Taking Space

This story begins in Paris, where I found myself one day about a month after college graduation. I had just wrapped up a trip during which I led and taught American high school students, who were now en route back to the US with another of the teachers. I was set to catch a flight to meet my parents in Rome the following day. With 24 hours in my favorite city, free of any obligations and with some money left over from my teaching salary, I had expected to be jubilant on this last day, roaming the city’s streets without a map, popping into tiny cafes and boutiques and daydreaming about the next time I would return. Instead, I found myself consumed with agitation and anxiety. I felt the need to run and escape, though I had no direction. An unpleasant incident had occurred the previous night, in which one of the teachers had made poor decisions that endangered a student, and although the situation had been resolved safely, my mind still swam with confusion, betrayal, anger, and disappointment that I had yet to process. So I stalked the streets distractedly until I realized where I needed to be, then made my way to one of two small islands situated in the Seine right near the city’s center and entered the cool cavernous sanctuary of Notre Dame.

I am not religious, and if I were, I’m pretty sure I wouldn’t be Catholic. Though I am only vaguely familiar with the faith – growing up, the little girl across the street always seemed to be wearing pretty dresses when she played in the driveway after church, from which I deduced that this must be one of the fancier denominations – I do know that organized religion is not, at this point in my life, something that appeals to me. Regardless, I felt a strong pull toward the cathedral.

I have made many visits before, each time falling more deeply in love with the stunning architecture, so I attributed the draw to this fondness and familiarity. I sat in a pew, thought hard and let my mind wander, focused on breathing and being.

***

This month, I am rotating in a partial hospital program, which is a treatment program for children who carry concurrent (and often connected) medical and psychiatric diagnoses. It is organized similarly to a school; the kids arrive and check in each morning, then return to their families for evenings and weekends. It can be very difficult, especially for kids suffering from anxiety, to always be around others and to participate in group activities and therapy. Thus, a child always has the option of “taking space.” This involves going to a separate room where he or she can remain - supervised by a staff member – until the feelings of anxiety or panic or being overwhelmed have subsided.

I’ve been thinking a lot about space and its importance in relation to different activities and even states of mind. I often get frustrated with myself for failing to integrate meditation into my life, until I look around my cute by small apartment and realize that there is no area where I would feel serene and calm (and not totally bizarre) sitting on my meditation cushion. In the living room with the TV towering over me? Nope. In the bedroom between the dresser and desk? Not so much. It’s the same reason that yoga performed on a mat spread out in front of the couch just isn’t as relaxing as that practiced in a studio with dimmed lights and soft music and a teacher and other students surrounding me. Different spaces have different distinct purposes and connotations, and while there is some overlap and fluidity, attempting to assign too many tasks to one particular space, or not having enough space in general, can be mentally and emotionally constricting. Which is probably why I am writing this in Tay’s large, bright, windowed apartment in Boston, where I only come to relax, and which feels vastly different from the spaces I use for studying and the tasks of everyday life.

When I look back, I have to laugh at myself because there have been many times in the past when I have fully - though subconsciously - appreciated the importance of space, such as when I chose to study for both steps of my board exam in Vermont. At the time I conceptualized the decision as "Vermont is a place where I am happy and not distracted," but I clearly needed to remove myself from my everyday milieu and the aura of stress that permeates the study areas at my school and even at my desk at home. I took space without even knowing that I was doing so.

In retrospect I understand that my pilgrimage to Notre Dame was not one of faith in religion but of faith in my need, although I didn’t explicitly understand it at the time, to take some space. I needed a peaceful, comforting place to hide out from the disappointments of world for a little while; to work out how I felt about what had transpired, to take a rest from the effort required to exist in the unpredictability of the the everyday, and to shore up my mental strength to re-emerge and face it again.

On Service (Part II)

And now there is another kind of going on service: beginning a new rotation at a new hospital in a new city. Suddenly there is much to learn beyond patient names and conditions; there are new corridors, new computer systems, new commutes. While I had spent four weeks at a hospital in Boston this fall, the setting outside of the hospital was familiar. I knew where to buy groceries, where to mail letters, where to jog. Since Sunday night, however, I have been living in Providence, Rhode Island, a place of which I have minimal prior knowledge and in which my already-pitiable sense of direction has gone completely askew.

After making it to the visitors’ parking lot for my first day after only one quick request for directions (from a security guard who kindly pointed out that the lot was directly in front of me), I learned that I would be parking in a remote lot with shuttle service to the hospital campus; an issue to be addressed the following day. That afternoon, determined to get out and start establishing my life here, I programmed my GPS to find the nearest Starbucks. I couldn’t find it, so I aimed for the next one on the list. No luck there. Finally, on the third try, I found the coffee shop and even a parking spot just around the block. After spending some time reading there, I plugged in the address of a yoga studio I had located online.

I found the studio, parked on the street by a meter, then realized I had used all but one of my quarters feeding the meter near Starbucks. It was 5:30, so only a short time remained during which my car would remain fair game for a ticket. Deciding that my mental and physical health were more important than a possible fee, I went inside and found the studio, whereupon I realized I had left my mat in the car. Back at the car, I spied an emptying parking lot next to the building. Perhaps I could park there and ensure there would be no ticket. I pulled into the lot, then saw the sign threatening that all unauthorized vehicles would be towed at all times. I retreated to the metered spot. Re-entering the building, I noticed a sign inside explaining that clients were in fact permitted to use that lot in the evenings after 5pm without fear of being towed. Back out to the car and into the lot I went. And then finally to yoga. And, after a few wrong turns, back home to the apartment where I am renting a room.

The following day, I set out for the new remote parking lot, having Google mapped it the evening prior. Only it turns out that I had used the Pedestrian setting, in which the direction of traffic on one-way streets is not taken into account. With the help of my hastily programmed GPS, I finally made it, then learned that the card I was supposed to use to swipe in had not yet been activated. A parking attendant kindly let me in, I parked, and then I faced the next problem: where to catch this shuttle? And once I was on it, where would it drop me off in relation to where I needed to be? These issues were sorted out by a kind stranger working near the garage and by my own vague recognition of the buildings near the hospital. (The problem with the parking pass recurred on the following day and required two trips to the Graduate Medical Education office and one to Parking Services but was eventually resolved.)

All this without even setting foot into the hospital! The Partial Hospital Program (a day program for children with concurrent medical and psychological diagnoses) is staffed by two directors, two psychologists, two psychiatrists, two pediatricians, two social workers, three teachers, and numerous nurses and therapists, as well as a host of other trainees. It is a busy, busy place, and while everyone has been extraordinarily friendly, it has been extremely daunting to figure out where I fit into the mix, let alone to try to retain each person’s name and role. Plus, no one told me when to show up, when to go home, or what exactly to do in between.

