Beauty and the Beholder……

Everything has beauty. Not everyone sees it.

– Confucius

Somehow I ended up with another weekend off this month, and I feel like I need to get away. To somewhere far enough away from the Big City that I feel like I’m actually getting away, but close enough that I can be back on the floor by 0600 Monday morning. So I’ve been asking around for ideas on places I can check out in area.

When I asked my brother where he thought I could go, he nixed one of my ideas, then changed his mind and said something like, “Wait. Yeah go there, it’s kind of an ugly, gritty place, but you like those places.”

Eh??

I urged him to, uh, clarify and he said I seem to like places others might see as ugly and gritty. Apparently because I whenever I do have time off, I’m usually happiest spending that time taking pictures in such places.

Witness how I spent my last weekend off…….

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I had no idea I like ugly, gritty places in particular. I always thought I liked all kinds of places, and I find beautiful things (at least to me I suppose) wherever I’m at. Especially when I’ve got my camera in hand. I always assumed other people saw, and appreciated those things too.

Apparently not.

Whatever. I’m going to keep seeing beauty wherever I go, share whatever I manage to capture here, and maybe, you will see the beauty too.

Getting real……….

I have been a bad blogger. Sorry peeps. I blame Residency.

Because after three weeks, the honeymoon is over, and it’s getting real.

At this point I get up between 5 and 6:30 am to get to clinic or didactics, I’m in clinic until about 6 pm every day (I’m starting on a cush rotation with these hours, trust me, I am well aware of this), I get home and maybe take a little walk, and then get to studying. I’m mostly studying surgery and suturing skills (after getting my @ss handed to me in the Sim. Lab), or however many learning issues or articles/chapters I can get through (after getting a huge pile of them handed to me on any given day). And somewhere in there, I find time to record my patient encounters and work hours, check my work email, call my continuity patients or a non-work-related family member/friend, water my (one surviving) patio plant, feed Miss Kitty, and make sure I have clean underwear for the next day (don’t worry, thus far, I have made this one a priority).

And, I have to admit, occasionally I sneak a social outing in there. And then I spend the next three days compensating by adding to my rapidly accumulating slept dept. I get it now. Med School = $ Debt. Residency = Sleep Debt. I always wondered how every physician I have ever known is capable of sleeping instantaneously, anywhere, anytime. And I get the benefit of the Magical Work Hour Restrictions. How they got through without them? I cannot even f*@%ing imagine. Whatever, the social outings I do get to, mostly hanging out in some crazy fun/cool new place in The Big City with other (I am finding to my delight, also crazy fun/cool) OB/GYN residents here. Totally worth it.

Especially after my first night on L&D call (i.e. where after clinic all week, I spend my weekends). OMFG. This went beyond your run-of-the-mill, good old fashioned @ss handing folks. By now I’ve tucked most of that night safely away in the part of my brain that will probably give me PTSD some day. I don’t even know how to explain it. It was like 16 straight hours in a speeding bus with no brakes, full of pregnant women. Where I was simultaneously expected to steer the bus, fix the brakes, deliver the babies, and make sure I documented it all in a timely and most through fashion. I peed once and ate some stale birthday cake with my bare hands when my attending wasn’t looking at about 4 am.

Honestly, I walked away from that night, and from every day so far thinking “Meh. Overall, that was pretty good.” Because when I walk away, the good, the wonderful, the f@#$ing amazing things are all I can think about. Like delivering my first baby in residency, being there when a med student sees their first delivery period, working with med students period (I suspected I would like teaching peers, nope, I frickin’ LOVE it), telling adorably enthusiastic parents-to-be the sex of their baby, getting my first official page “Hello, this is Nurse, MD….” (!!!!!!), practicing (playing) with my home laparoscopy kit, any time I have the right answer for anything, nailing an abdominal circumference or BPD, reassuring and educating patients and seeing the understanding and relief on their faces, interacting with patients period….the list goes on.

Honestly, sometimes I walk away from work thinking, “I can’t believe I get paid to do this.” (I’m taking this as a good sign (once again) that I’ve chosen the right specialty.)

The major thing I’ve struggled with so far is speed. I loathe the EMR system here, it is the most counter-intuitive, time consuming system I have ever encountered. But, I know (somewhere, deep inside) that with practice and experience I’ll get faster. And then I’ll get to spend even more time with patients. Which is where I am also finding I am slower and vastly different in my approach from most of the attendings I work with.

Don’t get me wrong, so far they are all caring, very competent individuals. I guess, they’re just more businesslike and efficient than I am when working with patients. Businesslike and efficient are fine, and even very desirable and essential, when it comes to paperwork. But when it comes to patients, I am all heart.

