Mile 14020 + 638.1: Countrified Conversation

Above: Traffic in today's Decatur Rush-Minute.

YOU NEVER KNOW WHO YOU'LL MEET
AT A COFFEEHOUSE.

Ever since I started writing in this blog, I have always written about what I like about smaller communities. My stay in Decatur (about a medium size city) has been defined by amazing patients, great faculty, and a very intensive learning experience. The city perplexed me with not only having two Starbucks locations, but both locations are within 200 feet of each other (one is located within a Target, and there's a freestanding Starbucks right in front).

As I was studying in the freestanding Starbucks this week, I noticed one of the people that walked through the door looked familiar. That person came to sit down at the table next to me. It was then that everything clicked. I saw that person at the hospital and she was in the family of one of the patients that I saw during rounds. I ended up extending my hand out to that person and introducing myself...

"I don't know if you remember me, but I was at the hospital when..."

Her eyes lit up, and one of those looks where everything clicked appeared on her face. Another person related to my patient in the hospital also sat down with her. He shook my hand. Little did I know that just opening up to them would result in a hour in conversation about health care, patient education, and even stories about health care that either discouraged us or inspired us about the field.

Let me tell you, hearing about the healthcare shortage in rural areas meant so much more from people from the areas themselves than the media. I was hearing stories about how much family physicians were critical for care here in Central Illinois, stories about doctors moving out to urban areas for better support, and how much family practice meant a lot to this family. I really appreciated the open honesty and conversation we had.

They asked me what specialty I was considering to go into. When I told them I was strongly considering Family Medicine, the man held out his hand, and as I grabbed it to shake it, he said, "We need people like you here." The woman then said, "Are you coming back here?" I explained my love for Central Illinois (being a part of the alma mater) and told them that I would gladly come back if they let me back in. We all laughed.

Small / Medium sized cities have always caught my interest. Yes, Decatur may not have everything that Chicago has in terms of lifestyle, but the people are who make the difference in experience. It's not every day that one can run into patients at the store or in a coffeehouse, but its a part of the continuum of care: knowing that one can talk to his/her doctor even outside of the hospital is reassuring to our patients and helps build that patient-doctor trust.

(It was awesome to see that my Iced Coffee Property has some actual basis.)

Mile 9363: Countrified 4 - Growing Culture

Above: Nothing beats a tall set of golden arches to greet you on the road. Gilman McDonald's, Exit 283, on Interstate 57 in Illinois.

"I ROAMED THE COUNTRY
SEARCHING FOR ANSWERS TO THINGS
I DID NOT UNDERSTAND."
- Leonardo da Vinci

4:40 PM, Sunday - My friend Don and I were driving back on good old Illinois Interstate 72, after visiting an elective site I'll be attending this upcoming January. I-72 is a four-lane corridor originally designed to connect the mid-sized cities of Springfield, Decatur, and Champaign, Illinois. We got to talking about places that seemed so "perfect," that they were "too good to be true." And for some odd reason, that got me on a mantra to talk about what I liked about Champaign, a city I spent a good 4 years of my life in. To me, it was an example of perfection, but there seemed to be no strings attached to that experience.

----

The debate is still hot. Even though it has been just over a year since I've written anything on this topic, it's still something I do think about. I'm still attracted to the sense of urban sophistication that's given in the larger cities like Chicago, but something also pulls me towards the growth and potential in smaller cities found away from metropolitan areas.

I drove down to Champaign this past weekend to spend some time with my good friends Neal & Christine, who I've always wanted to spend time with (more than the 13 hour stop I made last time I was in town in May). On a cold Saturday morning, I whipped down I-57 and made it from the Chicago Area in a very efficient 2.5 hours (without speeding, and with a McDonald's stop for coffee placed in there). When I got into town, seeing a good chunk of people outside at 8:30 AM doing their morning jog on streets made me smile. It was good to see at a metropolitan area of about 100,000+ people (without the students at the University of Illinois) still had that sense of freedom that comes with safety. I soon found myself in the outer rim of the city, entering the "suburb" of Savoy where Neal & Christine live. I smiled when I noticed that when I looked to my left, I saw houses, but on my right, I saw the beauty of endless fields of corn blowing in the wind.

