Friday, December 12, 2008

A Narrow Escape

I survived a day at jury duty.

I get picked for service about every 18-24 months. I don't know why, but I do. I even got picked to serve on a jury for a Grand Theft Auto case. Very interesting. Everyone should do it. It really teaches you a lot about the justice system.

But, this time, I just didn't have the time to dedicate to serving. So, I walked into the jury assembly room just hoping for a break.

I got called to be on a panel for selection around 10:30a. "Great," I thought, "if I am lucky enough to get dismissed, it's so early, they'll put me in for another panel!" We walked up 2 flights to the 4th floor, and we went outside the courtroom door. We waited about 5 or 6 minutes, and a lady pokes her head out.

"Are you guys here for District 36?" We all moan a collective, "Yes." She looks confused and goes back in the room.

About 3 minutes later a fat man comes out and asks the same question. "Yes," we sigh again. "Well," he says smiling, "we don't need jurors until tomorrow, so you're free!" We must have looked too happy, because he quickly clarified: "You are free to go back to the jury assembly room." We all start to trudge back down the hall. One guy yells, "Hey, let's not walk so fast!" We all chuckled and moved like sheep toward the escalator.

At noon, they called me for another panel. Only this time, we were all to report to Traffic Court...19 blocks away. Again, the collective sigh, as we packed up our belongings and started to walk out to the parking lot. While reading the map in the car, I am pretty sure I ran a red light. I just envisioned myself getting a ticket on my way to serve at Traffic Court. The coincidence of it all.

Traffic Court was the Ritz Carlton of the court houses. I've been in 3 so far for jury service in LA -- criminal (where I served), civil (where I reported this time) and now traffic. At the Traffic Court, there are vending machines in the jury assembly room! The chairs are nicer! There are magazines ALL OVER for you to read! It was heaven for people stuck in potential-juror hell.

Here, again, I saw the walls of differences between people collapse. I saw an Indian guy on a lap top and an Asian girl start talking about nursing school -- he was finished and she wanted to go. I saw a Hispanic guy and a middle aged lady laughing about some private joke they had managed to develop during the last 4 hours of being in that room.

It got me thinking about how, at jury dury, everyone is on the same team. Everyone is hoping for a dismissal. Everyone is hoping to get out of it. Strangers with nothing else in common start talking to each other, laughing about their kids, etc. It was one of the few places I've even been that the playing field is level. We're all just there to serve.

It was a great snapshot of America. Or at least, the America we all want to believe in.

Sunday, December 7, 2008

Cancer Sucks

I was moonlighting last weekend (or the weekend before, I have lost track), and one of the patients I was called to see was a young man (less than 30 years old) with metastatic germ cell carcinoma. He was dying.

He had a wife, who came in when the nurse called her to tell her that the patient was having trouble breathing. Everyone knew he was in his last days, and even though there was nothing new that day to make anyone think that today would be "that day," you never knew.

So, I evaluated him and ended up transferring him to the ICU per the primary physician's orders. It was, in my opinion, an inappropriate transfer but that's another story for another blog.

The patient has a 3 month old daughter. She will never know her dad. She'll see pictures of the two of them, later on when she's older. She'll wonder what he was like, and what it would be like to grow up with a dad.

It seems sad and unfair that this little girl won't get the chance to be a "daddy's girl." And it is. But, it's actually a miracle that the patient got to see her at all. Six months ago, he was told he had 2-3 months to live. He outlived the predictions and in the meantime saw his daughter born and got to spend 3 months building his memories and trying to build some memories for her.

I never checked back in on him. Mostly because I thought he'd be gone within 2-3 days and seeing that he had expired would just depress me. It made me, yet again, appreciate my friends and family, and it reinforced by resolution to write an email a day to express my gratitude and appreciation. You never know when you won't get that chance again.

Sunday, November 30, 2008

The Day Before

So, tomorrow is December 1.

I like December for quite a few reasons. One is Christmas, and that's a big one. The lights, the trees, the bows, the festivities... I like December because it's cold. I've always liked the cold weather, which is odd because I'm always cold. But, I like that EVERYONE is cold in December, not just me. That wasn't meant to be as mean as it sounded. I meant that it's finally ok for me to say, "I'm cold," and people don't look at me like I'm a freak of nature.

I like hot chocolate. A lot. And that's also more fun to drink when it's cold. Don't forget the marshmallows.

I like getting together with friends and family. I like socializing with everyone, drinking, eating, laughing. It's so much fun, and everyone wants to hang out in December. There aren't a lot of other distractions, like vacations, trips to the beach, etc. Most people aren't doing a whole lot in December.

I've decided to try something this year. Since I can't go home, and since most of my friends are in fellowship and stuck working a lot, I want to make a list. One person for each day in December. And I will email that person on that day and tell them how much they mean to me. I think it'll help me keep up the spirit of Christmas -- the giving and the sacrifice Jesus made, as well as the love Mary and Joseph committed to him.

So, we'll see if I can come up with 31 friends and family to dedicate to each day in December. Feel free to do the same -- even just an email or two to a few people who have been especially helpful, amazingly loyal or just made you smile when things were gloomy. I know for sure they'll appreciate it. You can't give a better gift than to lift someone up like that.

