The Final Countdown

As many of you know, I've installed the "Final Countdown" app on my phone. Filed under "wellness," along with my meditation and yoga apps, it counts down the days, hours, minutes, and seconds until residency ends on June 17, 2017 at 5PM (with the start of cocktail hour at our banquet). As of this posting I'm at 35 days, 22 hours, and minutes and seconds that count down as I type. I've set it to display the countdown in a soothing electric blue that seemed somehow less aggressive than red or green event. As we inexorably move toward the end of residency, I find that in a similarly unstoppable fashion my to do list gets longer and my desire to complete those items evaporates.

Things I've been avoiding:

• Cleaning out my closet: There are things in there that I moved but haven't worn since residency began. I know, truly, that I will never wear them and that there are others in San Francisco who would, but the effort to remove them from my closet feels Herculean. 
• Recycling my old medical journals: So many of them have not yet been read. At some point I will just need to embrace that many of them will never be read, and resign myself to the fact that they were lightly skimmed at some point and recycle them. Until that point, however, they will sit, weighing down the desk drawer and my conscience.
• Studying for boards: This is sort of happening. I'm actually doing a little bit of studying each day, but nothing feels like enough.
• Finishing manuscripts that have languished for months/years: Can a little bit more languishing really hurt?

Things I've done instead:

• Went on a little vacation to Monterey: This involved kayaking with the dog, which Lynn thought was a great idea and I was quite dubious about, but which turned out to be fantastic. It also involved a lot of lovely walking, the aquarium, and some new yarn. See photos below.
• Knit: This could be it's own list. The parade of babies continues, and I have been trying out new techniques and some bold colors. Hopefully all of the expectant parents I know are feeling highlighter florescent accent colors and/or bold stripes...
• Pumped up my bike tires: I've not been on my road bike in months, and I'm trying to motivate in that direction...

This has to be one of the most photographed trees in the US, maybe the world - the "Lone Cyprus" on the 17 Mile Drive in Pebble Beach. 

The jellyfish were my favorite.

This little pulpito moved around a bunch for us. I kept thinking of Inky, the one who got away, and his mate Blotchy, who must rue the day he didn't follow his buddy to freedom. 

Walter, in the kayak. There is a longer story that involves him jumping out of the kayak and (later) being spooked by sea lions. Maybe for another post...

Some thoughts about regional cycling culture

In Michigan, looking cool on a bicycle meant several things. First and foremost, it meant sporting a variety of cycling clothes (jerseys, shorts, socks, etc) from the various events you had previously completed. Started riding DALMAC (the Dick Allen Lansing to MACkinaw) in 1971 when it originated? Then wear that vintage jersey from the first year they made them to show just how awesome and dedicated you are. Secondly, although there were probably small subgroups of cyclists that favored the matching kit, where the jersey and the shorts are made to match, the vast majority favored mixing it up, perhaps to demonstrate the wide range of interesting pieces of cycling gear available to the enthusiastic rider. My rides would leave me asking questions along the line of, "Huh, I wonder where I can get those bright crazy shorts that guy had, so that I can wear them with my florescent pink jersey with the little devil on it from the ride through Hell, MI?"

In San Francisco, and I suspect in most of California, the approach is completely different. Fitting in and looking like you mean it on a bicycle requires a matching kit. You may select a pattern or color, and if you are part of a professional or amateur cycling team, it is acceptable to wear that jersey, but otherwise black is the preferred color. All of the fancy cycling clubs seem to produce all-black cycling gear, perhaps with accents that attempt to prevent accidents and make you more visible. While my training rides here have also prompted question asking, they have been more along the lines of "Why would you market a line of black, solid colored cycling garments in a city with so much fog?"

While I'd like to avoid high inference statements about cycling clothes that demonstrate that you have money rather than cycling clothes that demonstrate that you have fun, this difference seems stark. Am I missing something? Is there another obvious reason to eschew mismatched cycling gear in favor of the all-black kit? Help me out, dear readers. Perhaps needless to say, I continue to pair pieces of my maize and blue University of Michigan kit with other random bits, like the bright pink jersey I mentioned earlier, and my Menstrual Cycles team jersey, all with the primary goal of making myself as noticeable as possible to cars on the road, and the secondary goal of wearing clean things while riding. Look for me on the roads in an awesome kit comprised of colors and patterns that were never meant to be!

 Looking out over the Marin Headlands

 Finally biked up to Muir Woods

Clouds from Twin Peaks

Hills and Island Snow!

