Opened eyes

Although I consider myself a fairly adventurous, if not just curious, person, I sometimes am a bit "behind the times" with experiencing interesting activities. This random post is about 3 recent awesome discoveries: 1) the TV show The Office, 2) Dodgeball on Trampolines, and 3) Facials.

The Office

Oh my goodness. I know this show has been out for, like, 6 years, but this is the first year I have ever watched an episode (and, mind you, that is not an episode from the current season but rather from back in beginning). I heard about the show and all of the inside jokes while in Peru earlier this year with Mindy and Kelvin, who can pretty much quote the show line for line. At the time, this was mildly amusing but made no sense to me. Now it is hysterical.

Those of you who know me pretty well know that I do not watch much TV at all. Growing up overseas, we just did not watch TV shows. I remember watching and being mildly obsessed with The Brady Bunch, which I assume I watched only when we lived in Virginia for 2 years, but other than knowing quite a bit about the characters on that show, I tend to stare blankly when people bring up TV shows that ran in the 80s or 90s when I was too busy reading Nancy Drew than to keep up with pop culture. I watched a lot of sports in high school, but never got into any regular shows because I think they (i.e. ER) were all on too late for my little 9 pm-bedtime eyes (neither my TV- watching habits nor bedtime has changed much since then!).

I don't currently have cable or any channels on my TV at home (which is not even an acceptable size to watch TV, according to some friends) and have to rely on others inviting me over to watch current shows and major sporting events. Luckily, I have next to zero friends who, like me, live in the dark ages, and I rather have very generous friends who are very accommodating to me inviting myself over for TV-time (while, at the same time, probably wondering how I can survive in such self-imposed deprivation. In any case, you know who you are... and I thank you!!).

Anyway, getting back to the topic at hand... There are a few shows which I really have adored, including Friends and Scrubs. I also think that the new show Glee is awesome, but (despite having listened to the soundtrack about 17 million times) have only seen a few episodes. However, I have to say that The Office might just top those. I started watching Season 1 when I got back from South America, and have steadily worked my way to Season 5. I am utterly and totally addicted! I have to cut myself off and even have to resort to watching the "deleted scenes" at the end of the episodes to "make it last longer" so I don't run out prematurely! I really do wonder when my next Office episode is going to come from. This is the true sign of an addiction, is it not?


For those of you who know and love this show, you probably know what I mean. For those of you who do not know of/follow it (it chronicles the ludicrous and hilarious escapades and relationships of the office staff of Dunder Mifflin Paper Company)-- please start watching from the beginning. Although I often try to multitask while watching TV, shows, or movies (the little I do watch), I recommend that, to get the full effect, you give this show your full attention and your totally undivided time. I have a feeling that, when I come to the end of the current episodes, I will be very depressed and suffer from Office-deprivation. So please, based on my tastes above, feel free to recommend other shows I should try next!!


2) Dodgeball on Trampolines

Does this sound like a good idea to anyone? As someone not very into getting pelted by balls, dodgeball on the ground would not have been an activity I was excited about. As a very klutzy person by nature (just last night, I managed to trip over a loose screw in the paneling between my bedroom and bathroom, ripping a hole in the ball of my left foot, gushing blood everywhere, and ruining my chance for an AM run today. And yes, my tetanus is up to date), trampolines definitely strike me as dodgy (and dangerous!). In fact, Brian, the husband of Rachel, one of the 2nd year residents, had just broken his foot jumping exuberantly at the trampoline place in town, Sky High Sports, where we were slated to go for our post-high-school-physical-resident-bonding-activity a couple weeks ago. Since I usually am game to at least try most things (if I can skydive, I can play dodgeball on trampolines, right?), while I didn't see any outcomes of such an activity being favorable for me in any way, I still went to bond with my graduating class.