I'll let you know how my experiment works out. I have a feeling I'm going to get a lot of out of this exercise as well.

Wednesday, November 26, 2008


Tomorrow is Thursday and Thanksgiving. And another day of work at the VA.

I met two vets today -- they are roommates right now. I was consulted on both of them. One (Mr. H) for bacteria in his blood and one (Mr. R) for a possible wound infection. When I saw the 2nd one, at the end of the day, it was dinner time. Both had gotten their dinner trays.

I finished talking to Mr. R and on my way out, said hi to Mr. H, who I had seen earlier in the day. He asked when he was going to get his food. He had a tray on his table, so I lifted the top and asked, "Isn't it in here?" He said no, that it wasn't right.

Mr. R said, "Oh, he needs a new tray, he can't eat the pork."

I was struck by this -- Mr. R and Mr. H had obviously talked about why Mr. H wasn't eating his dinner. Mr. H has dementia, and he's very pleasant, but he may have forgotten to tell the nurse that the pork was not something he should be eating. I found it very sweet that Mr. R was looking out for Mr. H, making sure he got a dinner he could eat.

What else could you ask for on Thanksgiving -- or any day -- but someone to watch out for you and make sure you got a meal you could eat?

Sunday, November 16, 2008

Home, Sweet Home

We had our Housewarming Party yesterday. We weren't sure we were going to make it at first.

We were up until 5a Saturday morning doing final unpacking, touching up paint in a few rooms, and cleaning. I ended the night by repainting the stairs (they are wooden floating steps, and they were badly nicked). We found the paint left by the previous owner, so I started at the bottom and went up, effectively painting us into our bedroom. :)

We woke up at 9:30 on Saturday and had to do some baking, final cleaning and decorating. The party was supposed to start at 3p. At 2:20p, Kevin hopped into the shower and then left for BevMo to pick up some drinks. I was hanging our pictures on the "Picture Wall" until 3p. I took a quick shower and prayed that people would be late. Since it's LA, the first guest arrived at 4:15p. Perfect.

In total, we probably had 50 people come through, and at critical mass we were near 40 at one time. Thankfully, we have a lot of room now, so it wasn't too crowded. I think people had a great time.

For me, it was the first time the place really felt like ours. We had our pictures up, it was our colors on the walls, and our furniture in the rooms. And, most importantly, it was our friends laughing, sharing, and goofing off. It was so special to be surrounded by everyone out here that we love. I wish my siblings and a few close out-of-town friends could've been here. But, that just means another reason to throw a party when they finally are able to come visit.

Monday, November 10, 2008


So, as some of you know, one of my New Year's resolutions was to run in a competitive race.

Well, I'm currently training for a half marathon. Some of my fellow fellows are running, and they talked me into it. I like that I have something to work toward - motivating myself to get out of bed was hard when it was just me. Now it's me against 13 miles. That's a kick in the pants to start your day.

So, we'll see how things wrap up over the next few months. The race is in February - February 1 to be exact. So, when you sit down to watch the Superbowl, give me a call to make sure I've survived. :)

Thursday, October 30, 2008

Fall is in the Air

Well, it's finally happened.

Fall is here -- although the weather in Los Angeles is a little schizophrenic. It was 85 degrees yesterday, so it doesn't often feel like fall. So far today, it's a bit cooler, which is nice.

We also finally bought a place! Yes, after all my ranting and raving, things fell into position. We have a wonderful townhouse in a condo complex in West Hollywood. We've put laminate hardwood floors in the two bedrooms upstairs...a LOT of work, but definitely worth it. We have a few more mini construction projects with that, like putting baseboard up and crown molding in one of the bedrooms. But, I hope that after this weekend, I can retire my hammer for a while!

As soon as I find my camera cord, I'll take some pictures and load them up here. I'm sure it's in some box, somewhere! We're also about 50% done with painting. The last thing is the living room area that extends up into the stairway. It's a pretty big job, and since I'm done with vacation on Sunday (sad, yes), I don't think I'll be able to finish it in a timely manner. So, we have someone coming today to give us an estimate.

Things are slowly coming together, although I get angina every time I come in and see about 37 boxes piled in the living room. But, I'm starting to see more and more of the floor, as the boxes get moved upstairs and unpacked. That's making me feel a little better.

The whole escrow process was a nightmare; I may or may not expand on that here. I really just trusted that God would handle things, because things were certainly out of our control. And, in the end, we've got our place!

Thursday, October 2, 2008

A Daughter's Love

I was in clinic today, and a woman and her daughter came in. The patient was about 60 or so, and the daughter was likely upper 30s. The woman had been diagnosed with a fungal infection of her sinuses and then her eye (zygomycetes, for any doctors reading this). The infection was so severe that the only way to treat it was to give anti-fungal medications and to remove her eye. Enucleation.

Obviously, that's a very severe and disfiguring treatment, and she was initially resistant. However, it was enucleation or risk dying from the spread of the infection.

I saw her today, and she is doing really well. She has finished her IV treatment and has moved on to oral therapy. I removed her bandages with the attending, and the eye socket looks really clean. There's not a trace of infection. Someone has done a great job keeping this wound clean. I left the room to take care of some paperwork for them. The daughter had brought wound care supplies to repack the eye socket.

