I got my flu vaccination last week – as a health care provider and one who has gotten the flu before, I get one every year. This year, I went for the nasal mist. I’m working on the consult service, so not in as direct of contact with the immunocompromised patients (those on chemotherapy) and I’m not that fond of shots. Both forms don’t reach full immunity until approximately 2 weeks after and the spray is a little bit of live virus which can make you feel a little ill. I woke up this morning with the sniffles (I initially typed “snuffles” but found out that that is a upper respiratory infection of rabbits and since my name didn’t change to Harvey overnight (oh I kill me), I had to be accurate and change it) and have been feeling just a little less than healthy today – not terrible, not enough to try to go home or even beg for chicken soup, but just bad enough that I think I’m making it an early night.

All About Me Day 5 – A picture of a place where you have been. I really should just remove the “A” from all of the questions and make it plural, because there’s no way I’ll ever be able to limit this to just one.

First stop: Guatemala. March 2004.

Tikal

I went to Antigua, Guatemala to learn medical Spanish. It was a course for intermediate to advance speakers – and I didn’t know a word, but the program agreed to let me go. So at the last minute, I asked for a rush passport (with truly the most terrible passport pic ever. No, believe me, I win), bought a ticket and away I went.

Tina and I, early morning in Tikal

My traveling companion was the unlikely combination of a procrastinating perfectionist. She would always put off doing important things, but then wouldn’t hurry up because everything had to be just so and we were often late. Very late. We almost missed the plane down there. And the plane back up. And the bus from Tikal, etc. It was the first time she had ever left home (except for her mission) and she had to talk to her parents every single night -which mean we missed out on seeing a lot of the city. I was much too nervous to break out on my own and go sight-seeing.

Antigua

We were there for just over three weeks. During the day we went to spanish language lessons or to programs around the city that provided care to the poor and the ill. We visited orphanages, an AIDS clinic, a poor farmer’s hut, a primary school, the mental hospital, a nursing home. The weekends we took trips: up north to Tikal and then to Lake Atilan.

Lake Atilan

Some of the culture was overwhelming. I never got used to the begging of the children, which usually occured only at the tourist sites. When we stepped foot out of a bus or a boat, they would come swarming. I hated haggling prices for souvenirs – I didn’t know the language and I found it frustrating. The food was pretty incredible, though and cheap. And the scenery more than made up for the frustrations.

Learning how to Salsa with Antonio

Tikal ruins

Learning the language was extremely difficult for me. The only language I had attempted to learn was sign language and there was very little cross over (the few months of online German in the 7th grade does not count either). I spent most of the month not knowing what anybody said. I had difficulty with the grammar and the pronunciation – I have a hard enough time with English, you should hear me slaughter drug names!

Admiring silk blankets

So while I came home only knowing how to say about 10 phrases (and I’ve forgotten most of those now), what I gained was an appreciation for a beautiful culture and the desperate need that other countries had. I realized how very spoiled I was by the American culture. I stayed in a middle class home, but even there, the showers were limited, the plumbing was fragile, electricity and food was very carefully utilized.

Colored sand with borders of flowers and fruit arranged in a Catholic cathedral for Semena Santa (Easter) Festival

I know it’s an overused phrase, but I can honestly say that Guatemala changed my life. It opened a thirst to see and experience new cultures and to make a difference.

I think I’m going to extend this over the next couple of days, because I’m am becoming more and more stuffy and my head is aching. Bed sounds really, really good right now.

It’s already interview season, where the neurology department interviews nervous 4th year med students who are eager to find the perfect place for residency. Five years ago, that was me. The best part is always the dinner the night before – we take out all of the applicants to a nice restaurant and spend most of the time catching up with each other. 🙂 Tonight’s dinner included pumpkin cheesecake which brought out Homer SImpson-type salivating.

I was a little miffed at the dinner, as two of the neurology fellows came (it’s supposed to be the residents only) – and one brought his girlfriend. Really? The department is paying for it, and you’re going to turn it into a free date? Scuzzy. Haven’t decided if it’s worth it to rant to the program director yet.

