Tag: family

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The Odyssey

Do you ever think sometimes that the internal state of your mind reflects exactly the kinetics manifested in the immediate environment? I am sitting here trying to articulate the torrent of thoughts and emotions that have piqued over the last few days, but as the narrative becomes refined and my fingers strike the keyboard I’m at once pulled internally by another powerful distracting idea. Another wave of excitement, or sadness, or terror, or you name-it washes through my consciousness and I’m once again at a loss for words to describe it, or the preceding thought. This mania is a peculiar personification and imitation of my external environment over this last week. Preparing to move (and move everything in a 4-door sedan). Graduation. Wedding celebration. A dive-bar band performance. The (good!) surprise of the decade. Brunch and more brunch. Graduation celebration with family. Reconnecting to a friend group whose bonds were forged in the crucible that is first-year medical school anatomy. And this morning’s near sleep-less jaunt to borrow much-needed energy from, as I’ve said in the past, the greatest group of people there ever fucking was. Was graduation already (and only) 5 days ago?

Physically distancing just means an equal and opposite friendship tightening amongst us, the greatest weekly gathering of people on the face of the Earth. The only unifying commonality is the only one necessary for human existence: The radical inclusion of any and all who participate.

I feel like I’ve never been happier in my life and at the same time have had a lump in my throat for a week. My mind has gifted me intermittent and overwhelming sensations of gratitude, of which have externalized as these sort-of “mini-crys” over the last few days that come and go as quickly as the frenetic thoughts and emotions I’ve been victim to. No doubt a reflection of my innate egoism and strong desire for attention being fed an inordinate amount of love, but also perhaps stemming from a modicum of love I’ve (hopefully) transmitted, of which I’m grateful to have relayed back to me by the beautiful people who tolerate my precense in their lives. I’m reminded of the words a fellow classmate (now doctor and colleague!) expressed to me at graduation regarding this blog. “You’re an inspiration,” is a phrase that, for the paradoxically self-effacing narcissist like myself, finds simultaneously endearing and wildly undeserved. But overall, I find it is a patent reminder of the ethos I strive to live by: The desire to produce and reproduce, as much and as often as possible, unconditional generosity. To be radically and unapologetically vulnerable so as to be not just honest to myself, but further normalize emotions as healthy expressions of our human selves. And to know, viscerally, that the incalculable sum of my impact on others is not reciprocated proportionally – the molecularly small impact I effuse pales in comparison to the cumulative benefit of having the company of people who reek of inspiration.

My life this week has been flooded by proclamations of personal success amongst my unbelievably smart and talented colleagues. It demonstrates the utilitarian aspect of pomp and circumstance. As much as I admonish the self-aggrandizing, masturbatory exercise of glorifying “achievements,” the silver-linings exist. Even though the torrent of emotions elicited by smashing together 200 students who’ve not seen each other in person in over a year can be manic in nature, it provided me an opportunity (a self-avowed lover of theatrics) to grandiosely bathe in sentimentality. But more importantly, it provided another reminder of what “success” means to me.

I was (once again) floored/shook/surprised/honored by the kindness and spirit of my surrounding friends today. It’s funny – I was too shocked to see much of substance after receiving the positivity award this morning (it’s not a cult I promise). But when I have something prepared next week for my final NP MSP workout, I’ll be equally speechless as I helplessly blubber through a farewell on my penultimate day in Minnesota. As long as I don’t lose the damn thing this time!!

 

For me, I cannot help but I understand my own “success” as the simple and inevitable product of the folks I’m surrounded by. Mentors who’ve inspired me since I was in college. Classmates whom I’ve learned from (and commiserated with to no end – an equally important exercise) and most importantly engendered lifelong friendships with. Residents who’ve set a seemingly unachievable example of success in every aspect of hospital medicine, and future coworkers who so warmly entertained me in my new home (Tacoma here we come!!). Old friends who’ve endured my bitching about medical school content, and who’ve guided me to reality when the vacuum of academia became all-consuming. And my family. Regardless of the divides that may exist amongst us and between us, they are unequivocally a repository of love older than any other I know. So, I’m really only the company I keep. “Success” is a shared experience that, similarly to the externalities that define and refine each of our individual personas, represents only an infinitesimally small product of our own volition (at least in my case). Recognizing the contribution of others, authentically, not with performative virtue signaling, is a process I’m working in an attempt to engender humility otherwise innately absent from my character or that I’ve (unintentionally) dispossessed myself of. Suffice to say (as I’ve written ad nauseum here now, and already in the past) my comrades are the foundation of all things “me.” My “success” is simply the recreated amalgamation of theirs.

