So this week, I’m in New York for a microvascular course at Columbia University. It’s a hands-on experience with different techniques for connecting tiny blood vessels and nerves under a microscope, using even more tiny sutures. It leaves my afternoons free for touring the city and getting together with my wife’s family here in Manhattan.

It’s funny how my wife’s cousin and I hardly ever had the opportunity to get together in Israel, and this week we met in New York for a beer. This weekend we’ll have a major family reunion during a family wedding, this time in Boston. On top of that, my parents-in-law are in town for a few weeks, so we spend time together daily, much more than we did back in Israel. Funny how things turn out; our international stint is constantly moving us in unexpected directions.

Life will surprise you!

Number 9, number 9, number 9…

Let’s go!

Table of contents

1. Main Article - New York

2. OMFS World

3. Stuff (Book, Gear)

“Clutter is anything that is excess - for you. It’s whatever you have that doesn’t serve you, yet takes up space in your world. To let go of clutter, then, is not deprivation; it’s lightening up and opening up space for something new to happen.” - Vicki Robin, Joe Dominguez, Monique Tilford, Your Money or Your Life

Main Article - New York

💼 Sunday, 5:40 am. I got up, went through my final arrangements for the trip, and left home for the week. New York is not that far from Boston, so I had three traveling options: ✈️ Fly over there, 🚂 take the train, 🚌 or ride the bus. There’s also the theoretical option of taking a car (which we still don’t have because of neverending bureaucracy), but car+New York equals a headache, so let’s scratch that one off. Leaving the price aside, I wasn’t keen on taking a flight. Something about riding to the airport, putting every electronic device in a separate security bin (I have many), tossing away my water, waiting in line at the gate, and delays - there’s a bad vibe written all over it.

🤔 So I was left with the bus and the train. I generally prefer trains: They have more room, the ride is smoother and quieter, and you’re not dependent on traffic. However, I thought it would be nice to try and compare these options solely for the sake of this newsletter, so I’m on the bus right now. I chose FlixBus, which stops just a 20-minute walk away from my house. Boarding took 2 minutes, and since they give you the option to add a few bucks and reserve the seat right next to you, I took on their offer. There are restrooms and an electric outlet under each seat 🔌, and you get to take three pieces of luggage with you: A large suitcase, a trolly, and a personal item. There’s no fee for adding these. I highly recommend earplugs or noise-canceling headphones 🎧 because the ride is noisy - not by passengers, but by the vehicle itself. The Big Apple, here I come! 

😎😎 May 2002 - My best friend and I, fresh out of 3-year-long military service (in Israel, it’s not voluntary), heading for five weeks in the USA, two of which are in New York. We had never been to the US before, and although we studied English throughout school, we hadn’t had much experience with real English conversations thus far. So after having major difficulties understanding the guy at the ticket office, who we just asked which subway we should take (he ended up shouting at us, “A! A! like an AAAAAPLE!”), we boarded the subway. We were greeted by an interesting individual standing in the middle of the train, shouting and gesturing dramatically while all the other passengers ignored him🙈🙉🙊. My friend and I, unfamiliar with this kind of situation where this behavior is permitted with no one doing anything, were stressed out🫣. After arriving in New York, we checked into our hotel, which was just a five minutes walk from Times Square (80$ a night seems unrealistic in today’s terms). It’s hard to put it in words, but let me just say that coming from a small country, seeing Times Square for the first time was truly magical. 

🍔 So, back to my current trip. After checking into my hotel, I went, of course, to Times Square. Actually, before that, I made one stop at McDonald’s since I was famished, and I was also interested in seeing how much discount I could get for junk food :-). So, after downloading McDonald’s app and giving them my email address, I got a whole meal for 1$ and another McChicken for free later that day. That was mediocre at best, but my successful challenge was worth it. The last time I had McDonald’s was 6 months ago, and the time before that was in 2019. I don’t see myself eating that stuff again anytime soon. So back to Times Square: I took the subway 🚇, which is extremely efficient, the same as 20 years ago. They now have the option of tapping your phone to pay for the ride (2.75$ for 2 hours), but I went for the 7-day unlimited ticket for 33$. It was nice to see Times Square again, and although the area was packed, it was still pleasant enough to roam the adjacent streets. 🎭 TKTS is still there, providing substantial discounts for the same day’s Broadway shows. 

😎😎May 2002 - We went to all the must-see attractions in New York and accomplished our Seinfeld challenge - to eat every candy that appeared on the show (Joogyfruits proved to be the most difficult). We also found great (and affordable) restaurants and ended up favoring a bar that served a pint of beer for 2$. As the days went by, we grew accustomed to the city and felt like locals.

