Archive | June, 2012

beach week xi in pictures

29 Jun

Love this!  Love us!

24 weeks

28 Jun

chickens and kittens

27 Jun

While in the thick of my surgery rotation, I took pause to plan what would likely be my last pre-infant hurrah during our two-week summer holiday.  The first weekend would be devoted to this fabulous Pittsburgh wedding, and the second week to Beach Week XI with these crazy kids.  That left me Monday-Friday of this past week to do whatever the hell I wanted, and I wanted friendship, adventure, and relaxation.  An Austin excursion to visit Kathleen, Isaac, and John hit all the criteria, and I roped in my close friend Matt (who will be attending Penn Med this fall!) for the journey at the last minute, which made the trip damn near perfect.

I visited Austin two years ago with John…which meant that, in addition to maximizing Kathleen time, we woke up at the crack of dawn so that we could get a jump start on seeing all the things!  (To give you a frame of reference for what vacations are like with the husband, I had to plead with him for us to have one day of not waking up to an alarm on our honeymoon.)  So this trip to Austin included no expectations, no real agenda except for one low-key adventure out to Pedernales Falls…oh, and kitten and chicken time.  Did I mention that Kathleen and Isaac have chickens?

Meringue, Lorraine, Benedict, and Megas make the most delicious multi-colored eggs–have you ever seen brighter yolks?

Annie is the little orphan pictured above that Kathleen took in a few years ago.  She had no problem snuggling during my mid-morning naps.

And to help me wake up potentially before noon…

still marinating

26 Jun

Not gonna lie, it took me from Thursday until this morning to finally finish this article that many of my female and male colleagues alike have been stewing over–and I still only managed to gloss over some of the sections.  This afternoon’s project is a hopefully more than cursory glance at this response and Sandberg’s speech.  I’m still gathering my thoughts, but I wanted to share a short passage I appreciated (in part due to my interest in palliative care)–not novel, by any means, but it rings true:

Seeking out a more balanced life is not a women’s issue; balance would be better for us all. Bronnie Ware, an Australian blogger who worked for years in palliative care and is the author of the 2011 book The Top Five Regrets of the Dying, writes that the regret she heard most often was “I wish I’d had the courage to live a life true to myself, not the life others expected of me.” The second-most-common regret was “I wish I didn’t work so hard.” She writes: “This came from every male patient that I nursed. They missed their children’s youth and their partner’s companionship.”

summer solstice

21 Jun

I had a Lady Macbeth moment this morning when I woke up, looked at my hands, and thought, “What the hell did I slaughter last night??”

Kathleen and Anna are ready to celebrate the official start of summer.

BTW, the “blood and guts” left between my fingernails this morning were the remnants of sangria prep from last night.  I am an excellent cherry-pitter.

Also, although I will be experimenting with these tonight and over the next 17 weeks (thanks Kathleen for looking out for me!), as a child of a Frenchwoman who I’m pretty sure had a small glass of red most nights of her pregnancies, I appreciate this article (thanks Isaac!), less so the holier-than-thou responses.

a petite yaya

20 Jun

We’re having a girl!!!

People have been asking us for weeks if we had a preference or any inclination about the sex.  John would say boy, I would say girl, but it was all in the spirit of needling each other a bit.  In truth, we were hoping for four limbs, a head that appeared firmly intact and attached, and organs that were within the confines of the body cavity.  We didn’t expect to see SO much more during the anatomy scan on Friday.

We were at the absolute last day of the 22nd week, though the size of my uterus and the length of our girl measures closer to 24 weeks–she’s already over a pound!  Our first view was of the inside of heart, and we could see all four chambers beating, the picture was so precise that we could make out individual chordae tendineae (the “heart strings”).  The scan took us through the heart and it’s major vessels (no tetralogy or transposition–two major congenital heart defects–for this kid!), the brain and spine, the kidneys, the limbs, etc.  We’ve seen our girl head to toe!

And she’s acting more like a little being too.  She’s clearly had enough of this whole womb thing and is ready to go exploring (don’t get any ideas, kid; you don’t really have lungs yet).  As I recently described to a friend mother, what began as subtle taps and shifts have turned into full-blown body slams, forceful enough to wake me from sleep (a preview of what’s to come?)!  She is definitely John’s child; I don’t stand a chance.

Here’s to 17 more weeks of happy gestation!

katie & michael

19 Jun

This weekend we took a roadtrip to Pittsburgh to watch Katie and Michael, two of our best friends, get married.  We had been looking forward to this event for a long time.

