew about Gordon's habits and threatened that he would have him arrested for embezzlement if he spoke any word of what he saw. The church was all he knew, and Gordon wasn't ready to give that up, so he obliged. Still, the Pastor was paranoid and eventually forced Gordon to leave. Gordon later heard whispers of his crimes amongst the congregation and he became ashamed, and furious. There was nothing he could do. Pastor Cummings had gotten in the first word, and anything he told now would merely look like the ramblings of a desperate sinner.

Gordon turned to drugs, though he continued to read the Bible everyday. Sometimes he would get them confused, the feeling of the Spirit when he prayed and the high when he injected.

When the infamous heatwave hit Pens, Gordon had been addicted for five years. His mind had become fried, and he obsessed over getting back at Pastor Cummings. He ended up hiring a HIV-positive prostitute to seduce the pastor. The pastor died during sex and became one of the many victims the day of the heatwave. Gordon didn't care either way. People now new the truth of Leroy Cummings. His sins had been paid for.

Gordon went through a change that day of the heatwave. He saw 'the light,' as they say, and it was good. He stopped drug abuse and studied the Bible even harder. Because now the Lord was speaking to him in a whole new way. The Lord had a purpose for Gordon. He had never felt that before. The Lord needed someone to bring the sinners of Pens to justice. Gordon's seen these sinners in his dreams, and has been making a list. And he would do anything for the Lord...

Gordon Ferrell may just turn out to be the most interesting character in this book. Is he doing good, or conducting evil? Is he a soldier for the Lord, or is he merely the Devil's pawn? As Pens goes to hell, how will his role be refined, intensified?

And, most importantly, who's on his list of sinners, and how will be prepare them for judgment?

'The Deadliest Sin' - My Novel in Progress

I'm writing a book tentatively entitled The Deadliest Sin. I don't want to give too much away, but it's about a small Virginia town which is slowly going to hell...literally. There will be (and are already many) characters in this tale, but the main one is Michael Barboza, a thirteen year old latino boy. He ultimate task is to discover what's happening to the town of Pens and save the people in it before.....that's right, before it's too late! Got to love the cliche.

There are a lot of journeys I'm currently conquering right now in my life. I'll be a married man in less than three months, I'll be in medical school (hopefully) in less than two years, and I'm still trying to find my own personal relationship with God.  This book represents that last journey a lot, but also allows me to continue with my passion for writing horror. I don't envision for this to be a book that any pastor would put on the Christian reading list, but at the end I want it to reflect some of my own thoughts about existence and God.

What I really like about this project is the prospect of building a whole town. It's a little intimidating and, honestly, might be outside of my current skill level. Hopefully that proves not to be the case, and even if it is, the only thing I've lost is time and bad writing habits. It's loosely based off of my family's hometown, Martinsville, Virginia. A little southern blip on the map which has been going through a lot of changes over the decades economically and culturally. What's the history of the town? Is it divided by socioeconomic status? Race? If so, in what ways? Is the biggest employer Walmart? Is most of the population Republican? Democrat? Christian? How would the city handle a natural disaster? Does everyone know everyone else or do you meet someone new everyday.

These are the questions I have to answer. The first part of the book is spent getting to know all of the different players, both big and small, as the town goes through its 'changes.' I like to think of these almost as a series of short stories that interconnect. Later in the book the focus will be on Michael and his specific journey. 

The plan is to keep blog posts as I go through the writing process, talk about the progress I've made, the obstacles I come across. I have to research a little bit the best way to do this. I.E., what's TOO much information to post on the Internet? I'm thinking of doing character profiles and tell about some of the residents of Pens, one by one, but should I keep that to myself?

I'll look around and see. But, for now, back to writing....

No time to write....or do much of anything

I have two tests coming up this week, one in Cell Bio and the other in Organic Chemistry. Surprisingly, I'm more worried about the Cell Bio test, but I'm studying more for OChem because...well, because' it's freaking OChem.