I’m mixing and matching the 30 day memes, because I thought some of the questions on the original one were lame, so I googled for other memes to supplement.

All About Me Meme Day 02 – Where you’d like to be in 10 years.
In 10 years, I will be finally, finally completed with my medical training (I hope), and finally, finally in a real job. Right now, it seems too distant of a hope. Everybody always asks me where I want to end up and the answer is always “I don’t know.” Honestly, I have loved living in the Midwest more that I thought I would. I miss the mountains and the quick easy getaways to nature, but I love this little city and I love the surrounding farms and villages, so there are times when I contemplate coming back. It would be fantastic to be closer to home and be able to see my family and friends more often. I’m missing my nephew growing up, not to mention all of my friends’ kids. My grandparents are getting older and frailer. When I interviewed at Portland, I could easily see myself settling there – the fellowship program was too weak for training, but as a job once I was done: pure heaven.

I do hope that I have a life where I’ll have some free time so that I can become involved in all of the little hobbies that were dropped once I started med school: some painting and writing. I’d love to be involved in community theater and take some real photography courses. I’m also hoping for enough flexibility that I can do some international work; while I no longer have the burning desire to flee to another country for several years, I think that spending 1-3 months at a time in needy areas would be more my style.

HP Meme Day 2: Your favorite movie.
I don’t have one – they provide a couple of hours of entertainment and that’s about it. The first two movies were just glorified picture books. The third spent so much time concentrating on floating leaves for “atmosphere” that there wasn’t enough time to explain anything. The fourth had the needlessly long first task and then skimmed over the return of Voldemort. The fifth: okay, I loved Luna and Umbridge, but I only saw it once. The sixth: the fire at the Burrow, Ginny tying Harry’s shoes, Ginny feeding Harry food – yeah, haven’t seen it again either. It’s not that I’ve hated them, but as they came out at the same time as Lord of the Rings, which besides the murdering of Faramir’s character, was the most perfect adaption of a book that I have ever seen, I have been disappointed. I AM looking forward to Deathly Hallows – it looks awesome. But not awesome enough to get midnight viewing tickets.

So, um, posting every day is really hard. Especially when you’re out of practice blogging and the most exciting thing going on in your life is the fact that you forgot you had an early morning meeting AND your parking badge didn’t work, making you really, really, really late.

So, I’m making it easier by doing a couple of 30 day memes that were floating around the interwebs a few months ago.

Snagged from claidheamhmor : 30 days of me:
Day 01- A recent picture of you and 15 interesting facts about yourself

This is a couple of months old, but I really like it:

Broke that board with one blow, yo.

