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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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.




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’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




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.

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).




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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I want more.

I love art, and one of my very favorite mediums is music.

Of course I can’t carry a tune with a five gallon bucket, and I’ve always been too impatient to learn to play any musical instrument with any sort of skill. But I love searching for and finding, or just by chance hearing that Perfect Song that pumps me up, makes me laugh, soothes, or expresses exactly how I’m feeling at the perfect moment. (I was lucky enough to discover The Black Keys during Gyn Onc last year – Yes, yes I have been living under a giant media-deprived rock – irregardless, fairly certain that was the essential factor in surviving until the next rotation.)

My brother and I have developed a habit of exchanging mix CDs of these Perfect Songs we find since I started med school. We send them to each other as gifts for birthdays, Christmas, and at random intervals just because we’ve accumulated enough of them or one of us really needs a new infusion. I’m not exactly sure how he feels about them, but not being a big accumulator of ‘stuff” myself, they are some of the most useful, meaningful, very best, and really my favorite of gifts to receive. (I’ll never forget my study buddy’s horror second year when he introduced me to the Drive By Truckers with “Nine Bullets” and “Gravity’s Gone”. I was busy falling in love with a new band at the time, but it still managed to register. Hah.)

So, my contribution to the Intern Welcome Basket this year was a mix CD. Initially I asked for input from friends for songs for the Perfect OB/GYN mix CD, needless to say the majority of the suggestions were not fit for general public consumption, but did give me a good idea of what the general population thinks of our specialty (and let me just say: #1. Yikes!! and #2. Really guys???!!). Luckily I have headphones or the radio on most of the time when I’m on my way into or out of work so I heard a lot of those Perfect (and not necessarily X-rated) Songs over the course of intern year and I ended up compiling a list of songs I thought embodied the ups, downs, and in-betweens of OB/GYN intern year.

I made a bunch of copies for the interns and one for myself, and listened to it constantly until a couple of weeks ago when in a fit of 5 am, sleep deprived, pre-coffee frustration/irrationality I tried to fix my car’s CD player by cramming two CD’s in to try and make the mix play. (Yes, yes I realized then, and still do, what a terrible idea this was, and have to reassure that I am a much better MD than user/fixer of technological equipmentry. Much better. I swear.)

That being said, here’s the mix:

  1. First Day of My Life – Bright Eyes
  2. Portions For Foxes – Rilo Kiley
  3. Help I’m Alive – Metric
  4. Blackout – Breathe Carolina
  5. Land Down Under – Men At Work
  6. Let’s Talk About Sex – Salt-n-Pepa
  7. Push It – Salt-n-Pepa
  8. I Wanna Be Sedated – Ramones
  9. Over My Head – The Fray
  10. I Need A Dollar – Aloe Blacc
  11. Breathe – Anna Nalick
  12. Paradise – Coldplay
  13. Some Nights – Fun
  14. Everybody Hurts – R.E.M.
  15. Hold On – Alabama Shakes
  16. Keep Your Head Up – Andy Grammer
  17. Do It Anyway – Ben Folds Five
  18. My Body – Young The Giant
  19. Girls Just Want To Have Fun – Cyndi Lauper
  20. I Love It – Icona Pop

I haven’t heard any the of interns’ reactions to the CD, or if they even actually got their copy as I was in the middle of my South American Medical Mission Adventure when they were supposed to have received it, but I really miss being able to play that CD. There is a Perfect Song for everything I am needing or feeling on my way into or leaving work if I can’t find it on the radio.

I just finished my first rotation of second year on L&D and the song I most listened to on my way home, and most wanted to hear before I completely ruined my CD player was #18. The lyrics of the chorus played through my head most nights as I walked out and drove home after the ruination anyway, “My body tells me no oh, but I won’t quit, ’cause I want more….’Cause I want more!”

It was, hands-down, the best rotation of residency so far.

I was exhausted most days, after 12 to 15-ish hours of non-stop L&D action – high-risk, high-volume, 5000 deliveries per year, one resident on at any given time and responsible for pretty much everything action – and I loved every minute of it.

