MelikaGirl

My SuperAwesome Marching Band Wedding (Part One)

2012-01-20T10:31:00.019+07:00

Before I wax poetic about the actual wedding, allow me some time to share with you, fine readers, the fabulous events leading up to the wedding.

Shower One: Tea with the Ladies of Michigan

First official wedding event was a shower in Michigan hosted by two of my mom’s BFF’s and her sister. This was an opportunity to allow my mom’s friends and Michigan folk to gather, celebrate, and wish us a happy soon-to-be marriage. It was ladies only and, in the true fashion of my mother’s ilk, was a very fine tea at a ritzy hotel. We sipped finely brewed beverages from fancy antique mismatched floral cups and ate little finger sandwiches.

It was very lovely. Karin and I were truly showered with love, and gifts, and well wishes. Both my siblings were there (a rare occasion - though my brother was banned from the actual shower) and my Aunt and Uncle flew in from Colorado. We were able to touch base with some of my awesome medical school friends who still live in MI and my mother’s friends I’ve known and loved forever, who are like family.

The only down point was that I was still pretty sick from my decompensation the several weeks before. Traveling was particularly hard on me. I was so grateful for the acceptance and flexibility of my friends and family as I’m sure my not feeling well put a small damper on things. I was in a bit of a drugged haze for most of the event (high on anti-emetics and the like) but in all it was absolutely gorgeous! As my mother-in-law would say, it was Fancy! (Photos from the Hotel's website!)

Shower Two: Shower/Bachelorette Brunch with Epic Scavenger Hunt

The second official wedding celebration was the shower/bachelorette event our local friends held for us. We started the day by gorging ourselves on an amazing brunch at one of our favorite local restaurants. After we finished stuffing our faces we waddled out the doors and commenced a truly epic adventure. One of our fabulous friends and shower-hostesses had designed a local scavenger hunt!

The Hunt

We divided in the two teams: Karin’s team, the Blue Team, and mine, the Green Team. We wore as much green or blue paraphernalia as we could cram on our bodies (points for each item of your team color). Then, we set off to scavenge! Almost all items were things we needed to photograph – either as proof or as the item itself. Creative interpretation was encouraged. Below is a random handful of items from the list (note: items couldn’t belong to a team member):

Convince someone on a wheeled “vehicle” to let someone on your team take a ride (pic below).
Take a photo of two people in love who are both drinking coffee.
Photograph your entire team plus two guests jumping. Everyone must be in the air at the same time. (pic above/left)
Take a photo of a pet wearing clothes.
Take a photo of the most unusual item with the Space Needle on it.
Someone who has been with their partner for over 25 years
Someone born in Karin’s/Liz’s home state
A white wedding dress -- extra points for someone wearing it, even more points if it’s someone’s wedding day!
Two people playing musical instruments (extra points for both in the same photo)
Go to a used clothing shop and dress a team member as a lesbian cliché (outfit must include 4 items not owned by a team member)
Etc... (there were about 30 items)

It was so much fun! We did a majority of our scavenging close to home, in Capitol Hill, the LGBTQ and artsy district of Seattle, and where Karin and I call home. We hit our first roadblock at the very beginning. We saw a gaggle of young gay men sitting at a table outside one of the bazillion nearby coffee shops. After our usual lead-in which included the phrase, “we are on a scavenger hunt,” we asked if any of them were in love. The laughed sardonically and very dramatically rolled their eyes. The answer was a unanimously bitter “no.” In fact, they were quite possibly the most embittered anti-love folks we could have encountered. No matter - we didn't let that slow us down! We expressed our condolences and trudged on another block or two to easily find another two big, burly men walking down the street with coffee cups in hand. They were indeed in love, and more than happy to pose for us.

About 2/3 of the way through the hunt, my Green team met up with two of my friends from Boston who joined us for a foray to Pike Place to complete some scavenger items, and then lastly to Lake Union for a sample of water to take to the finish line. They were very helpful, especially when it came to asking strangers at Pike Place (mostly scared tourists) if they were together more than 25 years or from Minnesota. Another funny fact, while the 5 of us Green-teamers crammed like sardines into a teeny 2-door Volkswagen bug for part of the hunt, poor Karin’s Blue team had dwindled to two, and were traveling in luxury in her enormous Nissan Pathfinder.

I have to also mention that the day we had this Shower/Bachelorette Scavenger Hunt was the day Seattle hosted the Great Urban Race! That meant that we were coincidentally in the company of hundreds of other scavengers, also strangely dressed and frantic to get their items from their list! At one point we came across a couple of gals who asked us to help by taking a picture with them - instant scavenger hunt karma!

After completing the scavenger hunt we treated ourselves to yummy frozen yogurt at my summer obsession, Yogurtland (photo left). All in all it was a great event. The only real casualty was my camera, it obtained a mortal wound while serving us bravely taking a photo of a beloved drag queen friend (see photo of her fabulous besocked hand, below/right).

One of the scavenger items was to write a poem. My team had to write one about Karin and hers had to write one about me. I’ll wrap up this blog post with hers for mine and then mine (ours, really, as it was a team effort!) for her. They are definitely corny but we were pressed for time! You should have seen the pictures we drew of each other with our eyes closed! The horror!

Next post may be about the actual wedding itself -- stay tuned!

Liz is great,

Liz is smart,

And she’s crafty,

And good at art.

She likes horses,

I like dogs,

She’s good at games,

And wins them alls.

She likes coffee

I like toffee.

Yay for Liz!

By Karin Riggs

There once was a woman named Karin,

Who didn’t belong to a harem.

Her dog’s name is Lucy,

She likes to chase goosies,

And the two of them together would scare ‘em.

One day Karin met Liz,

And her heart got all in a tiz.

It went pitter, patter,

Flitter, flutter and splatter,

And she said, with this girl I must live!

By Team Green

Increments

2011-11-12T20:12:00.001+07:00

Hello dear readers. Long time no blog, I know! Since it's been so long, instead of a chronological, month-by-month review as is my usual routine, I thought I'd cover a few of the most relevant topics. Things that will get some dedicated MelikaGirl time are: The status of my head injury, Wedding Events/Honeymoon and a celebration post for my dearest Sive who I lost October 22nd. So expect a few posts dedicated to those topics coming up soon!

In this post I'll focus on a brief-ish head injury update. As you may recall, I was felled by a decompensation in April. I recovered a bit late spring, early summer at the time of my last post and from there made incrementally slow improvements.

My return to working a regular schedule was painfully slow. At first it was minimal to no computer time. Then it was computer time until I had symptoms then stopping, moving to a dark quiet place and taking a 10 minute break or resting until symptoms went away again. Eventually I was able to work part days, then full days, seeing 1/3 patient load then slowly and surely a full patient load. I threw my expectations of having a social life out the window. I was medicated and in bed by 9:30 and up at 7 pretty much every day. I kept to my routine and even added nightly mindfulness meditation to my daily ritual, meditating from 30 minutes to 2 hours. I rested my brain at every opportunity. I nurtured my body as well. I start lifting weights and doing some interval training. Once I started working out more regularly my incremental improvements seemed to start increasing by, well, larger increments. By the wedding I could say I felt good most days. I even managed to climb a mountain (photo above from the descent), participate with my marching band in almost every parade as a banner carrier (photo at left) and do things that started to make me feel like I was getting my old life back!

I can't say I'm quite back to normal. Not yet. Screen time, loud sounds and bright and/or flashing lights are still hard to tolerate. But since September I have been successfully playing with Rainbow City Band, often with at least one earplug in, but it's been wonderful to make music again! This fall concert (can you find me at right?) we hosted the annual conference of the Lesbian and Gay Band Association and performed with around 300 other LGBT musicians and performers (the color guard also did an impressive number to a Danny Elfman arrangement). It was a great experience and it was so nice to see some familiar faces from Inauguration and New Orleans!

I still struggle with headaches, neck and jaw pain, some dizziness and difficulty sleeping through the night (usually due to one of the above). Additionally, when I get tired or am not taking proper care of myself, I'll have a hard time concentrating -- this can range from difficulty completing complicated tasks (like charting at the end of the workday) to difficulty with word-finding or expressing myself the way I'd like. These issues predictably seem to come up at the end of a particularly long day with a lot of computer use. It's terribly frustrating as problems staying focused or concentrating are things I've never had to deal with before and are harder for me to manage than the more simple symptoms like pain, dizziness, or nausea. I also sometimes find myself with a shorter fuse, more irritated at little things that used to not bother me nearly as much. But, like I said, if I care of myself, keep stress to a minimum, sleep well, eat well and exercise, these things are manageable and I think that maybe I'll someday be symptom free. *fingers crossed*

It's been HOW long?

2011-06-06T09:00:00.002+07:00

Expectations are high as this three month hiatus (has it really been that long?) is the longest in the history of MelikaGirl. But I had my reasons: A) Referencing my last post, The Accident, I did not recover as smoothly from my head injury as I anticipated, and, B) Despite my convalescence, Karin and I have been busy with visitors (mom's mainly), trips and misadventures.

So, please take those high expectations and save them for some other auspicious event. I will only try to reflect as best I can on my last three months.

March was less like lions and lambs and a little more screaming banshees and whirling dervishes. I actually did have a nearly complete blog post composed for March (never posted since I was struck down by PCS). It was mostly details and some gripes about my new job. However, now that the month is a little further behind me, my gripes about conveyor-belt medicine and quantity of patients over quality of patient care seem ill-timed and trite. I had (and still have) every right to be pissed about that kind of health care system/work environment, but the real issue in March was my own failing health, and I was too blind to see it.

I wonder, was I so blind to my own symptoms because medical school and residency did such a fabulous job training me to ignore how I felt and keep plodding along -- always putting work first? Or was my lack of insight some sort of psychocognitive unawareness that was actually a possible sign or symptoms in itself - a result of the concussion? Maybe it was a bit of both?

By the end of March I crashed. Hard. With hindsight as it is, I can see now that I was getting worse with each week. [WARNING: explicit details ahead.] Through most of March I was kept awake once or twice a week with vomiting. Each time, my denial or lack of insight chalked it up to something I ate, a virus, or some other such excuse. In the daytime I had horrific headaches. In the evening I was dizzy and clumsy and uncoordinated. Sleep was difficult at best. Near the very end of the month I had a handful of days of outright awfulness. I had this horrible sensation similar to that one feels moments before passing out. Nothing helped. I was weak, nauseated, spinning like a top, and essentially unable to do anything. But they passed.

With the hope that the symptoms would just eventually go away, I kept driving myself to keep moving forward. A majority of the month and into April I spent my work days pushing through 9-10 hours in clinic, followed sometimes by hours of band rehearsals, board meetings, social engagements. I even managed to play in RCB's spring concert until the last two songs, when I had to bow out and lay prone on a couch in the green room.

My days off I spent nursing my symptoms with anti-nausea medications and running around from acupuncturist, to physical therapist, to craniosacral therapist, to sports medicine doctor, to massage therapist and so on and so forth.... Eventually I couldn't sustain and I crashed. My doctor was worried about my decompensation and referred me to a neurologist and I had just about everything above my shoulders imaged by MRI. I took a little more than a week off of work. Returned to a couple of half days, was doing pretty terribly (even walking short distances was hard without an arm to support me, my balance and vertigo were so bad) and ultimately the neurologist insisted on a full month off. From mid-April to mid-May: No work, no band, just rest and only doing those activities that I could tolerate without any worsening of symptoms.

This was a hard pill to swallow. I needed the income. I was planning a wedding and training a new horse! I had band and was elected to the board of directors! I was just starting my career! I couldn't just put on the brakes and stop! What if I don't get better, I kept thinking. This isn't fair, I selfishly thought. Why me, why now? Why didn't I have disability or sick leave? Why did I take so much time off and let my saving deplete so low? The injustice of paying back huge loans I had to get the education needed to do the job I was too sick to do made me furious. But the bottom line was: I was too sick to do anything, and statistics were on my side. Rest, and I should get better.

For the first week I was pretty useless, doing nearly nothing except eating, drinking, bathing, and washing dishes for short periods of time. Then it extended to laundry, short walks, relaxing social events (like Easter Egg dyeing - pictured), rides as a passenger in the car (horse therapy!), and after four weeks of solid and strict rest I started to get better. My fears and worries abated a little and I could start to see a normal life for me again in the future. I even managed a short trip to see the tulip fields in Skagit Valley (right) and got to enjoy a few hours of HonkFest West.

This leads us to May. I was still resting most the first part of the month but was a bit more functional. Instead of counting good hours, I was starting to have the occasional good day. Both Karin's mom and my mom ascended upon our humble apartment and we embarked in Momfest 2011. We each had quality time with our respective mothers and had joint planned events so the mothers, meeting for the first time, could get to know each other and have a little fun. Resting most the day, I managed a night out at our annual fundraiser, Swing Fever, earplugs in place, and paying careful attention to not overdo it. The moms really hit it off as evidenced by their dancing photo left!

After the moms departed (Karin's mom had a two weekend stay) I successfully completed my first week of half days back at work. This was immediately followed by band camp. Officially called the "RCB Retreat", it's a weekend of intensive marching and music practice, and bonding for the marching band and friends. As a non-playing member I had time to rest and recoup from my first week back at work and still have a little fun to boot (see first picture atop at the Disco Alien Ball). I even got to sing some Bangles at karaoke!

The weekend after that we flew to Michigan for a bridal shower thrown by my aunt and mom's friends. It was a lot for me and my post-concussed brain, but the event itself was short and with family around and a plethora of homecooked goodness, I could focus on stress-free R&R between the few scheduled events. It was wonderful to see my family and a few friends. I was focused so hard on being present and not overdoing it I didn't take a single photo!

This coming week I hope to extend my work hours to work about 2/3 of a day. I'll give that a few weeks and if I continue to see improvement in my PCS I'll go back to full days. I'm grateful my employer is keeping me on despite my injury and unscheduled time off - I'm not benefited and totally replaceable. Another employer may have just sent me packing and found another locums doc to fill the shoes I should have been filling.

Sunday I visited Gus. He gets to run around all day with his friends in a huge field and work on getting fat (he's still a growing boy) and he was a dream to play with - well behaved and always curious and affectionate. While doing some ground work training with him I realized I felt totally and completely me. No headache, no dizziness, just happy, and just Liz. I hope to have more feelings like that until the point where I take it for granted again... except for the part where I take it for granted.

The Accident

2011-02-22T21:00:00.008+07:00

Understatement: The last month has been eventful.

For the few readers who don't know, I was in a riding accident shortly after my last post. In this entry I will try to explain what happened. Fair warning to my readers: there may be unpleasant descriptions ahead.

The Impact
Allow me to first say that I am no stranger to falling off horses. In 30+ years of riding and showing horses it is bound to happen. Not terribly often, thankfully. I have not been without injury, I have hurt my knee, ankle, broken my tailbone, and bruised and banged various body parts. However, with a few exceptions, the worst of my injuries to date have been from conquering jungle gyms and jumping on furniture. This tumble, however, was a bit more dramatic than the other times I've been de-horsed.

The entire day of Wednesday the 19th of January is gone from my memory (*poof), but the facility's trainer witnessed but the moments preceding and immediately following my accident. My dear, beloved Gus, who is truly good-natured but also young and still figuring out his new surroundings, was scared by a couple horses playing rough nearby. It took us both by surprise. He spooked forward, bucked, leaped, bucked again... we went out of sight... and next thing the trainer saw was Gus coming back around without me. She ran to the ring to see me laying on my back, unconscious, on the soft footing of the covered arena.

In the fall, my head must have hit the wall of the arena, or a hoof, or impacted something on the way down, because aside from a bit of a strained rotator cuff, I didn't have any evidence of a hard landing. No bruise, no broken bones, just a broken brain. But I guess you can't call it a freak accident it it makes a lot of sense, eh? Per witness report, I was unconscious for about a minute. After which I apparently got up of my own accord and declared myself fine. Despite my protests I was ordered to the nearest ER for a check up - a very smart thing to do.

On the way to the ER I apparently had a seizure (not uncommon after a concussion). After the seizure I was a lot less adamant about my well-being. Apparently I became very disoriented and confused. I had no concept of who I was, where I came from, who anyone was around me, let alone what had happened. By this time it was evident I had a traumatic brain injury, confusion, amnesia and a partridge in a pear tree. Thankfully, my head CT was without any bleed and for that I can surely thank my super awesome helmet!

At some point I gained more awareness and began to ask questions. The same 3 or 4 questions. Over and over again. With the same inflection, wording. Like a 10 second episode of 50 First Dates, or my very own Groundhog's Day. One of the exchanges on repeat went like this:

Me: What happened?
Karin: You were thrown from a horse
Me: A horse? Was it my horse?
Karin: Yes, it was your horse
Me: I have a horse?
Karin: Yes
Me: That's awesome!
Me: What happened?
Karin: You were thrown from a horse
Me: A horse? Was it my horse?
Karin: Yes, it was your horse
Me: I have a horse?
Karin: Yes
Me: That's awesome!
Me: What happened?
Karin: You were thrown from a horse
Me: A horse? Was it my horse?
Karin: Yes, it was your horse
Me: I have a horse?
Karin: Yes
Me: That's awesome!

And so on...

After everyone was positively 100% sure I didn't have a broken neck or a sneaky little bleed in my brain, I was transferred by ambulance to a hospital closer to home. When Karin arrived I was in the hospital bed, watching a video on fall prevention. I mention this little detail on my blog for a couple reasons: 1) to point out the ridiculousness of "educating" someone with amnesia by leaving them alone in a room with a video playing, and 2) I just had a traumatic brain injury, one thing I certainly should NOT have been doing is watching TV. Shame on you, Unnamed Hospital! While I have no memory of the video, I have it on good authority I still managed not to fall.

The worst of my amnesia and short term memory loss lasted until the next morning. Even though I was able to make new memories and keep them, the week after the accident still has some holes in it. And Karin reports that my personality didn't return until over a week after my discharge from the hospital. I can only imagine how frightening it might be when the someone you love who isn't acting like that someone anymore.

Silver Lining
The most amazing and wonderful thing about all of this was how my friends and family rallied. My friends from band and family in the area signed up to take turns staying with me that first week when Karin had to go back to work. I ended up with more ice cream than could fit in my freezer! People brought meals and cookies and picture books. Some people even had the patience to read to me (as I was unable to read for the first few weeks). Surely I wasn't good company, I would tire after short conversations and spent most of my time sleeping and resting on the couch. But people kept coming by and helping however they could. For two weekends in a row my father flew in from Michigan to help out and made his killer spaghetti sauce which usually only gets revived at Christmas. There's still some hoarded in the freezer!

There is excellent evidence that a good support system improves recovery rates in the ill - whether it be traumatic injury, chronic illness, acute illness; concussion, cancer or heart attack. And my support system ROCKED! I truly think I owe my quick recovery to my unbelievable support system. My accident helped me realize how lucky I really am.

Recovery
It took about three full weeks before I started to feel more like Liz again. Even now, more than four weeks later, I still have symptoms like headaches, dizziness, weird creepy-crawly, feverish-like feelings that come on when I stare at the computer too long, and a poor tolerance for florescent lights, but presumably those will fade over time.

I have started work. It's definitely not easy with the florescent lights and computer screen time, but talking to the patients and doing the exams is nice again after my 7+ month sabbatical. Plus, I am really looking forward to being able to pay my bills (yay paychecks!). And, I must say, I am thrilled to have the brain health to be able to do my job!

I also have learned that I need to get my DPOA paperwork, disability, and life insurance in order. Karin was there from beginning to end, and was as powerless as a stranger. So DPOA paperwork is complete and only awaiting to be notarized.

There you have it. My accident in one blog post. Hopefully that answered a lot of people's questions. The rest of February will hopefully be generally uneventful. In my next entry I may expound further on the New Job and other less traumatic adventures.

(photo borrowed from Google images)

Big changes for 2011

2011-01-16T04:20:00.019+07:00

Wow, 2011 is already proving to be a year of change! Here are some of the new things going on in the Melikagirl Universe since my last update.

The New Horse
I know I have already hinted at this, but allow me to officially state: I have acquired a horse! He was a gift, arrived January 8th from Kentucky, and he is all mine. Mine, mine, mine! He is 17 hands high (that's rather big, for those who don't know what that means), a bay (which means brown horse with black mane and tail), a Thoroughbred (America's most versatile breed, in my opinion) and only 4 years old (that's just a baby, he still may even have some growing to do). I've named him Augustus, or Gus for short. He's lovable, sweet, amazingly good natured (no one can believe he's just 4 years old), and he is still figuring things out under saddle. Here is a photo of him getting nose scratches from me on our second ride together.

You may not be surprised, but I'm totally in love.

We have a lot of work to do. Optimistically, he may start jumping in the next 6 months or so at the jumper facility across the street, but in the meantime, he needs to get his basics down a bit better. I'm boarding at a really nice dressage barn complete with very good trainers who can help me train Gus to reach his awesome potential. He is flexible, athletic, willing, mostly brave, and wants to please. I just need to be patient with him and he can go far. Next week we have our first professional training session and I can't wait to see how it goes!

The New Car
My little '95 Civic, with stick shift, sunroof, and oodles of pep, has officially been retired. I worked hard to keep her after she'd been stolen and violated my memorable intern year. My personal goal was to have her last through residency. And that she did. While most Civics are reliable and last forever, this one succumbed years ago to the salt and snow of Michigan. I used to joke with one of my mechanics that she was an Escort trapped in a Civic's body. Her poor rust-addled frame has been held together with spit, love and bailing twine for the last decade or more (I drew the line at duct tape). The amount of cash I've put into repairs in the last 2 years has added up to more than she's worth. The last time she was in the shop (after my calipers seized for, say, perhaps the 5th time) the mechanics recommended about $1800 in repairs right away. I paid them $600 to keep her drivable. Thus, as peppy and fun as that little maroon car was, it was time to let her go. Between the horse and work, I expect to spend about 10 hours (plus or minus) driving each week. And now that I will be dealing with rush hour traffic, I'm not going to lie, an automatic will be a nice break on my poor gimpy clutch leg.

So what am I going to be driving now, you ask? Karin wanted to upgrade to a larger vehicle so she can fit her piano and associated equipment without shuffling too many seats. We were also thinking about having the option to haul the new beast. So Karin settled on a Certified Used 2007 Nissan Pathfinder SE. Not the kind of vehicle I ever thought I would have (admittedly, I still lust after a 5-speed manual transmission V-tec Honda Fit...) but she's from the wilds of Minnesota and can handle a truck like a pro. But I don't plan on driving that behemoth! I'll be driving Karin's previous chariot, which is now officially mine, a 2005 Honda Civic LX. I will take over the remainder of Karin's payments and we traded in my '95 to go toward her new beast. I think she may call her new car Bo Jangles. I think I'll just keep calling it The Beast. The '05 Civic still remains nameless. (Grainy picture above was taken by my phone: my new car, Silver, is at left, and the old carl, maroon, is at right - the angle makes the sizes funny be trust me that the new one is a tad bigger than the old one. The stock photo at right is The Beast, Bo Jangles).

The New Job
My planned 6 month sabbatical was extended just one month longer than anticipated as I will be starting work this February.

I have accepted an offer of a locum tenens job with HealthPoint here in King County. Of course it's the the furthest point of the County, in the city of Federal Way, just about to Tacoma (about 40 minutes with no traffic), but it's the opposite direction of rush hour (mostly) and just 3 days a week. I was commuting from Seattle to Tacoma and visa versa about 2-3 times a week all last year anyway, so I think I can handle the drive again for another 8 months.

Admittedly, I have been worried about launching my fresh-out-of-residency career in a similar environment to my old clinic. I was a bit burned by my patients taking advantage of me and the fact we were a residency clinic. We were often the last place a patient could be seen after they had been "fired" by numerous other health providers (for prescription drug abuse, fraud, inappropriate behavior, and other various issues) and had to deal with some very difficult patients. Residency clinic and "real life" clinic are two very different animals, and while HealthPoint is a federally recognized community health center, and their patient population is largely uninsured and underserved, I feel I might be in a better position to set some boundaries right off the bat.

I am excited to see what clinic life is like in a new work environment. I am appropriately skittish to be practicing on my own (will certainly double check my own advice before doling it out to my patients for a while) and understandably ecstatic to start getting a pay check! I have no benefits or paid vacations but I also don't have a long term commitment and am only working part time.

So, new horse, new car, new job, a wedding to plan... this next few months will fly by. I am going to try and slow down and savor every morsel of the good stuff.

2010: Year in Review

2010-12-31T23:59:00.004+07:00

Time for my third annual "Year in Review" Post. Get your popcorn and diet soda and settle in for some nostalgia...

For those who like swimming in summaries, here lie 2008's and 2009's reviews. 2010 was indeed a memorable year. I started out in indentured servitude and am ending it in a very different, much more enjoyable place. (Aside from three obvious photos, pictures here are from the eventful month of December.)

Now, on to the very serious business of my annual month by month review, divided into the tidy categories of Uppers and Downers.

