Chapter 22

One looks back with appreciation to the brilliant teachers, but with gratitude to those who touched our human feelings. The curriculum is so much necessary raw material, but warmth is the vital element for the growing plant and for the soul of the child.
Read more at http://www.brainyquote.com/quotes/topics/topic_teacher.html#Mm2pWAbMG6u1wDDA.99

One looks back with appreciation to the brilliant teachers, but with gratitude to those who touched our human feelings. The curriculum is so much necessary raw material, but warmth is the vital element for the growing plant and for the soul of the child.
Read more at http://www.brainyquote.com/quotes/topics/topic_teacher.html#Mm2pWAbMG6u1wDD

"One looks back with appreciation to the brilliant teachers, but with gratitude to those who touched our human feelings. The curriculum is so much raw material, but warmth is the vital element for the growing plant and for the soul of the child." 

-Carl Jung

This morning I received a link to an obituary I never wanted to see.

"Pyser S. Edelsack. A dedicated and beloved educator, husband, father and friend, Pyser Edelsack died of lung cancer on May 5 in New York City."

Sometime in late February, I was piecing together details that he received the diagnosis of lung cancer. I couldn't believe it. This man was the healthiest person I know. At his age, who could bike from the Staten Island Ferry to Hamilton Heights and still squeeze in some laps at the college pool? He led such a healthy lifestyle, he couldn't possibly have cancer.

I needed to confirm for myself, so I sent him an email asking him if he will be attending my graduation party.

The response: "Joanne, When you have a minute could you call me so we can chat.  This spring is different for me than any other.  Any time this weekend would be ok…..pse".

I remember the day I called. I was on a highway on my way to Boston, anxious because I didn't know how I could deal with what he was going to tell me. So I did what I do best: smiled and spoke in the highest of spirits as if I knew nothing. The conversation was short since he was concerned that I was driving. We actually never got to speak about "it" but I knew something was wrong for it was all in his voice. He told me if he was able to make it some way, he will make it to my party.

I just didn't expect it to be in spirit.

I texted him shortly after to tell him he didn't sound like himself and that I had confidence that he'll be quite alright but in the process to not let it steal his sunshine. His response ":) pse ".

I can go through thousands of emails copying and pasting all his words of wisdoms and encouragement. His continuous support and non wavering belief that I will be a great doctor. However, that will not suffice. His impact goes beyond writing.

Not many people rubbed him the right way or understood the complexity of his character. The way he would violate all intimate boundaries and get so close to your face you're afraid to even breathe. The way his green oval glasses suited him so well because he was just that odd person or as Grace would say "ese viejo loco". Our multiple conversations about the Knicks and how maybe NEXT year we'll get the 'chip while I was quietly hoping one day he'll give me tickets to his seasonal seats that he's had since Ewing was in Georgetown. I must've sat in his office so many times with a defeated look. He would then ask me questions to a depth that I always left his office more confused than I was when I entered but in the end I knew he always had my back.

He shared the vision of his pal Jack Geiger with such a deep passion for primary care that it was unparalleled. A passion that was then transferred over to me. The endless scholarship, fellowship and program recommendation letters that I have asked from him and with no hesitation he would write them for me. I had every intention in calling him this week and I didn't. I owe him so much and it just hurts that I won't be able to repay him.

"Joanne,
what an honor to meet your mom and dad......to be really honest she is not as pretty as you are.....andre is your cheer leader and I am ghost of "let's get the job done",,,,,,i am here if you ever need to talk......i have total confidence in you, just keep your eye on the immediate job at hand.....NO MORE INTERNET......warm, warm regards,,,,,and most of all CONGRATS ON GRADUATING FROM SOHPIE.......PSE

pse mobile2"

The job is now done Prof. Edelsack (without sacrificing my birthday) and I thank you for that. Forever in my heart. May you rest in peace in the blue and orange skies.

Lesson Learned: Call your loved ones for tomorrow is not promised.