And then, just as with other services, be they with human patients or with my canine friends, small pieces started to stick. Yesterday I was encouraged to attend the pediatrics noon conference, to which I had accompanied one of the residents on the previous two days. Not that I had the faintest clue how to get from the Partial Hospital Program to the auditorium on my own.

Except that I did. I set out through the halls, hoping for the best, and suddenly saw a sign that looked familiar. Around the bend, I recognized a distinctive design along the wall that I was sure I had seen before. Several more serendipitous findings and a few hold-your-breath guesses and I had arrived at the conference.

Yesterday afternoon I went for a run. I had my cell phone with me, stuffed bulkily into my sports bra, just in case I needed a quick check of the route home. But it stayed right in my shirt the entire time, bouncing awkwardly while protecting me with its mere presence from imagined disaster.

Today, I attended a family meeting and a therapy session with a boy who I will be following. I set at least a preliminary schedule for meetings with the person leading his therapy. I arranged the weekly times when I will sit in on group therapy. I have some direction to my days.

And just yesterday, on a whim, I left the GPS in the glove compartment. I turned out of the parking garage, missed the turn I intended to take, then took the next one and figured it out from there. Slowly and with just the slightest bit of confidence, I wended my way home.

On Service (Part I)

When a physician begins a period of time – be it a week or a month or anything in between depending on the physician and the practice setting – taking care of a group of patients in the hospital (which could mean those on a certain floor of the hospital, a certain subset of that floor, or the patients scattered throughout the hospital on whose cases a subspecialty service, such as cardiology, is being consulted), it is known as “going on service.” Like any transition, this one takes time. For the first day or so, the physician must work hard to learn the ins and outs of each patient assigned to him or her, which can be exceedingly complicated given that some patients’ lengths of stay may already be measuring in weeks or months. In addition to learning the medical details, the doctor will gradually get to know the patients’ personalities and complicating factors – which ones downplay their pain, which ones have complex social situations involving certain family members who must receive daily updates while certain others most decidedly must not.

The same is true, to a lesser extent, as a medical student. When I join a service, either at the start of a new rotation or, during the longer rotations of third year, when we switched every two weeks so as to experience a variety of patients and care teams, I am confronted by a census (a list of the patients assigned to the team of one or more residents and an attending physician) that initially appears insurmountable (defining “surmounting” here as becoming familiar enough so that a face, a chief complaint, and a general hospital course become attached to each name). Rounds on the first day involve frantic scribbles of basic facts next to each: “CHF, on Lasix.” “Diabetes – endocrine consulting.” “Sickle cell – monitor for acute chest.” At the end of the day, the names on the list are only vaguely more familiar than before. Most ring a bell; few conjure up the image of a person and the gist of his or her story. By the third day, however, as we stop outside each patient’s door, I am usually somewhat startled to find facts floating into the forefront of my mind – a basic diagnosis, a general treatment plan, a face; perhaps a notable exam finding. By the end of the week, however, I generally know each patient and backstory, and have forgotten that these names ever rang foreign to my ears.

Conceived several months ago, this post was originally intended to segue into an examination of another type of service and the parallel nature of becoming accustomed to a different set of individuals. Last spring, I began volunteering at a local animal shelter, where I take homeless dogs out for walks and socialization. Once a week (though admittedly and heartbreakingly less often as I spend time doing rotations in different cities), we explore a path winding through trees, stride the length of a neighboring empty lot, or play off-leash in an enclosed dog run. The first time I consulted the list of names on the checklist where volunteers record which dogs they have walked on a particular day, it told me nothing; not which dogs were new and which still lingered, unadopted, after months; not what size collar and what thickness leash to collect from the supply area before heading out to greet a new friend; not which dogs were small and especially cute and thus likely to still get walked by others if I prioritized those who were larger or less traditionally cute.

But after only a few visits, I had learned some names and personalities. There was the pitbull who had both a collar embroidered with skulls and crossbones and a daisy-printed bandana around her neck, who regularly halted our walks to roll on her back in the grass, soliciting a belly-rub. There was the mix (part pitbull, but larger and with stripes, which Tay firmly asserted was less dog than tiger), who jumped in circles in her pen whenever I approached, and who made hilarious snorting sounds as she explored the olfactory phenomena that existed outside of the shelter. There was the tiny little chihuahua-like lady who supported herself on her stick-like front legs while squatting, so that her back legs were largely airborne whenever she peed. And there was the older, calm, loving female whose gait had an odd bobbing quality due to the large mass on her front leg but who soldiered on, forever stretching out our walks for as long as she could persuade my soft heart to allow. (Yes, ok, we can do one more lap around the path.)

Music Memory

My grandmother used to tell me how, when she arrived for her violin lessons as a child, her teacher would demand her left hand and clip her fingernails himself.

My favorite teacher loved sampling different brands of rosin [the substance that string players rub on the hair of their bows to help them grip the strings]; her favorite was Pirastro Olive. I bought a cake of it because I wanted to be like her. I will never use it up.

At the annual solo competitions throughout my youth, I scored the highest possible score every year except one. In seventh grade, I was too confident. I flew through the piece and lost points for careless mistakes. Excellent, not Outstanding. Devastation. Life went on.

Every year, my dad drove me to the solo competition, even after I had my license. He listened to me warm up, then listened outside the door during my performance for the judge. The year I auditioned for the All-State orchestra, he could see through a little window that my back broke out in hives as I played. When I came out, he told me that I had nailed it. He was right; I made it in.

When I went to my teacher's house for lessons the summer before she died, I would kick off my shoes and play barefoot. I practiced for her like I have never practiced for any other teacher in my life before or since. She pushed me toward boldness. I realize now that she wasn't just talking about music.

This is not a post about how lovely and noteworthy it was to pick up my violin this afternoon and how I wish I had time to do so more often. These things are true, but so what? This is about the flood of memories that rushed back before I had even wrestled the tuning pegs, sticky from neglect, into place. And about how there are more reasons than guilt over relinquishing skills that it took years of training to learn to pick it up and play again. And again. And again.

Spelunking

During orientation week of my first year of medical school, one of the deans spoke to us about the rigors we would face. He used the typical analogies – this is a marathon, not a sprint – to encourage us to find our own balance and make time for things like exercise and visits with family. But sometimes, he warned us, sometimes, we would need to "go into the cave and get it done."

I went into the cave in July. After finishing out third year with my surgery rotation, celebrating Tay’s and my first wedding anniversary, using my vacation week to move to a new apartment, and absorbing the news of my dad’s prostate cancer diagnosis, I had three weeks to prepare for Step 2 of the United States Medical Licensing Exam, a 9-hour, 352-question multiple-choice extravaganza of clinical knowledge and reasoning on which a passing score is required for graduation and which score can have a sizable impact on one’s residency prospects. So, after the first week of study, I packed my bags and took myself to Vermont.

