Inner Beauty

I’ve never enjoyed going into the anatomy lab, and the times when I do, it's usually only out of necessity. The sight of shriveled, gray cadavers and prosected organs bathed in formaldehyde – a powerful, odorous preservative – makes my stomach uneasy. And so it was with a sense of resignation that I put on my lab coat on Wednesday and went to the lab for a dissection. I washed my hands, snapped on a pair of rubber gloves and waited with nervous apprehension for whatever specimen was about to be plunked down on our table.

The lab coordinator walked over to my group with a metal tray bearing a pair of pig’s lungs and heart, which closely resemble their human counterparts. Unlike the preserved specimens, these organs were fresh, plump with hydration and gleaming red. My instant reaction: Wow, these are beautiful!

Even though our objective was to dissect the heart, I was far more fascinated by the lungs. I detached them with a few well-aimed slices and moved them over to my side of the tray. They are so incredibly soft that they jiggle when you prod them with your finger. The trachea, our windpipe, plunges through the top and separates into two main "bronchi", which further split into countless "bronchioles" with hundreds of millions of alveoli at their tips - microscopic sacs of air that exchange gases with the blood. I tried tearing an opening in the pleura (the membrane that bounds the lungs) with my hands - but it was incredibly tough,  the product of millions of years of evolution.

Fortunately the pleura stood no chance against my medical scissors. I cut through the lower right lobe like a knife through butter, revealing tiny air passages. Squeezing on the lobe, I felt an infinite number of little “pops” under my finger pads, the sensation of the delicate alveoli collapsing.

Our lungs have their own little universe within them, an intricate mosaic of airways, nerves and air sacs that sustain our breathing for our entire lives.

Later that day, on my car's radio, I listened to Christina Aguilera sing passionately about how we are all beautiful inside.

I couldn't agree more.

The Pulse of Human Connection

Two weeks ago, our medical school class received our white coats in a fancy ceremony at the Hamilton Convention Centre. It felt intimidating to walk up on stage in front of hundreds of people while one of the faculty members helped you put on your coat – I struggled to get mine on. Because McMaster has the second largest medical class in Ontario, we had to wait for over 200 students to walk across the stage. Afterwards we all headed into the main hall for refreshments and pictures.

To be honest, I feel a little pretentious wearing this white coat. I have never made a diagnosis, taken blood or even given a shot. And so it was a welcome relief a couple days later to shadow an internal medicine specialist in the Emergency Room of a local hospital. We stayed primarily in an area for patients (mostly very sick and elderly) being assessed for admission into long-term care. During my visit, the doctor focused mainly on an elderly man suffering from a severe infection and the beginnings of dementia. I, and a fellow classmate, performed basic cardiac and respiratory exams and helped hold the man as the doctor performed a rectal exam.

Here, the painful realities of medicine – of suffering and death – contrasted sharply with the glamor of the White Coat Ceremony. The old man we saw just wanted to be home with his wife, but he recognized that his body was failing and that he needed to be in hospital. I was surprised at how cheerfully he behaved, even though he was in a lot of pain and trapped in his hospital bed 24/7. He even told us a few snippets about his time fighting in World War II.

It was chilling to think about how this man was once strong enough to fight in a war, but was now extremely vulnerable and weak. When we asked him if we could perform certain exams, he always said, “Do whatever you want to do.” Clearly, he completely trusted his healthcare providers to protect and care for him in his final lap of life. I felt a need to do every thing that I could do (which is not much as a student) to make him feel comfortable. This was not just out a sense of caring, but also because I could imagine myself lying in that hospital bed one day, aged and sick.

The next day (Friday), hundreds of medical students from across Ontario descended on the Radisson Hotel in Sudbury for the annual Ontario Medical Students Weekend. I was expecting it to be an intense two days of skills training, but it turned out to be mostly a giant frat party. By 11 pm, the hotel was full of drunk med students being intermittently yelled at by the security guards for bringing alcohol into the hallways. At 2 am, a student pulled the fire alarm as a prank, and everyone in the hotel had to evacuate. Then the alarm was pulled again.

