Friday, March 30, 2007

Night at the Exploratorium


Stephen, Mary, Albert wearing special headphones at the Exploratorium
No school today (thank you, Caesar Chavez) for UCSF...so I spent most of it sleeping in (read: 14 hours). Tonight, UCSF students and staff members could get free admission to the Exploratorium in San Francisco from 6-9 p.m. So of course we visited! The museum was a blast; it was like a huge playground for budding scientists and congenital nerds alike. In fact, we were so enthusiastic about the whole museum that we felt that it may be wasted on children:
Albert: "These damn kids have no idea how amazing these exhibits are...they keep hogging the exhibits and getting in my way!"
Mary: "Yeah, some of them can't even reach the podium!"
Despite what you may believe from the following exchange, Mary and Albert are the sweetest medical students whom you will ever meet.
In other news, I've caught a little souvenir from Las Vegas (no, it's not an STD) and now I'm sick with an upper respiratory infection...obnoxious phlegmy cough, congestion, etc. At least all of my blockmates are sharing the same virus...it's a collective experience. Lovely.



Mary and me after we built a red rubber arch from scratch

Albert making sand designs on plates of metal using vibrations from a bow
Stephen and Mary playing with an infrared camera





Adios, Canvas Gallery

Image of Canvas Gallery from its website
I hate it when you fall in love with a person, place, or thing (e.g. a noun) and find out that your beloved noun is not long for this world. Hence, I've always walked past a cafe near UCSF (on 9th and Lincoln) called the Canvas Gallery, felt my interest piqued, and never walked inside until last Wednesday. The cafe is amazing with hip exhibits by local artists, ample space to rest and chill out, and an artsy fartsy atmosphere. Unfortunately, the cafe is closing on April 29th due to financial hardship. Ouch, it hurt a little to think of what might-have-been.
So even though I've already fallen in love with this newfound gem in my neighborhood, the taste of this brief encounter is one of my favorite flavors: bittersweet.

Tuesday, March 27, 2007

Typical Tuesday

8 a.m.-10 a.m. Histology lab on the thyroid

10 a.m.-12 p.m. Small Group discussion on endocrine disorders

12-1 p.m. Lunch elective ("Introduction to Clinical Research") on clinical studies observing how emergency contraception affects sexual behavior

2-3 p.m. Lecture on how to communicate complex things to patients

3-5 p.m. Problem Based Learning (PBL) session, continuing with the Standardized Patient (paid actress) whom we saw in our practice abdomen clinic a few weeks ago. It was a pretty complex medical case with some comorbidities and I was the lucky student who got to communicate to the patient in a second interview...we had to explain (a) the concept of autoimmunity (b) the physiology of pernicious anemia and primary adrenal insufficiency (c) the lifelong treatment regimen for these diseases...monthly injections, medication schedules, etc. (d) concerns that the patient had about the possibility of pancreatic cancer or being able to take care of her husband (who is suffering from Parkinson's and a recent stroke). Within 20 minutes. Yeah. It was a little challenging.

6-8 p.m. Meeting for the Medical Scholars Program (MSP), a student-run tutoring program for first-year medical students to help them with the material next year.

8 p.m.-now Letting my brain decompress.

