I quickly learned that Stanford is located in a region known as the “South Bay” that is very different from San Francisco, the city. It also became readily apparent that as expensive as the cost of living is in San Diego, it’s much higher in the Bay Area, in particular the South Bay. I made an ill-fated play at a lottery for university-subsidized housing that left me scrambling for housing a month before I was supposed to leave, ultimately deciding for a number of reasons to live in the actual city and attempt to commute to work.

Despite the hardships (or perhaps because of them), the friends I made while living in Loma Linda became a chosen family. Even after I moved to San Diego for residency, the distance was easily surmountable by car. We attended each others’ parties or stayed over weekends when we could. I routinely made the two-hour drive to Redlands to see the stylist and architect of my blue-purple hair; we’ve now known each other for thirteen years. Because of this, I wasn’t really starting over; the excellent friends I made in San Diego simply expanded my existing social foundation.

Between the variability of a residency work schedule and knowing a bunch of people who do interesting things, unpredictability has shaped most of my social life. I have enjoyed texting friends to go rock climbing, bumping into people I know at an event, or a spontaneous invitation for dinner. Rachel and I were able to trade Bast back and forth between our respective houses (he now permanently resides with his Best Mom, Rachel, along with the Basthauser I built for him). Additionally, in the past year I made a concerted effort to get more involved with and make friends in the queer community, which has been invaluable.

There have been a lot of major changes in my life in the past several years. During that time people I know have been there for me in myriad ways, some they know, others they don’t. Even though social media and air travel help to shrink the world, moving this kind of distance disrupts that stability and support system. Finally, although we separated two years ago, the end of residency also represents the conclusion of what Rachel and I set out to accomplish together.

Taking all of this into account, along with a hefty dose of my own gross incompetence, it is perhaps a little less surprising that I did my best to pretend this move wasn’t happening for as long as possible. I avoided talking about it even as I watched furniture I have enjoyed for years get carried off by enthusiastic buyers (and in the case of my favorite chair, a junk hauler). Which is how I found myself a week out from the hard deadline, utterly unprepared and unable to lift anything thanks to a recent surgery.

During that week, my brother and friends showed up and pretty much saved the day. They tore through the remains of my living space, helping me get rid of accumulated detritus, carrying heavy boxes and furniture, and in the case of Adam, packing and repacking the shipping container. Before I could fully comprehend what was happening, Mark and I were on the road to SF. I am still completely overwhelmed by the outpouring of love and care from so many people.

I now find myself reeling in the aftermath of a move to yet another new city. Some parts are exciting: epilepsy is a fascinating subspecialty, I wanted to experience working at a different institution, and I once heard there were a lot of queers in San Francisco or something. I’ve been lucky once again, running into some friends both from San Diego and pre-Loma Linda who have kept me company and helped me get more familiar with the city.

At the same time, I’m faced with completely rebuilding my local social groups. Finding a new queer community will take some dedicated effort; the world of medicine isn’t exactly bursting at the seams with us. I’m sleeping on an air mattress while I wait for my stuff to arrive and have no idea how I’m going to get it all unpacked: I now live on a steep hill with limited parking.

It would be undignified to admit how many times I have cried so far; I’m homesick and I miss my people. I do really hope to return after fellowship in a few years and, once I get established at work, fly down to visit in between.

If you’re in the SF area come visit me; my new place won’t be as comfortable as the last one but I’ll make it work somehow. Please don’t forget me, promise?

Once that change happened, I stopped thinking about (and using) the nav system—that is, until New Year’s 2022. I spent that one at Adam’s, on his porch wearing a coat, scarf and N95 mask, covering the on-call shift because his then-fiancé had COVID-19. When I turned my car on to drive home, I noticed something was off. The clock read:

12:00
Jan. 1, 2003 (Tue.)

From then on, every time I turned the car off and on again, the clock would reset to that time. Attempting to manually change it to the correct date and time was unsuccessful, as it would immediately jump back to the incorrect one. I wondered why this was going on and tried to look up how to fix it.

Remember the Y2K Bug? Actually…don’t answer that. If you found this page via my Instagram there’s a halfway decent chance you might not remember that whole saga. The idea was that many dates were stored in computers as only two digits, so when ’99 went to ’00, software would get confused and glitch. It turns out that a quick way people fixed that issue was to remap early 20^th century dates to the 21^st century: 1900 becomes 2000, 1901 becomes 2001, and so on.

Programmers working on the rudimentary Honda vehicle operating system in 2001 likely remapped dates forward through 2021, probably thinking there was no way that version would still be in use twenty years later. Apparently that system was still shipping with vehicles in 2009 when I purchased an Insight; thirteen years later, when 2021 became 2022 and I was still driving the car, it ran out of dates.

