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.

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!

Thanksgiving

This year, Thanksgiving was not only a time to reflect on how wonderful it is to spend time with my friends and family, but also a respite from the ridiculous interview season that has consumed most of October, November, and December. I had almost a full week at home over the holiday, and I made the most of it. This was the most delicious part of that week:

 To accommodate everyone, there are little sugar free and gluten-free versions of the pumpkin pie baking on the bottom rack. 

Yum!

Peach Cranberry Pie
adapted liberally from Mark Bittman’s How to Cook Everything

Two batches of pie crust
16 oz frozen peaches, thawed and drained
6-8 oz frozen cranberries, thawed, drained, and sliced lengthwise
3/4 cup sugar
1 tablespoon lemon juice
1/4 teaspoon ground cinnamon
1/8 teaspoon ground nutmeg
1 1/2 tablespoons cornstarch
Little bit of milk

Preheat the oven to 425F. Prebake the bottom crust (using a little more than half of your crust dough) for about 10 minutes with foil and pie weights (or dried beans, which is what I use) over it, and for another five minutes with the foil removed, or until it is very slightly brown. While this cools, mix the lemon juice with the peaches and cranberries. Increase the heat of the oven to 450F. Mix together the dry ingredients for the filling and toss the peaches and cranberries with this as well. Roll out the remaining pie dough, and cut it into strips a little less than an inch wide. Once the bottom crust is cool, pile the fruit filling into it. Lay four-five strips of crust across the top of the pie, and attach them to the bottom crust on one side. Starting at one side and working across the pie, weave the perpendicular strips across the pie, over and under the other strips. When it is all woven, press the edges of the strips into the bottom crust. It should look roughly like this when you’re done.

Brush the top crust with a little milk and sugar, and bake for 10 minutes at 450F. Reduce the heat to 350F and back for another 40-50 minutes, until the pie is golden. Let cool and serve warm or at room temperature.

In addition to eating, we also went to the parade, joined by Ash’s mom Cindy. The weather behaved so well that it was an ideal first parade year for her!

The Detroit Mounted Police

The clown fire brigade

Grover visits Detroit

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!

End of the CSA

My CSA this year caused more anxiety than last year. I think I was working so much last year that I got into the habit of cooking massive amounts of food on my limited days off, and eating salads at every possible juncture. This year felt much less organized, with rotations that were really radically different each month, and somewhat unpredictable. I wasn’t nearly as diligent about cooking regularly, and so I frequently had panicky moments until I figured out what to do with the massive lot of greens in my fridge. When I finally had some time at home a few weeks ago, I cleaned up my refrigerator and finally used the last of the CSA. (I will note that since it's very, very fresh when it comes to me, it's actually just fine to sit in the fridge for a week or two. Not ideal, but fine.) Some of it, okay, truthfully, massive volumes of it, became sautéed greens with a fried egg on top. But another large portion became this:

Eggplant + final tomatoes of summer + chick peas = delicious

There’s not much "recipe" to share, as I just roasted the eggplant in the oven and then warmed it on the burner with the tomatoes and chickpeas. I seasoned it with zahtar, which is a mixture of sesame seeds, coriander, sumac, thyme, cumin, and black pepper. The sumac adds a citrusy deliciousness to the whole thing, and I highly recommend it!

Time I got up to get to the airport in Boston: 3:15AM

Number of empty rows on each leg of my flight to Seattle: 10+

Number of screaming children traveling with me from Philadelphia to Seattle: 1

Cost of earplugs that I try to keep in my carry-on: $0.50

Value of laying down across three seats and sleeping for another four hours: Priceless

I have now forgiven US Airways for any past injustices, as I was on two very empty flights this morning, and I got to sleep for almost the entire flight from Boston to Philly, and then another few hours en route to Seattle. It was so incredibly nice to sleep a bit more since I needed to catch up after Boston evenings filled with a pre-interview mixer and a fabulous dinner with the most amazing out-of-town friends a girl could want, and mornings filled with interviews (starting at 6:45AM!) and flights (departing at 3:50AM!). My gracious host (a friend from med school) couldn’t have been kinder, but I didn’t spend nearly enough time in the bed she provided!