Viva Las Vegas

Sin City 2007
The Metabolism and Nutrition midterm last Thursday was more difficult than previous exams because it involved a microscope histology/radiology/gross pathology component AND an anatomy lab practical. That translates into a written multiple choice exam from 8-12 p.m., identifying anatomy in cadavers in the lab from 1:30-2 p.m., and looking at slides/pictures of films/preserved specimens from 2-3 p.m. Although it was definitely more challenging, the exam was also more enjoyable because it tested our knowledge in different ways.
It wasn't all strawberry fields, though, here were some of the thoughts running through my head during the anatomy/histology practicals:
"Gee, I wonder what that thing is...the lesser omentum?" [Doh, the pancreas]
"I have no idea what this slide is showing...I'm going to just guess it's cancer."
"Cancer."
"Uh, cancer?"
"Oh, God, is that a kidney?!"
After the exam, I went to visit my PedPALS mentee at the bone marrow transplant unit, went running/exploring in Golden Gate Park, grabbed some pearl milk tea with Paul and Albert (two of the nicest people ever), and then ran home to shower and see my mentee again before grabbing dinner at Crepes on Cole for an informal birthday celebration. Cake was eaten at Albert's, but the highlight was watching a YouTube clip of the Japanese hot dog champion competing against a live Alaskan Grizzly bear in a hot dog eating contest. The bear won, regrettably, without even trying very hard. Dropped by another friend's birthday get-together, hung out at BarNone in the Marina for a little less than an hour, and then went home to fall into a deep coma.
Last Friday, I flew to Las Vegas for a little reunion with my college friends (H translation: blockmates) and much fun was had by all. Our days were dominated by sinfully rich food (in both senses of the word...24-hour Korean BBQ, dinner at Spago's and brunch at the Wynn), searching for caged animals (flamingos at the Flamingo, MGM lions, Mirage tigers, Mandalay Bay Sharks), and a smattering of art (Ansel Adam's exhibit at the Bellagio, a failed attempt to see the mini Guggenheim at the Venetian, and the Cirque de Soleil show LOVE starring Beatles music at the Mirage). Our nights were dominated by caffeine and nightclubs (Jet, TAO, Pure).
Las Vegas is a unique American city...a town (the Strip) characterized by escapist excess and sensory overload....shameless consumerism and entertaining artifice. Built upon the foundations of the seven deadly sins (gluttony, greed, vanity, sloth, wrath, envy, lust); it's a curious mix of the finest material trappings that money can offer and the seediest places on earth coexisting side by side. As a fascinating mix of highs and lows, Las Vegas is a shape-shifter that has built its name upon replicating genuine articles and places to create a parallel universe -- a playground for adults. Nothing in Vegas (the Strip) is mundane or natural...but the very nature of its brazen artificiality enraptures any visitor. It is a self-absorbed microcosm that can be anything and everything except itself, a chameleon of a city ever-changing.
My friend Kim observed that Las Vegas is full of mirrors...I suggested that mirrors are shiny and attractive, suggestive of wealth and opulence, and able to give the illusion of infinity and amplified space. Kim suggested that mirrors allow vain people to look at themselves. But maybe the mirrors are there for both reasons; mirrors would be an apt symbol for Las Vegas. Secondly, there are no clocks in Las Vegas...especially in the casinos where the house intentionally obscures the time of day to encourage people to lose track of time...I think maybe clocks represent an intrusive reality in an otherwise self-absorbed fantasy world.
Sorry for the reflective post. Now I am back at UCSF and we are focusing on endocrinology, which will be a lot of fun once I start studying.

Wednesday, March 21, 2007

My Mom Forgot My Birthday

The following telephone conversation occurred at 9 p.m.:

S: Hello?
M: Happy Birthday, Stephanie!
S: It's 9 p.m. Mom, you forgot my birthday, didn't you?
M: I sent you a card last Monday, did you get it?
S: Not yet. How come you didn't call me until now?
M: I remembered on Monday...
S: I knew it! You forgot that my birthday was today.
M: No! I didn't forget per se --
S: Yes, you did!
M: Well, I was busy! March 21st was a big day for me, I had an audit.
S: And the date that kept cropping up, March 21st didn't ring any bells for you as -- gee, i dont know -- the date of birth of your firstborn child?
M: That was 23 years ago! I just forgot...
S: Yeah, mom, but you gave birth to me...I thought maybe it was a big deal for BOTH of us.
M: I sent you a card on Monday!
S: I can't believe that you forgot my birthday!
M: Ohh, here comes Dad. [Shouting to Dad]: Sam! Come wish your daughter a happy birthday!
Dad: [in the background, genuinely confused] Who?


By the way, my mom gave birth to me, and my dad delivered me. Or so they tell me.

My Birthday Present

Today is my birthday. A lady never reveals her age. Okay, fine, I'm 23.

This morning, I woke up at 9 and spent 2 hours in the anatomy lab reviewing some gastrointestinal material because...

I had the misfortune of being born the day before the Metabolism and Nutrition midterm exam...

which involves 4 hours of written testing and 2 hours of microscope/histology and gross anatomy testing...

Sunday, March 18, 2007

blah!

Wish that I had a camera...studying has been semiproductive...blah!

Friday, March 16, 2007

B. Lewis Quote

My preceptor, Dr. Lewis, told me a story yesterday about his first lecture in pharmacology as a medical student at HMS. A venerable and crusty old German professor who had flown for Germany during WWII (just to give you an idea of how long ago this was) spoke with a heavy German accent, and he told the students that if they would remember ANYTHING from that day, it should be the following pearl of wisdom:

"All drugs are poisons."

And Dr. Lewis remembered that lesson for the next few decades as a medical oncologist.

