I can explain. (No really. Just keep reading.)

I’ve started and then just never been able to post a bunch of posts in the last year for one reason or another. I noticed that it’s been pretty much exactly one year since I’ve posted. And a year it’s been. A rough year? An interesting year? I guess I’d have to say a year, so full of terrible and good things, that I have no idea how to classify it at this point.

One year ago I found out that my Dad, my primary parent, one of my best friends and biggest supporters in life and in all things medical, had cancer. A very bad cancer. After The Diagnosis he came to live with me for awhile and sought treatment at the Big Fancy Medical Center where I’m training. Soon after The Diagnosis, I got dumped, in an email by the guy I’d been dating for 3-ish years. I was on Gyn Onc at the time. (Anyone who knows anything about an OB/Gyn residency probably knows what I mean when I add on that little tid bit. Yeah.) Oh, and my laptop broke. I was too broke to do anything about that. Aside from using the computers at work to do strictly work-type things that did not include blogging.

Since all of that happened, almost exactly a year ago, a lot more good and terrible things have happened.

My Dad died.

And it was the most terrible thing. I can’t even explain right now, how terrible and horrible it was. Watching the rapid decline, and eventually being there at the end, seeing him suffer, waste away, his pupils dilate the moment that life left his body.

It was the most terrible thing I have ever seen, and I have seen many terrible things having been in medicine for a relatively long time by now. And I won’t write about it any more, I can’t at the moment. Maybe some time when I have a little more time to collect my thoughts and write something more eloquent and appropriate.

Somehow, in the middle of the terrible, horribleness, I also met someone. For a fair amount of time, after the unceremonious email dumping, I didn’t think this was possible. To meet a ‘someone’ again. But, through the magic of many, very encouraging friends, a couple of internet dating sites, and fate (?). It happened.

And that is primarily why I say that even though it has been a terrible year, it has had some good as well. While I watched one of the loves of my life disappear in a terrible, horrible way, another swept in and has carried me through it all.

I called him my Prince the other night. And in his typical, self-effacing way, he poo-poohed it a bit. I don’t know if he knows how much I mean it. The guy might well as ride around on white horse as far I’m concerned.

Through it all, I’ve still been in residency. I was at my Dad’s funeral the day I would have been starting third year. They said a little something about it at the service, which I found embarrassing but Dad probably would’ve liked it.

Several people have commented on the Nurse to MD thing since I’ve been in silent mode, I apologize for the lack of response and promise that I will respond eventually. The middle of third year of surgical residency, after all I’ve just mentioned above, is probably really not the best time for me to objectively comment on making such a move.

So, for the moment, I’ve explained as best that I can.

I am still in residency and of course have to get up early up in the am to get back to it, but I’ve ripped of the proverbial band aid, the new laptop is ready and roaring to go, and hopefully in less than a week, and in much less than a year of good and terrible things I’ll be posting again.

In the meantime, I’ve still been taking pictures. Here are a few I managed to get in the Year of Good and Terrible……..

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A Walk in the Woods.

Last weekend I decided/resolved to roll my lazy, hiding from Life in (really, actually REALLY good) GOT books behind out of bed to go and take advantage of my last free time to take pictures before the long Reign of Scary Call Shifts begins.

I might be completely broke right now, and have already taken pictures of (most of, I’m sure I’ll find more!) the interesting things within walking distance of my apartment, but fortunately, I am also really good at finding opportunities/places to take cool pictures on the cheap.

This weekend I considered a few options, and then after a brief web search decided to take a chance on an arboretum a short drive down the interstate. Even though I’d heard how awesome the place was from a few people over the last year, I still didn’t know exactly what to expect, but was heartened by the great pics on the place’s website. I did the photog-on-a-budget (of pretty much zero) math in my head: < $10 admission fee and basically no gas costs + probably excellent opportunity for many photographs/fun afternoon of taking said photos + facing long stretch of scary calls = WTH, let’s do it.

I am glad that I did.

The arboretum was located deep in the woods that do occur at random intervals around this highly urbanized place, and basically a quiet, beautiful, tranquil, oasis of nature, infused with the lovely sounds and scents of a place essentially untouched by man and the changes and stresses we bring in inherently with all of our messing and industrializing.

I was thinking as I was walking around, enjoying the quiet nature sounds, sniffing up the tantalizing flower and woods smells, that I understood why some people I’ve heard or read about over the years would want to run off and live in the woods, off the land and all that jazz. What a peaceful, simple life that might be, full of quiet and nature’s beauty.

(I understood, but then thought about having to catch and clean a fish or catch, kill and skin some sort of varmint for food, or sleep in the poorly constructed shelter I would be capable of building, and I was personally glad to live near but not necessarily in such a place.)