Possibly more harrowing than preparing for the test was the prospect of living in near-total solitude for fifteen days. It’s quiet up there in the summertime. Other than going out for runs and walks and the occasional foray to the grocery store, I wouldn’t be interacting with anyone. It’s funny how, back in the days of bad roommates, I couldn’t wait to live on my own, was bursting at the seams to establish my own domain. Now I’ve lived with Tay for four years. I wasn’t sure how I would do with so much time and space for my wandering thoughts.

Fast-forward to the day the scores were released and Tay, knowing I would put off looking at my score for weeks if given the chance, took charge and looked at it (just like last year) and you will know that I learned a good bit of medicine up there. But I also learned a number of things about myself that feel somehow both arbitrary and important to know:

-I can change my own tire, though I might need a little help loosening the lugnuts. Apparently I paid attention to my dad’s lesson that day in the driveway more than ten years ago.

-I’m still kind of afraid of the dark, or at least of going to bed knowing I’m alone in the building. (Yes, even in Vermont.) I never thought I’d be so comforted to hear what I’m pretty sure was drunken Czech floating over from two balconies away.

-I have no idea if I’m allergic to bee stings, and suddenly this hole in my knowledge grew to seem incredibly egregious as I considered the potential consequences should I happen to be stung by a bee and happen to in fact be allergic and happen to feel my throat closing with no one nearby to call 911 or give me an emergency tracheostomy…. Witness the limitless creativity that results when I off-load my test anxiety onto every aspect of normal life.

-I might consider getting a [small, subtle, classic and classily-placed] tattoo, assuming I can decide on a design that I will love for the rest of my life and get over my fears of getting Hep C.

-Finally, the lesson with actual ramifications: Writing will always soothe me. It will always inspire joy. Even when I’m alone in my cave of concentration and solitude, balancing the desire to close the curtains against what was likely a firecracker but could be imagined as a gunshot (stop laughing) with the need to let in the comforting sounds of boisterous Eastern European revelry (apparently they did not think it sounded like a gunshot), writing will do wonders. It might be a poem - which is how I calmed myself the night before my exam - or an essay contemplating the decision to ink or not to ink. I might not initially feel that I have much to say, or that saying it deserves precedence over the ever-expanding list of other things I "should" be doing. But if I can just let myself start, or get myself to start, it will carry me through every time.

Experience

You know you’ve gotten the hang of third year, of functioning on rotations, of being a good “clerk” (that term that appears in the written descriptions of your role on each service but that you’ve never ever heard anyone actually use in reference to you), when you arrive at the hospital at 5:15am to find out which patients you’ll need to present on rounds, which will begin at 6am. You’re already planning how you will log into the electronic medical record system and quickly scan your patients’ lab values for anything abnormal or notable and copy their vital signs and I’s and O’s (in’s and out’s, which is just what it sounds like – a record of the quantity each has taken in and excreted throughout the past 24 hours) right onto the page you already snagged from each of their medical records on which to write your note (no reason to waste time and pen-strokes jotting numbers onto scrap paper first and then transcribing them into the note when by now you know exactly how far down in your note to write them, leaving enough space above to record the overnight events and the patient’s status this morning) before scurrying off to examine the patients themselves. You’re aiming for only one computer log-in this morning - it’s so irritating to have to go find a computer and watch seconds tick by as it processes your username and password for a second time after you’ve seen the patients and have realized while scribbling your notes that you forgot to pull up the report of that chest x-ray that one of them had overnight.

You punch in the first patient’s medical record and squint at the abbreviation indicating her location in the hospital. Instead of the expected series of three numbers preceded by an N or a P for the North or Potter sections where most of the surgical patients reside, next to the name you see ADMH05. Huh?

You’ll do the other patient first, you decide, scanning the chart for his history and what surgery he had so you have some clue where to focus your brief examine and pointed questions. When you finish his note, you ask a nurse which area this cryptic bed location indicates, and she tells you it’s the Hoag building. Excellent; you know just how to get there. You run down three flights of stairs to the first level, where all of the building’s sections interconnect, and head up to the 5th floor. You scan the large board across from the nursing station, but the patient’s name isn’t listed.

You check with a nurse – there’s no such patient on this floor. She gamely checks the computer, translating the location code as Potter rather than Hoag, so back downstairs and over to Potter you go. You find the right section, find the patient, and find out that the patient is hard of hearing. Trying not to rush, you remind yourself to keep the pitch of your voice low rather than high because high-pitched hearing is usually what goes first. You ask the patient how she’s doing, whether she has any pain and if she’s peeing and pooping without problems. You grab the chart and copy down the vital signs, then run back over to the North building to finish writing your notes.

At which point you realize that you don’t have the I’s and O’s for this second patient. The residents are going to want this information on rounds, which will start right at 6:00am. Which is five minutes from now. There’s no getting around it; you need the numbers. “I couldn’t find them” won’t cut it. You log back into the computer, but they’re not listed there. You hesitate for half a second, then turn and dash back downstairs, back over to the Potter building, back to the patient’s chart. You flip through the sections of the chart until you find the I’s and O’s, copy them down, then run back to the third floor of North. It’s 5:58. You have time for two more sentences of your note and one deep breath. And then it’s time for rounds, and you’re ready.

Ice Queen

A few weeks ago, I found myself stuck in a conversation of my least favorite sort. I was taking an end-of-year-three exam that involved different scenarios with actor-patients, each with his or her own presenting symptoms, history, and physical exam findings from which I would need to riddle a diagnosis or at least the next diagnostic steps I wanted to take. Having finished one such encounter with time to spare, I sat quietly in the hallway that connects all of the exam rooms, staring alternately at the ceiling, the floor, and my lap so as to avoid giving the impression that I might be attempting to communicate answers with other students via eye contact or facial expressions.

The man proctoring the exam stuck up a conversation with me, asking what area of medicine I planned to pursue. I explained that I hope to do a residency in pediatrics, followed by a fellowship in pediatric hematology/oncology. Then I braced myself.

I am well accustomed to people’s responses. Even before I shifted my focus to pediatric oncology, I had spent ten years planning to treat cancer patients of some sort, and so I was used to people’s facial expressions – which landed somewhere along the spectrum between slightly troubled and downright aghast – and their comments. Wow, that’s tough and, I don’t think I could do that and even, Won’t you be really sad?

But this man decided to take it even further. He chose to pontificate. Grimacing, he began, “Wow, that’s got to be really hard. To do that, you have to have no emotions at all; you really must be made of ice.”

