Permissable waste (!)

So I have decided that it is a good idea to live in California, which, according to Erin's parents, is the "Land of Fruits and Nuts." Now, keep in mind that I am rather a Golden-State-transplant, moving from less awesome and perhaps less liberal parts of the country. I do love California. And while I consider myself curious, adventurous, resourceful, "green," open-minded, and pretty moderate in most viewpoints, I am definitely on the very conservative end of at least one thing.

An attitude towards placenta-eating.

The occurrence of this practice came up recently in a discussion with another resident. I was shocked in learning what he/his wife were going to do with their placenta from the delivery of the baby that they are expecting later in the year. I was thinking to myself, "gosh, Tara, you are both quite ignorant, and being pretty judgmental" as I heard (staring, with a likely gaping open mouth) about the multitude of benefits that placental consumption can confer, including staving off postpartum depression and increasing milk production. I seem to recall that I've heard that other animals do eat their "afterbirth." But us humans? Eat the product of the third stage of labor?! (this makes Nigerian goat head look like a bland piece of toast or something!). I wondered why, if it was such a delicacy and extreme health-booster, I hadn't been taught in medical school at the WFMC about all the benefits of placenta-eating. Or heard about it more on Labor and Delivery, where I have passed a good many of the past 24 months of residency. Did you know that placenta makes a pretty good/mean spaghetti sauce (or, as I learned today, a pretty hearty, wholesome smoothie) ?

Fittingly, just today, I came across an article by Joel Stein in TIME magazine. And so I felt obligated to post again in what might be my most productive week of blogging YET in residency (yay for being an R3).

Please enjoy the following article by Joel Stein entitled "Afterbirth: It's what's for dinner."

"There is so much you can't know about your spouse when you get married, like that one day she will want to eat her placenta. But there are two things you don't argue about with a pregnant woman: what she eats and that being full of life indeed looks sexy. So when Cassandra told me that for $275, a woman would come to our house, cook Cassandra's placenta, freeze-dry it and turn it into capsules to help ward off postpartum depression and increase milk supply, I said, "$275 is a bargain compared with the $20,000 I'll have to spend to tear out our kitchen immediately afterward."

Most mammals, Cassandra explained, eat their placentas, to which I countered that most dogs eat their poop. I stopped arguing there, figuring that like many of Cassandra's hippie ideas — the compost bin, rubbing lemon on her underarms instead of deodorant — she'd give up on this in a few weeks. Even as the due date approached and she was still set on eating her placenta, I couldn't imagine that she'd remember to request it from the doctor after the most physically draining experience of her life. This is a woman who, 9 times out of 10, forgets the bag of leftovers at the restaurant.

Though I am exceedingly squeamish, when my son was born, I was shocked that I saw only the beauty of childbirth. Until the placenta came out. There are many normal human reactions to seeing a placenta, ranging from screaming to vomiting to warding it off with a cross. For those of you who have never seen one, the placenta is to the baby what Stephen Baldwin is to Alec Baldwin. It's what your liver would look like if it got into an accident on the autobahn with one of those aliens from Mars Attacks! and their bloody carcasses threw jellyfish at each other.

When the placenta did come out, Cassandra, dazed from 21 hours of labor, somehow made sure the nurses delivered it to us in a flat plastic container, which I put into an ice-filled Monsters vs Aliens cooler I brought. When I asked if I could keep the placenta overnight in the refrigerator out in the hall, the nurses looked at me like I was crazy. When you gross out people who work at a hospital, you have accomplished something.

In a fog, I drove the placenta home, where I wrapped the container in a bag and wrapped that bag in a bag and wrapped that bag in every remaining bag we had in the house. I slept at the hospital that night, grateful that my son will never remember what his parents just did.

The next day I drove back to the house to meet the placenta lady, Sara Pereira. To my surprise, Sara did not look unkempt, frumpy, heavy or in any way like a Wiccan. She got into placenta-cooking after taking a Chinese-medicine course and has already prepared more than two dozen placentas this year — and orders are picking up rapidly. When I asked Sara if her parents were embarrassed by what she does, she told me that her father sells bull semen.

By law, Sara has to cook the placenta at the placenta owner's home. But to my great relief, she brought her own equipment, gloves, sponges and even more detergent than I'd hoped, scrubbing constantly as she worked. If I ever kill a man in my own home, I am totally calling the placenta lady.