As I was walking around sniffing, enjoying, and snapping pictures, I ran into another camera-toting nature lover. “Do you feel like we got here too late?” they asked me as we crossed paths.

I knew what they meant, I’d seen it too, and you can see it plainly in some of the pictures I got. The signs of summer’s retreat and the early onset of winter were everywhere. Leaves starting to fall, only a few varieties of hardier flowers left in full bloom, and produce starting to wither on the trees. It wasn’t worrying me though, and there was so much still to enjoy and appreciate, I just smiled and shrugged at my fellow photog’s comment.

Before I started to go through the pictures I’d gotten, I went through my WordPress reader and found an awesome new photography blog to add to my blogroll. I perused the blog, soaking up some tips about lighting and admiring all the beautiful pictures, and then I went back to my own. And promptly got super self-conscious about them.

Having gotten into photography by just decided that I really liked taking pictures one day, and then saving up and buying a sort-of fancy camera figuring I’d learn the rest as I went, I remembered that in addition to finding affordable photo ops, I still have a lot to learn to about taking good pictures when I find them.

But here are the ones I thought were decent enough to share.

:)

 

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Inspiration.

“Inspiration is hard to come by. You have to take it where you find it.”

- Bob Dylan

I am thinking about Inspiration today.

I don’t necessarily agree with Mr. Dylan on the first part of that quote. When I need it, when I’m looking for it, and when I’m open it to it, I find Inspiration everywhere. I posted the quote because of the second part, because Inspiration might not come in the form you expect, and you have to be able to recognize it, appreciate it, and take advantage of it when it does arise.

Like this comic by The Oatmeal:

TheBlerch

I was randomly searching for something, anything funny to cheer my brother up this week on The Oatmeal’s site (a frequent source of material for cheering my brother and myself up, as though we share basically no phenotypical qualities, we do share the deeper, genotypical (?) highly twisted sense of humor for which The Oatmeal regularly provides perfect fodder) when I came across an ad on the site for “I believe in THE BLERCH” t-shirts.

Hrmmm…..what could The Blerch be? I wondered.

Which led to me reading the comic, and BAM, the Inspiration. Which I have been looking for, for months now, to start exercising again. Not that I am some sort of Awesome Regular Exercise Type Person. But I do like to do something that at least resembles exercise on a regular basis because it makes me feel better and I get kind of (ok, more) squirrely if I don’t.

And because some jackhole stole my (actually chained up for once, tyvm) bike early this year, that has more often not than not, been in the form of jogging. (Jogging very, very slowly mind you, but still – completely objectively – faster than a walk. So will give myself enough cred to call it “jogging,” but not going to go all crazy and call it “running.” Sorry….just had to take a little break, and actually laugh at that. No, not running. Not even close.)

All of this actually (getting to the point here, promise) led to me going on said jog today. After which I finally felt much less like this guy…….

TheBlerch2

And more like this chick…….

WW

Please note, I actually, in reality, look nothing like her. But for approximately 2 minutes after that 30 minute jog today, I did kind of feel a little Wonder Woman-ish. And it was awesome. (Take that sedentary lifestyle! Pew pew! And that, scary call shifts! A Pew, pew, pew! Who likes endorphins?! I do! Pew!) Thanks Oatmeal!

Also, as I’ve said before, I’m frequently inspired by music. I have listened to this song……

Pretty much every morning the last 2+ weeks while hauling my sorry behind out of bed, and getting ready for another work-a-day, and it never fails to get me going. (I just listened to it again, Yep, still awesome.)

And lastly, I have been inspired to keep writing and posting more consistently by evidence that someone is actually reading, looking at my pictures, and would like to see more.

So, no saved uncropped version of the original Corn Dog Pic unfortunately Marcus, but maybe this one will do?

Corn Dogs Take 2. Mmmmmm.......

Corn Dogs Take 2. Mmmmmm…….

(And thanks for the Inspiration! :D)

Imagine.

I was saving up a link to share today, and as I went through the day, clinic, staying late to work on research, etc, I kept adding on to my list of more Things To Share.

So here they are:

#1.10 things you need to give up to become a doctor.

 

DocEatDoc2

 

One of my friends sent me a link to this article. Of course I don’t agree 100% with everything in the article (The creativity point, obviously. And the bit about changing the world, it might not be happening as quickly as I’d like, but it will happen. Oh, it will happen.), but they do offer some excellent food for thought.

