Bali

I hopped on a plane after yet another week-long night shift combo. But this time, the messed-up melatonin schedule in my head would do me a favor by matching with my new time zone at the other side of the world.
After roughly 18h of travel, I landed in Bali.

Already my drive to the hotel was filled with new sights and sensations. At nighttime, the streets of Denpasar and Kuta seemed both dodgy and full of promise, but I would have to wait until the next day to fully discover its secrets.

I woke up next to N, a pediatric ICU nurse from Colorado, as the first person I officially met in Kuta. She was friendly, chatty, energetic. With 4 careers and multiple travel experiences on her back, she never ran out of interesting stories to tell.
We headed to Kuta beach that first morning in a van with no seatbelts —us two and almost all the boys. As usual, I skipped the surfing session and sat on the beach instead, taking in the waves, the people around me and the countless dogs playing in the sand through my camera lens. It was cloudy, but humid and hot. I shared my first conversation with Aj, shamefully realizing how little I knew about Bali and Indonesia in general, how much I would have to catch up on to feel ok with myself, and how useless my tiny Bali survivor guidebook would be for that.

Back at the hotel I met the rest of the crew, with an overall positive impression. US American, British, Turkish, French, Australian… They all had diverse and interesting occupations that I was instantly looking forward to finding out more about in the upcoming days. I made the accurate guess it would be more of an outgoing, engaging social experience than Canada had been. Little did I know to what extent I was right.

After a free day of adjusting, resting and exploring, we finally started our journey to Kubutambahan. All of us except Bl, who was admitted at the hospital and would regrettably be out of the picture for 4 days. On our way, we enjoyed a traditional Balinese play including our first exposure to Legong dance as well as lunch at a community project supporting and assisting people living with disabilities. Learning that in Hindu-Bali, it’s a societal belief that being born with a disability is a product of "bad karma" was upsetting, but seeing this kind of local initiative to change such outlook did feel rewarding.

Finally, we arrived at Bulian. Our accommodation there was surreal. It felt more like an Indiana Jones movie than real life. Located in the middle of the tropical jungle, we slept in wooden cabins surrounded by the intense sound of millions of insects, geckos and all kinds of birds. The inebriating scent of exotic Frangipani flowers mixed with the omnipresent incense of balinese offerings, the sultry weather, the coconut milk, the artisanal canang saris, the spiritual cleansing ceremony, our walk to the local temple, the sunset in between ancient ruins and run-down streets. That one afternoon felt like a warm embrace to my soul. We enjoyed more mesmerizing traditional Legong in the evening… Followed by my first real conversation with B. It was strangely difficult to look directly into his blue eyes. Over time, I had the feeling I’d stumbled across a goldmine of some kind, but my tiredness got the best out of me, and I called it an early night.

We got ourselves immersed in Balinese culture further the next day, exploring more temples and secluded beaches, visiting a dragon fruit farm, a sacred well and swimming in natural hot springs. Interestingly enough, that was the first time I’ve ever truly felt like an intruder, or unconsciously disrespectful outsider. Wearing a bikini to the contrast of local women covered up completely made me feel extremely self-conscious in a way I’d never known before. Luckily, S offered me his tank top, which I took gladly. After a traditional lunch at yet another astonishing location, we made it back to base camp with enough time to take a nap just before our traditional cooking class.
And what a blast that was. The euphoria of all these previous experiences enhanced by S’s relentlessly witty innuendos made me laugh to the point of abdominal soreness. That was the evening I first felt truly close to my group in a more visceral way, also helped by the late night long session of live music and karaoke we shared lying down on colorful giant bean bags.

We visited Gitgit Waterfall on our way to Ubud. I thoroughly enjoyed the short hike through the forest, coming across the most humongous duran fruit I’ll ever see, an isolated coffee shop with a Spanish machine and refreshing mocha. Then after yet another delicious lunch, came gorgeous Ulun Danu Bratan. Exploring its gardens, the views to Bratan lake, felt otherworldly. My attention wasn’t undivided, largely drawn to the amount of banter and laughter shared with the group.

I had never witnessed traffic as frantic and reckless as Ubud’s. After the Monkey Forest, dinner at a pizza place felt strangely European, if it wasn’t for the palm trees framing the views out of every window as well as the loud bustle of the local traffic in the background.

