Monthly Archives: November 2013

To the Naysayers

“Why would you ever want to be a doctor?” That’s a question I often get when expressing my career aspirations. In light of the recent health care debacle, I can’t say I blame them. The new reforms are expected to cut salaries and increase patient volume, all together submerging physicians deeper in politics and bureaucracy. Still, though, I stand firm with my decision, and here is why:

Burnt dust kicked up behind the motorcycle as we lurched through hills and valleys. Hoards of people gathered along the side of the road, shouting interchangeably “Muzungu (White person)! Jesus!” Our destination was Kayanga, a rural village located on the outskirts of Rwanda’s capital, where we would be conducting home visits for a local health center program. The first one – a thatched-roof, clay-brick shack – was no bigger than my dorm room, yet it housed eight individuals from at least four generations. Cautious stares followed me into the house. The only thing breaking the silence was the mother’s footsteps. Careful not to wake the child strapped to her back, she rested her hand on my own. The sight of her mangled, infected wrist revealed the source of a putrid smell. The contrast was striking – Black and white, wise and naïve, sick and healthy. Indeed, my skin color had become a proxy for my healing abilities, of which I had none. Never before had I felt more powerless. Without an able body, how was this woman to support her family? How could she manage an income if she couldn’t even bring her harvest to the market? How could an ambulance ever navigate its way up here, never mind finding the home? Putting a face to global health inequities was as much a sobering experience as it was a call to action.

Three years earlier, my story was on a quite a different trajectory. Nothing about my upbringing was remarkable – I hailed from a prototypical New England town, was raised by loving, middle-class parents, and enjoyed the typical trappings of American adolescence. On top of this, I was deeply insecure about straying from conformity. It was comforting to be in the mainstream, inside the proverbial “box.” The way I saw it, risk aversion was the most certain way to succeed. Deferring to structure, however, left me with little cause to think about who I was as a person. When questions about careers popped up, the medical field appealed most, not because of sense of calling, but because the road to becoming a doctor was already well-established. If I could simply run through a checklist of requirements, in ten year’s time people would be calling me Dr. Brewster.

This is not to say that my thinking was completely misguided. Something that has always driven my interest in medicine is the challenge of connecting the small, isolated constituent to its larger context. To truly grasp a scientific concept requires a deep understanding of the elementary components from which it was derived. And, the synchrony of these parts, from the atom through the organism, is what gives rise to the universe and its occupants. Unpackaged from all its hypotheses and experiments and data, I’ve been convinced that science is merely the framework to discover the wonder behind the mundane the profound behind the phenotype. The human body is no exception. We see it as sacred and immutable when in fact it represents the product of billions of years of tinkering. Even in its current iteration, it is in a constant state of dynamic equilibrium. Doctors have the privilege of engaging this miracle, and ensure that it continues to be just that.

What I failed to realize, though, was that the big picture meant more than just managing a network of biochemical reactions. The medical practice is unique in that it is both a science and a service. It should seem obvious that preserving health can be both subject to and a determinant of an individual’s political, social, and economic agency. Access to medical care has been declared a fundamentally human right whose realization is inseparable from a person’s capacity to thrive. Yet, it took working with the most vulnerable populations for me to finally connect health to its social justice imperative.

“!José está sufriendo una parada cardíaca!” were the first words I had to translate as a Spanish-English medical interpreter. “He’s having a heart attack!,” I quickly relayed to the doctor, a retired family physician volunteering with the Open Door Clinic. The patient was one of the 1,5000 Mexican migrant workers in Vermont. Without legal documentation, they endure highly restricted living conditions and are oftentimes deprived of their most basic needs. José had effectively waived his right to health in the name of productivity. His estatus illegal had rendered him nothing more than a commodity. And as a commodity, he was disposable. So, when his condition had prevented him from working for three weeks, regardless of the clinic’s treatment, the farm owner had no recourse but to dismiss him. As I learned that subsequent summer in Rwanda, José’s story was a microcosm of the gross inequities in health care delivery around the world.

For someone whose initial motives for a medical career centered on self-interest, seeing health disparity firsthand went beyond a reality check. It was humbling to know that I had benefitted from a global system that has caused the suffering of billions. It was, in other words, that sense of calling. I realized that I had an obligation to serve those most in need, to guarantee health as a human right where it did not exist. Doctors, unlike laws, are not answerable to rules or politics; instead, they are answerable to whether a given intervention is in the best interest of the patient. The German biomedical scientist Rudolph Virchow once described physicians as the “natural attorneys of the poor.” From the farms of Middlebury to the hills of Rwanda, one’s physical well-being necessarily governs social and economic rights.  Thus, doctors can leverage medicine to promote a more socially-driven agenda. I want to be such a voice because I believe empowering communities through health can begin to right the deep inequalities between rich and poor. I want to be such a voice because I believe that where there is health, there is opportunity. Being idealistic and utopian is one thing, but I am reassured by that simple fascination of mine – Everything starts with an atom.

