Stream Change

So a classmate contacted all the students who are spending third and fourth year with me (in a different city from where we've spent first and second year; our school farms third- and fourth-years out to four different cities for greater experience, etc, etc). He has several friends' weddings happening in March and wanted to switch with someone who didn't have "IMED" (internal medicine) and surgery at that time.

That applied to me. And I actually discerned a decision (this is super rare, usually I just do something and then afterwards groan about how I didn't discern.) I thought about it, talked about it with my mom, prayed about it, and switched with him.

Now my rotations are happening in this order:

1. Psychiatry (one block)
2. Family medicine (one block)
3. Peds (one block)
4. OB/GYN (one block)
5. IMED (two blocks)
6. Surgery (two blocks)

There were things I liked about the other schedule, but things I like about this one, too. And OB/GYN still has its protected place. Surgery will lure me like a carrot through things, and I'll have IMED close to STEP 2, which I hear is a good thing.

Coffee with the Culture

Based on a coffee I had with a classmate the other day. All I did was omit her name.

The other day I met up with the Culture for coffee. She picked the place: it was a fashionable, relaxed coffeehouse, with catchy rock playing so softly that unless you listened, you would miss the profanities woven into the lyrics.

We got our steaming paper cups and sat down opposite each other at a round little table near the center of the room. Since we were only acquaintances, so I asked about her day. It was busy, she said; she'd been interviewed. I told her I'd been studying most of the day, and I didn't mention that I went to Mass that morning.

I asked about her background, to get to know her. She was very educated—in engineering, neuroscience, and medicine—but had complaints about the U.S. educational system, that no one learns to think. She wants more people to study philosophy and spoke much about recent scholarship and discoveries about older cultures. The books she recommended to me all sounded interesting, but they all sounded like negations of past assumptions. (I guess that's what still sells.) They all sounded like history and sociology, not what I know as philosophy.

Her mother identified with one religion but supported her when she chose to follow no religion at all, keeping only some remnants of her culture's behavioral standards. Her father was not much a part of her life. She'd chosen no religion, and told me she would never indoctrinate her children. "No scripture is true," she said once or twice. I felt like I was being used for archery practice and started praying with my fingers in sign language under the table. I l-o-v-e Y-o-u. I l-o-v-e S-a-c-r-e-d S-c-r-i-p-t-u-r-e.

Currently her studies were focused on medical ethics, she said. She spoke about conscience boundaries and patient autonomy (a few more arrows, right to the heart). She spoke about changing cultures and values, and the need to adjust what physicians are expected to do to include not only contraception and abortion but euthanasia. It was, after all, only a choice that should be available to patients. She was permeated with relativism. I didn't turn anything into a debate, but when she literally said, "there are no absolutes," I pointed out that this is an absolute. She seemed mildly confused and thought that she must have made a misstatement.

But she was polite and asked me about myself. I told her that I had a bachelor's in liberal arts and studied philosophy and theology; as usual, I expected that she didn't know what I really meant. And she didn't. How could she? I studied the objective and absolute truth and began to learn to find it; she does not believe that such a thing exists. To her I have a bachelor's degree in Fairies or Heliocentrism. I had to work to avoid feelings of embarrassment whenever she mentioned a philosopher that I hadn't heard of, since I spent most of college reading Aristotle, with a few landmark treatises before 1900.

Our conversation touched practical ethics, too. She told me how appalled she was to learn that a certain pro-life physician she'd discovered did prenatal ultrasounds and hid bad news from patients (fearing that they would abort). She though this was horrible.

Happy to find some ground for agreement, I agreed that he was not serving his patients well. (I didn't state why I thought so, but I will for you: a good pro-life doctor should share what he finds with patients and refer them to perinatal hospice, so that they could prepare for the birth of their child and parent them well). I didn't go into my reasons because I had a burning question to ask her. "Is this behavior always wrong?" I asked her.

"Yes," she replied.

"But you think good is relative," I responded. "Why would this always be wrong?"

Many words followed my question, but no answer came with them. The right thing is dependent on circumstances and culture and values, but there are some things that she would never do and which offend her, and which...no one should do.

"I think there is one right thing and one happiness," I said, "and that's why some things are undeniably bad for everyone."

She was quick to say much about how different people pursue different things and that she doesn't agree with me. But eventually she asked me, "What is happiness?"

