Congratulations Camille and Rajeev!

I went to a really lovely wedding last weekend. My upstairs neighbors (parents of Dante, a charming Corgi mix, to those of you in the know) got married and I had a simply delightful time. I got my hand decorated at the Friday evening Sangeet:

It got much, much darker overnight, but is starting to fade a little bit now. Most of my colleagues at the clinic are intrigued by it; one asked to clarify whether my hand was just dirty, or whether it was left over from the wedding.

They also had a photobooth, where I took some cute pictures of myself. Brighter folks than I took quick cell phone photos of the strip of pictures and posted them various places – I’ll try to remember to add that here when I’m back in Ann Arbor.

Out of phase life transition #1,000,000

My sister graduated from law school this past weekend. I'm super proud of her and am so looking forward to hearing about the amazing things she is doing now that she can put ",Esquire" after her name. That said, this is yet another person who by all rights was suppose to finish graduate school after I did who is now sprinting breezily across the finish line. And did it with style (Summa Cum Laude!). The psychiatrists call these events "out of phase" life transitions - like when a child dies before a parent or something good happens but it's still out of the order that you'd expect it to happen. Like when the students I taught as undergrads graduated from medical school before I was an M3. To distract myself from my seemingly never-ending graduate school career, I immersed myself in enjoying NYC for a weekend. A few pictures follow (with a bonus one of the dog thrown in for Claire - congratulations again!):

I was obsessed with the bridges on our Harbor Tour...

 

Mom insisted on singing the Emma Lazarus poem quite loudly as we approached the statue by boat. She threatened to reprise this performance when the guide read the poem as part of the tour.

 

A trash boat!

The graduation - my sister does not love photos of herself on the interwebs, so there aren't any here!

She loves Walter's face appearing on the interwebs, so here he is!

Welcome to M4 year, the best year since kindergarten

Cross-posted at Dose of Reality

I learned a lot last year, and one of the oft repeated nuggets of wisdom shared by residents and more advanced students alike was the joy of the year to come. They promised a less intense grading environment, electives chosen for purposes other than fulfilling core requirements, and more free nights and weekends. So far this is mostly true. I’m in the midst of a dermatology rotation at Henry Ford, a community teaching hospital in Detroit that is connected most closely to Wayne state, but at which UM students have the opportunity to do a few M4 year rotations. In spite of the fact that everyone seems slightly horrified that I’m not planning to go into dermatology, I’ve gotten to see a wide variety of dermatologic complaints while working with delightful residents and attending physicians.

Lessons I’ve already been applying from M3 year:

• You will never know exactly where you should be or what you should do, so don’t be afraid to ask questions.
• Smile a lot. People are less likely to think you are dumb if you also appear friendly and they like you.
• Fake it. Listen closely to what your resident asks of patients so that when you have to see a patient by yourself, you know what questions they will think are important to ask and report back. Eventually you will make it and understand why they have asked those questions.
• Wear gloves. Especially when someone has a rash on the palms of their hands, as it could be secondary syphilis and that is contagious through the rash.

New lessons I’m already learning about M4 year:

• The word elective not only means something you chose, but also something that is not required of everyone. This means that the rest of your medical school training is unlikely to have covered this material and you will need to read a lot.
• When someone tells you that something will be the best “X” since kindergarten, they do not necessarily mean that the entire thing will be filled with naps and snacks. They might mean that you can pick your poisons and that your schedule will be more predictable than previously.
• Smile more. Especially when someone gives you the stink eye after you delicately explain that you are leaning strongly toward (read: have already chosen) another specialty and are just there to learn about their specialty, not to audition for their residency program.

Anatomy of a bike ride…

I went for my longest solo ride this season this morning, and during the few hours on was on my bike I thought a lot about training. Last week, I took Monday as a rest day after my 35 mile group ride on Sunday, and then did relatively short rides on Tuesday, Wednesday, and Thursday. None of them were great rides, and I was feeling pretty frustrated about my training regimen. I felt slow and sore, and really wasn’t enjoying riding my bike. Adding insult to injury, the only five minutes that it rained really hard on Wednesday were during the last few minutes of my ride. It had been sunny, with blue skies and fluffy clouds, and just before I arrived home, the temperature dropped by 10 or so degrees, the sky darkened, and the rain poured. I was cold, wet, and miserable. I wasn’t sure how to solve what seemed to be a combination attitude and athleticism problem, but a little voice in my head said “Is it possible that you are pushing yourself too hard?” I had brushed off the same little voice as I headed out on Thursday, and ended up cutting my ride short because I just didn’t feel good. As I looked at the beautiful, cloudless sky on Friday, I decided to take another rest day. It wasn’t on my calendar, but I thought an extra day of stretching might make me feel better. Lo and behold, it did. This morning when I got on my bike, I felt much fresher and was able to enjoy the burn up the hills, the wind in my face, and the perfect temperature of the air. I also warmed up properly, letting myself amble along for the first ten minutes, spinning faster than I needed to and pushing less than I could. I realized that I might have been sabotaging myself, pushing hard right out of the parking lot, straining cold muscles up the hills while lamenting slow progress, day after day without enough recovery time to get stronger.