It ended up being an awesome time! There were individual trampoline panels on each side of the middle dividing line, and so you were not necessarily jumping right next to someone with the risk of falling due to a "double bounce." We'd quickly divide into teams and just go when the ref told us to. The court was enclosed, so you couldn't fall off. No one got hurt. Although I didn't get much of a workout due to my consistently getting walloped by a ball and thus gettingout within about 30 seconds of starting each game, bouncing and dodging flying balls was quite an aerobically- challenging activity! If you have such a place near you (although I'm not sure you would.... it is so random!), I'd give it a try! Or come visit me in Sacramento and I'll take you :)

3) Facials

I am not much of a beauty- product or "pamper yourself" kind of person. I think Wendi took me to get my first pedicure, in Rochester, MN before our Nigeria trip, about 3 years ago. Since then, I've had a couple, and while it's fun to get flowers and things doodled on my toes, I still think the best part of pedis (particularly after the hours I've been working in residency) is the foot massage. I've had a couple of body massages-- my first in Rochester (at a massage school... who knew I'd be introduced to so much high culture in the little MN town of the WFMC!), and my second (a "Mayan Massage") in Guatemala last year. If I had unlimited funds, I'm sure I would do such things a bit more often. But I tend to feel a bit guilty in general spending money on both "things" and frivolous activities for "myself" and so generally forgo such luxuries.

Today, my friend Julie, a L and D nurse here, held a "Spa Party" at her house. It was overall just a very fun time for girls to get together, eat yummy snacks, socialize, hear about issues with relationships, pregnancies, kids, etc., but also to get some "services" done by professional masseuses and estheticians who were there for our business. Initially, I wasn't sure if I'd sign up for anything. However, I decided to take the plunge.

I could have used a massage (who couldn't?), but haven't been doing anything too strenuous lately, so thought I'd save my next massage for after my next half-marathon or something (which is nowhere in sight). With my new left foot puncture, I thought I had better forgo a pedicure in order to reduce the risk of getting some sort of nasty foot infection days before I fly across the world to East Asia. I also wanted to try something new. So that meant choosing either: a) waxing (including Brazilian if desired), b) a manicure, or c) a facial.

Re: a) (waxing): OUCH. There is no way I would ever let someone do anything like that to me. I would rather have a child without an epidural. Or puncture my right foot, too. I could have gotten a manicure, although I'm not sure what all it entails. I don't have very attractive nails at baseline, and have to keep them short for work anyway. I'd like to get them painted prettily, but I'm not sure that we're allowed to have bright nails at work, either (? a professionalism thing?). So that led me to choose the facial.

I was a bit nervous, as I didn't want to have any crazy peels or anything that would make me walk out of there looking like a ripe tomato (I had to come to work tonight! And who can predict when it's going to be a night when I never see the inside of the call room?). I didn't know what to expect. But I would definitely have another one sometime-- it was a real treat! I felt a bit weird at the beginning, when the conversation I had with the esthetician went something like this:

Esthetician: So what do you do for your skin?

Me: Umm... not much, actually.

Esthetician: Do you use any facial products?

Me: Umm. Well, I try to wash my face a couple of times a day.. with like Irish Spring soap. Is that ok? Sometimes I exfoliate.

Esthetician: Well-- that's a start.

Then, [After looking closely at my face under a lamp]: did you have bad acne?

Me: No; those are from Chicken Pox.

Esthetician: All of them?

Me: Yup. I was a bad scratcher.

Esthetician: Do you use sunblock?

Me: Well- not daily. I definitely do when I play frisbee and run around outside.

Esthetician: You should use it more. You are showing signs of hyperpigmentation from the sun.

Me: Uhh... ok.....

But then, the rest of it was great! What she did NOT use was cucumbers on the eyes, which is what my facial-naive (or "facial virgin" as she called me!) mind was envisioning. She used some serial facial cleansers, then some hot towels on my face and neck (which reminded me of the airline towels!), an exfoliating mask, massaged my face, neck shoulders, applied some moisturizers, and then released me.

I definitely feel the difference. While I'm not sure I am "glowing," I do feel that my skin is smoother. I am not sure whether I wanted it to "take 10 years off" (many patients already tell me I look way too young to be a doctor or deliver their baby), but it sure was rejuvenating. I'm not sure that my current bank account nor my self-care tendencies can support a regular facial habit (she told me that one should get these about every 5 weeks!), but it was definitely worth it, and I probably will do it again sometime in the future!

So there you have it:

The Office, Dodgeball on Trampolines, and Facials. Go try them if you haven't :)

Night float: (not too much of a nightmare... for now)...