January: Rotation: ER, and the usual burden of "back-up". Downers: Slave labor in it's truest form. Scheduled to the max 6-7 days a week with little time to breathe, sleep, eat, care for myself. Uppers: A freak flooding rainstorm in the Southwest led to a canceled flight, a glorious weekend off (the only one for approx 12 weeks) and an engagement! Three cheers for happily ever after!

February: Rotation was NICU with q4 call. A meh rotation with lots of time sitting fully scrubbed and waiting for babies to get sick. Not the best time. Downers: My one golden weekend was a required residency retreat where I ended up getting food poisoning. Uppers: After recovering from said food poisoning my class won the TFM Talent show performing a song I wrote about a lost pager - it was a huge hit and lots of fun! Also, I enjoyed a post-call stuporous Valentine's Day dance with my fiance.

March: Rotation: Cardiology. Supposedly a break from all the call. Supposedly a break from working so many weekends (by March, aside from the freak storm and the work-related retreat, I had worked every weekend in 2010. Yes, I'm still bitter). Downers: due to coverage for other residents, official back-up duty, and my own laboring patients, I was still sleep-deprived and dearly missing my sweetie in Seattle. Uppers: I got to perform the 1812 overture with RCB, complete with [electronic] cannon fire! I managed a short escape to present at the AMSA conference. Passover Seder family reunion in San Fransisco! The Countdown Clock continued...

April: That was my "No Happy Bunnies" post, as you may recall. Rotation was in-patient family medicine. Downers: We were short-staffed and thanks to work, Karin and I missed out on our first anniversary and Honkfest, and I missed out on just about everything that makes Seattle Spring superawesome. I was still horseless and barely able to find time to play my trumpet. However there were Uppers: I groggily made one post-call Renegayde gig for the Roller Derby, and the month eventually ended. But the best upper was that it was the last month like that. Ever! The thrill of my last call was dampened by the fact that I was called in to cover more calls, but at the time I thought it was my last and I celebrated in style: Rounding on roller skates (as above).

May was a breath of fresh air! I finally had less back up and could use that vacation time! Downers: Not much. Just the surprise black weekend call after my much needed vacation, more residents down for the count and more chaos at TFM. Uppers: Band Camp! Vacation in buttery Minnesota! Sleep! Tick tick tick on the countdown calendar...

June was the last month of residency. It flew by. Rotation: Bastyr elective in Seattle. Downers: everything happened at once which was seriously stressful. But, all those things were overall pretty good (moving, the visits from my family, finishing residency). Uppers: Did I mention I finished residency? Moving in with Karin, Pride, Summer solstice festival, family. Oh, yeah, and as of midnight on 6/30 I finished residency! Woot! Countdown clock zero'ed out (I had two countdown clocks, one online and one on my iPod - the zeroed out one from my iPod is pictured at left)!

July: First month without an associated rotation since the month I had off between medschool and residency! Holy moly! Call it my rebound month. Downers: Board exams - ick. Some drama around RCB. Merging two households was way more stressful than I anticipated. At the end of the month the biggest downer was the death of a close family friend, as well. Uppers: OMG I got to do laundry! OMG! I got to do dishes! OMG I got to sleep in! OMG! I got to watch TV! Traveled to Boston for for a week for a GLMA Board Meeting. Rocked some parades with RCB. OMG I finished residency last month!

August: Oy. The biggest Downer occurred Sunday, August 1st: ripped my left gastrocs in two pieces, rolling it up like a window shade and rendering me useless for a large portion of the month. Uppers: Seeing some Aussie pals, Lisa and her mother. Camping with Karin's Neice. Storm games. And BLUE HAIR! Plus, all those rippling upper body muscles from those crutches!

September: It was full of so much adventure that I posted my entry late. Downers: what are those? Oh, right, I was still pretty injured but getting around a lot better and Uppers: No more cane! Seattle Storm Mania. GLMA Conference in San Diego. Another great Lullaby Moon gig.

October: The real recuperation month. As I reflect back, it wasn't until the end of October that I really felt I was starting to heal. I had more energy and dug into life. I looked for horses, barns where I could ride. I did some serious wedding planning and I went through a lot of old boxes and papers and finally finished unpacking. My blog posts were full of nostalgia about medical school and rotations. I was starting to get ready to get back into the workforce. Downers: More band drama. Karin took the Pysch GRE's (ick for her). Uppers: Huge headway made on wedding planning! Plus all the aforementioned healing! Freedom feels so good!

November was eventful. Downers: Snow put Seattle on hold Uppers: Snow put Seattle on hold just before Thanksgiving (making for a loooong weekend!) and Karin and I hosted a Little Gay Thanksgiving at our house. I made some headway on the job and horse search!

Bringing us to this month, December, HanuBirtMas time! Downers: After 34 years I still get bitter that my birthday is lumped with Jesus'. Is that selfish? Uppers: RCB Christmas concert! Birthday sushi (yum at left) with friends and family and ice skating. And, of course, the much anticipated Trip to Minnesota.

In the Tundra of Middle River, MN, among other things, I helped make a traditional Norwegian flatbread called lefse and drove a snowmobile. Ah the snowmobile lesson... it went something like this, "Here's the throttle, here's the brake, here's the emergency shut-off. Follow me." And with snowsuit, helmet and an 11 year old sitting in the seat behind me, I took off in the dark winter night, following faint tail lights and a cloud of snow. That first ride I can't say with total honesty that I had a lot of fun. Terrifying would be more accurate. But the following day was another story. Off we went, in the blazing sunshine across field and dale, through woods and trails. Glorious adventures were had. I smiled so hard my face hurt. And while I missed my family and my usual family traditions, I thoroughly enjoyed my time with the in-laws and actually look forward to another snowy Christmas in northern rural Minnesota - snowsuit and all (see photo above near February's summary)!

So, dear readers, 2010 was great, but I trust 2011 will be even better! It will be a big year - a real job, a wedding, and a horse! Yes, a horse. I know I keep promising more word on the topic... s0 stay tuned for more word on work and horses...

Happy New Year!

Sagittarian FTW (Happy HanuBirtMas)

2010-12-06T14:15:00.001+07:00

Thanksgiving, a horse swap, seasonal festivities and the Snowpocolypse... it's been quite a busy month since my last update. I sit here shortly after my ophthalmologist visit on our new Couch of Amazingness with my ginormous pupils and belly full of left over spinach dip contemplating where to start.

I suppose tossing a term like "snowpocolypse" in my intro may elicit some questions so I will start there. The snowstorm we had around Thanksgiving was a doozy. It's wasn't so much the fluffy stuff that caused the issues, it was the frozen wet stuff underneath. When one lives in Rain City, temperatures below freezing leads directly to total chaos. Especially in my neighborhood, where the hills are steep, and the salt trucks non-existent. In sum, the white stuff was lovely coating for the carcasses of abandoned vehicles and closed up shops while the city had their dry run for The End of the World and shut down the week of Thanksgiving. Commuters spent up to 8 hours in gridlock on the icy freeways and after running out of gas left their poor cars where they died. Click here for a recap of the madness (follow links therein for more video and photo fun) and note below an entertaining video of a street not far from my house. Oh Seattle, you amuse indeed. (Also amusing, Seattle men and their all-season shorts apparel as my photo above).

By the time Thanksgiving rolled around Karin and I had managed to create a cozy little space of our home and as the snow continued to fall, our guests arrived to partake in a true feast! We had incredible homemade pies (pumpkin and apple - crusts from scratch of course - see left), turkey for the carnivores with gravy, gluten free stuffing of awesomeness, cranberry sauce of glory, scrumptious mashed potatoes, the required yams with marshmallowy sweetness, crunchiferous green bean casserole, olfactory bliss home baked bread, and more! Five of us sat around the table and gave thanks for the food, each other, and leftovers. The the next few days involved finishing the foodstuffs (that Karin pretty much made on her very own with minimal help from yours truly - I was the clean-up crew) and preparing ourselves for the next Big Three: Hanukkah, Birthday and Christmas... which in this blog entry I am now naming as HanuBirtMas (strategic capitalization optional).

This year, for HanuBirtMas I want a horse. No... not a pony, a horse (although I do love ponies and if one should happen upon my doorstep with a note saying "free pony" I would surely take it in and love it and cherish it forever. Especially THIS pony!) Everyone should know by now horses have been a critical need of mine since my brain was developed enough to understand wants and desires. My first word may have been interpreted as "cookie" but what I meant to say was "double clear" - an obviously big mouthful for a baby but certainly reflective of my equestrian intentions. So to follow up from last months' horse report: King, the great big push-button gray gelding with "Grand Prix" written all over his massive head, was sold. I'm sure I'll see him on CBC someday, rocking the international jumper scene and will be able to say with pride, "I almost got to ride that horse." However, my consolation prize promises to be quite fantastic. ...And you fine readers will have to wait to hear all about it! I fear talking about it here may again tempt the fates, and out of pure superstition I will withhold full details in cyberprint until everything is settled. (Plus, I don't have any cool pictures to share yet!) Hopefully by my next blog post or two I can shed the superstitious malarkey and fill everyone in on the horse saga. In the meantime, appreciate my relaxed riding style, circa 1988, above.

Albeit still (momentarily) horseless, I have been busying myself these past few weeks with more job searching, present-buying, Christmas caroling with my band, preparing for our upcoming concert and enjoying in the birthday cheer of my many fellow Sagittarians in my social circle. I've been lighting Hanukkah candles and bought a little Christmas tree from the nearby Seattle AIDS Support Group annual fundraiser tree sale. Later this month, after a concert and some birthday sushi, Karin, LucyDog (who just turned 8 yesterday) and I will be getting the TSA-pat-down and boarding a plane to Minnesota (via Grand Forks, ND) to understand the true meaning of winter wonderland and to have a Midwest feast courtesy of the in-laws-to-be that will surely rival our turkey-optional, pie-fest, snowpocolypse Seattle Thanksgiving!

Happy HanuBirtMas everyone (photo: me + cake + fellow Sag = yum!)

The gimp gets back in the saddle

2010-11-03T06:23:00.019+07:00

Between wedding planning, physical therapy, job searching, volunteer work, band things and potential horse leasing my days have been jammed packed. I have been a budget-crunching, brain-storming, calf-raising, horn-blowing, attic-searching, phone-conferencing fiend! Days slip by so fast and my to-do lists seem to grow overnight (huge and frightening, like these giant spiders are to this poor damsel we set up for Halloween!)

Wedding Update
Wedding planning is going well. I'll be up front with you all: our budget is tight. There is no way we can invite everyone we want to invite to the reception. But, our ceremony will have no limit! Everyone is welcome to that part of things! We are even more limited for our humble rehearsal dinner. We would love to have an event that would make Martha Stewart jealous - wait! No we wouldn't - that's just not our style! Please allow me to rephrase: we would love to make everyone happy, but we can't. Truth is, it's already going to be non-traditional, so we are going to have to ask our guests to indulge us as we cannot provide every amenity Miss Manners reports is a wedding must-have (that's right, we may not even have wedding favors - the horror!). Once we (and our guests) get over those traditional wedding expectations, the whole thing is pretty liberating. So... what do we know about our wedding so far (guest list aside)? We know where we are having the reception (and the cake is included - woot!). It will be a dry wedding (enough alcoholics in both sides of our families to make that an easy choice). We know where we want the ceremony but can't book it until January so will have to hold our horses until then. We know we want a low-key, inexpensive (read: small), informal rehearsal diner. And, above all, we know we want our favorite band, RCB Marching Band, to march us down the aisle. We also know we want our good friend to be our photographer and make us some purty memories to look at afterwards. Everything after that is just icing.
The Gimp
On the physical side of things, turns out my leg injury was indeed a pretty big bummer. Here I am 12 weeks out and still not normal. Haven't run or jogged yet, but my PT has me "briskly walking" on flat surfaces for 1-2 minutes at a time. Still hoping to lightly jog a 5K by December 12th. I have started in with a massage therapist which rocks and I am so very grateful my health insurance covers most of the visit! I have about 40 minutes of PT exercises to do a day so it keeps me out of trouble. Between that and practicing trumpet I am sore from lips to toe at the end of a productive day.

Job search update: Well, I haven't much to inform you, dear masses, but I have started interviews with one large, local group. I had lost my stethoscope and after much searching, giving up, and searching again I finally found it. A sure sign that using it may be in my not so distant future. I had my first interview this week and was surprisingly pleased with the available position. We shall see... My goal is to work part time, which, in layspeak, means "not all the freaking time", or, in doctor-time means less than 90 hours a week. Ideally. I would like to not have to commute too far as well. Other than that, I am feeling rather flexible because work will be a means to the next update topic...

The four-legged beastie part: A horse? A horse! OMG OMG OMG! Can you just see a 9-year-old Liz galloping around the house in her riding clothes dreaming of having a horse one day? That little girl may not be able to gallop around the house, jumping over ottomans and pretending each sidewalk crack is a cavaletti, but she is still in full-fledged horse-love-euphoria. (And who knows, if it weren't for my bum leg I just might be galloping around. Just a little). For some girls it's a phase. For others, it's the real deal .

For those who only know older-Liz, I had a horse, a ways back. Technically, I had three, just never at the same time. "CC" (show name: Second Nature) was a grouchy off-the-track mare who was a joy to ride in fields and streams but a bit of a bear on the jump course (she liked to stop dead, half way over a fence, no warning). She was the first horse I could call my own, and therefore still holds a very special place in my heart. She wasn't the safest horse for a skinny 4'11" tween as she did really did hate to jump (even though when she did it, she did it gorgeously!). With great sadness she was sold to an educational facility where she'd get to play in fields and go on endurance rides in the woods and not have to jump anything, ever again. My fondest memory was playing with her at a horse-themed summer camp and beating the pants off of every other horse and rider in the relay games. No one was faster or braver than her (as long as it didn't involve any obstacles). I still have yet to know a thrill comparable to riding CC at a full gallop, the wind blowing so fast by my ears I couldn't hear the screams of the camp counselors telling me to slow down! Second there was "Buck" (show name: Up Front) a really handsome show stopper for the National Medal Classes but a big burly boy who did not like to work at all. At the risk of sounding sexist, he was a boys' horse, shunning any attempts to cuddle and preferring to play rough. I started competitively jumping higher than he could clear, so I had to sell him, too. I sold him to a lanky teenage boy who loved every bit of his rough-and-tumble attitude and got a smaller more athletic and more affectionate gelding, Sprout (show name: Mister Natural), who, to this day, is the SuperAwesome Horse to which all other horses are compared. (Photo to right from our championship hey-day - yes that's me. I was 15 I think.) Sprout was pleasant, happy, loving, and loved his job. I could stumble into a show ring, half alert and he would perk up enough for the both of us, winning more blue ribbons than I could count. But it wasn't just the show presence, he was a real friend in the barn. Sometimes I would sit with him (me in a chair, and he, standing) and he would just smoosh his face into my lap and take a nap. I sold him with much sadness in gloomy Michigan February, knowing that owning a horse and paying for a good college education weren't going to jive, but also knowing that one day my college education would allow me the means to another horse like him. God, I still miss that horse something fierce! *sigh

Cut to almost 15 years later and I found a true hooved friend in Shilo. She was an old lady, not quite with the athleticism of the horses of my youth, but I wasn't in tip-top shape myself either. I rode and competed a lot in college and intermittently in grad school, but never much on any single beast. It was usually a different horse nearly every time I went to the barn. So in the time span between Sprout (mid-90's) and Shilo (2008-2010) I got to know oodles of horses at oodles of barns from coast to coast. And, channeling that horse-crazy 9-year-old, I fell in love with nearly every one of them, but Shilo, unlike the horses I briefly got to ride while they were in between owners, got to love me back. I do miss that mare. And I could gush all day, but I'll spare you the torture. It is with great excitement that I launch into the next phase of horsiedom. I believe I have made a full-lease of a great horse work for my budget! I know, I know, it's hard to make a reliable budget without any income. But I have figured out the minimum I'd need to make this work and I am sure I can do it! It's not the same as owning my own horse, but it's the next best thing. I pay for the horse's care as if it were my own with some exceptions that will be the owner's responsibilities (like vet bills) and get to play with him to my heart's delight. He's a big boy (am afraid none of my things from the Sprout-days will fit him) and young. His name is King and he's from Ireland (I've been practicing saying "whoa" with an Irish lilt) and is a more awesome horse than I ever thought I'd get to play with on a regular basis. Here is a picture of him getting some love from a friend of his - he's the huge gray horse with the sweet expression!

So, now I just need to get this job thing in order! It's time for me to get back in both the proverbial and literal saddle, my readers. Until the next update...

Medschool flashbacks: Step One and Surgery

2010-10-19T10:12:00.024+07:00

More flashbacks as I continue to sort through old things. I have rediscovered a journal I kept during medical school. Herein you'll find some of the more memorable entries (for better or worse). Please excuse the weird formatting. Seems cutting and pasting is not Blogger's friend. Hopefully you'll be able to sort out the journal excerpts from the current narrative...

When I was in medical school we had many unpleasant things that were required of us -- terrible things, like our first round of Board Exams, called Step One. I began to call these "rites of passage" or "must-do's" The Flaming Hoops of Death, or, FHOD for short. Step One was by far one of the most challenging FHODs in that it was not only insanely academically challenging but also, if you really think about it, not all that useful for the real world. Really, who remembers (or even needs to remember) all the lysosomal storage diseases by the time we hit the wards?

Studying for Step One, as any medical student can attest to, can drive someone to the brink. Evidence in the below entry:

Tue, Apr. 12th, 2005, 03:26 pm -- Mini freak out:

This test is insanity. They might as well just stick us in a room of rabid raccoons with a disposable razor and tell us to make a fur coat. That might be easier.

For motivation I had a 4" stuffed horse I named Power Pony who would perch at my table where I lived to study and remind me to stay on track (see above photo of my study set-up circa 2005).

Fri, April 15th, 12:39 pm
Power Pony is trying to motivate me. He looks at me with that one cocked ear and those soulful eyes and just begs me to be productive so I can pass step one, go on and be an MD... then have my own stables or at least be able to board at a real jumper facility.

Ah, yes, the motivation: pass this test, get an advanced degree, have a career, buy horse. Certainly the path I thought my life would follow. And, hey, I'll let you more careful readers onto a secret right now, I'm working on the horse thing now. For reals. But since counting chickens only seems to make me look like a turkey (love the fowl metaphors) I'll wait until things are more certain before caw-cawing about it on this blog.

Sat, Apr. 16th, 2005, 11:37 pm -- Positive Thinking

All the studies show positive thinking works.

I will pass this test

I will pass this exam

I will ROCK the boards!

I will be productive the next three days, go over FA again, finish all the QB questions, and ROCK this exam!

Then I will spend a week on an island, drink piña coladas and ride horseback on the beaches.

Then I will get my ass busted on surgery and love every minute of it.

...and then I'll win the lottery (without even buying a ticket) and be able to pay off all my loans and buy an 8-year-old CET-trained jumper and ride him at Spruce :)

hey if i'm going to think positive, i'm going to think BIG :)

After the fun of Step One, I spent 10 glorious days in the Dominican Republic where I did indeed ride on the beach (evidence at left). I came home to a rude awakening. In my naive optimism I held out hope that after two years of classwork, relentless exams and the penultimate memorization leviathan of Step One I'd finally see real, live patients and realize how totally radical medicine was. Unfortunately, I started with surgery. Radical was not an adjective I found myself using. I used more words like exhausted, angry, abused, nauseated, discouraged and mistreated. Honestly, reading in my old journal about the blatant mistreatment of medical students, interns and even patients (both conscious and unconscious), the perpetual self pity and hidden tears behind facemasks and such probably doesn't merit much retelling. It's good to have those entries for posterity (and would make a great modern chapter in an exposé-style House of God-type novel) but it may just make you all feel as sick as I did. I did find this gem of an entry:

Mon, May. 30th, 2005 -- A good memory

I do remember one not bad thing. I was in the OR with Dr. C. and he took the omentum from the patient's abdomen pretending it was an alien and having it snatch his arm. I was so tired and beaten and this was such a light and strange moment I laughed hysterically. I told all my friends about it and how funny that was. I'm sure, though, the patient wouldn't find us playing with her omentum particularly funny. Nonetheless, it was one of the only times I laughed in surgery. Funny, when I do, it's always a desperate hysterical laughter, not real joy.

Funny but sad. My first rotation was colorectal surgery at the Catholic hospital follow by transplant surgery at the University Hospital. Both painful in their own ways but the first month was by far one of the more abusive (and, until my OB/Gyn rotation, I thought was as bad as it got on the wards).

After finally finishing the month with the evil colorectal surgeons I started transplant, and while certainly wasn't nearly as abusive, the hours were doubly challenging. Even though it was dead of summer I had to use my light box to simulate any daylight.

Tue, Jun. 7th, 2005, 05:34 am - Day one of the new rotation

Yesterday was interesting. I was up all night the night before totally sick to my stomach. Didn't feel any better in the morning. Was up at 5 AM to round at 6. Then after rounds, here was my day:

1. Nephrectomy at 7:30 - try not to vomit, I feel sick as hell.

2. Renal txplant at 10:00 - try not to vomit or break the sterile field and cradle my stomach (so tempting)

3: get Purell in eye and have to wear one contact lens at noon - take two bites of a granola bar - my first food of the day.

4. SPI case where i was out of it and uninterested. 12:30-1:30

5. Put contact back in. Still feel ill but try to eat. Not very successfully.

6. Meet more of the team, get "trained" by survival flight.

7. Make call schedule with other med studs. I'm on call every third day this month. Splendid.

8. Get ready for next OR case.

9. Next OR case takes forever to start. Sit and chat with patient getting surgery.

10. Finally, at 5, I go to the OR where they are preparing the pancreas for about an hour.

11. Surgery starts and I want nothing more than to lay on the Mayo and sleep.

12. The surgeon first decides to call me Betsy, then Nancy. Neither are my name. He knows this but thinks it's funny.

13. I get my pimping questions right. He starts using my first name.

14. Get a second wind when the pancreas pinks around 8 PM.

15. Start walking home a little after 9 PM. Feeling guilty for leaving "early" because there are other cases going on that night.

And here I am the next morning. Feeling sick to my stomach as usual (the worst part about surgery, I think). About to start it all again.

And that was just the first day. After that it didn't get much better. There was the day where I was post-call at grand rounds. Sleep-deprived and already feeling ill the topic was total facial reconstruction surgery.

Then we have grand rounds, where, much to my fatigued delight I get the pleasure of seeing people's faces being removed for surgery, their faces cut open down the middle, their jaws split in two and their faces splayed opened like books. It was probably one of the most gruesome things I've seen... more gruesome any autopsy because these patients were alive!

A great way to start a post-call day, eh?
Then there was the day I almost passed out. Note to non-medical folk - it happens to everyone. Even the hardened surgeons. It's nothing to be ashamed of and certainly isn't rare but it still is always embarrassing. My attending, of course, never helped matters.

One day I almost passed out in the OR. The operation was an AV graft (minor procedure). I felt it happening. Before the case I inhaled an egg sandwich from the caf so I know it wasn't low blood sugar - although I wasn't about to admit that to anyone, I'd rather them just have thought it was hypoglycemia.

I sat back on a stool and tried to put my head between my knees when I felt it coming. It didn't make it any better, just kind of held the sickness and fuzzy feeling where it was. The nurses asked if I wanted to go outside to the break room and eat or drink. I reported that it wasn't a good idea for me to stand up. Before I slumped off the stool they grabbed some blankets and rolled them out on the floor and I lowered myself and lay there for a few minutes. The patient, who was awake (as is standard during a procedure like this) asked if I was okay. How humiliating! I felt better quickly after laying flat. I went outside, got some water, and then scrubbed back in as if I never left.

Long term side effect: Dr. M has decided to call me Syncope Sally now.

And of course, the optimism that always tried to sneak out even in the darkest hours...

At the U there is literally a light at the end of the tunnel. As you walk from the main hospital toward the Cancer Center, toward freedom (i.e. The Exit), you approach this sky-lit hallway. It's a beautiful sight - especially post-call. Even with the construction being the view from the hall, and the smell of the coffee stand making you nauseated, it's still the most fabulous part of your day: a little preview of freedom. I reiterate, a literal light at the end of a tunnel. I can hear a choir of angels singing as I pass through to my freedom. Or maybe that's just my ears ringing?

And now, as I wrap up this flashback entry I look at a mailing from University of Michigan Medical School with the incoming class of medical students all posed together, happy, in their sparkling new white coats. It's a solicitation from the Alumni Society, asking for donations. But my reaction to that picture? Poor, poor kids. They have no idea...

Next flashback will perhaps be pediatrics in-patient. Maybe just in time for Halloween as, if I recall, there are some horror stories to be found in those memories...

The consequence of a right-brained person in a left-brain world

2010-10-12T07:34:00.010+07:00

This is what happens when you take a person's creative energy, smash it up into little bits and make them memorize things like the brachial plexus, or what every cell in the human body looks like under a high-powered microscope.Not sure what that octopus is doing on there... it's possible it started the whole downward doodle spiral. Octopuses have been known to do that.