I’ve gotten some comments and emails about getting into medicine, especially going from nurse to MD, and I see a lot of people find the blog with search terms in this vein. I’ve given some advice on technicalities of going from RN to MD, but I also (in hindsight) think it’s important for people to consider the implications that the choice to be an MD will have for their lives as well – which is a lot of the stuff in this article (especially as a non-trad when giving up the majority of your free time, sleep, financial security/money, and family time might be more difficult – because it is very true that that you will be sacrificing all of these things – especially if you are a compulsive perfectionist like moi and want to get good grades, get into the specialty of your choice, and ultimately do well taking care of real live human beings in residency/as an MD).

I would say (again, in hindsight) that the one thing I would make a concerted effort to firm up before taking the MD plunge as a non-trad, in terms of Other Life Stuff, would be the whole significant other business if you are at all interested in firming that sort of thing up, and are a hopelessly awkward-outside-of-work introvert. Because, good luck trying to do it afterwards. (Note: But if you are like most of the population, and not utterly handicapped at meeting new people who are not your patients and/or not in a specialty where you are completely surrounded at all times by people of the opposite gender from those which you like to make a significant other of, like most of the other medical peeps I’ve observed around me – Introverts = Good at observing, baaaaaad at interacting – feel free to disregard, you’ll be fine.)

I’m not posting the link to be a big, scary, downer.

I’m just saying, think about it. Hard.

Because one thing I do completely agree with in the post, is that medicine is not just a job, it’s a way life. And this quote (from Spider-Man, I know, in my defense I have never professed to be anything but a massive nerd-geek), has resonated many times over the last six-ish years:

With great power, comes great responsibility.

And then, when you decide that you want, and are ready to take on that responsibility and everything that goes along with it (the awesome, and the-not-so-awesome), go ahead, and send that app. As much as I might complain, knowing my own ridiculously single-minded and stubborn tendencies, I am 99.9% sure that I wouldn’t have done a d*mn thing differently. Not to mention, I am also completely, still makes my heart skip a beat, would (again, obviously) go through or do pretty much anything for it, in love with my job. (Not to mention, there’s no going back for me now, so it’s a pointless waste of time to wonder. And I have more important things to do like study, do research, work, sleep, complain, and keep up with this blog!)

 

 

#2. The Worse Things Get, The Harder I Fight, The Harder I Fight, The More I Love You.

 

Neko

Neko’s new album is streaming for free on NPR. And speaking of my love affair with medicine, the title says it all.

 

 

#3. #the world needs more

 

WHD

 

I said love. There can never be enough love.

When I said love, I thought of The Beatles and All You Need Is Love.

But I think this song says it better………

 

 

Imagine, be a dreamer, send that app, start or continue your own love affair, and change the world. Because even if it’s a small change, a small piece of the world, you will, and it will be worth it.

State Fair.

On a lighter note, I did take some of the free time I’ve had over the past few weekends off to go hunting for pictures.

I was driving to work one morning and heard an ad for the local county fair. I usually compulsively flip past ads to get to the good stuff on the radio, the music, but I had to stop when I heard this one.

Growing up, I loved a few things, animals, learning, the promise of the future and the adventures I’d have, and retro movies including everything Rodgers and Hammerstein. One of my favorites was State Fair, and one of my favorite things to do as a child was go to the fair, and the few times I got to participate as an exhibitor growing and showing animals for 4-H.

As I listened to the ad, it all came flooding back.

And, as luck would have it, the last days of the fair coincided with one of my weekends off. So I roused myself early and coffee, camera, and extra batteries in hand went to immerse myself in it, and the memories of fairs past, to try to capture some of it.

It was a perfect fair, with all the sights and smells I remembered and loved. I wandered only briefly, making my way quickly to my favorite parts, the exhibition barns. I went through them all, sometimes twice, snapping away. And then I wandered some more sniffing up the delicious smells of the fried foods I couldn’t afford to actually buy and eat (which is a very good thing, given my complete abandonment of any sort of exercise and subtly but undeniably expanding self at this point!), and observing the people also in attendance, also enjoying the sights and and smells of the fair, wandering, watching, snapping photos, eating, riding, and shopping.

These are the best of the pictures I got, and I have to say that while I think they do capture some parts and joys of the fair, they leave a large and important part out. Namely the people, as I regrettably continue to be too shy to snap away at random people or to ask to.

I need to work on that, but in the meantime, here is what I did get……..

Police horse.

Police horse.

 

The requisite carousel.

The requisite carousel.

 

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Prize peppers.

Prize peppers.

 

Priceless collection.

Priceless collection.

 

Instant princess.

Instant princess.

 

Beautiful bunny.

Beautiful bunny.

 

Cock of the walk.

Cock of the walk.