On Sunday, I switched from jeopardy to night float. Night float for FP is a two-week rotation working Sunday- Thursday nights, with about 14-hour shifts running from 6 p.m. to 8 a.m., as well as Friday morning post-nights "torture" clinic each week. Responsibilities include: evaluating/admitting from the ED any FP patients, as well as admitting other ED patients without primary doctors that fall into the "grid" (i.e. male abdominal pain, cellulitis, and "placement" with odd medical record numbers, and other arbitrary designations), evaluating OB patients that come to triage, managing laboring OB patients, covering the ward team floor calls, taking care of/admitting the newborns born to our FP obstetric patients, and answering "phone triage" calls (where patients call the operator asking for the family medicine person on call).

It can be overwhelming, for one person, if it is busy. I've had some busy call nights, but nothing out of control. Overall, I tend to be a very "white cloud" night float if you recall a former post I did about call and clouds.

So far, this week, I have had to do 3 ER admissions and scattered operator calls (interesting when patients call, half an hour shy of clinic opening, about sore throats, and a bump on the head!), but no OB triage, laboring patients, or deliveries (which, although stressful at times with other stuff going on, I actually regret because OB is so fun for me!). I tend to feel kind of guilty while on night float, actually, because I feel sort of bad "sleeping" while on the job, even if there's nothing going on! I have maybe, on maybe 1-2 occasions, slept for an hour without being interrupted while working nights on OB, which is where I more often am. I also don't sleep well in the FP call room, always worried that I will not hear the service pager if it goes off, even though that is pretty ludicrous because, at home, when I get pages throughout the day about free lunch meetings, etc., when my pager is on vibrate in another room, I still wake up. I leave half of the lights on in there, just in case. However, I have caught a few winks here and there.

Some downsides of night float:
- I tend to get lonely on night float, as the lone member of the FP team there in the dark, so sometimes I go hang out over on the OB floor with the OB team.
- Even when I don't sleep there, I don't sleep well at all at home during the day until, by the end of the night float week, I'm so exhausted from not sleeping that I sleep very well.
- It's weird working while others are sleeping, and I miss social activities like Tuesday night resident dinners. It can be isolating when you don't see your friends "normally" for a couple of weeks (it was nice that Char, on call in the MICU, came down to the call room on Monday and kept me company!)

However, I actually have been quite productive this week and there are some perks to night float:
- theoretically, I could run errands like go to the bookstore, grocery store, bank, post office, during the day, although I have not needed to yet this week
- I have weekends off, although it it sometimes tempting (although bad for social life) to stay on a nights schedule

Things I have done this week include:
- gone to the gym. I am very much a pre-shift worker-outer. I can never motivate to go to the gym or go for a run after working all day and generally prefer to go in the morning. However, working nights makes it easy to go in the afternoon, which is before my shift. And in daylight, too, which is a benefit over going at the crack of (dark) dawn.
- biked home and to work in the light. This is very nice, even though I did just get some nifty glowing wheel and front lights for my bike.
- read for pleasure. Monday, finished Eric Weiner's Geography of Bliss, about his search for the "happiest" places/countries in the world. Currently I am very into Dan Brown's latest and very fast-paced The Lost Symbol (thanks, Wai Kiu and Hanh for loaning it to me)

While at work, I have:
- paid lots of bills
- figured out getting replacement parking permits
- finalized travel and lodging for Kelvin and my upcoming Asia trip (we leave for LA on Feb. 6 and then to Manila on 2/8 for the month!!)
- made copies of documents for travel
- arranged for holding mail and forwarding email, which I doubt I'll be able to check often while overseas
- stayed on top of my EMR inbox and tried to get organized for patient follow up appointments for when I return in March
- worked on our STFM poster (Char, Rocky, and I are presenting at a Society/Teachers of Family Medicine conference in Vancouver in April)
- hung out, at Priyal's house, just a 5 min walk from campus, with my to-be-OB-chief class (all 7 of us in one room, which I don't think has ever happened while in residency!) discussing scheduling for next year
- caught up on AAFP and other medical magazine-reading
- emptied my yahoo email of, I kid you not, over 7600 emails (pretty much exclusively spam)
- caught up on other e-mails
- leisurely read friends' blogs
- done e-value evaluations which were long overdue for faculty I worked with and rotations I have done long in the past
- talked on the phone (something which I don't really like doing all that much)
- watched a little bit of TV (I could really work on this-- maybe I will try to watch IDOL tonight on the large screen in the call room :))
- managed 2 blog posts in one day, a feat which I don't think I have done yet in residency

Night float really has been anything but a nightmare... so far. But I still have 7 nights (2 more this week, 5 more next week) left to survive.

Spectacular powder!

