Since my birthday usually falls so close to Thanksgiving, my friend Susan and her family usually come up to celebrate the two together. For the last two years, this has meant yummy pumpkin pie and the opera on Saturday night, two of my favorite things. I’ve added an additional element this year:

I’m throwing myself a tea party! I’ve been browsing recipes all week for the perfect scones and sandwiches to make (they are so pretty and dainty!). I found blank note cards that, while slightly more modern that what I was looking for, were simple and elegant (aren’t they charming?). I almost went out and bought another 6 serving set of my white dishes so that everything would match, before talking myself out of that! (I have more dinnerware than you can imagine. But I lack a complete set of silverware and just have a collection borrowed from my many roommates over the years.) I did find a three tier plate holder perfect for holding all of the edibles. And I can’t wait to find some fall flowers to decorate with! I only drink herbal teas, but I have 3 different types of rooibos teas and chamomile tea, as well as hot chocolate to serve, and I might go down to the local tea store and find another.

Have any of you held a proper afternoon tea? Any recipe or decorating ideas?

Remember that parable about how if you carry a calf every day, pretty soon, you’d find that you could lift a full grown cow?

Residency is like that, I think. Because I’ve been doing this for so long, I can do things now without thinking about them. I just stuck a needle in my patient’s back (a spinal tap or lumbar puncture). At first I hit bone, but then, because I’ve done so many of these, I knew where to reposition and guide it through the ligaments into the subdural space. Champagne tap.

I got criticized last night by the fellow for giving tPA to the patient I mentioned, because patient had complications right afterwards, which didn’t show up on imaging and obviously, I had missed the diagnosis. My attending this morning criticized me for not arguing more, because, in his opinion, I was right. I didn’t have enough confidence (always a problem) in my thinking and honestly, you can’t convince this particular fellow of anything.

The cow named Residency and I need to do some more bench presses together. That’s okay. We’ve got another year and a half together.

(Obviously this was composed way too late at night and my metaphors and similes are rather poor).

I told Dr. L today that I’m doing critical care. I’ve worshiped him since I was an intern (some of the starry-eye devotion has faded as he became more human, but I still adore), so his opinion has been very important to me. He’s excited for me. I think if I want to stay here, I should have a position, which is a comfortable sort of feeling. Now if I could just get up the courage to ask for letters of recommendation.

My research project has stalled, because, as always, when I did the literature search, I found that all of my ideas have already been researched to death and I can’t come up with any cool spin on it. Lovely. Have I mentioned that I hate research?

I was going to share about my little flirtations with the cafeteria cook (we’re on first name basis now!) and how one of my favorite nurses just informed me that he could walk through paper and then proceeded to perform the lame magic trick. But I am tired and want to sleep. So I’ll just leave you with the little tidbits. 🙂

I gave tPA for the first time ever today. I can not tell you how many strokes/nonstrokes/pretend strokes/the-ER-docs-really-thought-this-was -a-stroke???? that I have seen during my (very long) residency, but this is the first stroke that I’ve had who came to the ER in less than 3 hours and who had no exclusive criteria (there are many) and who didn’t decide to wake up from their drug-induced state of mind just as I was pushing it (idiot. Please do not deny your illicit habits to the one who could kill you!). I was shaking a little, and forgot to unclamp the IV, but it all went okay.

Of course, patient is ancient and crashed an hour after I gave it (unrelated reasons, I think) and I don’t know if [patient] will make it home. But I gave pt a chance–without it, this spunky person would have been bound to a nursing home or wheelchair in the best of situations.

On call again tomorrow. I’m rounding in the ICU tomorrow and have to be there in a short 7 hours from now. So I guess it’s off to bed. Last call for the month, I’m so super excited!

I didn’t leave the hospital today until almost three o’clock, trying to figure everybody out and make sure that everything was ordered, discharging patients (inherited 18 patients today, discharged 8. Not too bad!). I then slept and slept and slept and if my stomach hadn’t awoken me unhappy about its prolonged fast, I might have slept until morning.

