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Posts Tagged ‘Hiking’

It’s been a busy month since my last post.  I’ve studied for and taken the United States Medical Licensing Exams (USMLE) Step 2 CS and (on Friday) USMLE Step 2 CK, two parts of what most people know as “the boards”.  I’ve attended and spoken at the 2013 Ancestral Health Symposium (AHS) and moved out of the apartment I lived in for the last 18 months.  I’m also half way through my “Acting Internship”, a clerkship most medical schools call a Sub-Internship, where I basically function as an intern (a first year medical resident).  I’m doing this rotation at a local community hospital and I’m really enjoying the atmosphere, personnel, and patients.  The hours are long, but not as long as for many of my classmates doing acting internships in Internal Medicine, Surgery, and Ob-Gyn (mine is in Family Medicine, the specialty I am pursuing). Applications for residency programs go live in just over a week which finds me struggling to write (for the fourth time) a personal statement that embodies me

 

Needless to say, things have been hectic , and the last month has been a touch overwhelming at times.  I’m certainly looking forward to some downtime after I finally complete my remaining med school requirements (just 8 more weeks!), have my residency lined up, and am able to catch my breath. 

 

I really shouldn’t complain.  Even in the last, relatively crazy, 6 weeks I’ve still had some good times.  The week of AHS in particular was one for the books.

 

I’ve written before about destinations and journeys.  The destination for AHS was clear- Atlanta Georgia- but the journey I took to get there wasn’t what you might expect. 

 

Many, many, months ago, when the location for AHS was first announced, I made a rather rash statement that Atlanta was almost close enough for a road trip.  While I had no real intention of road tripping to Atlanta, my longtime Twitter friend @PrimalRush (henceforth known as James) said he was keen to tag along for the journey.  At the time I thought an actual road trip was unlikely (it’s a good 13 hour drive and airfare isn’t that expensive), but as the time got closer I realized I would regret turning down the opportunity to create an excellent story (those that know me know all too well that I’m a fan of adventures and stories). 

 

Since I took 4 weeks off from school to prepare for the boards and attend AHS, I was able to take some extra time travelling to AHS.  About a week out, I vaguely mapped a path to Atlanta, made plans to pick up my Canadian travel buddy from the bus stop, and hoped for the best!

 

Three days before we planned to pull into ATL, James and I hit the road with camping gear, a cooler, and a tank of gas.  After making a stop at one of my favorite butchers to fully stock our cooler, we made tracks to Shenandoah National Park in Virginia.  We travelled the length of the park on Skyline Drive, stopping about midway to camp for the night. 

 

At times, we were in the clouds driving on Skyline Drive.  Driving the length of the park added a few extra miles to our trip, and certainly slowed us down a bit (the speed limit is 35mph and you can't help but pull over and ogle at the views), but it is certainly worth it!

At times, we were in the clouds driving on Skyline Drive. Driving the length of the park added a few extra miles to our trip, and certainly slowed us down a bit (the speed limit is 35mph and you can’t help but pull over and ogle at the views), but it was certainly worth it!

 

Without going into detail, our time in Shenandoah involved meeting some mushroomers who confirmed my Chanterelle (and Chicken of the Woods) identification, cooking a truly excellent camp dinner (with Chanterelles), having a run-in with a slightly disgruntled ranger, hiking part of the Appalachian trail in the dark, pitching a tent in the dark, waking up and breaking down camp in the dark, and then scrambling to a 360o viewpoint to watch the sun rise.  When we were finally able to tear ourselves away from our solitude and sunrise we hiked the couple miles back to the car and made tracks through the rest of the park and onto our next destination in Mortimer North Carolina.

 

A delicious addition to our dinner (good thing I had some Kerrygold butter in the cooler!)

A delicious addition to our dinner (good thing I had some Kerrygold butter in the cooler!)

 

I'll take this over dehydrated rice and bean camp dinners any night!

I’ll take this over dehydrated rice and bean camp dinners any night!

 

The view at dawn from Bearfence mountain.