I can’t help but keep remembering an encounter I had during interviews when I’m behind because I’ve spent “too much time talking with patients.” An interviewer actually asked me once if I thought, having been a nurse, I could still be efficient in clinic. Intellectually, I know it was an @sshole thing for them to say. The Insecure Intern in me wonders. And then, the Nurse, MD that I am, says Yes. I can have the best of both worlds. I can be efficient, but NEVER at the cost of caring for my patients. Caring for them, caring about them, and spending all the time with them they need. I will find a way (and in doing so I suspect I will become the speediest, most efficient documenter in the history of EMR).

I will also always find a way to take pictures. Here are a bunch I’ve managed to snap in my little walks……..

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Great Expectations

 

I was sweating like a pig, huffing and puffing from running around the hospital, up and down 10 flights of stairs repeatedly, utterly lost on my journey back to clinic from the cafeteria. I deposited my heavy bags full of reference materials (that I’d blatantly ignored in lieu of an admittedly indulgent text/FB catch up over lunch), at the nurses station, and walked down the hall.

I felt my sweat miraculously evaporate in the cool, air conditioned confines of the clinic halls. And then, I as watched the parade of pregnant ladies pass, heard the reassuring, rapid, regular beat of fetal heart monitors emanating from the NST rooms, and noted the pointed overabundance of Ladies’ rooms in the hallway, I sighed, felt all tension melt away, and a big, irrepressible, goofy smile of pure happiness spread across my face.

This, along with the ridiculous level of excitement I experienced after doing my first ever solo AFI on the Big Fancy Ultrasound machine today, reassures me, once again, that I definitely chosen the right field of medicine.

Which is good, because I am now off orientation and four days into my official OB/GYN residency. No turning back now kids.

Tomorrow is my first continuity clinic. I.e. I will be seeing my own patients for the first time. My patients. For realsies. I checked out my schedule for the clinic. It’s relatively light, with mostly routine visits for Pap smears and prenatal checks. I am inexplicably nervous about it. Inexplicably because at this point, I have probably handled hundreds of visits like this perfectly competently and comfortably, thanks to my clinical years and site which allowed such opportunities and independence. But I’ve had months off from dedicated OB/GYN rotations and I feel rusty. Plus, these are my patients. I want every patient I encounter to have the best experience and care possible, regardless of who their regular provider is, but I really don’t want to mess this up.

Which means I should probably wrap up this long-overdue post and get to prepping.

But before I go, a little about why this post is long-overdue. The last few weeks have been some of the best of my life. Every day I fall a little bit more in love with this city. There are so many wonderful things to do and see here: art, architecture, night life, nature, music, and food (don’t even get me started on the food!!). Not to mention the diversity. This city has multitudes of people from all over the world, and from every socioeconomic status  intermingling at any given time. It is at times and places, incredibly opulent, charmingly artsy-fartsy, and then, unapologetically gritty. I am absolutely reveling in it.

And any time I haven’t been at work or orientation, I have been immersing myself in it.

I have also been pretty continuously socializing, consciously making the choice to do so, foregoing my usual retreat in to solitude and studies. I am thankful that the people around me haven’t given me much of a choice in the matter. I have discovered heretofore unknown family members in the area to meet and greet with, along with visiting family (see I knew people would actually come to visit the minute I moved out of the wilds of Middle America!!), and new, exciting, extroverted, and unwaveringly inclusive friends from my residency program.

Which brings me to my residency program. What can I say? Except, much like the city, it has far exceeded my hopes and expectations on every level. The attendings, support staff, and the program are all dedicated to the highest levels of evidence-based, quality medical care, and above all, patient care. They are also dedicated to us, the residents. We are a small program, but it has been made clear from day one, that the (incredible, I’m talking pretty much every one we meet presents us with a signed copy of the latest textbook they’ve just published) attendings are dedicated to giving us the best education and best/humane residency experience possible. Oh, and did I mention they are also the most friendly, down-to-Earth group of providers I have ever met after visiting several similarly Rock Star Status academic institutions? Yep. They totally threw a BBQ in honor of the interns(!?) at one of the department heads’ homes a few weekends ago. A respectable showing of attendings came, in jeans, with spouses, and proceeded to make us feel like honored guests, colleagues, and old friends.

Which brings me to my class of interns. We are a very small, very diverse group, all previously independently, but now as a team, committed to making this program the most constructive, positive, friendly, and excellent OB/GYN program/group of residents in the U.S. I am so proud of my fellow interns, and of our vision for this program.