I have realized, again, how much I truly despise the attending on the team. I haven’t worked with him since I was a junior resident, but at that time, he told me (in front of a patient and his family) that I was an incompetent, lazy physician, who didn’t know how to take a history and couldn’t do a physical exam. Haven’t felt the love since then. He hasn’t changed. He chewed my interns and I out for admitting 2 patients, for not getting all of the details of the history on another (even after reviewing the chart 5 times, I still don’t know why such-and-such was done, so getting more details is impossible!) and so forth. He’s a big time researcher, and brings a lot of grants and money to the department, but I wish that he would stop doing inpatient rounds. He obviously hates it, and the rest of us don’t benefit either.

My social workers and case manager are bringing me pumpkin bread tomorrow, because I’m being such a good sport about covering all of the teams. So there are bright spots. 🙂

And now back to bed.

I’m exhausted. I stayed up late finishing all of my cooking projects (butternut squash soup, black bean soup, steaming asparagus, and then roasting the remainder of the butternut squash) and then decided that I really should be good and get the dishes done as well. Which I did, but it meant that I didn’t get to bed until almost 1 am.

I’m on call tonight. Starting tomorrow, I volunteered to cover for the stroke team, as their senior had a conference in Florida (yeah, I’m sure she’ll be going to all of the meetings!), so I get to round on those patients tomorrow (post-call exhaustion and a new team – best combination ever), plus my seizure team. Then on Friday, the general neurology resident is gone as well, so I cover for them as well. And then I’m on call again on Saturday. If I could just get a nap…

Or, I could go down to the ER to see another patient. Yeah, I guess it’s going to be option #2.

(ETA: 11/12: This didn’t crosspost to LJ last night. I keep forgetting that the hospital blocks the application.)

This was the poem for The Writer’s Almanac today. I’ve been tasting it in the back of my mind all day.

Dancing

by Margaret Atwood

It was my father taught my mother
how to dance.
I never knew that.
I thought it was the other way.
Ballroom was their style,
a graceful twirling,
curved arms and fancy footwork,
a green-eyed radio.

There is always more than you know.
There are always boxes
put away in the cellar,
worn shoes and cherished pictures,
notes you find later,
sheet music you can’t play.

A woman came on Wednesdays
with tapes of waltzes.
She tried to make him shuffle
around the floor with her.
She said it would be good for him.
He didn’t want to.

“Dancing” by Margaret Atwood, from Morning in the Burned House. Houghton Mifflin, 1995.

A recipe that I made tonight that was super yummy

So, how was your day?

On Saturday, as you now, I raked and raked and raked leaves. Then, after church yesterday, I came back home and raked leaves in the dark for another half hour. My lower back and shoulder was not happy with me. By the evening, they were both loudly protesting my mistreatment of them.

I could barely walk this morning. Acutally it was more the twisting out of bed that killed me. Once I started moving, it got better, but I couldn’t bend over or twist. Let’s not talk about the agony of getting up out of a chair.

I went to work to find that we, blessedly and blissfully, had a light service (I should know, I spent all of my time discharging them yesterday!) with no scheduled admissions, so I went home at noon, took some anti-inflammatory meds, and slept. I’m still in pain, mostly if I sit on the couch (hmm…), but it’s a little better. It’s so lovely to have an afternoon off, especially one where the sun was shiny (albeit briefly) and it’s 60 degrees outside. I just wish that I could have been able to put it to good use: done dishes or laundry or gone for a walk.

I hadn’t finished with all of my leaves (the joy of having 4 trees on my property!), but my friend, who really is one of the nicest people I know (even if she does fall prey to fad diets), came over this afternoon and finished raking them all to the street. There’s still some lingering leaves on the tree and some around my raspberry bush that if I feel especially motivated (and pain free!) later this week that I might try to collect, but oh, what a relief to not have to worry about this!

Website of the day: SparkPeople.com

Last night I was talking to a friend of mine who told me that while she was at home, she went on the “hCG Diet.” For those of you not in the know, this diet includes taking hCG (human chorionic gonadotropin is a protein that is produced by the uterus during pregnancy) and limiting one’s diet to 500 calories. She proudly stated that she had lost 15 pounds while she was at home (she gained 8 of it back within a week of stopping). I stared at her. She’s a physician-in-training and she is falling prey to these fad diets; it’s no wonder why the average overweight American desperate for an easy answer does the same (it also explains why I wasn’t surprised to see her Facebook status linking impending doom and gloom and (horrors!) socialized medicine because of the new legislature that was just passed. But that’s another blogging entry, which is coming up later this week, I think). I thought that we were past the days of severe, weird diets* (the grapefruit diet, anyone? The Juice diet? FenPhen?) and realized that the only way to lose weight was hard work: exercise, calorie restriction (there are still debates as to whether this means carbohydrates or fat. I’m a believer that it’s a little of both) and patience.