When I returned, the daughter had gloves on and was pushing gauze into the socket, which is a lot larger than you might think. As she is finishing, I tell her that she has done a great job keeping the eye clean and that she's very good with wound care. She continues her packing, and gives a little smile. Her English is pretty good. She says that the first time, when the nurses were teaching her how to do it, she was shaking and very scared. "But..." she shrugged, as if to say, what can you do?

I said, "You're right. It's your mom, and you did a great job stepping in to take care of her." She got tears in her eyes, and she nodded. "It's my mom..." People occasionally surprise me with their deep love and dedication. This was definitely one of those times.

Friday, September 26, 2008

Melt Down

I fancy myself as someone who does a pretty good job of holding it together, 99% of the time. I'm the "rock" in most of my relationships. People can count on me, I'm rarely late, I'm reliable. I'm like a Rolex.

Today, I had a melt down.

I presented a talk with a nurse practitioner at an AIDS conference in LA this afternoon. It was great. We both spent time in Kenya -- she's been living there for 4 years, working with some of the same people with whome I worked. She lives about an hour north of where I was, and in the HIV world in Western Kenya, everyone knows everyone. So, I got hear how my old friends were doing, how the country was, etc. I felt so connected. We met last night at the pre-conference dinner, and we really hit it off. It's hard to live there and not automatically bond with anyone who's also lived there.

So, the conference was a big success today. The NP and I spoke about HIV in Africa and how to make a successful program there. I'd been working on my portion of the talk for weeks, so I'm relieved to have it done. Needless to say, talking about HIV in Africa always makes me emotionally vulnerable, and talking about my time in Kenya is like picking off a scab.

Then, my phone breaks. It just locks up and it won't unstick. I try everything, and I eventually have to go to the Verizon store. The nice man there wasn't able to fix it, so they had to reset it -- I would lose everything. I had backed it up a few days prior, so I thought it would be no big deal.

I get home, and I can't get the phone to sync with the desktop. I'm sitting there with the phone in my hand, connected to the computer, and I just lost it. I'm literally bawling as I frantically search through program files, Windows applications, etc. I finally get it to work and calm myself down. My contacts and calendar appear on the phone, so I think I'm out of the woods. Oh, no. The medical programs I put on are gone. They, apparently, weren't backed up, even though I thought that's what I was doing every time I hit "Back up my Device." Cue the tears...and yes, I'm back to being a blubbering mess. I go back to the websites, download everything again (fortunately it's all free), and a mere two hours after starting the project, my phone is darn close to being the way it was. Except I lost all my pictures. Dang.

So, I'm an emotional wreck. I was frustrated that this stupid phone had so much control over me. (I'm working tomorrow, so I need the medical programs to be there!) And, I realized after gaining some greater insight, that I really just want to get back to Kenya. I was jealous that the NP gets to fly back on Tuesday. I was jealous that she gets to go back to really impacting a community. I was frustrated with spinning my wheels at the VA. It all came to a head, and I reacted like a champion: buckets of tears.

Once again I'm reminded that I'm no Superman. I'm just a girl, and a doctor, and I just want to make a difference.

Sunday, September 21, 2008

"I Can't Do This..."

Some people have known since the day they got their Fischer Price medical kit that they wanted to be a doctor. Some people knew when they got to high school biology. Not me. I decided to start pre-med in college because it would be easier to transfer out and finish in 4 years than to transfer in. I thought it would be a challenge, and I like intellectual challenges. But, it also scared me to death. I thought about optometry school, so I wouldn't have to take the MCAT. I abandoned that idea when I spent a summer working for an optometrist and was so bored I almost poked my own eyes out.

So, I get to med school, and I scrape by the first two years of classes. I get to the part I really want to do -- the clinical years. Ah, the clinical years. They seemed so glamorous when you're sitting in the library studying the nerves of the brachial plexus. Students running around in short white coats -- running with a purpose! They have people that need them, that are waiting for them. So much better than sitting with flash cards about pharmacology.

So, Day #1 of 3rd year comes. I'm doing General Surgery first. Three months of surgery. My first three weeks were going to be with the vascular surgery team. Red Surgery. Our Chief is K - she's driven, determined, and a little eccentric. Ok, more than a little. She wants nothing more than to prove herself. She's transferred into the program and wants people to take her seriously. The intern is haggard already (he's been on the job for 2 weeks before we started). He just wants to survive his time on the service. He also thinks K is a whackjob. Then there are the 3 of us 3rd year med students. A, C and me. A and C are super smart, both now doing anesthesiology.

So, Day #1. K and the intern take us around to our patients. They've decided that 6 is a good number. That is, we each now have 6 patients of our very own. In retrospect, that is WAY to many patients for 3rd year students on Day #1. But, I digress.

My first patient is Mr. B. We walk into the room, the motley crew we are - 3 med students in khaki's and short white coats, an intern in scrubs who hasn't shaved in at least 3 days, and K - scrubs with ballerina flats on, hair in a bun, and eyes piercing through her glasses. She means business.

