more than the eggs

Easter is here!

I know it's easy to get caught up in this...

  elhadadepapel.blogspot.com

 marthastewart.com

ourbestbites.com 

(creative Easter Egg Decorating ideas from a cute site, which I really enjoyed viewing despite being the least crafty person you will ever meet and someone who never decorates Easter eggs)...

... and this:

(heavenly Cadbury creme eggs, perhaps my favorite edible item in the whole world... and which I long for most Easters like this one, after I often give up chocolate for Lent)...

However, what we need to be overjoyed about is: the resurrection of our Savior!

Here are the lyrics and a recording of one of my favorite hymns, which we sang this morning at Sunday service:

       Christ the Lord is risen today, Alleluia! 
 Earth and heaven in chorus say, Alleluia! 
 Raise your joys and triumphs high, Alleluia! 
 Sing, ye heavens, and earth reply, Alleluia! 

        Love's redeeming work is done, Alleluia! 
 Fought the fight, the battle won, Alleluia! 
 Death in vain forbids him rise, Alleluia! 
 Christ has opened paradise, Alleluia! 

        Lives again our glorious King, Alleluia! 
 Where, O death, is now thy sting? Alleluia! 
 Once he died our souls to save, Alleluia! 
 Where's thy victory, boasting grave? Alleluia! 

Happy Easter!

not something we see every day

When returning home after a nice post-work walk with Pepper at the Marsh yesterday, we spotted this convertible parked outside the house next door, which struck us as very odd.

Convertibles are a rarity here with the awful weather! (I'm not sure I've ever seen an actual convertible, much less someone driving one, in this county!).
Sunshine is so rare!
Blue sky is almost never seen!

This (iPhone) picture captures all of that.  While we have had glorious weather in Arcata the past 1.5 days (sunny and 65-- as "summery" as it ever gets here), the forecast (surprise, surprise) calls for rain later today.  Back to the norm.

Maybe I should tell our neighbor (or a naive friend of his visiting from So Cal) that he'd better put his top up ASAP.

Bracket, busted...

... and why I probably shouldn't quit my day job (as much as I have complained about it recently).

It is (still) March. We love watching sports; we love college basketball. It has been wonderful to be off call on recent weekends and free to watch lots of the games of the NCAA tournament. However, I must say that I'm pretty abysmal at picking tournament winners. Mostly I pick early round winners based on personal/location ties (with the Spiders not in the tourney, I picked VCU [out already] to go to all of the championship game) or something other than solid research, although I feel that it is step up from choosing based on uniforms' attractiveness. I have rooted for Butler [out already] when they lost in both championship games in 2010 and 2011. I definitely like the underdogs and generally root against any team from around Durham, NC.

Florida Gulf Coast University is my new favorite team, who won me over when one of its guards in-bounded a ball off a Georgetown player's rear, when he was facing the other way, for an easy lay-up. Best highlight I've seen (even better than their alley-oop dunks!).

Thank you to Apurva, who again this year made a "POD" ESPN bracket (for fame, not money, thankfully!). Check out the screen shots below-- the first is the "un-Elite Eight." Although my chosen tournament winner is still in the tournament, I am only ahead of 5 people in the 27-person pool... a pool which includes my dear husband, who most often beats me in anything we try (not that either of us is competitive or anything :)).

Here is what it looks like at the top:

Seriously??  89.8% in this year of upsets?! We'll just see who stays up there after this weekend! We are excited for Sweet Sixteen tomorrow!

Taste of Main Street (aka a great excuse not to cook)

On Thursday night, Kelvin, Elise and I went to the 21st annual (and our second annual) Taste of Main Street in historic Old Town Eureka. We were able to sample food from up to 24 participating local restaurants and food vendors... including the high-end Avalon, favorite Kyoto sushi, Mekong Café, and much more. It was a fun evening, and so particularly wonderful because it was a great excuse for NOT COOKING (obviously, not one of my favorite activities).

While it was a sunny evening, it was freezing with the wind, and my only mistake was to accept some free Ramones Bakery coffee (attractive as it was HOT!) circa 7:30 p.m. which led to a long, sleepless night (worse than my "normal" nights of maintenance insomnia).