Confession: Four years ago, I woke up, stepped on the scale and realized that I had gone from being overweight in the BMI (body mass index) to obese. Not only that, I was severely out of shape, huffing and puffing and couldn’t keep up with my much more lean and well-build friend, Mr Ironman Chris. I monitored my calories, got a gym membership and worked out on a daily basis for 3 months and lost 15 pounds. Then the rest of third year med school happened. The exercise dwindled as I didn’t have time. I stopped bringing a lunch, because the hospitals provided free lunches of yummy noodles or Chinese food. By the end of the year, I had gained all of that weight back. And then a couple pounds more. And a couple more.

And then residency happened. Residency, where my free time was cut to next to nil, where my on-call food choices included chicken tenders or a beef wellington, where I learned to snarf down a meal in 3 minutes flat, because that was all the time I could spare. Not to mention the snacking: candy, chips, crackers, orange juice, etc, all used to keep me awake. I gained ten pounds my intern year. Last winter I hit my peak. 184 pounds. I can’t tell you how miserable I was. Due to the fact that I was sick the entire month of January, I managed to lose a little of the weight and slowly over the year, dropped a couple more.

I found a link browsing through an LJ community to a website where you could calculate the number of calories in any recipe. I was intrigued and started browsing around and was thus introduced to SparkPeople.com. I’m going to sound like a testimonial (and maybe even a Saturday afternoon infomercial), I apologize in advance, but I do realize that I have many friends out there who struggle with the weight and other friends who may be looking at just becoming more healthy all around.

Sparkpeople.com advertises itself as a “healthy-living” community and I think it lives up to its name. They have numerous articles about health, nutrition, exercise, that as far as I can see, are based on sound research and principles. There’s a nutrition tracker, where you can enter in the foods that you’ve eaten for the day, and it breaks it down into the calories, protein, fat, and carbohydrates consumed (not to mention the 20 other nutrients that you can track). I love seeing the breakdown at the end of the day of where I met my goals, and where I went over (or under). Their diet is a lower-calorie diet, but one based on age and base metabolic rate (and one that you could adjust to your particular wants/desires) and created by a registered dietician. If you want, they provide a complete meal plan for the week with ingredients and recipes. You can track your exercise and find out exactly how many calories you consumed raking leaves for example.

The best part, I think, is their very active online community. This week, I joined a holiday weight-loss challenge ala The Biggest Loser and have already met a woman who’s doing a neurology residency as well. I also found a Lord of the Rings group, where their challenge was to “Walk to Rivendell” which got me excited to get on my elliptical.

My only beef about the site is that each time you click on a link, it opens a new window. And I wish it was more like a LJ community, as I don’t like message boards much. But I guess those are minor inconveniences to live with.

I’ve been a part of the group for about two months. The first month, I just explored, the second month I started recording everything I ate. I bought a new scale, a new lunchbox (which I’ve since lost but hope to find in the lost-and-found) and a little pedometer to help keep track. I’ve lost a couple of pounds and am now ten pounds lighter than I was a year ago. I flub on the diet (Halloween is a evil holiday, which has nothing to do with demons) and could definitely do better on the exercise portion, as I’m still a slug and have a hard time motivating myself to get up once I’ve planted roots on the couch after work. But I’m learning more about myself and making small changes and seeing small rewards.

Part of the reason that I’m confessing this is because I need support. I need people to say “so, how’s those lifestyle changes going?” “what’s the weight loss this week?” and keep me on target, especially during the holidays. My ultimate weight loss goal is fairly modest, 30 pounds, which will put me right on the cusp of normal weight/overweight and is a goal that I think is reachable. I do have one reward in mind, if I make my goal: the Nikon 35mm f1.8G af-s lens. I’ve been admiring this baby for months now. I’m hopeful that by June, it’ll be mine.

How about you? Are you making any life-style changes? Is there anything that motivates you to become more healthy?

