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Some faves from our trip back to China; such a fun time with our boisterous bunch of extended family and friends! And also snuck in a few poses by the beautiful West Lake. (at Hangzhou, China)

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This is such a dream.

The Tweeting of the Lambs: A Day in the Life of a Modern Shepherd

On Twitter, James Rebanks is the Herdwick Shepherd. A little more than a hundred and nine thousand people, most of them trapped in office environments or riding public transportation, follow his account for gorgeous, wide-skied pictures of his flock, and for his evocations of the English countryside. In 2015, Rebanks’s memoir, “The Shepherd’s Life,” became an international best-seller, and he was compared to the nineteenth-century rural poet John Clare. Clare, the son of illiterate laborers from Northamptonshire, wrote about the land from within it; Rebanks’s writing has a similarly involved quality. When he feeds his ewes, he writes, “They line up behind me, with their heads down, like a massive scarf.” Rebanks has around two hundred and fifty sheep to look after, and when they’re lambing he has no time to write. He barely sleeps. “You are trying to keep things alive,” Rebanks said. “You make a mistake and something dies. And then—if you get through it—in a week or ten days’ time, the grass comes, the sun shines, and there is a feeling of absolute sheer exhaustion that turns to elation.”

Read more.

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marriage

I never expected for marriage to change the way we felt about each other. After ten years of fighting and compromising, and falling in like and love, dealing with all manner of drama and success and failure, we had seen and heard it all. Marrying him was a simple, powerfully straightforward choice; getting married had seemed more like a formality than any significant transformation.

We’re all familiar with the narrative that weddings are celebrations of happinesses found, of love triumphant over obstacles, of commitments made tangible with words stated out loud, with ink on paper. And I think they are. Save for a largely irrational obsession with certain silly details, I loved the way that day made me feel, most of all the words that were said, that gave voice to what we had created with our presence in each other’s lives. It all feels pretty miraculous that two people can be together in this way. It still baffles me how it all worked out.

But I didn’t know that our wedding would also awaken such sadness, though it was a joyful sort of sadness, a melancholy nonetheless, that covered me for days. Two days after we made it official, after I had finally slept more than four hours and after the buzz of being around a hundred of our most consequential people on the planet had finally faded, I woke up with a sudden sense of time passing by too fast, confused at where the last ten years had gone. 

Marriage, it seems, is not for the faint of heart, or those like myself, who are prone to have existential crises when one’s sympathetic nervous system goes into overdrive. I felt the tears hot and messy in the midst of my confusion over what was happening; it was a while before I could process my thoughts. As it turns out, I am the type of person who cries when sad, angry, happy, or confused. Something, somewhere, somehow felt shifted, but I couldn’t figure out what it was. The obvious answer was the fact that we had just gotten married, but it wasn’t the being married that evoked my melancholy. It was, after much thinking about it, more that we were no longer waiting for it all to start, that this was it and we had to make it count, right now. What is it that you do when the thing you'd been waiting for finally arrives. I hadn't really given it much thought, and it was all dawning upon me with the weight of all my fears, dreams, and jumbled emotions.

I realized I had been waiting around in some capacity for as long as I could remember, willing the time to pass, waiting to graduate and get a job, waiting to get into med school, waiting to finish med school, waiting to be in the same city, waiting to get engaged, waiting to get married. Eventually all the anticipation builds to a resolution, and then one is faced with the vast unknown of what happens next. Mostly I tend to replace it with the next thing to anticipate – where are we going to move for residency? When am I going to finally make it as an attending? There are always more goals to chase, more accomplishments to covet. But for better or worse, we are in large part already who we are meant to be. 

Perhaps ambitions change as people grow older simply because the tradeoff between the present and the future becomes less consequential. Our dreams become more realistic, more practical, at the risk of becoming more mundane. There is a fine line though, between complacency and the constant dissatisfaction of ever growing ambitions. We are told to live in the present; though who really knows what that means or how to operationalize that concept. What is the appropriate balance of work and fun and family and friends and saving and spending and sleeping and being awake. How do we balance these things in a marriage and in a life. In the midst of all of our stunning happiness, embracing this melancholy of time and what we do with it, seems a worthwhile if slightly uncomfortable project for the start of a new marriage. There is of course no right answer, but we’ll try.