Below, I started out drawing cute little flowers. I swear. But then the monotony of lecture got the best of me and evidently I felt a little homicidal. Remember, this is all pre-laptop in the classroom so all I had for extra stimulation was pen and paper.

Found this other nugget on the back of a handout. Thought the handout wasn't worth keeping, but the doodle was pretty telling. Sive looks so skinny in this one.

It is supposed to read "O.R.... Class... Floor... Clinic... ONE THOUGHT" Obviously I was feeling sleep-deprived even in 3rd year of medical school! I think the "Am I really done?" comment refers to something we were drilled in 3rd year that I have now blocked out.

I've been digging all of these doodles up while cleaning out my office things. I also found a comic I wrote (and posted on Facebook for Coming Out Day) about my friend taking a stand to some homophobic attendings/residents. True story.

Click on the image to see it larger (and maybe be able to actually read it).

Stay tuned for possibly more true stories of the horrors of medical school. There are some other little writings and such that I may transcribe and post on here (if they aren't too terrifying). But thought I'd share some of the the drawings first. Enjoy!

Bunnies and Lay-Ups, This Year's Harbingers of Fall

2010-10-02T20:57:00.005+07:00

For the second year in a row, I didn't post a September entry. But fear not, dear readers, as I will return back to that first month of Fall to recount my adventures.

The first few weeks of September Karin and I had a serious case of Seattle Storm fever. At the risk of seeming lesbian cliche, we were swept up in the excitement of WNBA finals where Seattle's best ever sports team (both subjectively an objectively) fought for the championship. Names like Swin Cash, Lauren Jackson (MVP) and Sue Bird were tossed around on a daily basis. Personally, I am a Tanisha Wright fan (she's smaller and has a killer sneak-attack lay-up that gets me every time -- see photo at right). We managed to score free courtside Western Conference play-off tickets from a friend early in the month and were hooked on play-off games, making every one in Seattle thereafter! Like good Seattle fans, we stood in the rain for hours to see the victory parade (I got a high five from Sue Bird!) and then, dripping wet, we continued the celebration in Key Arena downtown. It's been a long stretch since I've been able to enjoy a home sports victory (Go Wings!) and it felt especially sweet celebrating a woman's team and one so gay and family-friendly! Have I mentioned how much I love Seattle?

Coming off the high of Storm championship wasn't easy, but we managed well enough. I played for Lullaby Moon again (recall I did this with Karin last year in the pouring rain). This time is was a smaller group of musicians (Karin opted out this round) and a much larger (and thankfully drier) crowd. The estimate was around 4,000 spectators. The images from the event are, of course, spectacular and you can see them here. I peppered this blog with them as well. Seattle is certainly quirky and fun and it pleased me immensely to see thousands of people show up for such an esoteric arts event in a city park!

Later in the month I attended GLMA's annual conference and my last board meeting as Resident/Trainee Representative to the Board of Directors. I also ran two workshops and did one evidence-based presentation. Overall it was a very busy conference for me and while I crashed a couple nights with my Aunts in Ocean Beach I didn't get to see much outside of the six days of meetings and conference. I have mixed feelings about being off the board, I am glad to have one less thing on my very full plate but I will miss having some input into the organization.

I'm not going to lie. It will be nice to have more time to devote to wedding planning and preparations! We decided a wedding planner was out of our budget and have been doing everything ourselves. Honestly, it hasn't been too bad, but we haven't done anything really hard yet. We refuse to be bridezillas and big and schmaltzy isn't our style, so that helps a lot. We have started working on a website (or "wed-site" as they call it in the wedding website world) and made save the date cards with pictures from our fun photo shoot. Seriously, folks, planning a wedding is work! I'd joke about going to a Justice of the Peace but that's not an option in our state. Still, it's a party and it's going to be a blast. I only wish we had unlimited budget so we could invite everyone! Alas, food and places to eat it in cost a pretty penny.

And speaking of pennies... it's time to start thinking about work for me. I am still having occasional nightmares about residency and occasionally even hear a phantom pager going off. Nonetheless, at some point I will need money. October 1st I made my first loan payments since med school (24 years and 11 months to go!) and reality is kicking in. So despite the past month of grown men dressed as bunny rabbits, clocks riding ponies, sneaky Tanisha lay-ups and gay medical conferences I have been smacked by reality and need to be pragmatic. But not right this second. I can play summer vacation just a little bit longer...

The One-Legged, Blue-haired Wonder

2010-08-31T13:28:00.000+07:00

Well, this has not been as I had expected. The day after my last post (remember the one where I reported that I was just starting to get my life back and planned to run, horseback ride, go on vacation, etc?), I ruptured my calf muscle. It tore something fierce and I was slave to the crutches for approximately three weeks thereafter.

"What happened?" I heard asked over, and over, and over again. Evidently, there's nothing like crutches to make the etiology of your injury public knowledge. I told a couple folks I had injured the leg saving a frail old lady from a runaway school bus. Once, I replied it was running from the cops (both stories recycled from a riding injury circa '00). But, to put things to rest, here's what really happened: I went to start running, in bad shoes, without a warm up, on a bit of a hill, and POP my calf muscle just snapped. I felt it, maybe heard it, and couldn't even step on that leg for days afterward. It was the size of a tree trunk and took at least a week to ten days to come back to something resembling a normal leg, and by then the rainbow colors started sprouting. A grade two or three medial gastrocs tear is the likely diagnosis and physical therapy will hopefully return my gait back to something resembling normal. If not, an MRI and surgical consult is the next step.

Thusly, my week-long Vancouver vacation turned into a two day trip, mostly in the car and within a two block radius of our swank hotel. It was lovely seeing Lisa and Wendy (last seen in Melbourne, Australia February of Aught-Seven), eating Vancouver sushi, ice cream, and sitting in the sun. It had been too long since I last saw those two. Remind me why we haven't invented teleportation yet?

The first part of the month, the part where I dosed on NSAID's and spent my time on the couch trying not to throb or spasm, I spent working on a GLMA project. I spent probably 60 hours over the two weeks entering names into the databases, confirming addresses and locations and hospital affiliations. And now, after all that work, I can officially say GLMA has a mentorship program. I matched a bunch of students with mentors, notified them of their match and now am working on what I will be doing about this program at the national conference for this initiative I've been trying to get off the ground for two years! So being couch-bound, I suppose, had some advantages.

I'm still having residency nightmares, as if my subconscious still mentally sweating off the toxins of three years of torture. I'm slowly catching up on my sleep. I am working on not going stir crazy being unable to exercise or move around in any significant way. Naturally, I do get occasionally peeved, because after years of reassuring myself "it's going to be over," just "suck it up" for so many years, months, days, hours, here I am, at last free from the clutches of indentured servitude yet now trapped in a different way. Thankfully, the injury should heal okay, I hopefully won't need any surgery, I may even go back to being able to jog like it never happened. Maybe. And, I am thankful Karin's employer allows domestic partner health insurance coverage. And I remind myself, just because I'm not doing what I had planned or hoped to do, doesn't mean this isn't a hell of a lot better than sleepless 30 hour shifts and getting abused by drug-seeking patients who aren't getting what they want!

Around the 19th or 20th of the month, at the same time that Karin's 11-year-old niece arrived from Minnesota for her first real city visit, I graduated from crutches to cane and I was able to partake in all the originally planned adventures with minor adjustments! Shortly before that I had died my hair brilliant blue shades and glorified in being a new definition of a blue-haired little lady with a cane! We attended the most amazing Seattle Storm game in the history of professional sporting events! The Storm was victorious by one point thanks to a jump ball win and a stolen rebound in the last few minutes of the game. I enjoyed a Seattle Farmer's Market and a community theatrical production of The Music Man. I took a 5-hour private tour of the fabulous Woodland Park Zoo (via wheelchair as pictured above) and fed the giraffe, explored behind the scenes and learned amazing secrets of the place.

We also took a three-day camping adventure to Lopez Island in the San Juans which was gorgeous, and I ditched the cane and tried my hand at hiking a little. Slowly, carefully, I picked my way through woods, across beaches and driftwood, and held my own pretty well. Also spent a good amount of time resting and reading as evidenced at left.

Last weekend, after returning from camping, I unpacked my camping gear, packed the essentials right back up, and flew to Michigan for a very short stay where I attended the memorial service of Dr. Hugh Walker, one of those chosen family members, at whose house my Jewish family Christmased each year. It was a lovely ecumenical service at a Humanistic Jewish Temple with Gospel and bag pipes, flute, Walt Witman and so much more. Then back onto an airplane and shuttled another 2,000 miles back to Seattle to my life here.

Upon my return from Michigan, jet lagged, I lamented that I am now resigned to having lost a battle with a cold and Karin pointed out that perhaps the universe is trying to tell me to slow the heck down. That was just one of many lessons learned this month. While I have many obligations with non-profits and grassroots organizations and have previously had such a demanding "job" of being a resident, I now can recalibrate and reassess. The whirlwind of the last two weeks with a child in tow, the memorial service, as well as the realization that my wedding is coming up in less than year now, has made me think carefully about the old saying, "don't sweat the small stuff." I've decided I'm going to reel in pieces of me that are scattered throughout and redistribute this fall, focusing on home, family, and my own well-being above all else.

And, along that vein, Karin and I will be sending Save-the-Date info on our wedding soon now that our engagement pictures are complete. You can read more about the shoot at the photographer, Heather's, website here.

My first month as a free woman

2010-07-31T11:26:00.011+07:00

This is a particularly hard blog entry to compose. No, there's no bad news to share. It's just that after three years of waiting for this freedom I feel like there's a lot of pressure for the first month after residency to be about how relaxed, rested and happy I am.

Not that I'm not, I assure you, but it's really only been in the last two or three days that I have had time to read a book or take a run (two things that have been on my "things I can do with reckless abandon when residency is over" list).

The month has been busy. Sive and I moved, that was certainly a feat. My family was all in town, no simple thing either. Then, as soon as family left and all my stuff was in piles of boxes around Karin's (and now my) apartment, I left for nearly a week in Boston, not just for fun like last year, but for a slew of LGBT health meetings. When I returned the unpacking fairy (a.k.a. Karin) had tackled many of the boxes but there were still weeks worth to go through, too much furniture and not enough room for everything. At the same time there was the ABFM board exam - a day-long multiple choice test that I had to prepare for and take. And I can't forget the band gigs, local transgender health meetings, local community drama, all which absorbed free time and energy like thirsty sponges.

Karin and I updated our closet, remodeled our bathroom, filled trash bags and attics and basements. Sive, like Rapunzel, has been locked in the loft, high above all the activity of the rest of the house and safe from the Scary-Barking-Chase-Monster. I climb up there, careful to close the protective gate behind me, for visits at least once a day and to provide her with her yummy new wet-food diet. Her only two experiences down from The Tower have been too eventful and scary for her. One was an accident where she fell dramatically from the loft into the living room, bounced off the coffee table and landed on the floor where she righted herself, crouched low, poofed her tail, and hissed as a confused Lucy came up to her wondering why cats where falling from the sky! Both animals survived the event without injury and are still living in their separate areas. At the advice of a well-respected animal trainer, we are trying to clicker-train Sive so we can introduce the pets in a controlled and pleasant way. It's not easy. Lucy already has dibs on the actual clicker sound so we have resorted to the cumbersome alternative of a baby rattle for Sive - it's also not as loud and less scary for her. No progress has been made as of yet, but I'll sure keep everyone posted. I'm hopeful the two beasts will live in peace. Sive has coexisted with dogs in the past, but Lucy appears to be somehow more frightening than she can quite manage.

In sum, the first weeks free from the clutches of residency have not been quite what I anticipated. There's no backpacking in exotic lands or horseback riding every day. In fact, a large part of my days have been spent doing housework: dishes, laundry, cleaning, sorting, shopping and cooking (with various levels of success). But it is amazing how much residency took from me that those simple household activities suddenly seem like a luxury. The fact that I can do 6 loads of laundry and two sinkfulls of dishes in one day is like a dream come true! It will be curious to see how the next few weeks develop. They are also pretty packed. Half of August will be dedicated to entertaining Karin's 11-year old niece and I'm heading up to Vancouver, BC for a few days to visit my good pal, Lisa, from Australia. But maybe I'll also find a horse to ride and rekindle my relationship with exercise and self-care. Let my real life begin...

So long Tacoma, smell ya later!

2010-06-30T23:59:00.007+07:00

The month of June was rather eventful.

It has totally exhausted me and have as much brain power as a cardboard box right now so bear with the less flowery language herein (the literary part of my brain is resting and waiting for its big binge after my board exams!)

So... June: Let's start from the beginning and try to break it into bite size pieces...

TFM Day
June rushed in with the dreaded "TFM Day" - a full 8 hours of residents (and other notable speakers, but mostly residents) giving dry presentations on evidence-based topics that are on their way to publication via the FPIN Network. I won't bore you with too much detail about the event. Just know that the whole process involves at least a year's worth of work, research and stress. My topic? Anal pap smears. I had hoped to perform a evidence review on transgender primary care but that wasn't approved. So even though I didn't quite get my topic of choice, in the last few years at TFM I have had the opportunity to present transgender medicine topics on my own accord. My TFM Day butt-talk (as I fondly call it) went very well and was actually a pleasure to give. The paper for publication is another story for another time.

Cle Elum
To celebrate the end of TFM Day, and the nearing end of residency, my class head off to Cle Elum, a quaint little rural Washington town, home of yummy Pioneer Coffee, and spectacular views! We recovered a little, bonded a little more, ate a TON (including an awesome Indian dinner made by our Indian classmate). We were there two nights and one full day and at the crack of dawn on Sunday Karin and I head back for our first uniformed marching band gig, a picnic in the park just blocks from her house. Afterward, we waiting in line, in uniform, for nearly 2 hours to get our $1 BBQ fixings (veggie burger included).

The Last Rotation
My last rotation of residency was an elective. I chose to rotate at Bastyr Center for Natural Health, a comprehensive naturopathic, acupuncture and homeopathic clinic in Seattle. In order to do this, however, I had to battle my nemesis, I-5. During the rotation I drove 300-500 miles a week, commuting from clinic to clinic. My previous efforts to coordinate my TFM clinics into full days (freeing me to learn at Bastyr for more than a few hours at a time) was massively unsuccessful - so back and forth and back and forth I went. But the elective was fruitful and I even felt, with my own index fingers on the pulse of a 90 year old woman, the actual palpable changes acupuncture creates in a person. Pretty amazing.

Chaos
Then, the proverbial you-know-what hit the fan and I started hurtling toward graduation at breakneck speed. Moving, packing, vet appointments, address changes, insurance coverage changes, forms to complete, etc etc... And, for extra fun my Mom and step-dad flew into town. We celebrated her birthday at Ray's Cafe, and over the weekend enjoyed in the festivities of the Fremont Solstice Fair and Parade! (us at right - Karin is on the end with the bass drum and I am playing trumpet behind her.) They stayed at my place, on the pullout couch, while I was packing and working, and then, for extra fun, my Dad and step-mom came into town and we had graduation.

Graduation
Graduation was a nice event - good food, good company, ample beverages to soothe savage beasts. However, it was four and a half hours long. For just eight residents. I was the very last to be graduated and by the time it came around for me to say my piece everyone was exhausted and surely sick of being there so I just said a few words of thanks and that was that. Kind of anticlimactic, I think. It didn't help that after all those hours of graduation hoopla I had clinic the following Monday. The best part of graduation for me was giving gifts to my advisor and getting to share with everyone the movie I had been working on for the better part of 4 months! I would love to post it here but am not sure people would appreciate their images up here for the world to see, dancing around and such. I rewrote all the words to Hotel California to reflect life as a resident at TFM and TG and filmed various folks singing and dancing along to the words. It was such a kick to make and I spent way more time on it than I did my FPIN!

Pride
Then came pride, or, "the gay Christmas", as Karin and I call it. With both sets of parents in town, my move a matter of days away, residency finishing, and all my duties with the band I was spread pretty thin. But I managed to enjoy marching in the parade, partaking in some of the street fairs and the festivities at the Seattle Center after the parade was over. One of the highlights of Pride this year was the huge rainbow flag the Seattle Center put on the Space Needle! A historic day! Now if only we can get equal rights like marriage, or at least equal taxation for domestic partners!

Then back to work for me after Pride. It wasn't easy but I managed to work a hellish, soul-sucking clinic on Monday, finish packing, and move my whole life to Seattle on Tuesday. Tuesday night Karin came back to Tacoma with me to finish cleaning the apartment. Wednesday I went to work and closed my charts, tied up loose ends, returned my parking pass, all the usual last day stuff. Hilariously, I got in trouble my last day for not having my badge. Figures some safety big shot would be touring the clinic on June 30th. He was understanding after I told him it was my last day and I had just returned it!

Life as a free woman
Now, here I am, among piles and piles of boxes. Overwhelmed with how much stuff I have to fit into Karin's apartment. We are working hard to make it our place (not just me squeezed in to her place) and it's not going to be easy (33 years of accumulated stuff is a lot!) but we are doing it! The pets have been without incident, Sive lives in the loft with a gate separating the beasts for the time being. I am so happy to be done with residency and ready to start the rest of my life, with my fiance, my family. Karin, me, Sive, Lucy and a houseful of boxes. I couldn't have imagined a happier ending to this story.

Next step? Studying for boards, unpacking, nesting, and continuing my advocacy here in Seattle and through GLMA... now only if I can find where all my advocacy stuff is... and maybe, soon, the feeling of being done with my indentured servitude will hit me.

Like a speeding bullet

2010-05-28T07:00:00.022+07:00

Hello readers!

Winding down to the end of residency now. Hard to believe, no? If I keep to my once monthly posts this may be my second to last blog entry of residency. *Gasp!

Part of me (the biggest part) is unbelievably thrilled!
And part of me (that little noodley part) thinks: "ohmygodihavetotakeboards
andrecertifymyACLS
andpackandmoveand
beforeilosehealthinsureance
seeadoctoranddentist
andpreparemyhumongouspowerpoint
andpublishmypaperandholycraphowmanydays?"

But, like I said, most of me is just tickled pink!

So, panic attacks aside, shall we review the month of May?
It began at breakneck speed, starting with a post-call party at Swing Fever, the band charity auction where I stayed up way too late and bought way too many auction items. My wins included interesting items such as an off-peak week-day stay at some resort somewhere on the Washington Coast (exciting, yes?). I also won a gift basket from the Jet City Roller Girls and a few other small items. The coolest item was a drumhead from my own inauguration parade experience. The winning of this was somewhat incestuous as I donated the item with a few of my bandmates. But I wanted it, and wanted it something fierce! Fierce enough to outbid, so there!

Immediately after the event, or more specifically, after 4 hours of sleep, we head off to Minnesota so spend some QT with Karin's family (as I described at the end of April). We flew into Fargo, endured a nearly 4 hour delay, drove about 3 hours to that little place called Middle River and, after I was awake nearly 3 full days, I ate and slept the whole week away. One highlights of the trip was a D.A.R.E. graduation at the local middle school. The end of the ceremony was punctuated by a rousing version of Johnny Cash's "Ring of Fire" but with the lyrics altered to reflect the middle schoolers promise to not drink or do drugs. Then we had cake and fruit punch in the cafeteria. Another highlight was on a literally freezing cold rainy (and in some places, snowy) May day we planted 50 lilac bushes. We stayed in Fargo the last weekend an played in the swimming pool and perused the mall. Mostly, we ate. By the end of the week, we were butter soaked, lard-laden little roly poly's barely able to waddle on the the plane thanks to the Land of Lakes predilection for all things dairy. (Note lovely MN rainbow above!)

I was welcomed back by total TFM chaos. We were still two residents down, and with pores still oozing Minnesota sugar and butter, I took an extra black weekend call, spending my first Saturday night back again on the wards being paged all night with admissions I was admittedly uncharacteristically remiss in admitting. (say that 10 times fast!) It was as if I had never left.

See, my "last call," ending May 1st, was evidently not truly my last. In fact, this coming last weekend in May, the "holiday weekend," will hopefully mark my last weekend at the hospital (note the quotation marks to emphasize annoyance). I already know I will be working both Saturday and Sunday as back up. Regardless, back in the pre-vacation blissful ignorance of May 1st, I treated my (supposed) last call as such and celebrated its end by roller skating around the wards (See above). I'd been fantasizing about this since they installed laminate floors and since I noticed a gently sloping hill from the 5J patient wing to the resident call rooms that just screamed "roller skate on me!" Filming is not allowed in patient care areas so I got some footage of me testing out the skates on this part of the wards, the nice slopey part! Most of my bloggy fans are on Facebook (and may even be reading this blog on FB, even though it is far superior and actually formatted on its original host, Blogger). So, they've probably already seen the video. But... for the three of you who haven't, there you go.

[Insert seamless transition from evils of residency to joys of band camp here. Or not.]

Band Camp! Last experienced in the summers of 1991, 1992, 1993 and 1994 as a high school student, I remembered band camp as a time of sore arms, worn out chops (chops: trumpet-speak for lips) and sun burn. Grown up gay band camp has much the same, but is waaaay more fun! I got to hang out with my 60 closest friends and partake in a talent show, play games, and play my instrument, dance and get some vitamin D and be near the ocean! It was really spectacular. And exhausting. And, did I mention fun?

Coming down off of a weekend like that was hard. Getting back in the swing of things, I took a look at my to do lists and, BAM!, was hit by reality. Not only is residency over and done with in just about 30 days, but I also will be moving, and lose my health insurance and no longer have a salary. But, hey, freedom does come at a price, n'est pas? I have so much to do, I thought about making lists of my lists. Instead, I thought it would be more fun (and debatably less productive) to make a list of reasons I am grateful about moving and finishing residency. E.g.: #8: I won't have to mouth-breathe between exits 134 and 137 anymore on I-5 (the aroma part of Tacoma). #11: less left lane driver rage, etc. I do love Seattle dearly and am excited to officially be a resident. Karin and I, as an homage to our favorite city, wrote a little song we performed last weekend. Left lane drivers are featured in the middle of the song. See below:

So, this brings me to the end of this here blog entry... So much to blog about all of a sudden but so little time. Perhaps June will bring multiple blog entries? That's probably an empty threat however. I would like to tell everyone about the video I'm working on for graduation with my classmates. I would love to vent about all the job offers I'm getting in "random small town only 40 miles from a great golf course in somewhere USA. Call now to sell us your soul and we'll call you every five minutes to harass you until you explode." But for now I must take care of patients, do this pesky big TFM Day presentation and publication thingy (worthy of its own blog entry but annoying enough to avoid the topic altogether), and try to maintain as much of a normal life as possible in the next 30 days while accomplishing the great feats of my endless to do lists. Next on the list: world peace. ...wait... wrong list.... right! Correction: forward my mail.

Warning: No happy bunnies this April

2010-04-26T21:30:00.000+07:00

April hurt this year. Hurt like a month-long flogging. A combination of Chinese Water Torture and a constant spanking with a ventilated paddle. To put it simply, FP-inpatient is rough. Last April, while it was also rough on Pediatrics, I still managed flowers and Honkfest. The April before that, intern year, I made the Daffodil Parade and escaped to Seattle and managed a few adventures. This April was about struggling to stay under the 80-hour work week restrictions (did so-so), trying to eat more than the crap in the doctor's lounge (fail!) and sleeping when I can (also so-so). I would sometimes inadvertently check my countdown calendar twice a day, amazed at how slow it seemed to creep along (me celebrating 80 days, post-call, in picture). The patients were challenging (socially and medically), often manipulative, looking for secondary gain and the schedule was awful (5 weekends in a 30-day month is just plain cruel), all q4 call. Call days go as follows: arrive between 6 and 630 AM (as an intern it was never later than 6 AM so this may be a bit of an improvement), round, admit a patient during rounds, finish rounds, discharge patients, admit more patients, do your floor work, teach the medical students, manage ICU cross-cover, take calls from consulting nurses, etc, etc, so on and so forth until roughly 9 PM. Then back early the next day for more fun. Unless it's a Friday or Saturday, then the call goes on as previously described until 12 or 1 PM the following day (that 30-hour shift I often refer to). This is q4, or in plainspeak, every 4th day. But, these days aren't necessarily the hardest ones, it's all the other days that are starting to suck me dry. The non-call days go as such: Arrive between 6 and 630 AM, round, admit, discharge, admit, teach medical students -- so far similar to call days with the exception it all has to be done before 1:30 PM, a non-stop action-packed stress-filled 7 hours or so. A full day at work, for some people. But that's just the warm-up because after that chaos there's clinic. Twenty-minute visit slots filled with complicated and sick patients, most too poor for the services they need, and many too unmotivated and beaten down by their hard lives to seek out the alternatives that may make them less sick. All looking me to fix it. And, of course, never forget the drug-seekers that so adore residency clinics. After ten of these patients, not surprisingly taking more than the allotted 20 minutes each, I then check on the patients I left in the hospital about 6 hours earlier, my intern sometimes gone home for the day, making sure the discharges went home and the new admits got what they needed. I go home, eat something, call the fiance for a haggard "good-night", manage some sleep, lather, rinse, repeat the next day, and viola! we have burn out.