Motif of the Moving Van

Hi there,

The weekend is here! Boy, I am pretty screwed for this exam next week.

But that's not the purpose of this post...I was reading last week's issue of "Synapse" and there was this great article about a movie called "Two Weeks," a documentary on the last two weeks of a terminally ill patient's life. What struck me the most was an excerpt spoken by the director at the movie's Bay area premier, in which he describes his own personal experiences that led him to create this documentary (bolded). It seems that the director was also impressed with the image and memory of the white van taking away his mother's body at the end of an ordeal, and I am intrigued by this motif that seems to inadvertently reappear in life and in art. Since the article is short, I will repaste it here for archival purposes:

"Two Weeks: Touching Film About Death

By Catherine Dodd, Staff Writer

Many Bay Area End-of-Life practitioners attended the premiere of Two Weeks, a touching and surprisingly funny movie about four children caring for their mother during the last two weeks of her life. The premiere was a fundraiser for the Bay Area End of Life Network (www.sfeol.org) and for Final Choices (www.finalchoices.calhealth.org), the local and statewide organizations that encourages people to put plans in place should the “inevitable” (death) happen. The movie opened for the public on March 2. Film producer Steven Stockman spoke to the audience saying he hoped it would move people to talk about death and to plan for it.

Stockman says it happened like this: “My mother died at home, and the whole family was there. The mortuary guy came to pick up her body in an unmarked white van. He had one of those rolling stretchers where you flip a lever and the wheels pop down. My mom lived in a suburban neighborhood. It was about five in the morning, the sun was just starting to brighten the sky. The guy wheeled my mother’s body out of the house, and loaded it into the truck. I’d just had this excruciating night-long ordeal with my family and I stood there, watching from the top of the driveway as the truck pulled away. Just then, a car came up the street, dropping newspapers one at a time in the driveways of the sleeping houses. And I thought, I wake up every morning on my own street, in my own neighborhood. And somewhere, this is going on. It happens all the time, and I didn’t even know. This is part of everyday life. How come it’s hidden? Why don’t we talk about it?”

This film stars two-time Academy Award winner Sally Field who plays Anita, the mother, who is living her final Two Weeks of life. What amazed me is that while we see people die on television all the time, some violently, some quickly, never have I seen a character on television or in movies, that actually resembled what death looks like for real.

Anita’s children, played by Ben Chaplin, Tom Cavanagh, Julianne Nicholson, Glenn Howerton and Clea Duvall, experience the struggles that many families go through as a loved one dies. While the hospice nurse Carol played by Michael Hyatt is wonderful, the siblings provide the day-to-day physical care and administer pain medications. There are moving goodbyes and funny scenes that make the movie very watchable. The segment about forging their mother’s signature in order to close her bank accounts before she dies is a reminder that even patients whose death is not sudden, forget to take care of important business issues.

I highly recommend the movie and I highly recommend planning for the “big event” by consulting the Web sites mentioned in the first paragraph. To see the trailer check out: http://www.twoweeksmovie.com/movie/."

Thursday, March 15, 2007

Another Typical Day

Sorry, my camera is broken! No cool pictures of SF!

8 a.m.- 9:30 a.m. Liver physiology lecture
9:30 a.m. - 11 a.m. Liver histology lecture. I fell asleep.
12 p.m. - 1 p.m. Synapse lunch meeting!
1 p.m.- 6 p.m. Preceptorship at Kaiser SF with a medical oncologist whom I shadow every Thursday afternoon to practice my clinical skills in a real life setting. Every week, UCSF medical students travel to different clinics in the Bay area to work with physicians. I enjoy working with my preceptor and his patients and learning more about oncology. :-) I also fell asleep there today, too. Nothing personal.

I think that I have low-grade narcolepsy. Maybe study-induced attention deficit disorder (SIADD). Or maybe just "medical student syndrome," in which medical students convince themselves that they have every disease being studied. Lately, I've been catching myself thinking, "Hey, I think that I have that one!" So far, I've falsely diagnosed myself with anemia, celiac sprue, and peptic ulcer disease. Maybe irritable bowel syndrome (IBS), but we'll have to see about that one...when I read about it.

Wish me luck!