A dedicated and beloved educator, husband, father, uncle and friend, Pyser Edelsack died of lung cancer on May 5 in New York City. - See more at: http://www.legacy.com/obituaries/nytimes/obituary.aspx?n=pyser-s-edelsack&pid=170931105&fhid=2086#sthash.rXDVI9cs.dpuf

A dedicated and beloved educator, husband, father, uncle and friend, Pyser Edelsack died of lung cancer on May 5 in New York City. - See more at: http://www.legacy.com/obituaries/nytimes/obituary.aspx?n=pyser-s-edelsack&pid=170931105&fhid=2086#sthash.rXDVI9cs.dpuf

A dedicated and beloved educator, husband, father, uncle and friend, Pyser Edelsack died of lung cancer on May 5 in New York City. - See more at: http://www.legacy.com/obituaries/nytimes/obituary.aspx?n=pyser-s-edelsack&pid=170931105&fhid=2086#sthash.rXDVI9cs.dpuf

A dedicated and beloved educator, husband, father, uncle and friend, Pyser Edelsack died of lung cancer on May 5 in New York City. - See more at: http://www.legacy.com/obituaries/nytimes/obituary.aspx?n=pyser-s-edelsack&pid=170931105&fhid=2086#sthash.rXDVI9cs.dpuf

Chapter 21

We must use time wisely and forever realize that the time is always ripe to do right.
-Nelson Mandela

366 days ago I set out to start this blog as a means of sharing my daily lessons. 

Quite unsuccessful as I only documented 20 of those lessons.

So I guess let me start off the year with the 21st lesson.

As I read everyone's post on Facebook of how awful or awesome 2013 was and how excited they are to apply last year's lessons to this year, I ask what's wrong with reflecting everyday?

There's something about starting anew on a Monday, on 1/1, next year. (For which I blame marketing tactics.) Making promises to ourselves that the next week or year will be better. But why not break it down even further? Why not make yourself better the next day, the next hour? Why can't we press that internal restart button spontaneously instead of a programmed start date? There's this fear of change mixed with procrastination to gain some time to rush to all our bad habits before turning a new leaf. Which is why I didn't really make any resolutions. I've been listening to my body whenever it desires to speak loudly. For my birthday and towards the end of this year,  I needed to genuinely make changes to my diet. I was unhappy with my energy levels, with the woman I saw in the mirror squeezing into her jeans. So what did I do? I made changes right then and there. Didn't need a new year's resolution, a new week, or a new year. Just good ole desire to change, setting some goals and dedicating the time and energy. Now to apply that same mindset to the other aspects of my life. 

We're living in an era where time somehow escapes us, where we feel like in the 24 hours we're blessed with, it's just not enough. By just driving around, the 1 second the light changes, people are quick to honk the horn. Pardon my 5 second lag, that is impeding you from rushing to your destination. I noticed I was no different when I went to Florida and my uncle was grilling some steaks. Five minutes passed and I'm upset that he's not done yet. My uncle shouted from outside, "Joa, this is not New York, everything is not done fast. You need to take it easy." Boy, did that shut me up and it stopped me in my track.

It took me back to the movie "Crank" where Statham's character is poisoned and needs to keep his adrenaline levels high so his life is on 2x speed. That's how I feel like I'm leading my life. If it's not photographed, I probably won't remember. I try to rush everything in one day and don't know how to relax. I feel like that's the product of the 2000s because I remember the 90s being pretty slow paced. Why do I bring this up? Not sure but it's been on my mind lately.

Lesson Learned: We need to live in the moment. These years are zipping by us and we don't realize it until it mid way or the end of the year. Seize the day, stop and restart if you need to. Every day is a new opportunity and use it as so.

Chapter 20

“Dreams do come true, if only we wish hard enough. 

You can have anything in life if you will sacrifice everything else for it.”  

~J.M. Barrie

Reynosa, Mexico.

A city directly across the border of Hidalgo, Texas.

The common point that linked seven teenage boys that otherwise were complete strangers to one another.

Some were from Ecuador, others from El Salvador and Guatemala.

Although their origins varied, their mission were the same: to reach the USA.

However for six of them, they only got as far as crossing the border. One actually made it all the way to the Northeast and was about to begin high school when "La Migra" aka U.S. Immigration and Customs Enforcement caught him and took him away from his family.

I was working the night shift in the ER when the attending said "They're sending another van load of the boys to get their XRays." Out of curiosity, I asked where are these boys coming from and why are they going to the ER just for XRays. It was explained to me that there's a safe haven organization not too far from the hospital that predominantly houses boys that have unsuccessfully crossed the border into the US and serves as a transition home during the family reunification process. Many of these young boys had positive PPDs (positive tuberculin skin test) so in order to rule out TB we had to do a history, physical exam and Chest XRay.

I was glad to have been in the ER that night because there weren't any Spanish speaking physicians around so I would be able to speak Spanish to the patients. However, serving as a translator exposed me to the saddest stories I've ever listened to.