 

Precious piggies.

Precious piggies.

 

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Mr. Ed.

Mr. Ed.

 

Hero of the Herpetology Society.

Hero of the Herpetology Society.

 

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Monster truck.

Monster truck.

 

Corns dogs mmmm.......

Corns dogs mmmm…….

 

Sweet corn, fresh from the farm.

Sweet corn, fresh from the farm.

 

(Note: I thought of this while I was getting pictures, and now while I’m writing. I just have to add a disclaimer of sorts, with all the animal pictures that I’ve posted, that I definitely do not condone any cruelty to animals or intend to with the pictures. I love animals and wish that I could be a vegetarian because I do, and have tried several times, but sparing details, seem to physically unable to. So I personally don’t judge people either way. And, all of the animals I took pictures of were by all appearances very well cared for, and I thought an integral part of the experience I was attempting to capture. Just saying!)

The Waiting.

This was my Perfect Song on Friday morning………

 

 

I sent it to one of my best friends, a fellow Vedder lover, also stuck in the middle of one of life’s unavoidable, at times almost unbearable, holding patterns.

I feel like I shouldn’t have anything to complain about right now. I’m on the last of three weekends off, basically unheard of, but most likely due to the hellacious call schedule I’ve got looming over the next two months.

I am absolutely dreading/terrified of it, it’s been building over all these weekends off, just waiting for it to start.

Mostly I am terrified of the 24 hour, Big Girl call shifts we start taking second year at the Mothership.

Last year it was all 12 hour shifts on L&D. Really, no big deal, and after I’d done a few, mostly just fun. But this year, my remaining (we are down one resident, hence all the extra call I’ll be taking over the next few months) 20-something, Energizer Bunny-esque, classmates have decided to switch even L&D calls to 24 hours.

I have no idea how my body and brain are going to take it, but I’m thinking, it is not going to be good. When I mentioned this to one of my cohorts last week, they replied that I am definitely in the wrong specialty if I don’t want to be taking 24 hour calls, as many of our attendings do all the time. Which stung, until I remembered and replied with, well that’s why (at least one of the reasons why) I want to be a hospitalist on L&D (with the much more humane 10-12 hour shifts that will entail).

 

OhSnap

 

Career aspirations aside, I still have all those imminent 24 hour calls to deal with as long as I’m in residency here. I say that because I really am so freaked out about being able to do them. Like I said, especially at the Mothership, where I’ve had mostly horrible experiences so far. I’m pretty sure (/very hopeful) that they won’t actually, literally, kill me, but I am still extremely concerned about my ability to metaphorically survive them (and, therefore residency here), while maintaining competency, and a modicum of sanity.

Today I coped with all the dread by burying myself in bed, the (really, thankfully) meager food supplies I had on hand, and book two of the Game of Thrones series (which, btw, is also thankfully freaking amazeballs). Until my temporary roomie (it’s a long story) came home from her own over night call shift at the Mothership and (unintentionally, but again thankfully) shamed me out of my gluttonous, dread cocoon.

Mostly to go buy the third book of the series, but as long as I was up and briefly disengaged from the battles of Westeros (Okay, the girl at the book store who checked me out just named her new dog Drogo, I’m not that bad. Erm. Yet.), I also cleaned my apartment and did laundry.

And now I’m blogging. Seems a more productive step in coping with the dread than just going back to bed, reading, and dreading. And cheaper than therapy (as if I would actually be able to make it to an appointment).

And as I’m blogging about it, as I told a friend recently, I can’t help but think of all the tests and trials (sometimes seemingly insurmountable) I’ve made it through to get this far. I just seem to keep making it, and hopefully, I’ll make it through this too.

Until then, I’m waiting.

 

 

 

Adventures in International Medicine

I got back from South America over a month ago. A tad bedraggled and worn out after 48-ish hours straight in airports across the Americas, with a suitcase stuffed full of smelly laundry and two SD cards stuffed full of memories, I went to bed as soon as I got home late that night, and went back to work on L&D early the next morning.

And that’s pretty much where I’ve been since. (Not that I’m complaining! Now that I’ve finished my first rotation of PGY-2 on L&D, as I may have alluded to, I can’t wait to go back.)

But, after my first day on the out-patient Gyn (vacation) rotation (after a completely overblown, irrational, and ridiculous bout of nervousness that kept me up most of the night before – I have no idea), I have remembered, ‘Oh, Yeah, wait a minute, I actually do like Gynie too!!’ (Whew!!!!)

Not to mention, the hours on this rotation are going to give me a little more time to catch up on things like all that smelly laundry, sleep, studying, research, and blogging. First on my agenda, of course, has been writing a bit about the Great South American Medical Mission Adventure. (I can always wash and/or burn that smelly laundry later. Hah.)

