I'm kind of stuck about how to celebrate Earth Day. At first I thought I could ride my bike to work, but then I remembered I don't have a helmet up here (sorry, mom & dad, but we'll find it!). I have been trying to be a vegetarian, rather unsuccessfully, all this year, so there's that to maintain. I can't not use electricity because I have to do this being a doctor thing which requires the use of modern technology. Though I think it would be cool to see patients by candlelight again, very reminiscent of Africa. With the amazing weather, I'm totally in the mood to start a garden or plant a tree, but I rent a room and have no piece of earth to work with.

Two things I'm definitely doing: wishing my little brother happy birthday, and celebrating the anniversary of my first date with my husband 4 years ago (we went to a video karaoke bar where I got tipsy and sang Britney Spears.. and he still wanted to keep going out! <3 )

Maybe I will submit a comment in honor of Earth Day that my workplace is in desperate need of recycling. I carry home bottles and cans all the time to recycle them, which is so low-impact that people are always scoffing at me. What can I say - it's an affliction. What are you doing for Earth Day?

So I was just surfing around the web aimlessly (as I do every night when G is not here) despite it being ridiculously late, and reading a blog that one of my fellow intern's wives writes. She is a stay at home mom and has a blog for herself, and one for the family which is all pictures of their son. The blog makes being a stay at home mom look like all you do all day is laugh and play and eat cookies and go for walks in the park. What was I thinking with this career garbage, I thought, I spent the evening taking care of a drunk guy who refused to tell me why he called 911 and a drug-seeking diabetic with a huge draining abscess who kept demanding I give him just one more dose of pain medicine, despite having had enough to tranquilize a pachyderm, and pretending to burst into tears.

I am holding a baby shower for my fellow intern's wife next weekend. I have never even been to a baby shower and I am organizing one, this means that the baby shower is going to bear questionable resemblance to a baby shower at best.

The pictures and blogs were so cute. They made me feel all sentimental. I had this thought "every day that I wait to have kids is another day I don't get to know them! And another day that they don't get to meet their grandparents..." then I thought wow, where did THAT come from? That was the cheesiest thought ever! I ought to just quit my job and write sentimental poetry for the inside of greeting cards.

My disconnect from reality becomes apparent when you realize that I am thinking about how I should be having kids sooner as I sit in my little rented room full of boxes in various stages of packing, my belongings having been basically a shambles for about the past 10 months as I have been living out of my car. It's 3am, and the past two nights I've slept in a friend's guest room and in my car parked in a strip mall parking lot (awakening to a policeman shining his squad car spotlight in my window and demanding to see ID and know what I am doing there). I ate a bowl of cereal for breakfast today, a bowl of ice cream for 'dinner' at work, and a bowl of cereal when I got home from work at 130am. Clearly, I am beyond ready to have kids, we'd be the embodiment of the nuclear family. Why wait any longer?

hello world:
I've been nervous about the blog and tried to majorly tighten up privacy restrictions to make sure there were no privacy issues or liability issues with it (or issues of me putting my foot in my mouth, which seems to be an unavoidable regular occurrence online, given the tsunami of typing I put out on a daily basis and my tendency to let my fingers tap ahead of my brain...)

I miss writing a blog, but I am afraid to write anything too personal anymore. After all, I spend the majority of my time surrounded by stories that are by their nature private, and mixing that, me, and the internet is probably a bad combination.

I'm considering starting a blog that would let me write for the public, but I could just give commentary and interesting links and things like that. An official blog with a purpose, like the kinds I read that others write, since I really do enjoy those.

In fact, I'm considering two different blog topics, maybe I'll do both! or neither! Only time will tell. I get lots of wild ideas, so this might just be another one of those, but I thought I'd throw them out there:

1) Public health project related. This would be me giving commentary from my perspective running an international small nonprofit organization working on public health and development issues. There are a million other projects attempting to do what we attempt to do, with a million of their own friends and volunteers and donors, and we all have varying degrees of success. I have long wanted to start a website that is an actual networking tool for such projects, in fact, I've drawn up the structure of that website and written some of the content for it, but I just don't think it's feasible for me to work on that when I have a full time job as a doctor and running UVP and I'm having a hard enough time doing both of those things. So, I could do the blog whenever I was able to, and might be able to accomplish some of the same things.

