Prayers for Nepal

Help me pray the people and country of Nepal, a country dear to my heart, after the devastating 7.8-magnitude earthquake this weekend. My family lived in Kathmandu during two different posts with the State Department (1982-1985 and 1992-1995), and I have only fond memories of the lovely country (I think my favorite of all the countries we lived in), whose residents are suffering greatly right now.

Props go to my sis Vanessa for finding and posting this very old photo (my Dad is at the right, and our staff- maid, gardener, and cook Ram are behind us). I wish I had in digital form some of the more spectacular photos of the Himalayan scenery from the treks we took while there, as well as photos including the temples from "in town."

Here is a comprehensive list of some organizations to which you can consider donating financially to the disaster relief efforts.

Environmental Stewardship

I have been pretty environmentally-conscious for as long as I can remember (I think I wrote one of my college essays about being obsessive about scrap-paper-recycling, and somehow I wasn't deemed too quirky to be accepted :)). Kelvin and I and currently live in a very (literally) green area of the country, and we have become even more environmentally conscious and committed to reducing waste since being married and being here, particularly with a baby on the way.  Not only do a lot of the things we do reduce waste, but they also really save money. Here are some ways you, too can jump on board!

1. Drive an energy-efficient car 
We usually drive my hybrid Prius when we need to go on any substantial road trips, as it gets great gas mileage on the highway.  While it's not an "electric" car like my Dad's Chevy Volt (which he charges nightly for a few cents and for which he hasn't had to fill the reserve gas tank for almost a year!), it works well for us.

the plugged- in volt outside my parents' house last month

We also save greatly on gas (which is very pricey in our area due to its location) by living close (Kelvin - less than a mile, me- about 3-4 miles) to our primary workplaces.   Biking to work (for K, at least; I have to get on a highway) would make great sense (I biked the few miles to UC Davis all throughout residency and didn't own a parking permit), although our weather here in Humboldt makes that a somewhat tenuous option.

2. Don't waste food
I have always been a good rescuer (hence the name of this blog-- I will eat bananas way past their normal consumption date).  I have gradually and successfully converted Kelvin, too, to be a good eater of leftovers. He won't make the same extreme effort as I do to make sure everything gets finished in days or weeks, but, depending on the meal, is pretty game and cooperative to eat leftovers for lunches and some dinners so that I don't have to cook daily (I hate to cook, BTW).  He makes fun of my "rabbit meals" of random leftovers, but it works.  We also eat out very little, except when on vacation, and also try to buy locally and what is in season at the store.

We do have a compost tumbler bin off our back porch where our kitchen scraps go, which makes me feel like we are reducing landfill waste. While I have never been successful at getting anything to grow (see my black thumb) on which to dump my compost, I love the idea of growing your own veggies/herbs if you have garden space and the aptitude.

3.  Use reusable, not disposable items.
Like many, we are very insistent on using our reusable shopping bags for any trips to the store (we have heavy duty ones from Trader Joes and a huge blue bag from Ikea which is usually big enough to hold all of our groceries from our trips).   If we forget our bags in the car when we enter the store, we go back to retrieve them.

I totally support the idea that stores charge/tax customers for the use of disposable (plastic) bags for their purchases. I HATE plastic shopping bags, which always seem to multiply in your house regardless of how infrequently you get them.  We also like to use Chico reusable veggie/fruit bags for our produce, to save on those other small plastic clear bags. We sometimes need to use some clear produce bags, but we reuse them in our fridge or on subsequent grocery trips, or use them for Pepper's poop on our walks.

 

We have started using and reusing cloth napkins for our meals at home, which we just need to launder these every week or two, and have started to save greatly on paper towel usage.

My mom found awesome high-quality and classy-appearing plastic Costco dinner plates for parties, which are completely reusable and which we will try to get the next time we plan on having a large get-together.