Over the years, my response to the usual expressions of dismay has evolved. Previously, I was so uncomfortable with the discomfort of others that I grew almost apologetic, my voice rising in uncertainty as I explained the reasoning behind my decision as if imploring them to agree with me. Then I grew slightly more confident, presenting my thoughts earnestly, feeling the importance of making others understand my point of view. Now that I am inching closer to my goal – and to my thirtieth birthday – I just get pissed.

I agree that oncology of any sort is rife with challenges, and treating kids with cancer is another ballgame that most people can’t imagine. I’ve had plenty of doctors in other specialties tell me stories from their experiences in pediatric oncology during medical school. They describe situations that I find myself wanting to run towards even as I fake-sympathetically nod and cluck at how terrible the field is. I even realize that I could still change my mind. But what I can’t deal with is people who judge and criticize others’ career choices just because that area wouldn’t work for them. Do you want to know the truth? I really couldn’t stand surgery. There is not a cell in my body that so much as whispered of an interest in it. But that’s just me. Not only do I understand that others may disagree vehemently, I am thoroughly glad that they do, because we need surgeons and it would be best if the people who do surgery actually liked what they are doing. I’m really glad that some people out there enjoy it, because it means that I don’t have to enter a field that I don’t like. (Same goes for lawyers, engineers, accountants, etc.) I’d just like to politely suggest that they show the same deference for my career selection.

As much as I would have liked to walk away, I was stuck. I couldn’t exactly quit the exam midway through, nor could I excuse myself and go speak to one of my classmates, so I nudged us along to another topic. He asked where I planned to practice, and I gushed about Tay’s and my love of New England, adding that we are avid skiers. He asked if I had skied out west, and I said no, not since I was about four. And then suddenly there we were, back in judgment-ville. “You’ve never skied out west?! And you call yourself a serious skier??”

This time I didn’t shy away. “What can I say?” I shrugged, meeting his eyes without faltering. “I'm an Eastern skier. I love to ski the ice.”

Sundays

I recently saw a TV commercial that extolled the merits of Sundays. I don’t even recall what product it advertised, just that it talked about how all good things seem to take place on this particular day of the week. To which I would respond: whoever wrote that commercial has clearly never been in a long-distance relationship.

For those whose love stretches across county or even state lines, Sunday is a toughie. It starts out well, usually with a leisurely sleep-in, maybe a nice brunch over which to recount the fun of the past thirty-six hours or so. This can be followed by an afternoon outing or perhaps snuggling on the couch in front of a movie. But inevitably the hands on the clock move too quickly and excitement and joy are edged out by concern over whether one’s contact lens case made it back into the toiletries bag and just how many minutes of togetherness can be eked out while leaving enough time to reach the airport or bus terminal or highway. Even before the last kiss, a pre-emptive loneliness sets in.

I have a friend who took such Sunday good-byes so hard that she sometimes had to call in sick to work on Monday. Happily, she and her then-boyfriend are now married and living together in Boston. One of Tay’s former coworkers, a Turkish physician, once spent six months training in the US while her husband, also a physician, continued his job in Istanbul. They missed each other so much that he made the 10-hour flight to see her four times during that half-year.

Tay and I, no strangers to the commuter relationship, breathed a sigh of relief back in 2007 when we finally moved in together up in Hanover, NH. When I was accepted to Stony Brook he moved down to Long Island with me. We thought that we had put the days of too-frequent good-byes and prolonged absences behind us.

Yet here we are, doing it again. I am spending my eight-week surgery rotation at a hospital about 35 miles from home, and given that my alarm starts my day at 4:30am, I opt to stay in the free student housing across the street from the hospital, returning home on weekends. It could be worse; at least we get to spend every weekend together, as well as the occasional weeknight when he drives in to have dinner with me and stay in the cramped twin bed from which we can hear the rumbling of trains and announcements from the nearby station throughout the night. Neither of us sleeps well, but we don’t sleep any better being apart.

When Friday arrives, each moment of traffic that eats away at my precious time at home is torture. Our rituals after my arrival hearken back to our early days: we go out to dinner – a luxury that we normally wouldn’t allow ourselves weekly - and it seems we can’t talk quickly enough to spill out everything we wish to recount from the week apart. (Despite multiple phone calls daily.) Saturdays are the best, as we find ourselves well rested with still more than 24 hours stretched out before us. But then Sunday dawns once more, and the usual frustrations of trying to cram in grocery shopping, cleaning, and all of the other to-do’s that can be pushed off no longer is complicated by the struggle to fit in that brunch. That outing. That extra snuggle time.

So I disagree with the commercial. For some of us, Sundays don’t contain everything pure and wonderful. Unless you count the fact that every Sunday night puts us that much closer to the end of the next week, when we can see the one we love once again.

It's Only Kind of a Funny Story

First, I’d like to make a film recommendation: go rent It’s Kind of a Funny Story. It’s the story of a teenager who inadvertently ends up in the psych ward due to the trials and pressures of adolescence. It’s funny and it’s got heart. (It’s also got Zach Galifianakis, or Alan from The Hangover.)

But in reality, the psych ward isn’t all that funny. I spent four weeks there during my psychiatry rotation, and it saddened me far more than I had expected.

Yes, there are crazy people there, to put it crassly. But these are the sickest of the sick, people who are suicidal, homicidal, psychotic, or are so impaired that they are unable to care for themselves. So they don’t get better quickly, if at all. It is kind of exciting to see a textbook case of schizophrenia for the first time, complete with voices, paranoia, and bizarre behavior. But when the person is still hearing voices coming from the heating vents two weeks later and drinking mouthwash to make themselves throw up the medication because they believe the doctors are trying to poison them, it’s just heart-wrenching.

An episode of mania in a person with bipolar disorder can be amusing, too, for the first few minutes; my team treated several, and some believed that they were being stalked by millions of people, and that these people were also stealing all of their belongings. The patients jumped from idea to idea with no connection between them, leaving me with whiplash after each interview. Yes, they said some hilarious things, always with a completely straight face. But when I heard some version of the same stories day after day, despite increasing doses of medication, it became clear that these were people who likely would be unable to function on their own in society for long periods of time. They had their physical health, but their minds were seriously impaired.

Overall, I enjoyed the four weeks. I disliked not touching my patients and it was a little bit strange to need keys to let myself through the double doors onto the ward, but the hours (roughly 8AM-4PM) and autonomy (leading the team’s daily interview with my patients, taking full responsibility for calling patient’s families for further information and writing detailed daily chart notes) were great. I even had fun studying. But I quickly realized that, while I found it fascinating to read about the various diseases and symptoms that can affect one’s mind and personality, I could only feel frustrated and sad when I interacted with people actually dealing with them. It seems that pediatrics is still the field for me.