*I guess I’m not that surprised. I had a patient ask me for a prescription for amphetamine for weight loss a couple of months ago. She didn’t understand why I said no.

I had hoped to persuade everybody into thinking that I had just turned over a new leaf and decided to get back into the blogging/journaling habit. Which I did, but with a little motivation from signing up to do the National Blog Posting Month. I had so much fun doing it last year and as I never have enough time/inspiration to do Nanowrimo (one day, when I’ve finally am done with all of the training – meaning when I retire when I’m 88 – I’m going to take November off and do it. One day….), this seemed like a good compromise. You all will be very bored of me come November 30th, but I do enjoy the creative outlet that this provides. I’ve really gotten out of the habit of blogging and it requires a lot of thought and effort to come up with something new to say every day.

***

Speaking of leaves, this is my hand

after raking for 2 hours this afternoon and I’m not even finished yet. I left a smallish pile on my front lawn, a larger pile near by side door and I still have to go back over the lawn to gather all of the residue which will probably equal another large pile. Right now, I hate trees. Especially maple trees that are persistently holding onto leaves and refusing to give into peer pressure, which means, if it doesn’t snow, I’ll have to rake again. My parents suggested hiring somebody to help me out. I’m considering it, except that I calculated the number of calories consumed: 590 calories. Maybe the blisters are worth it.

From the LJ writer’s block:

What is your all-time favorite, romantic movie scene? What about it speaks to you?

This was a doozy! I thought and contemplated. My answer changes with mood, I think. I have a list of favorite movies and scenes that I watch over and over for the butterfly feeling and on a given day, I might tell you a different answer as to what is my all-time favorite. North & South, with its tender moment of reunion and forgiveness? Anne of Green Gables? “All I want is you.” Persuasion with its reunion of two separated lovers? I browsed through the archived answers of other LJ users. First choice seems to be Titanic. Second choice was a tie between Notting Hill (I hated that movie), Love Actually (I’ve never seen it, but I’ve heard its good) or Casablanca (a very fine choice).

I looked through my own DVD collection. Besides my X-Files box sets, my DVDs are, surprising to no one, mostly period dramas and romantic comedies. Then my eyes alighted on today’s answer. Big Fish. Of course. I had to do a (very small) picspam (my first!), which took me all night.

SANDRA: Daffodils?
EDWARD: They’re your favorite flower.
SANDRA: How did you get so many?
EDWARD: I called everywhere in five states and explained this was the only way I could get my wife to marry me.
SANDRA: You don’t even know me.
EDWARD: I have the rest of my life to find out.

EDWARD: I was drying out.
SANDRA: I see. We need to get you one of those plant misters. We can spray you like a fern.

EDWARD: Come now.
SANDRA: I don’t think I’ll ever dry out.

I love the surreal, colorful fantasy that he spins when telling the story of how he fell in love with his wife, contrasted to the reality of decades of life together. Not a kiss to be seen, but I honestly can’t think of anything more romantic.

What about you? What’s your vote for the all-time romantic movie scene?

I’ve definitely mentioned this before, but I have the greatest group of friends from college ever. It’s been almost 13 years since I met them and the whole group of us (The Plethora) are as close as family. I’ve been there when they dated, married, finished school, started careers, had kids, who grew up and learned to read (geez). Having a Plethora reunion is as important when I go home as visiting my grandparents because I’ve missed being around them so much.

About a month ago, somebody brought up the idea of a road trip. We toyed with going to California or to Yellowstone, but decided that the drive was too long. (Did I mention the kids? The probably 15-18 kids that would be coming? Crazy). Tonight we decided: Durango, CO in July. Mountains, Mesa Verde and Anasazi ruins, Telluride. Sounds like heaven. Even with 15 kids either screaming or asking “are we there yet? I need to use the bathroom” the entire ride there.

I have to figure out some logistics such as flying to Denver or to SLC and how much time can I take off. And we’re still looking for vacation home rentals (so if any one has any hookups, let me know) and other monetary details.

Anybody ever been there before? Suggestions, recommendations for places to stay, see, eat? Survival tips for the spinster who is afraid that the trip will turn into a variation of “get off my lawn, you mangy kids”?

I’m so excited!

(Written earlier. I fell asleep.)