For the record, it only rained a tiny bit on my ride today, which I consider a major victory. Also, my second lesson of the day was that I can, in fact, feel cold fronts move in while I ride my bike. They are not pleasant and I wish they would hold off until my ride was done…

Here’s to learning important things at the beginning of the season, and riding stronger AND smarter the rest of the summer!

Knitting in the new (M4) year

I’ve been on vacation now for a full week, and I must say that I am enjoying it. Although I generally like my vacations filled with tightly scheduled relaxing activities, I think I’ve had enough time off that I’ve been able to genuinely take it easy. I had a few things that had to be accomplished during the first few days of my break, and now that the manuscript is submitted and the abstracts are reviewed, I have been catching up on all of the amazing television-watching and knitting that I have not done over the past few months. What I have been working on and planning:

The wedding afghan: When my oldest friend announced she was getting married, I knew I needed to do something awesome. I love to make something beautiful and functional for a wedding, and while this often results in lovely dishcloths or winter socks (to remind the couple to enjoy even the small things), I just didn’t think that would be enough. I started looking at afghan patterns in spite of the fact that Laura lives in Miami, and finally found a throw I loved that would work in a cotton blend. I’ve finished it, and although it’s a tiny bit smaller than I’d hoped (maybe I just imagined that a throw was larger…), it’s lovely and I think it will serve them well.

The someday sweater: Perhaps this has been ill-fated from the beginning, but it is shaping up nicely. I’ve knit the entire body, knit and ripped out the neck edging once, and planned for the sleeves and finishing several times over the past several months. The current plan includes dropping and fixing a few stitches down the front, ripping back the bottom and adding a little ribbing, and then using ribbing for the neck as well. It is proving to truly be a someday sweater…

Other gifts: In the interest of not stealing the thunder from various other friends or spoil any surprises, I will simply say that I am working on several wedding and baby gifts.

Happy Belated Blogiversary!

I was looking back at my list of posts today and saw that I’d missed an opportunity for a reflective post. Not one to let that pass, I thought I’d share with you some reflections about the past seven years. That’s right, it’s been seven years since I started this blog on May 3, 2005, optimistically titling it “Someday I’ll Be Dr. Dre,” hardly daring to dream that one day I would actually be able to see the end of medical school coming up around the bend. I posted frequently for a little while, then less so, and then started blogging for the admissions office in January of 2006. At some point I moved all of those old posts over here as well so that everything could be archived in one location. Since then I’ve posted at least once per month (roughly!) in order to fulfill my commitment to the medical school, and much more than that over the past few years to fulfill my commitment to myself, to reflect on my life and share ridiculous images of my dog with the world.

In that time I’ve learned by reading others’ blogs to think about what is posted here, what is posted on the admissions blog, and what is kept private. I’ve learned by listening to friends and family what things they like to see and what motivates them to interact with the blog, through comments and surveys and even phone calls. I’ve learned by writing to identify my own many stages of burnout, to procrastinate creatively, and to frame my life in the way I’d like it to look. I’ve learned so much that I’ll probably keep going even after I’m Dr. Dre. Thanks for reading!

The sorting hat

Or, thinking about the residency application process

(Cross-posted on Dose of Reality)

Right before I finished my last rotation of M3 year, I had the opportunity to attend a dinner hosted by the Department of Obstetrics and Gynecology for prospective residency applicants. It was a great chance to say hello again to the residents and faculty I worked with on my rotation and to learn a bit more about the application process. These sorts of events are often overwhelming and sometimes cryptic, but I was particularly struck by the reassurances from many of the faculty.

“Come talk to us, we will help you make a list that will work for you.”

“People who come and talk to us are happy with their matches. We can help you identify the right programs.”

“No, there isn’t another way to find good programs. Come talk to us.”

I left feeling like there was a sorting hat that would sit on my head, discern my clinical grades and Step 1 score, geographical and program-type preferences, and spit out a list of 15-20 programs to which I should apply. While this seems a little fantastic, it is closer to true than you might imagine. Having met now with three faculty members to talk about this process, I’ve come away with three fairly comprehensive lists of programs to consider.

