My Changing Life

What is this??

2009-07-28T10:40:00.005-05:00

What is this, a new blog entry? I promise that I've been alive. My blog has been sorely neglected for the last (almost) 3 months, but hopefully this will change soon. My life became an insane whirlwind of activity, but things are slowly starting to settle down into a routine. Rather than give excuses, I'll give a quick recap of the last 3 months.

May - I survived the NICU. I had 2 fabulous co-senior residents that month, and I don't know how I could have done it without them! My worst dark cloud ever followed me closely that month. When I started the rotation, I had called the medical examiner to notify him of a death only once during residency; by the end of the month, I had done it an additional three times. I saw things I never want to see again and cried more than I hope to do for a long time. Again, I am beyond thankful for the doctors, nurses, respiratory therapist, dietitians, techs, and all other people that God calls to work in the ICU setting; they truly are special people!

June - I was GI senior and spent the last week of my residency with brand new interns. They actually did a great job, and the month wasn't nearly as bad as I thought it would be, but 4 service sub-specialty call almost handed my bootie to me a few times. I'm glad my former program is doing away with that because it's just too much work for one senior to adequately cover that many sick kids. I also turned 28, and Hubby and I had a wonderful dinner together to celebrate. He got me the new iPhone plus a new Tiffany necklace; I felt so spoiled!! :)

I finished residency at 4 PM on June 30th and almost danced out of the hospital! I'd already shed my tears several times as I'd said my goodbyes, so the actual leaving of the hospital for the last time wasn't nearly as emotional as I had thought it would be.

July - I slept in for one day, and then Hubby and I left for Paris on the 2nd! We were gone for a whole week, and it was amazing. I posted most of our pictures onto Facebook, so I won't go through the trouble of posting all 480 of them back onto Blogger. (I figure that if you're reading my blog, you're likely already my friend on Facebook. If not, give me a holler!) We ate like kings, saw so many amazing museums, and just generally had a great time not thinking about work and just experiencing the country.

I had about a week to relax after we returned, and then I started my new job. I LOVE IT!! I'm the second pediatrician in a practice, and even though it's only been a week, I am already so happy here. My entire staff is wonderful and have been such a big help to me as I'm getting used to things out here, and the physician who hired me as been fabulous to me. Seriously, there are moments where I can't believe that this is my life! The only thing I don't like about the job actually has nothing to do with the job; it's my 45 minute commute each way. Hubby and I are still trying to sell the house, and as soon as we do, we'll move much closer to my job.

All in all, life is great.

Stepping up to the plate

2009-05-06T18:40:00.002-05:00

In the last 60 hours since our new block started, I have spent 40 of those in the NICU. I've been to quite a few deliveries. Most of them have ended up very happy. One did not. I'm still mentally grappling with the things I've seen in the last two and a half days, and I doubt certain mental images will ever leave my mind. I keep talking with my co-workers about it because I don't know how else to process everything, and unless you've been right there, understanding the emotions and hearing the guttural cries of someone just given devastating news can be challenging. Even when you know there is nothing else you or anyone else could have done to change the outcome, watching someone suffer such a great loss is heart wrenching. I cried both at work and after work on Monday, and I've actually cried again today. I honestly hope that I never lose that sensitive side, and I doubt I ever will.

I am so thankful to those people that God has called to work in intensive care settings because I am definitely not one of them. I'm a relationship-oriented person which is a huge part of why I love working in a clinic; I get to form relationships with families and partner with them to take care of their children. I have less than 80 days til I start my new job, and I am so excited that words fail me when I try to explain!

I came home after my 29 hour call (yay for friends who let me leave an hour early) and crashed for a glorious 4 hour nap. I'm now waiting for Hubby to get home. He'll give me a big hug, and I know I'll start to feel a little better. Then he'll take me to get food, and since we all know how much I love food (both to make it and to eat it), I know that will help too. He'll make me laugh, and humor (even when it is dark humor at times) is a necessity to make it through the hard times.

A friend of mine told me about a sign posted in the ICU where she did med school that asked the families not to be offended if they saw providers laughing; it doesn't mean we don't care -- it is simply a coping mechanism for us to continue to keep hope and be able to come back to face another day of the battle against death and disease. Sometimes laughing is the only way not to cry, and there is definitely a time and place for both. I've had my tears today; now it's time to let my sweetheart make me smile.

Soon I will be able to go back to bed and sleep (the very opposite of what I did last night on call). I know tomorrow will look brighter, and I am looking forward to another day of helping people even if it's outside my comfort zone. May God give me strength when I am weak and words of peace for others in their troubles.

Slacker

2009-04-28T12:06:00.002-05:00

It's 1:30 PM, and I'm still in my pajamas. I worked in the ER til 2:30 this morning, so I don't feel so bad about my choice of clothing at the moment especially since I'll be back in the ER at 6 tonight. I know I need to update my blog, but I have been a slacker. I don't have a really great excuse; it just seems that every time I try to put my thoughts down lately, the words don't convey the depth of the experience.

To sum up the last 2 weeks in tidbits:

I really love my husband. We drive each other nuts sometimes, but I love that man so much!!
My experiments in the kitchen have been exceptionally tasty recently. I've made a ton of chocolate chip cookies, one delicious pot roast (thank you, Barefoot Contessa!), several yummy spaghetti dishes with extra veggies, a yummy butter cake, two batches of java-streusel banana muffins, mango sorbet for the hubby, and a batch of vanilla bean ice cream. I've given most of the food away which is why I haven't gained 50 pounds.
Swine flu is not my friend right now. Neither are the 300 parents crowding the ER wanting their perfectly healthy kids tested for the swine flu.
I think we've figured out where we want to move. As soon as our house sells, we'll re-examine the area to see what houses are available, but it's nice to have an idea of where we want to end up.
On the other hand, I really dread packing this house and finding a moving company!
Speaking of other hands, I already bought my birthday present even though my birthday is six weeks away. Hubby is taking me to see Fiddler on the Roof when the production comes through Dallas in May. I am SO excited!! I loved that movie when I was little and can still sing all the songs from the musical.

Roller coaster ride

2009-04-14T19:27:00.002-05:00

The last week has been quite a roller coaster ride. On more than one day, I cared for patients who have been the victim of child abuse. I actually started to cry in the ER after one particularly emotional case, and I had to sneak out for a few minutes til the tears stopped and I could compose myself. I hate that these kids are suffering, but I love helping them. I held one for a while during one of my shifts and whispered to this little one that they are loved. Who knows if this child had ever heard that before? The very thought broke my heart.

In stark contrast to those awful experiences, yesterday held an amazing moment for me where I sat down with a family and talked over a diagnosis that I correctly identified after two other outside physicians had missed it. I loved being able to provide reassurance to these parents, and 15 minutes after we started talking, the mom thanked me and proclaimed, "I feel 100% better; I think I'll actually be able to sleep tonight." When I left their room for the last time, I felt a serious sense of accomplishment. While I was proud that my knowledge base had expanded enough that I knew the correct diagnosis, I was even more thrilled that I had been able to connect with these parents and relieve their anxiety. They trusted me, and as I was talking with them, I realized just how much I love this part of my job!

I have been given a huge responsibility and a huge gift at the same time. What a thrill!

Stellan

2009-03-30T17:10:00.002-05:00

Those of you who read this blog will know what I'm talking about. I'm praying for Stellan.

Closing a chapter

2009-03-24T19:12:00.003-05:00

I've been pondering this post for a few days, and I still don't know exactly where it's going to go. I just know that I need to write it even if only for myself.

Three years plus a week ago, I opened a letter that told me I had matched to a residency in Dallas. Hubby and I had done a great deal of praying over the matter and believed God wanted us in Dallas; opening the letter confirmed it. A month after opening the letter, Hubby and I said our vows and started our life together. Another month plus a week after that, we packed up our two cars and drove to Dallas. I had cried many times as we said goodbye to friends over the preceding weeks, and I cried again as we drove out of Houston. I had spent the last seventeen years in Houston or in nearby College Station, and leaving home hurt. I consoled myself by thinking that it would only be three years before we would come back, and that brought me comfort.

The next year was truly the hardest year of my life, and there are still moments when I look back at it in sheer amazement that I came through in one piece. Intern year raked me over the coals (as it tends to do to most of us), and worse still, I was separated from my beloved most of that year. I missed him and missed my friends so much that it physically hurt. I felt like I was in such a weird position of being a married woman without a husband around, so I didn't know which direction to turn to find friends up here. I felt uncomfortable hanging out with couples being the lone female, but living the single life (obviously) did not feel right either.

At the end of my intern year, we learned that my in-laws were going to be divorced. I knew God had at least one reason for us to come to Dallas, and this was surely a big one. We live only an hour from them compared to three hours from Houston, and being close by has been exceptionally important. Even with this, I know I subconsciously held on to the thought that we might return.

As the time for me to search for a job began to approach, Hubby and I began to talk through the ideas of where we thought we should be looking. We came to the conclusion that staying here in the Dallas area was the right thing for us. My parents left Houston two years before I did, and we have no more immediate family down there. We have no intentions to move to Mississippi where my parents now live, and Hubby's family all live within an hour and a half of us up here. God willing, children will come in the future, and we desire to be near family when that time comes. We had built a new house a year after moving here and were in no hurry to move again. Hubby has also done very well with his job up here, and it would not have been a wise move for him to have to change offices for the second time in three years. From my perspective, I already know the lay of the medical land (so to speak) here in Dallas compared to Houston, so there were advantages for me as well.

I have to be honest that I was and still am a little sad about not moving back to Houston. Leaving my hometown is HARD; leaving friends behind is even harder. Last weekend, one of my close friends from college got married. I miraculously had the weekend off, so Hubby and I spent the weekend in Houston. We didn't have enough time to see everyone we wanted to, but we were blessed with the chance to catch up with several old friends. I almost knocked over one of them from hugging her so hard upon seeing her! I'm hoping that in three and a half months when residency is over, I will have more opportunities to see our friends than once every three years.

Sunday morning we went back to the church where we were members before we left, the same church where we were married thirty five months earlier (to the day!). As the lights dimmed for service and the music began, I nearly lost it. I started to cry and couldn't even sing for a moment because my voice was quivering so hard. I missed Houston. I missed my friends. I missed the roads I had driven for years but was starting to forget. I missed the hole-in-the-wall restaurants where I'd spent hours eating and laughing. I missed the memories that came to mind when I'd drive by a certain coffee shop or store.

After the service, Hubbs and I went to our favorite little Greek restaurant to meet up with another set of dear friends. Since we beat them there, we had a few minutes to talk and digest everything that had happened that weekend. I confided that I'd cried during service (the bangs can hide things really well!), and he listened as I explained why. I know that we belong here and know that God has a purpose for us in Dallas; I just needed a moment to release my emotions and acknowledge that it's okay for me to miss friends and even a city.

At this point, Hubby said something profound that I'd never considered. He pointed out that coming to Dallas was probably a great thing for our marriage; since we didn't know anyone else up here, we had no other friends to lean on when we felt lonely (me when he was out of town and him when I was on call). Had we stayed in Houston, when I was gone, he would have still had all his buddies and probably would not have "needed" me as much and vice versa. Both of us are fiercely independent creatures, and learning to depend on each other and to have another person be such an integral part of our daily life is something only God could have worked.

Eventually we wrapped up lunch with our friends and began to start the long drive back to Dallas. All weekend long, we'd intermittently talked about missing Sebastian, and now that we were headed back to pick him up, I truly began to get excited. He's our little canine child, and I couldn't wait to see him! Hubbs actually felt the same way, and it turns out Sebastian did too!

An hour after picking up Sebastian, we drove through downtown Dallas. Almost immediately, the thought "we're home" crossed through my mind, and I couldn't believe it. How can two places feel like home? I still don't have the answer, but I know that I'm going to be okay. I know that I'll always hold a special place in my heart for Houston, but I know that my place now is here. I know that God has a plan for me where He has placed me, and I will rest, satisfied in the knowledge that He is good and will not let me down.

YAAAAAY!!!

2009-03-11T21:48:00.002-05:00

I HAVE A JOB!!

I signed my contract this evening. I have a job in Plano joining a private practice; I'll be starting shortly after residency ends. Hubby and I are SO EXCITED!! God has been SO faithful through all of this. Now it's time to put our house out on the market and pray for a buyer.

Did I mention that I HAVE A JOB?

:)

Wisdom where I needed it

2009-03-09T21:55:00.004-05:00

To say that today has been stressful is the understatement of the year. As I did my normal Sarah stressing-out thing, God provided wisdom and comfort to me through the words of Charles Spurgeon.

"My grace is sufficient for thee."
2 Corinthians 12:9
If none of God’s saints were poor and tried, we should not know half so well the consolations of divine grace. When we find the wanderer who has not where to lay his head, who yet can say, “Still will I trust in the Lord;” when we see the pauper starving on bread and water, who still glories in Jesus; when we see the bereaved widow overwhelmed in affliction, and yet having faith in Christ, oh, what honor it reflects on the gospel! God’s grace is illustrated and magnified in the poverty and trials of believers. Saints bear up under every discouragement, believing that all things work together for their good, and that out of apparent evils a real blessing shall ultimately spring—that their God will either work a deliverance for them speedily, or most assuredly support them in the trouble, as long as He is pleased to keep them in it. This patience of the saints proves the power of divine grace. There is a lighthouse out at sea: it is a calm night—I cannot tell whether the edifice is firm; the tempest must rage about it, and then I shall
know whether it will stand.
So with the Spirit’s work: if it were not on many occasions surrounded with tempestuous waters, we should not know that it was true and strong; if the winds did not blow upon it, we should not know how firm and secure it was. The master-works of God are those men who stand in the midst of difficulties, stedfast, unmoveable,—
“Calm 'mid the bewildering cry,
Confident of victory.”

He who would glorify his God must set his account upon meeting with many trials. No man can be illustrious before the Lord unless his conflicts be many. If, then, yours be a much-tried path, rejoice in it, because you will the better show forth the all-sufficient grace of God. As for His failing you, never dream of it—hate the thought. The God who has been sufficient until now should be trusted to the end.

I love pediatrics

2009-03-04T17:04:00.002-06:00

Today I saw five patients in my weekly continuity clinic; 2 of them were my personal patients that I have followed since birth. Both of them turn 2 next month, and I cannot believe how big they have gotten. I adore both of these babies, and I love knowing that I have made at least a little bit of difference in these children's lives. I've been starting to let patients know that I'll be leaving at the end of June, and it has been so touching to have these families tell me that they don't want me to go!

I love watching my patients grow up in front of my eyes. I love meeting new families and establishing relationships. I love being able to teach a new mommy something wonderful about her baby. I love holding a newborn in my arms and feeling their little bodies snuggle down. While I obviously can't fix everything, I love the opportunity to talk to these families about important topics like obesity and diabetes before it's too late.

Three years ago, I wondered if I'd made the right decision when I chose pediatrics. I know beyond a shadow of a doubt that this is where I am supposed to be.

Pause

2009-02-25T17:35:00.006-06:00

I take after my dad in many aspects. One of those is my dislike of the uncertain. If you tell me, "I have something to tell you," I want to know now, not later, especially if you tell me that you have bad news. Hubby will back me up on this one; he has learned he can never tell me that we have something we need to talk about unless he's ready to sit down now. I can't stand the suspense!

Tuesday night I got an email from my attorney letting me know that she wants to discuss my contract with me, but unfortunately, she's had a death in her family and will be out of town til early next week. I definitely appreciate her letting me know why she'd be out of touch for several days, but it made me NERVOUS. I had really hoped to get the ball rolling on getting my contract signed this week, but now there will be a delay.

I was so stressed when I got the email last night. I actually had a momentary freak-out til Hubby and my dad both talked some sense into me. Now I'm fine; I still don't like waiting for a week to hear her opinion, but I know that it will all work out.

The situation reminded me of a quote from Evan Almighty; Morgan Freeman is playing God, and he asks Evan's wife this question:

Let me ask you something. If someone prays for patience, you think God gives them patience? Or does he give them the opportunity to be patient? If he prayed for courage, does God give him courage, or does he give him opportunities to be courageous? If someone prayed for the family to be closer, do you think God zaps them with warm fuzzy feelings, or does he give them opportunities to love each other?

In my old Bible, I underlined Philippians 4:6-7 (referenced in this post) and wrote "Do not be anxious, Sarah!" right next to it. I know God is using this time to teach me patience through practice. Now it's time to put it into action and be at peace through the next week or however long it takes to complete this.

When I have everything signed, then I will be able to tell more about the specifics of the job. Needless to say, I am VERY excited!!

Thankful

2009-02-22T23:32:00.004-06:00

I have a bad case of insomnia tonight while Hubby is curled up in bed and is snoring away. Bless his sweet heart, his allergies are really acting up, and he's also getting over a little cold. He apologized in advance before he climbed into bed because he figured he'd probably snore tonight.

Here's the thing: I am thankful for his snoring. We spent so many nights apart during the first two years of our marriage that I would rather have him snoring in my ear than be miles apart. Having to nudge him to roll over is something that I don't mind one bit; in fact, I appreciate being able to do so.

He's been back in town since August, four months longer than his project was originally scheduled to go. Even better, there's no real end in sight to this project. He'll likely be on it when I start my new job this summer.* Words truly fail me when I try to express how thankful I am that God has allowed my husband to be physically with me during this year of my life. I honestly don't think I would have made it through interviews and the decisions that followed without him here.

I'm finally getting sleepy, so now it's time to return to the most comfortable bed in the world and the sweet love of my life. Snoring or not, I'm so happy he's here.

(*Details on the job to come soon ... I'll likely sign a contract this week!)

Apparently I'm wise ...

2009-02-16T18:41:00.002-06:00

There have been two times in the last two weeks that I've been told I'm either very wise or very smart for stating things that seem very common sense to me. The first time, the front desk staff at an office where I was interviewing kept apologizing because the physician who was interviewing me was running fifteen minutes late. Fifteen minutes late in the middle of flu season is NOT bad at all! I made the comment that anyone who didn't understand running a little behind in the dead of winter probably doesn't belong in pediatrics. That statement got me big points.