I’m not a fan of sleep-deprived nights. The last six hours when you’re just endlessly discussing patients and writing notes and ordering studies are the most painful, torturous time imaginable.

But there are some nice perks to having a post-call day. Especially one where you got sleep the night before (in bed by 1 am, slept until 7:30 with no pages. Excellent) and when your coresident is willing to cover your patients for the morning, which means you can leave before 9 am.

1. The post-call nap. Depending on how much sleep I’ve gotten, this ranges from an afternoon doze to an 18 hour passout when I only wake up because bodily functions demand it. But there’s something so wonderful of sliding in between sheets and snuggling into blankets when the sun is filtered through the blinds.

2. Brushing teeth. 30+ hours without brushing your teeth leaves an extremely grimy sensation and horrible breath. My electric toothbrush takes that all away and leaves me clean and shiny.

3. Turning off my pager and shoving it under piles so I don’t hear it.

4. Being away from the hospital for 18 hours.

5. Breakfast. Historically, I used to treat myself to waffles with strawberries and real whipped cream. Now I usually go for a omelet with spinach and mushrooms. But if I’m really really lucky, the cafeteria will serve cream of wheat and I’ll load it with brown sugar, raisins and strawberries. Mmmm.

I wish I could say that I was productive on my post-call days. But I’m not. As I stepped out of the hospital this morning, I contemplated finding a fancy stationery store, raking my leaves (but thank you rain for making that impossible!), doing dishes, etc. I researched afternoon tea parties and went to bed instead. I may do dishes later tonight, but that’s it. I honestly don’t know how my friends with kids do it, as they have all of this demand on their time when they go home and they’re lucky to get a nap in.

Random recommendation: White Collar on USA is a fun show. I really enjoyed the free download from iTunes. It may get me watching tv again (how weird would that be?). Did anybody check out V?

I know that this made the rounds on Facebook a few weeks ago, but it still makes me happy. 🙂

After my previous post of the Sound of Music and now this, can anyone doubt my love of synchronized dancing? Are there any other good ones out there? I wonder why I don’t know synchronized swimming as much?

I’m on call tonight. (2 more this month, yay!) One subarachnoid hemorrhage that I helped the poor little intern manage (first call nights on neuro are beastly) and another TIA, so not a bad night. One of my friends surprised me with cookies earlier this evening: warm, buttery, chocolate chip cookies. Definitely not good for my diet, but so yummy it may just be worth it. I may just have to go to bed with a glass of milk and cookies!

I was on call on Halloween (which surprisingly, for a Saturday call wasn’t too bad), so I missed out on most of the festivities. I haven’t been able to pass out candy ever to the little trick-or-treaters, not because I’m on call every October 31st, but because the city off Milwaukee designates a Sunday from 1 to 4 pm as official Trick or Treating time (how utterly lame).  Luckily, my church had their Halloween party on Friday, so I still got to celebrate the holiday of sweets. It was still a juggling act, because Chris and Gretchen flew into Milwaukee for the weekend, as they had tickets to the Farve vs Packers smackdown. I met them and Gretchen’s parents at the airport in my costume, we went out for a late dinner and then I left for the party. I almost didn’t go. It was getting late and call is difficult enough without being sleep-deprived. But it was all worth it.

Thanks to spring english country dancing, I had a costume already made. I officially went as Emma Woodhouse, although I don’t think she wore purple in the latest adaption (which, my friends, is completely fantastic and Jonny Lee Miller makes my knees wobble and I can’t stop gushing about it).

There was cotton candy and a costume contest (I lost, boo) and dancing in the garage to Thriller. Good times.

My favorite costume was this:

You can’t tell it from the picture, but she’s Medusa, complete with snakes for hair and eyes that turn you to stone. Awesome.

Full pictures, as always, are on my Picasa page here

I went to a hockey game last weekend between the Manitoba Moose (Meese! aww!) and the Milwaukee Admirals. As it was my first hockey game ever, this was a new and exciting experience! There was a pirate ship and everything!

And a pirate A Capella group that sang the national anthem and a ballad at half-time (probably not the best choice given the audience)

I’m not sure that hockey is my type of game. I couldn’t figure out why they kept exchanging players after only 1 minute of playing (anybody know?). They spent more time climbing over the bench than actually playing.