On Idols and Not-So-Idle Thoughts (Part II)

Gynecologic Oncology – it was what I had dreamed of doing for ten years. I had spent a summer working in that field, and lost a loved one to ovarian cancer, so this wasn’t idle fantasy. The very reason I had chosen to do my ob/gyn rotation at this distant hospital was because it was home to one of the leaders in the field, and I desperately wanted to work with her.

I did get that chance, and it went well. Embarrassingly, we have nearly the same build and haircut, so on the day that I worked her office, multiple staff members noted, loudly and repeatedly, that we looked like twins. Just what this renowned surgeon wants to hear, I cringed, that she looks like a lowly med student. It was especially awkward for me because I had previously stated to family and friends that I wanted to be this woman, and here it looked like I was imitating her. Of course, she had no way of known about my prior reverence for her, so she probably didn’t view me as a creepy stalker. Another student told me later that she had actually spoken highly of me. (Yay!)

I did like gyn onc. But I still wasn’t sure I liked it enough to endure four years of the ob/gyn residency necessary to get there. So maybe, as Tay gently suggested, the important part for me was the oncology, not the ob/gyn. I had loved peds onc; in fact, I had often caught myself fantasizing about my career in the field, only to reprimand myself: You can’t do that, you’re going to be a gynecologic oncologist, remember? What’s more, I felt sure that I would enjoy the years of the general pediatrics residency that would precede an oncology fellowship. I loved the kids. I loved the parents - dealing with them, calming them, explaining things to them. I loved that the medicine incorporated all of the body systems, rather that just one as was the case with ob/gyn. And the more time I spent in gynecologic surgeries, the more I recognized that my favorite part took even before the anesthesia was administered: talking to the patient, explaining the procedure, answering questions.

On the surface, then, it might look like a simple decision. But I spent nearly the entire rotation torturing myself with endless ruminations and unanswerable questions. If I wasn’t going to be a gynecologic oncologist, then who was I? How well did I know myself? What else had I been wrong about? (And having been wrong, in and of itself, wasn’t my favorite thing.) My soul ached. I felt like I was failing. I felt like I was losing my identity. I felt like I was letting people down.

It took many long talks with family and close friends, as well as a good hard cry one night as I drove back home for the weekend. Through the rain I picked out the sign for the cemetery where one of my favorite people in the world, the one whose life was claimed far too early by ovarian cancer, is buried. Through my tears, I realized, finally, that choosing a different field and abandoning my personal vendetta against the disease that stole her away, would not be letting her down. She would probably even be proud of me for wanting to help kids with cancer… and for figuring out what I really want and going after it.

One other factor eased my decision. Last summer when I attended a medical writing workshop, I met a physician-writer whom I came to greatly admire. She had written a book chronicling her experiences in med school (sound familiar?), and it was one of the things I read at night to try to distract myself from my daily worries.

I enjoyed her stories and related to many of them. Then I came upon the chapter describing her decision of whether or not to go into Ob/Gyn. What, now? I knew that this woman was a pediatrician; had she once been less than sure about her path?

In a word, yes. I read faster and faster in disbelief as she gave words to the turmoil that raged inside me. She, too, had imagined a career helping women. She, too, liked parts of her ob/gyn rotation (truthfully, I think she liked more than I did). And yet, she, too, yearned to have a career with slightly more flexibility in order to allow her to develop her blossoming writing career. And she, too, agonized over the decision, lamenting the confusion she felt about her very identity and even admitting to questioning whether she wished to practice medicine at all.

Today, this woman is a successful pediatrician, wife, and mother, and she is also one hell of writer. And from the bit of time I spent with her, she’s an incredible person. And a happy one.

So I have a new career path and a new idol to go with it. I also feel a new sense of in-tune-ness with myself and what is important to me in life. I finished my ob/gyn rotation successfully and set up my fourth-year schedule with lots of electives in pediatrics. And I haven’t felt that knot in my stomach since.

On Idols and Not-So-Idle Thoughts (Part I)

Obstetrics and gynecology was my carrot throughout the first few years of medical school. It dangled in front of me, the reward for those years of grinding, crushing study; for giving up so much of what I loved in life along the way. Third-year rotations in general served as a general type of carrot – after all, seeing patients had to be better than hours hunched over textbooks – but as the first few rotations proved less than inspiring, ob/gyn hung promising on the horizon. I had scheduled it for January and February; I would start out 2011 on the right foot.

But by the second week of the rotation, I could no longer remember how it felt to live without a knot in my stomach.

Tay asked again and again for clarification of just what I was feeling. From what he could see, I had loved pediatrics and was just having a hard time adjusting to ob/gyn, likely due to a combination of: 1) residents who seemed to hate their lives and barely notice the students like myself who frantically followed them everywhere, trying to make sense of roles that were never explained to us; 2) my general aversion to change that reared up predictably at the start of every rotation; and 3) the fact that I was living in the free student housing, an hour away from my home with him, in an apartment that I would have shunned even when I was fresh out of college and scrounging to find a place that my embarrassingly small paycheck could cover.

(The best part of that housing was the skinny mirror in my bedroom. That and the bright pink striped shower curtain that had cost $8.99 at Target. Another plus was that the hot water didn’t always emit a scree like the sound the smoke detector would have made had it not been dismantled and disemboweled of its battery; sometimes a full five minutes could be spent in blissfully quiet pre-sunrise steam.)

I had met so many people – residents, attendings – who reminisced bitterly, “I thought I wanted to do ob/gyn... until I did my rotation!” This sentiment had frustrated me, with its negativity and with these individuals’ apparently easy dissuade-ability. I wanted to prove them wrong, to prove that ob/gyn could be liked, could fulfill what one hoped it would, could be a path charted at the start of med school (or even before) and followed without deviation. I didn’t want to be just another of the stereotypical women who had been all about women’s health until they realized how demanding the hours were or how catty the residents and then went running to something like psychiatry... family Medicine... pediatrics. I had been sure that one day I would look down my nose at them and announce that I, in fact, loved ob/gyn and found it to be nothing like the stereotype. So there.

Except here I was, hating every minute of every day spent at the hospital, and using up every minute spent outside of the hospital dreading my return to the wards the next day. I stayed up later than I should, lamenting my unhappiness to Tay over the phone, reading a few chapters of a book for pleasure and then feeling guilty about the indulgence; half fighting through the din of the ugly, noisy town in search of sleep with the other half always keeping an eye on the alarm clock, terrified I would sleep through my 5:30 wake-up. As a result, I was exhausted and cranky in addition to being frustrated and confused.