It got cold

Every year around this time a similar phenomenon happens at Middlebury. While we know it is coming, it inevitably always is a slight surprise: it gets cold.

The other morning I woke up and it was 7 degrees. Granted, this is particularly cold for November, but not unheard of. I happened to be driving up to Burlington that day when I passed a local middle school. They had one of the those signs that displays the name of the school, and space to post various announcements in change-able letters. Instead of the usual notifications like dates for Thanksgiving break or congratulations to the district choir champions, this sign said just one simple phrase: Pray for Snow!

Oftentimes when people are visiting Middlebury, particularly those from warmer climates, the weather causes them a lot of anxiety. It does indeed get very cold here, but unlike a lot of places that get equally cold, the winter brings excitement in Vermont in a way it does in few other places. I am from Philadelphia. In Philly it gets pretty much just as cold and snows some, but most people consider the cold a drag and the snow a headache. In Vermont, the cold is exciting because it means snow is not far behind.

While I still don’t identify as someone who loves the cold, when I am in Vermont I find myself praying for snow a little bit too.

Who Needs a Prof?

On Wednesday my political philosophy professor had a baby—his second, a 9 lb little boy. It was no surprise to me that he wasn’t able to make it to our Thursday afternoon class.

That didn’t matter, though. There is a student in my class conducting an independent study this semester with our professor on Nietzsche. Anticipating his absence due to parenthood, my professor reached out to this student and encouraged him to do his best to get a class discussion going. We are reading Nietzsche this week.

When I arrived to class, a quick scan of the room confirmed for me that our professor had indeed taken the day off. I considered leaving for a moment. What could a motley assortment of political science majors possibly have to say about the mysterious Nietzsche? He’s an enigma in himself… I suspect many students came to class particularly excited to hear our professor clarify things.

But no. The independent study student kicked things off with a few provocative remarks, and we were on our way. No one moved. Not a body stirred. There was a brief moment of awkward silence pierced by the conjecture of a brave soul. And then a response—a challenge, an inquiry. A back and forth ensued.

A few students tried to raise their hands. Our student-leader humbly noted, “There’s no way I’m going to start calling on people… Let’s just have a discussion.”

And we did. A few students left, recognizing the unstructured class period as an opportunity to hit the gym early, get a head start on some work, or catch up on some lost sleep. I get it; Nietzsche isn’t for everyone. Twenty minutes went by. Thirty. Our class was cut in half at this point, but it didn’t matter. We were deep inside Nietzsche’s labyrinthine pages, arguing about morality, overmen, government, Marx, Mill, even Plato. Fifty minutes of discussion without a professor.

I went to a high school where, if a professor didn’t show, we ran to the Senior Commons room to play Super Smash Bros. after yielding a five-minute grace period, max. But here at Middlebury, an eagerness and willingness to learn trumped a desire to be anywhere else.


That’s what we’re here for, after all.

26.2 Nouns: The Things Along the Winding Roads

Training for the New York City Marathon allowed me to discover new things. “Things” is an entirely inappropriate, lackluster, and ambiguous word to use for describing anything, especially the people, the places, and the things I have met and discovered during those months. Before I get to the things, I will start with people, turn the corner to places, and in the distance spot the ever-enlarging view of things down the road.

People – For sake of cyber confidentiality, all names have been changed and in there place I hope to elaborate with details on qualities, personalities, and characteristics. Something I remember hearing from a young age when learning about the many relationships we will form with each interaction we have, no matter for how long or how short, was “you may not always remember their name, their face, or what you did with them, but you will always remember how they made you feel.” Now, I cannot remember the sage of which bequeathed such words onto me, but I know, knew at the time, and will continue to know the feeling of gratitude I have for them shaping my views of leaving a lasting feeling of positivity no matter their name, their face, or what I did with them.

Along my way, I remember fondly feeling welcomed each time by the woman at the farmers stand up route 125 past the organic garden, I will remember the joy of the little girl pulling at her moms coat after getting out of the car and saying, “Mommy, look at her go! She must be so chilly.” (It happened to be a rather brisk early evening). The woman at the Half Way Diner who brought us glasses of water, that literally was halfway on my training partner and I’s epic 20 miler that turned to a 23 (we decided this diner was a symbolic place to turn around as “Haven’t we been running for more than 10 miles? We have been running FOREVER! Let’s turn around there.” Post run and a little google maps action, we discovered we had missed our 10 mile turn around point and the diner was more 11.5 miles out. Good thing we didn’t keep going). To my running partner, a dear friend who had hoped to run the NYC marathon the year before. It being cancelled, he came to school ready to train again after tackling another marathon last fall in place of New York. We got each other through, well, as I can only speak for myself, he got me through those long runs on the afternoons where a nap seemed so much better. We dove into long talks that made the musicless run fly by faster than any amount of Turbulence on repeat. To all the wonderful Vermonters who graciously moved over while whisking by in car, diverting their path so we could continue on ours (I’m counting them as the 1.2).