I probably practiced putting on that damn hood 3 times in the wings before I just said “fuck it.” I was as successful those three times as I was here. The damn cap almost came off throughout this entire ordeal and then like an idiot I walked behind the lectern on my way off the stage (though I’ll note I was not the only one to do so). At least I didn’t fall off the stage…though the terminal egomaniac in me would have been pleased to know that the attendees would have had a memory touchpoint from the ceremony involving me for the rest of their lives.

Our arduous journey of medical school is closed. This destructive, instructive, (re)constructive process of physicianship, an odyssey like no other, finds brief pause now. A foreshadowed exhale that once again will start the process of sculpting ineptitude into mastery, just as we’ve done in each stage of our journey thus far. And just as before, the stakes are increased. The prerequisite commitment demands, as always, a level of work that I’ve necessarily been unable to comprehend until such time as the responsibility to comprehend it is at once required of me. Another expansion of my medical expertise coupled with a paradoxically deepening and widening of the well that is the unknown. And, once again, ensuring I don’t flounder in the process. There exists (for me at least) a dialectic and evolving resolution/dissolution of increasing knowledge and practical expertise appositional to my internal feeling of incompetence. Each subsequent stage in training seems to embody both, with increasing magnitude, a sense of mastery and confidence while unveiling the broad and deep reservoir of yet-to-be-learned knowledge. College was my first foray into actually giving a shit about school, just in time to meet the demands of mastering (iffy on the mastery) gen-chem, o-chem, physics, etc. Acceptance to medical school provided me some confidence that I was capable of learning medicine, while ensuring my terror that I indeed was about to learn medicine. Two years of preclinical work assured me (or at least my school) that I had the medical knowledge to start scratching the surface of learning about medical practice during 3rd and 4th year – another terrifying proposition. And now, having just accrued enough confidence to say I know a thing or two about medical practice, here I am anxiously awaiting the ultimate phase of training where I learn to perform. Put into practice that which I’ve been merely a redundant, partially active observer to until now, and ultimately make decisions regarding peoples’ lives where the buck stops with me.

I have a bracelet I wear on my right wrist with the word “GRACE” on it. It’s an omnipresent reminder of the fundamental, quantum shift in my understanding of the necessity for unconditional love that occurred just half a year ago. There is a lot of lost time and memories between me and the folks pictured here, my parents, two of my siblings, their children. Time that can’t be recuperated but is never too late to stop losing. Perhaps with age, perhaps morbidity and facing mortality, but most likely expanding one’s consciousness through paradigm-shifting conversation, leads to abrupt changes in our awareness. But these changes can be transient without practice. Sometimes my practice involves just remembering what’s written on my wrist.

 

I know for certain only two things regarding this next chapter in the odyssey: I am, as in every preceding transition, feeling woefully underprepared and confident of success. But here I am, nonetheless. But most importantly: There is exactly nowhere else I’d rather be.

To all of you readers, friends, old and new, near and far, in Minnesota and everywhere – you are exactly perfect. I’ll see you all for the next chapter 😉

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A Link to the Past

The post you’re about to read are the ones I’m most looking forward to sharing. Just writing (typing) that is monumental for me. There was a time I would never have thought about going public with any of this. These posts are old journal entries from a notebook I have been writing my thoughts and musings in for the last five and a half years. These posts will be unedited and reprinted in their entirety (I removed last names of peeps for privacy). My hope is to give you a glimpse into how this completely haphazard yet still ostensibly functional organ inside my skull once was, and what I’ve learned (albeit with that same fucked up brain) from that tumultuous past.  It’s not a big notebook, however, which is unfortunate it’s taken me this long to complete it. For the sake of avoiding making this post an impressive wall of text, I’ve included pictures. Yes. Pictures of a plain black notebook. Just read on.