With a lot of smaller cities, especially those home to colleges, there is an investment into downtown areas, to infuse culture, improve the quality of life and to show that these cities have identity. The Champaign-Urbana area has exactly been doing that, and every time I come back, there's something new or something improved about the area. When I first visited the U of I in 2002, I saw the potential in the area, as this was when the improvements were beginning in the cities. And 8 years later, I can see there's something for everyone, with everything from a Weekend Farmer's Market in Urbana to fancy eating in the downtown area of Champaign to summer festivals that complement any social outing quite well.

No, this isn't a post to simply limit my future to be here in Illinois (although I would love to be), but an example of a place I would love to live. I look at other large college towns, like those in Bloomington, IN, Madison, WI, and somehow that "oasis" of urban-ness within miles of rural terrain pulls me to places like those too. From a professional standpoint, the mix of people coming from a city-life and from the rural areas to receive health services makes this an attractive patient base to work with in my future. For me, there's always something about a city that is with vibrant growth that will entice me to live there.

So, although I got some R&R by hanging out with my friends in Champaign, I also got to learn a little more about what I wanted too. And that's what made this past weekend quite awesome.

Countrified 3 - Suburbified

Above: A view of the 2007 Champaign-Urbana July 4 Parade. In any Independence Day parade, nothing beats the marching guard.

YESTERDAY, I flicked on the television, and one of my classic TV favorites, The Dick Van Dyke Show, was showing. In the episode, I saw that Mr. Petrie, portrayed by Van Dyke, was having an absolute hard time trying to write the story of his life into a biography. Soon surrounded by broken furniture, and a mound of crumpled up paper, he was just so distracted by being isolated from the real world to write his story that he just gave up.

As much as I get distracted, I have keep the story going. To begin, I’m going to take you a few weeks back.

July 4 Weekend: When I was in High School, my congresswoman, was a big help to me, allowing me to volunteer in her local office for my AP Government class and helping me to learn about the ins and outs of congress when I was part of the Presidential Classroom program in Washington, D.C., during the summer of 2002. In return, I help her out every year – provided I’m not in Dominica – I usually parade with her in her congressional district.

However, it wasn’t exactly the best day for a parade, with cloudy skies and light drizzle to light rain (there really isn’t much of a difference to me). In our attire, we were ready to hit the road, awaiting deployment from the gates and onto the main street. Soon, the policemen at the end waved his hands, and our feet started marching.

We then made the turn around the corner and started our route.

A warm feeling of community started to take over me. Even on this cold, dreary day, the streets were lined with people of all races and ages, a lot waving American flags and looking upon the marchers ahead of us with a multitude of smiles. At a moment, I did have to start looking up to wonder if I really am in the suburbs. I never expected the suburbs to have a community-like feel, but at least Hinsdale, the suburb I was marching in, certainly presented itself with one. Walking in the parade surrounded me with an astounding sense of community.

I had felt that a lot of suburban communities have lost their character, with large mass-built subdivisions, with houses that have similar facades and colors and streetlamps that you could probably find on one of the nearby expressways. Nearby businesses would be pushed into strip malls, and all of them could be classified either as a “chain” or a “big box” retailer.

HOWEVER… when we turned our second corner, right into downtown, I started to look at things differently. Many of the commuter suburbs of the western Chicago area have a downtown that surround the commuter/cargo rail line that pass right through it. With the recent trend towards bringing businesses back into the downtown areas in many smaller communities in the nation, a renewed vintage feeling has been instilled in many of them. And here in Hinsdale, the feeling of a small city downtown was preserved, while allowing businesses (such as the Gap or Starbucks) to niche themselves. Wide sidewalks, lots of foliage, and vintage streetlamps really set the scene for a relaxing time for some daytime shopping, or even a classy dinner.

So, in the race about where I should live in the future, suburbia finally hits the ball into far left field for a double. The recent "Downtown Revival" occuring in suburbs across the nation is saving a suburb from becoming just another "suburb." It's true: I enjoy that feeling of being in a small town, but also with the services and the sophistication provides. Perhaps living in a suburb that values its own identity would do the trick.

That’s a critical part of an area I want to live in: it has to have its own charm and character that makes everyday not just another ordinary day.

Countrified - The Sequel

Above: March 2007 in St. Louis, running one of my highlights as a RA... The St. Louis Trip.

"TED, WHAT IS THE FIRST SYLLABLE IN

RUT-TINE?"

So here we go again... the question of whether or not the country life is right for me. This time, a debate on living life is something that has been on my mind. Where did I leave off with the last entry?

OH YEAH... being adventurous.