Today I was talking with two medical students, one of whom is recently married and the other who is in a long term relationship. I mentioned that Hubby and I have a rule that we do not argue on an empty stomach, and that if either of us hasn't eaten, we postpone the "discussion" until at least part way through the meal. That rule has saved us SO many fights! Both of us can be quite cranky when we're hungry, so taking that factor out of the equation has made navigating the differences we have much easier. Both of them looked at me like I was a genius, and the male student said that he was going to talk to his girlfriend that night about implementing that rule.

Maybe I should look into Mensa.

Answered prayer

2009-02-11T07:05:00.003-06:00

I was talking with the girls from Bible study on Monday night and telling them about recent developments in my life. As I was speaking, I realized just how rich God's blessings on me really are. I have been praying for God to take my anxiety away and to make me want what He wants for me. I think it's happened, and I'm so excited about it.

Good news

2009-02-07T22:34:00.002-06:00

Today I got some good news. I think it's an answer to prayer, but time will soon tell. No, I'm not with child, and no, I didn't win the lottery. More details to come shortly!

Good day

2009-01-27T17:23:00.003-06:00

I had my first interview today. I have two more scheduled within the next six days, and I'm still working on scheduling another one. Today went really well, and I am very thankful for that! I know God will guide me where I am supposed to go; now I just have to be patient to see where that is. Can I mention that I looked awesome in my suit? I caught a glance of myself in the mirror, and I couldn't believe how much I looked like a grown-up. :)

In the meantime, I do have several fun activities lined up for the next few days ... dinner with the residency applicants on Thursday, lunch with my best friend from growing up on Saturday, and a Super Bowl party on Sunday. I'm excited about all of these but especially seeing Lindsay; she's pregnant with her first child, so I'll get to see her and meet her husband for the first time.

I have so many things for which to be thankful!

Growing pains

2009-01-19T17:56:00.003-06:00

This has been a rough two days. I finish residency in less than six months, and I don't have a job yet. To my knowledge, none of us in my class who want to go into private practice do, so I don't feel too bad, but I'm still scared. When I get scared, I tend to do one of two things: go into overdrive or freeze. When it comes to finding a job, I've been frozen in my tracks. I haven't had much guidance in the process, so I have drug my feet along. Over the last twenty seven years, I've gotten really good at applications for school and for residency, but again with each of those, I had a more clear direction on where to move. Here, I feel like I'm standing on the edge of the high dive on a cloudy night, waiting to dive headfirst into the dark waters below. I don't know what lies beneath, and it frightens me.

So why have the last two days been rough? I went to a gen peds interest meeting last night and talked to former residents who are now in private practice. Seeing them with their "real" jobs made me realize how scared I am that I won't find one. I know that I can get "a" job, but I want "the" job. I went home and emailed a few contacts that I'd been dawdling over and two new contacts that I had obtained, but still my mind kept racing. I tried for a few hours to fall asleep, but I was gripped with anxiety like I haven't felt since college. Anyone who knew me then will likely remember how uptight I was, but not all of them knew that I lived with a constant knot in my stomach. Many times I couldn't even verbalize why I was so anxious, but the constant worry of things to come clouded so many of my days.

I fell asleep last night with prayers on my lips and woke early this morning to find comfort in His Word. I am not a morning person, so for me to be fully awake and functional enough to have a quiet time that early was amazing. Later today I made a cold call to a practice that I really really liked and hoped would have an opening; the fact that I could even cold call an office, let alone this one, amazed me because I hate doing any sort of asking for my own needs. To my disappointment, I was told that they would like to hire another pediatrician but just don't have the funding for it right now to help me establish my practice.

I hung up the phone, crestfallen. This practice appears to have everything I want -- great physicians, great office staff, great location, great call schedule; I began to wonder if I would ever find another practice that I liked as much as I like this one now -- or any practice at all that would take me. I texted Hubby to ask him to pray for me as I could feel myself growing anxious again, and I know my sweet Heavenly Father provided comfort for me as I drove home.

As I spent time working out, I began to realize that while I have been praying "Your will be done," my evil, selfish flesh is wishing for "MY will be done." It's my will that I join this practice, but unless God is the master of it, the entire experience will be a disaster. He has never provided anything less than the best for me, so why should I doubt Him now in this area of my life?

I'm not saying that the next few months will be easy or comfortable for me -- NOT AT ALL! I have a telephone interview with someone tomorrow, and we will have to see what opportunities come from that. God already knows where I will be in six or seven months, so until He reveals it to me, I will do my best to rest in His peace and hold on to the words of Philippians 4:6-7:

6 Do not fret or have any anxiety about anything, but in every circumstance and in everything, by prayer and petition (definite requests), with thanksgiving, continue to make your wants known to God.
7 And God's peace [shall be yours, that tranquil state of a soul assured of its salvation through Christ, and so fearing nothing from God and being content with its earthly lot of whatever sort that is, that peace] which transcends all understanding shall garrison and mount guard over your hearts and minds in Christ Jesus. -- Amplified Bible

I love it!! I just got Jon Foreman's CD Limbs and Branches, and the first song on the CD speaks to me where I am now. Sometimes hearing familiar Scriptures in a new way makes them so fresh and so alive.

Heavenly Father, You always amaze me
Let Your kingdom come in my world and in my life
You give me the food I need to live through the day
And forgive me as I forgive the people that wronged me
Lead me far from temptation; deliver me from the evil one
I look out the window; the birds are composing
Not a note is out of tune or out of place
I look at the meadow and stare at the flowers
Better dressed than any girl on her wedding day
So why do I worry?
Why do I freak out?
God knows what I need
You know what I need

Chorus (3x):
Your love is
Your love is
Your love is strong
The kingdom of the heavens is now advancing
Invade my heart; invade this broken town
The kingdom of the heavens is buried treasure
Will you sell yourself to buy the one you've found?

Two things You told me: that You are strong and You love me
Yes, You love me
(Chorus 3x)

Our God in heaven, hallowed be Thy name above all names
Your kingdom come, Your will be done on earth as it is in heaven
Give us today our daily bread; forgive us wicked sinners
Lead us far away from our vices and deliver us from these prisons

Happy New Year

2009-01-04T16:46:00.002-06:00

I didn't mean to let 2.5 weeks lapse between entries, but as it usually does, life got in the way. I only have 1 week left of being senior on this service, and then it's 3 months of electives in a row for me. Can't wait! Less than 180 days left of residency -- whoo hoo!

Another first

2008-12-18T17:44:00.003-06:00

Tonight Hubby and I are going to my first Stars game! He got tickets from one of the men he works with, so as soon as he gets home, we are headed out. It will also be my first time to ride the TRE, the local commuter train that goes between Ft. Worth and Dallas. We have a station not too far from our home, so rather than drive through the thick fog blanketing our area, we're going to take the train. I had been to a few IHL games back in Houston, but this will be my first NHL. I'm excited!

Tear

2008-12-17T14:56:00.003-06:00

I started as senior on a new service on Monday. Last night was my first overnight call; I have five more left of these occurring once every 4 days (with the exception of 5 days off for Christmas), and after 31 hours at the hospital, I'm tired. Despite all the frustrations that occurred, I had a touching experience last night that reminded me yet again why I love kids so much.

Early in the evening, I did an admission on a patient that I hadn't seen since my intern year. I remembered that this patient's mother passed away about 3 weeks prior to our initial meeting, and I knew that Granny was now the primary caretaker. I re-introduced myself to the family including my patient's younger sibling that I had not met previously, and soon the family had me cracking up laughing over how hilarious the kids are. The younger child (who I'm guessing was around age 4 or 5) wanted to be the center of attention and asked me to do an exam with my stethoscope, so since I had a few extra minutes, I complied. As I placed my stethoscope on the sibling's chest, I explained that I was listening to the heart. The sibling looked up at me with beautiful, trusting eyes, and matter-of-factly informed me, "That's where my mommy is."

A lump caught in my throat as I looked up at Granny. She smiled at both of us, and I'm pretty sure she had tears in her eyes. This sweet child exuded such innocence and love; I couldn't resist giving out a hug before I left the room!

Electric

2008-12-08T22:05:00.004-06:00

Last week my mother-in-law and I went Christmas shopping. Naturally our day included a stop at Bed, Bath, and Beyond (honestly, is any shopping day complete without a visit there?). One of my purchases was a small square squishy pillow that I can use both in the car and in bed.

A few nights ago, I woke up in the middle of the night, and as I was repositioning the pillow, I noticed green sparks coming off my hand. I wasn't sure if I was just imagining it, so I went back to sleep. Early this morning, Sebastian woke up and started barking, so Hubby was sweet enough to free him from his kennel, allowing me to stay warm and cozy. As he climbed back into bed, I repositioned the pillow again; this time, I knew for sure I wasn't making up the green sparks! The static electricity from this pillow is amazing! I got Hubby's attention, and I'm know he saw the sparks too.

Had the room not been pitch black, I would have seen an incredulous look on his face in addition to the little sparks. I can only imagine the thoughts running through his head about how insane his wife was to be giving science lessons at 3 AM. He's so sweet to put up with my craziness. Now if I start explaining how to do medical procedures in my sleep, I'll know I'm in trouble.

Panic at the testing center

2008-12-03T07:54:00.004-06:00

I'm in the middle of applying for my license to practice medicine in Texas. I already have my provisional license to practice as a resident, but now it's time to get the full meal deal. My wallet is over in the corner crying again as it has already cost me over $1000 so far, but it will be worth it in the end. Among the many hoops through which I have to jump is taking the medical jurisprudence exam. It's 50 questions in 90 minutes, and we can only miss 12 to pass. I studied for it a little during PICU night float over the last 2 weeks, but since I didn't really have enough time, I devoted the first day of my vacation (Monday) to hitting the books. By the time I left to take the test Tuesday morning, I felt decent about the test and just wanted to get it over!

The testing center was about 30 minutes away from our house, so I left at 7 AM to make sure I had plenty of time to sign in before the 8 AM exam. In order to take the test, I needed to show my scheduling permit from the board as well as two forms of ID that both had my signature. As I was sitting in the waiting area getting ready to check in, I peeked into my purse again. Permit? Check. Driver's license? Check. Passport? Check. Since I recently got my passport with my new name and photo back in the mail, I decided to look again and the picture and see how much it didn't look like me.

To my horror, the face in the picture looked like me ... nine years ago. I had grabbed the wrong passport! My old passport has my maiden name on it, and since my new IDs don't include that name, I knew I couldn't use the passport to prove my identity. I frantically began to look through my wallet, and to my dismay, not a single credit card was signed. As fate would have it, I only had a pencil in my purse, so I couldn't even sign a card. I could not believe this was happening to me, little Mrs. Prepared!

I began to pray for anything that would help me out. A few minutes later, I noticed that the man sitting next to me was holding an electrical book and possibly looked like some kind of engineer. I asked if he happened to have a pen I could borrow, and by a miracle, he did! I quickly signed the back of my debit card that has my photo on it and profusely thanked him. Five minutes later, I was called to the front and signed in with no trouble!

I was a little worried about the effects of the morning on my exam, but I had nothing to worry about. I passed with flying colors. I've jumped yet another hurdle in my path towards practicing on my own! Now my vacation can really begin.

I'm a stalker

2008-11-26T09:44:00.002-06:00

I have to admit that I am an avid blog stalker. There are quite a few blogs I read regularly -- most of them belong to people I know (although many of them probably don't know I read their blogs), and quite a few belong to people they know but whom I have never met.

This weekend, I was shopping with the hubby at the mall. As I was searching through the petite section for a pair of jeans, I looked up to see a familiar face. My first thought was, "Hey, I know her!" I soon realized that I didn't actually know her; I just knew her blog. I thought for a brief second about introducing myself but realized how crazy that would make me look (especially b/c I couldn't remember who the initial connection was that got to me to her blog -- I now do remember). I'm just glad I didn't say anything stupid so that she wouldn't think I was a real stalker.

Sleepwalking

2008-11-24T18:12:00.003-06:00

I'm on PICU nights right now. I hate it. I work 7 PM to 9 AM Sunday through Thursday nights for 2 weeks in a row (except that on Sundays I come in at 5 PM). It gives me the required 10 hours off between shifts, but I think it's safe to say that not a one of us thinks 10 hours is enough especially when you work 5 shifts in a row. It's only two weeks, but it's already been a LONG week plus a day. Last night I had parents of a very sick child get angry because of things that happened before I even came to work, and they took it out on all of us. I understand people react differently when they are scared, but to this non-confrontational person, having someone cursing at me and insulting both me and my hospital was very unsettling. To top it off, I'm going 48 hours or so without seeing my husband; this may not sound like a long time given how much time we used to spend apart, but now that I've gotten used to having him around every day, it's awful to go for 2 days without seeing him. :(

Six shifts down ... four to go. Let the countdown commence. I finish Friday around 9 AM, and then I start a 10 day vacation!! My plans include decorating for Christmas, finishing up my shopping (almost done!), and sleeping. Since I'm working Thanksgiving night, I'm making our own Thanksgiving meal on Saturday; the full menu hasn't been planed, but it will definitely include my famous brined and roasted turkey! I seriously cannot wait.

What is that smell?

2008-11-12T20:45:00.003-06:00

When I woke up yesterday, I realized that the same muscle I pulled six weeks ago was feeling tight. Since I'd been on my feet for roughly 30 consecutive hours over the weekend and worked out on Monday, I decided to give myself the day off. I even tried a little Capzasin on it before I went to bed, but it's been REALLY tight today. It hasn't spasmed like last time, but it's been tight enough that I'm walking a little different and have really been uncomfortable. Hubby and I were out running errands tonight, so I asked if we could stop at CVS to get some medicine.

After looking at the ingredients in the creams, I ended up selecting the one with the most ingredients (which also had the highest concentrations of any of them as well). One of the ingredients happens to be methyl salicylate; one whiff of this stuff, and you'll be transported back to your grandparents' medicine cabinet. As I was putting it on, I made some crack to Hubby about being able to call me "Grandma," and we had a good laugh. He left the room for a few minutes, and when he returned, he exclaimed, "Honey, you really DO have that old woman smell!"

At this point, I don't even care. I have to say that the cream is working! My calf is tingling, and I can actually move my leg further than I've been able to do so for the last two days. If smelling like a Wint-O-Green Lifesaver is what it takes to be able to walk normally again, I will suffer through it!

The bubbly ...

2008-11-10T14:30:00.002-06:00

I hate tapping big kids. By tapping, I mean performing a lumbar puncture on them. By big kids, I mean anybody over twelve months. This weekend, I took a hellacious PICU call (thirty hours with no sleep thanks to one child who kept me baffled all of Saturday night and most of Sunday morning). During the day, we admitted a teenager who presented with some very abnormal neurologic symptoms, and the decision was made to do an LP. Since I was not on the admitting team and was just helping out another resident, I stood by and watched as she attempted the tap. She was very confident and did a great job, but for some reason, she didn't get CSF. I was so not thrilled about trying for it; feeling for landmarks on a well-nourished 16 year old female is so much harder than feeling for them on a skinny two month old! I said a quick prayer, marked my spot, and went for it. With a few adjusts of the needle, I suddenly had CSF ... clear, beautiful CSF pouring into my vials. We measured an opening pressure, collected our precious samples, and quickly wrapped up.

A few hours later, we were running labs and vitals. Lo and behold, I had a champagne tap. :)

I needed that.

Zzzzz

2008-10-29T20:27:00.003-05:00

Sarah = boring. At least my blog seems to make me look that way! I have actually been pretty busy with work but have had enough down time over the last week to make two delicious soups from scratch (crab & corn chowder as well as shrimp bisque), a pot-roast, and two baked goods (double chocolate cake with white chocolate-sour cream icing and cranberry-orange scones). Hubby and I had the opportunity to go out to eat with some sweet friends of ours at a great restaurant on Saturday night and again with another couple we adore on Sunday. We had a busy but great weekend!

I donated blood yesterday, and I've felt a little tired since then, but this feeling is totally worth it. I'm CMV negative, something a little uncommon by the time you're my age, so I get hit up by the blood bank every eight weeks since my blood can be donated to the little ones as well as to immunocompromised individuals. I haven't been able to give every time I'm eligible, but I try to do it as often as I can. I have a firm belief that since I have ordered so much blood for my patients in the last two and a half years, I should help to supply that blood while I am able to do so.

I love that the weather has started to turn cold. We've actually had to put our electric blanket on the bed! As my hubby likes to say, "yes, we are old." I'm curled up on our bed under my quilt and am about to snuggled up underneath the quilt and the electric blanket. Comfort awaits!

Amazing

2008-10-17T09:51:00.002-05:00

We've been back from Disney World for a week, and I have to say that our time was amazing. We had SO much fun! I have a decent amount of pictures to post, but our internet was down at home for part of the week. I took the pictures to work only to find that the computers there block me uploading anything, and now that I have internet at home again, the pictures are still up at work. Doh! Work has been killing me; I've been there from 8:30 to 7:45 almost every day (Wednesday was only til 5), so I have had little time for anything other than work. Today and tomorrow I'll work noon to midnight, and Sunday I'll work 11 to 7:45-ish. I can't wait to be done with this month!!

Highlights from our trip:

Meeting Mickey :)
Riding some really cool rides
Lines so short that we were able to walk onto many of our favorite rides or wait less than 20 minutes
Waiting in airconditioning for most of the rides :)
Laughing with Hubby at how silly we looked in our rain gear
The Ecpot food and wine festival
AMAZING sushi at a local restaurant recommended to us by a friend
Getting to feel like a little kid again

When I can, I will post some of the pictures. Hopefully next month will give me more time to get things I need to do AND want to do completed!

Countdown!

2008-10-02T22:18:00.001-05:00

Thirty six hours til Florida ... sixty hours to Disney ... I really don't know how I'm going to work a noon to midnight shift tomorrow!

Shoot me now!!