One of the key questions to ask if suspecting tuberculosis is noticing any weight loss or if their clothes fit differently. One slim teen stated he was in the desert for 22 days with only one meal and he approximated about a 30 pound weight loss. Another teen couldn't begin to imagine how much weight he lost because he's never been this thin. Amongst the rest of the teens, similar stories repeated. The longer the journey, the less amount of food. This wasn't the response I was expecting.

Many didn't know what cities they were in. Some didn't know how many days they traveled since leaving their home but they all knew that Reynosa, Mexico was the last stop before crossing the desert into Texas.

I had to take a mental break.

I just had one of the most powerful experiences in my young medical career from simply listening.

My whole definition of sacrifice was shattered. Standing in front of me were living proof of corporal and mental sacrifices. Standing in front of me were young men who left their families behind, paid a stranger and blindly entrusted this person to lead them to "Los Estados Unidos", the land of opportunities. Standing in front of me were survivors of physiologic defiance when people otherwise die before reaching the U.S. because their dehydration was so severe that a clot went to their brain.  Standing in front of me were the most courageous young men I've ever met.

There I stood, a spoiled, gluttonous American who constantly complained of first world problems never questioning my next meal or expensive bottle of water. There I stood emotionally vulnerable because all I can offer was the native tongue my parents taught me to speak. There I stood wanting to give more of me and help these seven boys become the future of United States. There I stood rewriting my blueprint so when I do receive my M.D. degree I will be donating my time to immigrant health. There I stood.

Lesson Learned: Many of our goals and sacrifices may seem like leaps of faith but we should try not to question our current position/situation as it may be a part of the grand scheme. We know where we started from and what we want the end result to be but what builds our character is the journey in between.

Chapter 19

For humanism also appeals to man as man. It seeks to liberate the universal qualities of human nature from narrow limitations of blood and soil and class and to create a common language and a common culture in which men can realize their common humanity.

-Christopher Dawson

“Andrew is vomiting!” yells the mother of one of our SICU patients. Before I ran to get the attention of the senior resident, I paused a millisecond because something was so different with that statement. It wasn’t the voice of Andrew’s mother, as I’ve heard it in daily conversations for the past two months. It wasn’t the fact that was he was vomiting for he’s had fluctuant health.  Throughout the day I gave it some thought and finally came to the conclusion that it was the fact she referred to her son by his first name. For 8 weeks, my surgery team has either referred to the patient by his bed number, the procedure that was performed on him or informally by his last name, military style. This small instance of humanism warranted reflection.

Since the beginning of my medical school career, we've been lectured on the principles of humanism in medicine, its importance in the patient's care and just in case we forgot, they gave us a nice pin during our white coat ceremonies that served as friendly reminder. However, something happens in transition in which we lose that touch. I caught myself slipping while I was on surgery.  The redundancy of our days in addition to long, dragging hours mixed in with the interesting personalities of the patients, I found myself becoming a grumpy robot. I'm typically a cheerful person but by the end of the rotation I was a cynical, grim, jaded student questioning my career choice. I guess that's the natural process for anyone that pursues something they love, sometimes you just fall out of love until you're reminded why you fell in love in the first place.

There's a blog post circulating on the Facebook walls of medical students and residents that highlights the nonglorious aspects of what it really is to be a physician in the United States, beyond the six figure salary. Oftentimes physicians are scrutinized for their lack of empathy and it's evident to the patients. I don't think it's fair that we blame our long work hours for our missteps. Just like it's not fair to yell at your child if you had a crappy day at work. I think the same applies in medicine. Our patients are more than just a disease, a surgical procedure, a collection of pill bottles. They're humans with feelings and emotions just like the people taking care of them. Before stepping in the door seeking your service, they were mere strangers. In just a matter of minutes, you know their entire personal history. And to think that despite this privilege, medical professionals forget that healing patients is a delicate process. 

Andrew's mother reminded me that for us that septic patient is still her son. Her cries of hurt, anxiety, and hope reminded me why I fell in love with medicine.

Lesson Learned: As generic and obvious as it may seem, everyone should be treated with fairness and respect. Whether on the train, your local McDonald's, gasoline station or your doctor's office, be courteous and polite because your simple, kind gestures can go a long way.

Chapter 18

The young always have the same problem
 - how to rebel and conform at the same time.  
They have now solved this by defying their parents and copying one another.  

~Quentin Crisp

I am genuinely baffled with present day teenagers.  