Of course it hasn’t been all wine and roses. My car and my internet connection have broken down at turns over the last few weeks. Normally, these would be Major Crises, but here, somehow, they’re minor snags. Thanks to the kindness of strangers and friends here who have bent over backwards to help me. The tow truck driver who picked up my car in the middle of the night with nary a compliant and a friendly smile, the incredibly helpful lady at the dealership who knocked the hundred dollar evaluation fee off my repair bill and had my car running again in under 24 hours, the fellow interns who hauled my carless self around with a healthy “Don’t you dare call a cab! I’m coming to get you!”, the internet repair person who came in on a holiday to fix my wireless and gave me their number “In case there are any further problems! Just call me!”, and of course, my local family members who consoled me over the phone, cooked for me and my friends in person, and have checked in with me continuously every step of the way.

Again, the city, the residency program, and the people here, all of them, continuously exceeding my greatest expectations…………

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

*Note: Most of these pictures were taken on short 15-25 minutes walks in the area around my apartment. What??????? How much do I love this city!!!!!!!

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!!

🙂

Just in time……

I finished my last shift as an RN a few mornings ago.

Just in time. It was the last of five night shifts in a row, and I’m afraid I was on the verge of getting, as one of my fellow night shifter RN buddies terms it, ‘stupid tired.’

Two days of trying to readjust to being awake during the day, lots of errands, goodbyes, and 27ish hours of sleep later, I still haven’t completely processed it. I am done being a nurse. It still feels like I’m going to get a phone call any second, that someone has called in, someone has a sick kid, or someone broke their [insert bone and/or joint here], and they need me to fill in. They need me to be a nurse again, one last time.

I was supposed to leave for residency this morning. I don’t really have to I suppose. Orientation doesn’t start until the middle of next week, and what am I going to do? Unpack in a couple hours and sit in an apartment with no furniture, hot water, or internet, and stare at the walls for several days because I am trying not to spend any money (that I don’t have)?

Forget that.

I’m staying as long as I can. At home. With The Writer, where my friends are. Not to mention I couldn’t pack my car today anyway. The Hound decided to run off from the farm over the weekend and I had to take her back. She was fine until my friend who was watching her went on vacation. Apparently, she got bored after a couple days and ended up getting busted chowing down on a neighbor’s garbage. The Hound has never been able to resist a heaping, odoriferous, tantalizing (?) pile of garbage. I got a call from my vet while I was at work, letting me know she had been apprehended. I picked her up today, took her for a long walk, gave her some bones, and sat with her on the lawn scratching her belly. Naughty, spoiled Hound.

I drove her back to the farm and she happily slobbered, shed, and farted all over the back seat the whole way. Naughty, spoiled, smelly, sheddy Hound. I’d really missed her. She, however, hopped out of the hatchback as soon as we arrived and set out for some serious sniffage. With one brief look of acknowledgement back at me, “Hey, thanks for the ride!”, she was off, like she’d never left.

I drove away, knowing they will take good care of her, but still missing her. I followed the sunset on the way home. Suddenly realizing I had my camera in the car, that I haven’t taken a picture in weeks, so I lost myself in the chase. I managed to get a few shots, as the sun quickly sank, lighting up the sky and the clouds. Just in time.

 

 

 

 

 

I think I will leave in the morning. The car is packed, I just need to make the leap and go. It’s so tempting to wait as long as possible, to stay as long as I can, one more dinner with friends, one more visit with The Hound, one more cuddle on the couch with The Writer, until I have to race into orientation at the last second. Just in time.

Random.

Right.

So now here are a few random, previously unpublished photos from the past couple years because I have enough shame to want to bury that last tirade. And, I highly suspect it’s the pictures most of my followers are actually interested in (versus the ill-mannered rants).

🙂

 

 

 

 

 

 

 

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!

 

 

 

 

a

 

Stopping to smell the roses…..

I finished off the mini-indie concert tour last week with a show by Blitzen Trapper. I love this band on CD, and they are even better live. They put on another regular Rock Show, and the crowd went wild. One of the things I love most about them is the flexibility and variety of their music, from raging guitar to sweet serenades.

Raging guitar……..

 

Sweet serenades……

So good.

After the show I headed to The Big City to take care of a few pre-residency To Do’s, scope out the new apartment, and drop some things off.

And it’s been…..Let’s just say……An adventure.