2008-10-01T22:19:00.004-05:00

Last night started out on a really good note. Since I was working late again, Hubby grilled fajitas for us and even made a version of Chuy's creamy jalapeno recipe that I'd round on the Internet (very close to the real thing and SO tasty!). I went to bed with a full tummy, very excited about being able to sleep in the next morning; I was so tired that I fell asleep with the dog next to me (Sebastian isn't allowed to stay in our bed overnight). A couple hours later, I woke up with the sensation of having a large knife being stabbed into my right calf. I fell out of bed onto the floor and tried to bear weight on that leg, but the peach-sized knot that had formed in my calf forbid me from moving more than a step at the time. If Hubby had been out of town, I would have been screaming my head off from the pain, but as he was sleeping on the other side of the bed, I did my best to stifle my cries into whimpers and hobble into the bathroom where I could shut the doors and try to deal with this.

Moving into that room turned out to be quite beneficial. As the pain continued to increase, I began to feel worse and worse until all of a sudden, I was losing my dinner in the toilet secondary to the waves of pain washing over my body. I puked uncontrollably for a minute, and when it was all over, I brushed my teeth, drank plenty of water, and hobbled back into bed only to find a small Yorkie there just waiting for his mom to come back. I put the Yorkie to bed and dropped down into my half of the bed. Hubby, still barely awake at this point, made sure I was okay before we both gave into exhaustion and fell back asleep.

I didn't have another experience this bad again, but my calf still has a horrible knot in it. Hubby massaged it for a bit tonight, and I'm resting with a heating pad on my leg. I just hope this all gets taken care of before Saturday. Disneyworld can't wait! :)

My therapy

2008-09-23T15:39:00.003-05:00

After the last eight weeks, I desperately needed a day off with no pressing responsibilities or to-do lists. I had a great massage yesterday followed by a quick, short-notice trip to visit my mother-in-law. I had planned to spend yesterday afternoon relaxing, but since we made the trip instead, I decided to use today for my relaxation today.

I spent the morning curled up with Sebastian watching Season 2 of Heroes. Since we missed the season premiere last night, I figure I had time to refresh myself on last season (thank goodness for DVR!). Now I've moved into the kitchen (bringing the laptop and the rest of the season with me) and have started on my own version of therapy -- baking. I trialed a new recipe for a dessert called Serendipity Deluxe bars (3 layers of deliciousness -- all from scratch!) and am waiting on my yeast roll dough to finish its 2nd rise before I split it up into rolls and do the 3rd rise. I'm also testing the new breadmaker to make a loaf of fresh bread for sandwiches. Knowing what ingredients I'm putting into my recipes appeals to me, and making all of these treats from scratch has been so fun. I have some flour left over from the bag I opened today that won't fit into the flour canister, so I think I may make some peanut butter cookies too in a little bit. :)

Hubby's not going to know what to think when he walks in the door tonight! At least I know we're having salads for dinner tonight; that will help counter-balance some of the yummy goodness awaiting us for dessert.

Go, Cowboys, go!!

2008-09-21T20:01:00.003-05:00

This weekend my parents came to visit. Since Hurricane Ike wiped out a large portion of Houston, the wedding in which my brother was a groomsman was postponed, so he and my sister traveled to Dallas to join in the fun. We have had a blast!! The siblings had to leave this morning, but my parents get to stay until tomorrow. Right now we're doing what every good Texan family is doing -- watching the Cowboys game. It's fun to watch the boys get so riled up!!

The last two weeks have been long, and I have enjoyed these last two days off immensely. I have tomorrow off as well, so I am being blessed with an hour and a half massage (winning that gift card really paid off!), and then I'm probably joining Hubby for a quick trip down to his mom's to get some furniture out of storage.

Thirteen days from now, Hubby and I are headed to Walt Disney World -- my fourth trip and his first. He has no idea how much fun we're about to have and doesn't have a clue why I am so excited. I'm praying that no hurricanes come to ruin our fun, but no matter what, I'm looking forward to having time with him with no work to hang over our heads during our vacation. We've both been averaging 60-70 hours a week for the last few months, so this vacation will be very welcome!

Sister time!

2008-09-07T14:57:00.002-05:00

I had the weekend off, so my sister came to Dallas to visit. We had so much fun! Saturday morning Hubby and I finished cleaning the house, and I took Sebastian to the vet to get caught up on his vaccinations. He sure wasn't happy with me that day! By the time we got home, Becca was already waiting for us at our house. It was time to let the fun begin!

The three of us (Hubby, Becca, and I -- not Sebastian) went to Chuy's for lunch since Becca and I were craving some creamy jalapeno dip. Unfortunately, they forgot to bring out Hubby's plate, and by the time his food arrived, we were almost done eating; at least they gave him the meal for free since he pretty much had to eat alone! (He did encourage us to eat so that our food wouldn't get cold while we waited on him -- so sweet.) After lunch we did a little shopping and bought tons and tons of red meat for our weekend feasting (my hubby LOVES beef in any shape or form). I made a yummy mixed greens salad with bacon and balsamic vinaigrette as well as fully loaded baked potatoes while Hubby grilled his signature filet mignon. Becca agreed with me that his steak is better than most steakhouses and stated it was the best steak she'd had in years. My boy can grill!! :)

Becca brought us genuine kolaches from the Czech Stop in West, Tx, so we had those for breakfast. Becca and I are half-Czech and extremely proud of it (one of my next goals is to learn to make kolaches from scratch like the ones my grandma used to make), and having the kolaches reminded me of being a little girl going to visit Grandma in College Station and having cream cheese kolaches for breakfast in her little house. After church this morning, we had steak and grilled onion sandwiches, and now that Becca's gone, we've begun a long afternoon of watching football. Go Cowboys! This weekend was just what I needed; I now feel better equipped for another twelve straight days of work.

Lack of sleep leads to random thoughts

2008-09-03T18:10:00.006-05:00

Cardiology has been a pretty good rotation so far. While my call last Friday was way worse than my PICU calls, the day-to-day work has been easier. My interns are awesome, and I have even had great interns working with me when I'm covering other services! I had another long day at work today but at least got to see some REALLY cute kids in my clinic. I've worked 113 hours in the last ten days and will hopefully only work about 23 more over the next two before getting Saturday and Sunday off (isn't that sad that I just used the word "only" when describing that)?

I couldn't stop yawning while I was talking with my mom on my way home. She even asked if I thought I could make it home without falling asleep! I took an accidental nap on the bed with Sebastian sprawled across my shoulder, and when I woke up, I realized just how hungry I was. I grabbed a handful of ranch-flavored Goldfish crackers to tide me over, and I must have wiped my hand on my pants or something because Sebastian is going NUTS. He keeps trying to lick my pant leg and the spot on the bed where I put my hand down. It's hilarious!

I found out as I was walking out to my car today that another patient with whose care I was very involved passed away yesterday. That's three kids in four days. I didn't expect pediatrics to be this hard.

Hubby and I did some serious shopping this weekend. Several months ago, I lost the mixing blade to our breadmaker, so it's been out of use as I was having trouble finding a replacement part. This weekend I found the entire breadmaker on sale for only several dollars more than the blade alone by the time I factored in tax and shipping. Hopefully I will have time to bake bread again this weekend!!

I'm taking a big step by putting my blog address on my Facebook page. This blog has been a haven for my ramblings and is read by a couple close friends but more by people I wish I knew better (and maybe a few random people as well). I don't really know why I'm motivated to do this. It reminds me of something a friend once told me in medical school: "People just want to be known." Maybe that's part of it; I have a huge shy side (the loud side really is just a big act!), and I often feel like I have to put on a certain face depending where I am. I desire authenticity; I just want to be real.

Untitled #2

2008-08-31T18:58:00.004-05:00

I hadn't seen him in nine days.

I hadn't checked up on him through the computer in three days. The last time I looked, he was getting better and moving closer to going home.

I found out this morning that he had suddenly gotten worse through another resident who didn't know him but had helped move him to the ICU.

I learned an hour and a half later that he had already left this world and was with his Creator.

Ten minutes after my discovery, I was holding his mom in my arms and whispering, "I'm so sorry."

Fifteen minutes after that, I was weeping in the stairwell.

Ten hours later, I'm still praying for his sweet family.

I'm hoping that it will stop hurting in a few days, but I doubt it will. I mourn his passing but rejoice for his healing; he will never need my help again.

Sweet sleep

2008-08-23T22:46:00.002-05:00

Today was my first day off after working twelve straight days. I figured out I worked 140+ hours in those last twelve days, and sleeping in until 7:30 was such a treat this morning. Hubby and I cleaned the house this morning, I had my hair appointment at noon, and tonight I had dinner with one of my best friends from college who is now a vet back in Houston. It was a totally awesome day!! Tomorrow I get to attend church (a much enjoyed rarity!), and later we're having dinner with our pastor's family and a few other families who live near us. This weekend is breathing life into my exhausted soul.

Monday morning I start a new 4 week block; this time around, I'll be the senior on the cardiology service. It will hopefully be a little less intense than the PICU, and I already know most of the members of my new team and am really looking forward to working with them! I'll still work twelve days on/ two off for the 28 days I'm there; I already have a massage scheduled for the day after the block ends.

Right now Hubby and Sebastian are both sleeping away, and I'll soon be joining them. I love knowing that my alarm won't be going off at 5:15 tomorrow and that Hubby and I will get to spend quality time together where I'm not falling asleep in the middle of our conversations. Everyone needs a little break now and then, and I'm no exception.

Rainy day

2008-08-18T14:14:00.003-05:00

No profound thoughts on this post ... I'm on the 12th floor again today, and it's raining so hard outside that I can't see anything but gray outside the window. I only slept about 2 hours on call Saturday night/ Sunday morning and then dozed on and off for about 4 more hours Sunday afternoon, so I could really use another good sleep to get caught up.

Hubby and I went to see his mom yesterday. Seeing her was fun, and it was even better to have the time to hang out with Hubby. Even though I slept most of the way there and back, just being together was great. I have really enjoyed having him back in town! I have loved cooking dinner for 2 at night and having someone there to laugh at the little things with me. This is the start of the 3rd week in a row that he's been in town, and I am loving every minute.

Alrighty, time to get back to work ... it never ends here in the PICU!

Miracles still happen

2008-08-14T18:19:00.004-05:00

As I've said before, being a physician has strengthened my faith in God and pushed my faith to new limits like no other experience in my life. The intricacies of the human body remind me daily of how fearfully and wonderfully made we are, and I constantly marvel at His handiwork.

The last few weeks in the PICU have reminded me of that so much. We have had many sick patients who have not done as well as we have hoped, but we also have one patient in particular who has overcome incredible odds and is doing so much better than we could have ever predicted. Many people including me as well as many of the nurses and other providers have been praying for this patient diligently, and it's so incredible to see God working and restoring health in front of my very eyes.

Being able to participate in this patient's care has been such an honor. A family member thanked me today for all the work the team has done for this patient, and I was reminded of what I told this patient's mother (a fellow believer) a few days ago: "You know why [this patient] is doing so well, and so do I. God is the one who is healing."

I pray for my patients often, and I want to be more consistent at it. Doing so is a reminder of where my place is and what my role is, and I don't want to allow myself to get so easily caught up in the day to day rush of residency that I can sometimes forget that praying is one of the most important things I can do for my patients. I am simply a tool in the Master's hands, and my earnest hope is that He will use me as He sees fit to bring comfort, healing, or both to many families according to His plan. My post from almost a year ago still rings true in my heart.

Numbers

2008-08-05T18:12:00.004-05:00

I have worked 106 hours in 9 days. I still have 3 to go before I have a day off. I have lost 1 patient but helped many more. I have dreamed about the PICU 4 times since I started this rotation last week.

I am tired.

Definitely back

2008-07-29T17:58:00.003-05:00

I'm definitely back in the PICU. This time around, I feel that some of the kids I'm taking care of are even sicker than the ones I had last year. One of my patients is on both ECMO and CVVH and is hanging in the balance, so I have had a crash course in both of these over the last two days. Both of these are largely run by the fellows and attendings, but I'm doing my best to keep up with what's going on. I spent thirteen hours in the PICU yesterday and another seven and a half today plus an additional four in clinic; I'm tired of being at the hospital! I have another thirteen to fourteen tomorrow and at least ten on Thursday, and then I'll be there thirty hours straight Friday through Saturday. I will work again Sunday through Friday (no more overnight call during that period though) and then will have two glorious days in a row off. :)

Being the most senior resident on the team has been a very interesting experience. I have a sub-intern (4th year medical student) on the team, two second year residents, and one second year outside rotator, and since none of them have been in the PICU before Monday, they have been looking to me for guidance. I've actually surprised myself at times when I give answers I didn't even know that I knew. We had a new admission early this morning right before rounds, so with the help of the night float team, I did a quick history and physical in addition to seeing my regular patients. I didn't have time to print up my history, so I apologized to my attending that I was going to present off memory. When I was done, he gave me a huge compliment in front of the team by telling the med student, "Now that was a perfect history; Sarah told a story with that one -- something that tends to get lost when people have their papers in front of them ... great job, Sarah." I actually felt not on top of my game since I had been so rushed that morning, so when my attending complimented me like that, I got a much needed boost. Being that I'm back in the PICU, I'm a little more emotional than normal, so I'm surprised I didn't start crying in front of the team!

Knowing that Hubby will be back in town in two days for two months (yay!!) makes this month easier to bear. I also love having Sebastian home to greet me at the end of the long day; his little tail wags a mile a minute every time I walk through the door, and he makes me laugh with his silly puppy antics. My little family is my escape from the stress of the PICU, and I am so thankful for them!

Wakey wakey ...

2008-07-25T11:26:00.003-05:00

I am done with nights for a bit! I have three days off, and then I switch back to PICU days for a month (only two overnight calls for the four weeks). To try to switch my body back to days, I'm going to stay up as much as I can today and sleeeeeep like a baby after a sushi date tonight. Poor Hubby has barely seen me this week; I left for work Sunday around noon, got home the next morning around eight AM when he was already working, and proceeded to sleep until five PM. I'd leave for work around 6:30 and be gone all night til eight the next morning every night through last night, so it almost felt like an out of town week for us. He was so sweet and grilled filet mignon two nights during the week so that I would be well fed for the night (hospital food gets old!), so that made me miss him even more. We decided to go out for a date night to catch up on everything that has happened this week; I can't wait!

Even though we didn't see much of each other this week, I was so thankful Hubby was here this week; I was part of a really sad situation involving a young kiddo earlier this week, and when that got combined with another stressful situation at work, I broke down crying in front of one of my favorite pharmacists. Coming home to a long hug helped my tears to dry and my spirit to heal. I already know that the PICU will have sad stories (as it always does), so I look forward to having his support close at hand.

On another exciting note, Hubby will be out of town for another week and then will be back in our own city for at least TWO MONTHS. There really aren't words to express how overjoyed I was when I heard this project came through. We haven't lived in the same city consistently for that long since we were engaged, so I am THRILLED. This project is such an answer to my prayers. As an added bonus, the project is coming when I should only have to spend four of those nights in the hospital. While they will be difficult intense months for me (PICU and Cardiology senior), having my best friend home at the end of the day will make everything more bearable.

Same old song and dance

2008-07-17T21:30:00.001-05:00

My internet isn't working on my laptop at home, and even when I have been home, I have been sleeping for the last four days. I'm on my fifth night in a row of night float. I have a great team, so it has been bearable, but I am ready to be done. I get a two night break starting tomorrow, and then I just have five more nights to go after tonight!

If things will slow down a little tonight, my team is going to have a dip party. I brought fixings for guacamole, my intern brought hummus as well as artichoke and crab dip, and one of the second years is bringing cheesecake dip for dessert. Yum!! Having fun when you're stuck here at night is essential to survival, and tasty food sure doesn't hurt.

Hubby is scheduled to get home tonight, so I should see him in the morning when I get home. We're going to make fajitas again either Friday or Saturday night so that I can make my guacamole for him again (one of his favorite things in the world). Kroger had a huge sale on berries this morning, so I bought strawberries, raspberries, and blueberries to make a delicious dessert that also utilizes marscapone cheese and ladyfingers. I'll still be on night float next week, but he'll be home that week, so we'll at least get to see each other when I get home and before I leave. We're going to have good times this weekend!

(I know the font is messed up on this post, but the computers here won't let me adjust it. I will fix it after Hubby fixes my internet this weekend.)

Travel Size Comfort

2008-07-08T16:09:00.004-05:00

My hubby is a frequent traveler, and before we got married, it became a joke among my family that everything in his life is travel size including his wife (we have a 12 inch height difference between us). A little over a year into our marriage, we adopted Sebastian, the best Yorkie ever, so we now have a travel size dog. Prior to getting our dog, I had done a lot of research on breeds and decided that I wanted a terrier; I was scared of having a big dog pulling me behind him down the street, and the terriers seemed to have such great personalities. I had originally selected a Norwich terrier but then found out that these dogs are ridiculously expensive, so our plan changed to a more easily accessible Yorkshire terrier.

Sebastian turned out even smaller than we expected; he still only weighs about four pounds and is small enough to pick up with one hand. Don't let the size fool you though; he is all dog! He loves to hide his puppy treats, and when he thinks someone is intruding on his home turf, he is quick to jump to my defense and growls up a storm. That being said, he's one of the sweetest dogs I've ever met. We have 2400 square feet in this house, and he typically wants to be in the two square feet that is my lap. Unless he gets extremely fired up, he almost never barks (no yappy dog for me!), and he somehow always seems to know when I am upset or sad and sticks extra close during those times.

I started getting migraines on my thirteenth birthday. My worst experience with them was a period during the winter of third year of medical school when I got into a bad cycle of headaches and had to take some pretty strong medicine to break them. Since then, I've been blessed to have had the headaches space out, and when they come, they have been easily controlled. Today I worked from home, and this afternoon I was hit with a horrible migraine out of the blue. Many times I have auras before my migraines (vision changes are my normal auras), but I had no warning with today's headache. I put Sebastian outside for a bit and retreated to our dark, quiet bedroom. After about 45 minutes, the worst passed, and I was able to get up and leave the bedroom.

