September 3, 2022

1. Cola


So take your orchidsElsewhere, elsewhereI loved you to deathAnd now I don't really care'Cause you're runnin' 'round over there

"Cola" by Arlo Parks

 
Her hair gleams lavender gray under the decaying yellow spotlight, a shade icier than the purple lace draped from the shoulders down her torso. Fingers armored in antique silver rings grasp the vintage microphone as her body sways to the pulse of the double bass. Instinctively, his fingers trace lines mirroring those curves into the condensation on the glass of the Old Fashioned he has barely consumed. 
 
Then, her mouth opens, and the voice of cayenne and honey that has haunted him for decades pours forth. 
 
This is how it begins again. It starts with a jolt within the ribcage, a path blooming red from the chest, tendrils climbing up the flushed neck and snaking down to the stirring groin. It starts with that sensation of deja vu, that we've been here before, perhaps not in this lifetime, but another turn of the wheel prior to this one. I do not know you, but I have known you for an eternity, does that make sense, darling?
 
What he does not know is that the moment she re-entered his life, the clock reset. Within seventy-two hours, he will die once more. 
 
 

September 2, 2022

The Id List

In other words, the buttons that were installed in me at an impressionable age and now make want me to gobble up and bang my fists like a toddler, GIMME.
  • Fate/Prophecies, especially if there is a tragic or romantic bent
    • X/1999 by CLAMP is full of prophecies
    • The Song of Achilles by Madeline Miller
    • Actually, Greek myths in general
       
  • On a similar note, fated across lifetimes (reincarnation)
    • Karou/Madrigal and Akiva from Daughter of Smoke and Bone
       
  • Masquerade/Ball scenes and Fancy Dresses
    • Cinderella (2015) has one of my favorite entrance scenes
    • All of the fancy dresses in Anastasia (1997)
    • What can I say, I'm a superficial bitch who loves a glow-up entrance
       
  •  On a similar note, fancy costumes in general
    • Cardcaptor Sakura by CLAMP
    • Crimson Peak (2015) - the costumes are divine
  • Mistaken or hidden identities
    • Love in the Afternoon  by Lisa Kleypas (Cyrano-esque retelling, except the heroine is penning love letters)
    • Saint Tail (manga) - student by day, phantom thief by night
    • Lioness Quartet by Tamora Pierce (Alanna pretending to be her brother while at knight school and then being in a secret relationship with the prince lol)
    • Basara (manga) - Sarasa is the leader of the rebellion, Shuri is the ruthless Red King responsible for her brother's death. But the two fall in love without realizing the other's identity as their sworn enemy. 
    • Again, Cinderella trope times infinity
       
  • What is PINING if not denial persevering?
    • Persuasion by Jane Austen
    • Also, all the longing glances and pining in the TV series North & South
    • I am not ashamed to say this Dramione fanfic has one of the best slow burns I have ever had the pleasure of reading.
       