Places – Morgan Horse Farm, the Meat Shake, the covered bridge, the Middlebury Farmer’s Market in Leatherworks, the Half Mile Diner, Porter Hospital (just running by…except for post marathon xrays…but that’s a different story…), the gas station at the junction of 125 and 22A, the first horse farm out past Porter, the little stretching spot in that farm’s horse pasture a little ways past that, the Middlebury Fishing spot.

Things – Cows, horses, sheeps, more cows, fuzzy bears (the furry caterpillars that always crawl onto the edges of the warm road. Endearingly named by my long-distance running buddy), the piles of hay wrapped in white plastic that look like giant mozzarella balls, the giant wolf spider the size of my palm (even on exhausted legs that caused me to run faster), the great blue heron that would fly away startled by a human disrupting its stillness, the road kill (deer, possums, skunks, snakes, foxes, porcupines, squirrels, fuzzy bears. RIP lovely creatures), the GU packets (necessary companions on long adventures), the beautiful golden lab that would always be lying in the same one last sun beam as the sun was setting, the sunsets over expansive fields of corn.

And there you have it, 26.2 things along the way. These nouns had yet to be discovered, truly discovered, until I laced up my running shoes and hit the ground, well, running. My own two feet carried me on an adventure of Vermont and an adventure of my own self through the journey. Taking on this challenge allowed me to explore the beauty around me and has excited me to continue this quest, soaking up every inch of nounery illustratively described through feelings, emotions, adjectives, and memories.

As a nonreligious but spontaneously spiritual person, I have always found solace in the words of this traditional Gaelic parting blessing: 

May the road rise up to meet you. 
May the wind be always at your back. 
May the sun shine warm upon your face; 
the rains fall soft upon your fields 
and until we meet again, 
may God hold you in the palm of His hand.

Classes Classes Classes Galore!

November 13th had been on my calendar for about 2 weeks. My alarm was set for 6:55 am. The night of the 12th, I put my laptop next to my bed and stuck a post it to it with all my desired classes and their numbers so I could register at 7am. November 13th was my last registration of college.

Registration is the process by which students choose their classes for the next semester. The week before you’ll hear the dining hall buzzing with “are you taking this class” or “I really want to take that class but I bet its going to fill up with seniors” or “that professor is supposed to be awesome!” and for the first time I was in the first batch to register. Registration goes according to class year, so as the oldest in the school, we get first pick!

As I started looking through the course catalog and started writing down classes I wanted to pick, it occurred to me that I could only take four! I remember sophomore year, thinking that as a senior I would take three classes, have a fun last semester, and now that the time has come I wanted to take 8!!! I finally decided to take cartographic design, modern architecture, economic history and thought, and the global economy.

As I submitted my classes, I realized that was it. I would never again have to look at classes for future semesters and decide what to take, and I smiled because I’m going to enjoy my new classes to the fullest!



Not Your Average Saturday

Last Saturday, instead of digging into my homework in the library or (as is more likely) avoiding the day’s chill in my sweatpants and LL Bean moccasins (guilty as charged, Nathan LaBarba), I was lucky enough to attend a lecture series here on campus called TEDx. An offshoot of the TED (Technology, Entertainment, and Design) organization, TEDx events are individually, locally organized events in the TED tradition of promoting ‘ideas worth spreading’. The event combined a sprinkling of TED videos with live speakers discussing their experience in a wide range of fascinating topics, from the revitalization of Central Park to the study of empathy and doctors’ bedside manners. There was even a student speaker, a current senior chosen by the TEDx committee to reflect on the college experience from the perspective of both an introvert and an extrovert.

Needless to say, it was a fascinating day. When the session broke for lunch, my friends and I crowded around a table with our Noonies sandwiches and soups, discussing the overlaps between each talk. I have to admit, this is one of my favorite parts about academics here at Middlebury, too. If you take the time to reflect on each of your courses year after year, it is incredible to see the overlaps, the continuities, the meaningful discrepancies.

The best part of the day, though, was not the insightful speakers or even the food (though the apple cider doughnuts were pretty hard to beat), but it was the vast swath of the Middlebury student body present at the talks. There are a million different ways to spend a Saturday at Middlebury, most of them much less intellectually overwhelming than TEDx. But on Saturday I ran into  friends from all walks of Middlebury life (and several Senior Fellows!), each as excited as the next as they alluded to the forum’s themes, “Research, Rethink, Rebuild”.

Middlebury is many things, and if you’ve ever attended one of our information sessions on campus I’m sure we’ve made that evident. Focused as my sessions are on the internal growth that comes with the Middlebury experience, I often forget to state that ultimately, Middlebury is a great big incubator for new ideas worth spreading. Sitting in the CFA concert hall, full to bursting with locally-sourced cider doughnuts, I was reminded of the diversity of new ideas being developed, spread, and implemented here on campus. And as I chatted with my friends at the forum, many of us seniors attending TEDxMiddlebury while we still can, I couldn’t help but wonder what bright ideas students like us will spread when we leave for the wider world.