Randomness from the past four weeks...

As I realized this morning that tomorrow was September, I also realized how few of the usual markers of fall I have around me this year. There are no changing colors in San Francisco, I'm not going back to school, and the weather is basically the same, if not warmer, than earlier in the summer. Despite the lack of cues, time does appear to be passing... I keep meaning to write some of the thoughtful reflections I enjoyed so much during medical school, but to be honest I've been going to sleep instead of doing that. I've been on vacation for the past week, however, and so I have some random photos to share as well as a few entertaining stories that do not involve the hospital, or work, or being an intern...

Here is Alex, not looking particularly restful, on top of a lovely dry-clean only wool blanket that Walter, sleeping beneath, also loves. There is no convincing the pets that fine natural fibers are not intended for their sleeping pleasure. There is also no convincing Alex that I'm not out to get him - since I've been off for vacation he's taken to biting my feet and arms, and swatting at me regularly. I think he thinks I've just moved in...

Laura and I went to the De Young Museum on one of my days off this week. Here we are in front of the observation window (hence the glare). We also ate at DragonEats and Smitten before we went the museum, so it was a lovely day. 

And finally, the requisite shot of Walter snuggled in the clean laundry. We hadn't had a chance to fold it immediately when we brought it upstairs, and Walter needed no further invitation. 

Walter...

The first is the two of us after a long day at work. Walter in particular has been working hard.

And the second is Walter relaxing in the fog of August that passes for summer here in SF...

Trails of the city…

Commuting by bike is awesome in San Francisco. Aside from the crazy hills I mentioned in my last post, there aren’t a lot of downsides. In fact, I will list all of them that I can think of, as well as some unforeseen upsides to each of these here for your enjoyment.

• Arriving at work sweaty
  I like to think that this makes me look intense and dedicated. I think it probably actually makes me look disheveled, and definitely means that I have to wash my clothes more often than I might otherwise, but I try to look on the bright side.
• Looking like an idiot when you choose the wrong route
  If you were to find that being an intern did not provide enough humility, climbing a hill that no person in their right mind would attempt on a bicycle would complete the sense of personal incompetence you were seeking. I have an app on my phone that GPS tracks my bike rides, and also has little segments where my times are compared with other users of the app. I’m pretty sure that only segment where I am listed as #1 is a hill that I walked up with my bike and that no one else has ever suggested that they did on a bicycle.
• Negotiating left-hand turns
  Left hand turns in SF are a whole new take on improving spatial reasoning skills. There are so many streets that intersect at weird angles (thank you, Market St) into one-ways and other such craziness that it’s still really difficult for me to figure out how to turn left without either running into traffic or going wildly out of my way by making three right turns. I’ve tried strategies including 1) crossing the street with the green light and then stopping in front of the right lane of traffic on the street I want to turn onto; 2) stopping at the red light, and then wheeling my bike into the crosswalk in front of the left turn lane; and 3) going several blocks out of my way until the traffic is clear enough to turn left in the usual fashion. I’m still not sure which is best…
• Chronic dehydration
  Ironically this is super helpful in clinic. I rarely have time to go to the bathroom, so apart from the small hit I’m sure I’m taking to my kidneys each day, this is actually great.
• Having to change clothing in public restrooms
  I cannot come up with something really positive to say about this. Maybe it improves balance and dexterity?

That’s all for now. Hopefully I can get some pictures of the dog to post soon, for those of you beginning to develop the shakes. Apparently while I was at work today he got his head stuck in an ice cream container he wasn’t supposed to be able to open and eat out of…

The first days…

and weeks…

Apologies for the long delay. It will, if you have talked to me since June 19, surprise you not at all that I’ve been a little bit overwhelmed with work. Here are two stories from my first weeks as an intern.

I’ve started on my ambulatory rotation, and on Fridays I’m in one clinic in the morning and another, all the way across town, in the afternoon. I’ve been biking to work most days, and figured this would be no exception. Google maps said 30 minutes, and despite my previous experiences getting lost due to low-visability signage, I presumed that it was true. After biking incredibly slowly up one of the steeper hills I’ve attempted since being here, I realized that I would never make it to clinic on time. Huffing and puffing, I stopped, called the clinic, and said that my morning clinic had run a little late (which was true), and said that I would be there a few minutes late (which was also true). I walked my bike up the rest of the ridiculous hills, and then road the downhill/flat portion of the route to clinic. I arrived sweaty and chagrined… The next week I figured out a bus.

There is nothing wrong with crying at work, if you do it in the right place. I learned this during my first call shift, totally overwhelmed with all of the things that my colleagues promised me that I wasn’t expected to be able to do alone, but that I nonetheless expected myself to be able to do alone. One particularly charmed chief resident gave me the door code to a call room, told me to get myself some water, and let me collect myself for a bit before I continued seeing patients. Everyone was right, and my second shift was astronomically better, but having that space was so important.