And then, one of the absolute highlights of my time in Bali. S, M, N and I hopped in a car at 2:00 am. That was the only time I ever saw the streets of Ubud completely empty. We drove for around an hour to our destination: the base of active vulcano Mt Batur. We hiked under an awe-inducing starry sky in pitch darkness for two hours, fighting against steep cliffs of slippery gravel until, at around 5 am, we finally made it to the top. Barely minutes after settling, the first lines of orange slowly appeared in front of us. A choir of gasps and cheers exploded around us as the light progressively spread across the horizon revealing what we had been unknowingly facing all along: the majestic peak of neighbouring Mt Abang hovering above the clouds. It was magical.

Getting back at barely 9am after what already felt like a whole day worth of adventures was invigorating. After a well-deserved breakfast, B and I headed to a nearby bookstore so I could put my hands on anything that’d enrich my knowledge of everything Bali. Our quiet conversation in between bookshelves unexpectedly turned into one of my fondest memories of those days. With me still barely able to hold his gaze for longer than two seconds but without the need to do so, as the books all around us served as the perfect excuse for my eyes to focus on without added awkwardness.
“Of all these, which are your favorite genres?”
“I would say, probably fiction and non-fiction”
“Well, that narrows it down”
For someone as introverted and quiet, he knew how to extract the most heart-felt laughter out of me.

The rest of the day I spent getting a Balinese back massage (ouch), reading my new book and indulging in creative endeavors turning one of S’s hilarious comments into an actual illustration. Bl finally joined us again that evening, and I made sure he didn’t feel left out by writing him a funny welcome card we would all sign for him. But talking about his stay at the hospital, his symptoms and treatment during dinner brought more negative karma upon the already sick male collective. B, sitting on my right side, was growing increasingly pale. The way he looked while mentioning his lightheadedness reminded me of every young male patient I’ve had faint in front of me at the sight of a needle. And sure enough, shortly after partially unbuttoning his shirt, drenched in sweat, he collapsed on my shoulder. That unleashed an internal battle for me. Fueled by the knowledge of the trivial nature of a common vasovagal syncope, to my own embarrassment, a tiny part of me allowed herself to take in the feeling of his muslcly shoulders and wide neck under my arm and the such. But I forced myself to snap out of it into a more professional mindset ASAP. When I thought the evening couldn’t get any weirder, I spent part of it sitting next to my new patient in his bedroom, trying to talk him out of googling his symptoms, followed by my first ever critique at being thoughtful, spoken by his roommate upon walking in on us:
“By the way, that card you made for Bl was just weird”.
Ironically, as one of the few to not get sick at all, I went to bed that night with a spinning head and enough contradictory feelings to burst one’s cranium open like a Balinese coconut. 

The boat ride to Gili Island was an absolute nightmare.
As soon as the engaging conversation with Bl was over, my brain suddenly decided to register the violence of the waves rocking us from side to side, which in turn made me seasick enough to feel nauseous. One more minute on the water and I would have fed my Balinese breakfast to the fish. Based on my refusal to miss out on a potentially awesome snorkeling session yet not wanting to relive the previous boat experience, I chugged down the equivalent of an elephant dose of first-generation antihistamines provided by N. I didn’t get seasick, alright, but the drowsiness I experienced during that whole morning was unprecedented and probably the closest I’ve ever felt to being absolutely wasted. Fighting to stay awake during lunch, I could barely make out coherent statements without giggling, to the amusement of those around me. Once the effects wore off, I could actually focus on my snorkling experience… which blew my mind. Coral reef, tropical fish and marine creatures I’d only ever seen inside of an aquarium. The absolute highlight: sea turtles. Following one of them at its own speed, barely one meter and a half above its shell for minutes on end was incredible. I would probably have had tears in my eyes if it wasn’t for the goggles pressuring against my lacrimal glands. Yet another beautiful nature related memory to cherish.

Overall, my visit at Gili islands was like nothing I’d known before. Dirt streets deprived of any motor vehicles, only populated by countless bikes and carriages pulled by horses and donkeys. Nothing but souvenir shops, cafes, cars and lounges. Adhan recited early at dusk. Chillout or deep house everywhere at sunset. Riding a bike with no lights, no helmet, under no other light source than that of the crescent moon. I couldn’t imagine anything less Swiss or German than that.
I got to spend my last day with B. We completed a whole loop around Gili Trawangan in less than two hours, enjoyed a giant cup of frozen yogurt with Oreo cookies while sharing more intellectually stimulating conversation, and chilled by the pool until sunset.
After our last dinner as a group at the beach, the two of us headed back early to watch a movie together, despite headache and broken AC.

