Monday, February 11, 2008
Wows (and the VAcation continues)
It is truly amazing how painless travel can be when things actually go according to plan. Don't get me wrong--I will travel in spite of the various mishaps that occur involving lots of strange weather, missed/delayed flights, lost baggage, flight switcheroos, arbitrary regulations, etc; however, it is just a beautiful thing when none of those things happens! Yesterday, Wendi dropped me off at the Ft. Walton Beach airport (which is, much like JB's hospital, very cute) with plenty of time to spare for an early a.m. flight. Flight left on time. Flight arrived on time in Memphis. Layover was 50 minutes (often a troubling thing with my travel luck but, this time, it worked great!). Second flight left on time. Second flight arrived on time (actually, 10 minutes EARLY!). Called Mom when plane landed at National airport. Bag arrived on time. No, scratch that. The important thing: BAG ARRIVED. Walked outside, where Mom had just circled around to come back to the arrivals area to pick me up. Drove home, without traffic, arriving by noon (EST! I left CST!). Aah (in contentment; not AAAAAAAAHHHHHH in exasperation).
Tara flies first class
Since I was feeling rich and thinking it would be fun to spend some extra money to treat myself on my vacation, I opted to fly first class this leg of my journey. Ha. Just kidding. I would never do that. But, for some reason, the NW flights I was on from Fla to VA had me in seats 2A or 3B or something which are those front, business-class seats! I initially panicked, thinking that, somewhere along the way in booking this convoluted multi-city ticket, I accidentally picked business class instead of economy and somehow got gipped of my precious miles or some hard-earned cash. But my boarding passes said "silver/elite member" and maybe that's why I got those seats (as the flights weren't full)? I guess, at this point, I've flown so much on Northwest to qualify for this special status? I'm not sure. I was thinking of my long-legged friends back in Florida and must say that, even for a vertically-challenged girl, the extra leg room was quite nice, but it was obvious that I don't fly business class very often because when the stewardess presented me a basket of fruit, snack packs, and other things, I wasn't sure if I was allowed to take one of each, or just one item and just looked really confused. And who needs two drinks over a flight of 1.5 hours' duration? Really.
Three Cups of Tea
Now THIS is a very inspiring book which I would highly recommend (and am trying to promote as the end of the book suggests). It is about an American climber, Greg Mortenson, whose failed attempt to climb K2 in Pakistan leads to his life's work in funding and building schools (primarily for girls) in the rural villages of northern Pakistan and Afghanistan. Here is an excerpt for you, when Jahan, one of the brightest graduates of one of the early schools, returns to talk to "Greg sahib" about her life's plans in women's health care:
"When I was a little sort of girl and I would see a gentleman or a lady with good, clean clothes I would run away and hide my face. But after I graduated from the Korphe School, I felt a big change in my life. I felt I was clear and clean and could go before anybody and discuss anything.
"And now that I am already in Skardu, I feel that anything is possible. I don't want to be just a health worker. I want to be such a woman that I can start a hospital and be an executive, and look over all the health problems of all the women in the Braldu. I want to become a very famous woman of this area," Jahan said, twirling the hem of her maroon silk headscarf around her finger as she peered out the window, past a soccer player sprinting through the drizzle toward a makeshift goal built of stacked stones, searching for the exact word with which to envision her future. "I want to be a ... 'Superlady,'" she said, grinning, defiantly, daring anyone, any man, to tell her she couldn't.
Mortenson didn't laugh at all. Instead, he beamed at the bold granddaughter of Haji Ali and imagined the contented look that would have been on the old nurmadhar's face if he had lived long enough to see this day, to see the seed they planted together bear such splendid fruit.
Five hundred and eighty letters, twelve rams, and ten years of work was a small price to pay, Mortenson thought, for such a moment."