The sucky thing is (well, besides having a test one day and then a test the next...) is that I haven't had much time to write this past week. I've gotten literally sick sleep-depriving myself and still couldn't find the time to do the thing I love the most. And, of course, the last few days any free time I might have maybe could have possibly obtained was spent getting rest because....well, because I'm freaking sick!!

Excuses, I know, but hopefully things will get better this upcoming week. Although I do have a problem set due Wednesday in Physics (the day after my second exam). It shouldn't be a problem, as Physics is one of those subjects that comes easily, but it simply means I will either be up late Tuesday night or rushing to get it done.

When I decided to start taking classes again I was afraid I would hit this road: choosing between studying and writing. My classmates study a lot more than I do...I can hear them talking about it all the time. Even though I've been sleep-deprived this past week, I've spent some of my time doing things like reading novels (because a writer has to read!), going to my writing group, and trying to get my Twitter game going. Oh, and I've found this awesome podcast, Writing Excuses, and you should definitely check it out.

Don't get me wrong, I've been fairly on top of my assignments. Homework turned in on time, online quizzes mastered, pre-labs done, and I've been to every single class. Even an office hour or two! But I can't help but feel I am less prepared for Monday and Tuesday than everyone else, and I hope I can make this happen. To be honest, the biggest thing that bothers me is that writing has no logical weight in my priorities now. As in, if I chose to spend 2 hours right now writing instead of studying, that doesn't make any sense (assuming I need those 2 hours).

Still, that's what I'm about to do. And hopefully my plan to pull a pseudo allnighter doesn't backfire. I seem to be getting over my sickness. I once heard that once you get over a cold, you won't get one for at least another 6 weeks because of the body's immune system. It's probably a crock of shit, but sometimes shit is all us writers can depend on.

'Creative Writing Can't Be Taught'....

Interesting commentary by Stephen King. Can Creative Writing be taught? He's mostly focusing here on that the reason writers pursue a career in teaching is to make ends meet while they are trying to become successful as writers, but there is something else implied: taking creative writing classes is a waste of time. The only way to become good/better at writing is to read a lot and write a lot.

Hmm....let me cogitate on it for a while.

When the Air Hits Your Brain - My Thoughts

When I was walking back to my car after one of my shifts this past summer at UC Davis Medical Center, I had brief small-talk with a surgery resident. He asked me what services I had been on and what I was interested in the most. When I mentioned neurosurgery, he suggested I look When the Air Hits Your Brain by Frank Vertosick, Jr., M.D. He was a surgeon, and I a lowly pre-med student, so of course I wrote down his advice as if he were God and I was Noah and the ran showers were starting. I started reading it a couple weeks ago, and finished within a few days. Here are my impressions.

Dr. Vertosick begins at the beginning of his medical career: medical school and how he became interested in neurosurgery. His reasoning was more than a little odd to me. Neursurgery was his first rotation in his third year of medical school. At the time he saw the specialty and the work involved in it as boring and tedious, and there was no strong consideration during to pursue it as a post-graduate option. Still, there are stories he remembers from the rotation, one of which had significant importance. One day he was doing a physical on a patient who had been admitted for the removal `of a herniated cervical disk in his neck. Frank noticed that the man's pupils were aymmetrical. That, coupled with some other key symptoms, led Frank to believe the patient didn't have a herniated disk at all, but a tumor. He reported his finding to the resident physician and was able to save the man from an unnecessary and potentially harmful procedure. Some months later, the director of neurosurgery called Frank the Med Student in for a meeting and offered him one of the two neurosurgery intern positions after graduation for his 'good eye.' Frank said he had to think about it. Later, while working in the immunology lab for a side research project, Frank was moving materials under a microscope, where the slight tremors in his hands were exacerbated. The lab technician teased him about it and flippantly commented 'I hope you aren't going in to neurosurgery.' Frank was so offended by the jab that he called the neurosurgery department that night and told him he accepted.

