Almost six months later and I
- started my last year of medicine. In less than a year I’m supposed to be a doctor!
- am able to play through the first movement of the Händel concerto
- discovered that my thumb placement in harp playing is TOTALLY wrong (I’m trying to get it right, but I’ve played the harp like this for 14-16 years…)
- have changed from a ‘shy’ ‘introvert’ person into an ‘assertive’ person (according to my evaluations.) It could have something to do with the fact that this year, my performance is graded based on 1-to-1 observations of patient encounters instead of how I function in a group full of extraverted people during a 1-hour teaching session…
- Still can’t stop procrastinating. Tomorrow, I’ll have to present something about psychiatry and it’s 20:30 already…
Somehow, the internships just zap my mental energy, after an entire day in the hospital I don’t feel the wish to struggle on the Händel anymore. I’m still working on the folk pieces, of course, because I’ve scheduled lessons on them, but as it will be a while before the next lesson, all semblance of regular / focused practice has come to a halt… My big harp has gotten quite out of tune after being neglected for a while… I wanted to tune it again but the tuner just broke on me (no idea how! Changing the batteries certainly didn’t help and it were new batteries which worked fine in other appliances).
Today was just like watching a bad .gif over and over. The attending with whom I was working did oncoloy clinic and while all cancer is bad, cancer in the head/neck region is especially bad. It basically eats your face and the only treatment is to remove everything it can get to – so then you will hopefully be cancerfree but also missing half of your lower jaw if you are unlucky. And I thought end stage colon / breast carcinoma was bad, but imagine a tumor sitting near your brainstem and there’s nothing they can do about it so it’s a matter of time before you become basically brain dead…
Fortunately, I didn’t have to say anything so I just sat there on my stool (the doctor gets the real chair) and watched as the attending patiently explained everything to the patients and their families. Halfway someone would inevitably being crying and then everyone except the doctor was crying – and of course, as a med student you should be professional so I was pinching myself discreetly to not to join in. And that over and over, just like a .gif where you already know the ending – they came in not really knowing the diagnosis / implications or perhaps they knew but it didn’t sink in yet and then the news is broken to them and you almost hear the shattering of their plans and dreams…
But then there is the doctor, who leaves room for a silence, offers a tissue, asks a few questions… And the room is filled with a bit of hope – even while there is no hope, the doctor is there and will stick to their side until the very end.
This is what continues drawing me to medicine, even though I sometimes wonder whether I can be a good doctor as an introvert. Being there with and for someone in the worst parts of their life and hopefully being able to help them through it… And even when they don’t make it, knowing that you were there for them, that you really took the time to listen to them and reassure them, guiding them through the storm…
But I wonder whether I’ll be strong enough to avoid being knocked off my feet.
It’s been a while! I’ve accumulated several posts with that very same opening sentence – I’ve started several drafts, then decided I didn’t really know where I wanted to go with the post and eventually, I sort of let them be. I’d like to write meaningful things about my journey in medicine, but I can’t share the most interesting stories because they’re much too recognizable. I think it just takes time – when I’ve seen more patients, I can merge stories and change details more efficiently. Also, every post about medicine eventually ends up with me contemplating depressing things like death and suffering and is it all worth it and if there’s a God (which I sort of think there is), why would he allow so many innocent people to suffer — there are a lot of questions that I’m trying to find anwers to, while also trying to learn something about medicine. So I think I will let these stories stew and brew for a little longer – but that doesn’t mean I can’t write about the harp, does it? :).
During internships, the harp is really my escape, my way to focus on something entirely different than patients and medicine and trying to cram all kinds of facts into my head. I can’t always work up the energy to actually practise – doing more than playing through a few pieces – but when I manage to, I can really get into a flow.
As this year is the last internship year that is slightly compatible with having ‘a life’, I’ve started taking folk harp lessons with Cheyenne Brown. There are a lot of teachers around here that can teach you to play classical music, but there are few who really know what folk is – the rythms, the ornaments – the art of making a rather simple melody sound like it’s a virtuosic piece – which is related to the art of touching people’s hearts by just playing a ridiculously simple arrangement. It really takes skill and musicianship to make such melodies come alive.
Any classical performed will agree that you can’t properly play a piece if you’re just playing the notes. Unfortunately, due to a lack of good folk teachers (and lack of exposure to folk performers), in the Netherlands, a lot of people ‘just play the notes’, reducing folk music to something that’s only suited for beginners. I even fell into the trap of thinking that folk music was ‘too easy’! Fortunately, I was cured of that mindset by Youtube movies and harpist-friends who were really into folk!
So, I started doing workshops – some specifially geared towards the harp, others more focused on ensemble playing (arranging tunes for a group etc) – but I noticed there were certain things I just couldn’t do. Like triplets. I’ve gotten loads of advice, even a few informal private lessons with a folk harpist, but I was never really able to do them.
I still can’t do them. I love them, but I hate them as well. I’ve overcome most hurdles – there was a time that I just couldn’t do four-fingered chords, a time when I couldn’t understand how to do syncopatic chords – but eventually it clicked and I was able to do it. However, I still can’t do triplets properly, they become strange muffled ‘things’. Having regular lessons with a folk teacher is a really good incentive to practise them daily – but it’s VERY frustrating that I don’t seem to make any progress. I can sort of ‘fake it’ by playing the tune at full speed, but in my fingers, I feel it’s still not quite right.