"Love," I said. We all hunger for it, and try to find it in all kinds of ways.

"And what is the opposite of love?"

I looked at her levelly. "Apathy," I answered. I wanted to explain more, but she did not want to hear it today.

As we left and went out to the parking lot, she was still puzzling that "nothing is absolute" is an absolute. But I am not sure if a thousand coffee dates would ever sway her, so deeply ingrained is everything. Finally, coffee and words are just occasions; grace changes and intercession and penance open the gates to it.

I'm a Codfish

Source

So, once upon a time I was headed back from an awesome CMA conference, poster tube in tow after presenting the results of a literature search on IVF alternatives. I get in line to board the plane and someone gets in line beside me  whom I perceive to be liberal. I couldn't tell all at once, and it's hard to explain or excuse, but I could tell (and I was right) that this person probably disagreed with 95+% of my social issue positions. I don't remember who initiated the conversation (probably me, believe it or not), but eventually the gentleman asked about my poster tube.

"So, what's that?"

"It's a poster," I explained. "I presented some findings at a medical conference this weekend."

"Oh, really? What's it about?"

And I had a chance to say, "it's about IVF alternatives. Did you know that there are methods that are cheaper and more effective than IVF, but IVF is still treated as 'first-line' therapy by most infertility doctors? Isn't that weird? You'd think couples would like to try something better first, especially if it didn't involve drugs and masturbation. And with everyone complaining about our healthcare system, you'd think we'd prefer cheaper stuff. Right?"

But did I do this? No. My fear of being alienated was so strong that I just said, "IVF."

"Oh really?" the gentleman was pleased. (He seemed sort of leery of me before. Like, 'you're dressed like you think you're body's sacred or something. You must be benighted, backwards, and indoctrinated.')

"My sister is doing that," he said.

Feeling wretched and ashamed of myself, and still not strong enough to tell him what the poster was really about, I started the sympathy song: "Oh, wow. That can be really hard."

"Yeah," he said, his tone and body language heartily agreeing. The conversation went on about how I'd been to college in California (facepalm) and how L.A. is a bastion of liberalism (the first true thing said).

I'm such a coward!

But wait, it gets worse. Last month our class had an exam. A few minutes before it was scheduled to start, the classmate behind me and I struck up a friendly conversation about our streams. I told her that I ranked so that I'd get OB/GYN sometime in the winter. "Oh, that's right," she said pleasantly. "You want to do OB/GYN!" And then, "Are you interested in infertility?"

"Yes!" I said warmly. And I'd already hashed out my shame at the airport failure, and resolved to be more courageous and here was an opportunity. I could have said something like, "I'm really inspired by the speed and success rates of fertility-awareness based infertility workups. Have you heard of that?"

But I didn't. And while I was hesitating, she went on. "I'm an IVF baby," she said happily, smiling as though I would be inspired by this.

There was a very small pause, then I said "Aw, wow!" and my delight was real: I am glad that she was born and glad that she was my classmate. But I was also thinking to myself "oh, gosh, IVF right in front of me," and "glad I didn't say anything bad about IVF," and "I guess Mormons must not see a problem in IVF" and "can we please start this GI test so that I can make decisions on multiple-choice questions instead of with conversations and IVF??"

More courage is needed. Good thing it's Lent.

Finally, draw your strength from the Lord and from his mighty power. Put on the armor of God so that you may be able to stand firm against the tactics of the devil...and, having done everything, to hold your ground. So stand fast with your loins girded in truth, clothed with righteousness as a breastplate, and your feet shod in readiness for the gospel of peace. In all circumstances, hold faith as a shield, to quench all [the] flaming arrows of the evil one. And take the helmet of salvation and the sword of the Spirit, which is the word of God. With all prayer and supplication, pray at every opportunity in the Spirit. To that end, be watchful with all perseverance and supplication for all the holy ones.... (Ephesians 6)

God's Ideas and Turkey Sandwiches

Ash Wednesday was awesome. I stayed after evening Mass on Tuesday to help prepare the Newman center for the nine Masses said on Ash Wednesday. (Almost stupidly, in this culture Ash Wednesday is treated as a bigger deal than Easter even though it's not even a holy day of obligation. It's the sacramentals, I'm telling you. There's something about being marked that people really like.) I took unconsecrated altarbreads out of sleeves and packaged them in small quantities in ziploc bags, so that the priests would not overconsecrate at the Masses celebrated on-campus.