When I read this I literally took a second to scratch my head. Huh? He became a neurosurgeon to prove something to himself? It's certainly not a reason you would bring up in an interview (which it sounds like he didn't have to have). As a pre-med student, I'm starting to get various strings of advice, and some of them have to do with interviewing. We are constantly presented with the question: why do you want to be a doctor? There are the good reasons and then there are the not-so-good reasons. 'Because someone told me I can't' doesn't sound like it would impress anyone.

At the same time, the real world is different from what people say in interview settings. So while it bothered me a little why Frank originally went into neurosurgery, in the grand scheme of things, I don't think it mattered much. He was honest with us, and from the rest of the book it is clear that he cared for his patients and his profession at the level we would all hope from someone with such responsibility.

Dr. Vertosick goes into great detail on some of the surgical procedures he was apart of. Having recently observed a few neurosurgeries myself, I especially enjoyed these pieces. One of them I'd even seen in person. With just about all of the procedures he described, he also told the backstory of the patient. He used these as examples of the many lessons he learned throughout his residency, such as being a surgical psychopath, not being too confident, and that no matter how bad a patient is, you can always make him or her worse.

I really clicked with the commentary on surgical psychopathy. It's an aspect of being a physician I am both apprehensive and understanding of. On the one hand, I never want to become the type of person who is unaffected by death, or who looks at the patients as just numbers on a chart or another procedure. If I make a decision that ends a person's life, I don't want to be able to shrug it off, go have a beer, and forget about it the next day. On the other hand, I don't take death well (at all) and I realize it will be extremely taxing on me as an individual if I let each mortality hit home. Will I be able to strike a balance? Can I gain some of the psychopathy without crossing totally over to the other side?

From reading When the Air Hits Your Brain, it seems that Dr. Vertosick has walked the line and has ended up somewhere on the caring side. There was a particularly heart-wrenching case of a newborn with a brain tumor. They worked on the infant but the tumor was so deep that the damage done to remove it was seemingly irreversible. That, and the cancer would almost certainly remit. The advice to the parents was to say their goodbye's and not come back, move on with their lives as soon as they could, as there was nothing that could be done for the child and the longer they lingered, the longer it would take to try again in starting a family. But the baby ended up living longer than expected, and had more cognitive development than expected. She was soon able to laugh and play, and Frank visited her often. As predicted, however, the cancer came back to take her. Before it did, though, Frank spent nearly a whole day with her. He says he will always remember how, in those moments, he was the most important person in the world to her.

What more fulfillment could you get in a profession?

There were other stories just as thought-provoking, but I don't want to spoil it all here. I have a few areas of critique, as is inevitable with any public piece of work.

For one, the narrative seemed a little rushed at points. For example, I think he went from his first days as an intern to his third year of residency at the turn of the chapter. Or, at least, I was temporarily confused about the progression. All of a sudden he seemed very comfortable in his environment, and the story quickly migrated from telling of his personal transition to focusing on the patients. I was wondering where his confidence had come from, and at what point he went from feeling like a clueless med student/new physician to a surgeon who could challenge the knowledge of other people.

I must admit that I felt a little disappointed by the amount of detail left out concerning the lifestyle of a surgeon. When I picked this book up, I was hoping to come away with a better understanding of how residency is for someone who chooses this profession. I'm getting married in December, and one of my main apprehensions about surgery (and especially neuro) is the demanding lifestyle, and if I can be successful in both my career and my family at the same time. Dr. Vertosick mentioned his girlfriend/eventual wife only a few times, and those were in passing. I was wondering how he maintained the relationship during, or what arguments and hardships might have come out of the lifestyle he chose? When did he get married and how did that affect his career? How did he deal with the long hours of being a surgeon, and was he able to balance work with other aspects of his life? None of that was in there. I can see why the decision was made to keep the focus on the patients and the procedures, as that is more exciting for the average reader, but I came away feeling like I only got one side of the life of a resident: in the hospital.