2) Medical related. My favorite would be to do medical nonfiction, as you know, I love putting my patients' stories into words. Unfortunately, this involves the privacy and liability issues. So I have to continue doing that privately. My second favorite topic I think would be medical economics, which I'm sure most of you will think is horrifically boring, but I think I could make it interesting. Plus people love reading finance-related blogs - or some people do, anyhow. I read personal finance blogs every day, and I love them. There are already a million personal finance blogs, though, so I want to do 'medical finance' - it would be medical economics, finances for medical students, residents, and attendings, things like that. I don't know of any other blogs that cover this, not that I have looked at all. I am afraid to look because I'm afraid they will all have really clever names, and half my excitement comes from the idea of dreaming up clever names for my blogs (I know, I know, the current blogs I maintain do not have clever names!)

so anyway, if there's anyone out there, feel free to comment on my ideas.

Sometimes I like to just reflect on the fact that no matter where I am or what I'm doing, I know that parked in Kampala, next to the dusty taxi park, is a white car perpetually blasting 'The Macarena'.

After spending 34 hours at work, I was feeling appropriately gray and irritable on this gray autumn day. I tried asking my fellow interns if they'd like to do something this evening, but they all seemed to be otherwise occupied. I came home and stared out the window at the gray sky and bright leaves for a while. I went for a run in the park, and all the geese had their heads hidden in their wings as they floated on the water. The crowds of people were conspicuously absent, which I assumed was due to the drab weather. I had a milkshake with lowfat ice cream and skim milk, and sold an item on eBay to a buyer in Croatia. I felt more cheery. Then, as I was absentmindedly surfing the internet, I realized that every other red-blooded American in the tri-state area is watching the Red Sox tonight. No wonder everything seems so quiet and lonely!

I am having a very light week at work. Last night things were so slow, my resident and I were sneaking snacks from the patient kitchen (saltine PB&Js, anyone?) and watching videos about "how to saber a champagne bottle" on YouTube. I'm not much for champagne but I have to admit, I was inspired. Now all I need is a saber. My resident is an antiques buff, and I watched him bid hundreds of dollars on these old handpainted clay pots on eBay. I am glad that I am just using eBay to get rid of clutter instead of creating it. More and more stuff is exactly what I don't need.

I noticed a few days ago that in the medical ICU, I spend almost my entire shift writing orders and notes, and making phone calls. I only see the actual patients I am taking care of during our brief walking rounds in the morning and then if something terrible is happening to them, like they are short of breath, or they are having an irregular heart rhythm.

I had decided to try to avoid the patients less, since I felt like I was getting distanced from the things I like about medicine. Then I noticed that if I start to get to know a patient and start to like them, inevitably things go badly for them. For example, an elderly patient with few medical problems who came in just because he had been taking a toxic medication daily instead of weekly. I spent some time in his room talking with his daughter as he watched, since his throat had been ulcerated by the medicine and it hurt him to talk. The next day he was dead.

There had been two patients in the ICU who I felt I knew well because I admitted them initially through the ED last month. I sent them both to hospice. The one I sent on Friday I was particularly upset about, because she had this elderly husband who sat at her bedside every day and was hoping for a full recovery. I was listening to the radio and heard this cheesy love song that reminded me of them. The one that goes:
"There'll be lines upon my face/from a lifetime of smiles/and when the time comes to embrace/for one long last while.../we'll have a laugh about it/how time really flies/we won't say goodbye/because true love never dies/you'll always be beautiful in my eyes." It completely broke me up.

Last time I was on call, I had to put a tube down one of my patient's throats so that we could feed her and give medicine through it. She was on a ventilator and sedated, so I hoped that maybe she would be so out she would hardly notice. Instead, she watched me set up my things, and when I explained what I was going to do, she shook her head violently. I wanted to know why she was refusing, so I tried to let her write me a message or point to letters on a letter board (you can't talk on a ventilator). She just kept looking sadly at me and spelling/writing nonsense. The nurse finally asked "does your throat hurt?" and she vigorously nodded YES! So I said that's fine, we can help with that - we will spray some numbing medicine in your throat and try to make it more comfortable. I waited with her while the nurse went to get the medicine and tried to make conversation, though she couldn't speak. "Your family came to visit you today!" I said. "They love you very much." She looked at me with the sad look again. Then she clearly mouthed, around the breathing tube "You remind me of my daughter." I thanked her awkwardly, feeling terrible that she was being so sweet and here I was about to force a tube down her throat. Of course, since then she's been doing poorly and it looks like she might not get off the ventilator for some unknown long period of time. All this sad stuff is really challenging.