I'm not even a decade older than most but it seems like there's this generation gap that keeps widening and I need to watch my step.

Last weekend I had a conversation with my cousin about how "grown" our teenagers look. Gone are the days where a clean, young face is appreciated.  Or that awkward pubescent transition phase where a girl's body is becoming a woman's body, unsure about what to wear without overexposing so the clothes fit just right but not too tight.

Now I can't even guess who 30 or who's 15. 

Every woman looks the same to me ...... except the geezers with failed attempts of Botox.

I went to buy a Lotto ticket last week and the clerk asked me my age. I replied "24" and he still had his doubts and asked for my ID. He gave my ID one long stare and calculated my age. My ID was returned with a "God bless you." At that time, my eyeliner has worn out, I had a bright green North Face bookbag and my energy levels were on E, so I probably looked underage. 

It's amusing that at some point in our lives we wish to look younger but when we have that youth, we rush to look older and do the things older people do. All for what? Some bragging rights? 

Today I was reading the news about Courtney Stodden, the "teen bride" of Doug Hutchison. She's barely 18 and with all the makeup she has on, on any given day she looks like she's going on 30. Who made it okay or even acceptable for someone her age to look like that? I was literally shaking my head in disapproval as I was clicking through her photo gallery.

Besides looks, the behavior and manners of these teenagers leave us hopeless for the future. 

I saw the video of Penelope Soto, a teen attending a hearing for possession of Xanax. The fact that was she was abusing Xanax warrants another discussion but her erratic answers to the judge sentencing her was just surreal. No fear of authority whatsoever and for that her defiance and sassy remarks earned her 30 days in county jail. 

Not only would I have been scared for my life to even fathom the reaction my mom would have if I called from jail but to add insult to the injury and say I disrespected a judge?! 

Where did that gut wrenching trepidation go?

All these unanswered questions presents as a unique challenge not only to society but to myself.

I've had failed attempts at mentoring the youth and that bothers me. I want to make an impact, I want to show these teenagers their potentials.

As much as I cringe with the thought of it, it excites me even more to want to pursue adolescent medicine.  To have a teenager come to your medical office speaks volumes. There's something wrong in which can't be pushed aside any longer. This is the point in which their veil of indestructibility comes down and their vulnerability shows. 

Lesson Learned: As adults, we question whose fault it is that our teens have become this way. This game of pointing fingers needs to rapidly end. It takes a tribe to raise a child. It's all our social responsibility to steer the youth in the right direction or we're doing a disservice to our future.  

Chapter 17

Habit is habit and not to be flung out of the window by any man,

but coaxed downstairs a step at a time.

~Mark Twain

Ever since my classmate told me about Vegetarian's Paradise on West 4th Street, I haven't stopped going. During my 4th attempt of vegetarianism, I tried this place out and their soy nuggets are to die for.

I haven't returned to being a vegetarian but I'm currently on Day 15 of the Simple Green Smoothies challenge. Everyday I drink some leafy green with fruit concoction so I would be able to get my servings of fruits and vegetables. It actually tastes better than what it sounds. This is something I want to carry over beyond the 30 days because I feel great. I also ran two miles before going to the hospital. The whole day I was euphoric because my energy levels were so high and my soul just felt rejuvenated.

I realized that I've always tried drastic measures to lose weight compromising the foods I love to eat and imposing strict guidelines. It shouldn't be like that. I need to learn how to take small steps in the right direction whether its in my weight loss goals, career goals, savings plan, whatever. It's just more realistic.

Lesson Learned: Slowly changing the direction of a ship over time is safer than changing its direction right before you hit an iceberg. It's better to have gradual results panned out over a long time than drastic changes in which you're susceptible to relapse.

Chapter 16

Love overcomes hate. Love has no color
Love has no orientation. All is love.
~Adam Lambert

I had a very interesting conversation with the resident I'm shadowing: our significant others. She asked "Does your family like him?".

That question often makes me cringe while I go through a number of emotions.

My response: "I guess. It's hard to tell because he's Black." She then asks "But aren't there Black people in Dominican Republic?" The million dollar question.

I come from a culture where a racist dictator brainwashed the people of the country for decades that black is ugly. However, I will not solely blame him for the ignorance because people can choose to surpass that. There's a saying that "everyone has Black behind their ears" which means essentially every Dominican has SOME Black in them. We're a country that began with indigenous natives that were colonized by Spaniards that brought in African slaves. Our people are a color spectrum, which is a beautiful thing.