So, really, call days are quite refreshing in a sense, since my duty is predominately to the patients in the hospital (never mind the labs, studies, results, phone calls and refills from the clinic patients that keep rolling in all the while).

And I forgot to mention that I had the joy of having four OB patients deliver this month plus a surprise set of twins that our clinic assigned to me to round on in the hospital. OB really, truly is joyful. Delivering babies a pleasant part of the job. Even with shoulder dystocias and methamphetamine addiction and teen moms with two possible baby daddies, it's still a real highlight to my practice. But when already being eaten alive by the FP inpatient service it's hard to really revel in the joy of delivering a baby after being awake for 40 hours straight and then adding the moms and babies to the chaos of morning rounds and admissions.

I missed Honkfest thanks to a killer, internless black weekend. I missed the tulips blooming (I did end up driving to the Skagit Valley with Karin to see them but they had all died by the time I had the time off). I missed the Daffodil Parade and (cue sad violins) even had to miss Karin and my anniversary. I did manage a night in a lovely hotel in beautiful Bellingham, WA (a belated anniversary treat) and a post-call, fume-fueled gig at the Jet City Roller Girls (photo of Renegayde above), but despite those small glimmers of the non-work life, I'm burnt. To say I'm in need of a vacation is like saying humans need an atmosphere composed of 21% O2, 78% N2 and a dash of Argon, H2O vapor and CO2. I will suffocate without it.

And that said... my last day on this rotation is also my last call. Friday night. A 30 hour shift. Last call ever of residency! And after it's over (and I take a brief nap) I head to Swing Fever , our RCB Fundraiser/Auction! There, I'll party with my 80 closest friends, blow some money for a good cause, and, if I can stand upright, dance! But Wait! There's more! After Swing Fever, I hop on a plane for rural Minnesota, Middle River to be exact, population 319, to meet the in-laws (eek!), get some much needed R&R, and recover from this mad, mad April. Sixty-five days and counting...

Lions, Lambs, Four-fingered mice and cannons

2010-03-31T22:00:00.000+07:00

As I examined my droopy fender today, I started to wonder if I've been spending too much time on I-5. It rattles quite loudly when I'm driving over 30 mph and I wonder if a big gust of wind might not rip it off entirely. However, like the other droopy side, I am pretty confident I can fix it with some string. My fender dangles because my car has lived a hard Midwestern life of salt and snow and is so rusty it seems just a few years from turning to dust.

So, I was thinking about I-5 today. While my rusty bumper tick'tick'ticks in the breeze I work hard on I-5 to navigate left lane drivers, mysterious traffic slow-downs and the ever-present construction. Of all of these, it's the left-lane drivers that really get me. Something about Washington State compels people to pick a lane that seems to be the least occupied, pick the speed they feel most comfortable with, hit their cruise control, and hope no one gets in their way. Unfortunately, they pay no heed to anything going on beside them. Or, for that matter, the entire line of traffic behind them, begging for them to move right! It's a WA phenomenon, one that would earn blasted horns, flashing lights, and possible a wielded semi-automatic weapon on I-696 in Detroit!

But, I only have 30 minutes to blog tonight and didn't want to spend it whining about I-5 traffic woes. There are numerous websites devoted to this left lane driving evil. Please explore the links for more info.

This month, maybe even more than others, has really been one worth blogging about.

You may remember that this month was cardiology. Which, you may also recall, that like any outpatient rotation really means lots of back-up duties and continuity deliveries. I worked a few half days with a cardiologist but wound up being called in as back up, covering some of my out residents, and delivering a number of patients and rounding on them in the hospital. Same old FP stuff as usual.

My activism got a much needed jolt of life when I travelled early in the month to Anaheim to present at AMSA's 60th convention on the LGBT history of the org. My co-panelists were two great guys who helped revolutionize LGBT provider visibility and competent patient care even before the DSM was revised in 1973! It was an honor to sit among them. I think that may have been my 6th or 7th attendance and 5th or 6th time presenting. While there were still some national leaders I can still call friends, I definitely felt old and somewhat more disconnected than usual. But, nonetheless, it was an exceptional conference and not only did I get to participate with AMSA, but I got to meet up with a local buddy of mine I haven't seen in ages and see the new Alice in Wonderland Movie (not so great) have yummy creole food (very good) before my flight back to Seattle. Plus, I got to enjoy the total and utter creepitude (yes, new word, you may steal it if you want) of all things Disney (see above for the Bosch-like incarnation of a Tweedle). Am I the only one who sees twisted things in just about everything Disney?

Mid-month I played a killer concert with the Rainbow City Band where I got to play a terrifyingly exposed solo (Pictures at an Exhibition) and hear my sweetie play a wicked concerto AND the cannon for 1812 Overture. The entire performance was amazingly difficult and rewarding featuring Tschaikowsky, Moussorgsky, Rimsky-Korsakow, Shostakovitch, Stravinsky and more! We played two shows and at the end of the weekend I got to celebrate with my 80 closest friends/bandmates at the after party and toast a major milestone: 100 days left of residency!

The weeks around the concert were also colored with a shooting schedule for our class senior video. I have written another song (the last one performed at the TFM's Got Talent Show) and am working with my class in filming a video to go with it to entertain all at graduation and have as a keepsake for the grads and interested staff/faculty. I would tell more but I can't give away the secrets because the contents of the video will be a surprise at Graduation (shhh).

This month wrapped with Passover in San Francisco. Every 3-4 years my family makes an effort for everyone to come to a big family seder. It's a big Jewish Family Reunion. Complete with gefilte fish and bitter herbs. The event this time was particularly fun for me as I had Karin as the newest addition to the family seder. The first full day we had there we spent mostly exploring San Francisco, walking about 10 miles and wearing ourselves out just enough to then spend the next day and a half saturated with loving family.

One of the bigger events of our family passover is the family talent show. This passover, while sadly missing a few of my cousins and their families, was still very well attended. I didn't take a head count but I imagine it was well over 30 folks. The talent portion consisted of sing-a-longs, dances, sneezes, jokes and a reenactment of the RCB Thriller Dance by myself and Karin accompanied by my niece, Zoe on guitar. It was fun and I look forward to the next one. It also reminds me how much more often I would love to see my family. If only we weren't so spread out! They should all move to Seattle and make it easier for me. (at left is a grainy cell phone pic I took in SF)

Amazingly, the adventure didn't end there, the day we flew back from SFO we managed to just squeeze in and make the first marching band rehearsal (which started a mere 30 minutes after our flight touched down). I mention this because the music is really exciting this year! It is quite possible that my band will be adding to its usual marching fare such songs as: Jai Ho from Slumdog Millionaire and Bad Romance by Lady Gaga. Nothings set in stone quite yet, but Magic 8-Ball says "outlook is good"! I can just see Jai Ho now at Solstice and Gaga at Pride!

And, now, I must wake in 7 hours and start my last in-patient rotation of residency. The notorious, "we never cap" Family Medicine Service. The rotation on which I spent my unforgettable intern Thanksgiving and Christmas. It's a rough one and although I'm sad I'll be missing Honkfest, my favorite thing ever, Spring, time with my fiance, sleep, eating well and all those little things... I will surely be happy it's the last month like this.

2185 hours and counting...

Swing, Hula and the Dance of the RRC

2010-02-28T20:51:00.001+07:00

February is normally an easy month to hate. Persistently cold, bleak, it's the dregs of winter. However, just when I was prepared to give February its usual due this one pleasantly surprised me.

First off, despite being q4 I managed a wonderful Valentine's Day, post-call but alert and oriented and feeling just dandy to swing the night away to the Mood Swings, an all female swing band out of Seattle in which one of my great friends, JB, plays. Picture at left from the dance.

Additionally, we had our all TFM retreat. This is a required event for all residents, faculty and other staff including their significant others and families. Unfortunately my significant other wasn't able to make it. Another co-resident also was stag so the two of us shared a room and managed to make the most of the weekend. The weekend involved a few required meetings including the "State of the Residency Address" where the hot topic was the recent Residency Review Committee (RRC) review. The RRC is an accreditation committee that, like JCAHO or OSHA, picks apart a system, looks over it from top to bottom, inside and out, and compares it to a check list of requirements. Once its pending arrival is announced, everyone scrambles and runs around in a blind panic like roly poly bugs after their rock has been lifted. At the end (and here I'll change my metaphor) the RRC sits on a big throne while the residency director, supplicated at its feet, accepts a sentence of death or life, or, sometimes, probation. The Director then returns to his or her residency and shares the news. Thus was our Saturday morning. Our program seems to do very well in all aspects except one: Work hour rules. Or, perhaps, we fail by being honest in our work hour reporting. Apparently only 13% or so (a vaguely remember number from one of the meetings) of US residencies report work hour violations. Our level of violations was much, much higher. (The question asked was "in the last three months have you ever violated rule X"). I think our residents answered honestly and other residents have not. And, as a result of this, we may get a little ding for our violations. Or not. Who knows? The RRC has yet to give us their rulings. For those unclear on the hour rules, you can click the above for a Wiki entry, or the ACGME's cache of wordy PDF's. But, in short, the ones we struggle with is 1) no shift longer than 30 hours and 2) 10 hours off between shifts. Raise your hand, residents, if you haven't broken one or both of those in the last three months! ...I thought so.

Aside from the State of the Residency Address we also had unstructured fun time which included this year a Talent Show! Each class performed an act. Each was a surprise. The first year class (interns) dressed up in their concert best and played Ode to Joy on recorders. The second year class performed a sock puppet show to the yodeling song from The Sound of Music (and did all their own singing!). Our class performed a song I wrote called "The Pager Song" - I played ukulele and kazoo and two of my classmates danced the Hula while a fourth played percussion and manipulated props. The rest of our class made their pagers go off at certain points of the song. The acts were judged a la American Idol with four judges each picking us apart ruthlessly. And... we won! But the competition was stiff. There were some musical numbers from faculty and an impressive Gilbert and Sullivan performance as well. Hopefully, I will have video to share on here soon! At left is a picture of me preparing the song on call.

Lastly, this has been a gorgeous February in Seattle. Spring has Sprung! There are daffodils and tulips, cherry blossoms and so much more! So while the East has been slammed with snow we are getting showered in sunshine and flower petals. No bones about it, the Pacific Northwest is the most beautiful place on earth. (My photos of the blooms aren't uploaded from my camera yet so I took this one from the CHS blog's haiku comparing the flower petals to snow. Jealous, NY-ers?).

Tomorrow I start Cardiology. Hopefully a lighter month, however I do have several patients ready to deliver soon so I imagine sleep may not be something I will get much of. The month does end with a mini vacation to San Fran for Passover where Karin will finally get to meet my wonderful and somewhat crazy (but in that good way, of course) mother's side of the family.

And count this! As of today 122 days left: One more inpatient month, 8 more calls, three more back-up stints, probably 60 or so continuity clinics, a pesky board exam and I can call myself done with indentured servitude! Happy Dance with me tonight!: Swing or Hula - your choice!

Big, fat, juicy news

2010-01-28T02:41:00.007+07:00

Remember about this time, last year, I made some calculations? From the 600,000 in Seattle I calculated a handful of women in my dating pool. Not too much longer after that post went live I met one of those women. Technically, I met her nearly a half year earlier. But, in the 9-10 months following that post, [warning, hokey love simile coming] just like the spring, would blossom into something brighter and more rich and beautiful than I could have even begun to imagine.

So, here I am, ending January 2010, finishing my Terrible SPER Rotation of the Miseries and the NoWeekendNoSleep Achies finding myself lifted up by something amazing that happened.

I got engaged.

Now, I see you scratching your heads. I am a woman. And, I am engaged to a woman. And some people don't know how to react to that. Some pointers: engagement usually implies marriage. So, yes, we are getting married. No, it is not legal in WA (but it's pretty darn close). It is legal in Massachusetts, Connecticut, Iowa, New Hampshire and Vermont. Many other countries as well -- e.g. Canada, which is a mere 123 miles from my front door here in Tacoma.

Who asked Who? It was a mutual agreement. We had been talking about it for a few months. The time seemed right. For the record, we both did ask each other. But we did it giggling with happiness, the answer known, since we had already purchased our rings a few hours earlier.

Other frequently asked questions have been, "When is the wedding?" Or, "Where will it be?" And, most importantly, "Will I be invited?" The answer to these questions will be coming soon-ish. Just know that the guesstimate place will be here-ish and the guesstimate time will be end of August 2011. But don't hold us to it!

There were other things that happened this month worth talking about. There was good, bad, ugly. I bruised my knees intubating ferrets. I sewed up the face of a boy mauled by a border collie. I delivered babies (ho-hum, what's new?). I got rained out of my board meeting for GLMA in Phoenix and learned to play the 1812 Overture. But, out of all of it, The Engagement trumps all!

2009 in Review

2009-12-30T01:53:00.019+07:00

Now for the traditional Year in Review Post!
2009 was really a year of changes for me.

Click here for last year's entry, if you are feeling extra nostalgic.

Most photos are from my recent trip to Detroit for Christmas.

January: Rotation was Night Float and Geriatrics, emphasis on the Night Float. Uppers: The fabulous inauguration of the new President Obama. Marching in his parade. The world-wide sigh of relief at the end the "W" years. Downer: The start of the Dental Saga of 2009. Inauguration and a wedding not included, I had all of 2 days actually off the entire month, yet somehow managed to cram in 4 dentist appointments and a two-part root canal.

February: Night float and geriatrics continue. Upper: Vegas, baby! Downer: That night float crap was getting really old, the dentist crap even older. My only weekend off was spent at an all-TFM retreat. I was so dizzy and sleep deprived I think I may have hallucinated once or twice.

March: My "Away" Rotation with Puyallup Tribal Health. Uppers: Shilo turned 20, Sive turned 10. I ran a 5K, started in on Honk Fest excitement and spent a ton of time on horseback. I got back in shape, I took care of myself, and finally wrapped up the Dental Insanity. I also completed my USMLE Board Exams. Downer: My friend's wife died. My community, Rainbow City Band filled an entire section of the funeral home. So, the silver lining: It made me realize how lucky I am to be a part of a community like RCB.

April: Ah April, the best and worst of times. Rotation: Inpatient Pediatrics. Downer: Peds just about killed me. The hours were insane, the patients sick as hell, and the attendings, ruthless. But the uppers! The Uppers! I played at HonkFest West which magically fell on my one weekend off that month! And, most amazingly (include all superlatives here), I fell in love. And while residency tried its damnedest to crush me with my peds rotation, I was like one of those trick candles and sparkled despite it all!

May: More blasted Peds and the start of clinical GYN. Upper: Swing Fever with RCB. Vacation in Boston (the only thing I managed to blog about). Downer: Yeah, peds was still killer, and just when I thought it was over I was back rounding on the service my first weekend after vacation, covering for another resident. But despite the peds interjections, GYN heralded my last rotation of R2 year. And any free time I had was spent with my girlfriend, Shilo, and my band. In that order.

June: GYN continued. Upper: Realized I was almost done with R2 year! Woo! Started my Countdown Calendar. I played some awesome gigs including ones for the Majestics, Solstice Parade and Pride. It was a very RCB-heavy month for me. Downer: Getting the swine flu sucked.

July: Internal Medicine. Uppers: Played for the Rat City Rollergirls, Mom came to visit, got to see my friends Suhani and Rachel even if it was just for a few hours. Downers (this wasn't my best month): q4 call, new interns, and most insane month for the hospital ever. My one weekend off that month spent over-caffeineated, sleep-deprived at a board meeting in Chicago. Missing playing in the Seafair parade. And did I mention getting totally and mercilessly spanked by Tacoma General Hospital. How much left on that countdown? I was so brutalized that month by work I didn't even have time for one little blog entry! I did highlight a bit of the month in my first of two August entries under the subtitle: Red, white, blue and burned out.

August: First two weeks the flogging continued as Night Float. But, at least this time I didn't have a dozen dentist appointments keeping me up during the day while I should have been sleeping. Instead I had elevator construction and a record-breaking heat wave! Uppers: Dad and Julie visit from Michigan. Mount Rainier! Downers: Said goodbye to Shilo, the horse that kept me sane and human. One of the hardest things I've ever done. Here it is almost 5 months later and I still feel heartbroken. And to add to it all, my dear, sweet dog, Kiki, passed on. It was indeed a month of loss.

September: Rotation? Keep reading. Summed some of the month here. Upper: LGBA in New Orleans - very, very awesome. GLMA in DC, also pretty fabulous. Lullaby Moon - surreal. A good month for recovery from the losses of the month prior. Downer: I spent so much time working in the hospital as back-up I completely have forgotten was rotation I was on. Had to look it up. It was ophthalmology, urology and ENT (OUE). Go figure.

October: Away rotation on the East Coast, LGBT Medicine. Adventures aplenty. Uppers: I completed my GLMA conference. My talks were huge hits. I loved, loved Mazzoni Center. My RCB "TV Land" Concert was sold out and fantabulous. I only wish I had video of our awesomeness to share! Our pep band played at Macy's in a mall which was a really fun experience. I celebrated Karin's birthday for about 2 weeks straight! I dressed up as Daddy Warbucks this Halloween and had tons of fun with my friends in Seattle. Downers: The month had to end. And I missed the long-time coming, awesome, big, gay Connecticut wedding of my old friends Stevie and Jill.

November: Rotation was HIV Medicine. Uppers: A low key Thanksgiving on the Oregon Coast. The rotation rocked. Educating my program about transgender health and making TFM officially a trans-friendly place for patients! Downer: My 99 year old grandpa died. Half my program was struck down with the flu and, as above, I had to struggle for my balance.

December: And here we are. Rotation: Pediatric ER and sports medicine. Upper: my first week vacation since R2 year! Christmas with family and Karin and Lucy. Christmas caroling with Renegayde. Adventures in Detroit. Another sold out concert with RCB (left). Downer: Good-bye weekends, I'll see you in March.

For a Cheeto

2009-12-16T07:02:00.002+07:00

Wrote this ditty in my head in the elevator today. Proof I might be going mad.

Little Cheeto in the hall,

What careless eater let you fall?

The cleaning lady was just here,

And left you sitting in the clear.

Your orangey self, posed on the rug

Staring at me, oh so smug.

I had some carrots and snap peas,
A little taste of low fat cheese.
The Holidays loom so near,
My waist is getting big, I fear.
And there you are right by my toe,
Cheesy, salty, just below.
The elevator! Ding! I'm saved!
Just in time before I caved!
Little Cheeto on the floor
I win, you lose, next time it's war.

Oh, the weather outside is frightful

2009-12-11T11:14:00.013+07:00

Get this straight. I'm not complaining. I love it here. It's far preferable to being in the Midwest right now. Or the blustering, snow-covered Northeast. Really. But, for this week, it's bitterly, bitingly, abnormally cold. My friends are taking pictures of their temperature gauges because single digits awe them. I imagine them craning their heads, looking for the preceding "3" before the "8" sitting solo like a headless snowman on their digital dashboard reading.

But, like I said, I'm not complaining. See, we also are having blazingly beautiful, bright, sunny days with the mountains all snow-capped and glistening, and the usual slate blue of the Puget Sound looking brighter and more cerulean than it has a right to be this time of year.

It's the interview season for residencies. Which is interesting because it helps me look at TFM from a fresh angle. Last year I got to interview people I hoped to work with! None of who ended up here, as far as I can remember. Now, at the time I write this, I have 202 days left of residency. So, interviewing is more like interviewing my replacement. I'm hoping to get a queer-friendly, pro-choice extrovert to come here. Wish me luck!

This weekend I am caroling with my band in downtown Seattle. I did this last year and it was great fun! Next week we get to have a fun Holiday Concert. I say "holiday" instead of Christmas because interjected into all the X-mas classics is a little klezmer medley ending with a dizzying rendition of the hava nagila. Jews even got a little cookie parity at rehearsal last week (see left)! My favorite song we perform this year, however, is not the usual Sleigh Ride (because I'm a sucker for the horse whinny) but a kazoo rendition of Jingle Bells, to be performed concert night with local school children. See video below for a short preview from rehearsal!

Now, I hate to kill the mood, but I have to wrap up with a bit more somber news. Tacoma has been rife with tragedy and crime lately. The economy has hit everyone hard but for some reason gun-related crimes seem abnormally high. Most have already heard about the four police officers who were gunned down the day after Thanksgiving. Their memorial was this week. Also, my neighborhood bank was robbed and my favorite breakfast place was held up at gunpoint and the elderly owner assaulted by one of the robbers. My bank was robbed! Two blocks from my house. Seriously?

In hard times people are supposed to band together. It seems some haven't been getting the message. For Christmas this year I want a Kevlar vest and all the weapons in Tacoma and Seattle to turn into gumdrops.

November's not for sissies

2009-11-30T22:15:00.004+07:00

How to cram the last 5 weeks in one blog post? Halloween weekend was a celebration of the last weekend of freedom before my return to being a slave to my pager, to TFM and to the needs of patients, colleagues and administration. I enjoyed it fully with a weekend in Seattle, playing a remarkable concert with RCB to a sold out house. Our concert theme was TV Land, complete with a LGBT and Ally friendly Brady Bunch video and sing along (below!!).

I dressed as a mad scientist last year. This year I was daddy Warbucks, complete with a bald head, three piece tux and pocket watch. I also had with me a pretty convincing Orphan Annie!

November rolled in like a steam truck and plowed pretty quickly over the peace and balance I had spent most of October carefully cultivating. My grandfather, not a month after his 99^th birthday, died. It feels like one minute he’s doing his morning calisthenics, shoving 5-dollar bills in my hand, telling the same jokes he told me last time I visited. Then, the next minute, my mother calls to tell me he’s dying. In a way, it was a good way to go, relatively quickly with people you love by your side. His funeral was in Ft. Lauderdale, Florida in a plot adjacent to my Grandmother, Minna. My mother and her sister, their two children, and the five of us cousins were able to make it. A pretty amazing event. I can’t even recall the last time all five cousins were in one place. I think it would have made Grandpa very happy to see us all.

The most riotous part of the funeral (yes, we put the fun in funeral) is hard to pick out. Getting lost in a minivan with family had its charms. Mother’s quirks were particularly funny – in that van adventure she must’ve called her sister 2 dozen times announcing each intersection as we passed it to make sure she knew we were finally going the right way. Self-depreciating humor was rampant and the men poked fun at the suggestion of their submission to the powerful Jewish women in my family. We Detroiters had stories of being held up at gunpoint, Black Panther and police evasion, and mayoral corruption (circa 1970’s and 80’s – how retro! Funny how little things have changed). Somehow, even the darkest jokes coaxed everyone into laugher at one point or another. The resident Catholic even managed to get a few colorful nun jokes in there.

From the funeral I basically went right back to work, where I found my fellow residents falling out here and there, felled by the flu or other family emergency. I worked twice as hard as I had anticipated, filling in on extra clinics, working as back up on the weekends, working on my elective at an HIV clinic in Tacoma. Not to mention a number of presentations I’ve done over the month: formal, informal, at meetings, teaching sessions and the like. In fact, instead of writing this blog post, I should be preparing a presentation on the culturally competent care of transgender patients and a quick overview on hormone therapy and standards of care. But, I’m not! Or, rather I should be working on my research for my 3^rd year project. But, obviously, I’m not.

Thanksgiving 2 years ago I was on call at the hospital, getting pimped in the morning by ruthless (er, invested) teachers and feeding my sorrows in the afternoon with 12-hour-old, 3,000-calorie cinnamon rolls listening to cheerful voicemails from my family’s respective celebrations. Last year was a huge improvement. While I still had to work too much to travel, I did find some time to enjoy Thanksgiving Seattle-style with sushi and salmon at my cousin’s place surrounded by a number of relatives from around Washington State. I also had the immense joy of busting my chops Christmas Caroling with Renegayde.

This year traveling far was out of the question as the time off was not guaranteed, and the two days of traveling it would take to get to anything in the Central or Eastern time zone would make the trip essentially futile (and maybe more stress than its worth). So, Karin and I opted to hit up a beach on the Oregon coast. We were pleased to have some sunlight and enjoyed the hotel hot tub and in-room fireplace. Always non-conformists, we walked the beaches on the windy day and flew a kite on the calm and sunny day (pic at left). We visited bookstores and toy stores and tried to whale watch, however, as I lifted the binoculars to my face to try and spot a spouting behemoth the woman working at the whale watching center mentioned to another employee that "there's nothing out there this time of year". No whales. Maybe in a few weeks. Alas, before I could even focus the binoculars, I put them back on the table. They were probably teeming with bacteria anyway, and we were much better off eating bagfuls of salt-water taffy driving up Highway 101 admiring the view.

Restore Order

2009-10-20T23:48:00.006+07:00

Intro:
It goes without saying, parking in Capitol Hill is a real bitch. Since I've been spending so much of my time there, I've noticed that parking spots could be markedly increased if people would only follow proper parking etiquette. In fact, over the last few months I have been fantasizing about making some sort of friendly, but firm, reminder to drivers that their poor parking choices affects us all.

