Thursday, February 3, 2011

Excruciating Present, by February blogger of the month Irene Koplinka-Loehr

Excruciating Present. Punctuating my consciousness these two words reel me back into an existence of appreciation, compassion, understanding. They center me to my experience—acknowledging the current moment. Here, right now. It was my mother that first used the words—excruciating present. I was fortunate enough to spend a fantastic break with my family in Ithaca, NY between the semesters. These two words were our mantra, allowing us to fully appreciate the time that we were together; I brought them with me to a discussion on grief and loss that we had last week in Healer’s Art (a course aiming to address the emotional dimensions of medicine). They remind me of the value of mental and emotional presence with friends, family members, and future patients.

Here, we balance between worlds. West Bank, Israel, United States. Friends from home, Israelis, family, Students in our program. Hebrew, Arabic, English. Clubbing, running, the medical library. Dipping cautiously into each, feeling the coolness on our toes as we test the boundaries of our experience. I begin to challenge my understanding of science and medicine. This evening, initiated by a physician who has started a few clinics just outside of Jerusalem, a small group of students began to delve into the now-familiar territory of gender-based medicine. This lens allows us, as physicians, to critically analyze information presented as status quo—many of the studies for signs and symptoms of disease have been done on middle-age, white, 70kg males. By acknowledging that our understanding of medicine comes from that perspective, I feel that I am better able to ask the right questions for differences in medicines, treatment protocols, symptom identification, and basic care. I am continually amazed that in changing our framework undiscovered layers of medicine become apparent.

Rain rolling away, viewed from our classroom
on the 6th floor
Walking back from the shuk I was recently surprised to see brilliant oranges and lemons on dangling laden branches over the sidewalk. My neighbors have fruit trees, made bright in sun. At this time of the year, when I wake early to run, the sun rises with me. Fifteen minutes up to the monument on the northwest edge of the city, and I turn to see all, dipped in gold. Sunrise, sunset; we are given new minutes of this pale orange light each day.

A bird hiding from the rain in our shutters.
On Sunday, the rain arrived; enthusiastic bursts of water falling, rapidly turning our desert into a mud-pit. I find myself looking at the sky, lost for what it holds; “What is this stuff we call rain? 

Drenching this desert country, caving in drain-pipes, coursing along asphalt, giving new meaning to Beer Sheva as the sister city of Seattle. I watched the clouds this morning en route to class. Each one piling up after the last, scurrying across the sky trailing little speed lines, before bumping into a brooding mass of gray. I am astonished by rain. Startling when I hear the large drops hitting the window of the library and smiling when I see them slamming into puddles—so anxious to get to the ground. It is unlike any other rain I have understood; as with many things, I appreciate it more, in absence.

Bird's eye view of the Medical Library
Pre-rain, last week, on the excuse of celebrating a golden 27th, our class trouped to the old city to find a somewhat elusive venue: ‘Castle’. Tucked behind a sandstone, turreted fa├žade, this microcosm filled with tavern tables and gothic arch chairs proved a fantastic setting for the birthday bash. Spirits were high as we toasted Spencer and the beginning of a new semester. While Beer Sheva may lack the suave, chic outlets found in the central cities of Israel, it is well studded with unique locales. - by blogger of the month, Irene Koplinka-Loehr