Facts about me:
1. I am unable to tie shoes properly. I learned the “bunny ears” method when I was 4 and any other way feels wrong to me. I can do a mean surgeon’s knot, now, thanks to the hours spent tying threads as a med student. I prefer an instrument tie- it just feels tighter to me.
2. I wrote a limerick collection to memorize the brachial plexus in med school. It was fabulous. I just found it again tonight while looking for an old “25 Things about me” meme that I started and never finished two years ago. Look for it tomorrow. Be prepared to be astonished (in all definitions of the word!).
3. It’s taken several years, but for the most part, I’m okay with the fact that I probably won’t ever get married. I’ve wanted to be in a relationship since I was a teenager, but it’s only been in the last 2-3 years that I think that I could be a good partner, but I also know that it’s not very likely. At least not until I’m 60-70. I’ve got great teeth and I expect to be quite the hit in the nursing home.
4. I’m a road trip junkie and want to see every state of the USA. I’ve got 16 to go, all of them in the south, except for Delaware and Maine. I’ve been within 20 miles of both of those states, but still couldn’t manage to cross the line. I’d love to take a Yay! Residency’s Over!! trip this summer and see the rest of them, but since I’ll be spending a fortune moving, that’s not the wisest decision.
5. I still want to do international work, once I’m done with residency/fellowship. But the thought of doing it alone without friends makes me really nervous.
6. I used to read voraciously and was probably the only kid who was ever forbidden to go to the library by their mother. Now, I read about 5 books a year if I’m lucky. The last series of books I read was The Hunger Games Triology. I chewed through them during my flights back and forth from SF: incredibly good.
7. I have a genetic bone disorder called Hereditary Osteochondromatosis. I’ve had 10 surgeries so far, with scars that crisscross my knees, shoulder blades and hip. The most obvious deformity is my shortened R ring finger – its just about the same size as my pinky. Most people don’t notice it. Because it’s short I tend to type with just my index and middle finger on my right hand.
8. My feet are horribly ticklish. The one and only time I got a pedicure was the most tortuous experience of my entire life. I don’t care how thick my callouses become–never again!
9. I can’t fall asleep unless my feet are warm. Hence, I wear socks pretty much every day of the year.
10. I can’t wear high heels. No really. I never learned how to properly walk in them, so I tend to clunk heavily and they cause so much pain to my ankles
11. Logically, I’m okay with getting older every year. But I find it unbelievable that it will shortly be 10 years since I graduated from college (May 2001) and almost 5 since med school, and wow, I feel like it was just yesterday and I can’t possibly be that old. But I guess I am.
12. I miss having summer vacations. If I had one now, I’d become a campground host for a remote place in the mountains, sit by a campfire, meet and greet people from all over the country, make sure that the pit toilets didn’t stink too much and sleep under the stars.
13. I worry everyday about my decision to do critical care. If I had known me when I was making the decision for residency, I would have just done internal medicine and would have been quite content as a hospitalist. Or at least, I think so. I’ve worked many, many months in the ICU and love it, but I worry about finishing at the end, still thinking that “yep, could have been a hospitalist.” That said the decision to do the double residency and move to Milwaukee was one of the clearest answers to prayer that I’ve ever had and I don’t regret it either. When I visited and interviewed in San Franscisco, I felt the same sort of “This Is The Place rightness” – something that had been lacking in my other interviews.
14. I go back and forth daily about whether or not to sell my house now, or wait for things to recover. I’m not sure how much of it is emotional attachment to my home; even with all of the multiple water issues and heating issues, it’s been my home and the thought of somebody else owning it is heartbreaking.
15. I can remember random numbers really well. A patient’s temperature curves. Or their lab results for the last 3 days. I wish that it would cross over better into actual academic learning, but sadly, I seem to have very poor retention of details related to what I’m studying. It’s making me very nervous for boards in (eep!) 9 months.

And in honor of the last Harry Potter movie coming out: 30 days of Harry Potter
Day 1: Your favorite book.

The Order of the Phoenix. I know, it’s everybody’s least favorite. Harry’s so whiny and angsty. It’s so long. And it is – I definitely think that Rowling’s needed an editor at this point who slashed away the fat – and it only got worse). I’m partially sentimental because my roommates and friends read it aloud to me that summer, which was really awesome. My sister Karin does an awesome Delores Umbridge impression. I loved the twins. I loved Dumbledore’s Army and Harry waking up to the fact that he could be a leader. I love the plot – it was well-crafted and made sense and didn’t seem to have a lot of dei ex machina plot fillers that populated the later books. The death of Sirius was so tragic – I seriously cried for days. And Luna!! Oh, Luna is the best!

So, those at home can follow along. 🙂 I mixed and matched questions because I didn’t want to answer lame questions or the same question, just asked in a different way.

30 Days of Me
Day 01- A recent picture of you and 15 interesting facts about yourself
Day 02- Where you’d like to be in 10 years.
Day 03- A picture of you and your friends
Day 04- A habit that you wish you didn’t have
Day 05- A picture of somewhere you’ve been to
Day 06- Your earliest memory
Day 07- A picture of where you live
Day 08- Bullet your whole day
Day 09- Your hobbies
Day 10- Songs you listen to when you are Happy, Sad, Bored, Hyped, Mad
Day 11- Your views on religion
Day 12- Your current relationship, if single discuss how single life is.
Day 13- Somewhere you’d like to move or visit.
Day 14- A picture of you and your family
Day 15- Put your iPod on shuffle: First 10 songs that play
Day 16- Favorites: movie, tv show, song, color, food, actor/actress, book, quote
Day 17- Someone you would want to switch lives with for one day and why
Day 18- Something you love about yourself
Day 19- Nicknames you have; why do you have them
Day 20- Someone you see yourself marrying/being with in the future
Day 21- A picture of something that makes you happy
Day 22- What makes you different from everyone else
Day 23- Something you crave
Day 24- A letter to your parents
Day 25- What I would find in your bag
Day 26- What you think about your friends
Day 27- How important you think education is
Day 28- A picture of you last year and now, how have you changed since then?
Day 29- In this past month, what have you learned
Day 30- Who are you?