What was so bad about it? The residents, for starters. The younger ones – the interns – were all very sweet, but personalities seemed to go downhill as one climbed the ranks. I spent idle moments trying to pinpoint at what stage in their training the kindness was beat out of them. Teaching was rare; the few questions they asked ranged from those requiring magical mind-reading abilities and ones so ridiculously simple they made you wonder what you were missing. I once scrubbed in on a C-section and received only two questions: What is this? (pointing to the uterus) and Very good, now what about this? (holding up the fallopian tube). They were the only words spoken to me throughout a procedure in what is supposed to be a teaching hospital.

The lack of organization, for another thing. The rotation was ostensibly well-organized, with each student spending one week on each of seven services: Gynecology, Labor & Delivery, Nights (which was basically more labor & delivery but with horrible hours and less action… in other words, an atrocious week), Urogynecology, Reproductive Endrocrinology & Infertility, Maternal-Fetal Medicine (high-risk obstetrics) and Gynecologic Oncology. The problem was that the organization ended there. No one had any clue about appropriate roles for students, so they didn’t really give us any; we chased the residents all day, with no warning about when we might be able to eat lunch or use the bathroom or when we had to attend a meeting in a building several streets away. Multiple times, I nearly followed residents into the bathroom because they hadn’t told me where they were going – hadn’t told me anything at all – so I judged it safer to follow along than risk losing them. At other times, the residents would be busy and decline my offers to do anything to help, so I would be left literally holding up the wall, torn between trying to look available eager to help out and trying to look busy, like I wasn’t just standing there counting the seconds.

And then there was the actual medicine of it. Truth be told, I just wasn’t feeling as excited as I’d anticipated. Yes, I got teary-eyed at each birth (especially if the dad cried – that really got me), but that didn’t make me want to do it all the time. And the surgeries were interesting the first time I saw them, but with each repetition my interest dwindled. Once upon a time, I had been excited by the uterus and its neighboring organs, by the infections that could plague them, the tumors that could grow, the changes that took place monthly and throughout the arc of a woman's lifespan. But now that I was faced with them each day, I wasn't all that thrilled. I missed the heart and the kidneys.

Of course, as everyone reminded me, I had planned to subspecialize in oncology, so maybe it was ok that I wasn’t so excited about the general stuff. They suggested I wait to see how I felt during my week on Gyn Onc. So I tried to control my freaking out until then.

Transition from Turkey

Well, we're home. We had a very smooth, nearly 11-hour, flight back to New York on Monday and after a few days we were able to kick the jetlag. Tay returned to work and I've had the past week off to finish some of the writing projects I've been working on during the past month of elective time (yes, even in Turkey) and to get organized for one final rotation of third year.

But before I jump ahead, though, I need to go back and play some serious catch-up. Prior to my Turkey posts, I hadn't posted any updates since the New Year. I recently spent some time writing those overdue posts, and I'll put them up over the next week or so.

For now, though, one evening of freedom remains before I start eight weeks of surgery. So forgive the short post; there is fun to be had. :)

Avrupa ve Asya

The past few days have been truly special. Having checked most of the must-see tourist attractions off our list, we’ve been leisurely exploring the city, revisiting favored areas and wandering through some new terrain.

On Friday, we took a ferry to the Princes’ Islands, visiting the largest, known as Büyükada, or Grand Island. There are no cars on the island, so we were temporarily free from the dangers of Istanbul traffic. The main attractions are little shops and restaurants and the amazing views. We toured the island in a horse-drawn carriage, which brought us up a hill from which there are sprawling views of the water, the coast, and even Istanbul an hour and a half away.

That evening, Tay’s cousins and their wives took us out to dinner in Taksim, one of the young and modern areas of the city. We went to a restaurant that serves small pieces of meat on skewers; you wrap a very thin, crèpe-like pieces of bread around them with one hand and use the other hand to pull out the skewer. Then you add toppings from a variety of options on the table, such as greens, diced tomatoes with pomegranate juice, an onions, fold it up, and eat it. Afterwards we went back to one couple’s apartment for wine, çay, fruit, and nuts. Unfortunately, my cold had progressed, and it’s hard to keep with five people speaking Turkish, only a few of whom are able to translate for me, so I was completely wiped out by the time we got home… after 3am.

Obviously no alarm was set for the following morning, and we spent the afternoon strolling around and checking out some stores in the old part of the city, near the Blue Mosque and the Hagia Sophia. We found a store completely dedicated to Tay’s favorite soccer – sorry, football, as everyone here reminds me – team, so he is coming home with a very sharp-looking jersey. We enjoyed lunch at an outdoor café, and the food must have fueled my brain, because when I greeted a salesperson in the next store we visited, he asked if I was Turkish! I had to admit that I am not, but I was able to explain (in Turkish) that my husband is. This put a big proud smile on my face. :)

Outside, we heard music and stumbled upon a concert by a traditional military band for the national holiday celebrating some aspect of the formation of the Turkish Republic.


Then we continued our meandering, stopping to purchase fresh-squeezed pomegranate juice by the side of the road and some much-needed decongestant at a pharmacy, and eventually met up with Tay’s friend from college who lives here. He has season tickets to one of Istanbul’s main soccer (I mean football) teams, Galatasaray, and had offered to bring us to a game. We had been disappointed that Tay’s team, Beşiktaş, had games scheduled for one day before our arrival and after our departure, but he likes this team as well, and it would be a fun opportunity for me to experience a European football match.

I had a great time – when I told Tay how much fun I was having, his eyes lit up like he’d won the lottery :) - mostly because the fans are hilarious. They come all decked out with their team’s jerseys, jackets, and scarves. I never understood what the scarves were for, but they swing them around over their heads. Right from the start, entire sections were cheering and chanting together, jumping up and down in sync. The funniest part, though, was that with every call against their team, the fans all made the exact same hand motion (arm sticking straight out at about 45 degrees from the front of the body, with the hand out like Hey, come on!) and shouted the same things (not that I knew what they were saying). It’s exactly what I see Tay do whenever he watches a game on TV; now I know that he’s not crazy, he’s just a typical Turkish fan.


Today we did some last strolling and shopping, then took a ferry across the Bosphorous to Asya (Asia, as you probably guessed). Many Turks live on the Asian side and commute to Avrupa to work. The ferry only took about 15 minutes, and two bridges also connect the two parts of the city. There, we met Sumru, a friend of Tay’s from our Boston days; she’s an ophthalmologist who did a uveitis fellowship at the practice where he worked. She and her husband are incredibly sweet people, and took us to a fish restaurant right on the water. I tried a number of different foods (some of which I might not have tried had they told me what it was first, such as sheep’s liver) and different ways of eating them (one small fish can be eaten whole, except for the tail; you can swallow the bones). Another type of fish – shield fish, which was my favorite – is only caught during a certain season, and Turkish fishermen apparently cross into Russian waters to catch it. If they are found doing this, they can be jailed for 6 months, yet they still go back and do it again the next year because the fish is so good. Being the incredibly thoughtful person that she is, Sumru had bought us the special kind of tea kettle needed to brew the Turkish çay that I love, as well as another set of tea cups and spoons, so now we are coming home with everything we need – plus extras – to make çay. I hope you are all ready to try some the next time you come over!