I’m optimistic to be posting more, but probably shorter, bits about residency in the coming weeks. I have only a few weeks left on ambulatory, and it’s been promised that life with only get crazier from here, but I’m finally starting to settle in. Pictures of the dog and cats hopefully also coming soon…

PGY-1

Today is my first real day of residency. I know there's been a bit of a gap over the past few weeks, but it can mostly be summed up in a few brief words: packing, unpacking, and orientation. I'll post more later, but here are a few photos of my new home to tide you over... (The unifying theme? There are a lot of hills here and they make for pretty pictures.)

By popular demand...

...some documentation that Walter is coping well with the move.

You'll see him here relaxing in some packing material, sleeping in his bed, and creating an impromptu bed out of a trash bag filled with random stuff. I think he's adjusting just fine.

A fond farewell

Cross-posed on Dose of Reality

I’m writing this now from San Francisco, sitting on an air mattress in my new apartment, with the dog curled in a packing blanket that I also used as a comforter last night. We’ve spent the past four days traveling across the country to arrive in our new home. Some highlights from our trip:

• Our route took us through Michigan, Indiana, Illinois, Iowa, Nebraska, Wyoming, Utah, Nevada, and California. This totaled 2,358 miles over 35 hours of driving time.
• The cats were supposed to be constrained by a pet barrier to the back few feet of the minivan we rented to make this journey. They figured out how to climb over it within minutes, and spent the remainder of the trip free-ranging throughout the van, in particular enjoying cuddling in Walter’s bed. You can see the barrier standing uselessly in the background of the photo...

• We stopped in Des Moines, IA on the first night to see my grandmother (and accept her generous hospitality, having invited me, Mike, Lynn, the cats, and the dog to stay with her). I hadn’t seen her in years, and it was wonderful to catch up.
• There are Whole Foods stores approximately every 9 hours along I-80. Lynn did a pretty incredible job finding places for us to eat along the way that would accommodate our various needs for tasty vegetarian and gluten-free food.
• We had one pretty remarkable Google snafu that led us to an interesting off-roading experience in the minivan. We ultimately found the relaxing State Recreation Area we’d been looking for (about 12 miles up the highway), but only after about 40 minutes of harrowing round-trip craziness and then an easy jaunt down the interstate. We actually passed several ATVs, who looked at us with a level of incredulity I had not previously experienced.

The beautiful two-track road...

The van after our adventure...

For those of you who have been following me on the Dose of Reality site, thank you for your lovely support throughout the past eight years. I hope you’ll consider adding this link to your favorites, and continue to follow me through residency. For the rest of you, stay tuned for the further adventures of one Dr. Andrea in SF…

Recipes for a move

The moving truck is coming in a week, and we’re leaving in twelve days, and I’m trying to clear out the fridge, freezer, and pantry. I’m also trying not to waste food, and to enjoy the last few days of cooking in my current kitchen which, although inferior, is nonetheless much larger than the kitchen in San Francisco. This has meant several things:

1. Making muffins. I am not particularly creative with frozen fruit, but it is delicious in muffins. Similarly, canned pumpkin. I love it in pies, and soups too, but one of those things takes a lot more doing than muffins, and the other just seems out of season.
2. Cooking beans. My slowcooker has been working overtime to cook the volumes of dried beans that I don’t want to move with me. Right now, I’ve got navy beans cooked and sitting in the fridge, ready to become baked beans, and dried peas ready to stand in for split split peas cooking now. I didn’t think I’d have anything positive to say about the terrible spell of cold weather we’ve just started, but at least I can make split pea soup!

Here are some recipes for your enjoyment…

Pumpkin Muffins
Adapted from Mark Bittman’s How To Cook Everything

2 1/2 c flour
1/2 c corn meal (You can use flour for this if you prefer.)
1/2 tsp salt
1 tablespoon baking powder
1 tsp cinnamon
1/2 tsp ginger
1 pinch cloves
1 pinch nutmeg
1 c sugar
2 eggs
1/4 c melted butter
1 1/4 c milk
1-2 c pumpkin (I often err on the side of more pumpkin.)

Preheat oven to 350F. Butter/oil muffin tin, or use silicon muffin cups, with which I am now obsessed. Combine all dry ingredients. Beat the egg with the butter and milk. Pour the wet ingredients into the dry, including the pumpkin. Combine the ingredients quickly, stirring and folding rather than beating, and stopping as soon as all the dry ingredients are moistened. The batter should still be lumpy. Pour into the muffin tins, and bake until a toothpick inserted in the center comes out dry. This is about 20 minutes.