So, we go in to see Mr. B who is about 60 and has had his esophagus removed because of cancer. He now has his stomach where his esophagus was and his small intestine where his stomach was. Imagine that they just pulled the opening of the stomach up into the throat. It's called, appropriately enough, a "pull through." His course was complicatd by an abdominal wound infection and dehiscence. That means that the wound is open, not sutured close. He just has a few big retention sutures holding his fascia together. Below the fascia is the abdominal cavity. The remainder of his abdomenal wall is open -- from the skin, to the fat to the muscles, all open. So, K is explaining to me that Mr. B is my patient. As she rehashes his history, she is taking his bandages off and pulling out a long, long stretch of gauze that is packed into Mr. Brown's abdomen. She pulls out the roll of gauze, not unlike a circus clown pulling scarf, after scarf, after scarf out of his open mouth.

The gauze is called Kerlex, and it's covered in nasty pus, blood, dried skin, etc. It's about 3 feet of Kerlex. She tosses it into the biohazard bag. She turns to me and says, "So, you'll need to repack Mr. B three times every day. Whatever you're doing, whatever your day is like, you have to unpack and pack Mr. B three times. So, don't go home at night unless you've packed him." She takes the Kerlex and shows me how to wet it with saline and how to pack it into his wound. She starts again, "You'll want to make sure you pack it into the far corners, because we're trying to pull out all the infection each time we do this. We can't leave any area unpacked." Then, she adds, quite nonchalantly I think, "And don't press too hard, or you'll eviscerate him." She looks up at us: "You'll poke into the abdominal cavity and his insides will then be outside. If he eviscerates, you page me. Immediately."

I walked out of Mr. B's room feeling nauseated. We walked out to the stairway and ascended to the next floor to see the next patient. K is talking about how shit runs downhill so if the attending is having a bad day we all will be having a bad day. We, as med students, are at the bottom of the shit hill. I thought I was going to pass out. I was lightheaded, I thought I was going to vomit, and everything started to go blurry. Wow, I thought, I can't do this! I made the wrong decision. Can I get a refund on my Stafford Loans? Where do I go to quit? The Dean's Office?

We went around to the other patients. I decided that I would give it one day. After all, C and A all needed me. I couldn't leave my fellow students high and dry...we were in this together!

So, I did it. Every day for 3 weeks (I got but 1 day off in those 3 weeks). I'd pack him when I got in, at 4am. I'd pack him before lunch around 12pm. And then I'd pack him before I went home, around 9pm. Three times a day, every day. I didn't skip one. He was usually delirious and out of it. Occasionally he was combative, and I'd have to duck and weave as he threw punches at, unaware that I was trying to save his life...or at least not eviscerate him.

Well, many months after I left the comfort of my dysfunctional family known as the Red Team, I was walking into a different unit and K sees me. She tells me that Mr. B is not only awake and talking, but he's ready to go to a rehab facility on his pathway home. "You made a big difference in him," she said. "Actually, I don't think he's be alive if it weren't for your three times a day wound packing."

As you can see K, the Red Team and Mr. B made quit an impression on me. I retell his story often, both to remind the current students of how good they have it, and to show them that even one measly 3rd year med student can make a big difference in some one's life.

Monday, September 15, 2008

The VA

We lovingly refer to the VA -- the Veterans Administration -- as the VA, pronounced "vah." The VA and I have a love-hate relationship. On the one hand, these men and women served our country -- often against their wishes in Vietnam -- and anything I can do to diagnose, treat or help in anyway I'm glad (even honored) to do. On the other hand, it has to be the most inefficient place I have ever worked.

Last week the MRI broke. What did that mean? It meant we needed to wait for a part, which is understandable. When a part breaks, you wait for that part to be replaced. Was there an all-alert call out to get the nearest part brought over ASAP so that we could get the MRI back up and cranking out scans? Oh, no. Not for the brave men and women who once wore the Uniform. No. We had to wait for the part to be flown in...from Germany. Really? Germany was the one and only place to go for this part? Oooookaaaaay.

Just one frustration for me in the past 2 weeks. We'll see if I don't have a break down in the next 2.

Saturday, September 6, 2008

Fall is (Almost) Here

So, it's early September, it's not so freakin' hot, and the stores have started to put out mass quantities of candy in orange and black bins. Everything is pointing to the fact that it's almost fall. My favorite time of year.

Back at Valpo, when it got to be fall, it would cool off, the leaves would change and we'd have a few days of rain. As it got to turn more to winter, there'd be snow and the inevitable slush -- old snow made dirty, wet, cold and nasty by rain and/or the warming of the environment so that the snow would melt. Like someone took a dirty brown slurpee and covered the earth with it.

On those cold, rainy days, my now-husband-then-boyfriend would say to me as we ran to the cafeteria trying to not get too wet, "Where are all those fall fans?!?" He loves the summer, which probably has something to do with why we live in Los Angeles now. But, back at Valpo, I'd laugh and raise my hand -- I loved the fall. The rain, the slush, the cold was so refreshing! Such a contradiction to the hot, humid summer we just had.