April 17, 2022

Bullet Barf

  •  I have too many thoughts running in my head today, and I've come to the realization that I am more dishonest with myself than I've realized. So here it goes in barfy bullet format:
  •  I am currently on vacation. I can't even begin to describe how relieved I am. I also feel a little like I shouldn't be feeling this way? I had an entire month of research elective in March. I wasn't totally chilling--I still had to go to clinic two half-days per week, and I still had to attend conference. But my mornings were mine; I was running on the treadmill every morning, sleeping full nights, and just generally taking better care of myself.
  • Being in fellowship is constantly feeling like you don't know anything. For me, it's even worse than in residency. There's always this nagging sense that you should be reading more. Not to mention that every attending evaluation will say something along the lines, "Sophelia should continue to read more to further her knowledge base."And yet, there's a stack of Blood journals from the past three months collecting dust on my desk. 
  • Seriously, how am I going to feel ready to practice after three years of fellowship? I'm almost one-third of the way there, and I only feel slightly less dumb than I did ten months ago.
  • On that note, I am probably going to forget everything about hematology by the end of this month, because I would much prefer to not do any reading in the next two weeks.
  • We are going to Hawaii on Friday. I am looking forward to the change of scenery. I am looking forward to not having to answer any damn pages or e-mails. All I want is to eat and hike in peace.
  • Until Friday, I have been forcing my butt to sit down and write.
  • As I have mentioned multiple times here, I have two main writing projects in progress:
  • EP is the light of the life and the bane of my existence. To recap this long-ass saga, the story came into being when I was fifteen years old and obsessed with Phantom of the Opera and alt rock bands, which materialized its first iteration on fictionpress.net. (Is that website still alive?). I wrote intermittently in college until I finally finished a full draft in medical school. You know when something has been brewing for too long and it ends up turning out mushy? That's kind of what happened. And eventually, the fire that had pushed me to write EP for so long just slowly kind of... petered out.
  • Med Rom Com (I still don't have a catchy title) started stewing in my head while I was in residency. I wanted to write about residency, but I didn't want to write about myself. The characters came to me first, and it was a way for me to document and process what I was going through. Plus, I was convinced (and had gotten advice from others) that I needed to put EP aside because it was driving me bonkers.
  • But then, once I started really trying to write Med Rom Com, it became clear to me I wasn't over EP. Under all the overcooked slabs of fat on that story were the shiny little pieces that made me remember the joy. You know when you're submerged in a deep writing session, and when you emerge from the trance feeling like you absolutely NAILED it? And when you read those parts again, you're like, Damn this is good, did I write this? 
  • It's like that scene in the Pixar movie Soul where the artists are in this area called "the zone" which I guess brushes up into the afterlife. It's a spiritual plane.
  • I've mentioned before that I started listening to the Fated Mates podcast during the pandemic. Romance author Sarah Maclean has spoken before about how debut novels have a certain edge to them. It feels like when someone has been voraciously reading for ages, and over the years, they've collected all their favorite tropes and bits and let it percolate into an amazing blast of excitement and freshness. She and her co-host Jen have also referred to "writing to your id," which refers to certain aspects to a story that give your brain that euphoric hit of PUT IT IN MY VEINS. 
  • Once I heard that, things started to make sense. EP is essentially a blend of all the things Sophelia has been hardwired to react to on a primal level. (i.e. masks, secret identities, musicians, gimmeeee)
  •  So, essentially, I realized I wasn't ready to write off EP just yet.
  • But at the same time, I know logically that it might be time to just let it die. My mother had the analogy of watercolor painting, where if you keep trying to go back and fix with water and paint dabs, it'll end up a mess. 
  • I've been writing on most Sundays with a Zoom writing group hosted by Laini Taylor. As I've written on this blog before, when I discovered her book Daughter of Smoke and Bone back in college, I inhaled the first two books and pre-ordered the third book (which is not something I typically do). I've also proselytized her books to numerous friends... Anyways, it's a little crazy to me when I think about how I'm doing these Zoom writing sessions with a writer whose work I've admired so much?
  • She called me out and asked what I was working on, and I kind of rambled a bit. But I mentioned that I was working on something I'd set aside for a couple years. And she mentioned something about how it's always neat to get a fresh perspective with the distance of time, but also to be careful of mucking around on something for too long.
  • WHICH IS EXACTLY WHAT I'M WORRIED ABOUT.
  • But really, all I can do is stop wallowing and just swing for the fences, go hunting for big game. Which is easier said then done. I almost feel like I need to be super rigid with myself and give myself deadlines and scheduled writing times, because otherwise I always find excuses.
  • But this is only possible on vacation, because when I'm in work mode, I constantly feel like I should be studying... reading... so that I don't screw over my future patients...
  • I'm about to turn 31 years old, and there's this growing feeling of fear. Fear that I've been stuck in inertia, and one day I'll look back and think about how I squandered my potential. 
  • But I guess again, the only solution is to just suck it up. And just do the work. 
  • Finis

April 15, 2022

Excerpt 1.0

When you have cared for hundreds or thousands of patients during residency, there are names you will never forget. They are structural beams in the blueprint of a physician, a piece of your humanity preserved in amber that your fingers idly skim across years later. 

Guadalupe Fuentes. Was this during the first surge, or the second surge? To Elise, it has been all the same, a single monstrous swell rising and rising towards an infinite height. Seven months ago, Elise was the overnight MICU resident when Lupe was transferred from the floor. 63-year-old woman with diabetes, contracted COVID from her 87-year-old father who was briefly hospitalized for a few days and had already made a complete recovery. She’d initially required 4 liters of supplemental oxygen on the floor and had been started on Dexamethasone and Remdesivir, but that night, her oxygen requirements suddenly increased. Rosy apple cheeks and impeccably arched tattoo eyebrows, Lupe was always awake when the night team passed by her room, flashing a thumbs-up through the window as the high-flow nasal cannula obscured part of her face. 

Her final night is imprinted upon Elise in pieces. 

The alarm of the bedside monitor ringing, the blue numbers never rising past the 80s, shallow fluttering breaths as the respiratory rate climbs to the 30s, then 40s. 