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M3

Often this role feels like any other job. The daily lists of things to do, the labs that need checking and electrolytes that need repleting, the note writing and the documenting, the relentless rounding, the endless clatter and beeping, the sound and fury of the machines and alarms and notifications that keep our patients alive, but also serves to slowly drive us all insane. We wake our patients before dawn and inspect them, interrogate them with questions asked too loudly, prick their already bruised arms and take their blood, discuss their numbers, assess and plan, as if all reduced to a series of checkboxes for completion. The level of objective measurement and objective action in the day to day surprised me. The rigidity of medicine often feels stifling. But it is also comforting, that there is after all a rhyme and a reason to how we heal, treat and cure horrible and not so horrible ailments. It is remarkable how we have evolved such a system to catalog and logically organize a response to physical deterioration and human suffering. It is remarkable how much DOES work, even though we often fixate on the many parts of this system that do not. 

There are also moments that make you lose your breath. People that walk into the hospital one day with a cough can die the next. Their names in the electronic medical record greyed out, and italicized after they have been “discharged as deceased." People who are healthy one day have pancreatic cancer the next day. The line in between is more tenuous than I had imagined. It is difficult not to feel guilty when we suspect the worst but wait until we are certain to tell the patient. Sometimes they already know, sometimes they are completely blindsided. 

I have questioned this path, in the moments when I am walking down a dark Madison avenue, the only people on the sidewalks a steady stream of teal and blue scrubs moving toward the glowing hospital doors. There is little glamour in the conference rooms of mismatching chairs and peeling paint and a dozen cups of cold coffee littered around the computers jammed into every spare corner of the room. The bathrooms that smell intensely of antiseptic, unsuccessfully masking the odors that permeate everywhere I turn. Is it too early in this career to have doubts? Is it too late to turn back?    

But then, when I am least expecting it, the algorithm fatigue and the evidence based medicine and fear of doing something terribly wrong intersect with something that I can’t properly describe. Sometimes it is a little old lady who gets better, and goes home. Sometimes it is a simple piece of pathophysiology that I had learned long ago that suddenly makes sense. Even if this giant mountain of knowledge is overwhelming in its weight and expansiveness, every so often I feel myself inching toward some kind of understanding, ever elusive, but perhaps just enough to motivate and guide the path forward.

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Letter from my then baby sister circa fall 2007. Memories like this make me oh so grateful for my never throw away pieces of paper tendencies.

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The sweetest thing in all my life has been the longing—to reach the Mountain, to find the place where all the beauty came from—my country, the place where I ought to have been born. Do you think it all meant nothing, all the longing? The longing for home? For indeed it now feels not like going, but like going back.

C.S. Lewis, Till We Have Faces (via robi-won-kenobi)

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Under the Microscope: @pondlife_pondlife Takes a Close Look at New York City’s Waters

To see more of Sally’s photos and videos, follow @pondlife_pondlife on Instagram.

Her videos look like lava lamps. Her stills look like abstract art. But the stunning subjects Sally Warring (@pondlife_pondlife) captures are residents of New York City’s pond waters. Hooking up her smartphone to a microscope, Sally, who’s a Ph.D. candidate at New York University, documents microorganisms that she’s collected in water samples from Central Park and other urban bodies of water at 100 or higher magnitude. Sally’s Pondlife project aims to educate nonscientists about single cellular life, and she captions her samples in layman’s terms, while slipping in details, like the difference between green algae and cyanobacteria: “Green algae … has a distinctive cell wall, and inside each cell there’s a whole bunch of stuff. Little round balls they look like to me,” she writes. Sally hopes to show people that these organisms have behaviors that we usually associate with more complex life forms, like animals and plants. “We’re living amongst them, and they’re living amongst us,” she says.

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“I was working as a school safety officer when I met her. She was a teacher. But she kept working her way up. She became a principal. She went to work in the central office. She got her doctorate. Eventually she became the highest-ranking black woman in New York education. She was always taking that next step. I was working as a custodian when we got married. She was making five times more than me. It bothered me at first. It took some counseling to convince me that she hadn’t ‘settled’ for me. I’d been raised on the idea that the man was supposed to provide. But eventually I came around to the idea that money wasn’t the only way to provide. I could support her by doing chores, or taking the kids to school, or picking her up from the airport. Her work benefited all of us, so I could help provide by making her job easier. And eventually she inspired me to want more for myself. She’s the one that convinced me to go back to college.”