So, around this time, besides missing fall, I miss my family. This is probably the hardest time for me to be away from home. So many of my memories are of the family during fall -- school starting, volleyball season in swing, raking leaves, shovelling snow, just being outside and playing together. There are no leave changes here, no real rain (not until January, if at all), and none of my family is here. [This picture is circa 1985, our annual "First Day of School" photo]

I'm secretly hoping that they all find reasons to move out this way. Short of that, I'm hoping we make enough money to visit them often. Hopefully this will be the last of my homesick ramblings for awhile. I'm at the VA this month, which should provide enough fodder for discussion that I can focus this blog back on life on the wards!

Sunday, August 24, 2008

A Day to Relax

I'm off today.

Completely off - no moonlighting, no pager.

I was off last weekend, but my brothers and sister-in-law came to visit. And while it was fun, it wasn't relaxing. We went out every night, usually leaving as soon as I got home from work. Like I said, we had a blast! But, it's been nice to just sleep in. (The photo is from the Venice Canals, off of Venice Beach. Quite amazing.)

Yesterday, I finished putting together a big presentation that I'm doing in September. It's about creating successful HIV programs in Africa. It was very interesting to learn about, and I'm excited to refine the talk over the next month. This presentation is why I missed the bachelorette party a few weekends ago. It's finally done!

Sure, I have a little reading to do today. Some chapters to get caught up on. But, over all, I feel like a normal person today.

It's kind of nice.

Wednesday, August 20, 2008

A Sad End

So, one of the great things about ID is that you can cure people. Not always, not with HIV or Hepatitis C, but for most, run-of-the-mill infections, you can cure people.

Not so last week.

We had a fantastic lady with a raging pancreatitis. The worst I had ever seen. We see a lot of pancreatitis, and most people do fine. In fact, we get kind of cavalier about it. "Oh, it's just pancreatitis." Not this time.

Our poor lady got super sick, then seemed to rebound. Then, a turn for the worse. But, she popped back! - not quite as good as the peak before, but she looked ok. Then, she tumbled again, farther down than before. A little blip back up, but then down down down.

We kept searching for abscesses, more infections, etc. We had her on excellent coverage for the bacteria we knew about; the rest was up to her body to make a come back.

It wasn't meant to be.

Her family decided that she'd had fought enough, and they elected to make her comfort care only. So, the ICU team made her comfortable, and she died not long after she was extubated.

We were really pulling for her, so our team took it pretty hard. She was such a nice, nice lady, too. I'll miss seeing her everyday.

Saturday, August 9, 2008

Square One

So, fellowship is grand. I enjoy specializing and learning about just infectious diseases. I even (usually) enjoy getting a call for a new consult, because it's a new case and something to learn from.

With this new position comes a big piece of humble pie. I don't know anything. Well, I know some things, but I get a lot of calls that require me to call the person back after spending time looking up the answer...and then frustratingly having to call the attending just to make sure I've got it right.

It's a rough transition -- from attending to "intern" again. It's not the workload, which I don't mind and am very used to. It's the impotence I feel when someone asks me a question about MY specialty, and I have absolutely no idea how to answer it.

Last night the ER called me about a patient who had just returned from an African vacation with a few weeks of fever, nausea and vomiting. They wanted to make sure that if the malaria smear was negative, was it ok to discharge her from the ER with follow-up. Well, I'll be darned if I know! So, after checking the CDC website and finding nothing terribly useful about fevers post-Africa, I had to call my attending. Did I mention it was midnight? Yeah, embarrassing. She was terrific, and we talked things through (no, there's nothing else to work-up acutely in the ER). But, I still felt bad calling her.

So, I'm hoping with time I'll pick up a thing or two and be able to handle some of these questions on my own.

Monday, July 28, 2008

Ball O' Stress

So, fellowship has been busy for sure!

I've been at work most days from 7:30a-6p, if not later. It's a lot of work, and it's pretty much nonstop. But, I'm enjoying it immensely.

However, it caused me to miss a dear friend's bachelorette party in Vegas. I had booked my flight, arranged a hotel room, etc. Then, I got so overwhelmed that my back went out. I think it's from both a white coat with too many things in the pockets as well as poor posture while reading a million pages of ID material. I'm working on both now.

Nonetheless, I had to tell my good friend, "So sorry, I think I may have a mini-meltdown if I try to go to Vegas and still do the mountains of work I have left to do." It wasn't pretty, and I felt awful for it.

Another casualty of fellowship. Fortunately, the good friend is actually an awesome friend and didn't make me feel worse than I already did. I owe her a bachelorette drink before her wedding. Some quality time with her and the rest of the girls will do wonders for my current mood.

Sunday, July 6, 2008

Last Word

I was moonlighting last night, and I got a call from one of the nurses to pronounce a patient at 6:30 this morning. Doctors don't have to be the one to pronounce patients as dead, but nurses for some reason think we have the ultimate power.

Or perhaps it makes them uneasy.

So, I got out of bed and walked up the stairs. I went into the room where the patient -- an elderly woman who had survived 10 years after a liver transplant (no small feat) -- lie dead in her bed.

There's an eerie sort of air in the room of a dead patient. I don't know how to explain it. Perhaps it's because you know going in that the person is dead. Maybe it's the void of life you can sense. Whatever it is, it's unmistakable.