Split Pea Soup
Adapted, but not yet tested, from Mark Bittman’s How to Cook Everything

2 cups green split peas, washed and picked over
6 cups vegetable stock or water
2-3 carrots, cut into 1-inch sections
1 medium onion, minced
1/2 cup rice
Salt and pepper to taste
Croutons of some kind

Combine the peas, rice and stock in a large deep saucepan and bring to a boil over medium-high heat. Add the carrots, turn the heat to low, cover partially, and cook until the peas are very, very soft. Alternately, put these things in a slow cooker and let them cook unattended for a long time. Either way, add the onion about halfway through the cooking time. Mash the cooked peas with a fork, food mill, or immersion blender, and add stock or water if necessary to get the desired consistency. Season with salt and pepper, and serve with croutons.

Someday came so quickly…

I started blogging here just over eight years ago as I was preparing to start medical school, and started blogging for the medical school shortly thereafter. I named the blog for a nickname, Dre, after some good laughs that I would ultimately be Dr. Dre. I didn’t know at that point that I would ultimately be accepted into the MD/PhD program, and that someday I would be Dr. Dr. Dre, if that were really a title that anyone used. As of Friday, and for another ten days, however, I am writing to you as Dr. Dre! Someday is here! My PhD was conferred on 5/3, and the medical school graduation is not until the 17th. I think I’ll plan to keep the title of my blog until I’m as well-recognized as my namesake, Dr. Dre…

Ruti and I after the hooding ceremony! 

Some things…

from the interwebs…

I don’t usually just post links, but there were two things that I just couldn’t pass on sharing, and that seemed somewhat linked.

First, a lovely infographic from the lovelier Ania, a fellow MSTP, about the incredible Ann Arbor. While I’m excited to be heading out of town in a terrifyingly few short weeks, there are definitely things I’ll miss about being here.

Second, an article about deciding whether to go to graduate school. It’s written by a former humanities graduate student, but I think captures a lot of the feelings that I have when students ask me whether they should think about the MSTP or just go to med school or grad school like everyone else. Enjoy it here.

First bike ride of the year!

Cross-posted on Dose of Reality

I spent the last week in San Francisco finding an amazing apartment (although I was not really responsible for the finding… credit where credit is due, Lynn) and noticing the cyclists there. As many of you know, there are hills in San Francisco, and they are not for the faint of heart. Or the faint of leg. Despite the fact that I have been trying to stay on the stationary trainer this winter, I was gripped with a sudden and gripping fear that I would arrive in SF and make a fool of myself on the hills. Arriving home in the 35F with sleet and rain, however, was not helpful. Finally, today was beautiful. It got up to almost 50F, it was sunny, and I got out my bike. I have many friends and colleagues who are much more intense cyclists than I, and even more who were industrious on those few very warm days we had earlier in the year. But today was the day for me, and it was glorious. Thank goodness I made my rank list in the winter!

And then we came to the end…

Cross-posted on Dose of Reality

Believe it or not, my last real day of medical school was Friday. I finished all of my exams for OB/GYN Boot Camp (which was the most fabulous last rotation I could have imagined), and now I just have a month of vacation before I graduate. The phrase “and then we came to the end,” which I used to title this post, is the title of a book by Joshua Ferris that I read a number of years ago, courtesy of the free book room at Borders, if I’m remembering correctly, which chronicles the end of a company as employees are laid off, and moral falls. I keep thinking of it, in relation to medical school, because a few of the characters get a little crazy with the stress of the uncertainty of their fates. I suspect it’s clear why this seems to relevant to my life right now. Despite having checked a number of things off of my list over the past few days (i.e., finish exams, give conference presentation, buy chips and salsa so that Lynn does not go into withdrawal when she comes home today), everything still feels pretty up in the air. As annoying as I find the “Keep Calm & Carry On” memes, that is, in fact, the mantra I keep repeating to myself. Here is a paragraph I posted in 2007, as I was finishing my second year of medical school:

Remember riding on the merry-go-round at the playground when you were little. And you’d hold on so tightly as your parents or friends spun it as fast as they could run, terrified that you’d lose your grip and fly off into the hard ground. Remember how you smiled as you screamed, loving every minute of the terror. And then, remember how gentle it seemed as the merry-go-round slowed to a delicate spin, how calm you felt as your heart slowed, your eyes adjusted to the gently revolving world, no longer a blur. Finally, remember how unsteady your legs felt as you climbed back onto steady ground. Now imagine that the merry-go-round spun until you felt sick - that it wouldn’t stop even when you started crying instead of laughing.

It’s amazing how little has changed, how frequently over the past eight years I’ve felt like I was hanging on for dear life, just hoping it would all slow down soon. Despite the impressively high amplitude of fluctuations between the ebbs and the flows, I’ve loved it, and will certainly be a bit nostalgic as I walk across the stage in another month. For the next few weeks, however, I’ve got a lot of things to catch up on, so, much to my chagrin, I’ll keep calm, and carry on.