I love the cover of this notebook. Two things that evoke truth more than anything are writing and running. I’m trying to get better at both.

I was given my notebook, along with some other goodies, after completing the Twin Cities Marathon in 2012. Something about the ‘middle of the pack’ award where they gave me a duffel bag that had that notebook, a (signed!) copy of Ultramarathon Man by the legendary Dean Karnazes, a $25 gift card, and a bunch of snacks and Clif bars. Needless to say I was elated. Ask anyone who knows me how much I love free stuff (or stuff that I make free…it’s really all about perspective. I’m not a thief). Anyway – that gift card and those snacks were gone quickly. The book was less easy to devour – and honestly I didn’t believe this guy. People don’t run 100’s of miles at a time. That’s impossible! Well, just a few years later and I’m one of those so-called ultramarathoners. You can read about that cold adventure here. Someday I’ll make it out to a race like Leadville or Western States. So many inspiring athletes out there suffering though unimaginable conditions. Anyway! That’s another post altogether.

It’s amazing to me that this notebook has remained in my possession for as long as it has. It’s somehow free of coffee spills and ketchup stains. The same cannot be said of quite literally anything else I own.

Let’s get to it. This entry comes a few days after Christmas four years ago. Two of the most spectacular women alive that I’m fortunate enough to call my friends came to visit me during the coldest winter I can remember. We went to Phantom of the Opera, and as you’ll see, I had some pretty intense feelings that surfaced as a result of having had the opportunity to spend time with, and shortly after say goodbye to, my best friends. Read on. If you’re feeling good, stick around while I go full-throttle Freud on myself.

It is unblevelable how sad I get having to say goodbye to friends when they leave. I believe it is something I have felt my entire life but I haven’t actually realized it to this extent. Last night, Hallie, Mollie, Hallie’s younger sister and I went to Phantom of the Opera. Poor Hallie’s dog got sick yesterday though and she got a call saying that the dog would probably not survive. Poor kid. Anyway, it was fun, and I shouldn’t have anything to be upset over. But right after they left I was literally almost in tears. It’s like I am always holding out for some moment of catharsis, where we just sit and reminisce and talk for hours like I used to do with those who I have been close with. I miss having a best friend. I feel as though I haven’t had a meaningful conversation with someone for 3 fucking years. I haven’t made a new friend since I was in high school and have only lost them since. That used to not bother me. In fact I was almost “proud” of it, in a way. Now I feel so bored and isolated I barely want to hang out with Abe or Eric, or even Rebekah. And why would they enjoy being around me? My interests have largely faded – there are not a lot of things I really enjoy doing. What areas of interests do I share with other people? Nobody really wants to get up and run with me. Nobody wants to talk about Italian shit with me, or video games, or Chipotle. How many other people my age envision a good time as sitting around and shooting the shit, or going to a show? Everybody wants to party. I DON’T. It’s not fucking fun for me. I take no pleasure in meeting new people. I know who I like already, and I love those people to death. Talking to other people isn’t the same and I just want my old friends back. It’s funny – I remember before leaving for college all I wanted was to get out and make new friends. Then I realized how uninterested I was in other people. Given the choice between meeting new people or being by myself, I pick the latter every time. And nothing excites me more than just being around people I love – and just talking. It’s why I was always would be on the phone with Hallie until she would literally hang up on me. And why I have sat at Rebekah’s house until 6 or 7am, until I could hardly stand I was so tired. And why I would spent almost every free hour of my life senior year with Zoe B. It’s even why I would spend so much time hanging out with people like Kevin in Junior High or Brandon or Abe in high school (albeit to a much lesser extent). I loved (and still do) just hanging around. But I’m smart enough to know it’s not normal and its certainly not what other people want from me. Nobody wants to be my friend that much, or in that way. Most people (everybody but me) enjoys the company of many. I am the only person I know who is by far the happiest when I can be with on other person. For some reason it generally works better with women. I would give just about anything to be as good of friends with Hallie, or Zoe, or Hailey as I used to be. I can’t lie when I say they were the most memorable times of my life. And I feel as though I will never have these kinds of friendships again in my life. And it has nothing to do with physical intimacy. In fact I would do just about anything to throw all of those where things got physical – from the sex right down to every kiss. It only ruined all of these friendships. It turned all of those relationships to shit. I feel like so much has happened in two years and I have absolutely no one to trust with it anymore. My mom has a heart attack – and the only person I tell is Zoe well after we stopped dating. My mom threatens suicide and sends me a “good-bye” message – the only person I got to tell that is myself, twice in this fucking notebook. But what can I do? I don’t know how to make friends. I’d rather just have my old ones back.

