Today, snow fell on Manhattan for the first time this winter, and I almost didn’t notice! It was a pleasant white flurry that stuck on the trees for a few hours. As it drifted lazily outside my window, I ignored it entirely and continued studying for my Step 1 board exam.

This is bad. I’m supposed to get giddy when fresh snow falls! Snow quiets the streets, both by muffling the acoustics and ushering people inside. Snow bites at my cheeks and toes and fingers, but in a pleasant way. Snow accentuates shapes with sharp contrast and covers blemishes with gentle white. Nothing else can transform a city overnight into a completely different brand of beauty. Last winter I ran around the city six times to take photos just because it was snowing. Today, I just sent two texts and continued studying.

I do it because I must. Step 1 is a massive exam, and it necessitates cramming nuanced information into my brain for five weeks straight (because standardized test escalation bla bla). Long-term semantic memory is finite, and that means my other brain-taxing activities must be held temporarily, or else they would detract from the mental space for my studies. I feel as if every additional point of medical trivia I forget is another question I might get wrong on test day, and that’s miserable.

But… snow! It served as a slight boost for my mood, but I largely ignored it because keeping my ‘photography brain’ active takes significant attention. Perhaps it’s better that when I see a tree, I think not “ooh where should I stand to photograph its branches?” but instead think “ooh let me mentally reconstruct the celiac trunk artery and its branches.” Same with piano; instead of developing the expression I want for my Debussy piece, I sit at the piano bench and physically reenact the different presentations of nerve injuries in the arm. So yes, why enjoy the snow when I can recite antimicrobials instead?

Now, I might believe this deliberate ignorance is a necessary evil. After all, it’s my duty to learn what I must to provide quality healthcare in the future. Sacrificing pieces of my identity or even my awareness of external happenings might be the price I pay to become a doctor. Yet, while deciphering diseases like diabetes, autism, or Alzheimer’s feels like a noble and worthy goal, sometimes I get the itchy feeling (pruritic sensation?) that I might have chosen the wrong fight. Climate change is way more urgent, and we’re all ignoring that. Hell, by the time we’re full-fledged doctors, our world of medicine is not going to look like Step 1 anymore.

As much as I’m ignoring the snow, I’m keenly aware that today, January 17, is awfully late for winter’s first snowfall. So… when winter stops happening entirely, are we going to give year-round flu vaccines? Where are we to find new drug compounds when all our trees and shrubs are burned or chopped down? Well, maybe there won’t be any more sea urchins to worry about tetrodotoxin poisoning; bee sting allergies might not be an issue anymore either. Then again, with the rampant flooding, will the Aedes mosquito make a grand homecoming and have zika/yellow fever/dengue/malaria tag along? Meanwhile, we might consider building dedicated COPD clinics because everyone will be effectively smoking smog all day. Or, while we’re at it, should we think about constructing whole hospitals to replace all the coastal ones when they flood?

Food for thought. Back to studying.

 

 

PS. more food for thought: “Cancer and Climate Change,” a NYTimes opinion piece by an astronaut and climate change scientist with a <1 year prognosis.