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Fireworks for Lunar New Year! Cai Guo-Qiang uses fireworks and gunpowder to create drawings like this one. 

[Cai Guo-Qiang. Drawing for Transient Rainbow. August 2003. The Museum of Modern Art, New York. © 2016 Cai Guo-Qiang]

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A Sunday in Sullivan County, New York

Condé Nast Traveler’s creative director Yolanda Edwards—along with her 12-year-old daughter, Clara—shows us the sights inside and outside her modern country home. See more here.

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15 things

1. visited new orleans, boston (2x), san francisco, nogales, zurich, basel, johannesburg, cape town, nairobi, eldoret, rome, copenhagen, asheville, charlotte

There is so much to say about each of these places, but of these Rome was the first city to which I’ve traveled alone, without local contacts, and without any agenda other than to wander. On one afternoon I wandered into a bookstore near piazza navona and struck up a conversation with an old Italian man who had been in the foreign service in china in the 1970s. He then gave me suggestions for dinner spots, and though I cant be certain I actually ended up at the restaurant he meant to suggest, it was nevertheless the best pasta I had ever tasted.

2. went on my first, second, and third safaris (Kruger, Masaai Mara, Nakuru parks) and saw giraffes, zebra, elephants, kudu, pink and white flamingos, wildebeest migrating into Tanzania, lions, leopards, birds of every color

3. spent 6 weeks in Kenya learning about global health cardiology and seeing the breadth (and limitations) of medicine

4. mark moved to new york and we got a pretty awesome apartment, convenient to school (me) and work (him) and I finally got all the stuff that had been in storage since we moved out of our last apartment in boston

5. read books but did a bad job of keeping track. some favorites included Delancey, and a book of short stories called The Weight of a Human Heart

6. after all these years of long distance and bi-coastal living, he asked me to marry him in the middle of a patch of trees in my beloved cleveland metroparks (I said yes)

7. we got a (real) christmas tree despite my ambivalence about buying a decorative object that you can only use once before needing to kick it to the cold and sad January curb more on this by Adam Gopnik

8. witnessed the moment my baby sister was admitted to my alma mater and felt ever so proud to have Duke as part of the family

9. hung out with a cool llama

10. ran for miles and miles

11. finally got around to seeing a show on broadway (the amazing fun home) and planning to see many more in 2016

12. saw Duke win another national title in basketball

13. and then also a bowl title in football (!)

14. so much gratitude for the ongoing and incredible journey that is becoming a physician, and for all my people who keep me going when the going gets a little too heavy

15. ended the year (and began a new one) in a shower of confetti at a 1920s jazz party

here we go into 16! may we all continue to grow further, see wider, and live happier.

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Tea Charlie Logo & Package Design by Yan Yaoming

“Strictly observing the ideas (ancient procedure for manufacturing tea, innovative design), choosing carefully cultivated tea and following the traditional process. These crafts, born a hundred years ago from numerous ancestors, are the accumulation of human experience of this industry and our respect and adherence to nature.”

Yan Yaoming is a graphic designer based in Beijing, China. He is focused on packaging design, branding, graphic design and print design.

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Book Gifts For Travel Nuts: Visiting family over the holidays can be tough, we know. Escape to the distant reaches of your childhood bedroom, and into one of these foreign stories.

A Strangeness in My Mind by Orhan Pamuk

China Rich Girlfriend by Kevin Kwan

The Italians by John Hooper

After The Dance by Edwidge Danticat

The Diamond Caper by Peter Mayle

Bird Dream by Matt Higgins

The Last Bookaneer by Matthew Pearl

How to Travel the World on $50 a Day by Matt Kepnes

Transit Maps of the World by Mark Ovenden

Without You, There is No Us by Suki Kim

Under Magnolia by Frances Mayes

Peruse all of our holiday lists here!

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Source

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Contrast and Beauty with French Illustrator @malikafavre

For more of Malika’s illustrations and travel snaps, follow @malikafavre on Instagram.