I've been in my relationship for close to seven years. However, to my family the first two years never existed. Yup, I hid my relationship for two years.

I was afraid of the "consequences" of coming out. No one else in my family had dated a Black person and the Dominicans I know don't hide the fact that they don't like Black people. Forget the fact that he comes from a great family and finished grad school, his skin color was of utmost importance. So I was stuck. It wasn't fair to him that I have him hidden but I didn't want to be the "black sheep".

To me biracial couples are one of the greatest products of living in the U.S. Here you are, in a heterogenous country where you can meet the love of your life whose ancestry is halfway around the globe. You don't need to understand their culture or speak their language, all you need is love. Families should be content that you have found a person that loves you for who you are. Despite all the animosity and racist remarks (i.e. going to have little monkey children, better know how to braid hair, I was such a good daughter until this, etc) Aundrée has stuck it out with me because he believes in our love and I can never be more appreciative.

Lesson Learned: Shatter the blinds of ignorance. Don't be afraid to confront people and stand up for what you believe in. Love goes deeper than a hue.

Chapter 15

In times of great stress or adversity, it's always best to keep busy, 

to plow your anger and your energy into something positive.  

~Lee Iacocca

Something is off and I have no idea what. 

I've been in the ophthalmology clinic for two weeks and it's a pretty relaxed environment. However, I've been feeling this looming stress recently.

So I did what I usually do when I'm stressed: clean. I clean when my anxiety and stress levels are super high. My roommates pointed it out to me some time ago. I would snap at them the day before an exam because they failed to do their chores. Shortly after I take the exam, I would go back to the apartment and got my clean on.

I usually prep myself by playing some bachata and letting the Ajax sit in the bathtub. I scrub every tile and scrutinize every crevice. Once I'm done, I stand at the doorway and admire my work of art. Today, I also wanted to clean my room so I repeated the same procedure. There's something about a clean environment that just feels like a breath of fresh air. 

Speaking of fresh air, yesterday I was really unhappy with how my body felt. I told myself I would go running at 630 am. Let's just say waking up at 730 am felt amazing. However, I wanted to follow through with the promise I made myself. After cleaning my room, I went for a run by the FDR Drive just to clear my mind and get rid of this unknown source of stress.

According to my Nike Run app, today was my longest and farthest run. I also realized I pushed myself to stop as little as possible. Those 2.6 miles went by like nothing and I feel really good (well not entirely because my knees are aching).

Lesson Learned: Often times we carry this unforeseen load of stress that can be triggered by so many different aspects of our lives. As long as we are be able unload the stress and channel that energy into something productive there's nothing wrong with a little bit of "healthy" stress.

Chapter 14

I like to keep my feet on the sidewalk.

~Joshua Homme

I've been living in the Upper East Side for a mere two weeks and I'm already fed up.

This is presumed to be the neighborhood of the wealthy, educated, well-to-doers and their respective pups.

Well let me tell you something, not even a medical degree can cover the amount of dog poop on the sidewalks. (I'm not sure if that made any sense).

I have the worst luck when it comes to poop. I can date back as far as seventh grade all the terrible accidents I've had stepping on dog poop and having a trailing scent for the rest of the day. What do you do when you're far from home, don't have a hose to apply water pressure to remove the poop or let alone napkins to somehow remove it from the intricate lines on the bottom of your sneaker? Do you go on your merry way and pretend it wasn't you? 

On my walk to work, I enjoy observing my surroundings. However, my observations have been truncated by constantly having to look down on the sidewalk to avoid poop. Literally every 6 inches there's some dog's intestinal residuals. On one of my walks, someone made the poop amusing by putting a little "waving" flag on top of it.

To add more insult to the injury, some blocks smell like dog urine. Not only do I have to focus on the sidewalk but I must also hold my breath because the scent is extremely potent and nauseating.

There are traffic police officers all over the neighborhood giving parking tickets left and right. I'm pretty sure they can multitask and give the dog walkers a summons for not picking up after their pets. I'm not going to lie, I am guilty of leaving my dog's feces on my neighbor's lawn but at least its a lawn and not all over the sidewalk. (That doesn't justify it.) This is not only a visual sore but it's not sanitary issue with plenty of ramifications. I'm sure if the dog crapped on your living room floor you would pick it up. Then why not do the same on the streets? The street cleaning vehicles don't clean the sidewalks so who's expected to clean the crap? The bottom of some innocent person's foot?