On that Wednesday after morning Mass, I went to class with marked forehead. Whenever I saw a classmate who also had ashes I'd gesture to my own forehead and say something silly, like "that's a good look for you," or "penance looks good on you." I even saw someone across the pump at the gas station with ashes, and we started talking about sacramentals! Crazy.

It also prompted some conversations with non-Catholic Christians, who also observe Lent and give up the radio in their cars or soda. It made me very glad that I know the Church's teachings about Lent: that adding prayer and almsgiving and fasting to remember that our only and ultimate desire is Christ, and that Lent has no value in itself, except as preparation for the joy of Easter.

And finally, it revealed some sad truths about a few of the Catholics in my classes. I spoke with one about Lent and found out he doesn't go to Mass. As soon as I found out, I took a step toward him as I started to encourage him to go. But he took a step back.

"Don't smite me," he said sort of jokingly.

And I took a step back again. "It's not about me," I said. And I gently and frankly urged him that this was nourishing to his soul. He was noncomittal about it, and shifted the topic back to Lent. I told him about prayer, fasting, and abstinence and what I hoped for: to focus constantly on Christ and love what He loves. "Because I want to be saint," I said finally.

"A saint?" he repeated. And he playfully tried out saying "Saint" in front of my name, as though I were aspiring to the presidency or the papacy or something.

"But we're all called to be saints," I said. "We're all made for it, and it's possible for all of us. You, too!"

And he paused, but then only said in an admiring tone, "you're very free with your ideas."

"GAH!" I wanted to say. "My ideas?? That's God's idea!"

But the conversation shifted to studying for STEP. (I try to never corner people into talking about spiritual things, so I'm pretty practiced at shifting gears to lower things. In this case, it was easy because STEP is a big stressor, and stress and holiness are on a similar plane of interior importance.)

Later, I went to the free lunch we had that day that came with a healthcare system presentation. I had forgotten to sign up for veggie, so I peeled the turkey off my sandwich. As I did, I realized that the classmate next to me was a Catholic (he'd been to a CMA meeting and the White Mass), and I thought I recognized him from Mass.

"Did I see you at Mass this morning?" I asked cordially.

"Uh, no," he answered. "I haven't been to Ash Wednesday yet."

There was a pregnant pause, punctuated only by the sound of potato chips and sandwich paper.

I wanted to say a lot of things, first among which was "Seriously?" followed by "Do you....know that this is a holy day, not an event? And the event is called Mass.... Ash Wednesday is not that big a deal compared to, you know...the second Person of the Trinity truly present in the Paschal Mystery on the altar...." But the presentation was starting, so I simply tried to be obvious with my turkey-peeling, and said "Too bad this [gesture to sandwich] was on Ash Wednesday."

"Yeah," he said, but he missed the hint.

Pope Benedict XVI: Deo gratias

I love Pope Benedict XVI. In high school, I rushed to the TV in the music hall to watch white smoke waft up and pilgrims in St. Peter's Square greet the new Vicar of Christ. In college, I walked over his coat of arms every day on the way to the altar rail to receive the Eucharist, and the motto summarized the entire life of faith. And in medical school, I read his encyclicals and felt like he was writing to me and confirming everything I thought was important or true and reshaping it to teach me more and more.

His renunciation (that's the term, even though it sounds strange in English) of the papacy came as a complete surprise to me. I walked into the kitchen last Monday morning and instead of "good morning," my roommate said "did you hear about the Pope resigning?" And she might as well have said "did you hear that Obama was assassinated?" or "did you hear that the other hemisphere cracked off and is floating in space?"

There was a pause while I tried to process things. I did not disbelieve her, but I was in shock. I said, "What? No pope has ever done that," and then I realized that I didn't know that was true, and so I said, "well, I'm sure someone has, but...oh my gosh."

My first reaction was "but, Papa..." and it wasn't until I later called my mom and she helped me see how great an act of humility and virtue this was that I realized I was being sort of selfish and silly. This is no tragedy or scandal; moreover, this holy man will be praying for the Church in a contemplative life (such a cool way to retire!). I'm now full of gratitude and admiration for him, and I look forward to discovering the fruits of his work and prayer in the future.