For the next year, the clock essentially functioned as a timer of how long the car had been running. It’s possible that if I got a new navigation DVD it might contain a software upgrade; however, like everyone else I use my phone for that. I wasn’t going to pay around $100 for the mere hope of a functioning dashboard clock.

I assumed this was the new normal for the remaining life of the car, but there was another surprise waiting for me on New Year’s 2023, when the clock started displaying:

12:00
Jan. 1, 2003 (Wed.)

Instead of resetting, the year had updated! I thought that would be the only difference, but no, there was more. The time stopped resetting every time the car turned on, instead synchronizing itself to a time that was the correct minute, except two hours ahead.

As time went on, more changes became apparent: while the year remained 2003, the month and date appeared to be selected at random, no longer stuck on January 1st. Interestingly, the day of the week started matching up with the correct one; when I took the picture it was, in fact, a Sunday. I have no good explanation for this behavior other than that as far as this Honda is concerned, we are in an uncharted new future where anything can happen. Perhaps in 2024, we’ll get to the correct month.

Enter epilepsy. On my first day of dedicated EEG training we talked about differential amplifiers, and it was as though some long-forgotten area of my brain woke up, motes of dust flying up into a ray of sunlight. “I love this stuff!” I thought, and proceeded to be absolutely horrible at reading EEGs for the rest of the month. I wanted to get good at them, though, and the idea of doing an epilepsy fellowship began to take root.

I didn’t want to do a fellowship. By the end of child neuro residency I’ll have been at this for thirteen years, eighteen if you count undergrad and the year I spent working afterward. I wanted to be done, to stop trading more years of my life for levels.

I got more information. If you want to run an epilepsy monitoring unit (EMU), you need to do the fellowship. If you want to work with fancy invasive electrode setups and surgical planning and treatment-resistant seizures, you need to add that “Epileptologist” specialization to the character sheet. In 2021, I spent two months at the beginning of PGY-4 on the EMU trying to convince myself I didn’t like epilepsy. It was about as effective as my cat-proofing strategies: I loved it.

Unfortunately, epilepsy fellowships were somehow competitive enough that positions filled a full eighteen months in advance, in a wild free-for-all of deadlines, dates, interviews, and offers (they’ve since moved to a Match, which trades this for an algorithmic selection process like residency). When the dust settled, I emerged to find I had a position at Stanford University.

Technically, only one year of fellowship is needed to become an Epileptologist, but with my dreams of research in EEG analysis and desire to lead presurgical workups, I am planning on two years. That’ll bring me to a nice twenty years since high school in some form or another of advanced education or training. Plus, with an extra two years of practice, I might finally become as proficient at reading EEGs as an average neurology resident!

Perhaps it is fitting that my review of the memoir authored by The Minimalists is brief. Overall I enjoyed the book even with the style choice of having commentary in endnotes (I maintained two bookmarks so I could flip back and forth). Using a memoir to illustrate how the authors arrived at their life philosophy is a neat approach especially for someone who wasn’t very familiar with their brand beforehand.

There are certain aspects of minimalism that I don’t like because I think that it causes one to lose a fair amount of self-sufficiency. There are occasions in the story where the author has to use the electronics or internet access of friends and nearby coffee shops to accomplish a task. To me this feels a little bit artificial, a personal minimalism bolstered by a wide availability of financial and urban resources.

As one example that is also used in the book, cancelling home internet access because one can simply go to a café assumes that a person can afford expensive café purchases and has no need for remote work access or to be on-call from home, among other things. The authors do emphasize that different people have different needs and the specific choices that work for them need not apply to others in 1:1 fashion, but even with that caveat, there seems to be a fair amount of external dependence.

In thinking about these things I realized that I personally place a high value on being prepared and having the tools I need to accomplish tasks readily available. Even though I may not use it on a regular basis, when it finally is needed it can save a lot of time (see: my neuro bag). I also like being able to use those things to help others, too. The caveat to this position is that these things are only beneficial if you can find them when needed. To that end, I have come to highly appreciate the KonMari principle of striving to ensure that collections of items are fully visible wherever possible.

That arbitrary day occurred this week, which makes Bast seven years old. I’m still bewildered as to exactly how that much time has passed, although following my dubious career decisions might give one an inkling. I decided to approximate a birthday cake by decorating an open can of tuna (Bast’s all-time favorite treat) with a candle, and set up a camera to record the little event.

I expected Bast to maintain a safe distance until I could help him blow out the candle. Instead, he took matters into his own hands paws, striking quickly to protect us both from the Flaming Menace. It was all captured on video, which I quickly cut together to share.

Bast was quite unharmed, and after his feast could be found sleeping off a food coma in several of his favorite places.

Enter the Neuro Bag. There are a lot of different approaches, from the humble fanny pack that has unfortunately made a major resurgence, to the Norman Rockwell physician bag (as most recently acquired by the inimitable GrandBig Sib Dr. Jennifer Yang, neuroimmunology fellow).