For those of you not already familiar with this process (and those of you who are can skip to the next paragraph), the residency selection process is a match. Students submit applications through a central application system, and much like many other application processes, schools that are interested in particular candidates can offer them interviews. The similarity with most systems stops there, however. After the interviews, each applicant makes a rank list of programs and each program makes a rank list of applicants. These lists are fed to a computer algorithm that matches applicants and programs. The result it spits out is legally binding for one year. Because of this process, the list of program list an applicants starts with is important – there is only one application/interview cycle so there is no (easy*) way to go back and apply if one’s rank list seems a little thin or the match doesn’t go well.

As I’m looking over all of my lists, I’m wishing that there really were a sorting hat that could spit out a definitive set of options, but there aren’t, and honestly, I feel pretty lucky just to have a good sense of what specialty I’m entering and what I’m looking for in a program. I’ve created a spreadsheet (cue either scary or optimistic music, depending on your perspective), and am looking forward to doing a little sorting of my own. 

*I should note that if an applicant doesn’t match, then there is a second small match that used to be referred to as the Scramble, where applicants re-apply for program spots that have been left unfilled. This doesn’t happen often at Michigan, and certainly isn’t the best way to get the match of your dreams as the most desirable spots are already taken, but can yield an acceptable outcome for all involved.

Still life with dog

I have all kinds of ideas for posts about what I learned during M3 year, and the craziness that M4 year holds, but right now I’m on VACATION!!! I’ll be working on all of those posts in good time, but for now, I share with you my latest work of art. I call it “Still Life with Dog.”

One more week

Also posted on Dose of Reality:

I have one remaining week of M3 year. It's hard to believe, and I have enough studying to do that now is not really the best time to reflect on lessons learned or experiences gained. Suffice it to say for now that I'm looking forward to being done, and when I take brief study breaks, I imagine what my two weeks of summer vacation are going to look like before M4 year is off and running. It's an awful lot like this:

 

Walter enjoying the newly remodeled Huron River canoe route just past Argo Canoe Livery.

 

Things I am planning to do starting 4/28:

• Ride my bike: I've got to get in shape for that ride coming up in July!
• Walk the dog: He deserves it after a year of craziness. 
• Reading for fun: The list of books I need to read at this point is endless, but I might as well try!
• Things that are as yet unscheduled, because I will not need to be scheduled within an inch of my life...

Hitsville USA

 

I don’t know how I had never visited the Motown Museum before. It’s been around since just before I was born, nestled on Grand Blvd in the heart of Detroit, a monument to the incredible music that flowed from our lovely city.

Ruti and I went and checked it out (along with a million other people who bought the Groupon) a few weeks ago, and found it to be wonderful.

The two houses that form the museum include Motown Studio A, the original offices of the company, and the apartment of the Gordy family who owned the business and lived upstairs. The tour guides sing and dance, and it is totally worth the wait. (You have to stand in line a bit because a tour is the only way to see this compact but amazing little gem.)

And the winner is…

Thank you to everyone who took the time to offer me your opinion about which bike ride I should do for my century ride this summer. To refresh, the options were all 100 mile rides in Michigan, on in Ann Arbor, one outside Grand Rapids, and one outside Kalamazoo. Here are the results:

All of you were on board with riding somewhere other than Ann Arbor. Rationale for this included statements like “go see something new” and “you know [Ann Arbor] all too well.” The one vote for the Kalamazoo ride was based on one lovely friend’s happy experience on the west side of the state and her love of the scenery there. The rest of you were wooed by the covered bridges. You made comments like “Bridges! I mean, seriously” and “the scenery will be the best on this one” and overall emphasized the loveliness of the bridges and of that part of the state. One person suggested that covered bridges were “so Iowa,” but did not leave a name for me to follow-up about this assertion. And then there was my mom. She left a treatise on the various tourist attractions around Grand Rapids, including a knit shop she likes nearby and an exhibit at the Gerald R. Ford Museum she thought was worth checking out. I love you mom.

Aside from these useful comments, I also learned that it is a good idea to use a free text box that asks “who are you?” because while some of you put your names, others of you use descriptive phrases that include childhood nicknames, obscure and anonymous comments about how well I knew/know you, or read entertainingly to the point (i.e., “your mother”) and a full quarter of you used smiley faces in your identification response. This made me happy. Thanks!

I make no commitment to the Covered Bridges ride just yet, but I’m leaning strongly in that direction.