Payback

Paul (green striped shirt) and his adoring fan base/well-fed friends
Last Wednesday, Paul invited us over to his house for the most delicious homemade steaks ever tasted, he even made them to order (medium rare, etc.) and had side dishes! He does this for free, for fun, and for his friends. Of course, the steaks were the last straw in a big pile of meals that Paul has prepared for us every Wednesday for the last few months, so Jenny took it in her hands to make sure that Paul would NOT prepare dinner this week...but since none of us can cook that well...we took him to Korean BBQ instead. At first, Paul resisted. He refused. Then Jenny found out that he loves My Tofu House. When she suggested that we eat there tonight, Paul quickly gave in. :-) The food was good, but not as good as Paul's home cooking!

Wednesday, March 14, 2007

GORD? GERD!

In the United States, we call it gastroesophageal reflux disease (GERD).

In the UK, they spell the esophagus as "oesophagus"...

so they call it GORD instead of GERD!

*rolls eyes* GORD just sounds weird.

Action Is Eloquence


Today I was studying half-heartedly at the library when my mother called me in tears, because she was trying to decide what items to place inside the vault with my grandmother's ashes. Grief is a multi-layered creature, and I'm pretty sure that when you lose someone whom you love very much, the pain never entirely goes away, but rather grows to lie dormant inside a little nerve in your cheek until your mind dangerously lingers a little too long on a memory or until an object, sight, smell, sound triggers a flood of tears. My mom has been taking everything the hardest, and of course I worry about her.


Tuesday, March 13, 2007

Typical Day

A day in the life of a medical student:

8 a.m.-10 a.m. Class - we watched a radiologist, surgeon, and GI internist approach the hypothetical case of a 57-year-old woman with a sudden onset of nausea, vomiting, and abdominal pain. Most students really enjoy these 'simulations' that allow them to watch experienced clinicians in action (mentally, that is).

10 a.m.-11 a.m. Class - a lecture on how to approach geriatric patients and how we all have misconceptions about the elderly.

12-1 p.m. Meeting for PedPALS, an informational session on pediatric palliative care for pediatric oncology patients. I have never really thought about how to approach children with terminal illnesses, and this session was very interesting and memorable.

2-3 p.m. Practice clinical session with Carson, a fellow medical student, in which we interview a standardized patient (SP) (a standardized patient is a paid actor/actress who is playing a role). The SP had an abdominal complaint and we performed an interview and directed physical exam. Then she gave us feedback on our performance, which is very helpful. Once, again, I forgot to screen for depression and abuse history during the patient interview, which are two items that I am trying to consciously include in my work-up after attending the domestic violence conference and failing to pick up on depression in a previous (real) patient.

Today was a relatively light day in terms of content and hours, but I still feel pretty unmotivated to study. :-p The weather in San Francisco is fabulous!

Sunday, March 11, 2007

Kitschy Kitchenware

The Ex 5-piece Knife Set with Unique Holder from Overstock.com
Ironically, this little treasure of a bargain ($60) was pointed out to me by my boyfriend. I think that this might qualify as the most disturbing commercial product since Clay Aiken.
The logo in the upper left hand corner is hilarious: The EX (knife crossed by a bar). "Got an Ex? Get the Ex!"
See, I am so not studying.

SF MoMA

Picasso, "Seated Woman," 1927
from the SF MoMA
I visited the SF Museum of Modern Art today with some med school classmates to see an exhibit on Picasso and his influence on American art. The weather was so lovely today, a balmy 60 degrees with warm sunshine. It was as close to summer as SF will ever get!

Saturday, March 10, 2007

PedPALS

"The Dance Examination," Degas, c. 1880
from the awesome Artchive
Yesterday, I met my mentee for PedPALS in the hospital for the first time. She is a teenager who had a bone marrow transplant last year for apastic anemia and she's currently spent an entire year at home due to her immunosuppressed state. It must be so hard to go through an ordeal like this when you are just beginning to learn more about yourself and as you enter puberty and adulthood. Since she was at the hospital and the social worker warned me that she was painfully shy, I bought a "paint by numbers" kit from the UCSF bookstore at the last minute so that we could paint something together. The canvases were actually much more complex than I anticipated, it was obviously for adults, but she chose to start on a canvas with a ballerina dancing in front of what looks like ancient ruins and shrubbery (ah, monty python, how you've ruined the mundane quality of that word for me). This would probably be consistent with the fact that her favorite color is pink, and she likes to drink boba too. That is very exciting to me. =)
We spent three hours together at the hospital, and I was surprised by how many hospital people came in and out within that period of time. Nurses, dieticians, child life therapists, doctors, social workers, me. It was also striking how busy the doctors were, and how genuinely nice everyone is. A nice nurse wanted my mentee to swallow some medication, even though she had already swallowed 8 pills that morning. After 15 minutes of cajoling, my mentee agreed to take the medication. I know that it must be hard for the nurse, when you know that the patient should take the medication, but you also feel sorry for the patient because you know that she's just plain sick of pills. When my mentee couldn't swallow a pill, and ended up throwing everything up onto the blanket, the nurse told her it was okay, brought her a new blanket, and said not to worry about it and that they could try again tomorrow.
It touched me because that ability to relent, I think, would qualify as grace.