So I just logged into livejournal and saw that I have not updated in 16 weeks.

I think that is about as long as I have been in residency! There may be a correlation between these two events.

I do write in a paper journal regularly, but the problem is I just don't have time to say all that I want to say. I have all these journal entries bouncing around in my head that want to come out. I only remember things when I tell stories about them, so I have some good stories from residency thus far.

I will just say for now (because I am exhausted and working in the MICU) that I had a wonderful day post-call today. Even though I had to take a nap in the middle of having fun just so that I could wake up and continue. (ever have to tell your friends "hey, I still want to keep hanging out, just wake me up in an hour") I went apple picking for the second time in a week, and now am almost to the point where I am sick of the taste of apples. but it was worth it!

My first day of residency was as expected... sort of. I always think that when I get older I am going to learn to deal better with stress. That doesn't seem to be true, though, it's just that I don't get stressed about as many things the older I get.

I get very stressed whenever I start a new endeavor. The first day of every semester in college I would skip breakfast and sometimes lunch as well to try to keep my stomach from imploding. One particularly bad start day was the beginning of Molecular Cell Biology... I practically collapsed under my desk because I was so freaked out by the course orientation. The weird part is that I always am successful at things, even including Molecular Cell Biology, in the end, so I have no idea why I get so worked up about them. Or one theory I have is that most people who are successful become that way because they get worked up about things.

So I was trying to spend a last few moments of time with my new husband (!!!) before starting orientation at noon today. We had a nice sunny afternoon at the beach with my family, then went off to the driving range and I tried to learn how to hit a golf ball and failed. We had some quasi-Mexican food for dinner which was not very good, and then returned to G's apartment to spend some quality time. As I tried to fall asleep I kept having disturbing dream-ish thoughts... then woke up in the middle of the night feeling very ill. Ended up quite sick, and I'm sure it was all stress and probably not Mexican food poisoning.

Of course, the orientation itself was very laid-back. We had a very nice lunch and then relaxed through a few motivational talks by our very personable residency director. I spent most of the rest of the day learning that Price Chopper is my new favorite supermarket ever!

Many websites give a sample 'wedding timetable' to tell you when to arrange events and how much lead time you need for each item. I am hereby promoting my own personal wedding timetable.

3 months before wedding: Get engaged
2 months, 3 weeks before wedding: Find location for wedding, order invites, buy dress
2 months, 2 weeks: Make invite list and send invitations, make website, pick bridesmaid dresses, reserve rental items, buy rings and dress accessories, book band
2 months before wedding: go on pre-wedding honeymoon
On pre-wedding honeymoon: book photographer and justice of the peace
1 month before wedding: Dress alterations, visit wedding location
3 weeks before: Bridal shower, pick menu for wedding
2 weeks before: Get caterer

1 week before: Order cake, buy suit for groom, send suit for alterations
5 days before: Get outfits for groomsmen
4 days before: Order flowers for bouquets and pick out flowers for tables, book post-wedding honeymoon
3 days before: Make place cards for tables, learn to dance
2 days before: Gather bridesmaids from various cross-country locations
1 day before: Rehearse
Wedding day: Go to spa for pedicure


As you can see, it is easy as pie and fun. Don't know what people get all stressed about.

While driving thru New Zealand sheep fields, I noticed this typical rural billboard posted on a farm:

"SAVE THE HUMAN BABIES"

I assume that what this means is "hey tree-huggers, HUMAN babies are dying and you're whining about fur seals and polar bears and maybe some native New Zealand species on the brink of destruction. but they're not PEOPLE, so get over it."

I kept thinking of this sign as I was trying to choose which charities to put on my wedding gift registry, which is with JustGive.org's charity registry service. Feeling a bit cynical about people at the time, I thought that I should only list environmental charities, because animals don't have as many people to stick up for them, since there are plenty more HUMAN BABY fans out there. Then I realized that poverty is the root cause of many major environmental problems such as no waste disposal systems and burning forests or chopping them down for subsistence farming, and that every time refugees have to flee a conflict, they completely ravage whatever area they move to (as their prior homes get ravaged by bombs) environmentally. Meanwhile, if the human rights groups don't help with ending corrupt and cruel practices, dictators will never allow some countries to become environmentally conscious. And if we can't get decent people into office (campaign finance laws, voting fraud, and evil corporations and lobbyists to blame) then we'll never have politicians who care about the environment or humanitarian aid of any sort. Obviously the truth is that all the important issues in the world are intertwined with each other. So... I picked mostly environmental charities. :-)

One solution might be if I could just figure out how to fund the cool types of enterprise that address many issues at once: meta-charitable-enterprises! For example, the guy who invented this solar-powered flashlight. That man is a hero! He is saving the human babies of hundreds of years from now. I'm gonna put a sign in my sheep field about him.