A taste of summer in the springtime

I get a lot of frozen fruit with my wintertime CSA, and I’d struggled a bit to know what to do with it all. I mean, pies and crumbles are delicious, but I was pretty sure that it wouldn’t be good for me to eat pounds of fruit in the form of baked desserts. I also enjoy smoothies, but they are hardly a winter beverage. I’ve baked a lot of fruit into muffins, which works well, but still doesn’t use quite the volume I’d had in my freezer. Enter ice cream. Sort of.

 

This is my most recent batch, featuring peaches, raspberries, and a few mint leaves. I didn’t know that color of fuchsia could occur in nature, but it can. Also, did I mention that this stuff is good for you? It’s basically a really, really thick smoothie. It won’t keep in the freezer (or rather, it will keep beautifully as a giant block of ice), but who would want to do anything but eat it all?

 
Not quite ice cream
1c frozen fruit
1/4 c soy milk (approximately)
sugar/sweetener to taste

If you are using large frozen fruits, like peaches or pears, let them thaw a little bit in the food processor. Once you can actually puree them, you are good to go. Add a little bit of soy milk and any small fruits you are adding (berries, in particular) and process until the consistency is nice. Add a little sugar/honey/sweetener if you’re using rhubarb (which is a little stringy, but pretty good) or some other not-so-sweet fruit.

Enjoy!

This tree smells like poop, and other signs of spring

 

There is a particular type of tree that, while lovely, smells a little bit like poop when it blooms. Perhaps there was a sale on these poop trees (bonus points if you can tell me what kind of tree it is…), because my apartment is surrounded with them. My neighbor said she thought that someone had forgotten to pick up after their dog until she realized that it was the tree. Unfortunate aroma aside, the trees are blooming and that means it’s springtime. Other signs:

1. Random public art. No one wants to make random art when it is cold outside. There is some artful string I noticed out behind my apartment (pictured below) and there are new decorations on the fence around the abandoned lot on my way to school. Perhaps the creative juices freeze and thaw too?

2. Walter still thinks it’s too cold for a long walk in the morning.

3. I have awesome new bar ends on my bike!!! Alicia helped me pick them out and I rode with them for the first time today. It was amazing, and as Ash predicted, I do not know why I didn’t do this sooner. They have cushy nerve padding and give me more hand positions that I had before. I’m looking forward to riding long distances with them – I’ll be sharing the results of the ride poll in the next week or so, so vote now if you wish!

100 miles

Not to be outdone with the imminent end of M3 year, I thought it would be prudent to set a new gigantic goal for the coming months. Some of you may recall that in the summer of 2010 Alicia and I did a 64 mile bike ride. Although I did not realize it at the time, this was basically a metric century, or a 100km ride. Never one to let an opportunity compete with myself pass my by, I thought that another long bike ride was in order – this time I’m doing a real century ride! Alicia’s agreed to join me on a 100-mile ride at the beginning of July, and I’m really excited. I have one day left of inpatient medicine, and then I’ll have outpatient (read: free evenings and weekends), vacation, dermatology, and a research month all in a row. This may be the last time I have 2.5-3 months of reasonable training time for the foreseeable future, so I’m doing it. What I’m not sure yet is exactly where I’m doing it. Last time I had a decision like this to make, that is, where all of the options were good but I knew that other folks would have interesting perspectives, was when I was deciding whether to visit Budapest or Prague. You all were very helpful at that time, so let’s have at it again. There are three options:

1. Iron Horse Ride: This takes place in Ann Arbor and is a fundraising ride for the Michigan Chapter of the ALS Association. I have mixed feelings about a charity ride, no matter how amazing the cause, as I worry that I won’t have enough time to train AND fundraise properly. Also, the ride is in town, and I will have ridden around Ann Arbor plenty by the time the ride arrives. The major plus is that I wouldn’t have to drive in the morning to the ride.

2. Covered Bridge Bike Tour: Organized by the Fallasburg Historical Society, this ride starts in Lowell, MI, outside of Grand Rapids, and winds around the scenic countryside featuring, as the name would suggest, some covered bridges. It looks beautiful, and is also a bit later in the season that the Iron Horse Ride. Major downside is that it’s a few hours away and so would require either a hotel stay the night before or an early drive out there.

3. Kalamazoo Scenic Bicycle Tour (KalTour): Another ride with more scenery, but a longer drive; I think that Lowell, MI and Texas Township, MI are about equidistant from Ann Arbor. As stated before, would probably require a hotel stay or a really early drive.

What do you think?