We have registered for several brands of cloth diapers and, at this point, plan to do as much cloth diapering for baby (including cloth wipes) as we can sanely handle. While the use of water to launder them bothers me, they really are MUCH better for the environment (I read somewhere that one diaper may stay in a landfill for up to 500 years before decomposing, and the average child produces about 5,000 disposable diapers before potty training).  We will also save a ton of money on diapers over a child's (or children's) lifetime.

We use reusable glasses whenever we can. I bring a tea/coffee thermos to places (like the hospital) that may have paper or disposable cups, and try to refill cool drink containers out of larger bottles rather than using single-serve juices or sodas.

I have convinced Kelvin that buying bottled water is a waste of money and resources (yay for regular tap water, or, for guests, water through a Brita filter).

We buy bulk handsoap to refill our different dispensers, rather than getting a new small bottle each time we need more!

I use refillable razors.


4. Get more out of your product
There is lots of waste that comes with buying new products and new dispensers. I now routinely re-use teabags, as I usually get get at least 2 cups of plenty-strongly-flavored tea out of each bag.

We have two Cuisipro foamers which allow you to use about 75% less handsoap than from the regular soap-dispensers.

We plan to and try to use all electronics "until they die" rather than upgrading to newer products -- this includes our two cars, iPad (yes, the new one may be out but the old one works just fine!), TVs, etc. 

We try to upcycle things. Now, I am not a seamstress or a huge "do-it-yourself"-type person due to very limited time, so I can't really make old shrunken sweaters into iPad cases or anything, but I love the idea of upcycled products. I have a great seatbelt bag that K got me for my birthday a couple of years ago.

I have started saving old spray bottles and lotion pump bottles for homemade solutions and sprays, as well as jars for baby food in the future. I am going to attempt to make some homemade baby wipe solution and creams using essential oils, coconut oil, and castile soap.

5. Why buy new?
I have always been a thrifty shopper. I generally see very little reason to buy anything non-electronic or non-hygiene related (i.e. toiletries) new. With the exception of the clothes my MIL got for me and my dress for my sister's wedding, my maternity wardrobe has come from a variety of thrift shops since I see little point in buying new items that will have short lifespans.  Craigslist has become my best friend for baby things, which are often extremely gently used due to their limited time of use. While I am definitely a bibliophile, I can't recall the last time I purchased a new book. My book sources are (in order); ***the public library, used book stores where books are on the sidewalk (when they are $2 or less-- in which I consider reading and then recycling, to another used store or the library, as a "rental" of the book), Amazon marketplace (and only when I can't find it at the library) or on kindle/Nook, where at least I feel like I'm creating less paper/tree waste.  I love the e-books for travel.

6. Less is more
We try not to buy *extra things* but rather would spend our money on experiences and travel.  As above, I don't hang on to many books, but, once done reading them, try to pass them on to friends, used bookstores, or back to the public library. We are trying to be baby-gear minimalists. I recently went through and cleaned out our closets to cut down on our general clutter, which I think should be done at least once or twice every year, and was able to resell many items (ipod accessories, printers, a palm pilot, some pet items) on Craigslist and even ebay, and donate many other things. It's great to borrow, not buy, things, if possible.

7.    Turn trash into treasure
For things I couldn't or didn't feel like would sell, I decided to post items on Freecycle, a yahoo-based group where you can post things-you'd-like-to-get-rid-of in your local community so that someone that may find use of the item can pick it up. I've passed on items like an old phone, posters, and kitchen pans to a grateful recipient.  This saves items from ending up at the dump, and provides someone else the opportunity to give them a second life.

Happy recycling!!!

Amazon Promise

Colin Powell, Patty Webster

 “There is joy in transcending self to serve others.”
Mother Teresa

 

I know there are many worthy causes to which to donate your well-earned money. However, as we approach the "season of giving," I have to mention and make a plug for one organization (Amazon Promise), which greatly touched me during the early years of my long course of medical training and which I continue to support.