(Save, goalie, goalie, goalie!)

And the fans are weird too. They take hating the referee to a whole new level and shout things in unison at the announcer. There were two fight, which sent the crowd into ecstasy, even more so than scoring a goal.

In true Wisconsin fashion, there was a two-third-time (what do you call the break if you have three periods?) race by food products, this time cheese:

My favorite part was the PeeWee game during one-third-time where the little tots came out and mostly fell trying to hit the puck. I don’t think anybody scored, but they sure had a lot of fun.

We won the game in overtime (which was NOT the sudden death shoot out that I thought it would be) 2-1. Yay!

It did put me in the mood to watch my favorite movie when I was thirteen: The Mighty Ducks, which can be found, in very poor quality on youtube. Rewatching it as an adult confirmed that it was not as wonderful as I remembered (oh the stilted dialogue!), I may have to start watching Fringe because I still think Joshua Jackson is awesome (even if his prepubescent haircut is absurd), and the Admirals game would have been even better if they had performed “The Flying V.” Maybe next time… 🙂

I met with Dr. W, my neurology program director, for my semi-annual review today. As Dr. F, the internal med director didn’t show up, and I’ve been in near constant contact with Dr. W over this “remediating” situation, it wasn’t quite as nerve-racking as usual. They’re still not planning on kicking me out, so I’ve got another 6 months to breath easily.

He did ask me, point blank, what my “end of residency plans were” and I admitted that I’ve been struggling with that very decision, trying to make up my mind. I feel like I’ve been wrestling with it since starting residency. Unfortunately, as applications for fellowships are due in just a few short months, I can’t afford to be indecisive for much longer.

Was I interested in multiple sclerosis? He probed.
No.
Dementia?
No.
Movement disorders?
Neuromuscular diseases and doing EMG and muscle/nerve biopsies?
Epilepsy and electroencephalograms?
Headaches?
No. No. No. So much no.
Having a continuity clinic and seeing general neurology or medical patients?
No!
And critical care?

Critical care? I love critical care. I love the patients. I love the systematic approach to complex medical decisions. I love the procedures. I love/hate that moment when the patient arrives sicksicksick and I’m terrified of how I’m going to mess this up…and then take the deep breath in and just listen to the lungs and heart while I figure out what to do. I love having the family meetings and helping people figure out what their loved ones would want, arriving at “good deaths” if necessary.

But. But. I can see myself as happy as a hospitalist or maybe working as a stroke attending. I can. And I could do that without any extra training.

My attending laughed at me by this point. Dude, he said (and yes he did say dude), You have to go into critical care and you know it. He basically parroted back everything that I had said… and he was completely right. I’ve been trying to convince myself to do critical care, (honestly since third year of medical school), but truly, I’ve been looking for excuses not to do it… and really haven’t come up with any. Except that I don’t want to go through the application process again (which, since I have to eventually apply for a job, is logically ridiculous) and that fact that I’m not nearly competitive enough. My CV (curriculum vitae or resumé) right now reads that I’m doing residency and not much else.

Dr. W. gave me some fabulous ideas of how to enrich my CV, including talking to some of my favorite attendings for letters of recommendation, and research ideas that I’m much more interested in, such as quality of life measurements and how we communicate with families. Exactly the type of stuff that I’m interested in.

So I have a plan. I’m emailing Dr. J and Dr. BFF for assistance and ideas on the research projects. I’m talking to Dr. N, Dr. L and Dr. H about letters of recommendation. I’m getting a list of good programs which to apply from my classmates.

And I’m applying for fellowship.

Every month, I switch rotations. As an intern, those switches occurred on the first of the month; as a resident, I now switch on the 28th. Just like I  think of the year starting and stopping on July 1st, I have a tendency to think of my months as only have 28 days. I mistakenly assume that I should get a paycheck on the 28th and have often planned for that, leaving me a bit in a lurch for those last couple of days (not good).

So, my October starts tomorrow. I switch from the relatively benign rheumatology (rheumaholiday as it were) rotation, where I had clinics every day and every weekend off, to the inpatient stroke team. I knew it was going to be a rough month. I hate switching from the medicine department (where I’ve spent the last 3 months) to the neuro department (where I’ll be spending the next 4) – I haven’t done neuro for several months, I find neuro to be more challenging and difficult intellectually, and the services can be overwhelmingly busy as there are no caps to admissions and we are constantly admitting and discharging patients. To say that I’ve been not looking forward to this would be an understatement.