In any case, it is a great read. If you purchase books from the above-linked website, 7% of proceeds will go to a girls' education scholarship fund in Pakistan and Afghanistan. Or if you're looking for a good charity to support (in addition to personal favorites Faith Alive or Amazon Promise), consider the Central Asia Institute that Mortenson founded and runs (the book's acknowledgments section details that it costs $1/month for one child's education there and $1 for a teacher's salary for one day). Wow, huh?
Okay, that's in it for plugs, except...
Election madness
On my first afternoon "home," after I was welcomed by the massive "Obama '08" banner on our front door, my Dad already had me distributing Barack Obama fliers around Hallcrest Heights (our townhouse development). I felt slightly weird, but am okay with some degree of Democratic activism. The "Potomac Primary" (VA, DC, and MD) is tomorrow, when he'll be busy all day shuttling people to polling stations and whatnot (at the moment, he is trying to convert people at the Metro stop during rush hour!). If I was undecided before, all I know is that, if I desire to remain a member of this family, it is now more than obvious which candidate I shall support from henceforth :)
Brrrr
I've been told that it was like -10 (or maybe even colder, I'm not sure.... and this is WITHOUT WINDCHILL!!) in Rochester, MN yesterday. This, folks, is just crazy. Or more than that being crazy is that people voluntarily live there (Lesley, Rachel, Kristen, are you still alive?? Comment if you are! :)) or move back (Ray family! Are you nuts?!). We had a cold front come in to northern VA last night and this is barely tolerable! How 'bout some comparisons:
Currently:
Rochester, MN: 5 (Yes! This is FAHRENHEIT!!!!) (feels like -8)
McLean, VA: 28 (feels like 20). Brr.
Sacramento, CA: 63 (feels like 63).
Eglin AFB, FL: 66 (feels like 66).
Okay, John. You win again. But I chose pretty wisely, too.
:)
Tia does q3
I finally caught up with Tia on the phone today! Since she is severely overworked, she wanted me to send love to everyone she has not had a chance to talk to. Although she says she is doing "better" and that her IM residency in Boston is "not that bad," q3 call for 2 months of ICU (if you recall, I whined about q4 call, with q4 OFF, on my ONE month in the unit) sounds utterly miserable to me. She definitely wins the most overworked intern award. I can't believe her schedule. Or her optimism, which she seems to have regained to some degree.
In any case, I'm enjoying continuing to NOT be in the hospital and rather being at "home,"where I am doing lots more sleeping/reading, relaxing, and catching up with friends and family. I love VACATION!! Please, please, let it never end!
Saturday, February 9, 2008
More Fla. "Fotos" (and fewer words :))
Scrubs loves to eat John
We caught a movie, Fool's Gold, at Destin Commons and then got a little tour of JB's "cute" AFB hospital before coming home to rescue/exercise poor Scrubby, who had to be locked in his kennel all afternoon while we were out exploring Destin.
This is the bay that is 5 minutes' walk from their house! How neat is that?
My attempt at video-loading (Wendi showed me how!)
Florida sunset. Aah.
We are going to have some dinner and lay low here on our last night together here. It's been so fun! I strongly encourage you to book now your trip to the Kitsteiner B and B while there are vacancies!!!
I will miss you tons, John and Wendi (and crazy Scrubby, too)! Thanks for being such awesome hosts. Come wine-tasting soon :)
Thursday, February 7, 2008
Overdue (finally, some pics!)
So to recap the vacation....