30 days of Harry Potter:
Day 1: Your favorite book.
Day 2: Your favorite movie.
Day 3: What house would you be in?
Day 4: Least favorite female character and why.
Day 5: Favorite male character and why.
Day 6: Moments in the books/movies that made you cry
Day 7: Favorite female character and why?
Day 8: Hogwarts subject you would most like to take
Day 9: Least favorite male character.
Day 10: Horcruxes or Hallows?
Day 11: What character would you say you are most like.
Day 12: Favorite ship.
Day 13: What aspect of the books has been best translated to film?
Day 14: Your favorite villain
Day 15: Who would be your best friends at Hogwarts? (three only)
Day 16: Favorite professor?
Day 17: Are you excited about The Deathly Hallows movie or scared it won’t do the book justice?
Day 18: Least favorite book
Day 19: Favorite book moment
Day 20: If you had to meet one member of the cast, who would it be?
Day 21: Out of all the characters that died, if you could bring one back, who would it be?
Day 22: Harry Potter or Twilight?
Day 23: Any part of the books/movies that makes you cry?
Day 24: Any particular scene you wished would have been put in the movie but it wasn’t?
Day 25: Nineteen years later. Are you happy how it turned out, or do you wish something was different, ie Neville married Luna?
Day 26: If you could be able to work one spell without a wand what would it be?
Day 27: Would you rather own The Invisibility Cloak, The Resurrection Stone or The Elder Wand?
Day 28: Fandom: discuss and share
Day 29: Favorite quote
Day 30: What affect has Harry Potter made on your life and how much does it mean to you?

2 windows! 2 pretty windows done! Bah ha ha!

The great achievement of the week:
Destruction:


Construction:


We have installed one of the six windows in my basement! It’s not perfect, but it looks like it will do the job. We’re hoping to get another two done before Dad leaves on Sunday. Plus finish pulling up tile, caulking the basement joint, applying sealant to the walls, clean out gutters and maybe redo the trench in my front yard. The weather hasn’t exactly been cooperating – it rained most of the day yesterday, the wind was atrocious today and it’s supposed to be cold tomorrow – which has made things much slower going than hoped.

I have to head back to work tomorrow (grumble, grumble), but yay for progress!

(FYI, for those who read my blog via Google Reader, my RSS feed wasn’t working last week, so you may have missed a couple of entries. It seems to be back now.)

I have no idea how it got to be the 20th of October already. Seriously?! Seriously???

I’m on a lazy rotation this month. An elective, which on the neurology side, means I can pick and choose how I spend my days. Or as my colleague said “I’m on elective and I elect not to go.” 🙂 I haven’t been quite that bad. So I’ve had a couple of days of clinics, several days studying for boards, working on a couple of research/quality improvement projects and lots of lazy morning sleeping in and finally feeling somewhat human again. It’s been lovely and I’m sad that it will be coming to an end so quickly.

As I was driving home tonight, I was overwhelmed with the pulchritude (good word!) of the setting sun over the autumn leaves, and I managed to get home in time to catch the last rays of the day. It very shortly thereafter darkened and started to rain, so I’m glad that I was able to get these shots:

If you are at first lonely, be patient. If you’ve not been alone much, or if when you were, you weren’t okay with it, then just wait. You’ll find it’s fine to be alone once you’re embracing it.
We could start with the acceptable places, the bathroom, the coffee shop, the library. Where you can stall and read the paper, where you can get your caffeine fix and sit and stay there. Where you can browse the stacks and smell the books. You’re not supposed to talk much anyway so it’s safe there.
There’s also the gym. If you’re shy you could hang out with yourself in mirrors, you could put headphones in .
And there’s public transportation, because we all gotta go places.
And there’s prayer and meditation. No one will think less if you’re hanging with your breath seeking peace and salvation.
Start simple. Things you may have previously avoided based on your avoid being alone principals.
The lunch counter. Where you will be surrounded by chow-downers. Employees who only have an hour and their spouses work across town and so they — like you — will be alone.
Resist the urge to hang out with your cell phone.
When you are comfortable with eat lunch and run, take yourself out for dinner. A restaurant with linen and silverware. You’re no less intriguing a person when you’re eating solo dessert to cleaning the whipped cream from the dish with your finger. In fact some people at full tables will wish they were where you were.
Go to the movies. Where it is dark and soothing. Alone in your seat amidst a fleeting community.
And then, take yourself out dancing to a club where no one knows you. Stand on the outside of the floor till the lights convince you more and more and the music shows you. Dance like no one’s watching…because, they’re probably not. And, if they are, assume it is with best of human intentions. The way bodies move genuinely to beats is, after all, gorgeous and affecting. Dance until you’re sweating, and beads of perspiration remind you of life’s best things, down your back like a brook of blessings.
Go to the woods alone, and the trees and squirrels will watch for you.
Go to an unfamiliar city, roam the streets, there’s always statues to talk to and benches made for sitting give strangers a shared existence if only for a minute and these moments can be so uplifting and the conversations you get in by sitting alone on benches might’ve never happened had you not been there by yourself
Society is afraid of alonedom, like lonely hearts are wasting away in basements, like people must have problems if, after a while, nobody is dating them. but lonely is a freedom that breaths easy and weightless and lonely is healing if you make it.
You could stand, swathed by groups and mobs or hold hands with your partner, look both further and farther for the endless quest for company. But no one’s in your head and by the time you translate your thoughts, some essence of them may be lost or perhaps it is just kept.
Perhaps in the interest of loving oneself, perhaps all those sappy slogans from preschool over to high school’s groaning were tokens for holding the lonely at bay. Cuz if you’re happy in your head than solitude is blessed and alone is okay.
It’s okay if no one believes like you. All experience is unique, no one has the same synapses, can’t think like you, for this be relieved, keeps things interesting, life’s magic things in reach.
And it doesn’t mean you’re not connected, that community’s not present, just take the perspective you get from being one person in one head and feel the effects of it. Take silence and respect it. if you have an art that needs a practice, stop neglecting it. if your family doesn’t get you, or religious sect is not meant for you, don’t obsess about it.
You could be in an instant surrounded if you needed it.
If your heart is bleeding make the best of it.
There is heat in freezing, be a testament.

How I spent my Saturday night (it took me two days to figure out how to download it off Facebook):

I’ve never seen a video of me dancing, and I’m glad to see that I don’t look nearly as clunky as I feel. I ain’t never going to make it to SYTYCD, but my moves aren’t half bad. 🙂

Ya’ll, I have missed this. Learning new dance steps, remembering old (it’s been a long, long time since I did the Lindy Hop, most only know the basic east coast swing; I kept switching back into the 6 count rhythm). A partner with a firm grip who knows how to lead. It brought back floods of memories of dancing in the smelly, hot and humid Navy Science building on Thursday evenings or the MAC on Saturday nights. My foot still remembers the feeling of hitting a nose during an unexpected flip (never again). I lust again for a comfortable pair of saddle shoes, brown and creamy white and a frilly, satiny red dress.

My partner invited me dancing on Saturday, as I will be visiting bjorks_defender for the weekend and he lives there and there’s a swing club. With a live band. So tempted. Soooo tempted.

For better or worse, I matched!

Chris called me at 5:50 this am (!!!) asking me where I had matched. As I had stayed up late and then tossed and turned for hours, I was pretty blurry eyed and groggy. But I logged on the computer and there were the results. No fanfare, no congratulatory email from the department (it was 4 in the morning pacific time, so I guess that’s not too surprising), just results that had probably been released at midnight. I was rather stunned to just see them there – the past few days, I had had the habit of clicking on the “match results” link to test if they were accidentally released, so I was used to the curse “please check again” webpage. I had promised Chris that he’d be the first to know–I think it dawned on him faster than me what the results were!