Martha Fuentes, holding it together just long enough to say goodbye to her mother over Facetime, her voice cracking before a trickle becomes a rush of sobs, begging Elise to take care of her mother. Theo, the MICU fellow, calling out the orders for rocuronium and etomidate from the head of the bed as he wields the blade of the GlideScope in his hand. Elise, foolishly placated by the calm that follows a smooth and uneventful intubation. Foolishly lulled by the back-to-back success of her flawless placement of a central line catheter and arterial line, with Theo remarking that Elise was ready to do the procedures solo. 

Fool, fool, fool, fool, she has told herself a thousand times since. 

The phone rings while Elise is signing out overnight events to the day team. Her intern announces that Bed 40 is coding. Dread strikes like electricity shooting from the roots of her hair, through her scalp. Theo is already gowned up in the room when Elise gets there, calling out orders for one amp of sodium bicarbonate, one milligram of epinephrine. Elise jumps in to perform the next set of chest compressions, the sweat dripping down her neck under the gown as she feels the ribs rolling under the clammy skin beneath her gloved palms. They achieve ROSC after one cycle of CPR, but then the oxygen saturations drop and they are coding her again, three more cycles of CPR. Finally, they call it. Time of Death, 7:04 AM. 

She remembers how Fortino spared her from having to call Martha, telling her to go home, that he would take care of everything. But as soon as she was alone in the call room, Elise could no longer move, body dull as lead as the last gasp of adrenaline abandoned her. She sat on the bed in a daze for what felt like hours, until Rigo entered the room. It’s funny now, when she remembers how awkward things were between them back then. Neither knew how to behave around each other after what happened in Vegas. Trapped together as the night float residents for their respective MICU teams, she couldn’t look him in the eye as he stood in the doorway. 

Hey, are you okay? 

How many times had she been asked that question before and answered with a lie? Before she could even get the words out, the tension in her facial muscles gave him the answer by letting go. 

This was the last time Elise cried for one of her COVID patients. How many others has she lost since then? Ten? Twenty? Fifty? The story repeats itself, one by one, the bodies in her mental graveyard lining up in rows. Dexamethasone, full-dose heparin drip, Nimbex drip, Vancomycin, Cefepime. Nothing works. They slip through her fingers one by one like sand. 

 

March 27, 2022

Saplings

When immigrant families are uprooted, sometimes the entire tree is transplanted. Both sides of my partner's families crossed the Pacific to escape war and genocide; the ones who escaped alive came together, a sprawl of aunties and uncles and cousins across California and beyond. 

But there are other immigrant families, where the seeds were carried off in the wind, sprouting into saplings a great distance away from the roots. 

When my mother's father died, I didn't feel sadness about his passing. Rather, I felt sad on behalf of my mother. I could count the number of times we had interacted on one hand. I had a vague recollection that A-Gong liked to travel. I remember the scent of cigarettes he used to smoke. When a heart attack eventually took him, I was in ninth grade and had only visited Taiwan twice. I can't recall a single conversation I had with him---not that I could have conveyed much to him with my grade-school Mandarin and non-existent Taiwanese.

My father's mother passed in the autumn of my first year of medical school. I hadn't learned what cirrhosis was yet. I didn't know what it meant when they had to "take out fluid" from Nai-Nai's abdomen. I didn't understand the implications of Nai-Nai going to China for a liver transplant. When she eventually succumbed to pneumonia, I felt somber but it was a more cerebral than visceral reaction. After A-Gong had died, we had visited Taiwan more frequently to make up for lost time. Even still, I wouldn't know what to tell you about Nai-Nai. She liked to watch TV. She had tattooed eyebrows. Everything else I know about her is from second-hand stories of family drama.

#

Even if I hadn't lived her for six weeks in 2012, A-Ma had always been different. A-Gong and Nai-Nai were line drawings, sketches in my head. A-Ma was already more vividly painted in my head before that summer, lines and curves shaded in by the stories my mother told.

A-Ma, like my mother and myself, was the eldest child and oldest daughter. She was a child in Taiwan under Japanese occupation during World War II. Food was scarce then. She ate so many yams during that period that as an adult, she never wanted to eat another yam again. 

Her father pulled her out of school after sixth grade. He didn't see the value in a girl getting secondary education. Her first job was at a shop that made and sold jerky. She soon discovered her business acumen and was exceptionally quick at calculating mental math. After she married A-Gong, they opened a business specialized in making fabric for children's clothes. While A-Gong was the face of the business, in reality my grandmother was the one running the show.