It started leaving Sacramento early in the a.m. on Tuesday (kind of a bummer that I feel my two-week vacation didn't start until a Tuesday because of the whole Sunday call thing...but I'm almost over it). What was annoying was being stuck at the Dallas-Fort Worth Airport for 4 extra hours.... Now, don't get me wrong, I have always wanted to visit Texas, but I was irritated this time as I was so excited to get to Fla. to see the Kitsteiners! First, the plane arriving that was supposed to leave from Dallas to Pensacola was late in arriving. Then, once we were on the plane, they discovered some "mechanical" issues with a wing ding that ended up being nothing. Then the weather inbetween TX and FL was apparently horrendous so, after hanging out on the tarmac for a good half-hour, they decided to take us back to the gate and de-plane. Then they cancelled the flight altogether and gave us a 1-800 # to call to reschedule. Luckily, I got on the next flight to Ft. Walton Beach, which is actually closer to John and Wendi (actually, right on base and I was trying to figure out how this would avoid the same weather, as the path would have been the same, but I didn't care if it would get me there!). We left about 2 hours late and then the flight became longer as we circumvented the bad weather by apparently flying around it, but I made it to Florida by about 7 p.m. (I had been scheduled to arriave at 2:30) and Wendi was right there at the gate to pick me up! Very cool! Except that my luggage was on the next plane to Pensacola, about an hour away. You would think that with all the luggage and travel disasters that have happened in my last year or so of air travel, I would learn to pack smarter (as Rachel commented on Wendi's blog, "If I ever travel with Tara, I'm only bringing carry-on luggage!"). However, there's still this part of me that thinks "It can't happen again. This time everything has to get there fine. I'm only going from sunny state to sunny state! How bad can things be??!" In any case, after Nigeria, it is true that not much can really ruffle me. I knew Wendi could loan me a shirt or two and, this time, we'd actually have electricity and running water! My bag came just fine yesterday afternoon, after I'd been called several times by an extremely apologetic baggage-handler that was very concerned that I'd be stressed out by not having my luggage for 24 hours or something. No worries. It's all here.
Since being here I've:
- Slept in. I've been waking up between 8:30 and 9 every day so far (now, granted this is 6:30-7 on west coast time). It's so wonderful to NOT have to round or write notes!!!
- Read. Currently I'm reading Three Cups of Tea, which Fizzah and Adeel gave me for my birthday. It's great so far!
- Gone for walks/runs in the Florida sunshine. The weather is great! I thought it was warm in CA (although it's been rainy and around the 50s in Sacramento for much of the past month), but it's close to 70 here in the daytime! Even I, who tends to be cold all the time, can wear shorts and a t-shirt and be fine!
- Played a bunch with Scrubs (who I will actually now call by name. I admit, it does fit him). He is quite a crazy dog, although, per Wendi, he has "turned a corner" when it comes to obedience. I really wonder how he was before ;)
- Slept more. This usually consists of 1-2 afternoon naps.
- Gone out to Destin for sushi (mmm). I love sushi. John loves sushi. Wendi hates sushi. (Sushi was half-off on military Wednesday).
- Broken a drinking glass. It is inevitable that I spill, drop, or break something when I visit the Kits. They said, "Aah. Just like old times." :)
- DONE WENDI'S DISHES!!!! Now those of you who know Wendi know that this is quite a big deal! I knew that Tiffany, one of her friends here, has gotten away with this, so I figured that I had a right to try as well. Success. She barely put up a fight. :)
- Tried to figure out the baby's name. No luck. No slippage from Wendi yet. But I still have a couple of days.
- Tried to guess the baby's weight. I hope I'm closer than Justin (15 lbs.?!?!) :)
- Hung out with the wife-ia (i.e. wife mafia) of girls that form Wendi's big social network here. They are great! It's true that I felt like I already "knew" some of them from reading Wendi's blog (and blog-stalking Joia's) this past half-year, but it's great to now connect voices (most of these women have sweet Southern accents!) and personalities with faces and names. We had brunch over here at the Kits' house yesterday and then a "book-club" meeting tonight (I hadn't read the book but it didn't matter much!) in town.
Here are some pics:
With JB and Scrubs on the newer Kitsteiner brown couch (Les, the old Kitsteiner couch of consolation is in two pieces which Scrubs uses as beds!). I think it's crazy that this is what JB wears to work most days.
"Dancing" with Scrubbers. He's gotten so big!