When Elise and I would duck inside the restaurants' doors to grab our samples, K hung out with Pep (who found her fair share of street morsels) outside.

Here are a couple of flashback photos to Taste of Main Street 2012, which we attended right before we went to Italy last year. Looks like we had great weather then, too (overall, a Humbolt Co. rarity)!

Pepper got a tasty snack, too

Can't wait for Taste 2014!

A little pick-me-up

To make me (and you) smile this week, here is an MSN special article/slideshow on "23 hilariously unfortunate ad placements." Which is your favorite?

Shakespeare and the State of Jefferson

After the awful last week I (we) had, we were lucky to be able to get out of town to spend the weekend in southern Oregon.  We learned something new and quite interesting-- the region where we hung out (Medford/Ashland area) was part the "State of Jefferson," a proposed (49th) state in 1941 which would have included rural southern Oregon and northern CA. The secessionist movement apparently was somewhat abandoned after we entered WW2 after the bombing of Pearl Harbor, but the spirit of the area persists :)

On Saturday, we spent a half-day skiing/snowboarding at Mt. Ashland.  The last time we were there (about a year ago, on an Oregon Christmas Getaway), the snow was really pitiful. This time, there was more of a base, but no real fresh powder :(  Nevertheless, we enjoyed hitting all the blue, Shakespearean-named slopes on the small mountain.

Southern Oregon has a lot of fine vineyards. We did some wine tasting at the Quady North tasting room in Jacksonville...

... and at RoxyAnn/ Hillcrest Orchard.

Ashland, Oregon is home to the Oregon Shakespeare Festival, which is less a "festival" than a 9-month-long season (Feb-Nov) of Shakespeare plays performed at the town's three theaters.
Being there brought back good memories of Stratford-upon-Avon, Shakespeare's home town, and the Globe Theater in London about eight years ago where I was lucky to catch Romeo and Juliet.

Pre-show walk in downtown Ashland

On Saturday night, we saw "The Taming of the Shrew," a very entertaining comedy which was done with a modern twist.

Today, we checked out the Rogue Creamery, which was heaven for a cheese-lover like me and kind of a bore for K :). The creamery makes wonderful, award-winning blue cheeses which you can sample and obviously purchase. 

We then took Pepper for a nice hike to Prescott Park and Roxy Ann Peak above Medford.

 

Here is Pep in her "car cave" on our way back. She tries to escape to the trunk where it's cooler :)

After some much-needed R and R, I am hoping to have a much better week :)

and then it got worse...

So it is obvious from the last post that I am struggling a bit with work demands.  Since the first of the month, the hospital has been transitioning to EMR (electronic medical records) from paper... which has been pretty horrendous for efficiency and patient care there (especially as doctors weren't given access to view anything, and some labs are unorderable and irretrievable). While I am all for EMR, I know that the transition (like it was in residency) will be really painful for a few months. Patient care has and will continue to suffer. And when you're already stressed and squeezed for time, this really doesn't help things. But I was getting used to that.

And then we got another blow. In clinic, EMR is the one thing that we can depend on... and we lost it the past two days of this week-- slightly ironic given the hospital issues, above. A vandal apparently cut the cable for Suddenlink, the company which basically has a monopoly on the internet and phone services in our area. My clinic lost all phone access/internet access/EMR access on Thursday and Friday (although, on Friday, apparently 95% of the rest of my town was back online). When we got to work on Thursday, we didn't know which patients were on our schedules, nor could we easily find out. Without being able to look up their histories (now, ALL held within the electronic system, as "paper charts" are completely obsolete!), every patient was a blank slate and virtually *new*. It's one thing to blindly treat a UTI or strep throat. But when about 80% of patients were there for "follow-ups" including med/lab follow-ups, and most of them did not know their own meds, much less if they were due for a pap, it was pretty ridiculous. Exhausting, and incapacitating.