Friday, March 09, 2007

Clinical Sciences Journal Club

H2 Receptor Antagonist
Today I presented a paper for clinical sciences journal club on how taking gastric acid-suppressive drugs like proton pump inhibitors and Histamine-2 receptor antagonists increases your risk of developing community-acquired pneumonia (Laheij et al., JAMA 2004). It was a fairly good paper, but the best part was being among so many fellow MS1's who come every week so faithfully for the FREE friday lunch and the lively discussion. Seriously, there is such a sense of community at UCSF and I grow to appreciate it more each day.
Last night, I went over the first part of my presentation with my roommate and her friends from the school of pharmacy, and they asked me why I was presenting and what I would get out of it. Albert, who kindly stopped by to give me some last-minute critiques, bluntly pointed out that you gain absolutely no benefit from presenting at the journal club...the speakers are strictly voluntary, you get no credit and no record of ever attending journal club much less presenting at a session, and you spend hours and hours angsting over a stupid powerpoint file and reading background papers to cram yourself full of facts and knowledge so that you can sound semi-authoritative when people ask you about confounders.
But really, I would beg to differ. There is a tangible benefit to volunteering and putting yourself out there. You get to research an area extremely thoroughly which I admit is really intellectually satisfying (and painfully nerdy) and you get to practice your presentation skills and learn to think on your feet. If I had to give myself a grade for my presentation today, I would rate it as a B or B- (grade inflation is a way of life at Harvard you know...just KIDDING!). The biggest problem wasn't fielding questions or my foundation of knowledge, but the fact that my public speaking skills are pretty shitty and out of practice right now. My voice wobbled more than Britney Spears' career and it cracked on several occasions. One audience member commented on that fact that it sounded constantly like I was going to cry, which wasn't the case at all but it was like I couldn't speak because my airway felt like it was closing and that I was going into anaphylactic shock.
When I look back on this in a few years, this entry is going to be a very funny read.
Anyway, I just wanted to say that presenting at CSJC was probably one of my best learning experiences thus far at UCSF. To a lesser extent, it is because I learned in great detail about the specific controversy between proton pump inhibitors and the risk of pneumonia, I learned that you are allowed to statistically compare incidence rates using a chi square test (pretty nifty trick comparing cases/person-years), and I learned from Albert that you can find old journal articles from the 1960's, 70's, and 80's in the basement of the UCSF library that are not available on PubMed (I am very satisfied with the library resources at UCSF by the way). To a greater extent, presenting was a great learning experience because I feel like I'm learning how to do public speaking all over again. Sure, my public speaking skills suck more than a vacuum and I sound like I'm going to cry, but at least I said, "screw it!" and went ahead and did it anyway. Next time, I will be better and maybe it'll be an oncology paper. :-)

Wednesday, March 07, 2007

Easy, Breezy, Beautiful Cover Boy (for Cell)

Our very own Alex Fay from the UCSF med class of 2010 has a first-author paper in Cell (February 2007). Not only that -- he's a cover boy! Congrats! Our class is so proud of him...if we ever have a question about gap junctions...we'll remember to ask.

I would talk more about our current block, Metabolism and Nutrition (abbreviated as M&N, which reminds me of M&M's or Eminem), but frankly I haven't been in class for a while and I haven't really started studying. Most of the last two weeks of February were spent at home in Los Angeles, and then last weekend I flew to Boston to pseudo-surprise my boyfriend on his birthday. Boston was wonderful...we saw a little play called "Almost, Maine," took advantage of restaurant week by eating lunch at Ruth's Chris (steaks fried in butter taste so sinfully good), and explored little shops and new businesses (to me). I visited my first Best Cellars (the people who supply wine to JetBlue), a very clever business that makes affordable wine more appealing and accessible to the average consumer. Bravo. Another new business that caught my eye: Johnny Cupcakes...a small shop that opened on Newbury St. specializing in punk-style printed t-shirts.

BlaH! So much work!