Dinner at Tijuana Flat with the "Wife-ia": from left: Wen, Tif, Joia, Jodi, Andrea, Sarah, and me)
I talked to Shomir today who was like, "you haven't done very much out there." It's true. I'm not really in the tourist/travel-mode that is usually my style when away from home in a new place with much to explore. And this area is certainly a resort area with lots to do! I think it's partly that I'm worn out from internship and just need some time to veg! Wendi also is working full-time and is not just around to entertain me (plus, they've had a ton of visitors here already and have taken them all around already!). But I also think that my outlook on vacations has changed somewhat in that I am just content to relax and enjoy the company of people I love rather than constantly be on the go!
It may change tomorrow, though. John thinks he only has a half-day, so we are thinking we will head out to Baytown Wharf and the Destin beach (which I hear is among the most beautiful in all of the U.S.!) or maybe the dueling piano bar. There is some talk about going out on a boat on Saturday, which sounds fun. Until then, I am pretty content to just sleep, eat, read, run, sleep (did I mention sleep? :)), and play with the doggie. :). Goodnight (i.e. time to sleep :))!
Monday, February 4, 2008
Sometimes that's the way it ends
I completely lost it when I passed by to see her, calm and not crying, still at the beside as he lay there breathing, now without the endotracheal tube that had been in there for almost two weeks. While I knew he was very sick, I didn't expect to have things turn this way on my watch, on my last day on the service. Crisis worker was called to help comfort his daugther who was understandably emotional in contrast to Mr. C's wife's collected serenity; however, she ended up sitting me down for several minutes trying to validate the way I felt. I just hurt for the family. And if I, who'd only known him for two weeks and whom he probably didn't even recognize, could feel such grief, how could they even go on? I think, despite being his "doctor" as part of the medical treatment team, I had started (shockingly) to forget how to think of him as a person (husband and father) and, yesterday, as he passed his last hours, I remembered good and well.
Mr. C died yesterday evening at 8:17 p.m. and I was called to pronounce him. All I can say is, I hope that I pass my last hours surrounded by people that love me as much as his family loved and supported him.
Just before Mr. C passed, I had also admitted a 50-year-old woman who was in her normal state of health until about 3 p.m., when she complained of a headache. She was found less than an hour later, unrespsonsive, and brought to the ED where she was discovered to have a massive intracranial hemorrhage for which really nothing could be done. She was already showing signs of brain herniation and, although I admitted her to our service with treatment to lower intracranial pressure and her family wanted her to be full code, we feared that she, too, would also likly not survive the night. As Jacob, my senior, was initially tied up with other sick patients on the floor, I had to be the initial bearer of devastating bad news to her sons and fiance who then had to summon the rest of the family to the hospital rapidly to see their loved on in what would likely be her last hours.
She went into v-tach around 2 a.m. and we successfully resuscitated her; however, when she began to tank again on pressors, the sons decided that it was time to disconnect the ventilator, stop the pressors, and let her pass peacefully. Twelve hours after she was talking, walking and interacting with her family, she was no longer with us.
That's the ICU for you. After pronouncing her, I had to go work on another admission, a 39-year old woman admitted to our service after having a cardiopulmonary arrest on the floor. I wonder if she has survived the day.
Seeing people this young, this sick, makes you really value health... and life.
The call day did finally come to an end. In some ways, it was a very fitting way to end my last day in the ICU, with a lot of closure in the passing of Mr. C, Mrs. Y, and another patient on a different team. I definitely got the full ICU experience. Jacob, the awesome senior and all-around guy that he is, actually let me off today after my *work* was done, i.e. after dictations and notes were done, but before rounds, so I didn't have to be there until noon on my first day of vacation. This was a real gift. However, I'm still thinking about my patients. Despite now taking a little "break" from medicine (Florida, Virginia, here I come!), they are still with me and will be for a long time. I think it's a good thing.
Coastal Cali (and more bad bowling)
Bowling on Friday (in pictured above, from left, are: me, Shomir, Arash, Amy, Sonia, Alvin, Darina, Din Hai)
Amy with the "clown" shoes-- they must have been lucky, because she kicked our butts (or maybe it's just her supreme skill). Yes, I still suck at bowling. I think I broke 100 one round, though, which was a major accomplishment.