I still get updates from the president, Patty Webster (pictured above), who is the founder and President of this great organization, whose mission is to serve the residents of the Peruvian Amazon. Patty was recently chosen as a recipient of a 2013 Caring Award for her service, in the spirit of the award/Mother Teresa, "to transcend self and devote their life to serving the disadvantaged, poor, disabled, and dying."  Senators Bob Dole and Tom Daschle recently announced the 2013 winners, who were honored last week at a ceremony in Washington, D.C. (where the above picture was taken), and who will be inducted to the Hall of Fame.

As a third-year medical student in 2006, I spent a few weeks with this amazing woman and her "AP" crew in and around Iquitos, Peru (the Amazon Basin), doing clinics for the severely underserved, and Peru will always hold a dear place in my heart for this reason. I hope to go back with the organization sometime to serve again in a (more experienced) medical capacity; however, for now, my financial support will have to do. 

Patty recently sent out this letter; please read it and consider donating to this very worthy organization in its 20th year of outstanding service.

Dear Friends,

 
In 1993, a promise of hope, health, and healing was made to the people living in the Peruvian Amazon. It was a commitment to change the lives of thousands — one person, one family, and one community at a time — to create a healthier future.

Twenty years later, Amazon Promise, together with its dedicated volunteers and friends, has fulfilled that promise and more. Thousands of volunteers from across the globe have given their time and resources to support our mission in over 50 villages. We have helped over 100,000 individuals, many of whom have no other access to health care; no one is turned away.

By showing our compassion, friendship, and support to communities in need, we have helped to bring newfound optimism for those living with disease and extreme poverty in Peru. Our dedication was recognized in October, when I was awarded a 2013 Caring Award by the prestigious Board of Trustees of the Caring Institute, a nonprofit organization inspired by the example of Mother Teresa that honors and promotes the values of caring, integrity, and public service. I am humbled and honored to receive this recognition, but I could not have done it without you—our dedicated volunteers and friends. Thank you for your support.

In honor of Amazon Promise’s 20^th anniversary and our continued efforts to build a healthier global community, please make a tax-deductible donation to Amazon Promise today.

Your gift can support our ongoing health and education programs in remote villages; regular clinics in the sprawling river community of Belén; the ¡Soy Capaz! HIV-prevention, education, and patient care program; the distribution of mosquito nets to combat malaria; a new women’s well being education program, which provides cervical cancer prevention and interventions; and medical, nursing, and dental student internships.

Each day, I am driven by the belief that every life is important and that every human being has the right to health and happiness. Seeing a person carried into one of our clinics, and then walking out after receiving good treatment, is like no other feeling in the world. You know you’ve done your job.

However you choose to give, together we can continue to invest in a healthier Peru. Please make your gift today through our website at http://amazonpromise.org/index.php/donate or send a contribution to P.O. Box 1304, Newburyport, MA, 01950.

Thank you.

Sincerely,
Patty Webster
President

Doctors' Sacrifices

With myself often feeling stressed, overworked, overwhelmed, exhausted, emotionally drained, and underappreciated, I found it interesting to read some good recent articles which do explain what it takes and what we give up to be (particularly family) doctors.  I can definitely tell you that most of us are most definitely NOT overpaid for all that we "put into" and sacrifice for our jobs.

10 Things You Need to Give Up to Become a Doctor - By Leo

Following a recent article elsewhere which generated an interesting discussion, I started thinking about the things one must give up on the road to becoming a doctor.  It’s a long road, beginning with an initial decision, some early voluntary experiences, an application to university and some hard work trying to achieve the barely possible. 

But it doesn’t even end there. The hard work really only begins at medical school where long hours and repeated exams are considered normal and where you need your patients more than they need you.

