Hey, hey

About 4:15 AM early Sunday morning after 21 hours of being on my feet, I felt the need to start singing, "I Will Survive." My senior resident (who has been sick for the same period of time I have) and I were dealing with a big problem down in the ER, and she was starting to get overwhelmed. Seeing as I've been there quite a bit myself lately, I wanted to do something to cheer her up. Luckily for her, I only sang a line or two; I didn't want to damage what little was left of her hearing.

While my serenade was in jest, I realized that night (or morning?) that I really will survive this. I think every function of my head except for my vision has been affected within the last two weeks with all these bugs I keep catching. My attending diagnosed me with an ear infection last week (I felt like a little two year old!), so I've been acting like my grandmother and making everybody talk into my good ear, and now I have a raging case of laryngitis. I sound HILARIOUS. I got zero sleep on call Saturday night, meaning I was up on my feet working for 28 hours straight. I crashed when I got home Sunday morning and probably only spent a few of my awake hours remotely coherent before my husband left for good old California again last night. I honestly think I've just been too tired to be sad! This week has been really good for me. No, I really am being serious.

I keep getting pushed further and further with every day, but I feel that I'm adapting to the pushing and becoming a better person for it. I've gotten some positive feedback during moments when I needed it most, showing once again how impeccable God's timing is. While being separated from my husband brings an indescribable ache that nothing can remove, it has forced me to be honest and vulnerable with God in a way that I haven't been in a long time. During late college and medical school, I allowed Him to change me so that I no longer consider myself a failure when I am not perfect at something, but the environment where I now find myself is bringing out some of my old tendencies of striving to be the best. I need His gentle reminders that He does not seek perfection according to man's standards and that my greatest efforts should be to bring glory to Him.

My husband and I have been reading through books of the New Testament together as one way to stay connected during our time apart. We recently worked our way through Philippians, and these verses (2:14-15) have stuck with me:

Do everything without complaining or arguing,

so that you may become blameless and pure,

children of God without fault in a crooked and depraved generation,

in which you shine like stars in the universe

I could very easily find reasons to complain about many aspects of my job, but I try to save those for my family or for my blog; when I'm at work, I try to focus on the positive and have a good attitude towards my job. I don't want to be one of the residents that nobody wants to work with because of her bad attitude (in the 3 months we have been interns, we are already discovering some of those!). I want to be one of the ones who has something different about her, something that points to a force greater than me who sustains me when all good reasons for being positive are gone (reference I John 4:4 for another great verse!).

I have SO many questions right now about what the future holds. I have no idea when my husband and I will be together again for more than four days at a time. I have no idea where we will move when our lease runs out next June; we truly believed we had found the answer for where to build our house, but God has since closed the door on that option or at least on our time frame for it. I am unsure about my plans for fellowship and am very nervous when I contemplate the odds for me getting into the one I'm considering. I'm praying my car holds out and doesn't break down on me for at least another year. I don't know where He will take us in so many areas, but these last few weeks have reassured me that He is holding my hand and guiding me where He wants me.

On another very happy note, it's 3 PM, and I'm still in my pajamas. I don't really have any intention of getting out of them today although I do plan to change into a fresh set after a long bath tonight. I LOVE my days off. This is my 2nd day off in the last 15 days, and I am relishing every minute of it. I slept for 10 hours straight last night and have every intention of going to bed early tonight. Right now a thunderstorm is JUST starting outside, so I think I'll leave the harsh glare of the computer and head for my favorite spot on the couch with my warm quilt and a good book. If I happen to fall asleep in the process, that's even better. :)

Different verse

Seriously, what's up with this? It's a good thing that my vows included "in sickness and in health" because it's been a lot of the former lately. I'm sitting at home right now while the hubby is at church since I'm now the proud owner of a ferocious cold. I started feeling under the weather on Thursday, and by the time I got home postcall Saturday morning, I was siiiiiiick. We tried to go to the Rangers game last night, but we had to leave after the 5th inning since I'd run out of Kleenex and sounded like Val Kilmer in Tombstone. My poor husband ... it seems like the only time he sees me, I'm either sick or asleep!