The view at dawn from Bearfence mountain.

 

It was certainly worth waking up at 5, and hiking in the dark, to watch the sun rise over Shenandoah.

It was certainly worth waking up at 5, and hiking in the dark, to watch the sun rise over Shenandoah.

 

How could I resist?

How could I resist?

 

Mortimer North Carolina holds a special place in my heart.  One of my longtime friends has a family cabin in Mortimer, and I’ve twice travelled with her for an escape to the mountains and the beauty of Wilson’s Creek.  Mortimer is also home of Betsey’s Ole Country Store an establishment owned by my friend Bruce.  The address to Betsey’s is a little deceiving- let the record show that “Highway 90” is a gravel road where you need to pull over to let oncoming traffic pass. 

 

Anything I say about Betsey’s or the owner/operator of the establishment, Bruce, would sound like a paid advertisement, so I’m not going to even start.  What I will say is, if you want to visit a beautiful part of North Carolina- visit Mortimer. And if you visit Mortimer- visit Bruce.  He’s got cabin rentals, inner tube rentals, and more knowledge of the area than you’ll find anywhere else.  If you ever find yourself that way, tell him Victoria sent you… Seriously!

 

With Bruce’s back yard as our home base (he is a gracious host), we put in many miles of hiking, had numerous dips in local swimming holes, and managed to spot some of the Perseid meteors.  It was hard to tear ourselves away in order to make it to Atlanta on schedule (we actually didn’t make it to Atlanta on schedule because we opted to take a morning hike before we hit the road).

 

Betsey's. "Peace and Love, Y'all"

Betsey’s. “Peace and Love, Y’all”

 

Putting in some miles in Pisgah National Forest...

Putting in some miles in Pisgah National Forest…

 

I was keen to keep my socks dry, and I did! At least for the first half of the hike (darn slippery rocks)...

I was keen to keep my socks dry, and I did! At least for the first half of the hike (darn slippery rocks)…

 

My new favorite swimming hole, at the top of Gragg Prong fall.

My new favorite swimming hole, at the top of Gragg Prong fall.

 

The reason we didn't make it to Atlanta on schedule- I had to introduce James to one of my favorite spots- Big Lost Cove.

The reason we didn’t make it to Atlanta on schedule- I had to introduce James to one of my favorite spots- Big Lost Cove.

 

It goes without saying that Atlanta was a big change of scenery in comparison to the preceding few days.  I actually didn’t see much of the city, save for the inside of the Sheraton Conference center, a few of the fine dining establishments, and Boyd Eaton’s gorgeous house where the presenters dinner was held.  Prior to the official start of AHS, a number of the Physicians and Ancestral Health docs got together for a brief meeting.  It was great to catch up with these like-minded Docs, and I was reminded, again, how refreshing it is to spend time with people who share passions and interests. 

 

AHS itself was fantastic, save for a few AV snafus. I thoroughly enjoyed some of the plenary talks: namely Nassim Taleb’s antifragile talk, Gad Saad’s talk on The Consuming Instinct, and Geoffrey Miller’s talk on Sexual Fitness (not talking about “reps for time”).  I was a bit surprised by Mel Konner’s and Boyd Eaton’s talk on the history of modern “paleo” diets, where they repeatedly said that our modern diet is much higher in saturated fat and lower in polyunsaturated fat than historic diets… I find it hard to believe that any diet that contains modern vegetable oils has anything other than an excess of polyunsaturated fats. 

 

There were many excellent talks over the course of the conference, and it was often hard to pick which talk to attend out of a very tempting schedule.  I look forward to catching some of the ones I missed online when the videos are posted.  On that note, my talk on Dietary Fats and Fatty Liver Disease, went well.  When the video becomes available I’ll try and post it here!

 

As much as I enjoyed the various lectures, workshops, and posters, the highlight of AHS was catching up with friends and making new ones.  There is quite a vibrant online community of those interested in evolutionary and ancestral health, and AHS can sometimes seem like the interwebz in 3D.  As someone who would happily trade days of online interactions for even brief face-to-face encounters, AHS was a social occasion that refilled my tanks and renewed my enthusiasm. 