It was sad to say goodbye. But strangely enough, even at goodbye, the positive feelings overrode the negative ones. I felt mostly thankful. For the opportunity and the means to travel the way I do. For being able to step into an oasis of summer in the middle of winter. For the culturally enriching experience that allows for my understanding of humanity as a whole to grow and shift, for some of the most revealing, grounding conversations I’ve had in a while, shared with several of my new-found friends. And ultimately, for whatever is this that I started to feel around B. I had started to wonder whether I’d ever be able to look at a man with anything other than indifference of skepticism. The excitement and butterflies, and the flirtatious goofiness he inadvertently brought out of me were elements I had almost started to think of as forever lost. Despite his hinted intentions to ditch his ongoing trip to Australia for the Polyball, despite his troubled trip to the airport to spend those last hours with me, playing cards, building memory palaces and eating noodles, I know I might never see him again. But regardless, I am grateful for this random stranger coming out of the blue to challenge my fears, melting my walls a bit more with his soft British accent, his endearingly jerky demeanors, his aura of aloofness yet deep introspection, his sharp intellect, shy and awkward ways, his unexpectedly witty under-the-breath comments, and his collapsed sweaty torso on my shoulder.

There are many things I have probably left out. But I am hoping that whenever I come back to this blog post and read all this again, I’ll be able to relieve those hundreds of nuanced beautiful emotions that I felt throughout this journey. Back in winterly Basel, I can’t believe just this week I was 12000 km away from here, sipping on my virgin mojito at Sunset Point on a teeny tiny island in the middle of the Pacific Ocean, thinking of nothing but how I wouldn’t trade that moment for anything in the world. 

Namaste.

October

I usually kind of think of October as a “filler month”, during which not much really happens. Something to stretch out the transition from summer to Christmas long enough for the weather to change.
Yet this one has challened that perception in unprecedented ways.

My new clinical rotation and the conditions around it set the novel tone from the beginning, allowing me the added free time from getting off work at 5pm every day. I've worked out almost daily, and I have had more time to draw, read, and talk to my friends. It's amazing what one extra hour a day can do.
But Interventional Radiology has also granted me the privilege of meeting Hati. Spending my days with her has been not only fun but inspiring in many ways. She's funny, kind, smart and wise. Supporting one another during our first PICC-line mornings, grabbing our daily Thon Silserli (me) and at least 6 cups of coffee (her), investigating our cases, philosophizing about Medicine, family, cultural differences, travels. Snort-laughing during our lunch breaks. Plotting evening plans. Spending so much time together this past month has allowed for a friendship to grow, and I am glad about it. I am going to miss her when she leaves. And even though we haven’t been able to find Shakira tickets just yet, I am hopeful we will in the future.

Early in the month, our department's yearly resident outing took place in Europapark. I was not excited, but I try not to engage in avoidant behavior as a coping mechanism. So I went.
We picked the first rainy weekend of the season, the place was packed regardless, and I was separated from the group within 10 minutes. Wandering around aimlessly on my own in the Halloween decorated theme park while completely drenched evoked memories of my last visit several years ago, which I had been dreading, and with them came a lump in my throat. For the most part I felt like a spaced-out zombie, blending perfectly with all the spooky decorations around me. I randomly stumbled across a face paint booth and decided to offer mine as a canvas, perhaps metaphorically in hopes of painting over with new memories of the place. It wasn't until I reunited with Lorraine, Jonas and the rest of my favorite colleagues for lunch that I had some honest fun, while telling silly stories and singing the Salmonella song. I still felt compelled to leave as early as remotely acceptable, though. Overall, it was an ambivalent, challenging day.
But at least I enjoyed some tasty churros and popcorn.