Still, Dr. Vertosick writes with care, detail, and a poignant grasp of humanity. He is a person who rips people apart and puts them back together, sometimes with dire results, and he knows it. It really is amazing the types of things he has done, and for that I recommend this book to anyone who can read. Sure, it's about being a doctor, but it's about being human more than anything else. And who can't relate to that?

Scraps

I used these for a writing exercise for an editor back in February. Apparently, they were too 'violent.' I guess I am forced to agree. The prompt was: 

This lesson is designed to test your ability to ‘set the scene’ and write effective imagery:
in one document/file, write a single narrative paragraph that describes in simple, clear imagery [= description of scene only, no dialog, no action, or thoughts/feelings/opinions], each of the following: a child alone in a rooma city in ruinsthree people at a conference table not meant to be the start to a ‘story’… just a scene that the reader will be able to ‘see’ as if there, thanks to your wording… and be sure to give it all a careful proofread/edit before sending...

The small room looked as if someone in a rush had cleaned it. The bed was made, but the superhero-themed blanket was tucked in on one side and hung just short of the floor on the other. The toy chest against the wall overflowed with monster trucks, action figures, and lego blocks. Except for an Elmo shirt and matching pajama pants in a heap at the foot of the bed, all clothes were in the hamper. And on the carpet, right in the middle, was a pink stain the size of a basketball. All of this was in shadow, and a bit of moonlight was the only thing that kept the room from complete darkness. It crept through the window and its glow barely reached the corner beside the door, where the small boy sat with the tip of his head touching the wall. Red welps started at his shoulders, crossed the deep indentations of his ribcage, and stopped at his buttocks. Around them, the skin had started to swell. His hair was wet and stuck to his face in thick lines. Beside him, on the floor, was a long piece of twig. It looked as if it had been painted red.

The fog was thick enough to block out the sun and what was left of New York’s skyline, but it did nothing to cover the bodies. Hundreds of people—from women, to children, to soldiers—were laid out on their backs, arms folded across their chests. Large sections of the street was raised, and between the corpses ran cracks wide enough to drive through. And yet there were no functional cars left, only twisted balls of metal sitting in pools of broken glass. Stop signs, lampposts, and mailboxes were all overturned, and paper littered what had once been the financial district. Huge slabs of concrete and broken buildings jutted up from piles of debris. Some were ablaze, while others only smoldering. The smoke from each disappeared in to the white mist. Everything was broken and in ruin, except for the bodies. Not one of them held even a scratch.  

Mrs. Maronee kept her classroom as colorful as her checkered dress. The walls were decorated with alphabet charts, photos of the American presidents, and posters of muppets characters. Small desks were arranged in clusters of four, and each cluster had a different color scheme of greens, blues, and yellows. The blinds on the windows were rolled all the way up and the sun seemed to hit everything in the room. At the center was a red, round table, which was barely big enough for today’s conference with Hank and his mother. The three sat in a small, tight triangle. Their sizes contrasted greatly. Mrs. Maronee wasn’t exactly skinny, but the other woman dwarfed her. The fat of Hank’s mother’s back hugged the top of her chair and thin strands of her gray hair was caught between wood and flesh. The child was tall for his age, and thin. He hung his head low and his face was wet with tears. In the middle of the table was exhibiting A: the body of a baby doll. On its leg, in scribbled ink, was the name ‘Amy.’ Next to it, eyes still open, was the baby doll’s head.

Tommyknockers - Good, but not King's best.

Tommykockers, tommyknockers, knocking on your door....

I still don’t know what the tommyknockers had to do with this story, but it made for a cool name. Actually, I do 'know.' Jim Gardener, the closest thing to a main character, was thinking about the Tommyknockers when all this started, and it stuck. In my opinion, it was incorporated a little weirdly. It seems like it was just a good, intriguing title for the book.