 

Back in May, on the Wilderness Medicine elective in Utah, our instructors expressed that one of the goals of the elective was to “stock good memories” for the rough times that were to follow in residency (all but 2 of the 12 students would be starting internship in the next month).  I still have quite a bit of time until I start residency (though the march towards June of 2014 soldiers on), and my goal between now and then is to bank as many good memories as I can.

 

Stashing good memories (and looking for Hobbitses).

Stashing good memories (and looking for Hobbitses).

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Gather

Time to take a break from breasts- though I think I may have one more post in me on that subject.

 

I’m a fan of a paleo diet. There, I said it.  To me it is not “the” paleo diet, and there is no single set of “rules”, but I embrace the idea of thinking about our evolutionary past when talking about health and disease.  Like it or not, what we eat (and of equal importance, what we don’t eat) is one of the major forces that shape our health.  Let’s face it, it’s much easier to change what you eat than to change your genetics (and probably your job, your geographical location, and other things that affect health).

 

There’s been increased coverage of a paleo diet in the media of late- usually not a resounding endorsement, not that I’m surprised- and it’s sometimes referred to by other names such as “the caveman diet” (except our ancestors largely didn’t live in caves) or the hunter-gatherer diet.

 

I generally like (and use) the term ‘paleo’.  For me (and many others), it’s a term that has developed a definition that we all understand.  That being said, I also like the idea of talking about a ‘hunter-gatherer diet’.  It gives a nod to seasonality, encourages us to think about naturally available quantities, and a personal involvement in the food we eat.  Sure, a lot of people who “eat paleo” don’t hunt or gather their own food (though certainly some do), but it’s good to be mindful of when you might actually have access to different foods and in what amounts.

 

I’ve never been a hunter (though I love having friends that are, and appreciate the stock of venison I have in my chest freezer), but I’ve been gathering since I was little.  I’ve been involved in two different types of “gathering”- spending a portion of my summer childhood raiding (or being put to work) picking in my family’s garden and also time in the woods scouting for wild edibles.  It’s funny how times change: these days I love getting out in the sun to pick berries at a local pick-your-own place, but as a child I really thought of it as a chore (I’m guessing it’s mainly because when the plants are yours you don’t want to let anything go to waste so you pick whether you want to or not, and you also pick *everything* instead of just as much as you want).

 

Of course, picking quarts of strawberries at the local pick-your-own place is NOT gathering (in the truly ancestral sense of the word), but it’s fun (at least for me), and while I’m picking vitamin C I’m getting vitamin D for free.  I’m also supporting  local farming families, keeping money in the local community, and keeping an eye on how the food I eat is grown.

 

The farm I go to grows a variety of strawberries, I exclusively pick the “Early Glow” variety. They are, without a doubt, the best in the field, though arguable more tedious to pick since they are quite a bit smaller than most commercial varieties. They are well worth any extra effort, as the flavor is unparalleled (though their shelf life is very limited).

The farm I go to grows a variety of strawberries, I exclusively pick the “Early Glow” variety. They are, without a doubt, the best in the field, though arguable more tedious to pick since they are quite a bit smaller than most commercial varieties. They are well worth any extra effort, as the flavor is unparalleled (though their shelf life is very limited).

 

As a child, while I was duty bound to pick strawberries, raspberries, blueberries, blackberries, and whatever else we had in the garden, I still would go out “exploring” with friends and bring home wild bounty.  To this day wineberries are one of my favorite fruits. Seedy, waxy, and plentiful (if you happen to beat the birds to the punch), I would spend hours with my friends gathering these treats.  I still find it difficult to pass a stand without stopping for a snack.

 

Stopped for a snack- I’m being a bad Pony Clubber, allowing my horse to grab a quick bite with the bit in her mouth, but it seemed unfair to stop for a snack for me and not let her grab a mouthful as well!