Today I intended to have a relaxing afternoon at Kailua Beach. I did not, however, take into account that it is the week between the holidays, when everyone who is going to vacation in Hawaii ever descends upon the beaches, and that the first family is vacationing in Kailua itself, and that I have very little tolerance for crowded beaches. So I ate my lunch there briefly and headed out on my bike! More hills today than any prior bike ride, which was lovely. Not anything crazy, but probably a good reminder for my legs for the Presidio when I get home.

 I think we might be able to kayak to these...

I stood in line at the Obamas' preferred shave ice location, Island Snow. This one is lilikoi and coconut. There is a scoop of macadamia nut ice cream on the bottom, which I thought sounded interesting even though the president apparently does not take his shave ice with ice cream. I think there are some other famous shave ice locations I could check out, though I'm currently feeling more interested in breadth than depth in my dessert exploration...

Biking Oahu

I've been working on biking all the way around the island in little segments. Since there aren't a lot of roads further inland to make loops, I just bike half the distance I want to go, and then turn around and bike back. So far, these are the rides I've done:

The longest was today, along the leeward side of the island between Kapolei and Ka'ena Point. It was lovely! 

Snow for the holidays

On Sunday I was again post-call and had quite an adventure. I had slept quite a bit on call the night before so elected to go directly to the North Shore for another bike ride. I'm sort of trying to bike around the entire circumference of the island before Lynn arrives. I've been making decent headway!

To start, I saw my first Hawaiian rainbows. They made the gas station I was at seem much more scenic and lovely.

Then I rode my bike from Waialua to Ka'ena Point, stopping at a few scenic places along the way.  

 On my way back, I took a little side trip onto a road that was recommended by Midwife Mary. She said, and I quote, "It is a nice paved road that goes up into the hills and has beautiful views. You just go into a gate that is across from the polo fields and before you get to the airfield." I followed her instructions to the letter, but somehow ended up here, on my road bike. This photo was taken in the middle of a nature reserve that, although lovely, contained locusts that I initially thought were birds because they were so large. I will be follow-up up with Midwife Mary regarding her recommendation. I don't know where I went wrong. 

Once I had recovered from the locusts and the dirt road, I went into Haleiwa for some food. I went to Giovanni's Shrimp Truck which proved as delicious as the reviews promised. Then I noticed that there was a truck called the Snow Factory right next door. Now, I had tried shave ice, which is basically just a sno-cone, and although delicious at the end of a totally unshaded hike is not a life-changing event. I had also heard that "island snow" was a concoction consisting of a scoop of soft serve underneath a snow cone, mostly in the news due to President Obama's dedication to the dessert, though he apparently doesn't like the ice cream and prefers just the shave ice. I was curious about this truck, and learned that they make finely shaved milk-based shave ice that is not only beautiful but delicious, and is served with toppings that include mochi balls and weird gelatin-encased juice droplets. This is my mango-passion fruit flavored bowl, and a picture of the fluffy inside. This was amazing. So amazing that a little friend tried to join my snack time. 

I may have overdone it a bit, and did nothing with my post-call day today because I was exhausted. There are worse things. 

Post-call

I rested enough overnight last night that I had energy to do some things this morning! I'll probably need a nap, but the sprinkling of hours over the night seems to have been just enough.

First, I celebrated the first day of Hannukah. (Traditionally the nights are celebrated, I know, but I am neither Jewish nor was I available yesterday evening, so cut me some slack. This was mostly an excuse for doughnuts.)

I celebrated with a passion-fruit-flavored, custard-filled malasada (Portuguese doughnut) from Leonard's. There are apparently several places to get malasadas in Honolulu, but this one was open and I had a delicious breakfast post-call. Happy Hannukah!

Then I decided to bike around Pearl Harbor since it is December 7. There is a rails-to-trails path around much of the harbor, so that's what I did. There are some nice views of the boats, but mostly it is a kind of stinky path. There are a very large number of tent cities along it, and Google subsequently directed me to ride my bike onto a highway in order to access another beach, which I did not do but only barely missed, so it was an exciting morning. 

These ships are in a NavSea Inactive Ships On-Site Maintenance Facility in Pearl Harbor. They are gigantic, though my views were limited by the various and sundry fences and restricted access roads. 

Here I am sporting my Menstrual Cycles jersey in Hawaii. You can see another boat in the background.

The other nice thing I can say about the Pearl Harbor Bike Trail is that it included some plumeria trees. They smell lovely, though they could not compete with the swampy smell of the rest of the trail.

The photos from the top

I realized that I didn't share any of the victory photos yesterday - the ones I took at the end of the hike or the end of the bike ride... See below.