But on to the story. To me, Stephen King is the master of small-town tales. Salem’s Lot, IT, his latest Under the Dome. To some degree, I even consider The Stand as in the same category. It was far from small town, but it had the same large cast of characters that King developed throughout the book. And that's what I love about these stories. If you notice, all of the books listed about are more than 700 pages, three of them breaching the 1000 page mark. King spends ample time building a diverse ad interesting cast of characters and then plunge them into bizarre situations.

The Tommyknockers is definitely a smalltown novel. And, clocking in at just under 750 pages, it has the length. I thoroughly enjoyed it for that. Still, it was my least favorite out of the ones I’ve mentioned.

Let’s look at IT. That book was as much about Derry as it was about Pennywise the clown. Through a thousand pages, you got to know the town, its people, and what made it special. And you had six main characters whom each had their specific personalities, quirks, and downfalls. The story got a little bizarre (especially towards the end), but it didn't really matter but the characters were ucking fawesome.

With The Tommyknockers, I didn’t come out feeling like I had gotten close to knowing that many people, and Haven didn’t taken on the same reality that Derry had. Some of the side stories were interesting, such as the kid who made his brother disappear (permanently) during a magic trick, or the police officer who gave her life to alert the outside world of what was happening in Haven. But I don't think it was focused enough. I wasn't sure that Jim Gardener was supposed to be the main character until more than halfway through. With his drinking problem, his resistance to the power of the ship, and his many internal conflicts, he was interesting enough. But his partner, Bobbi Anderson, was honestly a little boring. I kind of just wanted her to die.

And what about her sister? Sister Anne? Trying too hard, Stephen? He does those rough, malicious characters pretty well, but usually they are three dimensional. Anne Anderson was basically King saying, how vile can I make a female who isn't breaking the law? Even to the end of her life she was snarling like a rabid dog and it's like...really? Do people like this really exist?

The story got a little weird at times, but most of King's stories do. He's a great tale-weaver, but when you zoom away, some of his stories sound a little...off. But that's how the real world is, isn't it? He stays true to what could really happen in extraordinary situations, even if it leaves us wondering...what the fuck? In the end, he delivers the goods where it matters: character development and scaring the shit out of you with his wonderful tension. The Tommyknockers missed the mark on these elements at time, but then again I'm comparing it to other King works, so it had a tough grading rubric to begin with.

'I Remember' - A Poem for My Aunt

I remember a woman who always smiled
I remember it vividly, back to when I was but a child
I remember the cards she sent on special occasions, always
I remember visiting in summer, and I begin to miss those days
I remember she'd call me to ask about wheat bread, white rice, and saturated fat
She knew her body as God's temple--she really cared about that
I remember how much she and my mom would commune
They were like soulmates, but separated too soon.
I remember crying when i heard she was ill
But when I came to visit, I remember her will
She did crossword puzzles to keep her mind bright
And when I lost hope, she had only God in her sight
I remember her strength as inspiration in time of personal spiritual doubt
The cancer took her body, but it couldn't take the praise from her mouth
I remember a broken heart, because that's what I have now
To express how much she will be missed, words cannot allow
But most of all I remember her love, her laugh, how she held us all dear
And though she is far, she will always be here (points to heart)

Scribophile Posts: "Is Stephen King a Good Writer?" and "Race in Writing."

These here posts got a lot of comments over at Scribophile, so I thought I'd link to them from here:

Is Stephen King A Good Writer?
Race and Writing

"The Brain is Sexy"

That's what one of my peers said to me as we were watching neurosurgeons take off the half the top of the neurocranium of some poor victim of a hit and run accident. I'm nowhere near far enough in my education to pretend like I knew exactly what was going on, but the patient had been operated on before and had since suffered sinus problems. The surgeons were going to go back into the skull and plug up the sinus. The procedure was described to me in writing as an "anterior fossa skill base repair in a child with traumatic brain injury and a fracture through the anterior skill base that extends into the frontal recess." Yeah, whatever that means. I only recognize a few words in that, and I think my definition for one of them is wrong (recess is that time you get to play on the swings, right?).