Lesson Learned: Wealth doesn't buy you hygiene, cleanliness, or class. The Upper East Side needs to get their shit together. 

Chapter 13

Growing old is mandatory; growing up is optional.

~Chili Davis

Today we celebrated my cousin's 27th birthday.

It was a bunch of women sitting at a table talking about: babies....for about 5 hours.

Just a year ago we were all sitting at the same table talking about our significant others, plans for the future, and just gossiping.

In just a matter of a year, four babies later, and four more due to arrive, we have all grown up. Our priorities have shifted, our outings are limited and so are our cocktails.

Three (including me) of eight are not pregnant or have children.

Which is a new experience for me.

I don't have much biological family in USA so I never got to meet many of my "blood" cousins's offsprings and now suddenly all these babies creeped up on me. It's seeing beauty in a new light: cuteness in a 1 month old farting, a 1.5 year old always telling me no, or a 2 year old who kindly gives you an item placed on a chair so she can have a seat.

We've grown up.

Which is not a bad thing, I guess but at times I get nostalgic of the good times when time used to go by slower, money was never a problem and laughter was in abundance.

The three of us guesstimated that in next 5-8 years perhaps we'll contemplate having a child. Which then got me thinking, much of our generation obsesses with planning.

We plan trips, education, children, our whole freaking life but sometimes we need to add some spontaneity and break free from the rigidity. Its good to be prepared but not overly prepared. If things always go as planned, we won't know how to respond when they don't go in accordance to our timeline. We're at a stage where even the most natural gift women possess, childbirth, is now planned.

Much of my life has been planned and I must admit it's quite lackluster. The unknown frightens me. Not being able to control an aspect of my life just makes me nervous. If it wasn't for the unforeseen failures or life's pleasant (and not so pleasant) surprises, I wouldn't be able to say with confidence that I can react decently when a curveball gets thrown at me. Although I believe my whole world is crashing when I get thrown off course, I convince myself some good will come out of it.

Lesson Learned: We'll never be ready for the next step if we keep prepping and not move forward from this grand"plan". As much as we find successes in completing tasks according to plan, we should also be willing to accept new, unpremeditated challenges as the process of growing up.

Chapter 12

Wise men don't need advice. Fools won't take it.

~Benjamin Franklin

I love shopping and I'm really observant.

Often times, I just zone out at gatherings and just watch people. There's just something so interesting about observing people in their element.

I was in the jewelry section of Loehmman's when a young girl tripped. She was running around, screaming but as a true New Yorker, I was able to ignore her shrieks. However, once she tripped I snapped out and was concerned. When a child falls, you wait for those longest seconds to see whether the child reacts with laughter or cry of death. This rugrat got up and resumed her running as if nothing happened.

She only had one shoe on and her older sister stepped on a stocking. Another bystander told the girl to be careful but this wild child wasn't having it. Once this bystander commented to the child, out comes the mom. The bystander, white perhaps American woman, was telling this mother how it's dangerous for the little girl to be running around especially in her stockings. And this is where it gets interesting.

The mother of European descent in a thick accent explains to this American woman that she cannot control her three and a half year old daughter. She states she cannot yell at her or beat her. The American woman was puzzled and replied to the lady "What?! I'm not going to get in to this but you are the parent, she has to listen to you."

This mother goes on to explain that there's nothing she can do for this child, she just allows her to do whatever she wants and if she gets hurts then she'll learn.

As all this is going on, I'm hiding behind the sunglasses eavesdropping thinking what I would've done with this kid.

Everyone has their two cents on how a child should be raised. Do I agree with this nut case of a mom? Absolutely not but I'm not going to give her a lecture on parenting in the middle of Loehmann's. The poor mother looked disheveled, exhausted and defeated. Who knows what she's going through? Do we just fault the child for being in that "difficult stage" or fault the mother for poor parenting? What do we even coin as "good parenting", a relative term?

Lesson Learned: Sometimes it's best to just ignore what's going on around you. As many good intentions you have, we have to learn when is an appropriate time to dish out advice and how receptive the audience is.

Chapter 11

I don't believe an accident of birth makes people sisters or brothers. 

It makes them siblings, gives them mutuality of parentage. 

Sisterhood and brotherhood is a condition people have to work at.

~Maya Angelou

My brother is a test question.

On every cardiac exam I've taken, my brother's heart condition doesn't fail to make an appearance.