The Multi-Dimensional Experience of My Grandmother's Death.

It is 10 p.m. on a Saturday night, and I am reading on my bed at home in Los Angeles while enjoying a short break from medical school. My grandmother enters the room dragging a plastic-encased acrylic blanket because she is afraid that I will get cold in the early morning.
Around midnight, my grandmother spies me getting ready to sleep.
“Go to bed,” she tells me.
It is the last time that I see her alive.
At 1:43 a.m., the sound of my little brother calling my name rouses me from a dreamless sleep. I hear the slap of my mom’s slippers flying down the hallway and I rush to the bedroom shared by my grandmother and my 11-year-old brother, Jeremy. Jeremy is sitting bolt-upright in bed, his eyes wide with fright, and I assume that he had a nightmare. Then I realize that my grandmother is missing from her bed; the sheets are untouched.
Nothing frightens me more than the memory of seeing my grandmother sitting on the carpet, slumped against the side of her bed. She sits in an upright position, but her head sags at an unnatural angle, so that her face is completely buried in her chest. Her limbs are tangled together like wet noodles, and there was an eerie stillness and silence surrounding her form. It was like someone had cut the strings to a marionette and dropped the plaything into a haphazard pile on the floor.
My mom begins to shake my grandmother, telling her to wake up, and her voice becomes increasingly shrill. We call 911 and try to perform CPR via directions over the phone, but I notice that my grandmother is not breathing at all and her pulse is impossible to tell. As I watch the stillness settled over her torso, I realize for the first time that seeing a chest rising and falling is a miracle that I will never take for granted ever again.
During those minutes, I feel the intense irony of being a medical student and seeing my grandmother’s life slip away. When she remains lifeless despite the CPR, I find it impossible to decide whether my grandmother is (in a sense) failing my mother and me by not responding to our rescue efforts…or whether we are failing my grandmother through our sheer inexperience.
For medical students, death is a familiar specter. Personally, death has become a multi-dimensional experience. Last year, I worked with terminally ill cancer patients under the knowledge that almost everyone would be dead within a year. It broke my heart. Last year, I was also excited to pass on my job working with cancer patients to my gifted friend from high school, but she passed away unexpectedly in a rafting accident in Peru before she could graduate from college. These professional and personal experiences show death as a sudden truncation, a disappearance from the world, a strange sort of disconnect between life and the void that follows. It was like looking inside a tube and seeing a barrier represented by death.
This year in medical school, working with cadavers has given me insight on death from the other side of the tube – a postmortem perspective. I can see nerves, muscles, organs, but my insight into the emotions, characters, and personal lives of these donors has been cut off by that same barrier.
As a medical student, I knew that someone would die in front of me eventually. I just never expected it to be my grandmother. She crossed that barrier between life and death in front of my eyes, and it was painful to remember her loving admonishment to go to sleep while also recalling how every angle, line, and shape of her form struck me as those of a cadaver almost two hours later.
When the paramedics arrive, they declare that my grandmother is already gone. The police make a brief appearance to rule out any foul play, but by 3 a.m. the authorities vacate the house and leave my grandmother’s body on the floor of her bedroom. We have no idea how to handle the body. It is a ludicrous moment. So we call a funeral home and they send a pick-up service van to recover her body at 4 a.m. in the morning. I remember watching the red tail lights of the van carrying my grandmother’s body turn a corner and disappear into the darkness.

A week later, in another ludicrous moment, I sit next to a stranger at the airport surrounded by a group of fans. The stranger whips out a gold statuette – an Oscar – which he earned the night before. Curiosity wins over potential embarrassment when I ask him, “Excuse me, what did you win an Oscar for?”
“Best Original Screenplay,” he responds.
This isn’t helpful; I didn’t watch the Oscars.
“Little Miss Sunshine,” he nudges.
We chat briefly, and for some reason I tell him about my grandmother and how the experience reminded me of a moment in Little Miss Sunshine when the grandfather unexpectedly passes away in a motel. The stranger tells me about how he watched a documentary depicting a terminally ill patient in life and in death, and how he was struck by how death can transform a human being into a lifeless object wheeled onto a van. It was really important to include in Little Miss Sunshine, the stranger says, a little scene showing Greg Kinnear’s character watching his father’s body being borne away in a van that turns a corner and then continues onto the open road.
“It’s strange how life imitates art or how art imitates life” I say, realizing that my grandmother’s death will gain more subtle dimensions as the years progress. An experience never remains static, but instead grows more complex with time.