As she steamed the placenta with some herbs, the kitchen got that ironlike smell of cooked organ meat, with vague undertones of a consciousness-raising group and a Betty Friedan rally. Sara said Cassandra had a particularly robust placenta, and she hoped to get 120 pills out of it. As she sliced the cooked organ and put it on parchment paper in a dehydrator, she told me that some people drink the placenta raw as a smoothie. "I do this for a living, and I couldn't do that," she said. The pills, she explained, were superior, since Cassandra could stretch their hormone-rich benefits much further, perhaps even freezing some for menopause. Sara did not understand that when Cassandra's looks fade in her 50s, there's no way I'm putting up with this crap.

I drove back to the hospital where, thanks to my experiences, the food looked good. When we got home the following day, Sara gave us a truly beautiful placentapill presentation: a pretty glass jar, a card, a CD of lullabies and a satin pouch. In which was part of my son's umbilical cord, fashioned into a heart. When I asked Sara what the hell I was supposed to do with that, she said people often use it to keep a baby's first tooth and lock of hair. That's when I realized that placenta-eating is really just the beginning of how gross we humans are. And I went to change my first diaper."


So please comment and let me know your thoughts.

Hans/Rach-- what are your placenta plans when baby Josie arrives in a few short weeks?

There are not too many things that I will not eat, or at least try. But placentas???? I do not see placenta-consumption in my future. If I am blessed to someday have children, I think I am comfortable letting my placenta go to "waste" (if standard biohazard disposal of bodily tissue is considered true waste). And I think I am okay (are you with me, Les?) with others' (i.e. my patients') placentas being wasted as well.

Exclusive photos

From la camera de K.R.-- much awaited photos!! :)

Me and my phenomenal "big sis"

A long ago dinner of tapas with next year's FPOB team -- me, Jessica (1), Kyla (chief), Joe (2)

And for more recent festivities...

OB graduation

Kyla, Suzanne, Aline, Jessica, Sarah, me


(con kiddos)-- with Kenia, Magnolia added



OB Roast
We had fun with the headboards! (well, mainly just Aline's ... :)

(on this pic, can you make out my major sunburn from that day's hike w/ Erin??)

Striking likeness!

Out and about...

Aline, Lucy, Kyla, me

Lucy, Kyla, me

Aline, don't leave us!!!

Times two

"24 months down, 24 months to go!"


As depressing as that might sound (24 more months of "jail?!?!"), it's actually quite reassuring.
It is so hard to believe that I'm halfway done w/ residency! I really think that year 2, which was quite fun at times for me, went by very quickly.

As of TODAY, I am no longer a 2nd year but rather a big third year (or 2.5 year or something screwy like that). We did a grand rounds last week where we had role playing for our "huddles" that start every clinic half-day, and somehow, while Phi got to be called a "senior resident," I was titled "mid-level resident." Hmm. Not sure how that works :). However, I can really say I'm a PGY-3, which will bring its own challenges and responsibilities!

The last couple of weeks have been filled with lots of more social events. As of Thursday, I was DONE with stinky ER shifts and actually had about a four-day weekend to enjoy some of these!


First, here are some pics of the OB graduation last weekend. I thought it was so funny when Aline (soon out of here to CO... sniff, sniff) told me that her little 3 year old daughter asked her this past weekend (after 2 back to back weekends of FP, then OB graduations), "Mommy, are you graduating again this weekend?". I can claim credit for none of these pics. Hoping Kyla (ahem!) can send or facebook more my way.

Numas, Kenia, Aline (we will miss you so much!!)



Graduating OB chiefs (Noel, Jelriza, Sara, Dr. C [res director], Hao, See, Andi)
Really hard to believe I will, in two years, be standing in their place.





Interns no more! (and don't they look thrilled!!... Congrats to Siobhan, Helen, Sarah, Cara)





Cara, me, Sarah (love these now-OB-twos!!)




Dr. N, Helen, Sarah, me

New interns (Jessica, Anna, Mike, Allison, Stephanie-- don't they look optimistic??)

The OB roast party was this past weekend. It was a fun-filled night of laughs, including "roasting" the outgoing chiefs (all pictured on big headboards below), and fellowship with both current and former residents and faculty. This was followed by some more hanging out, dog-letting out, lounging, and dancing (which I don't even enjoy! Kyla is very persuasive!) with bedtime far later than I have done in a long long, while. Kyla, I need some pics, por favor.

Erin also came into town from Palo Alto to spend some time with me this weekend!

Friday, we did (on Joe's suggestion) a little hike to some waterfalls, University or Pilot Creek Falls, near Auburn. After only a few wrong turns in the woods, we made it to these pools. Unfortunately, we didn't bring our bathing suits but you can slide down the granite into the water below.