As always, my emotions are in turmoil. I’m super excited and ecstatic and happy, and then the other side of me is shell-shocked and grieving at the thought of moving and leaving behind this life that I’ve created here. I’m happy here, even with the crazy snow storms and muggy heat. I love my house, I love my friends, and the thought of leaving that terrifies me.

I’ve joked before that The Match is very much like a marriage ceremony, albeit a rather sadistic one (even in arranged marriages, you at least know the name of the person to whom you are vowing). By submitting the list, I tell whoever selects me, that for better or worse, I’m committed and that I’ll pick up my life and become theirs. I knew when I submitted the list that I would be leaving Milwaukee. As much as I’ve loved being here, this isn’t the place that I wanted for training. The program director belittles and torments when he’s not a in good mood, which is not something that I want to endure for two years. I wanted a place where I would have women mentors and colleagues, which I couldn’t get here. So I chose to go elsewhere, just like I chose to come here for residency, leaving my comfy life behind. I grieved then, and I’m grieving now, between the smiles of elation.

So a couple of weeks ago, I finally discovered how much easier Google Reader made my blog reading and stalking. I put on all of my usual haunts, it suggested more… and more… and more. I’m now subscribed to more than 50 blogs. Luckily, most of them only post once or two a week. Right now, I think that Google Reader can’t decide whether I’m a happiness-seeking, frugal-living, eco-friendly Buddhist, a Mormon mommy/infertility/woe-I’m-single blogger, or a fiction author stalker. Probably a little of all of them.

A couple of days ago, I stumbled on an all about Jane Austen blog and added it to my reader. Well, that brought a flood of suggestions! Now, I’ve got Austen book reviews (what is with all of the paranormal “retellings”??? This is getting ridiculous!), JA quotes and best of all, regency costumes on my daily readings. Today, I browsed through a dozen different blogs, which stirred my longings to make proper stays and shifts, so my own gown would hang properly. My favorite gown that this particular seamstress made was this one. Isn’t it gorgeous?

I’m not one of those who wishes that I was born in a different time period. I like my indoor plumbing, electricity, quick transportation and electronics, thank you very much. But I do wish that I had excuses to dress in exquisite gowns more. And also that I had been blessed with the desire to be a seamstress. Mom tried her hardest to instill her sewing loving ways into us girls, but it’s only now that I’ve been hit with the bug – when I completely lack the time or know how.

I also just discovered that the Jane Austen Society has a Wisconsin branch that has “book discussion groups that meet three times a year. We also have a fall event in Milwaukee, toast Jane Austen’s birthday at a luncheon in December, hold a Spring Gala in Madison and celebrate summer with a Box Hill picnic.” Sounds like heaven to me!

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 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 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.

Surprisingly, I love night float. I love working the night shift, when it’s quiet and I can just focus on getting the patient taken care of and tucked in. I love running into CuteIntern in the cafeteria and having a moment to catch up (well, he had only a 30 sec pause; the ER keeps the radiology department pretty hopping at night)–my heart still hasn’t quite recovered for the palpitations. I love the nurses that I work with and getting to know them. My six days stretch was pretty benign – I think I averaged 3 patients that I admitted (out of a possible 7, go me!). Last night, of course, since I was really wanting sleep so I’d be fresh for my four hour drive today, I had a patient that I had to transfer to the unit, which kept me up, but it still was nothing compared to an average neuro call.

I love seeing the sunrise too. The sun is just peeking over the horizon at 5:30, turning the sky a hazy pink. I was going to take pictures of it; even brought my camera in, and then got a stern email from the head boss that no pictures were to be taken inside any of the buildings without written permission. Even if it wasn’t a patient. Grr. I’m so tired of rules and regulation all of the time.