Jeremy, Noelle, and I drove up to Tahoe to ski/snowboard last Saturday (I was able to get my jeopardy covered-- yay!, and Jeremy's mom watched baby Kacey for thd day!). While the drive up took a long time-- there was rain, slow traffic, we saw signs for mandatory tire chains and so put ours on, but then realized the road was too good for chains, and took them off, we made it (about 3.5 hours after departing-- normally takes less than 2 hours) to Northstar by a little after noon.

Since we have been having nothing but RAIN in Sac for about 2 weeks, we figured there would be excellent powder up there in Tahoe. There was (about 10 feet of it!). Tons of other people had our same thought.

The lifts were a bit crowded, although the slopes weren't too bad. Although with only a half-day, we didn't get tons of skiing in and it was a bit cold (20s), it was perhaps the best snow I have ever been on. I mainly stuck on groomed blues, but maybe could have dared a black diamond because the conditions were so great (maybe next time :)). Noelle, in her first time back on her snowboard after having baby Kacey last year, did great, and Jeremy attempted the moguls on skis, which he hasn't been on in 7 years (Phi has converted him to a snowboarder)!

It was such fun being out there, as well as hanging out in the car with Jeremy and Noelle, singing Glee songs the whole way there and back, and catching up on their lives :)

Noelle and Jeremy

Us three

We'll see if I can go skiing again this weekend before the Asia trip in February, as I'll be gone and missing out on a big ski month. At least I'm not on jeopardy anymore!

Jeopardy Jail

I am currently on Jeopardy Same Day Access clinic for 2 weeks.
It might be my least favorite rotation yet.

While it means that my "scheduled" hours are quite nice in that I am supposed to be present and see patients in FP clinic from 8-5 (M-F) and have no scheduled weekend calls, I am only opened up for "same day" clinic slots in the chance that someone a) gets ill or has an emergency and can't go to work, b) forgets about and doesn't show up to work or call, c) has an alternative educational opportunity to attend during their rotation/call, d) is busy with a continuity OB delivery, or e) there is a scheduling snafu and someone's clinic has to be covered because they somehow were scheduled to be in 2 places at once.

There may be more scenarios that I am not aware of.
Basically, I am needed nowhere, but I have to be accessible at all times.
It is kind of a bummer.

It was actually convenient this past Monday, when I felt awful after fighting a week long URI with hacking cough (which certainly was not improved by skiing last weekend... more on that below) and was sent home from clinic (never mind the 30 or so patients I probably infected while seeing patients all day, bearing a mask, last Thurs and Friday). No one had to cover for me, because I am the jeopardy resident and, as mentioned above, I am sort of an "extra body" but not really anyone of any importance.

I would say I'd rather be on OB as Antepartum resident or at Mather VA than on Jeopardy, but that might be just being dramatic. I'm not sure I believe that. However, it is just quite restrictive and rather annoying.

I am not allowed to schedule in advance any of my own patients in clinic, in the off chance that I get "jeopardized" somewhere else to cover someone else. With already-limited clinic slots and somewhat lagging (relative to my classmates) in patient "numbers" (we are required by the residency accreditation committee to see a certain number of patients before graduating or completing each year) due to all the time I spend on inpatient OB, and with an upcoming away rotation in the month of February, I definitely don't have enough clinic slots to see my own patients on my panel. And I am still not really building numbers because they often don't open me up in same day clinic until a few time slots in the day have already gone by, so I basically sit in clinic, bored, "trolling" other residents' schedules for patients I can take off their hands in order to be doing something useful, if not only just something. It is not efficient. It is bad for continuity. However I must say, my inbasket (of results, patient calls to return, refill authorizations, etc.) is pretty pristine (perhaps the cleanest it's been in residency!).

And while I technically have weekends off, I don't really, because I have to be within an hour of here, and bearing my pager 24/7, to potentially cover someone if they need it. Bummer, with a three-day weekend coming up, and it being ski season with Tahoe so close.

Last weekend was awesome (note that it was the end of my ENT/ophthalmology block and pre-jeopardy). Despite not having a voice due to a bad cough, I was not about to let plans fall through (esp ski plans with good friends!) and I joined Erin, TJ, Christian, and Mike (friends of theirs from Stanford) skiing at Sugarbowl up by North Lake Tahoe.