Erin, looking pensive

Fun pic w/ my camera on timer

Love this girl!! Hiking buddies forever!


Saturday, we did a long hike at Mt. Diablo State Park, which is just over an hour from here (between here and Palo Alto) by Walnut Creek. OOF DA! It was about 100 degrees at the base, we ended up taking a wrong turn and then decided to go for the summit (approx 15 miles round-trip!), I fell down several times on my behind on the way down due to sandy and dry trails, and I got toasted worse than I have in a long while, despite thinking I had applied sunblock in a reasonable distribution!! The good things were that we had brought plenty of water, the great views on the hike, and the exhilaration at having finished.

At the top

Monday night, I joined the now-R2s (with whom I will graduate) on a mini camping trip around Folsom. Fun times! After dipping in the icy cold water near Folsom Lake, we (on the 100 + day [it hit 114 on Sunday!!]) set up camp, then played some rousing Mexican dominoes and Times Up (love those games!), barbequed, played Mafia, and ate smores before dark. It was a good bonding experience!

Potentially more pics to come, but here are a few that I did actually take (I think I'm going to have to steal these from Brenden).

Kelvin letting us know, just outside Ashby's tent, where the restroom is :)

The "round table" of chairs around the fire we were hesitant to use because it was like 110 degrees out

Group: (Brenden, Kelvin, Rachel, Kristin, Serena, Ashby, Hanh, Wai Kiu)

I need to motivate w/ the camera! Will try to be better!

More pics may be added-- stay tuned :)

Graduation!!

Ah.. In just over two years, I will be graduating this lovely residency program.
Here are some stolen pics (I can't seem to take ANY pictures of my own anymore!) from the FP grad festivities Saturday. It was at a lovely place, Bridges on the River, although we were all freezing! I can't believe we had to wear sweaters in Sacramento June!!



FPOB team: Aline (4), Joe (1), me, Kyla (3), Suzanne (faculty), Sarah (faculty)-- some of my favorite people ever!!!

More:
Shom/Sonia-- on their way out!!!



Phi, Rosha, Brenden (sticking around for a bit longer...)



Aline, me, Joe

Anna, Sunny, Sonia- superchiefs

Only 2 weeks left of this year! Hmm... how many more ER shifts is that ??! :)

Pilfered wedding pics

I must say that I cannot take credit for even a single one of these pics (thank you Lesley and Wendi for sharing!), but wanted to post them for posterity.

Happy Joneses (Les's sari was amazing)



On the dance floor (David looks pretty happy, interestingly!!)


Girls (+ little E)


Baby duty!!




Groom with a funny face (er.. or funny-looking groom... :)). I, too, cannOT believe we didn't get any pics of Jeny or the couple!!!



Two of God's greatest gifts (the two people on the right :)...

Little Isaac, roaming the pews...

Boys galore

Blessings

Okay; so not only am I (solidarity, Lesley) near or at the bottom of Wendi's blogroll, but, yesterday, I also had the mother of a very important groom call me out on the infrequency of my blog updates. I guess it's due time for some May updates.

It's actually been a pretty great month! Some things I am certainly thankful for:

Smooth sailing at the VA
Despite having a rough 7 weeks on OB and still claiming I'd rather go through that again than go to Mather Veterans' Hospital, I actually had a pretty sweet month on Medicine at the VA. I started out with 2 weeks of being the ward "senior," an interesting role in that I was technically supervising interns and responsible for a whole service! I have done that on OB, but somehow, medicine seems different. I have to say that I was very blessed with Mike and Annamaria, who really didn't require much supervision (I caught them in May of intern year!) and with whom I really enjoyed working-- we had some fun times!!

After the weeks of wards, I went to dayfloat which, I have to say, was my least favorite week and one which I think most people dread. You are basically the screening hospitalist and take calls from outside facilities and/or VA hospitals wanting to transfer patients for whatever reason, as well as accepting all the admissions from the Urgicenter (ED) downstairs, which certainly tends to overadmit. You do all the admissions-- medicine, CCU (cardiology) and ICU admissions which come before noon (while the teams are still rounding) and then, in addition, fill in as ward "senior" for the various teams as needed when they have clinic, days off, etc. It is a tricky role because everyone always seems mad at you for making more work...

I ended (last week) with a week of night float, where you do some more admissions here and there and cover the CCU/ICU services. I was quite nervous that "stuff" would always go down in the middle night, but with the exception of one night, it was pretty benign. Some ICU players acted up from time to time, but no one crashed or coded (phew). I even got to sleep some, which always, for some reason, makes me feel incredibly guilty!