Before the late stages of ALS captured her voice, my grandmother was the loudest woman I knew. Her daughters seemed to have inherited this trait. When she and my aunt came to visit our family in California when I was in third grade, my brother and I grumbled about not being able to sleep from the cacophony in the kitchen from the chatter of their excited reunion with my mother.

Before ALS took away her freedom, my grandmother sped off on her moped each morning to the temple and the market. She'd clamber up and down the four-story house, with the ancestral altar on the highest floor, the kitchen on the second floor, the garage on the first floor.

She continued her bustling day-to-day routine after my grandfather died. But my mother noticed that afterwards, A-Ma had seemed prepared to die. She had already planned where her coffin would be displayed on the first floor of the house as part of the funeral rites. She reserved her cremation urn in the temple when she made arrangements for A-Gong. This was even before the disease began to slowly eat away her physical strength. Once she stopped being able to cook, stopped being able to bathe, stopped being able to walk, it was as if her greatest desire was to die. Buddhism does not condone taking one's own life. It's what they would call Passive Ideation in psychiatry. You may wish for it with all your heart, but your hand will not---or cannot---make the move.

#

In the summer of 2012, I was a rising college senior riddled with angst about my chances of being accepted to medical school. My mother came up with the idea of going to Taiwan for the summer and shadowing an emergency room physician she knew through mutual acquaintances. She accompanied me for a week to make sure I was all settled in Tainan, and once it came time for her to return to the States, it was just me and A-Ma in the four-story house. 

I quickly learned that around A-Ma, you had to be careful about any food you expressed preference for. After I commented that the pineapples were deliciously sweet, bags of fresh-cut pineapples from the market were stocked in the refrigerator every morning. After I mentioned that I loved the curry udon, she made it for me every single day.

Mandarin was neither of our first languages; she preferred Taiwanese, while I spoke English. Her Mandarin far surpassed mine, but we were able to cobble together conversations. I would return from the hospital and tell her about the funny observations I had made. The language muscle I exercised each day bulked up in tone, and by the end of summer, my Mandarin was the most fluent it had ever been. 

There was one particular evening, where A-Ma and I sat in front of the TV after dinner. The kitchen/dining room was on the second story of the house. If you walked into the room, the first thing that would catch your eye is Keanu Reeves' brooding visage on an enormous movie poster of Speed directly above the kitchen table. The explanation I was given was that my youngest aunt had a celebrity crush on Keanu, but that didn't explain why his face was still hovering in the kitchen nearly a decade after my aunt had married and moved out of the house. As much as we were bonding, I wasn't about to ask A-Ma in bungled Mandarin if she found Keanu pleasing to the eye.

A-Ma used to watch dramas on the 'Big Love Channel' produced by a Buddhist charity foundation. Something in the show must have inspired a conversation about relationships. How we got to this point eludes me, but what I remember clearly is the story A-Ma told me about my mother, from a time before she met my father. I hesitate to use the word secret. There was nothing scandalous about it. But it was a piece of my mother's life that she never would have told me. There is a point in your life when the kaleidoscope turns, the pieces shift into new shapes and colors, and suddenly you view your parents as full-formed people who had their own life, hopes, and dreams before you ever existed. My grandmother told me not to tell anyone what she had told me. I carried that piece she gave me close to my chest. 

#

I realize I haven't mentioned Ye-Ye yet.

The yin-yang symmetry is evidence of a higher power with a sick sense of humor. My mother's mother, her brain as sharp as ever, her body whittling away as her muscles failed her. My father's father, physical health as pristine as could be, his mind wringing dry from the cruel squeeze of Alzheimer's.

What would you rather? The question has crossed all of our minds. Maybe there is something merciful in not knowing. Could you bear to live with the full knowledge that your disease has trapped you in a body that refuses to cooperate? But then I think of Ye-Ye. He was a former ship-builder who once took pride in the fact that he could speak a little German, Japanese, and English. He was already growing more forgetful when I saw him in 2012. By the time I was in medical school, he would ask me the same question every ten minutes. When I saw him the spring before I started residency, he asked me if my brother was a doctor yet. By the time my brother went to visit seven months later, he had no memory of him left.

Alzheimer's is not a blissful slide into unknowing. In reaction to his eroding ability to remember, he compensated with increasing stubbornness. In the early stages, like a toddler unable to express himself, Ye-Ye would lash out. In some ways, I find that aspect even more frightening. That sliver of consciousness, the awareness that your sense of self is disintegrating and that there is nothing you can do to stop it from slipping through your fingers.