On a side note, I hope I don't ever become a crazy parent. I've seen enough in the last two months to become really afraid of the possibilities!

The punchline

I truly believe that God has a sense of humor. He knew I needed a break from work, I'm on the GI (gastrointestinal) service this month ... put two and two together, and six hours after my last post, I woke up unable to keep down anything I'd eaten for the last month. At 5:30 AM, I made the stupid decision to tough it out and go to work, and by 11 AM, I was being sent home since I couldn't even keep down Gatorade. I knew for certain that something was really wrong when I got home and couldn't even stand the thought of watching the Food Network. It's been a Law & Order/Scrubs few days for me; I want NOTHING to do with food!! I took today off from work as well; when I didn't have enough energy last night to stand up for a shower, I knew I wouldn't be any good to be around sick kids today. This afternoon I've managed to eat 2 pieces of toast, and I'm contemplating my dinner choices right now. I have NOTHING bland on hand except bread for more toast, and that just doesn't sound good. Looks like I'll be making a run to the local grocery store for some soup and sugar-free popsicles.

On the bright side, I got more sleep last night than I've had in weeks, and I was relatively unstressed today. I didn't need this virus, but I did reap the benefits of a day and a half off work. I never thought I'd be thanking God for being sick! :)

Beyond my limits

This is hard, so very hard. I'm being pushed beyond the limits I can handle, another obvious reminder that every day I am in desperate need of my Savior.

Being an intern is rough. I know it's nothing compared to "the good old days," but for those of us living in 2006 who weren't there for the good old days, it's not easy. Several things that have been far out of my control have gone on at the hospital and have made my month more difficult than I anticipated. I'm easily working 60-70 hours each week, and I'm just tired. I'm getting 2 days off every other week for a total of 4 days this month; I'm now on my 9th day straight and can't wait for this Friday evening to get here! I am gladly counting down the days until I am off this service (just 3 more!!). I got behind in my chart dictations and stayed til 10:30 PM last Wednesday to get caught up (never again) and still had to be back at 6:30 the next morning. This week has pushed me to the edge, and I have almost cried twice when I'm hidden in a bathroom or walking down a lonely hall. It's amazing how many lessons I am learning on how to treat my own physicians and my children's pediatrician one day from both the good and bad treatment I have received from families. It's also amazing the attachments I'm forming to some of my patients; I am afraid I'll cry again when I have to say goodbye to one in particular that I have watched transform from a cranky little one who always screamed "NO!!" when you entered the room to one who asks me for a hug daily and kissed me on the cheek this morning. I find myself sitting at home worrying about my kiddos and looking them up online to see how they're doing and if anything has changed on them; I even dreamed about them on my weekend off earlier this month. I have to get better at separating my work life from my personal life; however, it's simply not an easy task.

My husband is working in California right now. He flies out Sunday night or Monday morning and gets back Friday night after dinner; if I can, I try to wait to eat with him around 9 or 9:30 PM so we can share a meal especially if I'm on call that weekend and won't see him for the rest of the weekend. I get up when it's 3:30 AM his time, and I'm in bed by 8:15 PM his time, so we don't have much of a chance to talk. Today we were both so busy that I didn't even get to talk to him until 8:30 my time after having dinner with his mom (she was sweet enough to drive up to Dallas and take me out for a real meal!). It's difficult being separated from the one you love. I carry 2 pictures of us on the back of one of my badges, so when I miss him during the day (which naturally occurs often), I can look at pictures from our wedding and from our honeymoon and remind myself that this separation is temporary and that we will be together again soon.

My car has been giving me a little trouble lately; the key has been sticking in the ignition when I have gone to start the engine. It has always fixed itself with a little jiggle and a few prayers, but last Thursday while I was parked illegally in a reserved spot (just to check our mailbox - I promise!), the car gave out on me. I tried for over 45 minutes to get it to start, and after sweat, tears, several calls to my husband in California, and a few unladylike words, I called a tow truck. While I was waiting, I continued to try the key, and by a miracle, it started. I drove it to the nearest dealership. I was quoted an estimate of $100 for the tow (which I didn't end up needing), $750 for the repair, and $100-150 for a rental car for 2 days. Ha ha ... such good times.