(Weird detail: last semester (in September or something) I'd started a post on the CMA-SS blog about how a pope is elected, just for fun Catholic trivia. I'd never published it, but now I guess it'll be relevant. Another weird detail: my spiritual director was just telling me about a movie she was viewing with an Italian class on campus, and how it detailed the process of election for the pope. It had been in the syllabus for a while, but now it will be extra-interesting. Third and last weird fact: we've been reading about the pope and college of bishops in the Catechism-in-a-Year, and this isn't the first time that exercise has been extremely relevant to Church happenings.)

Pray for a Cardinal in the upcoming conclave with this prayer to the holy angels:

Bless the Lord, all you His angels. You who are mighty in strength and do His will, intercede for Cardinal ____ at the throne of God. By your unceasing watchfulness protect him in every danger of soul and body. Obtain for him the grace of final perseverance, so that after this life he may be admitted to your glorious company and with you may sing the praises of God for all eternity.

All you holy angels and archangels, thrones and dominations, principalities and powers and virtues of heaven, cherubim and seraphim, and especially you, dear guardian angel who has been charged with the care of Cardinal ___, intercede for him and obtain for him special graces as he participates in the conclave to elect our next Pope. Obtain for him purity of intention in seeking the will of God, wisdom in discerning it, and the faithfulness to implement it.

Glory be to the Father, and to the Son, and to the Holy Spirit, as it was in the beginning, is now, and ever shall be, world without end. Amen.

There's a facebook group listing individual Cardinals that you can spiritually adopt until the end of the conclave. And if you haven't seen these, they're a good help:

Several people recently have pointed out that these posts don't really reflect my daily schedule. This is true; I lean heavily toward clinical experience. So here's an update

6:00am: wake up, chart, meditation, and Morning Prayer

7:00am: cook breakfast and eat

As soon as possible thereafter (e.g. 7:30): begin studying by watching lectures or doing STEP questions. I attend lecture only when there's a mandatory activity at school in the afternoon, when there is a CMA meeting, or when there's a reproductive sciences lecture. STEP-wise, each day I must read through a certain number of pages of the review book, do at least 25 practice questions (and review the right/wrong answers with the review book), and review one microorganism and one drug (and make a flashcard for each).

11:00am: exercise, if I'm not at school

12:00pm: Midday prayer and lunch. Studying often goes through lunch, but I also take breaks by reading the news (i.e. New Advent) on my phone while eating.

1:00pm: Studying starts again, and goes until 4:45pm, when I leave for...

5:10pm: Evening Prayer at St. Mary's, followed by Mass

7:00pm: home for dinner, followed by (guess what!) more studying.

9:00pm: take a break for reading the day's Catechism, the readings for the next day, and other spiritual reading.

9:30pm: back to studying, until

9:50pm: Night Prayer, and

10:00pm (that's the goal, anyway): bed.

I feel worn out by this regimen. I can't wait for STEP to be over, or at least for classes to be over, that way I'm not double-booked. I normally have about ten hours of traditional lecture per week, and one afternoon in the SIM center per week being evaluated with standardized patients. Nights at the Convent and other events related to consecrated life happen about four times per month, and CMA meets once a month for Mass and once a month at lunch. Somehow, even though I've bowed out of 1flesh writing and leadership, CMA's presidency and MedSFL's major responsibilities, I still feel spent.

We Should Stop Taking the Hippocratic Oath.

No, I'm serious. That title is what I think, not what someone else thinks.

The other day a classmate and I had a long talk about the Hippocratic Oath (read it here). She is a pro-choice relativist, but she will take the Oath because she maintains that paragraphs like

...I will neither give a deadly drug to anybody if asked for it, nor will I make a suggestion to this effect. Similarly I will not give to a woman an abortive remedy. In purity and holiness I will guard my life and my art.

I will not use the knife, not even on sufferers from stone, but will withdraw in favor of such men as are engaged in this work...

are clinical vignettes meant to illustrate general principles like nonmaleficence, and not to bind a doctor never to perform an abortion, give an abortifacient, or aid in suicide. This is understanding the Oath in its history context. (Meanwhile the immediately succeeding paragraphs, which state

...Whatever houses I may visit, I will come for the benefit of the sick, remaining free of all intentional injustice, of all mischief and in particular of sexual relations with both female and male persons, be they free or slaves.