As a medical student, I somehow managed to fit my entire Welch Allyn Starter Pack into the ample pockets of my short coat. This “utility coat” probably weighed about ten pounds, something that hardly registered on shoulders already weighed down by impending doom (both likely contributed to my loss of about two centimeters of height).

As an intern, I tried keeping everything in my scrub pockets, “cargo shorts” style, a technique that works decently well for basic supplies but has a more difficult time accomidating heavy metal instruments. There’s also the problem of adjusting/repacking one’s “loadout” every time one wants to put on a clean set of scrubs.

Once PGY-3 started and I became a “real neuro resident,” I decided that I really needed to keep up with my peers and get a bag. During the brief window of “healthcare heroes” I picked up a very nice shoulder bag from The North Face, one with all the functionality of a fanny pack but with a far more stylish positioning (they’ve since stopped making it, although this one adapts to a similar cross-body position).

I proceeded to stuff that bag to the brim with tools and “just in case” supplies. And yes, I have needed to use the spare spinal needles and vitals of 1% lidocaine. Now, in PGY-4, I started needing to add toys to attract the attention of the pre-ambulatory set, and I ran out of available volume.

My latest Neuro Bag incarnation comes from Topo Designs, also the maker of my non-work shoulder bag. While still compact overall (the whole thing fits nicely inside my backpack), it has more room for the larger instruments. My favorite items are probably the Panoptic ophthalmoscope, array of spinal needles, and zebra finger puppet. There are a few valuable items that I do not keep in the bag, namely my stethoscope and Trömner reflex hammer; however, safety pins, surgical marking pens, and spare batteries are all included among the vast treasures contained within.

As a child, when something like this happened, I would get called weak. Honestly, then (as now) they would be factually correct, although I’d prefer to think of it as my being capable of putting more torque on a hand tool than my skin can take. I don’t think my skin is particularly soft, but it’s always been this way: I remember getting blisters from sweeping out the barn with a push broom at one of my first jobs. I would trim or tear the skin off and keep going, somehow never quite developing the callouses characteristic of a stronger person.

Perhaps it’s because I approachd a variety of unrelated activities with the same vigorous intensity, each one interacting with a new area of my fingers and palms. At any rate, a solution to this problem appears to have been devised by others some time ago: I recently purchased a multi-pack of work gloves, which I hope will have the additional benefit of protecting any recent manicures as well.

One may recall that, theoretically against my will, I continue to find myself cohabiting with a cat. While working on the structure, Adam’s then-fiance called from her bachelorette weekend to let him know she had found a stray cat. Throughout the day, I mentored Adam in my most effective techniques for resisting feline incursion—within 24 hours he, too, had a cat. I dare say he has accumulated even more cat-related paraphenalia than I have: the apprentice surpasses the master. Much like Bast, Sequoia is quite lovable. I, however, remain immune to feline charms, which is why I readily agreed to help look after her during their honeymoon.

I found a powder that may once have been a wrapped stick of gum coating the bottom of my last messenger bag. It formed a seed, a katamari that went on to collect bits of lint, paperclips, batteries, and diphenhydramine tablets. I also discovered several semi-precious stones that had been polished smooth—although, come to think of it, that process was clearly started done long before they entered my possession.

My mom always echoed the idiom, “a place for everything and everything in its place.” As simple as it sounds, throughout my life that adage has proved far more aspirational than I would like. Of late, I have found a bit more motivation to put forth the considerable energy required to try and rectify that.

During this process, I came across a strap. A perfectly good strap to be sure, adjustable, made of a sturdy weave, and equipped on both ends with spring clasps. Clearly, it once attached to something, but what? Does the bag or luggage it belongs to even still exist? Will I one day find it, and think, “Ah, such a nice bag, it’s too bad the strap is missing,” and have to needlessly spend money to replace it?

I am reaching the stage of unboxing where I often find myself winnowing the rubble that has accumulated. Like a prosepctor panning for gold, I carefully sift through ever smaller boxes of objects. In some cases, it is clear where the contents should go; those are achieved immediately. Others are part of a category and can be collected for transfer to a different room (often in another box). Still others, however, have no clear place, or are stuck in a holding pattern until some other, larger task is completed. Acquiring a new piece of furniture, ordering a specialized container, or some other sundry item upon which progress fully depends.

Somehow, even among the bags of trash and recycling going out, I still need new items. I repeatedly find myself heading to a store (online or physical), returning with another armload of fasteners, components, or gadgets needed to make something or other function correctly.

I’ve wondered if ultra-compartmentalization could help the situation: If there are spaces with a single, specific purpose, it becomes clear where to store or find that object, and the space is less likely to attract random items.

I have not yet decided if there should be a dedicated location for straps.