On a time of transitions (or Inpatient Neurology: a post-mortem)

This week, I have faced three major transitions: the end of my clinical rotations of medical school, beginning the move from our student home into our residency home, and the death of my paternal grandmother.

The end of clinical rotations for medical school.

Now, I am less than two weeks away from receiving my diploma and those two letters behind my name: MD. I’ll be honest, it is tough to reflect on that larger milestone right now, so I will focus mainly on the past month with the inpatient neurology service.

These four weeks with the neurology team has been wonderful. I rotated two weeks with inpatient neurologists during third year. I enjoyed myself immensely during those weeks and have only had more fun during this past month. Neurologists are a funny bunch, much like psychiatrists.

Three weeks of this past month, I rotated on the same service that I will rotate through as a PGY1. Perfect preparation for intern year, a gift that other soon-to-be residents could barely imagine. I have a decent idea of the patient population, the busy-ness of the service, and the personalities of the providers.

I spent one week on the ICU neurology consult service, where I worked with a young neurointensivist. In the afternoons, I would follow him around like a good medical student and watch him follow-up on patients and pages. Most of that was watching him yell at patients, asking them to move their hands/toes or to look at him.

Initially, very sad to see so many sick and comatose patients in quick succession. Eventually, morbid comedy injected itself into the routine happening. The attending had a slight accent and I found it rather endearing the way he would yell into his patients’ ears. I can hear it now, “Brenda, wiggle your toes for me! Brenda! Wiggle your toes!”

Rotating through the services with third year medical students reminded me how green I was back in those days. I know a lot now. Not nearly everything, but I am far more comfortable discussing CT scan findings and items on my differential. I think the attendings notice that and speak to me differently than the third years. When the service picks up and they need help seeing patients in the ED, they lean on me for support rather than treating me as too much of a distraction. Feels quite good to be useful.

I’m entering that phase, where I can contribute but cannot practice on my own. In many ways, I’m like my son. He can sit up when assisted with a gentle guiding hand here or there. But if he tries to sit up on his own for too long, he will tumble.

Beginning the move out of our student home and into our residency home.

Back when we nested for Joonsu’s arrival, I packed up many of our things to create space for his things. For the past month, with my mother and father staying with us to assist in childcare as Mackenzi and I returned to clinical rotations, we have been quite cramped. Not much space for four adults, one baby, and a fur sister.

Looking forward to our new home, we will have so much room for activities. We will be able to spread out and have a weightlifting room, a roll around on the ground for baby room, and a hangout room for both Mackenzi and I as well as my parents. This student home has served us incredibly well over the past two years, however we are outgrowing the space and need to set down roots in a bigger pot.

So yesterday, we began building boxes and stowing things in them, once again. I love the process of moving. I spent a summer working as a professional mover, and I have retained many of those habits. I find building boxes in my muscles’ memory. I deeply enjoy filling a box with things, and then sealing that box shut. My body loves picking up a well-balanced box and moving it from here to there.

During my move from NH to FL, to begin medical school, I was a single man preparing to live in a single bedroom apartment. Then Mackenzi moved in with me, combining our things in a weird slurry. We moved together, as a couple, from FL to PA. We moved into this Coopersburg home with a good friend of ours to share this space. Then, he left for a life on the road once this baby arrived. Now, we are moving out of this home as a family and into a family home that is not just the space for Mackenzi and I, but our family’s space, to include my parents for a while.

What I mean to say is that for the past four years, I haven’t left a place in the same condition that I arrived. I couldn’t have. There has been so much growth in my life that I am a constantly growing plant, moving from container to slightly larger container.

I imagine that this next home, our Orefield home, will be sufficiently large enough for the next several years of residency. I doubt we will grow out of this home for a while: I could imagine Joonsu attending school in the area. We will, more likely, find a place to truly begin setting down roots and into the earth as a family. No more containers or vessels to foster the next level of growth. Instead, we are approaching the stage where a pot will only limit our development and potential.

When to make that transition and where to plant ourselves? That is a question which will simmer for the next few years. Now, we need to get down to the business of settling into this pot, rather than worrying too much about what’s to come.

The death of my paternal grandmother

In many ways and with lots of practice, my family saw this coming. We just didn’t know when it would happen.

I got the call from my mother on Tuesday morning, walking over to round on my neurological consult patients. My grandmother had died a few hours earlier, in Tennessee, with a hospice nurse at her side. We always called her Halmoni, the Korean word for a paternal grandmother. She spoke only Korean, I spoke only English, so we never had much of a relationship. However, I knew this death would affect my father greatly.

As timing would have it, my father was actively preparing to leave NH to join us here in PA, about a six hour drive. My mother and I deliberated on whether or not to tell him before he left: would it be wise for him to drive in such an emotional state? We opted to defer giving him the news of his mother’s death until we could do so in person.

Unfortunately, in this age of social media and internet-based connectivity, he found out despite our efforts. His older brother in South Korea had messaged him condolences as he got the car ready for the drive south. My younger brother would find out from social media posts from our cousins, right before I could call him to tell him the news.

My father took the news well. We had a few scares with Halmoni over the past four years, each time forcing his siblings to confront the nearing reality of their mother’s death. So on many fronts, we were executing the plans we had created earlier. I disseminated the news to my siblings, who got in contact with cousins. My father organized with his siblings a possible date for a funeral service before leaving NH.

He arrived in Coopersburg without a problem. Once here, he was able to play with his grandson and lift his spirits. I stayed home from my clinical responsibilities for the rest of the week, knowing that I have a unique opportunity. For many folks of my age, when a grandparent dies, the death occurs across the country and the grieving child/parent is also hours away. For me, my grieving father was staying in our home.

So I asked for time off and was granted the ability to be with my family, instead of neurology consults. I had a few conversations with my father, which I wouldn’t trade for any clinical pearls or patient encounter. For this, I thank those neurologists for their understanding and compassion.

The grieving process has only begun. My parents left on Friday morning for their Jacksonville, FL home. This Sunday morning, there is a memorial service at their church for Halmoni. The funeral service, with all the siblings together, won’t be until late May.

My paternal grandmother was a complicated woman. She had complicated relationships with all of her children. She is part of the reason why I have a complicated relationship with my father.

And she is part of the reason why I want Joonsu to have a simple and loving relationship with his grandparents, my parents.

For that, I will always thank her.

Long Form Sundays

On Death Podcast

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