I think Sebastian knew something was wrong when I let him back inside. He's been extra sweet and has been glued to my side ever since I let him inside. Hubby's out of town this week, so it's just me and the puppy tonight. I remember our first year of marriage when I would be all alone during the week when he traveled, but now I have Sebastian. :) He may be just a puppy, but he provides 4 pounds of warm snuggly comfort and keeps me from feeling alone when Hubby is gone. Other dog lovers will understand; he is more than just a dog to me!

Outside my comfort zone

2008-07-07T22:25:00.002-05:00

Last week I had the blessing to spend half a day in a clinic for refugees. As it was explained to me, these are not just people who have come to America in search of a better life; they are people who have been forced out of their homes by persecution and are here in America because it has been deemed unsafe for them to return home. The stories the clinic staff told me left me flabbergasted and reminded me just how naive and sheltered I am. Few of these people speak English, and many of them know no one else here except for the family members who have fled here with them.

By the time the patients are seen in this clinic, they have typically been in the country for a week or less and are being seen by a doctor because some flag popped up on their initial screening exam by one of the nurses. Frequently this complaint turns out to be something very minor such as a cold or a knee ache from five years ago, but sometimes it turns out to be something more. During my visit to the clinic, a patient returned to the clinic for the results of blood work drawn a few weeks earlier. It turns out that this teenage patient had a chronic disease that we were the first to diagnose. The patient had initially come for evaluation of a cough and had no clue that we were about to present dramatically important news.

Had this patient been born in America, we would have caught this disease when the patient was less than a month old. Although there is no cure, we would have been able to provide close monitoring as well as therapy to help deal with the symptoms of the disease. I honestly do not know what the future will hold for this patient since I have never seen this disease diagnosed so far along.

I'm guessing my attending figured that since I will be through with my training in less than a year, I was qualified to deliver this news, and she reminded me to keep it as simple as possible since the family had likely never heard of the disease. When we brought the patient and the parents back to the exam room to speak with them, we quickly ran into an obstacle. Like most of the other patients in this clinic, the family did not speak English; we were prepared for this and used a worldwide translation phone line that we have available. Unfortunately the language spoken by the family is extremely common in their home country but barely spoken elsewhere; my attending informed me that there are only two or three workers in the entire world that are employed by the translation line who speak both English and this language, so when they are not working (as was the case this day), we were just out of luck. We ended up figuring out that the father spoke a little of another language in addition to his native tongue, so we used a translator to speak that language, and the father then had to translate into his native tongue for his wife and child. The situation was far from ideal, but I hoped that we were able to provide a little help to them.

The entire experience left me speechless for several days. I started residency two years ago with minimal comprehension of Spanish; now I'm comfortable taking a quick history and answering simple questions in Spanish, and even when I use an interpreter, I understand the majority of what is being said. Working in this clinic was completely different. I didn't have an interpreter readily available, and most of my patients that day did not have any resources whatsoever. The clinic was located where it was because most of the patients would be able to walk to it, and we had to figure out ways to get the medicines we prescribed for the patients rather than just writing a prescription and sending them on their way. I felt like I was almost practicing medicine in a third world country, yet here I was in the middle of one of the biggest cities in America.

Even with everything I see on a regular basis, I still am sheltered from certain parts of the world. I get to go back to this clinic again this week, and I'm looking forward to having my eyes opened again to something new.

EEEEEEEEEEEK!!!

2008-07-06T21:41:00.003-05:00

I didn't feel like cooking tonight, so Hubby and I decided to make a fast food run. We're trying to keep Sebastian adjusted to riding in the car, so I carried the little guy out to the car with Hubby following behind us. As he opened the garage door, I let out what was apparently a blood-curdling scream -- there was a dead mouse lying in the center of the garage right next to my side of the car!! I touch disgusting things at work all the time, but seeing the mouse really caught me off guard. Hubby thinks the mouse died from the heat; I don't care why he died, but I am glad he wasn't alive to scurry up onto me!

I don't think I'll be going out to the garage in the dark anytime soon.

Happy 4th of July!

2008-07-04T23:57:00.004-05:00

I've only been off nights for five days, so I'm still not fully adjusted to living normal hours. Hubby and Sebastian are both fast asleep next to me, but I'm wide awake; at least What Not to Wear is on. :)

I'm about to enter my longest stretch of time off in weeks; I had today off, won't work Saturday or Sunday, and don't have to go to work until Monday afternoon. This is phenomenal!! Hubby and I spent the day scrubbing the house from top to bottom; we are exhausted, but the place looks amazing. Tonight he grilled fajitas while I made guacamole from scratch ... soooo yummy with lime tortilla chips. We also enjoyed a lime curd tart that I made yesterday. After dark, we attempted to walk to the end of our street to watch a local fireworks display about two miles away, but some local geniuses decided that popping fireworks over parked cars and small children was a bright idea, so we left. Poor Sebastian couldn't take it outside; he did just fine once we got him away from the madness.

Tomorrow we're going to run errands, and I may try my hand at another new dessert if I can make a selection among several great recipes I've been wanting to try. All I know is that we are going to relax!

On a different note, I doubt that anyone from the military reads this, but on the off chance that someone does, I want to say thank you to all the brave men and women who are serving our country and to their families for supporting them as they serve. We appreciate your sacrifices and are grateful for all that you do.

I still got it!

2008-06-26T19:00:00.003-05:00

I worked four hours in clinic yesterday, had a two hour break to run home and back to the hospital, and survived a twelve hour overnight shift in the ER as pit boss. When I got home today, Sebastian wanted to play nonstop, so I only managed to get about three and a half total hours of sleep today. I knew I'd be too tired to put on makeup when I woke up this afternoon, so I did my makeup as soon as I got out of the shower this morning. I don't think the makeup really helped because I still looked pretty scary when I woke up.

I had a hair appointment at my usual place in Coppell at 5 PM, so I had about a 30 minute drive to get there. I stopped for a strawberry shake at Sonic just to keep me full until Hubby gets home tonight, and the sugar rush helped to keep me awake. Whitney, my stylist, said I was "in the zone" and more out of it than normal, but I eventually walked out of there with an AWESOME haircut (pictures to come later when I don't look like a zombie). I stopped at Target on the way home to get dishwashing liquid, and as I was bending over to reach the detergent, I heard a voice behind me say, "Hello."

I looked up to see a young Indian man standing there. This part of town where I had stopped has a large population of recent immigrants from India, and I have worked with a few of them in the past, but I didn't recognize this guy at all. Our conversation proceeded like this:

Guy: "Hello, are you in college?"
Me: "Ha ha ha ... no, very far past it, but thank you for the compliment." (I go back to picking out my dishwashing liquid.)
Guy: "Oh, I am in college." Awkward pause.
Me: "Oh really, that's nice ... where?"
Guy: "I'm getting my associate's at *insert local community college here.*"
Me: "That's great! Good for you." (By now, I have my two bottles and am trying to turn around to walk off.)
Guy: "Do you mind if I ask you out sometime?"
Me: "No, I'm sorry; I'm married. Thanks anyways!" (I bolted out of the aisle as fast as I could at this point!)

I felt bad for the poor guy; I guess he didn't see my wedding ring. It was a nice little boost to the ego though; even sleep deprived, I still got it! ;)

Sleeeeeepyyyyyyy ...

2008-06-22T16:51:00.003-05:00

I'm so tired; I have worked the last two nights in the ER and have one more to go tonight before i get a little break. A patient's dad asked me last night, "Who did you anger to have to work a Saturday night shift?" I responded, "The better question is, 'Who did I anger to work Friday, Saturday, AND Sunday night shifts?'"

The new goods is that I'm getting much better at LPs; I actually had one of the techs request me to be the one to tap a child last night because he "wants someone who's good at it." It was definitely a boost to my confidence, and hitting the tap on the first try didn't hurt either.

Now it's time for me to go throw on yet another set of scrubs, make a quick dinner for me and Hubby, and then head back out. Unfortunately Hubby will be gone by the time I get home tomorrow, but we'll see each other Thursday. It's just another week in the life of this tired resident!

From the inside out

2008-06-16T09:58:00.004-05:00

I find being transparent exceptionally difficult. I innately desire for people to approve of me; therefore, I often feel as though I need to show only the "good" side of me. Paul reminds me that it's all an image and that it's only because of Christ that there is anything good inside of me.

For the past few months, I have really been struggling. I've been dealing with several painful things, and my response has been to shut down emotionally. If I don't feel anything, then I can't hurt when the painful parts come. While doing this can help me make it through an individual day, it has robbed me of my joy. Shutting down has definitely affected my relationship with God as it has become a moving through the motions rather than a developing relationship.

Being the amazingly faithful God He is, He hasn't left me alone or given up on me. He has nudged me until He has gotten my attention, and I am thankful He has been so gentle. I'm now working my way back to where I need to be. I'm sticking my neck out and knowing that I may get hurt in the process of life, but the reward far outweighs the risks. I cried for the first time in quite a while today as I listened to one of my favorite mixes on my iPod and spent sweet time with God this morning.

I know that my resolve will be challenged in the upcoming months as I face two weeks of ER nights with a pretty understaffed crew, two weeks of night float as the most senior resident on call in the hospital, a month in the PICU, and a month as Cardiology senior on the inpatient service, but I know God will meet me in my place of need just as He always has. Making it through these next few months will undoubtedly be more bearable with His help.

Birthday thoughts

2008-06-11T20:43:00.002-05:00

I'm now five and a half weeks through my eight weeks in a row in the ER. Double ugh! In light of the fact that I feel progressively more brain dead after each shift, here are some random thoughts from this week.

I had a great birthday. My mom sent presents in the mail before she and my dad left for Spain, and Hubby sent me flowers at work the day before my birthday (I was the talk of the ER!). I also didn't work for 2 days in a row, so life was great.
While I'm talking about work, let me say that I am so over the ER. I only have eleven more shifts to go; they can't end soon enough.
When children are seen in the ER, parents have the ability to call back and speak with a doctor if they have a question about discharge instructions or prescriptions. That doctor is whatever second year resident happens to be running the ER that shift, and I was that resident earlier this week when a mom called to talk to me. Typically the front desk takes a number down and has me call them back whenever I have a free moment since the residents are often in traumas or urgent situations; however, this time a new person at the desk put mom through to my portable phone without notifying me I had a "mommy call." As soon as I answered the phone, this mom told me, "Hold on a second" and then proceeded to place her order at Sonic. She then started to ask me her question but told me to "hold on again" and corrected the error in her order. Really??? After finally getting the story out and realizing this would be an easy problem to fix, I told her I was happy to help her but needed the number of her pharmacy to correct the issue; that's when she realized she didn't have the number to her pharmacy and needed to go home to get it. The call was priceless.
Sometimes a popsicle can fix everything.

Reflection - June 3rd

2008-06-03T12:16:00.005-05:00

I found out this morning that a few of our chronic patients have died over the last few weeks. I already knew about some of them, but finding out about one in particular has really made me pause today. I don't think I'll ever understand why things happen the way they do. I will never understand why some kids are born sick, why some healthy children are suddenly stricken with illness later in life, or why some healthy children end up with horrible parents that hurt them. My heart breaks for all of these sweet children. To be allowed to care for them in any capacity is such an honor. I will continue to pray for these families in their time of need.

Hanging in there

2008-05-28T10:50:00.004-05:00

Slowly but surely, I'm recovering. I've felt well enough to work my two 12-hour shifts Monday and Tuesday, and I'll be going to my clinic this afternoon. I still can't really hear much, but my cough is MUCH better. I'm still very tired, but I'm definitely on the mend.

I have to give Hubby props for the extreme patience he showed with me this past week while I've been sick. He was working from home that week but still paused to get us meals and would bring me whatever I needed no matter how busy he was. He also dealt extremely well with my turning down his dinner ideas and requesting spicy meals (since I really couldn't taste much else).

Hopefully by the time I'm back in the ER in three days, I will be so much better that people will stop asking me if I'm okay!

On the mend

2008-05-24T11:22:00.002-05:00

I am finally starting to feel a little better. I can actually breathe somewhat through my nose, and my cough doesn't make me sound like Doc Holliday anymore. :) My voice is still gone, but I don't feel like I'm knocking on death's door anymore. Yay!

Worse still

2008-05-22T15:57:00.003-05:00

So just when I thought things were heading in the right direction, I got a new blow today. Hubby and I watched CSI last night, so I spent at least half the night dreaming I was at work but had to do some CSI-like things on one of my patients. It was truly bizarre. I woke up this AM with no voice but a slightly improved cough, so I decided to tough it out and go to work.

On the drive in, I began to regret the decision. I had no voice to order my regular coffee, but at least the Starbucks ladies had a vague clue what I was ordering. My checkout started off with, "This little guy needs an LP ..." which of course I proceeded to miss completely while I sweated profusely and snot poured out of my nose (I was wearing a mask, so no one knew). I then proceeded to pick up a chart for a 15 year old who busted his lip open at school when he tripped and his grill ripped his lip WIDE open. He actually had 2 grills (upper and lower), but his wise mother told him to kiss the grills goodbye after today's incident. With a little supervision from the fellow, I sewed up that laceration very nicely (if I do say so myself) and saw several more patients before finally admitting how awful I felt. I had another resident that I really trust look in my ears because I noticed that my right one was starting to hurt and that I was having a really hard time hearing out of it. Oh yeah, this pediatrician has an awful ear infection!! It's the second one I've had since start residency, both of them associated with horrible colds. My fellow resident wrote me a script for antibiotics, and I had it filled at the hospital pharmacy. The pain is actually getting worse, and I'm just hoping the eardrum doesn't rupture at this point (although I'd probably feel better if it did).

Around 2 PM, I finally called uncle and called my chief to tell her that I didn't think I'd make it in tomorrow. I was dragging all day today and honestly couldn't picture another day back at it, and by the tone in my voice (or lack thereof), I think my chief realized that I'd really tried but couldn't make it all day. She called another peds resident in the ER and had him send me home so that I could get some rest.

Now I'm back at home in my spot on the couch, orange juice in hand, waiting it out. Hopefully this will all turn around soon.

Worse

2008-05-21T20:32:00.003-05:00

Last night was another night spent without sleep. Despite multiple doses of medicine, I still couldn't sleep more than 2 hours at a time because of my cough. This morning I still had no voice, and my sinuses are becoming tender, so with the encouragement of my hubby and my clinic attending, I called in sick today. I felt horrible doing it, but like my attending pointed out, I'm probably more sick than most of the patients coming to clinic today.

I've used probably half a box of Kleenex today, and despite having the ones with lotion in them, I still look like Rudolph the Red Nosed Reindeer. When I was going downstairs to boil some water to make steam, Hubby wisely reminded me that we have a steamer he uses on his pants, so I've intermittently been breathing in that steam for the last few hours. It's actually making me feel better! I still can't really breathe out of my nose, and my voice is still nonexistent, but I'm hopeful that I will be on the upswing in the next ten hours so that I can make it through my twelve hour shift in the ER. If the day is light enough, there is a teeny chance I will get to go home early, but since I'm pit boss tomorrow, I'm technically in charge and may have to stay the entire time.

I haven't had a cold this bad in just about a year. I hope it doesn't come back anytime soon; I don't think I could take much more of this.

Ughhhhhhhh

2008-05-20T17:52:00.003-05:00

I forgot to mention that I have been sick all weekend. It started with a sore throat Friday morning and has now progressed to a yucky hacking cough, fever, laryngitis, nasal congestion, and a still horribly sore throat. My voice kept getting deeper throughout work yesterday, and by last night I felt horrible. I couldn't sleep flat, so I spent most of the night curled up on the chaise lounge. Hubby woke up at 6:30 to start working, but I ended up sleeping in til almost 11:30. He checked on me around 10:30, but it took me another hour to muster up the energy to get out of bed. He suggested I go see a doctor, and (as usual) my response was, "I am a doctor." I knew this was just a virus, but I conferred with my dad (also a doctor) who agreed and suggested some supportive therapies to try.

Now I'm sitting on the couch relaxing with a Yorkie curled up next to me while Hubby watches some ridiculous movie on TV. We've ordered dinner in since I'm obviously in no shape to be cooking tonight, and I've already taken my first dose of cough medicine. I am scheduled to be in clinic tomorrow at 1 PM, and I really really hope I'm feeling better by then since cancelling my clinic that late isn't an option (my fellow residents would have to pick up the slack and see my patients). Here's to Chinese noodle soup and lots of rest before tomorrow!

Hilarity ensues

2008-05-19T20:36:00.002-05:00

There is no way I could not blog about some of the things that happened today. My first shift back on days s-u-c-k-e-d. There was up to a seven hour wait during the day in the ER, and people were in all sorts of bad moods. That said, here are the two highlights of my day.

1) I needed to sew a 3 cm laceration on the forehead of a two-and-a-half year old. My attending decided the little guy didn't need to be sedated, so we "papoosed" the little guy (wrapped him up good and tight on a backboard). It took two fire fighters in training (they come to the ER to learn some basic skills) plus the papoose to remotely hold this child still. My attending sewed the deep layer and left me to sew the superficial sutures. The little man was not happy, and my attending started to sing "You Are My Sunshine" to distract him. He wasn't very amused, so she quickly switched to "Jingle Bells." I poked fun at her since it's May, and she told me, "Be quiet, that's the only other song I know!" The next thing I know, I heard these words over my shoulder: "Come and listen to a story about a man named Jed, a poor mountaineer, barely kept his family fed ..." I almost died laughing as one of the fire fighters joined in singing the Beverly Hillbillies theme song to my little Hispanic patient. Priceless.

2) Later I was taking a history from a mom about her five-and-a-half month old who presented with nasal congestion. As I was running through my review of systems, she mentioned, "Yeah, I've noticed that his right ear smells like corn flakes or a burrito." I think I stopped dead in my tracks for about two seconds before proceeding on. Completely random.

There are still six weeks of fun to be had in the ER!

Did I really just do that?

2008-05-13T17:27:00.004-05:00

I'm back in the ER for 2 months straight! That translates to 4 weeks of day shifts and 4 weeks of night shifts. My merciful chiefs have split up the nights so that I work 2 weeks of nights, 4 weeks of days, and then 2 additional weeks of nights. I just finished working four 12 hour night shifts in a row. By the time I count in checkout and the drive to and from work, I'm only home for about 10.5 hours each day. I have been tired but okay, but after work today, I came home and crashed. I've been go-go-go for the last four nights, and I am beyond thankful that I'm not bad for a fifth night in a row!