All of us exhausted, we began skills workshops the next morning. I learned how to suture using artificial, rubberized skin followed by a session on IV injection. The conference organizers provided us with these incredible rubber arms that had their own veins and a working system of blood supply. We learned how to find a “juicy” vein and inject the needle at the proper angle.

Since returning from the thrill and exhaustion of that weekend, I’ve buried myself in studying the heart’s conduction system, the current focus of our curriculum. I even went into the lab a couple days ago and held a few prosected hearts in my hand. Not to mention spending hours learning obscure cardiac medical terminology.

But I’ve realized that all this terminology, the white coat, the ceremonies – all pale in comparison to the value of connecting with the patient. While shadowing the internist, I had checked the heart rate of the elderly man. Placing my fingers over the bottom of his wrist, I felt his warm skin and a gentle pulse. I could sense the patient looking at me, and I felt a sense of deep appreciation from him. That sense of appreciation was more real than any ceremony could ever be. 

The Drumbeat of Marriage

The day before yesterday, my aunt and uncle flew back to India. They had visited Canada for a month, staying in our guest bedroom and sharing in our daily lives. I felt uncomfortable at the prospect of this level of closeness after I found out that they had gotten their Visa to visit in early September. In the past it was always I who dropped in on their lives in Northeastern India, and when I did, it was just for brief spells of time.

Although they are nice people, I have always felt a sense of disconnection from them. We have vastly different beliefs on every facet of life imaginable – caste, marriage, religion, racial minorities, the role of women in society, gay people… I could go on. Their world view was developed in a traditional, middle-class Hindu household. Mine was forged in a liberal, interracial family living in Canada.

My father, the rebel, left that traditional Hindu lifestyle and married a Canadian woman. Although both sides of the family came to embrace the new couple, I often wondered how I would be viewed in my Indian family as a half white, Westernized young man. Would I be considered Indian? Would my grandmother still insist on arranging my marriage?

The answers to these questions have become much more clear over the past month. Little did I know, I occupy an important position within my extended family hierarchy. I am the oldest son of the oldest son of the oldest son on my father’s side. Take of that what you will, but the Hindu tradition regards this as being spiritually significant.

Even better, I apparently haven’t even let my Indian family down, despite my Westernization. Going into university, studying medicine and generally being well behaved mean that I’m a good Indian boy. But of course I’m going to fail the next and perhaps most important step: marrying an Indian girl.  

The older generations of women in Indian families comprise a highly effective marriage machine. As soon as a young man has graduated from his studies, they begin to sweep through their vast networks of friends and track down girls to marry. Once they decide on a suitable prospect, they arrange a meeting between the woman and man. If they like each other, then they will get hitched in a massive ceremony several months later. They may not even see each other until the wedding. 

Oftentimes, as with my uncle, the man leaves the responsibility of selecting his wife entirely to his mother and grandmother. His objective is to find a beautiful and hopefully docile girl from within his caste. But in turn there are factors that affect his attractiveness as a potential suitor;  first his income and caste with his height and looks as distant, secondary factors. 

Not to boast, but since getting into medical school I’ve become an ideal Indian groom. A doctor’s salary in Canada is enormous when converted to rupees (the Indian currency). My father was also of a “decent” caste, I’m tall, fair-skinned (a plus) and can speak Hindi. My dad claims, quite seriously, that my grandmother could have a long line of gorgeous Indian girls waiting to marry me, ready to serve me hand and foot for the rest of my life and have my children – two is traditional.

Personally, that sounds like a nightmare. I don’t want someone to marry me based on economic convenience, and I don't want to marry purely on looks; what about factors like a sense of humour, kindness and personal interests? Sure, on paper it may sound like a good idea to marry a random, beautiful brown girl – but what happens when you find out that you don’t get along with said hottie? What if she has a terrible temper or hates puppies?