What I may see or hear in the course of the treatment or even outside of the treatment in regard to the life of men, which on no account one must spread abroad, I will keep to myself holding such things shameful to be spoken about...

are literally binding.) She maintained that she understands the Oath and swears by it, while others (presumably like me) think they know what it means and take it ignorantly but pleased, bending it to their agendas. Taking the Oath is an appeasement to both sides.

The only study of the Oath I've had is Leon Kass' work and reading other Hippocratic works (his medicinal treatises). My classmates' position came out of lots of recent scholarship (i.e. 1980s, around Kass' time), and it makes up the body of the official presentation on the Oath to the first years.

My response to her was: why are you so attached to this Oath? Who cares about Hippocrates, or his culture (about which we obviously don't know everything, about which people disagree, and which you rightly point out is so different from ours)? Why shouldn't we just swear what we mean? On graduation day, you can swear what you told me you think the Oath means:

I will do no harm.

(Which isn't in the Oath anyway, it's in the Epidemics and in later European medical humanities. Stop being so Western-culturist.) Maybe you will also add some of the other things you told me:

I will never allow my personal beliefs to get in the way of what a patient wants. I will never indoctrinate anyone. I give them all the information and options and allow them to make a free choice, for the contrary is absolutely abominable (although good is relative).

You can swear that. I will swear this:

To God and all men, I profess that I will fulfill according to my ability and judgment this oath and this covenant:

I will improve or palliate the condition of the sick, treating each as a whole human person for their benefit [because beneficence is primary] according to my ability and judgment. I will do no intentional harm [because non-maleficence is secondary].

I will actually not give a deadly drug to anyone, nor will I make a suggestion to this effect. Similarly I will actually not give to a sexually active woman an abortifacient (including hormonal birth control, IUDs, emergency contraception, or RU-486) or perform an abortion on a pregnant mother. Further I will actually not prescribe any contraceptive.

In purity and holiness I will live and practice. I will not exceed my competence. Wherever I work, I will work for the benefit of the sick, remaining free of all intentional injustice. What I may see or hear about the lives of patients I will keep to myself, unless there is danger to the patient or to others or unless summoned by sufficient legal authority. I will honor my teachers and those with whom I work, and will treat the poor with special charity.

If I fulfill this oath and do not violate it, may it be granted to me to use life and this art unto my salvation and the salvation of others. If I transgress it and swear falsely, may You, O Lord, and my fellow men have mercy on me and forgive me.

I'm obviously not married to the Hippocratic Oath. It's fine, but it really doesn't capture everything. It was perpetuated for so long (through the Middle Ages) in Catholic cultures and their offshoots (including Islamic and Protestant cultures) because it was a very close approximation of Catholic teaching. Perfect? No! Misused after the Reformation in Germany? Yes!

The relativists are bending over to interpret it, the Christian doesn't think the literal interpretation is immaculate either...so who cares about Hippocrates? It's better that we be frank and say what we mean.

Dark Diagnoses and Extraordinary Forms

I told you I needed to be more poetic, and this is the story I was trying to write when I realized some parts of human lives are too great for clunky prose.

A man came into the office, I saw him, and he left with a diagnosis that will either accompany him or hurry him along his walk towards death. And although he feared a diagnosis like that (or at least, his wife did), I truly don't think he expected to get it. His major goal of the day was to figure out what was wrong and fix it, so that he could get back to the way life was before his symptoms were bothering him. But instead, he walked out of the clinic with a dark diagnosis.

His 'dark diagnosis' is one of many that I store in a mental box in a corner of my growing art. Myasthenia gravis, multiple sclerosis, diabetes, some cancers, HIV/AIDS, hepatitis C, congestive heart failure, chronic obstructive pulmonary disease, etc. I am not the master of these diseases, but I am the one who sees the signs of them and shakily opens that slim black case and pulls out the corresponding diagnosis, handing it solemnly to the person as I introduce them to their unwanted companion.

Sorry for getting so very poetic so quickly.

Actually, I'm not sorry. All death is poetic. Prose isn't adequate for sacrifice, suffering, birth, death, heaven, hell, love, or God. All these things overwhelm the speech of ordinary life and we need the extraordinary forms of poetry or song.

And these dark diagnoses are a kind of death, because I must tell them, "Life is different now. I wish I had different news to tell you, but you can't go back to the way life was before."