As a second year, I'm responsible for making sure the traumas and critical patients are covered. I was definitely terrified of this when I started second year, but I've now realized that I have sufficient back-up and have learned enough to feel comfortable working with the sickest patients. Our nurses, techs, and respiratory techs are AWESOME and help me out so much.

I'm working on becoming proficient in my procedures and have gotten to do a few laceration repairs and lumbar punctures (spinal taps) over the last several nights. We are supposed to be signed off on lumbar punctures (or LPs) as interns, so I have been "signed off" for a while and am allowed to perform them without being observed. Unfortunately, I have had a run of HARD taps for the last few months ... so hard that people with more experience me have not been able to get these taps either. I know that should make me feel better, but my self-confidence has been shot. The most frequently tapped patients are little babies less than 2 months old who are undergoing a work-up for sepsis, but we also tap older children as we see fit according to their clinical picture and our index of suspicion. My personal feeling is that the little babies are easier to tap due in large part that it's easier to hold a baby still than a big squirming kid still, but even in babies, performing a tap can still take a while even if you do everything perfectly. A few days ago, I tapped a four year old; while it took some time and a little help from our fellow, I still got it on the first stick! I have been feeling a little better about my ability after that.

Last night a 4 month old needed a tap, so despite my nerves, I set everything up and got the baby into position. I cleansed and prepped him and felt one last time for my landmarks. I slipped the spinal needle in where it was supposed to go ... and beautiful clear fluid immediately came out. The clinical tech who was holding the baby laughed at me when it was all over because of the look of joy and surprise that washed over my face. I was done with the entire procedure in less than two minutes, by far the fastest I have ever done and, according to the tech, the fastest he has ever seen done by a resident. The analysis of the fluid showed that it was a near-perfect tap and actually provided us with essential information in treating this patient. I was grinning ear to ear when I finished. I'm back, baby!!

I was still riding off the high of rebuilt confidence when my shift ended shortly after 7, so I expected to have trouble falling asleep later. Ha ha ... apparently the adrenaline wore off because after I showered and ate my first meal in 14 hours, I was asleep within 30 minutes and slept for seven hours straight. I'm extremely thankful that I have tonight off because tomorrow I will have clinic at 1 PM and will then work my 12 hour ER shift starting at 7 PM, and I still have more sleep on which to catch up. I'm actually looking forward to tomorrow night's shift; I'm back and ready to roll!

The Big Apple -- Part 3

2008-05-05T10:34:00.006-05:00

Wrapping up!

Friday

We had been tipped off by the concierge that if we wanted to go to Ellis Island, we needed to get there early. The line for tickets opens at 8:30, but he recommended getting there an hour early. When we got there, we were probably already about 10th in line, but the line quickly grew to over 50 people in a matter of minutes. I was glad we listened! Oddly enough, there's no actual charge to go to Ellis Island or Liberty Island, but there is a charge to ride the ferry. After we purchased our tickets, we stood in yet another line to walk through security prior to boarding the ferry. In further proof that my Hubby knows more people than I could ever hope to, he ran into another guy from his work while we were waiting in the security line. We finally made it on to the ferry and had an AWESOME view for the ride in. We stopped at Liberty Island first. An interesting (and important) fact is that a ticket on the ferry does not necessarily guarantee you entrance to the Statue of Liberty; if your ticket did not say "monument access" on it, you were out of luck. There was a little French lady who did not speak any English in front of us whose son had stepped out of line for a minute, and the park ranger kept trying to explain that she wouldn't be allowed inside the Statue. It made me sad that I didn't speak French! Her son finally came back, and when she realized that her ticket wasn't also for the Statue, she got mad! Oh well, c'est la vie. ;) We had to go through another security line to get inside, and once we walked through the museum, we had to walk up about six flights of stairs to get to the observatory at the base. No one is allowed up to the torch or crown anymore, but the view was still great. Hubby took some great pictures! After we finished on Liberty Island, we went on to Ellis Island; we easily could have spent the rest of the day there, but we were getting hungry! We decided that we wanted pizza again since it's just so different and delicious up there. We had Lombardi's for lunch - yummy! That night we decided to enjoy another steak dinner at Benjamin's Steak House. We then walked over to Grand Central Station before heading back to Times Square. We wrapped up the night by visited the huge Toys R US (there is a ferris wheel inside!) and heading back to the M&M store to buy some candy and a little souvenir for me.

On the ferry on the way to Liberty Island

He always makes me laugh.

Still another beautiful day

Having fun

Hubby took this.

He took this one too.

Saturday
We were worn out, so we slept in late and had Jamba Juice for breakfast. We had to leave the hotel by 12:30 to catch our flight, and since I was craving a burger, we decided to walk over to Ruby Tuesday's and get something nearby that would be quick. The ride back to the airport was not nearly as eventful as the ride over, and we made it through security so quickly that we had an hour and a half to wait before the plane took off. Hubby and I relaxed through the uneventful ride home, and as soon as we made it back to Texas, we drove for about an hour to pick up Sebastian from Hubby's mom (we told him he was going to "puppy camp" for the week). Our vacation was awesome, and I couldn't have asked for a better week with Hubby, but it was still so great to climb back into our own bed and go to our own church the next morning. Anniversary vacation 2008 was a success!

The Big Apple -- Part 2

2008-05-05T09:44:00.008-05:00

Continuing on ...

Wednesday

We had initially planned to go to Ellis Island this day, but after our big dinner (and the wine), we decided to sleep in. :) It was wonderful! Since Hubby is a platinum member at the hotel where we stayed, we were able to partake of the hotel's complimentary breakfast buffet each morning. When we went down this particular day, we happened to run into one of Hubby's close business associates who regularly works in New York; after talking for a little bit, the Associate offered to take us out to lunch - yay! This only left us with about two and a half hours to walk around, so we decided to amble over to Central Park. That place is huge! We watched a group of high schoolers play softball, little kids riding the carousel, and a group of people setting up to film a scene for a movie or TV show.

We could not have asked for a more beautiful day.

The tulips were amazing.

Strawberry Fields, a tribute to John Lennon

If you look directly over my left shoulder, you can see this weird guy who was dressed up like a wizard.

After Central Park, we met Hubby's buddies for lunch at Bobby Van's Grill; I was so glad I changed to get a little more dressy for lunch! We had the best steaks of our entire trip here (although I honestly do prefer Hubby's steaks -- my boy can grill like none other). After we finished lunch, we walked over to Rockefeller Center and perused the NBC gift shop for a bit; Hubby later ended up getting this t-shirt as a sign of his devotion to one of our favorite tv shows. We did a little more shopping, and I finally found a pair of black high heels that is narrow enough to fit my little heel. I was so excited! We were both getting pretty tired from all the walking and dodging, so we went back to the hotel for a nap before the evening. We had tickets to see Wicked that night, so we ate dinner at a little restaurant right around the corner from the theater. Can I just say that Wicked was amazing? WOW, I was so enthralled! It was definitely one of the highlights of the trip!

Thursday
After breakfast, we wandered back to Rockefeller Plaza to watch the taping of the Today Show. We actually made it on TV! We got really tired of having this group of pre-teens screaming in our ears over Fran Drescher (the Nanny? really?), so we left and went back to Greenwich Village to get more pizza at Joe's Pizza. The restaurant itself is extremely tiny, so we took our slices and sat out in a little park across the street. It was yet another lovely day, so we had a really good time! Afterwards, we walked down to Ground Zero and looked at some of the historic buildings in the area. We were craving sushi for dinner, but unfortunately the concierge was out that evening, and the girl at the front desk obviously didn't know what she was talking about when it came to recommending sushi (she was sweet, but a boring California roll is not my idea of great sushi!). Thanks to my iPhone, we found Kodama and were able to have some very interesting rolls that I'd never tried before. After dinner, we went to Serendipity 3 for their famous frozen hot chocolate. It was good, but I have to admit that I was a little let down after all the hype (plus I was slightly annoyed that the waiter made us each order one as there was an $8.50 minimum per person -- I only drank about a third of mine, and I knew ahead of time I couldn't come close to finishing one!).

9/11 memorial

Like I said, these things were huge!

Our last two days soon ...

The Big Apple -- Part 1

2008-05-03T14:43:00.014-05:00

I had to skip work today because the dreaded gastroenteritis has hit me, and I don't want to get all the Heme-Onc kids sick (I'm cross-covering for an intern this weekend). I've been pretty much useless today, so since I've had a nice little nap, I feel that I should do something relatively constructive like blog about our trip.

Sunday
Our plane was an hour and a half delayed in taking off from the airport, so we were late in getting to NYC. When we finally landed and got our bags, we took a car service from the airport to Times Square. Scary!! The driver talked on his cell phone and was yelling in Arabic most of the time, and I was so thankful that we had seatbelts on! He was definitely not paying close attention to the road, but we arrived safely in one piece. After getting settled in, we decided to walk around Times Square for a bit and ended up having dinner at John's Pizzeria; the pie was delicious, and Hubby got to have one of his favorite beers that he can only find in the Northeast. After dinner, we continued our exploration by foot and made stops at both the M&M store as well as the Hershey store. We finally got tired and headed back to the hotel where we slept like babies; I was really surprised how quiet the room was considering we were facing 7th Avenue.

The wind was crazy!

My boy loves chocolate. :)

Monday
We got up that morning, had breakfast at the hotel, and headed out for our Foods of New York tour. Our tour guide was very interesting, and we spent over 3 hours wandering around the west side of Greenwich Village and tasting all sorts of different foods. We had a slice of New York style pizza from Joe's Pizza, samples of fresh bread, pesto, olive oil, and balsamic vinegar from O & Co, a cheese/ meat/ bread/ olive sampler from Murray's Cheeses, chocolate-covered pecans and almonds sold at this really cool herb store called Aphrodisia, chocolate chip cookies from Milk and Cookies, Thai chicken dumplings from Lime, and a final slice of pizza from Bleeker Street Pizza. We also learned quite a bit about local history and architecture and had such a blast! After the tour was over, we walked over to Chelsea Market; unfortunately, we weren't able actually to visit the Food Network, but we did see some really cute shops. I would totally shop there if I lived in New York! We easily walked over 5-6 miles that day, so despite all our snacking for lunch, we had still worked up a good appetite for dinner, so we walked up to Hell's Kitchen and had dinner at Uncle Nick's Greek Cuisine. I had some of the best gyros I've ever had, and Hubby enjoyed some lamb kabobs while we were both introduced to Greek wine. So good!

Hungry at the beginning of the food tour

Bleeker Street Pizza was a great way to end the tour.

These cupcakes from Chelsea Market were precious!

Tuesday
Our anniversary was here! We spent the morning shopping; I managed to find three pairs of petite pants that fit me, and (joy of joys!) they were all on sale. I was so happy! :) Then we went to what we are now referring to as the biggest rip-off of NYC, the Empire State Building. We got suckered into this thing called the NY Skyride; it turned out to be a Kevin Bacon-narrated movie attached to an inside roller coaster simulator. I got extremely nauseated at the end of the ride and took almost 30 minutes before I felt back to normal. :-p After visiting the top of the building, we walked back to the hotel for a nap before dinner. We had dinner at this extremely romantic restaurant called One If By Land, Two If By Sea. Hubby had the quickly seared buffalo rib eye, the beef wellington, and the dark chocolate souffle with rocky road garnish; I had wild mushroom and Parmesan crumble, the cushion of veal with butternut squash and broccolini, and the warm chocolate tart. All of the food was absolutely amazing, and my mouth is watering right now just thinking about it. We had an amazing bottle of French Bordeaux wine, and the service was superb. I will remember that dinner for a long time!

So in love

More to come shortly ...

Survey

2008-04-27T18:16:00.002-05:00

Hubby tagged me, so instead of trying to figure out how to condense a week's worth of NYC fun into a post right at this moment, I'll fill this out first and get to the trip summary soon.

Rules for the game:
1. Put these rules at the beginning of your post.
2. Answer each question (see below) in your post.
3. Tag five people at the end.

What was I doing 10 years ago?
April 1998 ... I was just about to graduate high school. I got my first speeding ticket less than two weeks before graduation and quickly found out that since I wasn't seventeen yet, the State of Texas would not let me take care of the ticket without a parent present. I still remember crying outside in the parking lot and thinking there was no way I should be allowed to leave home if I couldn't even take care of my own speeding ticket!

Five things I would do if I were a billionaire:
1. Tithe and offerings
2. Pay off my student loans and our mortgage
3. Put a large chunk into savings/ investments
4. Pay off mortgages for our relatives
5. Take a long trip to Europe and Australia
(6. Open my own clinic where I could practice medicine the way I wanted without having to worry about the money side of things.)

Five jobs that I have had:
1. Quality assurance contractor for a computer company
2. Office assistant for Continuing Medical Education
3. Research assistant
4. Neuroscience TA/ tutor
5. Pediatrics resident

Three of my habits:
1. Putting on eye cream, hand lotion, and lip balm before I go to bed (I have extremely dry skin, and washing my hands/ using hand sanitizer between every single patient does not help!)
2. Reading blogs every day
3. Checking for my "wallet, keys, pager, cell phone" in that order before I leave for work in the mornings

Five places I have lived
1. Coralville, Iowa
2. Memphis, TN
3. Houston, TX
4. College Station, TX
5. Irving, TX

Five people I want to get to know better
1. Jeanine
2. Carissa
3. Rob

I'm out because all the other people are those whose blogs I stalk or who have already been tagged. :-p

So excited!!

2008-04-19T14:07:00.001-05:00

We leave for New York City tomorrow; I am so so so excited! Big city, here I come!

Blah

2008-04-14T16:39:00.002-05:00

My last day off was Friday, April 3rd; that was a relaxing and oh-so-fun day! Hubby was able to take the day off from work, so we cleaned the house together (actually not such a bad chore when he's around) and then had 2 of our sweet friends over for fajitas and Wii. I came in dead last in bowling but actually got 2nd place in golf. Good times!

Ever since then, I've been hard at work. I broke down crying Saturday the 4th in front of the NICU nurses over my frustrations regarding the inequality of the workload among the residents and the different management styles of my superiors that left me stuck in the middle. The next day I was on call and cried again in front of my fellow and my attending because the large majority of my patients were getting sick again in front of my eyes; I spent that 25 hours going to deliveries and just trying to survive the night. The following Tuesday I started an elective in child abuse; I have learned SO MUCH and even got to go to court one day to watch one of my attendings testify. Thursday I spent the day getting recertified for PALS (Pediatric Advanced Life Support), so if anyone under the age of 18 crashes, I'm your girl! Over this past weekend, I got to cross-cover Heme-Onc for the weekend -- definitely NOT my favorite thing. 11 brand-new (to me) patients with rounds that dragged on for 4 hours each day (they normally last 2-2.5 hours during the week) ... I was beat down by the end of yesterday.

I've spent the rest of my free time last week studying for my Step 3 licensing exam -- two FUN days at a Prometric testing center! Today honestly wasn't too bad; I was able to finish up early and did a little shopping while I was out. Now I have to get myself excited to go back tomorrow morning and finish it!

In six short days, Hubby and I leave for NYC. Since he travels so much, we have decided to use his airline and hotel points for an anniversary trip every year as long as he continues to travel frequently. Last year was Napa; this year is New York. I've never been before, and he's only been for work, so we're both so excited. We're going to be staying here, taking this food tour, and going to see this musical. The plan is also to go here for an anniversary dinner. We're going to work on a final itinerary this weekend (because I love having a schedule) to see if anything else needs to be pre-arranged before we leave. We're leaving our sweet puppy with his Granny on Saturday, so getting to see my MIL will be a nice way to start our vacation (yes, I actually like my MIL!).

If I can just get through the next 18 hours, I know I will be fine. It's all downhill from here!

I think this was a compliment

2008-04-01T20:34:00.002-05:00

Today's conversation occurred after we finished rounding on one of my babies. We proceeded to the next patient in the isolette down the row, but my patient in her open crib was getting fussy. I picked her up, untangled her multiple IVs and tubes, and proceeded to rock her as the nurse practitioner presented her patient. After she finished her presentation, she turned to look at me and my little friend.

My attending: "Sarah, why don't you explain to the nurse practitioner what your patient's condition is?"

Me (a summary) : "She has condition X which only left her with about 25% of her small intestine and about 60% of her colon. She's two weeks old but has only gotten nutrition through her IV. Today will be her first day to try any real food!"

Nurse practitioner: "Oh, that poor poor baby!"

Me: "No, it's okay! Compared to one of my other patients, she's doing awesome! Look at her all wrapped up; you would never know anything is wrong with her. She has good lungs and a good brain; I was just telling her parents last week all the good things she has going for her!"

Nurse practitioner: "Wow, you really are an optimist, aren't you?"

2 random thoughts

2008-03-31T20:02:00.003-05:00

1) Speaking of sweet husbands (see post below), my hubby bought me an iPhone this weekend. Oh my gosh, I love it.

2) I have had multiple hits to my blog via people searching on Google for "Dog swallowed an ear plug" or some variation thereof. Craziness -- glad to know I'm not the only person this has happened to.

So sweet

2008-03-31T19:18:00.003-05:00

Last week I was talking on call with one of our fellows and some of the nurses. This fellow was talking about her soon-to-be husband and happened to mention a particular nickname he has for her.

Fellow: "Yeah, he calls me 'Fat Girl.'"
Me: "Excuse me ... WHAT??" (This fellow is about an inch shorter and 10 pounds lighter than me.)
Fellow: "It's just a nickname. He thinks it's funny."
Nurse: "Yeah, my husband likes to poke at the dimples in my butt and then laugh." (This nurse is one size bigger than me at most.)
Fellow: "I know he doesn't mean anything mean by it."
Me: "Wow, my husband actually told me he hopes I don't ever lose a lot of weight because he loves my curves."
Nurse: "Yeah, my husband says he's only kidding, but ..."