Smiles

Cross-posted on Dose of Reality:

It’s really warm out, and although that makes me very nervous for the imminent destruction of the earth as we know it, it is also really nice for walking the dog. For the last week or so, Walter has been smiling. Literally. His nose is so short that when he pants he has to open up his whole mouth and it looks like a giant clown smile. This is an old picture, but gives you an idea of the kind of grin I’m talking about:

I’ve got a week and a half left on my current service (general medicine at the VA) and then four weeks of outpatient medicine, and then this year is officially over, so I’ve been doing a little bit of smiling myself. Lots of friends matched last week, solidifying the plans they’ve been hedging around and making contingencies for over the past few months, and I really love seeing folks so happy and going to the residency programs of their dreams. Ann Arbor is a great place to live for a lot of reasons, and one of the bittersweet perks is that lots of friends will leave for amazing places and incredible opportunities. Match day was a wonderful reminder that at this time next year I too will be at the end of this crazy program, preparing for residency. I’ve also been really enjoying my time at the VA. For a host of reasons I won’t enumerate here (since many of them are administrative and therefore both complicated and boring), I feel so much more useful than I have on many of my rotations. Finally, I've actually been out riding my bike. Smiles all around!

2,000,000

Those of you who know me personally know that I have a great many soap boxes. I try to be judicious in my hopping up and ranting, and remember that it’s important to pick my battles. While I know I’m preaching to the choir here, I’d like to take this opportunity to point out that there were 2,000,000 people registered as Ravelry users on February 29, 2012. Ravelry, for the unintiated, is a social networking site for knitters and crocheters. It’s not much use if you don’t do either of these things, but if you do, it’s pretty awesome. To start with, there are 1,999,999 other crafters posting cool things to look at. But the point of this post was not to extol the virtues of this particular knitting-related resource; it was, instead, to remind the world that there are prodigious numbers of knitters (and crocheters) out there in the world and slowly but surely we are all realizing that we are not alone. A quick google search revealed that 2,000,000 is approximately equal to the population of the city of Houston in 2010, and higher than the population of Philadelphia in the same year. Imagine that a major US city was emptied – it could be completely refilled with knitters and crocheters. So next time someone near you, jokes that he or she saw a knitter on the latest rendition of “Girls Gone Mild” remind him or her that, first of all, boys knit too, and second of all, that we are not mild and will poke you with sharp sticks. Happy 2,000,000th, Ravelry!

Quick Soup

The last month, as you will have noticed from the marked decrease in blog entries, has been busy. I’ve been back on an inpatient service, meaning that I’m back to only have one day off in seven, averaged over the length of the month. Since we get the switch weekends off (the weekends between services), that means we get 3 days off during the month; this brings the grand total to 5 days. As I have undoubtedly whined here before, and I’m too tired to take the time to look that up right now and reference it for you, 5 days/month is not enough. More specifically, one day at a time is not enough to both accomplish some relaxing and some grocery shopping/laundry/checkbook balancing/cooking/sleeping/studying. Arguably there is not enough time in the world for that second list, but one day each week is not even enough to gets started. This has resulted in an unfortunate dependence on eating random meals at the hospital (thank goodness for the magic of money on my hospital ID graciously put there by the medical school to ensure that I eat), things from my freezer that my mom has brilliantly prepared and stashed away for me, and the crazy stuff I can cook up in the stolen moments between arriving home from the hospital and studying and sleep.

This brings us to the soup. The soup was inspired by two things.

1) The new presence of the Pacific Rim noodle bar in the hospital cafeteria. It’s delicious, vegan (at least if you want it to be), and available at the hospital.

2) This ancient packet of miso soup mix that has been languishing in my pantry for years. I moved that packet of miso soup mix almost two years ago, and I’m pretty sure it had sat in my old apartment for a while prior to the move. I am not one to throw away food that has not really gone bad, and that packet of soup was tormenting me. I could remember that the last packet I ate was not as delicious as I’d hoped, but couldn’t bring myself to just throw it away. So I made it better. I added some random stuff from my pantry (dried mushrooms, dried seaweed, noodles), and it was pretty good. This reminded me that I had a tub of miso paste in the refrigerator that had also spent more than it’s fair share of time in the fridge and would probably actually make better soup.