I went through the formalities of listening to her heart ("absent heart tones") and her lungs ("no breath sounds"). I also checked for corneal reflexes ("corneal reflexes absent"). I then called her primary doctor to tell him the not-so-surprising news. The patient was DNAR -- Do Not Attempt Resuscitation. That means no heroic measures, no intubation, no chest compressions and cracking of ribs.

The primary physician said he would call the family, since he had a relationship with them. I wrote my note in the chart and went back to bed. My note will be the last written word in her medical history. "The patient was pronounced dead at 6:30a on 7/6/08." No hoopla. No fanfare. Just a simple testament to the ultimate change in condition. I hope to leave this world as peacefully.

Saturday, July 5, 2008

Big Bad Fellow

That's how two of my friends have, individually, referred to me in recent days. One is a fellow herself. The other soon will be. It's a different sort of feeling, mostly because you realize that people see you as a "specialist" and you have no idea what you're doing.

Thank goodness for Attendings.

So, I had two days of orientation, harmless enough. Oh, except that I got lost traveling up to a hospital affectionately known as The View. I took another expressway up there, and it threw me off. So, here I am, a big bad fellow, about to cry because I've just passed my exit, I'm about to be late to orientation, and I have no idea when the next turn around is going to come. Rest easy, it all turned out OK.

Then, I had a day of on-the-job training. The old fellow, and residency classmate of mine, helped me learn the ropes. He's rounding this week, then I officially take the reigns on Monday. He'll be there Monday to make sure I don't make a complete debacle out of things, and then the job is mine.

Let the games begin.

Saturday, June 21, 2008

Seeing Your Parents

Perhaps because so many people my age are having babies, I've been thinking about the other side of things: Parents. My Sister, for example, is a great mom. However, I know her simply as my Sister. I know her as the little girl who put orange slices in her mouth and smiled broadly, revealing her big orange peel grin. I know her as the girl who would run through the sprinkler and do hoola hoop gyrations in the front lawn. To me, she's the girl who would listen in on my phone conversations with RW in 7th grade.

So, I extrapolated to my own parents. My Mom was once a little girl who probably played dress up with her cousins. My Dad was once a teenager who could have gotten into scuffles at the school yard. It's hard to look at your parents as people...and not as Parents. Is it possible to see your parents as people?? Or will we always look at them through the lens of a child's eye?

I wonder if my Mom was scared when she went on her first date. Was my dad a heart breaker in grade school, or did he wish the Pretty Girl would say hello at lunch? Did they experiment with drugs? What did they talk about with their best friends? What were their aspirations when they were 12 and 13? What did they say about me and their lives the day I was born? Did they worry about the economy and the Vietnam War? Did my Mom get in trouble for wearing tube tops and hip huggers to school?

As I turned 30, I remembered my own parents turning 30. Well, I remember my Mom turning 30. I was 8. I don't have anyone to parent, so the dichotomy of Parent-Person didn't hit me. Until recently, I always looked at my Folks as Parents -- almost history-less and devoid of an individual personhood. I have had one candid conversation with my Mom a few years back, which helped put my Folks' lives into some historical context. And, hopefully, I will get the chance to know them a little more as people, though I suspect it will be hard to shed the child-colored glasses.

Thursday, June 5, 2008

Unofficially Over

So, today marks the first day that I'm not chief. Well, I'm technically still chief through the end of the month, but the new chiefs have started, and the transition period has begun. My replacement is fantastic and a quick study. He'll be wonderful.

So, I'm going to start a month of reflection. While that may sound like a lame attempt to procrastinate and delay my reading for fellowship, I think I need some time to decompress. I've been "on" for the last 365 days. I was on pager call everyday -- because even when I wasn't technically on call, people would call me with questions. They never really bothered to look to see which of us was on call. Which was fine. So, today I handed "my" pager over to the new guy. I can't say I was sad to see it go.

So, hopefully, over the next month, I'll have some good things to say about the last year. And, if not "good" at least interesting and character-building. :)

Friday, May 23, 2008


So, my sister Tagged me in her blog. Here are the rules...

1. Link your tagger and list these rules on your blog.
2. Share 7 facts about yourself on your blog, some random, some weird.
3. Tag 7 people at the end of your post by leaving their names as well as links to their blogs.
4. Let them know they have been tagged by leaving a comment on their blog.

I already Tagged a few people via my myspace account, so I'll Tag a few more who weren't a part of that calamity.

7 'Fabulous' Facts:

1. I can't hear high frequency sounds in my left ear. This means that I can't hear anything in that ear when people whisper into it. It's embarrassing.
2. I have to eat things in pairs...2 M&Ms, 2 green on each side of my mouth. Or I feel unbalanced.
3. I'm always cold. Always.
4. I have one double jointed finger.
5. I can't keep any plant alive. Except my bamboo plant, which has been with me since January 1, 2006.
6. I don't wash my hair everyday, but I do wet it in the shower daily.
7. I think my feet are ugly, but I think I have pretty hands.

Christian Girl

Lil Kate


The Brother - already Tagged (first by me on myspace, and now by Julia!)

That's all...

Wednesday, May 21, 2008

You down with NYC? Yeah, you know me...