🍺 Back to the present. As a pretty simple guy, I looked for a simple place for an afternoon beer in New York. Four hours later, still no luck. I eventually found myself in a wine bar on 9th avenue with a happy-hour glass of wine (7$) which was, the same as my McDonald’s experience earlier that day, mediocre at best. As someone who visited New York multiple times over the years, it seems that numerous places in New York charge high prices for food and drinks, but for many of them, the price is unjustified. I found some nice and affordable places to eat, but they were scarce. My stroll around New York also exposed a vast difference between distinct areas in the city. Some of these gaps are similar to the ones I experienced in the past, but some are definitely new. It may stem from the Covid-19 pandemic or represent ongoing demographic changes. Whatever the reason may be, the city’s heart and soul are missing.

😎😎 May 2002 - After spending some time in New York, we embarked on a road trip. We went south to Florida, turned to Alabama, Mississippi (which greeted us with a Tornado), New Orleans, and then headed north to Tenessee (Elvis mansion, of course), Chicago, Detroit, Canada, Boston, and back to New York. We had one of the most incredible times of our lives, and after arriving back in New York, we felt we had returned to a magical place. A city where you have everything you want, anytime, any place. As two guys in their twenties, we loved the “always-on” experience of the city.

🏃‍♀️ Back to the present. So the city still feels “always-on”, but I’m unsure if it’s a good “always-on”. It may arise from my being in a different place in life, but the city feels intense. Too intense. Finding quiet or calm places is extremely difficult, and the sirens of FDNY 🚑 🚒 are way too loud (what purpose does it serve to hear them from 15 blocks away?). If you go to the supermarket, you can hardly find a spot to stand and examine the products. In just 10 seconds, about 20 people will go past the same shelf, almost pushing you aside to reach the ingredients. Do I want my kids to see New York? Definitely. We’ll see Times Square 🏙, catch a Broadway musical 🎶, and admire the statue of liberty🗽. But sadly, for me, it is merely a cluster of attractions. Old New York is no more.

OMFS World

👩‍🎓For the student - Some students prefer to study alone, while others find that they learn better with a study buddy. If you’re on the fence about whether or not studying with a companion is right for you, remember that a study companion can help hold you accountable to your goals, offer motivation and encouragement, and improve your knowledge retention. One thing I find extremely helpful is being a sounding board for each other’s ideas. It means that explaining concepts to one another, and getting acquainted with a different way of seeing things, will do wonders for your knowledge and scores.

🥼For the OMFS resident - There’s no point in preparing yourself for surgery by solely reading a text, and as a resident, it is easy to forget the power of a single image. An illustration of a surgical technique can teach us in a way that words often cannot. So, the next time you try to remember something important, ditch the lengthy text and use some illustrations instead. I highly recommend the Atlas of Oral and Maxillofacial Surgery by Tiwana and Kademani(2nd edition will be published soon), Surgical Approaches to the Facial Skeleton by Ellis and Zide, and, although old, Atlas Of Head & Neck Surgery by Lore & Medina. You may be surprised at how well it works.

“Forget mistakes, forget failures, forget everything, except what you’re going to do now and do it. Today is your lucky day.” - Phil Jackson, Hugh Delehanty; Eleven Rings

🩺For the non-MD medical professionals - Smoking is one of the leading causes of preventable death worldwide. Even though most smokers know that smoking is bad for their health, quitting can be difficult and often unsuccessful. Advising our patients to quit smoking and providing them with the means are essential components of EVERY VISIT to our clinic. We should remember the 5 A’s: Ask about smoking at every office visit; Assess readiness to quit; Advise patients to quit; Assist with medications and behavioral therapy; Arrange a quit date and follow up. Pharmacologic treatments include nicotine replacement therapy (NCT, such as nicotine patches), Varenicline, and Bupropion.

Stuff

📚Book I read - Die with Zero by Bill Perkins. “The business of life is the acquisition of memories. At the end, that’s all there is.” Based on this notion, Perkins believes that you should invest your money to achieve meaningful experiences, the same ones you will cherish for life. On the other hand, each hour you invest in making money is an hour you deduct from your life and an experience lost. How many life hours are you willing to put into making money, if that money will eventually not be invested in life experiences? This book brings a fresh and fascinating look and has changed the way I perceive money.

💡Gear I use - Sony WH-1000XM3 noise canceling headphones. There’s a newer version, WH-1000XM5, which I haven’t tried. If you’re looking for headphones that will help you tune out your surroundings and focus on what you’re doing, noise-cancelling headphones are the way to go. These headphones sound great, they have excellent battery life, and are relatively light-weighted. While on the bus to New York, the Sony’s tuned out all the noise, while my Apple Airpods Pro (1st generation) struggled. It’s the same while riding the subway: The Sony’s do a much better job while also maintaining higher sound quality.

Epilogue

That’s it for this issue.

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Stay tuned for next week’s newsletter - How I Study. I will also discuss my train ride back to Boston, which will occur after this issue is published.

Have a great weekend!

Shay