Those desires to do things new... do things differently... explore things all I possibly can... for me, seem to be most associated with urban life. And not to mention, going out and finding adventurous people to do things usually comes associated with city life. Everything from clubbing, to sightseeing, to seeing shows, watching sports (some of these things I've never done if not only once or twice in my life)... things associated with genuine American life.

YOU'RE RIGHT... I can travel. However, there's something about living in the daily aura of active lifestyle that keeps me going. The thrill of not knowing what's behind the corner when driving into the city or even throwing darts at a dartboard to choose a new restaurant to eat at every night. I really appreciate having the desire and the ability to try something new, something different. This is a reason I love the suburbs of my hometown, Chicago (there's always something new, I haven't done yet).

Examining one of the thoughts in my previous entry: It's really not Dominica that's really having me get this urge. And also, don't get me wrong: Dominica has things to do. Okay, you lack a lot of options because yes, it is a third world country, but I've done a lot of firsts down here (everything from jumping off a rock cliff graced with a waterfall right next to it, to yes... eating conch). Sometimes I think its just everyone's dedication into studying that "ruts" my plans to do more adventurous things away while in med school. Sometimes it makes things seem like med school is more like a routine than anything... or like Barney said on How I Met Your Mother, a "rut-tine."

It seems that the country, at least initially, seems However, like I said, everything does come with a price, and I do value very highly the community lifestyle of the country. It also powers me to keep moving and do what I'm doing. However, I want to find a way where I can combine both the aura of excitement with the community of appreciation.

... and the debate continues.

Countrified

"ALRIGHT MAN... ALL THE BEST."

7:32 AM MONDAY MORNING, and I'm on my to Roseau, cruising down the Dominican "main road" on a Nissan Peoplemover (my way of describing the public vans that transport people around the island) at about 100 km/h with 7 of my other colleagues to Goodwill (one of Roseau's Suburbs, where Princess Margaret Hospital is). I have my headphones on and I'm listening to my favorite crusing music (most probably something on Eric Clapton's Complete Clapton compilation). The sun's popping out over the mountains to the east, and I'm just staring out and thinking... about what? I have no idea. But I know that it's another day I'm looking forward to working over at good old Princess Margaret.

PMH has grown on me. Mind you, I was really looking forward to this experience for quite a few semesters now. At Ross, with fifth semester you get a choice to go to fifth semester either in Miami, Michigan, or Dominica for what they call Advanced Introduction to Clinical Medicine (full-blown lingo for getting thrown into the real medical world). I have heard the stories about what you get to see in the hospital (i.e. in surgical observation) and how much you time you can actually get to study for exams (a lot more) were compelling reasons to stay. However, this was an opportunity to go back to the states, and finally enjoy America again...

SO I STAYED...

I'll be honest, working in a Dominican hospital has been more than I ever imagined. I've seen some of my friends participate in the operating room, get scrubbed up, and assist in operations such as herniaplasties (removal of intestines or other organs "sticking out" where they shouldn't be, like near your abs). We have access to all the tools needed (that PMH has) to assess a situation, and not to mention most of the doctors here are truly willing to help. Some of them even invite us to come back at our own time (provided we have the time).

However, one of the things that impresses me the most is how the Dominicans respect us. I remember walking in one day to interview a patient. He was sitting up on her bed, and she greets us with, "Good Morning, Doctor." ... But no, we're medical students! ... "Good morning, Doctor." The patient had treated us with the same respect as her real doctor, although we were truly there to just interview him and perform some physical exams simply for practice. When we left, he said to us... "All the best." (That's Dominican-Caribbean for our American "Take care.") We'll come back to check on her two days later and she'll still know us, and treat us with that same respect.

Not to mention, I enjoyed walking into the dialysis department with my wards group and feeling comfortable wishing everyone in the room a "Good Morning," and every person in the room saying back to me "Good Morning." Mind you, it's the morning, so not everyone is quite perky, but you could tell that the custom of respect has been so ingrained that it just becomes instinct. It occurs all over Dominica... on the sidewalk, getting on the bus, entering a store... there's always a "Good Morning," "Good Afternoon," and you guessed it, a "Good Evening."

In conclusion, this small-town feel is really getting to me. Getting appreciated what you can do, knowing that you made a difference, and being able to build that rapport with patients is what's compelling. However, that hospital feel of networking, working with a team & staff, and getting "exciting" cases is still very attractive to me. Princess Margaret Hospital in Dominica offers a great combination of both.

However, it got me to start thinking... is the country really for me? Being from the suburbs of a large midwestern city... only time can tell. This definitely won't be the last countrified post...