Anyway. I just finished packing for my camping trip. Yay!! I’m heading up north, way north today to camp over night in the remote, forested and laked (silly word check, I know that’s not a word), bear-populated country, then coming down to a tamer county park for Friday and Saturday where some of my good girlfriends will be joining me. I’m bringing my art supplies, a notebook, a few of the Harry Potter books, some games, makings for smores, etc. We’re going on a nature walk, and just taking it easy for a few days. I’m so super excited. I have to shower, get the oil on my car checked and then I’m off. At least to the next rest stop – I have a feeling that I’ll be stopping for siestas all along the way. Luckily, I do have a friend going with me who will help drive and keep me awake. No worries, Mom!

Alrighty. See you all on Sunday!

1. How good a long workout can be. Did I tell you that when one of my friends moved this spring, she gave me her elliptical machine and weight bench? I can’t remember. In any case, I haven’t use them more than 1-2 times a month. Did I also tell you that my friend had a household of cats, and the elliptical machine had the unfortunate residence in the litter room? I like cats (although I’m slightly allergic which keeps me from giving in and buying a cute ball of fur), but I don’t like my hands smelling like cats after a workup. I’ve sprayed it with bleach, baking soda (no worries, I washed it with water in between), more baking soda, and two applications of Febreeze and with a towel, it’s tolerable.

In any case, I walked for 30 minutes today and burned 300 calories! Go me!

2. The perfection that is the show Everwood. Oh, my poor, neglected, canceled-in-its-prime show. TPTB at the WB finally, finally heard the numerous pleas and released the second season on DVD, and I had forgotten how much I love this show. The relationships, the characters, the acting is just perfect. Every single week. It makes me homesick (in the cathedrals of new york and rome, there is a feeling that you should just go home and spend a lifetime finding out just where that is) and heartsick and happy all at the same time. I miss good tv like that. (Season 2 can be purchased here from Amazon if my little missionary moment convinced you. 😉 )

In other news: I had a lovely 4th of July weekend. I had a blissful three days off, and caught up on sleep and read for fun for the first time in months (East by Edith Pattou, The Princess and the Hound by Mette Ivie Harrison and Princess of the Midnight Ball by Jessica Day George. Hmm, wanna play spot the theme? Actual book reviews are forthcoming, I hope), helped my friend paint her mother’s bathroom, went to another friend’s house and played with sparklers for the first time ever, and ate strawberries and ice cream cake, and just had a nice time. I really miss not having a summer vacation; this was a small but appreciate glimpse of freedom.

Picture evidence of the weekend and of the rest of my adventures in May and June can be found at my Picasa web site, including English Country Dancing, seeing Carbon Leaf in concert (one of the best concerts ever), and hanging out with my crazy yet beloved coworkers.

The VA emergency department has continued to be somewhat slow. I’ve seen a total of four patients in the 3 days that I’ve been there. I’m not complaining – I’ve gotten caught up on my clinic notes (it’s amazing how quickly I can get behind if I don’t do them immediately after clinic) and I have a big fat 1000 page book that I’m determined to have read by the time I switch to the medical ICU in August, so I appreciate the chance to study. I start night float on Friday. Meaning, I work 8 pm to 8 am (or 6 pm to 8 am on the weekends) for a week, admitting the sick patients who come in from the emergency department. Long ago, I lost any semblence of a circadian rhythm, but it’s never been tested like this before. I’m kinda excited to see how I handle it and I’m hoping to get a couple of things done in the day, such as getting a basement/foundation specialist to diagnosis why my house leaks and taking my car to the garage to figure out why it suddenly sounds like it’s been possessed by a family of crickets.

And that’s it with me. How are all of you?

My morning was free today. I celebrated by taking a long nap, buried in blankets. I honestly think we could bring peace to the world by initiating global nap time.