The art starts with shapes. “Big shapes,” illustrator Malika Favre (@malikafavre) says. Much of her abstract work is inspired by graphic photographers and real-world objects and patterns that she shoots herself — not other sketch artists.

“I always try to spot beauty in everyday things, from a shadow cast on a wall to a beautiful object,” the 32-year-old, who is based in London, says. Then, she starts “cleaning,” cutting away at the image, because Malika is obsessed with negative space. But, she also seeks to add a human element to her canvas, which is why she describes her aesthetic as “bold, minimalistic, colorful and playful with a hint of sexiness.”

Growing up in France in the 90s, when people with graduate degrees had trouble finding work, Malika actually thought she would never turn her passion for drawing into a job. But, when you see art everywhere you look, creating may be the only possible path.

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It’s been just over a week since my last exam of the year, packing in a fury and bounding home to Ohio in a storm of lost gates, missed flights and weather delays. Old friends, wedding festivities, and a generosity of ice cream helpings later, I finally feel myself emerging from the cloud of exhaustion and excitement that was this year.

The quiet (and unexpectedly cool evenings) of suburban Cleveland have been a much welcome interlude – on Saturday I’m making the cross country trek to see Mark in the bay for a few days before we both fly back east to move into our new apartment in New York. I’m moving across the street and he’s moving across the country, but it feels less like the big moving-in-together this time around and more like a reshuffling of belongings – mine from the dorm filled with things that did not belong to me in a shared space that I feel like I’ve been borrowing, and his – from spaces never fully occupied with suitcases never fully unpacked. Mark proudly declares to our friends that it’s because he prefers to live like a minimalist. He could never be bothered to make a space livable, though he does not complain when I do it for the both of us.

Though I admit I’ve always been the self-designated appointer of spaces, I had not expected to be as affected by the space around me as I have been this past year – constantly lamenting the feeling of being a stranger in my own home, feeling anxious at the sight of couches, cushions, forks and knives long since left behind by doctors-in-training past. So much so that I could barely bear to spend any time in my own apartment, opting instead to occupy corners of neighborhood coffee shops, the aromas of overpriced espresso lingering in my hair and clothes.

By January, I had decided enough was enough. I had been woken up by enough loud conversations and mysterious music playing at odd hours to decide I was too old for shared spaces. Mark and I made the trek downtown to officially domestically partner up and prove that our application for the school’s couples housing was legitimate.

In exchange for 35 dollars and a few vague questions answered through a sheet of plexiglass, we received a very official looking piece of paper, that upon close reading, ended up meaning mostly nothing.

In May, Mark left his job in San Francisco, and I started looking for furniture in earnest.

There have been differences to consider since our last reshuffling, three summers ago when we moved into an airy and bright, if small 4th floor walkup above Newbury St. 

Boston was the first place we lived together, and Sunday mornings we tumbled down the old brownstone steps, past the ground floor Italian restaurant (with a penchant for setting off the building fire alarm) onto rarely silent sidewalks. The early runs along the Charles that started and ended at those old double doors will always hold special sentiment. In Boston, where we each struggled and strived to find our places in the world of enterprise and fortune, there was striving to find how our lives would fit together. When I wasn’t working late, and when the green line functioned at its predictable slow clip, Mark would get back in time for dinner. The trader joes up the block served as private pantry, at the ready for replenishing whatever ingredient had run low. On any given Tuesday evening Mark would come home with a bottle of gerolsteiner under one arm and a bunch of bananas under the other.

But more often than not, I ate a dinner of cold sushi from Douzo at my desk, staring at a massive color coded mess of numbers. Then walked home to find Mark also still on a conference call with someone in California. We’d crawl into bed after banishing outlook for a few precious hours, watch an episode of Downton Abbey (which I forced Mark to like, or if he hated it he did a good job of hiding) before falling asleep, dreaming of PowerPoint.   

Gratefully, it has been a while since my last PowerPoint dream, this year of physiology and biochemistry and so, so much medicine buffering current and previous lives.

This current life if only for a week – of pause and leisurely book reading (!) and day dreaming and if I’m honest – a healthy amount of fretting (as I always do with time on my hands) sails by suggesting it just might last forever – until the suitcases get repacked, borrowed spaces returned, and its time to be off again.