On the bright side, getting up at 5:30 every day is finally getting easier for this non-morning person. I have finally had my root canal, so I'm almost pain free -- a very welcome change. The car repair ended up only being $450, and I got a friend to pick me up from the dealership, saving me the car rental fee. My husband gets to come home Thursday evening, and he gets to come with me to a conference I'm going to in Austin this weekend on my potential career move after residency (stay tuned to the blog for more details over the next few years). Did I mention that my only expense for this weekend will be gas money? The conference is covering the registration fee, the hotel, and both of our meals for 1 day. Exciting! My husband has been so supportive of me and does everything within his power to be there for me. I can't imagine anyone else putting up with all that he has to, and I'm so thankful that God has placed us together. We joined a church last month that has provided us with so much of what we need, and we can't wait to dive in and get involved. It's been harder for me because I work most Sundays, but everyone has been very understanding, and I am welcomed with open arms when I have the chance to be there.

God's timing is perfect. This month has been hard, and there have been many times I've dropped to my knees with tears in my eyes asking "Why?" or "When will this end?" Every time that I am pushed beyond my limits, He is there for me. He is my strength. He gives me grace to deal with parents who yell at me for things out of my control. He give me patience when disorganization rules on the floor. He gives me laughter when I want to cry. He provides gifts when I have done nothing to deserve them. He amazes me.

My inviting bed is calling my name, and all too soon, the alarm clock will be buzzing me awake. Here is to a night full of sweet dreams (not of work!) and a day full of surprises and smiles. Today's kiss from my patient has made my entire rough month worth it. May I stay focused on the good and let the bad fall to the side.

My prayer

This week has been so hard. I get up every morning at 5:30 to be at work by 6:30; my beloved husband is 2 hours behind me and still sleeping for at least an hour after I get to work. I work without a chance to call him until 4ish to 7ish, but even when I get off work, he usually doesn't get off until 8 or 8:30 PM my time. Since I've been up before the sun and will do it again until my first day off next Saturday, I typically fall asleep pretty early while he's just barely finishing dinner. We have spent less time talking this week than we have since we first started dating. It's been difficult. Most of the week, I've just numbed myself to how mentally tired I am and how much I miss talking with people about things other than medicine. Today at work I almost cracked. I heard my husband's voice on the other end of the phone and almost started to cry at the nurses' station with 10 people standing around me. I held it together until I could get home, and God has provided me with much comfort tonight.

I don't understand why things are the way they are, why our schedules have to be so opposite, why God has placed us here. I don't have to understand, and that's comforting. I read the following prayer, and it really spoke to me where I am tonight.

From Francis of Assisi:

Lord, make me an instrument of your peace;

where there is hatred, let me sow love;

when there is injury, pardon;

where there is doubt, faith;

where there is despair, hope;

where there is darkness, light;

and where there is sadness, joy.

Grant that I may not so much seek to be consoled as to console;

to be understood, as to understand;

to be loved as to love;

for it is in giving that we receive,

it is in pardoning that we are pardoned,

and it is in dying that we are born to eternal life.

My goal for this month is not going to be impressing my attending or getting in good with the fellow. My goal is to shine Christ through my words and deeds -- even if that means staying late to cover for someone else, not complaining when I get extra patients, and having a positive outlook when the group around me just wants to complain. I pray that I will find the good in my patients and in their families no matter how much they frustrate me. I have been able to share with patients before that I am a believer and have prayed for them; I am praying that He will open more doors for me to do that as I continue to practice medicine.

I better run ... I think my better half is finally off the airplane. I'll be gone from tomorrow at 6:15 AM until Sunday around 1:15 PM, so I better soak up what time I can tonight.

(Halfway to the) Weekend Update

The good news: My 8.5 hour day turned into a 12 hour day yesterday, but I still left the hospital happy. I love my team, and even though I have some really tough patients, I have some really great ones too. I think this will be a good month.