Miso Soup
3 cups water or vegetable broth
2-3 Tablespoons of miso paste (I used mild yellow miso, you could also use an ancient packet of miso soup here)
dried shitake mushrooms
2-3 baby carrots, thinly sliced
1 stick seaweed kombu, broken into small pieces
1 serving udon noodles (you be the judge here)

Heat the water or broth, add the shitake mushrooms (as many as you’d like) and the seaweed, and bring to a low boil. Add the noodles. I broke them up so that they would be easier to eat. When they are nearly soft, stir in a little bit of the miso paste at a time until you like the flavor of the broth. Add the carrots to the soup, and heat for another 10-15 minutes. The noodles, mushrooms and seaweed should be soft. Enjoy!

Not a product placement

I recently realized that my white coats were, how shall we say, not white. They were not as gross as you might now be imagining, because the average day in the hospital does not include getting others’ bodily fluids on my coat, but the collars and the cuffs showed that grey tinge that comes from a revolting combination of pen ink from note-taking, water from hand-washing, and sweat from question-answering. I usually use an “earth conscious” detergent, one that is slightly cheaper than the wholly organic versions, but still leaves out most of the chemicals I dislike. Much as I love the lavender aroma and non-toxic fumes of this particular detergent, however, it lacks the vigorous stain-removing properties of a more earth-killing soap. At the recommendation of a classmate, I invested in some Oxy-Clean and pre-treated my white coats, and then soaked them for several hours, and then washed them in hot water. They are now mostly white, and I feel reassured that they do not contain any kind of terrifying bacteria because the combination of detergent that probably hastens the end-of-days with it’s whitening power and hot water is apparently a winning one. I feel a little guilty, actually admitting that the soap that kills is the soap that actually works better, but sometimes, maybe, I guess, a little man-made miracle is necessary. But I’ll probably keep hiding it deep within the closet and only bring it out for the white coats that themselves harbor germs that could bring on the apocalypse.

Winning the game

Cross posted on Dose of Reality

I’m now two weeks into my internal medicine rotation, and I’m learning a lot. It’s been, how shall we say, a steep learning curve, and I finally feel like I’m getting the hang of it; it’s humbling to realize that even in the 10th month of my M3 year I still don’t really know what I’m doing. In spite of bumbling around more than a little, I realized that yesterday (and carrying over to today) I won the game, or rather, my residents won the game for me. Inside the hospital, patients who are admitted go to different teams on different days depending on who is on call. My team admits new patients every other day. This means that the other every other days (except for some minor technicalities) we don’t admit new patients, and instead just care for those that we already have on our service. This also means that if one manages to discharge all of one’s patients on a call day, that the next day there isn’t anything to do! This is called winning the game. That’s what happened yesterday – while I was away at lecture, my patients were discharged and I showed up this morning with very little to do. The reality of being a medical student (and arguably this is the only situation in which the interns have a better deal), however, means that I just picked a new patient from one of the many already on our list, and started reading about her for Monday.

Somewhere between celebrating that I might get to head out a little early on a Saturday, and lamenting that a med student’s work is never done, I wondered a bit at the phrase “winning the game.” It’s obvious that being in the hospital isn’t a game for most people; I’ve heard some general lecturing about how inappropriate it is to joke about patients, and do my best to be respectful of every person I encounter. That said, if you can’t laugh about your life (and my life is pretty much the hospital at this point), what can you do? Of all of the different coping mechanisms we all use to keep working when our patients leave for home, hospice, or the hereafter, I’m not sure that humor isn’t one of the least destructive options, so I guess I’ll just keep on laughing until I can’t…

Wonder Dog

The NYTimes posted a really beautiful piece about service animals for children with emotional and other mental health issues that I read this morning. It described how sensitive dogs are to people’s emotional needs, and how perceptive they can be to subtle disturbances in mood and behavior. I thought the article was a nice follow-up to my last post about how helpful Walter was in coping with the emotional ups and downs of medical school. Read the article here, and if you care to, leave a comment about it below.

A prescription for sanity

Take 1 ridiculous moment as needed for anxiety

I’ve just finished my psychiatry rotation, and am more convinced than ever that all of the little things we do to keep it together during medical school are really, really important. Even with the amazing hours (and they call it “psych-ation” for a reason), psychiatry can be really emotionally taxing. There are generally a lot of small steps between mental illness and recovery, and at points it can feel like you aren’t going anywhere. My antidote to the sometimes overwhelming sensation that nothing I was doing was helping anyone was to spend a few hours to make something for someone else (and particularly for the little photogenic snuggly someone else you see pictured above and below).

Note to self: try not to forget this lesson for the 1,000,000th time…

For those of you who are wondering, the pattern for the coat is courtesy of my very own nemesis, Martha Stewart. I considered several other options, including this one, but was drawn in by Martha's dog fashion show (scroll to the sidebar)...