I've been interested in neurosurgery since I was a little kid, when I read Ben Carson's Gifted Hands. Smart black kid reads about another smart black kid growing up and becoming one of the best neurosurgeons in the world? C'mon, I ate that shit up! Since, I have strayed from the path of not only neurosurgery or even surgery for that matter, but medicine as a whole. That's another story, and the end result is I'm back on that path now. Being in the operating room with those surgeons was inspiring. But I was only there for a short period of their life. They are in the hospital at 5am to prepare for rounds, give updates on all the patients at 6am, and then go to see them at around 7. Surgeries start at 7:30 am, and in neurosurgery, the longest ones can go until midnight. I've heard the average surgery is 4 to 5 hours long.

There was another case where a 17-year old boy with bad epilepsy had been implanted with electrodes from his brain to a fMRI. They monitored his seizure activity, saw where it was located, and determined if the area of the brain was safe for excision. Unfortunately, they found that the seizures were coming from the locomotive and language area of the brain, and doing anything in that area would be too risky. I watched as they cracked open his already sawed-through skull and removed the electrodes. When they peeled back the dura--the thin layer of membrane covering the brain--it was the first time I'd seen a brain in person. It was beyond cool, to see in person the thing that controls our humanity. I wish they could have done more for the boy, but even the ability to identify the source of a problem, determine if it can be fixed, and if so, actually go in and fix it....that's crazy to me. And awesome.

The brain boggles my mind. That thought by itself is crazy. The brain...thinking about itself. Fully utilizing  a process we don't understand to try and...well, to try and understand. Then I look over at my dog, Rambo, with his glowing eyes and propensity to pee five times a day whether I'm around to take him outside or not, and I think about how he'll never even come close to understanding himself the way I do. Or, at least, asking the questions that lead to understanding/the knowledge that you just can't, in fact, begin to understand. Yet his brain make those same connections (just less of them). But still, it's so limited. If you think about it, we're all kind of a prisoner of our brains. We perceive the outside world through a series of interpretations. Analogous to someone who has been blind his whole life, what else is there to perceive that we're missing out on? How much of the world is as we actually see it? Who knows.

If you're religious, I think it's fair to say that the brain is the closest connection to our soul. We often say 'with all your heart', but no...if you get a heart transplant, you're still you. Get your leg amputated, you're still you. If I take out a slice of your brain...well, then, you essentially become a little bit more like something else.

These are my random thoughts, transcribed over a series of a few days. The brain and my recent experiences in the hospital have definitely given me ideas for stories. We'll see what happens.

A Night in the Hospital

I'm writing this from UC Davis Medical Center. No, I don't have my laptop out, or even here with me. That would be rude, not to mention hell to carry around. It's three a.m. and I'm shadowing a trauma surgeon on overnight service. She is currently putting in notes for all of her 25 patients, so she doesn't mind that I'm busying myself with other things. She's a surgery intern, meaning that this is her first year and she is still nice. Who knows, maybe she will continue to be nice as her career goes on, but I don't think it's a coincidence that all of the 1st years I've encountered have been bright eyed and helpful while the Chief Resident...well, it's best to just stay out of their way.

Trauma is interesting. It's the unexpected to the extreme. Most illnesses give the patient and the family (and, for that matter, the physician) time to accept and understand what's going on. Even the ailments that strike relatively fast will still allow some time for transition. Trauma strikes fast. One minute you're planning your vacation for summer and then the next you're being stripped of you clothes by an ER doctor and having needles poking all over you.