Having this conversation broke my heart. These two women are being belittled by their significant others in the name of humor when I can clearly see how much this name-calling hurts them. The crazy part is that both of these women are beautiful, but they are being told otherwise by the one person who is supposed to think they're beautiful no matter what!

I am blessed with a husband who compliments me all the time. Even though I've lost some muscle tone and all of my tan to residency, I've actually never felt more beautiful on a regular basis than these last almost two years. Of course I have my fat days and my ugly days, and there are times when I just want to hide under my loosest set of scrubs, but those moments are eclipsed by the overall knowledge that my husband sees me as attractive. I will never be a Catherine Zeta Jones or be able to bounce a quarter off my abs, but I do know that the one person who matters most views me as lovely.

Tired (again)

2008-03-26T19:30:00.003-05:00

Why do I feel like all my recent posts are about residency? It must be because I've felt consumed by it since mid-January. I can't wait for next block when I will have a few minutes to breathe. I'm taking Step 3 one week into the block (April 14-15), and I am in desperate need of some studying time for this exam. Hopefully I can get myself into gear; it's just about 2 weeks away, and I am SO not ready for it.

I had a truly wonderful call last night. I actually got to lie down for five hours in a row. To me, that's virtually unheard of on a NICU call night. I was a little deeper into sleep than I usually get on call, so when the resus page came across our walkies at 3:45 AM, my fellow second year and I looked pretty funny with our pillow marks fresh against our faces and our eyes blinking against the bright lights of the delivery room. The babies ended up being fine (yes, babies -- we went to 2 deliveries back to back, and 1 was for twins!), so life was good. My attending this month is extremely diligent in getting us out on time, so I was actually able to leave at 29 hours instead of the maximum of 30. It really was a great call!

Now I'm sitting at home after a lovely little nap and a warmed up dinner of leftovers. I'm watching reruns of CSI (which I am just now getting into), and I have a small Yorkie curled up asleep on my tummy. I've been reading blogs and researching sightseeing and restaurants for our trip to NYC (just 3 more weeks!). Hubby's out of town, so I'm planning on turning in early and catching up on my sleep. Tomorrow should be a relatively long day (6 AM to 5 PM), and then I'll be on call again Friday, so I will rest while I can!

Catching up

2008-03-24T12:00:00.003-05:00

Today is my 2nd day off this 4 week block -- yay! Unfortunately Hubby had to leave for Philly this morning, but I was so out of it that I barely remember him saying goodbye. I slept for eleven hours straight!! I still can't believe it. At least I feel well rested now; tomorrow night I'll be back for yet another no-sleep call in the NICU, so feeling not tired for now is a great feeling.

My parents came into town on Thursday so that my dad could speak at our church; it was so awesome both seeing them and getting to hear again the message of all Christ has done for us. I think this was my 4th time hearing the talk, so I got teased that pretty soon I'll be able to give it since I've got the medical background as well. If only I didn't have my extreme dislike of speaking in public! To make Easter even better, I was able to finish my work up early that morning and make it to church only 5 minutes late. I had gotten to work at 5:30 so that I might be able to finish early, and praise God, I was able to wrap up quickly and get out! I've had to miss a decent amount of church recently because of work, so being there at all is a blessing, but being there with my church family on Easter Sunday was a special treat.

After sleeping half the day away, I'm working on getting the house cleaned up and back in order. It's not too bad since my parents were just here, but there's always laundry to be done or something to be cleaned. Then I'm running to one of the best and most fun stores in the world, Target, later today to clean up on post-Easter candy, and then I'm going to come home and bake! My mom brought me this AMAZING cookbook, and I'm eager to try out some new recipes. It's going to be a very relaxing day off!!

True conversation

2008-03-18T12:29:00.003-05:00

Hubby is working from home this week, and today is my first day off after eight straight days and 2 calls in the NICU. Thunderstorms have been roaring over the house today, and since my parents are coming into town Thursday for my dad's Crucifixion presentation at church, I've been doing a ton of cleaning.

I paused to make Hubby lunch, so we ate while watching Paula's home cooking on our new TV. A commercial for Yaz came on. I don't think Hubby was particularly paying attention to it until they started talking about how it relieved headaches, fatigue, irritability, and bloating among a whole host of symptoms. "There you go!" he exclaimed. "That's what you need!"

Me: "HUH??"

Hubby: "The commercial says that this relieves headaches, fatigue, and irritability. If this can help you feel better, don't you think you should take it?"

Me: "Honey, that's a commercial for birth control that helps relieve PMDD, not PMS. My PMS isn't even that bad." (In my head, I'm thinking, "Are you NUTS? And as for the fatigue, I'm a resident; that has NOTHING to do with hormones!")

Hubby: "Well, what's the difference between PMDD and PMS?" (I proceeded to explain.) "Oh, well I just thought it might help."

Me: "Thanks ... I think. You know, you're lucky to be married to me; most women would be really offended if someone suggested they needed to take a pill for their PMS."

Hubby: "I still don't understand why. I really was just trying to help."

So sweetly clueless! I love my hubby. He left to go back to work (after taking his dishes downstairs without even being asked) but proceeded to come back a few minutes later to compliment me on lunch and how good the house looks. I'm a lucky lady. :)

Little peanuts

2008-03-12T19:12:00.004-05:00

I'm 3 days into my 28 days of my rotation through the NICU. I'm already tired, and I haven't even taken my first call. Tomorrow afternoon will be the first time I'll be going to "resus" (short for resuscitation) calls. It'll be the scary deliveries, but at least I will have back-up with me including a respiratory therapist and a nurse both specially trained for this with the ability to call a fellow if needed. I know I'll be saying many many prayers for myself, my team, these babies, and their families. By noon Friday, I will be 30 hours into my call; hopefully I will have helped to save a few lives by then!

Thank God

2008-03-06T16:28:00.003-06:00

Last night I had a big scare. I was scratching something on my back when I noticed a new very dark spot in the middle of my back. It was just out of decent view, and since Hubby was out of town, I couldn't ask him to examine it better. I even tried to take a digital picture of it by sticking my arm behind my back, but I was unsuccessful. I have extremely fair skin and have already had a few concerning moles removed from my back several years ago, so finding this new spot really scared me. Hubby had actually fallen asleep already by the time I found this, so I wasn't even able to tell him about it last night. I left him a message on his voicemail and managed to finally fall asleep.

This morning I managed to find an appointment for 1:30 PM with one of the dermatologists associated with the medical school with which I am affiliated up here. She took a look at this spot and then called in another dermatologist to take a look, and they made the decision that it's nothing! I am SO thankful. I didn't even need a biopsy! They even complimented me on how well I am taking care of my skin and told me to keep doing what I'm doing now. (It's easy not to get any sun when you work from 7 AM to 7 PM!)

To make my day even more exciting, I managed to get caught in a snow storm on my way home; the lady at the store where I had stopped laughed at me when I told her that I have no idea how to drive in the snow! Thankfully I made it home safely. Hubby's flight home got cancelled, but he was able to make it on an earlier flight and should be home shortly after seven tonight. I'm so excited!! God's grace is abounding in my life today, and I am so thankful.

This is why

2008-02-29T09:13:00.002-06:00

Two days ago, I had an experience in clinic that completely reinforced why I want to be a general pediatrician. I looked at my schedule and saw many names that I didn't know (sick visits for patients of other residents), but I also saw 2 names of my own personal patients. Both of them are babies that I have followed since they were born. The first was a 1 year old well child check for a baby that I first met when he was five days old; I cannot believe how big he has gotten! He has the best parents; they both always show up for his appointments and are raising him so well.

My later appointment was with a ten month old that I have seen for all of his check-ups except one when I was working nights for a month straight. His mom identifies me as his doctor and even commented on how she liked my new haircut; that she knows me well enough to notice that I cut my hair just warms my heart. I am her baby's doctor! This poor little guy had been running a low grade temp along with tons of congestion and cough; just like everybody else, he's got a nasty virus. The FDA as well as the American Academy of Pediatrics have recently recommended against cough and cold medicine in this little guy's age; I had already warned this mommy about that at his last check-up, and she had actually listened and remembered! She told me that she brought him in Wednesday because she knew it was my day to be in clinic and she just wanted me to check him out and make sure his ears were okay. I reassured her that his ears looked great and gave her warnings on when to return to clinic or to the ER. As I left that room Wednesday, I was reminded of the incredible blessing and responsibility I have of parents entrusting their child's care to me. I hope and pray that I remain this excited throughout the rest of my career, wherever and however long it is.

Chicken soup please

2008-02-18T13:33:00.004-06:00

Having all those toddlers coughing in my face has finally caught up to me; I am sick. At this point, I'm just calling it a cold, so I'll be taking it easy tonight and pushing fluids. I have a required workshop tomorrow from 7:30 AM until 7 PM, so I'm praying that getting caught up on sleep tonight will help me feel better and survive tomorrow. I had Friday and Saturday nights off and then worked last night, and last night's shift was so much better than the previous one about which I blogged. I didn't cry, and I even had time to go to the bathroom. :) Since I don't work tonight, I plan on doing nothing productive today and then going to bed early! It will be my reward to myself for a long but successful night in the ER.

Best gift

2008-02-15T14:55:00.004-06:00

I have worked 12 hour night shifts in the ER for the last two nights. I don't think I've ever wanted a shift to end as much as last night's. Around 2 AM, I actually broke down crying in front of two of my fellow second years and two sweet nurses because of some horrible experiences from earlier in the evening added to my total inability to sneak away to eat anything substantial for my entire 12 hour shift (I didn't even get a bathroom break til 8 hours in). There was quite a bit of confrontation last night, most of it unnecessary, so being the total peacemaker I am, I was visibly shaken by some of the things that happened. I checked out to one of my sweetest friends this morning, and as I was getting ready to leave, she hugged me and said, "Sarah, you're a great doctor; don't forget that, and don't let anything make you question that. I love you." I got all choked up and teary again, so I left as quickly as I could so that no one would see me cry. This friend had never said that before, so hearing it at one of the moments I needed it most makes me so grateful for such a great friend. Lucky for me, Hubby got home last night, so I was at least able to get a reassuring hug from him this morning to remind me that everything will be okay.

The reasons parents bring their kids to the ER in the middle of the night absolutely astound me. Some of them are totally valid, but there have been several times over the last two nights where I enter a room, talk with the family, and think to myself, "You have waited seven plus hours for this?!?" All you future parents, please call your child's pediatrician before you take your kid to the ER for a cold (or call EMS to bring your child into the ER for a cold). Don't get mad at us when we tell you that she doesn't need antibiotics and that we have no medications to recommend for your baby. No, we are not trying to be mean, and no, we are not trying to make money by telling you not to give your child medicine that the FDA has deemed dangerous for your baby. We are just trying to keep your baby safe; if we wanted to make money, we would have chosen another specialty. Please remember that this is an emergency room. When I don't come by your room for over an hour because your child is on room air, smiling and happy, please know I am not trying to ingnore you; I have probably been in the trauma bay dealing with major badness, and trust me when I say that I would much rather not be back there!

On a different note, Hubby and I agreed ahead of time that we weren't going to make a big deal out of Valentine's Day. To me, it's a big ploy by retailers to get your to spend money. That said, I did use it as an excuse to buy him a Wii game that I had planned to get for Christmas but couldn't find in stock, and he surprised me with delivery of some beautiful pink and white tulips yesterday (my fave!). However, the best gift of all came this afternoon. The construction workers building on the empty lots immediately behind our house have been intermittently playing their music so loud that we can hear it inside the house. We have called to complain at least 3 times in the past two weeks; it's annoying to listen to the thumping bass, but when I only have nine to eleven hours at home between shifts, I need every minute of sleep that I can get. This afternoon, the workers yet again parked their truck immediately behind our fence and proceeded to blast music at the top of their speakers. Unbeknowst to Hubby who was working in the office upstairs, it woke me up, but I was so tired that I couldn't drag myself out of bed. Apparently as soon as it started, he called up someone at the front of the subdivision, but an hour and a half later, they still had not done anything about it. He tried again with the girl at the front of the subdivision, and when she basically twiddled her thumbs, he told her his plans to file a noise complaint with the police. Her response? "Yeah, that's a great idea! It will definitely make them stop." So he did, and the music magically died (I think word got out he called the police because the music stopped 10 minutes later). It truly was one of the greatest Valentine presents ever. Love is trying to ensure your sleep-deprived resident wife can get a good nap uninterrupted by someone else's music!

Decompressing

2008-02-11T07:40:00.000-06:00

Hubby had his alarm set for 6 AM this morning, but after 2 nights in a row of dreaming about the PICU, I didn't even need his alarm to tell me it was time to get up. I'm working the night shift in the ER tonight, so I have several hours to spend here at home before going it. The weatherman is predicting a HUGE line of thunderstorms to come in right about the time I start my shift, so I'm looking foward to fun times in the ER tonight. Bad weather always bring in sick patients, so I need to put on my gameface.

This weekend we went to a love and marriage mini-retreat at our church; it was so great to learn and be reminded of the priority of our marriage. We capped the weekend off with the most delectable dinner at Del Frisco's Saturday night; I think I'm still drooling about the experience. I may gave gained five pounds from it, but it was worth it! Sunday afternoon after church, Hubby finished painting the bedroom while I kept falling asleep in the middle of the room. I still can't believe this awesome looking room belongs to us!

My sweetie had to get on a plane this morning again, and when he gets back Thursday night, I will be working all night til 7 AM. I'm not a huge Valentine's day person, but it still makes me a little sad that I won't see him until Friday. When he hugged me goodbye today, I couldn't stop the tears from leaking, and even now I'm having a hard time turning off their slow drip-drip-drip. All the emotions and messed-up sleep habits from the last two weeks are starting to catch up to me, and I just need time to clear my head. Fortunately I am not working Friday or Saturday, so I will have time to be with him for more than just a quick hug before one of us heads to bed or heads out the door.

For now I think I'll spend a little more time watching TV and relaxing this morning before I get up to work on laundry or whip up something yummy in the kitchen. I will work hard tonight, but today is for relaxing and renewing my tired heart.

Surreal

2008-02-07T08:32:00.000-06:00

Thoughts on this week on PICU night float:

3 codes in the last 3 nights
3 episodes of listening to mothers scream as their child's monitor shows flat lines
3 rounds of controlled chaos as the team frantically moves to save a life
1 loss and 2 saves ... for now
1 family irreversibly changed and 2 families waiting in limbo
3 nights of me realizing just how much I hate this place and how glad I am God has placed people here who love it
1 more night until I'm out of here
Miracles do happen
Every day I am alive is more proof of God's grace

SIlence

2008-01-31T03:03:00.001-06:00

It's 3 AM, and I'm hiding in one of the callrooms in the Pediatric Intensive Care Unit (PICU). Those of you who know me well know that I hate the PICU. The kids are too sick and the stories too sad for me to enjoy it up here. I am beyond thankful for those God has called to minister to these precious ones, but I know my time here is only for a season.

I've got the TV on in the background to break the silence, but even silence would be a relief from the beeping of the monitors I hear every time I walk through the doors of the unit. Alarms are constantly going off, and something is always happening up here. It's never silent, never totally quiet. Some of these kids will walk about on their own with little proof they were ever here. Some will walk out physically broken from the tragedy of a horrible accident or from a crippling disease. Some will never walk out. We all hope and pray that our patients will fall in the first category, but those who don't simply break me. In between the lack of sleep (I've spent 51 of the last 82 hours here and will spend 20 of the next 30 here as well) and the emotions, I'm worn out.

Morning labs will be coming back in less than an hour, and then I'll have more decisions to make. Change the ventilator settings or not ... increase IV fluids or go down ... continue antibiotics or turn them off ... the decisions never end. Fortunately my shift does in about six hours, and I will be off for a refreshing ten hours before arriving again, coffee in hand, ready to face the battles all over again. Six more nights ... eighty-six more hours ... then I will move to a different battlezone.

Memories of my grandma

2008-01-24T18:37:00.000-06:00

I didn't have to work today (although I did have to go to the hospital for a meeting at lunch that lasted an hour), so I used the afternoon to clean the downstairs. Since I had a little extra time before Hubby gets home, I thought I'd make a loaf of bread. I just checked the dough, and yeasty smell of the bread along with memories of my Grandma hit me in the face like a ton of bricks.

My Grandma, my mom's mom, was and still is one of my favorite people ever. Her husband, my Grandpa, died before my parents even met, so she is the only grandparent I have ever known on that side. She and Grandpa M were both Czech and grew up deep in the heart of Czech country in Texas; she spoke the language fluently, grew up on a farm, and even gave birth to her first child out on a farm. My grandparents moved to College Station before my mom was born and raised their little family there. They were strict Catholics and in spite of this were only blessed with two children. My mom was born almost ten years after my uncle, so my Grandma considered Mom her little miracle. Grandpa M died unexpectedly of a heart problem in the early 1970s, and my Grandma never remarried. For her, he was it, but the entire time I knew her, she never seemed sad or discontent with her life.

My main memories of Grandma revolve around the kitchen. She was a good Czech woman and knew how to bake the most amazing creations all from scratch. Her kolaches were beyond anything I've ever eaten to this day! I remember her making bread in the kitchen and showing me all the steps; she even used to pinch off little pieces for her grandkids so that we could make our own loaves. Of course we didn't do everything correctly, but somehow Grandma's loaves were always the imperfect ones. I seriously didn't figure out for years that she switched them when she handed them to us! I know that my love of baking comes from her.

When I was around twelve, Grandma went to the hospital for routine gallbladder surgery. She had a massive stroke while she was there and was never the same. When I hear the word "Grandma," I flash back to her before the stroke because it's too painful to think about how changed she was afterwards. She passed away several years later, but I still miss her. Hubby and I each have a grandparent that we were really close to who died before we met and who we wish could have met us; I know she would have loved him as much as the rest of my family does.