He was diagnosed with Wolff Parkinson White at a young age. Because he was so delicate and we couldn't agitate him, he was treated differently which led to being spoiled.

My brother has a complex personality. He's a constant tug of war of opposites. He's an intelligent young adult who has this facade of a lazy thug. He's a sweetheart who pretends to be a player. He splurges on high end products when he's a product of middle class.

At one point, my brother and I couldn't stand the sight of one another. We would fight, bash each other against the wall and wish the other would just disappear. Presently, we've reached a happy medium where we enjoy each other's company, vent our emotions and have sporadic conversations about life. He encourages and pushes me to reach my goals. However, when I try to suggest weight loss or not buying Louis Vuitton, he throws the ball right back and tells me to focus on my own goals.

Not everyone understands my brother . Actually, not everyone takes the time to understand my brother. Instead they fixate on his negatives and criticize my mother's parenting skills.

As my brother picked me up today and drove my car, I was just in awe how quickly he grew up. Here I am yelling at Junior about his reckless driving and he's yelling back that I'm just like mami. With him I learned the art of compromise. I can't impose my views much less measure his success against mine. We may have been born from the same parents, grew up in the same neighborhood, went to the same school but our life experiences are vastly different. I can't expect him to do things my way, my parent's way or any other person's way. I accepted his way.

Lesson Learned: Teenagers are complicated (duh!). You need to constantly play tug of war until a balance is met. As much as you only wish the best for them, they need to learn from their own mistakes. Let them have some independence but of course with firm guidance. You can only learn to ride a bicycle by taking off the training wheels and being there for them when they fall.

Chapter 10

Time and health are two previous assets that we don't recognize until they have been depleted.

~Denis Waitley

I'm exhausted. Not from working all day but from exercising today. Unintentionally.

It must've been written in the stars for me that today my fitness was to be tested.

I decided to hang my scarf on my bookbag because the day looked warm. Once I stepped outside, walked to the corner, I concluded that it was a little brisk and I should wear my scarf. I go to reach for my scarf and its not there. It must've fallen on the stairs. I proceed to walk back to my building and wished it was on the 1st floor. Now, I live on a 5th floor of a walkup building. Every afternoon, I dread going home because I have to climb those steps. My scarf isn't on the 1st floor or the 2nd or the 3rd or the 4th. It fell right outside my freaking door. I picked it up, shook my head, and chuckled.

After work, I decided to pick up dinner from one of my favorite restaurants. It was just 5 blocks away from my apartment. The hospital is already 15 blocks away from my apartment so 5 blocks is no biggie. On my way there, I received a message that I needed to go back to the hospital for a meeting. By this time, my feet were throbbing and I was pooped so I took a cab back. However, I trekked the walk back home, again. Today I walked 50 blocks. Doesn't seem like a lot but when you're wearing Steve Madden Intyce boots, boy do your feet feel the heat.

In my short lifetime, I have gone through so many exercise regimens. I may just be the most fit, chunkiest person you've met. I've tried Bikram Yoga (hot yoga), Capoiera, spin class, kickboxing, Barry's Bootcamp, Bally's and Lucille Roberts. I've paid for a nutritionist (which was successful for a small amount of time), done the Special K diet, drank only water. You name it, I've probably done it.

This year I've committed to an overall healthier lifestyle. So what if I walked a bunch of extra blocks or went up another set of 5 flight of stairs. This can only benefit me. I've also took up the 30 day green smoothie challenge, something I see myself doing beyond the 30 days because I honestly feel better drinking it.

Working in the hospital, I've witnessed so many regretful faces when they are diagnosed with malignancies or chronic illnesses due to disregard of overall health. We pollute our lungs with smoke, abuse our liver with alcohol, dirty our veins with drug use, clog our arteries with fast food, and never do we think about the consequences. Yea, we shoulda, woulda coulda, but we didn't. It's time we get serious about this borrowed body we have and do good to it because once health is gone, it's gone forever.

Lesson Learned: Don't push back what you can do now. Create small, tangible goals that works towards one large one. Our bodies can only handle but so much abuse until our luck runs out.

Chapter 9

A successful marriage requires falling in love many times, always with the same person.

-Mignon McLaughlin

My parents are old school in every aspect you can imagine.

Boyfriend can't stay past 11 pm unless its a Friday or Saturday, can't invite guests unannounced because the fridge has to be stocked, or you have to say "con permiso" if you'd like to talk to them while they're on the phone.