"Now your body is not the instrument you knew it was: it won't obey you, you can't rely on it. Now you have to do special things and change the focus of your life."

I study this dark box often because these diagnoses have many effects and are chronic, debilitating, and common. Many times I had spoken with patients and they had said "and I have COPD" or "I'm diabetic." They already carried their darkness.

But I had never visited with someone, examined him, presented his case my preceptor, and heard that we must open that box. Hearing my presentation (which is made privately outside the patient's room), Dr. H's mouth fell open and he said with raised eyebrows, "You think maybe organ failure?" as if saying, "are you opening that black box?"

And I could have said, "Oh, no! Not that, not for him." I had though his symptoms were from a relatively benign condition. And I liked this patient. We were alike somehow, even though he was a huge man with the build of a sailor, a square jaw, and the bronzed skin and bleached hair of decades of work in the open sky. We had a good rapport. (Maybe because we were both choleric?)

But I instantly knew my preceptor was right: organ failure fit with the patient's story much better than my idea, although my idea was still on my differential. In that instant I swallowed my "No!" and answered aloud evenly and honestly, "I don't know, but..." and I continued with the presentation. I watched as every word I said corroborated Dr. H's diagnosis and the lid of that box opened wider and wider.

We walked into the room and I looked at the patient with different eyes. Now I recognized the signs of that diagnosis in him. Now I saw that he had a dark companion which he did not know about but I did. It was like I could see his future, and I saw that he would become a different man.

(Sadly or happily, this man didn't grasp the impact of that diagnosis. He was relieved to have a pill to start taking to fix the problem so that he could go back to work. Dr. H may have broken the news to him a little too gently for a man so choleric. But I won't go around asserting that I know how to break bad news better than a successful, experienced, and sensitive family doctor. I actually started to see the wisdom of Dr. H's approach: the patient may be more likely to come back for follow-up if he feels his goals were met. And coming back for follow-up is good for chronic and serious diagnoses. The impact of the disease might change based on how the patient fares in two weeks.)

And I can't help it: I have to draw a spiritual parallel because it's not actually a parallel, it's a true instance of what I'm talking about. We all have a dark diagnosis--much, much darker than anything in medicine's little box. The name for people with this chronic, hereditary, debilitating disease (the name for all of us): sinners. Our appetites are not the instrument we knew in Eden: they won't obey us, we can't rely on them.

And alone with this condition, our future is completely black: we spiral down gradually to eternal death or separation from God, who is all that is loving and good. But God planned mercy, prepared us for it, and executed it beautifully by sending a Physician (or, better), the Cure Himself.

And now we work out the cure in our own souls day by day. Now we have to do special things and change the focus of our lives. And since it is simultaneously a kind of sacrifice, suffering, birth, death, heaven, hell, love, and is altogether of God, it sometimes takes extraordinary forms.

The Hulk and Holiness

So, to all outward appearances I am a calm, quiet person. I might even be described as reserved and shy. I dress conservatively, I speak politely, I just want to finish my training and quietly do good in my hometown... And even though (as a Catholic who loves the Church's teachings) I hold some controversial truths, when it comes to arguments, usually I'm like...

Can't I just keep helping sick people?

...and if I have to have to have to have to talk about controversy/deep truths, I try to listen and be charitable but I have a threshold and I'm always wary because I know that at any moment it can get internally out of hand, like today at a talk by a visiting pro-choice lecturer.

I AM ANGRY AND FLYING THROUGH THE AIR AND RIPPING YOU APART (well, not literally the last two)

Any time I'm really frustrated (be it with people, paperwork, or politics) I can get really angry. Like any fault, it really gets in the way of virtue sometimes. There is an original, righteous anger but it's so polluted with my own short temper that it's hard to tell what is Godly and what is mine.

Sadly, this is not the only excess I'm disposed to. Right after this pro-choice talk I was almost capsizing in a choleric melancholic sea.

Choleric: SO MANY ERRORS WHAT AN ILLOGICAL MESS HOW DARE YOU WHERE IS A TABLE I CAN FLIP?!?1!

Melancholic: oh, so many lies ingrained in so many souls, and so many lives being spent without the truth, where can I begin, this is so hopeless......

Despair and wrath...two deadly sins I have to avoid. Other major dangers are sloth (too much avoidance of defending virtue) and pride (forgetting my imperfections while looking at all the culture's). It might at first seem that steering between all these would be quite complex and difficult. I have to remind myself that holiness is simple (Hulk needs simple):

I do this...

and God does this...