It’s drizzling and cool today. The weather forecasts only mild rain throughout the day. No major thunderstorms for which I am thankful. Did I mention that I had a plumber out to my house last week, who pulled off the rusted cap to the sewer drains, peered down and stated that snaking the drains wouldn’t help the flooding situation at all? It’s a city system problem, that the water backs up in everybody’s drain when it becomes overwhelmed with the rain water – my neighbors fair slightly better because they have sump pumps installed. If I installed a flap in the drain to prevent the water from coming up, I risk building up pressure so that the water comes up through my sinks or toilet instead, causing even more problems. Installing a sump pump could cost thousands. Over $100 dollars to be told that there is nothing that I can do, except petition my city officials to expand their drainage systems.  I haven’t decided whether or not to seek a second opinion. And neither have I figured out how to address the leaky windows/floor either. All I can do is hope that we’re done with the thunderous rain storms for now and keep everything up off my floors (the cinder blocks are staying).

The ER is “mercifully benevolent” today, in the words of one of the attendings today, a change of pace that I am enjoying. Either everybody got the message that the hospitals are to be avoided on July 1st or they’re all at the baseball game down the road. It’s now 4 pm and there’s been nobody so far. I’ve been good and have used the time to catch up on some clinic notes. I’m sure as soon as I suggest an early end to the day, the patients will start pouring in.

• Today marks the end of my third year of residency. Tomorrow, I start work at the VA emergency department (ugh. I like the VA. I hate the ER) as a fourth year. Two more years to go.
• I told the director of the neurology critical care fellowship here that I’m planning on applying. I still vacillate about it, mostly because I dread putting together the application, asking for letters of recommendation, and somehow fitting a new, amazing, novel research project into my already busy-enough life. I hated the application process going in to medical school and into residency. The thought of doing it again makes me want to weep. But neuro critical care is really where I thrive the most. I still have tons to learn and I find it intimidating but… I think it’s where I should be.
• I finally made up with the attending that I was arguing with last week. He felt pretty bad about things, told my program director that I was really great, etc. Except that I kept getting confronted with all of the drama and it was this continuous awkward situation. But I apologized for for the emotional breakdown today, he apologized for being harsh and misjudging, we hugged, and hopefully it’s all good. I’ve got three months before I’m back anyway, enough time for it to be completely forgotten when I ask him for a letter of recommendation.
• Chris moved to Boston. I didn’t get to see him off. Three years ago, I cried for 2 days straight when he left for Asia, thinking that it was the end of our friendship. It wasn’t. This won’t be either. But I still miss him dreadfully.
• I heart Milwaukee. Especially the baseball games and tailgate parties. And I really heart my camera. Look for pictures later this week.
• TWO YEARS MORE!

The good news: the leak in my basement when it rains extremely hard does not seem to be coming from the toilet. Horray!

The bad news: I have no idea where it is coming from. Well, I fear that it is dripping down the inside of the bathroom walls, but I can’t seem to locate a source. It just seems to appear, like zombies rising from the ground. Or something like that.

For now, it’s trickling down the basement drain. I only flooded a year ago because the downpour was too much volume and speed for the drainage system to accommodate. I am sure tired of dealing with this issue.

I should have spent tonight finishing up clinic notes. Instead I spent it looking at neurological equipment that I’m not sure I’ll ever use and updating my WP blog to 2.8, importing LJ entries with their new import system. Somehow it messed it up, transferring everything in triplicate and when I attempted to delete it, it deleted the entry on the LJ side. Of course, Livejournal, in their infinite wisdom has decided that you can’t import blog entries to their database, so I had to repost, losing the comments (on LJ. It’s still there on the WP side). It’s going to take me forever to delete (correctly!) and merge everything.

The rain is really coming down now. Come on, little drains, keep up. I’m going to try to sleep.

ETA: Scratch that. It’s coming down the majority of my windows now. The drain that my church installed for me is not keeping up and I’ve got a large puddle puddle at my back door. My rug has already been taken up. It’s supposed to last for the next two hours before letting up. CRAP.

ETA #2: And the drains stopped working and I flooded my basement again. This time I had the sump pump, which I pumped into a sink and managed to keep from flooding every where. Sure am glad that I kept it all up on cinder blocks too. I’m going to be utterly useless at work tomorrow. What I really need to do is take the day off, get everything bleached and call a plumber to come look at my drains. And figure out how to waterproof windows

again

.

Of course, it’s starting to rain again.