So, I just got back from a fun trip to the East Coast. I love it there. I was back in DC for a conference -- the first trip back since I graduated 4 years ago. Crazy how time flies. I will have to go back more often. It's absolutely one of my favorite places to be.

Then, we went up to visit my old Med School roommate in NYC. Dr. R hasn't changed a bit. :) Still a blast to be around and a total trooper. She had to be at work by 7a every morning, and she was out with us until the wee wee hours. Granted, she lives right next door to the hospital, but she didn't complain once! This is why I love her. Thanks, R for a great time!

We went to Brooklyn to visit our actor friend, Ian...who was back home in Chicago and unable to take us around NYC. Bad timing, right? But, he gave us a list of things to do, which was great. We went to Times Square, the East Village, Chelsea, the Upper West Side, the Seaport, the Met, Central Park...despite the gloomy weather, we had fun. It was my first vacation this year, and it was great to have nothing to do and nowhere to be. Here's one more photo -- The Husband at Central Park...

Friday, May 2, 2008


Well, the Husband and I were hit with a rude awakening this week. Despite saving a good deal and being good stewards of our money, we were thwarted in our efforts to by a condo this week.

I had seen #8 (unit #8 of an 8 unit condo) the middle of last week. I loved it. It's kind of like a loft, but has 3 levels to it. A master bedroom downstairs with a huge closet, fire place and little courtyard outside. The main floor was amazing -- beautiful kitchen, living room, another fireplace (does it get that cold in LA??). Then up a few steps to a half-bath (full bath downstairs), and up a few more to the loft. A decent sized open room, but attached and through some French doors was a cute office. The Husband and I went to see it on Tuesday and loved it. We had a quick meeting afterward at Starbucks and got very excited to make an offer. Perhaps it was the caffeine. Nevertheless, I said I'd run the numbers to see what kind of bid we'd need to make. He said he'd call our Mortgage Broker friend to see about a loan.

We have been house hunting for a few months. We started last fall, but quickly abandoned when we realized a) we didn't have enough for a 10% down payment on most of these places and b) the housing market was really starting to tumble. So, I moonlighted (moonlit?) like crazy and we saved a good chunk of change. Enough, we thought, to put down 10% and not be "house poor" -- we'd still have some cash left in case the car broke down, the dishwasher flooded the place, etc. See, we were being financially responsible.

So, the Mortgage Broker (MB) gave us sad news. Within the past 2-3 weeks, the rules changed. No longer can you put 10% down, get a 10% line of Equity and get a loan for 80%. Now, in order to avoid mortgage interest, you have to put 15% down. So, that puts us in the exact spot we were last fall. Barely enough money for a down payment. In fact, I'd have to clean out the change cup in my car to make it. But, then what?? What if my car eats it? What if the washing machine breaks? What if the Husband gets put on hiatus for a few weeks?

So, people have totally screwed us. Thanks to brokers who set up people who shouldn't have been getting mortgages. Thanks to lenders who should know that a shift-manager at Coffee Bean can't afford a $612,000 condo in Hollywood. Thanks to morons who either didn't read their mortgage terms, didn't care to know their mortgage terms or didn't have the foresight to think about what would happen to the terms in a year. Thanks to all of those people, we're out. Again.

Who is going to "bail" us out? All of this talk about giving relief to people who bought over their limits. What about those of us who played by the rules, who were financially responsible? What happens to us? Oh, that's right: we get to wait and save another 8 months, and hope they don't make the minimum down payment 20%.

I guess it's true. Nice guys finish last. People who play by the rules get screwed. I'm trying not to be bitter (it's not working, is it...). I know there's a better time for us to buy, and it'll be soon. At least we're not in debt. At least we can make our monthly bills. At least we are healthy. Blah blah blah. :) I'm blessed, I am. I just want a place of my own already!

Tuesday, April 22, 2008

To Do List

So, I've decided that when you say something, and it's out there, you have to deal with it. The #1 rule in weight loss is to tell people you're dieting, so they can keep you accountable! Once you say you're going to do something, you look foolish if you can't get it done. Like the Handle With Care event. Once I committed, well, there's no going back.

So, here's a list of 5 things I'd like to accomplish by the end of the year. This way, I will have something to blog about on 01/01/09. :)

1. Learn enough Spanish to not need an interpreter during clinic.
2. Run a competitive race.
3. Travel abroad with The Husband.
4. Write a collection of short stories.
5. Buy our own place.

So, it's out there now. Hopefully this will inspire others to at least think about what they want to accomplish this year. It's something we do in January, but do we reassess quarterly? Monthly? How can I hope to accomplish things, unless I've put them on my To Do List?

Monday, March 31, 2008

Babies Galore

So, I had a few brush-ins with kids this weekend -- real and virtual.

First the real: I went to a friend's BBQ yesterday. He and his fiance (mostly his fiance) are having a baby in the fall. They are super excited! At their party was a Dad and his twin girls -- about 2 years old. His wife was home with a 3 month old. I gave him a gold start for bravery -- taking twins to a friend's BBQ?? Wow.