The bad news: I made my 4th trip to a dentist in 4.5 weeks. She thinks I'm going to need a root canal on at least one tooth, but she doesn't do them. The specialist's latest appointment is a 2:15 PM. I work until at least 3 PM every day. I have an appointment for next Tuesday for an "evaluation with possible procedure;" I never thought I'd be this desperate to get out of work. ;)

The sad news: My brother is moving to New York this week for law school. Even though we rarely talk and only see each other about 3-4 times per year, it still makes me sad to know that he's going to be so far away. My parents and sister are driving up to New York with him to help him move his stuff in a few days. I really wish I could be with them.

The random news: I need to get caught up on my DVR. I DVR-ed about 5 hours of my favorite Food Network show "Good Eats" (yay, Alton!) on Saturday while I was in the ER, and now it's just sitting there taking up space.

The dumb blonde news: By law, everything I sign at the hospital must have the letters "M.D." after my name. I've gotten so much into the habit of writing them behind my name that at the dentist today, I started to sign my receipt with those initials. I'd gotten the "M" out before I realized I didn't need to sign that like it was an order in a chart. Oops.

Ambivalence

There are days when I hate my job. There are days when I love my job. Honestly, I usually hate it and love it both within the same day. Sometimes I feel so confident in myself; I led a 3rd year medical student around today and could not believe how much more I knew than he did. Wow, I know that sounds dumb. I'm a doctor; I'm supposed to know more than he does, but there are so many times when I am reminded how much about children I still do not know. The good news is that I'm learning more and more with every shift. The bad news is that I switch services in 1 week, so I'll be thrown into a completely different territory and will start from scratch again. It's all good; I'm looking forward to learning a different specialty and facing the new challenges. Okay okay, so that's not entirely true ... I'm not a big fan of change and am just starting to get comfortable with the ER, but this change will be beneficial for me, so I'm keeping a positive outlook.

I love what I do so much; I can't find words to express how amazing it is to hold a baby in your arms and know that his parents trust you to make him better. To have a mom smile and say, "Thank you, doctor; this makes me feel so much better, and I'm going to sleep well tonight" after you explain what's going on with her kiddo makes all the crap that we deal with worth it. The downside comes when you can't give parents the good answers, when you have to give them bad news. I haven't had to deliver any earth-shattering news myself yet, but I've been there when it's happened, and it's so hard to fail the one time that it matters most. All of these precious children are ultimately in God's hands, and we are just tools that He uses, but it still stinks when His plan doesn't work out the way we wish it would.

I'm going to be honest; most days I ask myself, "What have I gotten myself into?" There are even days when I wonder if it's all worth it -- all the sleep lost, all the HUGE debt accrued, all the time away from my husband, all the friends that I have left in Houston, all the times I've gotten sick from a bug my patient has passed on. Every time that I begin to question, God always whispers to me that it is worth it because it's something He asked me to do. I never planned on being a doctor; in fact, I fought it until 3 months before the application process opened (taking the MCAT and knowing I had a single shot taught me real reliance on Him!). I wanted to go to med school in Dallas, but He put me in Houston where I made some of my best friends and met the love of my life. Like the old Caedmon's Call song states, "Looking back, You know You had to bring me through all that I was so afraid of; though I questioned the sky, now I see why I had to walk the rocks to see the mountain view. Looking back, I see a lead of love."

I will never have all the answers this side of Heaven. I'll never understand why so many things happen the way they do. This journey that I'm walking has left me so changed; I am not the woman I was 5 or even 2 years ago. I pray that I'm a better woman for it and that I will be above and beyond what I've ever expected through His grace alone.

A new world record

There are few things funnier (or occasionally more annoying) than watching my husband try to entertain himself in the car. I'm enjoying a week of vacation right now, so we took a trip for a few days out to the hill country. While there, we relaxed, ate lots of delicious food, and visited several local wineries. We had an absolute blast, but we did spend quite a bit of time in the car. I have a serious problem with any car ride lasting longer than 20 minutes as the rhythm of the road lulls me into peaceful slumber, so my poor lonely husband created ways to keep himself entertained while Sleeping Beauty caught up on her naps. Most of the time he simply browsed radio stations or popped in fabulous CDs (ahhh, Jack Johnson), but his new favorite way to prevent boredom required an empty road and several hills. Yes, he has created a game he calls "Car Coast."