It’s entirely different from trying to learn the Händel concerto. There it’s just guiding my fingers into the right shapes, memorizing the patterns and then building up speed (which also takes LONG but at least, there’s progress if you work on it diligently). The quality of my triplets seems to worsen when I try to analyze what I’m doing and what’s not going right. So then I stop trying to analyze it and I force myself to just practise it and hope it gets better…
Perhaps it’s a little bit similar to what I’m going through with learning medicine. There are some things that you just can’t understand, you only need to trust that it will be alright in the end, that the hard work will finally pay off…
Here’s a little recording – the harp wasn’t totally in tune and the tempos are a little bit off, but I wanted to share what pieces I’m practising for the folk lessons.
I often get ideas for comics a la Dr. Fizzy’s but I can’t draw at all. Alright, you don’t need to be good at drawing to make nice comics, but creating a comic does require that you put the idea in comic format. And that’s where I fail. So, without further ado, the text version of my comic ‘idea’, which I really needed to share.
A lot of medical students in the Netherlands are required to take a progress test four times a year. The idea of this test is to gauge your level of knowledge and see how you progress – in year one, you only need to get a few questions right, but after 6 years you need be able to answer all of them. (not really true, I think it was about 75% or so but they say that these questions are things every doctor should know. As if every doctor knows the exact prevalance of pyloric stenosis in the population…) Anyway, four times a year, medical students from all over the Netherlands are put into a sports hall for four hours and made to do this test. It’s a great moment to meet up with people from past tutor groups etc.
Shivering (it is ALWAYS cold in these halls!) you open your test booklet. Some questions depend on pure knowledge (I still can’t remember dermatomes) but others can be answered using the most efficient cheat sheet ever – your own body.
1. Lesion of which nerve causes the so-called ‘dropping hand’?
Being Pencak Silat player, this is rather easy to find out. Just hit yourself in various places and examine the result. This may impact your ability to hold a pencil, however, as I found out.
2. The m. supraspinatus assists in which movements?
This muscle is located at the top of the schoulder blade, so you can actually feel it. Try various movements to determine when it contracts.
3. Which muscle is responsible for lateral flexion in the ankle?
This question can be answered similarly to question 2 – try to do the movement and feel which muscle contracts. Of course, this only works if it’s a multiple choice question.
4. The diaphragmal muscles have a function during vomiting, true or false
This question actually made me feel sick – I tried to simulate vomiting movements (silently of course :P) and tried to feel whether I felt my diaphragm doing anything. I think I slightly overdid it.
5. What happens when the Thomson test is done on a person with a ruptured achilles tendon
The Thomson test involves squeezing your leg calf – the foot is supposed to go in plantar flexion when everything is alright. Yes, I looked that up because I couldn’t remember – I tried pinching my leg during the test but you can’t really bend sideways so you can see what’s happening under the table…
The new harpcolumn is awesome! It’s like a social network for harpists! I still prefer having a blog – it’s a bit odd that all blogposts are synched to a central page where all recent entries appear – but I’m starting to fall in love with all the features it offers (just go and look ).
Regarding harpcolumn.com – partly through reading such forums, I got back to the harp. Reading about everything that’s possible with the harp, issues people encounter (and recognizing, hey, I’m not the only one who has difficulties with x), interesting posts about effective practice… I’m not really active there, because there are much more knowledgable people than I am. But it’s great to read along with the discussions and sometimes contribute something.
Other new things: a new year has started, I’m a fifth year med student now! Only 2 years to go and I’m a ‘basisarts’ (junior doctor). I haven’t found a new harp teacher yet, but after a very nice three-hour session with my first harp teacher, I feel confident to really get started on the lever harp version of the Händel concerto.
Also a rather sad new development – rat #2 (Mr White Rat with a Slightly Darker Stripe than the other one) seems to have developed a tumor. After the events of last year, I’m rather reluctant to go to the vet again, so at the moment I’m trusting my clinical judgement that immediate action isn’t necessary. Actually, he’s not ‘ill’ at all – he’s still eating, drinking, he can still climb (the tumor is the size of a small chestnut!) and it doesn’t appear to cause him pain. And he’s two years old – we’re not expecting him to live forever anyway… but I’d have preferred to discuss appropriate end-of-life care for him. Perhaps we’ll give the vet a call next week…
Yesterday I had an awesome lesson with my first harp teacher. It was great to see her and she had lots of useful feedback. She’s really able to discern what a particular piece needs and her suggestions just felt right.
In Nataliana, we worked on adding silences, letting the melody ‘breathe’ and generally taking a step back. It doesn’t need to be fast and loud all the time, there is lots of space for decelerations / accellerations and dynamics.
In the Minstrel’s Adieu, we also worked on the same, adding much more pauses and trying to incorporate the sense of loss that is present in the piece. A lot of parts started to make so much more sense! There’s an entire page of flageolets and I didn’t really know what to do with them, how they fit into the whole of the piece. Now I know :).
In Danse d’ automne #3 we worked on emphasizing specific notes and on letting the notes last their entire duration. Somehow, I sort of forgot that several notes are really meant as ‘pauses’ in this very fast piece.
All in all, it was about taking a step back, leaving silences and removing the unnecessary clutter. Actually, it felt a little bit like sculpting – removing outer layers so the inner music can be revealed.
*notices strange red rash/bump on right leg*
OMGWTFBBQ IT’S CELLUTITIS I NEED TO GO TO THE DOCTOR!@#$%!!!!!!!
Wait. I bumped into the table this morning.
Being a doctor in training: freaking out over totally innocent skin lesions…
How can you be sure you really studied enough for orthopedics? If you can name exactly which muscle is aching after a particularly intense Pencak Silat training.
When your most profound and touching experience of the day consists of finally understanding the inguinal canal.