Methods:
Karin and I had been ruminating what would go on this flier. She is particularly peeved at those who don't use their driveways (#4) -- especially the yahoo across the way with the gigantic SUV. Me, I wanted to make sure people don't perpetuate poor line-up (#2).

Finally, I did it. Using scissors, a glue stick, ball point pen and magic marker, I made the flier! When done, I emailed it to Karin who then posted it on the famous Capitol Hill Blog.

You can read the post (and view the original flier) if you click HERE
Click on the picture above/left to see it up close and personal.

Discussion:
First of all, I think it's hilarious that people were angered by inaccuracies! Apparently my glue-stick and cut-out artistic rendering of the parking situation wasn't quite enough to scale for the sticklers. Additionally, some folks just HATE being told what to do! One person sarcastically suggested I teach them how to brush their teeth. too. Which inspired me to make a "how to" poster on brushing teeth just for them, but in their cowardice they didn't leave an email address to which to send the poster!

The "5 foot law" - which I was very well aware of when I made the flier (as well as the 72 hour law which states you can't leave your car parked in any one place more than 3 days) - seemed the thing most people focused on so I did make a revised copy that I can use when passing out this flier.

Conclusion:
Conclusion is yet to be determined. We'll see if my fliers do any good in Capitol Hill. God knows it couldn't get much worse!

*and to you researcher folk - I know this blog post may rankle those of you noticing missing "results" section and out of order discussion/conclusion, etc. For the love of god, it's a blog post about a parking flier!

My Big Gay Autumn

2009-10-11T09:00:00.015+07:00

I know, I know, I let you down, I didn’t post at all this September. It wasn’t for lack of activity. As reported in my previous post, I rotated through OUE. I did enjoy looking at retinas, tympanic membranes and bladders which, surprisingly, do resemble each other once magnified through one sort of scope or another. I was also “back-up” a good portion of the month, and as is my curse, it was overwhelmingly busy on the wards and I was called in most of my back up days, weekends included, to round and cover for other residents.

But… I also partook in some awesome band adventures! The LGBA had its annual conference over Labor Day weekend where I got to play both concert and marching gigs. New Orleans was gorgeous. If you hadn’t told me I would never had known the city was recently ravaged by a series of hurricanes. Apparently LGBA was the first marching band allowed in the French Quarter in more than 40 years (thanks to narrow streets and close quarters). In addition to the pure awesomeness of thousands of screaming fans (and yes, some nudity, some protesters, and a plethora of drag queens), some of my favorite things were: Beignets and iced coffee at Café Du Monde (pictured), Bananas Foster at Brennan’s (the inventors of the dessert!), gumbos, étouffées, crab, oysters and more oysters… in short, THE FOOD! The street music was also pretty amazing featuring predominately brass music. New Orleans deserved its own blog post but the trip was so crammed full of rehearsals and sweltering hot marching and dehydrated sun-stroked performances it just didn’t happen.

Here is a one of many YouTube video's made of our performance. I picked this one because it doesn't have all the expletives the other ones do.

(never mind on the imbedded video - formatting issues too frustrating to work out - try the link: http://www.youtube.com/watch?v=6T0x36qWdM4)

[ Download ]

Two other awesome band events were with Renegayde Pep Band: Lullaby Moon and Seattle AIDS walk!

Lullaby Moon is awfully hard to describe. I tell people to imagine Lewis Carroll meets Julie Taymor. It's a performance art event that happens each new moon (for the last year) in Seattle. Funded, I think. by the City, by the UW Arts Department and well staffed, well executed and well attended. Renegayde was asked to play a "sleepwalking marching band" in their 12th and finale-esque installment. Attached is a picture a friend took (as I was busy performing) but go to their website to see some amazing pictures (or check out this from the Seattle PI) and maybe videos as well. It was breathtaking. The only damper on the whole event was that ultimately it ended up pouring rain. So we were frozen and wet to the bones by the end - yet people stayed to watch and enjoyed. Seattlites are a fun-loving and fearless bunch!

AIDS Walk was my first real gig with the organization last year and it was great to come back and do it again. Karin made a video of part of the gig and after she finishes it up and submits it (for a grant for our org!) maybe I can get permission to post it here. It is always wonderful to give back to the community and perform for such an important cause.

October, while not yet half over, has so far been an adventure the likes of which I haven’t had in some time! The last two days of September I head back East for my GLMA conference where I thoroughly enjoyed two days of engaging board meetings (seriously) followed by 3 days of conference programming where I presented twice: once on LGBT advocacy and once on transdermal estrogen in male-to-female transgender patients with clotting disorders (two obviously very different presentations). I went to several social events, rubbed elbows with some more famous individuals (Bishop Gene Robinson laughed at all my bad jokes, I like him!), made a few speeches, schmoozed and surprisingly rekindled a very old friendship with someone I had traveled with in Cameroon 12 years ago! I also lobbied on capitol hill, traipsing from senator to senator’s office making sure we don’t let health care reform go stale and letting them know about LGBT health disparities! LGBT folks are 2-3x more likely to be uninsured than their straight counterparts. Why? Think about it: the top two ways people get insurance are 1. From their employer and 2. From their spouse.

Some highlights from the conference:

-Did you know King James was not straight? Me either? Bishop Robinson was commenting on the irony of his bible being the one often used to prove homosexuality as a sin.

-One of Bishop Robinson’s best points is that homophobia (and to a larger extent, transphobia and violence) is really about the end of patriarchy, not so much LGBT acceptance. Men who don’t act like men or chose to become women are most brutalized and victimized.

-When it comes to LGBT Disparities, Congresswoman Tammy Baldwin knows her shit (pardon my French, but it's true!)

-The following exchange was relayed to me. In true “Operator” fashion, the quotes are certainly not exact. Senators Kyl (R-male, Arizona) and Stabenow (D-female, Michigan) were both in a discussion about women’s health and maternity care and accessing prenatal care to prevent adverse outcomes in pregnancy. Senator Kyle: “Maternity care? I don’t need maternity care!” Senator Stabenow (dryly) “It appears your mother did.”

-There was a medical student who flew 36 hours from Perth, Australia to come to the conference. Proving my point that there remains a critical need for an LGBT Medical Organization!

After DC I took the Chinatown bus (another adventure in itself) to Philadelphia where I worked at the Mazzoni LGBT Health Center. At nights I stayed with a new friend from LGBA (who I marched with both in DC and in New Orleans) and her family of 4 (including husband, daughter and lovable 14-year-old Elkhound mix). Mazzoni was simply a fantastic experience. I got to work with HIV/AIDS patients. I drew blood, gave flu shots, did STD checks, transgender care, primary care, free adolescent clinic to mostly HIV+ homeless youth… at one point I thought to myself “ah, this is what it is like to actually make a difference!” I actually honestly LIKED my job! Go figure!

In case you haven’t noticed, residency has gone past rubbing me raw, now I seem to have ended up a huge callous. I think I need a good long soak to rid myself of it. Mazzoni was a nice break but I think I need more time to rediscover non-resident Liz. Still have my countdown going...

&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;a href="http://www.7is7.com/otto/countdown.html?year=2010&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;month=7&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;date=1&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;hrs=0&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;ts=24&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;min=0&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;sec=0&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;tz=local&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lang=en&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;show=MWdhms&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;mode=t&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;cdir=down&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;bgcolor=%23CCFFFF&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;fgcolor=%23000000&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;title=Liz%27s%20Residency%20Countdown%21"&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;Liz's Residency Countdown!&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;/a&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;

Hopefully the rest of my month will continue to bring me more smiles than piles. (Hm! I think I just made up a new saying!). And, who knows, maybe I’ll get another blog post in this month to make up for the last…

August ends with a whimper

2009-08-31T21:30:00.000+07:00

As you may remember from my last post, August started with night float. Running like a mad woman around the hospital. Some of those nights truly tested my reserve. Between attendings scutting me to the point of near breaking (so they can get more shut-eye) and technological mishaps such as pager blackouts and electronic medical record crashes I survived by the skin of my teeth!

Mid-month, after a well deserved first weekend truly off in over 7 weeks, I changed gears and started my next rotation: ophthalmology, urology and ENT. Whoever thought eyes, ears, nose, throat and prostates were well lumped may have been a little nuts. But I can't complain. For the most part, I have had just about the whole of the last two weekends free and it's been wonderful.

One highlight of late was a totally awesome Seattle Storm game (Karin's iPhone pic at right at overtime!).

Another more recent highlight was a weekend in Rainier National Park with family and my super awesome girlfriend who put up with two distractable, hyperactive Eamans in a place without telephone, TV or Internet!

This photo at left is just a sampling of what an amazing place that park is! Walking through the clouds, wild flowers, clean air, blue skies, was pure joy.

But the same weekend I frolicked in the wild flowers something sad happened back in Michigan. My dog, Kiki, the sweetest beast on 4 legs, passed. She had battled cancer for years. My mother had treated her with this experimental "electric probe" device that supposedly cured her. I'm not sure that's true, but maybe it gave her a year or more of a decent good quality of life. Kiki was a red leopard Catahoula (or, so we think - she was a rescue dog). She probably weighed a good 50 lbs more than your average Catahoula and was a good two heads taller. She may have had more Dane or some other big breed in her but god knows she was the most devoted and lovable creature I've known. I'll miss her! The below video was before a leg surgery to repair her torn doggy-version ACL. She was particularly wobbly but so devoted she couldn't resist my mom's voice and had to get up for love at the sound of it!

Looking ahead
In a few days I head to New Orleans for the LGBA national conference. It coincides with an event I originally thought was a large LGBT event to help rejuvenate the city of New Orleans but on further research seems to be more of a gay-boy circuit party? Who knows - I'll know more once I get there. All I care about is that I get to play music with awesome people from around the US and Canada and explore New Orleans for the first time. The coincidence isn't lost on me that Catahoulas are the state dog of Louisiana. I'll be thinking of Kiki while I'm there, I'm sure.

See you in September!

The nightstalker

2009-08-06T10:32:00.023+07:00

Nothing like showing up as the sun sets to a full bay of ambulances, their engines pumping diesel fumes, smokers sneaking puffs below the “This is a Smoke Free Campus!” sign, certifiably insane patients of mine yelling to their cell phones with central lines flopping around their necks. This is how my nights will start (although, admittedly, the insane patients of mine don't always greet me at the entrance). Then, about 12 hours later (plus or minus), I will drag myself back through the same ER doors, past that wet sound of people vomiting into blue condom-shaped emesis bags, past another line-up of rigs, not nearly as plentiful as the night before, sometimes EMS personnel joining the patients and families in creating that silver cloud of stank under those “no smoking” signs.

Such is the life of a night float resident.

I’m plodding through the night as I type most of this post. Admitting patients to Pediatrics, Internal Medicine and our own, beloved, family practice service which includes not only our bottomless barrel of sick TFM patients but additionally the Indian Health Service patients who happen choose Tacoma General over the multitude of neighboring hospitals and ER's. I cross-cover the same panels of patients and am the back up for the labor and delivery deck, in case things get a little crazy in their neck of the woods, too. It has the potential to be eerily quiet or insanely mad.

When not on the wards or in various ER's or delivery rooms I will camp out in our call room (me being insanely mad in the call room at left). This call room is located in the "M wing". The patients reside in L, K and J wings. The call room is flanked by volunteer services and the learning and development offices. Neither which are staffed after 5 PM. Thus, at night, the lights are off, the hallways are dark, and this part of the hospital feels completely abandoned, in a Stephen King kinda way.

One night in the winter, last time I was night float, I was walking back to the call room in the dead of night when out of the corner of my eye I spotted what I thought was a man down at the end of the dark hallway. The eyes play tricks on you that time of night so my first instinct was to ignore it. Then the man-shaped blob moved and I looked again. "Oh hi! You scared me!" Or some such generic statement miraculously came out instead of a yelp. He reported he was lost and looking for the elevator. How one would end up in the abandoned wing down a dead-end dark hallway looking for the elevators is beyond me. "They are over there," I pointed and discreetly entered the code to get into the room and closed the door behind me.

Not much later I get called to standby for a delivery on obstetrics. On my way down the yellowed stairwell of the M-wing I find the same man sleeping on a landing between stairs. I call security: "Does he have a red baseball hat on?" They ask. I recall that he did. "Thanks," they offer, "we have been looking all over for that guy!" I tell them his location and later find out they have evicted him from the building with the promise of arrest should he come back. I spend the rest of the night safely nestled in the bustle of a nurse's station.

But I digress. I wasn't talking about creepy night stalkers! I was talking about my current rotation: Night Float! Brought to you by the letter W! W: Withdrawal, the act or process of ceasing to use an addictive drug. Seems to be the flavor of the week for me and my adult admissions. And before I get called to admit another patient brought to TG by the letter W I will also present to you a superfast ubershort summary of July.

July 2009: Red, white, blue and burned out

Hold on tight, here we go.... July 1st I get the pleasure of starting on call. In the deep end from the start. On my first day a patient expires, my second day I get threatened with a lawsuit (by a crazy patient, go figure), and my third day we get 14 admissions. I get a day off on July 4th - march in a Parade, get this amazing photo taken (left) by the Adventure School photographers. Then back to work on the 5th for more insanity. Things persisted to be totally and inexplicably crazy until my "golden weekend" where I take a red eye flight and a train to Chicago and proceed to engage in a weekend long board meeting before coming back just in time to be on call the following day. By this time I am exhausted and worn out and amazed I'm still upright. Post call on the following Saturday I manage to stay awake well into the night, hell, into the next morning and finally crash after being awake for nearly 48 hours straight, a gig with my band at the Roller Derby and Bite of Seattle squeezed in for kicks. And did I mention my mom was visiting that weekend? Finally, I get a day off, it's spent perusing a farmer's market in the sun and before I know it I'm back at work and don't have a day off until August 1st - when I change rotations and now find myself immersed in the life nocturnal.

So there you have it. I won't even begin to go into the week-long heat wave with temperatures topping 104, the joy of having only one working elevator, the horror when that one decides to break, and how hot the stairwell can feel after 15 flights in 100 degree heat!

Ahead: another week of nights and then, holy crap, I have a full entire normal weekend off! The first real weekend off since the last weekend in June! Plans? I'm going camping and and plan to eat, nap, sleep and spend some QT with my cutie! (first photo is from my apartment window, of course)

June's post - just under the wire

2009-06-30T07:55:00.009+07:00

Last day of June. Tomorrow I officially start my last year of residency.

June was a pleasant month overall. The only really bad part would have to be the terrible bronchitis I had for four weeks. In all, I had several weekends off. It was filled with many wonderful band gigs. Renegayde played for the Seattle Majestics (the women's full tackle football league). We played for Bat n' Rouge, the fundraiser for the LGBT Alano Group (12-steppers) which was a blast. One of my favorite Renegayde favorite pieces is our rendition of the hip-hop song, Low, by Flo Rida - we toss in little dances, and shout out a "hey!" or two and the piccolo's rock. We'll be playing it again, surely, at our Rat City Roller Girls gig next month.

The marching group marched in Solstice and for Pride the last two weekends. I missed a few other parades and will be missing a few more but feel lucky to at least make those two events since they are freaking awesome! and being a part of them was filled with unspeakable amazingness (so cool, I make up words!). The best part easily was when the band would put down our horns for the the Thriller dance in, obviously, Thriller, by the recently departed Michael Jackson. The roar over the crowd (even before his departure) was so deafening it gave me chills and kicked my adrenal medulla into high gear! I have a video of it a band-aide got for us that I'll try to post later. Some random folks have posted pics up us doing the dance on the web so if you google Rainbow City Band and Thriller you may get a few hits like this one!

The rotation I've been on is GYN/FPO. Which basically means a hodgepodge of gynecology stuffs and touchy-feely stuffs the residency makes us do so they can make sure at the tender age of 32, and after 6 years of back-breaking medical training, we still know how to write an essay about feelings. No, really, it's potentially a very good opportunity for making sure we stay in touch with understanding our patients and, probably most importantly, coming to terms with things we can't understand. Since, as doc's, admitting we "don't know" sometimes feels comparable to showing up to work without any pants on.

I feel I've gotten the most out of the gynecology component, however. I do really enjoy working at Planned Parenthood and I particularly enjoyed learning to do colposcopy and treating cervical cancers with excision techniques. I feel pretty good about my colposcopic skills and wonder if I'll want to do them in practice. I also put in enough IUD's this month to put the Mirena manufacturer's kids (and their kids' kids) through college, I'm sure.

Next up: 4 weeks of in-patient Medicine (q4 call of course, first call tomorrow), followed by 2 weeks of the back-breaking Nightfloat. I have to reluctantly admit that I'm kinda sorta maybe looking forward to the next four weeks of in-patient. Don't get me wrong, I am NOT excited about the hours, the lack of time off, the sleep deprivation, the lack of time to see my girlfriend, or any of those terrible things. But I am looking forward to a routine - in the mornings at least, because as a 3rd year resident my afternoons will be spent in the unpredictable no-man's land known as clinic as opposed to the more structured wards. Additionally, I will be the senior to a fresh out of medical school intern in his first week of work as an MD! It's a little exciting to help him be a part of that. It's especially great because it's too soon for them to be bitter or burned out, maybe I can soak up some of that fresh perspective and get to see my job through new eyes again! Remember my first month of internship?

Additionally this month, I travel to Chicago for 30 hours or so (on my Golden weekend, getting there by plane, train and automobile). Which hopefully will be productive for myself and GLMA. My mother also visits which should be fun and we have that Roller Derby gig I'm thrilled about! On a sad note, Shilo will be leaving. For the next year at least, so there's a possiblity that this may be the last month I will get to spend time with her. I try not to think about it however and have been out to see her as much as possible in the month of June. That horse saved me when residency was about to break me. I owe her a lot (and of course her owner, who recognized a horseless rider when she saw one).

(photo credits: Michael Clark for the first, official Bat n' Rouge photographer for the second, and me for the third!)

Vacations make me happy

2009-05-19T04:35:00.007+07:00

Ah Boston. My old haunt. What a great welcome you gave me! First you make me feel all at home with your Seattle-like weather, gradually warming up and showing me, step-wise, what the sun looks like so I don't run like a little groundhog back in my hole. It's bright! Then you awe me with your fabulous queer culture and I rediscover the sore muscles that come after playing kick ball in the park.

Since I last saw you you seem to have grown a little. I remember you smaller. Your gay band is really awesome, The Freedom Trail Band, and they were exceedingly welcoming and kind - even finding an old trumpet for me to borrow so I could join in on their practice!

Boston, thanks for always being there for me. JP, Somerville and even Cambridge still feeling a little like a homecoming!

Now if we can just do something about that East Coast Hospitality...

Coffee at Diesel: check
JP Licks ice cream: check
Queer kick ball: check
Chinatown: check
Naps: check
Lay in the sun: check (photo above)
Read my book: check
Frolicking in a garden: check (photo below)
Picnic in the sun: check
Meeting up with awesome old friends: check

Tomorrow: more sun-bathing (weather permitting), maybe another run in the park. Some Queereoke in JP and more naps.

April - the cruelest month

2009-04-30T21:12:00.006+07:00

It has been pointed out to me that I have been slacking on my blogging this Month. As it stands, it's been a rough month for me rotation-wise. April Fool's day I started on call. I knew it wasn't going to be easy when the first words I hear walking into the resident call room, back into the cruel time-suck of inpatient life was, "Hey! You wanna do an admit?"

Let me talk about pediatrics for a moment. Kids are great. About half the time the kids I round on are adorable. The other half of the time their are either too sick, too scared, or too old to be fun. Rounding on an angry teenager is about as much fun as rounding on a 2 year old who kicks and bites when you try to listen to his lungs. However, I'd take the angry teen over the biting terrors... most days.

That said, I enjoy the patients much more on pediatrics. They actually get better when you treat them. Their parents are another issue that I won't get into here. Adult patients can be hard on the soul - sick, multiple problems, unmotivated to change, blaming the health care system for not fixing their diabetes, threatening to sue when they can't leave the ICU to go have a cigarette... kids just don't do that.

The attendings we round with are mostly awesome. They do a lot of teaching and, with a few exceptions, are fun to work with. The problem is, we get a new one every 3-4 days. So, while I am rounding for 46 days, that means more than a dozen attending change-overs. Every fourth day or so it's like the first day all over and we have new expectations, new rules, and new ways of doing things. In medicine you learn quickly to adapt to this kind of thing. Attending A likes to see the medical students give a teaching nugget with every new case, Attending B likes to do entire bedside rounds, presenting the patient in front of the patient and the whole family, Attending C likes to play devils advocate and question everything, Attending D takes forever to round, Attending E is fast, Attending F wants all our notes and discharges done before 9 AM... so on and so forth.

Plus, pediatrics is classically the rotation where work hours are routinely violated. It's pretty much impossible to work only 80 hours a week with the kind of work needed to manage the pediatric service, all the patients, parents, calls and not to mention clinic.

So that's my big fat excuse.

Fun things that happened in April:
Honkfest West was a HUGE highlight for me. I played a my trumpet all weekend and thoroughly enjoyed myself. Most everyone has heard about it by now. I hope to blog about it but it may have literally been too cool for words. I also went to the Tulip Festival north of Seattle (not too cool for words but pretty amazing nonetheless). And Shilo turned 20 (see right)! Those things pretty much cover my fun adventures for the month of April. I wish I could wax poetic about all the fun things as much as I did pediatrics but my time is up. April ends in just a few short hours and tomorrow herald a long day for me. Some other amazing things happened to me this month.... but I have to leave a little mystery, don't I?

Happy Spring!

2009-03-20T09:28:00.015+07:00

I've had a lot to blog about lately. My work at Puyallup Tribal Health, my band, an amazing instrument, my 5K. It's been a whirlwind month and I'm giving myself about a measly 15 minutes to write about it.

Puyallup Tribal health
My rotation at has been going well. I've had the opportunity to make some interesting diagnoses and see some true pathology. Patients come in to the walk-in clinic with everything from "I've had a runny nose for the last hour" to "I haven't been able to swallow for 2 years" or "I ran out of my diabetes medications in 1998, I need refills". Of course there has been plenty of people looking for pain medications, but I'm not one to pass those out like candy so I've had some unsatisfied customers. Sorry, but you won't get percocet for your stomach pain if you tell me you have the stomach flu! I refuse to be swindled. Don't let my youthful appearance fool you into thinking I'm naive! The time I have off between the clinic days I've been trying to study for Step 3 of the US Medical Licensing Exams - a two day exam I'll sit for in just a couple days.

The Band
For some reason, as loquacious as I am, I can't seem to find the right words to describe how much the band means to me. I have attempted to describe "community" and how important it is, especially those who have been disowned by their biological families for being who they are. All these attempts just wind up sounding like some sort of corny essay for sociology class. But I feel I have to say something! The band... what is the band? It is more than a group of musicians who get together once a week to toot their horns. It's a place where we know to support each other, accept each other, kick each other in the butt if we need to. The LGBT community is a particularly strong one, bound by events like the AIDS crisis and the fight for civil rights. What inspired me to write about Rainbow City Band is a funeral I went to last week. A member of the band tragically lost her partner. They had recently been married (obviously not in Washington state). And while I had only met her partner on a few occasions, I felt a very strong urge to be there for her, for the community. I wasn't the only one. A portion of the chapel in the funeral home was taken up by band members doing the very same thing I was. I love my band.

On a lighter note. We have a concert coming up. Some of the music a very challenging, and I'm not sure how we sound, some of the songs are fabulous, while some still need a lot of work, and we only have one rehearsal left. But, as I have been struggling to state, it's about much more than how we sound! Come see us if you can!

The 5K
I'll try to describe the race: It was bitterly cold, raining cats and dogs, wind gusts to 50 mph. My feet were soaked, my hands were numb. 20,000 people were there to run (there was a 5K, an 8K and a 15K)! It took me 15 minutes after the starting horn to actually get to the starting line. It was too crowded to actually run at first, but in a while I felt I could go at a decent pace. I was surprised that I passed a lot of people. Not surprised that lot of people passed me. I felt great! The second mile was all uphill. I kept telling myself it was okay, I could walk anytime, lots of people were, but I felt I could push forward and ran the entire hill. On the home stretch I had a great stride, big, fast, easy... then for the last 100 yards or so it was total gridlock. We came to a halt and then shuffled like cattle, gradually approaching, and then finally across the finish line. The shuffle probably took about 5 minutes at very least. My official race time was about 34 minutes. So I figure, if it weren't for the bottlenecks thanks to the thousands of participants I would have finished certainly at less than a 10-minute mile! A very good time for my little legs!

Afterwards I was freezing and soaking wet! The wind storms toppled the starting towers at one point before the races started (thankfully no one got hurt!) I used a porta-potty that almost blew over with a gust of wind. I leaped out of there (pants still on thank god!) and found one that seemed more secure. I could just imagine doing a Dorothy impression and spinning madly around in the wind in my porta potty, my Auntie Em riding by on a broom!