There are plenty of things you have to give up along the way, here are my top 10:
1. Your desire to be wealthy
Very few people in medicine ever become hugely wealthy, at least not in Europe. If riches are what you desire there are many many easier ways of getting that involve alot less heartache, money and stress. If you want to be a millionnaire before you’re 30, my advice would be to avoid university altogether. Most doctors are in the profession for genuinely altruistic reasons as well as the satisfaction that comes from knowing that you have the skills and knowledge to save lives and apply these every single day as a routine part of your work. [Most doctors start their careers in a lot of debt and in a high tax bracket which is unfortunate].

2. Your desire to change the world
Equally you must, eventually, give up on the idea of becoming some sort of medical superhero who can solve the worlds medical problems one by one. Yes doctors can do some impressive things when applying their skills to the right situation. But remember that however good your intentions, you will not be able to overcome the problems caused by poverty, war, government neglect or abuse, or coorporate profiteering at the expense of the sick. That doesn’t mean you can’t try to help people afflicted by any of these, you’ll just find that you are usually too small to make any real systemic difference.

3. Your free weekends
It starts at medical school when the work starts to pile up, and weekends are sacrificed to meet deadlines and for exam revision. Once you start working as a junior doctor, you’ll find yourself scanning each new doctors rota to work out where your on-call weekends have landed and who can swop with you so that you can still go on that holiday or get married or whatever. There will be sunny weekends when your non-medic friends will be having a barbecue whilst you sweat it out on a ward seeing yet another gastrointestinal bleed wondering why you chose this path.
[Man how I would LOVE some more weekends off to do things like "normal people."] 

4. A good nights sleep
Gone are the days where doctors would be on call for 48 or 72 hours and then do a clinic for the boss before retiring to bed [not gone in my world! I still do this on a weekly basis!]. However, modern working arrangements have brought into existence the 'week of nights'  where you work 4 or 5 and sometimes 7 night shifts in a row.
As someone who has done these I can confirm that doing nights is pretty inhumane. The talk amongst doctors doing nights together often centres around changing specialty or leaving the profession. Don’t worry, it all gets forgotten once normal daytime duties are restored.
[OH, how I miss my sleep. Why do babies always seem to come between 1 and 6 am?!]

5. Your desire to avoid feeling like a fool
You will make mistakes from time to time in this job and your mistakes will all be potentially serious ones, simply because everything you do affects your patients’ lives directly.
Furthermore, there will be times when you have to withstand an onslaught from senior doctors who feel that teaching by humiliation is the only way forward. You will feel like an idiot at times and if the thought of that frightens you you should promptly pick a different profession.
[I wish I knew everything and I didn't have to look stuff up so much! I definitely worry about the consequences of my medical decisions every day.] 

6. Your desire to always put friends and family first
As a doctor your job usually takes priority and you simply cannot shirk your responsibilities simply because you have prior engagements of a personal nature. Over the years I’ve known many difficult situations including a colleague who had to turn down a role as best man for a close friend because nobody could swop his on-call weekend with him and the hospital refused to organise a locum to cover him.
Apart from sickness or bereavement, your first priority will be to your profession. Your friends and family may find that difficult to understand at first. They’ll come round to it with time, especially once they delete your number.
[This is certainly one of the hardest things about this profession. It's hard to be a great physician and a great family member.]

 

7. Your desire to please everyone.
Whether it’s your friends or family, as above, or your future patients you’d better get used to upsetting people from time to time. Telling your wife you need to postpone an evening engagement because you are still operating on a difficult case, or telling a patient you won’t be operating on them as they only have three months to live, are both likely to be met with upset. Each situation has it’s unique challenges and needs some communication skills, but the bottom line is that you will have times when you will have to make someone want to either hit you or cry in despair.

[This is, perhaps for me, what makes this job so very hard and what I struggle with the most. I am a people-pleaser. I want to make people both happy, and well, which can't always happen.]