Stopped for a snack- I’m being a bad Pony Clubber, allowing my horse to grab a quick bite with the bit in her mouth, but it seemed unfair to stop for a snack for me and not let her grab a mouthful as well!

 

Wineberries are just ripening in my area, but I haven’t had a chance to get out and pick any yet.  However a couple weekends ago I was out hiking on the Appalachian Trail (AT) and came across blueberries- LOTS of blueberries.  I’d seen the green berries at other places earlier in the season, and fortuitously happened to be out on the Blue Mountain portion of the AT when the berries in the area were ripening.

 

These had caught my eye on the trail a week or so before I hit the motherload!

These had caught my eye on the trail a week or so before I hit the motherload!

 

I felt a little bad for my hiking partner, since I seem pathologically incapable of walking past a good stand of berries without stopping to pick.

I felt a little bad for my hiking partner, since I seem pathologically incapable of walking past a good stand of berries without stopping to pick.

 

For a bit of comparison you can see the wild blueberries (or are they bilberries? [ http://en.wikipedia.org/wiki/Vaccinium_myrtillus#Confusion_between_bilberries_and_American_blueberries]) next to some that I picked in my parents’ garden (this years crop are particularly large)

For a bit of comparison you can see the wild blueberries (or are they bilberries?)  next to some that I picked in my parents’ garden (this years crop are particularly large)

Out on the AT, I don’t look all that out of place gathering handfuls of berries, but in the park opposite from my apartment I get some weird looks when I stand on tiptoe to pick the ripening Mulberries.  As I’ve said, my drive to gather might be a little pathological, though I suspect it is a deeply human urge.  Most of the kids that I’ve met have loved to gather food (berries, vegetables, eggs, etc.), but perhaps it’s novelty not nature…

 

When I was up in Maine a few weeks ago I went beach combing with a friend. To our excitement, while we were out at low tide we came across a few pools that housed beautiful large mussels.  We were looking forward to cooking them up in some white wine until we discovered there was a red-tide warning for the area- what a shame!

 

Seafood can’t get much fresher than this…

Seafood can’t get much fresher than this…

 

Most recently I’ve been gathering watercress from a local stream.  I know the thought of this makes my European friends cringe, but the liver flukes that make this practice a hazard in other countries don’t live in the US- or so I’ve been told.

 

WaTERCRESS

 

In the fall I’ll be gathering chestnuts, a task I’ve been doing for years.  My neighborhood has quite a few old Chinese Chestnut trees- I wonder if there was a local craze to plant them some decades back.

 

Best roasted, though I have been known to make a dark chocolate/chestnut mousse at times- don’t tell the paleo police!

Best roasted, though I have been known to make a dark chocolate/chestnut mousse at times- don’t tell the paleo police!

 

A “paleo” diet isn’t about prehistoric reenactment. The point isn’t to only eat foods you’ve hunted or gathered, but personally I like having a role in sourcing the food that I eat, and I do enjoy time spent outside gathering foods.  The food “gathered” at a pick your own berry farm certainly isn’t the same as the food our ancestors gathered (I’ll refer you back to the post I did on bananas– check out the difference between the wild and the domesticated fruit), but what you pick yourself will be infinitely fresher than what you buy at the supermarket.

 

As I was finishing up this post, I heard an interview on NPR with the author of a new book, entitled Eating on the Wild Side. Her premise seems to be that the plants we evolved eating were very different from their domesticated ancestors that we eat today, and that somewhere in the mix foods have lost some of their most valuable micronutrients *.  I can’t speak on the book, but the interview is certainly worth a listen!

 

*Interestingly, some people have suggested that some of the nutrients that the author above touts can actually be problematic.  You can check out Dr. Ede’s talk from the 2012 Ancestral Health Symposium exploring the darker side of plant foods.