I ran to my car, got my topmost, soaking wet layer off, pulled on my raincoat and jogged back for the complimentary clam chowder. The line for the drink tent was insanely long so I passed on the 9:30 AM green beer. Freezing cold, I watched the first 8K and 15K runners finish and then abandoned the waterfront park and went back to my friend's house to try and feel my feet again.

My only regret is not having anyone at the race with me. I would have liked someone to chat with, to run with, or just to celebrate crossing the finish line (even though the cattle-shuffle was highly anti-climactic). Next time I drag someone to a race with me. And, there certainly will be a next time!

Little Old Ladies from Whidbey
I have told many of you about my amazing story. Out of the blue, sometime in February, I received a phone call. A woman said she read about me int he Seattle PI. She saw I had marched with LGBA in the inauguration. Her partner used to play cornet and, after reading about me in the paper, felt I would be a good recipient for her cornet and some music she had from her heyday at the conservatory in Cincinnati. She had been holding onto these things for some time. She is in her 80s and, since her stroke, can't play anymore. The two of them are retired, one a former nurse, the other a retired psychologist. They live on Whidbey Island (thus the moniker "The little old ladies of Whidbey") and are an adorable couple.

After nearly a month of phone tag we managed to find a date and time we could meet. It worked out they could make it to my rehearsal with the band on Saturday. They came to Seattle and brought their vintage cornet (at least 100 years old! See above!) and some yellowed music nearly as old as well. In fact, mixed in with the music is a 1917 Boston newspaper. A real treasure trove! The cornet is beautiful. After the little old ladies from Whidbey left, I shared my find with the band. Several other women in the trumpet section got a chance to see how this beauty plays - and it sounds pretty darn good!

Alas, my time is up. I have horses to ride (see me and Shilo at left!), a test to study for, and music to practice. I am off of work today but plan to be very productive nonetheless. Here's to the little old ladies from Whidbey, my band, and the coming of Spring!

Smelly, Brassy and a Strip Tease

2009-03-01T02:31:00.010+07:00

I went to the dentist's again Friday (yep, that makes 8 visits in 4 weeks between the two dentists). I had just been riding and, since the horse needed a little extra work and the ride took a lot longer than expected, I appeared all dusty and smelling like leather and horse sweat. While this may be one of my personal favorite smells ("the barn"), I know others aren't nearly as fond of it so I apologized. The receptionist, surprised I wasn't just coming off a grueling night shift (as I had been doing for the last 4 visits) asked me what was going on - why do I have a life! I explained that I am now entering a lighter rotation and will have some free time. "Free time! I bet you don't even know what to do with that!" I laughed. I reported that I had actually made a list, and told her some of what I was planning on doing.
I am going to run a 5K in the middle of the month.
I plan to ride as often as possible.
I need to practice my trumpet for a concert at the end of the month.
My list is rather long, it involves little things like "read every day" and by read I mean fiction, fun, good stuffs.
I also have on there "study for boards" since I am taking step three of the USMLE exam this month as well (a fact I like to conveniently forget about every time something fun comes my way.)
So Friday I didn't get a chance to practice, but I did ride, go for a run, and I ended up doing some work even though I was technically "off". I also went to this awesome fundraiser for HonkFest West, Tits and Brass.

For those who may or may not remember, I was lucky to be in Boston for the very first HonkFest where my friend's band played (Stick and Rag Village Orchestra) and I serendipitously ran into my recluse Uncle Albert who lives on an island on the Atlantic. The festival was probably the most amazing musical event I had witnessed. Ever. And I have been fervently seeking similar events and bands in the meantime. I even had posted a wanted ad on Craigslist when I first moved here: "wanted: leftist marching band". I got clued into a cool guy and a cool band neither which, as a new intern, I had time to truly connect with. Both the cool guy and the cool band were at the event last night. Titanium Sporkestra (run by the cool guy) was amazing, as was the Yellow Hat Band (one of my inauguration buddies play in this band). I had never seen the Freemont Philharmonic but they were also fun and musically interesting. The dancers were a riot, ranging from amazing aerialists, twisting and flipping from big red fabric hanging from the rafters, to stoned out hippie-folk writhing around on the floor. There were very post-feminist, post-punk empowering strip teases and larger group numbers that were riotous and reminded me of carnivals and circus acts. The music ranged from sexy 40s ballads to hyped up klezmer and Titanium Sporkestra, a punk drum core, was just a category of its own.

If it sounds interesting, click on the links! Pics are all from the first HonkFest in Somerville.

The rest of Vegas: reflections from 30,000 feet

2009-02-23T08:52:00.008+07:00

Saturday was a good day. We both woke around 3:30 in the morning and both managed (A with a little more difficulty, being on that pesky EST) to go back to sleep until a reasonable time.

Our day:

Breakfast again at the hotel. Smoked salmon two days in a row! I feel so spoiled!
Lay bundled in our layers by the pool, getting some cloud-filtered sunlight, talking, people watching (a favorite game of ours was pointing out cute lesbian couples to each other)
Walk the strip again. This time we made it almost to the end of the strip – the Stratosphere looming just a block or two away.
On the way we found our caramel apples (they were at The Venetian, not the Bellagio), got a massage at Brookstone from these massive chairs that, after the ministrations of the sales people, held us captive, reclined and listening to the in-store Motown medley. A highlight from this part was pulling the leg of one of out chair jailers – we claimed dryly that Motown music history and basic mechanical car knowledge is part of the State of Michigan education exams, a requirement for all Michigan students.
I drooled over the cutest over-priced hoodie in Paul Frank, spend a little bit at David and Goliath, and put blinders up as we walked by the numerous designer show stores.
Then we booked back up the strip, returning to Todai to make it just 30 minutes before their lunch buffet closed, gorging ourselves on sushi stuffs, their little mini-desserts rounding off the meal quite nicely.
Then I forked over the money and bought one of the amazing dresses we tried on at the Betty Page store the day before.
We found ourselves being followed by a group of cheerleaders who insisted on one-handed death-defying lifts all over the city.
By then we were spent, rested in the room, I even got a good nap in.
After the sun went down, we went out again. We dolled up in dresses, me in my new one and A in a hot little black number and we caught some free shows. Treasure Island (TI) Sirens – the cheesiest of cheesy show girls lip syncing to really bad music and pretending to have a little pirate fun. The tall gentleman and his wife watching from behind us were almost just as entertaining as he shouted his Arrr’s and his wife drank a big yellow margarita out of a plastic skull larger than some human heads. (Avast me mateys! See "sinking" ship at right).
On this trek I did catch an Elvis – carrying a studded leather cape and whisking conspicuously through the crowd.
We caught the Volcano erupting at the Mirage on the way back from TI and then meandered back to the Flamingo, still dolled, A nursing her cold and me a bit dismayed that there really aren’t any slot machines with actual slots for coins (I had put aside a coin of every face to try for Luck but it turns out they were better suited for tip jars).
We each had a slice of pizza, watched a movie while we packed, and hit the proverbial hay, A missing her boys immensely and me missing A already.
A left early in the AM while I fell back asleep and woke two hours later.
The airport was crowded. The driver of my shuttle was from Sierra Leone and we talked about the war while navigating the way there. The Texan with the Mohawk and the reluctant New Yorker (“Where am I from? For now, New York”) joined in the conversation as well.
Beside me on the plane was a Marine reading about Java programming and, as I type this, we land in just under an hour. I finished Fahrenheit 451 (finally) and realize that it makes me want to read and write like I used to – every day.

Funny how a trip to Vegas ended up with inspiration to read more. And maybe grow some kick ass sideburns. That would be Elvis-y-cool for sure.

Viva Vegas Vacation

2009-02-19T22:03:00.011+07:00

I started this blog entry in my PJ's before heading of to Vegas. I think it was the chill of my apartment and the need to keep my fingers moving to prevent them from becoming little fingersicles. I wrote about a nightmare I had. Family Practice was suddenly no longer a viable specialty. They were going to shuttle us all to either Obstetrics or Medicine-Pediatrics. It was part of Obama's restructuring of health care. I thought it was a horrible idea. Some thought it was genius. Suddenly, here I was, more than half way through my second year, closer to graduation than the start of it all and I didn't have a job! All those years of medical school, the "fun" of the last 20 months, for nothing. I don't know what brought it on. All things considered, it wasn't all that terrifying. It certainly was less so than the nightmares I'd been having about my building falling over.

Nightmares aside, here I am in Las Vegas! The sun has been out each day, the weather in the 60s. No poolside lounging for me, but I have explored the strip. There is so much going on all the time here. Even for someone who doesn't really drink and doesn't enjoy gambling there is a lot of fun to be had! My poor companion is battling a nasty head cold so we turned in early tonight but today was pretty busy.

Our Day:

Big breakfast bright and early. I had eggs Benedict with salmon instead of ham and fruit instead of hashbrowns!
Then nearly four hours exploring - our own Flamingo, Bellagio, Venetian, a few other places, some interesting people watching.
Back to the hotel for a break - supposedly for a nap but we wound up messing around on my computer instead.
Then another exploring trek. We checked out Planet Hollywood and Paris.
Late lunch/early dinner in the old Aladdin desert walkway (or whatever it's called now): Mussels and ahi tuna salad (we tried Todai but it was closed between lunch and dinner so we ate at another place)
At the restaurant we met a nice local lady who surprised us by paying for our lunch! Then helped us shop at the Betty Page store where I tried on 5 dresses and loved them all!
Next we caught a few shows at the Bellagio fountain
Then we went on a wild goose chase trying to find these caramel apples we swore we saw at the Bellagio but couldn't find again, gave up and came home for the night.

Tomorrow maybe we'll make it to Todai for lunch and find those caramel apples. Maybe we'll take a ride on a gondola and maybe we'll see a Vegas show, preferably one with impersonators - Elvis impersonators. And maybe we'll hang out in the sun, by the pool, in sweaters, seeing if our exposed skin can help us get enough vitamin D to bring back to our cloudy homesteads. (Our bathroom, by the way, above!)

The V-Day Special: My dating pool

2009-02-14T12:50:00.002+07:00

Since it’s V-Day I thought I’d go for a V-Day themed post. Inspired by an awesome program on NPR about being single I thought I’d do some math. I always joke about my dating pool being small. Let’s see exactly how small…

Population of Seattle (lets not even try with Tacoma): 600,000

Say half of them are women: 300,000

Percent gay population is 5%: 15,000 gay

Per one study 30% GLBT population is in a committed relationship, leaving me: 4500 single gay women in Seattle

Now I don’t date babies or elderly women so my age range, generously 20-45 maybe 1/3 of population: 1350 single, gay, women in Seattle that it would be at least legal to date

One of my most important criteria is education. I may be at an advantage here because the percentage of college educated LGBT folks was actually higher than the rest of the population in one study, 37% vs. 25%. However, that study was limited to one city (Chicago) and didn’t break it down by gender. Plus, given the level of youth homelessness in the LGBT community I estimate it actually might not be so high. So lets average that out to 30%: 405 educated, gay, women 20-45 years old in Seattle

Now… lets say I don’t want a smoker. Gross. LGBT folks smoke more than others, over 30%. That leaves me: 121 single, educated, gay women 20-45 in Seattle who don’t smoke.

Then, if I were to listen to Mom, lets find a nice Jewish girl: 2 women in my dating pool in Seattle Metro Area (actually its 2.43).

And that's not even starting to account for interests, belief systems, or incarceration!

And you thought YOUR dating pool was small!

(if I can, I'll post some links in for references later...)

Inauguration Adventures

2009-01-22T23:01:00.022+07:00

Below includes videos, because everyone wants those!

Getting there

I made it to DC twelve hours later than I intended, but there were many moments when I wondered if I would make it at all, so I was grateful when I got there. The ordeal was so ridiculous it's worth describing (if you want to skip ahead that's okay, too).

I booked my flight with Northwest Airlines. Was supposed to leave Seattle about 12:45 on Friday. That flight was delayed nearly three hours because incoming craft was late. Meaning I would miss my connection in Detroit. I asked if there was another flight to either DC airport from Seattle that I could catch. Yes! They booked me on Delta, from Seattle through Atlanta to DC (are you still following?). I arrive at the airport and try to check in... to no avail. I find out the flight is delayed 40 minutes I have to go to the ticket counter where, after waiting in line for nearly an hour and a half, find out that not only will I not make my connection but that the flight was overbooked from the start and I didn't have a seat on it. The lady at the ticket counter was just as frustrated as me and had a very unpleasant exchange with someone from Northwest on the phone when she realized that they had not actually released my original ticket and I was living in ticket limbo, unable to get a boarding pass from either agency (merger shmerger). She suddenly disappeared and returned many minutes later declaring there was no way I could get to DC that day.

So after much deliberation and another futile attempt at talking to NWA (they had washed their hands of me as I was now officially Delta's problem) I was booked the following morning from Atlanta, no seat assignment. And they couldn't accommodate me as this last delay was due to weather. Ironically, my first delay was an equipment delay and is what landed me there in the first place.

So around 1:30 pm, a good 24 hours since I had last slept, medicated with sudafed, afrin, tessalon perles (for my URI), and a small handful of ibuprofen (for the root canal I needed last week), I left Seattle for Atlanta. I slept maybe an hour on the plane.

My luck turned around as my sister had coincidentally just moved to Atlanta last week! I got a quick visit with her, a few hours sleep and was back at the airport 2 hours early to get my seat.

Successfully, I traversed the last leg and arrived to the welcoming home of my cousin's house with his fabulous wife and two criminally adorable children, ages 2 and 4 years old. They serenaded me with renditions of happy birthday, she's coming around the mountain and the like. I enjoyed a night out with the grownups and the following morning rehearsals began.

Rehearsals

I met up with my friend from the Seattle contingent at the hotel and took the Metro to our rehearsal site, St. Elizabeth's Hospital. The grounds were enormous and served as a perfect place to gather nearly 200 musicians to march around for hours on end. Interestingly, I believe the facility is a forensic psychiatric center and we were thankful that the DSMIV didn't include us anymore. We performed for the residents at St. Elizabeth's our last day there.

The following days were both awesome and arduous. We sounded terrible to start with and we couldn't turn corners in formation. It was blistering cold weather and I don't know about the other musicians but I was starting to remember anatomy class as I began to ache in muscles I forgot I had. At first we were a bit hard to organize. Quoting Lisa, one of our fearless leaders: "How many of you have cats? How many of you have ever tried to get your cat to do anything? Now picture your house with 180 cats. Now picture it with 180 gay musician cats."

We worked our tails off. Between the two days we played standing still, working on the music. We marched around the grounds more than 12 hours, horns held high, turning left, right, left again. We played through each piece countless times. Two camera crews chronicled our practices, a documentary project from NBC (click here to see if it's airing in your area) and a crew from the CBS affiliate network LOGO. We played and marched all day Monday, mostly in our uniforms, which resembled French rolls of duct tape with the puffy silver jackets and blue berets but kept me suitably warm. The only real hitch was the lack of coffee the second day. Those of us from Seattle, and those with incurable coffee addictions were holding coffee cups with our cream and/or sugar, hovering around a percolator trying not to snap.

The Real Thing

Exhausted from the switch from nights to days, the 3 hour time change, the two days of travel to get there and the two days of intense practice, my Seattle bandmate and I woke at 5 am to start our day of making history.

We took the Metro a couple stops to our meeting place in a large mall where at 7 a huge breakfast buffet was served and we received our credentials from the Secret Service. We were also again reminded that while on the parade route there would be no reaching in our pockets, stopping or deviating from our marching. I quote a DC police officer who spoke to us at rehearsal: "You're allowed to breathe, you're allowed to blow into the instrument or hit it, but don't do anything else or you'll get shot." The trombonists joked, but may have been genuinely concerned, that emptying their spit valves may result in bodily harm.

Journey to the Start Point

By 9 am we were loaded onto our 4 buses to head to the Pentagon for security clearance. We roasted in our umpteen layers and uniforms, listening to the inauguration coverage on the bus radio until about half way through President Obama's speech when we finally unloaded our sauna and were searched, scanned and fed a boxed lunch (yes, there was a vegetarian option. Go Pentagon!) We then proceeded back to our freshly screened buses newly frozen. We then waited again for a number of hours, roasting and antsy.

Finally we made it to the staging area near the White House where we were directed into warming tents for a period of time until we lined up outside for another hour or so before we were shuffled back into the tents to defrost again. The entire time from before our Pentagon screening through our march we were accompanied by military escort. They were responsible for giving us orders we were instructed to follow to the letter. (Photo from my cell phone as we first lined up - note the Washington Memorial in the background).

Before us was the Howard University Band and its sashaying dance squad (the Pennsylvania float would join us later) and behind us were the Mobile Alabama Azalea Trail Maids, fluffy petticoat-ed southern bells who were a total joy to look at. I took a picture of them with my cell phone as we hustled into the warming tents for a last warm up before the march (see right). Finally we lined up for the last time just after sunset, about 10 hours after our credentialing at breakfast that morning. We marched forward in the dark, the real thing upon us!

Down Pennsylvania Avenue

The first bit was so dark I couldn't read my music! Thankfully we had practiced enough that I didn't really need to. I also lost feeling in my right fingers (exposed so I could play) and my face (lips kind of necessary to play trumpet). But as we moved forward, the lighting got better and I actually began to sweat from the effort of marching.

It's hard to describe what it felt like to march down Pennsylvania Avenue, celebrating the inauguration of our freely elected 44th President, the first minority President, the first President to EVER publicly include gays and lesbians in his speeches and his parade, the first man who believes civil rights extend to all citizens, not just some. I wasn't marching to entertain anyone, I didn't care if we played cool music or looked like French duct tape rolls playing in the dark, I was marching to show all gay, lesbian, bisexual, transgender, queer people all over the world that in America we matter. We are part of this country and our President recognizes us as equal citizens.

We got a standing ovation from the mayor's viewing stand. We got cheers and jeers (mostly cheers) for freezing bystanders, and police, military and secret service cheered for us loudly! Some of the crowds screamed so hard for us I would start to tear up. When we turned the corner to approach the President's grandstand we had to stop playing and marched to the click of drumsticks. This was so bands wouldn't play over each other. As we faced the grandstand, listening to the rusty-voiced announcer (who had us in stitches with his grunting and throat-clearing between announcements) announce the band in front of us I tried to just soak up the moment. (You can see me in the pic on left!)

The light at the grandstand was blindingly bright. It shone through my crystal blue mouthpiece and I could see the heads in front of me held high. Then it was our chance to march under the camera cranes and into the light. The cadence started us off and we marched into history. I had Washington Post memorized pretty well and looked out of the corner of my eyes as we marched to see President Obama and his wife with a huge smile waving and, I swear, looking right at me! My heart swelled so full I couldn't play for a couple of measures, the lump on my throat made it impossible. Then, after we passed the grandstand, when I thought the moment was over, the largest crowd yet was there to cheer for us as we wailed through what I felt was our signature piece, Brand New Day.

By 7 or so, twelve hours from our AM meet-up, we were back in our buses to head back to Arlington, where we started from.

Homecoming

Not 12 hours after marching in front of President Obama back on all of 4 hours sleep, I was 30,000 miles in the sky on my way back to Seattle. Another 18 hour day - starting on one coast and finishing with my continuity clinic on the other. Making it through clinic sleep deprived, running on fumes and the left over adrenalin from the day before, I was in bed by 6:30 PM after clinic, dreaming our repertoire, Washington Post, Brand New Day, Manhattan Beach, Hold On I'm Coming and Ode to Joy over and over again...

Decompressing

I found out at our post inauguration dinner that three of four of our baton twirlers had left before the parade for personal reasons. This left one man as the sole baton twirler, leading us forward. When I see footage of us marching and the pure joy and pride in his face and step I am so happy he was there to show the joy we all felt but could only express through our music! Watching him raise his arms in the air with suge a HUGE smile makes me smile every time I see it!

I also was reminded of a story our drum major told us during the credentialing breakfast. He was at a required meeting the day before. After this meeting a number of military personnel went out of their way to come up to him and another LGBA leader to shake their hands and wish them luck and thanks. The sheer number of people to do so, and the intensity with which they did, made him realize that these people were saying with their handshakes what they couldn't say in the open, being military personnel, giving our marching all that much more meaning.

I'm so honored to have been a part of something so important and so meaningful. I could have told so many more stories in here - how many times I had to pee before we set off, 2 AM string cheese raids, the man on the Metro with the photo of the rainbow flag in space, laughing at the way Rick Warren said "Sasha" and singing our music in the buses, I will just leave it at this and hope that one day the gay presence at presidential and national events will no longer mean either a media blackout (did you all know a gay bishop and gay chorus were also a part of the weekend? Probably not) or special coverage, and just be another group of equal Americans partaking in the celebration.

Tofurky, graveyard shift and Obamarama

2009-01-15T18:50:00.012+07:00

1/15/08
Maybe its the night schedule. Maybe it's my cold, or my bad tooth. Whatever it is I decided to try Tofurky. In fact, I did more than this, I decided to try Tofurky and some veggie salami-wannabe at the same time.

Lesson learned: I should not grocery shop sleep deprived.

Night float is what it is. The hard work I can handle. And I've worked longer hours. It's the loss of the daytime that gets to me. Between Inauguration preparations, a wedding in rural Oregon, an out of town visitor, a dental disaster (three trips to the dentist in two days!) and a mean case of the rhinovirus I have to say I'm feeling a tad run down. But adrenaline and excitement goes far. Tomorrow I head to DC. Hard to believe since I still have to finish this shift, go to bed, wake up, pack, and then work for another 12 hours first, but it really is tomorrow! I arrive in DC around 11 PM EST. Saturday I kick back with my cousin and his kidlets. Sunday and Monday practice all day. Tuesday the schedule states we start preparations at 4AM and after a lot of credentialing and such we are at the staging area around noon. Then, after it's all over, we probably celebrate a little, then, pre-crack of dawn, I'm back at the airport to fly home. I get in around 11:30 PM and have 8 patients scheduled into my clinic a mere 2 hours after I land... what is it they say about the wicked and rest?

I have been practicing diligently in the call room between admissions. The janitor caught me one night, kicked back playing Sousa with my Harmon mute, the digital metronome ticking away at 112 beats per second on the computer. I wanted to memorize the pieces but don't think it's going to happen. I almost have two or three of them down but would need a few more weeks to really know them by heart. Thankfully, I think I know them well enough to learn to march the inauguration committee's massive regulation 28 inch step.

LGBA has been receiving a lot of press. Locally the Seattle PI printed something in their Jan 15th edition that is also available online if you click here. It made the front page! How cool is that? A news crew also came to band practice this week and did some interviewing and filming. I was, of course, here at Tacoma General Saving lives and Making a Difference so will redeem my 15 minutes of fame at some later date. I would not recommend reading the comments section of the news article. Lots of homophobic crap on there. Depressing. Instead, check out my band friend's inauguration blog here, much cooler.

I am thrilled about DC. The adrenaline is pumping. I have my Sudafed and my DayQuil, my trumpet and couple changes of clothes. I'm packing light - just a backpack (crammed to the gills with warm clothes) and my trumpet case for the next five days. I will be doing a lot of moving around and have lay-overs so I feel better bringing only what I can carry.

Tofurky aside, this should be an amazing inauguration weekend!

1/16/08
Things as things have been predictably hectic. Additionally, I just found out my flight was delayed nearly three hours, meaning a missed connection. But the friendly folks at NWA rebooked me with their new partner, Delta and I'm back on schedule, I just lay-over in Atlanta for 40 minutes instead of Detroit for more than an hour. I leave a few minutes later so had time to publish this entry. Send me good vibes everyone! I hope I don't trip and send the entire band crashing down in front of Obama!

2008 Year in review (complete with links)

2008-12-30T08:13:00.007+07:00

This year has been up and down. I made it through intern year by the skin of my teeth. I won’t lie, I battled both burnout and cat pee. The spring brought me some great surprises. I stumbled forward and ended up right here.

Since those yearly letter summaries have been so popular from my friends and fam this year I thought I'd spit out one of my own. So, here it is, my year in review. (Photos from my wintry vacation in Michigan: Kiki, Christmas cake, punch, Hanukkah cake, latkes.)

Jan: My second month of OB as an intern. Upper: Hawaii. Downer: my first whiff of burnout.

Feb: My away rotation in San Diego. Upper: pretty much the entire month. Downer: shortest month of the year

March: Surgery rotation. Upper: National Physician’s Alliance conference – reconnecting with my fellow activist doctors. Downer: surgery

April: Orthopedic surgery. Uppers: Daffodil parade, carrot soup, sun comes back to the PacNW!

May: In-patient pediatrics most the month. Upper: Vacation the first week! Meeting my friends’ twin baby boys! Meeting Shilo’s mom. Downer: q4 call and gastroenteritis.

June: Still in-patient peds. Uppers: Last month of intern year! Q4 but squeeze in… Solstice parade, Pride parade, horse time. Downer: Violating work hours this month and that stink of burnout creeps back. It’s not the Tacoma aroma, either. Only month without a posting.