It has been utter madness. We have been using paper for vitals, and paper for documentation... to be later entered to EMR (in all the spare/free time we obviously have). We have had to do all paper prescriptions.... which I'm sure has created prescribing errors. I forgot to write at least two patients' names on their prescriptions. Duh. Patients couldn't confirm or cancel their appointments or call for requests .... so we had lots of people just showing up randomly throughout the day wanting to be seen and asking for med refills, results, etc. Not that there was a way we could document any of that.

Personally, I thought we should close the clinic due to how dysfunctional it was. In line with my perfectionistic personality, if I couldn't be a *good* doctor and take good care of patients, I didn't want to even try. I didn't feel that mediocrity was good for anyone, and I didn't want to provide sub-par care (is bad care worse than no care?). Everything we did seemed like it was a waste of time. I wonder what the patients thought. I volunteered to go home and take time without pay (not accepted by admin). The stress was just not worth it. I have NEVER wanted more to take a "sick day," and I definitely felt psychologically (and physically) ill due to being so handicapped. I thought about taking up smoking. I wanted to chug a margarita after work on Thursday... and then realized I was on call. Bummer.

My dear hubby, who did have access to EMR at his clinic both days, was able to see my schedule and print and send over some of my last notes for the patients, which helped greatly today. And a genius from IT figured out how to turn my phone into a wireless hotspot to be able to view EMR remotely on a laptop. These were positive things. I have to pray that things are going to be fixed by next week... as I'm just not sure we can go on like this.  But at least things can't possibly get worse.

Job Stress

 

I am one of those people that definitely gets affected easily by stress. I was stressed out a lot in residency, where the learning curve was steep, and it never seemed that you had enough time or sleep; but then again, who isn't?  Currently, I feel that working full days in the clinic (with 1 day without pts scheduled per week) with almost 1000 patients of "my own," as well as taking about 3 days (24 hrs x3) of OB call per week is pretty stressful. Mostly, the stress comes from trying to: juggle patients (clinic and hospital), see a full load including "squeezing" same day patients, make appropriate and safe management plans, write all of my notes, be efficient and run on time (despite interruptions, talkative people, and late arrivals), return patient calls and do refills in a timely manner, not keep patients hanging/waiting... and manage some semblance of a "life outside of work" (even with zero kids and few extracurriculars currently in the picture). I often feel that I'm treading water (or drowning). The inbox is never-ending. If I don't tackle some of it on my "day off," it is overwhelming the next day... so there is never really a true "day off." And, on the weekend, there are either more babies to deliver or moms/babies to round on.... until it all starts over on Monday again. Some studies estimate that for a primary doctor to do everything it takes to appropriately manage a panel of patients, you need to work something like 15-18 hours per day.  It sure feels like it.

I feel like not all doctors have stressful lives. Without complaining about my salary, I'd probably work a lot less and make a lot more money if I were a radiologist, dermatologist, ophthalmologist, or anesthesiologist, or working for Kaiser. I'm sure I'd have less stress if I wasn't doing obstetrics and working in the hospital (as rewarding as that can be). But do you think job stress and income are proportional, or should they be?  Not necessarily, it seems. 

Here is some data from some online polls about "most stressful jobs":

 CNBC's list of MOST stressful jobs of 2012 includes the following titles, with their average annual income:

10. Taxi Driver - $22,440
9. Photojournalist - $40,000
8. Senior Corporate Executive - $165,830
7  Public Relations Executive - $91,810
6. Event coordinator - $45,260
5. Police officer - $53,540
4. Military General - $196,300
3. Airline Pilot - $103,210
2. Firefighter - $45,250
1. Enlisted military soldier -  $35,580

Here is a CareerCast list of the ten LEAST stressful jobs of 2013, with median salaries:

1. University professor - $62,050
2. Seamstress - $25,850
3. Medical records technician - $32,350
4. Jeweler - $35,170
5. Laboratory technician - $46,680
6. Audiologist - $66,660
7. Dietician - $53,250
8. Hairstylist - 22,500
9. Librarian - $54,500
10. Drill Press Operator - $31,910

I know that the second list above generated a lot of pushback (largely from university professors who claimed that they definitely had plenty of job stress!). It is interesting to me that doctors didn't make list #1, despite having the highest suicide rate of any profession. Maybe I'm exaggerating my stress. I guess it's more legitimate to be stressed by a job in which you could personally very likely get shot at or die, although physician stress, particularly psychological stress and burnout, is very real and requires real attention as written about very well by KevinMD here. You can also read about, in a yahoo article that recently came to our attention, the stressful jobs that pay badly, which allows me to feel a bit better in that, although I feel stressed a lot of the time, at least we are living on comfortable income.

