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.



































































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.




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.




Mr. Ed.

Mr. Ed.


Hero of the Herpetology Society.

Hero of the Herpetology Society.








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!)

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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The Definition of Insanity, Or, The Daily Something…..

“Insanity: doing the same thing over and over again and expecting different results.”

~ Albert Einstein

I think of this quote a lot.

Which, probably sounds kind of bad. So, let me (try to) explain – I think of it when I’m frustrated or not getting results that I want, which happens a lot. Hence, the quote, popping up like a warning light on my mental dashboard (except that I actually have some idea as to what this particular symbol means, versus the scary, flashy, light bulb-y looking thing I have been trying to ignore for the past two days on my automobile’s dashboard).

In this particular instance of frustration, I have been trying unsuccessfully to write and actually publish a post for weeks now. And when I thought of the quote today, I realized that it is time to change tactics. (This realization being accompanied by the always comforting secondary realization that I am probably not technically insane yet. At least, not according to Einstein.)

So here’s my New Tactic: Instead of setting out to write and publish some fantastical, deeply meaningful, thoroughly comprehensive Masterpiece Of A Post that covers and compensates for the months of absolutely nothing (that will apparently never, ever happen), I will just try to write a Daily Something.

I know, and now you’re like ‘Um yeah. A Daily ‘Something’ sure sounds like a thing I would like spend 3 minutes of my precious, fleeting life reading. Or not.’ But hold on now, I do solemnly promise that I will I only distill it down to the most interesting, entertaining, funny, important, etc. of Something’s. Because I do believe my life is full of them, if I’d only get around to sharing. And certainly Something will be better than nothing.

Onto the first [Of Many!! She confidently (mentally) exclaimed.] Daily Something………

As I left work today I realized something. (Yes. Yes I do just walk around all day realizing stuff. Tyvm.) Lately, I have been feeling like crap. As in, What in the h*ll am I doing here, stressing myself to death in residency when life is too short to feel like crap all the time? I want to go home and be a dog groomer. Or anything but a resident. I wish I had never gone back to medical school and/or could go back in time and Ninja chop myself as I’m about to submit that d*mn application. (I recently stumbled on an article in a respected medical journal from 2008 that said something like 40% of medical residents regret going to medical school, which makes me feel, if not better about, then slightly less alone in that last bit.)

I mean, for pete’s sake, I think I actually have an ulcer. That, admittedly, may be due to my habits of drinking coffee and Diet Coke like water (instead of actual water, which I never, ever drink), and several glasses of red wine per week. But I’m mostly blaming work-related stress, because that, and just the thought of Work, is mostly what wakes up and seriously p*sses off the angry badger that has been clawing at my epigastric area for the last five days. At least that’s my story until I get to see a doctor in about a (friggin’) week. (Because same day appointments apparently do not exist in this place filled with 50 gazillion doctors, if you are a resident, and you refuse to use the ER – i.e. Pit of Doom – unless you are half-dead. Oh. The irony.)

I am also on Gyn Onc right now. The rotation I have been dreading all year, because it is Oncology and I already feel bad for all the poor cancer patients, and it is by all accounts a work hours wrecking, intern scut horror show. And stuff like this little gem I just found in my pocket reference:

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Do not help in my attempts to approach the rotation in a rational, non-panicked manner. Very funny Dennis Siegler. Very. Funny.

Luckily, they are starting me out slowly on out-patient, but the badger was still angry and clawing away when I walked in today. Armed with a bottle of Tums and coffee cup (sadly) full of milk, I went anyway.

And then time went by very quickly. I saw several very nice patients, worked with a couple completely reasonable attendings and several very sassy nurses, and the day was over.

I left, and as I walked away, I realized the badger was quiet. My stomach didn’t hurt, and I was thinking about the nice patients I saw, talking with them, helping them, and I was….happy????

It’s maybe the hundredth? thousandth? time I’ve had that realization. Here’s to hoping for a hundred, thousand times more. At least enough to get me through the next three years.


And, here’s a picture. Because along with the Something’s, I’ve been saving those up too.


Easter Cookie. Yumsies.

Easter Cookie. Yumsies.

Improvising and Inspiring

I am currently in the middle of an ungodly long stretch of work days. I made the call schedule this year and one of the interns ended up with more weekends on than anyone else, and being the one who made the schedule, if anyone was going to end up with a disproportionate number of weekends, it was going to be me. Hence the current ungodly-long stretch.

Its fine actually. It means I get more time on L&D, and I knew it was coming, so I took a vacation day today, right in the middle of it, so I wouldn’t be triggering any GME investigations. Unfortunately, after my last crazy-busy week, most of my Big Day Off today consisted of me laying in bed until 5 pm eating, spooning with my cat, and finishing Gone Girl.

This kind of day off might be perfectly acceptable, warranted (and probably healthy) for most people, but I hate it. There is SO much I could be doing. Of course there is the residency-related stuff like the 10 Tons of Reading I Should Be Doing In Any Spare Second and learning an entire second language before June and getting cracking on The Research Projects, and then there is blogging and taking pictures – the two main pursuits I want to be pursuing when I’m not buried in residency-related stuff.

By the time I managed to make myself crawl out of bed, it was dark outside and I could hear the wind howling. Crap. The opposite of ideal conditions for any kind of easy, outdoor photo expeditions. And any easy, indoor expeditions I could think of require money. And enough ambition to shower, dress in something other than fuzzy, pajama-type clothing, and drive somewhere. Of which I currently have neither.

So I decided to improvise.

I recently downloaded Instagram. I really like it, because as I have mentioned previously, I see pictures everywhere, and 99% of the time I don’t have my camera with me. I usually like the quality of the pictures that I get with Instagram, and I really like the editing tools. Normally, with my real camera, I only use the editing available with the basic Windows Photo Gallery, so it’s fun to do something beyond that.

Hence, I decided to use my new toy combined with whatever I could find readily available in my apartment.

I started making note cards with some of my favorite quotes last summer when I moved away from home and one of my best friends was having a seriously difficult life situation. I couldn’t be there for her in person anymore, but I could send her love, inspiration, and (hopefully) hope in the form of these little, painstakingly written and decorated cards. I ended up making hundreds of them, and inspiring myself in the process. And at Christmas time, I sent them to all my nearest and dearest in their cards as gifts, which seemed to go over very well (of course they all know I’m basically destitute and working on the thought that counts principle at this point, there is a reason they are my nearest and dearest).

So today I decided to play with combining my new (free) toy with my two primary non-residency related pursuits. When I downloaded the pictures, honestly the results were not up to my usual pictures with a sort-of-fancy-camera standards, but here is what I got that I thought was good enough to post.

Let the inspiration begin!






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