I know I missed a couple of days. My dad is here (w00t!) and it’s distracted me from taking pictures. We’re destroying my basement this week – removing and replacing windows, scrapping paint, covering the walls with sealant – so maybe I’ll get some pictures of that fun project.

In the meantime, here’s a few more pictures of autumn here (still the favorite). I went to a playground on Friday as the sun was setting. Unfortunately, a weather system was moving across, so the light was not as perfect as I had hoped, so the pictures are very slightly altered to bring out the oomph.

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:

This is a little bit of a cheat, since I took this picture back in August, but as it was what I had for dinner and I photoshopped (or rather apertured) the image tonight, as it was yellow-toned, I think it counts.

Grilled Salmon with North African Flavors or as I call it “The Meal That Is Going To Get Me Married.” Or at least declared passionate love. My dinner partner that night pronounced it wonderful and seemed to swoon at my feet; alas, he is gay and while my fish is good, it’s not that good in overcoming biology.

This is my signature dish. I was introduced to it in college, tracked down the recipe, lost the recipe, found it online and now it’s in my head forever and ever. I’ve improved the recipe: I don’t use parsley, I no longer just marinate the fish (in fact, I skip it if I don’t have time), I drizzle the sauce over the salmon and then sprinkle Parmesan cheese on top and grill it in the oven. It’s unbelievably flavorful and yummy. Don’t believe me; just listen to these testimonials.

“You have to invite me over again for the salmon. This way I can make everybody jealous when I tell them what I had for dinner.” ~Sarah

“Our dinner parties were successful. But my sister always roped me in to help, and I ended up doing most of the work.” ~ Karin

“My girlfriend is lactose-intolerant. But I think it’s great!” ~Chris, who got rid of that girlfriend, just so he could eat more of my salmon

Tell me how my salmon changed your life in the comment section!

My “pseudo” niece and nephew. Love these two!

So glad that this meme incorporates “ish” because I am failing miserably at posting every day!

Driving through Illinois. I wish that there was a way that I could take pictures and drive at the same time…

On my way to study at the library, I stopped off at one of the local parks. The colors have been so beautiful, I couldn’t resist getting out my camera. Wisconsin, you’re going to break my heart when I leave.

(Taken through my sunglasses. I love the effect, but am irritated by the smudge at the bottom. Argh!)

All pictures can be seen here.

Corn maze outside of Waukesha, WI. It has truly been one of the most glorious autumns ever here. Warm weather, blue skies, vibrant colors.
All pictures can be found here.

I don’t know what all the fuss is about. You say it’s my birthday?
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My dinner tonight:
Roasted Vegetable Minestrone Soup with parmesan cheese
Pumpernickel toast
Milk
Oh my yumminess.

My study area at the public library. I haven’t studied at a library since med school. I was a little more productive there, though. Restudied the pituitary disorders and focused on the thyroid and my post-test scores were better. I need to complete all of endocrine tomorrow and make some headway through renal and pulmonary before my test on Tuesday. It’s times like this, when I realize how slow going this is, that I start really panicking about boards in a year (10 months). Right now, I’m able to put in 3-8 hours a day studying and I’m still making it only through 20 pages at a time. I’ve got 11 books to cover which average 80-100 pages each. When I take boards next year, I’ll be a fellow and won’t have the luxury of time off. Frightening. Here’s hoping for some retention.

Yes, I missed yesterday.

I’m supposed to be on vacation this week. My dad was going to come out, we were going to install new windows in my basement and paint the joints with sealant to help prevent some of the perpetual water problems. He called me from Nebraska to tell me that his Jeep had completely died. So much for the trip. Things happen and we’ve rescheduled the trip for later this month.

In any case, I have my internal medicine in-training exam (a mimic of the big boards that I’ll be taking in less than a year). I’ve never done very well on them, mostly because I’ve never gotten a chance to really study hard before taking them. So I’m trying to be good and study, but am failing miserably. Today I made it through 20 pages of endocrine – but I needed to get through at least double that. And when I took the “post-test”, I missed a lot of questions, so I have to go back and review hypopituitarism again.

I keep getting distracted by this picture:

Mt nephew turned one last week. I, of course, missed his birthday party,  but my sister finally updated her blog with pics of the festivities and the birthday boy. Footed pajamas kill me dead (must remember that for Christmas).

Oct. 5 Pic:

I love that its October and I still have raspberries!

Found during a midday walk. One has to wonder why the need for a tea party for a porcelain cat, but you have to admit, it’s a rather pretty setting.

It was general conference this weekend and for once, I had the whole weekend off. My bishop (equivalent of a priest or pastor) invites the ward (congregation/parish) to his house on Sunday morning for breakfast and lunch, in between the 2-2 hour blocks of talks. It’s one of my favorite traditions. His house is about 30 miles away from Milwaukee, in tree blanketed hills, so this time of year is just absolutely gorgeous. After the first block, we ate lunch and took a walk around the hills. For the first time in months, I could hear birds and squirrels and nothing else. I miss silence, sometimes.