Tu cracked us up with her strikes with the ball rolling 3-4 mph (does anyone realize HOW SLOW this is?!).
I tried to capture the "record" speeds.
Saturday was an expedition to Sonoma county and the coast!
Shomir and I headed out from Sac to the wineries in Sonoma county (there are HUNDREDS!!), stopping at B.R. Cohn's, Martinelli's, and then Martin Ray for some tastings. Now, it's a good thing he was driving and that there's someone who has an ounce of tolerance around here, because even the little tastings they gave us got me loopy by about 1 p.m.! We had some great local wines, though, including a yummy Muscat dessert wine, good Zinfandels, and also some tasty olive oil.
We had some really good pie at a local place in Sebastopol, Mom's.
We then headed out to Point Reyes National Seashore, which you may recall I saw from the air with Mike back in October (see below). However, the weather stank (rainy, stormy) and we could hardly see past the little curvy road that headed out there, despite some glimpses of the surf!
trying again...
The day concluded with a visit to Shomir's sister and brother-in-law's place south of San Fran, where I got to meet his three adorable nieces, Anne, Lily, and Emma, and rest for a bit before coming back to Sac-town.
CALIFORNIA IS SO FUN TO EXPLORE!!! :)
Monday, January 28, 2008
(Perhaps not so interesting) updates
- I realize that it has been over a week since I posted. I can't keep up with Kristen, though (props for all of the recent postings!)
- I guess my life is not that interesting.
- As for social outings: Amy, Shomir, Katherine, and I went to see "Bodies Revealed" (plastinated bodies) last week; not as good as "Body Worlds" which I saw at the St. Paul Science museum last year, but still good.
- "Tainted Love," an 80s band, played at Harlow's on Friday, where Amy, Kate, Shomir, and I jammed away. I wish I'd crimped my hair (some people went all out!). I love 80s music.
- I recently read House of God, which I wouldn't recommend. I hope to read some better books over break.
- I want to go see 'Kite Runner' but friends (ahem, Amy and Shomir [I realize that this is sounding a bit redundant, but no, we are not joined at the hip but do hang out a lot!!]) who said they would go w/ me want to "read the book first" but haven't been doing so much reading. I gave them a deadline of Saturday; otherwise, I'm going to go by myself or something on vacation!
- I realize I'm slacking w/ the pictures, but I've started to get made fun of...
- MICU (which, truthfully, has actually turned out to be pretty great with great attendings and fun other residents) continues. Three weeks down, one week left.
- I successfully, on one poke, placed a central (internal jugular) line last week and did not drop a lung or puncture the carotid (this may not be a big deal for some people, ahem anesthesiologists like Hansie, but it [placing it; don't worry, I haven't injured any structures on anyone before either] was really nerve-wracking for me b/c I'm not confident at all).
- Sadly, I learned (when checking up) that another one of my patients who we transferred to the floor died 2 days later. I have yet to learn the details but this shook me again. One thing I will NOT miss about the ICU is the frequent deaths. I don't think I will be transferring any more people to the floor.
- Luckily no one died my last night (Saturday) on call in comparison to one of the early ones when two did and when I had to pronounce one.
- I got called about 150 times to Tower 7 on my last night of overnight call. I kid you not.
- I started hanging out on Tower 7 so they wouldn't page me every 5 minutes.
- I slept near-continuously for about 19 (yes, that is nineteen!) hours after call.
- I don't think I'm made for q4 overnight call.
- I was a white cloud, though-- only 2 total (instead of 10!) admits.
- Today was my day off which I luckily got FREE from clinic (had to have clinic one of my days off on week 1) or testing responsibilities (had to take the CREOG, or ob/gyn inservice exam last Friday on my day off)
- I got a haircut today! No pics, though. You'll have to wonder what it looks like. Maybe I won't post any until I figure out the Kits' May baby's name (you realize, however, that they could significantly expedite this).
