Anthony Nuval

Since moving back to Chicago, on nearly every Sunday, I take the CTA to the old neighborhood to see my parents for Mass and lunch. I ride rails and buses that I’ve known since childhood. I pass both tourist landmarks and landmarks of my life. I remark at the changes that have taken place since I was away and embrace the reassuring constancy of what has remained. But most of all, there’s a part of me that’s still in a measure of disbelief that I’m actually home again. The excuse of my birthday got me to reflect (more so than usual) on just where I’ve been in these few decades and wonder just what I thought, during those times, I would be doing with my life. I’m not exactly sure that I had any concrete thoughts about where I’d end up, honestly, but at the very least, that certainly means I never thought I’d be back home. I mean, when it was time for me to go to college, moving Very Far Away From Home was no insignificant motivation; and it seems to me that a lot of my decisions subsequent to that were driven by the desire to establish Clear Separations between me and the life I left behind.

But all that seems somewhat silly now. My parents aren’t getting younger, and someone needs to watch over them…and maybe there’s some feeling of a need to make up for lost time. And, as much as I love and miss New York, and as much as I learned to love Wisconsin (and PA, too, I guess…), there’s no denying that there’s really only one place I consider to be truly Home, and it’s not a bad thing to come back to it. And if I consider that this all started with an invitation to interview received well after I had considered my application cycle as complete and had already begun planning for another four years in Wisconsin…I think I was incredibly fortunate. Weird, how these things work out sometimes.

Tragedy, I think, tends to whitewash the canvas of our memories, leaving only itself in its wake. The fun times I had in New York are hard to remember through the filter of September 11. My memories of a dear friend of mine from those days are discolored by the time I spent in earnest with him during his final days in the hospital. I promised myself I would write a remembrance of him, as so many did when he passed, but I was never sure what to write. Two years later, motivated by an excellent memorial penned by another good friend of his, despite the piles of studying awaiting me once I finish this post, I figured I should just sit down and recover what was lost before another year goes by.

***

Summer, 1998. Excited to live in the big city, I reached out to an alum from my high school that I knew lived in New York. We hadn’t met in person yet, but I knew of him thanks to the internets. His name was Scott.

Though I was but a green college freshman and he was already a few years out into the working world, having gone to the same high school meant we already had a lot in common. He took me under his wing as both friend and mentor and introduced me to the New York he knew, despite the great wilderness that separated us (Central Park), despite my gross inability to foot my end of the bill. It was the city of incredible cuisine, the city of immense culture. His love of the city was infectious. I’ll forever have this chronic disease of missing New York (and a love of Guinness and an appreciation of Scotch) because of him.

During those many days and nights spent out on the town, he would pass on to me the life lessons he’d learned, colored in no small part by the health problems he was born with and the recent breakup with his fiancée. When I knew him, he was a self-proclaimed evangelist of the bitter, and our shared pessimism and cynicism was doubtless a reason we were good friends, but the way he led his life betrayed his inner self–a more tempered realist, I think, with streaks of optimism that compelled him to do good. Whether these qualities that I also see in my own self were because of him, or it was because we also shared this same unspoken philosophy beneath the protective layer of the cynic that we got along so well, I can’t say. Maybe both.

Scott drifted out of my life rather literally, packing his things for Arizona to seek the love that had been missing from his but which in turn meant leaving the city he was so fond of. It wasn’t that long after he left that the towers came down, and I know a part of him hurt. Not only out of concern for the friends he had left behind, but also because his city was hurt, and, quite possibly, the fear that he, too, might have perished if he were on shift with the city’s emergency operations management located in 7 WTC. That was probably the last time I kept in regular touch with him. Although some years later we both found ourselves back in the Midwest, we managed to meet up for dinner only a couple of times.

***

Christmas, 2009. Possibly because he was still relatively sprightly when we both lived in New York, possibly because he (back in the day) hid his physical impairments so well, it was easy to forget that every day spent with him was a day his physicians weren’t predicting him to have. And so while it wasn’t completely unexpected when I got the call about Scott’s deteriorating health, it was still jarring. At first, I believed it to be just another fight he’d successfully win, but that soon turned out not to be the case. In those last days, though… to see all of the people that came to visit (and as it turned out, say goodbye), to see everyone who was touched by Scott’s presence in their lives, was truly incredible. To see the friends he made at IMSA that spanned multiple generations was remarkable.

Scott passed around 7:45 pm, on 11 January 2010. It was a quiet night in Streeterville, and a light snow was falling.

***

On one of the many days spent visiting him in the hospital, I remember jokingly chiding him for not waiting until I became a doctor to get sick. Fast-forward to two years later, almost to the day he left, and I’m a first-year medical student learning about the heart. In anatomy lab, we dissected those same structures that caused so much pain for him, and I couldn’t help but spare a moment of anger at how such a crappy manufacturing process that gave rise to such ridiculous defects that afflicted Scott would even be allowed to exist. But it was that same flawed design that informed who he was, and though I’m not given over to believe in invisible hands, I couldn’t help but think there was a reason why I should be holding a human heart so close to the anniversary of Scott’s passing…perhaps to remind me that, despite it all, I and all of his family and friends are lucky to have had him in our lives for as long as we did. Thank you for all you’ve done, Scott, and wherever you are, I know you’re walking carefree.

(1/366)

So many days have gone by since starting school and it’s all a blur to me. I think this is what happens when something–in this case, studying–is so consuming as to nullify any awareness of the world around you. On one level, this perception of the passage of time is a good thing, as I want nothing more than to be out of the classroom and in my clinical rotations, learning how to do the stuff I actually want to do; but on another, every day that goes by without so much as registering in my consciousness feels like a waste of a day. And days aren’t exactly an infinite commodity.

