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an online version of the magazine Winter 2007
Learning Curve

Snow in September

By Daniel Munoz, M.D. '04

illustration of a doctor

AS A RESIDENT, you quickly come to value being away from work. After three years, I can confidently report that how I spend time “on the outside” has an unambiguous impact on time “on the inside”; on my training, on my happiness, and ultimately on my ability to be an effective physician.

Residency is such that “outside time” can easily be defined by the mundane: the haircut, the house chores, the oil change, the dry cleaning, the bill paying … and when I really feel ambitious … the jog.

One of my proudest accomplishments came at the age of 9. Unsatisfied with the narrow window of time between school and dinner for playing with my neighborhood pals, I quietly gathered allowance for six weeks, enacting strict measures of financial discipline: no baseball cards, no gum, no ice cream. Finally, with enough amassed, I hopped on my dirt bike and pedaled my way to Vince’s hardware store on York Road. A few hours and $21.31 later, I gazed triumphantly out my second story bedroom window. As the sun disappeared, my basketball hoop stood perfectly illuminated by two strategically positioned floodlights, with extension cords snaking into the house. Playtime had just been extended by two hours. Thus began what has become a minor obsession of mine over the years: creating “outside time” when there otherwise might not be.


SOUTHWEST AIRLINES FLIGHT #2801 usually touches down in Manchester, New Hampshire, around 5:30 p.m. It’s an hourlong flight up the coast from BWI, with great views of the Philadelphia and New York City skylines on a clear day. During my years of residency, I’ve made this trip four times. It has become, by far, my favorite way to spend a full day off.

Mount Washington, the tallest peak in New England at 6,288 feet, offers stunningly beautiful terrain, from dense forest to bare rock to springwater streams. And it is home to the world’s worst weather. On April 12, 1934, scientists recorded a wind gust of 231 mph at the summit, the highest ever observed on the Earth’s surface. While the distinction of “worst” may be up for debate, what is well-established is the climate’s variability, evolving from hour to hour, and from vertical meter to meter.

These dimensions combine to guarantee a magnificent but demanding hike on any day of the year. And a perfect one for a medical resident looking to exchange the challenge of tackling a 30-hour shift with the challenge of assaulting this peak both aggressively and responsibly. I have been forced to abort the climb once. One early spring day in 2006, gale force winds and rain eliminated visibility, making further ascent prohibitively dangerous.

This past September, I was joined by Patrick, a friend and former Hopkins resident who now spends his 80 work hours a week as a pulmonary and critical care fellow at Harvard.

We began at sunrise, hoping to reach the summit and start our descent before an afternoon that promised strong winds and wintry precipitation. A steady rain greeted our entrance to the main trail. Dense clouds wrapped themselves around the mountain, frustrating any desire we had to see the peak from afar.

Part of the hike is like the hospital, with one difference. I am more a patient than a doctor, vulnerable to Mother Nature’s decisions and plans for the day. Weaving through brush, over streams, and into the clouds, I constantly process data (Where does my hand go next, where are my feet, am I warm enough, am I dry, am I hydrating enough?). It is a role swap I have come to find oddly restful.

The higher Patrick and I climbed, the more clothing layers we added, the shorter the trees, and the stronger the winds. Rain turned to sleet. Once we got above the tree line, sleet turned to a driving September snow.

It was perfect. Brushing snow off my jacket, I felt peacefully distant from the hospital. Just 18 hours earlier, I had pulled out of the Orleans Street garage on an 85 degree day to the noise of cement trucks and city traffic. Now, all that was audible was snow pattering against mountain rock and the front of my face. Tasted pretty good, too.

Around 11:30 a.m., we reached the top. We sat in a makeshift shelter enjoying a celebratory meal of crackers, cheese, Gatorade, and beef jerky. I felt entirely satisfied. With full workdays both behind me and ahead, this unquestionably qualified as “outside time.”


THAT NIGHT, MY EYES opened as the wing flaps deployed and Southwest Airlines flight #2038 pierced through the cloud line at around 5,000 feet. Out the right side of the aircraft were the downtown Baltimore skyline and a couple miles to its east, the well-lit silhouette of Johns Hopkins.

There would be one final stop before heading back to my Federal Hill home. It was after 10 p.m. by the time I made the short drive to my parents’ house. I let myself in the back door and found them reading in bed. After reporting on the day’s events, namely on how the snow tasted, I walked down the hallway to my old bedroom. From the bottom drawer of my closet dresser, I removed two floodlights and the extension cord I’d bought from Vince two decades ago.

Though my memory of the hour I spent in the driveway that night may be fuzzy, I don’t think I missed a shot.


Daniel Munoz is a third-year resident in the Department of Medicine.

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 Like Something From Nothing
 Managing the Menagerie
 Circling the Dome
 Medical Rounds
 Annals of Hopkins
Class Notes
 Where Are They Now?
 Learning Curve
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