July: No longer an intern. But, launched into 9 weeks of OB and continued q4 call (solo! Ack!) thus wasn’t feeling very celebratory. Uppers: Learned a ton. X-Files movie with an old friend. Downers: that not sleeping every fourth night thing.

August: Still OB. Uppers: Mom visits. Shilo time when I can. Downer: Became grumpy and not particularly pleasant to be around most the time. Are you sure I’m not still an intern?

September: Life smacks me with a big wet kiss! Rotations: In-patient family practice and behavioral pediatrics. Uppers: Vaycay in Colorado. Join the Rainbow City band! Become officially a board member of GLMA. Downer: Sive won’t pee in her litterbox – might smell worse than burnout.

October: Surgery. Again. Uppers: Dad visits (escape to Whidbey!), GLMA national (gay docs take over Seattle!), My first RCB concert! Downer: New computer system hell in the hospital.

November: In-patient medicine followed by ER. Uppers: Election. Thanksgiving with a million cousins. Caroling in Seattle. Downers: My health: Gastroenteritis (again). URI. Chemical pneumonitis.

December: Here we are. ER rotation. Uppers: Three amazing concerts. Get into the inauguration parade with LGBA! My program is supportive! I realize, I heart Seattle and I, gosh durn it, I kinda heart TFM. Christmas with family in Michigan. Snow in Seattle. Start riding at a jumper barn. Sive starts peeing in her litterbox again! Downers? What are those?

The Big Three and a little pig

2008-11-26T01:35:00.009+07:00

Religiously atheist, culturally Jewish, spiritually Buddhist, and madly in love with Christmas carols. What can I say, there's nothing like Ella's Let it Snow on a cold night to warm the cockles. Thankfully, this year, I can bask in the holiday music spectacular with three concerts and at least two caroling sessions!

I was hoping I could head to San Diego to see my activist Grandpa and my recently married (and more recently bitch-slapped by Prop 8) Californian aunts for some pescetarian Thanksgiving fare. Unfortunately, thanks partially to the holiday plane fare monopoly (thanks, airlines, for capitalizing on a holiday about family by charging exorbitant amounts so it becomes prohibitively expensive to see that family) and thanks partially to the recent 4 G's I had to spend on my car, my cat, my eyes and a plane ticket for the X-mas season I will be spending Thanksgiving in Seattle.

The fare at my cousin's house promises to be appropriately pre-winter stuff-your-selves extravagant with the first course of Sushi, followed by Greek fare then sweet potatoes and pies. Notably splendidly meat-free. There will be nearly a dozen cousins of mine at this unique feast (maybe more) and a few others, I'm sure. The morning after, in my wasabi and soy sauce bloat, I'll wobble downtown and play some carols for the shoppers with the Renegayde band.

Tangent: everyone knows I stopped eating meat, right? I provided a link to "pescetarian" up there for those confused. Initially it happened with a loss of the taste of chewy sinewy flesh. But now, after my more recent Peta video adventures I realize deep down inside, I can't justify eating slaughtered animals. Fish I can rationalize, they don't show affection, but pigs? Seriously, these animals are smarter than dogs. Would you eat a fried puppy strip? Of course, I do not hold any judgement against anyone who eats meat. I honestly don't mind watching my friends take a bite out of a juicy home-grilled burger or munch on a crispy strip of greasy bacon. Really. I just don't want any, thanks for asking.

I went on a lactoovovegetarian stint after my summer of autopsies in 1998 (holy moly, was that really 10 years ago?) But it didn't last long as I grew tired of falafel and fried eggs and for some inexplicable reason missed hard salami sandwiches more than anything else. Maybe this won't last either, but for now, for today, I'm perfectly happy with green beans, garlic and tilapia dressed in Johnny's seasoning.

Where was I? Ah yes, Thanksgiving, Christmas Carols... Holiday shmear. This time of year is also the time of extravagant spending. I am not anti-consumerism. I would love more than anything to have the income to buy everyone I loved what they needed and wanted for every special occasion. But, this economic crisis thing is a bit of a buzz-kill, isn't it? Thankfully I haven't made enough money to tuck away in some conservative retirement fund that tanked with the market. But, still, I worry about the non-profits, the programs that depend on donors and big hearts to stay afloat. Because people are tightening their proverbial purse strings and non-prof's are paying for it.

I'm also a little worried about the Big Three. It's easy to write off Big Corporations as evil and carbon energy-sucking, however, the Big Three are the foundation of the economy of an entire state in the US. One single city closed its plants and the result was so damaging an award winning documentary was made about how sad the outcome was. Imagine that in the whole state! Of course, I am not an economics guru. Hardly. But I am a worrier, and that's all I need to keep my eye on the news. I think I'm going to make an effort to shop Michigan this year for the holidays (yes, hard to do 2000 miles away, but I can sure try).

GLMA Summary

2008-10-27T00:07:00.009+07:00

Conference was great. There is nothing better than getting together with the GLMA folk - all ages, sexual orientations and gender identities... all intellectual, educated, and motivated to help make it safe to practice as an out doc and safer to be an out patient. Some people are hard core activists by choice, and some by necessity. Take Janice who wasn't allowed to visit her same-sex partner as she was dying in a major academic hospital because they were both women. Her story (click here) was heartbreaking and it amazes me that less than a year later she can talk about what happened to hundreds of health professionals.

The transgender and genderqueer presence this year was spectacular, I feel. The programming also was excellent, as I said in my last post. Especially for trans health care this year. I went to several sessions on transgender health care and inclusion as well as adolescent transgender issues and gyn care. I also went to many of the plenaries which were very engaging. I networked and met clinic directors from places large and small, NY, San Fran and Boston LGBT-focused clinics and rural practices. One rural family doc told his story about being fired for being "too gay" after working in the same clinic for 33 years. He was told that his being out was slowing the growth of the practice. It still happens people! Read an article about it here.

The workshop went really well. I started out asking people to establishing goals for the session. Everyone is at a different place. Some may be the only out person they know at their whole institution and they need to find a way to start a group without jeopardizing their safety. Some people may be senior faculty at a major academic institution and need to know if gender and sexuality issues are part of credentialing requirements. Many want to know how to convince their colleagues/Dean that LGBT health concerns are important enough to take up lecture time. Some people may have awesome LGBT curriculum at their schools (UofM in the house!) but want to know how to conduct a survey to see if there are new needs or how the programming is received. I could go on....

But I'll spare you all.

Point being: There is a HUGE spectrum of need in this arena. I'm so glad to be of service for all these folks. I ran out of business cards very early in the conference. But the good news is, like I said, this is still a hot issue and there are a lot of folks like me out there who know how to help other people problem solve on this very topic.

The conference ended with the Gala Banquet which we had on a vessel that traveled around the bay with a spectacular view of the nighttime skyline. I MC'ed the event with a longtime MC who, of course, sang a couple show tunes. When you get a queen, a spotlight, a piano, a microphone and a captive audience, the only outcome is a showtune (or two). Of course some of the crowd was not ga-ga for Sondheim, but everyone was good natured and after raising $90,000 for the GLMA and the Lesbian Health Fund over the weekend it all ended with a fun dance floor party.

It's sad that I only see some of these folks once a year but it's awesome that I even get to do that! It's also sad knowing that some of the students may never come back, maybe because they are on rotation and won't be able to make it, or maybe because the cost of membership and conference is too much, or maybe because the excitement will wear off and they'll forget what a great conference this was and what a great time they had. As a board member I think my new goal is to figure out what GLMA can do to help slow the attrition rate.

Next post: News on the Cat, the Car and the fabulousness of the Sci-Fi Museum. Maybe.

You want an update? I got your update right here.

2008-10-23T01:48:00.022+07:00

UPDATE: Reunion
Quickie update on being able to go to my 10 year college reunion. Remember my 23 steps to get a vacation? Well it failed at step 10. I got a phone call from the pediatric rotation liaison where she called and said, "We all discussed this switch at length and after much deliberation we decided: pppffffttt!" (okay, not a direct quote, but that's what I heard).

So I tried another tactic. Instead of swapping the week I proposed swapping out the entire rotation. It was accepted! So now I'm at the point where I need to request the week off. Here's the updated to do list for just this step (step 15 is where we are if you remember the old list).

Find coverage for my colposcopy clinic - DONE
Find coverage for my AM and PM gynecology clinics - IN PROCESS
Find coverage for my obstetrical patients.- DONE
Find coverage for my patients that may be admitted to the hospital while I am gone.
Find coverage for my in-basket and mailbox and any patient calls or concerns while I am gone.
Get signatures on the request from each person covering all the above
Submit this signed request to the chief resident.
Then on to the scheduler for approval.
Then to the clinic director for approval.

So much more manageable than the last list, don't you think? (Photo is actually of New Haven, but close enough...)

UPDATE: Band
This swap will also give me the opportunity to play with my band during the marching season. Which I'm totally excited to do! I'm really really geeked about the band. In fact, I think everyone (including the homeless lady outside of Starbucks) is really tired of hearing about it. We have two Christmas shows. I am on call for one of them but am trying to swap the call. I get to play the horse whinny solo in Sleigh Ride so it's definitely worth extra effort to go!

The fall concert went swimmingly. I hear there's a CD of the performance, maybe a DVD - not entirely sure. I am still singing the songs we played. If something shows up on YouTube and isn't entirely embarrassing I will definitely post it here. The turnout was great - a few hundred from what I hear? I played horrifically out of tune for the very first portion of Thriller and was inspired to improve in my tuning and pitch. It will be really helpful for the ballad-y holiday pieces we are playing like Imagine. So I bought a KORG tuner. An awesome invention and totally fun and I will probably talk about it more another time.

UPDATE: Sive's health
For those who don't know, Sive has been having a bit of a peeing issue. She had this issue a little after I first moved out here. Now it's back and it started looking a little more serious. She had gross hematuria at the vets office and even passed some clot (that's medical talk for peeing blood and blood clots). We had an X-Ray done which was a little ambiguous and some lab studies. So about $500 later and after a specialist read of the X-Ray we still aren't sure. It doesn't look like frank stones, no evidence of obstruction, no massive tumors. Her bladder had some sludge in it and her urine culture is still cooking. So we'll see what bugs grow as it is likely she may have an infection as well. (Sive watching TV)

UPDATE: What am I doing right now?
Right now I am at the GLMA national conference. I serve on the Board of Directors and presented again this year on LGBTI curricular change and integration. What's amazing that this is still a very hot topic. It's great to think how far UofM came in just my four years there. So many schools are trying to go through the same changes and its an honor to serve as a resource for all these medical, nursing, naturopathic, social work, PA and other students, residents and faculty. Blah blah blah education blah blah advocacy and all this stuff that is really awesome and I've been talking about this whole weekend...

So now for a snippet of the pure fun that was Friday night out at Seattle Trannyshack (filmed by the iPhone of the guy standing next to me). Strung out Judy Garland and some stage diving below:

I wish I had a video of Ben de la Creme - the BEST performer - a robot strip dance with light-up body parts... excellent performance art. And she's a local drag queen so maybe I'll get another chance to see her!

Weekend on Whidby

2008-10-18T08:18:00.012+07:00

The weekend I spent on Whidbey Island with my father was fabulous. I was thankfully able to swap out my weekend of back-up to have the freedom to roam off of TFM boundaries. I even turned my pager off. Our ferry landed in Clinton, we stayed both nights in Langley and also visited Useless Bay and Coupeville.

As my Dad put it, we "ate our way though Whibey Island". The highlights of the weekend were:
1. The Food - Penn Cove Mussels in Penn Cove, the most incredible chocolate mousse in a a chocolate tulip (pictured), the most amazing caramelized kettle corn from the farmers market and a tasty salmon omelet breakfast are just a few highlights.

2. The Digs - A gorgeous two story beachside residence with a to-die-for panoramic view of the water. Warm, cozy, with a gas fireplace and flat screen TV. Luxurious down comforters and a pile of pillows I could get lost in.

3. The sunrises. See picture, taken from our window.

4. The beaches. Each with their own smooth volcanic skipping stones, bleached driftwood, washed up jelly fish, views of cliffs, mountains.

And there was so much more... It was peaceful and restful. The weather was cooperative all day Saturday (though certainly brisk - great hot chocolate weather). The place we stayed in Langley was called the Boatyard Inn. Check it out.

We rounded off the weekend with a nice dinner with the Seattle cousins and then it was back to work on Monday for me. Amazingly I was able to have some breakfast with Dad before he head off on Tuesday morning and we had the BEST Tacoma breakfast ever at Southern Kitchen. Definitely a place I'll have to return to. The fried catfish breakfast looked incredible but I had to have the cornmeal pancakes. I won't even get started on their famous beverages. Click on the link above for a great review.

As when family usually visits I had a bit of a low afterwards. Thankfully I had band practice and Shilo planned Tuesday and Wednesday respectively. A difficult call on Thursday (thanks to our new live in-patient electronic medical records) and a busy workday today rounded up the week and here I am back in action. I have my concert tomorrow with the Rainbow City Band. I'm a little nervous. The woman sitting next to me in the trumpet section said that she thinks we sound the worst we have ever sounded at a dress rehearsal... but you know what they say about bad dress rehearsals, right? Of course I have invited everyone and their mother. A couple of my resident friends, Shilo's mom and my faculty advisor plan to be there if they can make it. Hopefully we won't suck too badly.

On a side note, today a clinic patient about 10 years older than me exclaimed as I was introduced: "A doctor! But she's a kid!" I'm flattered that to some people I look half my age, but it gets tiresome. Maybe I should spend more time in the sun and get more wrinkles, of course skin cancer isn't fun either. I actually had one patient say to me "You don't look old enough to be qualified to be a doctor!" Qualified? Even Doogie was qualified. Hm. I should start thinking of ways this may work to my advantage... maybe people will sue me less than other doctors because they think I'm so young?

So I'll leave this lengthy post with that last reflection and this hilarious pictures of cat "costumes" Pet Smart tried to market to me.

Fun? Did she say Fun?

2008-09-30T09:04:00.018+07:00

Wow. I am way overdue for a post. Sorry about the hiatus. I have been (surprise!) very, very busy. Still am. But lately I've found new ways to interject fun things. (That's right, I said the f word!)

I've been riding Shilo about three times a week or so. Just yesterday, in my post-call stupor, I managed a very briskly paced trail ride lasting more than 2 hours through Banner Forest. A far stretch from our usual training sessions. I'm not entirely sure, but I think we may have gotten lost for a good portion of it. We made it back to the barn in time for sunset. All three of us who rode the trails forgot our cellphones, but rumor has it there's no reception there anyway. The photo isn't of us (obviously) but Banner looked a lot like the forest at right, but lots of the trees were fatter - and leg-crushingly close to the trails.

I've also been having tremendous fun playing with my new band, Rainbow City Band. I hope to march with them this summer but am on call the parade days. I can, however, make it our next concert where we are playing Danse Macabre, Hall of the Mountain King (a particularly interesting interpretation in that link), Night on Bald Mountain, Nightmare before Christmas music, music from the musical Wicked, Thriller, and possibly more (missed a few rehearsals unfortunately). So check out the links, I bet you know more of those songs than you realize.

All that is not to say haven't been working my tail off. In fact, I have been working essentially every single day from the day after I got back from my Colorado vacation until October 11th - my first guaranteed sleep-in day in a 19 day stretch. Whoever thinks second year is easier than intern year is on crack. I am putting in 80-hour weeks at the least and have been getting up hours before the sun creeps into my patients rooms (in fact, the darkness has been the source of some amusing patient mix-ups). Routinely, I return home long after the sun has set, as the above extracurriculars require about 90 minutes in the car. But it's worth every $4 gallon!

Next rotation... Surgery. Bleh.

7 Days in Colorado

2008-09-05T21:48:00.014+07:00

My trip started eventfully with a two hour delay due to a leaking oxygen line in the cockpit. We found this out, of course, after we had all boarded, returned our seats to the upright position and fastened our seat belts. They were kind and let us deplane if we'd like. I had lost my boarding pass in the boarding shuffle so did not deplane, instead, stuck in flight delay limbo hell, paced the pictured skyway over and over and over again.

Nonetheless, it all worked out amazing well and I landed in Denver the exact same time as my friend, Suhani, who landed two gates over. The thrill of being in Not-Tacoma was overwhelming. I was brought back to earth when using a public bathroom that was obviously transplanted from some preschool to the rental car agency. I managed to give myself a closed head injury in the tiny stall and wound up with a goose egg and a headache. More than 10 days later my scalp is still sore.

The first night I saw my way pregnant cousin and her family on Pearl Street. We ate yummy deep dish pizza and settled in to our awesome cabin right at Eben G. Fine park (the name which I kept thinking sounded like a jive remark: eben g'fine, jive turkey!). We were a stones throw from multiple trails, paths leading to the funky, liberal city of Boulder and vigorous mountain hikes.

On the third day, when we were not quite acclimated to the altitude but certainly motivated, we took a 4 hour hike, about 2.5 hours which were straight up. Thankfully, we motivated each other and made it to the top where we were literally greeted with applause. While the trip up was hard, the trip down had its own challenges. At times we were almost crab-walking between cracks in boulders and at times slipping a bit. In fact, there was a terrific wipe-out from my climbing partner. One that had us in stitches all day and her practically in crutches the rest of the week.

I really liked the Foot of the Mountain Motel where we stayed. Aside from the funny smell in the apartment. However, this mystery sewage, metallic smell (that Suhani only was able to sense on one occasion but which seemed to invade my nostrils every time I started to relax) inadvertently led to meeting the hippie, Indian flute-playing, fly-whispering, hotel attendant who reminded me a little of my brother and totally brought a smile to my face).

Tanya arrived and we continued to explore Boulder, shopped, strolled, had a meal or two at the lovely Tea House and just enjoyed the relaxation.

The last two nights I spent at a fancy hotel. I made good use of the hot tub, pool, free apples and Tanya and I halfheartedly explored the nearby shopping areas.

Mostly I just relaxed, caught up with a couple friends, read my book, and ate during the week. Exactly what I wanted to do.

Sleep, Loss, 5 Days Until Vacation

2008-08-24T20:15:00.009+07:00

Well, I tried to crank out a quickie blog entry before my last call. Didn't work so well. Here I am post-post-call about to go back to work to round on all the c-sections I did on my last call (yep - every delivery was by c-section, half of them emergent under general anesthetic - just a typical call for this black cloud). I am very drowsy so I apologize in advance for the typos. Pre-call I didn't get much sleep as I kept hallucinating my pager going off all night and had to answer all the non-pages. Last night I think I did sleep most the night, but now the days are shorter and I wake up in the dark again, groggy and disoriented.

I am so excited that my last week of the massive marathon twelve-week Q4 call is upon me. One more day as rover (i.e. secretary, ultrasonographer, referral nurse and slave to the OB clinic), one more crammed packed high-risk OB clinic, two more of my own nutsy clinics and ONE more call. That's it. Then I start vacation. Thank GOD!

Speaking of vacation... On the way back from riding the other day I saw a car drive by with a Yale sticker and felt a longing for Connecticut. I still haven't heard about my May rotation swap. For all I know it's circling around some committee somewhere. I'm anxious to submit it back to my own people so I hope I get approval soon so I can move on to step 11 of 23.

In my initial attempt on this blog entry I was reflecting on last Friday. It was a particularly hard day for me at work. Sure, I had to get up extra early round on the bazillion patients I delivered (plus pre-termers trying to keep their buns in the oven a little longer). But then I find out one of my favorite panel patients is losing her one-day old baby to child protective services for some vague unspecified reason. The patient, me, her nurse, and even the social worker were all shocked. How come they don't take babies away from totally unfit mothers but then take them away from rehabilitated mom's? I don't get it.

Then, I had my "One on One" in clinic. That means that a faculty doc shadows me all clinic, sits in the room while I interview and examine my patients that day and gives me instantaneous feedback. Sounds fun, eh? It's kinda like being a medical student all over again. Then, after she didn't show for her appointment, I find out one of my patients died. She was one of the hardest (I've blogged about her before) and one of the crotchety-est patients on my panel. But she really liked me, trusted me, and we had a great time together. I looked forward to seeing her each clinic even if I knew she would whip out some health-threatening surprise each time. I easily spent more time with her than any other patient. I rounded on her in the hospital, in the ICU, saw her each month in my clinic, talked to her while she was ventilated, even watched the snow fall at 5 am on Christmas morning post-call and she gave me root beer as a gift (and because it didn't jive with her diabetic diet). Funny, I always talked to her about her end of life plans but she was so resilient I think everyone thought she would never die, even though we all knew better. I also imagined myself being able to say goodbye at her funeral instead of finding out days later from a "why did you miss your appointment" phone call from my nurse. SG, I hope your passing was peaceful and you are breathing easier wherever you are...

Thankfully I had a Saturday off to try and process all of this and catch up on a little sleep before hitting up another week of everything and my Sunday call was too busy to think about anything other than work.

Twenty-Three Steps to Get a Vacation

2008-08-11T03:21:00.011+07:00

They say time flies when you are having fun, so is the opposite true? Is it like that last scene in that X-Files episode where the former speed-addicted teenager watches the second hand creep, creep, creep and then skip back a beat and creep another second forward? The agonizing passage of time...

I bought my ticket for vacation in Colorado. I hope to be there for the birth of my new little cousin and I hope its warm and pleasant. Not surprisingly, given my incredibly regimented schedule, I have most of my vacations planned through the next 12 months. All except the last. My last vacation of the year has been exceedingly hard to manage. See, the residency gives us our schedule for the next full year at one time. Then it's on us to try and find a time during one of the few rotations where its allowed to vacation to find coverage for our work and maybe get it approved to go.

I want to go to my 10-year college reunion very badly. I miss my college friends and they think they might be able to make it. This could potentially be a very fun reunion and I could get some QT with Boston and my friends that live there. (Picture of Obama speaking at this year's May Commencement and Reunion - will be hard to top next year).

So here are the hoops I have to jump through to make it happen:

I have to swap my rotation week. I need to find a person to be willing to take on a week of in-patient pediatrics that week in exchange for their out-patient rotation. DONE
I have to make that week as equivalent as possible in call days, call points and days off. DONE.
I have to make sure that our swapped out-patient weeks are also as equal so we don't end up taking unequal back-up or hospital call. DONE
I have to get a signature from said person. DONE
I have to submit it to the Chief Resident for approval. DONE
It has to then be submitted to the scheduler for approval. FAILED - now onto #7
It has to be documented that the during said swap we are actually covering for each other - me covering for her out-patient duties and her for me (The whole idea of a "swap" apparently not obvious enough to get authorization). DONE.
I have to get my faculty advisor to sign the swap request. DONE.
I have to get the other resident's advisor to sign it. KINDA - he signed conditionally, adding step #10 to the mix.
I need approval from the in-patient hospital service involved in the switch. This is now going to be discussed in the meeting for the service faculty, if it is appropriate for the switch to occur. PENDING.
I have to resubmit to the chief resident.
Then back to the scheduler.
Then to the clinic director. - if this is approved then the swap is for sure and I will have an out-patient week the week of reunion.
Then I have to request the week off.
Find coverage for my colposcopy clinic
Find coverage for my procedure clinic.
Find coverage for my obstetrical patients.
Find coverage for my patients that may be admitted to the hospital while I am gone.
Find coverage for my in-basket and mailbox and any patient calls or concerns while I am gone.
Get signatures on the request from each person covering 15-19.
Submit this signed request to the chief resident.
Then on to the scheduler for approval.
Then to the clinic director for approval...

And then, after step 23, the vacation might be approved and I can attend my 10-year college reunion.

All this for 7 days off in May 2009. I wasn't kidding when I told my college friends that I may have to move mountains to go to attend.

On a positive note, only three weeks left of OB. That means only three weeks left of this endless 16 weeks of inpatient life - on call every 4 days, only 4 days off a month, living by my pager, sleeping little, eating crap and falling out of touch with everyone that matters. Then I get one week vacation, one week of a more relaxing rotation and then right back to in-patient life.

689 days left of residency...

Why I may need a tetanus booster

2008-07-17T09:09:00.010+07:00

My last call, as usual, was long. Endless, you might say. My few chances to lie down resulted in the inevitable page. One aspect of taking call on OB is to do "courtesy checks" for the community docs. This can vary from everything from looking at a slide a nurse prepared to a full vaginal and cervical exam to a complete delivery. I am also the person on hand to assist with c-sections, of course. Between my bazillion speculum "courtesy checks" I assisted a handful o' sections and slept barely a wink. My own patients didn't deliver overnight. Which was particularly fine as two of them were preterm anyhow.

This afternoon, after a couple hours sleep after that endless call, I decided to walk to the post office to mail some letters. On the way I was brutally attacked by a crow. I was listening to my iPod, innocently walking on a well-traveled path, surrounded by kids, homeless people, campers, families, gangster wannabes. The park was pretty crowded for an early Wednesday afternoon. I get to a less populated part of the park (but equally as urban with a big construction project across the street and a bus stop) when my head gets slammed from behind so hard that my neck snaps forward. At first I thought maybe I got hit by a rock until in my peripheral vision I see big black wings and talons.

