I used to be full of stories.  So much so, that I would live through my characters.

Growing up a socially challenged Indian American in a predominantly white area was no walk in the park.  I put my foot in my mouth so many times that eventually, I decided to completely shut up.  Writing was my love, my life, my only escape.

I knew my characters inside and out.  I knew their middle names, their fears, their strengths, weaknesses, what they wore, and what their dreams for the future were.  They were my everything, you see.  They lived in an almost ethereal place called Lake Grove.

In Lake Grove, there were no bullies.  Sexism and racism did not exist.  Like a Marlo Thomas song, everyone was free to be themselves.  Just a bunch of kids and teenagers who would have adventures in love, life and popularity that girls like myself could only dream of.

My favorite of all the characters was a girl named Jacqueline Sara.  She was me, of course-popular, pretty, more badass me.  I called her Jackie for short.

Jackie was beautiful.  She didn’t wear glasses or braces.  Her bangs were Aqua Netted to the point of perfection.  Her dark hair never frizzed, and her jeans were always double folded at the bottom (what can I say, I’m a proud product of the 80s and early 90s). Her biker shorts NEVER rode past the Umbro shorts she wore over them.  She had a pair of Adidas Sambas that she wore like a boss.

More than anything, though, Jackie was fearless.  She stood up for what she believed in-and was all the more admired for it.  She was a singer, a dancer, a painter and a poet-yet still managed to keep her grades up to please good old mom and dad.  She was an all-star.  Every other character just served as her worker bees.  Always the popular humanitarian, she managed to keep the peace between the social outcasts and the ‘cool’ kids.  She was class president, of course.  The product of two hard working, upper middle class American parents.

It was hard being different.  Eventually, though, I began to embrace myself for who I was-even though I knew no one else would.  Jacqueline Sara eventually evolved into Leela-an Indian American girl with many of the same qualities.  She was a tennis maestro and a soccer star.  Thankfully, she had ditched the sambas and the biker shorts by then.  She had a future at Harvard-after all, what else was to be expected?  She wanted to be an astronaut.  Her sidekicks evolved to be a mixed crew-some white, some Indian, some black.  I had heard Martin Luther King’s I have a dream speech by then, and decided to evolve, too, if only in my fantasy world.

My heroines had many adventures.  They went traveled all over the world, and met so many people.  Most of their escapades were home grown, though. They babysat, snuck behind the treehouse and played pranks on each other.  They went to parties, learned how to behave at school dances, had first crushes, first kisses, and best friendships.  They were my saviors through some very arduous years.

They say time flies.  I don’t think that is true for many of us when we are 10-18 years old.  Most of us are not the prom kings and queens.  Most of us are nobodies.  Most of us are duffs (if you don’t get the reference, watch the movie.  It’s awesome).  Your best bet is to find similar friends who will commensurate your misery, and to develop interests and hobbies that will slowly build your confidence.  When you’re a nobody living under your parent’s rules, and trying to survive adolescence/middle and high school, time goes by SLOWLY.

Thankfully, adulthood eventually arrived-and the blessed freedom that came with it. I abandoned my childhood friends.  Finally, FINALLY it was my turn to go to parties, not just write about them.   Which I attended-a little too often.  It was time to study hard-which I did.  But not nearly enough.  I wanted to be a doctor.  It was all I talked about.

Which left me with my next muse-the human body.  Even on a molecular level, we are so wonderfully designed.  Each cell, each tissue, each organ has a myriad of functions.  On every level, the human body is artfully constructed.

Take the circulatory system, for example.  Human blood is composed of red blood cells, platelets, various proteins, clotting factors and plasma.

Each red blood cell is cleverly constructed.  It contains an iron molecule in the center; each which bind to 4 hemoglobin molecules. Every hemoglobin molecule will bind to oxygen and carbon dioxide, allowing for it to be transported all over the body.  It is even designed to favor oxygen over carbon dioxide -allowing us to maximize our ability to transport oxygen all over the body even in low oxygen settings.

Furthering this intricate system is a 4 chambered heart that pumps oxygenated blood all over the body and allows for deoxygenated blood to return.  It goes from our arteries, then arterioles, then capillaries, where, at each level, oxygen is being exchanged for carbon dioxide.  The blood then completes its journey back from the capillaries to the venules to the veins back to the heart.  Then, we exhale the carbon dioxide, inhale oxygen, and this intricate process begins all over again.