An afternoon of “the circus arts”

Ruti and I discovered the Detroit Fly House when we saw some photos from a friend and colleague of mine doing aerial yoga, that is, yoga poses on trapeze, aerial silks, and on that suspended round ring that is apparently called an aerial hoop or lyra. We were quite intrigued, and the inspired and wonderful Ruti arranged a class for us. While not all of the photos taken were the most flattering the world has ever seen, we had a wonderful time on the trapeze and the fabrics yesterday!

We started on the trapeze, and did some crunches there to get the blood flowing. Then we got to climb the fabrics, which took me back to my days of climbing the rope to the ceiling in gym class…

We then did some poses on the trapeze, which made me realize that I do have a slight fear of heights, but actually feels quite secure once you are twisted around it in some way and not just standing.

 

After that we did a few more poses on the fabrics, and another series on the trapeze, and called it a day. I was almost unable to use a fork due to extreme fatigue of my arm muscles, and today my hip flexors are approximately 1000 times shorter than they were yesterday, but it was totally worth it.  

Happy New Year y Bienvenida a Miami

Apologies for the brief blog hiatus; I’ve had a slower start to this new year than ever before, and am kind of enjoying it. Details below…

I rung in the new year in a decidedly more relaxed fashion this year than in previous years, by watching movies with the dog and going to bed early. It was great; there was no disappointing party, no crabbiness when I got tired, and no giant let-down at midnight when the magical ponies (or whatever I thought was supposed to make midnight on New Year’s Eve so amazing) failed to materialized. Walter and I looked approximately like this when midnight passed:

Early the next morning, I boarded a flight to visit Laura in Miami. We went to the beach, saw the sights around South Beach, and visited the Everglades. I also got to spend more time with her lovely fiancee and their endearing dog. It was a fantastic trip, and a wonderful way to get the new year started right.

 The view of the Bay of Biscayne outside their condo.

 

Trooper

 Laura and I (below) at the beach (above)

 Art Deco beauties in South Beach

 Everglades flora and fauna: ferns (above), pelicans and alligators (below), and vultures (bottom)

Since returning home, I’ve started a new block of my psychiatry rotation, scheduled one of the two parts of the board exam for later this year, and planned out a draft of my M4 schedule. 2012 looks awfully promising, and I’m not yet convinced that the low key new year wasn’t the key to this awesome set-up… Happy 2012 everyone!

2011 in knitted goods

Based on yardage alone, I knit a little less than half this year than I did in 2010. This is not particularly surprising, given the prodigious number of items that I produced during that year, and given the rather abrupt decrease in knitting time that occurred in May of this year. (I will also note that this total does not include things that have yet to be completed; there is a 3/4 finished sweater and some mitten cuffs that are not reflected here.) The tally for 2011 stands as follows:

4 cowls
2 pair socks
5 hats
2 baby sweater
4 pair baby legwarmers
1 pair adult legwarmers
1 BlackBerry cozy
1 pair mittens

For finished items, this totals 1.91 miles of yarn, or 121,017 inches. If each stitch is slightly less than an inch of yarn, which seems like a reasonable estimate and is one I’ve used before, that’s almost 1/8 of a million stitches. If each stitch takes an average of 5 seconds (with a mode closer to 1-2 seconds, but with some distant outliers with more complicated patterns), that’s 605,085 seconds of knitting, or 10,085 minutes, or 168 hours of knitting this year. That would seem to average out to about 0.46 hours of knitting each day. That seems high, but I guess days of vacation where I knit for 4-5 hours in an evening would bring that average up quite a bit, as would days of lecture where I knit for 2-3 hours in an afternoon, and would perhaps compensate for what seemed like many, many days in which I did not knit at all.

Here’s to a 2012 filled with knitted things!

A little holicrazy?

Cross-posted on Dose of Reality:

I think I’m not alone in occasionally feeling on the edge of hypomania around the holidays...


Clinical definition: Hypomania is an episode of at least four days of elevated or irritable mood different from the individual’s normal mood that does not cause marked impairment of function or hospital admission, and which includes at least three of the following

• gradiosity
• decreased sleep
• more talkative than usual
• racing throughts or flight of ideas
• distractability
• increased goal direct activity or psychomotor agitation
• excessive involvement in pleasurable activities even if they have a high potential for negative consequences.