It was awesome! Due to an early start, we basically got a full day in, from lift open to close.
It was so great to see Erin and TJ, as well as Mike and Christian, who I'd met before, both in Palo Alto and at Erin/TJ's wedding.
Mike had never skiied before, but (a true natural) was doing blue slopes by the end of the day!
The snow was good, it was not too crowded, the slopes were varied and interesting, the weather was great (warm in the 30s just until it started to rain at the very end of the day), I think I inadvertently made it down a stretch of black diamond (which I swore I would never intentionally get on), and I didn't fall the entire day (that is my measure of true success!).
Good times. Here are some pictures:

me and Erin on the gondola up

at the top

all looking at something interesting!

Jeremy asked if people wanted to go skiing this or next weekend.

I want. I want a lot. But I can't. I'm not a gambler and I can't head up there if the off chance I could be called back.

Please let me know if you want to be jeopardy jailbird for any of the above weekends :) I will pay you well :)

A new year...

Happy New Year 2010!!!!

It's hard to believe 2009 is now behind us. It was a very good year, filled with great friends, travel, adventures, and lots of fantastic memories! I stole the idea of "recapping" in pictures from Wendi, so here's a brief synopsis of what I was doing in 2009 (besides working hard as a third-year resident, that is :))

January 2009 -
Lots of skiing at Tahoe (actually, how we brought in the New Year 2009)



Monterey- Trip to the Aquarium and whale-watching


February
Skiing in Salt Lake City and visiting Molly!




Cruise from Florida to Jamaica!


Parasailing in Key West

March
Visiting the Kitsteiners at Eglin

Running the Shamrock Half Marathon with Chrissie

Hosting Cathleen's visit to Sac-town (and finally getting to visit the Jelly Belly Factory in Fairfield!)

April
Celebrating many friends' pregnancies:
Triple baby shower for Noelle (and baby Kacey), Betza (and baby Rafael), and Anika (and baby Madeline).


Congrats to other great friends who are now parents after babies in 2009-- Wendi/John
(Elijah), Laura/Tony (Abbie), Hans/Rachel (Kaia), Katie/Ryan (Luke), Natasha/Nikola (Cristiano), Sarah/Matt (Eleanor), Susanna/Mike (Gemma), Wai Kiu/Hanh (baby Mason who I had the privilege to deliver!)

Can't wait to see the 2010 round!

May
Attending Ajit/Jeny's wedding in New York ...



... where I got to also catch up with the Kitsteiners and Joneses


June
Hiking with Erin: Mt. Diablo


Graduations, where we said goodbye to Aline :(

FP/OB force


OB graduation


OB roast


Camping with my new class (now R2s) at Folsom Lake

July

Hiking in Mammoth Lakes over the 4th of July

Playing frisbee: a new tradition!

Roadtripping to Mendocino/Ft Bragg


River Rafting!

Courtland Pear Festival

August

Visiting with Jeremy in San Francisco

Jumping out of a plane with Kelvin

September

Swimming in San Diego with Molly for Labor Day Weekend

Celebrating Amy and Jesse's engagement

(and subsequently, celebrating engagements of also Kate/Darrel, Kyla/Ben, and Phi/Cassie!)

Visiting Lassen Volcanic Park

October

Peru: Lares Trek hiking (Mindy)

Machu Picchu, for the second time


Salar de Uyuni, Bolivia




November

Seeing "Wicked" in San Francisco

Turning 28

December

Getting to fly home to Virginia to see my wonderful family for Christmas

I love my little sis!...

... and dogs :)

... and godparents....

New Year's Eve was spent at a house party with Amy and some friends of hers. It was a really fun time, and I'm super excited that I made it until midnight without falling asleep :)

While I hope there are more great times ahead to be had in 2010, I welcome the New Year with a bit of wistfulness. While I have another year and a half of residency training left, some great friends I've met in California with whom I started residency are going to be finishing their third year and graduating in June. I am quite sad when I see them all looking at jobs/fellowships (some far away) and at what they will be doing in their next stage of life. While they are moving onwards, I feel that in some ways, I am being left behind. While I have definitely bonded with the class (R2s) that started last year and with whom I will graduate, I am hoping that some of my "original" classmates stick around to keep me company so that I don't miss them too much.

I am reminding myself:

"Just because something good ends doesn't mean something better won't begin." - N. Bowers

"Learn from yesterday, live for today, hope for tomorrow." - A. Einstein

Best wishes to all for a happy and healthy 2010!