Let’s not even get started on platelets, and the various clotting factors. Any time someone cuts themselves, various platelets and clotting factors travel to the area of the cut.  The platelets, which are activated by something called tissue factor, then adhere to the wound and clump together, along with the another blood product called fibrin.   This sets in motion a series of complex molecular cascades that allows for clotting to occur.

                                (I want to date this diagram.[1]  I’m totally normal, right?  Right?  Anyone? Anyone?  Buehler?)

What boggles my mind is that all of this complexity occurs on a cellular level alone.  When trillions of cells, various tissues, organs, and organ systems work together in concerted motion to allow for the human body to function, what you have is truly one of the greatest masterpieces of all time.  One that works beautifully.

That is, of course, until it doesn’t.

Take the heart, for example.  If the left chamber of the heart weakens, the entire pump system is backlogged. All of this can lead to eventual failure of the remaining chambers, eventually, causing death; as we do need for our blood to transport oxygen and carbon dioxide all over our bodies efficiently.

Then, there’s clotting.  So many steps have to occur concurrently for the human body to function.  Any deficiencies in any of the enzymes involved (von Willebrandt factor, Factors 7, 8 ,9 10) can cause major problems for the human body.  If we can’t form clots, we can potentially bleed ANYWHERE-into our brains, our guts, or even any open wound on the skin.

What can we do as doctors?  Modern medicine is truly spectacular.  We provide drugs that stimulate the heart muscles to work just a little bit harder.   We try to minimize-and prevent-anything that will weaken the heart further.  If you’re missing a clotting factor?  We give blood and platelets as needed, and try to provide the clotting factors.  Many times, we set up ideal conditions that allow for the human body to heal itself.

Unfortunately, it’s not always enough.  Mistakes happen.  People die.  The average human’s bloopers suck, yes.  An error on an Excel spreadsheet gets you yelled at by your boss.  Or worse, gips your client out of a sizable tax return.

Our oversights, on the other hand, may be the reason your baby stops breathing at night.  We fret and fume-always wondering if we did the right thing.  We worry about our patients.  We check labs and bring them back-just to make sure everything is okay.  It is enough to turn the most laid back of us into an anxious mess.  We count on our village of nurses, medical assistants, nurse practitioners and pharmacists to save us many a times.  They count on us, too.

Throw in the massive sleep deprivation and psychological abuse that often occurs during medical school and residency training, and you have a socially deficient, often suicidal profession that spends entirely too much time healing others and the expense of themselves.  Not to mention, all of this occurs during the formative years in which we are getting married and starting our own families.  It’s not uncommon to have residents that are separated from their babies for long periods of time.   After all, someone has to raise them.

It was during these years of residency and early parenthood that I lost track of Jackie and Leela.   I sacrificed my love of reading and writing for medicine instead.  My once large vocabulary has now been reduced to medical jargon.  Not to mention, replaced with thoughts of sleep schedules, potty training, baby talk and nursery rhymes.

Now, more than ever, I realize I need my characters.  But it’s time to evolve.  Right now, I’m working on Priyanka-a newly minted pediatric intern-as she explores life during residency.

I am hoping to follow Priyanka as she deals with many moral and ethical dilemmas during her medical training.  Not to mention, her adventures in love and loss.

I wish I could say Priyanka was as fearless and Jackie and Leela.  But she’s fearful-and all the more wiser for it. Life DOESN’T always work out as it should.  Sometimes, it’s one endless series of disappointments after the other.

But when it works out-and even when it doesn’t-living life and loving others is the best thing we do.   I hope to be any of these women one day.

Or maybe, just maybe, I can quit playing a character and start playing myself as the leading lady in my own life.  Which is why I’m here.  Healing.  Writing.  Speaking out.  Putting myself out there, hopefully.

I hope you enjoy my blog, and whatever else may follow.

 

[1] https://upload.wikimedia.org/wikipedia/commons/4/42/Classical_blood_coagulation_pathway.png

By Dr Graham Beards (Own work) [CC BY-SA 3.0 (http://creativecommons.org/licenses/by-sa/3.0)%5D, via Wikimedia Commons