Lack of sleep leads to random thoughts

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

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.

Reflection - June 3rd

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.

Surreal

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

Memories of my grandma

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.

Tired

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!

Strength to carry on

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.

Ready to quit

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!

Brokenhearted

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.

Goodbye

We buried my grandmother today. Today was horribly difficult and draining, but it was healing as well. I felt God removing my anger and was able to realize that despite her flaws, my grandmother still really loved me. I'm looking forward to seeing her in Heaven; until then, I want to make sure that my sweet grandfather is surrounded by love even if we're not physically there to show him how much he means to us.

My dad preached the funeral today. I forget how beautifully he speaks sometimes, and his words today moved me to tears. Throughout his speech, he spelled out the plan of salvation and the story of Christ's sacrifice and love for us. He quoted I Thes 4:13-18 -- "But we do not want you to be uninformed, brethren, about those who are asleep, so that you will not grieve as do the rest who have no hope. For if we believe that Jesus died and rose again, even so God will bring with Him those who have fallen asleep in Jesus. For this we say to you by the word of the Lord, that we who are alive and remain until the coming of the Lord, will not precede those who have fallen asleep. For the Lord Himself will descend from heaven with a shout, with the voice of the archangel and with the trumpet of God, and the dead in Christ will rise first. Then we who are alive and remain will be caught up together with them in the clouds to meet the Lord in the air, and so we shall always be with the Lord. Therefore comfort one another with these words." And he did.

Heartbroken

My grandmother is dying. She has Alzheimer's among several other diseases, and after having her health slowly decline over the last five years, she has recently progressed to sleeping almost 24 hours a day and is barely eating or drinking. She was placed in hospice care over the weekend, and every time my phone rings or I find an email in my inbox, I'm expecting to get the news that she has passed.

My grandmother and I have had a horrible relationship; she verbally and emotionally abused me almost daily as a child for over 4 years. When my parents found out what was happening, they took me out of daily contact with her, and I don't think she has ever forgiven me for that. I wasn't able to really talk about what had happened with my mom until college five years later, and I couldn't even truly talk to my dad about it until my second year of medical school almost ten years after it all ended. After all, it was his mother, and I felt that if I told him the truth of what had happened, I'd be forcing him to choose between his mother and his child. I finally realized one day that he had already made that choice long ago and that as my daddy, he will always be on my side and be my protector when he can. I have continued to see my grandmother over the years, and with God's help, I have been able to forgive her. I can now look at her with pity, realizing what a rough life she had and what led her to the life she lived. I don't condone how she treated me or other family members, but I am able to understand and to forgive as I have been forgiven.

I tried so hard to be anything but her, but I became scared when I observed some of the negative traits she carried coming to life in me. I used to be extremely demanding, informing family, friends, boyfriends, and anyone around me how things had to be done the right way, my way. I would get mad and blow up at people for little things that didn't deserve such a reaction. I tried so hard to be anything but her that I was becoming the very thing I hated. I cried countless tears over the years as I faced up to my shortcomings and to my past, and with God's help, I faced the problems head-on and let go of so many of the painful pieces of my past. I don't know if I will ever be totally free of what happened as certain things still bring an ache when they come to mind, but I am free of my chains of captivity. My family tells me that I am a completely changed woman compared to six years ago, so having the ones who know me the best confirm the work that He has done in my heart makes the journey worthwhile.

My grandmother professes Christ. I truly do believe that she is saved, and I look forward to seeing her again one day, whole and healed from the bodily afflictions she's now enduring. I used to think that when she died, I wouldn't cry, that all my tears would have already been shed. Getting the email on Monday that she had been placed into hospice care showed me just how wrong I was; I sobbed as soon as I finished reading it. I know that it was just one more small sign that God is still working in me.

My heart is so heavy now. I weep for my grandmother and all the pain she endured in her life -- losing her father at age 3 to appendicitis, likely abuse at the hands of her relatives as she was passed around the family since her mom couldn't care for her, losing her firstborn daughter to mumps at age 4 ... the list goes on. I ache for my grandfather; he has spent over 60 years of his life with her, so will he be able to live now without her? I ache for my father and his siblings; imperfect as she is, she is still their only mom. I ache for myself; I never truly expected to have a conversation with her about why things happened the way they did, but I feel that there is a piece of our story that won't be complete until the next life when God will have wiped away all tears and none of this will matter anymore.

I will soon likely be making my first trip back to Houston since moving up here for residency over a year ago. I wish it weren't under these circumstances. My husband has been out of town since Monday morning, but I think the tone of my voice told him today just how much I am struggling right now and how much I need him here because he changed his flight to come back Thursday instead of Friday. I am glad that my feelings are those of sadness and love rather than of anger and hatred. God truly can work miracles.