However, some days I just don't want to be stressed. I want to go to work somewhere where I can work uninterrupted for 8-9 hours and not have to juggle. I want to come in at 8, leave at 5, and have no paperwork or worry hanging over my head. I don't want to be fought with, made to feel incompetent or unsympathetic, deal with others' meltdowns, poor decisions or noncompliance, or have meltdowns myself. I don't want to tell anyone they have cancer. I don't want to feel guilty for taking a "sick" day-- which I haven't taken in about 10 years, although I've definitely been sick (Kelvin recently worked through the flu because we all feel bad cancelling patients).  I sometimes do wonder, though, how much of stress is "internal"-- i.e. self-imposed. I think some people who struggle with perfectionism (definitely guilty here) seem to internalize stress more... and that some parts of me think I'd probably be a stressed out jeweler or seamstress, too.  Is it a good tradeoff to make 25-50% of your current salary but have a 50-75% reduction in stress?  Some days I think, "ABSOLUTELY," and really want to be a librarian, which is my dream job.

But until I go back to school for my library science degree, I will continue to counsel patients and parents, try to get patients to live healthier lives and to get their age-appropriate cancer screening and VACCINES, and head to the hospital at 2 a.m. to bring in new life to the world. THAT keeps me going. I have to remember that, despite the stress, this profession comes with many rewards and that when you have a grateful patient, it is all worth it...

Banana poll!

K and I don't disagree on too many things. However, "the way to peel a banana" is one of those things on which we do not see eye-to-eye.

Having a blog entitled "thatbananaisstillgood" makes me, in my opinion, the obvious "banana expert" in the family; however, my hubby disagrees.

So, which is the *correct* way to peel a banana?  I'm interested in polling the audience, so please comment with your thoughts!!  So as to not bias anyone, I will omit the critical information about who (in our family) chooses which "method."

                                                        METHOD #1 (peel from the "stem")

 peterstuifzand.nl

METHOD #2 (peel from the "blossom end")

monkeyconveyancing.com.au 

In doing some reputable research (wikihow), I found that method #2 is how monkeys generally peel their bananas. It may require less force and can perhaps mash a banana less (and lead to fewer "banana strings") than method #1. I also refreshed my memory that bananas grow like this...

... not that that should influence anyone.

   

I'm aware that there are many ways to skin a cat, and thus other ways to peel a banana, but the above two methods are the most common. So which is *right*? Please make a case for *your* way!

a lot of new Pisces

I don't often blog about work but this is what I've been up to:

* 3 weeks
* 11 deliveries, including
- baby with a 8 cm sacral teratoma (http://www.youtube.com/watch?v=-xXCoSsGe1c), NSVD
- 29 week active preterm labor who delivered
-  a VAVD (vacuum-assisted vaginal delivery) and 6 other NSVDs (+ 4 c-sections and one almost crash CS)
- a 5-lb term baby (VBAC)
- a 12 # 7oz baby (yes, that is almost 12.5 lbs. This was luckily a planned CS... my arms still hurt from that dystocia. This is the biggest baby I've ever delivered!)

* 15+ continuous hours at the birth center yesterday, countless more spent rounding in the past weeks
* talking with new parents who wonder what astrological sign their children now are (I'm not strong on horoscopes but apparently you're a Pisces if born after 2/19)
*a new hospital EMR to which nurses have access to vitals, labs, etc. but to which doctors don't, making rounding incredibly inefficient/painful (UGH)
* lots of outpatient clinic visits
* a great husband who holds down the fort at home

It's been a challenging few weeks!
This is what I feel like doing:

Praying for some rest this weekend on call... (and really looking forward to our May vacation!)