I think, I have found my calling, and I absolutely loathe leaving it, even for an out-patient “vacation” rotation (followed by another Gyn Onc rotation, the very contemplation of which makes me nauseated even though, rationally and logically, I know The Worst Rotation Ever was primarily due to the The Most Giant A-Hole Chief Ever, so I’m going to not think about it until approximately 5 seconds before it actually starts).

Until I am happily running up and down your hallowed halls again L&D………..

The Daily Something: Concentration.

I developed a habit over the course of intern year of randomly texting people lolcats in spare seconds of stress, during inordinately boring meetings or lectures, and/or frankly, whenever the mood strikes.

(I have no idea, it just makes me happee. And luckily I haven’t been permanently blocked from any major calling plans for harassment. Yet.)

I was searching for the perfect lolcat to represent the fickle moods and feedback style of a certain, well-known and well-intentioned, though highly labile staffer last night to send to a fellow resident I was sure could commiserate, (i.e. got my you-know-what-chewed with a full and rapt audience of ancillary staff, once again, for L&D circumstances I am as likely to be able to control and predict as well as the next jackpot Powerball digits, and felt compelled to cope with a little lolcat humor) and in the process found this guy:




Thought #1: “Dang! Hope I don’t look that when I’m delivering somebody’s baby. How scary would it be to be all pushing your brains out and look up to see that?!?”

Thought #2: “Oh wait. I’m wearing a mask. Probably a good thing.”

Thought #3: “I think, I should probably go to bed now.”

Thought #4: However much I might be enjoying this 12-day stretch of L&D insanity/awesomeness, part of me hopes whoever thought up medical residencies and 12-day stretches is reading this post.

The Daily Something: Gratitude.

I’m currently experiencing a spontaneous burst of gratitude. Probably, mostly, some kind of fatigue-induced euphoric state, but nice nonetheless.

I got back from my South American Medical Mission Adventure on Monday night this week and started my first rotation (and a 12 day stretch of 12-ish hour days) of second year at 0630 Tuesday morning. So, I’m a whole five days in to second year, and I’m realizing that even though I have a long (LONG) ways to go, how far I’ve already come. I keep thinking back to last year on this same rotation, when I did it at the beginning of the year, and I can’t help but realize how much more I know and how much faster, efficient and proficient I’ve gotten in the relatively short interim. And I am grateful. I am grateful for some evidence (for my ever highly skeptical and self-criticizing self) of improvement. Everybody keeps telling me that it gets easier, I’m going to make it, yadda, yadda, yadda, but tonight, I think I might actually believe them for the first time. At least a little bit.

And I’m grateful for other things as well.

For the excellent training I received at my little rural medical school, that most have no idea exists and some would probably scoff at because they have no idea how much hands on, practical experience I got with no other med students, residents, or fellows to jump in and do all the things I got to do (i.e. approximately three times more OR time first-assisting in my 3rd year of med school than my intern year). Which probably made last year go approximately ten times easier for me than if I had trained elsewhere. There is definitely something to be said for little, rural, no-name medical schools Tyvm.

And for having been a nurse before going to medical school. Which also probably made last year go exponentially easier for me, and still thankfully lets me establish a usually hard-won (and deservingly so) rapport and easy friendships with all the floor nurses and some of the patients I spend most of my time with these days.

And lastly, in addition to all those nurse buddies, I am grateful for all the great attendings I’m lucky enough to work with. I chose to come to this residency in particular based on my interactions with the attendings I met during my interview, and their down-to-earth, very straightforward, yet friendly, approachable, and enthusiastic personalities despite all the accolades and appointments (which I invariably find out about after meeting them and hopefully not completely disgracing myself) at one of the best hospital systems in the world. I am grateful that my initial impressions and instincts didn’t fail me, and that at least 97% percent of the time I am working with the best teachers, and best people, I could possibly hope for.

Especially on this rotation. Which also may be (and is probably) at least partially at fault for inducing all the gratitude euphoria as well, because it’s L&D, my own personal, very favorite of work place happy places.

Once again I wish I could stay on this rotation for the rest of residency, of course, with a few more International Medical Mission Adventures thrown in as my other most favorite of work-place happy places, wherever they may take me. I will be posting soon about my latest, but until I get through the current stretch and get some sleep, here’s a little a picture preview of the latest to kick things off………