Thanks to all for the congratulatory messages. you're right, it IS awesome! Sorry for being a bad livejournal friend and not often having the chance to send congratulatory messages your way. I will try harder on that.

Meanwhile, back to this entry title. Ever hear the song 'Waiting On the World to Change' by John Mayer? That songs just bugs the hell out of me. The whole song is basically like 'hey, everyone says that we young people don't care about political issues, but we care plenty! we just don't think it's worth doing anything about that. and that's OK because probably the only way to win is to wait for all the old people to die, become the old people ourselves, and then we'll tweak the way things work around here.' Does anybody including John Mayer really think that 'waiting on the world to change' is a good life philosophy? Last time I checked, it takes hard work to change the world, and he's just sitting there with his guitar convincing people that 'just give up and wait, that's better than doing things like voting, raising awareness, protesting, and other such ineffective actions.'

I know I'm the only fool out there who actually listens to the words of stupid songs like this, but it made me so angry I almost wrote him a letter. Everyone makes fun of celebrities who try to get involved in activism, but I think having influence and money and not trying to use it for the power of good is reflects very poorly on a person's ethics.

Hey public audience, I guess it's about time that I included the fact that I got engaged in my livejournal! That might have something to do with why I haven't updated in forever, but I figured if I have enough time to change my Facebook status to 'Engaged' then I really have no excuse. :-)

I got engaged the night before match day, and we were flying over a beach in Hawaii and he had spelled 'Will you marry me?' out on the beach in coconut shells painted white! .. or not. Actually, it was more like we were cuddling on the couch and he said 'I've been thinking about it and I want us to always be together. We should get married!' and so I say 'Yes, let's get married!' and think that the conversation's over. He then says 'no joke, I want to get married!' and I say 'If you're going to propose, shouldn't you be more formal and get down on one knee and have a ring and stuff?' Then he looks a bit guilty and says 'Well, I tried to get on one knee but you pulled me onto the couch. And I don't have the ring yet because I was going to wait til New Zealand, but I couldn't wait, because I've been thinking about it so much.' Well, that is cute. At least I think so, and that's the important part.

Then we kept it a bit hush hush for a few days and convened with the parents to figure out what we should do, and decided to go for it fast and get married in early June. Hence, the bridal frenzy. There are too many things you have to do to set up a wedding. But I guess that is why it turns out to be the best party you'll ever go to.

I got an e-mail today, subject "Did I Match?" From the NRMP. What the heck is that? Someone had a cruel little cackle over that one at the Match office. Why not just title it 'You Matched!' or 'Congratulations!' ? That is just mean spirited. But I did match, so I'm not complaining. And using the handy dandy Gmail preview feature, I didn't have to worry even for a split second.

In the meantime, I haven't been posting because I have been enjoying the good life! Sleeping late, eating ridiculous amounts of homemade brownies, and playing videogames. Why did Nintendo have to try to come up with a videogame machine that girls would like too? It's freaking fun. I had Cathy & Josh over last night and we played until our arms hurt. We rented this silly game called Wario's Smooth Moves, which is basically just a mishmash of random Japanese insanity and seizure-inducing graphics. It's hilarious.

So this afternoon I'm going to evaluate an offer on the house, which is exciting. I'm also holding a virtual yard sale of the furniture I have over there. Since I am probably moving pretty far away, it will be too expensive to move everything. Craigslist has been almost too helpful for this - I posted an ad and have been deluged with like 20 e-mails since yesterday about the furniture. I got a last minute sentimentality attack and took this cool tall-back chair off the market. Then I decided to take a corner table off the market too... yesterday, while I was showing my house, I opened up a tiny drawer in it to hide my keys, and came across a little treasure trove of calendar pages from a quote-a-day calendar that my great aunt had had and apparently liked. Wonder where I get this pack rat gene from? :-) It was a little nest of Erma Bombeck quotes. It was so cute, I decided I could not part with the corner table.