Why is it cold again?

I am not handling well the recent drop into the freezing temperatures. It was so nice and warm last week that it just seems cruel to see temperatures in the 20’s now. Fingers crossed this was the last of it, and we won’t have any more snow this year…

Walter agrees.

The books of M4 year

Over the past eight years, I’ve frequently posted about “The books of…” various portions of my training. There were the books I read during my first summer of medical school in 2006, with the last few listed in a second post. Then there were all of the books I read while in South Africa just before starting graduate school in 2007, so voluminous that they couldn’t be captured in a single post. Then there were the books of the summer of 2008, which also required some wrapping up in an additional post, confirming my tendencies not only to read in binges, but also to post summaries of small portions of my life before they are actually finished. Continuing this trend, I’d like to post about the books I read for pleasure during M4 year, even though there are still some weeks left before graduation.

1. House of God by Samual Shem
I started reading this during 3rd  year, as I’d been strongly recommended to do by several faculty members, but was too overwhelmed by my internal medicine rotation to finish it at that point. I think I struggled through it for a variety of reasons, first and foremost being the volume of reading and studying I was doing for my rotations, but a close second being how disturbingly close it remained to my experiences as a medical student, even as so much about the hospital has changed in the intervening years.

2. Privatizing Poland: Big Business, and the Remaking of Labor by Elizabeth C. Dunn
My introduction to history and anthropology in Eastern Europe, I thoroughly enjoyed this. I was smugly pleased to note that when someone asked why I was reading this book, that I could casually mention knowing someone who is doing engaging and important work in that part of the world…

3. Lolita by Vladimir Nabokov
What can I really say about this that hasn’t already been said. It was disconcerting to enjoy so much a novel with such a troubling plot. I read this on flights while I was interviewing and creeped out many a neighboring traveler while passing the time. Mission accomplished.

4. Gold by Chris Cleave
This was no Little Bee or Incendiary, but I liked it nonetheless. As I have explained to several folks, I felt that his other two books took impressively extraordinary situations and made them feel intimate and quotidian, while Gold made a rather big deal out of situations that felt a bit like the daily grind. I suspect that some of this was my particular career choice, as the hospitals featured prominently in the book are a much larger part of my daily life than they are of many, but I also didn’t the writing was quite as skillful. Despite this, it was a good read, and motivated me to get on my bike.

5. The Tiger’s Wife by Tea Obreht
I’ve just started this, so I’ll need to write a second post both to maintain parallelism with my previous book posts, and to let you know how this goes. The first thirty pages have been great.

How far I have come?

As I prepare to move across the country, I’ve been doing some sorting at my mom’s house (read: mostly throwing away things that probably should have been thrown away a long time ago). When I moved out for college, she let me keep a bunch of things there and, although some of it has been culled over the years, there are still some piles. I’m making my way through them, keeping the photos but trashing things that have neither real sentimental value to me nor resale value for others. In my most recent visit, I came upon this:

Lest you feel puzzled, let me clarify. It is a reconstructed mouse skeleton from an owl pellet, posed with a Polly Pocket doll in its mouth climbing the Eiffel Tower, or at least a King-Kong-like-scale replica of that notable monument. I made this in ninth grade biology, learning about skeletal anatomy for the first time. I have only Mr. Bassier, my high school science teacher, to thank encouraging us to not only reconstruct the skeletons, but also pose them creatively. There may have also been a contribution from my already-slightly-off sense of science humor...

We now return to your regularly scheduled programming...

With all of the craziness surrounding Match Day, I know you were worried that Walter had been forgotten. Fear not. He is very excited to be heading to a city with notably less snow, despite having notably more fog. He has been hiding from the weather recently...

Matched… and then…

Cross-posted on Dose of Reality

As some of you have heard, Match Day is over and I’ll be heading out to San Francisco to start my OB/GYN residency at UCSF in June. It’s hard to believe that the day is past, and no one really said what we could all anticipate after Match Day itself. Some had hinted that it was somewhat anticlimactic, but I didn’t find it to be that. Finding out where I would be living in just a few short months was nothing short of exhilarating, to say nothing of sharing it with so many important people in my life. Confirming that I’d be leaving the University of Michigan after 12 years here was monumental. What have been odd are the days that have followed. All at once I have nothing to do and so much to do. It’s too early to find an apartment, but too anxiety provoking not to peruse the SF Craigslistings; I don’t have any of the paperwork I need to sign yet, but I know that it’s coming and will need a quick turnaround; I don’t have the energy to really focus intensively on academic work, but there are so many things I’d like to get done before I graduate. I know it’s only been a few days, and it is all starting to settle into place, but I’m getting the sense that this is only a beginning.