8. Your creativity
Not many people admit this but medicine takes people who are often very creative and turns them into workaholic, automatons who have little room left in their lives for creativity. If you want evidence for this, go to any dinner party that includes more than one doctor. Chief discussion topic will be work and medicine. That’s partly because anecdotes from doctoring are entertaining, but also because if the medics stray from this conversation topic, they will rapidly expose their banality and limited insights in other areas particularly all things creative.
Much of medicine does not allow much creativity in it’s day to day practice and the intensity of the work beats any desire for creative thinking right out of you before you even realise it’s happening.* Of course whilst accepting this fact you must fight this tendency and attempt to keep up your other interests, otherwise, I can guarantee medicine will invade everything you do.
*There are a few notable exceptions to this!
[I miss being "well rounded"-- haven't played my flute or been involved in music in years.]

9. Your desire to stay in one place / live close to friends and family.
Want to do something competitive, like medicine? You have to realise that choosing your location is a luxury and you may have to follow your dream in a less than ideal location. Even after you graduate, having your heart set on one specialty is a sure way to geographical instability. Some people don’t mind this, but some with strong family ties or a mortgage, the need to move frequently is a pain.
I began to come to terms with this when I found that even the most obscure places have hospitals. Working in these places you’re just as likely to meet doctors who have also had to move from here from the other side of the country. It’s a great way to meet people but easy to lose touch once you move on.
[I really miss being around family and friends and it does get old to move so much.]

10. Good health
You may not know it, but you’re joining a profession that has high rates of physical and mental illness as well as drug and alcohol misuse. Doctors are also less likely to seek help than other professions which all adds to a rather worrying picture.
Although ill health isn’t guaranteed in a medical profession you should realise the future risk now and take steps to formulate good lifestyle habits to minimise your risk factors. A good network of non-medical friends should also protect you from neglecting your own needs while you’re treating your patients.
[Doctors don't really take sick days. Our health always comes second to that of our patients]

That’s plenty to sacrifice just for a job isn’t it? However, I guess the reason you’re in medicine (or trying to get in) is that you’ve realised that medicine is not just a job, it’s a whole way of life, that’s difficult to let go of once you’ve decided to enter it, and these sacrifices are simply part of the deal.


And here's another article, From Medentzz - We Care, Not Just Cure

"SUBJECT: HOW MUCH DO DOCTORS MAKE??

Somebody asked:
"You're a Doctor? How much do you make?"
I replied: "HOW MUCH DO I MAKE?" ...

I can make holding your hand seem like the most  important thing in the world when you're scared...

I can make your child breathe when they stop...

I can help your father survive a heart attack...
I can make myself get up at 4 AM to make sure your mother has the medicine she needs to live...
and I will work straight through until 4 AM to keep her alive and start the day all over again!
I work all day to save the lives of strangers...

I will drop everything and run a code blue for hours trying to keep you alive!!!

I make my family wait for dinner until
I know your family member is taken care of...

I make myself skip lunch so that
I can make sure that everything I did for your wife today was
correct...
I work weekends and holidays and all through the
night because people don't just get sick Monday
though Saturday and during normal working
hours.

Today, I might save your life.

How much do I make?

All I know is, I make a difference."

Out on top? (A Sports Dilemma)

I have now temporarily recovered from my intense tennis-watching addiction and have had much more free time now that the U.S. Open (which ended on 9/9) is over.

It was a bit of a sad tournament in my opinion and I'm only now able to write about it :)

Roger Federer, who I adore, and who leads all men of all time with number of Major Championships, just doesn't have the game to hang with the top seeds anymore (and was seeded 7th at the Open). I was unfortunately too sucked into the demands of med school and residency to watch him when he was most dominant, and now, to my great disappointment, he's definitely on the downward slide. After an early Wimbledon exit in the second round, his U.S. Open tournament also ended unfortunately prematurely in the 4th round just before he would have faced Rafa Nadal (the eventual champion [boo]) in a much-hyped potential quarterfinal matchup.

I wonder how long he'll stick around. The debate exists: should he retire now?  Does he have it in him to win another major tournament? When is it the right time to retire from sports?