Thanks to my dearest mom & dad, my house has gotten pretty sparkly clean and ready to sell. Today I went over and put some more good old fashioned elbow grease into it. I scrubbed the ceramic cooktop alone for like 45 minutes. Word to the wise, NEVER get a ceramic cooktop! You have to scrub at them with this horrid chemical cream and somehow the cooked-on particles dissipate, but I have no clue how it works because no other method of scrubbing or scraping makes any difference at all. It is a racket dreamed up by ceramic cooktop cleaner businesses.

Anyway, I've spent about 6 hours probably touching up all the scratches and smudges on the paint in the house, and I even got down on the floor and scrubbed the whole kitchen floor, washed the fronts of all the appliances, rubbed stains out of the carpet, trimmed the loose ends off the carpet, vacuumed the floors, cleaned and organized the kitchen cabinets, washed the front door, swept the front step and walkway (treacherous, not just because of the ice, but also because realtors are waiting outside to try to chat up anyone trying to sell their own house). Little trick - I used a black permanent marker to touch up the black front door. It turned out better than it sounds.

My neighbors must be extremely annoyed at me. The house next door has put up a for sale sign since last weekend, and they are offering their house for $30,000 more than mine. I feel kind of bad about it, but I think that's quite overpriced. They do have a finished basement and probably some other bells and whistles, but it's essentially the same house.

The house is now listed on websites and in the newspaper, so I'm just waiting for the calls to roll in. So far I've had 2 realtors, 1 house appraiser, and 1 'investor', and 1 potential buyer. sigh, hopefully that ratio will improve, but at least I have G to pick up the phone and say "we're not interested!!" for me.

happy v-day everyone!

We are having a winter wonderland of a day here. Last night G and I went walking through the park in the snow, which was lovely. We made a snow castle, then back home for hot chocolate (I got some flowers and chocolates too...)

This morning it was not so lovely when we had to thrash our way through it around dawn to get to work. Without the Outback we never would have made it. We slid through snowdrifts - none of the roads had been plowed. It was probably foolishness to go - we packed up the car with snow gear in case we got stuck, and I think we could easily have been. So, we worked, and the medical students held the ICU together, because the interns didn't make it in (of course, the attending did, in his brand new SUV).

Tonight, G has a special menu planned, and I have to go shovel the driveway! :-) Sounds like a good deal to me.

Reviews:
The Great Influenza - fabulous book. It isn't so much a history of the pandemic, it is more of an anthropology of scientists.

Kitchen Confidential - this is a fun book. If you like the idea of illegal Mexican immigrants cursing up a storm as they prepare your vichyssoise, read this book.

On another note, here is a story I liked very much from today's New York Times.

This story shows how the American philanthropic drive is getting turned inside out - and what a beautiful example!

I guess somebody needs to donate to institutions in the United States. But I think many people are like this family - they have become unsatisfied unless they can help those in desperate need. This proves that despite the low opinions many have of Americans, we really are becoming more aware and more able to network to aid others who are far from ourselves.

I'm very excited because I'm knocking things off my to do list left and right.

Hopefully I passed the exam I took on Friday, which was my last exam of medical school. Since I passed Step 2, and I finished my public health project for my primary care acting internship, that only leaves 3 things left to do to graduate medical school.
1. Show up for work every day at my SICU acting internship and don't kill anyone (i.e. pass)
2. Pass the clinical skills exam March 7th.
3. Finish my medical student research project, due March 31st - this is going to be the tough one, but I am devoting the entire month of March to it so if that doesn't do it, I don't know what will.

Then on April 2nd I depart for New Zealand and will be there until May 7th, which is about 2 weeks before I graduate.

On the personal front, from now through the end of March I will mainly be working on selling my townhouse and getting ready for the 2007 summer projects with UVP. I have a meeting in San Francisco next weekend to plan them - free flight from Harrisburg with frequent flier miles! So all this ridiculous interview travel did pay off after all. All in all I have very little to do, relatively for me, and that usually makes me kind of depressed so it will be a challenge to stay active and find ways to entertain myself.

Also I am taking any nominations you have for great books to read. I have this 4 or 5 month interval where I can actually do some reading for fun, and I'm going to maximize it! Here is what I am currently reading:
The Great Influenza: The Epic Story of the Greatest P