You can imagine the challenge posed by packing up all of our goodies in preparation for tomorrow’s flight. We wish we could stay longer; I feel very acclimated to the city and am able to learn bits of the language pretty quickly and Tay feels a great sense of belonging with the people here. (The other day, he had to leave a message for his cousin, and when he gave his name, the person taking the message just wrote it down, spelled correctly, with no quizzical look or questions asked. How often do you think that happens to him at home?) Tomorrow we will say goodbye to Istanbul, but only for now. I’ll leave you with one more shot of the unmistakable skyline:

Güzel Bir Gün!

A beautiful day!

Today’s weather was exactly what we have longed for – fantastic sunshine! We headed up to a different part of the city, Ortaköy, where we met up with another of Tay’s cousins for lunch. We had a local specialty, kumpir, which is a baked potato topped with butter, cheese, and anything else you want. (Choices include olives, corn, carrots, mushrooms, pickled red cabbage, chopped hot dog, ketchup, and mayonnaise.) Then we enjoyed the requisite post-meal çay at a café right on the water.

Istanbul straddles Europe and Asia, with the Bosphorous Strait dividing the two continents and connecting the Sea of Marmara to the south with the Black Sea to the north. (We are staying on the European side, where most of the sites are; sometime in the remaining few days, we hope to go over to Asia!) After wandering the cute, cobblestoned, shop-lined streets for a bit (and possibly buying some books and a pair of earrings…) we took a sight-seeing cruise on the Bosphorous. The views were really spectacular, and it was a perfect day to be on the water. The shot below shows the mosque right on the water (on the European side) and one of the bridges spanning the Bosphorous.


Next we strolled for quite awhile and returned to the tram, taking it to an area called Nişantesı, which boasts some of the city’s higher-end shopping. Also on the European side of Istanbul, it is separated from the section where we are staying by a bay known as the Golden Horn. We spent a few hours browsing, still enjoying beautiful sunshine, and finding a really pretty long flowered dress. :)

For dinner, we headed back across the Golden Horn and, along a different stretch of water, got some delicious fish sandwiches. Men dressed in black uniforms with gold decorations cook the sandwiches on these ornate little boats that bob right at the dock and then pass them up to you when you order. They only make one simple kind, so all you have to do is tell them how many you want and then go grab drinks from a freezer. For dessert, we grabbed a few of a pastry that I hadn’t yet had, which I call baklava balls; sort of like baklava but spherical and lighter. I guess today’s themes were sunshine and special Turkish treats, as we grabbed little cones of maraş dondurması, a type of ice cream that’s kind of sticky, on the way back to the hotel.

So what happened yesterday? Well, it rained. But we still saw some pretty amazing sites, starting with the Hagia Sophia. Originally a church, it was converted to a mosque during the time of the Ottoman Empire, and then became a museum after the Ottoman Empire became Turkey. Because of this, there is the interesting juxtaposition of a mosaic of Christ and Madonna flanked by two large medallions with words written in Arabic. The whole thing was literally breathtaking. See for yourself:


Then we checked out Topkapı Palace, former home of the sultans. It’s absolutely huge, but we visited the Harem (where apparently the concubines were supervised by eunuchs), a display of the sultans’ clothing, and the treasury, which contains dozens of amazingly ornate goodies, including the famous Topkapı Dagger (set with 3 enormous emeralds in its hilt) and all 86 carats the Spoonmaker’s Diamond (so called because it was originally found in a garbage dump and sold for 3 spoons).

After making our way back to the hotel, we met up with one of Tay’s friends, whom he met it college, but who is Turkish and was raised and still lives here in Istanbul. He drove us to yet another part of the city that we had not seen: Bebek. It was truly amazing! Just when I thought that I had gotten the picture that Istanbul has a number of modern sections, the areas he showed us blew my mind! They were so chic and upscale, with gorgeous views of the Bosphorous. This city is truly a marvel.

Tomorrow our plan is to take a ferry to the nearby Princes’ Islands and then to go out with both of Tay’s cousins and their wives (2 of whom speak English; yay!) My goal is that, the next time we come back, I will be able to chat with them in Turkish. I’ll keep you posted, both on tomorrow’s adventures and progress with Türkçe.

Alış Veriş Istanbul’da

The theme of the day was shopping! After sleeping until a slightly more normal time of 6:45, we enjoyed breakfast and then headed out on the tram again, intending to see the Hagia Sophia and Topkapı Palace... but the first had a huge line and the second is closed on Tuesdays. So we improvised, spending several hours in the Istanbul Archeology Museum, which has an impressive array of artifacts, including some enormous sarcophagi decorated with ridiculously detailed carvings.

From there, we wandered back to the area of the spice market, but stayed on the surrounding streets, where things are cheaper. We bought some apple tea since we had enjoyed it so much when one shopkeeper shared some with us yesterday. Walking by the water, Tay got us each a simit, or a circle of sesame seed bread. (Yes, it’s pretty much a sesame seed bagel, just proportioned differently.) We wandered through mazes of cobblestoned side streets lined with shops, taking advantage of the fact that the weather forecast was wrong and we actually had no rain today. We found our way to the book bazaar, which is one of my favorite experiences so far. As soon as you climb a few steps onto this street, the world is suddenly quieter, and the bazaar has a cozier feel, shaded beneath trees and the side of a mosque.


We made a few purchases – when can Tay and I ever pass up books? – and, on a whim, decided to enter the mosque. We were met with fantastic mosaics of bright red and blue; it was our favorite mosque thus far, even over the famed Blue Mosque. Just beyond this was the impressive entrance to Istanbul University.

Taking advantage of the surprisingly dry day, we decided to head up to Taksim Square, on the other side of the city, where Tay’s cousin and his wife had taken us for dinner on our first night. They had showed us around a bit, but we wanted to explore for ourselves. We walked partway, stopping to purchase a set of Turkish tea cups so we can preserve our daily ritual of sipping delicious tea from the special glasses once we are back home. Due to tired feet and no nearby tram stop, we took a cab the rest of the way and were greeted by an impressive statue depicting Atatürk, the founder of modern Turkey, leading the military and then emerging as a statesman.