On the twelfth day of Matchmas…

My ERAS gave to me,

a major scale serenading from Yale,

some hubbub about U Dub,

a hurrah for the Yellow and Blue,

a disco to lure me to San Francisco,

an evangelist for Los Angeles,

the pitter-patter of palpitations for Pittsburgh,

a passionate yen for Penn,

the paragon in Oregon,

a turn toward Northwestern,

a hopscotch path to Hopkins,

a Partners program love telegram,

and the awesomeness of Beth Israel Deaconess.

Fantastic things about Yale:

• Some of the happiest residents I met on the interview trail
• Incredible School of Public Health
• New Haven! A surprisingly endearing town with fantastic pizza

On the eleventh day of Matchmas…

My ERAS gave to me,*

some hubbub about U Dub,

a hurrah for the Yellow and Blue,

a disco to lure me to San Francisco,

an evangelist for Los Angeles,

the pitter-patter of palpitations for Pittsburgh,

a passionate yen for Penn,

the paragon in Oregon,

a turn toward Northwestern,

a hopscotch path to Hopkins,

a Partners program love telegram,

and the awesomeness of Beth Israel Deaconess.

The University of Washington was fantastic for the following reasons:

• The only OB/GYN residency in the state – that means all kinds of excitement
• Amazing research resources and residents who are excited about using them
• Seattle! So many friends, so much delicious food, and such a beautiful part of the country.

*Just a reminder that this list is alphabetical, and is in no way indicative of the order of my preferences. I said that at the beginning, but wanted to say it again. Alphabetical. All alphabetical by program name as I had them listed on my list (so basically random, since they were sorted by all kinds of odd abbreviations)…

On the tenth day of Matchmas…

My ERAS gave to me,

a hurrah for the Yellow and Blue,*

a disco to lure me to San Francisco,

an evangelist for Los Angeles,

the pitter-patter of palpitations for Pittsburgh,

a passionate yen for Penn,

the paragon in Oregon,

a turn toward Northwestern,

a hopscotch path to Hopkins,

a Partners program love telegram,

and the awesomeness of Beth Israel Deaconess.

Awesomeness at Michigan:

• Fantastic residents that I know I adore
• An amazing chair who has mentored me for over a decade now
• Friends and family so nearby

*For those of you who do not already bleed maize and blue, this is a line from the alma mater, The Yellow and Blue.

On the ninth day of Matchmas…

My ERAS gave to me,

a frying pan-Rube Goldberg-plan to get to San Fran,

an evangelist for Los Angeles,

the pitter-patter of palpitations for Pittsburgh,

a passionate yen for Penn,

the paragon in Oregon,

a turn toward Northwestern,

a hopscotch path to Hopkins,

a Partners program love telegram,

and the awesomeness of Beth Israel Deaconess.

UCSF has so many great things going for it:

• Awesome residents who are friendly and accomplish great stuff while doing all kinds of other things (like biking!)
• San Francisco! Family, friends, and all the queer culture a girl could want in an overall amazingly fantastic city.
• A great range of clinical experiences (including a PGY-3 rotation in Hawaii…)
• Faculty in my research area

We interrupt your regularly scheduled programming…

…to announce that I matched!

I find out where on Friday, but I got the official e-mail today letting me know that I’ve matched somewhere.

Let the Matchmas continue…

On the eighth day of Matchmas…

My ERAS gave to me,

an evangelist for Los Angeles,

the pitter-patter of palpitations for Pittsburgh,

a passionate yen for Penn,

the paragon in Oregon,

a turn toward Northwestern,

a hopscotch path to Hopkins,

a Partners program love telegram,

and the awesomeness of Beth Israel Deaconess.

UCLA was an exciting surprise on the interview trail, as I’d never really visited LA before:

• Great mix of academic and county hospital experiences
• Phenomenal School of Public Health and research resources
• The beach – many of my other options are near the ocean, none offers a beach experience like LA
• LA! Great food, Hollywood, giant pits filled with tar, good friends, who could ask for anything more?

On the seventh day of Matchmas…

My ERAS gave to me,

some palpitations for Pittsburgh,

a passionate yen for Penn,

a paragon in Oregon,

a turn toward Northwestern,

a hopscotch path to Hopkins,

a Partners program love telegram,

and the awesomeness of Beth Israel Deaconess.

Offerings from the University of Pittsburgh:

• Big program filled with friendly residents
• Women’s Health Research Institute with amazing resources
• Pittsburgh! A surprisingly charming city that somehow straddles the East Coast and Midwest, retaining the best of both worlds, including a reasonable cost of living
• Every OB/GYN fellowship you could possibly imagine available

On the sixth day of Matchmas…

My ERAS gave to me,

a passionate yen for Penn,

the paragon in Oregon,

a turn toward Northwestern,

a hopscotch path to Hopkins,

a Partners program love telegram,

and the awesomeness of Beth Israel Deaconess.