All of the rest of the pictures can be found here on my facebook. I think you should be able to see it without being my friend or signing into fb.

Mt. Olympus hamburger: artichoke and spinach dip, feta cheese and a garlic mayo. Incredibly yum.

It’s October (how can it be October already??). I’m trying to resurrect this journal. I’ve had too many thoughts and emotions that have crowded my head that I have not been able to get down on paper; they fade in significance once words are applied. So I haven’t written. Maybe sometime soon I’ll be able to get them down. But for now, posting a photo a day seems like a good start into blogging again.

I just got home from a birthday dinner/movie, and I’m exhausted, so I’ll have to wait to upload the pics from night, but here’s some recent pictures from a very short visit to San Francisco. I went for a neurology conference; I’m not sure that the combined cost of the registration, air fare, hotel, transportation was really worth it for 3 days, but I did get to spend some time with my new boss, which was excellent. She’s as fabulous as I remember and we really connected. I also got fingerprinted for the FBI and the DOJ, so that the state of California will sometime in the next year grant me a license. All in all, it was a fulfilling trip.

I didn’t get a lot of time to see the city: I flew in Wednesday night, was in lectures most of Thursday and Friday, and then left Saturday morning. I had really wanted to explore the city, find neighborhoods where I wanted to live, but I guess that’ll have to wait for another visit. I did sneak away to go to a baseball game. The SF Giants were playing the Brewers; one of my friends had bought tickets and was not able to go. As I have not seen the Brewers play this year, I jumped at the chance. I couldn’t find anybody to go with me, and I was thoroughly annoyed with most of my colleagues by that point (I was annoyed with them before the trip, but that’s another story), so I went by myself: navigating the bus and subway system and sitting alone in a midst of orange, cheering for the team in blue. Brewers won, 3-1. I do like the stadium; I can see myself adopting the Giants for a few years.

I woke early the next day. My motel was just on the edge of Union Square, so I rode one of the streetcars to Fisherman’s Wharf and wandered around for a little while, before coming back for the long journey home.

I have 37 blog “drafts” that I have started and not finished over the last several months. I’ve been a really bad blogger. Since I was grumbling to my mom tonight that my sister does not post nearly often enough to her blog with pictures and stories about my darling nephew, I realized that I needed to recognize my kettle-blackness. Of course, my life doesn’t change nearly as much as my nephew’s who has gone from creeping to crawling in a matter of minutes, but still.

Gratuitous piccy of nephew:

His first steps! His red hair!

Of course, just when I think about crawling back to blogging, LJ (Livejournal)’s overlords start making bizarre decisions again that make Facebook’s privacy woes look like frolicking in dandelions. Oh LJ. I’m not sure I entirely understand the situation about the Facebook/Twitter crossposting and how exactly it works and really, why you would want to share comments. I already cross-post to LJ from my primary blog, which I’ve done for a year now because I had planned on moving it over to my private site and then friends-locking LJ (still will, eventually). I keep my blogs completely separate from Facebook. My privacy settings on Facebook are iron-clad: only friends can see personal information and even that is kept from groups that I don’t want to follow me. My boss friended me on FB a couple of weeks ago; you can bet that I made sure that he could not follow me here as this is a venue where I can express frustations in a HIPAA compliant manner. My blogs are not linked to my FB and they never will be. Consider your comments/posts safe.

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.

So I have basement problems. Water coming into my basement problems.

I’ve known about this since 2008, when I first had water coming in through the windows, and then the floor drain stopped draining and it all backed up. I spent two days, pulling up glued carpet squares and cleaning and mopping floors (and putting my couch and washer/dryer up on cinder blocks). That summer, my church came over and dug a drain to help with some of the drainage and I bought new window well covers and caulked the windows and that seemed to take care of it for a while. Until the next big storm a year later, when it flooded again. My little portable sump pump tried its best to keep up with it and it wasn’t quite as bad. I had real hopes when in April, I got notification that I couldn’t use my plumping for two days because they were revising and rewiring the sewer system: I hoped that that would mean the end of backup problems.

But I started noticing more “leakage”, especially in the bathroom, and with less intense rainstorms. I was somewhat worried that my foundation floor had cracks and I wasn’t sure where the water was coming from. So, my dad and I pulled up the tile; the foundation floor looks fine, it’s leaking from the foundation “joints” where the walls and the floor meet. A big problem, one that to completely fix will require complete excavation of the foundation and the drain tiles. But I brainstormed with knowledgeable friends and came up with a few more reasonable suggestions to help alleviate some of the symptoms. And after I fixed some of the downspouts, things seemed better for a rain storm or two.

It rained hard a couple of weeks ago; and I had quite a bit of water collection. I moved up my plans to convince friends that they wanted to spend their afternoons shoving clay-based dirt to form a better gradient around the perimeter.

And then it rained again last night.