Okay. You still there? Awesome! You made it. PHEW. There was a lot of shit in there. That was even difficult for me to transcribe. And I wrote it! So what do we take from this? What insight can you or I glean from this rather old stream of immature consciousness? Firstly, I promise I’m not that despondent anymore. Like holy shit 21 year-old Duff, have you ever heard of Xanax? Second, there is a lot that needs to be said about isolation. Third, (just know you are reading this almost as directly as it’s coming from my mind) there is even more to be said about limitations.

Let’s talk about isolation. Something I’ve grown to learn that I feel is truer every time I’m reminded of it is that, (purposefully) barring any 3rd party intervention, I can convince myself of any negative emotion running through my mind. I’ve obviously learned a lot about the power of being an observer of thoughts though meditation, but when it comes to those nasty self-deprecating habituated thought patterns, reflecting on them with trusted friends is crucial. It’s easy to see how isolation led me to believe that ‘only I feel this way,’ and ‘everybody else is like this,’ and all the other snippets you can pluck from the passage. As paradoxical as it seems, one of the things that keeps me grounded and confident (relatively) is knowing that I’m really not special. I’m not the only person in the world who misses their old friends. I’m not the only person who finds it hard to make friends. And I’m definitely not the only person in the world who likes to run in the morning (read about it here and here). Nor am I the only person who likes video games, Chipotle, medicine, food, sports, and all the other things other normal people like. But it wouldn’t be too difficult for me to believe I was if I did exactly what I did – shut myself in, be too stubborn and scared to make friends, and not have the gumption to connect with old ones more often. Just reading this makes me wanna go back in time and slap the living hell out of me and say “YOU’RE NOT THAT COOL CALL A FRIEND, DUMBASS!” Because, in reality, it’s not cool, or tough, or a measure of fortitude to feel you’re unique in how lonely you are. There was no reason I had to be – or feel that I was. Which brings us to the last point.

There are things I am limited from doing. I will never dunk a basketball. I have no desire and even less ability. I will also never understand why people watch NASCAR, or why at concerts the instruments are so loud you can’t actually understand the words people are singing. What I am not limited from doing is changing my mindset. Reading this post, I was never actually prevented from being closer to any of the aforementioned folks. I was never actually inhibited from forging new friendships or figuring out a way to enjoy life in my current circumstance. Those were entirely constructs that I had created. I was not being held hostage in my apartment every weekend. I wasn’t limited to access for help from friends, and family. I convinced myself that those were denied to me. I was so unable to recognize that being sad was completely normal, and there were very normal, human remedies for it. Please, if you’re reading this, know that I haven’t had a stream of thoughts this negative in months. Maybe for the better part of a year. Recovery, real, true recovery, is a beautiful thing (read about it here). Any affliction of thought is curable by real action, and I can take any instance in the above passage and can say with some certainty in how I would go about resolving the conflict exemplified. Most would involve calling a friend, watching a move, or just being present and aware of those thoughts and letting them go.

Now you might be asking, ‘Ryan, what was that about your mom, and your old high school friends, and women, and –’ don’t worry. There is a lot left in this notebook that we’ll get to. And believe me, I’m learning as much about me as you are. Alas, I only have so much learning I can cram at a time. Graduate school has excavated that well of knowledge capacity greatly, but for this entry, it’s tapped out. Thank you for joining me on this first un-buried post! I’m having fun – hopefully you are too!