More voting!

That’s right folks, vote early, and vote often…

I wanted to share a few more links for those of  you looking for more information about local elections than I’d provided here. I did a lot of my own research during the primaries, and so didn’t have to do as much this time around, but here are a few organizations/news items that helped me out.

If you’re voting in person, print out a sample ballot to make notes to take with you! You’re allowed to take whatever notes you like into the polls with you, as long as they don’t look suspiciously like campaign materials – leave the buttons and yard signs in your car.

American Federation of Teachers (AFT) Michigan endorsements

AFT Michigan includes a link to local AFL-CIO endorsements

Ann Arbor News article about the school board candidates

Ann Arbor News article about the library bond proposal

Ann Arbor Journal article about the library board candidates

Have fun with your absentee ballot, or making notes to take with you in person on Tuesday, and remember to vote all the way to the end of your ballot!

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.

A reflection on Blogger stats

This blog, in case you hadn’t noticed, is hosted on Blogger, which uses a simple version of Google Analytics to tell you about how many people look at your blog, where they come from, and what platforms they are using. I like to check this out, as it has revealed an interesting conglomeration of both surprising and unsurprising things. I will leave you to decide for yourself which are surprising, and which are not:

• that my blog has been posted on a list of medical student blogs;
• that everyone loves Walter more than any other kind of content I could post;
• that some people don’t access my blog through Facebook, an RSS feed, or Google Reader, but instead search for things like “dr dre medical school”;
• that some people arrive at my blog after searching for keywords like “tree smells like poop” and “purple vegetables list”

Those of you who have been long-time, or even just diligent readers will recognize that those keywords most likely refer to one wildly popular post about the Bradford Pear trees on campus and to one very obscure post from back in 2009 about all of the purple vegetables I bought at the farmer’s market. I wish I had some way to predict which random posts would be most popular.

Residency interviews get off and running at the end of the week… I’m a little nervous, but will keep you all posted!

Cycling update

My last mention of a cycling-related topic was in a post about how little I had biked during my month in the ICU. Sadly, the two months that followed did not look much better.

 I had a few notable rides, and a few trips to and from the hospital for my rotations, but mostly I felt tired and sore from standing all day, and lazy because I wasn’t on my bike. You’ll notice, however, that is has leveled out since I started my month of vacation and interviews. Here are some highlights from my fall riding thus far:
1. Taco Tour Cinco! I didn’t take any photos, as I hadn’t yet gotten my new (fancy!) phone and I didn’t want to lug my camera around, but this was a great event. As per usual, the tacos were fantastic. My favorite is always Dos Hermanos, for their amazing black bean tacos, but this year Taqueria La Fiesta had a really fantastic nopalito taco that was a close runner-up for me.
2. New Jersey! I ordered a University of Michigan cycling jersey back in April, and was planning to wear it for the century ride. It got caught up in some administrative disaster, and I didn’t get it until just a few weeks ago. Since I ended up having to wait so long, however, I got a great deal on some other Michigan cycling gear. Now that I have it, it’s heavily into the rotation and I decide to try out all of it together on a ride this week. I probably won’t wear the full kit again (as I think it makes me look a we bit more intense than I am), but will definitely be sporting bits and pieces of maize and blue spandex on my rides!

3. Fall colors! This is the best time of year for beautiful rides, and my new phone takes way better pictures than the old one…

Dear Anonymous

Dear Anonymous commenter,

I’m not sure how many people read the comments on my blog, but those who do have surely noticed a large volume of comments from you, “Anonymous.” I have reason to suspect that you are only a single person, Anonymous, because the tone of your comments is always the same. You do choose interesting moments at which to comment, however, and you are always entertaining. Here are some of the things I have learned about you by reading your comments:

1. You, like everyone else who reads the blog, love Walter. You love him so much that his the primary focus of your comments.
2. You enjoy capitalization of words for EMPHASIS, and wild punctuation!!!! I suspect that you talk like this too.
3. You may be a crazy, dog-loving comparison shopper, given that when I posted about a dog bed, you posted a similar but less expensive one in the comments very, very quickly.
4. You care a lot about my emotional well-being, but somehow not enough to use your name in your posts and reassure me that I don’t have some creepy anonymous follower who may or may not try to steal the dog in my sleep.