Things Penn has to offer:

• Fantastic public health research resources
• Diverse patient population
• Nyia! One of my original med school classmates is an OB/GYN resident there
• Philly – a fun, new city with a super cute gay-borhood

On the fifth day of Matchmas…

My ERAS gave to me,

the paragon in Oregon

a turn toward Northwestern,

a hopscotch path to Hopkins,

a Partners program love telegram,

and the awesomeness of Beth Israel Deaconess.

OHSU (Oregon Health Sciences University) is truly an exciting OB/GYN residency programs:

• Closely-knit residents with interesting curricular and extracurricular interests (i.e., great research and bikes!)
• Unique research resources
• Portland! Friends, food, family nearby… Also bikes everywhere… AND affordable housing. I love Portland.
• Engaged and excited program director

On the fourth day of Matchmas…

My ERAS gave to me,

a turn toward Northwestern,

a hopscotch path to Hopkins,

a Partners program love telegram,

and the awesomeness of Beth Israel Deaconess.*

Amazing things about Northwestern:

• Chicago! Friends and family so near by! Countless academic institutions so near by! Delicious food so near by!
• Partnership with Storger (Cook County) Hospital for an exciting breadth of experiences
• Possible Physician Scientist Training Program for a fellowship when I’m done with residency (Please do not groan – it would be nice for someone to pay me to do my research…)
• Friendly residents who are excited about research

*I realized I had forgotten one of the key features of the Twelve Days of Christmas, which is that every new one is repeated every day following. Please forgive me…

On the third day of Matchmas…

My ERAS gave to me,

a hopelessly happy hopscotch path to Hopkins…

• So much history…
• Incredible connections to a great School of Public Health
• Beautiful new hospital
• Baltimore: It’s the Detroit of 2030 – an exciting and vibrant town with a troubled past that has lots of affordable housing
• So many friends living in or heading toward Baltimore, DC, and New York

On the second day of Matchmas…*

My ERAS gave to me,

a Partners program love telegram…

The combined Brigham and Women’s and Massachusetts General Hospital program, also known as the Partners program, has all kinds of great things going for it.

• Vast resources and connections to the rest of the Harvard system (i.e., School of Public Health)
• Boston! So many friends live in Boston!
• Residents dedicated to research and scholarship
• My PhD advisor’s PhD advisor is one of the chairs there, so it would complete some sort of crazy circle…

*We are going to need to double up for a few days, since I missed a few posts due to emergency medicine shifts and sleeping…

On the first day of Matchmas…*

My ERAS gave to me,

the awesomeness of Beth Israel Deaconess…**

• Small, friendly program
• Teaching oriented
• Boston! I love Boston!
• Easy to live near work
• Fantastic research support, including dedicated research staff who work closely with the residents

*Apologies for the terrible rhyming and alliteration that is about to ensue…

**We’re starting alphabetically, lest you think I’m giving away my rank list completely.

Sometimes it’s hard

Cross-posted on Dose of Reality

I’m in the midst of my emergency medicine rotation right now - my last real clinical rotation of medical school. I didn’t save it until the end intentionally, and I was a little worried about how burned out I’d be during a rotation that included night shifts and an unpredictable schedule. This turns out to have been justified. Now that I’m safely on the other side of a cluster of 3PM-midnight and 11PM-7AM shifts, I am feeling better, but the last few weeks have been really rough. The biggest challenge, however, has not been the schedule. The disaster that is my sleep schedule pales in comparison, as the most difficult aspect of this rotation has been the intimate partner violence. Little has made me feel more powerless than the women* who have been bruised and beaten by their partners. They come in to the emergency room because of pain that won’t go away, because of unborn babies that have them worried, and because of risks for disease they can’t ignore. They leave with medical assessment, reassurance, and treatment for these things, but to be honest, I’m not sure whether they really get what they need. I say I’m not sure, because I’m embarrassed that I’ve not taken the time to find out whether a social worker sees them, or whether they are given references for shelters or other resources. I’ve been too overwhelmed by assessments of the pain, ultrasounds of the babies, screening for disease risks, and, most of all, the management of my own emotions, to get much past the emergency care they ask for explicitly.