Michael and I grew up next door to each other since we were four and three, respectively.  He’s one of my oldest friends and, in truth, much more like a third brother to me.  His sister and I would spend summer nights sleeping under the stars in our backyards, winter days sledding the slope down to the creek, and all the days in between walking to and from the bus-stop, taking part in other outdoor adventures, rehearsing in school plays, celebrating holidays with our families…together.  Even then it was clear he was special–remarkably brilliant, clever, and kind, an inventor of all sorts of childhood merriment, and John and I were so excited when he began medical school this year.  He will be the doctor to which I would send my child (or any loved one), regardless of field or specialty.

Both of us met Katie in college.  She was one of the girls I admired from afar long before we actually had a meaningful interaction.  (In their letters to each other during the ceremony, I nearly laughed/cried out loud when Michael said something to the effect of, “While others found you intimidating or scary, I thought you were fascinating.”)  She is a born leader, artist, and writer, would seemingly effortlessly elevate any organization in which she took part, and I think we all marveled at the profound impact we knew she would have in her profession, her passions, and her relationships.  She’s the woman who can literally do anything.

As a couple, they are so, so strong, independent, passionate.  I know I’m fortunate to have them as friends, and I can’t help but look anxiously forward to all the feats they’ll conquer, the places they’ll go, the joy they’ll create.  Congratulations on your marriage, and to a lifetime of happiness and success together.

big day tomorrow

14 Jun

At 10:30am, I’ll be done with my surgery clerkship.

By noon, my emergency medicine clerkship will be complete.

Around 3:30pm, we’ll get the most recent snapshots of our papaya-sized gymnast.

Please wish us luck, and hope the current tenant of my uterus doesn’t chose to make a trampoline out of my bladder between the hours of 7:30 and noon 🙂  Thank you!!

the ER has everything, including cancer

13 Jun

I used to think I would hate the ED, in part due to my “processing issue” (as John calls it) and in part because I thought having continuity of care would be important in my career.  But, while the ED doesn’t exactly have constant continuity, there certainly is an element of it that exists beyond the drug seekers, addicts, and gunshot victims–although those patients too make for fulfilling/exciting work.  For example, there are the patients with inflammatory bowel disease with unexpected flares…having a familiar face during a crisis (and small bowel obstruction can be a crisis) is like a gift from higher power to them.

And then there are the cancer patients.  Is it possible that I’ve seen more cancer patients in my three weeks in the ED than I did in eight weeks of internal medicine?  Between the constantly evolving disease, complicated diagnostic procedures and treatment regimens, and metastases, these patients have good reason to need the ED on a regular basis.  I was the one to inform one woman of her diagnosis because she had either not heard it or not understood it from her other physicians.  I thought it was a good, though of course never pleasant conversation.  I was gentle but direct, using words like “cancer” rather than “adenocarcinoma.”

At the end I asked, “So, can you tell me a little bit about what you understand about you disease right now so I can make sure we’re on the same page.”  She responded, “I had an x-ray in the emergency room today, and it didn’t show anything.”  I guess my analogy of an x-ray being like a mirror that can only show objects that are within its frame and not blocked by something else was not the best (and it’s also inaccurate, but it was what I could think of in the moment to address her confusion about cancer being in her body but not on x-ray).

My point is not that I desperately crave for the careful delivery of bad news to be a main component of my medical practice.  But I’m attracted to a field that includes it among so much else.  You can have profound relationships with your patients in the emergency department and, what makes it all the more challenging, you have to establish them at breakneck speed.  My husband is really good at that.

maninka

12 Jun

It’s a language, and a relatively widely spoken one at that.  I had no idea, so I’m feeling a lot less wordly than I did a few days ago.

My last ED shift was the Friday/Saturday overnight.  At around 4am, I was having a conversation in Maninka–pretty cool, hunh?  The hospital has these interpreter phones that can actually work brilliantly well.  Within about 90 seconds of placing the call, I had a fluent speaker of Maninka on the other line, translating for my patient and me.  Of course, it was all a bit awkward to have to explain the purpose and procedure of a pelvic exam through the voice of a gruff old man, but the point was conveyed and the patient consented.

(By the way, if you have a chronic, not too troubling complaint and you don’t have insurance, 4am is a fantastic time to go to ED in order to be seen in a somewhat timely fashion.)