Like I said earlier, Grandma was a strict Catholic and raised her children Catholic as well. My mom came to Christ when she met my Dad in the mid 1970s, and I know that they both preached Christ to Grandma multiple times after that. She told them that she believed but that she kept going to the Catholic church because it's what she knew and because she didn't want to upset her family. After her stroke, she came to live to us, and I remember reading aloud a passage about salvation to her and my sister one night, praying the words meant as much to her as it did to me. When she passed away, we held her funeral at the Catholic church where my grandpa is buried out of respect to her family. To this day, I still do not know if my Grandma believed, but I am full of hope that I will see her again one day.

In the meantime, I'm going to back and check on my bread. If I want to keep at least a piece of her legacy, I need to ensure I can make a decent loaf of bread ... even if I use some help from a machine.

Ouch! Double ouch!

2008-01-23T20:31:00.001-06:00

My wallet is in the corner crying softly. I just spent almost $800 in the last seven hours! Fortunately, I'll be reimbursed for $75 to cover the cost of my required Pediatric Advanced Life Support (PALS) renewal course, but I'm left alone to cover the $670 for my USMLE Step 3 exam. All doctors have to take this test at some point to be licensed, and I decided today that I have been putting it off long enough,so I started the registration process online. The test covers all the medical specialties, and I'm already a year and a half out of medical school (yikes!). I forgotten SO MUCH about grown ups in that time (but learned so much about peds in that time as well), so I used $35 to buy this book to help me prepare. I figured it was worth the investment not to have to take the exam again! :)

Online registration for this exam as well as for licensure later has not been fun, so I have the new show "The Moment of Truth" on in the background. This show is CRAZY. I came in twenty minutes late, but I cannot believe how uncomfortable this is. The distance these people are willing to go just to earn money is heartbreaking. One question asked a man married for 2 1/2 years, "Is the reason you've put off having kids because you're not sure Catia (his wife) is your lifetime partner?" He answered "Yes" right in front of his wife! And it was true! Several questions later he was asked a question regarding whether he had ever touched a woman more than he had to as a personal trainer. He answered "No" -- but it was false! NO amount of money was worth the damage that couple did to their marriage tonight. Absolutely heartbreaking.

I'm still plodding away at these online forms. How much data can they really want about me? I also had to go find a 2"x2" picture of myself to mail in with my application -- ugh. Now I have to find a notary to prove I am who I say I am. The fun times of being a resident never end!

Doctora!

2008-01-22T17:34:00.000-06:00

Today I left work at 2:30. Before you think to yourself, "Wow, that is a short day," consider that I arrived in my parking garage shortly before 6 AM and spent my day in the Neonatal ICU taking care of some pretty sick kiddos (plus I really hate mornings). Yuck.

We needed a few things from the store, so I stopped at one of my favorite Targets on the way home from work. This particular Target frequently has wonderful clearance deals, and those who know me know how much I love a good bargain. I was wondering through the aisles looking for a warm pair of slippers when I heard a lady whispering loudly in Spanish right behind me. I speak a decent amount of Spanish, and that amount goes up when the words are spoken slowly. This lady, however, was chatting at breakneck speed, but I was able to understand one word very easily: "Doctora!"

I continued to amble down the aisle, thinking that perhaps she was just pointing me out to her son because I was still in my scrubs or that seeing me reminded her to make a doctor's appointment for later. No such luck. Suddenly I hear a male voice saying, "Excuse me." I turn around to find myself with the whispering lady and her almost pubertal son. She shoves 2 pregnancy tests in my face -- an EPT test and a Target brand test. Her son asks, "Do these two do the same thing? Are they the tests to tell you if you are pregnant?"

Wow. AWKWARD!! I told them something to the effect of this: "I think they do, but I'm not an OB, so I'm not sure." I make it a practice not to give medical advice outside of the hospital; I watched my dad miss too many church services as a child because people caught him outside the sanctuary doors and wanted to run a free clinic in the Sunday School classrooms, and I just want to be "Mrs." not "Dr." when I'm not at work. I also wasn't about to get into pregnancy counseling with a woman who doesn't speak my language using her twelve year old son as our interpreter. I listened to her son translate an extremely abbreviated version of what I said to his mom, and she smiled, thanked me, and walked away. I don't know which test she ended up choosing, but I hopes she goes to see her own doctor.

I walked away and wandered into another section of the store before it hit me just how laughable the situation was. I immediately grabbed my phone to text a few people about it. My mom's phone cut the message into 2 messages, and she accidentally opened up the 2nd one first. All she saw was "2 pregnancy tests ... This is my life!" She was smart enough to read the first one before calling me up, but when we did talk a few minutes later, we had a good laugh about her thinking I was sharing some important news over a text message! (For the curious, no, there is no baby on board here.)

Tired

2008-01-17T13:20:00.000-06:00

I haven't worked much for the last several days, but I am just tired. It's a little after 1 PM, and I'm still in my sweats, snuggled up on the couch with the cuddliest dog ever and watching Food Network. I had a horrible headache Tuesday afternoon, so after heading home from the grocery store, I did nothing productive that day. Hubby and I had dinner with some friends Tuesday night, and I managed to keep the headache at bay that evening (thanks, Aleve!). We finally got the coat of primer and one coat of paint up on the first wall yesterday evening, and it looks SO GOOD. If his job gives him enough time today, we will try to get a second coat up on the wall and start on another wall. His job has been working him to the bone, so we may not get to do as much as I had hoped. It's back to work for me tomorrow, and then Hubby leaves early Monday morning for yet another trip to Philadelphia. I switch to PICU nights 1 week from Sunday, so little to nothing will be accomplished for 2 weeks following that.

Hopefully I can get my bootie off the couch soon and start to be at least semi-productive. My brother bought me The Barefoot Contessa at Home cookbook for Christmas, so tonight I will be making a delicious chicken piccata. I'll be using my breadmaker to make dough for focaccia bread too, so hopefully Hubby will be able to take a short break for dinner. :)

I haven't blogged about work lately, but I'm still loving it. Kids are awesome, and watching my clinic patients growing up in front of me is one of the coolest experiences of my life. I'm having a bit of an emotional time right now because we've lost several children to cancer lately. Even when I haven't seen these kids in a while, I still feel a connection to them and to their families. I'm probably just a faceless resident to them, but losing these kids still affects me.

That's about it for now; I think Sebastian and I will hang out for a bit more before I head down to the kitchen to do something worthwhile!

Motivation

2008-01-14T22:19:00.000-06:00

My schedule this week has worked out so that I had the weekend off and did not have to go to work today. Tomorrow I just have a meeting at lunch, Wednesday I have afternoon clinic, and then I have Thursday off as well. I will definitely be making up for this week later, but it's worth it right now.

Because of my free time, I was able to participate in my church's 15/15 prayer experience. Starting eight days ago, we have committed to having 15 people per day pray for 1 hour each for 15 days, and I was blessed to be able to go up to my church and pray this morning at 8 AM. Those who know me well know that I am NOT a morning person. I HATE mornings with a passion. God knew this and thought it would be funny to have me marry one of the world's biggest morning people, so when Hubby is in town, there are many mornings when his cheery greetings receive grunts in reply.

When I signed up for this, I saw open spots later in the day, but I wanted this to be a sacrifice, so while 8 AM really isn't that early and I have often been at work for a few hours by then, I still struggled to get out of bed and be ready on time today. To be honest, I was a little worried about how I would be able to pray for an hour straight, but as I started whispering to Him, He continued to bring people to my mind, and I actually worried that I had gone over and was holding someone else up (I was close but not over). This morning was one of the most beautiful experiences I have had in a while, and I am immensely thankful that my God is so wonderfully large and yet amazingly intimate at the same time.

In another direction, I've also become motivated to use my days off to continue my efforts to turn our house into a home. We went to Lowe's tonight and bought the supplies to start painting some of the rooms. Those of you who have been to our house may have noticed that many of the rooms and walls flow together, so painting has posed a problem since there are few natural breaking points in the house. I love how open everything feels, but it's been a challenge to figure out how to decorate and paint. We've decided to paint the game room a lovely shade called "Belgian Chocolate," but unfortunately the Lowe's near us did not have the correct base for the paint. We tried it in another base, but it looked more like chocolate milk rather than Belgian Chocolate, so we're holding off. Hubby has taped off most of the first wall for me, so tomorrow I will be priming the wall before I head in for my meeting and will hopefully find the correct paint at another Lowe's. I'll just have to remember that this is indeed paint and not liquid chocolate. ;)

The aroma of freshly baked bread is wafting through my house

2008-01-13T22:09:00.000-06:00

Dillards has been running an amazing clearance sale this week. I have been contemplating a bread machine for quite some time but haven't been able to bring myself to buy one. It is hardly a necessity, and the cheapest decent one I could find was a little over $60 at Bed, Bath, and Beyond. On Thursday I stopped by Dillards to get some necessary undergarments and made my usual stroll through the home section. There I happened upon a bread machine originally priced at $70 reduced to $50; on top of this, they had just marked it down another $15. I pulled out my Dillards giftcard that I'd been saving for a while, and I had almost $30 left on it. Add in a little tax, and I only paid $8.13 for a beautiful little bread machine!

I've already made one loaf of white (almost gone) and just finished a loaf of honey wheat a few hours ago. The house smells soooo good right now. I think I'm going to try a loaf of French bread tomorrow. This machine is so fun!

A much needed break

2007-12-22T11:26:00.001-06:00

The last eight weeks of work were absolutely draining. I spent 4 weeks in the PICU and then 4 months as senior resident on one of the general pediatrics inpatient teams. While I was inpatient, I took overnight in-house call every 4th night, and I am so tired. If I don't see another child with RSV for a while, it will still be too soon! I had so many random hilarious things happen last month and so many random frustrating things to balance out the funny that I am just exhausted.

I managed to work out my days off from last month, my vacation time, and my Christmas break time to work together to give me 13 days in a row off. I will probably NEVER have this much time off again, so I'm definitely enjoying it while it lasts. I'm now on day 8 and have loved every day of sleeping in (which means not getting up til 7:30). We hosted our Sunday School class Christmas party at our house last Saturday and had a blast! We spent last Sunday afternoon with Hubby's dad and 2 sisters and had a mini-Christmas since parts of that side of the family won't be together again this year. This afternoon, my parents and 2 siblings are coming in to stay with us for the next 4 days, and I cannot wait.

Christmas is my absolute favorite time of year. I love everything about it -- the food, the smells, the gift-giving, the decorations. This year has been even better since Hubby and I are the ones hosting Christmas. We have scrubbed the house from top to bottom and hung all our decorations. We have our formal Christmas tree downstairs and our homey Christmas tree upstairs. The house smells like a combination of the sugar cookies and cranberry-orange scones I baked last night, and my first turkey is sitting in the fridge getting ready to be brined soon (thanks, Food Network and Alton Brown!). I even have the cutest Santa outfit for Sebastian! Best of all, I have been able to attend church last Sunday with Hubby and will go tomorrow with my side of the family as well as Hubby; sharing fellowship with my brothers and sisters in Christ is even more beautiful to me this time of year after my long absence due to work. I am so thankful for the miracle of my King's coming, and while I know this time of year is likely not the actual time of His birth, I enjoy using it as a time to celebrate His story. Thanks be to God for His indescribable gift!

Nice surprise

2007-11-12T18:23:00.000-06:00

Earlier today I began an entry on my experience this weekend as I watched the aftermath of a horrible tragedy that resulted in a young child dying in his mother's arms. I was not there for the end due to duty hour rules, but I was there for the beginning. It was so horrible that I pray no one else ever has to go through this. I recognize that we unfortunately live in an imperfect world, and this terrible scenario will likely play out again in that same unit time after time.

That said, I'm not ready to deal with the emotions that this experience is evoking. Instead, I've decided to blog about the happier side of the last three days.

Saturday I left the hospital and came home to Hubby. It was the first time I'd seen him since Sunday night (technically I saw him Monday morning, but I was half asleep, so it doesn't count), and boy was it good to be in the same house with him.

Sunday I had to go to work, and I had a SICK patient. She was a complete mystery to multiple teams, so I ended up staying in the PICU hours later than I had planned. I didn't have an official breakfast that day, and my lunch consisted of a cold piece of pizza I ate as I left the hospital at 2:45 that afternoon. The upside of Sunday? My dad was in town, so we picked him up and had a delicious dinner at Cantina Laredo.

Today I slept ten hours straight -- glorious. I had a meeting with my program director at 3, so I left the house after lunch to run some errands before the meeting. I'm asking for new jeans for Christmas, so I dropped into my favorite store for jeans to try on a pair. To my extreme pleasure, I have dropped a jean size!! I noticed that my jeans had been quite loose lately, so today's dressing room revelation came as an expected but pleasant surprise. After I got home, I made a HUMONGOUS batch of fudge and 2 loaves of pumpkin spice bread. Now I'm preparing to watch my favorite TV show, Heroes. Life is good! :)

Strength to carry on

2007-11-05T08:26:00.000-06:00

This weekend I experienced one of the hardest moments of my life. I've been in the Pediatric Intensive Care Unit (PICU) for the last two weeks, and I have seen children make it through things I never want to think about again. On Saturday, one of our team's patients didn't make it. We had tried to keep him alive for a few weeks, but eventually even out last ditch efforts were obviously beginning to fail. Almost all of us, including me, knew that we needed to let him go, but we had been giving his family time to come to that realization as well. By Saturday, his mom was there, but his dad was still asking for more time.

I had to be in the room as our attending explained to this child's parents that we were rapidly running out of interventions to keep him alive. My attending comforted them by reminding them that their child was not awake and that he was not feeling pain. The chaplain and a family friend made it to the room, and I helped the nurses clean his broken little body as best we could. We disconnected his lines, we turned off his monitors, and finally they pulled out his breathing tube and the other tubes going down his nose and face.

None of us really knew this patient. He had never opened his eyes, never spoken, never woken up for the entire time we cared for him, yet through hearing his family speak about him and seeing pictures of him, we felt like we knew him. We all watched as this patient that we had fought so hard to save took a few shallow breaths and then stopped breathing. His parents began to cry, and I fought so hard not to cry myself. We stepped out of the room to give them time alone with their son before returning a few minutes later to make the final pronouncements.

It was interesting to see how the different members of the team responded to this. Some stood around joking about inane little things to take their minds off what happened, some immersed themselves in busy work, and some left our part of the unit entirely. Until Saturday, I had never been in the room when a child died, and it was every bit as hard as I anticipated, so I didn't know what to do to make this any easier for myself. As we had been in the room with the family, I found myself silently crying out to God for them, but after we left the room for the last time, I was too busy taking care of the patients I still had left to stop and focus on everything that had just happened.

This patient was not one of my normal patients. I had never been the main provider for him before; it had always been someone else, but due to shift requirements and work schedules, I was covering him for only four hours that day. Right before he was handed off to me, I knew how sick he was, and I found myself hoping that he wouldn't die on my shift. Initially I felt guilty for hoping that he would survive five hours instead of three, but when I realized the source of my fears, I didn't feel so bad. This was previously uncharted territory; I had never directly been in the room when a child died, and I didn't have a strong connection with the family. I didn't know what my role would be, and I was scared of doing the wrong thing. I am not personally afraid of death because I know what will happen to me when I die, but I was and still am afraid of death when it comes to others. As it became obvious that we wouldn't be able to keep him alive, I just began to pray that God would help me do the right things and be a tool in His hands.

After it was all over, I made the appropriate phone calls and filled out the necessary forms. His dad asked me if he could keep the blanket we had covered his child with so that only his face and shoulders, the least visibly damaged parts, would be seen. We heartily reinforced that this blanket and anything else they needed was theirs, and they thanked us before quietly slipping out, never to come back.

The chaplain found me later and thanked me "for everything," but it felt so ridiculous that she would thank me at all as I felt I hadn't done anything for them. She told me that on the way out of the hospital, our patient's mom had expressed that she didn't know why God had allowed this to happen but that He was in control and that she would continue to trust Him. Such amazing faith in the face of such tragedy! How I pray that my faith would be as strong!

I was at work for about an hour and a half more after the death before signing out to the night shift person. While I was there, I was able to smile and keep a cheerful appearance, but as soon as I stepped out of the hospital, I began to feel a huge weight being lowered down onto my shoulders. I called Hubby to let him know I was on my way home, and for once, I didn't feel like talking during the drive. I started to cry as drove down I-35 and began to call out to God for this family. I don't know if half of my words would have been intelligible to the human ear, but I know that God heard and understood me. After I got home, I just needed to be held by Hubby as I cried. Later he listened to me as I talked through the events of the day, and I was begin to process what had just happened.

I still don't have answers to make all of the pieces fit together. Why this happened will never make sense to me, but I have faith that God is good and that He works in ways I will never understand. I will continue to pray for this family and for myself that I may be a tool in His hands.

Again?!?

2007-10-25T17:48:00.001-05:00

I am sick yet again. I didn't feel so hot in clinic yesterday, and by the time I got home, it was definitely not good. I threw up around 8 PM and went to bed without dinner. This morning I ate a few crackers for breakfast as rounds were starting, but I didn't have the appetite for anything else. Around 10 AM, my attending told me to call in sick call because he could tell I didn't feel well. I almost started crying right there in the middle of rounds because I was doing everything I could not to call in sick call, but I felt so horrible that I just wanted to go home.

I made myself some soup when I got home, so in the last 30 hours, I have eaten about 6 saltines and a cup of chicken noodle soup. I'm considering some Jello for dinner, but we'll see. At least I have tomorrow off, so I don't have to worry about calling in sick call for a second day.

I'm in the PICU this month. I'm definitely not an intensivist! There are plenty of valuable lessons for me to learn in my 28 days here, but I am so out of my element. I'm seeing such horrible things that I usually want to go home and cry to get it all out. These kids are so sick, and I'm seeing horrific child abuse that turns my stomach. This month is turning me into even more of an advocate for my patients than I was before! I am so tired; I'm waking up at 4:30-5 am every day, and at least two days a week, I work til 8 PM. I'm only on 30-hour call twice this month, but the first time is Saturday. I'm a little nervous about it, but I know that it will be okay.

I think it's time for Jello and a second episode of Law and Order. I don't have any plans for tonight other than to relax and watch TV with Sebastian. Tomorrow Hubby will be home; I'm hoping that I will at least be eating real food by dinner tomorrow.