We talk about intimate partner violence during the pre-clinical years. We talk about the statistics, how many people are harmed by those closest to them in a given year, and we talk about the shelters and resources available locally. I seem to remember a panel discussion featuring survivors of intimate partner violence, and maybe a few healthcare providers who were some sort of experts in this area. We learn that we should ask every patient whether they feel safe at home. And I think most of us do it. I know I tried to include that as a part of the social histories I took during M3 year. And I don’t think a single patient told me “no” in response to that question all year. I’m certain some of them were lying, definitely to me, and maybe to themselves, but I nonetheless really didn’t confront this kind of violence directly. I do recall patients I saw in clinic who discussed their past or present violent situations either with me or with a previous provider who had documented it, but it was hard to connect the women I was seeing in clinic with what I knew to be going on at home.

The ER is different, and so much of what we see there has just happened and is written all over the faces of the patients who present there. I get the sense that for people who love emergency medicine, this is a big part of why. There is a rawness to the undifferentiated nature of many of the complaints in the ER that can be exciting; there is an adrenaline rush that goes with being the systematic hero, even when the heroic measures aren’t enough. But what do you do when the raw edges were supposed to be soft? And when there are no heroic measures? I’m not sure, and I’m still reeling a bit from having something revealed about the world that I’d really rather not know. What do you do when sometimes it’s hard?


*I know that men can also be victims of intimate partner violence, but the patients I’ve seen have all been women.

Waiting

Cross-posted on Dose of Reality

Today is the deadline for certifying rank lists. This blog is no stranger to talk of rank lists and matching, and I’m about ready for it to end. I talked about my list starting to emerge here, and if you need a refresher on how the whole match process works, check here. If you care to, you can also take a look back at my post about when my original med school class matched and graduated, not-so-optimistically titled “Moving on when everyone else is moving out.” I certified my rank list a couple of weeks ago, sitting with a coffee shop with Michelle, another fabulous MSTP, who helped me proof my list to make sure I wasn't accidentally ranking a program where I didn't interview, etc. A few of the highlights of this waiting game:

• I reviewed my list again today to make sure it was right. The application program (ERAS) and the ranking program (NRMP) don’t use the same program codes – that would be too easy – so I double checked and cross-referenced the codes when I made my list, and checked them for a third time today. I live in fear that I've accidentally left my favorite program off the list.
• Somehow this deadline is only the beginning of the waiting. Even though I feel like I've been waiting since December 14, when I finished my interviews, it will take the matching algorithm almost another month to grind through my list, and those of all of the other wishful applicants, and assign me a spot. March 15 feels so far away.
• I’m fairly certain that no matter where on my list of twelve I match, I will be happy and get great training. I think I’ll be taking the advice of one sage AMSA friend, and in the twelve days leading up to Match Day I’ll go in alphabetical order through my programs and share with you all of the things I love about each of them. We’ll call it the Twelve Days of Matchmas. I haven’t decided whether I want a partridge or not.

Melon Salad

Lynn and I went to Isalita for the first time right before she left. It was amazing, and I can’t wait to go back. We had a wonderful server, and the food was absolutely fantastic. One of the many delicious things I ate there was a melon salad that I tried to reproduce at home, with some moderate success.

Melon Salad   

Cantaloupe (the restaurant used a mix, but I didn’t have that)
Lime juice
Sunflower seeds (would have been better with the pepitas they used)
Cayenne pepper
Salt

Cut up as much cantaloupe (or other melons) as you like. I made one serving at a time to avoid spoilage. Sprinkle the sunflower seeds or pepitas, drizzle the lime juice, and dust the cayenne over it. Sprinkle it with a little salt and enjoy.

On the theme of orange foods, my brother felt that I should have something "aged" for my birthday this year (thanks a bunch, Jake). My gift included some delicious cheeses. Yum!

The babies...

To start off my return to the blog, here is a picture of Alex, attempting to stow away in Lynn's suitcase. (Little did he know that he would be safely in his kitty carrier on the plane!)

Also one of Walter, attempting to stow away in... well... nothing, really. Just in a blanket, as per  usual.

Just haven’t felt like sharing…

I apologize for the rather substantial gap in blog posting that’s happened over the past month. If you’d asked me a month ago whether I had anything to post about, I probably would have said yes, but now I feel like I’m just waiting for things to happen. Things I am waiting for:

1. Match Day – March 15
2. Lynn Returns – April 8
3. Graduation – May 17

Otherwise, I feel a bit like I’m treading water. Also, I turned 30, which I have mixed feelings about. Despite this, I continue to cook and knit, and learn things about clinical medicine, so stay tuned for more posts coming up soon…

And the winner is…

I’d somehow anticipated posting more in between the initial giveaway post and announcing the winner, but that didn’t happen… I’m happy to announce that Tanya, my awesome friend, will be the happy recipient of the hooded scarf. I’ll be dropping it in the mail to her this week. Even better, the charity she chose, The Moveable Feast, will be receiving a lovely donation that will help them continue to provide meals to people who are sick and need their support. Thanks Tanya!