As you get past a certain age in life, there is an expectancy of getting ill. If you are obese, don't exercise, and eat Twinkies everyday, becoming diabetic isn't necessarily a shock. Nor is a heart attack. It's rattling, and life changing, and sad, and tragic, but inevitably we all have to go someway, somehow.

But traumatic accidents don't hold the same bias that common diseases do. We just came back from visiting a patient who was in a bike accident. He's a 41 year old male who looks 31. He had multiple broken rips and a tube in his chest to drain excess fluid from his lungs. "You have a biker's heart," the surgeon said as she listened with her stethoscope. He was inquisitive, and interested, and she explained how the hearts of athletes are used to pushing out large amounts of blood, and the sound is different. Overall, his prognosis looked good. He was a little beaten up, but he'd go home soon. At least, that was my impression.

Earlier tonight I saw a 23 year old get a neck scan because she was in a car accident. I remember looking at her information and noticing she was born in 1988, just a year after me. A 6 year old deformed child hit his head after falling 10 feet from the top of a slide. He came in with a Glasgow Coma Scale (GCS) of 7, which is pretty bad. They intubated him and did x-rays and CT scans. The mother was the calmest I've ever seen a parent in the ER. It was obvious that she was not new to rushing her son to the hospital. I don't know what happened to the kid.

Life hits fast here. And then sometimes it is depressing for other reasons. There was a a 15-year old stab wound victim. He was Latino, and had one hell of a mouth on him. He cursed out whoever he could, was uncooperative, and told his mother to 'get the fuck away from me' several times.

In case you didn't notice by my picture in the two right hand corner, I'm a black guy. Can you guess what race most of the gunshot and stab wound victims that come in are? Latino and African American. On one hand I feel that I can relate to these youth more than the white attendings, residents, and nurses who are administering care. I'm a minority, I grew up in DC, my cousin was gunned down in its streets. I can't totally relate to their lifestyle: I can't say I was on the edge of going down the wrong path, because honestly I never was. But I've been around people who were.

Yet at the same time I couldn't help but feel a little uncomfortable. And, yes, ashamed. Embarrassed. There were times when I wondered how many people in the room were thinking that me and the patient were cut from the same tree. I wondered if anyone held back a comment or a joke they would have normally said if there wasn't a minority around. There's just a big disconnect between patient and doctor in these situations.  What makes it worse is the white, educated doctor taking care of the ignorant, foul-mouthed street thug who has little chances of ever amounting to anything. Or, at least, I'm sure that's how most would perceive it to be. It makes me think that maybe, one day, I'd be able to make a difference in such a patient's life. Perhaps that's naive, to think they would listen to me any better just because I'm black.

There was this one patient who had been hit by a car while biking. He'd recently had a tracheostomy, so he couldn't talk. He had been bedridden for some time and had developed a bad sore on his buttocks. Over time, laying in one spot can put more pressure on the capillaries than they are designed to handle and it causes the skin to die really slowly. Apparently, even when we sleep normally and think we are perfectly still, we wiggle around enough to keep this from happening. Not this patient. There was a hole above his anus large enough to stick two fists through. It looked painful. His entire back was tattooed, and he was missing rows of teeth. He was skinny and his skin hung off like rags. After the surgeon checked his wound, I asked her how old the patient was while taking a guess of my own: 87.

He was 52. When we went back later to change the dressing, he had shat himself. He couldn't talk, he couldn't get out of bed, and he didn't have control over his own bowels. He had effectively been aged 40 years. I felt sorry for him.

We went over to pediatrics next. I could tell the kid had been in there for a long time as soon as I stepped into the room. Posters on the wall. Balloons in every corner. The surgeon knew his name without having to think about it. And I guess now I do, too.

The visit was brief. It was around 4 am and the kid was sleep. The doctor quickly listened to his heart and lungs and then we left. She then told me he has been in a boating accident. He was being pulled on a small raft down a river on a leisurely family outing when he hit a rock, and, just like that, his spinal cord suffered irreparable damage. He's paralyzed from the waste down. He's currently learning how to deal with his condition. He has to use a self-administered catheter to urinate. His bowels also don't work as voluntarily as they used to. Specialists came in just to help him understand the fact that he would never walk again.