There were ways to slow things down that I used to do a lot of. Write. Take pictures. Only nowadays it seems like I don’t have time for that because of school. Well, that’s not entirely accurate. I could make the time, but I need to improve my studying discipline: it presently sucks.

I think I’m going to try to write more in addition to this (and I’m definitely going to have to make sure I’m on the ball with my studies), but because my earlier Project 365 seemed to work brilliantly, here goes one for 2012. And because 2012 is a leap year, it’s actually a Project 366. The aim is the same, though.

So. Let’s begin.

One quarter down, five exams completed, five passing grades. So far, so good. P=MD. That doesn’t mean that it was easy (not that I was expecting it to be), but I could definitely do without that sense of uneasiness over the question of “did I pass?” after each exam, the likes of which haven’t been seen since organic chemistry (for which, in those days, the prescription was this drink). I don’t recall noticing it back in undergrad, but I suspect that’s because studying engineering exercises a completely different part of one’s brain (mmm…math). As a practicing engineer, life consisted of analysis and problem-solving (and let’s not forget the metric tons of documentation generated) instead of memorizing and regurgitating. And so, there’s a bit of an adjustment period. Eventually, I’ll get to use more of those brain muscles, but first I have to learn the language. And it is basically just that–you have to learn the alphabet, then simple words, then simple sentences, before you can start to begin to think critically.

(On the other hand, if I want to be really cynical, I could say that learning about the human body is like trying to reverse-engineer a system for which no one from the original design team is still employed and zero requirements or design documents exist and you’re like “who the hell designed this shit” and you have a gazillion customers with broken systems all demanding they be fixed and you can’t just tell them to buy the upgrade.)

But the mechanics of studying and doing well on exams are fairly straightforward. It’s simple enough to analyze what I’m doing wrong and devise a corrected plan of action. (Following through on that plan is another story.) I’d much rather deconstruct the psychological aspects of being a med student who went the non-traditional route. First, some words of wisdom (from an Internet board that shall go unidentified):

…I actually had a board member pause the interview just so he could advise me not to lose the identity I’ve developed (as a non-trad with a career) because apparently many non-trads “regress” (as he put it) once they’re in med school surrounded by much younger students.

For non-trads, the difficulty is that you’re not just developing your adult identity, you’re taking on a new adult identity on top of the one(s) that you already have.

I read these quotes at the start of the quarter, but it’s not until now that they’ve started to ring true. It’s all too easy (especially for someone who doesn’t look all that different from his new peers) to assimilate into the culture and thus feel like one’s identity is being lost. Maybe that’s why I feel the need to assert myself as that old fogey of an engineer every so often; but doing so may also have the detrimental effect of creating too much of a separation between my classmates and me, or perhaps coming off as having airs when that couldn’t be further from the truth. And sometimes it’s hard to contribute the perspective of someone who’s had a bit more time to percolate and has a bit more experience without sounding preachy or condescending. So, there’s a balance that must be struck.

I don’t even have a clue as of yet what this new adult identity is that I’m crafting.

But in the end, it’s just an interesting thought exercise that I won’t get any credit for. For now, the order of business is to relax, rest, and recharge, ready to hit the ground running when the next quarter begins. (And given that it’s the cardiovascular/pulmonary block, if I don’t ace it, I should just quit right then.) Here is one more quote I found hilarious:

But the life arc is undeniable. I couldn’t stay in a night club with 18 to 25 y/o’s with sh!tty music pumping unless I was seven different kinds of loaded. And I’m not into that anymore. So.

Some things you don’t forget.

“Did you have classes on September 11?”

“Yup.”

“When were you supposed to be in at school?”

“I wanted to be there at 12:00.”

“What day was September 11?”

“Tuesday.”

“Did they cancel classes?”

“Eventually.”

Some things you can’t remember.

I can’t remember if I tried to call any of my friends to see if they were okay.

I can’t remember if I tried to call anyone, for that matter.

I can’t remember who called me or tried to call me.

I can’t remember whether anyone who tried to call would have been able to reach me, anyway.

I can’t remember when I finally turned off the TV.

I can’t remember when they let us back below 14th Street.

I can’t remember when I finally let myself go below Houston Street.

Some things you wish were not even a dream.

“What are you going to do when a patient dies?” Vicky, the M4 I was pseudo-shadowing, asked me. Wasting no time in lobbing the hard questions at the not-quite-a-first-year, I see. And one who hasn’t yet fully wrapped his head around the fact that he’s no longer an engineer, but a doctor-to-be…

It’s not that I’m naive about the sadder aspects of my new profession, nor that I’m a stranger to death. I just think it’s one of those things that you can’t fully anticipate nor fully prepare for. And her question certainly wasn’t something I was expecting at a health fair for school kids.

I stood in silent contemplation for a few moments; but I dare say I wouldn’t actually be able to answer her until I’m actually faced with it.

I never made much of an express effort to get to know Wisconsin. I didn’t want to waste time dating it if I didn’t think I was in it for the long haul, didn’t want to get attached. I’m only passing through, I thought to myself. Then, at some point in these last almost-eight years, these surroundings became so familiar, these people I have met have become such fixtures in my life, as to tinge this long-anticipated departure with a hint of sadness.

I’m moving back home, but in a way, I’m also leaving home.

Seen on a forum I read, in a side discussion of whether private schools always trump public schools: “Have you ever heard of the ‘Illinois Math and Science Academy (IMSA).’ I got to college and like 13 people in my class went there. It sounds amazing and it’s a public school.”

I messaged her later. “I chuckled at your use of quotes. Makes it seem like IMSA’s this fictitious place.” Her response: “Until I see it, I think it’s Hogwarts of the Midwest.”