A giveaway… of knitwear…

With the particularly terrible turn in the weather this morning, I was forced to consider my options for cold weather gear. I dug through the giant tub of things in my closet, searching for the one item I actually wanted. I’ve been wondering for a while about the best way to cull the herd, if you will, and move along some handknits to make room for the new. Looking at them again this morning, I realized that it had grown fairly urgent. Pre-dating my concern that my collection of hats and scarves and mittens (and gloves and cowls and leg warmers) had reached a critical mass was a blog posting by Stephanie Pearl-McPhee in which she raised some money for a charity by posting knitted items and having folks bid. They let her know how much they'd give to a charity in exchange for the knitted item. I’d like to do the same, giving back by giving hand-knitted goods.

I present to you the hooded scarf. It was a great idea, and I loved it for a few weeks after I made it, but I’ve found that I much prefer the hat and cowl that I made out of the same yarn (they all match my mittens). It's an alpaca and wool blend, and a very dark teal color.

If you, or someone you know, would like to sport this for the rest of our terrifying winter, and beyond, please fill out the form below in the next few days. If you submit the winning bid, I’ll let you know. At that point you can send me the receipt from the charity you've donated to, and I'll get the scarf to you.

The end of break

Amazing voicemails…

For the past several years, every time I’ve listened to my voicemail I’ve also resaved several messages that I just couldn’t bear to delete. Several of them feature one of my best friends singing customized songs for and about me. Many of them feature my hilarious mother. And none of them should ever disappear. When I got a new phone in the fall, I was initially worried that I would lose my precious voicemails. Once I realized that they were tied to my phone number, and not my phone, however, I could rest assured that they were safe. At least for now. I would occasionally worry that I’d push the wrong button and then hang up, losing my message forever, and wonder why there wasn’t a way to transfer these gems to a more permanent home. Apparently Google Voice offers better ways to manage your voicemails, but regular old cell service does not offer a particularly smooth or easy way to transfer voicemails to mp3 files or some format that another program can read. I finally found this page, which explains how to record your voicemails with reasonably high quality into mp3 or other audio format files, and did it this morning.

For your listening pleasure, I present this little treasure, recorded immediately following my mom's dissertation defense in 2010...

Chocolates, again!

Now that all of them have been shipped out, I wanted to share another fun holiday recipe. Last year, motivated by something I’d heard on The Splendid Table, I decided to make chocolate bark for some friends and family. This year I did it again. The recipe is included in last year’s post, and on the Splendid Table website. Last year’s flavors: Mexican hot chocolate, candy cane, fleur de sel, and gingerbread. This year I repeated the candy cane, gingerbread, and fleur de sel, but added cinnamon and ginger brown sugar flavors. They were all pretty delicious.

Enjoy!

The chocolate comes in giant bricks...

Then it is transformed into giant sheets!

 I stored each of the different kinds in a bag in the refrigerator.

And then I packaged them in little baggies in little boxes. 

 Martha Stewart, you have my number...

 

The knitting of 2012

2.16 miles of yarn =

3 cowls

3 pair of mittens

2 hats

2 scarves

1 afghan

2 pair of baby booties

2 baby sweaters

2 hot water bottle covers

2 candle sweaters

2 bangles

1 pair of fingerless gloves

The 2.16 miles of yarn is equivalent to 137,100 inches. Employing a now tried and true calculation, that’s about as many stitches, which would take approximately 685,500 seconds of knitting, or just over 190 hours of knitting this year. As with last year, most of my knitting was concentrated during breaks, during points of heightened travel (read: interviews), and around the holidays. Goals for next year include not trying to knit so many gifts that it becomes a chore and taking advantage of idle minutes with small projects!

And the CSA makes one more appearance, from the freezer…

So when I posted previously that the summer CSA was finally complete, I’d forgotten about one small remaining item. The corn. Toward the end of the summer I was getting lots of corn on the cob, and just couldn’t keep up with eating all of it. So I would boil it, cut it off the cob, and throw it in the freezer. When I finally took stock of what was in there, I realized that I had about 12 cups of frozen corn languishing in there, taking up valuable real estate as my winter-time, frozen CSA was about to begin. Someone brilliant (Lynn, for the record), sent me this recipe, and it was a wild, wild success. I doubled the recipe, in order to use a full 10 cups of frozen corn, leaving only a little bit still in my freezer. The soup was delicious, and the salsa/garnish was not only fantastic on the soup, but was also great with tortilla chips once I realized that I had more than I really needed for the soup. All of it was made with frozen corn, and was just summery enough to make me almost forget that it's really gross outside, and warm enough to keep me cozy when I had to brave the weather. Enjoy!

The giant vat of soup. I recommend an immersion blender!

The garnish. I think the only modification I made was adding avocado to taste (meaning as much as possible) rather than limiting myself to the recommended amount in the recipe.