I hope that you continue to enjoy the blog, because I continue to enjoy imagining a nameless follower I’ve never met who occasionally frets over my anxiety level, but also needs a regular fix of the puppy photos and has lots of OPINIONS!!!! You leave the oddest anonymous comments I have every seen. Please keep posting.

Sincerely,

Your daughter

PS. That's right, mom, silly letters aside, I know it's you.

PPS. Please don’t bother to start using your actual Google profile to post comments, as the anonymous ones are hilarious.

PPPS. Just for you...

When Walter gets sleepy, he can't keep his tongue in his mouth or ensure that his eyes point in the same direction. So cute!

To the polls!

I am often annoyed by the e-mails that the Michigan Democratic Party sends to me, as I have no money to give. None. At all. The last one contained a few useful links, however, and reminded me that around this time of year I usually post some election-related material (like this, and this).

October 9th is the deadline to register to vote in order to be eligible for the presidential election, so if you haven’t done so already, register now at the site the MDP sent, which seemed reputable and non-partisan when I clicked through some of it.

You can also confirm your Michigan registration or look at a sample ballot here, or get other voting related questions answered at the Michigan Voter Information Center Website.

As I’ve shared in the past, Michigan requires identification in order to vote, but if you don’t have ID you can simply sign an affidavit and vote anyway. Details from the Secretary of State about the law and how to get a state ID card if you’d like one can be found here.

ACLU Voting Rights Guide: This has information on what to do if you're told you can't vote at the polls, including the Election Protection Hotline: 1-866-OUR-VOTE and the Michigan Bureau of Elections 1-517-373-2540. You can also visit their Let Me Vote site to learn about state-by-state voting rights.

I’ve actually already got my absentee ballot since I’ll be in Seattle for a residency interview the day before election day, and likely flying home or getting ready to at the time when I’d need to be at the polls. If you’ve got yours too, check out the following websites to get information about the candidates. When I get to my ballot later in the month, I’ll try to post some updated links to information about the more obscure elections, which often don’t make it into national analyses.

League of Women Voters: They collect information about the candidates and line it up so you can compare their views on different questions.

Citizens Research Council of Michigan: Look here for nonpartisan analysis of the ballot initiatives that we'll be voting on here in Michigan.

Still have questions or didn’t find what you were looking for? If you don’t live in Michigan, visit www.publius.org to print out a ballot, find your polling place, and find contact information for local officials, or check your local Secretary of State website for details on how to vote near you.

Rolling, rolling, rolling…

Cross-posted on Dose of Reality

The residency application is definitely moving along. The official opening date for application submission was September 15, and everyone has been doing their best to get their materials in as early as possible. My application has been in for a bit, and the stress of watching my e-mail has increased so much! Here is a snap-shot of my thought process over an average afternoon during the past few weeks:

Hmmm, I should look at my phone and see if I have any new e-mail. I wouldn’t want to miss an interview invitation. Everyone keeps talking about how quickly the dates fill up after they are offered. Oh my goodness, look, an interview request that was sent 45 minutes ago already! Ahhhh! Let me open up my Google calendar where I have all of the potential interview dates entered and figure out what other programs are in the same region and need to have interviews that are near the same date. And also there are national holidays in November that I’d rather not miss. And also I would rather not fly to the West coast 12 different times. And also I need to make a decision on this half an hour ago. Ahhhh! Okay, it looks like this date should work. Take a breath, Andrea, so that your e-mail doesn’t read like some crazed and desperate applicant. Try for “Thank you so much for offering me an interview” rather than “I am so glad that someone will take me as a resident some day.” Okay, breathe. The tone is okay and the address is correct, so hit send.
Done.