 The view from Koko Head

 The back of my rental car, ready for anything. Catalog includes: bike, cycling shoes, bike lights, bike pump, walking shoes, swim suit, towel, clean clothes. 

The beach where I ended my bike ride

Koko Head and a bike

Today was my first scheduled, non-post-call day off. I did a lot with it. First I hiked up Koko Head.

 You may not be able to read the sign, but it says that there is a shooting range right next to the path. 

 This is what I would describe a short, but steep hike.

 I bought a bike on Craigslist! And it's great. 

This is what rest-stops on the side of the road look like. 

Diamond Head

Yesterday I was post-call and went and hiked around Diamond Head. Here are a few highlights:

 Sweaty and windswept

Honolulu from the top

December in Hawaii

Just when you thought this site was dead forever, I moved (temporarily) to Hawaii and realized that it would be a reasonably efficient way to post pictures that most of you could see on Facebook, and that those without Facebook access could also see. Don't count on a lot of text...

Day #0: Poke from the grocery store

Day #1: Good morning Hawaii, oh, and it turns out it rains here in the winter

Day #1: The view from the parking garage at the hospital

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…

Burn out

Cross-posted on Dose of Reality:

Between October 4 and December 14 I did fourteen residency interviews, although most of them were concentrated between October 27 and December 14, so all told I did an average of two interviews a week for seven weeks. I was home for 17 days during that period, spread out over the interview season.

Things that were wonderful about the interview trail:

• Catching up with friends in distant cities
• Enjoying cuisines that aren’t available in Ann Arbor
• Meeting so many delightful future colleagues/potential co-residents

Things that were terrible about the interview trail:

• Sleeping on floors, air mattresses, couches, and guest beds; thank you to everyone who hosted me, but the cumulative effect was rough
• Air travel
• Leaving Walter with every friend and relative I have in the greater Ann Arbor/Detroit area

I’m glad I did it, but I’m really glad I’m done. Now the excitement of making a rank list and holding my breath until March 15 when I find out where I’ll be heading for the next four years. Stay tuned!

Emergence of a rank list?

Cross-posted on Dose of Reality

At the beginning of the interview process, I had some sense of which programs would be at the top of my rank list*. I also had some ideas about which would be at the bottom. I'd set up a list for myself of programs likely to be in the top 5-6, and programs likely to be in the bottom 5-6, but the middle of the list was a bit of a mystery. Now that I'm through nine of my fifteen interviews, I'm getting a better sense of what I'm looking for in a program, although it's still difficult to make concrete pre-interview predictions. Some things I have learned:

• As promised by all of the residents and faculty I've talked to, interacting with current residents is really important. Not only do they have a completely unique, insider perspective on the programs, but their personalities and preferences seem to be the best indicators available of what kinds of applicants match at particular programs, and what sorts of people do well there.
• I'm really glad I'm not couples matching. Applicants who have a significant other (or anyone they want to match with, really, as there is no requirement that you be in any particular kind of relationship) who is also applying to residency this year can choose to link their match lists with that person's. The match algorithm then processes the two lists together so that if Applicant A only wanted to be at Program X if Applicant B were at Program Y, and Program Y isn't an option for that applicant, then the algorithm moves on and looks for a better match. This means that although OB/GYN isn't the most competitive specialty, those applicants who are couples matching with someone in a crazily competitive specialty have to apply and interview to many more programs. The travel is already wearing on me, and I can't imagine having to do more than I already am.
• The fit and feel of a program are much more obvious after an interview day than I'd expected. I know it sounds dubious, but you really can get a good sense of a program after an informal mixer/dinner with the residents and then an interview day. There are, I'm sure, lots of things that can't come out in that amount of time, or that are intentionally hidden away during interview days, but the personality of a program really does come out quite clearly in that brief interaction. 

I've definitely not finalized my list at this point, as there are still lots of interviews to come, but it's exciting to feel like I'm getting closer.



*For those of you confused about what a "rank list" is, I refer you to a post from May that describes a bit of the match process.

Catch up

Somehow it's been ten days since I last posted. I was home for a week over Thanksgiving, and thoroughly enjoyed the break from the travel. I'm back on the road again, and wanted to share some highlights from my interlude visiting Ruti in DC!

 She lives very, very near to the White House, and I realized that I'd never seen the front side of it. Here it is, in all it's glory!

 We tried a delicious soft-serve spot that starts with bars of frozen yogurt and actual fruits (or pumpkin, in my case) and then blends them into delicious soft-serve. I got the pumpkin spice flavor with chocolate ice cream - a perennial favorite for me, but new to the astonished gentleman behind the counter. It was amazing.