I can only imagine. I have a hard time accepting it myself. I asked about three times in three different ways if the kid would ever have a hope. Even now, after three no's, a part of me feels like something should be possible for the kid, somewhere down the line. But I'm no doctor. Not yet.

The kid was 15.

There were other interesting patients throughout the night. An older psych patient wanted to sleep on the floor of the waiting room and the police were called to deal with her. She was on 24-hour superveillance, and she didn't like the idea of eyes always watching her. She wanted to be discharged, and wanted to have a man's company again. The surgeon sat down and talked to her for about thirty minutes, explaining the conditions of her stay and assuring that she would try her best to get her discharged. It was truly a display of patience.

There was another psych patient who had beat up a couple nurses just a few days before, leaving them hospitalized. He had just been taken off restraints again and, apparently, he was off his psych meds. Sounds fun, right? He looked just like Mel Gibson in Braveheart, only hairier, and bigger.

I stayed with the intern all night while she checked on patients, administered physical exams, updated notes in the computer system, and responded to the many, many questions the nurses continued to have. At about 6am she presented her patients to her attending and the rest of the trauma surgery team, and then went home to get some rest before coming back that night to do it all over again. When she presented, she was an intern again, a little nervous and hesitant about the questions asked of her, and constantly being grilled on hypothetical situations by the attending. But during the night she was the one everyone looked to--from nurses to patients--to have the answers, to know what to do. And she did. It was inspiring, to say the least.

That, and a tad bit tiring.

A Year Goes By Fast

Without even knowing it, it's been a year since I posted on this blog. Shame on me, right? I said I'd start a video blog, but that fell through. Honestly, who the hell wants to see me just talk anyway? I think I was just excited about my new iPhone. It's still here, minus a piece or plastic or two missing from the back. And the home button sucks.

I've still been writing. My first thought is to say not as much as I want to, but that's not completely true. Not as focused as I want to is more accurate. I've written a number of short stories (10+) since last year, and have started a new novel. Not to mention I went through the hell of trying to get a book published last year. I got a few agents to request more pages, and one (or two) agents even requested to read the whole thing. At the time I was excited, but now I figure they must have been half-crazy. Still, it's a stepping stone. I might be back at square one, but it's like getting halfway through a video game and having someone hit the reset button. You have to go through all that shit again, but you know how to get to where you left off faster.

There are a number of changes in my life worth noting:

1) I'm engaged. I popped the question in June and I'm getting married in December (yes, this December...there's a very logical explanation on why it's so close, I promise!). I couldn't be happier....well, if weddings were about $15k cheaper I could be a tad happier.

2) I'm taking classes to apply to medical school. I'm actually writing this post from a Starbucks in Sacramento. I'm doing a Pre-Medical Surgical Internship at UC Davis Medical School. In about 90 minutes I'm going in for a 7-12 hour shift to shadow trauma doctors and surgeons. Cool, huh?

3) I'm writing children stories for this new company. I can't say much about it (hell, because I hardly know that much), but I'm getting paid $100 a story and they should launch later this year. I'll definitely be promoting my work on it when it's made public. All I know is that the stories I'm writing will be illustrated. How cool is that?

4) I'm working on a new novel. I wrote 80 pages long-hand, decided it sucked, and started over at the beginning. Now I'm actually planning out the novel and the characters. I'm excited about it, and I'm even more excited about the idea I have for the one after this.

With those changes, I think that this blog might transform into a chronicling of both my writing journey and my medical journey. I don't want to think of them as separate, necessarily, because they both blend to define the most important journey: my journey. My experiences in the medical field will no doubt influence my writing, and my creativity and the way I view the world will no doubt influence my impact on the world.

So here....we...GO!