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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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 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………

 

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Sights & The City

Well I finally took the leap, and I made it to the Big City. I had a whole day to unpack and get somewhat familiarized and settled before I started orientation, which hasn’t left much time for blogging or taking pictures.

I did get a long walk in tonight though, and I have to say, for as nervous and woeful as I was to leave home and cherished friends, I LOVE the city so far! Apart from one accidental foray into an, er, rougher part of town, the Big City has been a wonderland of charming, historic, and distinct neighborhoods. Especially my neighborhood! I wandered my little district tonight while the sun set peering in the windows of whimsical shops, watching people gather at sidewalk cafes and bistros, listening to the music and basking in the savory aromas wafting from the various eateries.

Just….so lovely.

Not to mention, I’ve reconnected with long-lost family members in the area, and I even found a few completely heretofore unknown relatives living within a few miles. Hooray! I am not all alone in the Big City!

As opposed to the past many years of upheaval, constant moves, and school work, I feel strongly compelled to feather my cozy, eccentric, old hard wood floored, little nest here and make it a home. Just as I feel the urge to get out and document this city with my camera. There is so much to see here, so many photo-worthy sights, hopefully four years will be enough time to (at least somewhat) do them justice………

 

 

 

 

 

 

 

 

 

 

Oh yes! And orientation is going well too so far, aside from a few of the usual clerical snafus. It is definitely a brave new world of towering, teeming, tertiary medical facilities versus all the relatively small (to comparatively miniscule) rural clinics and hospitals I’ve worked and trained in previously. I am choosing to see it as…… an Adventure.

So, here’s to Adventure!!

🙂

What road trips are made of……..

I did manage to get a few pictures on the road over the weekend. We were on a pretty tight schedule getting to The Big City and back, but I did have to insist on stopping at a couple places.

I got this picture at a friend’s place. It was my first view of their digs and it made quite an impression to say the least. This person has a real knack for finding elderly landlords with mansions who like to rent rooms to residents for a song. Not bad buddy, not bad.

The rest of the pictures were taken on a pit stop on the way back. Tight schedule or no, we were on a road trip dangit, and I wasn’t going to miss the chance to get pictures of these bridges (yes, they are the bridges). I saw the sign for them on the way out, there they were right off the interstate on our way. Score! Stuff, and pit stops like these are what road trips are made of!

The Writer, bless their road weary, butt sore self, tolerated me stopping, but grew a tad impatient when I promptly got us lost and wasted an hour driving up and down gravel roads that didn’t even show up on my GPS. Hence, I only got pictures of two of the bridges. So I took full advantage of the opportunity and got shots using all different angles and filters on my camera. My time may have been limited, but I love the creative challenge of getting a good picture, and how you can use your camera to make a single scene look very different using different techniques.

Good times!

 

 

 

 

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Roads less travelled…….

I had a couple days off last week, and in the spirit of cramming every spare second before intern orientation starts with meaningful activity (and not being bored), I decided to take an impromptu road trip to see two of my besties one last time before I leave.

I also took my camera (naturally), and for the first time I did everything I could to stay off the interstate while traversing the (pretty much the entire) state. Turns out, The Adjacent State is really quite beautiful once you get off the interstate.

Who knew??

For the first time I was completely entranced with my surroundings instead of numbly following the dotted lines to my destination with only a succession books on CD to ease the boredom. (Though I did listen to a little of Amy Sedaris’ I Like You: Hospitality Under The Influence. Note: The only way I would ever be interested in an instructional book about ‘hospitality’ or ‘cooking’ is if it is written by a Sedaris. Hilar.)

Though I enjoyed my trip very much, even the misguided (literally) attempts at ignoring my GPS in favor of navigating from an 11 year old U.S. Atlas (Look at me! Eat your hearts out Lewis & Clark! Wait. Where the h*ll am I???), I can’t help but feel bad that any outsider who drives through The Adjacent State, stuck in interstate ruts, must think it is The Ugliest Place On Earth. But, as I theorized with one small town gas pump jockey (Yes, apparently there are still places that offer full service and pump before you pay. I know, what!?), I guess that means more for The Adjacent Staters. Or as the jockey said, “It keeps the riff raff out, dontcha know.”

Anyway, here’s just a little bit of what they’re (I’d been) missing……

 

 

 

 

 

Note: I am not a particularly religious person, but I seem to be (obviously) kind of obsessed with country churches. I can’t help it. When you’re driving for miles in the middle of nowhere and all of the sudden, out of nowhere, a gorgeous, perfectly preserved, early 19th century church just pops up in front of you, (often with an accompanying centuries-old graveyard and/or school house) reeking of history and incongruous architectural majesty, a person is pretty much obligated to take notice. (Right, well I am anyway.)

 

 

 

 

 

 

 

 

 

Note: The above angels were captured in a (very) rural country cemetery. When I told Nurse NICU this, she thought it was morbid. I just thought they were beautiful. *Shrugs*

 

 

 

Below are critters from a country garden. Once again, I love how wielding a (sort of) fancy camera makes you look at things differently. Not long ago, in my pre-(sort of) fancy camera days I would have passed this little garden by without a second thought. Now, I see possibilities. Magically, everywhere……

 

 

 

 

In addition to country churches, I kept noticing little town halls every so many miles along the rural highways, randomly appearing on corners of deserted sections. I’ve never seen these little buildings with such profusion and regularity in my own state and I’m assuming it must be an Adjacent State Thing. (Every state around here has a ‘thing.’ *More Shrugs*)

Anyway, after I’d passed at least a dozen of them, I realized I probably should have been stopping to take pictures so I could do a series or something. Because they were all different and unique, some brick, some white clapboard, some with bells attesting to their former uses as town hall/country school, all interesting and charming in their own way.

I had to share a few that I did get. The first one in particular caught my eye as the outhouses are still prominently preserved, attached, and (I’m guessing?) still in use (at the back of the building there). But you have to bring your own JC Penny catalog. Love it.

 

 

 

 

This week I am on a mini-Indie Rock tour of the Middle States, versus the big festival I had been planning on attending, having done the grown-up thing and relinquished the big festival tickets (with the big festival price) in the name of fiscal responsibility (i.e. Moving Funds. So I don’t have to resort to hitch hiking to residency. Not going to say I didn’t consider it. I really wanted to go to that festival.)

Bygones.

So far, the mini-tour is Totally Awesome.

Cats + Slammin’ Indie Gurl Rock? How could I not love Best Coast??