...and we repeat those two steps for every moment of every day. (Until I forget, in which case we start over by His grace.)

The results are in!

I got my stream on Monday:

1. Internal Medicine (two blocks)
2. Surgery (two blocks)
3. OB/GYN (one block)
4. Peds (one block)
5. Psych (one block)
6. Family (one block)

Yay, it's going to be awesome!

I love my liberal arts education.

Check out this facebook conversation.

Classmate: Hi, I'm a classmate...and I've been a huge fan of your posts and likes on facebook. [Thanks newadvent.org] I'm a Protestant Christian who's really into theology. This kinda ties into med school I guess. This is a philosophical question and I"m curious about your opinion, what would a catholic say about brain transplants. If two people were to switch brains, would the souls follow. Would they just be people in new bodies now. I'm on the fence concerning physicalism.

Me:...By physicalism, do you mean the position that holds brain equivalent to, or the only container of, the soul? It's important to be clear about terms. : ]

C: I think physicalism refers to the idea that humans are primarily physical beings and the soul is not made of another type of immaterial substance, although they can still freely make decisions because the whole is more than just a sum of it's parts. So people can still make moral choices despite not having soul substance. You don't have to answer. It's a difficult question. I was just curious. Thanks for the reply!

M: I don't think it's as difficult as you think. Watch. Our physical abilities, like our senses, our ability to move, and our imagination, need physical organs to work. For instance: sight needs the eyeball; our ability to move needs muscles, motor neurons, the motor cortex, the pons, and the medulla; and the imagination needs areas like the limbic system. But we also have abilities that come untied from physical things: our intellect for instance, can behold things totally abstract from matter (e.g. "triangle," "justice," and "God.") This non-physical power has no use or need for a physical organ. So, this part of the soul is wholly immaterial. Since the soul is not divisible, the entirety of the soul must also be immaterial, though parts of it employ physical organs. Since the brain is the organ only of a part of the soul (or, more likely, a combination of organs of various parts), transplanting it would not mean body-switching or soul-switching. It would be a pretty dramatic transplant, but the immaterial soul is not moved just because one/some of its organs are. What do you think?

C: I think that was beautiful.... It's wonderful to talk philosophy with another person....

I guarantee you I couldn't have just pulled out that explanation without TAC. And what other education allows me to pull out my external hard drive and click click click to a boiled-down version of St. Thomas' five ways (which I created before Junior midterms)?

Way 1

• We perceive things in motion (common experience, effect of God) 
• From Aristotle's definition of motion (actuality of potency as such): nothing moves itself, everything is moved by another
• [The mobile] is [not in act]
• [The mover] is [in act]
• ∴ [The mobile] is not [the mover]
• Regarding these "anothers": there is either some first mover or we regress (which annihilates the intelligibility of the universe, which we assume)
• If there is [no first mover] there is [no second mover]
• If there is [∞ regress] there is [no first mover]
• If there is [∞ regress] there is [no second mover]
• There is a first mover. "First mover" is a name of God. Therefore, there is a God.

Way 2

• We perceive an order in efficient causes now causing
• Again, the thing caused cannot be identical to the cause
• Again, there is either a first or an ∞ regress (which would be, again, absurd)
• There is a first efficient cause now causing. This we call God. Therefore, there is a God.

Way 3

• We see that there are things now existing that can be and not be.
• For these things it is impossible to always exist (if not and such a thing exists at all times: it is incapable of not existing; a thing which possesses contraries is able to enact them one by one, right after another, so the contingent thing must have not been before being).
• If all are contingent, at some time nothing was (absurd)
• So there is some necessary being.
• Necessary beings are either caused or exist per se. There cannot be an ∞ regress in causes, so there must be a being whose necessary existence is per se, and this we call God.

Way 4

• Gradations in things are named from the highest (of trancendentals, e.g. true, good, beautiful, one)
• Most true = most knowable = most being
• The highest in the genus is the cause, so the cause of all being/good/etc. we call God. Thus, God is.

Way 5

• We see unintelligent nature (e.g. all material creatures besides men) acting for an end.
• This presupposes a good, an intention, an intelligence directing all these to their goods.
• This intelligence we call God. Thus, God is.