There is a small amount of adrenaline that goes with each of these exchanges. Maybe a large amount. I’ll be glad when they are all scheduled and I can just deal with the anxiety of interviewing!

Warm Blankets

Cross-posted on Dose of Reality

Inside every operating room, or at least very nearby, is an appliance that looks like a refrigerator. It does not, however, keep things cold. Instead, it is devoted entirely to keeping things warm; specifically, it keeps blankets warm so that when patients first come back to the OR, or when they are just waking up, they can be wrapped in a warm blanket (or two, or three) so that they are comfortable in the subarctic temperatures that sometimes occur. Today, I got the opportunity to experience the warm blankets for myself. I was watching a laparoscopic operation (read: a procedure performed with instruments on the ends of sticks inserted into an abdomen blown up like a balloon, so that there is no need to really open up a giant incision). One advantage to these is that, during most of the procedure, there is not much for the medical student to do since it is all inside the abdomen and it is all shown on huge TV screens around the OR. There is then no need for the student to scrub, wear a sterile gown and several pairs of gloves, and focus vigorously on contaminating neither her/himself nor the operating field. Instead, the student can stand or sit and watch the TV. In the cold. The cold that is usually mitigated by said gown and gloves, as well as by the lights and the pressure of working not to contaminate anything. I was cold, and while I was lamenting not having grabbed a scrub jacket from the locker room, I saw that one of the nurses had a blanket wrapped around her shoulders. I snuck into the hallway, grabbed a warm blanket, and wrapped it around myself. It was amazing.

It turns out I am not the only one who loves warm blankets. In addition to at least one notable person in my life who extols the virtues of heated mattress pads and heated throws, look who else loves warm blankets. He snuck into the basket while I was turned away to fold a sheet:

As the weather turns toward the chillier, but it’s not quite okay to turn on the furnace, consider joining me in front of the blanket warmer, or if you aren’t quite ready to invest in one at home yet, in front of the dryer. It’s warm.

Puppy Love

I think I won points with my urology resident today because I have a cute dog. She also has dogs (who are both adorable), and we bonded over their love of being covered when they sleep. Also our love of them… She informed me of a product called a “cave bed” that is a normal dog bed, but with a plush cover that creates a cave in which your pet can snuggle. You see them here or here (complete with a review). Maybe someday, Walter…

Urology!

Cross-posted on Dose of Reality

Somehow it’s already been two weeks of my urology rotation, and I haven’t shared with you all how awesome it is. I have been busy with other things (like ERAS – the online residency application – which I will tell you more about later), so here are a few highlights:

• My first week included “the Nesbit,” which, as far as I could gather, is a symposium organized each year to feature interesting research from urologists at UMMS and other important people in the field. This hear it was specifically about Health Services Research, which was a fantastic coincidence. Everyone was very gung-ho public health (with the possible exception of one speaker, but he was there primary to remind us of how much we need to continue to work on communicating our work with colleagues who do not have lots of statistical background), and it was fascinating. Topics ranged from specific descriptions of interesting studies and funding mechanisms to frontiers in urology (both methodologically and geographically).
• I’ve gotten to spend some time with the Neuromuscular and Pelvic Reconstruction (NPR) service, who are the urologists that spend the most time with female patients. They do joint cases sometimes with the urogynecologists (with whom I thoroughly enjoyed a rotation last November), and provide a slightly different perspective on things going wrong in the pelvis. I’ve seen some crazy reconstructions, some procedures for incontinence and some interventions for painful bladders.
• I’ve also gotten to see other things that I’ll likely never do again, like the construction of a new bladder from a piece of stomach combined with a piece of small intestine, for a child who was effectively born without one. So cool!

I would highly recommend a urology rotation for anyone. Here are just a few of the the specific (and I’m sure widely applicable) skills I have learned or refined so far: foley catheter placement, suturing and knot-tying, cystoscopy, penis jokes, and smiling and nodding at gynecologist jokes.