The theme park was not the only place I visited this month. I also got to experience the Tinguely Museum from the inside for the first time. Albeit not for long, as I found it spookier than spooky Europapark. I can appreciate the originality in the artist's approach from a pragmatic perspective, but I am not and will never be a big fan of modern art. Some of the child themed sights disturbed us away from staying for the sound bar, so Hati and I decided to attend the open evening lecture at Ubas' Biozentrum instead, held by Cambridge Faraday Institute for Science and Religion's executive director, Graham Budd. That turned out to be a much better way to spend our evening. Witnessing eloquent knowledgeable speakers delivering interesting ideas in an articulate way is one of my absolute biggest pleasures and so I enjoyed this man's talk the way I would an XXL jar of Ben and Jerry's cookie-dough ice cream. It was gratifying to be part of an audience that presumably shared some of my concerns on the (moral and spiritual) future of our kind regarding the upcoming A.I. era, and to have my question selected and answered at the end of the talk: “In a world of dying religious faith, does A.I. have the potential to substitute God?” (Provocative, right?) The event concluded with a delicious apéro —a very welcomed free dinner.
There were many interesting ideas discussed that would require a whole bog entry of their own to fully cover… Staring at the city lights beautifully reflected on the Rhine River waters with the cool evening breeze brushing against my face crossing the bridge home that night, I remember being in that state of intense brain stimulation where one can almost feel it inside the skull.

I finally went out in Basel "for real", too, after almost two years. I have never been a nightlife person and getting ready after 9pm takes me some serious willpower. But I always stare at the Rhystärn near Dreiländereck during my afterwork summer runs, and now I finally set foot on it. I did so during the Boatlife Festival at a 90's party, cruising up and downstream on the basler Rhine River for hours. What a strange and almost ostentatious, yet original concept of turning a boat into a floating club! Sharing the night with an outgoing group of girlfriends felt liberating. It reminded me of how much I love to dance. The inhibition, the expression, the fun. And so, I got home almost 4 hours past the curfew I had set for myself (my first Uber ride in Switzerland as well!).

Just a couple of days after this I received an email from the Spital's marketing department offering me the doctor role at a photo-shooting for a patient education handout. It took me 0,0001 seconds to reply with a big fat yes. I met the most creative people at the Unispital that day, as well as very nice lady from the Neurosurgery department who acted as my fake patient. The awkwardness of talking to her about the weather and other irrelevant matters while holding up a laptop with an unrelated screen and pretending to engage in transcendental conversation to the non-stop bombarding sound of camara clicks, is what actors must feel during filming. It was weird. And I loved it. But I only completely lost it to the thank you gift: one free lunch, one free warm drink, two pairs of USB socks and a Müslibecher. I am going to wear my new garments until I got all of my toes poking out of freaking holes.

This month I’ve also attended a couple of social events at unexplored venues, where I’ve met some people. I think about how every time I talk to a new person, there is adventure in discovering the complex intricacies of someone else’s mind, just like landing on a new planet. Planets can be dry and inhospitable, too hot, too cold, vibrant and fertile… Candid interactions sometimes mirror one’s own planet back to oneself as well, and through a series of recent experiences where I’ve felt myself more open, I can increasingly see myself as warm, funny, quick-witted, engaging, curious and inviting, which in turn contributes to a sense of inner comfort and peace. I don’t think there is enough available land for an astronaut to safely land on my surface yet, but for what it’s worth, some things lately have helped illuminate the way back to myself from icy Outer Space. 

When I thought it couldn’t get less October-like, this year’s Science Slam came along. Lorraine and I had the best time. I had no idea what to expect, but finding myself laughing hysterically was not it. At times, I was fascinated, too. The idea of nuclear fusion to generate unlimited energy and all the potential ways in which that would (will!) change the course of Humanity forever kept my mind busy for a while. But what really made me almost jump out of my seat and scream “HECK YEAH” to the top of my lungs was Dr. Jasmin Barman´s presentation Die gesundheitsökonomische Kenngrösse „QALY“: Vom Recht der Untoten auf Verbesserung ihrer Lebensqualität. It touched upon a really relevant topic that I have seen in some ways indirectly reflected time and time again at work. The QALY-concept and its implementation, as well as other established methods for cost-efficiency optimization in healthcare, were taught to us in "Health Economics" in a very matter of fact way back in uni, with no real room for questioning or discussion, and it's only due to my actual work and my own experience that I am now able to look at such matters much more critically. Her delivery was brilliant, eye-opening, and very funny and even though she didn’t win, I thought hers was the best presentation. I appreciated her work and mission and I am happy and thankful to have been exposed to her ideas. I hope people like her continue to inspire and challenge the status quo with courage and wit in the benefit of patients and doctors against health economists.