I am more into watching tennis than I am into other professional sports, so I'll use it for most of these examples.

Last year, we saw Andy Roddick (while a Major Champion, not an overachiever by any means) announce his planned retirement from tennis at the U.S. Open. This year, James Blake, another American (and wonderful, resilient human being although not a dominant sportsman) announced his planned retirement but exited after losing a heartbreaker five-setter.

In contrast, several athletes have gone out "on top," after the high of winning. Pete Sampras retired from tennis in 2002 after beating Andre Agassi to win his fifth U.S. Open title. Marion Bartoli, the dark-horse Women's Wimbledon Champion of this year also announced her retirement this fall, just after winning what is arguably the most desired trophy in all of tennis.  In football, Ray Lewis was able to end his career on a high note after the (unlikely) Baltimore Ravens won the Superbowl (sadly, beating our Niners) last year. 

For mediocre players, the issue of "when to retire" is probably not as critical or difficult a decision. However, for a former #1, which option makes more sense-- to go out/retire on top with the possibility of forsaking a few more years of *pretty* good play and money, or to continue to collect a good (but not top) salary while playing a "B" or "C" game?

Personally and as a perfectionist, I feel that if I were a pro athlete and (former) #1 player, once I felt or started to see that I couldn't compete at the same, top level, I'd probably retire (/quit). It's sad to me when I see former standouts- i.e. Grant Hill (one of the top players in NCAA basketball history at Duke, a former Pistons star, and gold medalist) or Juwan Howard (one of Michigan's Fab Five) warm the bench of teams like the L.A. Clippers or Miami Heat (the latter which won back-to-back NBA Championships including last year).  This also brings up another question-- would you like to be a benchwarmer on a championship team (a small fish in a big pond) or a starter star on a mediocre team (big fish in a small pond)?

                                                                     www.ocregister.com


In any case, I found out that between July 2012- July 2013, Roger Federer's salary (including endorsements as well as prize money) was something like 70 million dollars.  I guess I could handle being a #7 seed if I made that much. But, retired, he'd probably still make 500x or more what I'd make in a year.

What do you think? What would you do?

Paycheck drama

If you were on facebook this weekend, you may know that I had a little incident with my paycheck. An envelope that had both my most recent paycheck+paystub, along with two previous paystubs, fell directly into our shredder (on the "auto-shred" setting). Luckily, I reacted fairly quickly, stopping the shredder and then extracting the remaining documents before more than just about a corner of each item was eaten up, but it was still horrifying. I sort of sat there in shock for a few minutes trying to figure out a) how it happened (I obviously have exceptional klutzy aim and really bad luck) and b) how significant it was.

This sounds really funny right now (and thank you, all who "liked" my FB status update... this one needed a "dislike" button), but, having just gotten reimbursed for the hospital OB work I'd done so far, I was really stressed about how the partially-shredded check should be handled. I generally do direct deposit, but, due to some changes in our directed retirement contributions (to catch up to all of you who actually have been making money for several years; I think the payroll department knows my name pretty well), there is some lag in the direct deposit mechanism (it usually takes a pay period or so) and so I have gotten a few actual checks. From now on, I am going to avoid that at all costs, due to this unfortunate near-catastrophe.

As you can see from the picture above [the back of the check, for obvious reasons], only a portion of the check got shredded; the information missing was the actual check number (which actually could be ascertained from the attached stub), but the entire amount, the employer's name, and my name were all intact. Thankfully, our local bank accepted the check without a problem although the clerk looked at me with a weird expression (I'm not sure she'd ever had a request to deposit a shredded check), had to check with her manager, and then tried to hide her smile...

Thankfully, I didn't have to go to the payroll lady on my knees to beg for a replacement check (as I'm pretty sure she's annoyed with me from all the changes we've made to our contributions). I'm hoping to lay low for a while and have no further payroll incidents. And I might put our shredder on the neutral setting for now... until I actually intend to shred something.