One more thing ...

2007-10-18T21:49:00.000-05:00

One more thing I am thankful for is the ability to swallow. My precious patient has lost that ability. I found out today through a text page from another doc taking care of her, and now she is going to require tube feeds. I almost started crying in Fry's shortly after I found out. Later after we got home, I soaked in a hot bath with water up to my chin as I cried out to God and told Him again that I don't know what to do for her. No one seems to know. She is getting worse right in front of our eyes, and there is nothing we can do to stop it.

This is the point where my flesh wants to start disengaging. Looking into her mom's eyes hurts so badly because I cannot provide answers or an honest hope of recovery at this point. Caressing her sweet little face reminds me how fragile she is. Although I continue to pray for a miracle, I am preparing myself for what happens if God chooses not to provide one. She may live a long life, but at this point there are no answers.

Fortunately the Holy Spirit refuses to let me disengage. I am frequently reminded that the best thing I can do for her is to pray. The first time God began to whisper to my heart what He had in store for my life, I was a 14 year old teen volunteer at Hermann Hospital. I was wheeling a patient from the front of the hospital to his room when he began to vomit in front of me. I was a helpless teenager who had no clue what to do, but I was overcome with a desire to help this man. The words from a song called "Not Too Far From Here" (originally sung by Kim Boyce) popped into my head: "Help me, Lord, not to turn away from pain; help me not to rest while those around me weep. Give me Your strength and compassion when somebody finds the road of life too steep."

Little did I know that six years later, He would call me to medical school, and four years later, He would call me to take care of His little ones. I see His fingerprints every day in the beauty that is the human body. I see His miracles everywhere I turn. How one could practice medicine and not believe in God is beyond me.

I can cry for my patient. I can pray for her. I can feel helpless. I can come up with new ideas. I just need to keep remembering that God has a perfect plan, and I need to be ready to be a tool in His hands in any way He wants to use me.

Somebody's down to their last dime
Somebody's running out of time
Not too far from here
Somebody's got nowhere else to go
Somebody needs a little hope
Not too far from here

And I may not know their name
But I'm praying just the same
That You'll use me Lord to wipe away a tear
'Cause somebody's crying
Not too far from here

Somebody's troubled and confused
Somebody's got nothing left to lose
Not too far from here
Somebody's forgotten how to trust
Somebody's dying for love
Not too far from here

It may be a stranger's face
But I'm praying for Your grace
To move in me and take away the fear
'Cause somebody's hurting
Not too far from here

Help me, Lord, not to turn away from pain
Help me not to rest while those around me weep
Give me Your strength and compassion
When somebody finds the road of life too steep

Now, I'm letting down my guard
And I'm opening my heart
Help me speak your love to every needful ear
Jesus is waiting
Not too far from here
Jesus is waiting
Not too far from here

I am thankful ...

2007-10-18T14:41:00.001-05:00

... that I'm incapable ... of doin' any good on my own.

Seriously, the tragedy I have been watching around me makes me stop and reflect how many things for which I have to be thankful. Let me give an abbreviated list:

My beloved husband
My family
The best dog in the world
My home
Indoor plumbing :)
Delicious food that is readily and easily accessible (and often somewhat nutritious)
Clean, drinkable water
My overall good health
A supportive work environment
Freedom of speech and of worship
Easy access to medicine
Laughter
My new Barista and the delicious coffee that Hubby makes for me before I go to work
Christmas CDs that arrive early (yay Amazon.com!)
A baby's laugh
Seeing miracles everyday with my own eyes
Most of all ... my Savior

Reflection

2007-10-09T19:32:00.000-05:00

Tonight I decided to skip an optional journal club meeting, so Sebastian and I are chilling and doing nothing worthwhile. He's sleeping in my lap while I'm working on wiping out my classic iPod and starting from scratch. Unfortunately my largest CD case is in hubby's car at the airport, but my smaller case with many of my favorite CDs was in mine, so I have decent starting material. I've been enjoying songs I've loved for the last ten+ years, so I felt inspired to fill one of these out.

1. What were you doing 10 years ago? It was October 1997, and I was applying to colleges and going on trips across Texas to figure out where I wanted to be. I was also stressing over my ex-boyfriend (although, as I joke with Hubby, we never officially broke up, so technically ...) and wondering whether or not we should get back together. For the record, we didn't. I had just gotten my driver's license four months earlier and my own car one month earlier, and my braces had FINALLY come off on the same day I got my car. I thought I was the stuff!

2. What were you doing 5 years ago? October 2002 -- I was into my first semester of medical school and FREAKING OUT over anatomy. Yuck. I was also driving almost every weekend to be with a boy who turned out to be bad news. Between studying and driving to see the boy, I didn't have much time for anything else, and I was missing College Station very badly.

3. What were you doing 1 year ago? October 2006 -- I was finishing up my easiest month of intern year (clinic selective) and starting one of my harder months (night float). I was so exhausted and extremely stressed over residency and missing my hubby. I missed Houston so much it hurt! Funny how a place in which I felt so uncomfortable 4 years earlier seemed so much like home.

4. What did you do yesterday? I went to Surgery Clinic and learned about all sorts of surgical problems kids have. Some would gross out anybody non-medical, so I won't give any links. :) Then I went to one of the best stores in the world, Target, and came home to hang out with Sebastian.

5. Snacks I enjoy -- I get on kicks where I will eat certain things over and over and over until I get sick of them, and then I won't touch them for months. The latest passions? Red grapes, pineapple, grill cheese sandwiches, and a glass of milk with a cookie (although I don't eat all those at the same time)

6. Things I would do with $100 million dollars -- Automatic $10 million to my church as a tithe, then extra for missions both abroad and in my hometown. Pay off my student loans, our house, and my car. Take my family and Hubby's family on a trip. Find a family in need and buy Christmas toys for all their children. Save the rest and continue to live our life in a manner much like we live now. It would be nice to not have to pay off my loans and the house, but other than that, I don't think I would want to change much of how we live. God has blessed us with far more than we need.

7. Locations I would run to -- I'd love to go back to Maui with Hubby and take him to Italy and France for his first trip to Europe. We're talking about going to NYC for my first trip there during our vacation in the spring, so I would have to stay I'd go there as well!

8. Bad habits I have -- I bite my nails and do it more when I am nervous. It is so gross, but I do it unconsciously, and that makes it so difficult to stop. I also tend to tune things out when they don't interest me.

9. Things I like to do -- Hang out with Hubby and Sebastian, read, cook, drink a glass of nice wine over a delicious dinner

10. Biggest joy of the moment -- Getting to see my parents this weekend for the first time in ages! I saw them for 1 day at my grandmother's funeral in August, but other than that, I don't think we've spent time together since March. They're going to see our house for the first time since it's been completed and meet Sebastian for the first time. PLUS when they leave on Sunday, Hubby won't be leaving out of town the next day!!! He'll be in town for at least one week -- the first time in eight weeks he won't be getting on a plane on Monday! I am thrilled beyond words. Thursday can't get here soon enough!

A time of renewal

2007-10-08T18:24:00.001-05:00

I've been having a pretty rough go at it for the last few months. My patients have been very sick, and I've been separated from my husband much more frequently than I would like. I haven't been "sick" per say, but I have been so much more tired than usual. I have been emotionally drained and haven't felt very "happy" in a while. This has not been an easy time for me.

This weekend was my church's ladies' retreat. I was initially very hesitant about going, but one of the girls from my Sunday School class invited me to stay in her room, so I decided it might be a good idea. I really had no idea what to expect, but I now can see that God was preparing this weekend for me.

Our pastor's mom spoke to us and discussed Romans 12:1-2. The theme of the retreat was "A Time of Renewal," and the Lord used the twenty-two hours I spent in Waxahachie to refresh my soul and meet me in my deepest places of need. He allowed me to deepen relationships with my sisters in Christ and to establish a few new friendships with ladies outside of the typical age range I usually hang out with. He gave me the ability to see my life in a new light and to remember the importance of joy even when trials arise. I was able to return to Dallas with a lighter burden than the one I had brought to the retreat.

The best moment of the retreat came after lunch on Saturday. The main conference room was opened up 30 minutes early to allow us quiet time to pray, read, or meditate on Him. I slipped into the room and curled up in my chair with my head resting on my Bible. As I wept and cried out to Him for myself, my family, my lost friends, my patients, and so many other things, He brought verses to my mind and whispered comfort to my soul. What a sweet and merciful Savior!

Sometimes

2007-10-04T19:16:00.000-05:00

Sometimes things cannot be explained. Sometimes there are no answers.

Ready to quit

2007-09-25T15:20:00.000-05:00

About fourteen hours after my last post, I stood in another patient's room in the ER as an intern and I explained that their only child likely had cancer and needed to be admitted to the hospital for further tests. Yuck yuck yuck. I was so ready to quit by the end of the week. Four new diagnoses in less than a week ... YUCK. I love pediatrics, but I hate cancer.

I'm back on days. I think today is the first day that my body has remotely been adjusted to normal people hours. Sebastian is so happy to have someone at home with him during normal hours, and since I have not had anywhere to be for the last two afternoons, he and I have been spending some serious quality time together. He's been playing with his new puppy toys while I've been doing research for a presentation I'm giving in two weeks, and now we're both chilling out while Paula Deen teaches us how to make a sinfully delicious caramel apple cheesecake. Yum.

Hubby is still gone during the week. He's on his sixth week in a row out of town and has at least two more to go. Having him gone is horrible; this house is too big for just one person!

Time to get back to work ... I'm no closer to being done with this presentation than I was yesterday. The more research I do, the further I seem to get from finding an answer to my question. Time to press on!

Drained

2007-09-18T09:58:00.001-05:00

About 3:45 AM today, I rubbed a mommy's back as she waited in the ER for her baby to move up to the Pediatric Intensive Care Unit (PICU). This particular mommy had just gone home YESTERDAY afternoon (I signed the discharge order myself) after a several week stay in the hospital for cancer-related issues. 24 hours later, they were back since their precious one had a fever (and a very serious infection as the story and the labs are unfolding). I had met this mommy a few hours earlier as we were preparing to send her baby up to my floor, but while he was in the ER, he took a turn for the worse and needed a higher level of care than we can provide on the floor. I wanted to come see the little one as well as this sweet mommy since they will hopefully be returning to my floor after the badness subsides. My Spanish is meager; I'm much better at asking direct medical questions than carrying on a conversation, but since no one around spoke much better Spanish than I did, I figured something was better than nothing.

Her eyes were red as I tried to comfort her. I don't know how much she understood, but I hope I was able to let her know that she's not alone and that we are going to do everything we can do to care for her little one. This baby was so fussy because of many factors including a strange environment, blood draws, and the infection to name a few, but one look at mommy made things so much better. I wish I could have provided the same thing to her.

Btw, my sweet little patient from my last post went home yesterday. I'm so happy for her and for her family.

This month is so hard, and I am so drained. I haven't been taking care of myself, and I am really starting to feel it. Working 68+ hours per week and fighting your natural circadian rhythm can really wear you down.

Brokenhearted

2007-09-14T10:31:00.000-05:00

Late Wednesday night/ early Thursday morning, I helped deliver the news to three different families that each of their daughters has cancer. Each family's reaction was slightly different, but a common theme that ran through the night was one of shock and fear. Fear of pain, of death, of the unknown ... each family had so many questions. Two of the girls were old enough to understand what was going on, but the unassuming three year old and her family touched me the deepest.

As the fellow spoke and I nodded along, we explained to this family what the next few days held for certain and what the next few weeks and years possibly hold. Over the next several days, she would undergo several procedures and start a chemotherapy regimen after we completed an ID of the cancer cells. Late last night, I visited with the family as their little girl returned from her surgery and first dose of chemo. She was crying in pain from the procedure as well as from fear of the alien nasal cannula giving her the oxygen she needed. Her mom was cuddling her sweet little girl in her arms and trying her best to comfort her as her nurses hooked up her fluids and monitors. I explained to her parents why she needed the oxygen and then offered them the alternative to try a mask to give her the O2. They accepted my offer, knowing that this meant we had to remove two large adhesive patches from her cheeks. We have a solvent we use to help dissolve the glue, but it's still not a comfortable process.

My sweet patient continued to cry intermittently as her nurse removed the tape. Watching this process was difficult for me, so I can't imagine how hard it was for her parents. What almost made me cry was hearing her mom whisper to her, "Jesus will help you, my baby." Soon the tape was off, and I saw this little girl smile for the first time since I met her.

Ever since I walked out of the hospital this morning, this entire family has been on my heart. As I walked through Target this morning, I began to pray for them as I perused the aisles. My prayers later turned to myself as I asked God to use me as He will to support this family as much as I can.

For privacy reasons, I cannot disclose my patient's name, but if you read this, please pray for her and her family. God knows her name, and He is holding her in His hands.

Wow

2007-09-07T10:33:00.000-05:00

What a night. I'm so glad I don't have to go back this evening! I seriously don't know how or why the hospital is so insane right now. I just need to sleep.

My calling

2007-09-06T09:17:00.000-05:00

I am so tired. These last two weeks have been crazy; we have been so busy at the hospital that we have filled all the beds for the past two nights, a feat usually reserved the busy winter season. I'm gone five nights a week, and when I'm home, I pretty much just want to sleep.

There are so many days where I wonder why God called me to this. I never had plans to become a doctor. I realized I was supposed to go to medical school only 3 months before the applications opened, but the signs were so clear that I couldn't ignore them. I had planned to do Med-Peds, but yet again God made it more than obvious to me that my place was with children only. Each time He has blessed me for following Him, but there are days when I wish He hadn't asked this of me. There are times when I am just so tired that I wish He'd asked me to do something with more normal hours or less pressure. Then there are times when the emotional burden is so heavy that I can't hold back the tears.

I know there is a purpose for me being here where I am now. I know I will never be a famous name, nor do I desire that. I just want to make a difference in my patients' lives. I want to reflect the love of Christ in everything I do. VERY early this morning I was called to mediate a conflict between a "difficult" mother and the rest of the floor team. I spent an hour and a half with this mom and her child, and I think all the woman really wanted was to be heard. I was able to convince her to let me treat her child appropriately, and I watched this woman cry as she divulged to me that she knew her sick child would not be with her forever and that she was just doing her best to take care of a very complicated, very sick girl. I truly could feel Christ's love pouring out of me on to her, and I was surprised at how much patience I felt during the situation.

I don't understand even half the details of my life right now. I am so confused about figuring out the "right" time for everything in my life, but in the end, I know it comes back to clinging to God the same way I have for every other major decision. He hasn't led me wrong yet!

In the meantime, I should probably get some sleep. Tonight is shaping up to be a doozy!

I love the night life ...

2007-08-26T16:06:00.001-05:00

Starting tonight, I'm back to nights for the next four weeks. Sunday through Thursday nights, you can find me at the hospital from 7 PM til about 7:30 or 8 the next AM. Good times! I'll have Friday and Saturday night off, and for the last two of the four Sundays, I will be at the hospital at 1 PM instead of 7 PM.

The good news? I'm not the intern anymore. The bad news? I'm not the intern anymore. I won't be the all the dumb calls, but I will be the one getting all the serious calls. Scary but exciting!

Update on my little girl

2007-08-24T11:49:00.000-05:00

A few weeks ago, I wrote about a patient of mine who is a mystery to me as well as multiple other doctors. Unfortunately, I'm thinking I may be getting closer to the answer, and I don't like what we're seeing. We thought we had found a possible diagnosis, but we didn't think she fit it too well since she was missing one big characteristic. My heart sank when I walked into her room in clinic this week, and I immediately observed her performing this missing piece. There is a gene test that can be performed to assist in confirming this diagnosis, but it is extremely expensive and not performed at our hospital, so we would have to draw her blood and then send it to another lab in another city. We couldn't order the test in good faith knowing that her parents would get the bill when they couldn't even afford a month of one of her medicines that is likely 10% of the cost of this one test, so until we can work out the financial aspects, we will just continue to treat her symptoms. The results of the test will not change how we manage her care, but I know these parents well, and I know in my heart that if I can provide them an answer to why this is happening to their precious baby girl, I need to do that. Right now they still blame her seizure medicines for all the changes that they have seen in her, but I have a dark suspicion that it is something far more than the medicine itself. If it is within my power to do so, I want to be able to give them something more than "I don't know" when they ask what her life holds. If my hunch is correct, there will still be so many times I will say "I don't know," but at least I will be able to provide them with examples of what has happened to other children in the past.

That said, I firmly believe that God works miracles. I have seen more than one child come back from something horrible in ways that no one expected. My own little sister should have died fourteen years ago when she developed a horrible pneumonia and an empyema that was missed for over a week while she was hospitalized. She spent a total of two weeks in the hospital including several days in the pediatric ICU, and the doctors there told my parents to prepare to lose their little girl. Instead, God performed a miracle, and my sister is now a healthy 22 year old college student! I can only pray that He will work a similar miracle in my patient's life. If He chooses not to do so, I know that He has a perfect plan, and I pray that He will provide comfort both to her family as they care for her and for me as I feel helpless to make it all better.

Ouch!

2007-08-24T11:29:00.000-05:00

About seven weeks ago, I was in an accident where I was hit on the driver's side (my fault). Ever since then, my back has been hurting. It has actually been getting a little worse over the last two weeks. Hubby knows it's actually bothering me when I'm talking about going to see "a grown-up doctor" as I call them. In the meantime, I've been taking some advice from my dad (a grown-up doc) and trying several suggestions to alleviate the pain. One of them is so use capsaicin on my back, so last night we stopped at CVS to pick up a bottle. Dad had suggested I use the liquid because it is less messier than ointment and would be easier to apply when I'm at the hospital for the next few weeks (my month of night float starts Sunday -- whoo hoo!).

As we were getting ready for bed, I made sure I put my eye cream on before the capsaicin so that I wouldn't burn myself. Unfortunately I didn't realize how often I really touch my eyes because I inadvertently rubbed my upper eyelids 20 minutes later. Despite having washed my hands, I still had some residual on them. Ouch! It was quite warm!