Their marriage is pretty old school too or maybe my dad is inattentive. If and when my dad has a craving for calamari, he'll invite my mom to his favorite restaurant and that's the extent to quality, alone time I've seen my parents spend. I can't blame them entirely because this economy has my dad slaving at his own bodega. However, that is no excuse as to why I've been purchasing gifts for my mother from my father since elementary school.

Today I received an email for the presale of the Marc Anthony concert. My dad wants to see a Nets game at the Barclays and my mother wanted to go to a Marco Antonio Solis so I decided why not modify the two wishes and have them go to a Marc Anthony concert at the Barclay's! I bought them two floor seat tickets (just FYI, if you don't want to tumble like ragweed, I'd suggest not sitting in the nosebleeds at the Barclay's) for the day after Valentine's and I'm sure my dad will take the credit as this being his idea. It'll be a romantic concert with an amazing singer that'll give them the opportunity to not only share their love of music but share quality time together. 

I've noticed that in order for things to happen at my house I have to impose them. Both my parents get caught up with their jobs that at times I think they forget they're humans and not only do we have to allow our bodies to rest but we need to nourish our relationships, create hobbies and interests to allow our minds to decompress. Habits can be easily created but difficult to break so if we're constantly in this vicious cycle of all work no play, we tend to forget the things that matter most. It's not the house, the car, the money. It's the underlying love, the fruit of the marriage, that made it possible for all that to happen. 

Lesson Learned: If in a relationship or marriage, make sure to dedicate some time to your spouse/significant other. Go on dates, it can be as simple as walking in the park and just communicating. Remind yourselves why you fell in love with the person in the first place. During your time together, forget the worries and focus on fortifying your love. 

Chapter 8

Everyone is like a butterfly, they start out ugly and awkward and then morph into beautiful graceful butterflies that everyone loves.

~Drew Barrymore

I'm awkward. Super awkward. Especially around strangers I'm forced to meet.

The beginning of every rotation is like the first day of class ALL over again.

Because I'm a transfer student, many of my colleagues give me puzzled looks when they see me at orientation. To make it even more uncomfortable, I'm not socially outgoing. In order to make up for this flaw, I default to my cellphone. I somehow manage to have so many emails and texts to respond to which forces me to have my head down for some time. This stint can only hold up for but so long until I approach borderline antisocial.

So I switch to staring into space which in my head makes it easier for me to introduce myself. I look up, to the sides, to one person's face but only long enough before they notice and then quickly go back to looking up. This continues until someone breaks the ice and asks "Are you a Sophie Davis student?".

Sigh. Finally. Once that happens, I loosen up and become friendly.

I wish I possessed the networking skill in which I can gracefully walk into a room, introduce myself and instantly spark a conversation. I've gone to so many seminars, lectures, workshops on how to network that I can give a lecture my damn self but I can't even begin to put it in practice.

When I was a Colin Powell Fellow, the administrators thought it was a good idea for me to go a fundraiser hosted by Mayor Bloomberg and Gen. Colin Powell. It took place at Gracie Mansion and there were potential donors who wanted to hear from the fellows themselves. Boy was the pressure on. I stood in a corner and watched my colleagues work the floors. I honestly tried to initiate a conversation but upon reading the name tags and their positions, I blushed and just smiled.

Breakfast was to be served so I sat at the table in the back corner. A friendly gentleman, whose name tag I couldn't see, began talking to me. We made small talk until I struck a cord bringing up Dominican Republic. Here I was talking to the ambassador of South Korea about the beaches of Dominican Republic. I wasn't nervous, my face wasn't flushed, I didn't stutter. This conversation went so smoothly.

Similar situation occurred when I went to a summit for Hispanic Scholarship Fund. Again, I sat at the back table in the corner. A gentleman sat next to me and again Dominican Republic struck another cord. He spent some time abroad in the countryside of Dominican Republic. For the rest of the night, the conversation went smoothly. He was called on stage and he happened to be some head honcho at Wells Fargo that donated $1 million dollars that night.

If its one thing that I learned about myself is that I'm at ease if I can speak to people not knowing their titles, who they work for, or what they do for a living. All I need to know is their name. Plain and simple.

Lesson Learned: If all else fails, talk about Dominican Republic. Just Kidding. At times we get entangled with the accolades of a person which can be intimidating and in my case paralyzes you. However for many of these people their work is what they do and not who they are. There is so much more to a person than their position of their job. When meeting people for a first time, try to get to know the person for who they are and you'll notice how much easier it is to start a conversation.