Having lived in very sparsely populated area for the last decade-plus, I was not exactly prepared for the traffic. I think I’m going to adapt pretty quickly though. On the way out to The Big City I had to pull over at one particularly bad point (I’m calling it The Corridor of Madness, directly south of a Huge City, where 55 mph apparently, roughly translates to 110 mph) and hyperventilate into an Arby’s bag for 10 minutes before I could continue. On the way back, after I’d taken a wrong turn right into The Huge City, almost jumped a curb (second time in one day, awesome), and skipped a toll, I just laughed (fine, somewhat hysterically). But, no signs or symptoms of an imminent syncopal episode at all the second time through. Definite progress.

I am currently sitting in a hotel room in a random Super 8 in some Middle States town (I didn’t see the name, just a sign for a Super 8 and a Starbucks. Sold.) just a few hours from home.

Home.

Not for much longer. I’m struggling with how pleasantly surprised I am with The Big City, soon to be my new home, and how heart broken I can’t help but feel at the prospect of leaving my old home, and the family I made for myself there. Not much I can do about it. So, I’m going to stop thinking about it for the moment.

Instead, I’m thinking about some time I took to, literally, stop and smell the roses last week in a friend’s garden.

Before I visited my friend and their garden, I stopped to get them some beautiful lavender roses I espied in a florist shop on the way. I chatted with the enthusiastic florist as they wrapped up the flowers, and told her I was getting the flowers just because. Just because my friend is so sweet, and loves flowers, and deserves to get them often. Just because. The florist loved this and told me a story about preparing funeral flowers one day. The customer arrived to pick the flowers up, and told the florist they wished they’d bought their loved one more flowers when they were alive. Just because. And that it should be a lesson to us all.

Indeed.

The florist then asked if I liked to garden, and I replied with an emphatic ‘No.’ Like cooking, I much prefer to just enjoy the end result. When I officially moved out of the shack last week, I left with never having turned the stove on. Not once. In two years. (Okay, this may have been in large part because it was a gas stove, I had no idea how to light it, and was afraid I’d blow myself up.) But, I choose to go ahead and err on the side of being proud of that. Stuff like cooking and gardening is right up there with scrubbing the toilet for me. Messy, tedious chores. Nothing I personally wish to do in my rare, spare time.

But, as I said, I do love to relish the results of someone else’s labors, by savoring a good meal, or wandering a gorgeous garden. Taking time to smell the roses. And to take a few pictures of them while I’m at it.

Naturally.

 

 

 

 

 

 

Soul Food

I was super grumpy when I set off for work last night.

I had gone over to The Writer’s in the morning after another busy night shift, hoping for a more decent quantity of quality sleep than I’ve been getting at home. Because, since I started working (pretty much) full-time nights until I head off for residency, the hound has decided that her job while I’m trying to sleep during the day, is finding new and exciting ways of waking me up every two hours. Such as, curling up all cute-like right next to the head of the bed and passing rank “I like to eat garbage, lots and lots of garbage” gas right in my face until I wake up gagging, or, patiently, persistently licking whatever exposed part of my body happens to be hanging over the edge of the mattress (face, hand, foot, knee, elbow) until I wake up yelling incoherently.

I snuggled down into the man cave that is The Writer’s basement apartment/dungeon yesterday morning, after eating enough McDonald’s breakfast sandwiches to feed seven post-nighter RN’s and two Tylenol PM’s, anticipating at least six, solid hours of dog-free snoozing. And then, I heard the tribe of big-footed pygmies(?) that has apparently moved in upstairs stampeding across the ceiling. And then stampeding back. And then back again, until they broke into some sort of unholy Riverdance routine (?).

Personally, I thought I showed remarkable restraint by tolerating this racket for the three minutes and 14 seconds the Tylenol PM kept me drowsy enough to tolerate it. And then I very (very) huffily got the H*ll out of there and went back home. Where the dog let me get a whole three hours of sleep before I headed back to work again.

Super. Grumpy.

On the way to work I had to drop the hound off at my friend’s farm where she will be living while I am living at the hospital during intern year, for a ‘sleep over’ to see if she can actually manage to behave herself on a farm. The GPS took me the back way to the farm, and pretty soon I was driving like I stole it down dirt roads. I couldn’t help but notice how brightly the sun was shining, how startlingly blue the sky was, smattered here and there with fluffy white clouds, and how verdantly green the countryside was after recent rain showers.

Next thing I knew, I had the windows down, the radio cranked up and I was relaxed back into my bucket seat with a huge smile on my face, singing along with Bob Seger, reveling in the view.

Bobbin’ dog approved view.

 

 

I might be a little bit older and a lot less bolder, and weary when the work day’s done, but nothing fails to feed my soul and pump me up again like driving fast on the back roads and losing myself in the music and the countryside.

Here are a few images I’ve collected from other recent sojourns, so that I never forget.