The best part of night float was that I had the weekend off to go to Ajit and Jeny's wedding in NY!!!

Wedding bliss
There was a lot of travel time involved, including leaving post-call on Friday morning to ride the bus to the airport, 2 flights (I realize now that CA is quite far from NY!!!!) with a looooong layover (+ weather delay due to the east coast) in Denver, a 3- hour time change, and an airport shuttle from Laguardia to Long Island, but I made it to the hotel by midnight to stay with Dave and Lesley.

Ajit and Jeny's ceremony was beautiful-- a church service part in English and part in Malayalam, followed by a fantastic reception at a country club. It was also so awesome to meet up with old Mayo buds, including the Kits, Joneses, and Antonio/Latova! Unfortunately, I will have to wait to steal pictures from the others, as I, totally preoccupied with the growing Kit munchkins Isaac and Elijah (champion spitter-upper), neglected to really take out my camera.

The literally 2 shots I took all weekend:

JB and Isaac at the lunch/dinner table


Hanging out in the hotel room... we wanted to see what little Elijah would do when placed on sleeping Dave's chest...


Unfortunately, I had to leave pre-dawn this morning to catch the shuttle back to the airport to get back to Sac, but all the travel went smoothly and I was back here around 1 p.m. with plenty of time to enjoy the rest of the beautiful Sunday!!

I am so blessed to have been able to go to the ceremony!! Please see Wendi's blog later for pics :)

Super Sac-town weather
I must say that although it's a downer to leave wonderful friends to head back to "real life" and work (MRSA- filled ER awaits me tomorrow at 7 a.m.), it is lovely to come back to Sacramento in the summertime. While we had some 100-degree days last week (I even adore the 100-degree days because it means I don't have to bring a fleece w/ me everywhere), today was 85 and characteristic of the cloudless months of summer that await me!! I went for a long run on the American River Parkway enjoying the outdoors (much more possible since I discovered Zyrtec, which is far superior to Claritin in my opinion) and wondering why no one was using their backyard pools. Two thumbs up for California weather.

More old friends
Adeel, one of the residents in our program here last year but who transferred to NY, was in town a few weeks ago to visit. Here are some random shots after hanging out at Chipotle...

Brenden, Jeremy, me, and Adeel


The boys (love Brenden's pink bag): Brenden, Phi, Jeremy, Adeel

Good reads

I've been fortunate lately to have some free time for reading! I just finished Michelle Richmond's "The Year of Fog," (about the search for a missing little girl) and Thrity Umrigar's The Space Between Us, about the saga between two Indian families of different class in Bombay.

Send additional book recs my way!!

Fall travel

I am looking forward to October, when I head to Peru to join one of my former professors and some Richmond sophomore students helping conduct dental, public health/hygiene, nutrition, and primary care clinics in a rural Andean village!! I have 2 weeks of vacation that follow, and I just found out that my college roomie Mindy will be free to travel around with me in South America!!! I have to start planning and get the tickets. Soooo excited.

Jail near halfway over!!
It is very hard to believe, but I just have one month left (grr... ER) before 2nd year of residency is over and I will be halfway done! Despite long hours, the stress, and sometimes being less than thrilled to have chosen the field of medicine, it really has gone by quickly. I can't believe that the 3rd years are graduating in a few short weeks-- will definitely miss them. Seems I should maybe start thinking about where I will be headed after I am through...

Okay, I think that was enough updating for a while and should hold me over until... maybe... July? :)

Mommy time!!!

It is so exciting to me that many of my friends are now newly-becoming, or soon-to- be becoming mothers!!! It is with great joy that I learned that today at 2:16 am, just in time for Mother's day, my dear friends Laura and Tony welcomed their little Abigail Christine (stolen pictures above) into the world. After 14+ weeks of torturous bedrest (now around 35w2d if my OB wheel works right [Laura, you knew I'd bust it out and you know I want details!]), and a quick 3-hour labor, they are equally (well, perhaps a bit more, although that would be difficult!) as excited. SO HAPPY for you guys!!!! I can't wait to meet Abbie!

Happy Mother's Day to all you Moms out there, as well as to my wonderful Mom (pictured below in Giverny during my parents' recent trip to France), Godmother, and Grandma (only one of whom will probably read this blog ;))!!!



Love!!!
t (a free babysitter and/or family doc anytime!!)

P.S. Vanessa-- does this post satisfy your blog-reading requirement?! :)