#

A-Ma seemed to think she would die quickly. But months coalesced into years. When she began having trouble breathing in January, the family in Tainan worried about the logistical nightmare of arranging funeral arrangements around Lunar New Year. But then, February 1st came and went. A-Ma rented an oxygen tank and seemed to be sleeping better. Because Taiwan continued to require a fourteen-day quarantine for all international visitors, my mother relinquished the idea of going back to see her mother. Instead, she video-called her mother every day. 

Perhaps because there had been numerous false alarms over the years, I was caught me off guard when I received a text while at work that her wish had finally come true. But my mother later told me that this time had felt different. My grandmother, who had eaten nothing but dietary supplements for years, suddenly asked her caregiver to make her pumpkin and water spinach soup. Maybe she knew this time, the end was truly near. 

On her last day, my uncle's family had come to visit her. Four generations were under one household: my grandmother, my uncle, my cousins, and my cousin's daughter. Palliative nurses have told me that the dying often seem to wait for permission to let go. I imagine her lying in the bed, listening to the four-story house reverberate once more with noise and life. I wonder if she thought of the rest of us. Picture a forest in Tainan, a cluster in California, a lone sapling in Connecticut. The roots stretch below the ground for miles. The rain falls, but tomorrow, the leaves will stretch towards the nurturing sunlight, the flowers will bloom, and the seeds will sail aloft once more.

January 29, 2022

All We Have

 "Searching for a signal
It's all within your touch
And I know you've given up
But all we have is now

All we have is now."

"All We Have" by SG Lewis ft Lastlings

 

Most days, I feel as if I have aged decades in the span of four years. My hair is thin and brittle, with a halo of flyaway baby hairs around my crown. My brain is in a fog, slipping its grasp on conversations I had just hours ago or the plot of a book I just read last month. Sometimes I wonder what I would be like if I hadn't sacrificed my twenties to the altar of medicine. Maybe my hair would be thicker, my memory sharper. 

Most days, I don't think too deeply about what I do. But occasionally, during the morning commute toward downtown, my thoughts drift afar like a detached observer. I think about the stress I carry on a daily basis, and how some of the people who knew me in earlier stages of my life have no comprehension of the heft of that perpetual weight. Or, how there are decisions I make each day that could tip a person's life closer or farther away from death.

When I was younger, I was baffled by people who said they only watched "happy" movies or TV shows. Indignantly, I would point out that there were quality works of "art" that were not "happy" and that it was a damn shame to avoid those works. Now in my thirties, I am reluctant to watch anything that I suspect will stress me out.

Has it all been worth it? I suppose that's a double-edged question. I don't consciously regret the path I took. My profession comes with its privileges. I understand more clearly why immigrant parents push their children towards medicine. How daunting is it to navigate the healthcare system and interpret medical jargon, never mind if the information is flying at you in your second language? My knowledge is an asset and a tool I did not come by lightly. It has helped me give advice to family members. It has given me the financial security to live without constantly worrying about money. And though it's easy to forget on the days when you have especially difficult patients, for the most part, there is purpose and meaning to the work that feels larger than yourself.

But on the other hand, I can feel a weariness that wasn't there before. 

The other morning, I stumbled across a video clip of 2NE1 reminiscing about their career, and it inspired me to play my nearly decade-old BIGBANG playlist. I haven't paid close attention to BIGBANG in a long time. There was that MeToo scandal involving the youngest member Seungri, and at some point I learned that Taeyang had gotten married, but otherwise I have no idea what any of them are up to nowadays. 

As the rumbling bass line of my once-favorite rapper floated into the car, nostalgia kicked me in the face. I remembered how I once kept his picture on the wall of my college dorm. To remind me that he hadn't given up. That when they told him he was too fat to be in a Kpop group, he came back after he lost forty pounds. That during his trainee years, they told him he sucked at dancing. When his photo first appeared on my wall, I was eighteen years old and had tanked my GPA after getting a C in Multivariable Calculus. I didn't know if I'd be able to salvage my GPA enough to get into medical school. I listened to his voice, a lulling chant of baritone rapidfire foreign syllables, to calm myself down before exams. 

I remember also who I was back then, in my late teens and early twenties. When all the paths before me seemed infinite. That uncertainty of the future can be suffocating, but by the same token, there was a freeing sense of self-importance and arrogance that led me to dream big. I dreamed with absolute certainty that EP would be the magnum opus of my life.

I think of who I am now, thirty-years-old, having ambled far down one path as the others closed, either too tired to think about dreams now, or wondering if some of those doors have already closed for good.