San Francisco Symphony

Stream of Consciousness



Stream of Consciousness: Hospice

Twenty Minutes, One Theme, No Edits. Backspace is OK

By Akshay Govind
Staff Writer

Today’s Theme: A Visit to Hospice

Ms. S. is a 59-year-old woman who presented to the emergency department two weeks ago with brisk bleeding from her genital region. She had noticed a small amount of bleeding over the past few months, but an underlying condition of paranoid schizophrenia had prevented Ms. S. from believing the doctors during prior hospital visits, when they tried to tell her they were concerned she might have a tumor of the cervix or uterus.

She told me she thought the bleeding was either the return of her menstrual cycle or because of taking too much aspirin.


Stream of Consciousness: Bowtie Friday

20 Minutes, One Theme, No Edits, Backspace is OK

By Akshay Govind
Staff Writer

Today’s theme:  Bowtie Friday

He was 96 when he passed away, and until his death in early 2011, every single periodontist who ever trained at Harvard School of Dental Medicine had been a student of his. There was a service held for him at the school, where several senior faculty members recalled being students of his. They told stories of his dedication as an educator, his warmth with patients, and his love for fine cigars and an old coupé.

There was a box of bowties at the entrance. He had hundreds of them, and no one had ever seen him without one since World War II. Service-goers took one each by which to remember him. Mine was a beige wool tie with clay-colored tear drops, slightly worn in the spot where the material would overlap if tied around Dr. Epstein’s collar.


Stream of Consciousness: A Med Student Preps for the Boards

Photo by jurvetson/

20 minutes, one theme, no edits, backspace is OK

By Akshay Govind
Staff Writer

Today’s theme:  Board exam preparation

Welcome to the first installment of what will hopefully be a fun column I can keep throughout the next several years of my training. The goal is to give the reader insight into the thoughts of a trainee at various important points on the professional path.

Studying for board exams is an age-old tradition of stuffing random facts into your brain for the purpose of quantifying your worth at … well, this stage of life.

For those attending schools with a pass/fail curriculum, this exam is the single quantitative measure of their first two years, and the pressure that comes along with this is enough to make most people a little crazy.