By popular demand

Walter's tongue many weeks post-op - I think this is our new normal.

Same sleepy puppy...

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!

Tub Birth!

Cross-posted on Dose of Reality

For the past month I’ve been rotating with the midwives, as I outlined here. One of the things I was most looking forward to this month was getting to attend a tub birth. Delivering in the tubs, which are fairly spacious and definitely still located inside the hospital room, seems to make most of the physicians delivering babies nervous. As a result, I’d never seen one, and was very curious. It didn’t seem that this wish would be made reality until the last day of my rotation. Due to some quirks of the healthcare system that I won’t enumerate due to HIPPA requirements, this particular mother decided to labor in the tub. The whole process went very quickly and easily, and she and I caught the baby together. So exciting!

This whole rotation has made me think a lot about how I’d like to do antepartum, intrapartum, and post-partum care in my own future practice. While lots of things, like having 30 minute rather than 10 minute prenatal visits to allow for questions and teaching, have helped me to understand why so many women so strongly prefer the midwifery model to the physician model of care during pregnancy, few things seem to emphasize this as starkly as the tub birth. In the world of low risk, low intervention pregnancies and births, there’s no reason not to get in the tub and deliver there if that’s what the woman wants. It’s warm, is really helpful for pain during labor, and is a great way to get skin-to-skin with your baby right after birth. In the world of high risk, high intervention pregnancies and births, it seems that behind even the most benign of deliveries lies a strong concern about something possibly going wrong, and the need to do everything possible to prevent that.

This preoccupation with potential problems is what physicians are trained to do. We see the possibility of a critical airway with every cough, spinal cord compression with every twinge of back muscles, and hidden malignancy with every fever. While we are continually told in school to think “horses, not zebras” when we hear hoof beats, the rare and the bizarre are emphasized in lectures, exams, and the questions we’re asked on rounds. How then, is the well-intentioned medical student to take a step back and recognize a truly uncomplicated and normal process as it takes place, rather than waiting and finally conceding after the fact that nothing went wrong? After working with the midwives for a month, I confess that I haven’t shaken the niggling doubts I have each time someone mentions a mother pushing for seven hours before her baby is born. I think that most of the midwives have some doubts too. But they’ve helped to remind me that most women know how they want to birth their babies, and that most of the time, they’re right.

Whoa...

Cross-posted on Dose of Reality:

Somehow a few weeks have flown by since I last posted. This may be related to how much I'm loving what I'm doing right now... No, I'm not thrilled to be studying for boards, which I am also doing, nor to be preparing my resident application. Neither am I incredibly pleased that the dog required another small procedure to get rid of some infection at his old surgical site. The primary thing I'm doing this month, however, is working with the midwives, and it is fantastic. I'm actually posting from the callroom, so I will be brief. Here are the things I've loved so far:

• Prenatal visits in English and Spanish and with patients across the demographic spectrum that Ann Arbor and Ypsilanti have to offer
• Natural deliveries and the proud and happy mothers and babies that result
• Hands-on learning; I've helped with a couple of deliveries, a few repairs of perineal tears, and lots of physical exams, prenatal teaching, and post-partum follow-up!

These last few weeks have been a flash-back to the best weeks of medical school, my OB/GYN rotation, but with an extra emphasis on the collaborative relationship between pregnant women, their families, and their healthcare providers. So wonderful!

Picture made from 1,000 words

Last year I posted a few images generated from the RSS feed from this blog. The website that generated them seemed to intuit how my life changed over the course of the first half of M3 year. I decided to repeat this again today, just to see how different it was now. Turns out that I posted a lot about the ICU... Also about radishes, which I think are wholly deserving of their front-and-center placement here.

Thoughts?

Another box checked

Today was my last day in the ICU. I have the MSTP retreat this weekend, so I finished on Thursday instead of the usual Friday. While I feel a little bit sad about the end of such an intense experience, I can safely say that I’m looking forward to having a lot more free time next month. This sums that up reasonably well:

I biked a total of 4 miles this month...