- This is the first haircut since May, before graduation!
- There are no costcutters or Haircutteries in Sacramento! (I went to SuperCuts).
- My fridge went on the fritz again. This time the temp was 56 degrees.
- My landlord is as frustrated as I am and... drumroll...now I have a new fridge!
- I can officially feel okay about grocery shopping for less risk of things going bad; however, I still hate grocery shopping and do not enjoy cooking.
- Shomir introduced me to gummy vites today. OH MY GOSH. If I had only known about gummy vites (chewable, gummy-bear-like vitamins!) when I was a child, I would have been much more vitamin-replete! Those Flinstones vitamins my parents forced on us were nasty (remind me to tell you about my sister's love and history with Flinstones vitamins sometime...). Maybe I will never have to go shopping... I could survive on these things...
- I promptly went to Target and bought gummy vites, among other miscellaneous things.
- I realize that I'm on call on Superbowl Sunday :(. Not that I'm a *real* football fan, anyway (Phi gives us a hard time about this), but I do like to watch the 'big game.' :)
- I love days off.
- I am very inefficient on days off.
- The hours in my day off are passing too quickly.
- I should go for a run.
- This post is nearly as random as Ebby Ray's.
- In one week, I will be post-call, DONE with the MICU and PACKING to prepare to head to Destin and then to McLean!! (Yay, vacation!!!)
- I like vacation.
- That's all I got.
Sunday, January 20, 2008
q4 call, q7 posts
Last Monday, the first call night where I had to carry the pager, was about as busy as a call night could be with 10 (!!!!) ICU admits, a near-record. Although it was quite tricky to answer all the cross-cover calls on what ballooned to a 46-patient or something service, I (on the "team that has it easy") was blessed to have both another intern to split them with (no, Hans, I, unlike you, am not superhuman and could not physically do that all!) as well as a great senior who took one of them himself. Some firsts for the night: anoscopy to evaluate for a source of GI bleeding (this little bedside funnel-thingie.... I'd never used one until then!) and pronouncing death in a patient who I had never seen before... very difficult and moving. Similarly sad was learning, this past Friday (our next call, where I again took the pager but which was just BORING in comparison), that one of the patients I'd recently transferred to the floor died the next day in the hallway in his second (this hospitalization) cardiac arrest. I was really shaken. Despite feeling more comfortable with the ICU setting, this is one of the many reasons I don't particularly enjoy ICU medicine. I cannot handle deaths.
On a lighter note, are some pics from some recent fun outings.
Then, today, as I had it off, Amy and I took off for a mini day trip to Berkeley (East Bay- around 75 min. from here) and a movie in SF. Berkeley was cool! I'd never been there, but it is home to CAL and has a very hippie feel... Amy and I walked around a bunch, visiting some quirky shops and then going to eat at Cafe Gratitude, a restaurant that specializes in Raw food which, from what I understand, proposes that the best food for you is that which has not been cooked over a certain temperature... The menu was interesting (all items had names like "I am triumphant" or "I am peaceful"-- very "granola,") but the food-- the sushi bowl I had and the enchilada Amy had (which I definitely tried)-- was great! I also tried some almond milk with my organic tea and we did break down and split some raw carrot cake, which was yummy and quite healthy, too!
"I am grateful"
Amy and I then headed just a bit further west to hit San Francisco to see The Business of Being Born, a documentary (only playing in select cities) recommended to me by my advisor, which discussed many aspects of the birth process and which really raised great points about doing it the "natural" way with midwives and home-births. Although that may put me out of a job, I really took many points home and think I'm going to try to seek out some exposure to labor in these settings, as I think we truly are too aggressive and interventionalistic in our hospital setting and in medicalizing something which is truly, most times, very uncomplicated.
In any case, we are back in Sac now (I still can't get over how close SF is!) but, as there is no MLK day off for me, I should head to bed. Good night! Until next time...