Sadly, in my experience, many arranged marriages end up cold and lifeless but stay bound together for life because of the deep taboo against divorce in India. Faced with this prospect, young Indians turn to Bollywood films to get their fix of love relationships. It’s also becoming trendy among middle class youth to have a wild love affair with whomever they like before settling down into an arranged marriage with their family’s chosen suitor.

While we were shopping last week, my aunt suddenly asked, “So... what nationality will you marry?”

I replied, “It could be Indian, or black, white, Chinese… whoever I fall in love with.”

She smiled. “So it will be a surprise?” For a second I imagined introducing my future spouse to my Indian family. 

All I could say was, "Yes auntie. It will probably be a very big surprise."

When Life Gives You Lemons...

Hanging out with friends as an eleven-year-old, I went into the kitchen and came back with a lemon and salt shaker. After slicing it neatly it half, I showered it with salt and devoured one of the halves in a couple minutes. This particular lemon was plump, sour and delicious. 

To my surprise, both my friends looked horrified.
"Why... why would you do that?" one of them stammered. The other gave me a look that said: You're weird.

I suddenly got the awful sensation of being "different". I had assumed that eating lemons as a snack was perfectly normal; after all, my sister did it too! 

After they left, I shoved the uneaten half into a bag and shoved it in the fridge. From time to time, I would jostle by it as I reached for milk or butter. I would stare at the lemon... and it would stare right back. I wanted to douse that sucker with salt and spices and devour it. But I resisted... I didn't want to be that weird guy who ate lemons. I didn't want to be different.

And so I let the lemon, once so vibrantly yellow and bursting with juice, shrivel and brown until my mom threw it away.

As the weeks, months and years passed, I stopped eating lemons altogether. Once in a while I would get a craving and cave in, bicycling to the grocery store and later guiltily eating a lemon alone in my bedroom. At restaurants, I would sometimes try to chew on the cut-up lime they give you along with your drink. But to be honest, a lime is too sharp and bitter to be eaten raw. It really is a sad excuse for a fruit.

But soon I had a surprising experience that changed my attitude toward lemons forever. After high school, I flew to India to volunteer for a few months. Sitting in the living room of one of the locals, I was surrounded by a sea of brown faces eager to see the videshi or "foreigner". Then, to my great surprise, a young boy walked in bearing two gigantic, juicy lemons the size of soccer balls.

This picture would be perfect if it wasn't for the girl.

So this is what lemons are like in India, I thought. My host cut up one of those mammoth specimens and served me several lemon slices in a bowl, along with a packet of masala (Indian spice). I showered them with the spice and squeezed the salty-sour juice into my mouth; raw and delicious. It felt great to be alive.

Flying back to Canada, I couldn't help but ask myself: Why did I deprive myself of this pleasure for so many years? 

We change ourselves all too easily to fit in with the expectations of others, especially as kids. While it's natural to seek acceptance, sometimes those expectations don't make any sense and we end up losing a precious part of ourselves. Beyond citrus fruits, this could extend to major life decisions. It could be a boy who, despite his love and talent for painting, trades in his brushes for dumbbells because his father thinks that painting isn't manly. Or a woman who rejects friends from outside her ethnicity because of the closemindedness of her own cultural tradition. 

Fortunately, we have the ability as (young) adults to consciously be our genuine selves, but it may take a long time for us to recognize that. In my gap year, I would weightlift for at least an hour a day and down protein shakes like they were candy. Eventually I realized that I was subconsciously doing this to seek others' approval, as if there were a correlation between muscle mass and worthiness as a person.

Now I spend most of that time reading great books and writing (this blog included). Sure, I'll miss the bulging muscles (*ahem*) but living out my genuine interests has made life far more fulfilling. Whether it's choosing what you study, who you love or how you worship (or what citrus fruits you eat), basing your decisions on authentic passion rather than programmed fears opens up life in countless new ways.