Some of you might have seen some of the pictures, especially this one:

I came home, after a 40 minute commute home, avoiding the flooded roads to find this:



I think it was about 8 inches deep at the location of the drain. I can’t know for certain, because I couldn’t check: the water was deep enough to submerge some electrical equipment that made stepping into the puddle somewhat dangerous. (I think my video cassette rewinder has seen its last day). It took about an hour for it to drain, leaving me with a mud/probable sewage covered floor.

Luckily, my church is still fantastic and I was able to call my home teacher who came over with a friend and we mopped and mopped and got it cleaned. It continued to rain off and on last night and I still had my leakage problems, but those feel almost manageable at this point.

I researched how to fix the problems all day today (thankfully a quiet day, as I didn’t want to deal with anything). It’s probably telling that all of the articles that discussed sanitary water backup in basements mentioned Milwaukee and its terrible sewer drain system. It’s unfortunately, however, a problem that I might not be able to fix; most solutions were to bother the officials until they redid the sewer system. Grrr. I could improve things and make flooding much less likely if I install a sump pump, which may not be too horribly expensive. I’m still exploring options and talking to people. I’ve got some numbers for a basement consultant and I’m going to talk to my real estate agent about people she might recommend; and how much of it I should try to get fixed before I try to sell it.

I’m lucky, there were 7 houses up north were the basements washed completely out and collapsed. And I was supposed to be on call last night, but switched at the last minute. Hooray for small graces.

I have pretty much made up my mind, that even after I finish training and am finally settled, that it’s going to be a long time before I buy a house again.

Oh, and it’s supposed to rain again tonight.

(more pics of the flood and Milwaukee can be found here)

Random thoughts for random people
1. Longest week ever. Seriously. I had heard tales and legends about the attending that I worked with, but since the first day had gone well and I had managed to keep her on task and we were done by 4:30, I thought that it was all exaggeration.

Oh silly mortal!

Hours of rounding. HOURS of telling and retelling families of what’s going on. None of my opinions mattered. She kept changing her mind as to what was going on. One minute she was harassing the primary teams about consulting us without a properly formulated question; the next, she was condescendingly putting me in my place for “refusing” a consult. I’ve never been so openly snarky before, because I was so tired and frustrated of the endless circles. And did I mention tired?

It also confirmed why specialists SHOULD NOT EVER try to do anything besides their specialty. Hello contributors to the rising cost of health care! Of course, I’m the one who getting the lectures from radiology as why a particular test wasn’t warranted; I knew that perfectly well, thank you, I just couldn’t convince my attending to listen to me. Ugh.

I get a new attending tomorrow, one who I’ve worked with before and adore.

2. I hate non-accidental trauma. Number 1 reason why I decided not to do peds. Heartbreaking.

3. I miss my friends who recently graduated. Some of them are still around for fellowships, but it’s not the same. One who moved accidentally called me on Thursday and I was so excited thinking she was in town. But she wasn’t. So instead I entertained myself looking at pictures from Neurobowl:
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One year from today, I will officially be finished with residency. Four years ago, I was an intern, freshly minted from medical school, nervous about prescribing tylenol to my patients without double checking their med list and past medical history and making sure that they were awake enough to take it without aspirating and are you sure they don’t have to be NPO in the morning???

Time flies, it’s true, but it also feels like I’ve been a resident forever. It’s been hard. There have been times, particularly my entire second year, where I wanted to quit. There were times when I was fighting depression and anxiety and hated my life, but I was too tired to do anything more than just sit on my couch. Times when I wanted to stage a mutiny. Times when the thought of dealing with particular patients would make me cry in frustration.

There have been patients who have died on my watch. Most died because of inevitability of mortality and their disease processes. There are a few who sit on my conscious, a worry that I might have through action or inaction contributed to their demise. I’ve fretted, I’ve worried. I’ve cried during rounds. I’ve told patients and family members about inescapable death and not cried. I’ve held hands with patients. I’ve stood in doors, impatient with the endless questioning, ready to move on to the next patient.

Over the last four years, I have had approximately 300 call nights, where I spent 24-30+ hours in the hospital. The majority of those, I had less than 4 hours of sleep. I can do 24 hours without a problem. It’s the remaining 6+ that kill me still. On call nights, I hate the pagers and I loath the ER. I think I always will.

I’ve written hundreds of histories, listened to a thousand stories of illness. I’ve auscultated over a thousand hearts and still could not tell you what a S3 gallop sounds like. I still hate gaping wounds and eye infections. I’m still terrible with names of muscles and their innervation, and well as anything related to heme-onc and rheumatology. I’m bad at daily studying (I still haven’t lost my natural tendency of procrastination), but love to find little bits of data and explore how to put a challenging puzzle together for a particular patient.

I’ve loved being a doctor. I’ve hated being a doctor. I’ve hated being a resident, treated like a high schooler, with the responsibilities of an adult. I’ve loved having support and backup in making decisions. I’m dreading the moment, a few years from now, when all decisions end with me.

One year more. Another year, another destiny, this never-ending road to Calvary. Or something like that. 😉

(And now off to study before bed… I’m trying to do better!)