To the best of my understanding, Car Coast involves driving quickly up a hill, building sufficient momentum, and shifting into neutral as the car crosses the apex of the hill. The record for not having to shift back into Drive without dropping below 45 mph was two minutes and thirty seconds and occurred somewhere near Luckenbach. It's sad that I remember this. We came close to breaking that record several times but were foiled -- darn those other drivers making us share the road!

This game made me laugh for the first few times, but by the 50th time, I was really getting tired of hearing it. I swear that my irritation only provided more entertainment for him! I'm thankful that Dallas is relatively flat; it should keep Car Coast at bay for a while.

Such a front

The last 10 days have stretched me and tested me like I haven't been tested in a long time. It's been a very rough period starting with the pain in my teeth and ending with a heartfelt "thank you" to my precious Father in Heaven.

10 days ago, I woke up in pain from my teeth as explained in my previous post and then worked a 12 hour shift after only sleeping 2 hours in the previous 24. 9 days ago, I was told I needed 4 root canals and would be charged $8000 to get them done. That weekend was filled with tears and questions as I pondered different options and was reminded by a wise advisor that God would provide for all my needs even if I did not immediately see where the financial part would come from. I stuck the next few days out, and the pain, while still present, began to decrease and become more of a constant nagging rather than continual torture.

Even with all of this, I still wasn't getting the message. With the recent flurry of events in my life from getting married to moving to a new city to having everyone at work call me "Doctor" and think I know WAY more than I really do, I'd begun to get pretty self-reliant. I hadn't even realized I was thinking this way; I had slowly begun to think of myself higher than I should and not to lean on God for everything the way He wants me to.

Wednesday night woke me up. I had an event happen at the hospital that terrified me to my very core. Within a few seconds, something happened that could have possibly changed my life. While it would probably turn out to be nothing, its repercussions were potentially deep and far-reaching, so much that I began to question things such as my own mortality and whether I'd be able to bear children one day. This happened two hours into my twelve hour shift, so I had ten more hours to sit up at the hospital and work. Fortunately (or not), it was the busiest night shift I'd seen yet, so I really had no down time to stop and stew. I did break into tears a few times at work, but I managed to hold it together for the most part. As soon as I got home, I collapsed into my husband's arms and sobbed. He held me and prayed over me, and in the middle of his calling out to our Father, I began to feel more at peace. After he left for work, I called my (earthly) father, and he reminded me that in the end, only God could comfort me and help me through this time; he also reminded me that I could use this to be a witness and that Romans 8:28 would always hold true.

After getting off the phone with my dad, I headed to my new dentist. They agreed to see me a day early since I was still in constant pain, so I was extremely thankful for that. However, I didn't get seen for over an hour after my appointment time because I was on the phone trying to work out details with my new insurance company that they had already promised were worked out; the office finally agreed to see me even though the details STILL aren't worked out. When the dentist finally saw me, I told her that I'd been told I needed 4 root canals; she said she didn't think that was necessary and wanted to try simply filing down the fillings because they'd been filled too high. Basically, the high fillings were smacking into each other every time I close my jaw, and this was causing the pain and inflammation that were keeping me up. I let her give it a shot, and within an hour and a half, I was eating again with no pain. Even now, 3 days later, I can still feel that the right side of my mouth is a little sensitive, but that is it -- no more pain waking me up, no more inability to chew, and (best of all) NO ROOT CANALS!! I was so so so so thankful to God that He spared me 4 root canals for the time being and the $8000!!

I went home from the dentist on Thursday and tried to rest. I got 2 hours of sleep again before having to go back to work my last night shift this month. Thursday night was hard, but I made it through without any major difficulties. I came home and CRASHED. I didn't eat breakfast but instead headed straight for the shower. After I got out, I fell asleep on the couch from 8 AM to 4 PM; I didn't even wake up when the phone rang! I woke up feeling better than I had in days, and shortly after waking up, I got the news that all the tests they'd run as a result of Wednesday night's incident had come back negative. I was so happy that I almost cried!