Although oftentimes my family and friends' extracurricular expectations of me are low, I love finding, wrapping, and giving gifts, and have been known to go a little overboard sometimes. This year I think it was brought on by the realization that I hadn’t handmade any gifts for anyone. Usually I knit like crazy during the summer, fall, and early winter to make sweaters, socks, hats, and scarves for friends and family. I knew that wasn’t an option this year, with the clinical calendar as it is, but decided to make small gifts for my extended family members. This blossomed from a well-intentioned little craft project into a bit of a crazed mission involving large volumes of chocolate and Martha Stewart branded craft materials.

(Another note: This gifting is not the extent of the holicrazy. I also made squash soup from scratch, which included roasting the squash seeds as a snack, and was posted earlier this week… Also, I drafted all of these holiday posts in a single morning when I was feeling particularly productive…)

Since they were all mailed last Saturday, and should have arrived already, I think it won’t be spoiling anything for anyone to post some pictures and the recipe here…

Chocolate Bark
adapted slightly from Seriously Good Improvisational Chocolates by Sally Schneider
Chop up 1 lb (or more, or less, depending on how much you want) of really good chocolate into 1-inch or smaller pieces. I used Callebaut chocolate, which they carry at my bulk food store, and Ms. Schneider recommends Valhrona, which I’ve seen at Whole Foods, or Sharfenberger. You can use either dark semi-sweek chocolate or milk chocolate. Cover a baking sheet with parchment paper. Melt 1/2 of your the chocolate in a saucepan floating in another saucepan of water on the stove (or use a double boiler if you have that sort of fancy equipment). When half the chocolate is melted, remove it from heat and stir in the remaining chocolate until it’s all melted. Use a spatula and spread it into the parchment paper so that it’s about 1/8”-1/4” thick. Let it sit for 3-4 minutes to set a bit, and then sprinkle with the toppings of your choice. I’ve listed the festive holiday options I chose below. Let the chocolate sit for a few hours or until it’s firm. Break it into shards, and package it up! Per Ms. Schneider it will keep for several weeks in a sealed container at room temperature.

For Mexican hot chocolate: Vietnamese cinnamon or other very fragrant cinnamon, and cayenne pepper. Sprinkle the cinnamon liberally, and go easy with the pepper.

For candy cane: Crush candy canes in a plastic bag (I used a rolling pin) and spread the shards over the chocolate. This is pretty!

For fleur de sel: This may seem obvious, but it’s just fleur de sel. It can be as coarse or fine as you’d like to grind it.

For gingerbread: This was (I think) the best one. Smash up some gingersnaps or other gingercookies in a plastic bag until the largest pieces are about 1/2” across. Sprinkle these over the chocolate, preferably dark chocolate and spicy cookies, and enjoy.

Soup for the holidaze

I tried out a new recipe last week, and it has quickly skyrocketed to the top of my list. It would be delicious with canned squash or pumpkin, but working with a whole squash was fun (if a bit time consuming). I modified the recipe so that it was more healthful and also vegan, but you could obviously use heavy cream in place of the silken tofu, although the soup might be a little thinner (and with less protein!). It was equally delicious reheated the next day, so it’s also a convenient weekday lunch…

 

Squash Curry Soup
adapted from the Fall/Winter 2011 Good Health, which Blue Care Network sends to me on a quarterly basis, ostensibly to lower my health care costs for them

1 tablespoon olive oil, plus a little for roasting the squash
1 cup finely chopped onion
2 cloves garlic, finely chopped
1 cup diced celery
2 teaspoons curry powder
1/4 teaspoon ground coriander
1/4 teaspoon crushed red pepper
3 cups water
1 cup low-sodium vegetable broth
1-2 squashes (total weight 32-40 oz, or one 32 oz can)
1 package silken tofu

(Skip this part if you’re using canned squash/pumpkin.) Preheat the oven to 400F. Wash and peel the squash. Cut it into slices, and set the seeds aside if you want to bake them later. Arrange the slices of squash on a baking sheet with a small amount of olive oil, and bake at 400F until they are easily poked/smashed with a fork. Let the squash cool a little, and then transfer to a food processor. Process until you’ve got squash puree. Set aside while you work on the rest of the soup.

 
Heat the olive oil in a soup pot over medium-high heat. Add the onion, garlic, and celery and cook until tender. Stir in the curry powder, coriander, and crushed red pepper and cook for another minute.
Add the water and broth, and bring to a boil. Reduce to a simmer and cook 10-15 minutes to allow the broth to take on the delicious onion, garlic and celery flavors.

 
Stir in the squash puree and the silken tofu, and cook until heated through. Use an immersion blender (or carefully transfer to a blender or food processor) to blend until creamy.

 Garnish with fresh thyme or other herbs and enjoy!

Future patron saint of the holicraze

Sister Mary Walter of the Blankets