I went to the Renwick Gallery, the Smithsonian Museum of American Craft, and saw some of their permanent collection as well the 40 under 40 exhibit, which featured 40 works that had been created since the opening of the gallery 40 years ago. 

There were no pictures allowed in the special exhibition, but upstairs in the permanent collection I was particularly taken with this "Bureau of Beaurocracy."

On my way to the museum I stopped at the food trucks (below) just a block or so from Ruti's house. I did not get the most exotic tacos, but they were delicious (above).

We also went to an aerial yoga class, but mercifully there were no photos of that experience. Unlike the class we did last year, it was not explicitly directed toward producing impressive photos. Instead, it was focused on destroying one's triceps, and it did an admirable job of that. Thanks Ruti, for an amazing visit!!!

"I have always depended on the kindness of strangers"

Cross-posted on Dose of Reality

While I'm optimistic that the end of my interview trail will not parallel the end of Blanche from Streetcar Named Desire, I nonetheless feel that, at least right now, I am wholly dependent on the kindness of friends, family, and even some strangers. I'm writing this post from dearest Ruti's living room, having stayed with my sister last night and a gracious UM alum the night before*. In Boston I stayed with a med school classmate, and an old friend in Seattle. I've got friends lined up for many of the rest of my interviews as well, and I feel incredibly grateful at their willingness to pull out their air mattresses, unfold their couches, and make up their guest rooms for me. I'll be working to balance my karmic withdrawals by hosting some applicants interviewing at UM back in Ann Arbor. I can't say thank-you enough to all of these folks who have made the first half of the interview trail that much more hospitable. Don't hesitate to call if you find yourselves in Ann Arbor. Thanks!

*The Office of Alumni Relations runs an impressive hosting program that connects interviewing fourth years with UMMS alumni across the country. I've only used it once so far, but was thrilled with it. Yay for having a gigantic alumni network!

And the interview season marches on…

Cross-posted on Dose of Reality

I’d had a bit of a break since my first residency interview, but this weekend I was on the road again for interview number two. This really marks the beginning of the craziness that will be my interview season. Looking at my calendar for November, there are a total of about 10 days (including the week of Thanksgiving) when I’m not traveling somewhere. Here is how Walter feels about the prospect of my being away so much:

I'll note that these photos were taken on two different occasions. The dog has taken to smooshing his face into small spaces that look ridiculous. And adorable.

Despite having similar feelings about so many flights, rental cars, trains, and hotels, I’m pretty excited. [For the record, I’m not sharing here the full list of places I’ll be interviewing, out of courtesy for the match process and my friends and colleagues, so if you know them, please don't share!]

The following are some highlights from my trip this weekend:

• I ended up in the airport Friday waiting for a rebooked flight for about four hours after my original flight was delayed enough to miss my connection and thus cause me to miss my interview dinner. [Insert diatribe about what air travel has become.] But I was calm.
• I ate the following (delicious?) airport food while waiting: a hummus and pretzel cup, a California roll, a Snickers bar. Only the last item really helped my mood, although it’s possible that it was really a cumulative effect.
• I made it to the last 20 minutes of the dinner/mixer on Friday night, and everyone was delightfully welcoming and wonderful.
• My interview was great, and I ended up being more impressed with the program than I anticipated.

Here’s a photo of me in my interview suit, seeing a bit of the campus.

Catch-Up

Somehow, in the midst of rotating with the midwives, a family wedding, and two board exams, the blog was a bit neglected last month. Oh, and the month before because of the ICU… Sorry! Here is a quick catch-up post to share some fun things that I did but didn’t blog about.

1. Hell’s Kitchen. I went to Minneapolis to see my lovely cousin get married, and in doing so got to see my mom and sister, among others. On the Saturday morning before the wedding, we decided to try Hell’s Kitchen, advertised as the most amazing place since sliced bread. We’d gotten mixed reviews from some, but wanted to check it out. It did not live up to the hype. I got the huevos rancheros, which were by far the best of anyone’s breakfasts, and they were fine. Not amazing, but fine.

2. Creamy Turnip Soup. This was an adaptation of Mark Bittman’s Creamy Carrot Soup, and used up many of the turnips that my CSA so vigorously produced. It was delicious, and delightfully simple. Sautee a chopped onion and as many turnips as you wish (or carrots, in which case you may wish to add a potato) until they are just tender. Add about 5-6 cups of water or stock and cook until the vegetables are soft. Use an immersion blender to make it smooth, and season with salt and pepper.

3. A lovely picture of peas. Nothing more to say, just wanted to share this pretty picture from my CSA back in June. Join a CSA here!