I wish I would have written about it sooner. I did try to write a bit to friends and family when I was there, but now trying to blog about it retrospectively, it seems like it was a million years and miles ago, like a dream almost.

A couple of things did stick out in my memory as I went through and picked some pictures to post. How beautiful the country was, how much I enjoyed and appreciated the warmth and friendliness of the people, and how much (much like when I left L&D the other night) I wanted to immediately start planning my next trip as soon I’d set foot on U.S. soil again (and still do!).

I think that growing up constantly on the move, with little money and few possessions, and a complete imperviousness to motion sickness (which comes in very handy while careening around switchbacks up remote mountain passes at high speeds in rickety vehicles, much too busy frantically snapping away at scenery to notice sheer drop offs) has made me highly adaptable (MacGyver came to mind more than once, especially during a particular incident when attempting to ask for a socket wrench in broken Spanish – to fix equipment, not a patient FYI), well-suited, and very happy to work in foreign places with limited resources. (But I did have to draw the line at doing pap smears with splintery Popsicle sticks at one point – just, no – and insist on being driven to a nearby clinic get proper supplies. Which still consisted of 1960’s era spatulas, microscope slides, and a can of Aquanet for fixative. The combination of which actually worked quite well tyvm.)

I think if I could spend the rest of my life alternating between Medical Mission Adventures and L&D, I would be a very happy Nurse, MD.

But the trip wasn’t all perfect, happy adventurousness.

I am still, and probably always will be, haunted by the ones I couldn’t help. And by some of the well-intentioned but completely half-@ssed interventions of the group I went with that I couldn’t avoid being pulled into. (It still burns, and I’m just going to say – there is a right way, and a wrong way, to do international medicine – and giving people expensive medical equipment when they have no infrastructure or training to actually be able to use it, is the wrong way.)

As for the people I couldn’t help, there was the elderly lady in a remote mountain village with stage 4 cervical cancer, no means to access care, and nothing to be done for her even if she could. The other elderly lady (I have no idea how old they actually were, and neither do they as they were born before any sort of record keeping was in place, most just said they were 100) who limped into one of our mobile mountain clinics at the end of the day. I held up the bus to see her. Initially all I saw was the giant shiner around her left eye, and I thought, Nah, there’s no way. Then I saw the wounds on her hands and arms bound with dirty paper and some kind of poultice. I gently unwrapped, cleaned and re-bandaged them with some bottled water, antibiotic ointment, and gauze. As I did this she told me (through her granddaughter who translated from the native mountain dialect into Spanish) how her father had beaten her when she was growing up and how her husband does now. I was busy bandaging (and mentally picturing finding said husband then breaking him over my knee like twig) when she grabbed me around the neck, kissed me on both cheeks, and thanked me for being so kind. I can still see her in my mind’s eye, sitting on a mound of dirt, surrounded by sheep, looking forlorn and giving a little wave as the bus drove away.

Or, there was the middle-aged lady who presented with symptoms that she thought meant menopause, but turned out to be early pregnancy instead. She burst into tears when I told her, distraught at the thought of supporting another child when she was barely managing to support the five she already had. The med student I was working with, so earnestly, turned and asked me if we should counsel her about “options.” “What options? She doesn’t have any,” I replied, reminding them that abortion is illegal in that particular country. All I could do was give her some Kleenex, a script for some vitamins, a little hug of reassurance, and encouragement to seek prenatal care.

But I also remember that there were so many I could help. I probably did 200 or so pap smears for women that otherwise would not have had screening, who will be able to follow up and be treated if necessary, and will (hopefully) never get to a stage 4. And I did countless prenatal ultrasounds, educating local providers as I did them, finding a case of cleft palate – the patient was subsequently transferred to deliver in a place with a pediatrician on hand to help with any difficulties that might arise.

And I know that there is so much that can be done. Programs that can be implemented, as in not just dropping off, but also training providers to use equipment and do preventative and life-saving procedures.

While I absolutely love and appreciate the adventure and opportunity to see and explore a new place and culture, seeing the prospects and opportunities to help women medically in a real, meaningful and lasting way – along with the memory of those patients, the ones I couldn’t help, and the ones I hopefully did – is what makes me anxious to go back, and to go elsewhere.

All of that being said, I had better get back to the business of catching up with everything else besides blogging.

Out of respect for patients and their privacy (no matter where I am), I refuse to take pictures of patients or pictures of the clinics with patients in them, but I will let a sample of the pictures that I did get tell the rest of, or their own story…………

 

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