My other friends were there, sans their little boy. He's adorable and almost 2. He wasn't planned, though his parents love him to death. But, I can feel from the Mom that she's not 100%-all-the-time on board with having a child. He's been sick a lot since starting pre-school, they can't hop on a plane and go to Jamaica, they have to get a sitter to go out with friends...And it's put a hamper on her career for sure. But, then she'd talk about him and all the words he's learning, and she'd just light up.

Contrast that with another friend -- he turned 30 this weekend, and he and his wife had a big party. Their daughter is the absolute light of their lives. The Mom stays home with the little girl, totally content to just be there and raise her.

My virtual run ins: Lil Kate is now the proud fiance to a man with 3 boys (ages 6-9). She has become "Instant Mom" in a way (just add water). Very different, because they aren't her biological children, they don't live with her and the Fiance all the time, etc. However, still a big adjustment and a big mental leap to take.

Second, is my friend (whose amazing blog is here). Her sister had a baby (unplanned, but very loved). My Friend can't wait to find her One and have a family. Her sister, however, is lamenting over missed social events and fun times with friends. I'm not AT ALL trivializing this sentiment...that's my sentiment! That's how I feel. My Friend and I are so similar, but we don't quite see eye to eye on the baby issue. I am trying to do some soul searching and figure out why I'm so reticent to jump in to the baby pool. [Unlike my Sister and Niece -- watch Hannah swim!] Perhaps when I have a stable job, income and house, it'll be different...???

Sunday, March 16, 2008


Well, it's finished. A year in the making and our charity event was amazing! We had about 200 people buy tickets, 68 auction items sold, and one lucky winner got a week vacation in Belize!

Jesse Spencer did an amazing job as our host for the evening. He really brought the heart of AMPATH home to a few hundred people. He highlighted the holistic approach that AMPATH takes in treating patients, getting them job skills and helping them achieve independence. (for more, go here)

My mom, brother and sister came out for the event. That was a great time. I didn't expect anyone to come out -- I mean, I wasn't graduating, I didn't feel like I had accomplished anythign that warranted people flying out to LA. However, I'm so glad they did! I couldn't have done it without their help -- they really stepped up and made the whole day run very smoothly. The Bro and Sis did a great job with the backdrop -- they made the red carpet really work!

The Residents did a great job, as well! They checked in over 200 people in less than one hour. They answered questions and sold raffle tickets. They managed the silent auction and got the winners their items in a seamless fashion. It was quite impressive.

Overall, we raised $32,000 which goes a long way in Kenya! And, at the end of the night, that's what it was all about. We had people from such varied backgrounds all coming together to help fight HIV/AIDS. It was heartwarming in every sense of the word. Thank you to everyone who made this night so special...Thank you for caring enough to give of your time and money for those less fortunate...Thank you for giving them hope.

To make a donation or read more about the event, please visit our charity website.

Saturday, February 16, 2008

Big 3-0

So, my husband just turned 30 on Valentine's Day. We are both looking forward to 30, unlike most people. I feel like we've been working really hard throughout our 20s, and I'm hoping for a big payoff in my 30s! I think we've spent the last 10 years putting ourselves in the best position possible for success.

We've been saving a lot, so I hope we can get a condo this year.

We've been working a lot, and I think we're both making strides in our respective professions. My abstract was accepted at the ACP annual meeting in DC this May. I'll put together a poster for the event, and the local ACP chapter is going to repay my expenses!

It's strange, because I remember my dad's 30 birthday party. I was 6. My mom threw a surprise party for him, which was fun! Remember hiding behind the chair, jumping out and yelling "Surprise!" Weird that my parents had 3 kids at that point. My life is turning out very different from my parents, and I keep telling myself that (like that old commercial) "different is good."

Here's to 30. We'll see if I feel that way in 2 weeks, after my birthday. :)

Oh, please check out the charity website: -- you can make a donation or buy tickets for the event. Get your tickets asap as we've got a limited number to sell!

Tuesday, January 1, 2008


I know that's a strange title for New Year's Day, but I am feeling especially thankful today.

My charity event is really coming together. With this event, I've had to ask a lot of people for favors, to be generous, to sacrifice. It's not something I enjoy doing, as I hate feeling like I'm using my friends.

Well, I emailed a friend who is amazingly talented and has her own jewelry line ( - check it out!). I asked if she'd be willing to either donate a piece, which would be awesome, or even design a piece unique for us, that people could buy to support our cause...which would be out of this world! I prefaced it all by saying there was no obligation, no pressure, and no hard feelings if she couldn't commit. I told her that I didn't want her to feel "used," but that I really admired her work.

Her reply was so touching to me, that I teared up immediately. She said, "First of all, when you are doing something like this, you must realize it can only be The Great Deceiver telling you that you are "using" anyone. if people are not honored to be asked to participate in such a great thing, that's their problem. i am absolutely delighted that you thought of me, and i LOVE the opportunity to do stuff like this."

I am so thankful for such graceful, amazing friends.
I am thankful that I'm turning 30 this year, and I'm right where I wanted to be.
I'm thankful for my loving, giving family. For my husband, who is supportive, energetic and my life source.

And I'm thankful for the charity event -- for the chaos, for the small victories, for the generosity of the residents...for the chance to do something for the countless people in Kenya fighting HIV.