Prior to our trip, I had read and heard that Istanbul is a city that embraces both the old and the new. Though I had been warned, the stark contrasts between Taksim and the parts of Istanbul we had previously seen shocked me. This section is incredibly modern, with trendy clothing stores and Westernized restaurants. The architecture is more similar to that seen in other European cities; in fact, we could easily have been exploring Paris or London. The people who frequent this area are, in general, younger and less conservative; brightly-dyed hair, piercings, and trendy styles of dress abounded.

We finished the day browsing the main thoroughfare and a number of smaller offshoots (and, yes, made more purchases… you know, to support the economy) and enjoyed a delicious dinner before taking the tram home. Tomorrow we will attempt to see the Hagia Sophia and Topkapı Palace, but with all the things to see here, we never quite know where each day will lead us.

İyi akşamlar

…or good evening! We had another somewhat quirky but really wonderful day.

Our sleep schedules are still not adjusted, and even though we are exhausted at night, our long afternoon naps fill our sleep tanks enough that we don’t sleep through the night. Around 3:30 this morning, we were both awake; tired, but somehow unable to sleep more. We read and watched TV, and at 5 I wrapped myself in the comforter and leaned out our window into the chilly air to take a short video with the camera recording the sound of the morning call to prayer. Each mosque starts within a few minutes of one another, so the one nearest us is heard the loudest while the others form a sort of canon in the background.

We stayed awake; I studied some Turkish and we got to breakfast right when it started at 7am. Most Turkish people can tell by looking at us that Tay speaks Turkish and I don’t; however, today several assumed I spoke German, so that was entertaining. (Tay maintains that I look like I would fit right in with the large German tour group staying at our hotel. It’s probably due to my hair cut and color, but I’m going to go ahead and say that I really appreciate Germans’ organization and orderliness, too.)

Our hotel is one block off of a main road, down which the tram runs. We hopped on and rode seven stops (~15 minutes) to the old section of the city and walked around for a bit, stopping into the New Mosque before making our way to the Grand Bazaar. It’s a must-see anyway and, since it’s an enclosed structure housing 4000 small stores/stalls. You end up seeing a lot of the same things (especially touristy trinkets) over and over, but it’s certainly entertaining to wander through. One shopkeeper invited us in to sit down when he found out Tay is Turkish. He went to a little intercom on the wall and ordered us each a cup of apple flavored tea. (Have I mentioned how much I adore Turkish tea – çay - and the adorable little glass cup – bardok – from which you drink it?) He and Tay chatted while I picked out a necklace and earrings.

After a few hours of wandering through the bazaar, we felt that we had gotten the experience we’d hoped for and decided to brave what had turned into a torrential downpour. Under umbrellas we navigated to the spice bazaar, and then to a little place for lunch. From where we sat, I spied a baklavacı across the way, so went and had some baklava and çay before moving on to the Sultanahmet, or Blue Mosque. Tay talked them into letting us in through the front entrance – free, for Turks only – and we marveled at the amazingly intricate and deeply colored mosaics in this enormous, elegant structure.


To finish the day, we walked over to the Basilica Cisterna, and underground cistern built in the 532AD – yes, the 500s – to collect and house water for a palace during the Byzantine era. It contains 336 columns in 12 rows, through which a walkway winds. Fish swim in the water, and the columns are lit by orange lights that give the whole place a glow that photos can only partially capture.


We swore we wouldn’t nap so that we could go to bed tired and get a full, normal night’s sleep, but we caved once we finally escaped the cold, wet, windy weather. We meant to limit our nap to an hour, but of course woke up three hours later, still tired but now hungry as well. Luckily, we found a little casual dinner place several blocks away. Now we’ll see what kind of sleep tonight brings! Here’s hoping tomorrow morning’s call to prayer awakens us rather than us waiting in the predawn for it to begin.

Merhaba Istanbul!

Two days into our honeymoon, we are starting to adjust to the time change. We hit the ground running yesterday; after a nearly 10-hour flight, Tay’s cousin and his wife (who are our age) and an aunt met us at the airport and brought us back to their apartment for lunch. We also visited with his grandfather. Gung ho, I greeted each of them with a nice big “Merhaba” (hello) and kisses on both cheeks. This might have misled them a bit, as they then answered in Turkish, and I replied with a completely blank look. I have been studying some Turkish, but there is little use for numbers, dates, or phrases such as “the old house is big; the new one is small” in everyday conversation. Shocking, I know.

They dropped us off at our hotel around 2pm, where we discovered that they did not have our exact specified room prepared, and gave us one with two twin beds. We were too exhausted to care, and promptly dropped our stuff and napped for several hours. After showering and changing out of our traveling clothes, we met Tay’s cousin and his wife, who took us out for the evening. They showed us some streets with very good shopping and took us to a delicious restaurant with live music and, starting at 11pm, belly dancers. Oddly enough, the women in the restaurant were more into the belly dancers than the men, getting up to dance with them and continuing to dance near the tables even after the dancers had moved on to (and I do meet up onto) the next table.

It was a lot of fun, although the jetlag and language barrier made things more difficult. Tay is very attentive to me and translates as much as possible so that I can take part in the conversation, but this becomes incredibly difficult when multiple people are speaking at once; by the time I get the translation, I have no idea which of their gestures accompanied which words, and the laughing over a joke is over.

We had trouble sleeping through the night despite our exhaustion because our body clocks were so off. We were laying awake at 5am when we heard the muezzin doing the call to prayer. It’s done in Arabic, and the sound, especially in the otherwise-silent night, is haunting. A few hours later, the cousin and his wife picked us up again this morning and took us to a park with a 6km trail running through the forest. It felt quite remote, but was technically still part of Istanbul. We walked and ran. It was beautiful, with occasional water fountains with water from mountain streams. Running isn’t that big in Turkey, and everyone who looked serious and wore running tights seemed to be of different nationalities – American, Scandinavian, etc. A lot of people were out, though, especially the middle-aged.

Afterwards, we went to breakfast at a famous place right on the Golden Horn. A typical Turkish breakfast consists of tomatoes and cucumbers in olive oil, various types of cheese, bread, eggs, honey and very sweet cream, and, of course, tea. I love Turkish tea and the adorable little teacups.

We returned to the hotel and sat in the lobby and they gave Tay about 2 hours’ worth of information on how to spend our time, going over the things we had planned to do and giving us advice on what to skip, how much time to spend at different sites, and some new suggestions we hadn’t known about.

Luckily, at that point the hotel had a new room for us, so we moved all of our stuff and crashed once again, with no alarm set this time. Around 6pm, we woke up, showered, and unpacked everything and got settled into our room. Then we went out strolling and found a little place for dinner. Now we are back at the hotel, me writing and occasionally translating bits of the movie playing on the French TV channel.