A couple of weeks ago, my program director approached me and stated that they were having problems with one of the junior residents. He didn’t know enough, he couldn’t be trusted to do an accurate exam, he had problems with managing more than 2 patients, he’s lazy, etc, etc, etc. In the end, they decided to hold him back a month and guess who gets to inherit the problem child and attempt to remediate him? *sigh* I spent an hour getting sign-out tonight from the current senior and wow, it sounds like a disaster. Hopefully, I’ll be able to meet with him tomorrow and establish some rules.

I was going to go into a whole rant about how I think this stems from whom my program director is recruiting and accepting into the residency, but it’s getting late, and I need to be in to work early tomorrow.

So instead, I’ll leave you with the latest pic (that I’ve gotten. The parents have been lax about getting them posted!) of my nephew:

Laura’s threatening that his hair isn’t as red as I was told. I think she just needs to eat more carrots. *nods* That’s how I got my red hair, my mom told me.

I’ve got a dozen nicknames that I respond to. Today, I just added one more*.

Meet Carden James, everybody. He arrived to this world sometime this afternoon weighing 6 pounds and 14 ounces and he already loves his Aunt Julia so much, he’s got her red hair fuzz.

Carden James

Isn’t he beautiful? I have a theory that the stork has given up hope of my body producing red-headed babies (me too, storkie, me too) and is giving them away to all of my family and friends. No matter, I’m willing to share!

Congrats to my beautiful little sister, Laura and her husband Josh. Laura had the easiest pregnancy ever. No morning sickness. Able to going running every other day until right before he was born. 1.5 pounds of weight gain (only slightly kidding on that one!). I haven’t heard the details, but I’m assuming that it was the easiest delivery ever, as I got the call about Laura being in labor and the text that he was here only 10 minutes apart. Totally not fair.

I’m totally in love.

*I’ve been Aunt Julia to all of my friends’ kids, but this is the first time biologically.

I think Susan’s convinced that I am a flirt. A flirt! Me! I think she mistakes my honest, winsome, cherry, wouldn’t-mind-if-you-come-hither smile for flirting. Most of the men with whom we interacted today were married anyhow. Cute, especially the eager fellow at the chicken raising lecture we attended, but married. Now give me a single guy and maybe, maybe, I might turn on a beguiling smile, but that’s my limits. 😀

Alas, the International Cheese Curling Contest was canceled due to rain. By the time we arrived, the cheese eating contest had finished as well (despite being advertised to last all afternoon and evening) and there was no inflatable cheese maze either. Illinoisans are weak, as it was only mild drizzle. Bah. We did look at the typical tents and booths that seem to follow these fairs/festivals (“homemade” flower wreaths and various trinkets and the lemonade/hotdog stands). There was free cheese and bread samples at one of the stores (imported from Michigan) and I ended up with a delectable dill Havarti to bring home. Yummy.

We went on a carriage ride, driven by one of the local Amish. Our driver was our age and super adorable. It was fun flirting (okay, I’ll plead guilty about him) with him. He hinted that he would like to get away, go to the west… I almost took him up on it, but Suz was convinced that he was probably married with three or four kids. Such is my luck, she was probably right. Drat.

We had a picnic (or “micnic” as Alice likes to call it) under the tents of the deserted cheese-eating contest of fried chicken, potato salad, brownies, peach angel food cake and cookies – rule number for a potluck: everybody thinks to bring the dessert. The little kids ran around in the rain, jumping in puddles. All in all, despite not getting to sweep a broom in front of a stone of cheese, it was a pretty fantastic day.

From Arthur Cheese Festival

Vacation has officially started. Nine days of bliss. I left my pager at home, freed, finally, from its tether.

The drive through Illinois was gorgeous, clear and sunny, with a breathtaking sunset over fields of corn. The moon was round and cheerful, guiding the rest of my path.

From Illinois Sunset

(Click for a couple more pictures). And now, to sleep. I’ve got to get my beauty rest so that I’m ready for cheese consumption in the morning. Ta!