Last but not least, on a muuuuuch lighter note, I finally found the perfect night gown for the upcoming Polyball. My experience with evening dresses is limited to weddings and New Year’s Eve. Those are generally cocktail length, just below the knee. But getting to wear an actual full length gown red-carpet-style is new to me and I. Can’t. Wait. It was almost a child-like excitement that I felt this weekend at Breuninger, sniffing around dresses of all cuts, colors and fabrics, trying them on and feeling like a princess in front of the mirror, as cheesy or childish as it might sound. I just couldn’t contain my smile with every new piece I tried on. It was love at first sight with the black sparkly one, though, very much in accordance with the ball’s official theme this year: Paillettes Illuminées (according to Google Translate “bright sequins”). I am excited about all that live music, 15 stages and 25 bands and DJs in less than a month!! I also cannot wait for the added bonus of Kay´s visit, spending the long weekend with her and treating ourselves to a one-night stay in Zürich…

Interventional Radiology — The Coolest Subspecialty

Fall is here.

Through the windows of the angiography office my peripheral vision catches glimpses of falling leaves just behind my computer screen. It's a nice subtle distraction and such a refreshing change of setting from the otherwise rather dull underground windowless facilities of the Radiology department.

What I'm focusing on my screen is new to me. I am writing very short reports now —this time not on chronic suspicious findings, emergency imaging or oncology follow-ups, but on procedures I've actually undertaken myself. Like a true (very amateur) surgeon.
And with less than two weeks of experience, I've concluded the most surgical branch of my field is the coolest.

This is interventional radiology.

And yesterday was probably the best day I’ve had ever since I started working at this Unispital.

I successfully placed my first PICC-Line on a female patient. In such a way that even she was surprised at the speed of the procedure. “Oh, is it over already? I didn’t feel a thing”. That felt so good.
I’ve always found it strange to pose in front of people as a poised, experienced doctor from day one. And the experience repeats itself with every new rotation. But the fact that it helps so much for both parties to ease into the situation with confidence and trust makes it ok to state things such as “of course, we do this every day” or “it’ll be over very quickly”. Even when I forget to occlude the punctured vein after removing a dilator and there’s a puddle of blood forming on the blue sterile field.

When I know I can finally be successful without any help, it’s really fun to work in sterile conditions, to wear silicone gloves and a surgical gown and to actually talk to the patient in front of me, which is something you barely get to do as a radiologist. I am able to use the ultrasound and fluoroscopy experience gained in the past year at this very same Spital to locate an accessible vein, inject local anesthesia and access the deep vessel with the needle with enough precision not to injure an artery or a nerve. I am able to use a modified Seldinger technique to guide a wire up to the superior vena cava, and to place a catheter all the way up to the heart.

The day continued in this uplifting, reassuring way at the neurology ward, where I helped translate for a Spanish patient, mixing English, German and Spanish over the course of 20 minutes around my fellow international neurointerventional colleagues and the sweet Spanish lady. Delivering good news. The gratitude in her eyes, the kinship, sense of familiarity in her accent and her demeanors, left me fulfilled and happy. Even if I was not the one to coil her aneurysms. Yet.

And then, after work, a more or less unexpected social evening with my newfound favorite medical student, and her friends. We cooked and laughed and talked, and then enjoyed our home-cooked ceviche on a balcony looking out to the rooftops of south Grossbasel to a beautiful sunset, a bit too warm for October.

Finally, while taking a shower last night, I had an epiphany. One of the reasons I wanted to study medicine was to be medically helpful to my family, just like my dad had been to us growing up. Just recently I got to read my own mom’s CT-study, and cousin’s x-rays. It hit me. I already am someone my loved ones can rely on regarding medical issues. And it’s a nice feeling to realize I can already fulfill one of the reasons why I embarked in the journey over a decade ago. Such small things give me the motivation and energy to keep pushing, despite any setbacks, even when times are harder.

I know it’s going to be a lonely winter. It will not be the first, and I'm used to those. But overall, it’s such a good feeling just to have this amount of responsibility and fun at work. To connect with my colleagues. To walk around the hospital and talk to patients. To have many relaxed moments in between tasks to just look through the window and watch the autumn leaves falling, maybe daydreaming a little bit.