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I have spent only 5 of the last 25 nights in a bed (4 different beds, to be precise). At this point I feel a touch claustrophobic in bathrooms and feeling clean is certainly a novelty.  My Wilderness Medicine elective is over and I have had an exceptional visit in Moab (more on that in another post). Tomorrow I head to the mountains of Colorado for one last stint in the wilderness before heading back to New Jersey where I will start a radiology elective on June 3rd.  From a month in the wilderness to an elective spent in dark, windowless rooms- the change in environment couldn’t get much more extreme (which is saying a lot, coming from someone who has gone from alpine camping to desert camping in the course of 3 weeks).

 

This is the final installment of “Pic of the Day”, at least for the Wilderness Medicine Elective.  I may not be able to resist a “Pic of the Day, Moab edition”… we shall see.

 

For the desert portion of the course we headed to Canyonlands National Park, specifically The Needles District of the park.  We spent 4 nights in 3 different sites, hiking up to 12 miles a day with heavy packs.  I found this portion of the course the most physically demanding, but at the end of the day it was unquestionably my favorite section.

 

I’ll write details in future posts, but for now: Pic of the day- desert edition.

 

Day 1- Canyonlands

 

The geology of Canyonlands (actually, the geology of much of Utah) is stunning and fascinating.  This is in the needles are, near Lost Canyon, where we spent our first night in the park.

The geology of Canyonlands (actually, the geology of much of Utah) is stunning and fascinating. This is in the Needles District, near Lost Canyon, where we spent our first night in the park.

 

Day 2- Perspective

 

Looking back at Lost Canyon as we hike out to Elephant Canyon, our next campsite. From many vantage points in the park you could see the snow capped La Sal Mountains.

Looking back at Lost Canyon as we hike out to Elephant Canyon, our next campsite. From many vantage points in the park you could see the snow capped La Sal Mountains in the distance.

 

Day 3- Druid Arch.

 

Before we packed hiked our big packs out to Chesler Park, we took an early morning park out to Druid Arch.

Before we hiked our big packs out to Chesler Park, we took an early morning hike out to Druid Arch.

 

Day 4- The Joint Trail

 

Probably one of the coolest trails I have every hiked, winding through a narrow slot canyon.

One of the coolest trails I have every hiked, The Joint Trail winds through a narrow slot canyon.

 

 

Day 5- Sunrise and out.

 

We left camp at 4am for the 3+ hour hike out.  I led the group of 19 by head lantern for 2 hours before stopping on a bluff to watch the sun rise around 6am.  Pre-dawn hikes are something I will be adding to my repertoire.

We left camp at 4am for the 3+ hour hike out. I led the group of 19 by head lamp for 2 hours before stopping on a bluff to watch the sun rise around 6am. Pre-dawn hikes are something I will be adding to my repertoire.

 

I did not expect to fall in love on this trip, but I have certainly fallen in love with the desert.  I don’t know when I’ll be back, but I hope it is soon…

 

Chesler Park.

 

Chesler Park

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Waste not, want not

As my part of the country battens down the hatches as Sandy approaches (all the businesses in my town have boarded or taped their windows and sandbags line the sidewalk), it seems appropriate to write about nature.

The changing of the seasons is always a beautiful sight here in the northeast US.  Early in the year, greens and yellows of spring welcome a new year of growth and productivity.  The banner at the top of this blog is a picture taken in my parents’ garden of aconites, a flower that blooms in February when the rest of the world is still brown and gray.  Now, in the throes of fall, the changing of the seasons is obvious in the reds, yellows, oranges, and browns of the changing leaves.  When you see the cycle of the seasons, with trees budding and leafing out in the spring only to see the leaves turn color and drop 6-months later, it can seem a little wasteful.  So much growth, only for the trees to be bare once more.

But what is waste, in nature?

One of the arguments frequently used against the eating of meat is the toll that animal waste takes on the environment. The run-off of nitrogen-laden (not to mention antibiotic-riddled) water from large-scale feedlots can wreak havoc on waterways and land (though it bears mentioning that run-off of nitrogenous fertilizer from crop land can be equally detrimental).  In a non-industrial setting, however, is “waste” really such a problem?