The point of all of this? In church this morning, we sang the hymn, "It Is Well With My Soul." As I sang, I recognized that in the middle of everything that happened this week, it was not well with my soul. I was not at peace. I was not accepting that my life is not my own, that I've been bought with a price. I've been living like I'm the one in charge, but in reality I've never been holding the reins. God is the one who is in control, and I'm ready to live that out actively. I'm so thankful that He has gotten my attention before it was too late.

I don't remember too much of this weekend ...

But I have a good reason. Wednesday night was AWESOME. I could not believe how quickly things came back to me, and my attendings were really great when I would say, "I don't know" in answer to a question. As 7 AM drew near, we basically cleared the ER and had no patients waiting to be seen, so they let me go home 15 minutes early. As I walked across the skybridge to the parking garage, I watched the sun come up and realized that would be one of the great walks of my life. Walking down the aisle during my wedding and walking across the stage at graduation were both amazing, but during this walk, no one was paying attention to me or watching to see my reaction; it was a precious moment where I got to whisper thanks to God for helping me survive my first night as a doctor and love it!

I went home, ate some breakfast, and took a much anticipated shower. I climbed into my oh-so-comfortable bed and closed my eyes, expecting a wonderful long nap. I had to be back up at the hospital at 7 PM for another 12 hour shift, so I figured I'd have plenty of time to catch up on some sleep. Ha ha. How wrong I was! I'd barely dozed off when I began to feel that something wasn't right. Before long, the right side of my face was hurting so badly that I was in tears and writhing in agony.

To give a bit of history, I had some fillings done on "pre-cavities" in May. 1 week after the fillings (10 in all), my teeth began to hurt. I was convinced the pain would improve, and since it never stayed more than an hour or two, I wasn't too concerned. Thursday morning was entirely different. Both the top and bottom right side of my mouth were hurting so much that I couldn't sleep, and I didn't know what to do. I took a pretty strong painkiller, but it didn't touch it. I couldn't take anything too strong because I had to be back at the hospital at 7 PM, so I did my best to relax and to try to ignore the pain. I spent lots of time on the phone with my husband and with both of my parents trying to figure out what to do, and in the end, I got an appointment for 7:45 the next morning (45 minutes after I got off work) with a new dentist.

I ended up getting only 2 hours of sleep in 10-15 minute stretches on Thursday after being up all night Wednesday, and then I stayed up all night at work on Thursday. Diet Pepsi was definitely my friend that night. Thursday night I was pretty uncomfortable and even sent several text messages begging for prayer for relief so that I could focus on my job, and thankfully the pain never got quite as bad as it had during the day. I left the ER on Friday morning at 7 AM and drove straight to the dentist. It turns out that despite my obsessive brushing of my teeth since I was a kid and possibly because of the work that was done in May, I will still need FOUR root canals. I was in shock. The new dentist offered to do them that day, but the fillings I'd had done in May that started all the pain had actually used up all my insurance benefits that I had while still a student. The bill for the root canals? Well, the estimate was $7500. My new insurance for my job was scheduled to begin on Saturday, so for a fraction of that price, I could find a different dentist and get the root canals done. This dentist gave me some antibiotics and some painkillers, and I've decided to tough it out. I have an appointment next Friday with a dentist in my plan, and SO FAR my teeth have been doing okay.

My reason for not remembering most of the weekend is that I spent it catching up on my sleep. 2 hours of sleep is just not enough over a 48 hour period! I was so tired that I actually fell asleep on the phone as I was explaining the options to my husband on Friday morning, and once I actually got some relief from the pain, I was able to sleep for more than 10 minutes in one stretch.

I work 3 more night shifts this week and will actually leave from my last night shift on Thursday to go straight to the dentist Friday morning. Here's to hoping that everything works out and that I'm a tough girl until then! :) I'm seriously questioning how I'm going to be able to function on Friday morning; I already had a mild phobia of the dentist before May, and knowing that I will likely be having a root canal (or four) on Friday is a very scary prospect to me. Only my fear of continued pain will actually drive me into that chair!