It got me good. Thankfully wasn't bleeding all over myself (last thing I wanted to do was go back to the hospital) but I do have a rather large lump, a very tender scalp and a few nice scabs where some hair used to be. After the attack, the bird followed and continued to scream at me. I pulled out my Nalgene bottle, turned to face the oily thing and dared it to come at me again, completely prepared to defend myself with deadly force if necessary. I didn't have to, but the way my adrenalin was pumping I was more than willing to fight back.

I love nature. I feel, in most cases, we have encroached on nature's little beasties. I'm starting to feel that crows, however, are less the victim and more the perpetrator. They are just plain mean. They drive out native birds and take over. I've seen a murder of crows (yes, a group of crows is called a murder) attack a lone eagle or barn owl before here. The are just big black feathered bullies.

I decided it was time to learn a little about crow attacks. My first source was Cornell:

My 10 year old son keeps having crows trying to attack him. He will be out in the yard and they come swooping down on his head. He has done nothing to them and he is terrified to go out side alone now. I have been out there and they have not bothered me. Please tell me what I can do.

Since you gave no indication of where you live, I have to guess on exactly what is happening. But, right now (late May) in most areas of the country crow babies are just fledgling (leaving the nest). In the first couple of weeks that the young are out of the nest they cannot fly well and are very vulnerable to predation. They hide in the trees and the parents are very protective of them. At this time the parents will mob (attack) any potential predator in the area. Usually this means cats and dogs, but it appears that your son elicits the same response. You are too big to risk getting too near. Just wait a few days and the fledglings will leave your yard and the parents will calm down. Try to keep in mind that these birds are not vicious fiends bent on your son's destruction, but merely dedicated parents trying to defend their own young in the best fashion they know.

Hm... so am I like a 10-year-old kid these crows? What aren't I "too big to risk getting near"?

Apparently, this is an issue in London as well. Check out THIS article. More than one Hitchcock parallel made surely.

And, now, a 60 second video about the true nature of crows as I see it:

Resident Evil Extinction-Crow Attack
Uploaded by systemofevil

The Old Gray Mare

2008-07-14T11:06:00.009+07:00

Thank god for Shiloh (right). I can't remember if I mentioned, but my last couple weeks of pediatrics were hard on me. We had more than our fair share of tragedy. There were kids we diagnosed with cancer, babies we diagnosed with fatal and permanently debilitating diseases, a violent rape of a little girl, it was harsh to say the least. Earlier in the rotation we did have a handful of cute kids with lacerated organs from horse accidents.... bringing me back to my original topic. Some people have yoga, some people have meditation, some people have church. Me? Right now I have an old gray mare and endless fields of clover and wildflowers. I manage to get out there two or three times a week. most weeks. I don't ride every time. Sometimes I only have time to pet her a bit, let her graze at a clover patch (above). And the only fee for all this horse QT is the bridge toll ($4 per trip).

The last few weeks of OB call have been predictably busy. I have delivered a bunch of babies the old fashioned way, and and am getting the hang of c-sections. Still not a big fan of the OR but according to the attending on the last c-section I apparently "have excellent surgical skills" with an added-on, "and I don't usually tell people that". Are you all laughing at the irony with me? What this really means is that I'm going to have a terribly hard time just assisting at this point and am getting some serious pressure to be the primary surgeon. Need I comment again on the irony? On my last day of pediatric surgery I sewed up a small hernia incision terribly - poor kid. But sewing together big things like a uterus or the tough stuff that hold the guts in (fascia) is a bit easier - and the needles are much bigger and easier to see squinty-eyed at two in the morning.

As an aside, I never went to the Tall Ships festival. But I had a pretty good view of the actual ships from various other spots in Tacoma, sometimes even my windows were enough. It looked a little campy, certainly touristy. I did, however, find some good pics of the event. In the last picture (below), click on it and you can see my apartment (and even my window) behind Stadium High School (the white high-rise on the left)!

Today is my last day off for two weeks. I've stocked up on groceries, did laundry last week, went for a short run, a long hike, and sorted through the last two weeks of mail. I also finally vacuumed (yay me!). I don't know how I did it but the day is over now. Back to the grind tomorrow. My next day off, while far away as July 26th, also heralds the release of the new X-Files movie!

Rah Rah Happy Birthday America

2008-07-05T05:49:00.008+07:00

So my first call on the OB deck as a solo resident went surprisingly well. There was a three or four hour period where things were a little crazy. I had to call in help from the resident on call for internal medicine. However, by actually running between deliveries (literally) I was able to catch all the kiddos. The nurses, I cannot emphasize enough, are really amazing. In OB it's standard to have one nurse for one patient. Sometimes a nurse will go to lunch break (ah, unionization) but overall it's really consistent for the patient and, I have to admit, great help for me. The nurses really know their stuff. Sometimes there are conflicts as they have their idea how to manage the labor and you have yours, but overall the coordination of care goes pretty smoothly and we have a baby at the end. My nurses saved me last night. When I had five laboring patients, a cesarean section and triage was full with concerned moms-to-be, they help manage things to the point where I could pretty much just run from vagina to vagina to OR to vagina and catch babies. Heck, I even got about an hour or two of sleep in the 30 hours I was there...

...which is good since here I am, post-call, and there are fighter jets and B52s flying around outside my window in celebration of the USA. Sometimes, when the fighter jet flies spiraling up into the sky, flips around upside down and back toward the waterfront, it emits a sonic boom and all the car alarms go off. It's all very exciting but definitely not conducive for sleep. However, just to show how tired I was, I did sleep through it for about an hour or two. (photo, by the way, is patriotism, the Sisters of Perpetual Indulgence way).

I was on call last 4th so I'm not sure what is Tacoma typical, but especially exciting now is that the Tall Ships are here. Those who don't know what that means (like me until I looked it up) it translates as really cool ships with big sails (a rigged sailing vessel according to Wikipedia. - source of the photo). It's a yearly festival and at a different location each year. Tacoma is the lucky waterfront this year. For pictures of some of the ships and info about the various "villages" as part of the festival you can check out the Tall Ships Tacoma Website. Traffic yesterday when the ships were sailing in was apparently atrocious (2 hours to go two exits on the freeway per one report).

So this weekend is a Golden one for me. Which is particularly nice since I'm still recovering from pediatrics. Case in point: there's a stack of unsorted mail and random papers surrounding my couch like a moat. I haven't vacuumed since who knows when and I think the dust bunnies are so plentiful they are starting to organize a guerrilla attack.

The most ambitious plan for my sleepless post-call Fourth will be to ride my bike down to the waterfront to see the Tall Ships... if I can muster the energy (and if this iced coffee I'm drinking now does its trick). The rest of the plan includes laundry, sorting mail and watching fireworks from the windows. In all, not a bad post call day. If I'm lucky I'll get decent breaks between loud things to sleep! Tomorrow I head up to Seattle for my little cousins' joint b-day party. I bought them hula hoops. And couldn't resist so I also bought one for myself. (One of my cousins at left hula hooping - and, look, another Utilikilt behind her!)

Internship Over

2008-07-01T09:51:00.017+07:00

Wow. I can't believe it's been a month since my last entry. I'm staring at my computer screen through slitted eyes, I'm so tired. I have finished my 7 weeks of Pediatrics and tomorrow start 9 weeks of OB. OB has a routine, it's hard as hell but at least I get to sleep post-call and I know, essentially, what I'm in for each day.

In the last month I have worked A LOT. So much so that my priorities list had been shuffled multiple times. For example, sometimes I have to prioritize something elective like emailing in regards to something crucial like sleeping. This last long rotation I had to prioritize the crucials, less sleep to eat, or less eating to get my work done. With the exception of the week containing my golden weekend I was between 80 and 90 hrs every week.

The other day I was making a joke about residency but I realize now there's some truth to it: residency has made me soft on the outside and hard on the inside. Looking back on my intern year I would be lying if I said I didn't have fun now and again, but... if you gave me the choice between having teeth pulled without anesthetic and repeating intern year, I'd lose the teeth.

Hey! And speaking of fun.... my golden weekend was during Solstice. I got to go to the Solstice parade in Freemont (it's a particularly leftist part of Seattle). The parade started, as is tradition, with naked bicyclers (one at left - click on it to see "details"). They had body paint designed to look like feathers, clothes, in hand prints, etc. It was really neat. After the naked bike riders came the actual parade, a celebration of summer, solstice, the sun, etc. There are no corporate sponsors of the Freemont parade. The floats are all man-powered, not motorized and if there was music it was thanks to live bands, not stereos. There was hula hooping, a flying spaghetti monster, pirates, unicorns, zombies, belly dancers, dragons, robots, free hugs, a giant joint, hula hoops, storks, stilts, a funeral for the statue of liberty, George Dubbya, chickens, chile pepper-people and "the last virgin" riding a pink, sheep-skin pony. I wish I could post all the pictures here. I took so many. I attended the parade with my cousins and their kids and sat with some friends of theirs who brought bubbles, hula hoops of their own, and pogo sticks. It was fabulous.

Then this weekend I had Sunday off. I went to Pride in Seattle which also had its own awesome parade. The night before I went to see the Seattle Men's Chorus, which was quite possibly the gay-est thing I have ever seen. Ever. And that's saying a lot! The next day was the parade which also featured pirates and the spaghetti monster. I also came to a revelation about the utilikilt. It's made in Seattle and I have seen it everywhere. I never made the connection but it's exceedingly popular in the gay community out here (for men, women and gender non-specific folks). They were everywhere. I have never seem them out of the NW (as far as I can remember). Learn more about them here.

This parade, unlike the Freemont one, did have corporate sponsorship, and being in the NW, Microsoft, Starbucks, Alaska Airlines and WaMu were very well represented (and very, very gay). The Obama love was everywhere. And, my favorite, Dykes on Bikes, was exciting! I can't help but blame my Detroit roots and the Woodward Dream Cruise conditioning to make my heart go pitter-patter with a rev of an engine. Some of the folks at the parade with me felt otherwise, but I couldn't help but find that as possibly my favorite part of the whole parade.

I have soooo many picture from these parades. It was impossible to pick the best ones for the blog. I may have to just post them periodically throughout the year... the pirates, the utilikilt peeps, the drag queens, the Sisters of Perpetual Indulgence, The roller derby girls, the leather fetishists, the rugby folks, WNFL players, the half-naked pregnant goth chicks (above), PFLAG's awesome signs, people dressed as fruits, people dressed as recyclables, more naked bikers and rollerbladers, and more! I'll try to see if I can email a few folks the photo album when I can get it uploaded but if you're interested and haven't received it, feel free to email me for the full photo fun! The photos I've included were picked at random. The one at left only partially shows the scope of the post-parade party that happened at the Seattle Center. Apparently there were 250,000 people there last year. I wonder what the count was this year?

And, as an aside (just to show where my priorities are on this blog), we had graduation for the R3's. It was a festive bitter-sweet event. I got to reunite with Molly, my fellow from my first month of fellowship who has been practicing for the last year in Port Townsend. I also got a fancy certificate saying I finished intern year. The graduating class each had a moment in the spotlight razzed or praised or even serenaded by their advisors. There were lots of speeches, some more relevant than others, mediocre-tasting, but fancy-looking food and a stupendous view (left)!

And, with that, I need to crash. This was a long entry. I feel obligated to reminiscence about the last year. Maybe later. For now sleep is trumping nostalgia. Until later...

Honeymoon over

2008-05-28T19:09:00.007+07:00

So I was loving pediatrics. Not that anything has actually changed, but, like I've said before, even if you like doing something, doing it too much can kinda kill the joy.

The last two weeks have been busy, with long hours. Most regular days have been about 13 hours long. Sometimes 12, on one occasion, 11. Calls have been busy, hard, intense. On my last call I admitted 5 patients between 9 PM and 3 AM. What doesn't help the feeling of pediatric saturation is the fact that my precious golden weekend was almost entirely spent on my bathroom floor barfing, and the following several days I was barely strong enough to stand.

Last week: Monday: 16 hours, Tuesday: 12, Wednesday: 11 (woo!), Thursday: 14, Friday/Sat: 32. Grand total of 85 hours (correct me if my math is off).

The good news is, I have found something awesome for my few hours of spare time here and there. Randomly, I ran into a girl in my building who has a horse and not enough time to ride it. And, hey! I'm a rider without a horse! It was an arrangement that met both our needs. Total mutual awesomeness. I can't even begin to emphasize what a great coincidence it was that I ran into her. I had just happened to get on the elevator wearing a horse shirt and it all just... happened. The horse's name is Shiloh and she's kept out in Gig Harbor (a 20 minute drive and $3 toll bridge). She's a adorable, very sweet, good ground manners, speedy as all get-out and pictured at left (took that with my phone today). My goal is to try and get out and ride her on the 11 and 12 hour days, when I have a few hours before having to go to bed. It really is making my 80+ work weeks a little more bearable. It's better than drugs, therapy, massages, beaches and just about anything except a day off to do it even more.

Today, sadly, was my last day off for two weeks. I grocery shopped, rode Shiloh, took out the trash, did my laundry and cooked like a fiend. I made hummus, black bean soup and lasagna to hopefully last the two weeks. Now, I buckle down and watch time fly... hopefully.

Oh, and as an aside. Also a random coincidence. As soon as I find out about Shiloh we start admitting kids with organ damage (lacerations of livers, spleens and kidneys) from horse accidents. No kidding. We've had three in the last week. Thankfully, aside from being a bit grouchy when it comes to cinching the girth, Shiloh has been a perfect doll!

A Week in the Life

2008-05-18T09:51:00.011+07:00

Monday: Finish orthopedic surgery/sports medicine. AM at the army base, PM in sports med clinic. Done by 6 PM. Get sign-out on the patients I'm picking up in the hospital tomorrow for new rotation. Some are really sick kiddos. Finished with sign-out/chit-chat at 8 PM. Realize I have to go to bed in 30 minutes to get 8 hours sleep. All in all, just about a 10 hour day (not including sign-out).

Tuesday: First day on new rotation. In-patient pediatrics. Get there at 6 to start rounding. Round until 7, then it's morning report where I hear about new kids that arrived overnight. Then round until 9:30. Finished seeing my 7 spanking new (to me) patients just in time. Then round again with the whole team until 12:30. Then do floor work until 5 PM (discharge about 5 patients). Sign out to the person on call and get out before 6. 11-ish hour day (doing really well so far!)

Wednesday: At work by 6ish. Similar deal. Finish rounding around 12:30. Have required conference until 1:30, back to work to finish floor work. On call, take sign-out for other services. Admit only two patients. Am signing out by around 9 PM (night float is overnight Su-Thu for those confused about overnight vs. non-overnight calls). Home just before 10. Finish preparing a presentation I have to do the next day. Bed by midnight. 15 hour work day (not including presentation stuffs).

Thursday: At work at 7 AM. Round until 1 PM. Floor work until 2-something. Get to go to about an hour and a half of didactics (didactics from 12:45-5 on Thursdays). Give my presentation at 3:50. Run back to hospital for sign out. Am exhausted and leaving between 5 and 6 PM. Go for a walk at point defiance to enjoy rhododendron garden (see pics). Have DQ for dinner. Somehow end up not going to bed until 9:30-10 PM. Excited to sleep. Am sick and decide not to take Nyquil for some reason. 11-hour work day.

Paged at 12 AM.

Friday: Up at 12 AM due to page about a patient in labor. Can't go back to sleep because I'm coughing so much. Paged again at 2 AM. Go into hospital. Glad I didn't take Nyquil. Manage her labor until 6 AM when she actually starts pushing. No sleep in interim. Deliver baby around 7 AM. Sew up her lacerations for a half hour. Paperwork and examine baby for next half hour. Frantically round before 9:30. Round with attending until 12. More frantic floor work until 1:00. Try to nap from 1-1:15 but get paged three times. Cry a little out of frustration that I CAN'T SLEEP! Then stuff face with lunch and go to clinic from 1:30-5 (manage to brush my teeth too). Of all the days, I have my a one-on-one with an attending observing me to critique my clinical skills. On two hours sleep no less. Thankfully it randomly is the attending that was my back-up for the delivery so he gets where I'm coming from and is wicked tired himself. We are punchy, loopy and totally out of it but manage to rock through clinic. Leave around 5:30 after convincing people I am okay to drive home. Walk out of door holding car keys in hand yet immediately forget I drove to work and walk home. Get to my apartment and wonder why I have my car keys out. Figure it out and shrug. Let myself in, eat, make a couple calls, watch a little TV, go to bed at 8 PM. About an 18-hour work day.

Saturday: OFF! Wake at 9 AM - a good 13 hours after crashing. Grocery shop, laundry, go get my car. Am groggy most the day and forget about both a friend's daughter's birthday party and an R1 outing. But am grateful to catch up on sleep. Go to bed around 8:30 with some cough syrup bedside.

Sunday: On call. A measly 14 hours of work. But insane nonetheless. The night was full moon worthy. But I was relatively well rested (thanks to my cough syrup with codeine).

This week was just about 80 hours. Not too bad considering the crazy delivery that mucked everything up.

The good news is that all the work I've been doing has been pretty nice. I have enjoyed the week overall. I hope that feeling sticks! It probably also helps that it's been sunny. And check out the size of that uprooted tree! HUGE, eh?

Nose, meet grindstone

2008-05-13T08:51:00.009+07:00

Back from vacation and now it's on to four consecutive months of 80-hour work weeks with the usual four days off a month.

Please allow me to heave a huge sigh of self-pity.

*sigh*

On the bright side, I'm getting one the of most dreaded, dangerous rotations of second year out of the way right out of the gate. By dangerous I don't mean the rotation is performing prostate exams on sky-divers. I mean the well-being of pregnant women and unborn children at Tacoma General will depend primarily on little old me every fourth night all of July and August. Translation: every single delivery, tragedy, ER case, c-section, pre-eclamptic seizure, preterm labor rule-out, everything, anything, that could possibly happen to anyone pregnant at Tacoma General is my responsibility. There are exceptions for private doctor's patients but, really, until that private doc comes in from, say, Gig Harbor, to see his or her patient I'm the back-up. Also, it is true that there will be at least two attendings available to help me. At least one of them in-house. And there is another resident in the hospital doing night float that I can call for help in dire situations. Despite all that, I can't help but feel that this is a risky way to go about bringing life into this world. However, it's not my call and it's been done like this for a long time without any truly adverse events (that I know about). I'll be sure to let you all know what it's really like when I'm in the thick of it.

As for the two months before that. These remaining 7-ish weeks of internship I will be rotating on in-patient pediatrics. I think the last time I did that was October of 2005. So wish me luck on that.

The bad thing about this stretch is that I will not be able to take advantage of the NW's supposedly gorgeous summer - the reward we get for enduring the abysmal weather of the last 6-7 months. The silver lining is that at least in my 80 hour weeks I will get to still see some daylight. Even if it's just during my trip from hospital to bed. The other silverer lining (wordsmith = Liz) is that the dreaded two consecutive months of R2 OB will be o.v.e.r. and I will begin to have a better idea if I want to pursue OB as part of my future practice. (photo I took of tree in Wright's Park).

I feel like I should include a brief summary of my vacation. It was rather nice. I got to see lots of friends, spend some QT with family and even got to finish reading a book. I went for a few runs in a park, walked around Detroit (took photo at left of Spirit of Detroit), saw a ball game, and spent part of a day in Grand Rapids and ate awesome Indian food at a friend of a friend's Hindu celebration/ceremony. I relaxed, I rested, I ate a TON of ice cream. It was good and I actually feel pretty refreshed (despite the nasty cold I caught somewhere along the way).

25 months to go, but who's counting

2008-04-30T07:45:00.006+07:00

I have 25 months left of residency. That is, 761 days. Approximately. I would make little hash marks on my wall but I might lose my deposit.

The last couple weeks were eventful. In addition to working I managed to sacrifice a lot of sleep to go and have some fun. I saw Ani Difranco in concert at The Moore in Seattle (great venue!). My friend knew her bassist so we got backstage passes and hung out with him after the show. He was a Wesleyan-o-phile so we had lots to talk about! I've scanned our cool backstage passes that had Ani's label logo on it (Righteous Babe records).

I also participated in Dining Out for Life - a fundraising effort where restaurants donate proceeds to HIV/AIDS foundations (nearly 70 restaurants in Tacoma participated and donated 25% of the check). I went out for sit-down Greek (a differentiation they make here since most Greek seems to be take out). I have to say I was actually disappointed. The saganaki wasn't really cooked, just kinda warm around the edges, the grape leaves looked sad, and my veggie Moussaka was kinda tasteless. But the pastry at the end was fabulous. Hard to mess up filo dough and custard, but I could be wrong. It made me miss good, real, Greek food from Greek Town in Detroit!

I also traveled to Seattle for a two-day course for life support certification in obstetrics required for my practice. It was over the weekend which was admittedly lame, but in Seattle which was great. I really loved my time in Seattle. It was so nice seeing cars with liberal bumper stickers, the occasional Jewish star here or there, young alternative rocker couples, gay and straight, with their babies, people commuting on bikes, rollerblades and kayaks (yes, commuting by kayak!). I am ashamed to admit I was depressed coming back to Tacoma. People here are very quiet about their political beliefs, education, Judiasm and sexual orientation. Which is great for them, and I totally respect, but it means that we can't identify each other and things feel very homogeneous in a way that certainly doesn't include any religious, sexual or political minority (or political majority as the case may be). I felt like I fit in in Seattle. It was really a nice feeling and one I kind of forgot about. Now that I remember that feeling, not having it is making me feel restless and irritable.

Next week I return to Motown for my last vacation of intern year. The first half will be in Walled Lake (more or less), the second in Detroit (more or less) and my plans involve a Tiger's game (vs. Red Socks if I'm not mistaken), a rock concert (the Kills !!) at the ever-awesome Magic Stick, catching up with friends and family, and hopefully sleeping a lot and relieving stress as opposed to creating it!

Pre-Pesach Preparations

2008-04-20T07:01:00.006+07:00

Happy Passover everyone. If you all remember last time I posted about Passover it was an eventful holiday where, among other exciting activities, a 58-year-old Psychiatrist and I battled it out for the Afikomen and its $2 prize. This time around, like every holiday so far in residency, I am on my own. But I did a little research online and found a surprising number of Seders in the area. Most required advanced tickets (yes, tickets!) so with my late notice there were only a few still taking Passover Orphans like myself (to steal a term from my sister). I will be heading to Seattle for what sounds like a potentially exciting event, and at the very least, it sounds blog-worthy. The organization holding it is the Kadima Reconstructionist Community. Here's part of their passover flier (photo, by the way, of some plague finger puppets!):

It respects tradition while making the story of Passover accessible and meaningful for modern Jews who want and need inspiration while working for a just and peaceful world. Interweaving song, inspiration from our own and other's histories of standing up for justice, and appreciation of the crucial role of women in our liberation, a Kadima Seder is refreshingly relevant and empowering.

In sum, it seems to be a girl-power, activist, singing Seder. Sounds cool, n'est pas?

For the event (potluck for most food, the Kadima Community will be providing the traditional stuffs) I made a ton of my carrot soup. In fact, I made so much, it got a life of its own and started terrorizing the locals. See photo below:
And for some serious passover fun you can learn about the 10 plagues via a peep show. No... not that kind of peep show, the little marshmallow kind of peeps! It's quite awesome, I must say. Click here if you know what's good for you.

Seasons Change

2008-04-15T21:33:00.004+07:00

"Winter":

"Spring" (view from my living room couch) or, "Why I don't watch so much TV":

And of course, there's Mt. Rainier. Looming like a ghost over Tacoma. This picture was taken a block from my apartment after walking back from the Daffodil Parade.

Today it is about as dreary as it comes, no rain yet no sucker holes to be found (sucker holes: the blue patches of sky that fool you into thinking it might clear up).

I should leave for Madigan soon. Go hang out and maybe get to cast some broken bones today. It's so hard to get motivated when the sun isn't shining, I have to admit. Although, it's also hard to be cooped up inside working when the sun is shining. Such a dilemma. This week I have the usual out-patient workload with an additional trip up to UW to teach first and second year medical students about joint exams. I apparently have been assigned the ankle, that mysterious complicated joint. The foot and ankle combined have: 26 bones, 33 joints, more than 100 muscles, tendons, ligaments, and of course all the blood vessels, nerves, skin, and soft tissue. The ankle itself is really just four of those bones (hooray for me and the medstudents who have to learn from me!) but there are still lots of tendons, ligaments and muscles to go over. If I had to pick a favorite joint I'd have to pick the knee. Sure, it's popular, sure it's sexy. Perhaps it's like a 14 year old saying Orlando Bloom is her favorite actor. But I still think it's a great joint. I won't wax poetic about it, but it is a rather fun joint to examine. Unfortunately, when joints go bad, there's not a lot we can do that works. We can inject, scope, do physical therapy, and with some joints (really, only the knee and hip) we can replace. But, in the end, there is no replacement that's as good as the original (case in point: Julia Ormond is fine but she was no Audrey Hepburn in the Sabrina re-make).