On the contrary- in a more natural world “waste” is not a toxic hazard, but rather an important part of life.  I snapped this picture at a farm near where I grew up. For as long as I can remember, this land has been “hayed” (in our area, farmers usually make 2, sometimes 3, cuttings of hay per year). In the last couple of years this land has changed hands, and now belongs to a vet with a great interest in grass-fed meats (as well as quality horses). The fields that have been farmed for vegetative crops will now be home to livestock… Just look at what their waste has done!

Animal impact: “waste” = growth

Look inside the fencing. See those dark green areas where the grass is particularly lush (and extra long)? THIS is what nature does with waste: nature turns waste into growth.

This land was productive as crop-land (you can see in front of the fenced land that part of this property is still in hay), but I suspect that with the return of animals to this land the grass will actually grow more, not less.  Hayed land can be (and should be) replenished with potash (for potassium), lime (to maintain an appropriate pH), and nitrogen (in some bioavailable form to help plants grow) to compensate for the nutrients being continually removed by the cutting and bailing of hay. While many farmers slack on replacing the more expensive lime and potash, most put down nitrogen to help the grass “pop” so they get a good yield (biomass). Putting animals on the land reduces (or eliminates- once the soil is replete) the need for added fertilizers, as the grass is not being shipped off the property as hay, but is rather being cycled right there on the property into biomass (beef) and fertilizer.

What our modern, industrial world sees as waste is really part of a natural (not to mention efficient) cycle…

This isn’t just true with animals.  I recently took a lightening visit to go hiking in the mountains of North Carolina. With a surprise 3-day weekend on my hands (my out-patient medicine preceptor was sitting for the boards), I couldn’t say no to a last minute invite.  With views like this- I’m very glad I said yes!

It was almost the perfect time to visit, with leaves seemingly changing colors in front of our eyes. The palette of fall colors was stunning, and led to an enjoyable arts and crafts session of the patio of my friend’s cabin while enjoying a post-hike cider.

Nature- embrace the rainbow

In the woods, these leaves lay where they fell (save the ones I carried back or the few the chipmunks and squirrels use to cushion their nests).  Again, it can seem like a dreadful waste, until you realize that this process, which occurs every year, feeds the insects, grubs, fungi, and molds that turns these leaves into rich topsoil to encourage new growth.

One childhood family activity that I remember was raking leaves. I somewhat fear that the advent of leaf blowers has replaced good old-fashioned rakes (and more importantly, good old-fashioned leaf piles that were great for jumping in!), but whatever the mechanism of collection, leaves are generally not abided in our modern world. While I take no issue with clearing leaves, it pains me to see leaves bagged up and put out to be collected as “trash”. There is definitely an increase in people composting “yard waste”, but the name, again, shows how people see the world and nature- a progression, not a cycle.

A bit of google-mining suggests that the saying “Waste not, want not” can be attributed to Benjamin Franklin (1706-1790), but it is nature that best embodies this philosophy.

(Stay safe out there- all my fellow northeasters in the path of Sandy!)

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…thoughts on hiking, med school, and life…

The last couple of weeks have been a bit of a whirlwind.  First there was the Ancestral Health Symposium (more on that later- if I ever get my thoughts together), then there was the flurry of activity that marked the end of my Family Medicine Clerkship (topped off with a nice 2.5 hour exam), and before the dust settled I was off to the airport to make the most of every hour of the one-week vacation that my school grants third year medical students at the end of the Family Medicine Clerkship.  I spent that week touring Colorado with my long-time best friend.

I expect that everyone has heard the phrase “It’s the journey, not the destination”.  A quick internet search suggests that this gem comes from Ralph Waldo Emerson (1803-1882), though this is unsubstantiated by any reference… Sourced or not, it seems to be a sentiment that most people can get behind.  My recent mental meanderings- while hiking, while musing about med school, and while thinking about life- have me wondering otherwise.

I enjoy hiking.  As the demands of my degrees have changed I’ve had to take a step back from my equestrian endeavors and embrace other activities that can be picked up and put down a little more easily.  I’ve had a pretty good season for hiking thus far- hitting up a number of beautiful locations.  Some, like my recent trek up Matterhorn Peak in Colorado, were out and back trips, while others, like Falls Trail at Rickets Glenn in Pennsylvania, were scenic loops.  When it comes to hikes, these two adventures were very different.  Climbing the Matterhorn was, in all honesty, a grueling trudge through rather stark scenery to “bag” a 13er (a peak over 13,000 feet- Matterhorn is 13,590).  The Falls Trail at Rickets Glenn, on the other hand, is a non-stop feast for the eyes of waterfalls and lush greenery that takes you back where you started, with no single “goal” for the trip.  In the context of this post, one could easily argue that the former was all about the destination while the later was about the journey.

I said that the trek to the top of Matterhorn was a grueling trudge.  I’ll admit that I was rather ignorant of what I was getting myself into when I boldly posited that “We should climb Matterhorn.” Honestly, I made this statement based on the general location (in the San Juans near where we wanted to camp) and the name (named after the Swiss peak- which has a much higher death toll!).  I didn’t quite realize when we set out the magnitude of the mountain we were climbing, nor the type of country we would be traversing.  Unlike the lush countryside I am used to exploring back east, much of the hike up to the summit was above the tree line, in alpine tundra.  While the trip to the top was interspersed with pauses in which I appreciated the absolutely awe-inspiring views, it was a hike that in all honesty was rather dull.  The top, however, was anything but dull. Visually, the uninterrupted views of the Rocky Mountains extending for miles were breathtaking. Personally, the satisfaction of successfully climbing (I’m mildly averse to the term “bagging”) a large named mountain was immense (and I did it in Vibram Five Fingers- an additional triumph).  Was the journey worth these end satisfactions? Yes! But in this circumstance- the destination certainly trumped the journey.

View from Matterhorn

View from Matterhorn: A place to think…

Med school is also a journey.  Much like the climb up Matterhorn, parts of it are grueling and significant portions are unpleasant.  There are, however, moments of awe and wonder.

There are people that grew up knowing they wanted to be a doctor; I was not one of them.  In fact, I actively told people I would not be a doctor when I was asked the dreaded “What do you want to be when you grow up?” question.  Even as I completed college my inclination was always towards research and not clinical practice, and I committed to an MD/PhD program with the thoughts of using the clinical knowledge (and the professional clout of the MD) to pursue medical research.  Much like climbing Matterhorn- I really didn’t know what I was getting myself into when I signed on to attend med school.  The MD/PhD degree was a destination, something to be obtained without much thought to the journey.

Now that I am in med school, and I recognize the magnitude of the effort required to reach this goal, I wonder- if I knew what I was getting myself into when I embarked, would I have started?  While it is surely not the case for everyone, I entered med school with my mind on the destination, with almost complete ignorance of the journey that entailed.  It has been, and continues to be, one hell of a journey.  There are many aspects of this adventure: the people I have met (classmates, friends, professors, and patients), the events I have experienced, the emotions I have witnessed, the intimate details of their lives that patients have shared… These have made for an incredible experience, and are things I would never have experienced without the end destination of a degree in medicine.

Playing at Rickets Glenn

Playing at Rickets Glenn: Sometimes it’s about the journey, and sometimes the journey is more fun when you go off trail!

Destinations change.  Sometimes they are unreachable, sometimes they are not what you expect, and sometimes they are just a point on the way to a yet further destination.  They do, however, inspire journeys.  Journeys vary based on destination, and while life is not a destination, one might argue (and indeed I do) that the journey of life gets more interesting when you choose a destination.

Choose a destination. It can be big or it can be small, but it should be something you choose. The journey of life seems much more interesting when you are chasing your own goal than when you are treading the path of someone else’s expectations. And don’t worry too much… you can always change your destination if a better one comes into view.

En route to Diamond Lake (Colorado): What you find on the way to your destination, and what you do with it, is all part of the fun.

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